It is increasingly recognised that brain structure and function show experience dependent modification throughout our lifespan. The current presentation summarizes four lines of evidence regarding brain plasticity in bipolar Disorder.

We present data on brain plasticity changes in BD inferred from behavioural, cognitive and neuroimaging data.

(a) We defined the first empirically derived staging classification of BD based on two underlying dimensions, one for illness severity and another for cognitive function. We identified a good and poor functional outcome groups defined by the degree of impairment in inhibitory control, density of episodes and level of residual depressive symptoms; (b) We derived a cognitive typology of patients with BD which was robustly replicated in three independent patient samples. Patients could be classified in three groups with poor (20–30% of the samples), normal (50% of the samples) and higher (20–30%) cognitive performance across multiple domains, (c) We are developing diagnostic tools for the assessment of individual patients based on their structural and functional neuroimaging data. This work is still in development but our initial results suggest that we can achieve diagnostic accuracy of approximately 80%, (d) We have analysed longitudinal data from a sample of 2200 Dutch youth assessed at aged 11, 13,16 and 19 and we have mapped individual trajectories to disease expression in BD based on the CBCL-MS new scale for the identification of subclinical manic symptoms.

Our data demonstrate a range of approaches that can be used to examine brain plasticity in BD.

The clinical diagnosis of personality disorder in adolescence tends to be conservative and unspecific.

To examine the prevalence of personality disorder, and the involvement of stigma effect in adolescents with Axis I psychiatric disorders.

A sample of 100 patients with psychiatric disorders (M = 15.8, SD = 0.9 years, range 15-17, 70% women), were assessed and diagnosed for personality disorders in a mental health public centre.

The prevalence of PD identified by clinicians (12%), differs from the prevalence identified by the semi-structured interview (34–37%) showing a greater number (p < .001) of people affected. In the present sample most of the cases identified by clinicians are related to personality disorders (PD) not otherwise specified, while with the implementation of semi-structured interviews, most of the sample met criteria for Cluster B PDs. Additionally, 11% of the sample has dimensional pathological features (probable PD) without complying categorically the criteria for a full PD.

In clinical settings, a considerable proportion of adolescents with psychopathology meet features for PD, although few of them have a confirmed clinical diagnosis. Considerations about impact of the stigma are discussed.

To compare mental health at 5 years in children born extremely preterm and at term and assess associations between functional abilities and mental health within the preterm group.

In a national Norwegian cohort with gestational age (GA) 22–27 weeks or birthweight 500–999g mental health was assessed with The Strengths and Difficulties Questionnaire (SDQ), cognitive function with WPPSI-R, motor function with ABC movement test and severity of cerebral palsy (CP) with the Gross Motor Function Classification for CP (GMFCS).

Neurodevelopmental disabilities (NDD) were described as mild and moderate/severe. SDQ of the preterm children was compared with that of a non-selected reference group born at term. SDQ sub-scores ≥90th percentile were defined as a mental health problem and a total difficulty score ≥90th percentile (TDS90) as suggestive of psychiatric disorder.

Of 361 eligible preterm children parents completed SDQ for 255 (71 %). 28 (11 %) had TDS90 compared to 10 of 758 (1 %) of the reference group (OR: 8.4, 95% CI 4.0 to 17.0).

For the preterms the rate of TDS90 was higher for those with moderate/severe NDD (12/37 vs. 6/116, OR: 9. 3.0;26.0), but not for those with mild NDD (10/102 vs. 6/116) compared with those with no NDD. For preterms with no NDD TDS90 was more common than for the term reference group (6/116 vs. 10/758, OR:3.7, 1.3;10.0), and the most distinguishing features were emotional and peer problems.

Extreme prematurity is associated with increased risk of later mental health problems, particularly if they have other functional impairments.

Group psychoeducation is an effective psychotherapy in the treatment of addictive behaviours.

To evaluate the efficacy of group psychoeducation on quality of life in relatives of dual diagnosed patients.

To investigate the impact of group psychoeducation on treatment compliance.

A case-control study was conducted between January 2012 and July 2012. Case group: seventy relatives and 53 patients included into an 8 session systematic psychoeducational group designed as follows: 1.5 hours every 3 weeks. The control group was formed by 53 patients who did not participate in psychoeducation during the same period. To assess quality of life in relatives, we used the Health Status Questionnaire (SF-36). Attendance rates for appointments were recorded in patients from both groups.

At baseline, relatives had poor outcomes in quality of life (Vitality: 49.8; emotional role: 49.3; mental health: 51.8, and general health perception: 54.9). Psychoeducated, as compared to control group relatives, had significantly better outcomes in quality of life (Vitality 71.0; emotional role 82.6; mental health 72.6, and general health perception 66.5). When compared to the control group, mean psychiatric appointments were higher in patients whose relatives were psychoeducated (8.2 vs.3.6).

Our findings suggest that psychoeducation can improve quality of life in relatives of patients with addictive behaviours. Attendance rates for appointments were higher in patients whose relatives were psychoeducated.

When we attempt to scrutinize the phenomena relating affect and health, we need to consider the activation dimension of positive and negative affect (PA and NA). In this study, after developing a scale to assess affect, we examined the effects of activated and deactivated PA and NA on depression and short-term life satisfaction (LS).

Participants were 496 undergraduate and graduate students (240 men and 256 women). They completed three questionnaires for assessing affect, depression, and short-term LS, respectively. In order to test the validity of the Activated and Deactivated Affect Questionnaire (ADAQ) that was developed in this study, the other two questionnaires were administered.

In the ADAQ, four factors, activated and deactivated PA and NA, were identified alongside sufficient internal consistency and concurrent validity. Results from hierarchical regression analyses showed that depression was negatively associated with PA and positively with NA, while LS was positively associated with PA and negatively with NA. These associations were found regardless of the levels of affect activation. Moreover, a number of significant PA x NA interactions revealed: (1) activated PA was negatively associated with depression, but this association was stronger with higher activated NA; and (2) regarding the effects on LS, the positive association between activated PA (or deactivated PA) and activated NA (or deactivated NA) was stronger with lower activated (or deactivated) NA.

This study suggests that the activation level of affect and relations of PA and NA would be differently influential on health and adjustment.

The involvement of affective temperaments in the field of addiction and addictive conducts has been studied very little, despite the interest that this approach can have in the study and understanding of this disorder etiopathogeny.

We conducted a cross-sectional descriptive study of 60 Tunisian addicts who consulted the Tunisian Association for Information and Orientation on AIDS and CHEMS center during the period between 01 January and June 30, 2013. The dependence diagnosis was selected according to the DSM IV-TR criteria. We used the Tunisian validated version of the TEMPS-A for the evaluation of affective temperaments.

Our population was predominantly male in 96.7% of cases. The average age of our sample was 33.13 years old. The most frequent temperaments found in our population were hyperthymic temperament with an overall prevalence of 68.3% and a score of 12.78±4.4 and cyclothymic temperament with a prevalence of 58.3% and a score of 11.52±4.7. The essential reasons for substance abuse initiation were looking for novelty/thrills among the hyperthymic, the struggle against conflicts among those with depressive temperament, and anxiolysis in anxious addicts. We noted that alcohol and cannabis consumers had higher average scores in anxiety and cyclothymic temperaments. Heroin and cocaine consumers had higher scores in hyperthymic temperament. This temperament was significantly correlated with polydrug use (p = 0.005).

The study of affective temperaments is a necessary and critical step in the management, prognosis and prevention of substance abuse.

In this triple blind randomized controlled trial 100 menopause women with age 50–60, whom had been visited in clinics of Tehran University of Medical Sciences (Year 2012) and suffered from insomnia after signing informed consent completed demographic and Petersburg Sleep Quality Index Questionnaire (PSQI) Volunteer participants randomly divided to two group (A, B) and received capsules of 250 mg Lemon balm, or 50 mg Capsules of Starch as placebo in the same shape capsules, two times in a day for one month. PSQI were checked again after one month intervention. Descriptive and inferential statistics (T-Test, pair T-Test) were used. Study approved by ethics committee of Tehran University of Medical Sciences.

Most of the women were in the age 50–52 (62%). The results show 20% of participants in intervention group and 8% percent in placebo group showed improvement in the quality of sleep. There was significant difference between average of PSQI in Intervention and Placebo group (P< 0.05)

The results show lemon balm had higher effect on improvement of sleep quality than placebo. Referring to effect of Starch as placebo in some components of PSQI, it is suggested that to do another study by using Starch as intervention.

Psychosis represents a profound disorder in personality development and organization which results in changing or losing contact with reality, emotional and cognitive deprivation, changing or losing contact with objects (people or things), insufficient or biased investment in objects and activities, as well as perception, thought, attention, will, mobility and speech impediment.

Genetics’ part in the onset of a psychosis, since the grandmother of twins ill with psychosis also had Schizophrenia.

A display of 15 year old, male twins, who showed psychotic symptoms, one after the other.

Presence of a psychotic disease in the family gave a biological possibility of its further occurrence, which indeed manifested in an early onset of psychosis in both twin grandsons of the ill subject. Patients were bizygotic twins, with lower intellectual capacities, lower Ego-potentials, and low levels of psycho-social maturity. Symptoms of depersonalization, cognitive and perceptive alterations, as well as intense fear, social withdrawal, loss of interest, and alienation from the outside world were observed.

Monitoring of body weight, psychiatric state, hormonal status, brain NMR after admission and six month after weight regaining is showing recovery of physical and psychical state of patient, which didn't mean total recovery.

Health-Related Quality of Life has been considered suitable for outcome measurements in chronic illnesses.

Feasibility of collecting routinely data on health gains during treatment was assessed during a outpatient service development project in Satakunta hospital district. Finland. Patients contacting the outpatient services for the first time were asked to fill in scales during their first visit. The sacles were sent by mail three months, one year and two years after the first visit. The instruments used were AUDIT-5, BDI-21 and 15D. 15D is a scale developed for purposes of estimating QALY’s in health economic research. It has been widely used in Finland in general population and patient populations including psychiatric patients. Previous studies have defined a population standard (0.9402 out of a score of 1) for 15D assessments and a universal cut-point (change of 0.03) for clinically significant change.

The use of routine-based outcome measurement has been well feasible in outpatient care. So far 949 patients have undergone the first measurement point, 590 the second assessment point and 312 the third assessment point. The data collection is still on-going and numbers of responses at later intervals are likely to increase. At the first assessment the mean 15D score was 0.7616, at three months 0.7857 and at one year 0.7995. Scores increased especially concerning anxiety and depression, but considerably less regarding sleep.

Routine measurement of health gains is feasible within the context of public psychiatric services. Measurement implied also need for development of insomnia treatment.

Schizophrenia is a major mental disorder without a clearly identified pathophysiology. The association between this disease and the antiphospholipid syndrome (APLS) has been recently reported.

The objective of this study was to determine the frequency of anti-cardiolipin antibodies (aCL) and / or anti-β2 glycoprotein I antibodies (aβ2GPI) in sera of patients with schizophrenia.

Our retrospective study was performed on 80 patients with schizophrenia newly admitted in closed wards of the department of Psychiatry. Eighty healthy blood donors with no history of autoimmune or mental diseases served as controls. Search for aCL and aβ2GPI antibodies were detected by ELISA.

The aCL antibodies are significantly more frequent in schizophrenic patients than in controls (21.25% vs 3.75%, p<10-3) and it is the aCL-IgM isotype witch is therefore most detected with a frequency of 16.25%. The seroprevalence of aβ2GPI was also significantly higher in patients than in controls (27.5% vs 1.25%; p=<0,005) and it is the aβ2GPI-IgA isotype witch is the most common (22.5% of schizophrenic patients). The prevalence of aCL antibodies was 21.25% vs 27.5% for aβ2GPI antibodies. The frequency of aCL and / or aβ2GPI antibodies is 31.25%. Among this seropositive group, 3.75% had only aCL antibodies and 10% had only aβ2GPI antibodies.

Our study supports the hypothesis of the high prevalence of aCL antibodies and especially of the aCL-IgM isotype in schizophrenia patients. In this study we have shown a high seroprevalence of aβ2GPI antibodies which are specific ma

The most modern method of substitution treatment of opiate dependants with Buprenorphine/Naloxone (Suboxone) has been implemented in Department of Psychiatry in Tuzla from 27 July 2009. The treatment helps in discovering of hepatitis C infected intravenous users (IVUs), who are included in treatment of chronic hepatitis C (HCV) with Pegylated interferon-alpha-2a or Pegylated interferon-alpha-2b and the antiviral drug Ribavarin for a period of 24 or 48 weeks, depending on hepatitis C virus genotype.

To assess epidemiological characteristics of treated opiate dependant IVUs infected with HCV in outpatient administering of substitution medicament Suboxone in Bosnia-Herzegovina.

The study was carried out in northeast part of Bosnia and Herzegovina, in August 2009-October 2011. We assessed 112 (eleven females) opiate addicts aged 27.2 ± 4.9 years who were in medically assisted treatment with Suboxone. In the sample we found 29 (25.9) of 112, (four females) who were HCV infected.

There were 61 (54.5%) of 112 who were IVUs. HCV infected and non-infected opiate addicts did not differ regarding age, age of the first drug intake, age of the first IV use, level of retention in Suboxone treatment and daily dose of Suboxone (P > 0.05). HCV positive drug users significantly more often did intake heroin intravenously inside one month before Suboxone treatment (p < 0.001).

Medically assisted outpatient treatment of opiate dependence with Suboxone helps in discovering of HCV infected individuals and helps in recovery of both: opiate dependency and HCV infected with simultaneous treatment of chronic (HCV) with Pegylated interferon 2a/b with Ribavarin.

Long duration of untreated psychosis (DUP) has been associated to brain morphological changes in schizophrenia in cross sectional analyses. It is unclear DUP relates to brain volume change over time.

Our aim was to analyze the association between length of DUP and total brain volume change in schizophrenia in a general population based sample.

All members of the Northern Finland 1966 Birth Cohort (NFBC1966) known to have had psychotic illness were invited for a field study at the age 34-years (in average 10 year after onset of psychosis) and follow up nine years later at the age 43-years. DUP was assessed from medical records. The total brain volume scan interval change and the DUP information were available for 32 subjects with DSM III R schizophrenia. We analysed the correlation between length of DUP and the mean annual whole brain reduction, adjusted for age of illness onset and sex.

The mean annual whole brain volume reduction was 0.66%. The reduction was 0.76% among those with shortest DUP, 0.58% among those with median DUP, and 0.63% among those with longest DUP. There was no statistically significant correlation between DUP and annual brain volume change when adjusted for onset age and/or sex.

We did not find an association between long DUP and brain volume decrease in schizophrenia in 9 years follow up. Although long DUP has been associated with differences in brain volume in cross sectional analyses, the significance of DUP on brain morphology in long term is unclear.

Sleep apnea (SA) is a common chronic disease that leads to higher morbidity and mortality; however, illness perceptions (IP) in patients with SA remain not well explored.

We aimed to assess the IP in patients with SA and to correlate them with the level of sleepness, the severity of the disease and the existence of a concomitant depression.

Sixty four untreated patients investigated for sleep apnea (mean age: 54 years, sex ratio = 2/3) participated in our study.

Excessive daytime sleepness (EDS) was assessed by the ESS, the severity of the disease by the apnea/hypopnea index (AHI) and the depressive symptoms by the HADs. Illness representation was measured by the Brief Illness Perceptions Questionnaire (B-IPQ); High scores reveal a more threatening perception of the illness.

In terms of cognition, our patients feel quite bothered by their symptoms (7/10) and enable to control their illness (1.3/10), but they believe that their treatment will be effective (7/10). Emotionnally, they feel pretty concerned (6/10) and negatively affected by their disease (6.1/10).

We also observed that the score of the B-IPQ (6/10 ± 1.5) was positively correlated to EDS (p = 0.004), the severity of the disease (p = 0.02) and the coexistence of a depression (p = 0.005).

Several factors seem to have an impact on the vision of the sleep-apnea's patients towards their disease and their life as well. The study of the IP seems interesting to better understand the coping behaviour of such patients so that their adherence to the treatment would be improved.

Effective treatment of schizophrenia needs medication that is taken regularly for a long period of time. Antipsychotic non-adherence is considered to be the main reason for relapse and hospital readmission.

The objective of this study was to estimate the frequency of non-adherence with antipsychotic medication in schizophrenic outpatients and to identify socio-demographic and clinical factors that may influence this behavior.

According to the objectives, the aim of the study was to find factors that have a predictive role in regards to attitude towards antipsychotic medication.

This prospective 6-month follow-up study was conducted in Timisoara Mental Health Center, Romania and included 60 patients diagnosed with schizophrenia according to ICD-10 criteria. Clinical interview and the BPRS-A were applied at baseline. Patients were assessed monthly with BPRS-A and a shorter version of the ROMI scale (Rating of Medical Influences).

46.66% of patients were adherent to treatment and 53.34% were not. Elderly patients were more non-adherent to treatment (p = 0.04), as were single patients (p = 0.05). We obtained significant differences between groups considering the duration of the illness (p = 0.04) and the mean number of hospitalizations (p = 0.02), both being higher in the non-adherent patient group.

The main factors influencing adherence were: age, marital status and duration of the disorder. The most prevalent reasons for adherence were: the daily perceived benefit and relapse prevention. Prevalent reasons for non-adherence were: adverse effect of medication and the fact that medication is not currently needed.