Negative symptoms are a key aspect of schizophrenia, significantly impacting a patient’s functioning and quality of life. These symptoms are deemed predominant when they dominate the clinical picture and positive symptoms are only minimally present. As articulated in the most recent guidance by the European Psychiatric Association, including self-report measures is encouraged in negative symptom studies as they can further complement the observer-rated scales when assessing negative symptoms of schizophrenia.

The objective of the poster is to compare the views of patients vs. doctors regarding predominant negative symptoms during a 1-year observational study.

This was a 1-year-long, prospective, multicentric cohort study with three visits after baseline at 3, 6 and 12 months. Adult outpatients with a schizophrenia diagnosis according to the International Classification of Diseases 10th edition who exhibited predominant negative symptoms according to clinical judgement were included. Patients received pharmacological and some non-pharmacological treatment as usual.

The primary outcome measure was the modified Short Assessment of Negative Domains (m-SAND), an anamnesis-based scale that is composed of 7 items: two positive items (delusions and hallucinations) which make the m-SAND Positive sub-scale (m-SAND-P) and five negative items (anhedonia, alogia, avolition, asociality and affective flattening) which make the m-SAND Negative sub-scale (m-SAND-N) Each item is rated from 0 to 5 (not observed; mild; moderate; moderately severe; severe; and extreme). Other measurements included the Self-evaluation of Negative Symptoms (SNS), a validated scale that provides meaningful information regarding the patients’ own perception of their negative symptoms.

Least squares (LS) means were calculated for the change from baseline to final visit using a mixed model for repeated measures (MMRM).

188 patients were included in the study. The mean age was 39.8 years and 65% of patients were men. The mean duration of illness was 12 years. At baseline, patients rated alogia and apathy (mean SNS score: 5.7) to be the most severe and then asociality (5.5). In contrast, doctors found affective blunting (mean m-SAND total score: 4.3), apathy (4.2) and anhedonia (4.0) to be the most severe.

After the end of the observational period all negative symptom sub-domains improved significantly according to both the patients’ and doctors’ views. The latter group reported -1.9 LS mean change from baseline in apathy, -1.8 in anhedonia, and -1.7 in asociality (all p-value <0.0001). Patients felt most change in alogia and asociality (-2.7), and apathy and anhedonia (-2.4).

In summary, both patients and doctors reported significant improvement in predominant negative symptoms. Nonetheless, there were some differences how they perceived severity and change in the specific domains.

J. Dragasek: None Declared, Z. Dombi Employee of: Gedeon Richter Plc., K. Acsai: None Declared, V. Dzurilla Employee of: Gedeon Richter Plc., Á. Barabássy Employee of: Gedeon Richter Plc.

The prevalence of mental health issues amongst domestic and foreign students in Slovakian medical schools and any differences between them is currently unknown.

The goals of this paper are to determine the prevalence and extent of mental health issues among medical students at Pavol Jozef Šafárik University (UPJŠ) in Kosice, Slovakia and to determine if there is a difference between domestic and foreign students’ mental health at UPJŠ.

A combined questionnaire utilizing well-known sources was distributed to UPJŠ medical students to self-assess their levels of anxiety, depression and hedonic capacity (Zung, 1965; Zung, 1971; Snaith et al., 1995). Two-tailed T-tests and regression statistical analyses were applied to determine the significance of the data and any differences.

27% (n=319) and 25% (n=300) responses were collected from domestic and foreign UPJŠ medical students, respectively. 57% of domestic and 74% of foreign students screened positive for either anxiety, depression, or a combination. The 17% increased rate of anxiety and/or depression amongst foreign students when compared to domestic students was statistically significant (P<0.001). The differences between the two groups regarding hedonic tone were not statistically significant.

The prevalence of mental health issues amongst domestic and foreign UPJŠ medical students is much higher than the worldwide average. The higher rate of anxiety and depression observed in foreign UPJŠ medical students when compared to domestic students may be due to a reduced social support system as well as studying in a foreign country. These data suggest special support may be necessary for medical students studying abroad.

Increasing numbers of reports concerning lipid dysregulation, diabetes and hyperglycaemia in patients treated with atypical antipsychotics have raised concerns about a possible association between these metabolic effects and treatment with these medications.

The available literature notes that ziprasidone is a weight-neutral antipsychotic and that lipids anomalies improve when patient are switched from other atypical antipsychotics to ziprasidone.

The purpose of this study was to examine the association of treatment with ziprasidone and changes in serum levels of cholesterol, triglycerides, serum levels of glucose and BMI changes.

Prospective, cohort, multicenter, open design in 373 in- and outpatients treated with ziprasidone for broad spectrum of psychotic disorders in flexible dose manner. The analysis was done in group of patients with no previous antipsychotic treatment or discontinuation of antipsychotic treatment longer than 3 months compared to group of patients directly switched from another antipsychotic treatment to ziprasidone.

Changes in fasting serum levels of total cholesterol were significant from baseline at week 24 in subgroup of patients directly switched from another antipsychotic treatment to ziprasidone (5,12 vs 4,94 mmol/l, p< 0,05, ANOVA).

We have observed statistical significant difference in fasting serum levels of total cholesterol in patients directly switched from another antipsychotic treatment to ziprasidone.

Depression seems to be an important clinical risk factor for the prediction of suicide attempts, similar to risk factors such as substance use disorders and borderline personality disorder. All of these factors share the same diathesis for increased impulsivity and suicidal ideation, which could explain comorbidity and suicidal behaviour (Pezawas L et al., 2002). Insufficient treatment of depression is one of the most important causes of suicide (Althaus D et al., 2007).

1. - The occur of suicidal behaviour (thoughts or attempts) - with focus on type of depressive disorder, age, gender, treatment and changes in the frequency of suicidal behaviour compared to a baseline

2. - The number of suicidal behaviour (thoughts or attempts) during depression

1. - Outpatient's files with depression from all Slovakia regions during 3 months in comparison with past

2. - Depressive disorder, n = 2570 (female 1800, male = 770) (DSM-IV), average age = 49 years

3. - 3090 questionnaires from 200 psychiatrists

1. - Every third patient with depression - suicidal thoughts and every tenth patient

2. - suicidal attempt (male more as female, NF)

3. - We observed the most frequent suicidal behaviour in patients with depression: 41 - 60 years (21 - 20 years)

4. - It was interesting: decreasing of consumption of hypnotics - decreasing of suicidal behaviour (SF), increasing of consumption of antidepressants - decreasing of suicidal behaviour (NF)

Bipolar disorder (BD) is chronic psychiatric disorder by mood swings, symptoms of BD are serious and life-threating. Suicide risk in patients with BD is 25-50%, more frequent during depressive episode (Compton,2000) but with adequate treatment suicide risk can be presented in nearby 50% of patients only (Goodwin, Jamison,2006). Despite these facts data about the changes of treatment habits over the longer period of time under naturalistic condition are lacking.

To assess presence of suicidal thoughts and attempts in inpatients with BD and follow-up changes of treatment with lithium over the period of time.

It was retrospective survey of in-patient's files hospitalized at the 1st Dept. of Psychiatry, UPJS, Kosice (1997-2007) with typical limitations for retrospective case survey. All patients had diagnosis of BD (DSM-IV), n=125 (67% of women and 33% of men). We discovered changes in suicidal behaviour with/without treatment of lithium.

The first episode was depressive in 62% of patients, average number of episodes: 8,2. There was trend of decrease in use of lithium over the time (68% vs 84% in men, 29% vs 60% in women). The suicidal thoughts were more frequent during depressive episode (in 50% of women and 18% of men). Suicidal thoughts and attempts were 3 times more frequent in women vs men with BD. Suicidal attempts were 4 times more frequent in women with treatment with lithium vs without lithium.

The prevalention of depression in in-patients is 33% and in patients with coronary disease /heart attack/ is 45%. The occuring of comorbid depression and heart attack is 16-22% but not recognized and not treated often.

To compare differences between male and female with heart attack and comorbid depression.

102 patients with diagnosis of heart attack were assessed for depression during the second week following heart attack, after week 12, 24, 52 and 76. 76% patient were diagnosed as having depression according DSM-IV.For assessment of depression HAMD and MADRS were used and CGI, Zung Rating Scale for Depression, Beck Anxiety Inventory, laboratory and internal parameters, number of rehospitalizations and morbidity.

In 76% patients with heart attack depressive symptoms were present (52% male). 37% male with comorbid depression /mostly not treated/ and acute heart attack died but only 13% male without depression. From 68% male without depression after heart attack nobody died.

We averaged more often occuring comorbid depression and heart attack in male /52 vs 46%/ and mortality in depressive male /mostly not treated/ is higher as in female. Number of rehospitalizations is higher in male /1.9x/ like in female /8x/ too in compare with controls.

Electroconvulsive therapy (ECT) is a safe and effective treatment for certain psychiatric disorders. It has long been known that ECT can produce deficits in anterograde, retrograde memory and non-memory-related cognitive functions.

Our research is focused to test selected cognitive abilities of patients undergoing electroconvulsive therapy. Our main concern was focused on changes in memory, attention, psychomotor speed and intellect.

Changes in cognitive abilities were assessed in 30 patients from the 1st Department of Psychiatry, University of P.J.Safarik in Kosice before and after ECT treatment session. To assess changes in cognitive abilities we have used Rey-Osterrieth Complex Figure Test (REY), Attention-Concentration Test (ACT), Trail Making Test (TMT) and Intelect Potential Test (TIP).

We have observed statistical significant improvement in visual and short-term memory test (preECT REY 10,92 ± 6,7 vs postECT REY 12,73 ± 5,06, p = 0,047), statistical non-significant improvement in psychomotor speed test (preECT TMT 68,88 ± 45,13 vs postECT TMT 65,15 ± 49,74, p = 0,062), statistical significant improvement in attention-concentration test (preECT ACT 0,74 ± 0,3 vs postECT ACT 0,85 ± 0,16, p = 0,021) and statistical non-significant improvement in intellect potential test (preECT TIP 7,45 ± 7,37 vs post ECT TIP 8,28 ± 6,45, p = 0,142).

Further research is required to determine changes in cognitive abilities associated with ECT in homogenous patients’ population. The validity and limitations are discussed.

Bipolar disorder (BD) is chronic psychiatric disorder characterized by remission and exacerbations of mood disturbances. Treatment of BD is often complicated and includes in the first step treatment with lithium, after with other ”mood stabilizers“, antipsychotics, antidepressants.

1. - To assess the changse of treatment with lithium over the period of time

2. - The number of hospitalizations in the patients with BD and differences in using of lithium, age and type of first episode

1. - Retrospective survey of in-patient's files(1997 - 2007) with typical limitations for restrospective case survey:

2. - BD, n = 125 (67% women with BD, DSM-IV)

3. - Number of hospitalizations, average number hospitalizations/year, type of treatment, using of lithium

1. - The first episode was depressive in 62% of patients and average number of episodes: 6,2

2. - There was a steady decrease in use of mood stabilizers medication over the time(68% vs 82%)

3. - We observed increase in prescription of atypical antipsychotics (in 80% of patients; last 6 years = 93%)

4. - The using of lithium was in 52% of patients (in 41% patients during first hospitalization) with average dose 1250mg of lithium and average surface of lithium in blood: 0,64mmol/l

We find out trend in using of lithium in 52% patients with BD last time again with average dose 1250mg per day and average surface of lithium in blood 0,64mmol/l and increasing of prescription of atypical antipsychotics (last 6 years = 93%).

Bipolar disorder (BD) is chronic psychiatric disorder by mood swings, symptoms of BD are serious and life-threating. Suicide risk in patients with BD is 25-50%, more frequent during depressive episode (Compton,2000) but with adequate treatment suicide risk can be presented in nearby 50% of patients only (Goodwin, Jamison,2006). Despite these facts data about the changes of treatment habits over the longer period of time under naturalistic condition are lacking.

To assess presence of suicidal thoughts and attempts in inpatients with BD and follow-up changes of treatment with lithium over the period of time.

It was retrospective survey of in-patient's files hospitalized at the 1st Dept. of Psychiatry, UPJS, Kosice (1997-2007) with typical limitations for retrospective case survey. All patients had diagnosis of BD (DSM-IV), n=125 (67% of women and 33% of men). We discovered changes in suicidal behaviour with/without treatment of lithium.

The first episode was depressive in 62% of patients, average number of episodes: 8,2. There was trend of decrease in use of lithium over the time (68% vs 84% in men, 29% vs 60% in women). The suicidal thoughts were more frequent during depressive episode (in 50% of women and 18% of men). Suicidal thoughts and attempts were 3 times more frequent in women vs men with BD. Suicidal attempts were 4 times more frequent in women with treatment with lithium vs without lithium.

In our study, the magnitude of EEG power spectra of delta, theta, alpha and beta power was examined to address the relationship between EEG spectral changes after activation methods and alcohol dependence. Electroencephalography has shown that the brain activity of alcoholics and nonalcoholics differs in some characteristic ways. These differences are consistent with an imbalance between excitation and inhibition processes in the brains of alcoholics.

We examined eyes-closed resting EEG and EEG after activation procedures (eyes-open, hyperventilation). A group of 54 male chronic alcoholics were selected according to inclusion and exclusion criteria. We compared this group with 54 age- and gender-matched control subjects from the group of healthy volunteers. All subjects in both groups were Caucasians.

Our results in power spectra of activated EEG /after eyes-open period, hyperventilation) showed statistically significant differences in reactivity to activation methods between alcohol dependent patients and healthy volunteers. Our data manifested significant contrast in modulation of alpha activity after EEG activation using eyes-open test.

In previous studies researchers compared eyes-closed resting EEG spectra in alcohol dependent study participants and age- and gender-matched control subjects. The present study reported statistically significant differences in reactivity to activation methods in both groups. Hence, the EEG spectra after activation methods in children of alcoholic, especially before alcohol exposure, need to be examined to consider these differences in reactivity to activation methods as an endophenotype marker of chronic alcoholism.

There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country.

Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration.

A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have ‘ever’ considered to move to a different country in their future, 53.5% were considering it ‘now’, at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%).

A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.