Majority of the available studies have shown that children with sickle cell disease (SCD) have a higher risk of depressive symptoms

To assess the prevalence of depression in a sample of children with SCD and evaluate the association between various types of social support and depression, quality of life in those children.

120 children were included in the study, 60 of them (group I) with SCD and 60 were matched healthy control children (group II). Depression was assessed in both groups using ThesChildren's Depression Inventory (CDI), The Children's Depression InNntory-Parent (CDI-P) and the Diagnostic Interview Schedule for Children version IV (DISC-IV). The Pediatric Quality of Life Inventory version 4.0 generic core scales (Peds-QL 4.0) was used to assess the health-related quality of life (HRQOL) and social support was measured with the Child and Adolescent Social Support Scale (CASSS).

Eight children (13%) of the 60 children with SCD scored >12 on CDI (mean score 14.50±1.19), CDI-P (mean score 14.13±1.12) and diagnosed as having clinical depression using the diagnostic interview DISC-IV. HRQOL was poor in group I compared with group II, reflected by significantly lower mean scores in all domains of Peds-QL both in self and parent report (P>0.001). Increased levels of parent support was a significant predictor associated with decreased depressive symptoms and better quality of life in children with SCD (B= −1.79, P=0.01 and B=1.89, P=0.02 respectively).

Increased parent support was significantly associated with decreased depressive symptoms and better quality of life in children with SCD, so support intervention focusing on increasing parent support may be important as a part of treatment of depression in those children.

The concept of psychosomatic family, introduced by Minuchin, refers to some family organizations that maintain and reinforce psychosomatic symptoms in their members. The literature indicates that some family factors may lead to the emergence of somatic symptoms in a child or adolescent.

The main objective of this study is the case report of an adolescent with recurrent abdominal pain and its integration in the existing literature.

A 14 year old girl presented to the emergency department (ED) with recurrent abdominal pain. She had already been hospitalized and undergone exploratory laparoscopy surgery that excluded organic causes. During observation the pain relieved with the injection of saline solution, and the adolescent was discharged from the ED and referred for psychiatric consultation at the outpatient clinic of the Child and Adolescent Psychiatry Department. Regarding the adolescent family history, her parents divorced when she was 11 years old and her father was living in another country for 7 years, maintaining an increasingly scarce contact with the patient. The girl had feelings of abandon regarding her father.

There is evidence that, as in this case, the families of children with recurrent abdominal pain are usually matrifocal, and virtual paternal deprivation may play a role in predisposing the onset of somatoform disorders. We also found a disturbed mother-father-child relationship with the establishment of an alliance between the mother and the adolescent, which was one of the interactions identified by Minuchin as being associated with somatization in children or adolescents.

Identifying the first presenting symptoms and determining the differences of the prodromal features of affective and non-affective psychosis were also important in discovering the psychotic break process [1].

43 adolescent patients (11 females, 32 males) who had been hospitalized within the first episode of psychosis were analyzed during a period of one year were analyzed for the first presenting symptoms. Prodromal symptoms were investigated retrospectively at the begining of the hospitalization. Mood disorders with psychotic features were included in affective psychosis (AP) group and the other psychotic disorders with unkown etiology were included in non-affective psychosis (NAP) group.

The most common first symptoms in descending order were dysphoric mood, sleep disturbance, ideas of reference for the AP group. In the NAP group, most common first symptoms were social withdrawal, dysphoric mood, ideas of reference. For the AP group; mean Duration of Untreated Psychosis (DUP) was 1,9 ± 1,2 weeks, mean Duration of Untreated Illness (DUI) was 24,6 ± 37,3 weeks. For the NAP group; mean DUP was 9,8 ± 15,5 weeks, mean DUI was 47,3 ± 55,9 weeks.

Affective and non-affective psychotic disorders have differences for prodromal presentations which may be clues for definitive diagnosis.

Our recent publication demonstrated that antipsychotic drugs (APDs) can modulate expression of RhoGDI in C6 glial cell line. RhoGDI is a key regulator of Rho proteins initiated signaling pathway. Activated Rho proteins can regulate gene transcription, cell cycle progression, vesicular trafficking, stress intracellular filament production and cell morphology. The studies of which glial cells involve in schizophrenia are important to understand the pathogenesis of this disease and the therapeutic mechanisms of antipsychotic drugs.

We examine the expression of RhoA mediated proteins in RhoGDI pathway in APD (haloperidol, risperidone and clozapine) treated C6 cells. The same works were also performed in APD-treated B35 neuronal cell line.

We tried to investigate and compare the APD induced the protein expression in APD-treated glial and neuronal cells.

Whole cell protein extracts from APD-treated cells were analyzed by Western Blot.

In C6 cells, RhoA expression could be increased by all three APDs. Both c-jun and p-JNK expressions were regulated by haloperidol and clozapine. Haloperidol and clozapine also decreased ROCK1 and MLC2 expressions. ARP2/3 expression was dramatically inhibited by all tree APDs. Only haloperidol inhibited PAK1 expression. N-WASP expression was not affected by any of the three APDs. In B35 cells, regulation of cjun and JNK expression were observed in risperidone- and clozapine-treated B35. Haloperidol increased ROCK and MLC2 expressions. Clozapine dramatically inhibit ARP2/3 expression. N-WASP expression was regulated by haloperidol and clozapine.

APDs induced protein expression regulations are similar but somewhat different in glial and neuronal cells.

We investigated clinical and sociodemografic features of mentally ill homicidal offenders without criminal responsibility to find out the predictors of homicidal criminal acts(1).

160 of the 197 cases, we could be able to contact and who were released from the forensic psychiatry clinic of the Bakirkoy Training and Research Hospital for Psychiatric and Neurological Diseases after mandatory inpatient treatment in 2006 were investigated with the treatment history for five years after release. 48 of the 160 cases, who were qualified for insanity defense had committed a homicidal crime. Sociodemgraphic variables and variables associated with disease are documented.

All of the homicidal offenders were male, they were more likely to be single or divorced, unemployed, were living in metropolitan areas and 83,3 % had a diagnosis of psychotic disorder, 14.6 % had a diagnosis of mood disorder. They usually had a legal guardian and had social insurance. Almost none of them had a history of regular psychiatric treatment before the criminal act.

At the homicidal offenders group, schizophrenia and other psychotic disorders were more prevelant, comorbidity was rare.

To define treatment adherence and criminal history before and after the mandatory treatment of homicidal patients and_correlation of these variables with the severity of the criminal act.

160 of the 197 cases, we could be able to contact and who were released from the forensic psychiatry clinic of the Bakirkoy Training and Research Hospital for Psychiatric and Neurological Diseases after mandatory inpatient treatment in 2006 were investigated for treatment adherence and criminal history for five years after release. Criminal Violence Rating Scale is used.

30% of the 48 patients who committed homicidal acts, had criminal history prior to the mandatory treatment and these were usually severe violent criminal offenses targeting directly at the victim's life and 14,5 % of them committed more than a criminal act before the homicidal act. After the mandatory inpatient treatment, the homicidal offenders were more likely to be kept in the mandatory outpatient treatment programme in comparison to the non-homicidal patients (87,6 % and 64,3 % respectively). 41,7 % of the homicidal offenders had been rehospitalized. Mean duration of mandatory treatment was 510 days and 148 days for the homicidal and non-homicidal patients respectively.

The number of criminal offences and number of re-hospitalizations were not significantly different between the homicidal and nonhomicidal patient groups. As a consequence of risk reduction strategies the homicidal patients were internalized longer in terms of mandatory treatment and after the release, their control assessments were done at shorter intervals.

Patients with criminal history and without criminal responsibility under compulsory treatment at the forensic psychiatry unit of Bakirköy Research and Training Hospital for Psychiatric and Neurological Diseases are included in the study and the relationship of various parameters like sociodemographic and clinic features and forensic histories are compared with the duration of the hospitalization (1,2).

One-hundred five schizophrenic patients are included to the study. Patients were divided into three different groups according to the duration of hospitalization. Each group included 35 patients: 1. Group: 2–6 months, 2. Group: 1–3 years, 3. Group: more than 3 years of time. An Interview Form of the Unit Identifying Sociodemographic Properties, Disease and Criminal Characteristics of the Patients, Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Three Components of Insight, Calgary Depression Scale for Schizophrenia and the Perceived Social Support Scale of the Family were applied.

Our data indicated that to be convicted before, to be under compulsory treatment before, severity of the criminal act and the level of insight seem to associate with duration of hospitalization of schizophrenic subjects under compulsory treatment. Besides parameters like the age of onset of schizophrenia, being under guardianship and the frequency of visitors were statistically different among the groups.

Our data underlines the importance of the level of insight, which plays a crucial role at the length of hospitalization for patients with schizophrenia in forensic units.

Gender identity disorder is an emergent and important disorder which may lead to devastating consequences and comorbidities if proper treatment approaches are not used.

We planned showing the improvements in patients’ life in multilple domains after sex reassignment surgery (SRS).

In our research we focused on changes experienced by people who gained new gender identity with sex reassignment surgery.

We interviewed at least one year after the operation with 20 sex reassigned transsexuals (SR-T) who were once on SRS programme of Istanbul University Psychiatry Department Psychoneurosis and Psychotherapy Unit and who had confirmative rapports for surgery and we also interviewed with 50 non-sex reassigned transsexuals (NSR-T) who applied to the same unit for SRS programme.

Worries about gender discrimination and gender victimization were lower, but worries of being uncovered about transgender identity were higher in SR-T group. SR-T group scored lower on Family Assessment Device, 4th and 5th items of Arizona Sexual Life Scale and total points excluding the 3rd item (item for penile erection and vaginal lubrication), but scored higher on Multi Dimensional Scale for Perceived Social Support, Coopersmith Self Esteem Scale and psychological subscale of World Health Organization Quality of Life Scale-Brief Form.

The SRS used in the treatment of transsexuality releases the conflict and makes the transformation on official gender and is associated with improvements in quality of life, self esteem, family support, sexual life satisfaction and interpersonal reliationships and reduction in worries about gender discrimination and gender victimization.

To examine psychological distress and quality of life in patients with medically unexplained symptoms (MUS) compared to those with medically explained symptoms (MES) in a primary care setting in Karachi, Pakistan.

472 patients attending a GP clinic in Karachi completed questionnaires to assess somatic symptoms, anxiety, depression, and quality of life. The patients’ GP recorded whether the complaint was medically unexplained or medically explained.

Patients with MUS were more likely to be employed (p=0.01) educated to a higher level (p<0.001), have less difficulty meeting day-today need (p=0.05) and have a higher percentage of people showing concern and interest in what they are doing (p<0.001). In addition, they have fewer problems with mobility (p=0.001), with usual activities (p=0.05), with pain/discomfort (p=0.004) and with anxiety/depression (p<0.001). They have a smaller number of family members (p=0.05), a higher income (p=0.019), a lower level of depression (p=0.05) and a lower number of life events (p<0.001). In terms of significant independent risk factors for medically unexplained symptoms, there were three such risk factors, the number of life events (OR 0.88, p<0.001), problems with anxiety/depression as measured on the EQ-5D (OR 0.53, p=0.003) and the amount of concern shown by people (OR 1.82, p=0.006).

Compared to people with MES, those with MUS had experienced less psychological distress and better health-related quality of life. Furthermore, those with MES had higher scores on the life events checklist and were more likely to come from larger families, be illiterate, unemployed and to have financial problems.

Among minority patients with depression, enrollment in CCM and higher baseline PHQ-9 score independently predict remission. CCM effectively achieved and sustained remission compared to usual care. Adaptation of this model across various population groups should be considered.

Certain baseline characteristics are significantly different between minority and non-minority patients with depression; however, both groups achieved effective remission under CCM. The odd of 6 month remission, although lower among minority patients, is not statistically significant.

To assess cerebrospinal fluid (CSF) β-site amyloid precursor protein (APP)-cleaving enzyme 1 (BACE1) activity in relation to Alzheimer's disease (AD) and to correlate the enzyme activity with protein markers of APP metabolism and axonal degeneration.

BACE1 activity and protein concentrations were measured and analysed in 342 participants of the AD Neuroimaging Initiative, including 99 normal controls, 75 stable mild cognitive impairment (MCI), 87 progressive MCI and 79 AD dementia cases. All statistical analyses were Bonferroni corrected for multiple comparisons.

No significant differences between controls and any of the three patient groups were detected for BACE1 activity and soluble APP (sAPP)β concentrations in CSF. Significant correlations with BACE1 activity were found for CSF APPβ and total tau in all four groups; and for CSF phosphorylated tau181 in all groups but the progressive MCI group. There were no correlations for CSF amyloid β (Aβ)1–42 nor for plasma Aβ1–42 and Aβ1–40.

The consistent correlation between BACE1 activity and sAPPβ supports their role as biomarkers of target engagement in clinical trials on BACE1 inhibition.

To analyze the manifestations of adjustment to aging (AtA) and subjective age (SA) identified by older adults and to investigate the latent constructs that can work as major manifestations in AtA and SA in an older Portuguese and Romanian population.

Measures were completed, using a variety of culturally appropriate methods, including demographics and interviews. Complete data were available for 64 older adults aged between 72–99 years (M=80.1; SD = 5.8). Data was subjected to content analysis. Representation of the associations and latent constructs were analyzed by a Multiple Correspondence Analysis (MCA).

The most prevalent response of the interviewed participants for AtA was’Accomplishment, personal fulfillment, and future projects’ (24.1%).’With apprehension’ (33.3%) was identified as the most frequent SA response. Findings showed a model for each nationality. AtA and SA for Portuguese elderly were explained by a three-factor model:’conciliated’,’young-at-heart’ and’involved’. A three-dimension model formed by’satisfied’,’attentive’ and’concerned’ was indicated as a best-fit solution for Romanian elderly.

AtA and SA are strongly explained by increased likelihood of specific constructs in its definition. AtA was differently related to SA in older adults in both samples.

This study aims at exploring a structural model of satisfaction with life's (SWL) predictors in a cross-national sample of older adults.

A community-dwelling sample of 1,234 older adults was assessed regarding SWL, sense of coherence (SOC) and socio-demographic, lifestyle and health-related characteristics. Structural equation modeling was used to investigate a structural model of the self-reported SWL, comprising SOC, socio-demographic characteristics (age, sex, education, marital and professional status, household, adult children, income, living setting and religion), lifestyle and health-related characteristics (physical activity, recent disease and medication).

Significant predictors are SOC (β = .733; p < .001), religion (β = .725; p < .001), income (β = .551; p < .001), adult children (β = .546; p < .001), education (β = −.403; p < .001), living setting (β = −.292; p < .001) and medication (β = −. 197; p < .001). The variables accounted for 24.8% of the variability of SWL. Moreover, differences between the four nationality groups (F(3, 671) = 3.671, p = .066) were not found concerning SWL.

Sense of coherence is the strongest predictor of self-reported SWL. Other predictors are religion, income, adult children, education, living setting and medication. The four nationalities did not present significant differences, concerning SWL. This study highlights the factors that influence older adults’ SWL, namely, SOC, religion and income, as promoters of aging well, within a salutogenic model of health for older populations.

This research aims to explore a causal model of subjective well-being predictors in a cross-cultural older population.

Measures were completed using a variety of culturally appropriate methods, including mail-outs, self-administration and interviews. For the purposes of this study, the Positive and Negative Affect Schedule (PANAS), the Satisfaction with Life Scale (SwLS), the Adjustment to Aging Scale (ATAS) one measure of cognitive functioning - the Mini-Mental State Examination (MMSE) and demographics, were included. All variables had fewer than 1% missing values and complete data were available for 709 older adults (M = 82.4, SD = 6.45, (range 74–102)) from eight different nationalities. Structural equation modeling was used. Controlling for age, gender and country of origin, we assessed the level of subjective well-being of elderly people, and its predictors.

Subjective well-being is predicted, not only by age progression, but also by adjustment to aging, among other variables. Age was significantly associated with cognitive impairment (β = .387; p = .003) and perception of health (β =− .172; p = .004). All estimates were statistically significant (p<.01).

Subjective well-being appears to be a catalyst to attitudinal markers of maturity and internal development, across cultures. This study highlights the predictors of subjective well-being in older age, warranting further study across cultures among frailer populations over time. Recommendations for future research on older adults’ well-being measures and clinical practice are also presented.

This research aims to explore a structural model of sense of coherence’ predictors in a cross-cultural older population.

Measures were completed using a variety of culturally appropriate methods, including mail-outs, self-administration and interviews. For the purposes of this study, the Sense of Coherence Scale, the Adjustment to Aging Scale, one measure of cognitive functioning - the Mini-Mental State Examination (MMSE) and demographics, were included. All variables prompted fewer than 1% missing values and complete data were available for 709 older adults (M = 82.4, SD = 6.45, (range 74–102)) from eight different nationalities. Structural equation modeling was used. Controlling for age, gender and country of origin, we assessed the level of sense of coherence of elderly people, and its predictors.

Sense of coherence is predicted, not only by self-reported spirituality, but also by adjustment to aging, among other variables. Sense of coherence was significantly associated with age progression (β = .426; p = .001) and perception of health (β =− .381; p = .001). All estimates were statistically significant (p<.01).

Specifically in late adulthood, changes may affect older adults’ worldview and thus their SOC. The older individual with a strong SOC has a greater ability to mobilize and exploit potential resources. In brief, this study stresses the predictors of sense of coherence in older age. Recommendations for future research on older adults’ sense of coherence and clinical practice are also presented.

The aim of this study was to build a structural model to explore the predictors of adjustment to aging (AtA) in a community-dwelling older population.

A community-dwelling sample of 1270 older adults aged between 75 and 102 years answered a questionnaire to determine socio-demographic (sex, age, professional and marital status, education, household, adult children, family‘s annual income, living setting and self-reported spirituality), lifestyle and health-related characteristics (perceived health, recent disease, medication and leisure). Several instruments were used to assert psychological variables, namely AtA, sense of coherence and subjective well-being. Structural equation modeling was used to explore a structural model of the self-reported AtA, encompassing all variables.

Significant predictors are self-reported spirituality (β = .816; p < .001), perceived health (β = .455; p < .001), leisure (β = .322; p < .001), professional status (β = .283; p < .001), income (β = .230; p = .035), household (β = −.208; p = .007), sense of coherence (β = −.202; p = .004) and adult children (β = .164; p = .011). The variables explain respectively 60.6% of the variability of AtA.

Self-reported spirituality is the strongest predictor of AtA. This study emphasizes the need for deepening the variables that influence older adults’ AtA, in particular perceived health and further lifestyle-related characteristics, as being relevant for promoting aging well in later life, within a salutogenic context for health care.

A recent national survey highlighted the considerable treatment gap for depression (59.6%) in modern Singapore. Asians tend to focus on physical features of a disease than the psychological ones, which might contribute to the relative lack of disease pick up by physicians. Literature suggests a distinct clinical entity of depression among the elderly, with a different clinical presentation from adults.

This retrospective case series was undertaken to understand the clinical features and management decisions of elderly patients presenting with depression in Singapore.

To describe the demographics, clinical presentation, psychiatric and medical co-morbidities, and management decisions of depression in the elderly.

Inter-departmental referrals to the Department of Psychological Medicine of Tan Tock Seng Hospital from 1/1/2011 to 31/3/2011 for the management of patients ages above 64 with the diagnosis of depression were collated for case description.

A total of 40 inpatients ages 64 to 101 years (mean 75.7 years) were recruited. 15 (37.5%) were male and 25 (62.5%) were female. 22 (55.0%) have an existing diagnosis of depression. 28 (70.0%) of the patients were referred for review of symptoms of depression. The most prevalent symptoms were low mood (67.5%), followed by biological symptoms of depression (47.5%), and suicidal thoughts (37.5%). 23 (57.5%) of the patients were started on Selective Serotonin Receptor Inhibitors.

As the population of Singapore ages, clinicians should be mindful that depression often co-exist with medical co-morbidities, and the complex interaction amongst the two entities.