Most previous studies investigating the relationship between visual perception and anxiety have found that anxiety-provoking stimuli are perceived as relatively larger in size. Thus, the present study used neutral stimuli to investigate the relationships among anxiety, anxiety sensitivity (AS), and visual perception in a group of male and female university students.

The Visual Size Perception Assessment Test (V-SPAT), which requires subjects to define a neutral figure in a dichotomous manner (i.e., tall/short, large/small, wide/narrow, crowded/deserted) was administered to all participants (n = 76). Additionally, the anxiety level and AS of each participant was determined using the Beck Anxiety Inventory (BAI) and the Anxiety Sensitivity Index-3 (ASI-3), respectively.

The BAI and ASI-3 total and cognitive scores of female participants were correlated with perceptions of 'deserted”, whereas their ASI-3 social scores were correlated with perceptions of 'short”. The ASI-3 cognitive scores of male participants were correlated with perceptions of 'crowded”, and their ASI-3 physical scores were correlated with perceptions of 'tall”.

The present findings indicate that the visual perception of neutral objects is correlated with anxiety and AS. Furthermore, these data revealed sex differences in the relationship between AS and visual perception in that males perceived the objects as larger and females perceived them as smaller.

The DGPPN, as a German psychiatric professional society, demands a new, systematic viewing of the biographies, motivations, participations and defense patterns of important representatives of the discipline during the National Socialistic period.

A current evaluation of previously untapped sources makes it possible to assign an appropriate critical-historical position to Friedrich Meggendorfer’s role as NS-academic psychiatrist.

Relevant archive materials as well as primary and secondary literature have been reviewed.

Clinically and scientifically, Friedrich Meggendorfer worked under Emil Kraepelin (1856-1926), Max Nonne (1861-1959) and Ernst Rüdin (1874-1952). Meggendorfer earned a good reputation in genetic research during his activity as psychiatrist in Hamburg under Wilhelm Weygandt (1870-1939). This was the decisive reason why he was called to the Chair in Psychiatry in Erlangen in 1934. At the same time, Meggendorfer was appointed Director of the Erlangen Psychiatric and Neurological Hospital as an adnexe to the Erlangen asylum for the mentally ill. Because he had joined the NSDAP on 01.05.1933, he was suspended from office on 19.11.1945 by the military government. Meggendorfer was rated as a 'hanger-on' by the denazification court on 20.09.1946. In the post-war period, Friedrich Meggendorfer was confronted with comparatively strict restrictions. His removal from the faculty of the Friedrich-Alexander University can primarily be considered due to the post-war Director of the Erlangen asylum, Werner Leibbrand (1896-1974) and his reorganization of the psychiatric clinics.

Meggendorfer‘s role as an NS-academic psychiatrist is most likely trapped in the professional understanding of his time.

Burn out is defined as a syndrome of physical and emotional fatigue, which leads to a negative self-perception and negative attitudes at work. It affects particularly caregivers, because they are in tune with the suffering, misery, misfortune, sickness and death.

The objective of our study was to assess the degree of burnout among medical interns.

This was a cross-sectional study, which studied a population of 40 interns engaged in Hedi Chaker Hospital in Sfax.

To assess burnout, we used a psychometric tool: the Maslach Burn-out Inventory (MBI).

With each intern we collected sociodemographic variables (sex, age, marital status, spouse's occupation, number of children), the parameters concerning the occupation (specialty, professional grade, number of hours per week, number of guards per month …), the causes of exhaustion, and if there were consequences.

The average age of interns was 28 years 4 months. They were married in 47.5% of cases and 52.5% in single cases.

The results of the MBI:

• A high level of emotional exhaustion was found in 37.5% of interns, 40% had moderate levels of emotional exhaustion and 22.5% had a low score of emotional exhaustion.

• The “dehumanization of the relationship,” was high in 25%, moderate in 20% of doctors, and 55% spared them.

• Personal achievement was high in 25% of doctors, moderate in 35% and poor in 40% of them.

Once recognized, the burnout syndrome among medical interns requires concrete actions focusing on their professional lives and their privacy ones.

The object of this study is to determine the relation among optimism, hopefulness, and distress endurance in employees of sari heart hospital.

All employee from Sari heart hospital in which are employee on 2013-2014.statistical sample and the method of sampling has been selected simple randomly and sample volume has been selected about 180 persons by Morgan and Kerjesi table. We have used of three questionnaire 1: optimism designed by shayer and Koror (1985) and has been customized by Khodabakhshi(2004) 2. Hope questionnaire: Miler hope questionnaire is of recognizing one and have 48 aspects of hope and distress in which are based on clear or hidden behavior manifestations in hopeful or hopeless person has been selected. 3. Distress endurance test does have 15 chooser scales. We have measured choosers based on person capability to endure agitation distress, mental agitation evaluation, the amount of attention to negative agitation in events and regulating measure to mitigate agitation.

According to above table, the amount of regression correlation among the two variables of hopefulness, distress endurance and hopefulness has been meaningful and equal to 0.70 and meaningful level of 0.000(less than 0.01)and also the amount of t-test is meaningful for forecasting the amount of optimism on distress endurance.

We could say optimistic persons are more successes in solving problems or encountering them and also disease and therefore they have hope to live and does have mental health, too.

Erotomania is a rare delusional disorder. De Clerambault, a French psychiatrist, was the first who advanced the concept of pure erotomania, one of the ‘passionate psychosis', as a distinct disorder. However, some authors tend to consider this syndrome as related to other psychiatric disorders.

To describe the case of a female patient with erotomanic delusion with no remission under an antipsychotic and to review the links between erotomania and other psychiatric disorders.

Literature review and a case report

We report the case of a 32 year-old epileptic woman, hospitalized for a delusional erotomanic disorder. Initially, the patient was treated with an antipsychotic, with partial effectiveness. In fact, it appeared that the conviction of being loved began while she was depressed. After one month of combined antipsychotic and antidepressive medication, she became euthymic and her erotomanic delusions disappeared. Major depressive disorder with psychotic symptoms was diagnosed.

After reviewing the literature, we found that erotomanic symptoms frequently appear secondarily in other psychiatric disorders. Several publications indicate a frequent association between erotomania and mood disorder, especially major depression and bipolar affective disorder, and describe the efficacy of antidepressant and mood stabilizers. Numerous theories may explain the link between erotomania and mood disorder : from narcissistic needs, to the capacity of empathy and emotional processing. Further studies are needed to clarify the nature of this link.

In clinical practice, a mood disorder must systematically be searched for and treated in a patient with erotomanic delusions.

Stigma is defined as a discrediting and disgracing mark that leads to negative behavior in its bearer. Psychiatric stigma in adolescents and adults with personality disorders is hardly a subject of attention in international literature.

There is a marked overlap between psychiatric stigma and the specific features of a vulnerable identity (diminished self functioning, negative self experience and self image and increased self blaming) as seen in adolescents and adults with a personality disorder. It is therefore assumable that both stigma and personality characteristics contribute to the burden of disease.

To assess the important role of stigma in patients with a personality disorder.

133 adolescents and 216 adults were consecutively admitted to the study. All patients underwent a standard assessment with SCID-2 (adolescents) and SIDP-IV (adults). The Stigma Consciousness Questionnaire (SCQ) and The Perceived Devaluation-Discrimination Questionnaire (PDDQ) were used to assess stigma in both populations.

In the adult population, no personality disorder significantly predicted level of stigma. The experienced level of stigma was not associated with severity of personality pathology, as measured by the total number of personality disorders. Adolescents with a personality disorder experienced significantly more stigma, and having a borderline personality disorder significantly predicted a higher level of stigma. The experienced level of stigma was associated with severity of personality pathology, as measured by the total number of personality disorder traits.

There is a marked difference in stigma between adolescents and adults with a personality disorder. Further research is certainly warranted.

Few –if any-countries in the world are poorer, more totalitarian and, foremost, isolated than North Korea. The impact of this situation on the country's psychiatric care system is expected to be huge.

Literature review on Pub-Med, Scopus and Google.

Up to date, there are no studies on this topic from North Korea. Information comes only from North Korean defectors in South Korea, therefore caution is required. Anxiety disorders and depression seem to receive no specialized psychiatric treatment in North Korea. These disorders are ascribed to a malfunctioning autonomous nervous system and are commonly treated by neurologists. In 2012, according to WHO, 9,790 suicides have taken place in North Korea, a country of 22.5 million. Suicide appears to be viewed as an act of ‘treason’ against the state rather than a symptom of severe psychopathology. Patients with psychotic disorders are usually hospitalized in remote mental institutions called ‘number 49 prevention posts’ –after North Korea's cabinet decision No.49 on mental health-, under appalling conditions. The patients themselves are called ‘number 49 subjects’. Insulin-coma therapy seems to be still implemented in such places. Counseling and psychotherapy are apparently non-existent. Methamphetamine –used during the ‘Arduous March’ of the mid-90's for suppressing appetite-is the main substance of abuse. The low status of the specialty, the remote location and the terrible state of the mental institutions discourage the best medical students from becoming psychiatrists.

Based on the available data, North Korea's psychiatric care system seems to suffer from very serious structural deficiencies.

Self-transcendence, an indicator of spiritual well-being, refers to one’s capabilities to expand intrapersonal, interpersonal, and transpersonal self-boundaries. Studies about self-transcendence have reported a relationship between physical and mental health. Interventions including art, poetry writing, and structured reminiscence showed greater self-transcendence in elders. However, little is known about the association between social activities, which are often arranged to improve psychosocial life in long-term care facilities, and self-transcendence.

To describe the relationship between social activities and the level of self-transcendence in older Taiwanese adults in a long-term care community.

Cross-sectional, correlational study conducted in 12 long-term care facilities in western Taiwan. A purposeful sample of 176 elders was recruited. Inclusion criteria: 65 years or older, mentally alert, who spoke Mandarin or Taiwanese dialect. Exclusion criteria: any type of dementia diagnosis or lack of functional independence. Social activity was measured by the Socially Supportive Activity Inventory which included nine types of social activities and components of frequency and meaningfulness perceived by the participants (α=0.72 and 0.81 respectively). Self-transcendence was measured by 15-item Chinese Version of Self-Transcendence Scale (α=0.90).

After controlling for functional ability, the data showed that elders who perceived higher levels of meaningfulness during social engagements in nine types of social activities had a significantly higher level of self-transcendence. There was no significant relationship between frequency of social activities and the level of self-transcendence.

Findings suggest that meaningful social activities may promote self-transcendence in those elders’ who live in long term care facilities

Economic crisis(EC) has a great impact in the life of people dealing with it. Especially chronic patients like psychiatric ones, have additional difficulties since they must pay for medication and sometimes stay unemployed due to their health condition.

To investigate the possible effect of the current economical condition in Greece in psychiatric patients.

71 psychiatric inpatients participated in the study, 23(32.4%) males and 48(67.6%) females, with a mean age of 48.2±13.1. Data were analyzed with T-test, Anova and chisquare with the use of SPSS.

The majority of the sample were affected from the EC a lot (N=49(69%)), and moderate (N=11(15.5%) and only 12.7%(N=9) felt that they were unaffected since 25% had no reduction in their income while 75% had a reduction from 1-more than 1000 Euros/month. A positive result was that only 15,6% had to alter their medication since psychiatric patients are still covered from insurance policy. There was no difference between males and females in the effect of economic crisis(x2=.891 p=NS) income reduction(x2=.975 p=NS) and medication alteration due to low income (x2=1.689 p=NS). Anova revealed significant differences between income reduction and coping with medication(F=7.761 df=3.54 p=.001) between patients that had no income reduction(3.1±1.8) and all the other categories, more than 1000e reduction(1.2±1.2 p=.006), 500-1000e reductions (0.9±1.3 p=.001) and 1-500e reduction (1.4±1.1 p=.03).

Our results indicate that even though medication is still covered from insurance plan there is a negative impact of income reduction in the way that patients cope with their medication needs.

Studies about the association between parental rearing styles and self-criticism/self-compassion focus in adult´s perception about their parent´s rearing styles, their own levels of self-criticism/self-compassion and psychopathology (possibly associated with that styles). Our objectives were to: evaluate parent´s perception about their own parental rearing styles and levels of self-criticism/self-compassion; explore associations between these variables and between these variables and sociodemographic variables.

114 parent´s (women = 71.9%; mean age = 41.3/SD = 6.29) answered a sociodemographic questionnaire, the EMBU-PARENTS, the Forms of Self-Criticizing and Reassuring Scale/FSCRS and the Self-Compassion Scale/SELFCS.

There were no differences, by gender, regarding rearing parental styles and self-criticism dimensions. Women and parent´s with a higher level of education presented higher levels of Human Condition(SELFCS). Married parent´s presented higher levels of Emotional Support. Parent´s with a lower level of education presented higher levels of Control. Inadequate self correlated positively with Rejection and Control; Hated self with Rejection; Reassuring self with Emotional Support. Warmth – Comprehension, Human Condition and Mindfulness correlated positively with Emotional Support; Over identification and Isolation with Rejection and Control.

The results found regarding parent´s perception about their parental rearing styles, their levels of self-criticism/self-compassion show this perception is similar to adult´s perception about their parents rearing styles and levels of self-criticism/self-compassion. We can extrapolate, although in a cross-sectional study, that parent´s parental rearing styles and their levels of self-criticism/self-compassion (influenced by the same variables on their own parents) have impact in the levels of these same variables in their children.

People with schizophrenia are in greater risk for various physical deseases than general population. It is one of causes of earlier death in this population group.

In past 5 years has been noticed that physical health (PhyH) of users with schizophrenia and similar disorders was not monitored regularly by family doctors (FD) in Health Center (HC) Prijedor even is known greater risk for some diseases such as diabetes (DM), hypertension (HT), coronary disease (CD) or width gain (WG).

Community Mental Health Center (CMHC) need continuously work on better care for the users with schizophrenia in all services in HC especially by FD.

There were conducted two courses for 12 FD teams in HC Prijedor (March and June 2013). FD had training from prevalence of ten most common physical diseases and interventions aimed at their prevention. Also, we provided to every team a brochure about those topics. Patients with schizophrenia (n=30), age 20-55 years were monitored regularly in period of 6 months (June-December 2013) for 11 PHyH parameters: weight, BMI, waist circumference, blood pressure, ECG, blood glucose, cholesterol (total, LDL and HDL), triglycerides and prolactine,

FD were found on our patients hypertension (n=8), dyslipidemia (n=13), DM (n=3) and non-symptomatic hyperprolactinemia (n=4). Most of them (n=17) were obese.

Collaborative work between CMHC and FD were successful in the detecting of physical diseases in patients with schizophrenia. Also, new quality connections between FD and their patients were established. It is a stimulus for further enhancement of our cooperation.

Missed nursing care is inescapable and can result from several factors, subsequently affecting the healthcare system, nurses, and patients. Maintaining and improving nursing care quality and patient safety is a major challenge for nursing managers.

The main goal of this study was exploring factors affecting missed nursing care from the perspective of nursing managers.

The participants in this qualitative study were 10 nursing managers. The data were collected at a university hospital in Portugal through individual face-to-face interviews using an interview guide and focus group discussions. The data were analysed using a content analysis following Bardin’s method.

The findings of this study present the concept of missed nursing care from nursing managers’ outlook and the outcomes of missed care, and indicate that factors affecting missed care are broadly determined by system structure, contextual factors, barriers to reporting missed care, and outcomes of missed care.

Efforts to foster a supportive work environment, improve the relationship between nurses and nursing managers, and create professional and organizational commitment are examples of important actions that could reduce the incidence of missed nursing care.

According toepidemiologic studies, depression is one of the most frequentmental disorders in Germany. Based on the secondary data of three statutoryhealth insurers and the German Pension Fund, the utilization of mental healthcare services of people with depression was analyzed.

The analysesdescribe the utilization of in- and outpatient mental health care services ofpeople with depression by different disciplines and utilization patterns overtime (pathways of care).

The main aim was to analyze mental healthcareutilization of people with depression in Germany in 2005–2007 in order toidentify areas of potential optimization of mental health care.

Secondary data of three statutory health insurancecompanies and of the German Pension Funds of the years 2005-2007 were used forthese analyses. The analyses are based on 1,435,133 persons with at least onediagnosis of a depression (F32/F33) in 2005-2007.

The majority (73 %) of depression diagnoses wereclassified as ‘‘unspecified’’. For both inpatients and outpatients, aconsiderable proportion of care for mental illnesses was provided by primarycare physicians/other specialists in somatic medicine. Analyses of the pathwaysof care of people with severe depression revealed low levels of collaborationbetween primary and specialized care as well as outpatient and inpatienttreatment.

Setting aside boundaries between different disciplines and sectors, theuse of secondary data can, despite its limitations, contributes to thedetection of under- and overdiagnosis, mistaken allocation, and intersectoralinterface problems.

The patient readmission is commonly associated with the failure of the previous hospitalization/admission and is an important psychiatric and economic issue. Furthermore, it is still source of frustration to patients, their families and the teams treating them.

The authors propose a retrospective study investigating all the readmissions within 28 days of the last discharge in the general adult psychiatry ward of a portuguese hospital (Aveiro Hospital) from 2011 to 2013 in order to characterize the reasons and factors (social, demographic and clinical) involved.

Over the total 1994 discharges, 88 were readmited, yielding a readmission rate of 4.4%. The main diagnose was Schizophrenia, schizotypal and delusional disorders, according to icd 10, and the main reasons for readmission were suicide and psychosis. Most previous hospitalizations have lasted less than the average length of stay during the considered period of time.

Evaluating the characteristics of readmissions promotes a better understanding of the whole process in order to devise a strategy for prevention and improvement of mental health services.

Friedrich Schiller (1759-1805) was not only a famous German poet but also physician and one of the leading historians of his time at the university of Jena (Germany).

To show that Schiller was very early inclined for psychosomatic interactions.

Analysis of the secondary literature since the death of Schiller for the subjects ‘Friedrich Schiller” and ‘psychosomatics”

Already during his medical studies at the ‘Hohe Karlsschule’ in Stuttgart (Germany) Schiller studied very intensively psychosomatic issues on behalf of the disease of another student, Joseph Frédéric Grammont. After the tremendous success of his play ‘Die Räuber” he fled from his unhappy life as a military physician and lived as a poet, always threatened by diseases and poverty. Medical and psychological knowledge play an important role in the thought of Friedrich Schiller. His creativity seems to be of greatest importance for him to survive psychically and physically. The actuality of his plays is due to the description of the drama of life in every age group, beginning from early childhood. Critical turning points in his life very often caused psychosomatic reactions, especially pain. Towards the upcoming mesmerism he remained very sceptic and refused to be mesmerized by the physician Eberhard Gmelin.

Despite his own severe somatic illness he could cope with pain and emphasized in his writings the importance of the freedom of anxiety in difficult conditions. His descriptions of feelings, emotions and mental states are unique in their phenomenological precision and richness.

During the last decade there has been a resurgence of interest in the relationship between early adversity and the development of psychiatric symptoms later in life. There is accumulating evidence for a link between childhood trauma and the development of most psychiatric disorders, including mood and anxiety disorders, eating disorders, personality disorders and substance abuse.

Recently, a substantial number of studies have suggested that childhood trauma is also an important risk factor for psychosis. Indeed, a significant proportion of people with psychotic disorders report traumatic experiences during childhood and an increasing number of population-based studies have provided data that suggest that childhood trauma (and to a lesser extent adult abuse or experience of a traumatic event) is of aetiological importance in psychosis.

This work has as main goal, starting from a review of the literature on this subject, to reflect on the possible mechanisms that may mediate the relationship between maltreatment in childhood and greater predisposition for the development of psychotic symptoms in adolescence and adulthood.

There is increasing evidence that neurobiological mechanisms such as dysregulation of the hypothalamic-pituitary-adrenal axis and sensitization of the dopaminergic system may mediate the interaction between the experience of traumatic events at early stages of brain development and increased risk for psychotic symptoms later in life. Preliminary evidence also suggests that polymorphisms within the cathecol-O-methyltransferase and brain-derived neurotrophic factor genes may interact with psychosocial stress in the development of psychosis.

Insight is defined as the recognition that one has a mental disorder, the ability to identify its symptoms, and cognizance of the need for treatment. Lack of insight into having a mental disorder is found to be associated with a poorer clinical outcome, treatment noncompliance, and a more severe cognitive impairment.

Compare the insight and medication adherence in a population of schizophrenia and bipolar disorder patients.

We assessed and compared the insight and compliance of 60 patients with schizophrenia (n=30) and bipolar disorder (n=30) recruited in Psychiatry department Sfax, Tunisia.

Insight was assessed using the rating scale of consciousness disorder (Q8).

Adherence was assessed using the Drug Attitude Inventory [ICD-10].

Patients were mainly young adults, male (70%) and did not live in a couple (61.7%).

About half of them (43.3%) had no profession.

Insight was low in 15% of patients, intermediate in 53.3%, and good in 31.7% of cases. Bipolar disorder patients displayed better insight into having a mental disorder compared to schizophrenia patients (p=0.04)

Good adherence was observed in 64.4% of patients.

Factor influencing adherence in both populations was the type of treatment: patients treated with atypical antipsychotics have better compliance (p = 0.005).

A good insight was significantly correlated with good adherence (p = 0.000)

Our results showed that bipolar disorder patients have better insight compared to schizophrenia patients. So it is necessary; in schizophrenia; to work on awareness of the disorder and the need for treatment to improve adherence.

Impulsivity is recognized as a predisposing factor for addictive, suicidal and aggressive behavior.

The aims of our study were to evaluate the level of impulsivity in inpatients and identify risk factors associated.

Our study was conducted among 32 inpatients in the psychiatry ward ‘B’ in Sfax, Tunisia.

We collected socio-demographic and clinical data and we measured impulsivity using the Barratt Impulsiveness Scale (BIS-11), insight using insight Q8 scale and medication adherence rating scale (MARS).

The mean age of the sample was 36.72 years.

Patients had a low socioeconomic status in 50% of cases.

They had a criminal record in 25% of cases, a history of suicide in 34.4% of cases and addictive behaviors in 59.4% of cases.

Ninety-four percent of patients had a violent behavior.

Patients were diagnosed with schizophrenia in 59.4% of cases, suffering from mood disorders in 28.1% of cases, and had manifested personality disorder in 18.8% cases.

The percentage of patients with a high degree of impulsivity was 59.4.

Patients had poor insight in 75 % of cases and were not adherents to treatment in 65.6 % of cases.

Impulsive patients were smokers (p=0.046), had a familial history of violent behavior (p=0.01), had poor insight (p=0.02) and were not adherent to treatment (0.04).

Impulsive behavior is associated with several factors, including addictive behavior, poor insight and lack of adherence to treatment. It is imperative to detect and treat them in time to avoid serious consequences.