Delay discounting (DD) procedure has been used to probe the extent to which behaviour is insensitive to its long-term consequences. During the DD task, participants are offered a choice between a small reward, which is delivered immediately, and a larger reward, which can be obtained only after a delay. Several studies has been reported that drug addicts are insensitive to future outcomes in DD. Previous studies indicated that Methadone Maintenance Treatment (MMT) decreases risky behaviors such as illegal drug use, needle sharing and risky sexual behaviors. But, there is a serious question that could it change underlying cognitive processing of risky behavior or not?

In this study, we evaluated 266 opioid dependents (age: 31±9 years, education: 10±3 years) before MMT entry on DD. 78 patients (30%) has been completed at least three month MMT and re evaluated on DD. The Mazour model was fitted to data (V=A/(1+kD)) (K: delay discounting coefficient, D: delay) and least square parameter estimation was used to estimate delay discounting coefficient.

K was significantly reduced after 3 month successful MMT (0.12±.6 vs. 3.9±12.6) (P values=0.016). Successful patients in MMT had lower K in baseline but not significantly.

MMT could improve future time horizons in underlying cognitive processing of decision making. Based on this study, We could accept more favorably MMT as a real effective addiction therapy not just a substitution between street drugs and state drugs.

Neuroimaging studies in adults with borderline personality disorder (BPD) have reported alterations in frontolimbic areas, but cannot differentiate between alterations originating from disease and those occurring as side-effects of medication or other consequences of the disorder.

To provide a clearer picture of the organic origins of BPD, the present study reduced such confounds by examining adolescents in the early stages of the disorder. It also examined the extent to which alterations associated with BPD are specific, or shared more broadly among other psychiatric disorders.

Sixty right-handed, female adolescents (14-18 years) participated. 20 had a DSM-IV diagnosis of BPD, 20 had a different DSM-IV defined psychiatric disorder, and 20 were healthy controls. All groups were matched for age and IQ. Images were analysed using voxel-based morphometry.

No differences were found in limbic or white matter structures. Compared to healthy controls, adolescents with BPD displayed reduced gray matter in dorsolateral prefrontal cortex bilaterally and in left orbitofrontal cortex, but there were no significant differences in gray matter between BPD and other psychiatric patients. Like BPD patients, non-BPD psychiatric patients displayed significantly less gray matter in right dorsolateral prefrontal cortex compared to healthy controls.

These findings indicate that the prefrontal cortex is the earliest affected in the progression of BPD, but this does not distinguish it clearly from other psychiatric disorders. Alterations in limbic areas and white matter structures were not observed, but may play a later role in the progression of the illness.

Personality disorder, formerly referred to as a Character Disorder, is a class of mental disorders characterized by rigid and on-going patterns of feeling, thinking, and behavior. The underlying belief systems informing these patterns are referred to as fixed fantasies or “dysfunctional schemata” (Cognitive modules).

Patients and care providers have difficulty getting control of self-injurious behaviour. Nonetheless, there are patients who have succesfully stopped self-injury.

The aim of this study was to gain understanding of the process of stopping self-injury and to identify the determinants contributing to that achievement.

Semi structured interviews were conducted with twelve women with a long history of severe self-injurious behaviour who eventually succeeded in stopping that behaviour. The data were analysed based on of the Grounded Theory Method.

It was found that the process of stopping self-injury consists of six phases:

1. - the phase of connecting and setting limits: feelings perceived as unsafe are explored, and ways of strengthening feelings of safety are pursued. This sense of safety allows patients to reach out more to others and themselves;

2. - the phase of increased self-esteem with a further deepening of contact with the self;

3. - the phase in which patients “learn to understand” themselves: increased self-understanding makes patients realise they can control their own lives;

4. - in the phase of autonomy patients make active choices to increase control of their lives and immediate environment;

5. - the phase of stopping self-injury: learning and using alternative strategies other than self-injury to cope with unbearable feelings;

6. - the phase of maintenance focuses on preventing a relapse into self-injurious behaviour.

Contact was identified as key to all phases of the process

Interventions should focus on making contact, encouraging people who self-injure to develop a positive self-image and learn alternative behaviour.

We will present results of a systematic review of the effectiveness of methylphenidate in the treatment of adult ADHD. Furthermore, we will discuss the influence of methods on the results of meta analyses.

We searched Medline, PsycINFO and CCTR to identify randomised controlled clinical trials comparing methylphenidate with placebo in the treatment of adult ADHD. Studies were summarized with meta-analytic methods. Subgroup analyses were conducted with respect to parallel group vs. cross-over trials and self vs. observer ratings. The relationship between dosage and effect size was explored by weighted regression analysis. The results were tested for publication bias, and several sensitivity analyses were conducted.

Nineteen studies met the inclusion criteria of which 17 were included in the meta-analysis. The overall effect size was significant at d=0.42 different from zero, but this was only half the size expected on the basis of a previous meta-analysis. No significant differences could be observed in the subgroup analyses. The regression analysis showed no significant influence of mean daily dose on effect size.

These results contradict findings of a previous meta-analysis and challenge guideline recommendations. Differences between populations of children and adults and methodological issues in meta-analyses are discussed.

Over the past few decades the concept of dissociation has become more and more popular in the psychiatric and psychotherapeutic research community. Psychoanalytic theories (Kernberg, Fonagy) see the cause for dissociative symptoms in a troubled developmental history.

1. 1. In the present study we wanted to empirically study these relations between childhood traumatisation and dissociative phenomena in patients with a Borderline Personality Organisation (Kernberg).

2. 2. Further we were interested in examining personality and affect regulation factors of these patients. It was hypothesized, that certain personality traits (such as primitive defence mechanisms) would be associated with trauma and dissociation, while others (e.g. high-functioning personality structure) would be absent in the sample group.

52 psychiatric inpatients with a Borderline Personality Organisation completed the Dissociative Experiences Scale, the Childhood Trauma Questionnaire, and the personality and affect regulation measurement instruments SWAP and AREQ.

Significant correlations between dissociative symptoms and childhood traumatisation were found, especially with emotional abuse in childhood. Childhood trauma also correlates with severely disturbed personality characteristics.

The results empirically support psychoanalytic theories that a failure by the primary attachment figure in containing affects and sensations of a child can lead to dissociative symptoms and a disturbed personality development. Results are critically discussed within a psychoanalytic framework which should also help clarify the rather vague concept of dissociation.

Comparing coping mechanisms of 15-17 year-old inhabitants of “Tehran Correction and Rehabilitation Center” (named: delinquents) and the same age students of Tehran high schools (named: non-delinquents).

In a cross-sectional descriptive study, all 105 inhabitants of the center (81 males and 24 females) and 372 high school students (181 males and 191 females) who were randomly selected from area 6 of Tehran high schools completed the “Adolescent Coping Scale” which consists of 18 strategies and 3 styles. Results were analyzed using ANOVA and T-test.

Non-delinquent males and females used productive style more than reference to others, and reference to others more than non-productive style. Delinquent males used productive style and reference to others without significant difference, and also used these two styles significantly more than non-productive style. Delinquent females used all three styles without significant difference. Delinquent males used all three styles significantly more than non-delinquent males. Delinquent females used productive style less, non-productive style more and reference to others without significant difference from non-delinquent females.

In comparison with delinquent females, Delinquent males have a more comprehensive set of coping skills and can use external resources more effectively. Delinquent females use a very dysfunctional collection of coping mechanisms, which may have caused their vulnerability to social pathologies.

To examine the theory of the mind (TOM) in BPD patients.

Fifteen BPD patients (age>18) meeting criteria for BPD were compared to 16 healthy matched controls on two measures of TOM: mental state decoding (MSD) and mental state reasoning (MSR). MSD is the ability to perceive social cues (faces expression, voices) while MSR is the ability to infer on mental states with experiment, learning, context. MSR was measured by the faux pas recognition task assessing the ability to identify a faux pas in a social situation (range 0-60) and a comic strips task measuring the ability to infer intention (range 0-28). MSD was assessed by a video task reporting the ability to infer false belief and intention of deceit on visual motor action. Depressive symptoms (Beck Depression Inventory) and axis II comorbidity traits (Personality Disorder Questionnaire-4+) were also assessed.

Mean (SD) age was 26.0 (4.1) and two participants were of male gender (6.5%). BPD patients scored significantly lower than controls on the both MSR measures: faux pas task mean (SD) scores of 46.6(14.1) vs 58.0(2.8) (p=0.002) and comic strips mean (SD) scores of 26.1(1.5) vs 27.4(1.3) (p=0.001). No significant differences were found on the video task. Multivariate analyses showed that faux pas score was predicted by BPD diagnosis independently from level of depressive symptoms, history of hypomanic episode, schizotypic and antisocial personality disorder traits (F=4.32, df=6, p< 0.01).

BPD is associated with a TOM deficit on mental state reasoning tasks even after controlling for confounding variables.

To evaluate mutual interaction between sex and personality we tried to study 111 patients with QSAF 2009 and MCMI-III.

Hundred and eleven consecutive patients with sexual problems (76) or personality disorders (35) were examined with two tests. Only volunteer personality disorder patients were enrolled to this trial. The results were compared with 325 examinees evaluated with QSAF and 1600 patients evaluated with MCMI-III.

All patients with sexual problems showed at least two scores higher than 72 in their MCMI-III. This was more prominent in sexual deviations than dysfunctions. Homosexuals had higher scores in schizoid and schizotypal, pedophiles in schizoid and antisocial, voyeurs in schizoid and avoidant, masochists in dependent and self defeating personality scales…

We conclude that many deviated persons remain clinically latent and show themselves as alien, aloof and eccentric. Almost all deviated persons show high scores in personality disorder scales. On the contrary, only a minority of personality disorder patients show prominent sexual problems in the form of deviation. They predominantly have disturbed sexual self image, show inhibited sexual desire problems (dependent, schizoid and avoidant) personality, dyspareunia and vaginism (avoidant and schizotypal personality), spouse abuse (borderline and antisocial personality) postcoital disorders (borderline, dependent and narcissistic personality) and extramarital relationship in a series of disorders including histrionic personality …. as studied by the QSAF 2009 which evaluates 64 sexual scales.

To examine the association between sociocultural pressures, body dissatisfaction and disordered eating among female French students.

Participants were 201 women from a Toulouse University (mean age=20.70 years, SD=2.56). Pressure perceived from the media, peers and parents was assessed using parallel scales. The questionnaire also assessed body dissatisfaction (BD), drive for thinness (DT), bulimia (BU) and self-reported height and weight.

Participants reported higher scores of peer pressure (mean= 6.87, SD=1.82), than media pressure (mean= 6.14, SD=2.32) and parental pressure (mean= 5.41, SD= 1.44). The difference between the pressure perceived from each source was significant (p< .001). BD was significantly correlated with pressure from the media (r= .25), peers (r= .19), and parents (r= .21). DT was also significantly correlated with pressure from all three sources (r= .21; r= .25 and r= .17 respectively). BU was significantly correlated only with media pressure (r= .16). Hierarchical regression revealed that BMI, and sociocultural pressures, accounted for 38% of the variance in BD F(4, 190)= 28.63, p=< 001, with BMI, media and parental pressure as predictors. BMI, media and peer pressure were predictors of DT F(4, 190)= 28.26, p=< 001, R2=21. BMI and media pressure were predictors of BU F(4, 190)= 6.41, p=< 001, R2=12.

Sociocultural pressure contributes strongly to body image and eating concern among French students. These findings highlight the importance of developing sociocultural models among French populations, and the need for prevention interventions that build on these frameworks.

Psychotherapeutic therapies play an important role in borderline personality disorder (BPD) treatment. Pharmacotherapy can be helpful for some symptom clusters, but overall psychotherapy remains the most promising approach to treat persons with BPD. In the last two decades, disorder specific psychotherapeutic approaches have been developed and evaluated.

To systematically identify, integrate and review the current evidence on treatment efficacy using systematic Cochrane Collaboration review methodology.

Thorough literature searches were done to identify all available randomized controlled trials (RCTs) on psychotherapy in adult BPD patients. Retrievals were assessed by two reviewers independently in terms of matching the inclusion criteria and fulfilling a pre-defined study quality standard. Data were analyzed according to standards of the Cochrane Collaboration. Outcome variables were BPD pathology, associated psychopathology, and treatment compliance in terms of attrition.

Included RCTs comprised both comparisons of specific treatments (among others, dialectical behavior therapy, mentalization-based therapy, schema-focused therapy, transference-focused therapy, systems training for emotional predictability and problem solving, interpersonal therapy) vs. unspecific control conditions (such as treatment as usual or standard care) and head-to-head comparisons of specific treatments.

Most beneficial effects were found for BPD-specific psychotherapies, whereas effects of non-specific treatments were marginal. Short-time interventions yielded some promising findings, but sustainability remains questionable. Findings will be discussed in terms of evidence robustness and data quality as well as applicability to real-world settings.

Half or more of patients with borderline personality disorder (BPD) suffer from co-occurring alcohol use disorder and/or drug use disorder. The aim of the study was to investigate the development of substance use disorders (SUD) in patients with borderline personality disorder (BPD) in the long-term course.

175 patients with BPD and 396 patients with other personality disorders (OPD) were assessed with semistructured interviews at baseline and at 6, 12, 24, 36, 48, 60, 72, and 84 months. They were compared on the frequency of new onsets of SUD. Kaplan-Meier analyses were used to to generate time to new onsets, and Cox regression analyses were used to examine relevant predictors for new onsets.

BPD patients did show a shorter time to new onsets of SUD than the OPD group. Thirteen percent of BPD patients developed a new alcohol use disorder, and 11% developed a new drug use disorder, as compared to rates of 6% and 4% respectively for OPD. The number of antisocial personality disorder (ASPD) criteria predicted new onsets of SUD in BPD.

Patients with BPD have a two to three times higher risk than patients with selected other personality disorders of developing a new SUD. The severity of antisocial psychopathology is related to new onsets of substance use disorder in BPD. These findings support the concept of a spectrum relationship between ASPD, BPD and SUD.

One of the important purposes of health interventions is to enhance the quality of life (QOL). In mental health practice quality of life is related to disorders and treatment but also identification of high-risk group in healty subjects for lower QOL is necessary. Personality disorders in choronic diseases are reported to be related with lower QOL. In this study we investigated how character and temperament effect quality of life (QOL) in ‘healthy’ people.

70 healthy subjects (32 women, 38 men) with no physical and psychiatric diagnosis assessed with SCID-I are included to the study. They were examined using Temperament and Character Inventory (TCI) and WHO-QOL-Brief.

Harm Avoidance (HA) and Reward Dependence (RD) scores was negatively correlated with Physical Health domain of QOL. Self directedness (SD) scores were positively correlated environmental domains of QOL (p< 0.05). Marital status was associated with QOL as singles had higher QOL in physical, psychological and environmental domains (p< 0.05). In multiple linear regression models; HA and RD predicted lower Physical Health and marital status predicted Environmental Health scores of QOL.

In this study SD had significant correlations with environmental domains of QOL and higher HA and RD scores predicted lower QOL scores in Physical Health. With a bigger sample size all associations may occur clearly so an underground to identify risky temperament and character traits for lower QOL may be provided.

Personality and behavioral changes in epilepsy is known for a while. But neither quantitative characteristics nor etiology of these changes are not clear yet. There are many studies focusing on personality disorders in epilepsy using different methods. Cloninger has developed a psychobiological model of personality which provides to evaluate personality in a dimensional way.

In this present study, we examined the relationship between the Cloninger's dimensional psychobiologic model of personality and epilepsy. 73 outpatients of epilepsy and 70 healthy controls were examined using SCID I, Temperament and Character Inventory (TCI) and a questionnaire for epilepsy.

Epilepsy patients had higher harm avoidance (HA) and lower persistence, self-directedness (SD), cooperativeness scores than healthy controls.

In epileptic subjects no correlation was determined between TCI traits and age and duration of epilepsy. HA scores were higher in women. Subjects with partial seizures had higher HA scores and lower SD scores than generalized ones. Self Transcendence (ST) scores were different in groups due to frequency of epileptic seizures in One Way ANOVA but not corrected with Tukey HSD. Existence of comorbid depression was represented with lower ST scores. In multiple linear regression models only MDD predicted lower scores of SD.

This study confirms existence of specific personality changes among the epileptics by dimensional personality model of Cloninger and indicates a relationship between the characteristics of epilepsy and psychiatric comorbidity. Further investigations are needed for a clear understanding of common etiology of epilepsy and personality changes.

Mind and it's role in human growth and devoloptment & it's different layers are always an arena of great interest to the ancient philoshopers as well as the religious teacher of ancient India. In different religios sector in Hinduism or in Budhism mind and it's control was a key factor in attaining the bliss or the enlightment.

Here we examine some of the relevant philoshophical doctrines that may be applied/amalgamated with our modern pharmacology and therapy in a benefecial way. For the peace, calmness, attaining tranquility in distubed mind our approach may be hollistic with blending the aroma & flavour of those great philoshopers analysis on mind & their ways to derived a peaceful state in a restless mind.

it will be to beneficialy tuned the philoshophers insight into our modern way of management.

Here we willcite a few philoshopers connocation derived from GITA of Hinduism & from Budhist Philoshophy. According to Budda “…attachment is the root of all evils inmind…”. An non attachment theory or a non meself doing the things keeps the mind free. The 4 noble truth preached by Lord Budda are

1. 1) There is sorrow in life.

2. 2) there is cause for this sorrow or disrurbed state

3. 3) there is way for remedy of this.

4. 4) thatremoval of sorrow or non-peace is possible in life.

In Bhagbat GITA In karmay yog all works are directed to perform in a non ““I” state.

Calmness of mind could be achieved by “Practice” (meditation) & Dispassionate.

Philosophical aspects of mind will enrich our knoweledge.

Philoshophy is the ancient disciple that could answer the questions relating to human sufferings, their causes or a remedy. Doctors in dictionary meaning stands for a learned person. A psychiatrist may mean a more learned person on the matters of happyness or peace in mind or disturbances in the emotional sphere of a person, the cause of his behavioral disturbances.

Psychiatry in future will traverse faraway from patienthood to personhood. It will be more person concenerned, well person in some transient emotional crisis or a relationship conflict in a couple or a fear in mind in a teenager before examination or a person incapable of sustaining meaninful interpersonal-relationship. It will move from the tiny clinic &will fly like a dynamic butterfly to sit besides the emotionaly upset person.

A noble amalgamation of past philoshopical master's teaching and the knowledge of our neuro-transmitter imbalance may come out with a suitable blend that might be sustainable to remove the misery of mind in a less costly way.

Time tested some philoshopical ideas may be analysed with our objective of blending.

There were Hedonistic or pleasure seeking scool or school of dispassionate.

In 2500BC BUDDHA pointed, “Midle path is the best path”.(among sacrificing in totality or totalpeasureseeking sensces.)

Budha's 4 noble truth, that there is misery & sufferings, there is causation for sufferings, there is way to stop sufferings, & that is possible points towards aeitiology of passion and attachment as the cause of mental disorders.

Philoshopical amalgamation in psychiatry will open newer avenues.

Quest of happiness in life is time immortal. Meaning of happyness do differ from region or country & culture to culture. Still the search for happiness in life is universal & a goal that can be achived easily, specialy in the outlook of eastern philoshophical doctrine.

Happiness and peace of mind is out of out an inner thing, contained in each person. Only it's expression or realisation needs a practice, positive thinking attitude & positive lifestyles.

Happyness as such cannot be imported from any outside agency, or a person, that beutiful women, or a nice hanging decorating balcony on the opposite pavement.

Through rays onthe path that can increase output & efficiency in life.

3 practical way may bring happyness readily;

1. 1. Good thoughts, encouraging thoughts, positive thougts, positive attitude & life doctrine.

2. 2. Good works--meaning works that supports or serve others, that please others.& not irks others, not violate thier rights rather works that brings joys in other life sphere.

3. 3. Good behavior. Any moment it will not be a unpleasent behavoir or a behavior that will not brings us close.

Satisfaction with the little we have achieved.

What are the obstacles to the path of happiness?

“attachment is the root of all evils” was sais by lord budha.

Any attachment to property, to person, or even to self will desttroy happyness, by imparting expectatios & unfulfillment of desires borneout of expectation.

Dispassionate (“Vairaggya”) and non-attachment will make us free.

A selfness vision, works not done by me rather by thou.

Non-attachment & passionless living means happyness.