The decades bring increasing number of new medical specialties together with inevitable progress of medical science. This is caused by an expanding amount of knowledge, but remaining constant physical and intellectual capabilities of man. In the contrast to the time of Hippocrates, today you can not be an expert in every field of medicine. We need to consult with specialists in various fields to properly diagnose the patient. Without that often a definitive diagnosis is impossible.

The objective of our survey was to check how often psychiatrists use the consultation with physicians in other specialties and whether there is a relationship between the place of work, academic degree, work experience in the profession and the amount of commissioned consultations. It was also important for us whether consultations affect the place of the final diagnosis.

Most of the respondents are young doctors, specialists from large cities. They rarely consult with doctors of other specialties - 1/10 cases - take into account the recognition of these cases. However they are sceptical about the opinions of other psychiatrists. Proctologist, pathologist are specializations with which psychiatrists consult the least (> 76% did not cooperate). The most often they work with specialists in the field of neurology and internists.

The key to diagnostic success is a holistic view of the patient, which consists of components of knowledge about somatic and mental disorders. It is necessary, therefore, possibly the most effective cooperation of doctors of various specialties.

Psychiatry is a medical speciality. Yet in many (European) countries mental health is considered and remunerated differently from other medical specialties. Discrimination of psychiatric patients is at hand both implicitly in the public opinion as explicitly in the (medical) legislation in different countries of the EU.

How did this happen and who to blame. It must be said, unfortunately, that psychiatrists have also contributed to this negative image, but labelling psychiatric disorders as different and by acting themselves differently in terms of’medical’ availability as compared to other medical specialists.

Recently president Obama of the United States boldly took position to underscore the rights of patients with mental disorders as equal to those of any other fellow citizen. This sound should be heard in Europe too.

Moreover psychiatrists should take responsibility and action to regain their position within the corps of medical specialists. In this presentation an overview of how psychiatrists and psychiatry got into this as wrong as uncomfortable position will be given, alongside a proposal for a change for the better to get there where psychiatric patients are entitled to be and where psychiatry should be in the perspective of the recently endorsed WHO Mental Health Action Plan.

Pathological gambling and comorbide alcohol dependence are common occuring diseases. Disulfiram is one of the proven drugs for alcohol dependence. It was shown recently, that Disulfiram is also effective in relapse prevention of cocaine addiction. In addition to its inhibiting effect of the acetaldehyde dehydrogenase (ADH), disulfiram inhibits the dopamine β-hydroxylase (DBH) and thereby augments dopamine and depletes norepinephrine concentrations in the CNS. Inhibition of the DBH is suggested to be the responsible mechanism of Disulfiram acting in cocaine addiction. Previous research indicates common neurochemical substrates for pathological gambling and cocaine addiction. This suggests that dopamine substrates may directly govern the reinforcement process in pathological gambling.

In this report we now present the clinical data of a patient who was treated with disulfiram in our outpatient unit for addiction treatment due to existing alcohol dependence. The patient suffered also from severe pathological gambling.

Initialy we started to treat the patient with supervised disulfiram because of his alcohol dependence. During the treatment with disulfiram the patient’ desire for gambling disappeared entirely and he has not gambled anymore since then.

However, the exact mechnism of action by which disulfiram reduces urge to gamble is not fully unterstood, yet. Because craving is a key contributor to relapse, strategies aimed at modulate dopamine increases are likely to be therapeutically beneficial in gambling. Although uncontrolled case observations can only be interpreted with caution disulfiram seems to deserve further investigation and may hold the potential for preventing relapse in gamblers suffering from additional alcohol dependence.

Importance of prejudice and stereotypes among different communities has led many scientists, including sociologists and psychologists make extensive research in this field. But mainly, social psychology is a science that has had a major role in the investigation. In the study, researchers are trying to study about prejudice and its Sociological analysis, and to answer the question that how is gender stereotypes among student of Isfahan University.

The survey was conducted using questionnaires and BSRI index. Process of construct validity, sampling validity and face validity was carried out and questionnaire was acceptable. Cronbach's alpha was also calculated and indicates the reliability of the questionnaire is good. The population for this study is 14,507 students of Isfahan University and using Cochran formula, the sample size was 322. The sampling in this survey is quota sampling.

The research findings show that gender stereotypes are moderate and low and stereotypical beliefs of men are more than women. In terms of girls, strong personality and full-bodied is part of the male character. They believe that men should not be ruthless and aggressive. It is good to have an incident investigation and risk and selfishness and individualism is not desirable for men. The male perspective, the girls should be understood. At the next level, Children love being warm and friendly and caring and compassion for a woman is important. Being obedient and head to the sensitive and thin-skinned is not good for a girl.

Autism is an extensively studied disorder in which the gender disparity in prevalence has received much attention. In contrast, only a few studies examine gender differences in symptomatology. In a recent systematic review and meta-analysis (Van Wijngaarden-Cremers et al. 2013) of 20 peer-reviewed original publications we examined gender differences in the core triad of impairments in autism. Gender differences were transformed and concatenated using standardised mean differences, and analyses were stratified in five age categories (toddlerhood, preschool children, childhood, adolescence, young adulthood).

Boys showed more repetitive and stereotyped behaviour as from the age of six, but not below the age of six. Males and females did not differ in social behaviour and communication. Girls with ASD and an average to high intelligence are strongly underrepresented this could imply that females present another autistic phenotype than males.

In this presentation we will elaborate on the results of this study. As ASD is now defined according to the male phenotype this could imply that there is an ascertainment bias. We will show which research is needed into the female phenotype of ASD with development of appropriate instruments (eg ASSQ) to detect and ascertain them in clinical practice. Thus preventing women with ASD to be misdiagnosed often for years before getting the right diagnosis and treatment.

The diagnosis of depression appears recently in psychiatry history. It is in the early fifties when appeared in diagnosis summaries. Before, depression was understood as a regular symptom in the exploration, which was commonly observed under the use of other diagnosis like maniac-depressive disorder, schizophrenia, neurosis and hysteria.

Depression as diagnosis label in our daily clinical work is much more used in women than in men. There is a wide group of syndromes attached to reproductive woman life like premenstrual syndrome, puerperal psychosis and climacteric depression that finally contributes to different intensities of the depressive spectrum. Also women are the first consumers of antidepressant drugs in our culture. In men, many factors like alcoholism and cultural construction of masculinity based in inhibit emotional expression, explain that the prevalence of depression is less than in women.

In our work, we want to question why a diagnosis appears in one historical moment and why it is more applied to women than men, which are the factors involved in this process; therefore we wonder which elements of the performative discourse are shaping this diagnosis finally come real in clinical work.

To illustrate this, we will challenged the current data from a theoretic framework with different points of view as gender studies, science history and discourse philosophy.

Dysfunctions of the emotion processing circuitry are associated with Major Depressive Disorder (MDD) and can be modulated by antidepressants like selective serotonin reuptake inhibitors (SSRIs). Moreover, motivation, pleasure or interest are important neuropsychological states of emotional life, and are known to be impaired in MDD patients. Under SSRIs, some patients report decreases in motivation and/or in emotional responsiveness commonly described as emotional detachment (Corruble E et al, 2013) and having significant impact on drug compliance and quality of life.

The antidepressant agomelatine displays a unique neurochemical profile, different from SSRIs, being a MT1/MT2 receptors agonist and a 5HT2C receptors antagonist (De Bodinat C et al, 2010). Data from healthy volunteers and patients suggest that agomelatine is associated with less emotional detachment as compared to SSRIs notably with a more specific action in the facial expression recognition task (Harmer CJ et al, 2011), lower scores on scales for blunting (Corruble E et al, 2013), and absence of sexual dysfunction (Montejo AL et al, 2010).

Here, the effects of two antidepressants, agomelatine (25 and 50mg) and escitalopram (10–20mg) on emotional detachment, emotional processing, motivation and sexual function were assessed during a 9-week randomised, double-blind, placebo-controlled, parallel-designed study in healthy male and female volunteers aged between 18-45 years. A battery of neuropsychological and motivation tasks/questionnaires available in the literature were used. Investigating antidepressant effects on key psychological processes in healthy volunteers allows elucidation of the direct actions of antidepressants unconfounded by changes in mood symptoms. The study is on progress.

The recently published diagnotic criteria of Alzheimer's disease (AD) includes biological markers (determination of b-amyloid 1-42 (Ab), tau and phospho-tau) from cerebrospinal fluid (CSF), but their positive predictive value proved low, therefore a new biomarker indentification is needed. Apoptosis plays crucial role in AD pathomechanism. Ab interacts with mitochondrial proteins causing oxidative stress. That induces the impairment of energy metabolism promoting tau phosphorylation indicating apoptosis.

The purpose of this study was to identify pathognostic and apoptotic proteins in the CSF of AD patients.

Pooled CSF samples of 5x5 AD patients and 5x5 controls were used. ELISAs were performed to determine the concentrations of Ab, tau and phospho-tau. 10 ultrasensitive slides of peptide microarrays with 653 antigens were used. If the ratio of technical repeats of AD and control samples was under 0.65 that meant decreased protein concentration.

Apolipoprotein D (0,62), DNA polymerase gamma (0,51), parkin (0,58) and methylated-DNA-protein-cysteine methyltransferase (0,56) showed decreased concentration in AD in four chip pairs. The concentration of cyclin-dependent kinase 5 (0,45), granzyme B (0,37) and prostate apoptosis response 4 proteins (0,60) reduced in three chip pairs.

These data contribute to the database that will be used to elucidate the new biological markers for AD. Our findings may have implications for both the diagnosis and the understanding of AD pathogenesis, by defining a patient-specific signature to diagnose AD. Using these 7 biomarkers to identify AD prior to the onset of clinical symptoms and associated with neuronal loss enables novel clinical trial design and early mechanismbased therapeutic intervention.

This study was supported by grants from OTKA (83667), and the Hungarian Ministry of Education and Culture (TÁMOP 4.2.2-08/1-2008-0002, 4.2.1./B-09/1/KONV-2010-0005-3, 4.2.4.A/2-11-1-2012-0001).

One of the disorders that most affects school and social performance is attention deficit disorder associated with hyperactivity or impulsivity (ADHD). The criteria established by DSM-IV-TR edition distinguish three subtypes: inattentive, hyperactive-impulsive and combined. There are other factors that increase the severity of the disorder. These factors have to do with different associated psychopathologies such as learning difficulties, depression, oppositional defiant disorder, behavior disorder, anxiety disorders and mood disorders. Mean comorbidity of ADHD with anxiety disorders is estimated at 20–25%. The main goal of this investigation is to determine whether there are differential patterns of attention (selective and concentration using D-2 attention test) and anxiety (trait and state anxiety using State-Trait Anxiety Inventory for Children) for these three types of ADHD. The sample was made up of 220 children (6–12 years): 56 in the control group, 54 with predominantly attention deficit disorder, 53 with predominantly hyperactivity-impulsivity disorder and 57 with combined inattentive-hyperactive disorder. We used a design of four groups, three corresponding to the ADHD subtypes and a control group without ADHD. The results obtained show that the four groups of subjects were significantly different in the two attentional variables and in trait and state anxiety. The combined subtype presents higher trait anxiety, whereas the inattentive subtype shows higher levels of state anxiety. The results reveal a new path of great interest concerning objective and reliable diagnostic assessment, and pharmacological and behavioral intervention adapted to each specific situation.

Behavioral training in neurofeedback has proven to be an essential complement to generalize the effects of pharmacological support in subjects who have Attention Deficit with Hyperactivity Disorder (ADHD). The goal is to stimulate cortical activation, especially in disorders that require increasing intervals of attention and capacity of self-regulation and control. Therefore, this investigation attempts to verify the efficacy of neurofeedback compared with Pharmacological support and the combination of both. Participants were classified into four groups: Control group, students with ADHD who did not receive either pharmacological support of neurofeedback (n = 33, 11 girls and 22 boys); neurofeedback group (n = 33, 11 girls and 22 boys); pharmacological support group (n = 34, 15 girls and 19 boys), and combined group (neurofeedback + pharmacological support; n = 31, 11 girls and 20 boys). Participants were assessed at three levels (assessment of symptoms –EDAHassessment of execution –TOVA- and assessment of cortical activation –QEEG-) at two different moments (before treatment initiation and after treatment). The EEG-Spectrum was used for the neurofeedback intervention. The design was an ex-post-facto descriptive with four treatment groups (pharmacological support, neurofeedback, combined) and a control group that did not receive intervention initially. Results indicate that the combined group obtained more benefits and that the neurofeedback group improved to a greater extent in executive control than the pharmacological support group. It is concluded that this kind of training is an excellent alternative to stimulate activation in subjects with ADHD.

Attention Deficit and Hyperactivity Disorder (ADHD) is one of the problems that most affects academic performance in childhood and adolescence. Current research raises the existence of certain patterns of cortical activation and executive control, which could help to identify more objectively ADHD diagnosis. These studies consist on recording brain activation in central and prefrontal cortex areas through electroencephalographic measures using Q-EEG, and blood flood activity or hemoencephalography with nir-HEG. Moreover, executive control, evaluated with Continuous Performance Tests (CPTs), has been widely used to verify the incidence of brain activation levels on performance. This research aims to analyze the interaction between brain activation (nir-HEG and Q-EEG) and executive control (CPT) variables in a sample of 499 students (174 females and 325 males) aged 8 to 16, 256 (51.3%) with and 243 (48.7%) without ADHD. To accomplish this, a causal modelwas testedusing Structural Equation Modeling (SEM) analyses with AMOS.Results indicated that: a) activation measures influence different types of executive pattern, b) the relation between activation variables (nir-HEG and Q-EEG) depends on which brain areais studied and, c) with a good fit, both models (with and without ADHD), show important differences in variables correlation. These results highlight the utility of cortical activation and executive control measures for the differential diagnosis of ADHD, as well as from the standpoint of intervention, providing useful clues to delineate more adapted treatments.

Behavioral disorders at school have negative consequences for students' social development and academic achievement. A better understanding of their causes would help to develop more adapted prevention and intervention strategies. This study analyzes the association between behavioral disorders and executive dysfunctions in Elementary School students. A sample of 974 students from third to sixth grade of Primary School (aged 7 to 12), belonging to 30 schools in Asturias (Northern Spain), as well as their families and teachers, took part in this study. Behavioral disorders were assessed through teachers' completion of ACE rating-scale (Arias, Ayuso, Gil & Gonzalez, 2009). The frequency of occurrence of behaviors associated with deficits in nine executive functions (impulsivity, hyperactivity, emotional control, functional memory, planning, organization, cognitive flexibility, concentration and focus) was assessed by means of the EFE scale (developed by the authors) in its three forms (student self-report, and teachers and family rating-scales). Spearman correlation coefficients between scores obtained in ACE and the nine executive functioning components of EFE scale in its three forms were calculated. Statistically significant correlations between both measures were obtained. The strongest correlations were found between disruptive behavior and Impulsivity, Hyperactivity and Emotional Control. Results were consistent for the three forms of the EFE scale, being correlations higher when teachers were the informant. This study highlights the relevance of considering executive functioning components for the prevention and treatment of behavioral disorders.

Executive functions have been particularly useful in the differential diagnosis of numerous childhood and adolescent clinical disorders. However, although some behavior ratings of Executive Functioning are available today, its application is limited to English-speaking population. In this context, we designed a battery comprised of three questionnaires (family, teachers and self-report forms), being the aim of this study to present the psychometric properties of the questionnaire in its family form. Executive Functioning Scale for Families, formulated in Spanish language, was designed to assess executive functioning skills in children and adolescents from 7-18 years thorough the information provided by families. Consisting on 27 items grouped into 9 scales (Impulsivity, Hyperactivity, Emotional control, Sustained attention, Focus, Functional memory, Plan, Organization and Cognitive flexibility), scores range from 1 to 5, as function of assessed behaviors frequency. In order to analyze its psychometric properties, exploratory and confirmatory factor analyses were conducted. Finally, Cronbach's Alpha coefficients were calculated to examine reliability.1019 students aged 7 to18, belonging to 39 Primary and Secondary Schools in Northern Spain, took part in the study. Results concluded that the model which best fits the data is the composed by 9 first order factors, consistent with the hypothesized model. Reliability was high for the whole scale and moderate for its components. These data suggest some good psychometric properties of the designed tool and the potential usefulness of its nine scales in the assessment and delineation of different executive functioning components from the point of view of the observed behavior.

While Attention Deficit and Hyperactivity Disorder (ADHD) tends to be more commonly associated with externalizing disorders, mainly with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), comorbidity between ADHD and internalising disorders (specifically Anxiety) must be considered. This study analyses how trait anxiety affects attentional tasks performance in a sample of children with and without ADHD. 220 participants aged 8 to 12 took part in this study, 122 males and 98 females, classified into four groups: comorbidity group or students with ADHD and trait Anxiety (ADHD+ANX; n = 73); ADHD group (n = 53); Anxiety group (ANX; n = 15); and a non-clinical group of students (n = 41). Participants were asked to complete two neuropsychological tasks related to selective and sustained dimensions of attention. Group differences were examined using Univariate Analysis of Variance (ANOVA) for each dependent variable, with the group as the independent variable. Data showed that children with ADHD performed worse than controls and children with trait anxiety in sustained and selective attention tasks, while children with trait anxiety achieved similar results to healthy children. Finally, the presence of Anxiety symptoms in ADHD slightly modified the results in attentional tasks. These results contribute to better understand the clinical symptomatology that accompanies ADHD and comorbid Anxiety and highlight the usefulness of the applied measures in the differential diagnosis of these disorders.