Family interventions in psychosis are well established through systematic reviews and meta-analysis of outcome studies. Such reviews report that family intervention might reduce the risk of relapse, benefits in general social functioning, and reduction in levels of expressed emotion and family burden. But most previous studies are conducted in caregivers with chronic schizophrenia. Thus, the effects of family interventions in the early stages are largely unknown.

The study evaluated the effectiveness of group intervention in improving social support and reduction in expressed emotion among caregivers of first episode psychosis.

Using a quasi-experimental comparison group design, we evaluated the effectiveness of an add-on seven sessions of group interventions with treatment as usual group among 59 caregivers of first episode psychosis. Intervention included support, psycho-education, and communication components. The samples were recruited during participants’ inpatient stay at the hospital. Follow-up assessments were carried out after one moth and three months of interventions. Standardized instruments were used to measure the outcomes. Descriptive and inferential statistics were applied to the data.

Caregivers in group intervention reported significant reduction in expressed emotion (p<.007) and improvements in social support (p<.002) in one month follow-up assessment. But these benefits were not sustained at three months follow-ups. Overall, both groups showed significant changes on outcome variables over the time period.

Group intervention was effective for improving caregivers’ social support and reducing expressed emotion. Intervention need to provide longer period to sustain the benefits.

Dialectical Behavior Therapy (DBT) is a comprehensive psychosocial treatment developed by Marsha Linehan and originally designed for persons meeting criteria for Borderline Personality Disorder (BPD). DBT contains four treatment modes that are deigned to address core problems of BPD. The four modes of treatment include individual therapy, skills training group, phone consultation and therapist consultation meeting.

The skills training group is organized as 120-150 minutes group, weekly, for 6 months. Four modules are taught across the six months period which are core mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.

Although psychotherapeutic interventions are always the first line of treatment for BPD in most guidelines but adherence to therapy have been always a major problem.

Assessment of patient's compliance to DBT skills training group.

The aim of the current study was to estimate drop out rate in the first Egyptian DBT skills training group over one year.

Fifteen female patients diagnosed with BPD were recruited to DBT skills training over one year. Drop out rates were calculated based on the rule of being out of therapy if the patient misses four consecutive sessions for no obvious reason.

Three patients only out of 15 dropped out of treatment (20%). Twelve patients could complete the full six month DBT skills training or are still currently engaged in treatment.

Although this was the first time to teach DBT skills in Arabic, DBT skills training group among Egyptian female patients with BPD had a high compliance rates.

Several studies have reported that immigrant adolescents suffer high rates of victimization. Polyvictimization was established as a well predictor of mental health problems. Many authors have highlighted the need to study immigrant adolescents’ community as they were immersed in a stressful process.

The aim is to assess multiple types of victimization (polyvictimization) and mental health problems among immigrants (first and second generation) in comparison to native adolescents.

The sample was composed of 296 adolescents (62.2% girls) aged 13-18 (M = 15.63; SD = 1.19) in Catalonia. Participants were distributed in three groups: native (50%), first (34%) and second (16%) generation immigrants. The Juvenile Victimization Questionnaire and the Youth Self Report were used to assess victimization experiences during the last year and psychological distress, respectively.

Immigrant and native adolescents were comparable in average of total victimizations and in different types of victimization. Nevertheless, significant differences were shown among first immigrant generation and natives in relation to child maltreatment (p = .005). Significant associations were found between multiple kinds of victimization and mental health problems. However, for first immigrant generation who had experienced multiple victimizations were more associated with internalizing symptoms, while victimized native adolescents were more associated with externalizing symptoms.

Results emphasized the importance to assess victimization experiences which were suffered by adolescents, and also suggested that polyvictimization will be associated differently depend on the migration status group of the adolescents with mental health problems.

The migration experience is a complex process that involves a break with the society of origin and an adaptation in the host society. This process involves cognitive and emotional aspects, both conscious and unconscious, of individuals. All of that with the culture and ethnicity influence the mental health of this population.

To observe and describe what these population groups require of mental health care.

Collect data (sex, age, place of origin, work activity, diagnosis, treatment) of immigrant patients referred from Primary Care or Specialty Care Hospital to the Community Mental Health Unit of the North of Granada from 2010 to 2013.

We identified differences between immigrant patients and the remaining patients: younger age (“working-age”), with unskilled labor activity or unemployed, higher prevalence of affective pathology major discontinuity and treatment dropout.

In these groups the prevalence of mental illness is similar to the rest of the population, however, they have limited access to medical services that may be related to increased frequency of disability, social cost and human suffering.

We should pay special attention to these ethnic minorities for a better care and monitoring of mental disorders.

The modern circumstances of migration processes in Russia are unique in comparison with other countries. The mental states of children, their adaptation depended on interfamily relations and dialogue within a family, its educational potential that was determined by the structure of a family, social, material and educational status of parents.

There were used personal questionnaires, PARI method and Test-Questionnaire of Parental Attitude (QPA). Besides, Pathocharacterological Diagnostic Questionnaire by Lychko (PDQ) and a list of projective tests was applied to reveal characterological and psychological peculiarities of children.

In the most families before migration, it was possible to ascertain such conditions and style of upbringing, which characterized families as stable and safe. After migration, children get in the situation of long-term intensity with constant risk of adaptation mechanisms failure. The families, which structure after migration transformation became most abnormal, have incurred the greatest loss. Parents had feeling hopelessness, mood was reduced to depressions, discipline in a family fell down and ability to constructive actions was lost. There was also moral fall with complete disharmony and pedagogical inconsistency, and children suffered from diverse deprivations.

The complex of social and psychological influences accompanying by stress of social changes during migration fatally influenced on psychological health of family and its structure. Thus, the degree of disorder in great extent was determined by quality of the social-psychological characteristics, which were inherent in families before migration from the one hand and an adequate competitive psychological and therapeutic care on the other.

This study tested the associations between Language-proficiency (LP) and clinical, therapeutic characteristics among hospitalized immigrants to study how LP may influence the presentation and the outcome of mental disorders.

According to our previous evidences, lack of cultural adaptation may risk or worsen mental illness among immigrants, and interfere with assessment and treatment. Also, LP seems essential for access to foreign environments. In this study further considerations were made regarding LP on a larger sample of immigrant patients and longer period of observation.

We reviewed clinical records of immigrant psychiatric patients hospitalized at the University of Foggia in 2004–2012 (N=153), and compared characteristics of patients with adequate versus inadequate language proficiency (LP).

Subjects were 80 men and 73 women, aged 35.2±10.3 years, 50.3% emigrated from other European countries. Many were diagnosed with a DSM-IV adjustment disorder (31.3%) or depressive disorder (28.1%), and 69.9% were in first-lifetime episodes. Average comprehension and spoken language-proficiency (LP) was considered adequate in 62.7% and inadequate in 37.3%. Adequate-LP was more prevalent among women (p<0.0001), in first-lifetime episode cases (p=0.0005), among patients had entered Italy legally (p=0.0009), and emigrated from another European country (p=0.01).

Findings support an expected importance of LP among immigrant psychiatric inpatients, and encourage language-assessment and training as part of comprehensive support of such patients, especially men.

Prevalence of ADHD among people with intellectual disability (ID) is higher than people without intellectual disability (Reilly & Holland 2010), however it appears to be underdiagnosed (Rose et al 2009).

Describe the prevalence of ADHD in ID psychiatric clinics and patient characteristics in Surrey, UK.

Patients' records in ID psychiatric clinics were audited.

14 patients attending ID clinics had a diagnosis of ADHD. Age range was 18 to 32. 85% were male. Prescribed ADHD medications were Concerta XL, Medikinet XL, methylphenidate, atomoxetine and clonidine. 21% were on combination of two ADHD medications. 43% of the patients were also on other psychotropic medications. 36% of patients with ADHD also had a diagnosis Autism. 42% had another comorbid mental disorder.

Given the prevalence rate for ID (1.03%) and ADHD (6.8%), nearly 400 individuals with ID should have a diagnosis of ADHD in this catchment area. Presence of only 14 individual with ADHD shows that ADHD is extremely under diagnosed and under treated within ID population. This raises the issue whether patients are treated with psychotropic medications and psychological methods for behavioural and mental health issues due to under diagnosis of ADHD. Diagnosis of ADHD and complexities of such diagnostic processes among people with ID may be some of the reasons for under diagnosis (White et al 1995, Reiss et al 1982). Screening tools and increasing awareness may be needed to detect ADHD symptoms in this group of people when psychiatric diagnoses are often challenging.

With microarray analysis, several novel microdeletion syndromes have been ascertained that are often accompanied by a specific behavioural phenotype requiring specific treatment modalities.

Investigating the neuropsychiatric phenotype of Phelan-McDermid syndrome.

Diagnostic evaluation of an adult female with mild intellectual disability.

Detailed genetic, neuropsychiatric and neuropsychological examination.

The patient is a 22-years-old female. Aged 4, conventional karyotyping demonstrated a translocation 11;22. Her history is characterized by neonatal hypotonia accompanied by feeding problems, global intellectual disability, sleep disturbances, delayed development of speech, and ritualistic/compulsive behaviours. Since about two years recurrent mood changes paralleled by an increase of pre-existent autistic behaviours became prominent. Psychotropics induced severe extrapyramidal symptoms without, however, any reduction of problematic behaviours.

At examination, no dysmorphic features were observed. Her behaviour showed autistic-like elements and mood alterations. Neuropsychological assessment revealed mild intellectual disability (SON-R IQ: 61) and a developmental age of 6;3 years with marked attentional deficits. Visuomotor, speech, and memory functioning were in line with her developmental age. Fluctuation in mood and affect was substantiated. MRI-brain disclosed no abnormalities. Microarray analysis confirmed the de novo t(11;22) that had resulted in a 11qter duplication of 8,77Mb and a 515kb 22qter deletion, encompassing the SHANK3 gene, in agreement with a diagnosis of Phelan-McDermid syndrome.

Here a never reported unbalanced translocation leading to Phelan-McDermid syndrome with its characteristic neuropsychiatric phenotype is demonstrated. Apart from the implementation of systematic environmental measures, a plasma-concentration controlled treatment with valproic acid for mood stabilisation was advised.

The provision of support for people with autism spectrum disorder (ASD) within the community is improving as a consequence of policy and legislative changes. However, specialist services are not currently provided in prisons.

This aim of the study was to determine the extent of ASD and co-occurring mental health problems among prisoners. We tested the hypothesis that ASD traits would be unrecognised by prison staff and would be significantly associated with increased rates of anxiety, depression and suicidality.

ASD traits were measured among 240 prisoners in a resettlement prison in London, UK using the 20-item Autism Quotient (AQ-20). Anxiety, depression and suicidality were assessed using the Mini International Neuropsychiatric Interview (MINI).

There were 39 participants (16%) with an AQ-20 score ≥10; indicating significant autistic traits. Mental health data were available for 37 ‘high autistic trait’ participants and another 101 prisoners with no/low ASD traits. There was a significant positive association between AQ-20 and suicidality scores (r=.29, p=0.001). Participants with ASD traits had significantly higher suicidality scores (means=15.1 vs. 5, p= 0.001) and chi-square analysis showed that they were more likely to have a high suicidality rating (27% vs. 8%, p=0.003) than those without ASD traits. Moreover, those with ASD were significantly more likely to be experiencing a current episode of depression (30% vs. 6%, p<0.001) or Generalised Anxiety Disorder (GAD) (27% vs. 11% p=0.019).

Our initial data suggests that severity of ASD traits is a risk factor for suicidality and common mental health problems among prisoners.

In the last years there is more research in a differentiated view of the capacity of people with IDD. Besides the evaluation of cognitive functioning, studies also look at other developmental dimensions like socio-emotional skills. Because of their basically biological character, motor skills were not further studied in people with IDD. We wanted to study whether there is a correlation between these different dimensions in patients with IDD.

This presentation will look at possible connections and interferences between socio-emotional development, cognitive functions and motor skills.

We evaluated the level of motor development with the 'Movement Assessment Battery for Children” in n= 31 patients. Results were correlated with the level of cognitive impairment and socio-emotional status.

In contrast to cognitive functioning we found no significant difference between the socio-emotional and the motor skills for all study patients, regardless of sex, in the subscales manual and ball skills. Only in the subscale balance we found a significant correlation with the socio-emotional level in female patients.

With regard to the dimensions cognitive impairment and socio-emotional level we found no significant correlation with motor skills. This is in accordance with the literature. Only in the dimension 'balance” in female patients we could see a significant difference which is a new result and interesting for further evaluation. So another study with a bigger and more balanced patient sample to confirm this result is planned.

Non pharmacological interventions are recently proposed for the management of mild Alzheimer's Disease (mAD). Aims: The aim of this study was the comparison of the magnitude of the observed changes applying 2 types of cognitive interventions, the cognitive training (CT) and the cognitive stimulation (CS).

Fifty five systematically recruited mAD outpatients separated randomly in 3 subgroups, 2 experimental (CT CS) and one control group (CON). They were matched in age, education, duration and type of medication and style of living. The intervention programs were lasting 4 months on individual basis.

Statistically significant differences were found in the general cognitive state between groups (p=.000-.024) after the end of the program (1^st follow up) and 12 months later (2^nd follow up) and in trained and untrained cognitive abilities. Analytically, the CTs showed large effect improvement in general cognitive state in both follow up. Large to medium effect size improvements were observed in trained abilities as memory, naming, retrieval and time response, as well as in non trained cognitive abilities (prospective memory, shifting ability, face recognition). Both the CSs and the CONs showed large effect size general cognitive decline. However CSs were improved in time response.

CT intervention can cause large effect size improvements in the general cognitive state and the trained cognitive abilities and transfer of the effects to untrained cognitive abilities remoting the possibility of institutionalization. Non structured interventions without training processing don't seem to restrain the cognitive decline of the patients.

Schizophrenia is a chronic disorder which severely limits the social and occupational functioning.

Employment, education, relationships, housing and health are among the most frequently stated life and treatment goals among persons suffering from schizophrenia.

Rehabilitation for persons with schizophrenia aims at preservation and improvement of psychosocial functions, promotes recovery-oriented interventions and, therefore, serves the central goals of affected persons.

The goals of these models focus on improving knowledge, coping, self-care, social support and self-management strategies.

The aims of this cases report is to underline the effectiveness of multidimensional approach, which included drug treatment, psychosocial therapeutic interventions, supported employment, peer-supported housing.

We report 8 patients with a early onset psychosis, detected with EriRaos and clinical interview.

Diagnostically, these patients had a real improvement of their psychosocial functions in areas such as work, social relationship and independent living skills.

Cognitive functioning, education, negative symptoms, social support and skills, age, work history and rehabilitation service to restore community functioning have proven to be strong predictors for successful psychiatric rehabilitation.

Sporting practice for psychotic patients have been demonstrated to be efficacious as a rehabilitation tool at various levels, improving social interaction, self esteem, body self consciousness, reduce anxiety and depression, reduce stigma, improve compliance, reduce admission rates, reduce aggressiveness, reduce family burden.

Since 1999 the Fuoric'entro Polisportiva was founded in Trieste, with the support of the Department of Metal Health, with the aim of influencing recovery at several levels.

Evaluate the impact on participants' health.

Demonstrate the outcome of the rehabilitation program based upon the sporting activity.

The research is a descriptive, case-control study, led on 40 patients (20 cases and 20 controls) followed by the Trieste's Metal Health Department. We considered as items living situation, professional condition, gender and age, diagnosis, therapy and its compliance, admissions’ number and duration, main therapeutic interventions, following up a previous study on the same rehabilitation program.

In the cases’ group there is a stable improvement of the professional and living conditions, compliance and a reduction of admissions’ number and duration.

A rehabilitation program based on sporting can improve coping abilities, psychopathological conditions, person's 'social functioning”, family burden.

It has been reported that vesicular glutamate transporter 1 (VGLUT1) and 2 (VGLUT2) are implicated in cognitive deficit in schizophrenia rat model. However, vesicular glutamate transporter 3 (VGLUT3) has not been investigated yet. Bacopa monnieri (Brahmi) has been popularly known as a cognitive enhancer in elderly and patients with Alzheimer's disease. It consists mainly of bacoside A and B, which may increase cognitive function in schizophrenia by changing VGLUT3 density in the brain.

To study effects of bacoside A and B (bacoside A+B) on attenuation at cognitive deficit and cerebral VGLUT3 density in sub-chronic phencyclidine (PCP) rat model of schizophrenia.

Rats were administered PCP or vehicle. Half of the PCP-group was treated with bacoside A+B. Discrimination ratio (DR) representing cognitive ability was obtained from novel object recognition test. VGLUT3 immunodensity was measured in prefrontal cortex, striatum and CA1-3 of hippocampus using immunohistochemistry.

DR in PCP-group was significantly decreased compared with control. This occurred alongside VGLUT3 up-regulation in CA1-3, but not in prefrontal cortex and striatum. PCP with bacoside A+B showed a significant increase in DR score compared with PCP alone. This occurred alongside significant decrease in VGLUT3 immunodensity in CA1-3. No significant difference in cerebral VGLUT3 immunodensity was observed between PCP with bacoside A+B and control.

VGLUT3 up-regulation in CA1-3 could produce glutamate excitotoxicity, which then induce cognitive deficit in schizophrenia rat model. Interestingly, bacoside A+B can recover this cognitive deficit by reducing excessive VGLUT3 in CA1-3 to normal level.

Evidence suggests that the subjective experience of AVHs cannot be explained by any of the existing cognitive models,[1] highlighting the obvious need to properly investigate the actual, lived experience of AVHs, and derive models/theories that fit the complexity of this.

Via phenomenological interviews and ethnographic diary methods, we aim to gain a deeper insight into the experience of AVHs.

To explore the phenomenological quality of AVHs, as they happen/reveal themselves to consciousness, [2] [3] without relying on existing suppositions.

Participants with First Episode Psychosis were recruited from the Birmingham Early Intervention Service (EIS), BSMHFT. In-depth 'walking interviews' were carried out with each participant, together with standardised assessment measures of voices. Prior to interviews, participants were asked to complete a dairy and take photographs, further capturing aspects of their AVH experiences.

20 participants have completed interviews to date. Emerging themes cover the form and quality of voices (i.e. as being separate to self, imposing, compelling etc.), and participants' understanding and management of these experiences.

Authentic descriptions gleaned from participants have the potential to increase our understanding of the relationship between the phenomenology and neurobiology of AVHs and, in turn, the experience as a whole.

Social representations can give meaning to our beliefs, opinions and representations of the world; they assume an adjustment function to our membership groups and determine our behavior.

To compare social representations of schizophrenia in a sample of schizophrenic patients and in the general population.

This is a comparative study between patients with schizophrenia and a sample of the general population.

A semi-structured interview was undertaken around three questions.

The first issue of “mental illness names you know” is to gather the terms associated with the subject to the representation of mental disorders.

The following questions: “you think of when the term schizophrenia?” and” How does schizophrenia manifest? “designed to make the representations of schizophrenia emerge.

We performed this study on a group of 20 schizophrenic patients and a group of 20 subjects from the general population.

We found that the sample of general population considers the schizophrenic as a person with faults and not just “crazy.” We find no significant difference between our two groups regarding stigmatizing representations of the disorder.

Indeed, we found that control subjects have a greater variety in the terms used, and many patients are not aware of the name of the disease from which they suffer. Regarding the description of the manifestations of the disease, positive symptoms are most frequently cited by patients as well as control subjects.

This result highlights the important role of the practitioner in patient education and stresses the need working on representations associated with schizophrenia.

To establish any association between urinary tract infections and acute episodes of schizophrenia

A Case control study conducted in University Psychiatry unit, National Hospital of Sri Lanka (NHSL), Colombo, Sri Lanka.

Thirty four cases with acute episode of schizophrenia and 30 normal controls matched for age and gender were selected. Cases were patients who met the International Classification of Disease (ICD- 10) criteria to diagnose schizophrenia who attended the inward and outpatient care of the unit. Urine full report (UFR) and urine culture were performed in all cases and controls to detect and confirm urinary tract infections (UTI). Data was analyzed using SPSS software.

Number of cases was 34 and controls were 30. Mean age of cases was 34.8 years while in controls it was 34.1 years. In cases 18 (52.9%) were males and in controls, 16 (53,3%) were males. Among patients who had acute episodes of schizophrenia 5 (14.7%) became positive for UFR and from controls 2 (6.6%) became positive. (Odds ratio=2.4). Urine culture was positive in 1 case and 1 control each. (Odds ratio=0.88).

Patients with acute schizophrenia are more likely to have positive urine full report than normal healthy controls. But they are not more likely to experience urinary tract infections than the normal healthy controls during their acute episode of schizophrenia.

Training and development is central to the effective and efficient working of any staff group. Since apathy, anhedonia and avolition are frequent symptoms in schizophrenia and these motivational problems can compromise engagement in treatment, it is necessary to use the treatment approaches that facilitate motivation to adhere to treatment.

As part of the service developments within the Psychiatric Hospital No. 4 named after P. B. Gannushkin, a one-week long induction was provided to all staff joining the service.

This training programme was designed to equip the staff with the necessary knowledge and skill base for working with individuals deemed to meet the criteria of avolition\anergia that inhibit a patient's ability to engage in treatment.

The members of staff were each asked to complete a series of questionnaires both pre- and post-training, designed to assess their attitude and skills towards working with motivationally disordered schizophrenia patients.

This paper outlines the results of these measures and comments upon the impact of training on the inductee's attitudes towards motivationally disordered schizophrenia patients and the staff's perception of their skills for working with this patient group.

Dealing with those with schizophrenia is especially challenging because obstacles to motivation are characteristic of the illness. The implication of these findings for future induction training is discussed.

The aim of this study is to explore the different patterns of self-management among people with schizophrenia, in order to help professionals provide more effective support tailored to different characteristics and needs of clients.

Totally 214 clients with schizophrenia living in 8 communities of Beijing, China were assessed, using Chinese version of Schizophrenia Self-Management Instrument Scale (SSMIS). Cluster analysis was performed to categorize clients based on their scores in 6 self-management areas.

K-means cluster analysis revealed four different self-management patterns. 'Self-confident and Autonomous' (n=63), clients actively participated in self-management and had a certain skills. 'Overconfident' (n=94), these clients had high self-efficacy and did well in medication compliance, while not in other areas. In their eyes, this was enough and they were experienced enough. 'Passive and Compliant' (n=51), clients often relied on their caregivers to manage the disease, yet did worse either in dimensions of symptom management or using health resource and support. 'No involvement' (n=6), clients' self-efficacy was low. They rarely participated in self-management and did worse in every self-management areas. Four pattern clients had significant differences in educational level, work status and financial burden (P<0.05).

There are subgroups of schizophrenic people with unique multidimensional patterns of self-management behaviors. This may help health professionals provide more customized support to improve clients' health status.