N-methyl-D-aspartate (NMDA) receptors are ligand-gated receptor complexes that have been associated with learning and memory, pain transmission, depression, schizophrenia and neurodegenerative disorders. In these processes deficiency of magnesium has a significant role. Magnesium and MK-801, noncompetitive NMDA receptor antagonists, have been demonstrated analgesic efficacy against neuropathic pain, but there are no data about the effects of these compounds on visceral pain.

Comparison of the analgesic activity of NMDA antagonists against visceral inflammatory pain.

This study aimed at evaluating the effect of magnesium sulphate (MS) and MK-801 in writhing test in rats.

In writhing test, a model of visceral inflammatory pain, injection of diluted acetic acid into the peritoneal cavity of male Wistar rats induced pain. MS and MK-801 were given subcutaneously 15 min before the intraperitoneal injection of 0.7% acetic acid.

MS at doses of 5 and 15 mg/kg did not affect the number of writhing in rats, but doses of 30 and 45 mg/kg significantly potentiated writhing 2.9 and 2.4 times, respectively. MK-801 (0.005 and 0.01 mg/kg) produced dose-dependent antinociception manifested as reduction in the number of writhing and the maximum antinociceptive activity was 61.3%.

MK-801 in the writhing test produced antinociception likely due to the inhibition of NMDA receptors. Effect of magnesium was different from MK-801. MS did not inhibit and even aggravated pain evoked by chemical stimuli in visceral pain test. The present results suggest that the MS may not be useful systemic analgesic in the therapy of visceral inflammatory pain.

Truancy is a serious public health problem that affects adolescents from all countries around the world. It negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions. Young who are habitual truants are more likely to engage in at-risk behaviour like suicidal behaviours.

This analysis investigated the prevalence of truancy and suicidal behaviours in the Italian sample.

to reduce truancy among European adolescents improving mental health in European high schools.

the WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6±0,6; 64,4% females) was selected. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, suicidal behaviour and mental health issues was collected using a structured questionnaire.

6% has been absent from school for 7 days or more without a valid excuse during the past year (6.6% male); 20,3% as considered as truant student (three or more skipped days per month without a valid excuse in the past year). 4,6% have seriously considered taking own life during past 2 weeks have thought about suicide, and 1,2% tried to take own life in past 2 weeks. The analysis showed as correlation between skipped school and suicidal behaviour (p < .001)

Teens engaging in risk behaviours are at increased odds of depression, suicidal ideation, and suicide attempts (Hallfors et al. 2004). The preliminary We-Stay data confirm the prevalence of at-risk behaviours is higher among truant students.

Social anxiety (SA) is a dimensional psychological trait that unfolds as a continuum from normality to pathology. While studies have focused on brain response when individuals are exposed to social situations, little is known about neural correlates of trait SA in the absence of any social triggering.

To test the hypothesis that brain resting state activity is modulated by trait SA, we measured the Hurst Exponent (HE), an index of complexity of time series, in healthy individuals.

Resting-state fMRI time series were recorded in 36 subjects (16 F; mean age±S.D. = 26±3 years). All volunteers were healthy without any psychiatric, medical and neurological disorders. Each subject completed the Liebowitz Social Anxiety Scale (LSAS).

HE was estimated by using the discrete second-order derivative approach and its relationship with social anxiety was tested across the whole brain.

LSAS scores predicted HE in the posterior cingulate/precuneus (significant positive correlation).

Our results indicate that the brain pattern of spontaneous activity is influenced by the degree of social anxiety, as a continuum. Moreover, as this relationship between the degree of SA and brain activity was found at rest in the absence of any relevant social stimuli, our findings suggest that social anxiety may be a trait characteristic that shapes brain activity and predisposes to abnormal reactions to social contexts.

Obesity has been associated with cognitive impairment. However, it is not clear whether cognitive impairment may depend on concomitant psychopathology, since several psychiatric conditions, e.g. schizophrenia, include cognitive deficits among their manifestations.

To assess cognitive performances and psychopathology in obese patients, and to compare cognitive alterations in obese patients with those in schizophrenics and controls.

To compare cognitive performances in obese patients to normal percentiles. To provide an analysis of correlation with specific psychopathological domains. To evaluate whether cognitive performances in very obese patients were different from those in schizophrenia patients and non-affected controls.

88 obese patients were included. Exclusion criteria were: axis I and II diagnosis; severe medical, neurological, or endocrinology conditions. Patients underwent an extensive battery of cognitive tests and completed the Toronto Alexithymia Scale (TAS-20), the Barratt Impulsiveness Scale (BIS-11), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI). In the second part of the study, very obese patients (BMI>40; n=16) were compared for cognitive performances to schizophrenia patients (n=16) and non-affected controls (n=17).

Obese patients performed at low percentiles (<15) on the Problem Solving and the Social Cognition tasks. Mean scores on psychopathology rating scales did not reach abnormal values. No correlation was found with psychopathology. When compared to schizophrenics, no significant differences were found in performances on spatial working memory.

Obese patients show cognitive alterations even in the absence of abnormal psychopathology. Very obese patients share cognitive alterations with schizophrenia patients, which may imply common neurobiological basis.

Psychosocial factors are often underestimated in psychotic patients, although they may profoundly influence (and be influenced by) clinical presentation and effectiveness of therapeutic interventions in these people.

To investigate relevance, relationship with clinical presentation and overall quality of life of multiple psychosocial factors in psychotic patients.

To evaluate whether knowledge about the illness and utilization of health services are defective in psychotic vs. non-psychotic patients and whether these correlates with the type of psychotic symptoms, cognitive performances, global social functioning, quality of life, and acceptance of pharmacotherapy.

Approximately 110 patients were enrolled after written informed consent. Patients were administered the Positive and Negative Syndrome Scale (PANSS), the Personal and Social Performance scale (PSP), the Drug Attitude Inventory (DAI), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). All patients were also screened for cognitive performances. Patients and relatives completed a questionnaire on knowledge about the illness and on the level of utilization of mental health services. Patients were subdivided in psychotic (cases) and non-psychotic (controls) based on their score on the PANSS.

Psychotic patients and their relatives showed lower levels of knowledge about the illness. These features were associated with the other variables assessed in a very complex and multidimensional model of reciprocal influences.

Lack of response to pharmacological treatments and to overall therapeutic interventions in psychotic patients may also depend on multiple psychosocial factors, which may be carefully investigated and become the target of adjunctive, effectiveness-focused interventions.

Stigma still represents one of the main obstacles to effective treatment of mental disorders and to social integration of those with mental illness. Studies exploring the levels of knowledge and the attitudes of young people toward mental disorder may help to reduce stigma by improving integration of people with mental disorders.

to describe opinions and attitudes of high school students toward mental disorders.

to assess:1)the level of knowledge on mental disorders;2)the opinions about people affected by mental disorders in a sample of high school students.

This study, promoted by the Department of Psychiatry of the University of NaplesSUN within the collaboration with the World Health Organization, was carried out in a secondary school located in the catchment area of Naples. The level of knowledge and the opinions on mental disorder were evaluated using the Questionnaire on Opinions, previously validated.

177 students attending the last two years of secondary school were recruited. Fifty-four percent of the sample were female, with age of 17.5(±0.6) years. about 40% of students identified the main clinical characteristics of affective disorders. Half of the sample stated that mental disorders should not be treated by psychiatrists, but by other health professionals (psychologists, 32%; neurologists, 18%; general practitioners, 4%). As regards opinions on civil rights, about 50% of students affirmed that patients should not vote and 41% that they should not get married.

The results show that the level of knowledge about mental disorders in young people is still very poor and the levels of stigma are still very high. Informative seminars dedicated to target population may be helpful to improve knowledge and reduce stigma.

Internet currently has 513 million users worldwide and the young continue to be one of the largest groups of users. 23% use the Internet to look for information about depression or mental illness and about problems with drugs or alcohol (Rideout, 2001) but more than 20% of Internet help-seekers were dissatisfied with the help they received (Gould et al., 2002).

SUPREME (Suicide Prevention by Internet and Media Based Mental Health Promotion) is aimed to increasing the prevention of risk behaviours and mental health promotion through the use of mass media and Internet.

The main expected outcome of the project is to improve mental health among European adolescents and young adults.

A sample about 1800 students (average age of 15 years) is selected in six different European Countries. The prevention program consist in a highly interactive website that permit to inform the knowledge about suicide, stimulate young people to become active in promoting mental health and increase the probability to seek help. There are 3 intervention arms: Peer Ambassador, Professional Ambassador and a Control Group. A questionnaire was administered to the pupils for require the data on lifestyles, values and attitudes, psychological well-being, familiar relationship and friendship.

The transition between adolescence and adulthood is a fundamental period for ascertaining the current and future health of an individual. Through SUPREME project an high number of young are been achieved, providing them information about suicide prevention and mental health promotion

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopment disorder, which around 2/3 of the patients may still have ADHD symptoms (ADHDs) during adulthood. Symptoms’ presentation can turn into ongoing attention problems, disorganization and symptoms of emotional dysregulation throughout adulthood. Adult ADHDs may lead familial, academic and occupational dysfunction, risky behaviours and selfmutilation.

The study aims to investigate the relationship of ADHDs with risky behaviours and psychological symptoms among students.

Among a total of 803 randomly selected students from two universities, regarding exclusion criteria 582 was remained and grouped into three groups due to the Turkish version of the Adult ADHD Self-Report Scale (ASRS) cut-off scores, namely, highly likely (HLG), likely (LG) and without ADHD (WG), respectively. They were assessed through online close-questioned and likert-type data form related to risky behaviours and psychological symptoms. Chi-square test and ANOVA were used.

The size of three groups were 15,1%(n=88), 22,2%(n=129) and 62.5%(n=365), respectively. Although gender was insignificant across groups, age mean was lower for HLG than WG (not shown). The rates of psychological symptoms such as depression and anxiety symptoms, interpersonal sensivity, seeking excitement, risky behaviours and self-mutilation were higher in the HLG (not shown).

Consistent with previous studies, the HLG had more associated comorbid psychiatric disorder symptoms. Thus, assessment of ADHDs in university students may useful for realizing risky behaviours and psychological symptoms for this population.

Non-adherence to psychosocial and behavioral treatment is a significant public health problem that presents a barrier to recovery and effective treatment. An estimated 20-70% of individuals who initiate psychosocial mental health services discontinue treatment prior to the clinicians’ recommendation. Empirically supported, evidence-based stand alone or adjunctive psychosocial interventions treat an increasingly wide range of mental health conditions; however, a core underlying assumption of most, if not all, interventions is that clients will fully and actively engage in the treatment protocol. While the influence of medication adherence has been more fully investigated, psychosocial treatment adherence has received less scientific attention.

Study aims include: (1) conceptualize and categorize psychosocial treatment adherence, (2) examine predictors that influence adherence to psychosocial treatments, (3) identify treatment response patterns that relate to adherence, (4) summarize measures of adherence, and (5) describe existing interventions to enhance psychosocial treatment adherence.

Peer-reviewed publications on psychosocial and behavioral treatment adherence were searched using Medline and PsycINFO electronic databases between 1980 and 2013.

It is crucial that clinicians and researchers systematically consider the role of adherence in their intervention protocols, including: (1) identifying and assessing barriers that may place clients at higher risk for non-adherence; (2) measuring multiple forms of adherence in their work; (3) addressing identified barriers with their clients; (4) considering factors within their practice or approach that can be modified to reduce barriers to adherence; and (5) adding adjunctive adherence strategies or interventions to prospectively promote psychosocial treatment adherence.

According to several international guidelines, lithium is still the first choice for treating mania and for prophylaxis of bipolar disorder. Nevertheless, in the last decades clinicians prefer to use anticonvulsivant drugs such as valproate and carbamazepine to lithium, which are easier to manage and with less side effects.

1)to describe prescribing patterns in Italian mental health centres in patients with bipolar I disorder;2)to assess clinical and social characteristics of patients receiving lithium.

to assess the current status of use of lithium in the Italian clinical practice.

The study, coordinated by the Department of Psychiatry of the University of Naples SUN, was carried out in 11 randomly recruited Italian mental health centres. In each site, 16 patients were recruited if they had a diagnosis of bipolar I disorder, were aged between 18-65 years, were on the caseload of the local mental health centre for at least six months, and had experienced at least one affective episode in the past three years. Data on pharmacological treatments were obtained from clinical records.

The sample consisted of 140 patients, 118(84%) were receiving mood stabilizers, 84(60%) antipsychotics, 57(41%) antidepressants and 45(32%)benzodiazepines. Valproate was the mood stabilizer more frequently prescribed(58%); lithium was prescribed to 35% of patients. Those receiving lithium had a longer contact with the local mental health centre(105.9±77.6monthsvs. 79.0±68.5;p<.05), had more involuntary admissions(2.0±5.0vs. 0.6 ±1.7;p<.05) and a higher severity of depressive symptoms at the BPRS(2.2±0.9 vs. 1.9± 0.7;p<.05).

Our data confirm the general principle that lithium is not frequently prescribed in clinical practice and it is given only to more severe patients.

Despite annual investments of millions of dollars to develop and disseminate interventions for mood disorders in adolescence, approximately a third of youth dropout or terminate prematurely. Low adherence remains a fundamental impediment to treatment effectiveness and mental health outcomes.

To address this issue, the Tech Connect Program was developed as a proactive and simple to implement package of manualized between-session contacts (e.g., texting, phone calls) and structural supports (e.g., transportation, childcare) that are individualized to increase adherence of adolescents with mood disorders who are at high risk of treatment dropout from community-based treatments.

A 2-arm randomized controlled trial (RCT) with depressed youths (age 13-17 years) and parents randomized to either standard community-based mental health care (control condition) or the Tech Connect Program plus standard clinical care (treatment condition) was implemented to examine the feasibility and acceptability of the Tech Connect Program protocols, to estimate intervention parameters including recruitment and attrition rates, and assess the preliminary impact of the intervention on treatment adherence and mental health outcomes.

Findings show that Tech Connect Program is both feasible and acceptable to clinicians, youth and their families.

Although further research is needed to evaluate the Tech Connect Program, this feasibility pilot study has demonstrated an innovative, novel intervention to improve adolescent engagement and adherence to community-based mental health treatment.

Treatment early in the course of psychosis can improve prognostic outcomes, facilitate adaptive functioning, and reduce familial and societal burden. However, little is known about the pathway of first-episode psychosis (FEP) from the perspective of highly adherent adolescents and young adults.

To understand the pathways in youth self-determination and self-management of treatment by investigating youth and parents’ changing perceptions of illness in the early course of psychosis.

Twenty-eight (n=28) interviews were conducted using a semi-structured interview guide on 12 adolescents following their FEP hospitalization and 16 parents. Standardized self-report forms and hospital inpatient records were used to collect demographic and clinical data.

On average, three years had passed from initial hospitalization (age 16.2 years, SD=1.2) to time of interview (age 19.3 years, SD=2.3), thus allowing for a range of experiences across the early period of illness. Highly adherent adolescents experienced identifiable temporal phases of early psychosis, comprised of emergent and specific themes. Parents described a parallel pathways towards supporting their child's selfdetermination and self-management of treatments, with some distinct experiential differences. Five dominant themes that emerged across time were symptom recognition, awareness of change, negative appraisals, positive appraisals, and treatment self-management.

Examining how these themes evolve over the early course of psychosis can help guide interventions that are compatible with the parent and adolescent's perceptions of illness at that point in time, and can therefore work in concert with the family's existing efforts to understand and manage their emerging condition and progress towards recovery.

Long-acting injectable (LAI) antipsychotics have been used as an alternative to oral antipsychotic formulations.

to evaluate the impact of switching to a LAI second-generation antipsychotic (SGA) in terms of changes in patient's psychopathology, subjective experience of drug and quality of life.

18 adult outpatients diagnosed with Schizoaffective disorder (by means of the SCID-I/P) and attending the Psychiatric Unit of the University of Florence were recruited. All patients were under a stabilized therapy with a single oral SGA (either olanzapine or paliperidone) and were switched to its corresponding LAI formulation (olanzapine pamoate or paliperidone palmitate). Patients were assessed by means of the following questionnaires: MADRS, YMRS, PANSS, DAI-10, SWN and SF-36 at enrolment (T0) and after 6 months (T1).

A significant reduction was found between T0 and T1 (p<.05) in PANSS total, negative and general psychopathology mean scores, as well as in mean MADRS and YMRS total scores. No difference was found for positive PANSS mean scores. We observed a significant increase of mean DAI-10 and SWN total scores between T0 and T1 (p<.05). A reduction of side effects like sedation and blunted affect between T0 and T1 (p<.05) was confirmed by significant increases in mean SF-36 subscales scores, such as: general health (p<.01) change in health (p<.01) and social integration (p<.05).

Treatment with LAI SGAs seems to be a valid alternative in patients with Schizoaffective disorder. Our preliminary data suggest an improvement in patient's subjective experience of pharmacological therapy and health-related quality of life, together with a similar efficacy on psychopathology.

Few studies have compared the available antidepressants in terms of effectiveness in long-term treatment of Major Depressive Disorder (MDD) (Furukawa et al., 2007; Hansen et al., 2008).

Long-term prevention of relapses/recurrence should be the main goal of maintenance MDD treatment.

Purpose of the present study was to compare the different antidepressants in terms of retention in treatment (no discontinuation for relapses, hospitalizations or side effects).

150 outpatients with a MDD diagnosis and treated with antidepressants in mono-therapy have been included. Follow-up period was defined in 24 months and information have been obtained from charts, interviews with patients and their relatives and from the Lombardy regional database. A survival analysis (Kaplan-Meier) was performed, considering recurrences, hospitalizations or discontinuation due to side effects as ’death’ events.

48.7% out of patients presented a recurrence within the first two years after the beginning of antidepressant treatment. With the exception of Fluoxetine (p=0.09), Amitriptiline (p=0.13), Fluvoxamine (p=0.83), Venlafaxine (p=0.5) and Trazodone (p=0.58), Bupropione appears to be less effective in long-term treatment of MDD compared to other antidepressants. Fluvoxamine appears to be less effective compared to Citalopram (p=0.036), Paroxetine (p=0.037), Clomipramine (p=0.05), Sertraline (p=0.011) and Duloxetine (p=0.024).

Bupropione and Fluvoxamine would be less effective in long-term treatment of depression. These data should be confirmed by prospective studies with large samples.

According to literature dropout predicts insufficient results for inpatient treatment for anorexia and poor prognosis for adolescents or adults, with proven increased tendency to subsequent admissions. There are few qualitative studies on dropout, and its high rates for EDs remain a concern for clinicians and researchers alike.

To analyze in greater depth the ’addictive’ dimension of EDs – a category of analysis found by the clinical qualitative study, which has been little explored by literature.

Clinical qualitative method and semi-structured in-depth interviews recorded and fully transcribed. Sample composed according to data saturation, consisting of 8 ≥18 y.o. dropout patients diagnosed with EDs at a specialized outpatient unit in a public university hospital. Theoretical basis relies on scientific literature review on EDs and addiction, and on the psychodynamic description of EDs as ’addictions’.

The in depth analysis of the categories ’enslavement to addiction (compulsively)’ - addictive dimension of anorexia and bulimia, ’I don’t like if things get out of my control’ – dropout as relief, and ’Anorexia and Bulimia is for life’ – attachment to the symptom signals elements for treatment based on the ’addictive/compulsive’ lived experience.

The findings support refinement of treatment approach while understanding EDs in their addictive dimension, with possible impact on compliance. This often neglected facet is revealed by research subjects, adding symbolic elements considered with the discussion of neurobiology and psychoanalytic theory, demonstrating significant association between EDs and addiction and pointing out to new paths for treatment innovation.

The relationship between substance use disorders and aggression is complex and not only limited to direct effect of the drugs. Aggression increases the likelihood of substance abuse and is suggested to be a long term individual characteristic which is probably in association with personality traits preexisting before the substance use.

The aim of this study was to evaluate the relationship of personality dimensions with aggression among heroin dependent inpatients and to control the effect of psychiatric symptom severity on this relationship.

Participants were consecutively admitted male heroine (n=78) dependent inpatients. Patients were investigated with the Buss–Perry Aggression Questionnaire (BPAQ), the Temperament and Character Inventory (TCI) and the Symptom Checklist-Revised (SCL-90-R).

Character dimensions self-directedness (SD) and cooperativeness (C) were negatively and self-transcendence (ST) and severity of psychiatric symptoms were positively correlated with severity of aggression and its dimensions. Low SD and C, which are indicative of a personality disorder, were predictors of aggression. Other predictors for aggression in heroin dependents were higher persistence (P) and ST. Severity of psychiatric symptoms predicted aggression together with low C, and high P.

Aggression was more closely related with character dimensions rather than temperament dimensions. Nevertheless, low C and high P predicted the severity of aggression even when the severity of psychopathology was controlled. The careful evaluation of patients for the comorbid psychiatric disorders such as depression, anxiety and personality disorders are needed to handle aggression in heroin dependents which may be related with poor treatment outcome.