Indoleamine-2, 3-dioxygenase is responsible for tryptophan catabolism; IFN-β is a treatment for multiple sclerosis (MS) and it has been associated with depression. IDO activation might play a role in IFN-β induction of depressive symptoms. Depressive symptoms associated with MS illness and IFN-β treatment have been treated with pharmacological and non-pharmacological intervention.

Evaluation of the kynurenine pathway, IDO activation and neurotoxic agents, serum BDNF in MS patients during IFN-β intervention.

14 study subjects, aged 18-64 years with major depressive disorder and MS treated with IFN-β, before and after pharmacologic and non-pharmacologic intervention, and 34 age matched healthy controls were enrolled at the University of Rome "La Sapienza" and at the at the University of Antwerp. Depressed participants were randomized to sertraline-treatment or interpersonal psychodynamic psychotherapy.

There were significant improvements in both depression and anxiety symptoms with medication and psychotherapy groups, although the effect with sertraline was more robust. Sertraline treatment was associated with a decline in serotonin. In the psychotherapy group, a significant increase in 3-hydroxyanthranilic acid (HAA) was observed after 4 months treatment (p= .04) with a significant decrease in tryptophan levels at 6 weeks (p= .02) and a trend towards a significant decrease in BDNF after 6 wks (p=0.06), neither of which were seen in the medication condition.

The increase in HAA among the psychotherapy-treated patients raises the possibility of a neurodegenerative challenge for patients with multiple sclerosis during treatment with IFN-β which appeared to be prevented with pharmacological treatment.

To examine potential similarities in neural activation during the STROOP colour word test (SCWT) in patients with Bipolar Disorder (BD) and their unaffected first degree relatives of BD patients as an expression of genetic predisposition.

39 remitted BD patients were compared to 46 of their healthy relatives and to 42 controls. fMRI data were collected on a 1.5 T GE Signa MR system using a blocked periodic design and analysed in SPM5.

There was no statistically significant group difference in the behavioural performance. At the corrected cluster level threshold of p< 0.001 controls showed more activation than:

1. a. BD patients in the caudate, the inferior (BA 47), middle and superior frontal gyri (BA 8, 6, 46), the parietal cortices (BA 7, 40), the precuneus and occipital cortices (BA 7, 19).

2. b. Relatives in the caudate and cingulate cortex (BA 24, 31!). No other contrasts were significant.

These findings suggest that changes in neural activation during response inhibition may reflect genetic predisposition to BD.

Affective temperament is a phenotype underpinned by a constitutional substrate.

It represents signs related to certain mood stability and attitudes to react to environmental stimuli.

Temperament has been related to predisposition to bipolar disorder.

Bipolar disorder is highly related to Substance Abuse Disorders but it is less clear which affective temperaments are more involved in this relation and if they can influence substance abuse patterns.

The aim of this study was to investigate temperamental traits, according to the Akiskal and Mallya formulation, in patients with bipolar I disorder associated with comorbid substance abuse disorders.

Data from 120 patients with Bipolar Disorders and Comorbid substance abuse disorders, were assessed in inpatient unit.

The brief TEMPS- M self-questionnaire was used to assess the temperamental distribution. The temperamental scores on various outcomes were investigated using Sperman rank (Rho), Principal Component Analysis (PCA), Cluster Ananlysis (CA).

Chyclothymia was positively correlated to Opiate Addiction (ρ 0.18 p< 0.001).

Irritability was positive correlated with Alchol Abuse and Cannabis Abuse (ρ 0.26 and 0.27 p< 0.001).

The PCA and CA did not show statistically significant results although showed a trend to link irritability with alchool abuse.

Our results suggest that bipolar patients with comorbid substance abuse disorders exhibit a prevalent temperament of irritable and cyclothymic related to alcohol and cannabis abuse and opiate dependence respectively. Further studies are needed to explore this relationship.