As refugees and asylum seekers are at high risk of developing mental disorders, we assessed the effectiveness of Self-Help Plus (SH + ), a psychological intervention developed by the World Health Organization, in reducing the risk of developing any mental disorders at 12-month follow-up in refugees and asylum seekers resettled in Western Europe.

Refugees and asylum seekers with psychological distress (General Health Questionnaire-12 ⩾ 3) but without a mental disorder according to the Mini International Neuropsychiatric Interview (M.I.N.I.) were randomised to either SH + or enhanced treatment as usual (ETAU). The frequency of mental disorders at 12 months was measured with the M.I.N.I., while secondary outcomes included self-identified problems, psychological symptoms and other outcomes.

Of 459 participants randomly assigned to SH + or ETAU, 246 accepted to be interviewed at 12 months. No difference in the frequency of any mental disorders was found (relative risk [RR] = 0.841; 95% confidence interval [CI] 0.389–1.819; p-value = 0.659). In the per protocol (PP) population, that is in participants attending at least three group-based sessions, SH + almost halved the frequency of mental disorders at 12 months compared to ETAU, however so few participants and events contributed to this analysis that it yielded a non-significant result (RR = 0.528; 95% CI 0.180–1.544; p-value = 0.230). SH + was associated with improvements at 12 months in psychological distress (p-value = 0.004), depressive symptoms (p-value = 0.011) and wellbeing (p-value = 0.001).

The present study failed to show any long-term preventative effect of SH + in refugees and asylum seekers resettled in Western European countries. Analysis of the PP population and of secondary outcomes provided signals of a potential effect of SH + in the long-term, which would suggest the value of exploring the effects of booster sessions and strategies to increase SH + adherence.

Attribution style and reaction to frustration play an important part in both depression and paranoia. The objective was to study the attribution style and frustration reaction between persistent delusional psychosis with depression and persistent without depression.

Fourty patients diagnosed with ICD 10 persistent delusional disorder with a period of evolution of 8 years, was grouped into 2 subgroups:

1. a) with depression and

2. b) without depression.

All are part of the Cases Registrer of Timisoara Psychiatric Clinic (CRPTC) which monitors the functional psychoses from 1985. For each patient was applied in period of remission BPRS (Brief Psychiatric Rating Scale), ASQ (Attributional Style Questionnaire) and Rosenzweig frustration test.

The persistent delusional psychosis without depressive features present a more internal and less stable attributions of the negative events. For the positive events, the stability and globality is higher for those with depression. Concerning the response to frustrating situations, persistent delusional psychosis with depression give answers prevailling extrapunitiveness, whereas those without depression give prevailling need-persistence answers. There are significant similarities between the two groups concerning the type of persisting necessity.

Among the persistent delusional psychosis, those with depressive features demonstrate an agresivity directed more towards exterior in the frustrating situations and associate less the negative events with their own personality than the pure persistent delusional.

This study aimed to detect and quantify depressive disorders following strokes and to follow the evolution of such patients after administering anti-depressive medication in association with the rehabilitation program.

This is a prospective study on 36 patients suffering from post stroke hemiplegia, situated in an interval of two to twelve months after the stroke. The patients have been randomly divided into two groups, the study group consisting of 21 patients who received anti-depressive medication in addition to the rehabilitation program, and the control group (15 patients) who only received the rehabilitation therapy. All patients were evaluated for depression using the Hamilton depression scale (HAM-D) at the beginning of the study and after two months of anti-depressive medication. Their clinical and functional evolution was evaluated using standardized scales and quality of life scales (FIM). Other parameters were noted such as age, sex, level of education and family support.

As expected, both the depression and the functional scores improved significantly after two months of rehabilitation treatment associated with anti-depressive medication in the study group compared to the initial evaluation. Also, improvement was noted when compared to the results of the control group.

1. . in accordance with others published studies, this analysis shows the importance of early detection and treatment of post stroke depression

2. . A multi disciplinary team that includes a psychiatrist must be assembled for the treatment of stroke patients, as such a team brings the most benefit to the patients.

Concerns are growing from increasing prevalence rates for comorbid substance misuse and mental illness. Along with understanding which clinical populations are at high risk, an epidemiologically informed approach is needed to assess effectiveness of established service delivery. The aims of the study is to investigate the risk of developing an alcohol and other psychoactive substances dependence syndrome according to area of residence.

A cross-sectional survey design was used analysing data from the Psychiatric and Addictive Dual Disorders in Italy Study. Staff rating was used to assess comorbid substance use.

Significant differences were found between different geographical areas (Northern vs. Centre vs. Southern Italy). Peculiar diagnostic subgroups showed higher risk to develop such comorbid condition, whilst a number of clinical and sociodemographic variables, including area of residence, were associated with the risk to develop a dependence syndrome.

High comorbid rates do not seem necessarily the direct result of biological features inherent in schizophrenia, but social factors play an important role. A number of risk factors associated with dual diagnosis could build up an evidence base about how many people with dual diagnosis present and what the nature of their substance use is, providing targeted service planning and policy making. The higher risk of developing a dependence syndrome as associated with area of residence, could be considered as a reliable proxy measure of effective integration between mental health and addiction services. There is the need for implementing appropriate shared programmes to fill this gap in targeted areas.

Comorbid alcohol misuse in schizophrenia and severe mental illness is associated with significant clinical, social and legal problems. An epidemiologically informed approach to planning service delivery requires an understanding of which clinical populations are at particularly high risk for alcohol misuse. Most evidence about the prevalence of this comorbidity comes from the USA, Canada and Australia, and, though at a different pace, also from Europe.

A cross-sectional survey design has been used to determine the prevalence In Italy of comorbid drug and alcohol and any - even minor - mental disorders. Staff ratings was used to assess comorbid substance use.

Though overall dual diagnosis prevalence is around 2%, significantly higher rates were found in inner cities. Furthermore significant differences were found between different geographical areas (Northern vs. Centre vs. Southern Italy). Peculiar diagnostic subgroups showed higher risk to develop such comorbid condition, whilst a number of clinical and sociodemographic variables, including area of residence, were associated with the risk to develop a dependence syndrome.

Sampling and assessment procedures are major limitations which might explain the lower rates as compared with the current Anglo-Saxon literature. However, such variability emphasizes also that high comorbid alcohol misuse rates are not necessarily the direct result of biological features inherent in schizophrenia, but that social factors play an important role. Finally, a number of risk factors associated with dual diagnosis could build up an evidence base about the nature of their substance use, providing targeted service planning and policy making.

The incidence of the depressive disorder in the studied time frame was 2%, and female gender subjects were more frequently involved. MADRS scores were significantly higher (scores higher than 30) in patients with depression associated with chronic conditions (cardiac, oncological, respiratory). The most frequent condition associated with depression was arterial hypertension (38%). Both MADRS scores, and GAF scores were influenced by antidepressant therapy. Patients under long- term treatment due to medical comorbid condition (74%) have a less satisfactory evolution and prognosis than those without somatic comorbid condition.

Depression has a too large incidence in primary care. Family physicians need to be familiar with the features and monitoring of antidepressant therapy, as therapeutic compliance is the sine-qua-non prerequisite of remission and relapse prevention in depressive disorder.

The severity, prognosis and evolution of patients with depression are more reserved in those with associated medical conditions, than in those without co-occuring conditions.

frontotemporal dementia (FTD) is marked by progressive changes in behavior, personality, variable degrees of language impairment and preservation in other cognitive domains.

neuropsychological assessments must be more attentive performed, as FTD is the third cause of neurodegenerative dementia, in younger ages, being often misdiagnosed.

During one year we followed up every 3 months, 4 women, mean age 53.5 years admitted in Psychiatry Clinic. They all presented for depressive symptoms, started for about 4 years before, for which a series of antidepressants were used without any clinical improvement. Clinical, psychiatric and psychological evaluations were performed every 3 months, showing slowed verbal rhythm, difficulties in expressing themselves and finding right words, repetitive speech, lack of spontaneity and initiative. No perceptual disturbances or memory impairment were found. Systematically neurologic examination was normal except for bradykinesia and bradypsychia. MRI showed evidence of frontal and temporal involvement.

According to DSM 5, criteria for probable neurocognitive frontotemporal disorder were fulfilled, as there were a prominent decline in language ability, in the form of speech production with relative sparing of learning and memory.

Because of the nature of the symptoms and the fact that a patient is often 'too young' for dementia to be considered, FTD is often initially misdiagnosed. Especially when present in midlife, it can be a significant clinical challenge to distinguish it from primary psychiatric disorders like major depression, bipolar illness or even late-onset schizophrenia. A correct diagnosis may help us improve patient's quality of life and social restoration.

The authors have not supplied their declaration of competing interest.