Obsessive compulsive disorder is a separate diagnostic entity, but it occurs in a number of other psychopathological entities.

We will present 22-years old adolescent. Early psychomotoric development was ordinary. Because of father's insisting, and against his own will, the patient has intensively played tennis since the age of six until his seventeenth. He was achieving good results but the father was constantly objecting that he is not showing enough fight spirit. When he was seventeen, after verbal conflict with father, he broke his racket and he stopped playing tennis.His father continued to play tennis and “everything is infected with earth from tennis court”. He hasn’t achieved emotional relationship, social contacts with peers are insufficient. At the age of twenty he has looked for psychiatric help, in order to get acknowledgment that he needs “peace for study” which he couldn’t get from his parents because he has constantly needed to clean.

Of this case report is to show obsessive compulsive actions as a defense from psychotic decompensation.

Psychiatric interview, mental status examination, psychological testing, EEG.

In the April, 2008 he has been hospitalized because his mental condition was worse due to suicidality. In clinical picture compulsions were dominant (throughout the nights he was cleaning the house, he has given away all the cloths in orange color, he has even “get rid of” his hamster because it was orange). He was tense, elevated mood, outdistanced and erotized.

Obsessive compulsive actions helped our patient to delay psychotic decompensation.

Symptom (from Greek symptoma “anything that has befallen one”) is an each new manifestation by which some disorder is expressed. For the physician, it is a guide to diagnosis itself, and for the patient it is a signal which warns of new conditions of the body and soul or of a disorder.

Mental disorders are most commonly presented by a group of symptoms, among which the patients often can’t point out the leading one. Anxiety as a symptom can occur in a number of psychiatric entities and it can stimulate differential diagnostic dilemma in daily practice. We will show a 26-year female in which the internal anxiety is the main symptom.

To underlined the importance of taking in to account a leading symptom of the disease in the way of establishing the correct diagnosis.

The psychiatric and psychotherapeutic interviews were performed together with a clinical assessment of mental status and structured clinical interviews (SCID I and SCID II), EEG and psychological testing.

Internal discomfort is a subjective feeling, respectively a symptom which the patient in this case continuously underlined, and which guided us (along with a comprehensive analysis) to a clear diagnosis. Following the choosing of an effective psycho-pharmacological combination, and with the goal of reducing a leading symptom, according to enlarged diagnostic process, we decided to diagnose the Schizoaffective disorders (F 25.2).

To depict collage provoked an insight in female patient (31) suffering from borderline personality disorder following outpatient psychotherapy.

Cut of images technique for making collage which later on was used during psychotherapy sessions.

The patient could easily identify herself with the collage's image of a girl on the toilet. During psychotherapy session we discovered that the toilet was a very important place in her childhood because it was the only place where she got the chance to be alone, where she felt safe and where her boundaries were respected by her parents. the second most important figure she described as her inside. She became aware of inner wild and aggressive nature because of the enormous pain which comes from her feeling of being used and cheated.

The predominant symptoms in patient were impulsive, uncontrolled actions and the oppositionality was very low. She described the position of a victim many times in life, but we couldn’t approach this experience in experiential way until we used collage technique. Patient identification with figures brought her to awareness of her feelings and helped her to recognize it later in everyday life situation; she learned how to deal with it, how to take the space she needs and how to protect her boundaries.

The insight that she had using the collage technique moved her toward better understanding of the pattern of her actions and propelled her to different behavior which enabled her better social functioning and more satisfying life.

IDEA project is the outcome of Association for the Improvement of Mental Health programme and coordinated at Institute of Psychiatry, King's College London.

Are to explore experience of people treated in a mental health setting across nations, determine how inpatient experiences can be improved. Experience gained from interviews will be used to propose questionnaire for routine use, develop versions of interview for other services, inform a possible follow-up study.

30 consecutive patients are interviewed on day of discharge in own language. Semi-structured interview covers physical condition in institutions, experiences of treatments like medication, satisfaction with staff, privacy, dignity and whether rights were respected. Responses are summarized on several visual analogue scales and quantitative analysis will be performed. The scale will also be analysed by demographic indices within centres to see whether different groups have different experiences.

Qualitative responses will be analysed thematically, both within and between centres, identifying core themes for each domain and core themes for the protocol as a whole.

10 countries are participating, 577 interviews are completed. It is noticed a large disparity between institutions in regards to the amount of contact patients have with family, access to phone, quality of food, surroundings and view of medication and therapy.

It will be a better understanding of the size, structure and staffing of the institutions included in the study, which will help us with our observations about inpatient experiences by putting them in context and make recommendations to institutions.

To show the course of the disease and the clinical manifestation in schizophrenic patient, who during several annual treatment developed symptoms of Capgras syndrome and Mignon delusion.

72 year old female patient was admitted to the hospital due to deterioration of mental state.On admission in mental status dominated: accelerated opinion in form and in content with plenty paranoid ideas she also said: This is not my husband. Sometimes I know that this man wears a mask, so he looks like him, but my husband is not here he is in the U.S. Insight into previous medical records,showed that in the previous hospitalization she amounted symptoms of Mignon delusion and was saying that her parents were not hers and that she is a descendant of a noble family. It is Significant that those symptoms were followed after minor head injury.

Dynamics of changes in symptoms indicates the importance of further processing in order to determine whether these symptoms were result of underlying disease or may be caused by an organic lesion that is very often in the same substrate.

In order to compare estimates by one assessment scale across various cultures/ethnic groups, an important aspect that needs to be demonstrated is that its construct across these groups is invariant when measured using a similar and simultaneous approach (i.e., demonstrated cross-cultural measurement invariance). One of the methods for evaluating measurement invariance is testing for differential item functioning (DIF), which assesses whether different groups respond differently to particular items. The aim of this study was to evaluate the cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale (RCADS) in societies with different socioeconomic, cultural, and religious backgrounds.

The study was organised by the International Child Mental Health Study Group. Self-reported data were collected from adolescents residing in 11 countries: Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestinian Territories, the Philippines, Portugal, Romania and Serbia. The multiple-indicators multiple-causes model was used to test the RCADS items for DIF across the countries.

Ten items exhibited DIF considering all cross-country comparisons. Only one or two items were flagged with DIF in the head-to-head comparisons, while there were three to five items flagged with DIF, when one country was compared with the others. Even with all cross-culturally non-invariant items removed from nine language versions tested, the original factor model representing six anxiety and depressive symptoms subscales was not significantly violated.

There is clear evidence that relatively small number of the RCADS items is non-invariant, especially when comparing two different cultural/ethnic groups, which indicates on its sound cross-cultural validity and suitability for cross-cultural comparisons in adolescent anxiety and depressive symptoms.

This study evaluated the measurement invariance of the strengths and difficulties questionnaire (SDQ) self-report among adolescents from seven different nations.

Data for 2367 adolescents, aged 13–18 years, from India, Indonesia, Nigeria, Serbia, Turkey, Bulgaria and Croatia were available for a series of factor analyses.

The five-factor model including original SDQ scales emotional symptoms, conduct problems, hyperactivity–inattention problems, peer problems and prosocial behaviour generated inadequate fit degree in all countries. A bifactor model with three factors (i.e., externalising, internalising and prosocial) and one general problem factor yielded adequate degree of fit in India, Nigeria, Turkey and Croatia. The prosocial behaviour, emotional symptoms and conduct problems factor were found to be common for all nations. However, originally proposed items loaded saliently on other factors besides the proposed ones or only some of them corresponded to proposed factors in all seven countries.

Due to the lack of a common acceptable model across all countries, namely the same numbers of factors (i.e., dimensional invariance), it was not possible to perform the metric and scalar invariance test, what indicates that the SDQ self-report models tested lack appropriate measurement invariance across adolescents from these seven nations and it needs to be revised for cross-country comparisons.