Catatonia is a neuropsychiatric syndrome characterized mainly by motor disturbances, known to be caused by a variety of psychiatric, medical, neurological and toxic conditions.

There have been few cases reported in the literature of catatonia due to benzodiazepine withdrawal, with predominance in elderly population. Here we report the case of an elderly woman with initial symptoms of dementia and abuse of lorazepam, who showed catatonic symptoms after a sudden reduction of her habitual daily dose during hospitalization.

A 73 year old woman with a history of depression and recently onset of cognitive impairment compatible with dementia, was admitted at the psychiatry ward after the worsening of the behavioural disturbances. The patient had been a regular user of lorazepam for more than 10 years, which was maintained at the same dose. After two days she abruptly presented symptoms of inhibited catatonia. A family member reported on further enquiries a suspicion of abuse of lorazepam treatment.

After administration of intravenous Diazepam, a dramatic recovery was observed, and sustained improvement was achieved after an increment of the habitual lorazepam dose. Psychiatric and medical conditions were ruled-out during follow-up, and diagnosis of dementia of Alzheimer type was made after further assessments.

Benzodiazepine withdrawal is not an often, but still important cause of catatonia. Older patients are at special risk, as the increased probability of being hospitalized exposes them to sudden suspension or reduction of their habitual treatment. Nevertheless, aged related vulnerability to catatonia has not been well studied yet.

Paricipating in research is mandatory in the psychiatry higher training in the UK. The current view is that research should be embedded in the National Health Services (NHS) and that all trainees should have some involvement in research.

We aimed to assess the attitudes and satisfaction of trainees with the research activities in their training. We also aimed to identify the challenges they face and their views on how to improve the research experience.

We conducted an online survey of all General Adult Psychiatry (GAP) higher trainees in the Northwest of England. It was followed by Focus Groups during the regional training day involving 35 trainees. They were asked to reflect on the challenges to trainee's research and come out with solutions.

31 trainees returned the questionnaire giving a response rate of 66% of the GAP trainees. 83% of the trainees were participating in research. Half were in the preparatory stages, the rest progressed further. Of all participants 43% thought research should be part of the curriculum and 60% were satisfied with the research experience. The common challenges were time constraints, the difficulty in identifying a suitable project and lack of training in research methodology.

The provision of protected research time within the training is important. It is crucial to find innovative ways to link trainees to researchers and research centre. We advocate the adoption of a new policy with three research streams reflecting trainees desired level of involvement in research.

To reveal victims of the flood, assess the degree to which they were affected and determine risk factors

Comparative investigation of impact of various factors (such as age, sex, social-economic status and severity of stress) on the course and prognosis of Acute Stress Disorder.

Sixty two victims of the flood (28 men and 34 women) participated in the study. Stanford Acute Stress Disorder Questionnaire was used to evaluate presence and severity of Acute Stress Disorder symptoms among participants.

Vast majority (74.2%) of the flood victims were diagnosed with Acute Stress Disorder. Such factors as age (over 40 years) and (low/very low) social status were determined to negatively affect the onset and the course of Acute Stress Disorder*. In contrary, gender, education and, the most interesting, severity of stress were found out to not determine the prognosis of Acute Stress Disorder**. This may indicate that main contributing factors is rather realization of one's future difficulties in the struggle for comfortable life after the disaster, than the disaster itself. Improvement of social services work systemand implementation of property state insurance was recommended.

To develop a Support Vector Machine (SVM) algorithm as a predictive tool for diagnostic outcome in patients with FE-EOP, based on clinical and biomedical data at the emergence of the illness.

Two-year, prospective longitudinal study, where 81 patients (9-17 years of age) with a FE-EOP and stable diagnosis at follow-up and 41 age and sex-matched healthy controls (HC) were included. Structured diagnostic interviews, clinical and cognitive scales, a MRI scan and biochemical tests were conducted at baseline. Three SVM classification algorithms were developed (SSD vs HC group, non-SSD vs HC group, and SSD vs non-SSD group). Jackknifing was used to validate the algorithms and to calculate performance estimates. Enhanced-Recursive Feature Elimination was performed in order to gain information about the predictive weight for diagnosis of each variable.

The SSD-versus-non-SSD classifier achieved an overall accuracy of 83.1%, sensitivity of 86.6% and specificity of 77.8%. The variables during a FE-EOP with higher predictive value for a diagnosis of SSD were clinical variables such as negative symptoms preceding or during the psychotic onset, poor insight and duration of illness until first psychiatric contact. Biochemical, neuroimaging, and cognitive variables at baseline did not provide any additional predictive value.

SVM may serve as a predictive tool for early diagnosis of SSD during a FE-EOP. The most discriminative variables during a FE-EOP for a future diagnosis of SSD are clinical variables.

Depression is a serious illness that affects health, family and professional life of many people of all sectors of society. It also affects medical students, regardless of their geographical location. The stress of studying and the great responsibility awaiting students immediately after graduation may predispose the occurrence of depression.

To compare the level of depression among medical students from different countries.

Medical students from different parts of the world were asked to fill in an electronic form containing the Beck Depression Inventory(BDI). The form was created separately for each country, using official translation of the BDI, approved by the competent psychiatry association. The control group were students of the University of Technology. Google Drive and Statisticav10 were used for statistical analysis.

The form was filled in by 752 medical students from 7 countries: Poland-218, Taiwan-227, Germany-64, Portugal -102, Mexico- 65, Indonesia-45, Spain-31. The control group consisted of 195 students. The average score of the BDI of Polish medical students was 14.0+/- 10.0 points. The score of the BDI of the control group was: 9.5+/-8.2 points. The score of the BDI of the other countries: Taiwan-10,02+/-7,48, Germany- 7,57+/-5,92, Portugal-7,01+/-7,41, Mexico-9,85+/-8,05, Indonesia-11,33+/-8,96, Spain-7,24+/-6,92. There was statistically significant differences(p<0.05) between groups in terms of the mean score of the BDI.

Depression is a serious problem among medical students regardless the part of the world they are studying. A proper monitoring of depression is required, as well as rapid and appropriate help for those who suffer from it.

Sexual abuse of children and adolescents is a public health problem with potentially dire mental health consequences. Studies suggest that the first sexual experience of one out of three girls in sub-Saharan Africa is forced. However the relationship between sexual abuse and mental health problems among children and adolescents is grossly under-researched in Nigeria.

This study determined the association between sexual abuse and mental health problems in a sample of adolescents attending secondary school in Lagos, Nigeria.

A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, Global School-based Health Survey Questionnaire, Strength and Difficulties Questionnaire, Suicidality module of the Mini International Neuro-Psychiatric Interview and the Hospital Anxiety and Depression Scale.

The mean age of the participants was 15.9 (± 1.3) years, and 58.7% were males. A fifth (21.9%) of the respondents had experienced sexual abuse in the past year. Less than a tenth of the victims reported the abuse, and none had accessed mental health service. On regression analysis, being a victim of sexual abuse was independently predictive of depression (p=0.041), anxiety (p=0.007), peer problems (p=0.014), emotional problems (p=0.005) and suicidal ideation (p=0.014).

Exposure to sexual abuse is under-reported and un-detected among Nigerian school children, despite its association with several mental health problems. There is need for interventions targeted at facilitating the access of victimised children to timely supportive care and appropriate mental health intervention. Furthermore, efforts to protect children from sexual abuse must be intensified.

Pregnancy and postpartum are periods of increased vulnerability for psychiatric disorders, such as mood disorders, anxiety and psychotic disorders, that, when left untreated, imply serious consequences for the pregnant and the fetus. Since 1995, the Psychiatric Liaison Consultation in Bissaya Barreto Maternity (MBB) is part of the Early Intervention Unit (UIP), which consists of a multidisciplinary team that ensures a specific intervention in pregnant and postpartum women with psychiatric illness.

The authors conducted a case-control study to compare neonatal outcomes among pregnant women exposed to psychotropic drugs (antidepressants, antipsychotics, mood stabilizers and benzodiazepines), observed at the Psychiatry - Obstetric Consultation (n=100), with those of women followed at the Obstetric Consultation, without psychopathology during pregnancy, who were not exposed to psychiatric medication (n=93). The study was performed during a period of one year (October 2011 – October 2012)

The results were analyzed using the Statistical Package for the Social Sciences - SPSS (19th version).

Antidepressants and benzodiazepines were the most prescribed drugs during pregnancy. Concerning neonatal complications, there were no statistical differences between groups, in terms of gestational age at delivery, birth weight and APGAR score. Obstetrical and neonatal outcomes in the group exposed to psychiatric medication are as good as in the control group, supporting that the use of psychotropic drugs during pregnancy is safe to the mother and the baby, as long as used with caution. Early psychiatric intervention during pregnancy, in conjunction with obstetrics, is the gold standard to follow up pregnant women with mental illness.

Globally, children and adolescents are victims of various forms of violence, including physical, psychological and sexual violence perpetrated by peers or adults within the community, school or domestic setting. Suicidal behavior is public health problem with escalating trends among young people. There is dearth of research on the relationship between violence and suicidal behavior in sub-Saharan Africa.

This study determined the association between violence victimization and suicidal behavior (suicidal idea and attempts) in a sample of secondary school students in Lagos, Nigeria.

A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, the Global School-based Health Survey Questionnaire (violence module) and the ‘Suicidality’ module of the Mini International Neuro-Psychiatric Interview (MINI).

In the past year, a fifth of the respondents were victims of weapon-related violence (23.8%) and sexual violence (21.9%). More than half (56.4%) reported peer-related violence/bullying, while 60.7% were exposed to domestic violence. Less than a third (31.3%) reported lifetime history of suicidal idea, while 13% had attempted suicide. Suicidal behavior was significantly associated with history of bullying (p=0.020), sexual violence (p=0.014), weapon-related violence (p=0.005), and exposure to domestic violence (p=0.020).

Exposure to violence is associated with suicidal behavior among secondary school children in Nigeria. This highlights the need for urgent interventions to protect Nigerian children and adolescents from violence. There is also need for improved access of victimized children to mental health care and other support services.

Pregnancy and postpartum are periods of increased vulnerability for some psychiatric disorders that, when left untreated, imply serious consequences for the pregnant and the fetus. The Psychiatric Liaison Consultation in Bissaya Barreto Maternity (MBB) is part of the Early Intervention Unit (UIP), which consists of a multidisciplinary team that ensures a specific intervention in pregnant and postpartum women with psychiatric illness.

The purpose of this study is to characterize the perinatal period and the psychomotor development of the 123 newborns of mothers followed in the Psychiatric Liaison Consultation and exposed to psychotropic drugs.

The authors conducted a retrospective descriptive study using clinical processes from the babies born between 2001 and 2006, considering the following data: maternal age in pregnancy, psychiatric disorder and medication, gestational age, birth weight, Apgar score, breastfeeding and neonatal complications.

Preliminary results show that neonatal outcomes of newborns exposure to psychiatric medication during pregnancy are similar to those described in the literature, supporting that the use of psychotropic drugs during pregnancy is safe, as long as used with caution. This multidisciplinary intervention during pregnancy seems to be the best way to follow up pregnant women with mental illness.

Schizophrenia is a serious mental illness characterized by poor insight and poor adherence to the therapy. Antipsychotics are the mainstay of treatment but psychoeducational interventions are essential to improve these characteristics. Psychoeducation can be defined as a structured and didactical intervention, with the aim of informing about the disease and allow the patient to better cope with it.

Presentation of the results of a study of psychoeducation addressed to a group of patients with schizophrenia followed in the Psychiatric Service of Unidade Local de Saúde do Alto Minho. Brief theoretical review of the topic.

Intervention structured in 16 psychoeducation group sessions. Search PubMed for articles containing the terms 'psychoeducation’ and 'schizophrenia.’

Preliminary results show that patients with schizophrenia consider to be positive being informed about their disease. The intervention also improved the acceptance of their condition schizophrenic person, with the treatments and the limitations that this involves. Initially it was demonstrated enormous difficulty in the interaction between peers, which was not observed with the therapeutic team. This has been improving throughout the sessions.

According to the literature, psychoeducation in schizophrenia promotes adhesion therapy, prevents relapses and improves the quality of life of patients.

Our intervention although limited caused great enthusiasm among the patients making the therapeutic alliance stronger often hard to create and keep in this kind of pathology.

This work can be a starting point for more deeper and extensive studies on this subject.

we formed a small group of patients. All members were seen individually before they were integrated the group and informed about the aims and importance of the therapy. At each session, there was a psychiatrist, at least one clinical psychologist and a nurse present. The sessions lasted one hour and a half and used different types of supports (paper, video, brochures, books). The patients participated actively and were motivated and enthusiastic. They had information about the bipolar disease, worked on their life-chart and learned some CBT tools. At the beginning of each session, they received our written summary of the previous one. An evaluation sheet was circulated at the last session in order to evaluate the impact of the therapy.

none of the patients was hospitalized during the whole fifteen sessions therapy. The paper considers the cases of drop outs.

the experience was very beneficial for patients, their families and the therapists. In response to participants’ request a monthy consolidation session has been organized which participants can attend if they feel a need. A family group (family members and friends) of participants is also scheduled at our outpatient setting. The group of therapists will have a collaborative discussion before planning a new session of the therapy.

Several authors have studied and tried to describe the disturbing schizophrenic internal world: Jaspers, Conrad or Sobral-Cid, a portuguese psychiatrist from early 20th century.

The existence of a previous schizoid personality, delusional atmosphere and self-reference are examples of different steps that will lead to the emergence of delusion.

Louis Wain was an English artist best known for his drawings, which consistently featured anthropomorphized cats, and that suffered from schizophrenia. His work deeply changed as the disease evolved and his mental state deteriorated.

To analyse Wain's mental state by his biography and drawings evolution.

Review of the literature

Wain's drawings reflect his inner experiences and his mental state, so the progression of his artistic work translates his disease development: fragmentation and disorganization of the real. The psychotic deterioration that Wain's work reflects gave him a reputation and particular interest that persisted to the present day.

Insecure attachment and the inability to identify emotions are seen as possible explanations for dysfunction of the emotional system in borderline personality disorder. There is a strong association between Borderline personality disorder and insecure attachment, and the attachment types that are most characteristic of these subjects are unresolved, preoccupied, and fearful. Previous studies have demonstrated that insecure attachment patterns, a trait disposition toward negative affect and impulsivity are associated with borderline personality disorder features.

This review aims to identify the relationship between attachment pattern during childhood and the development of borderline personality disorder in adulthood.

The high prevalence and severity of insecure attachments found in these subjects support the central role of disturbed interpersonal relationships in clinical theories of Borderline Personality disorder.