Broadmoor is a high secure psychiatric hospital divided into personality disorder (PD) and mental illness (MI) pathways. Whenever an incident occurs, it should be recorded. To better understand which factors influence the rate of incidents, such as diagnosis or intervention by medical and psychological staff, we examined the difference in the number of incidents recorded on weekdays versus weekends, ward round (WR) versus non-WR days and the PD versus MI pathways.

All incidents recorded over a one-year period (3.11.2014–2.11.2015) were examined. Extraneous incidents were excluded, leaving subgroups of “aggressive” (physical and verbal) and “physical” (excluding verbal) incidents which were analysed. Data were adjusted for the difference in number of beds in each pathway.

Of the 2369 incident reports included, more were recorded per day on weekdays than weekends, with little difference on WR versus non-WR days. The rates of both types of incidents were similar on both PD and MI admission wards, although the rate of “physical” incidents was 2.6 times higher and “aggressive” incidents 3.3 times higher in PD compared to MI rehabilitation wards.

The findings suggest the presence of medical and psychological staff during the week, and possibly the requirements they place on patients, may increase the rate of incidents within the hospital. Despite comparable rates on admission, MI rehabilitation wards have far fewer incidents than PD rehab wards, which may reflect the more intractable nature of PD versus MI. More work is required to confirm these findings.

The authors have not supplied their declaration of competing interest.

Emergency leaves of absence (ELOAs) from high secure psychiatric care are both costly and increase the risk posed to staff, patients and the general public. ELOAs were analysed to identify whether greater on-site physical health provision could reduce their number, and quantify the potential financial saving to the trust to do so.

All ELOAs from Broadmoor hospital between 15.5.15–14.11.15 were assessed by a team of psychiatrists and a GP to identify whether they were “avoidable”, “unavoidable” or “potentially avoidable” if measures were taken. For the “potentially avoidable” group, we then calculated the staffing cost of these LoAs to help ascertain whether these measures would be cost effective.

There were 30 ELOAs during the period assessed, costing £79,240 (Table 1). The table also shows which additional on-site services or training may have prevented these ELOAs, and the cost saving to the trust if they had.

The number of ELOAs from the hospital could be reduced by increased on-site physical health provision and training. This would improve the quality of care patients receive, as well as reducing both the cost to the trust and the risk posed to staff, patients and the general public. We must also consider the large potential cost and risks associated with a patient absconding from an ELOA.

The authors have not supplied their declaration of competing interest.

Ischemic stroke is in increasing incidence, so that long term sequels are of great importance for management of quality of life and economics issues.

To determine risk factors associated with cognitive disturbances, after ischemic stroke.

Assessment of social and medical risk factors in outcome of cognitive disturbances.

During 6 months, 268 patients with antecedents of ischemic stroke and associated cognitive disturbances installed in first year after major stroke, were assessed in neurology department. We performed neuropsychological tests as mini mental state examination, sunderland clock test and beck depression inventory. Patients and caregivers were also assessed for quality of life. 53% were males, from urban areas (69%) and mean age was 72.2 years.

We found risk factors as hypertension (88%), dyslipidemia (63%), diabetes mellitus (22%), atrial fibrillation (11%), smoking (35%) and drinking (55%). According to DSM-5 criteria, 62.5% of our lot had major cognitive disorder and 37.5% had a minor one; most of the patients with major dysfunction had ischemia in left middle cerebral artery (31.71%) associated with language deficits and executive dysfunctions, and on the second place was the vertebro-basilar localization of stroke (29.86%). Ischemia in right middle cerebral artery was present only in 20.52% of the lot. 27% of our patients developed depression, more in patients with major neurological deficits.

Efforts must be done for primary prevention of stroke, early detection of risk factors and correct treatment, and for cessation of toxic habits. Treating associated depression may improve patients’ quality of life and increase comfort for caregivers.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Autism spectrum disorders (ASD) are highly heritable and first degree relatives (especially fathers) of autistic probands have been shown to often manifest a set of subthreshold autistic features. It is not known, however, the clinical significance of this subthreshold autism spectrum.

– to evaluate the prevalence of a subthreshold autism spectrum respectively in fathers and mothers of children with ASD;

– to describe clinical correlates of parents with and without a subthreshold autism spectrum respectively.

36 fathers and 39 mothers of preschoolers with ASD were administered the autism-spectrum quotient (AQ), the adult autism subthreshold spectrum (AdAS spectrum), the trauma and loss spectrum (TALS), the SCID-5 and the social and occupational functioning assessment scale (SOFAS).

Fathers and mothers did not differ for both AQ and AdAS spectrum total and subscale scores. Overall, 13 parents (17.3%) scored higher than 45 on the AdAS spectrum, as indicative of the presence of a subthreshold autism spectrum. This group showed greater prevalence of mood, anxiety and feeding/eating disorders, greater utilization of antidepressants and higher scores on the TALS and the SOFAS than the group scoring lower than 45 (all P < 0.05).

Fathers and mothers of children with ASD show autistic traits in equal measure. The presence of a subthreshold autism spectrum is associated to greater prevalence of mood, anxiety and feeding/eating disorders, to greater susceptibility to traumatic events and to lower levels of functioning.

The authors have not supplied their declaration of competing interest.

Social cognition enables the processing of social information and is needed to adapt one's behaviour to the perceived social scene. Its assessment is a very controversial issue, tests currently available often use unhelpful stimuli from the ecological point of view.

To develop a test based on genuine social stimuli–not on their representations–and to do so, a controlled social situation is created in which participants can be evaluated on their abilities to perceive and process such information.

A script was prepared, consisting of several interactions which are staged before the participants by two members of the research team. The sample comprises 50 subjects, being on average 22 years old (56% women), who took this test, the MSCEIT and the MASC.

The application showed no incidence, no one detected that it was a previously prepared situation and they were not upset when this fact was revealed. A final selection of 18 items obtained a reliability of 0.701. Multidimensional scaling, partly showed the subdomains taken into account. The correlation matrix confirms the validity of the instrument. (r = 0,465 alpha < 0,001 with MASC. r = 0,106 alpha > 0,05 with MSCEIT).

The instrument is applicable and tolerated by participants being evaluated with it. It is feasible to use it as a test to assess social cognition It is mid-high reliability allows its use for research purposes. The correlation matrix confirmed validity, showing a significant and moderate connection with MASC and no association with any of the scales of MSCEIT.

The authors have not supplied their declaration of competing interest.

The views of one's self-stigma and quality of life in patients with schizophrenia and depressive disorders are significant subjective notions, both being proven to affect patient's functioning in life. The objective of this research was to find out the quality of life and self-stigma in connection with demographic factors and compare the two groups of patients in those variables.

In a cross-sectional study, the outpatients with the schizophrenia spectrum disorders and depressive disorders completed the quality of life satisfaction and enjoyment questionnaire, the internalized stigma of mental illness scale and a demographic questionnaire during a routine psychiatric control. Furthermore, both patients and their psychiatrists evaluated the severity of the disorder by clinical global impression-severity scale.

The quality of life of patients with depression or schizophrenia spectrum disorders did not significantly differ between the two groups. In both groups, unemployment was perceived to be a significant factor decreasing the quality of life. Self-stigma was detected to be higher in patients with schizophrenia as compared to the depressive patients. A strong correlation was found between the two scales, meaning that those with higher levels of self-stigmatization were less prone to see their life as fulfilling and joyful.

The present study shows that the degree of the internalized stigma can be an important aspect linked to the quality of life irrespective of the diagnostic category.

The authors have not supplied their declaration of competing interest.

– to determine the frequency of sociodemographic factors (birth order)among subjects attending a psychiatric clinic;

– to establish psychiatric diagnosis of subjects;

– to bring out dominating frequencies of birth orders of the patient in relation with related diagnosis.

This cross-sectional study was conducted at outpatient clinic of Liquate university hospital Hyderabad during 1st January 2012 to 31st January 2012. One hundred consecutive subjects attending a psychiatric OPD with psychiatric symptoms, were assessed for the total siblings, birth order among siblings and their psychiatric diagnosis. The socio-demographic data was recorded through a designed semi-structured proforma, and diagnosis was established by diagnostic and statistical manual-IV text revised criteria (DSM-IV TR).

The age range remained 9-60 years and numbers of siblings were in the range of 1–12 siblings and fourth birth order was found to be dominant in this study to have psychiatric morbidity (38%). While, frequency of first order birth was 18%. Generalized anxiety disorder and depressive (GAD) disorders were dominant diagnosis (55%), while GAD was more in the male gender.

This study shows that psychiatric morbidity was more common in the lower birth order. This study may be carried out at different centers of psychiatry for the better assessment of psychiatric morbidity.

The author has not supplied his declaration of competing interest.

Compassion and self-compassion can be protective factors against mental health difficulties, in particular depression. The cultivation of the compassionate self, associated with a range of practices such as slow and deeper breathing, compassionate voice tones and facial expressions, and compassionate focusing, is central to compassion focused therapy (Gilbert, 2010). However, no study has examined the processes of change that mediate the impact of compassionate self-cultivation practices on depressive symptoms.

The aim of this study is to investigate the impact of a brief compassionate self training (CST) intervention on depressive symptoms, and explore the psychological processes that mediate the change at post intervention.

Using a longitudinal design, participants (general population and college students) were randomly assigned to one of two conditions: Compassionate self training (n = 56) and wait-list control (n = 37). Participants in the CST condition were instructed to practice CST exercises for 15 minutes everyday or in moments of stress during two weeks. Self-report measures of depression, self-criticism, shame and compassion, were completed at pre and post in both conditions.

Results showed that, at post-intervention, participants in the CST condition decreased depression, self-criticism and shame, and increased self-compassion and openness to receive compassion from others. Mediation analyses revealed that changes in depression from pre to post intervention were mediated by decreases in self-criticism and shame, and increases in self-compassion and openness to the compassion from others.

These findings support the efficacy of compassionate self training components on lessening depressive symptoms and promoting mental health.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

The purpose of this study was to investigate the effectiveness of the mental health improvement programs in Korean firefighters through cooperation with the urban fire station. And we assessed the firefighter's degree of traumatic events and psychopathologies including depression, anxiety, suicidal ideation and insomnia.

A mental health improvement program was provided to 502 firefighters working at Daegu, Gumi and Ulsan during 8-week period. The program included not only an evaluation and treatment of psychiatric symptoms through counseling but also a psychoeducation for mental health awareness. The validated Questionnaires to measure psychiatric symptoms were used; symptoms included depression, anxiety, suicidal thoughts and insomnia. Subjects were divided to two groups; PTSD high-risk group and non-high risk group. Psychopathological levels were compared before and after the program.

PTSD high-risk group included 57 subjects (11.35%) and non-high risk group included 445 subjects (88.65%). Before the program, PTSD high-risk group showed higher depression, anxiety, insomnia scores statistically significant. Multiple logistic regression analysis with PTSD high-risk group as a dependent variable showed depression as a factor for firefighters to become PTSD high-risk group compared to those not depressed. Insomnia turned out to be another variant. The program resulted in significant decrease total scores of BDI and ISI for PTSD high-risk group.

The results on this study showed that higher levels of depression and insomnia especially influenced the manifestation of PTSD in firefighters. The evaluation and management of psychopathologies including depression, insomnia with traumatic events for firefighters can be helpful.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Persons suffering from PTSD show less episodic specificity in recalling autobiographical memories producing what is often referred to as “overgeneralized memories” as it is shown by scientific studies.

In this research, we are focusing our attention on whether this phenomenon is the same for both men and women or it shows gender specificity.

The rehabilitation center for torture victims “Memoria” provided information about people who have recently experienced torture. Some of these victims of torture volunteered to participate in the current research. The participants were assessed with the Harvard trauma questionnaire in order to identify whether they suffer from PTSD or not. A sample of 40 torture survivors with PTSD was selected for the research–20 men and 20 women. The age range is between 20 and 45. On a computer screen, we presented the cue words with the task to recall a past event and time period (month or 5–20 years). The participants pressed a computer key indicating when an event had been recalled, and then, it was described in an audio recorder. The responses were scored 3 for a specific event, 2 a repeated over time event, 1 a general event, 0 none.

Both sexes revealed a significant correlation between specificity for autobiographical memories and episodic simulations, only in case of women this correlation is higher compared with men (r = 0.83 P < 0.001).

Further research is needed in order to eliminate causalities and to extend the results on other populations.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Late pregnancy loss (PL) is recognized as a very difficult life experience. Often, PL is regarded as a “feminine” trauma, experienced individually by the woman, thus neglecting the role of the parental dyad in coping with the loss. This study aimed to examine:

– the prevalence of PTSD and major depressive disorder (MDD) following late PL;

– the role of spousal relationship measures in vulnerability and resilience following PL.

Participants were 100 women, ages 24–49 (M = 35.07, SD = 5.28), who have experienced late PL. The mean pregnancy week of loss was 27.29, with the average woman being 22 months post-loss. 84.6% experienced stillbirth. Participants completed self-report questionnaires assessing PTSD, MDD, dyadic adjustment and dyadic self-disclosure.

We have found high rates of both PTSD (32.7%) and MDD (53%) among women following late PL, as well as high PTSD-MDD comorbidity rates. Interestingly, a negative association was found between the number of previous pregnancy losses and the severity of MDD, perhaps indicating an innoculation process. Both PTSD and MDD were negatively associated with the levels of dyadic consensus, dyadic self-disclosure regarding guilt and shame, and dyadic affectional expression.

Late PL entails a heavy burden of PTSD and MDD, presumably since mothers are already strongly attached to their unborn child. PL is often experienced by both expecting mother and father. Thus, the quality of the spousal relationship following PL is an important protective factor. Therefore, there is a pressing need for novel interventions in couples therapy following PL.

The authors have not supplied their declaration of competing interest.

Patients with post-traumatic stress disorder (PTSD) have shown disturbances in visual information treatment. However, most of studies demonstrated attentional bias towards emotional stimuli by using non-ecological paradigm. The paradigm of change blindness offers the possibility of studying sensitivity to the sudden irruption of visual information with ecological stimuli.

To compare the explicit detection with the implicit detection by using respectively motor response and eye tracking in patients with PSTD and controls.

Fifteen patients with PTSD and fifteen healthy controls had to detect changes in 96 scenes with (1) no change, (2) one neutral change or (3) one emotional pleasant or unpleasant change. We measured the participant's speed and accuracy in explicitly reporting the changes via motor responses, and their capacity to implicitly detect changes via eye movements.

The patients showed a trend towards slower explicit detection for the emotional change (P = 0.06) and more specifically for unpleasant change (P = 0.054). The two groups did not differ for implicit detection.

Patients tend to explicitly detect more slowly emotional change (but not neutral), especially for unpleasant change. This could be the result of a lack of access to consciousness of the emotional information. The emotional visual information treatment in PSTD could require more attentional processes than the non-emotional visual information and then lead to a decrease of the available attentional resources for the explicit task.

The authors have not supplied their declaration of competing interest.

Cardiovascular diseases (CVD) are the leading cause of death and disability-adjusted life years lost globally. Recent studies have shown that post-traumatic stress disorder (PTSD) predicts higher risk of cardiometabolic diseases, specifically cardiovascular disease and diabetes type 2.

To assess cardiovascular event risk differences between diabetic patients with and without PTSD comorbidity.

To explore a ten-year risk of fatal CVD events in diabetic patients with and without PTSD; to gain better insight in potential different functioning patterns in these patient subgroups.

We investigated a cross-sectional sample consisting of 390 psychiatric inpatients and outpatients. Ten-years risk of fatal CVD events calculated by HeartScore, European society of cardiology. Europe high-risk version was used. The risk estimation is made based on: gender, age, smoking, systolic blood pressure and total cholesterol.

By analysis of covariance, we controlled possible confounding effects of gender, age, education, marital status, number of household members, work status, average monthly income per household member, body mass index (kg/m2), number of somatic comorbidities, number of psychiatric comorbidities, duration of PTSD, clinical global impression scale–severity of PTSD at diagnosis. After the adjustment for all these variables, interaction of PTSD and T2DM was significantly associated with CVD risk (P < 0.001; Eta2 = 0.04).

A significant fatal CVD event risk differences between diabetic patients with and without PTSD comorbidity were found. Better awareness of possible underlying determinants provides better optimal individual approach planning, likewise effective prevention and control of cardiovascular diseases.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

It was analyzed 174 subjects (from Health Center Zivinice/mental health center) through a survey conducted in the period from March 2015 to June 2016, of which 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the post-traumatic embitterment disorder self-rating scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the clinician-administered PTSD scale–V (CAPS), the PTSD checklist (PCL), the combat exposure scale (CES), the Hamilton depression rating scale (HAM-D), the Hamilton anxiety rating scale (HAM-A) and the World health organization quality of life scale (WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52.78 ± 5.99. In the control group, average age was 51.42 ± 5.98. Statistical data were analyzed in SPSS statistical program.

Comparing the results, t-tests revealed significant difference between group veterans with PTSD and control group (t = −21,21, P < 0.0001). War veterans group with PTSD (X = 51.41, SD = 8,91), control group (X = 14.39, SD = 13.61).

Embitterment is frequent in war veterans with PTSD.

The authors have not supplied their declaration of competing interest.