The Wechsler Adult Intelligence Scale (WAIS-III) is widely used in clinical practice but has been subject to criticism due to lack of theoretical foundation. Particularly, the disproportionate assessment of cristallized intelligence (Gc), in comparison to fluid intelligence (Gf) is repeatedly noticed. Gf is in fact a reflection of executive functioning (EF) a set of abilities that includes mental flexibility, planning and problem solving, and (social) decision making. A more balanced assessment of Gc and Gf is important because Gf has significant impact on overall cognitive functioning.

Gaining insight in the degree to which WAIS-III variables are saturated with EF.

Examining the relationship between subtests of the WAIS-III and executive functions in a heterogeneous sample consisting both psychiatric patients and healthy volunteers.

The Behavioural Assessment of the Dysexecutive Syndrome, Wisconsin Card Sorting Test, and Stroop Color-Word Test were administered to a heterogeneous group of 234 psychiatric patients and 24 healthy volunteers. Maximum likelihood procedures with promax rotation were applied to two, three and four factor solutions.

The four factor model fitted the data best, confirming the four factor indices of the WAIS-III. All three executive tasks had their highest loading on the factor corresponding to the perceptual organization index of the WAIS-III.

Present study results confirm the overload of crystallized intelligence in the subtests and EF involvement in the Perceptual Organization Index of the WAIS-III. Results are discussed as to the need for an integrated, multifaceted view on cognitive disorders and intellectual (dis)abilities.

It is known that PTSD has a chronic flow is mainstream, especially in cases when related factors includes trauma of the situation. Such case is noticed in Kosovo 13 years after the war.

PTSD level research, characteristics and examination of its relation with some socio-demographic characteristics and type of experienced trauma.

The recognition with the presence of PTSD clinical and sub-clinical cases in mental health services in Kosovo, 13 years after war.

It is a retrospective study, in which cases were analyzed with PTSD in mental health services in Kosovo (UCCK, Regional Departments of Psychiatry, Mental Health Unit Center) in the period from January to September, 2013. Data were analyzed using Microsoft Excel 2007.

Were found 277 cases with PTSD. All cases are soldiers (128 cases) or family who has suffered losses in the war (missing, killed, etc.). Dominates cases from the regions with more intensive fighting, men age 40-50, soldiers and relatives of missing persons. In expressed symptomatology more often is found: change of mood, performance decline, traumatic memories, insisting for retirement, somatic problems / vegetative.

Despite that many years passed from the war, despite the efforts for social consolidation, the organizing and enhance the quality of psychiatric services, family support that is traditionally present in Kosovo, there is still a considering number of people with PTSD and this is a challenge for the society, because they require a greater sensitivity in the identification, treatment and rehabilitation.

Depression is one of the most common mental health problems, and its growing prevalence affects patients’ quality of life and health economical costs.

Psychiatric symptoms can be the first manifestations of central nervous system tumours: around 20% of the cases of supratentorial and 5% of infratentorial tumours.

Study of the relationship between central nervous system tumours and the onset of psychiatric symptoms.

Review of the literature about this subject through Pubmed and review of the patient's medical history.

55 year old women who consulted her GP due to an episode of apathy, fatigue and sadness. She suffered a previous depressive episode three years before adequately treated with antidepressants.

Her GP diagnosed a new depressive episode and started the treatment with Sertraline (100mg/day) and Alprazolam (0.25mg if needed). However the case worsened and progressively unspecific symptomatology added: syncope, dizziness, cramps, headaches.

The patient was studied by the Internal Medicine Service, being the results of their explorations and diagnosis test normal.

She was then referred to the Psychiatry service, where she was treated for five years. Several medications were tested (such as escitalopram 20mg/day, venlafaxine 225mg/day) with unsuccessful results.

In the last year appeared disorientation, mental slowing and difficulty swallowing liquids. Brain MRI was performed showing petrous meningioma (6 × 5 × 4 cm).

Brain tumors can be associated with different psychiatric symptoms such as anxiety, depression, mania, psychosis or apathy. This case shows the need for quick assessment for brain imaging when any atypical symptom is presented.

Patients with ‘simple’ mental health problems should be able to be managed exclusively in primary care. It is therefore anticipated that only the more complex cases would be referred to secondary care. In order to test this hypothesis, the number of patients registered with a community mental health team (CMHT) in Bedford, United Kingdom, who had received multiple psychiatric diagnoses in 2010, 2011 and 2013, was analysed.

Using an anonymised database that contains all patient data, the proportions of patients with more than one diagnosis were audited for the months of August 2010, June 2011 and February 2013. The total number of patients registered was also determined.

Many patients were found to have received multiple diagnoses. An increase in the proportion of patients with multiple diagnoses was observed; from 23.2% in 2010 to 25.2% in 2011 to 34.3% in 2013.

Several psychiatric conditions are associated with particular psychiatric co-morbidities, which may be one reason why many of patients receive multiple diagnoses. The trend observed may reflect improving mental healthcare in primary care and therefore fewer referrals of patients with ‘simple’ mental health conditions to secondary care, thus causing the CMHT's caseload to become increasingly complex. It may also reflect improving communication between primary and secondary care, which may also lead to fewer referrals. Finally, the trend may merely reflect better use of the available database.

We have found that numerous patients received multiple diagnoses. We have also observed an increase in the proportion of such patients over three years, which may reflect improved management of mental health problems in primary care. Our results may therefore provide an incentive to establish formal shared care of psychiatric patients between primary and secondary care to improve patient management even further.

Depression is more present among psychiatric disorders in the world, global trends is known that cause high levels of human and social disability. A depression for elderly is not easy, especially to the elderly that are in institutional care without family support.

Measuring level of depression, recognition of characteristics for depression and relation with psychotic symptoms in elderly at the nursing home.

Presentation and description of depression in elderly, without family support at the Nursing Home for Elders in Pristina.

It is a quantitative study. Nursing home residents are assesed with the Beck questionnaire for depression and anxiety, was clinically interviewed and also with the Geriatric Depression scale. Data were analyzed with SPSS 21 and Microsoft Excel 2007.

Number of resident = 85 samples. Residents above 65 years old (the oldest at age of 84). 74 residents have had psychiatric difficulties; in 15 residents were identified psychotic symptoms. A level of depression was found in all cases, the presence of depression with Geriatric scale is confirmed in 83% of cases. Various findings are evident in correlation with socio-demographic data's, gender, somatic diseases, neurological problems. This shows the low level of their involvement in daily activities and rehabilitation.

Institutional, social and mental health care is essential for the category of elderly residents in nursing home. High levels of depression require appropriate therapeutic and psychotherapeutic approach in order to facilitate the quality of their lives.

Bipolar affective disorder is frequently under-diagnosed and misdiagnosed, particularly as unipolar depression. This has implications on treatment and outcome of the condition. A community mental health team, has reassessed patients to examine whether it is possible to increase the sensitivity of diagnosis of bipolar affective disorder; to identify more cases and to identify them earlier, and so offer adequate treatment as early as possible.

Standards for diagnosis of bipolar affective disorder were based on the DSM-IV-TR diagnostic criteria for the diagnosis of bipolar I and bipolar II disorder. Patients were reassessed and patient data from 2006, 2007, 2010 and 2011, as well as from 2013, was collected. The results were audited with respect to psychiatric diagnoses for every year in question. The proportions of total bipolar, bipolar I affective disorder and bipolar II affective disorder diagnoses, as well as the proportions of recurrent depressive disorder and other unipolar depression diagnoses were determined.

There was a steady increase in the proportions of both bipolar I and bipolar II diagnoses -from 10.5% in 2006 to 11.0% in 2013 for bipolar I affective disorder, and from 0% in 2006 (4.9% in 2007) to 9.7% in 2013 for bipolar II affective disorder–, and a steady decrease in the proportions of both recurrent depressive disorder and other unipolar depression diagnoses – from 16.1% and 18.7%, respectively, in 2006, to 4.8% and 8.0%, respectively, in 2013.

The results confirm that it is possible to increase the sensitivity of bipolar affective disorder diagnosis and that this results in an increased number of diagnoses of the disorder, and a decreased number of diagnoses of unipolar depression.

This paper shows that it is possible to increase the sensitivity of diagnosis of bipolar affective disorder. Better identification, and therefore treatment, of bipolar affective disorder is likely to lead to better social and professional functioning of affected individuals.

The aim of this study is to assess the dependence between the obsessive-compulsive symptoms, the eating disorders symptoms and orthorexia in adolescents aged 15-19, due to define which of these areas orthorexia is closer to. The study controlled such variables as: age, sex, BMI, school type.

The study covered 1899 pupils of secondary schools. The OCD and ED symptoms assessment was carried out with the LOI-CV, EAT-26 and the ORTO-15 questionnaire (two threshold values: ON- 40 and ON -35). The research was financed by scientific grant of Nutricia Foundation.

Revealed correlations of risk factors of ON - OCD and ON - ED indicated the higher the probability of diagnosis of these disorders, the higher the probability of ON diagnosis, too. The compatibility of ON and OCD diagnoses was for ON-40 = 45.8% and ON-35, 76.5%. It was shown that the OCD increases the risk of ON at the threshold value ON = 35. In the case of ON and ED, the diagnostic compatibility was ON-40, 42.7% and ON-35, 84.4%. The analysis of various variables confirmed a significant dependency of ON from ED, which suggests that ON belongs to ED. The diagnostic accuracy in this case is better at the threshold value ON- 35.

The results of our study should be confirmed in further research.

Schizophrenia is a multifactorial disease requiring treatment that manages a broad spectrum of symptoms. Cariprazine is a dopamine D3 and D2 receptor partial agonist antipsychotic candidate with preferential D3 receptor binding.

Evaluate the pharmacological/behavioral profile of cariprazine in animal models.

To determine the activity and receptor occupancy of cariprazine in rat models at doses that confer antipsychotic-like efficacy.

Cariprazine was evaluated in rat paradigms that model symptoms of schizophrenia, mania, and depression. Occupancy of cariprazine, aripiprazole, and risperidone at D3 and D2 receptors was also compared.

Cariprazine showed antipsychotic-like efficacy on conditioned avoidance response and amphetamine-induced motor activity tests (ED50: 0.8 and 0.1 mg/kg) with potencies similar to risperidone (ED50: 0.9 and 0.2 mg/kg) and greater than aripiprazole (ED50: 18 and 3.9 mg/kg). While all 3 compounds displayed high in vivo occupancy of D2 receptors, only cariprazine displayed potent in vivo occupancy of D3 receptors at antipsychotic-like doses (ED50 [% inhibition]: cariprazine, 0.43 mg/kg [99.3]; aripiprazole, >30 mg/kg [26.4]; risperidone: ~2.3 mg/kg [53.4]). At or below antipsychotic-like doses, cariprazine demonstrated antimanic-like, antidepressant-like, anxiolytic-like, and procognitive effects in rats. As determined using D3 receptor knockout mice, procognitive and antidepressant-like effects of cariprazine were shown to be mediated via the D3 receptor.

At antipsychotic-like effective doses in rats, cariprazine demonstrated balanced and significant occupancy at both dopamine D2 and D3 receptors; other antipsychotics displayed relatively low D3 receptor occupancy. Additionally, at antipsychotic-like doses cariprazine demonstrated efficacy in different rat models of mania, mood, anxiety, and cognition.

Mitral valve prolapse (MVP) is a common cardiac pathology. There are some cases of a reduction in the intensity of clinical symptoms after the courses of psychotherapy and anxiolitic treatment of MVP patients (Stavrakaki, et al., 1991; Scordo, 2007).

To identify personality characteristics, emotional features and stress factors in MVP patients suffering anxiety disorders (AD).

To investigate the factors of mental health improvement under the long-term systemic integrative psychotherapy in MVP patients with AD.

During 15 years 14 MVP patients with AD attended integrative psychotherapy on request.

Psychological and clinical examinations of the patients were made before and after psychotherapy courses. Psychological testing embraced the assessment of’quality of life’ indicators by VAS, DISS and the Ryff Scales (PWB) as well as anxiety level (Spilberger Scales), and the level of frustration tolerance (Rosenzweig test).

The psychotherapy program consisted of the elements of CBT, Gestalt therapy, Interpersonal psychotherapy, and Psychodynamic Psychotherapy.

72,2% patients demonstrated valid improvements of QOL self-rating, reduction of anxiety level, and increasing of frustration tolerance after psychotherapy. Moreover, medical diagnostics showed a significant reduction in the depth of MVP.

Positive dynamics was associated with development of personality reflection, his/her emotional experience recognition, with improved skills of self regulation, and growing awareness of actual needs, individual purposes and resources of personality.

The importance of personality reflection and working on traumatic experiences and personality problems to reveale inner resources; as well as extension of one's repertory of coping processes were specified as facilitating factors.

We study coping strategies for hepatic, cardiac and renal transplant relatives. Relatives play a major role in the transplant life, and therefore specific psychological support has to be considered for them, something that is yet too rarely done in hospital.

We survey a population of 222 relatives, all volunteer for this research, of hepatic (52), cardiac (88) and renal (82) transplant. Most of them are husband or spouse (70%), the remaining being parents or children of the transplant. Evaluation is done through HAD (anxiety and depression), EAS (social support) and coping scales.

Relatives are confronted to traumatic effects of illness and have to reorganize themselves psychically. They face worrisome situation related to illness itself, heavy medical treatment (possibly at home), medical care, etc. They often regret not to be given room to express their sufferings or fears, a situation that can be a source of tension. Average score on HAD anxiety and depression scale are respectively (with population percentage scoring above threshold of 7.5) 8.81 and 4.53 for cardiac transplant relatives (67% and 16% above threshold), 7.92 and 4.55 for hepatic transplant relatives (48% and 18%), and 8.59 and 4.81 for renal transplant relatives (56% and 20%), thus clearly showing a population that is more anxious than depressed. We note that a depressed relative somewhat tends to get socially isolated and to rely on positive thoughts. Also, they say that they are not prepared to the changes resulting when their relative gets a transplant.

While knowledge of the aetiology of psychiatric disorders is complex and has not been fully elucidated, recently it has been noted that a sizeable proportion of psychiatric patients have coexisting immunological health conditions. Previous work has given weight to the theory that the immune system has important neuromodulatory roles in the brain, and disturbances in this system can lead to psychiatric manifestations.

Epidemiological evidence is needed to explore the strength of the correlation between immune conditions and psychiatric disorders, and this audit attempts to investigate this potential association using the psychiatric patient database of Bedford East Community Mental Health Team.

In this audit, the patient information was analysed to obtain prevalence data for an array of autoimmune conditions. This was then compared to the expected prevalence of the same autoimmune conditions.

The results showed that patients with each psychiatric condition had a higher than expected prevalence of autoimmune conditions overall. The most striking discrepancy was that the percentage of patients with coexisting hypothyroidism was higher than expected in almost every psychiatric condition recorded. Other patterns in prevalence of autoimmune conditions were also noted.

A causative link between psychiatric and autoimmune diseases is still questionable, and this issue needs to be researched further in terms of prevalence data and aetiological evidence.

There are significant implications for clinical practice if a greater incidence of autoimmune conditions among psychiatric patients is proven. This includes screening opportunities and risk assessments, as well as potential for new pharmacological therapies based around immune regulation.

In patients with Anorexia Nervosa (AN), troubles in facial emotion recognition (FER) have been reported using methodologies relying mainly on static tests. The morphing technique allows new perspectives in experimentation, by using dynamic expressions of emotions.

To compare prospectively FER using Multimorph, a morphing technique previously described (Robin, 2012) in anorexic patients and matched controls.

Population: 27 female patients with DSM-IV criteria for AN and 27 healthy individually matched controls were prospectively studied.

Multimorph protocol: Participants had to identify as rapidly as possible the 6 basic emotions. Emotions were displayed progressively by 2.5% incremental stages from neutral (0%) to a full-blend (100%) facial emotion (40 stages were displayed by trial). Each subject completed 36 trials (6 face x 6 emotions). Results are expressed as mean number of stages until the first correct response. Data were analyzed with a 2 (AN versus control) × 6 (anger, disgust, fear, happiness, sadness and surprise) factorial design. Comparisons were made with ANOVA for repeated measurements using Generalized Estimating Equations approach (Lipsitz, 1994). A p value < 0.05 was considered as significant.

Anorexic patients have an increased sensitivity to facial emotions, compared to controls.

Often the clinician is faced with bureaucratic demands and family that led him to opt for a diagnostic entity, despite not having enough natural history of the disease to make an accurate diagnosis, particularly relevant fact in child psychopathology taking into account patoplasty of mental illness.

Neuroleptic Malignant Syndrome (NMS) comprises several systemic manifestations which can be life threatening. Its pathogenesis is unknown but it is known to be associated with the use of antipsychotic drugs. Some cases are still seen in General Hospitals despite the extended use of atypical neuroleptics. The main clinical features includes mental status changes, fever, rigidity and autonomic instability. Due to the potential gravity, the identification of risk factors and early clinical diagnosis is essential in order to prevent or treat it successfully.

The objective of this study is to analyze the profile of patients who present NMS and the related risk factor described in the literature.

A sample of patients diagnosed with NMS was selected. They were hospitalized in the 12 de Octubre Universitary Hospital of Madrid over the last 10 years. The demographic variables, signs and symptoms and the risk factors were evaluated by a retrospective and descriptive analysis.

the clinical manifestations were similar to those reported in other series. Several risk factors reported in the literature were observed.

1. 1. It is essential the early suspect of this syndrome in patients with risk factors.

2. 2. In patients in whom the disorder is suspected, treatment should be initiated immediately.