Aberrant salience is the incorrect assignment of salience, significance or value to different innocuous stimuli. It seems closely related with dysregulation of the dopamine system that in turn relates with proneness to develop psychosis.

To evaluate aberrant salience processing in a clinical trans-diagnostic sample, its relationship with anamnestic psychotic symptoms and current psychopathology, and possible variations of aberrant salience after three months of clinical-based treatment.

Twenty inpatient subjects attending the Psychiatric Unit (Florence University) were recruited: 3 with Major Depression Disease, 6 with Schizophrenia, 3 with Bipolar Disorder, 4 with Obsessive-Compulsive Disorder, 4 with Eating Disorders. Patients were assessed by means of a clinical interview (SCID-I/P) and several questionnaires (AMDP, MADRS, HAM-A, MRS, PANSS and Aberrant Salience Inventory-ASI) at enrolment (T0) and after an individual and clinical-based treatment lasting 3 months (T1).

At T0 subjects with positive ASI (cut-off>14) reported more frequently past and lifetime psychotic symptoms (p<0.05) and constituted a distinct cluster from patients with ASI score < 14. A positive anamnesis of psychotic symptoms was significantly correlated with AMDP susbscales (delusions and perception disturbances), PANSS pos, PANSS neg, PANSS tot scores (p<0.05). A significant reduction of mean MADRS, PANSS tot and HAM scores between T0 and T1 was found (p<0.05). No differencesin ASI scores between T0 and T1 were observed.

Aberrant salience is significatively associated to lifetime psychotic symptoms. It represents a relevant psychopathologic dimension that, unlike other symptoms, seems not to significatively modify after pharmacological treatment and could represent a stable lifetime.

To determine how the presence of Schneider's first-rank symptoms in psychosis can influence the evolution of the disorder.

We analyzed a group of subjects (N = 106) who had a first-episode psychosis between 1995-1998. This group was divided into two subgroups: one that presented Schneider's first-rank symptoms (N = 70) and another group (N = 36) without these symptoms. The groups were compared in terms of subsequent evolution. It is worth noting that this study only included subjects who were currently in active psychiatric follow-up in the outpatient service.

There are differences between the two groups in terms of clinical parameters (age, onset, educational level, employment and family status, clinical diagnosis) and disorder progression (number of admissions), but without any statistically significant differences in the first 10 years of evolution. The existence of transparency-influence symptoms in a first-episode psychosis correlates with an increase in the number of hospital admissions after 10 years of evolution.

The transparency-influence phenomena are correlated with an increase in the number of hospital admissions across the longitudinal evolution.

Mood Spectrum Self Report (MOODS-SR) is an innovative instrument to assess mood spectrum symptomatology. This may provide a better way of conceptualizing the psychopathology of affective disorders.

Psychometric evaluation of the Swedish adaptation of MOODS-SR, lifetime version.

Patients with affective disorders were recruited from outpatient services at Sahlgrenska University Hospital. Patients and a convenience sample of healthy controls were offered to fill in the MOODS-SR. This is a preliminary analysis of the collected data; data from more participants will be presented at the conference. Internal consistency was evaluated using Cronbach's α and the mean score on subdomains compared between groups using a Student's t-test in STATA.

September 2014, 22 patients with affective disorders and 67 controls had answered the MOODS-SR. The age (mean ± sd) of patients was 39.8 ± 11.8 years compared to 40.7 ± 12.7 years of controls (p=0.79). The patient and the control group consisted of females by 73% and 69% respectively (p=0.33). Cronbach's α was 0.89 in patients and 0.90 in controls regarding the total score on the 7 subdomains; i) mood depressive, ii) mood manic, iii) energy depressive, iv) energy manic, v) cognition depressive, vi) cognition manic, vii) rhythmicity. The mean scores on the 7 subdomains were all statistically significantly higher among patients (p value<0.001).

The Swedish MOODS-SR, lifetime version, has good internal consistency among both patients with affective disorders and controls. Furthermore, the patient group displayed consistently higher mean scores than the control group in all subdomains.

Adverse childhood experiences (ACE) have been shown to be associated with negative outcomes in adulthood and risk factors for psychopathology.

To assess mental representations of children underwent to ACE administering a recently developed semi-projective method: the Coffy Test.

To compare mental functioning of children who underwent to one or several adverse life events with the one of a control sample of non referred children.

The sample, recruited at the Neuropsychiatry Unit after adverse life events occurred, was composed of 40 children (21 male, 19 female) (Mage= 108.10 months; SD= .26).

The control sample was composed of 160 children (86 males, 74 females) (Mage= 108.80 months; SD = 21,10). Children were administered the Coffy Test, which is a new projective method focused on assessing possible elements of distortion in emotional processing within the relationship with parental figures in middle and late childhood (Cardi, Leonardi, D'Amico, Battista, 2012).

Coffy Test scores of the sample underwent to ACE and the control sample did not differ significantly neither for gender nor for age. However, the differences of the Coffy Test scores between the two groups were statistically significant (U = 1.26, p < .0001). Only 4 children in the ACE sample reported a score higher than the median of the control one.

The Coffy Test score suggested that children underwent to ACE had a worst mental functioning and thus may be exposed to the risk of developing psychopathology in adulthood.

We studied the frequency of PLEs in a representative sample of 4483 participants of the German population recruited through the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH). Participants were asked if they had had psychotic or psychosis-like experiences over their lifetime. We used the psychosis section of the Composite International Diagnostic Interview (CIDI), the Launay-Slade Hallucination Scale (LSHS) and the Peter's Delusion Inventory (PDI).

33.3% of the participants endorsed at least one item of the CIDI psychosis scale, 68.8% of the PDI and 49.0% of the LSHS. In the PDI assessments, conspiracy-related delusional experiences were most often experienced as distressing, while religious beliefs were experienced less distressing, but with high levels of conviction.

Our findings show frequent endorsement of lifetime psychotic or psychotic-like experiences in the general population in self-report questionnaires with varying degrees of distress and conviction. This provides the needed baseline assessment for follow-up studies observing the development of mental disorders with a view to determine the predictive values of these tests.

Emotion recognition deficits in psychopathology have been extensively studied with a variety of measures. The Bell Lysaker Emotion Recognition Test (BLERT; Bell et al., 1997) is an effective method to assess emotion recognition by presenting affect stimuli which may have greater verisimilitude with real life events. Indeed, BLERT combines facial expressions with affective information transmitted in prosody or body posture. This method has allowed the study of emotion recognition deficit in psychotic patients, as well as its relationships with other aspects of psychopathology (Vohs et al., 2014).

We aimed at testing the validity and reliability of an Italian version of the BLERT.

First, a group-comparison was carried out between clinical and nonclinical participants. Then, correlations among BLERT scores and other indices of psychological functioning were explored.

We recruited 12 inpatients with psychotic disorders (mean age= 54.75; 58.3% female) and 45 nonclinical participants (mean age= 24.04; 75.6% female). We administered the BLERT (Bell et al., 1997), along with the following measures: Empathy Quotient (Lawrence et al., 2004), Interpersonal Reactivity Index (Davis, 1980), Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), and the Inventory of Interpersonal Problems-47 (Pilkonis et al., 1996).

Clinical participants resulted impaired in all indices of the BLERT. Further, the construct validity of the BLERT was confirmed by associations with measures of empathy, emotion dysregulation, and interpersonal problems.

The use of the Italian version of the BLERT seemed promising for the study of emotion recognition in both clinical and nonclinical samples.

To study the kind of disturbances of thought content (DTC) and perception (DP) observed in patients admitted at Centro Hospitalar Psiquiátrico de Lisboa – Affective Disorders' ward, with the diagnostic of Bipolar Disorder.

Retrospective analysis of all patients admitted between October 10th, 2013 and March 31st, 2014; measuring the presence and the type of DTC and DP.

A total of 149 patients were admitted, 52,3% had DTC (N=78). Overvalued ideas were present in 16.1% (N=24), and five of them showed more than one kind of them (10 with persecutory ideas, 7 grandiose, 5 of poverty, 4 of guilt, 1 nihilistic). Delusional ideas were present in 33.6% of the patients (N=50), 23 of them with multiple kinds of DTC,: 28 with persecutory ideas, 24 grandiose, 16 mystic, 6 of self-reference, 3 of guilt, 2 of poverty.

In 2.7% of the patients (N=4), both delusional (3 grandiose, 1 persecutory, 1 of jealousy) and overvalued ideas (3 persecutory, 1 of ruin) were present.

Hallucinations were observed in 11.2% of the patients (N=17), all of them auditory. From these patients, 5,8% presented overvalued ideas, and 70,6% delusional ideas (N=12): 7 patients with persecutory ideas, 6 grandiose, 5 mystic, 7 of guilt, 7 of poverty, 1 of self-reference (24% of the patients with delusional ideas had disturbances of perception).

More than half of the patients admitted with Bipolar Disorder presented DTC, mainly persecutory and grandiose. Less frequent, auditory DP are also present, the majority of them associated with DTC.

Xenomelia or Body Integrity Identity Disorder (BIID) is the oppressive feeling that one or more limbs of one’s body do not belong to one’s self. Some studies report absent comorbid psychiatric conditions, others point to abnormal psychological characteristics in BIID individuals.

We carried out a study in order to shed light on theseinconsistent results. Unlike many previous investigations we examined each person individually in the frame of an extensive personal interview.

We examined 15 men with BIID and 15 pair-matched control subjects. Psychiatric and psychological assessment was performed using the SCID-Interview and various self-rating scales.

The structured clinical interview did not produce any evidence for a psychotic disorder, but four BIID-participants werediagnosed with depressive disorder. The results of the self-rating scales did not reveal differences between participants with xenomelia and control participants with respect to body dysmorphic, obsessive-compulsive, schizotypal, depressive and anxiety symptoms. However, participants with xenomeliatended to be more impulsive (P = 0.07), and scored higher on borderline symptoms (P = 0.07) and dissociative symptoms (P = 0.08).

BIID is a rare, but dramatic and severe psychiatric condition. Individuals suffering from this disorder do not show major psychological or psychiatric problems and comorbidities. Suffering and depressive symptoms might be the result of the unfulfilled wish for an amputation and raise important ethical and medico-legal issues about the amputation of healthy limbs.

Trofimova's Functional Ensemble of Temperament model proposes linkages between temperament traits and various neurophysiological systems, particularly those involving biogenic amines, acetylcholine, GABA, Glutamate, neuropeptides and hormones as well as opioid receptor systems. Temperament is expressed through complex interactions between these systems and the environment which form contingent, contextual and emergent functional ensembles. Anxiety and Mood disorders are presumed to arise through dysfunction in one or more of these neurophysiological systems. Therefore the presence of one of these disorders should be associated with an alteration in reported levels of particular temperament traits.

To examine temperament patterns of individuals with anxiety and depression as compared to healthy controls and to ascertain whether there are systematic differences in reported scores.

300 patients with anxiety or depression and 150 healthy controls were administered the Structure of Temperament Questionnaire (STQ-77), PAI, and various rating scales for anxiety and depression. The 12 temperament scales of the STQ-77 include 3 emotionality scales (Neuroticism, Impulsivity, Self-Confidence) and 9 scales measuring dynamic aspects of activity (endurance, programming-integration and orientation) analysed separately for physical, social and intellectual activities. Emotionality is presented in this model as an amplifier of the arousal, lability and orientation aspects of activity.

The depressed group showed systematic differences in reported levels of 9 temperament traits as compared to controls. The anxiety group reported systematic differences in 3 traits.

The presence of anxiety or depression results in systematic changes in reported levels of various temperament traits consistent with the FET hypothesis.

Antipsychotic polypharmacy is defined as the co-prescription of more than one antipsychotic for a single patient. The practice has been criticised because of a lack of convincing evidence for its effectiveness and safety. It is associated with increased hospitalisation rates, more adverse effects, elevated cost, pharmacokinetic interactions, reduced adherence and increased mortality.

This study aimed to identify patients attending a community psychiatric service who are currently prescribed more than one antipsychotic. It aimed to examine their diagnoses, comorbid physical illnesses and other medications. Patterns of co-prescription were also considered.

A computerised database was utilised to identify all patients prescribed any antipsychotic.

98 patients who were prescribed antipsychotics were identified. Of these, 22 (22%) were prescribed two antipsychotics. No pattern of a preferred combination of antipsychotics was identified. 15 of those prescribed more than one antipsychotic (68%) were prescribed two second generation drugs, with the remainder on a combination of a first and second generation antipsychotic.

Antipsychotic polypharmacy rates (22%) were in line with the European average (23%). Antipsychotic polypharmacy should be a last resort after evidence-based treatments have tried and failed. It is recommended that it is considered only after a minimum of two trials of single antipsychotics at adequate doses and durations; after at least one trial of depot antipsychotic; and following at least one trial of Clozapine, with consideration given to ECT. Focused interventions rather than passive dissemination of guidelines are more likely to reduce antipsychotic polypharmacy rates.

The 22q11.2 deletion syndrome (22q11DS) is one of the most common microdeletion syndrome with a highly variable phenotype comprising among others endocrine dysfunctions and an array of psychopathological features including schizophrenia-like psychotic symptoms.

Studying the efficacy of antipsychotics in 22q11DS-related psychoses.

Review of the literature and systematic inventarisation of treatment history and efficacy of antipsychotics in 28 genetically-proven 22q11DS-patients.

Extensive neuropsychiatric and cognitive examination as well as documentation of medical conditions, psychiatric diagnoses and previous and actual psychotropic medications.

Apart from scarce case reports, no systematic reports were found on effectiveness of antipsychotics. History of the presently included patients showed an array of psychiatric diagnoses addressed with a multitude of psychotropics. In accordance with the 22q11DS phenotype, their psychopathological profile was characterized mainly by psychotic features with anxieties and mood instability. In two patients a neurodegenerative phenotype was present, compatible with early-onset Parkinson disease (PD).

Nearly all patients had been treated with more than one antipsychotic, frequently in combination with an antidepressant. In none, any effect of conventional antipsychotics, including risperidone, was recorded. All patients, except those with PD, were treated with an atypical antipsychotic and, dependent on the presence of mood instability, valproic acid was added. In a significant number of patients this regimen resulted in long-term remission with either clozapine or quetiapine in relatively low dose.

Dependent on individual tolerance, psychoses in 22q11DS-patients are preferentially treated with quetiapine or clozapine accompanied by contextual psychological measures.

Cannabis-induced psychosis is not uncommon and a lot of antipsychotics have been in use in clinical practice to address the problem. However, Blonanserin, a relatively new atypical antipsychotic has not yet been tested in cases like this.

This study aims to understand any possible role of Blonanserin in patients of cannabis -induced psychosis.

We recruited 20 patients as per DSM V criteria, coded 292.5,of cannabis-induced psychosis into the study and randomly divided them into 10 each of 2 groups, Group A and Group B and administered Blonanserin (4-24mg)and Placebo respectively for the two groups and then followed up for 6 months. All patients were assessed for their psychotic symptoms before and after the study, using Brief Psychiatric Rating Scale (BPRS) and statistically analysed.

Gr A patients, overall, showed better response (at least 50%reduction in BPRS score from the baseline in all patients)in comparison to the Gr B patients in terms of their psychotic symptoms as we could analyse from the t score measurement difference between the two groups before and after the study. Significantly, Blonanserin was very well tolerated.

While several antipsychotic drugs have already been proven beneficial in the treatment of cannabis-induced psychosis, almost all of them have troublesome side effects and even some of them, like Risperidone has actually been found to increase craving for cannabis in some patients, as available literature suggests. However, Blonanserin, because of its overall favourable pharmacological profile might be a very useful drug in such cases.

Simvastatin and other HMG-CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase inhibitors (statins) have been demonstrated to reduce mortality and the risk of major cardiovascular events. However, their neuropsychiatric adverse effects have not been sufficiently studied.

of our study is to elucidate effect of long term application of simvastatin on cholesterol level in the brain, serotonin uptake, microviscosity of membranes, and behavior in animal model.

We have studied cholesterol content in amygdala; hippocampus and prefrontal cortex, serotonin (5-HT) uptake and mitochondrial respiration in platelets, membrane microviscosity in erythrocytes, and behavioral changes in elevated plus maze in 6 male Long Evans rats in the control group and 6 rats in the simvastatin-treated group (30 mg/kg per day) after 2 and 4 weeks of treatment.

Our results show: 1) lower cholesterol content in all tested brain regions in simvastatin treated group 2) decrease of SERT aktivity after 2 weeks of treatment compared to 4 weeks treatment 3) disturbed mitochondrial respiration and 4) higher number of entrances and the time spent in the closed arms in simvastatin group.

These results confirmed cholesterol-lowering effect of simvastatin in brain and harmful effect on cellular energy metabolism and further supported the hypothesis that lowering of plasma cholesterol after simvastatin treatments affects membrane fluidity and transmembrane transport of serotonin. Effects on behavior require additional testing to better explain observed changes in experimental tasks.

Metabolic syndrome affect around 20% of general population, authors have incriminated antipsychotics as serious risk factor that may provoke such derangement. The aim of our study is to assess metabolic syndrome in patients presenting psychotic features (delusions and hallucinations) whether schizophrenia or mood disorder and compare results in terms of drug naïf, on medication and healthy control.

The study recruited 40 schizophrenic patients, half of them drug naïf and the other half on antipsychotics, 40 patients with mood disorder with psychotic features, half of them drug naïf and the other half on medication, 20 healthy control. Exclusion criteria were put in order to exclude patients having already endocrine or metabolic disorders that my interfere with results obtain to minimize confusion bias. Metabolic syndrome assessed by measuring parameters including weight, body mass index, waist circumference, triglyceride level, HDL, fasting glucose, fasting insulin and insulin resistance

No difference was found when comparing drug naïf to those on medication in both schizophrenic and psychotic mood disorder arms, schizophrenic patients in general tend to show higher fasting glucose while patients with psychotic mood disorder tend to show higher fasting insulin level

This study suggest that presence of psychotic features themselves regardless being on medication or not carries a risk for insulin resistance and metabolic syndrome.

To determine patient adherence to generic venlafaxine versus brand-name venlafaxin (Vandral®) and its impact on costs and outcomes in subjects with Generalized Anxiety Disorder (GAD) in routine medical practice in Spain.

A retrospective, observational new-user cohort study was designed. Electronic medical records linked from medical database of BSA, a health provider in Badalona (Spain), and corresponding community pharmacies dispensing's were extracted for analysis. Participants were beneficiaries aged 18+ years with pharmacy dispensing drug coverage between 2008 and 2012, an ICD-9-CM code for GAD and who initiated treatment with generic-venlafaxine or Vandral®. Assessments included adherence (measured as the medication possession ratio [MPR] and time until discontinuation up to 1 year follow-up), healthcare costs funded by NHS and outcomes (measured as the reduction in severity of anxiety symptoms with the HAM-A scale). Differences were estimated using a general linear model with covariates.

A total of 841 patients (60.7 years, 64% women) were identified: brand-name; 370 (44%) and generic; 471 (56%). The average MPR was 78% in the generic arm and 82% in the brand-name (p=0.047). Median persistence was 8.1 and 8.8 months, respectively (p=0.002). A 16% reduction in the adjusted healthcare cost was observed favoring brand-name; €1,110 vs. €928€; -€182 (p=0.020). Brand-name was associated with higher reduction in symptoms severity: -15.3 (62%) vs. -12.6 (49%) points (p<0.001).

Compared with initiating generic-venlafaxine, patients initiating brand-name venlafaxine were more likely to adhere, had lower NHS funded healthcare costs and showed higher reduction of anxiety severity symptoms in routine clinical practice.

Aripiprazole is an antipsychotic drug used for treatment of schizophrenia and bipolar disorders. Common side effects are on gastrointestinal system and their mechanism is not fully understood.

Ex vivo study the effect of aripiprazol on circular strips of stomach smooth muscle.

To study the effects of aripiprazol on the smooth muscles in order to understand the causes for the common side effects on the gastrointestinal tract.

Gastric corpus smooth muscle preparations from male Wistar rats (n=12) were used. Strips were dissected and mounted and super fused with warmed Krebs solution. The contractile activity of smooth muscle preparations was registered isometrically. The activity was periodically tested by stimulation with 1×10-6 mol/lacetylcholine. All statistical analyses were performed using a specialized software SPSS, version 16.

Aripiprazol (1×10-6 mol/l – 1×10-4 mol/l) caused contractions in gastric circular smooth muscle tissues from rats. M-cholinergic receptor-blocking agent atropine (1×10-6mol/l) significantly reduced the aripiprazol-induced contraction. In the presence of 1×10-6 mol/l acetylcholine, aripiprazol (1×10-6 mol/l – 1×10-4 mol/l) caused relaxation of the test muscle tissues. It was determined that the amplitude of the induced relaxation was concentration-dependent.

Our results permit the suggestion, that the effect of aripiprazol involves cholinergic neurotransmission on gastric smooth muscles. This is confirmed by aripiprazol–induced contraction in atropine–treated tissues. Residual muscle contraction suggests the possible drug influence on other receptors. The fact is confirmed by the relaxation effect of aripiprazol in the presence of Acetylcholine, i.e. other effects of aripiprazol become more prominent.

The use of benzodiazepines and z-drugs in clinical practice is a double-edged sword. There is a paucity of literature studying the prescribing trends of benzodiazepines and z-drugs in Singapore.

The objective of this study is evaluate the outpatient prescribing trends of oral benzodiazepines and z-drugs in a general hospital in Singapore over a 9 years period, from 2005 to 2013.

Data was obtained from the electronic records of all outpatient benzodiazepine and z-drug prescriptions over the study period. The parameters studied were daily dose (in mg/day), duration (in days) and total dose (in mg) of the drug of interest in each prescription. Stratification of these parameters by age groups and gender of patients was performed. A multivariate linear regression model was used to analyze the prescribing patterns across time while adjusted for confounders.

There was a significant drop in the number of benzodiazepine and z-drug prescriptions between 2011 and 2013. The specified parameters of Alprazolam, Diazepam and Lorazepam prescriptions showed steep drops between 2011 and 2013, while those of Midazolam increased considerably over the same period. Full Linear regression analysis for mean total dose showed negative coefficients for Alprazolam, Diazepam, Lorazepam, Zopiclone and Zolpidem prescriptions and a positive coefficient for Midazolam prescriptions.

There is preliminary evidence for an overall drop in the prescribing trend of benzodiazepines and z-drugs; this study is a stepping-stone for much needed future research in this area.