Suicide is a major public health problem with escalating global trends, and high rates of recidivism. Patients with suicidal behavior have frequent contacts with Emergency Departments (ED). Therefore, the ED has been recognized as a strategic site for initiating interventions targeted at engaging suicidal patients in treatment. However, there is dearth of baseline data to guide such interventions in Nigeria.

This study determined the rates of treatment-engagement (compliance with follow-up appointment) among patients with suicidal behaviour after discharge from a psychiatric ED in Lagos, Nigeria.

The clinical database of 225 consecutive patients discharged from the ED of the Federal Neuro-Psychiatric Hospital Yaba between January and June 2012 were retrieved from the out-patient clinics/mental health service they were referred to. Data were abstracted regarding their adherence with recommended follow-up appointments over a period of six months.

The mean age of the service users was 35.9 ± (14.2) years and 62% were females. At one week post-discharge from the ED, 71.5% attended their appointments. By the end of the fourth week, third month and sixth month, engagement in treatment declined to 54%, 35.5% and 23% respectively.

There is a low rate of engagement in treatment among suicidal patients in Nigeria. This finding highlights an urgent need to develop local ED-based interventions targeted at engaging suicidal patients in treatment, with the view of reducing the risk of recidivism.

Publication of scientific research papers is important for professionals working in academic medical centres. Quantitative measures of scientific output determine status and prestige, and serve to rank universities as well as individuals. The pressure to generate maximum scientific output is high, and quantitative aspects may tend to dominate over qualitative ones. How this pressure influences questionable scientific research practises remains unknown. This is the first study who relates publication pressure with scientific misconduct and questionable research practises.

We performed an online survey inviting all medical scientist (n=2400) of 4 academic medical centres in Dutch speaking part of Flandres, Belgium to participate. Apart from demographic data, they were asked to fill out 2 questionnaires; a validated Publication Pressure Questionnaire and a questionnaire assessing 12 most common items of questionable research practises (QRP).

In total, 316 medical scientists completed the questionnaires. among them, 72% judge that publication pressure ‘has become excessive’, 61% believe that publication pressure ‘affects the credibility of medical research’ and 52% judge that publication pressure has a ‘sickening effect on medical science’. The QRP questionnaire indicates that more than 8 of medical scientists invented or manipulated their data and more than 52% has ever deleted data in order to confirm a hypothesis. Significant and strong associations between different QRP and the level of perceived publication pressure were found. The main limitation is the possibility of response bias.

A substantial proportion of medical scientists believe that publication pressure has become excessive, and have a cynical view on the validity of medical science. These perceptions are statistically correlatedwith questionable research practises. Further research should address the effects of publication pressure on scientific misconduct in more detail in a prospective study design and can be used to find alternative ways to prevent scientific misconduct.

Bullying can occur in several circumstances but nowadays it is largely widespread in schools. Several studies reveal the amount of psychopathology and behavioral changes that it determines, with special focus on children that can suffer silently or react with somatic disorders.

The authors present a clinical case of a girl who was victim of bullying, with the aim to describe the potential impact of bullying, as well as its clinical and social implications.

Report and analysis of the clinical case of a 13 years old girl who was admitted as an outpatient at the Department of Child and Adolescent Psychiatry after being referred by her General Practitioner for having become hoarse abruptly. She has been followed in consultation, medicated with antidepressants and submitted to psychotherapy. We also performed a medical screening, particularly the otorhinolaryngology specialty, which failed to detect alterations that could justify the aphonia.

During the clinical appointments we identified some bullying episodes at school, whose worsening temporally matched with the moment when she became hoarse. After six months of follow-up and intervention, there was an improvement of the mood state; however she only regained her voice after an apology from the bully.

Although some would argue that bullying can teach life lessons and give strength, there is a consensus that it represents a way of abuse. We should pay particular attention in children, since as in this case, they often react with somatic symptoms that can delay and misled the diagnostic and intervention.

IBS is a relatively frequent disorder with about twice as many female patients as male patients. Gender role theories propose that aspects of the female gender role which may lead to increased vulnerability may also induce higher levels of co-morbid psychopathology among females.

Gender roles differ systematically among cultures, in particular in the degree of differentiation between genders. The objective is to investigate possible gender and cultural differences in the relation between IBS and psychopathology.

To test whether both gender and cultural factors such as degree of gender differentiation are associated with variation in the incidence of comorbid psychopathology of people with IBS.

Results from a corpus of 141 studies were analysed by means of a random-effects model in terms of odds ratios between IBS and comparison groups for psychological factors which are indicative of dysfunction (the procedure was analogous to that employed for laterality by Martin et al., Psychological Bulletin, 2010). Meta-regression was used to test for the moderating effects of gender and of the Hofstede cultural factors of masculinity (i.e., gender differentiation), individualism, uncertainty avoidance, and power distance.

Counter to expectations, higher IBS psychopathology odds ratios were associated with samples containing more males and lower gender differentiation. Further, higher levels of psychopathology were found in cultures with lower individualism and uncertainty avoidance, and higher power distance.

Cultural factors and gender are systematically predictive of psychopathology co-morbidity rates in IBS, but the detailed patterns revealed do not support existing gender role theories.

Most people perceive their own future as more positive than the average person's. This optimistic bias may be a concern if it leads to people misjudging health threats and therefore the need for taking preventative steps.

To investigate the generality of recent observations of a reverse, pessimistic bias (i.e., perceiving oneself to be more at risk) in people with Irritable E

The aims are to discover if a pessimistic bias is also found in another psychosomatic condition (CFS/ME) or in another chronic illness (Asthma).

CFS/ME and Asthma patients were compared with healthy controls (matched in age and sex) for their perceived risks of health threats (e.g., arthritis) and threats (e.g., being burgled), for self and for others.

The results for the 3 groups are shown in the graph.

People with CFS/ME tend towards the possession of a pessimistic bias with regard to health threat, but towards an optimistic bias with regard to physical Asthma group tend towards a pessimistic bias with regard to health threat, but tend to be neither optimistic nor pessimistic with regard to physical threat. control group tend towards an optimistic bias with regard to both health and physical threats. Thus, it appears that people with a chronic condition tend toward pessimistic bias, as opposed to the optimistic bias found in the healthy. Materials devised to promote appropriate health-related behaviour may need to be the two different populations.

The Olfactory Reference Syndrome (ORS) is a clinical condition in which patients are convinced that they exude an unpleasant odor that is noticed by others. It was described for the first time in 1891, but became relevant in the nosology with Phillips in 1971. Since then discussion remains about diagnostic framework of this clinical entity.

About a clinical case series, the authors intend to review clinical features, nosological framework and response to treatment of the ORS.

Review of literature collected from online medical databases. Report of a case series of five patients with ORS.

The literature on the ORS consists mainly of case reports, and there are few controlled studies and systematic reviews. It was found that in most cases the complaints relate to a typical body odor, more often fecal, genital or halitosis. These beliefs range from overvalued ideas to delusions with strong conviction and they are usually accompanied by ideas of self-reference. Patients do not always smell the odor that they believe to emanate. The disturbance has high social, family and work impact. The response to treatment is variable and it was observed at different rates when antipsychotics, antidepressants and psychotherapy are used.

Although it was proposed for integration in DSM-5 as an independent entity, the ORS was not so defined, remaining as a disorder whose characteristics overlap other diagnoses, including delusional disorder, in which is usually included, but also disorders from the obsessive-compulsive spectrum and social anxiety, given the variability of morbid consciousness. We also discuss the possible relationship of the ORS with symptoms of olfactory expression in other psychiatric disorders. The ORS deserves the attention of psychiatrists since it brings great suffering for the patient, as well as high demand for non-psychiatric care and the consequent delay in diagnosis and treatment.

Impulsivity is recognized as a predisposing factor for addictive and suicidal behavior in bipolar patients. We aim to study the impact of childhood traumatic experiences on the development of impulsive behavior in patients with bipolar disorder and the particularties of these patients

Case-control study during a period of six months. Euthymic patients with bipolar disorder were enrolled. The two groups were compared by the scores of the Barratt Impulsivity Scale (BIS-10) and the Childhood Trauma Questionnaire (CTQ).

The total impulsivity scores of motor and cognitive impulsivity in subjects with bipolar disorder were higher than in control subjects (with respectively p=0,001 ; p=0,005 ; p=0,002). There was a statistically significant difference between bipolar patients and controls regarding the CTQ total (p<10-3) and sub-scores for emotional abuse (p<10-3), physical neglect (p=0,01) and physical abuse (p=0,001) which were higher among patients. There was a correlation between the average total CTQ score and the average total score of impulsivity in the BIS-10 in patients with bipolar disorder (p=0,04). Impulsivity was associated with a childhood full of traumatic events, particularly in bipolar patients.

It is interesting to routinely use impulsivity scales (especially the BIS) and Childhood Trauma Questionnaire as indicators of high risk of addictive behavior in bipolar patients. This is paramount in order to develop appropriate therapeutic measures for this group of patients, often responding poorly to standard care.

To help out the new starters in psychiatry training to familiarise them with working in the NHS and the training scheme. This will also allow some kind of mentoring and support for the junior psychiatrists in Oxford deanery.

This scheme was piloted by psychiatry trainees in 2009.

Each new core trainee (CT1) is linked up with a more senior third year core trainee (CT3) on a voluntary basis. It is mainly designed to help the new trainee, but should also have benefits for the link trainee e.g. educational leadership and teaching experience.

A central feature of the scheme is that it should be adaptable to the needs of both parties. The Link CT3 should agree to a minimum commitment of 4 sessions, but it may be that the CT1 is happy with fewer than that.

The programme has been running over the last four years in Oxford and with the help of many colleagues we have been able to get very good and helpful feedback about the scheme and the way it works. Most trainees were happy with it and some of them suggested some modifications.

The Link Trainee Scheme is a very helpful programme that is widely accepted by psychiatry trainees both at a junior and senior level.

In a recent feedback, some trainees suggested involving senior registrars in the scheme and we have been piloting this for the academic year 2013-2014.

This scheme has been adopted by other deaneries in Britain.

The concept of delusional disorder was coined only in 1977 despite being used in reports and observations over the last 150 years. In fact, it was Kraepelin's seminal work that defined the frame for delusional disorder. The presence of nonbizarre delusions in the absence of other mood or psychotic symptoms characterizes this disorder. These delusions can be persistent and have a stable course. Its prevalence is of 0,03% and the mean age of onset 40.

To describe the case of a central hospital psychiatric outpatient and it's comparison with the international available literature.

Retrospective analysis of the clinical process.

the authors present the case of a 78 years-old woman, married, previously healthy and functional, followed in an outpatient Psychiatric liaison consult since 2010. She presented with behavioural changes towards her husband and family developed after clinical discharge related with the treatment of Chronic Lymphocytic Leukemia 3 years before. She had a delusional belief that her husband had a romantic liason with the house keeper, not folding logic. She also had delusional interpretations of their behaviours. Despite that, she had no other psychopathology and functioned normally.

Our current understanding of delusional disorder is limited by scarce scientific data consisting mostly of individual case reports. The psychopathologic characteristics and age of onset make this case unique.

When social anxiety and psychotic disorders occur in the same patient, they have mutual implications in both disease courses.

Social anxiety disorder is mainly characterized by the fear of embarrassment in social or performance situations, accompanied by the intense concern about other people's opinion.

Psychotic disorders are traditionally seen as being accompanied by affective blunting and deterioration of social skills.

The authors pretend to review different interactions between these disorders, by exploring several clinical scenarios where both disorders influence themselves in different ways.

The authors review reports and literature in the files of Pumed, Medline and others. They also consult psychiatry textbooks.

Many psychotic patients have other affective disturbances than that of affective blunting. Social anxiety is one of them; some studies point a prevalence of 25% in these patients.

But if in some patients social anxiety seems to act as a trigger of psychotic symptoms, acting as a persistent stressor, other patients have anxiety in interacting with others as a consequence of having a psychotic disorder and the fear of being noted as having a serious mental disorder affecting ones behaviour.

In a third scenario, social anxiety occurs as a product of a primary thought disorder (psychotic self-reference).

It is possible to identify therapeutic implications of these comorbidity, namely by the use of cognitive behaviour therapy.

Comorbidity between psychosis and social anxiety can occur in different ways, influencing the prognosis of both disorders. It also can challenge the knowledge about these disorders.

The aim of the hereby-presented multi research center studies is the description of how frequent sexual impairments touch the patients with affective disorders in diagnosis, as well as the assessment of illness’ and pharmacotherapy's influence on their occurrence. 207 patients aged 18-65 have been examined.

The research was based on a number of standardized questionnaires: The BSP Questionnaire (Pole's Sexuality Research), Female Sexual Functioning, Male Sexual Functioning, the Hamilton Rating Scale for Depression and the Young Mania Rating Scale. The above-mentioned questionnaires were then supplemented with data on patients’ social and economic status (education, professional activity) as well as a number of other health conditions that might influence the quality of sexual life (associated somatic diseases, drugs influencing the cycle of sexual responses). Additionally information was gathered on the course of illness itself, duration of episodes and types of pharmacological treatment.

The presence of sexual dysfunction in patients should encourage therapists to answer the question to what extent are they caused by the disease or antidepressant drug administrated. The issue of sexual dysfunction should play a greater role in the course of therapy. All patients in the course of the study were taking antidepressants. A significant difference between the percentage of patients reporting directly to their doctors the presence of sexual dysfunction and the results carried out on the basis of questionnaires should encourage therapists to direct questions about the presence of the disorder in this sphere of life.

As various studies show, women after mastectomy are accompanied by many problems in the sexual sphere; it considerably lowers their quality of life. Goal of the study is to describe the relationship between the illness as well as the treatment of choice and the sexuality of Polish patients. Another goal is a comparison of the study results with results obtained in similar studies in Europe.

The target group of 300 women after mastectomy is in the process of assessment. The subjects are recruited among Polish patients diagnosed and treated at the Department of Clinical Oncology, Cracow University Hospital in Cracow, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw and its branches in Katowice and Cracow.

The following questionnaires are used: Changes in Sexual Functioning Questionnaire (CSFQ – F – C), Body Image Questionnaire (KOC-BR), Sexual Interaction Inventory (SII), Quality of Life Questionnaire QLQ – BR23. Questionnaires were supplemented by questions related to socialeconomic status and oncology treatment.

The type of treatment has a major impact on patients’ health, including sexual health. During chemotherapy, hormonal therapy, changes in mood and appearance of patients are present, which has an impact on both self-image of women after mastectomy, as well as the relationship with their partners. Mastectomy patients feel less attractive, less likely to engage in sexual activities. They have ambivalent feelings about their body image and sexual attractiveness.

Mood and anxiety disorders are common in youth and are associated with reduced quality of life and high costs. Access to effective treatment is limited due to long waitlists, high costs and perceived social stigma. Given the high prevalence and treatment barriers, there is a need for brief, inexpensive and effective interventions.

Psychoeducational interventions are inexpensive, easily administered and more accessible than conventional interventions. There is some evidence that these are effective in treating or preventing mental disorders.

To compare knowledge acquired by participants via email or live psychoeducation groups, to measure symptom change and to compare effectiveness of each modality.

Psychoeducation (live or via email) in multifamily groups will be offered. Forty participants in each group will be enrolled. There will be six 40-minute sessions. Primary outcome measures are: change in parental knowledge about the child's disorder and level of expressed emotion in the parent-child relationship. Measures are Understanding of Mood Disorders Questionnaire and Expressed Emotion Adjective Checklist. To measure changes in symptoms the Children's Depression Inventory and Multidimensional Anxiety Scale for Children will be used. Questionnaires will be administered before, after and at 4 months.

Data entered in Excel format. ANOVA used to compare effectiveness of group versus email psychoeducation. Both methods equally effective in delivering psychoeducation.

Ontario has long waitlists for youth with mood and anxiety disorders. Psychoeducation is effective in increasing understanding of illness, improving symptoms and problem-solving skills of the family. Multifamily group versus email psychoeducation will facilitate access.

Multiculturalism has become a powerful force in Canada in recent years. Approximately 25% of physicians are International Medical Graduates (IMGs). In psychiatry, cultural variations affect the symptomatic manifestations of mental illness. Psychiatric trainees need to develop cultural competence since cultural knowledge is an important determinant of treatment outcome.

The Mental Health Commission of Canada in its Framework for Mental Health Strategy included addressing issues of race, ethnicity, national origin, citizenship, gender, creed, sexual orientation, class/socioeconomic status, age and disability. The Royal College Objectives for Psychiatry state ‘the resident must be able to address issues of gender, sexual orientation, age, culture, ethnicity, spirituality, and ethics in a professional manner.’

To teach residents components of cultural competency; to measure change in attitudes before and after the module; and to increase awareness of link of cultural competency to professionalism and communicator role.

The Queen's University Department of Psychiatry designed an innovative Cultural Competency Module for its residents. Queen's staff from Human Rights Office, International Center and Dept. of Psychiatry provided: a) a full day workshop on cultural self-awareness; b) modules on Sexual and Gender Diversity and c) Race/Ethnicity. Each section included didactics, case vignettes, small group discussions, and role plays of culturally sensitive interviews. Gain in knowledge and attitude change was measured by pre and post questionnaires. Residents also participated in an online version of the Intercultural Developmental Inventory to find out their group score.

Residents had shift in attitudes/knowledge of cultural competency after the module.

Blood was collected from patients diagnosed with chronic obstructive pulmonary disease and comorbid depressive symptoms (COPD+DS, (N=13), individuals with either COPD (N=16) or recurrent depressive disorder (rDD) alone (N=15) and from healthy controls (N=19). Levels of IL-2, IL-6, IL-8, IFN-g, TNF-a, IL-17 and GITR were detected with ELISA. Surface phenotype expression of T regulatory and T effector cells was analysed with a flow cytometery.

We observedthat COPD, depression and COPD with comorbid depression are associated with increased IL-6 levels when compared with healthy controls 42.2±1.87 pg/mL, 41.9±1.51 pg/mL, 41.7 ±1.31 and 34.7±1.36 pg/mL, respectively (p<0.05). Concentrations of IFN-g were significantly increased in COPD+DS patients when compared with controls (24.3±1.49 pg/mL and 17.8±0.70 pg/mL, respectively, p<0.05). IL-2 levels were highest in COPD+DS (3.20±0.389 pg/mL) and differed significantly when this group was compared with controls (2.30±0.176 pg/mL), p£0.05. GITR was significantly higher in COPD patients (0.332±0.04849) when compared with depressed (0.183±0.0492), when compared with COPD +depressive symptoms (0.194± 0.0357) and also when compared with controls (0.1601±0.0191), all p<0.05. We observed strong significant positive correlation between GITR and IL-2 and also between GITR and IFN-g in the study groups (p<0.001). Further, we checked the ratios of IL- 2/GITR and IFN-g /GITR. We observed significantly increased IL-2/GITR ratio in depressed groups (p<0.01). We also observed strong positive correlation between IL-2/GITR and Treg/Teffector (p<0.001).

In this study we identified GITR and IL-2 as putative inflammatory agents associated with depressive symptoms in COPD patients. Furthermore our study revealed that alterations of IL-2/GITR balance modulate immunological self-tolerance mediated by Treg cells. Our observations suggest that modulation of IL-2/GITR and its effects on T cell population(s)are putative immune pathways contributing to systemic inflammation in depression.

Stress exposure increases the risk for the development of depression, butonly in individuals combining a vulnerable genetic background with (repeated) stress exposure. However, it is currently unknown which (combination) of stressful life events is etiologically the most relevant for depressive symptoms. The mineralocorticoid receptor (MR) which is essential for optimal HPA axis functionality has been implicated in stress resilience.

To determine whether the effects of cumulative stress on subclinical depressive symptoms (Beck Depression Inventory) depend on MR haplotypes (rs5522 and rs2070951). Cumulative stress was operationalized childhood trauma, major life events, and daily hassles.

All three stress domains were independently and cumulatively associated with depressive symptoms. MR haplotypes significantly modified the effects of cumulative stress on depressive symptoms.

Cumulative exposure to stress is related to depressive symptoms, and our data implicate the existence of a multiple hit model in which independent but cumulative stress exposure leads to increased depressive symptoms. Importantly, MR haplotypes which are closely involved in HPA axis funtionality moderate the cumulative effects of stress on depressive symptoms. Together, these results provide more insight into the neurobiological background of stress resilience.