Globally, children and adolescents are victims of various forms of violence, including physical, psychological and sexual violence perpetrated by peers or adults within the community, school or domestic setting. Suicidal behavior is public health problem with escalating trends among young people. There is dearth of research on the relationship between violence and suicidal behavior in sub-Saharan Africa.

This study determined the association between violence victimization and suicidal behavior (suicidal idea and attempts) in a sample of secondary school students in Lagos, Nigeria.

A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, the Global School-based Health Survey Questionnaire (violence module) and the ‘Suicidality’ module of the Mini International Neuro-Psychiatric Interview (MINI).

In the past year, a fifth of the respondents were victims of weapon-related violence (23.8%) and sexual violence (21.9%). More than half (56.4%) reported peer-related violence/bullying, while 60.7% were exposed to domestic violence. Less than a third (31.3%) reported lifetime history of suicidal idea, while 13% had attempted suicide. Suicidal behavior was significantly associated with history of bullying (p=0.020), sexual violence (p=0.014), weapon-related violence (p=0.005), and exposure to domestic violence (p=0.020).

Exposure to violence is associated with suicidal behavior among secondary school children in Nigeria. This highlights the need for urgent interventions to protect Nigerian children and adolescents from violence. There is also need for improved access of victimized children to mental health care and other support services.

Pregnancy and postpartum are periods of increased vulnerability for some psychiatric disorders that, when left untreated, imply serious consequences for the pregnant and the fetus. The Psychiatric Liaison Consultation in Bissaya Barreto Maternity (MBB) is part of the Early Intervention Unit (UIP), which consists of a multidisciplinary team that ensures a specific intervention in pregnant and postpartum women with psychiatric illness.

The purpose of this study is to characterize the perinatal period and the psychomotor development of the 123 newborns of mothers followed in the Psychiatric Liaison Consultation and exposed to psychotropic drugs.

The authors conducted a retrospective descriptive study using clinical processes from the babies born between 2001 and 2006, considering the following data: maternal age in pregnancy, psychiatric disorder and medication, gestational age, birth weight, Apgar score, breastfeeding and neonatal complications.

Preliminary results show that neonatal outcomes of newborns exposure to psychiatric medication during pregnancy are similar to those described in the literature, supporting that the use of psychotropic drugs during pregnancy is safe, as long as used with caution. This multidisciplinary intervention during pregnancy seems to be the best way to follow up pregnant women with mental illness.

Schizophrenia is a serious mental illness characterized by poor insight and poor adherence to the therapy. Antipsychotics are the mainstay of treatment but psychoeducational interventions are essential to improve these characteristics. Psychoeducation can be defined as a structured and didactical intervention, with the aim of informing about the disease and allow the patient to better cope with it.

Presentation of the results of a study of psychoeducation addressed to a group of patients with schizophrenia followed in the Psychiatric Service of Unidade Local de Saúde do Alto Minho. Brief theoretical review of the topic.

Intervention structured in 16 psychoeducation group sessions. Search PubMed for articles containing the terms 'psychoeducation’ and 'schizophrenia.’

Preliminary results show that patients with schizophrenia consider to be positive being informed about their disease. The intervention also improved the acceptance of their condition schizophrenic person, with the treatments and the limitations that this involves. Initially it was demonstrated enormous difficulty in the interaction between peers, which was not observed with the therapeutic team. This has been improving throughout the sessions.

According to the literature, psychoeducation in schizophrenia promotes adhesion therapy, prevents relapses and improves the quality of life of patients.

Our intervention although limited caused great enthusiasm among the patients making the therapeutic alliance stronger often hard to create and keep in this kind of pathology.

This work can be a starting point for more deeper and extensive studies on this subject.

we formed a small group of patients. All members were seen individually before they were integrated the group and informed about the aims and importance of the therapy. At each session, there was a psychiatrist, at least one clinical psychologist and a nurse present. The sessions lasted one hour and a half and used different types of supports (paper, video, brochures, books). The patients participated actively and were motivated and enthusiastic. They had information about the bipolar disease, worked on their life-chart and learned some CBT tools. At the beginning of each session, they received our written summary of the previous one. An evaluation sheet was circulated at the last session in order to evaluate the impact of the therapy.

none of the patients was hospitalized during the whole fifteen sessions therapy. The paper considers the cases of drop outs.

the experience was very beneficial for patients, their families and the therapists. In response to participants’ request a monthy consolidation session has been organized which participants can attend if they feel a need. A family group (family members and friends) of participants is also scheduled at our outpatient setting. The group of therapists will have a collaborative discussion before planning a new session of the therapy.

Several authors have studied and tried to describe the disturbing schizophrenic internal world: Jaspers, Conrad or Sobral-Cid, a portuguese psychiatrist from early 20th century.

The existence of a previous schizoid personality, delusional atmosphere and self-reference are examples of different steps that will lead to the emergence of delusion.

Louis Wain was an English artist best known for his drawings, which consistently featured anthropomorphized cats, and that suffered from schizophrenia. His work deeply changed as the disease evolved and his mental state deteriorated.

To analyse Wain's mental state by his biography and drawings evolution.

Review of the literature

Wain's drawings reflect his inner experiences and his mental state, so the progression of his artistic work translates his disease development: fragmentation and disorganization of the real. The psychotic deterioration that Wain's work reflects gave him a reputation and particular interest that persisted to the present day.

Insecure attachment and the inability to identify emotions are seen as possible explanations for dysfunction of the emotional system in borderline personality disorder. There is a strong association between Borderline personality disorder and insecure attachment, and the attachment types that are most characteristic of these subjects are unresolved, preoccupied, and fearful. Previous studies have demonstrated that insecure attachment patterns, a trait disposition toward negative affect and impulsivity are associated with borderline personality disorder features.

This review aims to identify the relationship between attachment pattern during childhood and the development of borderline personality disorder in adulthood.

The high prevalence and severity of insecure attachments found in these subjects support the central role of disturbed interpersonal relationships in clinical theories of Borderline Personality disorder.

Suicide is a major public health problem with escalating global trends, and high rates of recidivism. Patients with suicidal behavior have frequent contacts with Emergency Departments (ED). Therefore, the ED has been recognized as a strategic site for initiating interventions targeted at engaging suicidal patients in treatment. However, there is dearth of baseline data to guide such interventions in Nigeria.

This study determined the rates of treatment-engagement (compliance with follow-up appointment) among patients with suicidal behaviour after discharge from a psychiatric ED in Lagos, Nigeria.

The clinical database of 225 consecutive patients discharged from the ED of the Federal Neuro-Psychiatric Hospital Yaba between January and June 2012 were retrieved from the out-patient clinics/mental health service they were referred to. Data were abstracted regarding their adherence with recommended follow-up appointments over a period of six months.

The mean age of the service users was 35.9 ± (14.2) years and 62% were females. At one week post-discharge from the ED, 71.5% attended their appointments. By the end of the fourth week, third month and sixth month, engagement in treatment declined to 54%, 35.5% and 23% respectively.

There is a low rate of engagement in treatment among suicidal patients in Nigeria. This finding highlights an urgent need to develop local ED-based interventions targeted at engaging suicidal patients in treatment, with the view of reducing the risk of recidivism.

Publication of scientific research papers is important for professionals working in academic medical centres. Quantitative measures of scientific output determine status and prestige, and serve to rank universities as well as individuals. The pressure to generate maximum scientific output is high, and quantitative aspects may tend to dominate over qualitative ones. How this pressure influences questionable scientific research practises remains unknown. This is the first study who relates publication pressure with scientific misconduct and questionable research practises.

We performed an online survey inviting all medical scientist (n=2400) of 4 academic medical centres in Dutch speaking part of Flandres, Belgium to participate. Apart from demographic data, they were asked to fill out 2 questionnaires; a validated Publication Pressure Questionnaire and a questionnaire assessing 12 most common items of questionable research practises (QRP).

In total, 316 medical scientists completed the questionnaires. among them, 72% judge that publication pressure ‘has become excessive’, 61% believe that publication pressure ‘affects the credibility of medical research’ and 52% judge that publication pressure has a ‘sickening effect on medical science’. The QRP questionnaire indicates that more than 8 of medical scientists invented or manipulated their data and more than 52% has ever deleted data in order to confirm a hypothesis. Significant and strong associations between different QRP and the level of perceived publication pressure were found. The main limitation is the possibility of response bias.

A substantial proportion of medical scientists believe that publication pressure has become excessive, and have a cynical view on the validity of medical science. These perceptions are statistically correlatedwith questionable research practises. Further research should address the effects of publication pressure on scientific misconduct in more detail in a prospective study design and can be used to find alternative ways to prevent scientific misconduct.

Bullying can occur in several circumstances but nowadays it is largely widespread in schools. Several studies reveal the amount of psychopathology and behavioral changes that it determines, with special focus on children that can suffer silently or react with somatic disorders.

The authors present a clinical case of a girl who was victim of bullying, with the aim to describe the potential impact of bullying, as well as its clinical and social implications.

Report and analysis of the clinical case of a 13 years old girl who was admitted as an outpatient at the Department of Child and Adolescent Psychiatry after being referred by her General Practitioner for having become hoarse abruptly. She has been followed in consultation, medicated with antidepressants and submitted to psychotherapy. We also performed a medical screening, particularly the otorhinolaryngology specialty, which failed to detect alterations that could justify the aphonia.

During the clinical appointments we identified some bullying episodes at school, whose worsening temporally matched with the moment when she became hoarse. After six months of follow-up and intervention, there was an improvement of the mood state; however she only regained her voice after an apology from the bully.

Although some would argue that bullying can teach life lessons and give strength, there is a consensus that it represents a way of abuse. We should pay particular attention in children, since as in this case, they often react with somatic symptoms that can delay and misled the diagnostic and intervention.

IBS is a relatively frequent disorder with about twice as many female patients as male patients. Gender role theories propose that aspects of the female gender role which may lead to increased vulnerability may also induce higher levels of co-morbid psychopathology among females.

Gender roles differ systematically among cultures, in particular in the degree of differentiation between genders. The objective is to investigate possible gender and cultural differences in the relation between IBS and psychopathology.

To test whether both gender and cultural factors such as degree of gender differentiation are associated with variation in the incidence of comorbid psychopathology of people with IBS.

Results from a corpus of 141 studies were analysed by means of a random-effects model in terms of odds ratios between IBS and comparison groups for psychological factors which are indicative of dysfunction (the procedure was analogous to that employed for laterality by Martin et al., Psychological Bulletin, 2010). Meta-regression was used to test for the moderating effects of gender and of the Hofstede cultural factors of masculinity (i.e., gender differentiation), individualism, uncertainty avoidance, and power distance.

Counter to expectations, higher IBS psychopathology odds ratios were associated with samples containing more males and lower gender differentiation. Further, higher levels of psychopathology were found in cultures with lower individualism and uncertainty avoidance, and higher power distance.

Cultural factors and gender are systematically predictive of psychopathology co-morbidity rates in IBS, but the detailed patterns revealed do not support existing gender role theories.

Most people perceive their own future as more positive than the average person's. This optimistic bias may be a concern if it leads to people misjudging health threats and therefore the need for taking preventative steps.

To investigate the generality of recent observations of a reverse, pessimistic bias (i.e., perceiving oneself to be more at risk) in people with Irritable E

The aims are to discover if a pessimistic bias is also found in another psychosomatic condition (CFS/ME) or in another chronic illness (Asthma).

CFS/ME and Asthma patients were compared with healthy controls (matched in age and sex) for their perceived risks of health threats (e.g., arthritis) and threats (e.g., being burgled), for self and for others.

The results for the 3 groups are shown in the graph.

People with CFS/ME tend towards the possession of a pessimistic bias with regard to health threat, but towards an optimistic bias with regard to physical Asthma group tend towards a pessimistic bias with regard to health threat, but tend to be neither optimistic nor pessimistic with regard to physical threat. control group tend towards an optimistic bias with regard to both health and physical threats. Thus, it appears that people with a chronic condition tend toward pessimistic bias, as opposed to the optimistic bias found in the healthy. Materials devised to promote appropriate health-related behaviour may need to be the two different populations.

The Olfactory Reference Syndrome (ORS) is a clinical condition in which patients are convinced that they exude an unpleasant odor that is noticed by others. It was described for the first time in 1891, but became relevant in the nosology with Phillips in 1971. Since then discussion remains about diagnostic framework of this clinical entity.

About a clinical case series, the authors intend to review clinical features, nosological framework and response to treatment of the ORS.

Review of literature collected from online medical databases. Report of a case series of five patients with ORS.

The literature on the ORS consists mainly of case reports, and there are few controlled studies and systematic reviews. It was found that in most cases the complaints relate to a typical body odor, more often fecal, genital or halitosis. These beliefs range from overvalued ideas to delusions with strong conviction and they are usually accompanied by ideas of self-reference. Patients do not always smell the odor that they believe to emanate. The disturbance has high social, family and work impact. The response to treatment is variable and it was observed at different rates when antipsychotics, antidepressants and psychotherapy are used.

Although it was proposed for integration in DSM-5 as an independent entity, the ORS was not so defined, remaining as a disorder whose characteristics overlap other diagnoses, including delusional disorder, in which is usually included, but also disorders from the obsessive-compulsive spectrum and social anxiety, given the variability of morbid consciousness. We also discuss the possible relationship of the ORS with symptoms of olfactory expression in other psychiatric disorders. The ORS deserves the attention of psychiatrists since it brings great suffering for the patient, as well as high demand for non-psychiatric care and the consequent delay in diagnosis and treatment.

Impulsivity is recognized as a predisposing factor for addictive and suicidal behavior in bipolar patients. We aim to study the impact of childhood traumatic experiences on the development of impulsive behavior in patients with bipolar disorder and the particularties of these patients

Case-control study during a period of six months. Euthymic patients with bipolar disorder were enrolled. The two groups were compared by the scores of the Barratt Impulsivity Scale (BIS-10) and the Childhood Trauma Questionnaire (CTQ).

The total impulsivity scores of motor and cognitive impulsivity in subjects with bipolar disorder were higher than in control subjects (with respectively p=0,001 ; p=0,005 ; p=0,002). There was a statistically significant difference between bipolar patients and controls regarding the CTQ total (p<10-3) and sub-scores for emotional abuse (p<10-3), physical neglect (p=0,01) and physical abuse (p=0,001) which were higher among patients. There was a correlation between the average total CTQ score and the average total score of impulsivity in the BIS-10 in patients with bipolar disorder (p=0,04). Impulsivity was associated with a childhood full of traumatic events, particularly in bipolar patients.

It is interesting to routinely use impulsivity scales (especially the BIS) and Childhood Trauma Questionnaire as indicators of high risk of addictive behavior in bipolar patients. This is paramount in order to develop appropriate therapeutic measures for this group of patients, often responding poorly to standard care.

To help out the new starters in psychiatry training to familiarise them with working in the NHS and the training scheme. This will also allow some kind of mentoring and support for the junior psychiatrists in Oxford deanery.

This scheme was piloted by psychiatry trainees in 2009.

Each new core trainee (CT1) is linked up with a more senior third year core trainee (CT3) on a voluntary basis. It is mainly designed to help the new trainee, but should also have benefits for the link trainee e.g. educational leadership and teaching experience.

A central feature of the scheme is that it should be adaptable to the needs of both parties. The Link CT3 should agree to a minimum commitment of 4 sessions, but it may be that the CT1 is happy with fewer than that.

The programme has been running over the last four years in Oxford and with the help of many colleagues we have been able to get very good and helpful feedback about the scheme and the way it works. Most trainees were happy with it and some of them suggested some modifications.

The Link Trainee Scheme is a very helpful programme that is widely accepted by psychiatry trainees both at a junior and senior level.

In a recent feedback, some trainees suggested involving senior registrars in the scheme and we have been piloting this for the academic year 2013-2014.

This scheme has been adopted by other deaneries in Britain.

The concept of delusional disorder was coined only in 1977 despite being used in reports and observations over the last 150 years. In fact, it was Kraepelin's seminal work that defined the frame for delusional disorder. The presence of nonbizarre delusions in the absence of other mood or psychotic symptoms characterizes this disorder. These delusions can be persistent and have a stable course. Its prevalence is of 0,03% and the mean age of onset 40.

To describe the case of a central hospital psychiatric outpatient and it's comparison with the international available literature.

Retrospective analysis of the clinical process.

the authors present the case of a 78 years-old woman, married, previously healthy and functional, followed in an outpatient Psychiatric liaison consult since 2010. She presented with behavioural changes towards her husband and family developed after clinical discharge related with the treatment of Chronic Lymphocytic Leukemia 3 years before. She had a delusional belief that her husband had a romantic liason with the house keeper, not folding logic. She also had delusional interpretations of their behaviours. Despite that, she had no other psychopathology and functioned normally.

Our current understanding of delusional disorder is limited by scarce scientific data consisting mostly of individual case reports. The psychopathologic characteristics and age of onset make this case unique.