Needs assessment has been highlighted as a crucial factor in the development, organisation and evaluation of mental health services. Moreover, meeting self-reported needs is of prime importance for ensuring quality of life and reducing social disability for people with severe mental disorders.

Service evaluation based on patients’ need assessments has never taken place in Greece. Furthermore there are no standardized needs assessment instruments. Given the underfunding of psychiatric services due to the current economic crisis, systematic need assessment is expected to contribute to the efficient use of their limited resources.

To examine the concurrent validity, inter-rater and test-retest reliability of the Greek research version of the Camberwell Assessment of Need (CAN-R).

Fifty-three schizophrenia patient–staff pairs were interviewed twice to test the inter-rater and test-retest reliability of the CAN-R (Greek version). The WHOQOL-BREF and WHODAS 2.0 were administered to the patients to examine concurrent validity.

The inter-rater and test-retest reliability of patient and staff interviews for the 22 individual items and the eight summary scores of the instrument's four sections were good to excellent. Significant correlations emerged between CAN scores and the WHOQOL-BREF and WHODAS 2.0 domains for patient and staff ratings, indicating good concurrent validity.

Our results suggest that the Greek version of the CAN-R is a reliable instrument for assessing mental health patients’ needs. This is the first CAN-R validity study with satisfactory results using WHOQOL-BREF and WHODAS 2.0 as criterion variables.

Substance abuse by young people remains one of the most widespread and costly problems in Europe. Some previous studies reported an association between sexual orientation and substance use whereas it is assumed that religiosity could be a protective factor regarding substance use.

To better understand the relationship between substance use, sexual orientation and religious beliefs.

The C>SURF study concerns Swiss male adults who have to go through the mandatory recruitment process at the army. Data were collected between August 2010 and November 2011. A questionnaire about the participants’ socio-professional and family background, their consumption of alcohol, cannabis and other drugs, as well as their personality was sent to be filled in online. The final sample included 5990 males between 17.9 and 31.4 years old (mean=20.01, sd=1.24). 77% of subjects declared belonging to a religious community whereas 29% said they are atheists. 91% described themselves as being exclusively attracted by females, 8% by males and females and 1.0% by males only.

Belonging to a religious community or declaring not being atheist seems to be a protective factor regarding any substance use. Heterosexual men declare most often belonging to a religious community but they do not differ regarding being atheist. Logistic regression on predicting the belonging to a religious community additionally shows a significant interaction between cannabis use and being gay.

There are significant associations between substance use, sexual orientation and religious beliefs and a better understanding of these relations would lead to a relevant clinical impact.

Ever since the first description of Lemere in 1936 describing the capability to ‘……produce ‘good’ alpha waves…’ to be associated with the ‘…affective capacity of the individual…’ 1, research on this EEG measure in Depression (MDD) has attracted wide attention. Several studies have shown that responders to various antidepressant treatments are characterized by increased posterior alpha power in MDD (reviewed in 2). Another dimension of alpha is its frequency; also called alpha peak frequency (APF) and several studies have found a slow APF to be related to non-response to medication and rTMS 2. Therefore, in this study we aim to investigate in a large sample whether these two alpha measures can predict treatment outcome to antidepressants.

A multi-center, international, randomized, prospective open-label trial (International Study to Predict Optimized Treatment – in Depression, iSPOT-D), where MDD patients were randomized to: Escitalopram, sertraline or venlafaxine-XR. Treatment response was established after eight weeks using the Hamilton Rating Scale (HRSD) and the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR).

A total of 1.007 MDD patients and 336 healthy controls were included in the study.

Sensitivity, specificity, positive and negative predictive values for remission will be reported for all patients and for medication types

Genome-wide association studies indicate that two single-nucleotide polymorphisms (SNPs) in the ANK3 gene, rs10994336 and rs9804190, increase the risk for bipolar disorder (BD). The ANK3 gene encodes the ankyrin-G protein and influences neuronal firing by changing sodium channel functions, thus impacting on brain regional activation.

We examined the effect of the two ANK3 SNPs on brain activation during a working memory task.

The aim of our study is to investigate whether the genetic risk associated with the two SNPs is coupled with abnormal activation in the working memory network.

We used functional magnetic resonance imaging data to investigate the impact of ANK3 rs10994336 and ANK3 rs9804190, on brain activity during a 3-back working memory task in 41 BD patients, 25 unaffected first-degree relatives and 46 healthy individuals (HI).

For the ANK3 rs10994336 (risk allele T), significant diagnosis x genotype interactions were observed in the left prefrontal (BA10/BA11), anterior cingulate (BA32/BA25) and posterior cingulate (BA31) cortex. These regions, risk allele carriers who were either patients or unaffected relatives showed increased activation compared to healthy controls carrying the risk allele. For the ANK3 rs9804190 (risk allele C) a significant effect of genotype was found in the right anterior cingulate (BA24), where subjects carrying the risk allele showed decreased activation compared to subjects carrying the protective allele.

Our data demonstrate that the effect of ANK3 rs10994336 and ANK3 rs9804190 on the brain converges on key regions involved in working memory processing.

Personality assessment of individuals entering treatment for alcohol dependence appears to play a key role in planning the therapy as well as in establishing viable therapeutic treatment goals and their implementation. High Neuroticism and low Conscientiousness (NEO-PI-R) are associated with problematic drinking and alcohol dependence and promote relapse.

Investigation of the personality in alcohol-dependent people entering treatment.

The aim of the current study is to analyze the personality traits of alcohol-dependent people in relation to Polish population norms.

Results for 977 alcohol-dependent patients at the beginning of the treatment programme were subjected to analysis. The focus group comprised 743 men (76%) and 234 women (24%); the average age was 42 years. Personality traits were assessed using the NEO PI-R Personality Inventory adapted into Polish, taking into account age and gender.

The method of agglomeration and k-means clustering for k = 2 were used. A comparison of the sten scores of the entire group with population standards did not reveal any deviations in the core factors; however, three components of Neuroticism displayed higher values. Two clusters emerged: the first group consisted of 556 patients (59%), and the second of 421 patients (41%).

The first profile, characterised by high Neuroticism and low Conscientiousness, is compatible with the majority of results in various populations and predisposes to alcohol abuse, addiction and post-treatment recurrence. The second profile corresponded to the population standard and the presence of traits which are desirable resources in treatment.

According to the cognitive theory, negative automatic thoughts (NAT) and dysfunctional attitudes (DA) are important causal factors for the onset and maintanence of depression. There is limited data on the effects of NATs and DAs on the recurrence of depressive episodes. This study aims to compare the NATs and DAs of first versus recurrent episode depressive patients. The hypothesis of the study is that the intensity of negative cognitions will parallel the number of recurrences.

For the study, 100 first episode and 100 recurrent episode major depressive disorder diagnosed outpatients and 100 healthy volunteers presenting to the psychiatry clinics of three hospitals in Turkey were recruited. The participants were diagnosed by MINI, asked to complete the BDI, ATQ and DAS. Statistical analyses were undertaken to predict the variables affecting recurrence.

The groups were not statistically different on sociodemographic variables. The mean NAT and DA scores were highest in the recurrent depression group. Regression analyses for the prediction of recurrence revealed that perfectionistic attitude, severity of depression and number of hospitalizations were the most correlated variables. The number of recurrences was correlated with the perfectionistic attitude scores.

These results show that the NATs and DAs of first episode depression patients differ from those of the recurrent episode depression patients, and the number of recurrences are predicted by perfectionistic attitudes. This has clinical implications in the treatment of depression, particularly points out to the need to manage perfectionistic attitudes to prevent recurrences.

Dysregulation of the hypothalamic-pituitary-adrenal (HPA-)axis is hypothesized to play a role in the pathogenesis of bipolar disorder (BD). Conflicting results have been reported when saliva or serum was used to measure cortisol levels. A recently developed method is to measure cortisol in scalp hair, with one cm of scalp hair representing one month. We studied whether there are differences in long-term hair cortisol levels between BD patients and healthy individuals and whether there are associations between hair cortisol, life events and disease characteristics.

Hair samples were collected in 100 BD patients and 195 healthy controls. Long-term cortisol levels were determined in 3 cm hair segments. Saliva samples were collected on two consecutive evenings. Documented disease characteristics were disease state, age of onset, psychiatric co-morbidity, and life events.

Hair cortisol levels were not statistically different in BD patients compared to healthy controls (p=0.233) and were not associated with the disease state at the moment of sample collection (p=0.978). Clinical characteristics, such as age of onset ≥30 years (p=0.004) and psychiatric co-morbidity (44.87 versus 31.41 pg/mg hair; p=.021), appeared to associate with higher hair cortisol levels. Panic disorder associated with decreased cortisol levels (22.13 versus 34.67 pg/mg hair; p=0.019). The occurrence of recent negative major life events, but not of positive major life events, was associated with an increase in HCC in BD patients.

Major depressive disorder (MDD) has harmful effects on an individual's personal life. In the European Union, in any given year, about 7% of all adults suffer from it. Primary choice of medical management is pharmacotherapy - second generation antidepressants (SGA). Some SGA are available as both immediate-release (IR), and extended-release formulations. Advantages of extended-release formulations may be the potentially improved adherence, and tolerability.

The objective of this systematic review was to assess the comparative efficacy, risk of harms, and adherence of IR- and extendedrelease antidepressants for the treatment of MDD.

To systematically review the evidence on differences between IR and extended-release formulations to provide an objective basis for clinical decision-making.

Abstracts were retrieved from PubMed, EMBASE, the Cochrane Library, PsycINFO, and International Pharmaceutical Abstracts from 1980 to October 2012 as well as from hand search. We dually reviewed abstracts and full-texts and assessed quality ratings. We conducted network meta-analyses using Bayesian methods, due to the lack of head-to-head trials. Response on the Hamilton Depression Rating Scale (HAM-D) was our outcome measure.

We located seven head-to-head trials and 94 placebo and active controlled trials for network meta-analysis. Overall, our analyses show that IR and extended-release formulations of bupropion, trazodone, venlafaxine and paroxetine have similar efficacy. However, evidence suggests that there might be a difference between formulations based on adverse events and adherence.

Current evidence couldn’t prove a significant difference in the efficacy of IR- and extended-release formulations.

To review the role of the precuneus in major depression

We will review the literature involving the precuneus in the pathophysiology of depression. We will also report a recent study of our group using structural MRI and VBM analyses to assess the role of precuneus in Autobiographical Memory (AM). Visual perspective during AM retrieval was assessed in two independent datasets of 45 and 20 healthy young adults with two different AM retrieval tasks.

Precuneus, a medial part of the parietal cortex, is a central component of the default mode network. Results from our VBM study show that the precuneus volume in healthy subjects is correlated with the ability to retrieve autobiographical memories with a first-person perspective. Consistent with its role in integration of self-relevant mental simulations with past experiences and visuo-spatial processes during AM retrieval, the precuneus may subserve emotion regulation processes in healthy subjects and depressed patients. The precuneus and the default mode network show abnormal connectivity in depressed patients that may indicate abnormal self-processing in depression.

Abnormal activity and connectivity of the precuneus within the default mode network is associated with impairment in self-processing in depression and may be related to the tendency of depressed patients to retrieve AM using third-person perspective. Further studies are needed to evaluate if impaired function or structure of the precuneus may predict the clinical response to antidepressant treatment.

Antipsychotic drugs (APDs) are the first-line pharmacological treatments for schizophrenia. Recent human studies have found that myelin integrity could be improved by APD treatment in schizophrenia patients. Previous studies indicated that regulation of oligodendrocyte development and function may be a novel target for APDs.

The aim of this current study was to examine the possible effects of the antipsychotic drugs (APDs) haloperidol (HAL), olanzapine (OLA), and quetiapine (QUE) on the development of oligodendroglial lineage cells.

CG4 cells, an oligodendrocyte progenitor cell line, were treated with various concentrations of HAL, OLA, or QUE for specific periods. The proliferation and differentiation of the CG4 cells were measured. The regulation of CG4 cell differentiation by oligodendrocyte lineage transcription factors 1 and 2 (Olig1 and Olig2) was examined.

The APDs used in this study had no effect on the proliferation of CG4 cells. The APDs elevated the expression of 2’,3’-cyclic nucleotide 3’-phosphodiesterase (CNP), a specific marker of oligodendrocytes, and promoted the CG4 cells to differentiate into CNP positive oligodendrocytes. QUE and OLA increased the expression of Olig1 and Olig2 whereas HAL only increased the expression of Olig2.

Our findings suggest that oligodendrocyte development is a target of HAL, OLA, and QUE and provide further evidence of the important role of oligodendrocytes in the pathophysiology and treatment of schizophrenia. They also indicate that the expression level of oligodendrocyte/myelinrelated genes could be profoundly affected by APDs.

Planning ability as a critical component of executive function has been used to investigate prefrontal cortex (PFC) function in Schizophrenia patients by several neuroimaging studies. However, the changes of PFC activation after effective antipsychotic treatment are still unclear.

The aim of this study is to explore whether there is any variation in the prefrontal hemodynamic response during Tower of London test after 6 weeks’ antipsychotic treatment in schizophrenia patients, and the relationship between the changes in PFC activation and some demographic factors as well as the severity of the patients’ psychiatric symptoms.

40 patients with first-episode schizophrenia were recruited for the present study. 28-channel NIRS (near infrared spectroscopy) was used to measure changes in hemoglobin concentration in the prefrontal cortical surface area during Tower of London (TOL) test—a classic neuropsychological test for planning abilities. The patients were examined before treatment and after six weeks’ treatment with second-generation antipsychotic medicines.

After the short-term treatment, the patients’ TOL test performance and the activations in PFC during the task period did not differ from baseline (P>0.05), although the psychiatric symptoms of the patients were improved significantly(positive subscale score 18.25±2.86 & 12.75±2.60; general psychopathology 33.67±3.65 & 27.00±3.67; PANSS total score 72.25±7.07 & 55.42±7.53; P<0.001).

It suggests that the impairment of cognitive function and the function of the PFC of schizophrenia patients would not be improved with the improvement of psychiatric symptoms, as further support the hypothesis that PFC damage is a durable impairment for schizophrenia.

It is well known that medical students are subjected to different levels of stressors during various stages of their study. Exposure to severe and prolonged stressors may cause serious psychological distress that may hinder students’ academic performance and may affect their mental and physical health as well. Therefore, this study aimed to determine the prevalence of psychological distress among medical undergraduate students throughout the different stages of their study.

A sample of 551 undergraduate medical students from Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia participated in this study (First year 141, Second 119, Third 109, Fourth 101, Fifth 81), the psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12), which is the short version developed by David Goldberg and Paul Williams. A binary scoring method was used to evaluate responses (i.e. 0-0-1-1). The rate was compared between different stages of the academic programme.

The overall prevalence of psychological distress among medical students was found to be 31.2% and the rate was higher during clinical than preclinical phases (33.7% and 28.5% respectively). Gender wise, it was found that the rate of psychological distress was significantly higher among female (35.5%) than male students (24.3%).

Psychological distress is common among medical students, it is higher among female than male students, and the rate is higher during clinical phase than preclinical phase.

Depression and pain symptoms are often comorbid and share common neurobiological and psychological background.

To find out the prevalence of painful physical symptoms (PPS) in otherwise healthy patients hospitalized due to recurrent unipolar (UD) and bipolar depression (BD) and to compare socio-demographic and illness related characteristics.

180 somatically healthy patients were recruited in the study. Symptoms of depression were evaluated with standard clinical tools. The presence of somatic illness was excluded. Visual Analogue Scale was used to evaluate the intensity and location of painful symptoms. Sociodemographic, illness and therapy related data, substance use, and suicidality were recorded as well.

41 patients met criteria for BD and 139 for UD. The average age was 50 years (75% females). Higher prevalence of PPS in group of UD (72.6%) in comparison to BD (58.5%) was found. The average intensity of painful symptoms was high. Patients with UD+PPS had higher total number of PPS and scored higher on HAM-D21 and Zung Self Rating Depression Scale than patients with BD+PPS. Use of analgesics and anxiolytics was high.

The study offers an insight in the high prevalence of PPS in patients with acute severe unipolar and bipolar depression and the results warn of possible over prescribing of analgesics and anxiolytics. Lower prevalence of PPS in BD might be explained with less severe depression symptoms. The results offer new information on PPS in acute bipolar depression since there is very little research data on this topic.