Psychotraumatism can constitute for some people a real existential fracture, a real upheaval of the psychic organization.

Immediate psychological reactions can vary from one-off and temporary reactions to far more severe and sometimes enduring reactions.

We collected the case of a patient who was hospitalised in April 2015 for manic symptoms in the immediate aftermath of a terrorist attack, with a review of the literature.

This is Mr. A. F., aged 38, with a personal history of AVP and a shooting wound following a terrorist attack. He had presented a psychomotor instability and an exaltation of the mood in the immediate aftermath of an ambush.

Behavioural problems were identified by the psychiatric team during the group debriefing conducted at the HMPIT emergency room. During his hospitalisation, a chemotherapy based on thymoregulators, neuroleptics and anxiolytics was introduced.

The evolution was marked by a significant regression of the manic syndrome after ten days, and the installation of a post-traumatic stress condition (PTSD). At the end of eight months, the patient was able to resume his work with long-term thymoregulatory treatment, a ban on weapons and safety posts.

Manic episodes are rarely observed as an immediate post-traumatic reaction. Their occurrence does not prevent the subsequent installation of PTSD. Has psychic trauma revealed a latent psychosis? Is it a trauma-induced mood disorder?

The authors have not supplied their declaration of competing interest.

To study clinical features of PTSD and adjustment disorders in refugees from the zone ATO.

We have a complex psychopathological and psychodiagnostic research 156 refugees in volunteer center in Kharkiv.

Among the IDPs observed, 75.9% have violations of adaptation: long-term depressive reaction and predominant disturbance of other emotions. The men reactive alarm indicators (average – 37.7 ± 3.0), were higher than trait anxiety (average – 32.6 ± 2.9). On the contrary, women figures trait anxiety (average – 38.6 ± 2.9) were higher than reactive anxiety (average – 34.7 ± 3.0). Severity of depressive symptoms also slightly prevailed in women. The mean score on the Hamilton scale for men was 17.0 ± 2.3 points, women – 18.0 ± 2.3 points.

Test results on a scale of quality of life showed no significant differences between men and women. We have developed a medical and psychological support system to correct the neurotic disorders in refugees.

The majority of people who left the ATO zone have psycho-emotional disorders of different severity and require a further correction in the specialized medical institutions.

The authors have not supplied their declaration of competing interest.

Mental health professionals find it very challenging to provide counselling and therapy when confronted with disclosures of ritual, satanic and extreme abuse. Psychometric and muscle testing can facilitate diagnosis and healing in this context. Psychiatrists of renown such as David Hawkins and Colin Ross have embraced and written about energetic medicine in their practice.

The presentation explains how somatoform dissociations are tell-tale indications of abuse and neglect of early childhood trauma and how ‘Energetics’ therapy facilitates healing.

Delegates will learn to recognise somatoform dissociation symptoms, understand advances and limitations of psychometric assessment tools, appreciate energetics approaches as an adjunct to other intervention methods and gain an insight into the origins of complex trauma.

Two case studies are used to illustrate causes, impact, diagnosis and healing of complex trauma.

A set of psychometric assessments helped to unravel a chilling revictimisation crime series. ‘Twice Exceptional’ characteristics were very high IQ coupled with Dyslexia, very weak auditory memory and psychic capabilities. In another case that stemmed from extreme abuse of ancient, commercial and high-tech varieties muscle testing and energetics therapy lead to a remarkable recovery.

Psychometric and muscle testing can inform diagnosis, therapy and healing. Energetics can be used to bring about profound healing for those who have repressed severe trauma. This method has many advantages in that parts of it are easily learned, it is non-invasive, has no side effects, gives patients control over their reactions, eliminates triggers and offers healing.

The authors have not supplied their declaration of competing interest.

Single prolonged stress (SPS) is an animal model of post-traumatic stress disorder (PTSD). Until now, it has not been known how PTSD develops from the first exposure to traumatic events and neurochemical differences between acute/single stress and PTSD-triggering stress. The object of this study is to determine neurochemical changes in prefrontal cortex of rats using in vivo proton magnetic resonance spectroscopy (1H-MRS) at 9.4 T.

Male Sprague–Dawley rats (n = 11; mean body weight: 200–220 g) were used. The SPS was used in this study. Rats were restrained for 2 h and then immediately forced to swim for 20 min in water (20–24 C). After a 15 min recuperation period, rats were exposed to ether until anesthesia occurred. MRS was performed 30 min before SPS, 30 min after the stressors, 3 and 7 days after the stressors to investigate time-dependent changes on metabolites levels in the PFC. Acquisition of MRI/MRS was conducted at four time points using 9.4 T Agilent Scanner. Concentration of metabolites was quantified by LCModel. A one-way ANOVA test with Tukey's HSD post-hoc test was used for statistical analyses.

The SPS resulted in altered absolute metabolite concentrations for GABA [F(3.0) = 1.450, P = 0.035], glutamate [F(3.0) = 3.417, P = 0.026], glutathione [F(3.0) = 3.759, P = 0.018], NAA [F(3.0) = 3.919, P = 0.015], total choline [F(3.0) = 7.584, P = 0.000], total NAA [F(3.0) = 3.760, P = 0.018], total creatine [F(3.0) = 3.248, P = 0.032] and glutamine/glutamate [F(3.0) = 3.552, P = 0.023] among the four time points.

PTSD in human is associated with decreased neuronal activity in the PFC. In this study, SPS decreased glutamate (excitatory) and total choline (membrane turnover) on day 7.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Both trauma-focused cognitive behaviour therapy and antidepressant medication are regarded as the first line treatments for post-traumatic stress disorder (PTSD). However, little is known about sequential or combined efficacy of these two different treatment options. This prospective study examined the add-on efficacy of eye movement desensitization and reprocessing (EMDR) therapy among adult civilians with PTSD who continued to be symptomatic after antidepressant treatment.

Adult patients with PTSD at a specialized trauma clinic who received treatment doses of antidepressants for more than 12 weeks were recruited; definition of symptomatic PTSD was a total score > 40 on the Clinician-administered PTSD Scale (CAPS). The CAPS and the global improvement from Clinical Global Impression (CGI) were rated prior to EMDR, after termination and six months follow-up.

A total of 15 patients underwent an average of six sessions of EMDR and 7 (47%) of 15 no longer met the criteria for PTSD and 10 (67%) were given status of very much or much improved. The CAPS scores and significantly decreased after EMDR therapy (paired t = 7.38, df = 14, P < 0.0001).

These results indicate that EMDR or trauma-focused CBT can be successfully added to those who failed to improve after initial pharmacotherapy for PTSD. Further studies are needed to explore the best sequence or components of therapies in the treatment of PTSD.

The authors have not supplied their declaration of competing interest.

ICU diary is effective in aiding psychological recovery and reducing the incidence of new onset PTSD in patients three months after ICU discharge. The impact of ICU diaries on PTSD in relatives of critically ill patients in Australia has not been fully elucidated.

To determine the impact of ICU diaries on the incidence of PTSD, stress and family satisfaction in the relatives of critically ill patients.

One hundred and eight consecutive patients, staying > 48 hours in a tertiary ICU were identified. A survey using DASS-21, IES-R, and FS-ICU questionnaires was performed followed by a repeat survey 90 days post discharge from ICU. An IES-R score of > 33 was used to define PTSD. A FS-ICU score < 5 was used to define dissatisfaction.

Forty subjects refused to participate, eight were excluded, sixty family members were included for analysis on an intention to treat basis which included 36 completed diaries. Whilst there was no association between PTSD at 3-month follow-up and diary use (P-value = 0.9), there was an association with PTSD at baseline (P-value = 0.02) and unemployment (P-value = 0.0045). Medical patients had mean PTSD score 3.0 units greater than surgical (estimate = 3.0, 95% CI: 0.3, 5.7). Families who were dissatisfied (FS-ICU score of < 5) were not at more at risk of developing PTSD than families who were satisfied (P-value = 0.74).

ICU diaries did not impact on the incidence of stress, family satisfaction with care and PTSD in relatives of patients in this index population.

The author has not supplied his/her declaration of competing interest.

The long-term management of psychiatric wounded patients with prolonged disorders requires a rethinking of our practice of care.

The aim is to propose an integrative model of all valid therapies in the post-traumatic-stress disorder while taking care of comorbidities and ensuring patient support in the different administrative procedures that permit reconstruction. Repeated short-term hospitalizations can meet this objective by mobilizing resources, creating group dynamics, restoring a space of safety, allowing a rupture with the environment, preventing recurrence of crises, and by encouraging the histicization of trauma by the temporal sequences of intra/extra-hospitalisation repetition.

We propose, by means of a review of the literature, to discuss on a psychopathological level the interest and limits of this mode of care.

This work reveals the specific therapeutic effects of repeated programmed hospitalizations, which constitute a new modality of institutional psychotherapy.

Rethinking the place of hospitalisation in the management of psychiatric illnesses can be useful to all psychiatrists who follow patients with chronic and co-morbid disease.

The authors have not supplied their declaration of competing interest.

A trauma is an uncommon experience of violence in which the physical and psychological integrity of an individual or group has been threatened. Intentional violence in general and terrorist attacks in particular are a perfect example of this. It turns out that during the year 2015 Tunisia was shaken by a series of terrorist attacks as sudden as violent. What impact would these actions have on the profile of consultants at the Razi hospital?

A retrospective and descriptive study of the consultants between January 1, 2015 and December 31, 2015, while determining the socio-demographic, clinical and therapeutic profile of the consultants for the first time at the outpatient clinic of the Razi psychiatric hospital, and indicating the different changes during the month following each attack; Bardo 18 March, Sousse 26 June and Mohamed V 24 November.

Our study pointed to an increase in the number of consultants at the hospital (31%) and outpatient (128%) levels during the year 2015, without increasing the number of consultants New consultants. The new consultants are younger with a strengthening of the female predominance (56.8). In the months following the attacks from the same period of the previous year, we found that diagnoses of acute and post-traumatic stress disorders (151%) and (93%) increased in percentage.

The impact of terrorist attacks is harmful to people directly exposed but also to vulnerable people. It imposes the necessity of a preventive activity involving multidisciplinary interventions in order to develop the concept of resilience.

The authors have not supplied their declaration of competing interest.

Prolonged exposure (PE) is recognized in many guidelines as an effective, evidence based treatment for post-traumatic stress disorder (PTSD), with the active ingredients being in vivo and imaginal exposure. Despite this, patients and clinicians are often reluctant to engage in this form of treatment. Imaginal exposure can be perceived as too anxiety proving, leading to discomfort among both patient and clinician. In vivo exposure alone, however, has also been established as an effective treatment for anxiety disorders that can provide significant results in a rapid manner.

A 31-year-old female with no prior psychiatric history presented to treatment in an acute depressive episode following a motor vehicle accident two years prior. She also met criteria for PTSD. Her Beck Depression Inventory (BDI) and PTSD Checklist for DSM-5 (PCL–5) scores were 42 (severe depression) and 64, respectively. Due to constraints, a modified form of PE was initiated, with five in vivo exposure sessions conducted.

After five sessions of in vivo exposure, the patient's PCL–5 score decreased from 64 to 36 and her BDI score decreased from 42 to 13 (minimal depression).

This case report underscores the effectiveness of a modified form of PE, using in vivo exposure alone as a treatment for PTSD. This has significant implications in particular for patients or clinicians who are unable to initiate imaginal exposure (e.g., patient finding it too difficult to tolerate/refusing to engage, language barriers, etc.). In such situations, in vivo exposure appears to be an alternate, effective, short-term treatment option.

The authors have not supplied their declaration of competing interest.

Loss of a loved one is a distressing event that may result in grief characterized by emotional distress, longing of the dead, and dysfunctionality. Persistent complex bereavement disorder (PCBD) is differentiated by extended and damaging bereavement [1], which is being treated by some with EMDR [2]. In this study, the effects of an EMDR session on a patient with PCBD will be analyzed.

G.Ö. (45) is a married housewife who had been working, mother of a kid and a baby. She has lived with her family and her mother in a metropolitan city until her mother died a year ago, unexpectedly. Then, she quitted her job and they moved in a small city upon her husband's wish. The inpatient had complaints such as active suicidal thoughts, marital dissatisfaction and an ongoing deep sadness. EMDR therapy is applied on her grief and dysfunctional beliefs.

After one session of EMDR, her mood improved, her ruminations declined, she sought job, and became hopeful for the future. In our case, even one session of EMDR let remarkable improvements on PCBD. Indeed, as for other trauma-related issues, EMDR therapy can be utilized on PCBD.

The authors have not supplied their declaration of competing interest.

In traditional medicine curriculum, internship is the moment in which students experience medical practice more intensively. Attitudes can be considered predictors of behaviors and actions. Evaluate them contributes to improve medical graduation.

Evaluate medical internship attitudes, considering medical practice and associated factors in a Brazilian public university.

Cross-sectional study with 69 students, using a structured questionnaire and an attitude scale. Descriptive statistic was carried out, classification of the attitude tendency, group analysis (‘clusters’) and F statistic.

The average age was 25.1 and 56.5% were male. Students presented positive attitudes towards four from six aspects and negative attitudes toward death.

Results suggest the necessity of educational intervention, which follows the educational objectives.

The authors have not supplied their declaration of competing interest.

Parental schizophrenia will potentially cause dysfunction in mother-child relationships, and it will also cause difficulty in adapting to motherhood.

We aim to study the implications of the relationship between mothers with schizophrenia and their children. The psychosocial environment and the impact of dysfunctional relationship in social skills development may cause behavioral disorders in children and further development of severe mental illness taking into account genetic factors and biopsychosocial factors.

Non systematic literature review, through the Pubmed and Medline database, with time constraints.

The development of schizophrenia is related to genetic and environmental factors. Children of parents with schizophrenia are at increased risk of developing psychiatric disorder compared to the general population. It was found early behavioral disorders, starting between 5 and 8 years old and the difficulties in social interaction may arise at this age and remain until adulthood.

It is important to assess the level of acquisition of social skills in children and families when there is a direct relationship with schizophrenia. It may be important in the future, monitorize the development of these children, as well as be aware of the surrounding social and family environment, to identify and manage early in the presence of behavioral disorders and possible development of serious mental illness. An early intervention at the level of social deficits in children can be a preventive intervention of later schizophrenia development.

The authors have not supplied their declaration of competing interest.

Schizophrenia and other psychotic disorders usually emerge during adolescence and early adulthood deteriorating the lives of young people. As a result, a lot of early intervention services have been developed worldwide.

This study aims to investigate the status of early intervention services in Greece related to similar programs around the world.

The literature was accessed in order to investigate the status of clinical early intervention services throughout the world. In terms of Greece, a naturalistic research was added to the literature one, since there are not enough published data available.

Hundreds of early intervention programs exist in Australia, Europe, North America and Asia, designed to provide early and sustained care with less prescription not only soon after psychosis has been diagnosed but in a prodromal state as well, like the outreach and support in South London (OASIS) team. In Greece, four early intervention services have been established since 2007, without funding, and they still operate in a volunteer basis. Furthermore, the field about ultra-high risk subjects in Greece remains neglected.

The specialized services play an important role in the prevention and proper clinical management of the illness and its outcome with a positive impact on the economy. Greece needs to recognize the significance of this issue in order to enhance public health and welfare.

The authors have not supplied their declaration of competing interest.

Over the past few years, several teams have built programs to detect patient at clinical high-risk state for psychosis and to develop interventions at an early stage of psychiatric troubles. The aim of this study is to provide an overview of the functioning and the results obtained by the specialized program developed in Brest, France (CEVUP).

We retrospectively analyzed the medical records of patients addressed to the CEVUP between June 2010 and April 2014. Data were double collected by two different investigators and we tested the inter-raters reliability. We included 49 help-seeking patients, aged from 15 to 30 years old, addressed by psychiatrists and general practitioners. The initial evaluation included a clinical evaluation, CAARMS scale, Rorscharch test and neurocognitive tests. Subjects were classified in two groups: not at risk for developing psychosis (NA) or at risk for developing psychosis (AR).

The main results at initial evaluation showed that 16 (32.7%) patients were AR and 33 (67.3%) NA. Among AR patients, 8 (24%) developed psychosis in two years against 2 (12.5%) for NA patients. These patients have psychiatric comorbidities, essentially depression or anxiety. Secondarily, there are more disturbances of psychomotor and affective development in subjects AR: 14 (41.1%) against 7 (20.5%) in group NA.

The present study describes the procedures and the main results established by a specialized program for patient at high risk to develop psychosis. The characteristics of the sample remain consistent with descriptions of such populations worldwide.

The authors have not supplied their declaration of competing interest.

Social values of health and health care are considered as important factors of health behavior as well as sources of self-regulation in health and illness. However, emphasize on medicine, health and body that is widespread in mass media nowadays may increase hypochondriac-like beliefs and behavior as well as the risk for unexplained somatic symptoms in some individuals.

Analysis of mass media revealed four models of health care value: health as a depletable resource requiring conservation, health as fragile value requiring protection and control, health as a necessary source of success and happiness, health as requiring periodic restoration by alternative medicine.

Aim was to investigate the relationship between these models and beliefs about body, illness and treatment.

One hundred and thirteen adults without history of mental or severe somatic illnesses filled checklist of values of health care, Cognitive Attitudes about Body And Health Scale (Rief et al., 1998), Compliance-related Self-Efficacy Scale (Tkhostov and Rasskazova, 2012).

The models of health as a depletable resource and as fragile value are dominated in the sample. Agreement with these models of health care is, on the one hand, related to willingness to seek medical help and follow treatment, but, on the other hand, to an excessive attention to bodily sensations, somatosensory amplification, monitoring and catastrophization about bodily sensations.

Possible pathways linking “hypochondriac discourse” in the society in its various forms and cognitive beliefs typical for hypochondria and somatoform disorders will be discussed. Research supported by Russian Foundation for fundamental research, project 17-06-00849.

The authors have not supplied their declaration of competing interest.

Study of psychosocial risk factors in the formation of burnout syndrome.

Based on a questionnaire developed by WHO experts for the European model of “health management, environment and security in the workplace”, conducted surveys 246 health care workers. Individual attention was paid to health, physical activity and nutrition.

Survey conducted of the medical personnel showed high prevalence among them psychophysical, social and psychological, behavioral symptoms that allows to think of high probability of formation of a syndrome of professional burning out. Part of medical workers who have one complaint in each group of symptoms (psychophysiological, sociological-psychological, behavioral) – 18,7%. Part of HCW with two and more complaints in each group – 39% (Table 1). Prevalence of psychophysiological, sociological and psychological, behavioral symptoms among health care emergency workers is different (Table 2).

Table 1

Table 2

The authors have not supplied their declaration of competing interest.

Specific learning disorders as defined in the DSM-5 are frequently diagnosed among children – 4–9% for reading deficits – (DSM-5, 2013). As any deficit can contribute not only to a child's emotional distress, it can also result in academic failure or school abandonment. Therefore, prevention measures should be considered.

The present study's objective was to compare the influence of a set of primary prevention measures on children's performance in reading and writing and improve their reading and writing.

We aimed to prevent specific learning disorders–dyslexia and dysgraphia in children from the second to their third year in the educational system.

Only children from the second year of school were considered (grade I). Children with clear potential for developing specific learning disorders were included in the present study. Children with any other comorbidity were excluded from the data analysis. Four experimental groups were considered – one control and three interventional – 1. Control, 2. COPS method, 3. Meixner principles, and 4. COPS method combined with Meixner principles and considering improvement of reading images, image filling, graphical schema orientation and discrimination, spatial and temporal orientation, orientation of objects, fine motor skills, temporal sequences, attention for details, perception of differences.

Findings indicated that the use of the combined methods significantly improved children's performance in reading and writing. Though all interventional methods improved children's performance. Results comparison was computed.

Early prevention programs which that target both reading and writing can improve children's performance in reading and writing.

The authors have not supplied their declaration of competing interest.

Vitamin D has been shown to be crucial in the regulation of dopamine and its relationship to major depressive disorder.

A five-year pre-interventional study of 25 hydroxy vitamin D levels in patients with major depressive disorder found values ranging from 17 to 32 ng/mL.

COMT Val/Val genotype has been associated with a 20–40% more rapid breakdown of dopamine in the prefrontal cortex as compared to individuals with a Val/Met genotype.

This retrospective study gathered data concerning outcome measurements in patients who displayed a baseline 25-OH level < 30 mg/mL and initially treated with sublingual tablet form of 10,000 IU vitamin D3. These data were compared to post interventional depression outcome scores for patients switched to oral vitamin D3 drops at a dose of 10,000 IUs.

Scores on the MADRS 1–3 weeks following the vitamin D3 switch showed an improvement in mood with the lowering of scores on the MADRS.

Patients with a COMT genotype of Val/Val showed clinical improvement with a switch from oral D3 sublingual tablets to oral D3 drops. Further studies are needed to draw from conclusions. Pre- and post-25-OH vitamin D levels and other dopamine synthesis variables including serum ferritin would be useful as well as prospective double-blind placebo controlled trials. The future use of genotype-specific and supportive approaches deserves serious investigation.

The author has not supplied his/her declaration of competing interest.