Serotonergic neurotransmission plays a key role in seasonal changes of mood and behaviour. Higher serotonin transporter availability in healthy human subjects in times of lesser light has been reported in recent studies. Furthermore, seasonal alterations of postsynaptic serotonin-1A receptors have been suggested by a recent animal study. Following that, this study aimed at identifying seasonal alterations of serotonin-1A receptor binding in the living human brain.

Thirty-six healthy, drug-naïve subjects were investigated using PET and the specific tracer [carbonyl-11C]WAY-100635. Regional serotonin-1A receptor binding (5-HT1A BPND) was related to the individual exposure to global radiation. Furthermore, the subjects were divided into two groups depending on individual exposure to global radiation, and the group differences in regional 5-HT1A BPND were determined.

Correlation analysis controlled for age and gender revealed highly significant positive correlations between regional postsynaptic 5-HT1A BPND and global radiation accumulated for 5 days (r=.32 to .48, p=.030 to .002). Highly significant differences in 5-HT1A BPND binding between subjects with low compared to high exposure to global radiation were revealed (T=-2.63 to -3.77, p .013 to .001). 20% to 30% lower 5-HT1A BPND was found in the subject group exposed to lower amount of global radiation.

Seasonal factors such as exposure to global radiation influence postsynaptic serotonin-1A receptor binding in various brain regions in healthy human subjects. In combination with seasonal alterations in serotonin turnover and 5-HTT availability revealed in recent studies, our results provide an essential contribution of molecular mechanisms in seasonal changes of human serotonergic neurotransmission.

Irony is a form of speech used to convey feelings in an indirect way. Patients with schizophrenia demonstrated an impaired irony processing, associated with poor theory of mind.

We used fMRI to examine neural circuitry underlying deficits in understanding irony in schizophrenia.

11 right-handed patients with paranoid schizophrenia and 11 right-handed healthy subjects were studied. Participants were asked to listen short scenarios. The 15 irony condition consisted an ironic statement, and the 15 control condition was physical causality. We used an event-related design. Every scenario started with a two sentences long context, followed by a 2-4 s (jittered) inter-stimulus interval. The third, critical ironic sentence appeared next, and finally a simple yes/no comprehension question followed. Between trials an inter-trial interval of 5-7 s (jittered) were used.

The schizophrenic group performed significantly worse in the irony condition than the control group (p=0.0008). Ironic statements resulted in significant activations in the left inferior frontal gyrus (IFG) and insula, right superior and medial frontal gyrus, left postcentral gyrus, posterior division of right superior and left middle temporal gyrus, left lingual gyrus, left cuneus and right inferior parietal lobule in the schizophrenic group. The control group showed significantly greater activity in the left IFG and insula compared to the schizophrenic group.

Among schizophrenic patients we found a significant underactivation in the left IFG and insula during irony comprehension, which may contribute to the impairements of social behavior in schizophrenia.

Schizophrenia is characterized by marked disturbances of cognitive functions. One core finding is a memory dysfunction. Recently, this has been attributed to impaired hippocampus function that is crucial in comparing new to known information. Hippocampal novelty detection triggers activity of neurons in the ventral tegmental areal (VTA) to which it is reciprocally connected.

Here, we examined whether neuronal activation during the detection of novel information is impaired in these structures.

We investigated novelty detection using an fMRI oddball face paradigm with repeated novel oddballs (1-4 repetitions) in 25 patients (12 female, mean age 26 years) suffering from paranoid-hallucinatory schizophrenia and 25 healthy controls (12 female, mean age 25 years).

Schizophrenia patients, relative to control subjects, showed impaired patterns of activation in mediotemporal areas, including the hippocampus, as well as in VTA/ Substantia Nigra during novelty detection. Furthermore, the activity related to detection of previously novel but repeatedly presented stimuli shows an altered adaptation in the patients.

In schizophrenia, the Hippocampus-VTA-loop displays a dysregulated activity pattern during novelty detection that is crucial for encoding into long-term memory. As this loop is mainly governed by dopaminergic neurotransmission these results underline the pivotal pathophysiological role of mesolimbic dopaminergic dysregulation in the pathophysiology of memory dysfunction in schizophrenia.

Recent research has shown that adiponectin levels in patients with schizophrenia vary similar to the general population. Moreover, antipsychotic medication may influence adiponectin levels, independent of metabolic parameters. We hypothesise different antipsychotics might vary in their effect on adiponectin levels independent of BMI and metabolic syndrome (MetS) status.

113 patients, with similar baseline demographic and metabolic characteristics, received either risperidone (n=54) or olanzapine (n=59). They were followed prospectively for 12 weeks. Adiponectin levels as well as general metabolic parameters were measured at baseline, 6 weeks and 12 weeks.

We observed a significant treatment by time interaction, showing an adiponectin increase in the risperidone treated patients and an adiponectin decrease in olanzapine treated patients. This effect was independent of BMI and the presence/absence of the metabolic syndrome. There was a significant association between fall in adiponectin and increase in waist circumference in the Olanzapine treated group (Figure 1).There was no change in HOMA-IR as a measure of insulin resistance in either group.

We observed a differential effect of antipsychotic treatment (risperidone vs olanzapine) on adiponectin levels over time, independent of BMI (and MetS) suggesting an effect of olanzapine on adipose tissues, similar to what has been observed in animals models. The effects on adiponectin levels may partly explain the increased rates of obesity with Olanzapine.

Quantify the burden of chronic insomnia characterized by nighttime awakenings (CINA) among diabetes patients.

Database analyses of National Health and Wellness Survey, an annual cross-sectional study of U.S. adults. Data were collected across the U.S. through self-administered, Internet-based questionnaires. Patients included in this study self-reported physician-diagnosed diabetes. From this cohort, subjects were categorized as CINA patients if they experienced nighttime awakenings, but did not experience difficulty falling asleep or sleep apnea. Controls did not experience sleep difficulties, sleep apnea, or symptoms of insomnia in the past twelve months. Outcomes included resource utilization in the past six months, work productivity and activity impairment as measured by validated WPAI questionnaire, and summary scores of the SF-8. Regression models were developed to assess independent effects of CINA on outcomes, adjusting for demographics and physical and psychiatric comorbidity.

Among diabetes patients, 150 experienced CINA; 2,437 experienced no insomnia (projected 0.56MM adults with CINA and diabetes). After adjustments, diabetes patients with CINA had 1.9 (p< 0.001) more provider visits, 11.8% (p=0.013) greater work impairment (among full-time employed) 17.0% (p< 0.001) greater activity impairment, and SF-8 physical and mental summary scores that were 5.2 and 5.2 (p< 0.001 for both) points lower than those without insomnia, a projected $33MM in direct costs and a loss of nearly six weeks of work productivity per year.

Among patients with diabetes, CINA in relative isolation was associated with a significant negative impact on healthcare utilization and its associated costs, work productivity, and health-related quality of life.

Increased levels of high-sensitivity CRP have been associated with e.g. major depression, chronic stress and obesity. The purpose of the present study was to investigate the association between generalized anxiety disorder and hsCRP.

The study sample consisted non-smoking women who were living in the town of Turku or nearby and had taken part in the longitudinal Health and Social Support Study (the HeSSup Study) in 1998 and 2003. Of these 312 women the address was unknown for 82, 230 were contacted and 153 subjects responded (67%), 18 (8%) refused to take part and 19 (8%) were excluded. All 116 participants signed and returned the informed consent. The MINI neuropsychiatric interview was used for diagnostics and blood samples were drawn for the analyses of hsCRP and cytokines.

The range mean of hsCRP-level was 1.7 mg/l (range: 0.17 -30.9 mg/l). The mean of BMI was 25.3 (SD=5.0, 17.3-50.8). There was an inverse correlation between GAD and BMI (rho= -0.19, p< 0.05). The odds for a person with GAD diagnosis to have high CRP was 0.37-fold (0.14-0.88), an increased IFN-G-1 0.74 -fold(0.61-0.90) an increased TNF-alfa 1.31-fold (1.01-1.71). Adding BMI to the multivariate analysis did not render the results insignificant.

We found a significant inverse correlation between immunity markers and GAD.

Decrease Mortality rate in all psychiatric care is an important goal. Survey on mortality patterns in different psychiatric disorder are essential for successful plan of treatment and preventive strategies. The present study describes rate and causes of mortality among psychiatric patients with a history of psychiatric hospitalization in Kashan city, Iran.

This survey was a retrospective study. The samples (cases) were all of the psychiatric patients who had died between years 2000 to2009.They were included 44 patients. Main instrument was the inventory included: Demographic questionnaire and main cause of death according to medical records and registration center of mortality in health organization.

Results showed that the highest mortality rate respectively were among patients with Major depressive disorder (n= 14, 31.8%), bipolar disorder (n=15, 34.1%), Schizophrénie (n=9, 20.5%), obsessive - compulsive (n= 3, 6.8%) post traumatic stress disorder (n= 2, 4.5%) and personality disorder (n=1, 2.3%).The most causes of mortality respectively were suicide (n= 8. 18.2%), cardio vascular disease (n= 8,18.2%), accident (n= 3, 6.8%), cancer (n= 2, 4.6%) Diabetes (n= 2, 4.6), respiratory disease (n =2,4.6%), kidney disease (n= 24.6%), Cerebrovascular disease (n=2,4.6%), Dementia (n= 1,2.2%) and 14 ones had died with unspecified causes.

Prevention of unnatural death (suicide) is an important goal for decreasing mortality rate in psychiatric patients and so attention to cardiovascular disease in this group is essential. Therefore we should consider medical problems in this group.

Cognitive functioning involves all aspects of perception, thinking, reasoning, and remembering. Cardiac surgery is associated with a decline in cognitive functions. The incidence of this complication ranges from 3% to 80%. Cardiac rehabilitation is a treatment programme designed to help heart patients manage their condition, improve their health and recover their quality of life after a cardiac event.

To evaluate the influence of cardiac rehabilitation on neuropsychological parameters of patients undergoing cardiac surgery.

Neuropsychological data were gathered from 20 patients (M=11,F= 9; mean age 66,5 ± 11,7 years) who underwent a four week cardiac rehabilitation program. To examine patients cognitive functioning following tests were utilized: Trail Making Test A and B, Stroop test A and B, FAS test and Digit Span Test (DST). Patients were qualified into two groups: Group - I after heart valve surgery. Group II - after coronary artery bypass grafting (CABG)

In TMT A and B both groups demonstrated similar improvement, though the results were below appropriate age norms. In part A of the Stroop test both groups improved their results, yet the improvement of the I group was greater. In part B of the Stroop test and in DST the results of group I improved, while the results of group II worsened. In the FAS test both groups improved their results, yet the improvement of group II was greater.

The group of patients who underwent heart valve surgery demonstrates greater improvement in processes associated with prefrontal cortex.

The objective of the present work was the investigation of the general health level and factors that influence the job satisfaction in a sample of health care workers that they serve in primary, secondary and tertiary health care in Central Greece.

500 professionals of health were administered:

1. a) a closed type questionnaire of job satisfaction evaluation, based on Likert scale, and

2. b) the questionnaire of general health GHQ-28.

Health Care Workers in the 2 general hospitals and in the health centers of Lamia and Larissa, as well as in the Regional University Hospital of Larissa participated in the study. 386 sufficiently filled in questionnaires were evaluated. Statistics was processed with SPSS (version 15.0). Level of statistical importance was considered at p < 0.05.

93 participants (24,1%) were men and 291 (75,4%) were women. The work load, the occasions of development and the collaboration with colleagues were the critical factors in which the nurses exhibited worse statistically significantly scores in comparison with the other groups of health professionals. In the factor “job satisfaction” the nurses had lower scores (intermediate =3, IQR=2-5) compared with non- nurses (intermediate = 5, IQR=3-6) p< 0,001. In the same parameters the workers in the hospitals presented with worse scores than the workers in the health centers. The anxiety level stress of nurses is high.

The nurses constitute the group of health care workers with the lower job satisfaction and the highest anxiety levels.

Increasing evidence suggests that symptoms of Attention Deficit Hyperactivity disorder (ADHD) could persist into adult life in a substantial proportion of cases. The aim of the present study is to investigate the impact of 1) adverse events, 2) personality traits and 3) genetic variants chosen on the basis of previous findings and 4) their possible interactions on adult ADHD severity in a sample of 110 Caucasian patients.

One hundred and ten individuals diagnosed with adult ADHD were evaluated for occurrence of adverse events in childhood and adulthood, and personality traits by the Temperament and Character Inventory (TCI). Common polymorphisms within a set of nine important candidate genes (SLC6A3, DBH, DRD4, DRD5, HTR2A, CHRNA7, BDNF, PRKG1 and TAAR9) were genotyped for each subject. Life events, personality traits and genetic variations were analyzed in relationship to severity of current symptoms, evaluated by the Brown Attention Deficit Disorder Scale (BADDS).

Genetic variations were not significantly associated with severity of ADHD symptoms and life stressors displayed only a minor effect as compared to personality traits. Indeed, symptoms’ severity was significantly correlated with the temperamental trait of Harm avoidance and the character trait of Self directedness.

The results of the present work are in line with previous evidence of a significant correlation between some personality traits and adult ADHD. However, several limitations such as the small sample size and the exclusion of patients with other severe comorbid psychiatric disorders could have influenced the significance of present findings.

The job of an engine driver appeared ideal for research studies because of its extremely high responsibility coupled with a high level of permanent concentration.

The main elements of the study focused on applying the EQ-5D (Quality of Life Questionnaire), SVF 78 (Stress Processing Questionnaire) and FBL-R (Freiburg Complaint List; revised version).

It turned out hat exactly fifty percent of all train drivers regret having chosen their job and judged their professional strain very high (p< 0.001). The SVF 78 reveals the following: persons of the First Group achieved much higher values in the scales regarding “escape” (p=0.029), “mental preoccupation after work” (p=0.003), “resignation” (p=0,011) and in the total amount of negative strategies (p=0.004), while Group 2 presents only higher values in the scale concerning the “playing down” (p=0.039) effect.

There were also a wide-ranging differences between the two groups, especially in the scales about “general state of health” (p< 0.001), “cardiovascular complaints” (p< 0.001), “pain” (p< 0.001), “sensory perception” (p< 0.001), “emotional reactivity” (p=0.001) and “total sum of complaints” (p< 0.001). The EQ-5D showed that train drivers who are content about the choice of their job judge their quality of life much higher than those regretting their choice (p< 0.001).

The results make clear that the dissatisfaction about the chosen job has negative effects on both the physical and psychological well-being.

In 1950, Kurt Schneider proposed that a considerable number of schizophrenic patients develop first-rank symptoms (FRS). In such cases, patients experience third-person auditory verbal hallucinations, audible thoughts, made experiences, replaced control of will, thought insertion, broadcast and withdrawal. This group of symptoms might therefore be seen as pathognomonic of schizophrenic psychopathology. Although a number of studies tend to explain these symptoms in terms of neurobiological and neuropsychological processes, the cause and development of FRS still remains unknown.

The method applied for the development of an explanatory model of FRS consists first in the overview of psychiatric and philosophical literature and secondly in the further development of the concept of disturbed intentionality and its implication to the FRS in schizophrenia. Intentionality is understood as a basic characteristic of conscious experience as being directed towards its object and, at the same time, implying a sense of mineness. This report also reviews and discusses some generally accepted views of FRS.

Current psychiatric research shows a significant increase of interest phenomenological explanations of FRS. In this contribution we introduce a phenomenological model of FRS based on the concept of intentionality. We also show that this concept offers an insight into the interrelatedness between particular FRS.

We propose that the experience of FRS in patients with schizophrenia is rooted in the disturbed and inverted intentionality of their mental and bodily actions. This theoretical model of FRS will open up new directions in psychiatric research.

The stress -vulnerability model is an extremely useful model for identifying and treating relapses of mental illness. We accept that human persons carry genetic and other predisposition to mental illness. However, the question arises as to how stress impacts on a person in order to cause mental illness to develop. Furthermore there arises the issue as to what other effects such stress has on the human body beyond the human brain.

To research and integrate the current literature in order to establish how stress impacts on the brain at the cellular level, and to establish whether there are other consequences for the human body brought about by the impact of stress on the human brain.

MethodLiterature Search.

The present literature describes a complex set of interactions involving stress induces elevated levels of cortisol, immune responses, enhanced production of corticotrophin-releasing factor (CRF), glucocorticoid receptor tolerance thus impairing the negative feedback mechanism of the HPA axis, neurodegenerative changes in the hippocampus, and balance between trophic and atrophic factors within neurons, thus affecting neurogenesis and brain plasticity. The poster explores the interrelationship between all these factors, and the genetic component which in large part constitutes the ‘vulnerability’ part of the model.

We also show that the effects of heightened cortisol levels are not confined to the brain. but also cause metabolic problems including the ‘Metabolic Syndrome’.

Such problems occur in many Psychiatric illnesses, including Depression, PTSD, as well as Schizophrenia.

The main objective of the present study was to compare the coping strategies used by adolescents with and without subclinical psychotic symptoms.

The sample was composed of 1,713 Spanish adolescents, 881 (51.4%) females, with a mean age of 14.7 years (SD = 1.7).

The results showed that the adolescents with subclinical psychotic symptoms used Avoidance-type coping strategies more frequently and Positive-type coping strategies less frequently in comparison to the control group.

These findings indicate a pattern of deficit in the strategies used to cope with stress similar to that of patients with schizophrenia, which is very interesting with a view to establishing lines of intervention within early detection and treatment programs for high-risk individuals aimed at modifying these patterns of deficit in coping with environmental stimuli in these populations.