No psychotropic drug has been approved by FDA for usage during pregnancy. Data on safety of the second generation antipsychotics in pregnancy and lactation are limited. Quetiapine is in FDA category C and limited human studies reported no abnormality during pregnancy, delivery and in the postnatal period after using quetiapine throughout the pregnancy. The foregoing is a case presentation of high dosage of quetiapine use during pregnancy.

Ms. N, a 30-year-old gravida one-para one woman, who had been treated for a diagnosis of bipolar affective disorder since 1994, experienced her third manic episode at the 21th week of her pregnancy, 6 months after quitting her lithium (1500 mg/day) treatment. When she was hospitalized, her mental status examination was positive for grandiose delusions, psychomotor agitation and pressured speech. Quetiapine 400 mg/day had been given the patient and the dose increased to 1200 mg/day in 15 days and then haloperidole 15 mg added to the treatment. During her stay at hospital her obstetrical and perinathological examination had done by consultant obstetrician and had been followed after discharge. At the follow up detailed ultrasound examinations, fetal echocardiography and blood investigations showed no abnormality. This combination was continued for 4 weeks and then haloperidole had stopped. Quetiapine 1200 mg/day was reduced to 400 mg/day slowly in 4 weeks period and the patient had stopped taking medicine 10 days later. 4 weeks after that, she gave birth to a healthy boy at 39th week of her pregnancy with C/S.

Depression is a highly prevalent comorbidity in patients suffering from chronic obstructive pulmonary disease (COPD). Both, depression and COPD are believed to be associated with inflammation. The aim of our study was to verify hypothesis that altered inflammatory response causes depression in patients with chronic obstructive pulmonary disease.

Blood was collected from 45 patients of whom 18 had COPD, 18 were depressed and 9 had COPD with comorbid depression. Total of 27 age and sex matched healthy controls were also included in the study. IL-2, IL-8 and IL-17A concentrations were assayed by ELISA technique in sera of all subjects.

We observed significantly decreased concentration of IL-17A in a group of depressed patients (D) when compared with controls, 4.46 ± 0.573 pg/mL vs. 8.87 ± 1.182 pg/mL, respectively, P = 0.0005. Increased concentration of IL-2 in depressed patients (D) as compared with controls, 3.00 ± 0.223 pg/mL vs. 2.30 ± 0.176 pg/mL, respectively, P = 0.013 was also revealed. There was also increased concentration of IL-8 in COPD subjects if compared with controls and depression group, 4.55 ± 0.176 pg/mL vs. 3.71 ± .132 and 3.95 ± 0.118 pg/mL, respectively, P = 0.008.

The results from our study suggest that there is significant difference between depression and COPDs with respect to IL-8 concentration also a lower concentration of IL-17A was noticeable in depressed patients (P = 0.06). We need more data on depressed COPD patients to argue the role of inflammation on depression in COPD patients.

Fatigue is of great clinical and investigational importance. It is a prevalent symptom in general population and a central symptom in many diseases, for example, cancer, ischaemic heart disease and depression. Besides, it's a side effect of many medical treatments. Fatigue has been shown to have a substantial impact on patients’ self care activities and, overall quality of life.

To compare levels of the various aspects of fatigue in three different populations.

To see if diagnosis is a significant predictor for fatigue.

We conducted a survey in a random sample of 69 patients with diabetes Mellitus (DM), 114 psychiatric outpatients (PO) and 383 healthy adults (C), using the Multidimensional Fatigue Inventory (MFI-20). ANOVA test was used to reveille the statistical significance between the groups in all levels of fatigue.

The control group had a significant difference to the PO and DM patients in physical fatigue (MDPO = -3.835 p < .001), (MDDM. = -2.745p< .001), in reduced activity (MD PO = -3.719 p < .001), (MDDM = -3.155 p < .001) and reduced motivation (MDPO = -3.569 p < .001), (MDDM = -2.349 p < .001). Psychiatric outpatients had a significant difference with DM patients and control in general fatigue (MDC = -4.135 p< .001), (MDDM. = -3.835 p < .001) and in mental fatigue (MDC = 4.638 p < .001), (MDDM. = 4.346 p < .001).

Analysis shows that both psychiatric outpatients and patients with DM experience fatigue in all aspects of the measurement as expected, in a statistical significant level compared to the general population.

Death is a daily, several and important occurrence in nursing. Nurse's death anxiety is effect agent on quality of communication and caring of patients especially dying patients. Death Anxiety has excellent effect on job satisfaction and mental health of nurses. Only few studies have been done in this issue.Aim of this preliminary study was compare of death anxiety in special and general ward's nurses.

This was a cross-sectional analytical study that 387 practitioner nurses in census method were recruited from selected Hospital of TUMS 2007. The data were collected using a personal - social questionnaire and Templer Death Anxiety Scale. The data were analyzed using descriptive & inferential (Pearson, ANOVA, Regression…) statistical.

Results show significant difference between mean score of Death anxiety in special (8/262/1) and general (8/302/4) ward's nurses and was correlated with some variables such as marriage statues (p< 0/04), education level (p< 0/03), organizational situation (p< 0/001) and the ward which nurses now worked (p< 0/02). But has not significantly correlated with age, sex, shift, care of end stage patients, partnership in CPR and etc.

Death anxiety effect physical and emotional aspects of nurse's life and so effect process of caring present by them. Results show death anxiety was higher in special ward nurses and they faced more than general ward nurses to dying and death so they need special attention to death anxiety and investigation causes of it, development of institutional support to enable nurses to provide good quality care for patients.

This paper outlines evidence from field work conducted in Sydney (a large capital city on the southern east coast of New South Wales, Australia) and in Alice Springs (a small town located in Central Australian desert in the Northern Territory, in the heart of Australia), among young adults living with mental distress. It aims to explore the efficacious effects of bringing young and elders together, in unconditionally supportive communities of belonging, providing mirroring and feedback in the journey of recovery and growth for both groups.

The paper applies case study profiling and autoethnographic practitioner reflection on work conducted between 2004-2009, in a PhD field group of 60 participants in an “open urban tribe”; and among all ages of the community involved with headspace youth mental health project in Alice Springs.

The paper describes positive impacts on both age groups from sharing in the practice of “working the business of life” together - in the indigenous sense of giving feedback, humour, witnessing and testimony, about individual's life choices.

The evidence arising from this work is that sharing perspectives, experiences, fears and triumphs, in environments of trust and safety, can lead to strengthening and growthful outcomes for all ages. The paper concludes that combining people of diverse ages, cultures and consciousnesses can have efficacious effects on all involved. This leads to further evidence for the author's All Fruits Theory, akin to Queer Theory only referring to diversity in consciousness rather than gender preference.

Promoting client empowerment in mental health service and treatment is linked with positive outcomes and is considered an indicator of quality recovery-oriented services. However, most public mental health services do not yet fully implement this goal.

Recognizing that shared decision-making (SDM) technologies have the potential to encourage more effective communication and collaboration, SAMHSA and Advocates for Human Potential are developing SDM resources for public mental health services and the people they serve.

We report on field tests of one resource, a decision aid (DA) for consumers considering use of antipsychotic medication.

After conducting a literature review and analysis of decision support materials, we performed consumer and provider needs assessments to guide DA development. We constructed a 7-module Webbased consumer-centered DA that follows IPDAS standards. We tested the prototype with groups of consumers and providers available to the team.

Responses to the DA have been mixed. Some providers are concerned about “sharing” treatment decisions with clients and feel there is too much information in the DA. Some consumers want more information yet feel the DA is too long. Both groups express enthusiasm about the use of a DA for antipsychotic medication.

Adapting SDM concepts and tools to public mental health settings has unique challenges. Traditional assumptions about competency of people with mental health diagnoses have resulted in a history of provider-dominated decision-making. While DAs are designed to help balance power in the clinical encounter, we recognize that there are more obstacles to overcome.

Over The Counter (OTC) medication abuse is an increasing yet under-researched public health concern, particularly in the UK and Ireland. Our study provides a descriptive analysis of the clinical profiles; treatment and prevalence of patients admitted with OTC opiate abuse.

Using a specially designed demographic form, the records of patients admitted to St. Patrick's Hospital, a 280 bed inpatient mental health and addiction treatment facility in Dublin, Ireland with a diagnosis of harmful OTC opiate abuse or opiate dependency as defined in ICD-10 were reviewed retrospectively. All patients diagnosed with OTC opiate abuse (ICD F11.1) or dependency (ICD F11.2) on admission to our centre were included in the study. Patients with a diagnosis of primary illicit opiate misuse were excluded. Diagnoses were established by a consultant psychiatrist.

Approximately 1% (n=20) of inpatients admitted in a year were diagnosed with OTC opiate abuse. The average daily codeine intake was 261.10 mg per person. Seventy five percent (n=15) of the inpatients experienced OTC opiate withdrawal and were treated with protocol driven withdrawal regimes for an average of 16.10 days. The female: male ratio was nearly 2:1 with an average age of 49.2 years. Patients tended to have comorbid psychiatric (n=19, 95%), physical (n=17, 85%) and polysubstance (n=13, 65%) illness. The relapse rate of re-admissions within six months of discharge was 35%.

OTC opiate abuse is a covert illness since abusers often have significant comorbid psychiatric, medical and polysubstance illness making its assessment, diagnosis and subsequent treatment challenging.

In 1808 German physician coins the term “Psychiatry”. Before that Doctors treating mental patients were termed “‘Allienist Doctor”, as the patients were kept in allination in that era. Before that in ancient times Hippcrates 460-377B.C identify epilepsy derives from brain, Plato387B.C teaches brain is the seat of mental disorders. Philophers or the religious monks tackled the behavioral problems or wories or the hopelessnes of suffered soul by their deeper insight as to the cause of sorrow or sufferings and the way towards relief from them. Lord Buddha Founder of Buddhisim admitted “Attachement is the cause of all evils”. Bhagbat geeta the epic of Hindu myhthology teaces on an unattached form of work, dperform the works as duty and never impart “self sensce”. as the They echoed on indefinity of soul in the life & which cannot be destroyed by fire, death or hit by any way. The seat of a divine soul inside the human body makes the definite body “infinity”.

Amalgammation of spiritual ideas and practices may help in the recovery of minor mental stresses & some disorders Is ascertained here.

72 patients (44 male & 28 females in the age range of 24-46,. ), those were suffering from anxiety disorders GAD and Ac. Panic disorders were mached against an equal number of other 72 patents as per ICD_10.1st group recieves spiritual philoshopy and practices for 10 minuteseach day.

Fast recovery & sustainicity in the 1st gr.were observed against the control gr. who receives drug alone.

Imparting philoshopy or spirituality helps in recovery of mental state.

The Personal and Social Performance (PSP) scale is a reliable and valid instrument that utilizes objective parameters for assessment of social functioning in patients with schizophrenia. The aim of this study was to determine the validity and reliability of the French version of PSP in a population of French schizophrenic patients.

Patients with DSM-IV diagnoses of schizophrenia and schizoaffective disorder were recruited and assessed in a cross-sectional design using the PSP, GAF, SOFS, PANSS, CGI severity. Internal consistency for the PSP was obtained and convergent validity was assessed using correlations between PSP, GAF and PANSS factors. Inter-rater reliability was evaluated with intra class correlation coefficient (ICC).

147 in and out patients, at 5 French sites participated in this study. The Cronbach's alpha coefficient of the PSP was good (alpha=0.77). The PSP showed very good inter rater reliability (ICC = 0.90). Pearson correlation coefficient for association between PSP and GAF (r=0.85) and PSP and SOFS (r=- 0.78).are high proving good convergent validity for PSP. Pearson correlation coefficients are moderate when PSP is correlated with 4 of the five PANSS sub factors (r from -0.43 to -0.48). The anxious and depression factor (r=-0.17) showed low correlation with PSP. Spearman Rank correlation coefficient between PSP and CGI severity was r=-0.72.

Our results demonstrate that the PSP scale is a reliable and valid instrument for assessing social functioning of patients with schizophrenia during the course of treatment as well as in acute state.

Dissociative amnesia is triggered by psychological stress or trauma. Its hallmark is a severe (usually retrograde) memory impairment within episodic-autobiographical domain, occurring without evidence of significant brain damage on conventional structural brain imaging.

This work’s objectives are establishing greater recognition of possible relations between memory performance and social cognition in patients with dissociative amnesia.

We review data on social cognition (affective and cognitive theory of mind, simulation, empathy, social judgment, moral judgment) from our own patients with dissociative amnesia.

Patients were investigated medically, psychiatrically and with neuropsychological and neuroimaging methods.

Patients with dissociative amnesia show variable degrees of impairments of components of social cognition, based on their comorbid conditions (e.g. concurrent clinical or subclinical depression), types of memory impairments (e.g. extent of retrograde amnesia, presence of autobiographical semantic deficits), pattern of brain metabolic changes, personality characteristics, neuropsychological profile (performance on executive functions or emotional processing) and testing paradigms.

The impairment in dissociative amnesia seems to go beyond the conscious mnemonic deficit, encompassing various aspects of social information processing. Knowledge about the pattern of metabolic and micro-structural brain changes in patients with dissociative amnesia as well as a fine-grained analysis of the neural correlates of various aspects of social cognition might provide an understanding of when and how episodic-autobiographical memory contributes to social cognition. As several studies emphasized, some structures involved in mnemonic processing may also play a role in social perception, cognition and behavioural regulation, including future-minded choice behaviour.