Most eldery patients with dementia are cared for at their home by family members, usually elderly spouses.

Important mission at associations for help at dementia is to facilitate public access to the most credible and up-to-date information on home caring of patients with dementia.

To determine how much Slovenian community health workers and other adults know about home caring of patients with dementia.

Hundered and twenty adult Slovenian e-mail users participated in a survey using a questionnaire consisting of 12 questions regarding dementia during May and August 2009. Questionaires were filled-out by 60 community health workers (mean age = 40.00, SD = 11.77, range 22–67), and 60 other adults (mean age = 44.27, SD = 16.20, range 23–83; t = 1.651; p > 0.05).

Community health workers were more knowledgeable and the other adults were the least knowledgeable on the subject of home caring of patients with dementia (3.03 v. 2.18, p < 0.01). Differences in responses between community health workers in other adults are shown in order of significance:

1. (a) finding help and professional support (49.6% v. 35.6%);

2. (b) setting a positive mood of interaction (28.8% v. 33.9%); and

3. (c) responding with affection and reassurance (7.2% v. 11.6%).

Findings suggest that there appeared to be gaps in knowledge in dementia among the community health workers and general public. As care of eldery patients with dementia shifts into their home, education is needed to increase the public awareness of dementia.

Some areas of the brain, such as basal ganglia and dorsolateral prefrontal cortex, related to a saccadic control are also involved in the pathogenesis of ADHD. Therefore, examination of problems of eye movements may constitute an effective neurophysiological objective diagnosis of ADHD.

The aim of this study is to assess the differences in fast eye movements (saccades) between ADHD individuals and healthy subjects. the study analyzed the following saccadic parameters: latency, duration, amplitude, average velocity, peak velocity, sharpness, and skewness.

Based on the results of psychological tests: TOVA and CAARS-S:L group of 50 people who had the highest score in the ADHD scales was distinguished. in this study we made use of a Saccadometer.

ADHD individuals compared to healthy subjects have more intrusive saccades, anticipatory saccades, and saccades with short latency (< 100 ms) and long latency (> 500 ms). in people with ADHD of low and moderate severity of symptoms duration is shorter and velocity is higher than in healthy subjects, whereas in ADHD individuals with a strong and very strong severity of symptoms duration is longer and velocity is lower compared to healthy subjects. in ADHD individuals amplitude accuracy match in a prosaccades task is better than in healthy subjects, and an antisaccades task is worse than healthy subjects.

The results indicate that the differences are varied due to the severity of the symptoms of ADHD. the statistical significance shows that the use of saccadometry for selected parameters of eye movements may improve diagnosis of ADHD.

Persistent impairment in cognitive function has been described in euthymic individuals with bipolar disorder. Collective work indicates that obesity is associated with reduced cognitive function in otherwise healthy individuals. This sub-group post-hoc analysis preliminarily explores and examines the association between overweight/obesity and cognitive function in euthymic individuals with bipolar disorder.

Euthymic adults with DSM-IV-TR-defined bipolar I or II disorder were enrolled. Subjects included in this post-hoc analysis (n = 67) were divided into two groups (normal weight, body mass index [BMI] of 18.5–24.9kg/m2; overweight/obese, BMI≥25.0kg/m2). Demographic and clinical information were obtained at screening. At baseline, study participants completed a comprehensive cognitive battery to assess premorbid IQ, verbal learning and memory, attention and psychomotor processing speed, executive function, general intellectual abilities, recollection and habit memory, as well as self-perceptions of cognitive failures.

BMI was negatively correlated with attention and psychomotor processing speed as measured by the Digit Symbol Substitution Test (P<0.01). Overweight and obese bipolar individuals had a significantly lower score on the Verbal Fluency Test when compared to normal weight subjects (P<0.05). For all other measures of cognitive function, non-significant trends suggesting a negative association with BMI were observed, with the exception of measures of executive function (i.e. Trail Making Test B) and recollection memory (i.e. process-dissociation task).

Notwithstanding the post-hoc methodology and relatively small sample size, the results of this study suggest a possible negative effect of overweight/obesity on cognitive function in euthymic individuals with bipolar disorder. Taken together, these data provide the impetus for more rigorous evaluation of the mediational role of overweight/obesity (and other medical co-morbidity) on cognitive function in psychiatric populations.

To explore tolerability, safety and treatment response of flexibly dosed paliperidone palmitate (PP) in adult non-acute schizophrenia patients previously unsuccessfully treated with oral antipsychotic monotherapy of risperidone (RIS), paliperidone ER (Pali ER), olanzapine (OLA), quetiapine (QUE) or aripiprazole (ARI).

International, prospective 6-month open-label study. Outcomes were response (≥20% improvement in Positive and Negative Syndrome Scale (PANSS) total score at endpoint), patient functioning (Personal and Social Performance scale (PSP)), treatment-emergent adverse events (TEAEs) and Extrapyramidal Symptom Rating Scale (ESRS).

Intent-to-treat population: n=191 (RIS), n=104 (Pali ER), n=87 (OLA), n=46 (ARI), n=44 (QUE). Patients presented some differences in baseline demographics, e.g. in age, years since diagnosis and BMI. Baseline mean PANSS total scores ranged from 74.7±14.9 (ARI) to 70.8±13.1 (QUE) and 70.8±15.1 (RIS). Between 67.4% (ARI) and 83.2% (RIS) of patients completed the study. At endpoint, 74% (RIS), 58% (Pali ER), 61% (OLA), 66% (QUE) and 52% (ARI) of patients had improved ≥20% in PANSS total score. Mean PSP improvement at endpoint was: 10.4±13.8 (RIS), 7.0±13.8 (Pali ER), 4.5±15.9 (OLA), 7.9±12.4 (QUE) and 3.9±13.2 (ARI); all p<0.05. TEAEs reported at least once in all subgroups were injection site pain, insomnia and psychotic disorder. Mean change in ESRS from baseline to endpoint was -1.2±3.5 (RIS), - 0.7±4.1 (Pali ER), -1.3±4.4 (OLA), -0.3±3.2 (QUE) and -0.6±3.4 (ARI; p<0.05 for all except QUE).

PP was well tolerated and associated with clinically relevant treatment response in patients previously unsuccessfully treated with oral atypical antipsychotic monotherapy, regardless of the medication that was switched.

Determinants of suicidal ideation in females and males may differ in older adults.

To ascertain gender specific determinants of suicidal ideation.

Data used in this study was from the ESA survey on a large representative sample of community dwelling older adults (n=2494). Multivariate logistic regression analysis was used to study the association between suicidal ideation, mental health service and antidepressant use and a number of clinical and socio-demographic factors.

The prevalence of suicidal ideation reached 6.3%. The findings of this study show that the presence of suicidal ideation in females is associated with younger age, single or widowed status, the reporting of daily life stressors and chronic conditions as well as the presence of depression. In males, suicidal ideation is associated with older age, single or widowed status and depression. Furthermore, suicidal ideation is significantly associated with antidepressant use in females but not males and this after controlling for a number of clinical factors.

Although no gender differences are observed between suicidal ideation and mental health service use, females with suicidal ideation are more likely to be dispensed antidepressants than males with suicidal ideation. The more prevalent use of antidepressants in females with suicidal ideation may lead to better management of symptoms related to depression and their consequences at an earlier stage of the disorder.

Normally described in settings of neurologic injury, pseudobulbar affect (PBA) is characterized by uncontrollable outbursts of laughing, crying, or both, that are unrelated to, or disproportionate to the subjective emotions felt by the patient. We describe here, a unique case of PBA occurring in the context of chemotherapy use.

To introduce awareness of this possible complication with the use of chemotherapy, and to consider PBA as a differential in the setting of consultation liaison psychiatry.

We describe a 52 year-old Chinese lady, without significant past psychiatric history, who was admitted to our hospital for the initiation of a course of chemotherapy in the treatment of recurrent breast carcinoma. She was referred to the Consultation Liaison Psychiatry team, presenting with episodic emotional lability. the symptoms were observed to last 6 days at the most, and always occurring on the second day post-chemotherapy. the affective dysregulation was out of proportion to her actual reported mood. We will discuss briefly about PBA and review the relevant literature.

After a short regime of benzodiazepines and reassurances given, she completed her planned course of 6 cycles of chemotherapy.

Pseudobulbar affect is known to occur in a variety of diseases of the central nervous system such as multiple sclerosis, cerebral vascular disease, as well as brain tumours. This case illustrates that medications could also cause PBA, albeit a transient course. We advocate further studies to investigate the pharmacodynamics which may be a clue to the mechanisms mediating this difficult condition.

Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder of childhood characterized by inattention, impulsivity and hyperactivity. This condition affects 3% to 5% of school-aged children in the general population. It currently has a major problem about its social and especially school impact. It raises the question of his prognosis and his functional impact in adulthood.

The aim of ours works in to determine the different evolutionary terms to adulthood of hyperactivity attention deficit disorder.

Our study is a cross-sectional epidemiological survey of descriptive type covering all medical records of patients with a history of Attention Deficit / Hyperactivity Disorder (ADHD) in childhood.

We found 80 patients who had an Attention Deficit / Hyperactivity Disorder (ADHD) in childhood.

In 89.7% of cases were men, the average age at the first consultation in adult psychiatry service was 26 years. They were unmarried in 33%. They had a high school education in 28.2%.

The reasons for consultation were in 52% of cases, addictive behaviors (tobacco, alcohol, cannabis).

The ongoing medical monitoring was in 43.8%, irregular.

Patients suffering from ADHD, should benefit of collaboration between child psychologist and psychiatrist for a proper management of trouble and prevent the negative consequences in adulthood.

Child and adolescent maltreatment is a severe problem which causes many psychological problems in them. of these problems, aggressive behavior is probably the best documented, and there are many studies that report higher prevalence of diverse types of aggressive behavior among adolescents who were maltreated.

To clarify the mechanisms through which exposure to violence leads to aggressive behavior in adolescents who were the victims of abuse and neglect.

To test whether cognitive schemas of justification of violence, expectations of maltreatment, and ideas of grandiosity act as mediators between exposure to violence and aggressive behavior.

A sample of 166 adolescents from child welfare and protection centers for victims of abuse and neglect completed measures of victimization and witnessing violence at home, schemas of justification of violence, mistrust, and grandiosity, proactive and reactive aggressive behavior, and depression.

Witnessing violence is more intensely associated with aggressive behavior than victimization, and that part of this association is mediated by schemas of justification of violence and grandiosity. Victimization, in contrast, was associated with less aggressive behavior and more depression, through the schema of mistrust. the results were somewhat different in the sample of girls because victimization in girls was associated with more aggressive behavior and, in general, exposure to violence was more intensely associated with aggressive behavior.

This study contributes to our understanding of the mechanisms through which transmission of violence takes place in maltreated adolescents. the contents of the schemas involved are themselves targets of intervention.

Brain tumors (BT) sometimes present with psychiatric symptoms, with or without neurological ones, and BT patients with psychiatric symptoms are sometimes mistakenly oriented towards psychiatric/psychological care. Case studies concluded that atypical psychiatric symptoms should lead to neurological investigation, but no description of such atypical symptoms has been provided.

The present study aims to quantify the prevalence and further describe psychiatric symptoms occurring before a BT diagnosis.

We aim to sensitize physicians to consider more systematically neurological options, and to provide them with a description of atypical pattern of psychiatric symptoms occurring in patients with BT.

Fifty patients with a first diagnosis of BT (21 males and 29 females, aged 25-81 years) completed an anamnestic interview, the Mini International Neuropsychiatric Interview, and the Beck Depression Inventory (BDI-II), in order to investigate and describe current and past psychiatric symptoms. A neuropsychological evaluation was also conducted.

Most patients (45/50) reported at least one psychiatric symptom during the months before the BT diagnosis. About half of them presented anxious or depressive symptoms according to the clinical interviews and the BDI-II. Interestingly, somatic symptoms of depression (tiredness, slower reactions, appetite changes…) were often reported, in contrast to cognitive ones (guilt, self-criticalness…). The influence of the BT characteristics and the neuropsychological profile will be discussed.

The results confirm the frequent occurrence of psychiatric symptoms before a BT diagnosis and provide a first description of these symptoms, as the basis of future recommendations for physicians.

Lurasidone has demonstrated efficacy for schizophrenia and bipolar depression in adults.

To identify a tolerated dose range of lurasidone for pediatric studies.

To characterize PK and tolerability profiles of lurasidone in a pediatric population.

Patients aged 6 to 17 years diagnosed with ADHD and conduct disorder/disruptive behavior disorder, bipolar disorder, schizophrenia, Tourette syndrome, or autism spectrum disorder were assigned to 1 of 5 open-label lurasidone dosing cohorts (20, 40, 80, 120, or 160 mg/d). If a dose level was tolerated, the next dose cohort was initiated. In the single-dose phase, blood was collected predose and for 48 hours postdose. In the multiple-dose phase, patients received once-daily lurasidone for 7 to 9 days; blood was collected before and for 24 hours after the final dose. Lurasidone PK parameters, including maximum serum concentration and area under the concentration-time curve, were calculated.

In 105 patients, the observed lurasidone PK were consistent with a PK model of adult exposure at steady state. The most common AEs were somnolence (42%), sedation (18%), and nausea (17%); incidence of AEs was generally dose-dependent across the 20-160 mg/d dose range. All 6- to 9-year-old patients experienced somnolence at 120 mg/d. Two serious AEs (parkinsonism, dystonia) were reported, both at 80 mg/d.

The PK and AE profiles of lurasidone in this heterogeneous pediatric population were consistent with data observed in adult populations. Based on this study, doses of lurasidone 20-80 mg/d are selected for evaluation in pediatric clinical trials.

Sunovion Pharmaceuticals Inc.

Worldwide, the Irish diaspora experience elevated psychiatric morbidity across generations, not accounted for through socioeconomic position. The present study assessed the contribution of intergenerational migration and settlementrelated adversity in accounting for adult mental health, in second generation Irish people.

Analysis of prospective data from a nationally representative birth cohort from Britain, comprising 17,000 babies born in a single week in 1958 and followed up to mid-life. Common mental disorders were assessed at age 44/ 45.

Relative to the rest of the cohort, second generation Irish children grew up in marked material and social disadvantage, which tracked into early adulthood. By mid-life, parity was reached between second generation Irish cohort members and the rest of the sample on most disadvantage indicators. At age 23 Irish cohort members were more likely to screen positive for common mental disorders (OR: 1.44; 95% CI: 1.06, 1.94). This had reduced slightly by mid-life (OR: 1.27; 95% CI: 0.96, 1.69). Adjustment for childhood and early adulthood adversity fully attenuated differences in adult mental health disadvantages.

Social and material disadvantage experienced in childhood continues to have long-range adverse effects on mental health at mid-life, in second generation Irish cohort members. This suggests important mechanisms over the lifecourse, which may have important policy implications in the settlement of migrant families.

According to various surveys, insomnia is found in 6–10% of the adults and more often when comorbid with a psychiatric disease.

To find out how many adults meet the ICSD-2 criteria for chronic insomnia and DSM-IV-TR ones for depressive, panic, anxiety disorder, somatoform or eating disorders, as well as alcohol abuse and adult ADHD.

To measure prevalence of chronic insomnia and common psychiatric disorders with validated screeners.

Adults, recruited via online adverts, were invited to fill in a battery of surveys consisting in the Romanian translations of the Sleep Disorders Questionnaire, Patient Health Questionnaire and Adult ADHD Self-Report Scale 1.1. Completion was online on Surveygizmo and analysis was performed with Excel 2007.

To date, one hundred sixty participants (114 females, 71%), aged 39 ± 13 were recruited. Chronic insomnia, somatoform disorder and alcohol abuse were suspected in 15% of the total respondents. Depressive symptomatology was found in up to 20%, anxiety and adult ADHD in 10%. Bulimia was likely in 3% (all women). Alcohol abuse was significantly more frequent among males (35% vs. 7%), while adult ADHD amongst females (10% vs. 6%). Moreover, except of chronic insomnia, bulimia and alcohol abuse, all of the screened disorders were more likely to be found in adults aged under 45. Adult ADHD, somatoform and depressive disorders were more likely to be comorbid with chronic insomnia in 20–40%.

With the exception of eating disorders, all of the screened conditions were rather likely to be found in this population.

Paraphrenia is a disorder similar to paranoid schizophrenia characterized by phantastic, paralogical and extraordinary imaginative delusions, with better-preserved affect and rapport and much less personality and cognitive deterioration. Most affected patients are women, with onset of symptoms in late adulthood. It was firstly systematically described by Kraepelin in 1913 in order to define a group of psychotic patients who exhibited characteristic symptoms of dementia praecox, but with minimal disturbances of emotion and volition, and marked delusions. Later, it was considered to be unfounded and the term paraphrenia was not included in the current DSM-IV-TR and ICD-10 diagnostic criteria. However, several authors suggest that the concept of paraphrenia has not lost its usefulness and it seems to be that some psychiatrists recognize the illness, but labelled it as atypical psychosis or delusional disorder for the lack of a better diagnostic category.

The aim of this poster is to underline the modernity of Kraepelin's paraphrenia concept, suggesting that it could be possible to define and recognize the illness if practitioners would be induced to use a viable diagnostic entity.

Herein we report a case of a 51-year-old woman who presented three years ago with a psychotic disorder whose clinical features resemble de classical description of paraphrenia.

Very few systematic studies on paraphrenia have been carried out in the past 70 years. Further research in this field is needed in order to recognize the viability of this diagnosis and provide patients a better care and therapeutic management.

Presentation of a case report.

This case is about a 32-year-old woman with a history of type 1 diabetes, coeliac disease, and hypothyroidism, followed since the age of 22 for a type 1 bipolar disorder. She was admitted in psychiatric care for psychomotor instability, irritability, logorrhea, aggressiveness, subtotal insomnia, and delirious ideas of greatness, all treatment having been stopped for about twenty days, with besides a diabetic ketoses and non-adherence to a gluten-free diet. We have retained the diagnosis of mania with mood-congruent psychotic features within a type 1 bipolar disorder. Psychiatric treatment was instituted, based on mood stabilizers and atypical antipsychotics, with an equilibration of diabetes, reinstitution of a gluten-free diet, and adjustment of the thyroid hormones therapy. This was followed, within 15 days, by a good stabilization of her condition, both psychiatrically and somatically.

It is well established that psychiatric disorders can exist in some autoimmune diseases. The imputability of the bipolar disorder to the autoimmune polyendocrinopathy remains possible. Further studies are necessary to elucidate the aetiopathological mechanisms.