The growth of the older population worldwide has been followed by an increase of mental illness, an important cause of morbidity. In the elderly, the coexistence of disability, physical and mental illness and social problems means that older people often have complex needs, which require comprehensive and systematic assessment.

To identify met and unmet needs and their relationship with cognition and functionality.

Elderly patients (≥ 65 years old), with mental disorders (ICD-9), were recruited consecutively from ULSAM, in Portugal.

All patients were assessed with the Camberwell Assessment of Need for the Elderly/CANE, Mini Mental State Examination/MMSE, Clock Draw Test/CDT, Geriatric Depression Scale/GDS, Zung Anxiety Scale/ZAS, Barthel Index/BI and Lawton & Brody Index/LI.

In this sample (n=306), the most frequent unmet needs were daytime activities (46.7%), psychological distress (25.8%), memory (13.4%), social benefits (11.4%) and company (8.2%).

A significant relation between global needs - CANE (met and unmet) and psychiatric diagnoses (F=12,888, p=.000) was found. Patients with dementia had a higher number of global needs and lower functionality.

The global needs correlated negatively with MMSE (r=−.666, p=.000), CDT (r=−.512, p=.000), BI (r =−.541, p=.000) and LI (r =−.854, p=.000), and positively with GDS (r =.385, p=.000).

Cognitive deficits, higher depression and lower functionality were associated with a greater number of needs. These results also suggest that dementia is an important determinant of the functional status and needs.

Besides cognitive behavioral therapy (CBT) and interpersonal body psychotherapy (IBP) psychodynamic psychotherapy (PP) has shown to be effective in the treatment of depression.

Application-oriented psychodynamic diagnostics can contribute to an adequate treatment of depressed patients who have a personality-structure based dynamic, which promotes intrapsychic and/or interpersonal conflicts that lead to triggering of depressive episodes and/or chronification. These dimensions can be measured with the Operationalised Psychodynamic Diagnosis (OPD-2).

Comprehensive psychodynamic and non-psychodynamic diagnostics is assessed within the Zurich depression study. A total of 120 probands (30 depressive patients treated with CBT/IBP/PP respectively and 30 healthy probands) will be measured before, after six months and after one year of psychotherapeutic treatment. This design aims at displaying the effects of different psychotherapeutic techniques with psychodynamic diagnostics. Secondary objective is a differentiation between CBT, IBP and PP.

OPD-2 provides an assessment of psychodynamic dimensions like (dysfunctional) interpersonal relations, intrapsychic and interpersonal conflicts and psychic structure (structural capabilities or deficits). The OPD-interview comprises a multimodal and multiaxial approach with an open, mostly unstructured, but also structured conversation style.

The concept of psychic structure is central in the Operationalised Psychodynamic Diagnosis system. The OPD structure questionnaire (OPD-SQ) reflects a broad spectrum of structure based characteristics using psychological concepts (e.g. empathy, communication of affects, selfreflection) and rather clinically meaningful conceptions (impulse control, affect tolerance, self-object-differentiation).

The Heidelberg Personality Restructuring Scale (HSCS) depicts processes of change on the basis of psychoanalytic concepts.

First results will be presented and psychotherapeutic implications will be discussed.

In the troubled times we are living concerning professional matters, job satisfaction is undoubtedly a highly topical subject. This is a factor that interferes positively in the service user and the relationship of the health care team.

To evaluate the level of job satisfaction of nurses in the study and determine the specific conditions in the work and lives of nurses which their professional achievement and satisfaction, in order to contribute to the progressive improvement of contexts of work.

A correlational study was conducted with 96 nurses from various departments at Hospital São Teotónio of Viseu, Portugal. A questionnaire measuring job satisfaction and professional achievement was used.

The instrument used for data collection was the questionnaire emphasizing the following results, 63.5% of nurses are satisfied with their work, 61.5% of nurses are professionally satisfied and 68.8% are achieved with the profession. The dimensions of job satisfaction are causing greater agreement are: satisfaction with the organization and satisfaction with Hierarchical Superior, on the other hand the dimension that causes the most dissatisfaction it is the Remuneration. Also found that 84.4% of nurses do not wish to leave the current place of employment in the next five years, and 85.4% plan to stay in the same profession in the coming years.

Early detection of psychiatric morbidity through self-administered screening questionnaires, as well as implementation of organizational mental-health promotion programs, is recommended to improve employees mental health and job satisfaction.

The self-medication hypothesis proposes that schizophrenia patients may smoke as an attempt to reduce their cognitive deficits, their symptoms or the antipsychotic side-effects.

to identify the relationship between the smoking topography and psychopathology among outpatients with DSM-IV schizophrenia.

The sample included 26 smoking outpatients with DSM-IV schizophrenia from a Mental Health Center sited in the North of Spain [65.5% males; mean age (SD) = 44.66 (7.83)]. Instruments: (1) Psychopathology: Positive and Negative Syndrome Scales (PANSS); Clinical Global Impression of Severity (CGI-S); n° antipsychotic. (2) Pattern of tobacco use: n° cigarettes/day; Fargerstrom test for nicotine physical dependence; Glover-Nilsson test for nicotine psychological dependence; Expired carbon monoxide (CO ppm).

prevalence was 59.3% for non-heavy smokers [<30 cigarettes/day; Mean CO (SD)= 24 ppm (9.70)] and 40.7% for heavy smokers [≥30 cigarettes/day; Mean CO (SD) = 36 ppm (16.06)]. PANSS mean score (SD) = 54.07 (12.45); CGI-G mean score (SD) = 3.50 (1.17); Mean number of antipsychotic (SD) = 1.79 (0.88). No significant differences were found between the severity of the psychopatology (PANSS, CGI-S, n° antipsychotic) and all the variables of the pattern of tobacco use (n° cigarettes/day; expired carbon monoxide; Fargerstrom; Glover-Nilsson).

In this sample of schizophrenia patients, there is no relation between the severity of psychopathology and the dependence of nicotine. However, the sample of this study is small.

Regarding the patient clientele with main diagnosis (MD) F19.*[ICD 10] new needs have been seen to emerge. The increase in the number of consumers of N-methylamphetamine (by 29 % in 2011) in Saxony correlates with an impressive increase of the number of inpatients and emphasizes the need of adapted treatment offers.

In this context, in 2009 an open-door ward (8 beds) for detoxification and motivation treatment for adults at age between 18-40 years with MD F19.* was opened which pursues an integrative therapeutic concept including both addiction-specific group- and talking therapy orientation and behavioral therapy approaches.

By using a pre-post study (pre: 2008, post I: 2010, post II: 2011, post III: 2012) selected key figures such as length of stay, readmission rate and kind of discharge, trends in individual substance-related detoxification motivation and associated mental disorders (F19.5) were monitored.

A continuous growing number of patients with MD F19.* has been achieved, marked by an increase of treated cases (pre: 77, post III: 156) and planned admissions (pre: 58 %, post III: 72%). Other data (length of stay, readmissions, treatment discontinuations) showed no significant changes. Individual detoxification motivation data point to a trend in favour of N-methylamphetamine. The number of patients with MD F19.5 (psychotic disorder) increased by >100 %.

The results refer to the necessity of identifying and monitoring valid quality indicators regarding our treatment concept. Therefore, those as yet evaluated indicators may act as a preliminary basis. Further projects are planned.

Mood disorders are very common and associated with significant disability. Stigma because of mental illness is also ubiquitous in the society.

We have created a new course for people with mood disorders to help them learn more and be able to practice ways to overcome stigma in their lives and themselves. The course is a closed group with five to eight participants, co-led by a mental health professional and a person with lived experience. The course consists of 7 two hour sessions and focus on the following topics: Introduction and orientation; Depression, Anxiety and Recovery; Self-Stigma; Social Stigma – Family, Friends and Medical settings; Stigma in Education, Housing and the Workplace; Disclosure; and Conclusion. There is a homework assigned between sessions

A pilot running of the course has been completed. It was used for a fine-tuning of the course and finalizing the course content. Feedback was encouraged and was used for these purposes

The course: ‘Overcoming Stigma in Mood and Anxiety Disorders’ may have a significant role in helping people with those disorders to achieve recovery

Cerebral palsy refers to a wide range of motor abnormalities which result from damage to the developing or immature brain. Parents of children with developmental disabilities experience heightened stress, impaired mental health, sense of devaluation and self-blame, frequently causing conflicts on the couple subsystem.

This paper aims to describe psychiatric and psychosocial maladjustment caused by this emotional and physically demanding pathology.

We describe a 8-year-old boy who developed hetero aggressivity admitted to our outpatient clinic.

His mother refers alert signs since patient's neonatal period, with axial hypotonia and global psychomotor development retardation. He also presented absence seizures, several congenital malformations that led to urological, otorrinolaringological and stomatological surgeries. While performing mental state evaluation we could clinically assess ADHD, as well as marked language difficulties, which made us consider introduction of psycho-stimulants, besides mood stabilizers prescribed by his neurologist, after excluding cardiaovascular abnormalities. During the various appointments serious problems were found within family relationships, specially father's difficulty in accepting his youngest son disability, which made us intervene holistically, supporting and validating patient's mother and brother work and efforts and psychoeducating his father in order to improve his psychosocial emotional development.

Psycho-social programs and coping strategies should be developed to respond to individual changing needs and to provide necessary support for the special needs of these families.

Tattoo prevalence among young people assumed epidemic. It transformed into tattoo-addiction (tattoo-mania) and influences significantly on personality psychology and mind. Youth addict-audience with searching, delinquent and psychopathy-like radicals, generated drug addictions is one of tattoo configurations habitation key cohorts.

was to study tattoo-addiction prevalence scale and clinical peculiarities for identification in narcology as sustantional addiction new form.

for the research were information sources: 1) mass media; 2) Internet-monitoring results; 3) own research of students' youth cohort; 4) testing cohort of chemical and substantional addicted respondents.

of the research gave evidence that tattoo-problen in modern human has pivotal constituents of addiction syndrome conforming to ICD-10 clinical criteria: 1) specific tattoo-sensations search («acute intoxication»); 2) stable desire for tattoo-designs persistent refreshing (pathological drive syndrome); 3) (psychological and emotional discomfort sensation on the eve of new tattoo-interventions (withdrawal syndrome psychic equivalent); 4) expansion of dimensions and volumes of tattoo-design and colour scale (tolerance symptom); 5) thirst for tattoo-rage while covering the body with diverse patterns, combined tattoo and piercing (dipsomaniacal state symptom); 6) change of integument localization zones at tattooing (rotation of sensations); 7) tattoo-aggression consequences evidence (skin defects, chronic septic foci, innervation disorders, mental, behavioural disorders). Large-scale involvement, stability and further spread of tattoo-phenomenon: 12% of youth assess situation as «bad» and «awful», the rest 88% – as «excellent», «good», «not bad».

New problem of tattoo-addiction emerged in clinical narcology requires study, identification, working out the program of treatment, prevention and needs considering in new ICD-12 Version.

Hyperkeratosis is characterized by abnormal palmoplantar skin thickening. These lesions can extend to other organs and be associated with a multiplicity of pathologies.

This paper aims to describe the features of psychosocial maladjustment in a patient firstly diagnosed as having hyperkeratosis of unknown etiology.

We describe a 14-year-old boy admitted to our outpatient clinic after verbalizing suicidal thoughts to his endocrinologist.

His medical condition had been evolving since he was six, when his palms and specially soles became grossly thickened and painful and he would be found awake at night clawing at his severely scaly and itchy lesions. He was seen by geneticists, dermatologists and plastic surgeons. However, the thickened patches continued to progress over the years, with almost no response to treatment. He was unable to keep up with his friends walking and had to give up on sports. Due to medication he has a reduced stature and low puberty development. On his first appointment he was reported to be unable to manage routine affairs or handle money matters and his scholastic performance was poor. During mental state examination one could assess restricted interests, social and communication defficits, tantrums, self and hetero aggressions and IQ below normal, despite an extraordinary visuo-spatial memory and no suicidal intent. He was medicated with risperidone and structural family therapy was applied, with good response.

Helping individuals and families dealing with behavioural problems improves family dynamics and quality of life even in the presence of such incapacitating diseases.

Maternal depressive risk has been linked to several dysfunctional outcomes. Empirical data indicate that the lack of adequate maternal responses over feeding may affect the quality of the early eating habits of the baby. Such a conclusion, however, is mainly based on cross-sectional research, which does not allow to establish causality.

The aim of the study was to explore in a longitudinal way the link between pre-partum depression and subsequent mother-child feeding interactions.

Participants were 64 women who voluntarily agreed to take part in the study. During their 3rd trimester of pregnancy, all completed a number of self-report instruments, including the CES–Depression scale (CES-D) and Multidimensional Scale for Perceived Social Support (MSPSS). Seven months after the delivery, mother-child dyads were videotaped during a meal session, and the Feeding Observational Scale (FS) was used so as to rate the quality of the feeding interactions.

During pregnancy, the CES-D negatively correlated with the MSPSS, r = -.32, p = .01. For three of the FS scales, the quality of the dyadic feeding interactions at seven months of age of the baby was significantly predicted by the CES-D, β ≥ .30, p < .05, but not by the MSPSS. In contrast, one of the FS scales was significantly predicted only by the MSPSS, β = -.29, p < .05, but not by the CES-D.

Clinical screening during pregnancy may help preventing the establishment of early dysfunctional eating behaviors, by identifying early risk factors for dysfunctional feeding interactions.

To evaluate the initial (3 months) all-cause discontinuation and safety of aripiprazole once-monthly 400mg (AOM-400mg), an extended release injectable suspension of aripiprazole, stratified by previous treatment.

These two studies (NCT00705783 & NCT00706654) were double-blind, placebo- or active-controlled assessing the efficacy and safety of AOM-400mg. Detailed study designs have been reported previously (1, 2). This analysis was conducted on the pooled population in the first 3 months after initiating AOM-400mg treatment, on patients who received at least one dose of AOM-400mg. Outcome measures are reported for groups stratified by prior treatment.

During the first 3 months of treatment, discontinuation due to all-causes (except for those who discontinued due to the sponsor stopping the NCT00705783 study early after pre-specified efficacy parameters were met) as well as due to adverse events are presented in Table 1. The rates of insomnia and akathisia are shown in Table 1

Aripiprazole once-monthly 400mg appeared equally safe and effective (as measured by all cause discontinuation) in the first 3 months after initiation, regardless of treatment prior to entering trials.

Medical professionals are exposed to numerous high intensity stressors. This may lead to increased occurrence of signs of burnout syndrome and depression. This phenomenon is further connected to higher probability of serious medical errors, lower attention to patients and other medically serious issues.

We have conducted a national study to assess the level occurrence of burnout syndrome and depression using standardized questionnaires. We have collected data from n=7428 medical doctors cross all specialties and types of medical institutions.

The results of the study confirmed high occurrence of burnout syndrome and depression symptoms among Czech medical doctors. The study also brought information about specific risk factors as the type of specialty, age, marital status or educational level which influence the levels of burnout and depression syndromes at statistically significant levels (p<0,001).

The study supports the hypothesis that medical doctors are highly endangered by development of burnout and depression symptoms and thus should get appropriate care.

The study was supported by the Czech Medical Chamber.

Social-psychological adaptation of war veterans is a practical, scientific and social issue both in CIS countries and abroad. In peaceful life veterans continue to encounter stressful situations triggering their avital activity. This certainly requires rehabilitation measures.

To diagnose psychological constitution of avital behavior, try our rehabilitation program and estimate efficiency of rehabilitation.

To study efficiency of medical and psychological rehabilitation of people with avital activity after combating stress.

We studied 116 males aged 25 - 43 years who fought at North Caucasus. Sixteen Personality Factor Questionnaire and Hamilton Depression Rating Scale were used. To study avital activity and defence mechanisms, we used Questionnaire for Psychological Diagnostics of Lifestyle Index.

Based on results of diagnostics, we divided respondents into two groups: patients with PTSD and self-injurious behavior who did not have rehabilitation, and patients with PTSD and self-injurious behavior who completed rehabilitation.

Our rehabilitation program included: personality treatment involving person-centered psychotherapy and rational therapy, symptomatic treatment involving neuromuscular relaxation, music therapy, self-regulation, behavior therapy and medication therapy, and social adaptation aimed at formation of adequate behavioral patterns.

The 1st group of patients more frequently demonstrated maximum values of somatic anxiety and depression. The 2d group of patients showed a statistically-valid decrease of somatic anxiety (by 37%), depression (by 34%) and guilt (by 33%).

The results show that our psychotherapeutic rehabilitation program allows to reduce intensity of PTSD and prevent from formation of pathological personality features typical for self-injurious behavior and avital activity.

Avoiding coercive measures is one of the most important aims in emergency psychiatry.

There were far-reaching amendments to the German Civil Code in 2012 (XII ZB 99/12) and the Saxon Law on Aid and Accommodation for Mental Diseases in early 2013 (2 BvR 228/12) concerning the constraint of coerced medication.

To analyze the process of change on our emergency psychiatric ward, we conducted a longitudinal measurement.

We performed a pre-post-comparison (pre: 2010, post: 1st half of 2013) with regard to several patient- and nursing staff-related criteria by using descriptive and test statistics.

Socio-demographic patient data and unit-specific performance data remained unaltered. The distribution regarding the following main diagnoses [ICD 10] changed significantly: F19* (pre 11.0%, post 22.0%; p<0.001), F2*(pre 11.9%, post 17.6; p<0.01) and F1* excl. F19.* (pre 31.2%, post 18.8%; p<0.001). After the amendments a significant reduction of administered medication and a significant increase in the ratio of assaults/property damages/elopements/attempts of absconding per patient (pre 0.007, post 0.021; p<0.001) were measured. Both a significant increase in the ratio of physically restrained patients (pre 22.3%, post 28.7%; p<0.05) and changes regarding involuntary commitment practice impressed. In the course of changing conditions and workload, influences on staff absent time were noticeable. According to these results a partly restructuring of nursing staff was deployed by leadership.

Both nursing management and treatment concepts may have to be reassessed and adapted by discussing several aspects (e.g. safety of staff, professional ethic, staffing structure and levels). Further analyses seem indispensable.

Several studies have pointed to the relevance of a positive attitude and optimism in people's lives. Optimism promotes mental and physical health, especially in coping with stressful situations, and may aid in improving cognitive and contextual resources, and coping that promote better mental health, such as fewer depressive symptoms. Optimists tend to perform better than pessimists in school, sports and work. The satisfaction of life plays an important role in healthy development. The positive affects attenuate the negative aspects of stressful life events and act as protective factors in the development of psychological and behavioral problems.

To investigate mental health indicators in Brazilian children and adolescents.

Investigate differences between boys and girls regarding the positive and negative affect, life satisfaction, satisfaction with school, family, self and friendship, and optimism.

This is a quantitative cross-section study with data collected from 730 children and adolescents with 6-16 years old (mean = 10.6 years, SD = 3.3) from Porto Alegre and Montenegro, southern Brazil. Instruments used: Predictive of Optimism Tasks for Children (TAPOC); Youth Life Orientation Test (YLOT), Multidimensional Scale of Life Satisfaction for Children and Adolescents; Scale Positive and Negative Affects.

The results show good levels of life satisfaction, positive affect and optimism and lower levels of negative affect. The results were substantial even for children under seven.

Young children already have a capacity of expression on their own well-being. The correlations between variables indicate the relevance of indicators of psychological health throughout development.

The use of coercion in emergency psychiatry is discussed controversially.

Concerning the constraint of coerced medication there were changes of the German Civil Code in 2012 (XII ZB 99/12) and the Saxon Law on Aid and Accommodation for Mental Diseases in early 2013 (2 BvR 228/12)

Against the background of the issue ’Coercive Treatment’, we aimed on monitoring the effects of these amendments on our 18-bedded closed psychiatric ward.

We performed a pre-post-comparison (pre: 2010, post: 1st half of 2013) by using descriptive and test statistics.

Socio-demographic patient data and performance data remained stable. Regarding the main diagnoses [ICD 10] F19* (pre11.0%, post 22.0%; p<0.001), F2*(pre 11.9%, post 17.6; p<0.01) and F10.* -F18.* (pre 31.2%, post 18.8%; p<0.001) there were significant changes in distribution. We measured a significant reduction of the administration of emergency medication, except for the intramuscular injection of Zuclopenthixol, Olanzapin and Diazepam, and for the oral application of benzodiazepines and antipsychotics after acute crisis. At the same time the ratios of assaults/self-injuries/property damages per patient day (pre 0.005, post 0.018; p<0.001), physically restrained (pre 22.3%, post 28.7%; p<0.05) and involuntary committed patients (pre 15.5%, post 24.1%, p<0.01) augmented significantly. The average duration of involuntary commitment (excl. outliers) remained unaltered, but the variance of average duration increased (p<0.001).

The reduction of administered benzodiazepines and antipsychotics seems to correlate with an increase of aggressive behaviour and alternative use of other coercive measures. Further research and a social discussion on this issue are required.

The rapid emergence of New Psychoactive Substances (NPSs), combined with the ability of the Internet to disseminate information quickly, represents a serious issue from both a clinical and a public health point of view.

Aim of our research project is to assess the knowledge of NPSs and the extent of their diffusion amongst Italian young people.

A questionnaire has been administered to a youth population (2700 subjects, 16-24 year old) randomly selected from a representative group, to evaluate their knowledge/use of a group of NPSs. Other items evaluate possible alcoholic abuse, use of other drugs, smoking habit, consumption of energy drinks/caffeinate beverages, time spent over the Internet per day.

In the sample a partial knowledge of NPSs has been reported. The use of Cannabis in form of ’Spices’, ’Bath Salts’ including mephedrone, and Salvia divinorum was found in 1,4%, 2.2%, and 0.8% respectively. Relevant is the consumption of alcoholic beverages, with an important prevalence of binge drinking habits (98% of alcohol drinkers, 48,4% of total sample).

The results evidence a partial, but presumably significant compared to the general population, knowledge of use of New Psychoactive Substances among selected Italian adolescents and young adults. Peculiar is the percentage of subjects with Binge Drinking habits (98%) among alcohol consumers (50,8% of total sample). We aim to widen the data with further questionnaire collection, in order to present more significant results

The SEYLE (’Saving and Empowering Young Lives in Europe’) randomized clinical trial is funded by the European Union (FP7). Its aims were to collect baseline and follow-up data on health and well-being among European adolescents and to test three different suicidepreventive interventions, in comparison with a control group, in order to recommend culturally adjusted models for promoting mental health and preventing suicidal behaviors. The present ancillary study presents results of the French Prof-Screen cohort.

1: to describe the psychopathological profile of ’at risk’ students. 2: to compare the profiles of students referred vs. not referred to mental health services. 3: to analyse judgment criteria of the professional for referring pupils.

The questionnaire was a composite of psychopathology scales: Beck Depression Inventory (BDI-II); Zung Self-Assessment Anxiety Scale (SAS), Paykel Scale, Delibarate Self-Harm Inventory (DSHI) and other questions addressing issues of substances use, social relationships...

In the Prof-Screen arm, when critical scores were reached in the baseline questionnaire, the pupil was considered ’at risk’ and was examined by a professional who had to decide, based on a semi-structured interview and his/her clinical global impression, whether the pupil had to be referred to mental health services.

among the 235 pupils in the Prof-Screen arm, 168 (71,5 %) were considered ’at risk’. 156 (92,9 %) were evaluated in the clinical interview, among which 38 cases (24,4 %) were referred to mental health facilities.

major predictors for referral were depression, alcohol misuse and non suicidal self-injury.

Anhedonia has been regarded as a core deficit of schizophrenia and has been assigned a central role in the pathogenetic models of the syndrome as well as in the disability associated to it. Current research suggests that schizophrenia patients do not have a deficit in hedonic experience but, instead, a reduced ability to anticipate reward that might underlie other aspects of schizophrenia, such as avolition and lack of initiative.

The present study was aimed at characterizing these aspects in a sample of 35 patients with schizophrenia stabilized on second generation antipsychotics by comparing them to a group of 26 healthy controls (HC).

In both patients and HC, instruments specifically designed to assess the experience of consummatory and anticipatory pleasure as well as trait social and physical anhedonia were used; the factor ’real-life motivation’ was extracted by the Quality of Life Scale.

Patients showed, with respect to HC, higher trait social anhedonia, as well as reduced real-life motivation, but similar scores for trait physical anhedonia and the experience of consummatory or anticipatory pleasure.

In our sample of patients with schizophrenia the preserved experience of both consummatory and anticipatory pleasure in the presence of a significant deficit of motivation suggests a poor ability to translate pleasurable experiences into motivational states.

Authors thank Compagnia di San Paolo-Neuroscience Call that funded the project 'Reward system and primary negative symptoms in schizophrenia'.