To explore a cognitive bias-Jumping to Conclusions-in patients with schizophrenia and to compare with non-psychotic siblings and healthy controls by means of the Picture Decision Task (PDT).

42 patients with schizophrenia, 20 non-psychotic siblings and 77 healthy controls were compared in the PCT. This task consists of showing drawings of common objects that are displayed on a computer screen in decreasing degrees of fragmentation: new features are added in eight successive stages, until the entire object is eventually manifest. There are two kinds of trials (“cued” and “uncued”; that is, with and without interpretative clues). According to the responses, five parameters were calculated: Jumping To Conclusions at first stage-that is, with the very first drawing-(JTC-1), Plausibility Rating at first stage (PR-1), Draws To Decision (DTD), Time Response at first stage (TR-1) and Time Response for Draw to Decision (TR-DTD)

In comparison with siblings and controls, more of the schizophrenia patients made a definitive decision at the first stage (represented by a significantly higher JTC-1), and they showed a higher Plausibility Rating (represented by a higher PR-1) than siblings and controls. For the uncued trials, patients needed fewer stages (a lower DTD) when making a decision than siblings (5.53±0.20 vs. 7.04±0.28; p=0.001) and controls (5.53±0.20 vs. 6.83±0.14; p=0.001).

These results suggest that patients make quick decisions with a high level of conviction and may manifest a data-gathering bias. Our results may indicate some degree of faulty appraisal and an inability to tolerate ambiguity when faced with decision-making.

Impaired sustained and selective attention have been seen as vulnerability factors to psychotic disorders. Relatives of psychotic patients are a risk population for psychosis, and previous studies have shown that they displayed more attentional deficits compared with healthy controls. Additionally, relatives have more pathological personality and schizotypy, the least considered also to be the expression of the genetic vulnerability to schizophrenia. There are few studies that relate attention to personality factors in relatives of psychotic patients.

To compare attentional performance of siblings of psychotic patients with those of healthy controls, taking into account their pathological and schizotypal personality.

The Spanish version of the SPQ and the DAPP-BQ were administered to a sample of 51 subjects that were divided into four groups by a hierarchical cluster analysis: siblings with high pathological personality (SHPP), siblings with low pathological personality (SLPP), controls with high pathological personality (CHPP), and controls with low pathological personality (CLPP). In all the subjects we assessed a sustained attention index (SUA) and a selective attention index (SEA). We compared the performance of the four groups on these attentional indexes.

We found that SHPP had worse performance on sustained attention compared with CLPP. Specifically this difference was in the reaction time item of the SUA.

The high schizotypy and pathological personality had an influence on sustained attentional performance in the siblings of patients with psychosis, but not in the healthy controls.

The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.

The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.

Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.

The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.

The aim of this study was to asses the impact of different psychological and/or biological effects in the recovery from surgery.

The sample was composed of 42 patients waiting for a surgical intervention. Patients with cognitive impairment were removed from the sample. Prior to surgical intervention (48 to 72 hours), patients were administered the Millon Clinical Multiaxial Inventory-II (Millon, 1986) and salivary cortisol were measured 24 hours before surgery. Following surgical intervention, recovery was coded as good or poor accordingly to Moix et als criteria (1995). Dietary intake, resting and sleeping hours, as well as the existence of fever, perceived pain and related surgery complications were daily registered and controlled for.

The cortisol values were increased in patients with high score in Histrionic Scale (t = 2.10, p = 0.043). There was a significant relation between personality, cortisol and recovery. the patients with low score in Dependent Scale (t = 2.33, p = 0.029), Histrionic Scale ( t = 2.51, p = 0.020), Alcohol Dependence Scale (t = 2.01, p = 0.049), Drug Dependence Scale (t = 2.08, p = 0.050) and cortisol show better recovery from surgery.

The results of this study indicate that psychological factors and levels of cortisol may have a critical rol in post-operatory recovery. Taking these data into account, it seems necessary to assess psychopathology on a regular basis in all the patients waiting for surgically interventions.

Ramon y Cajal Hospital is the referencial center for the mental health unit used in this study, whose outpatients are attended by psychiatrist consultants. First assessment is conducted by general practicioners, or other specialists. Once assessed, a decision must be made: to follow-up, carry out psychological therapies, refer to social workers or other resources.

To investigate socio-demographic and clinical profiles at the psychiatric outpatients unit as a result of an analysis of the first assessment data.

We include 9 variables from 104 first assessments carried out in our center.

48,27 is the age range of our sample, with 58,65% female and 50,1 % married. Most referrals are requested by primary care, being only 14,42% by psychiatric ward units and other medical specialities. Anxiety is the primary reason for requiring psychiatric care (36, 54%) and affective disorders (35,58%), followed by psychosomatic events. With respect to diagnosis at first consultation, we found, as expected, that the most frequent disorders are anxiety (37,50 %) and depression (32,69%).71,15% of our patients needed a follow up by us and 8,65 % are discharged after the first assessment. The rest are reffered to other mental health resources.

As a result of the analysis we found out that minor pathology is the most common reason for care in our centre, being refered mostly by general practicioners. So psycho educational programmes and continuous training in general medicine could be needed in order to improve mental health and to reduce costs of the mental health system.

The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.

The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.

Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.

The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.

From a dimensional point of view, the schizotypal features would be continuously distributed in normal population and individuals with schizophrenia spectrum disorders. in the latter, differences have been found in personality traits between the diagnostic categories of the dimension, and also different schizotypy scores between them. in this study our main objective was to specify the domains and traits of pathological personality that can be considered risk factors for schizotypy.

SPQ and DAPP-BQ were administered to a sample of 91 subjects that were divided in four groups: psychotic patients with schizophrenia spectrum disorders, siblings of patients from this spectrum, patients with personality disorders, and healthy controls.

Patients with personality disorders presented the highest scores of schizotypy measured with SPQ, followed by psychotic patients, siblings, and finally the healthy controls. both groups of patients obtained higher pathological personality scores compared to siblings and controls. in the psychotic patients and their siblings emotional dysregulation, dissocial behavior and inhibition domains correlated with the SPQ factors, while in the personality disorder patients SPQ correlated only with inhibition. the trait social avoidance appears to be a predictive variable of psychometric schizotypy.

Pathological personality underlying the schizotypy of psychotic patients of schizophrenia spectrum and their siblings is different from that of the personality disorder group. Social avoidance is a risk factor for schizotypy measured with SPQ.

In this study we examine potential mechanisms by which the stimulation of hippocampal neurogenesis may generate an antidepressant effect.

Study-1: Adult male rats (N = 24) were trained to segregate relevant from irrelevant spatial cues (spatial segregation); tested on this task four and 8-weeks late; then exposed (on week 8) to a modified version of the task that conflicted with the memory of the initially learned experience (mnemonic segregation); and then euthanized to detect hippocampal neurogenesis. Study-2: Adult rats (N = 24) were trained in the spatial segregation task; three-days later, half were re-tested on the same task and half the tested on the modified task (mnemonic segregation); and euthanized immediately to detect neurons that were synaptically active during task performance.

Study-1: Good performers on the modified task (mnemonic segregation) had significantly greater rates of hippocampal neurogenesis, but the increase was only in immature neurons and not in new neurons that had completed maturation. Performance on spatial segregation task was unrelated to proficiency in mnemonic segregation or rates of neurogenesis. Study-2: Performance on the mnemonic segregation unrelated to neurogenesis rates, but inversely correlated to synaptic activation of mature hippocampal neurons, which in turn inversely correlated with immature neuron rates.

Taken together, the data suggests that neurogenesis facilitates detection of subtle changes to experiences established over several weeks (not days); this occurs prior to forming synapses; and maybe associated with suppression of mature hippocampal neurons that presumably mediate older, interfering, experiences.

The aim of the study was to assess the impact of several psychological and/or biological variables in the recovery from surgery.

The selected sample was composed of 42 patients (age range: 25–70) admited for surgical treatment to a University Hospital. The patients who presented impaired cognitive functioning were excluded from the study. Prior to surgical intervention (48 to 72 hours), patients were administered the Family Adaptability and Cohesion Evaluation Scale (FACES-II). Salivary cortisol was measured 24 hours before surgery. Following surgical intervention, recovery was coded as “good” or “poor” accordingly to Moix et al.’s criteria (1995). Dietary intake, resting and sleeping time, fever, perceived pain and surgery-related complications were assessed on a daily basis.

Significant relationships between better recovery, family cohesion and salivary cortisol level were found. The patients with lower scores in the cohesion dimension of the FACES-II and higher cortisol levels had more complications during the recovery phase (F = 10.96, p = 0.006).

Our results suggest that social support (family cohesion) and the activity of the hypothalamus-pituitary-adrenal axis (cortisol levels) can have a significant influence on postoperatory recovery. Taking these data into account, it would be suitable to assess psychopathology and social support in patients waiting for surgically interventions.

In the past few decades, new and more efficient techniques to help solve fertility problems have become widely available throughout the developed world. The aim of this study was to determine whether there were differences on psychopathology factors between women who had conceived after in vitro fertilization (IVF) and women who had conceived naturally.

The sample was composed of 41 pregnant women of whom 28 women had conceived through assisted reproductive technology (IVF) and 13 had conceived naturally. Women were evaluated by week 20 of pregnancy at the Infanta Cristina University Hospital Obstetrics and Gynecology Service, in Badajoz. Women consented to complete the Symptom Checklist-90-Revised (SCL-90-R).

IVF women were characterized by higher scores on Anxiety Scale (t = 3.90; p = 0.045) and lower scores on Hostility Scale (t = 4.35; p = 0.041) than women who had conceived naturally. There were no differences in the others scales.

IVF women appear to present a temperamental profile characterized by a tendency to anxiety. Further research is needed to firstly, confirm these preliminary findings, and secondly, to longitudinally explore its impact on pregnancy outcome and mother-infant attachment.

To isolate clinical predictors of Expressed Emotion (EE) in relatives of patients with eating disorders.

Forty-three families of patients with anorexia and bulimia nervosa were assessed using the Camberwell Family Inventory (CFI). In addition, the eating symptoms, the general psychopathology and the personality of the patients was assessed using the Eating Disorders Inventory (EDI-II), the Symptom Checklist (SCL-90-R) and the Structured Clinical Interview for the Diagnosis of Axis II DSM-IV Disorders (SCID-II). Binary logistic regression methods (Forward Wald) were used for statistical analysis.

Maturity fear, depressive features and anxiety of patients were predictors of parental EE level.

Althoug more clinical research is needed, the results of our study suggest that the severity of the symptomathology and some personality features of the patients with eating disorders can influence the EE observed in their relatives.

Behavioural symptoms are the first reason of psychiatric assessment in patients with intellectual disabilities (ID), and also the most frequent cause of psychopharmacological treatment. Different rates of prevalence of these symptoms appear in literature data (10-60%). Paliperidone has shown effectiveness in the treatment of behavioural symptoms in patients with autism and asperger syndrome, with significant reduction in ABC-I subscale scores.

Objectives:

Study paliperidone effect in behavioural symptoms' improvement in patients with intellectual disabilities of diverse etiology.

10 outpatients with intellectual disabilities and behavioral symptoms were selected and treated with paliperidone. Sociodemographic and clinical data (type of intellectual disability, previous antipsychotic and paliperidone dose) were registered. Agitation subscale Aberrant Behavior Checklist (ABC-I) scores were compared prior and 4 weeks after psychopharmacological treatment change. Otherwise we assessed clinical improvement with Clinical Global Impression-Improvement (CGI-I).

All patients were similar in clinical and sociodemographic characteristics. Paliperidone mean dose was 8,4 mg/day (3-18 mg/day), changing from risperidone (44,4%), olanzapine (44,4%) and levomepromacine (11,1%). Mean reduction in ABC-I scores with paliperidone treatment was 6,2 points [with most significant improvement in items like irritability (1,2 points), aggressions (1,1 points) and slams (0,9 points)]. CGI-I scores showed a much better improvement in 60% patients, mildly betterin 30% patients and slightly better in 10% patients. No significant adverse effects leaded to treatment discontinuation.

1. 1. Paliperidone is an effective and safe treatment in behavioral symptoms associated to intellectual disabilities.

2. 2. Paliperidone treatment reduces ABC-I subscale scores, with most significant improvement in irritability and aggressions.

It is necessary to explore the possibilities of brief intervention of smoking cessation in bipolar disorder (BD) that may act on the level of motivation for change.

Assess the effectiveness of the 3 A's intervention (Ask, Advise and Assess) in a sample of euthymic BD patients.

260 patients diagnosed with BD that were in the euthymic phase and attended the Community care centers of Spain that have been evaluated for their history of smoking habits and current use.

Patients who consumed in the last month qualified for the level of motivation for change (measured by URICA scale); before and after conducting a brief intervention of no more than 30 minutes in total, divided in three contacts during a month, two face to face and one phone contact.

The 49% of the evaluated patients showed an actual use of cigarettes with an average of 28.73 (SD 11.82) years of consumption, with a mean consumption of 21.00 (SD 10.40) cigarettes per day and a level of nicotine dependency of 5.72 (SD 3.03). The 67% of patients were in the Contemplation stage of change, after the intervention 18% progressed to the stage of motivation and 14% ended up in the Stage of Ready for Change. In the third appointment the 21.4% of the smokers reported a reduction of the consumption.

The results seem to confirm its effectiveness, although it should be considered the possibility of carrying out specific tools of brief intervention for this sort of patients.

Interferon-alpha (IFN-α) and Ribavirin is the recommended treatment for chronic hepatitis C (CHC). Common treatment side-effects include neuropsychiatric symptoms such as anxiety, which impairs patient's quality of life and treatment adherence. Inflammation and neurotransmission systems may play a role in the pathogenesis of IFN-α-induced anxiety. The GC/GG genotype at a polymorphism located in the interleukin-6 synthesizer gene (IL6 gene) has been related with a higher production of IL-6 and “higher inflammation response”. A polymorphism in the serotonin transporter gene (SERT) has been related with anxiety and antidepressant response. The aim of the study was to assess the role of IL6 and SERT polymorphisms as predictive variables of IFN- induced anxiety.

A cohort of 385 Caucasian outpatients with CHC initiating antiviral treatment. Patients were euthymic and without current anxiety disorder (SCID) at baseline. Anxiety evaluation: Hospital anxiety and depression scale. Assesment: Baseline, 4, 12, 24, and 48 weeks after antiviral treatment initiation. DNA was extracted and polymorphisms genotyped. Hardy- Weinberg equilibrium: IL-6 (p=0.72) and SERT (p=0.41). Statistical analysis: linear mixed-effects.

Patients carrying the G allele (GC/GG genotype) of IL6 polymorphism (G vs. CC) had more anxiety symptoms (p=0.004) during antiviral treatment. We did not find a significant effect of SERT (S vs. LL) on anxiety (p=0.15). No significant interaction between both genes was reported.

GC/GG genotype, that implies higher seric concentrations of IL6, predicts interferon-α-induced anxiety supporting a role of inflammatory pathway on pathophysiology of anxiety.

PSICOCIT-VHC-P110/01827, and PSIGEN-VHC-EC08/00201. ERDF, European Union “One way to make Europe”.

Perfectionism is considered a risk factor and is very close related to Eating Disorders (EDs). It estimates heritability of 29-42%. However, it has also been related to psychosocial factors such as the insecure attachment style.

To study the relationship of perfectionism with personality dimensions, its likelihood of improvement and its treatment.

To analyze if Perfectionism is associated with dimensions of Temperament or dimensions of Character and therefore more psychosocial.

Participants were 151 female outpatients who consecutively started treatment at the Eating Disorders Unit (Ciudad Real University General Hospital). Personality was assessed by using the Temperament and Character Inventory (TCI). Perfectionism was assessed by using the Edinburg Investigatory Test (EDI-2) subscale (t0). One year later, patients were re-assessed with the EDI-2 (t1).

The scores on Perfectionism significantly improved from t0 to t1, (repeated measures ANOVA, F = 6.6, P < 0.01). At baseline, Perfectionism was related to any of the Temperament dimensions, but the Character variable Purposefulness (SD2) (β = .25 95% CI .17, 98), 2.7% of variance). Responsibility (SD1) and Self-Aceptance (SD4) were inversely associated with Perfectionism. At t1, Responsibility still was a protective factor for Perfectionism, regardless the effect of Perfectionism at t0.

Perfectionism is also related to psychosocial and developmental factors. People with an internal locus of control tend to take responsibility for their own actions and are resourceful in solving problems. Thus, Self-directedness, mainly Responsibility for their own actions, is a protective factor for Perfectionism in EDs.

The authors have not supplied their declaration of competing interest.