Individual's personality profile is one of the major determinants of one's behavior. Thus, poor personality disposition of fathers and the child's perception of father have been reported to be powerful predictors of subsequent delinquency and criminal offences. The externalizers resemble the dimensions of conduct disorder as prescribed in diagnostic statistical manual IV. The essential feature is their repetitive behavioral pattern wherein the basic right of others or major age appropriate societal norms are violated.

This study finds out the relationship between the fathers’ personality-disposition, having male children with conduct disorder (CDC, n = 30, experimental group), dysthymic disorder (DDC, n = 30, control group), and normal (NC, n = 30, control group), by applying the new five factor inventory, and children's perception of their fathers on the parent–child relationship scale.

The children were matched on age, sex, socio-economic status and other relevant variables. The CD and DD were selected on the DSM-IV criteria for the diagnosis of conduct disorder and dysthymic disorder. The fathers of each group of children were administered the aforesaid questionnaires.

The CDF showed only significantly poor agreeableness compared to the NF. The CDC's perceived their fathers most negatively compared to the DDC and NC. The CDF's conscientiousness was significantly correlated to a number of variables of the children's perception of them as observed on the PCRS.

The CDF showed lower agreeableness than the NF. The CDC perceived their fathers most negatively, hence, setting the model for the child to observe and learn socially inappropriate behavior.

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

ECT outpatient program recently created in the Psychiatric Day Hospital in Ávila was designed to assess the safety and efficacy of continuation/maintenance electroconvulsive therapy (ECT) in patients after ECT remission.

Description of the activity and objectives of an ECT outpatient program in a Psychiatric Day Hospital.

Retrospective cross-sectional descriptive Study. The three patients who received the continuation/maintenance electroconvulsive therapy during the 10 months this unit has been opened were chosen as a sample.

From the opening of Psychiatric Day Hospital 10 months ago, 58 patients have been admitted; among them, three patients come to the hospital monthly to receive the electroconvulsive therapy, maintaining their psychopathological stability over time.

With the creation of this new program we considered three types of objectives:

– therapeutic: a therapy applied in a more comfortable and satisfactory for the patient and family regime. To prevent relapse and exacerbations;

– management: benefits on the best use of existing resources:

– reduction in hospital admissions and readmissions,

– decrease in the average stay,

– reduction in visits to Emergency Services,

– allow referrals from outpatient department,

– individual monitoring of patients that complements the check at their Mental Health Team;

– teaching, training and investigation.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Living creatures are shaped by the their experiences in a constant process of adaptation. These experiences accumulate and so their relative weight diminishes across the lifespan. In children, the relative weight of new experience is high, and children's developing brains are programmed to learn like in no other life phase. Early adversities can thus have a major impact on later mental and physical health outcomes. However, the nature of impact of exposure to adversities early in life on further development is less straightforward than it may seem at first sight.

In this presentation, I will address and illustrate a couple of issues that manifest the complexity of this association.

The data will come from TRAILS (Tracking Adolescents’ Individual Lives Survey), a longitudinal study on the development of mental health from preadolescence into young adulthood, with bi- or triennial assessments from age 11 onwards, for a period of over fifteen years.

Results from various analyses indicate that early adversities do not lead to unfavorable outcomes in every person, and that the consequences of early adversities depend on their timing.

The experiences that individuals encounter during development are incorporated in a continuous process of adaptation that shapes them and keeps on doing throughout life. Considering the complexity and individuality of these processes, it is inevitable that research findings are often heterogeneous, and effect sizes small.

The author has not supplied his declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Older adults with depression resist accepting depression screening and seeking treatment due to stigmatization of mental disorders and little knowledge about depression. This study was undertaken to develop and determine the psychometrics of an instrument for assessing triggers of suicidal ideation among older outpatients.

Participants were recruited from older outpatients of two hospitals in northern Taiwan. An initial 32-item Triggers of Suicidal Ideation Inventory (TSII) was developed, and its items were validated by experts in two runs of Delphi technique survey. After this TSII was pre-tested in 200 elderly outpatients, 12 items were retained. The 12-item TSII was examined by criterion validity, construct validity, internal consistency reliability, and test-retest reliability.

TSII scores were significantly and positively correlated with the Beck Scale for Suicide Ideation (r = 0.45, P < 0.01), and UCLA Loneliness scores (r = 0.55, P < 0.01), indicating satisfied criterion validity. Participants with depressive tendency tended to have higher TSII scores than participants with no depressive tendency (t = 8.62, P < 0.01), indicating good construct validity. Cronbach's α and the intraclass correlation coefficient for the TSII were 0.70 and 0.99 respectively, indicating acceptable internal consistency reliability and excellent test-retest reliability. Receiver operating characteristic analysis revealed that the area under the curve was 0.83, indicating excellent ability to detect triggers of suicidal ideation. With a cutoff point of 2, the sensitivity and specify were 0.86 and 0.67, respectively.

The TSII can be completed in 5 minutes and is perceived as easy to complete. Moreover, the inventory yielded highly acceptable parameters of validity and reliability.

The authors have not supplied their declaration of competing interest.

To analyze the experience of BOS in medical residents of Mexico City.

Qualitative design with a phenomenological approach. Semi-structured interviews were conducted. Participants were medical residents in training who agreed to participate. Data analysis was based meaning categorization and condensation, as well as some elements of discourse analysis.

We had interviews with residents of gynaecology, otorhinolaryngology, family medicine and psychiatry. We have found that there are some specific aspects that contribute to the development BOS:

– the hidden curriculum that has become evident through unnecessary punishments;

– various roles to be met simultaneously by residents;

– the basic needs like sleeping and eating right are not being met due to excessive workload.

– impact in general health.

It is necessary to make visible the complexity of the BOS and its impact on trainees to prevent deterioration in the quality of life and overall health status. It would be to achieve the satisfaction of basic needs as essential conditions for physical and mental well-being of all human beings, and more so for those whose task is to contribute to the health of others.

The authors have not supplied their declaration of competing interest.

Schizophrenia is a chronic, severe, and disabling mental disorder. An evaluation of clinical predictors to clozapine was described.

Identify clinical predicting factors to clozapine.

This is a cross-sectional study including patients diagnosed with schizophrenia or schizoaffective disorder according to the DSM 5 criteria and treated with clozapine.

Of the 33 patients, 78.8% were males and 69.7% of them were single. The mean age was 36 years old. The mean age at the onset of the disorder was 24 years old. The mean number of hospitalizations was 6. The beginning of the mental disorder was acute in 21.2% of the cases. The mean duration of the disease course before starting clozapine treatment was 11 years. The mean duration of treatment was 19 months. The diagnosis according to DSM 5 criteria was schizophrenia in 87.9 and schizoaffective disorder in 12.1% of cases. The outcome was assessed by PANSS and BPRS scales with a symptomatic remission in 63.63% of cases. The analytical study revealed a significant correlation between favorable evolution and the latest onset of the disorder (P = 0.04), the number of previous hospitalizations (P = 0.009), disorder's duration (P = 0.032), male sex (P = 0.0004) and secondary resistance (P < 10−3).

The evaluation of clinical factors is important in our practice in order to improve the response to clozapine. Otherwise, adherence to treatment and quality of insight are determining factors of the treatment response.

The authors have not supplied their declaration of competing interest.

Use of prescription psychostimulants and nootropics for non-medical purpose is a growing trend, especially in academic environment. Seeing the risks of neuroenhancement we decided to investigate situation in Lithuania.

Analyze the use of cognitive enhancers among medical students in Lithuania.

1. Determine the prevalence of cognitive enhancement. 2. Figure out what drugs are mostly used and reasons for the usage. 3. Evaluate the contributing factors.

A cross-sectional survey study was performed in Vilnius University and Lithuanian University of Health Sciences. Students were asked to fill anonymous paper questionnaires consisting of 13 items concerning prevalence of substance use to enhance cognitive performance, reasons, and correlates during lecture time.

Results are summarized in Table 1. A total of 8.1% of responders indicated that they had used cognitive enhancers. Nootropics were the most frequently mentioned: 59.6%, while psychostimulants were mentioned less frequently: 38.3% (including modafinil, methylphenidate and amphetamine derived drugs), and 23.4% indicated other substances. Improvement of concentration and increased studying time were predominant purposes (55.3% and 48.9% of users). Male students reported 3 times higher prevalence rates than females (14.6% vs. 5.1%, P < 0.05). Prevalence were also higher in students, who knew someone using these substances as compared to those who did not (17.3% vs. 5.1%, P < 0.05); it was the most associated factor with cognitive-enhancing drug taking behavior (Table 1).

In Lithuania, 1 of 12 medical students admits to having used neuroenhancing drugs. Nootropics were the most used drugs. Knowing user was the most important factor for usage.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

H&F Multidimensional Perfectionism Scale is a widely used measure of perfectionism developed to measure Self-oriented perfectionism (SOP), Socially-prescribed perfectionism (SPP) and Other-oriented perfectionism (OOP) dimensions. The original scale comprises 45-likert items. We have previously developed a short version of The H&F-MPS, with 13 items, showing adequate validity in a sample of university students, using principal component analyses method with factors varimax rotation.

To examine the factor structure of the H&F-MPS13 with confirmatory factor analysis (CFA), using a different sample of Portuguese university students.

The sample comprises 245 university students (68.9% females), with a mean age of 20.95 years (SD= 2.19; range= 17–33) who completed the H&F-MPS13. CFA was used to test the model suggested by prior exploratory factor analyses of H&F-MPS13.

After correlated errors, we obtained a good fit for the second-order factor (X2/d= 2.577; CFI= 0.928; GFI= 0.915, RMSEA= 0.080; P[rmsea ≤ 0.05] = 0.001). The H&F-MPS13 showed acceptable internal consistency (α= 0.77) and the three dimensions presented Cronbach's alphas ranging between acceptable and good (α OOP = 0.67; SPP = 0.73; SOP = 0.89).

The H&F-MPS13 obtained through CFA is a reliable and valid measure to assess perfectionism in Portuguese university students.

The authors have not supplied their declaration of competing interest.

To assess and compare the subjective rating of quality of life (QOL) in psychiatric patients who attended two psychiatric outpatient clinics in Baghdad city [Al-Rashad psychiatric teaching hospital and Baghdad teaching hospital]. In addition, it also aims at studying the effect of socio-demographic and clinical characteristics on the patients’ life qualities.

A sample of one hundred patients divided equally into two groups (fifty patient) from each hospital were interviewed and diagnosed in accordance with the DSM-IV diagnostic criteria, for the period (from the 1st of March to the 1st of September 2011). The Arabic modified version of WHOQOL-BREF questionnaire (modified by WHO) was applied on each patient.

Data gathered from completed hundred forms showed that 50% of patients from Baghdad teaching hospital responded and scored (fair, acceptable) to describe their satisfaction in overall QOL, while (38%) of patients from Al-Rashad teaching mental hospital scored (bad) and (16%) scored (very bad). There was no significant difference in the four domains of QOL between the two studied groups. The findings were discussed accordingly.

This study showed that although the overall satisfaction of the patients’ life quality was higher in patients from Baghdad teaching hospital than those of Al-Rashad teaching mental hospital, a non-significant difference in the four domains between the two hospitals was found. The socio-demographic and clinical characteristics were not significantly correlated to the QOL domains except for the educational level, which was significantly correlated, with the physical health domain in patients from Al-Rashad teaching mental hospital.

The author has not supplied his declaration of competing interest.

To examine 5 years trajectories of secondary-treated late-life major depressive disorder (MDD), and evaluate whether pre-existing cerebrovascular disease and related risk factors are associated with more severe trajectories of late-life MDD.

Data were obtained from Danish registers. The sample included 11,184 adults ≥ 60 at index MDD diagnosis. Trajectories of in or outpatient contact at psychiatric hospitals for MDD over the 5 years period following index MDD diagnosis were modeled using latent class growth analysis. Risk factors included cerebrovascular disease, cardiovascular disease, hypertension, diabetes, and vascular dementia defined based on hospital diagnoses and prescription medications, demographic characteristics and characteristics of the index MDD diagnosis.

The final model included classes with consistently low (66%), high decreasing (19%), consistently high (9%) and moderate fluctuating (6%) probabilities of contact at a psychiatric hospital for MDD during the 5 year period following the index MDD diagnosis (Fig. 1). Older age, greater severity, inpatient treatment and > 12 antidepressant prescriptions within 5 years of the index MDD diagnosis predicted membership in more severe trajectory classes. Cerebrovascular disease and related risk factors were not associated with trajectory class membership.

A substantial proportion (34%) of individuals diagnosed with MDD in late-life require specialized psychiatric treatment for extended periods of time. We found no evidence that cerebrovascular disease or related risk factors predicted course trajectories in secondary-treated late-life MDD.

The authors have not supplied their declaration of competing interest.

Since 2004, herbal mixtures for smoking use have been sold under the generic brand “Spice”. Many of them contain synthetic cannabinoids (agonists of the cannabinoid receptors). JWH-018 was one of the first spice drugs. There is no scientific evidence of their effects on humans, except cases of intoxications and users opinions.

The present study describes the presence of the synthetic cannabinoids JWH's and their characteristics in the samples delivered for analysis to the harm reduction NGO Energy Control from 2010 to 2014 in Spain.

From 15,814 samples analyzed from 2010 to 2014, those containing synthetic cannabinoids JWH's were studied (n = 47). Analysis was done by gas chromatography–mass spectrometry.

From these 47 samples containing JWH, 55% were delivered as “legal highs” (n = 21) and 44% as JWH. Most common presentations were powder 47% and herbals 32%. Samples containing JWH 45%(n = 21) were mixed with more than one kind of JWH or were adulterated and other active principles were found 28% (n = 13) JWH-018, 11% (n = 5) JWH-210, 8% (n = 4) JWH-081 and the 6% WH-250 (n = 3). Origin of the sample was Catalunya 23% (n = 11), other provinces of Spain 46% (n = 22); other EU countries 23% (n = 11) and internet-unknown country 8% (n = 8). From the (n = 47) samples, were delivered (n = 16) in 2012, (n = 12) in 2013, (n = 11) in 2011, (n = 3) in 2010 and (n = 3) in 2014.

JWH'S represent a low percentage of new psychoactive substances analyzed. Its presence in the market seems decreasing.

The authors have not supplied their declaration of competing interest.

Harmane is a beta-carboline, which binds to imidazoline receptors and it has been previously shown that it may have an antidepressant effect when administered acutely. This study is planned to investigate the effect of harmane on chronic unpredictable mild stress (CUMS) model and microglial (Iba-1) immunoreactivity in the same model as markers of neuroinflammation.

Male Wistar Albino rats (290–360 g) were divided into groups such as control (saline), CUMS, CUMS + Imipramine (20 mg/kg; i.p.), CUMS + Harmane5 (5 mg/kg; i.p.), CUMS + Harmane10 (10 mg/kg; i.p.) groups (n = 10–12 in each). In CUMS model, various stressors were applied for 40 days. On day 20, harmane administration was started for 20 days. At the end, sucrose preference and forced swimming tests were performed. Then, brains were removed with paraformaldehyde perfusion for Iba-1 immunohistochemical analysis in hippocampus. One-way analysis of variance and Tukey's test were used for statistical analysis.

The time of immobility in forced swim test was significantly reduced while sucrose preference was increased in Imipramine and CUMS + harmane10 groups. In immunohistochemical experiments, Iba-1 were overexpressed in CUMS group and Harmane significantly reduced the overexpression of Iba-1.

Our results suggest that chronic administration of harmane has an antidepressant-like activity in chronic stress model of depression. These results support the notion of imidazoline receptors involvement in depression by modulating neuroinflammation and at least a part of its antidepressant effect might be through modulating microglial activation as a reflection of neuroinflammation.

This research was supported by Marmara University, Scientific Research Projects – SAG-C-YLP-110915-0415 and SAG-E-120613-0233.

The authors have not supplied their declaration of competing interest.

A meta-analysis was conducted to determine the effect sizes of placebo effect in 21 controlled studies on rTMS in the treatment of AVH in schizophrenia. MRI was also acquired in patients treated by rTMS to evaluate the scalp to cortex distances (SDCs) and the gray matter densities (GMDs) at the target of stimulation. Finally, we evaluated the efficacy of high (20 Hz) frequency stimulation in a controlled placebo study.

Weak or no placebo effect in the control groups led to reveal a superiority of active rTMS over sham rTMS in the treatment of AVH. Clinical efficacy of rTMS was also correlated with the SCD or the GMD at the region of the target stimulation. Finally, we also demonstrated that more responders were observed after 2 weeks in the active group treated by 20 Hz than in the placebo group.

We clearly demonstrated that several factors such as high frequency, the placebo effect, anatomical cortical variations can impact on the efficacy of rTMS. These results fundamentally inform the design and the method of further controlled studies, particularly with respect to studies of rTMS in the treatment of AVH.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

There are often substantial delays before diagnosis and initiation of treatment in people bipolar disorder. Increased delays are a source of considerable morbidity among affected individuals.

To investigate the factors associated with delays to diagnosis and treatment in people with bipolar disorder.

Retrospective cohort study using electronic health record data from the South London and Maudsley NHS Foundation Trust (SLaM) from 1364 adults diagnosed with bipolar disorder. The following predictor variables were analysed in a multivariable Cox regression analysis on diagnostic delay and treatment delay from first presentation to SLaM: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder.

The median diagnostic delay was 62 days (interquartile range: 17–243) and median treatment delay was 31 days (4–122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18–3.06) and treatment delay (4.40, 3.63–5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33–0.41) and substance misuse disorders (0.44, 0.31–0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.

Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder, particularly those with alcohol/substance misuse disorders. These findings highlight a need to better identify the symptoms of bipolar disorder and offer appropriate treatment sooner in order to facilitate improved clinical outcomes. This may include the development of specialist early intervention services.

The authors have not supplied their declaration of competing interest.