The association between major depressive disorders and personality disorders is an important factor to consider due to its clinical, therapeutic and prognostic consequences.

The aims of the present study were to determine the prevalence of comorbid personality disorders in patients with major depression, and to evaluate the relationship between some personality traits and outcome of depression.

A descriptive and comparative study was carried in the unit ‘E’ at the Razi Hospital. Only men were included. We collected the records of thirty six patients in whom the diagnosis of major depressive disorder was retained in axe I and personality disorder in axe II (as the diagnostic criteria of DSM IV). Assessment was based on demographic characteristics, medical history, clinical aspects of the index episode and outcome characteristics.

17 patients (47.22%) had personality disorder (which 23, 5% histrionic, 35,3% antisocial, 17,7% passive-dependent, 23,5% borderline). The patients with comorbid personality disorder had an earlier age at onset of their depression and more previous suicide attempts. Comorbid personality disorders were correlated to an impaired outcome, with more recurrences and more persistent symptoms.

The impact of personality disorder in the outcome of depression is evident. A taking into consideration of this comorbidity as well as a medicinal and psychotherapeutic care are necessary.

Codeine Induced Psychotic Disorder is a poorly characterized illness but is increasingly being reported amongst cough mixture abusers. A study done in Hong Kong found that substance induced psychotic disorder is the most common psychiatric diagnosis amongst cough mixture abusers.

We aim to describe the clinical characteristics of patients referred to our National Addictions Management Service with a diagnosis of Substance Induced Psychotic Disorder secondary to Codeine cough syrup use.

A retrospective audit of clinical records was done for patients seen at our National Addictions Management Service from Apr 2007 to Mar 2013 with a diagnosis of Substance Induced Psychotic Disorder secondary to codeine use. Patients with a prior primary psychotic disorder diagnosis were excluded from the study.

11 patients (9 male, 2 female) out of a total of 48 patients with substance induced psychotic disorder had used codeine cough syrup. 4 of the patients had concomitantly used other substances as well. The age range of the patients was 28-45 yrs with a mean of 37.3 yrs. The duration of hospitalization during their psychotic episode ranged from 4-38 days with a mean of 13.5 days. 10 out of 11 patients were started on antipsychotics at baseline. At the end of a one year follow up period, two patients had their diagnosis revised to that of schizophrenia.

Codeine Induced Psychotic disorder is increasingly being seen amongst codeine abusers and more research is needed to better characterize this condition and determine the biological mechanisms behind it.

To examine the associations between personality traits, measured as Murray's psychological needs, and mortality over 41 years in men and women and among the young and the old.

We used a general population sample aged 18-65 (n = 1094) examined in 1970 according to the Cesarec-Marke Personality Schedule (CMPS). Mortality data came from national vitality registers up to 2011. The associations between eleven traits - achievement, affiliation, aggression, defence of status, guilt feelings, dominance, exhibition, autonomy, nurturance, order, and succorance - were examined using factor analysis, and their associations with mortality in Cox proportional hazard models.

During the 41-year follow-up, 513 persons died (47%). In men aged 26-45, achievement and affiliation were associated with mortality: HR = 1.19, 95% CI 1.04-1.36 and HR = 1.16, 95% CI 1.01-1.33 per step on a stanine scale. In men aged 18-25, nurturance was protective: HR = 0.77, 95% CI, 0.64-0.98 per stanine. In women aged 18-25, feelings of guilt increased the risk of mortality, while dominance was protective: HR = 1.38, 95% CI 1.09-1.75 per stanine, and HR = 0.74, 95% CI 0.55-0.99 per stanine, respectively. In women aged 46-65, exhibition increased the risk of mortality: HR = 1.09, 95% CI, 1.00-1.18 per stanine. There were no significant associations when all age groups were combined.

Our findings suggest that personality traits, measured as Murray's needs, are associated with an increased risk of all-cause mortality, but the associations differ according to age at assessment and sex.

Memory services provide assessment to patients with memory difficulties. One important topic discussed is driving. This audit looks into whether discussions surrounding driving are documented in the patient's notes.

The objective was to see if discussions are held about driving with patients at memory clinics.

A similar audit was carried out in the south of the county. It was hoped that the findings and recommendations had been implemented in the North of the county, and improvements made.

Standards were set that 100% of patients seen by memory services would have a documented discussion about driving at the initial and/or disclosure appointment. A period of 6 months, August 2012 to January 2013 was selected. 423 patients were referred and 60 patient's notes were randomly selected using a random integer set generator to look at.

We are currently in the process of collecting and analyzing results. The results will be available before the conference.

By the time people with memory impairment access memory services they are likely to have been driving for most of their lives; it has provided them with independence and access to means. Despite this, requirements are set out by Driver and Vehicle Licensing Agency UK that they must be informed when the licence holder has been diagnosed with dementia. They can suspend a licence based on their assessment, for the safety of the patient and the public. It is therefore of vital importance that these discussions are taking place.

The violence experienced in everyday life by vulnerable men, women and children, including intimate partner violence (IPV) and child maltreatment (CM), is one of the main risk factors for mental disorders in Europe and worldwide. Resilience is described by the PreVAiL network <www.prevailresearch.ca> as 'A dynamic process in which psychological, social, environmental and biological factors interact to enable an individual at any stage of life to develop, maintain or regain their mental health despite exposure to adversity'. The experience of violence is significantly different in men and women and we may expect for this and other reasons including the social position of women that patterns and determinants of resilience will also vary by gender.

To review the factors contributing to resilience and evidence about effective means to promote resilience in women and men with experience of violence.

A narrative review of literature and a systematic review of studies on the effectiveness of interventions to promote resilience in adults with experience of IPV and CM.

Twenty studies of complex and simple interventions in community, welfare, employment, prison, and substance abuse and mental illness service settings were identified for review. Several studies emphasise the value of people with this history participating in design, conduct and reporting of the studies.

Better evidence is needed on how to promote resilience with clinical and public health interventions among women and men affected by violence. Obtaining this evidence is critical alongside work towards preventing the violence.

The front-line nature of mental health crisis services and the complex and acute presentations of their clients, require rapid decisions in response to medication requests. Prescribing is conducted by a combination of non-medical prescribers, advanced practitioners and medical professionals, with individual variation in prescribing habits and trends. This leads to an impact on the prescribing budget with spiraling costs evident.

We undertook an audit of the prescriptions issued for emergency medications over 6 months. We incorporated audit standards, from NICE guidelines for prescribing of psychotropic medications and local trust prescribing advice. We audited data to examine whether cost of medication had been considered, in the context of the efficacy and safety of medications.

Of 138 prescriptions issued, 72 (52%) were prescribed by advanced practitioners, 7 by non-medical prescribers (5%) and the remainder by doctors (43%). 213 items were prescribed costing £2828 during this period. We demonstrated, by introducing smarter prescribing methods, a reduction in the number of prescription items by 27.7% (59 items), resulting in a financial efficiency of 94.6% (£2677). We recommended implementing an acute care formulary acting as a guide to smarter prescribing.

The guide includes recommending generic versions of medications instead of trade brands, asking primary care to initiate medications, reducing quantities of drugs prescribed, increased accountability for prescribing decisions and stopping use of expensive psychotropics, where cheaper alternatives with similar efficacy and side effect profile are available. To assess impact, we would reaudit in 6 months, before consideration towards adopting the policy trustwide.

the development of a comprehensive system ofpsychotherapy and psychocorrection of anxiety disorders of neurotic case, based on the study of their clinical structure and peculiarities of emotional damages.

Clinical and psychological investigation, included the scales of anxiety and uneasiness CH.D. Spielberger, Eysenck Personality Questionnaire (EPQ), The Hamilton Rating Scale for Depression (HRSD), The studyof accentuation of personality by K.Leonhard.

100 patients with diagnostic categories: F41.0 - Panic disorder(episodic paroxysmal anxiety, F41.1-Generalized anxiety disorder, F41.2-mixedanxiety-depressive disorder who are on the examination and treatment at the psychiatric unit. A control group included 40 patients.

We performed the explorationof the peculiarities of clinical anxietyand patterns of therapeutic effect, based on the influence of short-term groupand individual psychotherapy in the treatment of anxiety disorders, andevaluation the effectiveness of its reconition.

The development of the methodology of applying a short-term group and individual psychotherapy in the treatmentof anxiety disorders based on combination relaxation, hypnosis, cognitive-behavioral teqniques in combination on with short-term group therapy.

In fact, this is a new realmodel psychotherapy based on integrative principles. The higt efficacy was shown in 82% patients, compared with 54% efficacy in control group patients.

We will offer a new comprehensive methodology in the treatment of anxiety disorders of neuroticcase that will improve the therapeutic efficacy of the treatment process, reduce the time of treatment, reduce the period of drug therapy

The suicide rate in Hungary is high in international comparison. The four-level intervention program of the European Alliance Against Depression (EAAD) is designed to improve the care of depression and to prevent suicidal behaviour. Our aim was evaluating the effectiveness of the EAAD on suicide rates in different areas.

The program was implemented in Szolnok, a town in a region of Hungary with exceptionally high suicide rate and in Miskolc, a town in a region with high unemployment and also high suicide rate. Effectiveness was assessed by comparing changes in suicide rates before to after the start of the intervention in the intervention region to corresponding changes of national suicide rates. In addition, changes in suicide rates were compared to those in a control region (Szeged). In Miskolc also the number of suicide attempts was used to measure the effectiveness of the program.

For the duration of the program and the follow-up year, suicide rates in Szolnok were significantly lower than the average of the previous three years (p=.0076). The suicide rate thus went down from 30.1 per 100,000 in 2004 to 13.2 in 2005 (-56.1%), 14.6 in 2006 (-51.4%) and 12.0 in 2007 (-60.1%). This decrease of annual suicide rates in Szolnok after the onset of the intervention was significantly stronger than that observed in Hungary (p=.017). Men had the same decrease in suicide rates as women in Szolnok. In Miskolc we observed changes in the types of suicide attempts, especially among males.

Needs assessment has been highlighted as a crucial factor in the development, organisation and evaluation of mental health services. Moreover, meeting self-reported needs is of prime importance for ensuring quality of life and reducing social disability for people with severe mental disorders.

Service evaluation based on patients’ need assessments has never taken place in Greece. Furthermore there are no standardized needs assessment instruments. Given the underfunding of psychiatric services due to the current economic crisis, systematic need assessment is expected to contribute to the efficient use of their limited resources.

To examine the concurrent validity, inter-rater and test-retest reliability of the Greek research version of the Camberwell Assessment of Need (CAN-R).

Fifty-three schizophrenia patient–staff pairs were interviewed twice to test the inter-rater and test-retest reliability of the CAN-R (Greek version). The WHOQOL-BREF and WHODAS 2.0 were administered to the patients to examine concurrent validity.

The inter-rater and test-retest reliability of patient and staff interviews for the 22 individual items and the eight summary scores of the instrument's four sections were good to excellent. Significant correlations emerged between CAN scores and the WHOQOL-BREF and WHODAS 2.0 domains for patient and staff ratings, indicating good concurrent validity.

Our results suggest that the Greek version of the CAN-R is a reliable instrument for assessing mental health patients’ needs. This is the first CAN-R validity study with satisfactory results using WHOQOL-BREF and WHODAS 2.0 as criterion variables.

Substance abuse by young people remains one of the most widespread and costly problems in Europe. Some previous studies reported an association between sexual orientation and substance use whereas it is assumed that religiosity could be a protective factor regarding substance use.

To better understand the relationship between substance use, sexual orientation and religious beliefs.

The C>SURF study concerns Swiss male adults who have to go through the mandatory recruitment process at the army. Data were collected between August 2010 and November 2011. A questionnaire about the participants’ socio-professional and family background, their consumption of alcohol, cannabis and other drugs, as well as their personality was sent to be filled in online. The final sample included 5990 males between 17.9 and 31.4 years old (mean=20.01, sd=1.24). 77% of subjects declared belonging to a religious community whereas 29% said they are atheists. 91% described themselves as being exclusively attracted by females, 8% by males and females and 1.0% by males only.

Belonging to a religious community or declaring not being atheist seems to be a protective factor regarding any substance use. Heterosexual men declare most often belonging to a religious community but they do not differ regarding being atheist. Logistic regression on predicting the belonging to a religious community additionally shows a significant interaction between cannabis use and being gay.

There are significant associations between substance use, sexual orientation and religious beliefs and a better understanding of these relations would lead to a relevant clinical impact.

Ever since the first description of Lemere in 1936 describing the capability to ‘……produce ‘good’ alpha waves…’ to be associated with the ‘…affective capacity of the individual…’ 1, research on this EEG measure in Depression (MDD) has attracted wide attention. Several studies have shown that responders to various antidepressant treatments are characterized by increased posterior alpha power in MDD (reviewed in 2). Another dimension of alpha is its frequency; also called alpha peak frequency (APF) and several studies have found a slow APF to be related to non-response to medication and rTMS 2. Therefore, in this study we aim to investigate in a large sample whether these two alpha measures can predict treatment outcome to antidepressants.

A multi-center, international, randomized, prospective open-label trial (International Study to Predict Optimized Treatment – in Depression, iSPOT-D), where MDD patients were randomized to: Escitalopram, sertraline or venlafaxine-XR. Treatment response was established after eight weeks using the Hamilton Rating Scale (HRSD) and the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR).

A total of 1.007 MDD patients and 336 healthy controls were included in the study.

Sensitivity, specificity, positive and negative predictive values for remission will be reported for all patients and for medication types

Genome-wide association studies indicate that two single-nucleotide polymorphisms (SNPs) in the ANK3 gene, rs10994336 and rs9804190, increase the risk for bipolar disorder (BD). The ANK3 gene encodes the ankyrin-G protein and influences neuronal firing by changing sodium channel functions, thus impacting on brain regional activation.

We examined the effect of the two ANK3 SNPs on brain activation during a working memory task.

The aim of our study is to investigate whether the genetic risk associated with the two SNPs is coupled with abnormal activation in the working memory network.

We used functional magnetic resonance imaging data to investigate the impact of ANK3 rs10994336 and ANK3 rs9804190, on brain activity during a 3-back working memory task in 41 BD patients, 25 unaffected first-degree relatives and 46 healthy individuals (HI).

For the ANK3 rs10994336 (risk allele T), significant diagnosis x genotype interactions were observed in the left prefrontal (BA10/BA11), anterior cingulate (BA32/BA25) and posterior cingulate (BA31) cortex. These regions, risk allele carriers who were either patients or unaffected relatives showed increased activation compared to healthy controls carrying the risk allele. For the ANK3 rs9804190 (risk allele C) a significant effect of genotype was found in the right anterior cingulate (BA24), where subjects carrying the risk allele showed decreased activation compared to subjects carrying the protective allele.

Our data demonstrate that the effect of ANK3 rs10994336 and ANK3 rs9804190 on the brain converges on key regions involved in working memory processing.