This systematic review is to provide evidence for the guideline for the treatment of interictal psychosis in epilepsy for Kempenhaeghe, a categorical epilepsy treatment center in Heeze, the Netherlands.

Life-time prevalence of psychosis in patients with epilepsy ranges from 2-7% of which 10-30% interictal.

Typical and atypical antipsychotic drugs are widely used to treat.

The combination with epilepsy, drug-interaction and the effect of anti-psychotic medication on the seizure threshold are complicating factors.

Evidence for the efficacy of pharmacological treatment is lacking.

The research question is: Which antipsychotic medication is effective and safe in the treatment of interictal psychosis?

We searched in: Medline, Embase, Psychinfo and the Cochrane database.

Two independent reviewers made a first selection from the titles and abstracts. If necessary the selection was made with the full text version. In case of disagreement, a third reviewer decided.

Study, patient, intervention characteristics

Cohort studies and Case control studies were assessed with the appropriate CASP (Critical Appraisal Skills Program) assessment tools.

The search yielded 206 articles. After final selection 6 articles remained. 3 prospective cohort studies, 1 case series and 2 case reports.

Anti-psychotic medication can be effective (grade 3)

Possibly the dose needed can be lower. (grade 3)

Possibly clozapine lowers the seizure threshold. (grade 3)

No other anti-psychotics lower the seizure threshold (grade4)

No anti-psychotic is especially effective (grade 4)

There is no evidence for length of treatment.

The review and the guideline will be presented.

Antonovsky's salutogenic construct of sense of coherence (SOC) includes the dimensions of meaningfulness, comprehensibility and manageability. SOC is assumed to promote and protect health in stressful situations, such as the adaptation to severe illness. There is highquality evidence on this in several areas of mental health, and one could expect dementia to be one of them.

We conducted a literature review to uncover the role of SOC as moderator or mediator in the ability of patients and their partners to cope with the impact of dementia.

We searched the major databases (1994-2012), using selection criteria, data extraction and methodological quality assessment. Nvivo10 software was used to accomplish a rigorous literature review.

The SOC within the dementia context has been explored in 8 different countries. Some studies addressed the caregiver's SOC, but the focus on the person with dementia and a systemic perspective on couples remain largely neglected. There were significant associations between SOC and lower caregiver's burden, and between SOC and higher caregiver's perceived health and quality of life, namely in advanced dementia.

There is a dearth of research-based discussions of the SOC role in living with dementia. Results highlight the importance of studying couples, in a dyadic perspective, while acknowledging the voice of the patients themselves, despite several methodological challenges. Research should address the role of SOC in the individual and family's ability to cope with dementia, especially at the early stages of the process, aiming to provide new insights into dementia care.

The combination of dementia and depression in elderly patients is challenging for the differential diagnosis of the clinical situation

To examinethe comorbidity of dementia and depression in elderly patients

231 patients aged 70 years and older.

MMSE and clock drawing test, HADS and Cornell Scalefor Depression in Dementia (SCDD).

The study revealed the presence of mild cognitive impairment in 118 patients, unequivocally proven symptoms of dementia - in 113 patients.

Depressive disorders were found in 88 patients. Depressive symptoms were found in 136 patients. In patients with mild cognitive disorders prevailed depressive disorders of mild to moderate severity.

The relations of depression and dementia in Alzheimer's disease or vascular dementia are the following options:

1. 1. Depressive disorders are often detected in the patients who later developed dementia.

2. 2. The clinical picture of depression in Alzheimer's disease may occur with atypical symptoms, as well as a number of symptoms of dementia can be mistakenly classified as a manifestation of depressive disorder.

3. 3. In some cases, patients with incipient dementia can be set psychogenic the nature of depression.

The development of depression in elderly patients, especially without the presence of a ‘trigger’ social factor may be a predictor or risk factor for cognitive impairment in the future. This applies particularly to patients who have depressive disorder is an atypical clinical picture and the processes of the clinic ‘pseudodementia’ and to the patients, in addition to having a depressive disorder clinically significant neurologic deficit.

Stigma can be divided into several subgroups – social, structural, and internalized (i.e. self-stigma).

The purpose of this study was to identify the extent of internalized stigma in in-patients with neurotic disorders with or without comorbid depressive disorders and to clarify the relationship between internalized stigma and change of the severity of the symptoms during a treatment. The following methods of evaluation were used at the start of the treatmen: MINI, Internalized Stigma Of Mental Illness (ISMI); and at the start and in the end of the treatment: BAI, BDI-II, CGI. All patients underwent a treatment by group therapy (CBT or psychodynamic) and pharmacotherapy.

76 patients were included, the mean age was 40.20 + 12.85 years. The primary diagnosis was an anxiety disorder in 52 patients (68.5%) and a depressive disorder in 24 patients (31.6%). The mean overall scores in BAI, BDI-II, subjCGI, and objCGI significantly declined during treatment. There was a negative correlation between a subjective evaluation of the change of the anxiety symptoms during the treatment and internalized stigma. As for the change of the severity of the symptoms evaluted by a physician, the overall score of the ISMI scale statistically highly negatively correlated with the change measured by objCGI (Pearson r= -0,7665; p≤0,0001).

The more individuals agree with prejudices about psychiatric patients and apply them on themselves, the less they improve in their anxiety symptoms severity during the treatment both from the subjective and objective point of view.

Schizophrenia is a major mental disorder, with complex symptoms involving psychosis, apathy and cognitive impairment. The Trail Making Test (TMT) is a useful tool to assess cognitive functioning. Functional transcranial Doppler sonography (fTCD) of basal cerebral arteries is a noninvasive technique that allows monitoring of cerebral hemodynamics with a high temporal resolution during cognitive tasks.

We assessed cerebral hemodynamics and lateralization in the middle cerebral arteries (MCA) using fTCD while patients with chronic schizophrenia and healthy subjects performed the TMT Part A and B, as well as a control task.

fTCD was used to asses bilateral mean cerebral blood flow velocity (MFV) changes in the middle (MCA) and anterior (ACA) cerebral arteries. Fifteen patients with chronic Schizophrenia and 20 healthy control subjects with similar sociodemographic characteristics performed the TMT during fTCD measurements of the MCA and ACA.

Schizophrenia patients demonstrated an overall poorer performance, with a significant different lateralization pattern for both forms of TMT than healthy subjects. There was a significant slowing both forms of TMT, schizophrenia was associated with initially left sided lateralization. Healthy subjects showed a bilateral pattern.

These novel results show performance and brain perfusion abnormalities in schizophrenia, supporting the idea that cognitive performance has a pathological functional correlate predominantly in the lateral hemispheres of the brain. It adds to the notion that fTCD is a valuable tool to correlate psychological paradigms with brain perfusion.

Social support is an important variable involved in the process of health/disease. In the particular case of immigrants, social support is also related to the success of their life project and the integration in the society that received them.

Although Duke-UNC Functional Social Support Questionnaire is one of the most used with immigrants (e.g. National Health Survey), it has never been adapted to this population. In this research, Duke-UNC was adapted to Romanian immigrants living in Spain, in order to analyze the relationship between social support and mental health.

Verify the factorial structure and the psychometric properties and analyze the relationship between social support and mental health.

We administered Duke-UNC and GHQ-12 to a sample of Romanian immigrants (N = 116, mean age = 33.26; SD = 11.04), and conducted an exploratory factor analysis.

In the case of Duke-UNC, the results showed a structure of one factor that accounts for 51.46% of the variance. Cronbach's alpha value was .90. A significant negative correlation was found between the social support and the mental health (r = -0.34, p < .000). This shows that people who have more social support also enjoy better health state.

This study demonstrates that Duke-UNC is a practical instrument that can be used to assess Romanian immigrants'social support. This variable has to be taken into account when therapeutic interventions and health programs are created for immigrants because of its relationship with mental health.

Suicide is a major cause of disability and mortality.

Examine the role of neurobiological factors of suicidal behavior, includingneyrotransmitternyh and neurohormonal systems, which include the metabolism ofbiogenic amines.

55patients aged 17 - 35 years of both sexes (58 men and 97 women) who havecommitted suicide

Clinicalexamination, biochemical and immunogenetical methods.

Found thattheir violation and imbalance, namely increased concentrations of serotonin inthe blood (2,39 ± 0,24 mmol / l) reduction in plasma melatonin (0,71 ± 0,07 mmol / l) and decreasedexcretion rate adrenaline and noradrenaline at night (0,39 ± 0,06 and 1,21 ± 0,25 mmol / h) and daytime periods(1,66 ± 0,26and 4,56 ± 0,86 mmol/ h), creates neurohormonal background for the development of psychopathologicalconditions that lead to suicidal intentions and actions.

Patientswith specified neurobiological changes have been unable to get out of the longconflict through active variant of overcoming conflict and completed suicidalacts. According to the results of biomedical research, with to appropriatecorrection is differentiated use of natural biogenic stimulants herbalantidepressant that selectively affect the turnover of serotonin, melatonin, or drugs that stimulate the function of epiphysis.

numerous studies have shown higher rates of anxiety and depression, post-traumatic stress disorder (PTSD), chronic diseases and other physical symptoms in women exposed to intimate partner violence.

to analyze the relationships between duration and frequency of abuse and diverse health factors (mental health, physical complaints, post-traumatic stress disorder and self-perceived health) in a sample of battered women.

This study is composed of 274 battered women from Chile and Spain. The instruments used were: a semi-structured interview for victims of abuse, specifically designed for this research, which assesses sociodemographic characteristics of victims and circumstances of abuse; the General Health Questionnaire (GHQ-12) (Goldberg and Williams, 1988); Complaints Questionnaire, extracted from the National Health Survey of Spain (INE, 2006) and the Severity of Symptom Scale for PTSD (Echeburúa et al., 1997).

the results show that both the duration and frequency of intimate partner violence are associated to poorer health outcomes. For example, higher duration of violence leads to higher number of physical ailments and higher severity of PTSD symptomatology.

this results allow a better understanding of women health that suffer this kind of violence from their partners, and let us to develop treatment programs that best suit their specific needs, both in the private and public health field.

The etiology of psychiatric disorders in children with vertically acquired HIV is assumed to be related not only to neurotoxicity of HIV virus but also to environmental factors. To presence of comorbid psychiatric disorders has many consequences including worse compliance and engagement in risk behaviors which may lead to the expansion of HIV virus. By the end of 2012 - 118 children were subject to antiretroviral therapy in Poland.

The goal of the study was to assess the prevalence of psychiatric disorders in children and adolescents with perinatal HIV infection.

The study is carried out in The Clinic of Infectious Diseases of Childhood in Warsaw's Hospital for Infectious Diseases. 59 vertically HIV infected children aged 6-18 were qualified for the study. The control group is made up of healthy children at risk of infection (healthy children of HIV positive mothers). All subjects are interviewed with K-SADS-PL, Child Behavior Checklist (CBCL) and Youth Self Report (YSR) questionnaires in the diagnostic process for the presence of psychiatric disorders and quality of life testing.

Out of thirteen HIV vertically infected children tested up to day eight met criteria for at least one current or past psychiatric disorder according to DSM IV including ADHD, mood and anxiety disorders. One patient met criteria for five psychiatric disorders.

62% of HIV vertically infected children presented symptoms of at least one psychiatric disorders. The results of the pilot study suggest that the continuation of the study is justified.

Many risk factors for cocaine-induced psychosis (CIP)in cocaine-dependent patient (CDP) have been described although there not exactly known. Differences in the personality traits or disorders in CDP with or without CIP has been described. However, there are few studies studding the relationship between CIP and personality with a dimensional approach in order to clarify if there are any personal dimension related with CIP or/and personality disorders (PD) in CDP.

This study the relationship between CIP and personality trails evaluates with ZKPQ, and attempted to identify any personality dimension as a risk factors for CIP.

We performed a cross-sectional, observational study in 260 (75.5% man, 36.5 y.o) CDP according DSM-IV-TR seeking treatment between May 2009 and April 2013. The SCID-I, SCID–II, ZKPQ and a structured interview about CIP were performed.

CIP was reported for 66.4% of the patients. Patients with CIP had an earlier onset of cocaine dependence (p<0.05). Any PD was identified in 46.9% of the sample. Patients with CIP were diagnosed with ASPD more frequently (28.9% vs. 15.6%, X2=9.9, p<0.05). ZKPQ mean were: Sociability (6.3± 3.6), Neuroticism-Anxiety (10.8± 4.8), Impulsive Sensation Seeking (10.8±4.5), Aggression Hostility (9.06±3.2) and Activity (8.3±3.4). Patients with CIP presented higher scores in Neuroticism-Anxiety (11,4±4,7 vs. 9,6±5, t=2.7, p<0.05) and Aggression-Hostility (9,4±3,1 vs. 9,4±3,1, t=2.3, p<0.05) than patients without CIP.

The detection of high scores of neuroticism-anxiety and aggression-hostility trails should lead to evaluate the presence of CIP in CDP in order to alert them of the risk of develop CIP.

NICE guidance (2009) advises not to use drug treatment specifically for Borderline Personality Disorder (BPD) or for the individual symptoms or behaviour associated with it. Despite this, the Prescribing Observatory in Mental Health (POMH UK, 2012) found that 82% of Personality Disorder patients with no co-morbid mental illness were prescribed at least one psychotropic medication. We aimed to assess characteristics of patients with BPD and their use of medication in an inpatient population.

The population included 100 discharges from four acute inpatient wards in Sheffield, U.K., with a diagnosis of Emotionally Unstable Personality Disorder (F60.3 and F60.31) from April 2012 to April 2013.

Of the 100 discharges, 69% were female, 91% unemployed, 59% single and 98% admitted under the Mental Health Act. Hospitalisation was usually after a crisis: 68% reported suicidal ideation, 37% a suicide attempt and 13% risk of harm to others. Most common co-morbid diagnoses were depression, (18%) illicit drug related disorders (7%), alcohol related disorders (5%) and schizophrenia (5%). Medications prescribed included antipsychotics (57%), antidepressants (66%), anxiolytics (38%), hypnotics (31%), and mood stabilisers (19%). Drug treatment specifically for BPD (e.g. repeated self-harm, marked emotional instability, risk-taking behaviour and transient psychotic symptoms) was prescribed to 80% of patients.

Findings highlight that despite national guideline recommendations, patients with BPD continue to be prescribed psychotropic medications in clinical practice. As most admissions are associated with crises, a comprehensive crisis plan including (only if indicated) appropriate use of medication is essential in helping during periods of distress.

A large number of studies investigated the genetic modulation of various personality traits with mixed results.

We examined the association between several previously investigated single nucleotide polymorphisms (SNPs) and personality traits, as a confirmatory analysis of literature data, in a sample of 158 healthy subjects (males: 83, 52.53%; mean age: 32.20±7.36 years). As a secondary aim we tested the potential modulation of personality traits by additional gene variants that have not been previously studied.

The Temperament and Character Inventory (TCI) was administered to all subjects. A blood sample was also collected in order to perform studies on several neurotransmitter and regulatory gene variants. Multivariate analysis of covariance (MANCOVA), controlling for sex and age, was used to test influence of single SNPs on TCI scores.

Examination of previously studied gene variants showed an effect of adrenergic alpha-2B receptor (ADRA2B) on Cooperativeness and of HTR2A (rs6314) on Self Directedness. Examination of previously unstudied variants revealed that Sex Hormone binding protein (SHBG) was associated with Reward Dependence, and tryptophan deoxygenase (TDO2) was associated with Harm Avoidance. Moreover, several additional variants showed a tendency towards association with several TCI traits, confirming previous studies.

This study suggests that ADRA2B, HTR2A, SHBG and TDO2 genes may be involved in the modulation of personality in healthy subjects.

The major limitation of this study was the small sample size.

The ITAREPS system (Information Technology Aided Relapse Prevention Program in Schizophrenia) developed in Czech Prague Psychiatric Center, presents a mobile phone-based e-Health solution for weekly remote patient monitoring and disease management in schizophrenia and psychotic disorders in general.

The program provides health professionals with home telemonitoring via a PC-to-phone SMS platform that identifies prodromal symptoms of relapse, to enable early intervention and prevent hospitalizations.

This work presents data on ITAREPS effectiveness obtained from a recent mirror-design follow-up evaluation carried out in Czech Republic and a randomized controlled trial performed in Japan.

A retrospective within-subject mirror-image study was performed to compare inpatient days and inpatient costs for 134 adults with psychotic illness (ICD-10 dg. F 2X.X) before and after at least one-year ITAREPS participation.

The total number of hospitalizations and (inpatient days) decreased significantly from 159 and (6980) in pre-enrolment period to 47 and (3138) post-enrolment respectively (Wilcoxon-signed ranks test, Monte Carlo, exact test, two-tailed, Z = 6.13 /hospitalizations/, p<0.000001 Z = 6.41 /inpatient days/, p<0.01). Methodological weaknesses specific to mirror-image design were controlled by use of resampling method.

Outpatients with schizophrenia were randomized to the ITAREPS (n = 22) or control group (n = 23) and were observed during one- year follow-up (1).

Results Time to rehospitalization was statistically significantly longer in the ITAREPS group than in the control group (Kaplan–Meier survival analysis, 13 p = 0.033 /Fig.3), with a hazard ratio of 0.21 (95% CI 0.04–0.99). The total number of rehospitalization days (Fig. 4) was significantly lower in the ITAREPS group (37 days) compared with the control group (710 days, p = 0.023).

The ITAREPS presents a novel approach towards relapse prevention.

The robust effectiveness of ITAREPS program together with its low start-up and recurrent costs makes it an attractive consideration for long-term treatment in outpatients with schizophrenia and psychotic disorders in general.

Its web-based platform allows for implementation in clinical practice across different health care systems.

This work was supported by grant IGA NT 14387 from Ministry of Health, Czech Republic.

Several studies associated Major Depressive Disorder (MDD) with an increased production of pro-inflammatory cytokines, such as interleukin 6 (IL-6). Serum IL-6 levels were found to be significantly increased in subjects with MDD and with Treatment Resistant Depression (TRD). Moreover, ketamine, a drug with fast-acting antidepressant properties, has proven to reduce IL-6 levels in rat prefrontal cortex and hippocampus. However, despite the clear influence of IL-6 in the pathophysiology of depression and in antidepressant response, studies evaluating the impact of IL-6 functional genetic polymorphisms on treatment response phenotypes are scarce.

We aim to evaluate the role of IL6-174G>C, IL6-6331T>C and IL6R D358A A>C functional polymorphisms in antidepressant treatment phenotypes, specifically remission, relapse and TRD.

We genotyped the referred polymorphisms in a subset of 80 MDD patients followed at Hospital Magalhães Lemos, Portugal, within a period of 18 months.

We found that patients carrying IL6-174 GG genotype are more prone to develop TRD (OR=4.125; 95%CI: [1.151-14.786]; p=0.038). We also observed that patients carrying IL6-6331 TC genotype have a higher risk of relapse (OR=3.988; 95%CI: [1.176-13.516]; p=0.022), and present a lower time to relapse, TC: 26 weeks vs. TT: 45 weeks (p=0.041, Log-rank test). No association was found between IL6R D358A genetic polymorphism and any of treatment phenotypes.

The IL6-174G>C and IL6-6331T>C polymorphisms influence antidepressant treatment response in our subset of MDD patients. These polymorphisms may possibly contribute to the elevated IL-6 levels found in patients with TRD. This research was partially supported by an AstraZeneca Grant

Recent research on depression treatment of cardiac patients indicated that there are depressive subtypes at higher risk for cardiovascular complications and exploring personality types with negative affect may help to identify them.

To explore the association of affective temperaments with cardiac complications in primary hypertensive (HT) outpatients.

Data of 228 HT patients, controlled monthly for hypertension by their GPs, was analysed. TEMPS-A and BDI was applied to measure stable affective temperamental traits and depressive symptoms. ICD-10 diagnosed depression, antidepressant medication and cardiac complications (CC) required acute coronary intervention (acute coronary syndrome or acute myocardial infarction) was checked from patients’ medical records.

Mean age was 64 (SD±14) years and mean duration of hypertension was 14 (SD±7) years. 16 patients out of 228 developed cardiac complications (CC+). Age, gender, systolic blood pressure, BMI, smoking, HDL cholesterol level, years of hypertension, ICD-10 diagnosed depression, BDI point score and family history of cardiovascular diseases (CVD) did not reveal significant differences between those with or without CC. However, serum cholesterol level was significantly lower (U=997, p=0.01) and bigger proportion of three or more CVDs was found (χ2(1)=24.4, p<0.0001) in CC+ patients. Cyclothymic temperament was more prevalent among CC+ group (U=1119, p=0.027) and increased the odds of cardiac complications with 16% (95%CI= 1.047, 1.295) independent of depressive symptoms, diagnosed depression, age, gender and smoking.

Cyclothymic temperament with lability and rapid mood shifts as main characteristics may help to identify hypertensive patients in greater risk of cardiovascular complications irrespective of depression.

Acute stress disorder (ASD) and its predictivity in development of posttraumatic stress disorder (PTSD) has been researched extensively so far. Symptoms of peritraumatic dissociation (PD) has been proven as a predictive factor for PTSD, but recent studies have shown greater need for distinction of peritraumatic versus persistent dissociation.

Symptoms of PD and of persistent dissociation in subjects diagnosed with ASD will be predictive of PTSD symptoms.

To investigate the development of ASD symptoms, symptoms of PD and of persistent dissociation within the first month of traumatic event (initial) and six months later (follow-up) in victims of traffic accidents.

At the moment, 25 subject were included in initial phase, and 18 at follow-up. Subject were interwieved, Mini International Neuropsychiatric Interview, Acute Stress Disorder Structured Interview, Clinician Administered PTSD Scale, The Dissociative Experience Scale, and The Peritraumatic Dissociative Experiences Questionnaire were administered.

10 subjects were diagnosed with PTSD in the follow-up. Preliminary results support for a greater risk for PTSD when dissociative symptoms are present, of PD or persistent dissociation.

Greater distinction of dissociative symptoms in the acute trauma phase should be taken into account when diagnosing ASD. It could be eventually helpfull with identifying individuals at risk for PTSD.

Social representations occupied a place apart in psychology both by the problems it raised and the scale of phenomena with wich it deals.

This survey examined the potential results of Greek's illness's social representations.

To tested the link between social representations of illness and psychopathological behaviours.

A cross-sectional design was performed. 280 healthy individuals (mean age± sd: 40.9±11.5, range:19-65 yrs)participated to the present study from different region of Greece. All the participants completed a) a questionaire for the recording of illness's social representations based on free associations and b) The Symptom Checklist 90-revised (SCL-90R) along with a quaistionnaire concerning socialdemographic characteristics.

Multivariate analysis was performed. No significant differences on social representations were observed in terms of sex, age and marital status. Chronic disease was found to contribute directly in the development of illness representation (F(1)=5.063, p=.025). Thus, GLM analysis was found strong association between illness representations and developing of somatization (p=.013), interpersonal sensitivity (p=.033), depression (p=.005), anxiety (.001), hostility (p=.004), phobic anxiety (p=.005), paranoid ideation (p=.045), and psychoticism (p=.011).

The results of the present study highlighted that social representations are not a quiet thing. But more crucially support the idea of using the development of social representations in terms of therapeutic process.

Depressive disorder occurs in 5-9% of adolescents and it is often associated with chronicity and positive family history. It often persists into adulthood. Depressive symptoms are reported in more than 25% of healthy high school adolescents. Depressive feelings in adolescents require our attention in order to make early recognition possible.

Evaluating frequency and stability of self-reported depressive symptoms in healthy adolescents in 2000 and 2010.

The research was conducted on 408 fourth grade high school students who were 18, during the years of 2000 and 2010. The depressiveness was assessed using the Beck's Depression Inventory (BDI-IA).

Depressive symptoms were found in 59.5% of adolescents (BDI score > 9) during year 2000. In 2010, 18.6% of the examinees had depressive symptoms. The average BDI score in 2000 was 10.23 which is statistically highly relevant (p<0.05) compared to 2010 when the average BDI score was 5.2. Average BDI score was statistically significantly bigger (p<0.05) in female adolescents both in 2000 (women 11.5, men 8.29) and 2010 (women 5.86, men 3.96)

Female adolescents show significantly higher scores on the Beck's scale which could be used in specific prevention. The difference in expressed depression in two adolescent samples requires further research which would include more predisposing and protective factors.