Treatment non-adherence is a major factor contributing to poor clinical outcomes in mental health disorders1(MHD). Patient adherence to treatment is likely to be influenced by a complex interaction of treatment, patient, and clinician factors. This compels the clinician to undertake a thorough clinical assessment with each patient to enhance the likelihood of engagement in treatment and develop strategies to improve treatment adherence2.

a. to assess the main strategies used by mental healthcare professional (MHP);b. to evaluate beliefs that difficult to implement strategies to enhance adherence to treatment.

The study explored the strategies used by MHP and their beliefs about patients with MHD.

We used the Difficulties Implementing Adherence Strategies3(DIAS) and Medication Alliance Beliefs Questionnaire4(MABQ). In DIAS, the participants were asked to rate how often they had difficulties using each of the 33 strategies with consumers who were nonadherent. The 22- item MABQ was used to assess clinician attitudes towards non-adherence.

A convenience sample of forty-five MHP working in a variety of settings is being collected. The results demonstrate that only 48.9% of MHP use strategies of adherence on a regular basis and the most used, according DIAS, is ’Discussing with the patient the link between disruptions in their life and the need to take medication’(n=45;often:53,3% and always:26,3%).

A vast literature has been developed on strategies to enhance patient adherence to treatment 5. This study also established the utility of the DIAS and MABQ to facilitate future work in this area-in particular, the identification of strategies and specific attitudes that might form barriers to the implementation of adherence strategies.

Healthy first-degree relatives to patients with depression have increased risk for developing depression and show brain structure and response anomalies in regions responsible for processing rewards. However, inherent behavioral and neural abnormalities related to valuebased decision making have not been explored in these individuals.

To address this, in a functional MRI study we investigated healthy mono- or dizygotic twins with or without a co-twin history of depression (high risk: n=36 and low-risk: n=31, respectively). Using SPSS10 and SPM8 statistical packages we compared behavioral and neural responses to gambling choices of twins at increased familial risk with twins without familial risk for depression.

We found no differences in risk choice behavior between high- and low-risk twins. Across groups, increased behavioral risk correlated with response in anterior and posterior cingulate cortex, ventral striatum, insula and raphe nucleus, as expected. Compared with twins at low risk, high-risk twins showed increased activation of left insula with increasingly risky choices (Fig1).

Healthy individuals at high hereditary risk for depression show elevated activity in left insula when making high-risk choices, region previously found to be causally involved in value-based decision-making by promoting risk taking. This might indicate a higher neural effort in these individuals during risk taking.

Suicide is a leading cause of death worldwide and a top leading cause of death among youths. Since younger age groups spend more time with internet-based applications, chances and risks of health forums have been scrutinized. It has been assumed that the use of health forums increases suicidality.

This study aims to disentangle the presumed causality between the use of online health forums and suicidality.

A German representative telephone survey and a two-wave online panel survey with same question wording have been concurrently conducted in 2013. Both surveys included questions on suicidality (Pöldinger, 1968) and internet-based health forums use.

The German representative cross-sectional data show significant positive correlations between suicidality and online health forum use, especially among younger age groups (Table 1). Using a large-size online access panel, we estimated an autoregressive model that reveals a positive cross-lagged effect of suicidality on internet-based health forum use one month later (Figure 1).

Despite the wide-spread notion that online health forums can increase suicidality our data shows an inverse effect. These results point to the preventive potential of accessible and helpful information in online health forums.

Table 1

Bivariate correlations between suicidality and internet-based health forum use for different age groups in a German representative survey.

Figure. 1

Higher suicidality (t0) influences the use of internet-based health forums or support groups one month later (t1).

Participants (n = 1319) were recruited from an online access panel (soSci Panel).

Suicidality was measured by the suicidality scale suggested by Poldinger (1968) and consisted of 16 yes/no questions. Internet-based health forum or support group use was measured on a 5-point Likert-like scale ranging from 1 “(almost) never” to 5 “(almost) every day”. For all scales, higher scores are indicative of more extreme responding in the direction of the construct assessed.

Coefficients are standardized coefficients.

p<.O5. **p<.01. ***p<.001 = 8.50

X2= 1, p <.01 ; = .075; SRMR = . 015; CFI= . 99; 71/=.96

Une étude transversale, conçue et accompagnée par le Collège national pour la qualité des soins en psychiatrie, financée par l’Agence régionale pour la santé de l’Île-de-France, a été réalisée une semaine donnée (10–15 juin 2013) au niveau des structures habilitées (n = 150 secteurs psychiatriques pour adultes), proposant un questionnaire « service » (renseignant les PS sur 2012) et un « patient » décrivant les patients en PS la semaine.

Cent dix fiches « services » (TR 76,7 %) et 1111 fiches « patients » ont été recueillies. Les PS étaient largement utilisés (94,4 % des secteurs ont fait au moins un PS en 2012), représentant dans les soins sans consentement 7,1 % des soins à la demande d’un tiers et 20,0 % à la demande du représentant de l’état.

Aucun des facteurs « service » testés (file active, nombre de lits, nombre d’ETP infirmier en extrahospitalier, type d’établissement) n’était lié à l’intensité de l’utilisation des PS, sauf l’engagement des secteurs dans cette pratique.

Parmi les patients, 79,4 % qui ont bénéficiaient des PS présentaient un diagnostic principal de trouble schizophrénique ou schizoaffectif. Les échelles de sévérité, d’observance et de dangerosité pour autrui ou pour soi ont objectivé une amélioration très significative entre le début du programme de soin et le moment de l’étude.

Les PS déployaient les interventions des centres médico-psychologiques avec des difficultés apparaissant notamment dans l’aide à attendre des forces de l’ordre. Des enjeux cliniques majeurs sont soulevés par les PS.

The phase 3 programme investigating nalmefene for reduction of alcohol consumption in alcohol dependent patients comprised two 6-month studies (ESENSE1 and 2) and one 12-month study (SENSE), conducted in 19 European countries.

To investigate the tolerability and safety of as-needed use of 18 mg nalmefene.

1997 patients with a diagnosis of alcohol dependence were recruited. Adverse events (AEs) and other safety variables were recorded.

797 patients in the placebo group and 1144 patients in the nalmefene group received study medication; patients took study medication on 62% and 51% of the days, respectively. The incidence of AEs was high in both the placebo and the nalmefene group (62.7% and 74.7%, respectively), and was not dependent on the drinking risk level at baseline. While mostly mild or moderate, these AEs did lead to dropout in some patients: 47 patients (6%) in the placebo group and 149 patients (13%) in the nalmefene group. Patients continuing in the studies seemed to develop tolerance with time for the most frequent AEs. Median time to event and median duration of these AEs were generally shorter for nalmefene than for placebo (many started after 1st dose). 35 patients (4.4%) in the placebo group and 57 patients (5.0%) in the nalmefene group had serious adverse events (SAEs). The majority of SAEs were not related to study medication and no apparent trends with respect to overall incidence or distribution across organ systems were noted.

Nalmefene was well-tolerated and no major safety issues were identified.

Group psychoeducation is an effective psychotherapy in the treatment of addictive behaviours.

To evaluate the efficacy of group psychoeducation on quality of life in relatives of dual diagnosed patients.

To investigate the impact of group psychoeducation on treatment compliance.

A case-control study was conducted between January 2012 and July 2012. Case group: seventy relatives and 53 patients included into an 8 session systematic psychoeducational group designed as follows: 1.5 hours every 3 weeks. The control group was formed by 53 patients who did not participate in psychoeducation during the same period. To assess quality of life in relatives, we used the Health Status Questionnaire (SF-36). Attendance rates for appointments were recorded in patients from both groups.

At baseline, relatives had poor outcomes in quality of life (Vitality: 49.8; emotional role: 49.3; mental health: 51.8, and general health perception: 54.9). Psychoeducated, as compared to control group relatives, had significantly better outcomes in quality of life (Vitality 71.0; emotional role 82.6; mental health 72.6, and general health perception 66.5). When compared to the control group, mean psychiatric appointments were higher in patients whose relatives were psychoeducated (8.2 vs.3.6).

Our findings suggest that psychoeducation can improve quality of life in relatives of patients with addictive behaviours. Attendance rates for appointments were higher in patients whose relatives were psychoeducated.

Disturbed body image perception is a common feature in eating disorders. To further investigate the etiology of these disorders, we have to study in depth body image perception during puberty in non clinical samples

To analyze the changes and evolution of body image perception in boys and girls from age 10 to 14.

Emotional, cognitive and behavioral aspects of the body image were evaluated in order to determine the changes that take place during these years and if there were differences between genders. The sample consisted in one hundred school 10-years old boys and girls of the general population of Extremadura Community, who were followed-up for 4 years. Assessment tools were: BPSS, BSQ, DST, BIAQ and EDI. For the statistic analysis, repeated measures ANOVA was used.

Between 10 and 13 years body image perception improves in boys and worsens in girls. From age 11 and after these differences start to be statistically significant between boys and girls, the satisfaction with body image increasing in boys and remaing low in girls.

Girls show more problems with body image perception than boys during these years. Further investigations during these period of life would be necessary.

Cannabis is one of the most commonly used illegal drugs worldwide. Cannabis use has been frequently associated with major affective disorders, and suicidal behavior.

We aimed to critically review the current literature concerning the possible association between cannabis use, major affective disorders and suicidal behavior. Early warning signs of affective conditions and suicidality in young adolescents who were cannabis users have been investigated providing a rationale for the importance of their early detection and assessment.

We performed a detailed Pubmed/Medline, and ScienceDirect search to identify all papers and book chapters focusing on the association between cannabis use, major affective disorders, and suicidal behavior during the period between 1980 and 2013.

Early warning signs of emerging affective disorders include behavioral, emotional and cognitive abnormalities. Hopelessness may be considered as a specific risk factor of negative outcome and suicidal behavior among depressed individuals with a history of early cannabis use. Vulnerable subgroups of individuals include those who were heavy users of cannabis during adolescence, and those with past suicidal attempts or current hopelessness. Socio-demographic, parental and individual risk factors for both suicide risk and early cannabis are discussed. Overall, cannabis use may be considered a risk factor for developing both psychiatric disorders and suicidal behavior.

Preventive programs should be directed at reducing cannabis use among young adolescents, as well as at preventing/treating modifiable factors such as adolescent hopelessness. The active engagement of patients in the early phases of affective disturbances is crucial to prevent psychosocial impairment.

Parkinson's disease (PD), PD dementia (PDD) and dementia with Lewy body (DLB), collectively termed Lewy body disease (LBD), characterize an array of emotional, neurobehavioral and cognitive symptoms. Pure psychiatric presentation (PPP) of LBD is the fourth subtype of LBD in which psychiatric symptoms lasted for many years in the absence of neurological disturbance.

The aim of this study is to localize the PPP and its clinical characteristics in subjects with low uptake of myocardial metaiodobenzylguanidine (MIBG) study.

Sixty MIBG-verified patients (28 women and 32 men) were grouped into three psychiatric pictures; depression (group D: 27 patients), isolated visual hallucinations (group V: 16 patients) and psychotic picture (group P: 17 patients). Fifty six cases were examined with cerebral single photon emission tomography study. Thirty-seven cases had hypoperfusion regions and 19 cases showed no abnormality. Final diagnoses of PD, PDD, DLB and PPP were evaluated with an aid of DSM-IV-TR, UPDRS part III, the Hoehn and Yahr Scale, MMSE and the movement disorder society task force diagnostic criteria.

Three clusters, PDD and Group P, DLB and Group V, and Group D and PPP-PD were found significantly with correspondence analysis. UPDRS average score showed negative correlation with average MMSE scores. All patients with PPP and majority of patients with PD featured depression.

PPP subjects are considered to be incidental LBD or depression of pre-motor PD. Psychotic parkinsonian features contributed highly to dementia of LBD, and visual hallucination was closely associated with DLB.