Emotional dysregulation is one of the key symptoms in borderline personality disorder often seen in clinical practice. BPD patients report higher affective lability and higher affect-intensity than do patients with other personality disorders. BPD represents a serious health problem, in particular among women. With a lifetime suicide mortality rate of almost 10% (50 times higher than in the general population), BPD afflicts 1% to 2% of the general population and between 10 and 20 % of psychiatric patients. However, compared to other psychiatric diseases, such as depression or schizophrenia, relatively few studies addressed the underlying neuropathophysiologic basis of BPD. It is hypothesised that borderline patients are hyper-responsive to emotional stimuli compared to healthy control subjects. To our knowledge, no EEG-study has examined the role of emotional information processing in BPD.

Thirty BPS-patients are compared to thirty normal control subjects in their electrophysiological response to emotional information. Participants were shown pictures with neutral, positive, and negative valence.

Borderline patients had larger LPP responses as a reaction to pictures with an unpleasant valence as compared to the controls.

Borderline patients show more emotional reactivity to stimuli with unpleasant valence compared to a control group as measured by EEG. Further research could be helpful to examine whether the neurophysiological abnormalities in BPD patients can be influenced by applying cognitive techniques.

The purpose of this study was to show any possible differences in relation to the degree of improvement between two groups of patients with borderline personality disorder. The patients of the first group exhibited self-inflicted injury in the past while the second one didn't.

50 patients took part in the study. 13 of them reported self- inflicted injury (group A) while the rest 37 didn't (group B).

All the patients followed a psychotherapeutic program based on a Kernberg model for borderline personality disorders. 10 of them received medication in addition to psychotherapy.

Several variables were examined: sex, age, medication and outcome of treatment.

From the results we noted that:

76% of the patients of group A showed a great or sufficient improvement while from group B, 78,4%.

Also, the patients of the group A who received psychotherapy and some medication and showed great or sufficient improvement were 23%, while those without any medication 53,8%.

In the group B those who received psychotherapy and medicine and showed great or sufficient improvement were 66,7%, while the others without medication 80,6%.

From the results, it seems that the outcome of the treatment, overall, regardless of which of the two therapies for both groups, didn't show any significant difference.

The noted differences between those patients who received only psychotherapy and those who received psychotherapy and medication could be attributed to the fact that the condition of the patients in the first group was more severe than the others.

The aim of this study was to determine the The effect of paramedical students' attitude toward their jobs on self-concept among first and forth year paramedical students at the Fatemeh nursing & Midwifery college of the Shiraz University of Medical Sciences. Iran

204 paramedical students at the first and forth years of education at the Fatemeh Nursing and Midwifery College were invited to participate in this cross-sectional study. The data was collected through a self-administered questionnaire to solicit information regarding to demographic data, paramedical students' attitude toward their jobs and Coopersmith self-concept scale were used for self-concept data collection.

The greatest proportion of students (66.5%) was between the ages of 20-24 years. The results revealed that the majority of the students (65%) have high level of self –concept. Job satisfaction in 51.2% of students was excellent. Emergency technician students and operation room technician had high levels of self-concept than to Nursing and midwifery students. There was also a statistical correlation between self-concept and paramedical students' interest toward their job (P<0.005). Self-concept score in last year paramedical students was significantly more than first year students.

This study has explored the potential impact of the paramedical students' interest toward their job on self-concept. Nursing and midwifery students' self-concept might be increased by expansion of intrinsic job characteristics, improving their job satisfaction and providing frequent positive feedback.

A great deal of knowledge has been accomplished along the last 20 years in the study of borderline personality disorder(BPD). However, the sexual functioning of individuals with BPD still remains to be well explored, and no systematic survey in the literature is available.

To find out in the medical literature evidence of problematical sexuality in patients with BPD.

A literature search conducted via PubMed and Psycinfo using the terms "borderline personality disorder" and "sexuality".

The literature on the sexuality of BPD has focused mainly on two aspects of sexual dysfunction: a) promiscuous sexual behavior as a manifestation of impulsivity, and b) homosexual orientation as a manifestation of the identity problems that affect many BPD patients.

Moreover, the research findings provided information about problems with respect to intimate and sexual relations. BPD have significantly more relationship problems regarding sex, greater sexual boredom, avoidance of sex, greater sexual preoccupation, sexual depression, and sexual dissatisfaction.

Sexual functioning may be relevant for the clinical course of BPD, so clinicians should pay attention to the sexuality of BPD patients, and to the sexual parameters of their intimate relationships.

Patients diagnosed with Borderline Personality Disorder (BPD) have disturbed interpersonal relationships and emotional dysregulation. However, it remains uncertain whether these patients are also deficient at processing other people´s emotions. The initial appraisal of emotional information (involving attention and interpretation of emotional cues) is viewed as one essential precursor to emotional response and may relate to emotional dysregulation in borderline individuals.

The aim of the present study was to investigate the differences in the recognition of facial expressions of emotion and to investigate the pattern of classification errors among a group diagnosed with BPD, compared to a non-patient control group.

40 outpatients diagnosed with BPD, and 91 control subjects completed the Picture of Facial Affect developed by P. Ekman (POFA, 1976), a computerized emotion discrimination test presenting 110 photographs of evoked happy, sad, anger, fear, surprised, disgust and neutral expressions using a fixed-response format.

We found significant differences in the patterns of error rates in POFA tests related to identifying emotions with a negative valence as well as in neutral expression responses between both groups.

Results are discussed in terms of emotional appraisal ability and dysregulation among individuals with BPD. Examining the predictive factors of emotional responding in borderline individuals may provide information on the nature of emotion dysregulation in this population.

Demonstrate that Mental Illness, as aberrant process, is not a genetic disease.

Analysis and record of all those animus states produced in the real I search, during 3 decades.

Unexpected assault of paternal dispositions and coercive ideas or impulses, attacking against the Being, like they both share: Their repeated persistence, initial rejection, ignorance of their origin, to ignore their real premeditation, to interrupt the homeostasis, not to represent an intrinsic need, not to execute it will increase the contradictions; try for ignoring it, suppressing it, neutralizing it without result; alternative does not exist before these, because they are incisive and vertical; any adopted attitude will not avoid such a coaction; to execute immediately against the will; to produce annoyance, alienation and loss of control; environment disconnection, a dual feeling appearance. Consciousness of: impotence, not to have the necessary weapon to revert it and that, of such a conflict, will leave loser. This mechanical repetition, with evident vexation, originating a dead time (Non-Being), it will make abort the existence, of the Being, in emptiness, toward future avoidance.

This demonstrates that ‘Mental Illness’ comes from that imperfect relation among parents and children; since both events are essentially identical.

Correct handling of the extinguishment of conditioned reflexes orientates toward the restitution of the lucidity and incorporation at the homeostasis again.

Planned introspection and meticulous evolved record of all internal conflicts triggered after the tireless search of the I, during 30 years.

Association and reinforcement of the punishment with the freedom and disobedience, for allowing the appearance of the I, considered like a transgression, and the recompense, with the obedience, allowing the arising of a false personality or I’, which value : The Social Conditioning.

Exact equivalence between the punishment gave to a child and the obsessive-compulsive disorder. Persistent disobedience of a child, for pretending Being Himself, opposite a infuriate father for losing his authority, precise reproduction of all the nosologic psychiatry's classification.

The First step toward the real being search points out the beginning of the Mental Illness. The conditioned reflexes extinguishment –with full consciousness– unchaining unrecognizable internal contradictions, is onset of the RESURRECTION OF THE I, but its incorrect handling is cause of ‘Dead in Life’ or Mental Illness: Structure and dynamic repeat invariably in all the clinical cases. Religion and Schizophrenia are improved, stylized and sophisticated polar extremes of the social conditioning.

To evaluate the relation between positive and negative symptoms in schizophrenic patients with history and risk of suicidal attempt.

This case-control study was carried on 65 Schizophrenic in-patients during the years 2006-2007 and 65 major depressive disorder patients as control group. Both of these groups were evaluated and compared on base of clinical assessments and California diagnostic tests and PANSS (positive and negative syndrome scale).

There was significant relationship between positive symptoms in schizophrenic patient and both the California number test (r=0/708,p<0/0001) and history of suicidal attempt (r= 0/558, p<0/0001) .

Also thtere was significant and reverse relationship between negative symptoms and both the California number test (P<0/0001, r= -0/529) and history of suicidal attempt (P<0/0001,r=-0/512.). That means rising negative symptoms decrease the risk and history of suicidal attempt.

Regarding the results of this survey, schizophrenic patients with positive symptoms such as paranoid schizophrenia have more insight to their illness and probability of depression and increased risk of suicide .

Schizophrenic patients with negative symptoms such as deficit Schizophrenia, have less insight to their illness and low probability of depression and risk of suicide.

There were approximately 20.000 patients with schizophrenia facing various psychosocial problems according to the State Mental Health Center's 2004 year's data. One of the most serious problems were suicidal attempts. That's why we aim to explore nursing demands in patients with schizophrenia after hospital treatment.

Research was carried out in four Kaunas primary mental health centers, from July to September, 2006. We used standardized international mental health quality of life scale questionnaire implemented by Phillip W. Long (2003). Our group was randomly selected and consisted of 123 patients with schizophrenia aging from 18 to 65 years.

Several main problems were disclosed: 46,0 % of respondents noted reduced everyday home activities, 68,0 % mentioned physical fatigue, apathy 60,0 %, sleep disorders 81,0 %, memory and attention disorders 64,0 %, communication problems 76,0 % . Depressed mood was found in 56, 0 % respondents and 25, 0 % had suicidal attempt. We disclosed statistically confident correlation between disease duration and suicidal attempts (p < 0, 05). There were more suicidal attempts in younger patients than others (p < 0, 05).

Most frequent everyday and self-care problems were: (1) unemployment, poor incomes, sleep disorders, difficulties in household activities; (2) physical fatigue, memory and attention disorders; (3) everyday and self-care problems most frequently occurred with older respondents.

Patients with schizophrenia encounter communication problems with friends and relatives irrespective to their age. The most frequent emotional problems were: apathy 60, 0 %, depression 56, 0 %, lack of self- confidence 49%.

UK mental health services envisage that patients with a first presentation of psychosis are seen by an ad hoc assertive service for the first three years and then are transferred for further follow up to a community mental health team or to primary care.

We have reported on the three year outcomes of 62 patients who were treated in such an assertive service, compared to 62 patients who received treatment as usual. Outcomes in all domains were significantly better with the assertive service. These domains included employment, education, family life, relapses, readmission and concordance with medication.

We now report on an audit of outcomes at the end of the fourth year in both groups of patients; the exercise will be repeated at the end of the fifth year.

A note audit is being carried out on the two groups of patients.

Work on the audit is in progress at the time of writing. Early results indicate that some patients have had significant relapses since leaving the assertive service. This has led to significant bed usage by some patients. Other patients appear to have remained stable.

Relapse leads to a reduction of quality of life for the patients. Thus, in some cases there appears to be a reduction in the more advantageous quality of life outcomes once patients are referred to the community mental health team. This mirrors five year outcomes of first psychosis patients reported by the OPUS project.

In order to implement a successful early intervention service for psychosis, we suggest that cultural, religious and issues surrounding language and communication should be considered.

The delivery of the standard psycho-social interventions used by early intervention services requires effective engagement with the patients.

In June 2003 an audit was conducted amongst 75 patients from different ethnic groups in Luton. Measures of engagement with mental health services included; number of missed outpatient appointments over one year and compliance with medication regimes.

The results of this audit showed that South Asian patients are more likely to miss appointments and refuse to take medication in comparison to their Caucasian or Afro- Caribbean counter-parts. Further analysis revealed that the Bangladeshi subgroup had missed more appointments and had a greater proportion of medication refusal in comparison to the other Asian subgroups.

These results support the pioneering work by Dr Robin Pinto in the 1970s; he observed that Asian patients perceive and utilise mental health services in a different way compared to the Caucasian population.

The observations from our study depict the difficulties in engaging ethnic minority patients into existing services. Hence we argue that future interventions should be adapted and tailored to overcome cultural and language barriers with patients and their families.

Psychotic symptoms may develop after traumatic experiences. This is documented in Wartime situations. Childhood Abuse is linked with psychosis in later life. PTSD, and ‘Borderline’ symptoms are often linked with a past history of childhood trauma.

We hypothesise that the development of psychotic symptoms related to trauma may occur in a different pattern than the development of psychosis of neuro-developmental origin [schizophrenia].

We present a series of Vigniettes, all of whom have developed psychosis. Three have experienced major trauma, in Early Adulthood, Two have experienced a major trauma related to a war situation., and two, have developed psychotic illness of a neuro-developmental type [schizophrenia].

As expected, the cases of neuro-developmental psychosis developed psychosis over a long prodromal period, in which symptoms developed from non-specific depression and anxiety to a gradual increase of positive psychotic symptoms over time, until full psychosis developed.

The five cases where psycho-trauma occurred in adulthood [including the two wartime cases and the three other cases] showed sudden development of symptoms at the time of the trauma including PTSD and borderline symptoms. The psychotic symptoms developed, also suddenly, some time later, after a subsequent episode of psycho-trauma.

These different patterns of development of psychotic symptoms suggest different mechanisms of causation. Nonetheless, in all these cases, a full blown psychotic illness may result. In cases of psycho-trauma, the illness may continue to be accompanied by ongoing symptoms of PTSD and Borderline features, making these patients difficult to treat.

Suicide and suicidal behaviour are major problems in schizophrenia. Our aim was to review the recent literature on risk factors for suicide in schizophrenia from genes to clinical characteristics to identify different pathways leading to suicide and present a life-span developmental model for suicide in schizophrenia.

We performed a database search in four databases (Medline, PubMed, PsycInfo and Web of Science) with the keywords suicide AND schizophrenia. A comprehensive hand search was also performed.

There seem to be five main pathways for schizophrenia patients leading to suicide: First is comorbid depression that leads to suicide. Second, there is a group of patients with a difficult, chronic course of illness and many relapses and exacerbations. They lose their hope progressively over time. Third group comprises patients (mostly young males) with impulsiveness, dysphoric affect and substance abuse. Fourth is a relatively small but theoretically interesting and clinically important group of mainly young patients with high premorbid functioning and above average intellectual capacity. Fifth pathway, failure in treatment, comprises patients lacking social support whose treatment has failed. We also propose a life span model showing these five different pathways to suicide in schizophrenia.

There are different pathways leading to suicide in schizophrenia. These suicidal trajectories could be useful in clinical work when evaluating patients’ possible suicide risk and treating them. They might also provoke some further research ideas and hypotheses.

The amenable neurochemical base of social phobia still completely has not been clarified, even if has been proposed a potential dysfunction of both serotonergic and dopaminergic brain systems.

Clozapine is the prototype “atypical” antipsychotic drug, defining the role of its individual complex actions. It has been reported that clozapine occasionally involves symptoms from the spectrum of anxiety disorders. These symptoms are attributed in the action of this particular drug mainly on the serotonergic system.

In this study is presented the case of a schizophrenic subject, who developed social phobia at the duration of his treatment with clozapine and while he was found in remission of his psychotic symptoms.

The patient is man of 24 years and has a 3-year history of schizophrenia, paranoid type. In his history also is reported casual abuse of Indian cannabis as well as alcohol.

Presented symptomatology of social phobia the first interval of his treatment with clozapine (14th week) and while the psychotic symptoms had receded. When in his treatment it was added sertraline, the social anxiety disorder was decreased in remarkable degree. The daily dose of clozapine was maintained immutable.

The elements are discussed under the light of new neurochemical opinion but also psychodynamic approach of make, that could explain the appearance of symptoms from the spectrum of anxiety disorders (as the social phobia) in a clozapine-treated psychotic patient, at the duration of remission of his psychotic symptomatology.

Catatonic schizophrenia has been described as being decreasing in prevalence. We present a case of a 16 year-old-girl, previously healthy, who develops catatonic schizophrenia in a 5 months period.

we present the case of a 16-year-old girl, previously healthy, with family history of schizophrenia, develops 5 months prior to hospital admittance isolation from friends and odd behaviour, like suddenly standing still and speechless (thought blocking). She maintains these attitudes and 3 months after, develops delirious thoughts of death with agitation (screaming and undressing). One month prior to admittance she becomes diskinetic and mute, with loss of sphincter control. She is medicated by a neurologist with olanzapine 5mg od and valproate 200mg bid. As her clinical state worsens, she is brought to a central hospital, where she has MRI and lumbar puncture normal. She is observed by neurologists and psychiatrists in the emergency room. Against the psychiatrist opinion, she is admitted to the neurology ward. After repeating MRI and lumbar puncture and searching for neurotrophic viruses and prions´ disease, which all turn out negative, she is proposed for electroconvulsivetherapy (ECT) and transferred to a psychiatric ward.

She is submitted to 14 ECT and medicated with seroquel 300 bid with dramatic improvement.

this case illustrates the secondary role psychiatry is sometimes appointed to in contemporary medicine. Catatonic schizophrenia is a rare disorder and an even rarer form of presentation of schizophrenia. Nevertheless, it exists, and should be taken into account in the differential diagnosis of diskinesia.

Four years of group work for outpatients with psychosis and its influence on various aspects, especially on negative symptoms in psychosis were evaluated.

A small group of 6 to 8 medicated patients is run in co-therapy. A modified, non-structured, psychoanalytic group technique which includes psychoeducation, cognitive techniques, nonstructured conversation and clarifications is used. Patients should be intrinsically motivated and well prepared for group work.

Better control and differentiation of the psychotic symptoms, emotions and improved social functioning were observed. Group situation affects and improves the negative symptoms of psychosis through several important group therapeutic factors €“ instilation of hope, universality, altruism, group cohesiveness, which has developed very slowly. Group members were able to manage transient worsening of their psychosis in an outpatient care.

With its progression of group work, we observed more honest and open conversation about symptoms and real life problems. The most frequent topics discussed were: psychotic symptoms, at the beginning mostly positive symptoms of psyhosis, later on, with the progression of therapy members started to talk about the negative symptoms, interpersonal relations and stigma of psychosis.

The stigma attached to mental illnesses is the main obstacle to better mental health care and to better quality. It affects the priority which is given to the development of mental health services and makes the discipline less atractive than others to the mediacl graduate in search for career. It prevents timely contact of the person suffering from a mental illness with mental health services and makes rehabilitation exceedingly difficult.

Psychosis is a highly stigmatised condition. Our clinical experience with long term groups of patients with psyhosis have shown that long term group therapy has an important destigmatising role.

A small group of 6 to 8 medicated patients is run in co-therapy. A modified, non-structured, psychoanalytic group technique which includes psychoeducation, cognitive techniques, nonstructured conversation and clarifications is used.

In the early phases of group work stigma was manifested as drop-out of at least two members. With the development of group cohesiveness the group started talking about stigma. A feeling of universality in group work is often a fundamental destigmatising step.

Patients fear that their symptoms could be unique. Talking about the psychotic symptoms and feelings helps to differentiate them. Improved control over the problems and their life has an important destigmatising power. Group therapy has a destigmatising role through several group therapeutic factors, especially feelings of universality, altruism and group cohesiveness. Subsequentely, patients with psychosis start using their healthier parts and experience less stigma.

schizophrenia is one of the mental illnesses with the highest risk of suicide, with very high rates of suicide attempts and suicidal ideation. However data regarding suicide attempts by schizophrenia patients is scarce. In this study a large sample of schizophrenia patients who had attempted suicide was characterized.

a fifteen year retrospective analysis of all records of adult patients suffering from schizophrenia admitted to our center was conducted. The index group (N=1094) was comprised of patients who had attempted suicide; the comparison group (N=1094) was comprised of the next admission of a patient suffering from schizophrenia who did not attempt suicide prior to hospitalization.

the index group consisted of 380 women and 714 men, with a mean age of 39.6 + 12.9 years. The comparison group consisted of 302 women and 792 men, with a mean age of 42.9 + 13.7 years. Four variables were identified as significantly differentiating between groups: Patients who had attempted suicide were younger (39.6 vs 42.9 years; p = 0.00), had a higher percentage of females (34.7% vs 27.6%; p = 0.00), with increased rates of co-morbid physical illness (27.5% vs 20.4%; p = 0.00) and with a higher rate of substance abuse (32.1% vs 12.4%; p = 0.00).

this study brings attention to some significant factors associated with attempted suicide amongst schizophrenia patients, especially physical co-morbidity and substance abuse. In order to decrease adverse outcomes in this group of patients these variables should be addressed in risk assessment schemes.