Pregnancy and postpartum both imply high risk for developing psychiatric disorders in women.

To study the relationship between life events (LE) and social support degree (SS) during pregnancy and depressive symptoms in early postpartum period.

A cross-sectional study of 309 consecutive Spanish women, evaluated the second day postpartum. They were all over 18 years old and have signed the informed consent. We excluded: illiteracy, cognitive impairment or severe medical illness, psychiatric disorders during pregnancy and decease of the newborn. We collected socio-demographic and obstetrical data, as well as family and personal psychiatric history, the Edinburgh Postnatal Depression Scale (EPDS), LE (Saint Paul Ramsey) and SS (DUKE-UNK).

Mean age (SD) was 31.6 (4.7). Most of women were married, had intermediated or high level of education. Sixty-one percent were primiparous. Twenty-six percent had family history and 22% had personal psychiatric history. Mean (SD) of LE was 0.95 (0.89) and of SS was 53.1 (7.6). The prevalence of depressive symptoms according to EPDS scores was 18%. This subgroup of depressed women had more psychiatric family history (p=0.046), less LE (p< 0.001) and more SS during pregnancy (p=0.048). Logistic regression analysis showed that SS was the only significant variable (OR=1.085; 95%CI=0.997-0.994; p=0.001). LE did not achieve statistical significance (OR=1.085; 95%CI=0.997-1.180; p=0.059).

Low social support degree during pregnancy is associated with depressive symptoms during immediate postpartum.

This study has been done in part with grants Instituto Carlos III: G03/184, FIS: PI04178; 05/2565.

Dhat syndrome is a widely recognized clinical condition from the Indian subcontinent characterized by a preoccupation with semen loss in urine and other symptoms such as fatigue or depressed mood. This condition has been considered to be a culture-bound syndrome, and may be considered to be a culturally manifestation of depression or anxiety.

The purpose of this paper was to perform a systematic review of published literature on Dhat syndrome.

A review of the literature on Dhat syndrome until July 2008, without any language restriction was conducted by a search of the MEDLINE and PsycLIT indexing services using the following key words:Dhat syndrome, semen loss anxiety and loss of semen syndrome. Inclusion criteria were any case-control or cross-over study.

Twenty-three studies were identified, of which 10 met the inclusion criteria. There were 8 cross-over and 2 case-control studies. The reviewed studies included a total number of 680 cases and 93 controls. Patients included in these studies were mostly unmarried, young males (25.4 years old;18-45 years) from a poor socio-economic status. Majority of the studies involved patients from the Indian subcontinent. Some studies reported concomitant depressive symptoms (50%), anxiety (40%), fatigue (30%) and sexual problems (40%). Only 4 studies reported information about treatment (psychotherapy and pharmacotherapy).

There was a high degree of heterogeneity among the studies reviewed. In conclusion, Dhat syndrome appears to be commonly associated with depression, anxiety and somatic symptoms. More studies are warranted related to the various treatment approaches for this condition.

Interferon-alpha (IFN-α) and Ribavirin is the recommended treatment for chronic hepatitis C (CHC). Common treatment side-effects include neuropsychiatric symptoms such as anxiety, which impairs patient's quality of life and treatment adherence. Inflammation and neurotransmission systems may play a role in the pathogenesis of IFN-α-induced anxiety. The GC/GG genotype at a polymorphism located in the interleukin-6 synthesizer gene (IL6 gene) has been related with a higher production of IL-6 and “higher inflammation response”. A polymorphism in the serotonin transporter gene (SERT) has been related with anxiety and antidepressant response. The aim of the study was to assess the role of IL6 and SERT polymorphisms as predictive variables of IFN- induced anxiety.

A cohort of 385 Caucasian outpatients with CHC initiating antiviral treatment. Patients were euthymic and without current anxiety disorder (SCID) at baseline. Anxiety evaluation: Hospital anxiety and depression scale. Assesment: Baseline, 4, 12, 24, and 48 weeks after antiviral treatment initiation. DNA was extracted and polymorphisms genotyped. Hardy- Weinberg equilibrium: IL-6 (p=0.72) and SERT (p=0.41). Statistical analysis: linear mixed-effects.

Patients carrying the G allele (GC/GG genotype) of IL6 polymorphism (G vs. CC) had more anxiety symptoms (p=0.004) during antiviral treatment. We did not find a significant effect of SERT (S vs. LL) on anxiety (p=0.15). No significant interaction between both genes was reported.

GC/GG genotype, that implies higher seric concentrations of IL6, predicts interferon-α-induced anxiety supporting a role of inflammatory pathway on pathophysiology of anxiety.

PSICOCIT-VHC-P110/01827, and PSIGEN-VHC-EC08/00201. ERDF, European Union “One way to make Europe”.

To study qualitatively different subgroups of social anxiety disorder (SAD) based on harm avoidance (HA) and novelty seeking (NS) dimensions.

One hundred and forty-two university students with SAD (SCID-DSM-IV) were included in the study. The temperament dimensions HA and NS from the Cloninger's Temperament and Character Inventory were subjected to cluster analysis to identify meaningful subgroups. The identified subgroups were compared for sociodemographics, SAD severity, substance use, history of suicide and self-harm attempts, early life events, and two serotonin transporter gene polymorphisms (5-HTTLPR and STin2.VNTR).

Two subgroups of SAD were identified by cluster analysis: a larger (61% of the sample) inhibited subgroup of subjects with “high-HA/low-NS”, and a smaller (39%) atypical impulsive subgroup with high–moderate HA and NS. The two groups did not differ in social anxiety severity, but did differ in history of lifetime impulsive-related-problems. History of suicide attempts and self-harm were as twice as frequent in the impulsive subgroup. Significant differences were observed in the pattern of substance misuse. Whereas subjects in the inhibited subgroup showed a greater use of alcohol (P = 0.002), subjects in the impulsive subgroup showed a greater use of substances with a high-sensation-seeking profile (P < 0.001). The STin2.VNTR genotype frequency showed an inverse distribution between subgroups (P = 0.005).

Our study provides further evidence for the presence of qualitatively different SAD subgroups and the propensity of a subset of people with SAD to exhibit impulsive, high-risk behaviors.

SPECT DaTSCAN is used in clinical practice for differential diagnosis between Parkinson disease and other movement disorders, dementias and drug induced parkinsonism (Park 2012, Scherfler 2007). Nevertheless, its rational indication in patients with psychiatric comorbidity has not been clearly identified.

To assess the rationale for the indication of SPECT DaTSCAN in psychiatric population, explore the therapeutic consequences and clinical outcomes.

A prospective case series of DaTSCAN applications requested from the department of psychiatry of a general hospital (2008–2012). Reason of request, sociodemographic and clinical data, side effects (UKU Rating Scale), diagnostic (DSM-IV-R) and outcome after one-year follow-up were recorded.

18 cases were included (13 hospitalized, 55.5% women, 65±13 years old). Baseline UKU showed: 89.5% bradikinesia, 68% rigidity and 31.5% tremor. The indications for DaTSCAN were: 1) Atypical extrapiramidal syndrome (AES; 55.5%) and 2) Parkinsonism presumably induced by drugs (PPID; 44,4%).

AES group (N=10): 80% of patients had an affective disorder and 20% a psychotic disorder; DaTSCAN identified three cases of Parkinson disease (30%), two non-parkinson dementia (20%) and one Huntington disease (10%).

PPID group (N=8): 50% of patients had an affective disorder and 50% a psychotic disorder; DaTSCAN identified one case of Parkinson disease (12.5%) and five of drug-induced parkinsonism (62,5%).

After one year follow-up, AES group showed a worse outcome and an important functional decline, while most of patients of PPID group experienced complete remission

The results of this study enable to establish the profile of psychiatric patients that would beneficiate most from DaTSCAN.

Chronic hepatitis C infection (CHC) represents a public health problem that affects around 3% of population worldwide. Pegylated Interferon-alpha (PegIFN-α) and Ribavirin (RBV) is the recommended treatment reaching about 40–80% of sustained virological response. However, a common treatment side-effect is induced-depression that impairs patient's quality of life and treatment adherence (1,2). This paper showed polymorphisms in HTR1A, NCR1, TPH2 genes as predictive variables of IFN-induced depression.

396 consecutive, euthymic, CHC outpatients treated with PegIFN-α/RBV were included. Patients were assessed at baseline, 4, 12, 24 and 48 weeks of treatment using PHQ and MINI-DSM-IV-R interview to diagnose depression. Survival analysis was performed. in the univariated analysis functions were compared using logrank test. Significative variables (0.1 level) were extracted for the multivariated model, using a Weibull regression model.

The incidence of induced-depression along the treatment was 39.4%. Polimorphisms on HTR1A (P = 0.0104), TPH2 (P = 0.0231) and NRC1 (P = 0.0702) genes predicted IFN-induced depression.

Genes related with serotonine and inflamation system may play an important role in the pathogenesis of IFN-induced depression. Knowledge of predictive variables for IFN-induced depression may help to better manage patients at risk.

Neuropsychological and neuroimaging studies of response inhibition in cannabis users have reported inconsistent results. The age of onset of cannabis use and individual genetic differences may play a critical role in the regulation of inhibition in cannabis users.

We examine the influence of COMT Val158Met functional polymorphism on the response inhibition brain network in a group of early-onset chronic cannabis users compared with healthy controls.

fMRI data was acquired from 27 chronic cannabis users who began use cannabis before 16 years of age, and 29 non-using control subjects matched in terms of age, educational level and intelligence quotient while undergoing the Multi-Source Interference Task (MSIT). Participants were male, Caucasians aged between 18 and 30 years. All were assessed by a structured psychiatric interview (PRISM) to exclude any lifetime Axis-I disorder (DSM-IV). COMT genotyping was performed and resonance imaging data was analysed by voxel-based morphometry (VBM).

Both groups did not differ on their behavioural performance and brain responses during the MSIT task. A significant group-by-genotype interaction was observed on task-related brain activation (and on MSIT reaction times), in which met carrier load was associated with increased activation in cannabis users and val carrier load with increased activation in controls. The interaction pattern included the medial frontal cortex, ACC, inferior frontal gyrus, ventral striatum, anterior mesencephalon, inferior parietal and superior temporal cortices and the PCC.

Chronic cannabis exposure interacts with the genetically driven dopamine function in the modulation of the neural mechanisms related to response inhibition.

Grants:PNSD/2011/050, PNSD2006/101, SGR2009/1435.

Antidepressants are amongst the most commonly prescribed classes of drugs and their use continues to grow. Adverse outcomes are part of the landscape in prescribing medications and therefore management of safety issues need to be an integral part of practice.

We have developed consensus guidelines for safety monitoring with antidepressant treatments.

To present an overview of screening and safety considerations for pharmacotherapy of clinical depressive disorders and make recommendations for safety monitoring.

Data were sourced by a literature search using Medline and a manual search of scientific journals to identify relevant articles. Draft guidelines were prepared and serially revised in an iterative manner until all co-authors gave final approval of content.

A guidelines document was produced after approval by all 19 co-authors. The final document gives guidance on; the decision to treat, baseline screening prior to commencement of treatment, and ongoing monitoring during antidepressant treatment. The guidelines state or reference screening protocols that may detect medical causes of depression as well as screening and monitoring protocols to investigate specific adverse effects associated with antidepressant treatments that may be reduced or identified earlier by baseline screening and agent-specific monitoring after commencing treatment.

The implementation of safety monitoring guidelines for treatment of clinical depression may significantly improve outcome, by improving a patient's overall physical health status.