Nonpsychotic mental disorders in children, bio-psycho-social assistance to children with mental and behavioral disorders, Center for comprehensive psychosocial rehabilitation of children, medical and psychological support, multi-modal system of providing medical and psychological assistance, psychotherapy is combined with animal-assisted therapy, psychocorrectional work in the «in / out door» system.

Develop a medical and psychological treatment system, support and prophylaxis disadaptive psychological disorders in children.

Diagnostic and advisory work, correctional work, rehabilitation work, social and psychological work, methodical work.

After the medical and psychological adjustment in four study groups (children with F90.0 – 1st group, F94 – 2nd group, F81 – 3rd group and F82 – 4th group) the following results were obtained:

-Positive’+’ marker of social adaptation (the stabilization of family relationships, positive academic performance and normalization of interpersonal relationships with peers) in 1st group was 74,5%, in 2nd group – 86,0%, in 3rd group –50,0% and in 4th group – 48,1%;

1. 1. The system of medical and psychological support for children with mental and behavioral disorders.

2. 2. The basic criteria for the effectiveness of medical and psychological treatment: the formation of a constructive type of family relationships and social adaptation.

3. 3. Testing results on the primary stage of the work of the Center has demonstrated its effectiveness in 74.5% of children diagnosed with F 90, in 86.0% - with F 94, in 50.0% - with F 81 and in 48.1% with F 82, who underwent medical and psychological correction.

In this study we evaluated long-term effects of frontal beta EEG-neurofeedback training (E-NFT) in healthy subjects. We hypothesized that E-NFT can change frontal beta activity and that changes in frontal beta EEG activity are accompanied by altered cognitive performance changes.

19 healthy women and 6 healthy men participated in this study. The subjects were randomly adjusted to a real E-NFT or a placebo E-NFT. EEG was recorded by means of a Deymed Truscan 32-channel system with 19 channels before E-NFT (t1), post to the training sessions (t2) and 3- years after E-NFT (t3). For E-NFT an average of respectively 14.3 and 13.2 training sessions were completed for experimental and control group. Each trainingsession took approximately 45 minutes; training-protocol: increase 12-18 Hz at Fz-electrode, auditory and visual feedback was given if EEG activity was increased at Fz for at least 1second.

Compared to the sham E-NFT, which was used for the control group, real E-NFT increased beta activity in a predictable way (postmeasurement1 after NFB training, t2, post-measurement after 3years, t3). However, regarding our sample of healthy subjects E-NFT did not result in significantly improved cognitive performance.

The main finding of the present study was an increase in cortical frontal beta activity after E-NFT. We also found evidence of a long-term effect on the basis of a follow-up measurement after three years. Based on our results we conclude that EEG-NFT can selectively change EEG beta activity, in the short and long term.

Over the last decade, the study of functional connectivity networks has dramatically expanded across diverse research fields as functional MRI connectivity (fcMRI) or EEG connectivity. The aim of this study was to evaluate functional connectivity in the course of the day using two different imaging methods.

27 healthy subjects (male and female students in the age-range between 18-30 years) underwent 6 repeated fcMRI measurements over 12 hours in a 3T Philips Achieva MR scanner. The subjects were instructed to close their eyes and not to think on anything in particular. Resting State EEG was recorded outside the MR scanner with eyes closed and eyes open using a Brain MR Amplifier with 32 channels. Sleep deprivation was kept constant across subjects and the subjects were restricted to low-calorie food. EEG was analysed for coherence and EEG-phase between all EEg channels in sensor and source space.

The time course of 20 functional MRI networks were extracted and previous described functional networks were found. Eyes closed and eyes open EEG showed similar and distinct spatial correspondence. We found a good overlap for the Default Mode Network and the Frontal-parietal network. Day of time influenced the EEG measurements partly.

The findings of fcMRI and EEG connectivity are unique with high spatial resolution for fcMRI and high temporal resolution for EEG. Both measurements methods contribute further to our understanding of complex functional connectivity networks.

It is believed that mentally disturbed offenders commit their crimes closer to their residence compared to other offenders; however, scientific data in this area is scarce.

Do mentally disturbed homicide offenders commit their crimes closer to their residences than other offenders?

To examine the distances between homicide offenders’ residences and crime scenes, and correlate distance to occurrence of severe mental disorder.

All homicide offenders in Sweden between January 1, 2007 and December 31, 2009 were identified through an official crime register and a forensic medicine database (n=249). Offender data was collected from police files, court verdicts, forensic psychiatric evaluations, and the National reception unit at the Prison and Probation Services. Coordinates for offenders’ homes and crime scenes were used to calculate Euclidic distance. Data is presented using descriptive statistics. As outcome data (distance travelled to crime scene) was highly skewed, non-parametric tests were used (Mann-Whitney test).

7% of offenders had a psychotic disorder (n=17). All but one committed the crime within, or close to, their residence (mean distance 0.7 km; median 0 km) compared to other offenders (mean distance 25.7; median 0.9 km). Offenders who committed the crime >100 km from their residence were rarely found to have a severe mental disorder, and more often had an instrumental motive; e.g. money or sexual abuse.

Mentally disordered offenders seem to commit offences in close proximity to their residence. This finding may have implications for police investigations, geographic profiling and forensic psychiatric evaluations.

Monthly affective symptom status ratings for 30 patients with BP-II were based on interviews conducted at 3- or 6-month intervals during 5 years of prospective follow-up. The clinical characteristics and number of shifts in symptom status and polarity were examined.

In these 5 years our patients with BP-II were symptomatic 61.2% of all follow-up months: depressive symptoms (55.4% of months) dominated over hypomanic (13.4% of months) and mixed (7.3% of months) symptoms. Subsyndromal (minor) depressive and hypomanic syndromes were evaluated in 23% of months. With mixed syndromes together it is 30.3% of months!

We propose the introducing of INTERMEDIATE STATE (subsyndromal depression, mixed and hypomanic states) in course of bipolar affective disorders, with special importance of this new clinical concept for etiological research and more targeted pharmacotherapy. We think that the new name/diagnosis TRIPOLAR affective disorders (depressive, manic and intermediate states - subsyndromal depression, hypomanic and mixed states) is more adequate for the course of this chronic affective illness.

Eating disorders are characterized by a persistent disturbance of eating behaviour that results in altered consumption of food and that significantly impairs physical health or psychosocial functioning. Treatment of eating disorders is complex and challenging and sometimes patient's hospitalization is needed. The Santa Maria Hospital's Eating Disorders Unit is a specialized multidisciplinary team with long experience in the treatment of such disorders.

To present and discuss the results of the inpatient treatment program for patients with eating disorders held at the Santa Maria Hospital's Eating Disorders Unit.

review of clinical files of all patients hospitalised at Santa Maria Hospital's Eating Disorders Unit during a twelve month period and statistical analysis of data collected using SPSS program.

The sample included mainly female patients with anorexia nervosa with a significantly low body weight. In this presentation we show the results of the statistical analysis performed for sample characterization (both demographic and clinical variables), evaluation of patient's clinical outcome and features associated with good or poor prognosis.

The results of this study show the importance of inpatient care especially for patients with anorexia nervosa with a significantly low body weight.

The addiction to buprenorphine hight dose (Subutex®) is a new plague of drug addiction in Tunisia. The absence of a substitute treatment in this substance as well as the only ambulatory care of these drug addicts, make that is the weaning in the BHD is difficult. The aim of this study was to describe the follow-up and the weaning of these patients.

A retrospective study was conducted on the records of 23 patients who consulted the outpatient service of Razi hospital, addicted to BHD, since January 2012 until now.

Forty eight percent of patients (11 patients) were lost sight at the end of the first consultation. Only 13% of patients (3 patients) are followed up until now. Most of the patients had been put under classic neuroleptic essentially chlorpromazine in association with a benzodiazepine. 2 patients have weaned at the end of 13 months. These 2 patients are at present in relapse but in lesser doses than their initial dose of BHD.

The coverage of the patient dependent on drug was upset by the substitution treatments. But BHD don’t benefit from it and this hinders the care of the patients.

Anorexia nervosa is an uncommon but life threatening psychiatric disorder that is characterized by persistent energy intake restriction associated with intense fear of gaining weight and disturbance in self-perceived weight or shape. The nutritional compromise associated with anorexia nervosa affects most major organ systems, including the brain.

To present and discuss the case of a patient with restricting-type anorexia nervosa who presents brain cortical atrophy.

interview with the patient, analysis of patient's clinical file (including neuroimaging studies) and literature review on brain changes, especially focused on cortical atrophy, in restricting-type anorexia nervosa patients using the Pubmed/Medline databases.

a 21 year-old female patient, with diagnosis of severe restricting-type anorexia (BMI < 15 Kg/m2), hospitalized for severe low body weight without any signs or symptoms besides memory complaints. The neurological exam was normal. Brain CT scan revealed generalized brain cortical atrophy.

In anorexia nervosa, long-term persistent energy intake restriction is associated with brain volume changes, particularly global gray matter reduction which can be reversed by normal eating and associated weight gain. Although most cases of brain cortical atrophy are reversible, some will still persist despite normal eating. This report presents a challenging patient with restricting-type anorexia nervosa with brain cortical atrophy whose successful clinical outcome will depend on anorexia's prompt and effective treatment.

Cannabis is a widely used drug, which effects on human health remain controversial. Recent studies have found correlations between cannabis use and brain structural changes that may be related to ageing processes. Eotaxin-1 is a chemokine described as a marker of ageing, which also appear to increase with cognitive deficits and neurogenesis. Here, we aimed at characterising the effect of cannabis in accelerating normal ageing processes, by studying eotaxin-1 plasma levels in people who currently use cannabis, have used cannabis in the past, or have never used cannabis.

A total of 87 healthy volunteers participated in the study. Participants completed the Cannabis Experience Questionnaire, the General Practice Physical Activity Questionnaire, the Sociodemographic, Morphometric, Alcohol and Tobacco Questionnaire, and provided a blood sample. Eotaxin-1 was assessed by ELISA. The three groups were compared using one-way ANOVA to assess levels of eotaxin-1, and nonpaired Student t-tests to assess other factors effects.

Current users of cannabis (n=18) had significantly higher eotaxin-1 plasma levels compared to past users of cannabis (n=33) and individuals who never used cannabis (n=36). The latter two groups had similar eotaxin-1 levels. Higher eotaxin-1 plasma levels were not attributed to gender, age, body mass index, physical activity or use of other legal/illegal drugs.

These results suggest that cannabis use increases eotaxin-1 plasma levels and could result in accelerated brain ageing. However, the effects appear to be reversible when cannabis use ceases. These findings have important implications for treatment and care of mental health disorders, such as schizophrenia.

The use of an electronic-cigarette (e-cigarette) resulted in some previous studies in reduction and cessation of conventional cigarette smoking. This study aims to examine the reasons of using e-cigarettes instead of and in addition to conventional cigarettes in Germany. Furthermore it is determined to what extent e-cigarettes are used as a smoking cessation tool.

A cross-sectional study was conducted. The I-Change Model was used as theoretical framework and existing questionnaires were used to build up the present questionnaire. 320 Smokers participated in the study, divided in three groups: E-cigarette smokers (e-smokers) (33%), conventional cigarette smokers (c-smokers) (37%) and smokers of both cigarettes (b-smokers) (30%). Pearson Chi Square tests and analyses of variance were used to assess differences among the group of smokers on demographic variables, smoking behaviour and the constructs of the IChange Model.

About half of the e-cigarette users used the e-cigarette in addition to c. cigarettes and the other half instead of c. cigarettes. E-cigarette users were most often men, were less addicted to nicotine and had a higher motivation to stop smoking than c-smokers. E-smokers reported a more positive health and had a lower carbon monoxide concentration compared to c-smokers. E-smokers had a higher self-efficacy in terms of being abstinent from c. cigarettes in certain situations.

The results confirmed most of the hypotheses and also important results of previous studies. In addition, a well-conducted randomized-control trial is needed to confirm the efficacy of e-cigarettes as a smoking cessation aid.

Previous research suggests that various types of childhood maltreatment frequently co-occur and confer risk for multiple psychiatric diagnoses. This may mean that childhood maltreatment increases vulnerability to a great number of specific psychiatric disorders through diverse and specific mechanisms or that childhood maltreatment engenders a generalised liability to dimensions of psychopathology. Gender differences have been suggested to play a role in this associations.

To compare demographic and clinical characteristics of young adults with history of childhood maltreatment admitted to a psychiatric unit, according to gender.

To delineate the impact of gender on the psychopathology of young adults submitted to childhood maltreatment.

Retrospective data of patients aged 15 and 23 and admitted to a psychiatric outpatient unit, from December 2010 and December 2013, were reviewed. The demographic and clinical characteristics of the two genders were compared.

Childhood maltreatment was associated with elevated odds of mood, anxiety and drug disorders in both genders, but gender differences emerged with physical abuse associated only with externalising liability in men, and only with internalising liability in women. There were no gender differences in age of onset.

Childhood maltreatment have gender-specific consequences for the expression of psychopathology, suggesting gender-specific aetiological pathways between maltreatment and psychopathology.

Hyperprolactinaemia is a common side effect of some APS, associated to important clinical manifestations (sexual dysfunction, breast disturbances and even increase of certain types of cancer risk).

To evaluate the levels of prolactinemia associated to different APS, including the newest ones, and its association with sexual dysfunction (SD).

Observational cross-sectional study. Adult patients treated with one APS for at least 4 weeks and with no other PRL-rising treatment were included. Hyperprolactinaemia was defined as 20 microgr/L in women, 18 microgr/L in men. SD was evaluated with the specific SD questionnaire PR-Sex-DQ-SALSEX (Montejo et al, 2001).

288 patients were evaluated, with the following APS treatment distribution: aripiprazol (22.2%), risperidone (17.01%), olanzapine (16.67%), quetiapine (7.99%), long-acting paliperidone (6.25%), long-acting risperidone (4.51%), oral paloperidone (4.17%), oral risperidone (4.17%) and others (21.18%; APS with N<10 were not evaluated). Paliperidone was associated with the higher mean PRL levels (98.28 and 71.48 microgr/L for LAP and OP respectively), followed by oral risperidone (71.36 microgr/L). Aripiprazol, oral olanzapine and quetiapine showed the lowest PRL levels (13.25, 27.10 and 28.55 microgr/L respectively). More than 70% of the sexually active patients treated with paliperidone or risperidone presented SD, less frequent in non PRL-raising APS.

In our sample paliperidone and risperidone were associated to higher mean PRL levels and sexual disfunction, while quetiapine, olanzapine and aripiprazol were the less PRL-raising APS. This might be taken in consideration when electing a long-term antipsychotic treatment for patients, given the important clinical consequences associated to sustained hyperprolactinaemia.

As weight-gain and metabolic abnormalities during treatment with psychotropic drugs are of great concern, we evaluated effects of psychoeducation and medical monitoring on metabolic changes among severely mentally ill patients.

During repeated, systematized psychoeducation about physical health among 66 consecutive patients diagnosed with DSM-IV schizophrenia (SZ; n=33) or type-I bipolar disorder (BD; n=33), we evaluated (at intake, 1, 2, 3, and 6 months) clinical psychiatric status, treatments and doses, rated drugs- attitude of patients, and recorded physiological parameters.

At intake, BD vs. SZ patients were receiving 3–7-times more psychotropic medication, with correspondingly higher initial body-mass index (BMI: 29.1 vs. 25.6 kg/m2), 12-times more obesity, and significantly higher serum lipid concentrations. During 6-month follow-up, ratings of drugs- attitude of patients improved, polytherapy decreased in BD, and BMI decreased slightly, as serum lipid concentrations declined continuously (e.g., total cholesterol+triglycerides: BD by 3.21 > SZ by 1.75%/month). Declining lipid levels were associated with: [a] older age, [b] BD diagnosis, [c] being unemployed, [d] higher antipsychotic dose, [e] lower initial BPRS scores (all p≤0.001).