Understanding the complex impact of epilepsy on a person's quality of life is increasingly significant since it is recognized as an important component of clinical care.

To assess the quality of life of patients with epilepsy;

To identify the influence of anxiety and depression on the quality of life.

It was a cross-sectional study involving 50 subjects with epilepsy and followed in the outpatient psychiatry. The state-trait anxiety inventory was used to assess the level of anxiety, whereas the Beck depression inventory was used to measure the severity of depression. The quality of life of our patients was assessed using the quality of life in epilepsy inventory (QOLIE -31).

The average age of our patients was 44.66 years. They were benefiting from family counseling in 80% of cases and family financial support in 64% of cases. Thirty percent of them were suffering from stigmatization and 38% from relational difficulties.

A low level of anxiety was found in 46 % of patients, while a mild to moderate depression was found in 52% of cases. The average overall score of quality of life of our patients was 71.66. A high level of quality of life was significantly correlated with a minimum level of anxiety (p = 0.012), but not with the severity of depression.

Health education of patients with epilepsy would improve their knowledge about this chronic illness, reduce their anxiety and contribute to improve their quality of life.

Common mental disorders are a leading cause of long-term sickness absence and disability pensioning.

To evaluate the effectiveness of a 5–15 session work-focused CBT integrating individual job support for people struggling with work participation due to common mental disorders.

Compared to usual care, increases the intervention work participation 12–18 months post baseline, and does it improve mental health and health-related quality of life as secondary outcomes.

The study was a randomized controlled multicenter trial with six secondary care centers, but with possibility for self-referrals. A total of 1416 potential participants were considered for inclusion, 197 failed inclusion criteria, 26 did not consent, leaving 1193 participants (67% female) to be randomized. The participants included both people on sick leave, people at risk of going on sick leave, and people on long-term benefits (>12 months). Primary outcome data were registry based, eliminating loss to follow-up.

Compared to usual care, participants in the intervention group had higher work participation (44.2% vs 37.2%, diff: 6.9%, P=0.015) at 12 months follow-up. The difference remained significant after 18 months (diff: 7.8%, P=0.018), and was even stronger for those on long-term benefits (diff: 12.2%, P=0.007). The intervention group also reduced their depression (t=3.44, df=625, P=<0.001) and anxiety symptoms (t=2.06, df=625, P=0.040), and increased their health related quality of life (t=2.45, df=616, P=0.015), more than the control group.

A work-focused CBT and individual job support was more effective than usual care in increasing work participation for people with common mental disorders.

Sexual problems noticed in patients with schizophrenia and who are treated with neuroleptics, are known but their meaning and importance is marginalized.

60 women and 64 men were examined before working out the results. These are just the beginning of the research which will include the results of 200 patients. The research was conducted in the Department of Psychiatry and Psychotherapy Silesian Medical University in Katowice, Poland.

Some of the data and the initial diagnosis were taken from the illness history card. Mini International Neuropsychiatric Interview (MINI) was used as well in the course of the research to confirm the final diagnosis. The data input was also conducted using the questionnaires (Sexual Function of Man according to Kratochvil (SFM/K) and of Woman (SFK/K), and Questionnaire of History of Sexual Life (BSP)) which the patients could fill in discreetly. The patients were also asked to provide such information as: the type of the received medicament, its pharmacological group.

Within the female group the frequency of the dysfunctions was 56,6%. The female patients pointed the following order of those dysfunctions: orgasm dysfunction 46%, vaginal dryness 20% and feeling pain during sexual intercourse 20%. 70% of men doesn’t report any sexual dysfunctions and the most common anomaly for the others is erection dysfunction (17% of men)

That issue should be often mentioned during the therapy, which in result can prevent the patients from putting the neuroleptic drugs aside or changing them.

Previous research suggests a possible link between insomnia and mortality, but findings are mixed and well-controlled studies are lacking. The aim of the current study was to examine the effect of insomnia on all-cause mortality.

Using a cohort design with 14 years follow-up, official registry data on mortality were linked to health information obtained during 1997–99, as part of the community-based Hordaland Health Study (HUSK), in Western Norway. 6,236 participants aged 40–45 completed baseline information included self-reported information on insomnia (defined according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), sociodemographic factors, health behaviors, obstructive sleep apnea symptoms, sleep duration, sleep medication use, anxiety, depression, as well as a range of somatic diagnoses and symptoms. Height, weight and blood pressure were measured. Information on mortality was obtained from the Norwegian Cause of Death Registry.

Insomnia was found to be a significant predictor of all-cause-mortality (hazard ratio [HR] = 2.86 [95% CI: 1.62–5.03]). Adjusting for several possible confounders did not attenuate the effect (HR=3.07 [95% CI: 1.53–6.15]). Stratifying on sex, the effect was significant in men (adjusted HR=3.93 [95% CI: 1.26–12.19]); but not in women (adjusted HR=2.11 [95% CI: 0.83–5.36]). The mortality risk among participants with both insomnia and short sleep duration (<6.5hours) was particularly high (adjusted HR=4.58 [95% CI: 1.22–17.19]).

Insomnia was associated with a four-fold risk of mortality in men during 14 years follow-up. The risk was especially high in combination with short sleep duration. Establishing prevention strategies and low-threshold interventions should consequently be a prioritized task for public health policy.

Driving is an essential activity of daily living for many patients. A diagnosis of dementia is likely to affect one's ability to continue driving safely due to cognitive decline. It is the role of the memory services team to inform the patient of the above, assess their risk and advise patients about their driving accordingly. Furthermore given that there are currently no gold standard assessment tools available, the method by which patient risk is assessed is often left of the discretion of the assessor. This literature review looks at assessment of driving to see if there is an effective method that could be adopted by memory service assessors.

To review literature with regards to assessing competency of driving in patients with dementia (pre and post disclosure).

To see if there are effective measures, tools or assessment criteria that can effectively determine if a patient is competent to continue driving.

PubMed and OvidSP search using ‘driving assessment’ and ‘dementia’ as search criteria for journal publications in English over the past five years.

The search gave 60 papers from pubmed and 14 from OvidSP. 12 papers met the criteria for selection.

There are many different tools that can be used to assess cognition, each with varying ability to identify those patients who are at risk when continuing to drive. The problem lies not only in detecting those at risk but there is also the issue over validation for the tests that are available

The aims of this study were to determine the presence of painful physical symptoms (PPS) and its impact on depression outcomes in different gender and age groups.

Three hundred in- and out-patients from China presenting with a new or first episode of major depressive disorder were enrolled in a 3- month prospective observational study from Asia (N=909). Hamilton Depression Scale (HAMD-17), Clinical Global Impression Severity (CGI-S), EuroQoL and the pain-related items of the Somatic Symptom Inventory were administered. Patients were classified into three age groups (<40, n=119; =40-<60, n=133; =60, n=48). Linear and logistic regression models were fitted to assess the relationship between PPS at baseline and outcomes.

Older patients had higher HAMD-17 severity at baseline. HAMD score was 25.9 (SD 6.1) in =60 vs. 22.5 (SD 5.0) in <40 and 24.8 (SD 5.2) in =40-<60. There were no statistically significant differences in the proportion of patients with PPS across gender and age groups. During follow-up, depression severity improved. There were no statistically significant differences in the degree of improvement by gender, but there were differences by age group. Mean change in HAMD was -16.4 (95%CI -17.7;-15.1) for those <40, -19.9 (95%CI -21.1;-18.7) in 40-60 and - 20.3 (95%CI -22.6;-17.9) in >60. PPS positive patients had worse clinical and quality of life outcomes across genders and age groups.

The presence of painful physical symptoms is associated with a lower improvement in depression outcomes and a lower quality of life in patients with major depression across different gender and age groups.

Medication non-compliance is common in the treatment of depression, particularly in Asia.

1) To describe the frequency and factors associated with medication non-compliance. 2) To study the influence of non-compliance on treatment outcomes.

Nine hundred and nine in- and out-patients from Asia presenting with a new or first episode of major depressive disorder were enrolled in a 3-month prospective observational study. Clinical severity and quality of life were assessed, using Hamilton Depression Scale (HAMD-17), Clinical Global Impression Severity (CGI-S), and EuroQoL measures (EQ-5D and EQ-VAS). Medication compliance was also assessed by the investigator and patient. Linear and logistic multiple regression models were used to analyze the consequences of non-compliance.

The proportion of non-compliant patients as assessed by the investigator was 16%. Sociodemographic factors and clinical severity were not associated with compliance at baseline. Regression models showed that medication non-compliance was associated with worse depression severity (difference in HAMD-17 -3.98; 95% CI -5.10, -2.87) and overall clinical severity (CGI-S difference -0.46; 95%CI -0.68, -0.24) at three months. Medication non-compliance was also associated with lower quality of life at three months (EQ-VAS difference -7.47; 95%CI -11.13, - 3.82) and EQ-5D score difference -0.08; 95%CI -0.1, -0.04)). Compliant patients had higher odds of response (odds ratio (OR) 3.18; 95% CI 1.98, 5.10) and remission (OR 3.94; 95% CI 2.42, 6.43) compared with non-compliant patients.

Patients non-compliant with medication had worse 3-month outcomes in terms of depression severity, quality of life, and response and remission rates, compared with compliant patients.

False-positive drug screenings have been reported for several drugs and can affect the therapeutic relationship.

We wanted to find out, which medication can cause false-positive phencyclidine drug screenings.

We systematically looked at all psychiatric inpatients with phencyclidine positive urine drug screenings using a kinetic interaction of microparticles in a solution (KIMS) based system treated in our psychiatric department between 2008 and 2013.

39 of 40 positive phencyclidine urine drug screenings could plausibly be explained as false-positives by psychopharmacologic medication. The most frequent common medication in our case series was chlorprothixene, which has not been reported as a cause for any false-positive drug screenings so far. We also found trimipramine as a medication in three cases, being structurally similar to imipramine, which has been reported before to potentially cause cross-reactivity. Other false-positive results could be explained by venlafaxine, lamotrigine, imipramine and tramadol, which have been reported to have the capacity for cross-reactivity. Chlorprothixene and venlafaxine accounted for almost 75 % of the positive screenings.

Confirmation by a second method like gas chromatography/mass spectrometry should follow positive drug screenings for phencyclidine.

Tobacco use and dependence is a chronic relapsing disease, due to nicotine in tobacco.

To assess smoking cessation rates and compliance to a smoking cessation program in moderate tobacco consumers with low and moderate nicotine dependence score.

Analysis of demographic variables, smoking profile, nicotine dependence score, type of cigarettes smoked, past history of nicotine withdrawal syndrome and medical history was performed. Patients underwent either pharmacological therapy and counselling, either counselling alone for 3 months. 6 months follow up based on face to face or telephonic evaluation was done to assess smoking abstinence rates.

Study group was made of 124 moderate smokers (40 % men, age average 31.2) referred to a smoking cessation center in the Clinic of Pulmonary Diseases Iasi in 2007-2009. While 31.2 % had low nicotine dependence (Fagerstrom scores < 3) and 40% moderate dependence (score 4-7) psychiatric co-morbidities were met in 12 % and 40 % of subjects described nicotine withdrawal history. 38.8% started smoking under the age of 14 and 30 % prefered nonfiltered or menthol cigarettes. 71.2 % of the study group underwent pharmacological therapy. Abstinence rate was 30 % at 3 months end of treatment and 12.5 % at 6 months.

Even if low or moderate cigarette consumption and low - moderate nicotine dependence score, quitting smoking may be difficult due to specific smoking patterns in this category of smokers, resulting in unexpected low abstinence rates.

Aggressiveness is one of the most stigmatization symptoms of paranoid schizophrenia with its possible roots in personality and/or acute psychopathology of schizophrenia.

To explore general and personality differences among suicidal, homicidal and non-aggressive male subjects with paranoid schizophrenia.

We recruited all consecutive inpatients fulfilling the ICD-10 criteria of paranoid schizophrenia during 2009-2011. Personality traits were determined by the NEO Five-Factor Inventory (NEO-FFI) scale which measures the five major personality traits: emotional stability, extraversion, openness to experience, agreeableness and conscientiousness).

The study included 359 male subjects diagnosed with paranoid schizophrenia. Their mean age was 37,8 yrs (SD 11,9) and duration of illness 13,77 yrs (SD 12,1). Majority were single (N=271, 75,5%), with 8-12 yrs of education (N=266, 75%) and unemployed (N=193, 53,8%). In an attempt to assess their auto and heteroagressivness, subjects were divided into three groups: subjects with suicide ideation (N=66, 18.4%), subjects with suicide attempt (N=67, 18,7%) and subjects with homicidal behavior (N= 86, 24%). These groups were compared against the comparative group of subjects without suicidal ideation, suicide or homicide behavior (N=140, 39%). Subjects with homicide behavior were significantly older, with longer duration of illness, majority were diagnosed with comorbid alcohol addiction and these participants scored higher on the emotional stability subscale (ANOVA F=7.8, df= 3, P=0.001).

These findings might contribute to discussion of the role of personality characteristics in paranoid schizophrenia.

There are four levels of human functioning: biological, ontogenetic and psychological, social-relational and cultural-spiritual. The social-relational level exerts its influence through specific individual groups that a person belongs to. Of all groups to which an individual belongs, the family group seems essential, from the ontogenetic-psychological perspective, in acquiring self-confidence, self-esteem and emotional stability.

To assess the possible impact of family group structure on suicidal behavior in suicide attempts.

All suicidal behaviour emergency cases that reached the ER at Bihor County Emergency Hospital (medical and surgical profile) as well as the Psychiatric ER were analyzed. A number of 292 cases were collected from 01.Jan.2012 to 31.Dec.2012. The structure of the family of origin and current family structure were analyzed.

Out of the monitored parameters present in the description of the cases, the existence of a psychiatric diagnosis, presence of somatic illness, marital status, presence of children had no statistical significance. In turn, the structure of family of origin analysis had an unexpected result. Out of all attempted suicide cases, 74.4% were only children. 14% of the cases had one sibling. Families with 3 or 4 children gave 5% of the studied cases, while 4 or more siblings had only 6.6% of the suicide attempters.

Being an only child represents a major risk for suicide attempts. The explanation can be complex and nonlinear. It is also a part of group psychology.

Metabolic syndrome (MS), which consists of several metabolic abnormalities, is highly prevalent in patients with schizophrenia. According to some studies, MS is characterized by a mild chronic inflammatory state, while for the elevated white blood cell (WBC) and neutrophil counts are considered to be positively associated with MS.

To determine the WBC and neutrophil counts and to establish their possible association with MS and its components in schizophrenic patients.

We conducted a cross-sectional study. The study group consisted of schizophrenic patients from the University Clinical Hospital Mostar (n=100), while the control group consisted of healthy subjects who came to the systematic medical examinations in the Health Center Mostar (n=100). The diagnosis of MS was made according to ATP III criteria, and on that basis the subjects from both groups were divided into two subgroups, one with and one without MS.

Schizophrenic subjects had significantly higher average WBC (p<0,001) and neutrophil (p<0,001) counts compared to the control group. Schizophrenic subjects with MS had significantly higher WBC and neutrophil counts compared to both control subgroups. WBC and neutrophil counts correlated positively with fasting blood glucose level and MS prevalence. There were no significant correlations between WBC or neutrophil counts with the number of MS components.

WBC and neutrophil counts are positively associated with MS prevalence and fasting glucose level. Routine monitoring of these inflamatory indicators might have an important role in predicting MS development in schizophrenic patients.

In Norway, it is mainly GPs that admit refer involuntarily to psychiatric hospitals. The process is regulated by legislation that requires that the patient suffers from a serious psychiatric disorder and is a danger to him/herself or that necessary treatment cannot be given otherwise. about 1/3 of patients are referred involuntarily in Norway. While legislators have tried to reduce the number of patients being referred involuntarily by changing the legislative requirements, the proportion of involuntarily referred patients has remained high. More knowledge is needed about why patients are referred involuntarily, and especially about GP's expectations.

To examine which expectations GPs have when referring patients involuntarily to a psychiatric hospital.

Semi-structured phone interviews were performed with 74 GPs that had referred patients involuntarily to a major Norwegian University Psychiatric Hospital. One topic that was discussed was GPs expectations. Each GP could give several expectations.

81% expected to solve an acute situation and make sure that the patient was cared for.

58% expected that appropriate medical treatment would be given.

38% expected a major change/improvement in the treatment or care of the patient.

22% expected that the patient's diagnosis would become clearer during the stay.

GPs may have different expectations when admitting patients involuntarily to psychiatric hospital. Solving an acute situation and making sure that the patient was cared for was the most important expectation given by the GPs.

N-methyl-D-aspartate (NMDA) receptors are ligand-gated receptor complexes that have been associated with learning and memory, pain transmission, depression, schizophrenia and neurodegenerative disorders. In these processes deficiency of magnesium has a significant role. Magnesium and MK-801, noncompetitive NMDA receptor antagonists, have been demonstrated analgesic efficacy against neuropathic pain, but there are no data about the effects of these compounds on visceral pain.

Comparison of the analgesic activity of NMDA antagonists against visceral inflammatory pain.

This study aimed at evaluating the effect of magnesium sulphate (MS) and MK-801 in writhing test in rats.

In writhing test, a model of visceral inflammatory pain, injection of diluted acetic acid into the peritoneal cavity of male Wistar rats induced pain. MS and MK-801 were given subcutaneously 15 min before the intraperitoneal injection of 0.7% acetic acid.

MS at doses of 5 and 15 mg/kg did not affect the number of writhing in rats, but doses of 30 and 45 mg/kg significantly potentiated writhing 2.9 and 2.4 times, respectively. MK-801 (0.005 and 0.01 mg/kg) produced dose-dependent antinociception manifested as reduction in the number of writhing and the maximum antinociceptive activity was 61.3%.

MK-801 in the writhing test produced antinociception likely due to the inhibition of NMDA receptors. Effect of magnesium was different from MK-801. MS did not inhibit and even aggravated pain evoked by chemical stimuli in visceral pain test. The present results suggest that the MS may not be useful systemic analgesic in the therapy of visceral inflammatory pain.

Truancy is a serious public health problem that affects adolescents from all countries around the world. It negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions. Young who are habitual truants are more likely to engage in at-risk behaviour like suicidal behaviours.

This analysis investigated the prevalence of truancy and suicidal behaviours in the Italian sample.

to reduce truancy among European adolescents improving mental health in European high schools.

the WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6±0,6; 64,4% females) was selected. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, suicidal behaviour and mental health issues was collected using a structured questionnaire.

6% has been absent from school for 7 days or more without a valid excuse during the past year (6.6% male); 20,3% as considered as truant student (three or more skipped days per month without a valid excuse in the past year). 4,6% have seriously considered taking own life during past 2 weeks have thought about suicide, and 1,2% tried to take own life in past 2 weeks. The analysis showed as correlation between skipped school and suicidal behaviour (p < .001)

Teens engaging in risk behaviours are at increased odds of depression, suicidal ideation, and suicide attempts (Hallfors et al. 2004). The preliminary We-Stay data confirm the prevalence of at-risk behaviours is higher among truant students.

Social anxiety (SA) is a dimensional psychological trait that unfolds as a continuum from normality to pathology. While studies have focused on brain response when individuals are exposed to social situations, little is known about neural correlates of trait SA in the absence of any social triggering.

To test the hypothesis that brain resting state activity is modulated by trait SA, we measured the Hurst Exponent (HE), an index of complexity of time series, in healthy individuals.

Resting-state fMRI time series were recorded in 36 subjects (16 F; mean age±S.D. = 26±3 years). All volunteers were healthy without any psychiatric, medical and neurological disorders. Each subject completed the Liebowitz Social Anxiety Scale (LSAS).

HE was estimated by using the discrete second-order derivative approach and its relationship with social anxiety was tested across the whole brain.

LSAS scores predicted HE in the posterior cingulate/precuneus (significant positive correlation).

Our results indicate that the brain pattern of spontaneous activity is influenced by the degree of social anxiety, as a continuum. Moreover, as this relationship between the degree of SA and brain activity was found at rest in the absence of any relevant social stimuli, our findings suggest that social anxiety may be a trait characteristic that shapes brain activity and predisposes to abnormal reactions to social contexts.

Obesity has been associated with cognitive impairment. However, it is not clear whether cognitive impairment may depend on concomitant psychopathology, since several psychiatric conditions, e.g. schizophrenia, include cognitive deficits among their manifestations.

To assess cognitive performances and psychopathology in obese patients, and to compare cognitive alterations in obese patients with those in schizophrenics and controls.

To compare cognitive performances in obese patients to normal percentiles. To provide an analysis of correlation with specific psychopathological domains. To evaluate whether cognitive performances in very obese patients were different from those in schizophrenia patients and non-affected controls.

88 obese patients were included. Exclusion criteria were: axis I and II diagnosis; severe medical, neurological, or endocrinology conditions. Patients underwent an extensive battery of cognitive tests and completed the Toronto Alexithymia Scale (TAS-20), the Barratt Impulsiveness Scale (BIS-11), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI). In the second part of the study, very obese patients (BMI>40; n=16) were compared for cognitive performances to schizophrenia patients (n=16) and non-affected controls (n=17).

Obese patients performed at low percentiles (<15) on the Problem Solving and the Social Cognition tasks. Mean scores on psychopathology rating scales did not reach abnormal values. No correlation was found with psychopathology. When compared to schizophrenics, no significant differences were found in performances on spatial working memory.

Obese patients show cognitive alterations even in the absence of abnormal psychopathology. Very obese patients share cognitive alterations with schizophrenia patients, which may imply common neurobiological basis.