Alcohol dependence is a complex psychiatric disorder and causes considerable costs throughout Europe. Lesch Alcoholism Typology (LAT) is regarded one of the most widely used clinical typologies of alcohol addiction and abuse. The aim of the study was to find out if the introduction of the LAT in general clinical practice leads to better clinical outcome and reduced costs.

This retrospective matched-pairs case-control study was conducted at the Regional Addiction Center of the University Clinic in Serbia. Patients were matched in couples according to sex, age and ICD-10 diagnosis. All patients fulfilled the diagnosis of alcohol dependence accrding to ICD-10 and DSm-IV-TR. The study involved 250 patients i.e. 125 pairs (non-LAT treated case joined to its LAT-treated counterpart), during the period of four years.

Mean number of hospital admission was 0.94±1.27/0.92±0.74(LAT/non-LAT). Mean total duration of hospital admissions was 12.49±14.77/10.80±11.52(LAT/non-LAT). Total direct medical costs of non-LAT addicts’ care were 4,835,084.23 RSD, while after initiation of LAT the same costs were significantly reduced - 3,425,016.93 RSD. Mean cost/patient was significantly lower after initiation of LAT based treatment (27,400.14±31,437.65(CI 95%- 21,888.98-32,911.30) vs. 38,680.67±40,582.80(CI 95%- 31,566.33-45,795.02) RSD)(p=0.007). Mean cost of single hospital admission among non-LAT treatment group was 285.45±311.82(CI 95% 232.79-342.11) € and among LAT 165.77±135.01(CI 95% 142.10-189.43) € (p=0.008). LAT software induced net savings amounted to € 112.8 per patient.

The implementation of the LAT software, due to more precise diagnostic assessment and sub-type specific pharmacotherapy and psychotherapy, lead to a total € 112.8 net savings on general medical care costs.

Neuronal plasticity is a characteristic feature of the human central nervous system. Impaired cortical plasticity has been reported to be associated with a val/met gene-polymorphism in the brain-derived neurotrophic factor (BDNF) gene. Based on former studies, impaired cortical plasticity has been described as a common, yet not fully understood phenomenon in patients with schizophrenia.

The aim of the study was to investigate the impact of the val/met-BDNF gene-polymorphism on cortical plasticity in patients with schizophrenia.

Cortical plasticity was investigated in a cross-sectional sample of schizophrenia patients (SZ) and healthy controls (HC) using anodal and cathodal transcranial direct current stimulation (tDCS) applied to the primary motor cortex inducing long-term potentiation (LTP) and depression (LTD). The after-effect of the applied tDCS was then probed by TMS before and after tDCS stimulation. TMS in all participants was conducted using a standard 70 mm-TMS figure-of-eight magnetic coil connected to a MagPro X 100 magnetic stimulator. Analyses were focused on resting-motor threshold (RMT), 1mV motor-evoked potential (MEP), short-interval intracortical inhibition (SICI at 3 ms), intracortical facilitation (ICF at 12 ms) and cortical silent period (CSP at 120% RMT).

The statistical analyses included n=43 SZ and n=44 HC participants (all numbers presented under reserve of further examination) thus resulting in the largest available sample to probe cortical plasticity parameters in BDNF-genotyped schizophrenia patients. Further results will be presented at the conference.

The findings will give new insights into the influence of plasticity-associated gene polymorphisms and the pathophysiology of schizophrenia.

Transcranial magnetic stimulation (TMS) has been established as a method to probe inhibitory and facilitatory networks in the motor cortex. Reduced motor-cortical inhibition is a common, finding in patients with schizophrenia. Based on neuropathological findings, the reduced cortical inhibition in schizophrenia has been linked to alterations in GABAergic networks.

The aim of the present study was to investigate the impact of disease state and antipsychotic medications on cortical inhibition.

Cortical inhibition was investigated in a pooled cross-sectional sample of first-episode (FE-SZ) and chronically ill (CH-SZ) schizophrenia patients and healthy controls (HC) using TMS to the left primary motor cortex. Analyses were focused on resting-motor threshold (RMT), short-interval intracortical inhibition (SICI at 3 ms), intracortical facilitation (ICF at 12 and 15 ms) and cortical silent period (CSP at 120% RMT).

There was a significant difference concerning the mean CSP durations between HC and FE-SZ (MW-U: p=0.001). An overall comparison between HC and all patients further showed significant differences in SICI, presenting in a shorter mean SICI of HC than of SZ patients (MW-U: p=0.031).

This is the largest homogenous sample presenting various parameters of cortical excitability in schizophrenia patients. Thus, the findings allow to reduce the variance of different smaller samples and confirm the complex pattern of impaired cortical inhibition and excitability in patients with schizophrenia. The findings further indicate an impact of an early disease state on GABAB network performance.

Agitation is a common problem in schizophrenia and bipolar disorder, often requiring drug therapy in an acute care setting. Experts in behavioral emergencies consider speed of onset as an important factor in choosing a treatment. One Phase 2 and two Phase 3 clinical trials were conducted to assess the efficacy of treating agitation with inhaled loxapine.

To determine if baseline severity of agitation influenced patient outcome.

All trials were multi-center, randomized, double blind, parallel group, placebo controlled. Two doses of inhaled loxapine, 10 mg and 5 mg, were tested. Study subjects were agitated patients with schizophrenia or bipolar disorder who provided informed consent. At baseline, subjects were required to have a minimum total score of 14 for the five items of the PANSS Excited Component (PEC). The primary endpoint was the change in the PEC total score at 2 hrs. This meta analysis compared the efficacy of inhaled loxapine across the 3 studies in subjects with PEC ≥ 20 (88 patients, more severely agitated; MSA) to those with PEC ≤15 (90 patients, less severely agitated; LSA).

In the 10 mg dose group, the mean PEC change from baseline for the MSA group was 10.5 while for the LSA subjects was 6.6. This represents a 50% change from baseline for the MSA subjects and a 45% change for the LSA subjects.

Inhaled loxapine has as good as or better effects in reducing agitation in more agitated patients as it does in less agitated patients.

In the recent years the phenomenon of early alcohol initiation is observed. This problem is often underestimated, in spite of its numerous negative consequences.

and Aims of this study is to determine the effect of early drinking onset on subsequent alcohol dependence.

The research study was based on authors’ anonymous questionnaire including questions reffering to: age of alcohol initiation, age of the first blackout after drinking alcohol and the reason of drinking alcohol for the first time. In the study group there were 125 people, members o Alcoholics Anonymous, mean age 43, 83 men and 42 women. In the control group there were 231 people, mean age 25, 136 men and 95 women.

In the study group alcohol initiation occurred before the age of 15 more often than in the control group (49% vs. 42%). The same correlation exists for the alcohol initiation before 12 years of age (13% vs. 8%) and is statistically significant (p<0.05). Drinking alcohol for the first time took place for some of the respondents before the age of 10 and significantly more often in the study group (6% vs. 2%, p<0.05).

The obtained results allow to conclude that in patients addicted to alcohol the initiation took place earlier that in the study group (age 13-15vs.16-18). Also, very early alcohol initiation (<12 years) occurred more frequently in the study group (12.8% vs. 8.2%). Based on our research, we confirmed that early drinking onset is associated with subsequent alcohol dependence.

Depression is highly prevalent and disabling mental disorder, less than one third of all cases receive any treatment, suggesting a remarkable level on unmet needs.

The aim of the study was to assess differences in health care utilization among people with depression and those with no symptoms in representative sample of the general Latvian population.

The study was a part of the FINBALT health monitoring survey in 2012, a collaborative project between Baltic States and Finland, which monitors health related behaviours; the questionnaire included depression module of the Mini International Neuropsychiatric Interview (MINI). A total of 3003 15-64 years old persons were interviewed by using face-to-face computerized data collection tool.

The 12-month prevalence of depression in the general population of Latvia was 7.3% (95% CI 6.4–8.3). Use of any health care service over last 12 months was higher among those with depression compared with those without symptoms (84.8% and 73.1%); these differences remained significant after adjusting for age and gender (OR=2.0; 95% CI 1.4–3.0; p<0.001). Primary care services were used 4.3 times (SD 3.0) during the last 12 months among those with depression as compared with 3.2 (SD 3.9) times among those with no depression (t=4.50; p<0.001); while specialist services were used 3.1 times (SD 2.5) and 2.4 times (SD 1.8)(t=-3.973, p<0.001), respectively.

Health care services are more frequently sought-after by people with depression, and taking into account underdiagnosis of depression in Latvia, more efficient screening and management tools are needed.

The purpose of this study was to assess to effects of the playing light music & story telling (with Radio) Regulations of sleep disorders on University girl's Dormitory.

This was a quasi-experimental study which covered 60 boys with acute sleep disorders in Shiraz University. The samples have been selected through purposive sampling and then Random assignment into intervention (30 Samples) and control group (30 Samples). Intervention was lasted 10 weeks.

The results suggested that playing light music & story telling (with Radio) could be an alternative treatment intervention to Regulations in girls with sleep disorder. Data analysis between the mean scores of playing light music & story telling (with Radio) an alternative treatment and sleep disorder samples before and after the intervention group showed significant difference (p<0/001).

According to the results of this research, development use of Radio in dormitory of our university.

Around 800,000 to a million people die by suicide every year, making it the 10th leading cause of death worldwide.

The aim of this study was to survey contact to Mobile by psychiatrist physicians with nursing before suicide attempt in suicide attempters with anxiety & depression in outpatient hospital in Tehran.

This research is interventional. In this study one questionnaire was distributed to nursing staff working in prevention suicide Unit. The questionnaire was to assess the knowledge of the nurses with regards to essential information required for; nursing care for patients with anxiety & depression disorders. Their knowledge was then re-assessed following forward of 22 Newsletter via SMS mobile phone to the same nursing staff during a one month. The two results, before and after sending the information, was compared.

The findings of this study showed there was significant improvement in awareness and knowledge of the nurse in the bipolar disorders ward of Tehran Psychiatry Hospital before and after sending E-newsletter containing the required information, via SMS. (p<.0/05).

Knowledge about behavioral patterns of suicidal persons before suicide attempt is needed for suicide prevention programs. Many studies have shown that suicide attempters had contacts with physicians before suicide attempt. Thus it is suggested that nurses and other medical group-s uses a Distance learning by mobile in suicide programs

The aim of the study was to examine the association between specific physical diseases and suicide in older adults as well as to assess whether depression or perceived burdensomeness might be causal mechanisms.

Individual-level register data on all older adults aged 60 years and over living in Denmark during 1990-2009 (N=2,301,709) was assessed using survival analysis. Relative risks of suicide were assessed for a total of 38 physical disorders while adjusting for age, period, conjugal status, income, physical comorbidity, and psychiatric disorders among others depression. Impact was examined within short and long term after diagnose.

In all, 6,012 deaths due to suicide were observed during more than 22 mill. person-years. Presence of a physical disorders resulted in a 51% and 39% higher suicide rates for older adult men and women, respectively. Men with no physical disorders had a suicide rate of 33.0 [CI- 95%: 31.6-34.4] vs. 49.7 [47.3-52.1] among those with 1-3 physical disorders. For older adult women the corresponding figures were 14.1 [13.1- 15.2] and 19.6 [18.5-20.6], respectively.

Significantly higher rate ratios of suicide were identified for lung cancer, intestinal cancer, chronic obstructive pulmonary disorders (COPD), liver disease, and male genital disorders when compared to persons with no diagnose. Men and women diagnosed with COPD experienced a 1.8 [CI- 95%: 1.6-2.1] and 1.8 [CI-95%: 1.5-2.2] fold higher risk of suicide during first three years, respectively.

Elevated risks of suicide were identified in numerous physical disorders, also when adjusting for psychiatric comorbidity.

Ayu rveda medicine is a system of traditional medicine native to the Indian medicine and a form of alternative medicine.

The purpose of this study was to assess to the effects of Ayurveda Reduce in Women's with dysmenorrhea in Shiraz Society in 2013.

This was a quasi-experimental study which covered 40 girls with acute stress reaction in Tehran stress Society. The samples have been selected through purposive sampling and then Random assignment into intervention (20 Samples) and control group (20 Samples). Intervention was meditation classes for 6 months (24 weeks).

The results suggested that Ayurveda exercise could be an alternative exercise intervention to Reduce in women with dysmenorrhea. Data analysis between the mean scores of meditation an alternative exercise and acute stress reaction samples before and after the intervention group showed significant difference (p<0/001).

According to the results of this research, Use of complementary medicine like this Ayurveda medicine is effective in treating dysmenorrhea.

A patient page is a document describing a disease in easy-to-understand, layperson's terms. It is considered important in motivating patients and their relatives to engage in treatment. Patient pages are distributed widely in many areas of health care and typically present general information about a disease and its treatment.

We believe that the value of a patient page would be improved, if the information was placed in the context of the patient's personal clinical data. We call this a personalized patient page.

The idea of a personalized patient page is fairly new, and until now it has not been applied to the treatment of persons with mental illness. With this in mind, we developed an example of a personalized patient page for a fictional patient with depression (see sample page). When the page is implemented in the clinic, we envisage that it would be generated automatically when results from an examination are recorded in the patient's file. Furthermore, the page could be delivered to the patient's e-mail inbox or smartphone application, and the page could have an interactive design. For example, if the patient wishes to clarify or know more about ‘minor depression,’ he or she would click on that term and the relevant information would be displayed.

We predict that implementing a personalized patient page in the treatment of persons with mental illness will promote patient engagement in treatment, motivate patients to take responsibility, and lead to greater satisfaction with patient-doctor communication.

(Published in Psychiatric Services, October 2013. Figure 10.1176/appi.ps.018120130)

The aim of this study was the prevalence of psychiatric disorders and quality of life patients with lumbar and cervical disc herniation.

One hundred twenty five patient with lumbar or cervical disc herniation and fourty healthy subject were included into the study. The axis I psychiatric disorders were diagnosed with Structured Clinical Interview for DSM-IV (SCID-I). Depression and anxiety disorders severity and quality of life (QoL) were assessed Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D) World Health Organization Quality of Life Assessment—Brief (WHOQOL-BREF), respectively. The severity of pain was assessed with Visual Analog Scale (VAS).

The prevalence of psychiatric disorders in patients group were higher than control group. The QoL of patients with LDH or CDH was significantly lower in domains of physical health and social relationship. There was no statistically significant difference between the localization of disc pathology and psychiatric disorders

In conclusion, results of the present study suggest that mood and anxiety disorders were more frequently observed among patient with disc herniation. Assessment of psychiatric disorders could not only be helpful in improving QoL but may also be used to relieve pain.

We detected significant differences in personality disorders evaluated by SCID II. Temperament and character items - as evaluated by NEO FFI and TCI -showed also significant differences in personality traits, such as novelty seeking and self transcendence as well as conscientiousness. These results may be relevant for prognosis of treatment seeking individuals.

Brain tumors may present with multiple psychiatric symptoms (> 50%) and in 80% of the cases tumors are located in the frontal or limbic regions. Neuropsychiatric symptoms may be the first clinical indication of a brain tumor in 18% of the patients.

Brain metastatic tumors may be associated with a greater incidence of mental symptoms and are probably due to the tumors being scattered throughout the brain substance.

The authors report a case of a patient where the severe psychiatric symptoms, secondary to a metastatic brain tumor, were the initial presentation of a primary lung tumor.

A comprehensive review of the literature was conducted for reports of brain tumors and psychiatric symptoms, through PubMed, between Jan 1970 and Out 2010.

We also reviewed the patient medical records and computed tomography (CT) scans in detail.

Neither tumor location nor type is associated with specific psychiatric symptoms.

Mood symptoms may be a harbinger to an evolving brain tumor.

There is a statistically significant correlation of anorexia, without disturbance of body image perception, with hypothalamic tumors.

We conclude that brain tumors can be neurologically silent and only present with psychiatric symptoms. The diagnosis and treatment in the early phase of the disease are determinant for the survival and quality of life of patients with brain tumors.

Neuroimaging (CT and MRI scan) should be considered in patients with new-onset psychosis, recurrence of previously well-controlled psychiatric symptoms, occurrence of atypical symptoms and in patient's refractory to psychiatric treatment.

Description of socio-demographic characteristics and symptoms of patients diagnosed with schizophrenia or other psychotic disorders, treated in Tirana CAP (Child and Adolescent Psychiatry).

Study included 38 patients 13-19 years old who had been hospitalized in child and adolescent psychiatry during 2009-2012 years and diagnosed with psychotic disorders and/or schizophrenia. P value was obtained at 0.01 critical value using SPSS 19 for Windows 2007.

52.6% of study group were females. 84.2% were presented with psychotic symptoms, 5.3% were suicidal attempts. More than 55.3% have had loss of interest in daily activities. Through the correlation coefficient of Kendal there is a statistically significant correlation between the time when the disorder started for the first time (in months) and loss of interest in daily activities (r = 0,347, p = 0.014).

We have a time lag of first receiving specialized service, especially when dominated with negative symptoms. Early treatment challenge is to identify patients with high risk for developing psychosis. Data from this study may represent a modest starting point for creating a successful albanian community network for early detection and interevention of early psychosis.

Aim of this study is to determine the prevalence of attention deficit and hyperactivity symptoms, and to compare social phobia patients with high and low level symptoms in terms of disability and quality of life.

The study included 16 (44.4%) female and 20 (55.6%) male patients with social phobia (SP). The control group consisted of 36 volunteers who did not have any psychiatric disorder. Study and control group were evaluated using Wender-Utah Rating Scale (WURS-25), Turgay Adult Attention-Deficit /Hyperactivity Disorder (ADD/ADHD) DSM-IV-Based Diagnostic Screening and Rating Scale, Beck's Depression Inventory (BDI), The Sheehan Disability Scale (SDS), and The Short Form 36 Quality of Life Instrument (SF-36).

No statistically significant difference was found between the social phobia and control groups, based on gender, education level and mean age. Medium and high levels of ADHD symptoms were determined in 50.0% (n=18) of the SP group. Mean scores of WURS-25 scale, total and sub-scales of the Turgay ADHD scale in the SP group were higher than those of the control group. In the group with high levels of ADHD symptoms, the mental health sub-scale scores of SF-36 scale was statistically significantly lower than the group with low levels of ADHD symptoms.

Our results showed that ADHD symptom levels in social phobia patients were higher than controls and this situation can be associated with the deterioration of their mental health.