Mentally retarded children in each family structure affects family and mental health of the affected families, especially parents.

The aim of this study was to examine the relationship between self-esteem and psychological well-being and mental health of parents of children with normal and border line iq children.

The fleece is in the form of cluster sampling. Overall, 317 patients were selected for this project borderline were educate parents and parents of normal children, 154 of 164 patients were. This tool consists of three types of questionnaires that included questionnaires assessing self-esteem and mental health and psychological well-being questionnaire.spss software was used to analyze the data, and the t-test and Pearson's correlation and regression, one way anova was used.

Based on the results of the study found that the mental health of parents, students boundary normal This means that parents border line iq children have more mental health

and self-esteem are also common between parents and the boundary was observed it was clear that the psychological well-being among parents, students, parents of students border line is more common.

self-esteem are also common between parents and the boundary was observed it was clear that the psychological well-being among parents, students, parents of students border line is more common.

Anti-psychotics have been used extensively in the past for BPSD. However, since the discovery that some atypical antipsychotics may be associated with an increased risk of cerebral thrombosis, this practice has been deemed more controversial.

People with intellectual disability (ID) have higher rates of mental illness compared to the general population, including dementia. In particular, people with Down's syndrome have a higher incidence of Alzheimer's disease and an earlier age at onset, due to excess amyloid deposition in the brain. Here we describe prescribing patterns used in people with dementia ID and comorbid dementia.

We aim to show that it is possible to minimise the use of antipsychotics for BPSD in people with comorbid ID and dementia by the earlier use of anti-dementia drugs.

In some patients, we discontinued antipsychotics in favour of anti-dementia drugs to manage BPSD, whilst in others we avoided the use of antipsychotics entirely. We used the personal and social performance scale (PSP) as an outcome measure.

Our outcomes show that it is possible to manage dementia symptoms and BPSD with anti dementia drugs whilst keeping anti psychotic prescribing to a minimum.

Similar findings have been reported in people with BPSD in the general population, but such findings but have not been widely reported in the ID population.

We were able to demonstrate the feasibility of keeping antipsychotic prescribing to a minimum and still remain in control of BPSD in a small number of patients with comorbid ID and dementia.

Active introduction modern neuroimaging methods (CT, MRI, EEG) to the practice of child neurologist has greatly advanced our understanding and knowledge about brain anomalies, determination their role in the assessment of neurological status of the child and further prognosis of disease.

of this study was to investigate the relationship of MRI, CT and EEG features in children with symptomatic epilepsy with anomalies of the brain.

MRI studies were performed in 17 children with symptomatic epilepsy which has anomalies of the brain. Debut of epileptic seizures was observed from birth to 8 years old, the average age at onset 2,3 ± 0,59 years.

the analysis of anamnestic data of all patients revealed reported moderate and severe psychomotor retardation, no reduction of tonic reflexes, delaying in the formation of reflexes of various severity, polymorphic seizures. In the neonatal period in 15 patients (88.2%) depression syndrome was diagnosed, and 5 patients (29.4%) excitation syndrome, in 2 (11.8%) children various convulsions.

MRI studies revealed expansion of interhemispheric fissure, subarachnoid space, ventriculomegaly without clinical signs of hydrocephalus. In 8 (47.2%) children an abnormality of the brain were various formations of sulcation.

Based on these results it can be suggested that the detection of brain malformations in the earliest possible time of child life cannot be overestimated. High diagnostic possibilities of MRI, CT studies and also EEG are promising to determine the diagnostic correlations and the further correct choice of treatment of epileptic seizures in paediatric patients.

Epilepsy is one of the most complex medical and social problem at present time. The high prevalence of the disease in paediatric population of Uzbekistan (10 per 1,000) determines the importance to develop effective measures for early diagnosis, new approaches to correction of treatment and prevention of complications of epilepsy.

to identify MRI findings of symptomatic epilepsy in children with inflammatory etiology such as meningoencephalitis.

: MRI studies were conducted with 35 children with the diagnosis of symptomatic epilepsy after meningoencephalitis. Children ages ranged from 1 year to 14 years.

in our study the main symptoms of epilepsy after meningoencephalitis were multiple lesions of white and gray matter, their predominant bilaterality and symmetry, a clear demarcation from the surrounding tissues. In the study of 35 children who recovered from meningoencephalitis following MRI signs were found, in 5 (14.3%) cases it was midline shift of the brain, in 12 (34.3%) cases it was asymmetry of the lateral ventricles. Subarachnoid perivascular space expansion was found in 22 (62.9%) cases, which often revealed in the fronto-temporal region of the brain. Expansion of the subarachnoid space was revealed in 19 (54.3%) cases, mainly due to atrophy of the brain.

Magnetic resonance imaging has an important role in the clinical diagnostics of epilepsy, the use of which in the study of symptomatic epilepsy is one of the important conditions of adequate diagnosis, treatment and prognosis of the disease.

Electroconvulsive therapy (ECT) is the most effective and fast acting therapy for treatment-resistant depression (TRD). Animal research has consistently pointed to neuroplasticity as a central mechanism of ECT action (1), however evidence in humans remains scarce (2; 3).

We assessed two independent samples of TRD patients referred for ECT. The Barcelona-sample included 13 subjects treated with bitemporal ECT and 10 healthy volunteers (HV). Four successive 3T structural MRIs were acquired: baseline, 24-48 hours after the 1st ECT session, 24-48 hours after the 9th ECT, and two weeks after ECT course completion. HV were scanned twice five weeks apart. Within the framework of the Barcelona-Sydney Clinical Imaging Collaboration, we also scanned 10 patients treated mainly with right unilateral ECT (Sydney-sample). Whole-brain longitudinal grey matter (GM) changes were measured using intra-subject diffeomorphic registration, within SPM12b.

In the Barcelona-sample, over the course of treatment bitemporal ECT produced a linear increase of GM volume in the limbic system (involving bilateral hippocampi and amygdalae). Additionally, volumetric increase within the right subgenual cortex was detected from baseline to the 9th ECT session. Such volume changes were not observed in HV. Furthermore, GM volume expansion correlated positively with depressive symptom improvement and neurocognitive performance (memory and executive function). Hippocampal and amygdalar volume increases were replicated in the Sydney-sample, although limited to the stimulated hemisphere.

ECT effects described here could be accounted for by the induction of regionally specific structural plasticity. Nevertheless, other mechanisms such as neurovascular changes should not be discarded.

Activated microglia express translocator protein (TSPO) on the outer mitochondrial membrane. PET ligands targeting TSPO allow in vivo non-invasive visualization and quantification of neuroinflammation. Whereas inflammation in schizophrenia was previously studied using 11C-PK11195, 18F-PBR111 is a novel second-generation tracer, with high specific TSPO binding and longer half-life.

To establish a protocol for 18F-PBR111 TSPO PET in schizophrenia.

A pilot study on a Siemens Biograph mCT PET-scanner in healthy controls and schizophrenia patients (n=9).

Subjects underwent a 90-minute dynamic brain PET-CT, following i.v. bolus injection of 214±13 MBq 18F-PBR111. An arterial input function was measured using continuous blood sampling (Twilite, Switzerland) with discrete samples for metabolite analysis. The metabolite corrected plasma input function (IPF) was calculated from the whole blood input function, individual plasma to whole blood and parent fraction data as determined by a SEP-PAK procedure. Dynamic PET data were reconstructed and a post-reconstruction motion correction was applied. Regional tissue time activity curves (TACs) were extracted from the PET images for regions of interest determined from individual MRI images. Total volume of distribution (VT) was then calculated from fitting a reversible two-tissue compartmental model to the measured TACs using the individual IPF. Prior genotyping for TSPO receptor polymorphism (rs6971) allowed to exclude low-affinity binders (estimated 10% of European population). The procedure was well tolerated.

We established a protocol for 18F-PBR111 TSPO PET in healthy subjects and schizophrenia patients, thereby providing useful information for others considering 18F-PBR111 TSPO PET imaging for evaluation of neuroinflammation.

Taste perception is a complex phenomenon modulated by different factors, such as taste receptors and memory brain circuitry. The palatability of the food, that activates central reward pathways, also plays an important role in taste perception. It means that taste is able to influence the choice of food and then the eating behavior.

It's well known that people with anorexia nervosa (AN) have lower sensitivity to reward stimuli and recent studies have shown that altered function of taste neural circuitry may contribute to restricted eating in AN.

The aim of this study is to evaluate, in patients suffering from AN, the activation of the brain areas involved in taste perception and in central reward mechanisms to both pleasant and aversive taste stimuli and to correlate gustatory neural circuitry activity with eating behaviors, temperament measures and/or sensitivity to reward and to punishment.

12 underweight AN patients and 12 normal-weight healthy subjects underwent a functional MRI to measure brain areas activation to repeated stimuli of a pleasant taste, a sucrose solution, alternated with an aversive taste, a bitter solution, and a water taste.

Preliminary results showed, in patients with AN, a dysfunctional activation of brain areas involved in both taste perception and reward mechanisms following both the pleasant and aversive stimulus.

These results, if confirmed in future analyses, may improve our knowledge about the pathophysiological mechanism of AN.

The aim of our study was to establish the efficacyof CBT on the sample of non-selected medication-resistant patients with OCDand to search for predictors of therapeutic response in such a group.

The treatment was carried out under usual conditionsat the department for anxiety disorders. Systematic CBT steps were tailored tothe needs of each patient. Pharmacology treatment remained grosslyunchanged during the trial period. We used the following outcome measures in thestudy: Yale-Brown Obsessive Compulsive Scale, subjective version (S-Y-BOCS),the Clinical Global Impression – Severity of Illness scale (CGI-S), BeckDepression Inventory (BDI), Beck Anxiety Inventory (BAI), Somatoform DissociationQuestionnaire (SDQ-20) and Dissociative Experience Scale (DES). The primary outcomemeasure was a decrease by 35% in Y-BOCS rating. Remission was defined as a12 point score or lower in Y-BOCS and 1 or 2 points in CGI-S.

47 patients completed the study (19 male and 28female). One female patient refused to participate. All patients completed atleast 5 weeks of intensive CBT programme and showed significant improvement on Y-BOCS, CGI-S, and BDI scales. At the end of the treatment 40.4% of the patientsachieved clinical remission according to the CGI-S scale. The maincharacteristics present at the beginning of the trial increasing probability of achievingimprovement or remission during the treatment were a Y-BOCS score lower than 22, goodinsight, higher resistance to symptoms, low level of dissociation, andaggressive obsessions. ¨

As negative predictors we identified higherscores in Y-BOCS, poorer insight, low resistance to symptoms, high level ofdissociation, obsessions focused on control/symmetry and obsessiveslowness/ambivalence as associated with poor improvement.

Supported by grant IGA MZ CR NT 11047-4/2010

Although skin picking has been documented in the medical literature since the 19th century, only now it is receiving serious consideration and has been recently approved as a DSM psychiatry disorder in DSM-5. It is characterized by repetitive picking or scratching at one’s skin, resulting in lesions and functional interference or distress. Prevalence rates of 1.4% to 5.4% have been reported. Association with psychiatric comorbidities are common, particularly mood and anxiety disorders. Psychotropic medications and appropriate counseling can be effective treatments.<o:p _rdeditor_exists="1">

The purpose of the poster is to highlight the prevalence of the skin picking disorder, particularly when co-occurring disorders are present, and to evidence the importance of its screening in mental health settings.

Here we report a case of a 66 year-old woman with the diagnosis of Bipolar Disorder who has been presented in the emergency department with a depressive episode and high anxiety levels. In the physical examination we observed large skin lesions, mainly on the back and abdomen, two of them complicated with localized infection requiring oral antibiotic. The patient was treated with clomipramine and pimozide with good response.

Data about pathophysiology of skin picking disorder are still limited. If untreated, skin picking disorder can result in substantial psychosocial dysfunction and may lead to life-threatening medical problems. Although most reports have concentrated on its relation to the obsessive-compulsive spectrum disorders, in some studies there is a significantly higher frequency of depression in those patients.

Obsessive compulsive disorder is a severe and disabling clinical condition that usually arises in late adolescence or early adulthood and, if left untreated, has a chronic course.

To report and discuss a clinical case, followed by the authors.

Consultation of the patient's medical file, serial clinical evaluations and scientific literature review.

33 years-old male, married, degree in economics. Observed in the emergency room for having thoughts dominated by ideas of obsessive content, with a sense of self-reference, associated with recurrent compulsions as cleaning and checking rituals, consequential high levels of hopelessness and a depressive mood, with jeopardized chronobiological rhythms.

This clinical condition started seven years before and seriously undermined the patient’s autonomy. Some of the difficulties outlined by the patient are: on his way to and from work, whenever he passed by a crosswalk he would circle the following roundabout several times, to confirm that he hadn't run over any pedestrian; at the end of the day, he would go through the same path in reverse, by bicycle, to confirm that no pedestrians had been run over by him. After two years of psychopharmacological and cognitive-behavioral therapy the patient showed significant clinical improvement.

On this case, the most likely diagnosis is an Obsessive Compulsive Disorder. The particularity of this case lays on its severity, given its evolution period, the psychopathological richness demonstrated and the functional commitment of the patient; and in the significant clinical improvements observed, largely due to optimal patient adherence to treatment.

N-acetylcystein (NAC), a precursor to the amino acid cysteine, has been emerging as an interesting add-on treatment in several psychiatric conditions and especially in Obsessive Compulsive Disorder (OCD). These results may be linked to its metabolic profile: antioxidant properties through glutathione production; anti-inflammatory properties; and modulation of the glutamatergic and dopaminergic systems of neurotransmission.

Review the potential therapeutic effects of NAC in psychiatry, with main focus on syndromes of the obsessive-impulsive spectrum with report of a clinical case.

Case report of a patient with OCD and Hoarding disorder, with complete clinical remission after treatment with NAC; bibliographic search using PubMed/MedLine database with the following keywords: n-acetylcysteine; OCD; hoarding.

We report and discuss the case of a 44-year-old man with a diagnosis of Obsessive Compulsive Disorder with orderliness and contamination themes, coupled with Hoarding disorder. The patient experienced gradual though slight improvement with Paroxetine (60 mg/day) to which was subsequently added Risperidone (2 mg/day) with further slight improvement. In combination with the previously given pharmacological agents, NAC (1800 mg/day) was introduced with subsequent complete remission of all symptoms.

Studies suggest that NAC may be useful in the treatment of several psychiatric conditions. Our case report suggests direct relation between treatment with NAC and remission of obsessive and hoarding symptoms. Although encouraging, additional controlled research will be required to ascertain NAC clinical usefulness.

to understand psychologically reports from outpatients in psychiatric treatment, diagnosed with OCD, in the search of developmentof strategies aiming egossintonia.

intentional sampling of nine outpatients from psychiatric service, enclosed by theoretical saturation. Clinical-qualitative outline, with semi-directed interviews withopen-ended questions. Fluctuating readings in search of units of meaning forthe categorization of the data.

five categories have emerged: (1) Control: the outpatient, in order to avoid anxiety, developsthe strategy of control, with a detailed planning of activities. (2) Socialisolation: diminishment of the social interaction due to the embarrassment ofperforming rituals in public. (3) Face-off: performance of activities in spite of rituals. (4) Rationalization: elaboration of forged explanations which dissemble obsessive ideations or rituals in order to attenuate psychic distressand social difficulties. (5) Dependence: search of involvement of other personsin the rituals, causing them to be less exhausting.

as the OCD impacts the outpatients’ quality of life, adaptation strategies are sought so as to minimize the discomfort. The awareness of such fact by health care providers enables greater empathy, leading to better adherence to treatments.

Keywords: obsessive compulsive disorder; ego-syntonic behavior; qualitative research.

One third to two thirds of patients with obsessive compulsive disorder (OCD) do not respond adequately to selective serotonin reuptake inhibitors (SSRIs). Augmentation strategies have been tried and are recommended. Antipsychotic augmentation is the most studied, but more recently other strategies were attempted, including the use of medications acting on the glutamatergic system, such as memantine.

The author’s aim is to understand whether there are sufficient evidences for the use of memantine as an adjunctive therapy in OCD.

A literature research was performed, using the following key words: obsessive compulsive disorders, memantine.Retrieved papers were selected according to their relevance for the subject.

Several evidences have pointed to a glutamatergic dysfunction in OCD. Drugs that act on ionotropic receptors or modulate glutamate neurotransmission, such as riluzole, lamotrigine and memantine demonstrated improvements in symptoms when used as adjunctive therapy in refractory OCD.

The use of memantine in OCD has been demonstrated in open-label trials and in two recent randomized controlled trials (RCTs). The RCTs analyzed a total of 82 patients and found a significant improvement in short-term outcomes and higher rates of remission achieved with memantine than placebo, without significantly augmented side effects.

At the present time, there is little evidence to recommend the early use of augmentation strategies. Concerning the memantine’s use, more studies are needed before recommending its use as a routine augmenting agent.

Apropos of a case we show that antidepressant drugs may cause a switch phenomenon in patients diagnosed with a psychiatric illness other than bipolar disorder.

To describe a case of antidepressant-induced mania in a patient with obsessive compulsive disorder (OCD).

X is an 18 year-old male who presented obsession with books and compulsive reading. He went to the psychiatric consultation and initiated treatment with sertraline 25mg. 24 hours later he began with soliloquies, restlessness, verbosity, increased performance of activities without purpose and persistent insomnia.

After the antidepressant was removed, the manic symptoms disappeared and the patient remained euthymic. Treatment with risperidone 1 mg was established and the obsessions and compulsions partially improved.

This case raises the hypothesis of a possible comorbidity between OCD and bipolar disorder.

Given the profound life changing event that having a child represents, women are at an increased risk of developing psychiatric illness during the postpartum period. Although postpartum depression and psychosis have been widely studied, postpartum onset obsessive compulsive-disorder (OCD) seems to be an overlooked condition, remaining many times undiagnosed and untreated.

Objectives/Aims

This work aims to review the prevalence, clinical features and characteristics of postpartum onset OCD.

A review of relevant literature was conducted alongside online database research (PubMed and Medscape).

In postpartum onset OCD obsessions are typically related to the baby and include: fear of intentionally or accidentally harm the newborn, fear of contamination, obsessions of symmetry/exactness, aggression and religiousness. These intrusive and obsessional thoughts, especially aggressive obsessions, create great distress and fear on acting on them.

To relieve the anxiety common compulsions include: avoiding taking care of the baby, repetitive and ritualistic washing, checking, ordering, counting, reassurance seeking, and praying.

The lifetime prevalence of OCD in general population is about 2 – 3%, however the prevalence of postpartum onset OCD is not known.

Further investigation is necessary to clarify the epidemiology, risk factors, and clinical course of postpartum OCD. Is it crucial to reassure parents that these intrusive thoughts are frequent, and do not translate any unconscious desires.

These symptoms should be screened appropriately and identified in the early postpartum period, in order to reduce the associated distress, family dysfunction, and the negative impact in the mother-infant bonding.

The association between obsessive-compulsive disorder (OCD) or symptoms (OCS) and schizophrenia has been accounted in literature for more than hundred years. Early conceptions stated that OCD could be a 'neurotic defence' or a protection against incipient psychosis. In spite of that, during many decades both pathologies were held as unrelated, namely because their phenomenological differences and because only few cases of OCD developed into psychosis. Nevertheless, OCS are present in many cases of schizophrenia, sometimes as first symptoms. Recently the hypothesis of OCD and schizophrenia being related is seen with more plausibility since they share same neurobiological pathways. Intrusive thoughts and delusions may form a continuum making, perhaps, OCD and schizophrenia two extremes of a spectrum.

To preform a non-systematic review about the relation of OCD with schizophrenia

Search for literature about the topic in PubMed using 'OCD AND schizophrenia' as keywords

OCD and schizophrenia co-morbidity has a prevalence six times higher than expected. OCD could be present in a psychotic prodrome. In some studies, both pathologies appeared to be risk factors for the development of each other. Moreover they appear to share some neurobiological correlates and neuropsychological aspects.

OCD and schizophrenia could be correlated and may be at extreme points of a spectrum of pathologies with intermediate clinical manifestations.

Difficulties in controlling symptoms such as pain, breathlessness or delirium in palliative care patients, may require sedation as therapeutic strategy.

To study the drugs administered to patients under Palliative Care Sedation (PCS) and its possible side effects.

Our retrospective study included 40 oncological patients with mean age of 69+14.12 years old, under PCS.

Morphine 0.35mg/kg/day, administered to 22,5% (9) patients, caused reduction of systolic blood pressure in 23.61%, diastolic blood pressure in 27.08%, heart rate in 6.09%, body temperature in 2.59%, respiratory rate in 18.26%. Morphine 0.35mg/kg/day associated with midazolam 0.42mg/kg/day, given to 35%(14) patients, caused reduction of systolic blood pressure in 24.63%, diastolic blood pressure in 27.58%, heart rate in 1.56%, body temperature in 1.58%, respiratory rate in 27.66%. The association of chlorpromazine 0.62mg/kg/day to morphine 0.35mg/kg/day and midazolam 0.42mg/kg/day administered to 42,5% (17) patients, also caused reduction of systolic blood pressure in 22.38%, diastolic blood pressure 20.00%, body temperature 1.79%, respiratory rate 22.00%, but the heart rate increased in 15.88%. The variations of vital signs were obtained by records registered right before the palliative care sedation had initiated and the values recorded in patients’ last day of life. The sedation period was 2,40+0,23days.

The association of neuroleptics could conduct to extrapyramidal motor agitation, in this case of deeply sedated patients it could be signed by the incresase of the heart rate. Considering the short period of time between the beginning of sedation and the patients’ death; and that palliative sedation should not include the hastening of patients’ death, we suggest a better drug association criteria.