Shizophrenia has traditionally been associated with higher rates of risk factors for cardiovascular disease and the metabolic syndrome, as a consequence of lifestyle habits, impaired access to health care and antipsychotic agents.

To determinate the prevalence of metabolic syndrome in patients with schizophrenia who are in Day Hospital regimen in Vizcaya area (Basque Country, Spain).

A cross-sectional study conducted from december 2008 to April 2009, in Zamudio and Barakaldo Day Hospitals (Vizcaya). Metabolic parameters were measured in 67 patients aged 20 to 65, with a diagnosis of schizophrenia. The definition of Metabolic Syndrome, as proposed by the International Diabetes Federation (IDF) was applied.

The analysis of 67 patients showed a prevalence of the metabolic syndrome of 41,79% at baseline. Obesity (49%), insuline resistance or diabetes (37,31%), and dislipemia (41,79%) can all contribute to the metabolic syndrome.

Compared to the general population, our sample of patients with schizophrenia present higher rates of the metabolic syndrome. The psychiatrist should be responsible for the implementation of the necessary screening assessments and referral for treatment of any physical ilness.

Shizophrenia has traditionally been associated with higher rates of risk factors for cardiovascular disease and the metabolic syndrome, as a consequence of lifestyle habits, impaired access to health care and antipsychotic agents.

To determinate the prevalence of metabolic syndrome in patients with schizophrenia who are in Day Hospital regimen in Vizcaya area (Basque Country, Spain).

A cross-sectional study conducted from december 2008 to April 2009, in Zamudio and Barakaldo Day Hospitals (Vizcaya). Metabolic parameters were measured in 67 patients aged 20 to 65, with a diagnosis of schizophrenia. The definition of Metabolic Syndrome, as proposed by the International Diabetes Federation (IDF) was applied.

The analysis of 67 patients showed a prevalence of the metabolic syndrome of 41,79% at baseline.Obesity (49%), insuline resistance or diabetes (37,31%), and dislipemia (41,79%) can all contribute to the metabolic syndrome.

Compared to the general population, our sample of patients with schizophrenia present higher rates of the metabolic syndrome. The psychiatrist should be responsible for the implementation of the necessary screening assessments and referral for treatment of any physical ilness.

Soldiers as well as civilians have suffered extreme tortures and terror during aggression on Bosnia. We wanted to assess consequences of that kind of war and to find how meny war veterans still have wish to revenge to enemy.

We used Harvard trauma manual (Bosnia and Herzegovina Version) to assess Posttraumatic Stress Disorder in sample of 105 war veterans. One of items assess wish to revenge.

Results shows that only 7.3% of war veterans without PTSD has wish to revenge and no one of them has it very often. Veterans with PTSD had higher number of wish to revenge. 42.6% of them has wish to revenge and half of that number has very intensive wish. Statistical analysis shows significant difference between those two groups (p< 0,001). Also it is shown that there is positive correlation between diagnosis of PTSD and wish to revenge.

It was expected that high number of war veterans has wish to revenge for that experience. But according to our study there is low number of war veterans that has wish to revenge. It was expected that higher percent of veterans with PTSD has wish to revenge. It was also expected positive correlation between PTSD and wish to revenge.

Violence and aggression are a major concern in acute inpatient psychiatric wards. Hard outcome data on the impact of service change are scarce. This poster presents the outcomes of service changes designed to improve the acute ward environment and patient experience.

To implement changes to the delivery of acute inpatient psychiatric services and to measure the outcome of these changes in objective verifiable form.

Significant changes were introduced to an acute psychiatric inpatient service. These included introducing a dedicated inpatient psychiatrist “hospitalist”, replacing weekly ward rounds with daily multidisciplinary care and discharge planning meetings and promoting increased roles for nursing staff in decision-making and patient contact. Outcomes measured included routinely recorded incidents of violence with and without injury, use of restraint for medication and use of constant nursing observation. The control group was a similar service in the same hospital subject to the same general policies and admitting patients demographically comparable, but that did not at the time undergo the interventions implemented in the trial service. All data was recorded by staff who were unaware of this study or even that any analysis of the data would occur.

Violent incidents in the intervention ward dropped by 34% per patient (p=< 0.02) whilst increasing by 3% in the control ward; restraints decreased by 28% (p=ns) whilst increasing by 12% in the control ward; with an overall reduction in constant observation. The intervention was highly effective in reducing violent incidents.

Bordern line personality disorders are seldom diagnosed in a rural setting. But on a routine longnitudinel & through & trough follow up, BPD cases are distinctly identified if the clinician is vigilant & aware of BPD.

Personality disorder in general & BPD in particuler, have less chance of diagnostic evaluation on the first visit due to colouration of mini psychoepisodic type presentation, mainly Hypomaniac type, or a depressive colour, but with a distinct subjective distress, & sufferings of the peripherial family members of the society it is identifiable.

Here is presentation of 26 female & 24 males, 50 in total persons those were diagosed in this year uptosept09, & their profile analysis to review them in the back-ground of such cases in other urban settings, and to make the clinitian aware of the possibility of BPD, specialy in cases where therapy results for long time are not yielding satisfactory expected results.

50 BPD cases those were diagonosed as per criteria of DSM 4TR constiuting 26 females & 24 males with 20-38 years age, were recorded upto sept09 in a rural clinic of a District HQTRS 126 k.m away from state capital city were analysed with a view of their presenting styles & distress in himself aswell as to the family members. There is a dificulty in maintaining interpersonal relationship for sustained period & smoothly. Substance & alcohol abuse, reckless spending, polygamy, family discord & violence even leading to seperation/divorce, banckrupcy or joblessstate exists.

There is a fanatic efford to avoid loneliness & strive for Identity.

BPD needs further evaluation.

The study aimed to investigate relationship among personality dimensions (introversion-extroversion E/I, intuition-sensing N/S, thinking-feeling T/F, perceiving-judging P/J) based on Jungian personality types and stress in university students.

200 students of university were randomly selected and Hogan-Champagne's Personal Style Inventory (PSI) and Coudron's Stress Inventory (CSI) were administered on them. The PSI assesses eight personality dimensions based on Jungian personality types mentioned above. The data were analyzed with Pearson correlation coefficient.

Findings showed significant positive correlation between introversion and stress and significant negative correlation between extroversion and stress. In addition, more analysis of personality dimensions showed female are more sensing than male and male are more intuition than female.

In regard to introverted are independently constraints and prodding from situation, culture, people, or things around them, so facing to stress factors interrupt their own world and reduce their function, cause to variability in situation and stress emerge.

Some psychological disorder-comorbid with a medical diagnosis-presents a challenge for treatment because of diagnostic and treatment dilemmas. This study investigated associations between Psychoticism and Paranoid ideas in internal medicine and A&E1patient in a university hospital.

In this cross-sectional study, we checked 150 patients of internal medicine department and 150 patients, who have admitted to the A&E department as a control group. They have chosen by a Purposive accessible sampling method. The psychopathological profile was assessed using the SCL-90 questionnaire by Iranian version. Data have been computed and analyzed by SPSS V.17 and we used t-student, Mann-Whitney tests and logistic regression methods. The results have been considered significant when the two tailed p-value was less than 0.05.

In internal ward 70% and A&E department 43.3% of patient have had Paranoid ideas (OR= 4.2; 95% CI, 1.9 to 8.9). Psychoticism were observed in 38% of internal medicine patients and 20% of A&E's patients (OR= 7.64; 95% CI, 3.2 to 17.8).

The present results confirm the high prevalence rate of Psychoticism and Paranoid ideas in patients that hospitalized in internal to A & E ward. Recommendation are made to further investigate by greater sample size and different setting in this field is warranted.

Estimation of clinical-and-psychological status was conducted among female patients with diagnosis of cervical carcinoma and endometrial cancer. There were 2 sample groups. The first group consisted of 16 patients of early reproductive age from 20 to 35, not having patient parity. Tissue retrieval of ovary with following criopreservation was carried out among the patients of this group during the surgery stage. To restore the hormonal function of the ovary and rehabilitate the reproduction function after finishing of the complex treatment all patients underwent autotransplantation of the unfrozen ovary tissues into the abdominolvesical wall. Rehabilitation of the reproductive function consists of centesis of Graafian follicle, obtaining of the ovule, in vitro fertilization and transmitting of the embryo of the surrogate mother.

Informal clinical interviewing, MMPI, The State trait Anxiety Inventory, Personality Questionnaire of the Bechterev Institution.

1. 1. High intensity of anxious reaction in both groups makes it necessary to provide psychological rehabilitations for patients.

2. 2. Euphoric, balanced and ergopatic Types of Attitude to the Disease have been frequently observed, which presents the picture not characteristic for the oncological profile patients.

3. 3. The exceeding rates in the scales of neurotic triad observed through the MMPI need adequate correction.

Restoring of the possibility for a woman to enjoy her natural biological function improves the quality of life of such patients. Probably this will also increase the efficiency of the antineoplastic treatment and the life expectancy for patients this oncological patholgy.

Explore the neurocognitive and temperament profile of borderline personality disorder (BPD) and schizotypal personality disorder (SPD) to better understand their underlying neurobiology for improved treatment.

17 BPD, 16 SPD, and 15 healthy controls (HCs) were given a comprehensive neuropsychological battery (CANTAB), the Iowa Gambling Task, a time perception task, and questionnaires of impulsivity, temperament, emotion, and frontal behavior (measures orbitofrontal cortex (OFC) dysfunction).

BPD and SPD patients performed significantly worse on the delayed match to sample (DMS) task compared to HCs, but had preserved function on decision-making, planning, time perception and attention tasks. SPD patients performed significantly worse on spatial working memory (SWM) tasks, and had higher religious commitment scores than HC and BPD groups, which correlated with their SWM deficits. BPD patients had significantly more frontal behaviors and emotions than both groups, which correlated with their emotionality, impulsivity, BPD symptoms, and temperament traits.

Both BPD and SPD groups had a deficit on the DMS task, sensitive to medial temporal lobe (MTL) dysfunction, but only SPD patients had SWM deficits, indicative of dorsolateral frontal cortex (DLFC) dysfunction, which correlated with their high religious commitment in line with their odd beliefs and magical thinking. Only BPD patients had frontal behavior deficits, related to OFC dysfunction, which positively correlated with their emotionality, impulsivity, and temperament traits. While both disorders may have a deficit in MTL function, DLFC dysfunction may contribute to SPD symptoms, and OFC dysfunction to BPD symptoms, suggesting treatment should target unique prefrontal cortex regions respectively.

The aim of our study is the evaluation of the presence of ADHD and cognitive-executive functions in patients with Borderline Personality Disorder (BPD).

We enrolled 54 adult male patients with BPD diagnosis (mean age 40,6 years). The Wender Utah Rating Scale 25-items (WURS) was used to assess the presence of ADHD in childhood. The neurocognitive assessment included the following tests: Wisconsin Card Sorting Test (WCST), Stroop Color/Word Interference Test, Verbal Fluency Test (VFT), AB-AC Test.

From scores obtained at WURS 25-items (cut-off score ≥ 46) the observed frequency of subjects with childhood ADHD was 27.8% (15/54). Therefore the subjects were divided into two groups: BPD without ADHD and borderline ADHD. Scores obtained were compared and statistical significance was observed in regard to WCST (p=0.006), VFT fonemic (p=0.04), VFT semantic (p= 0.05), AB-AC test (p=0.05).

Our study shows that borderline subjects with childhood ADHD have worse cognitive performances than borderline subjects without childhood ADHD.

Borderline Personality Disorder (BPD) shares many symptoms with Bipolar Disorder (BD) and Attention-Deficit/Hyperactivity Disorder (ADHD), like aggressiveness, mood instability and impulsivity, which are often treated in off label modality with mood stabilizer drugs. We point out the diagnostic, therapeutic and rehabilitative difficulties of BPD treatment through the analysis of two extreme and parallel cases.

Two females, born in extra-EU Countries in 1986 and in 1988, emigrated in Italy in childhood, presented overlapping traumatic early life events and ADHD during scholar age. Later, both the patients presented such growing relational problems and disruptive behaviours to be expelled from family and school. So they began a long psychiatric history, characterized by frequent hospitalizations, due to violent behaviour against themselves and other people, many unsuccessful rehabilitative programs, due to poor compliance, and various pharmacological switches, due to drug scarce effectiveness. Both the patients were followed by the same staff for 8 years, with an integrated psychotherapeutic, rehabilitative and pharmacological program, which consisted of a perseverant and meantime flexibly setting, a support of educational community operators and an off label prescription of two mood stabilizers combined to an atypical antipsychotic drug.

At the moment, the patients showed reduced dangerous behaviours, but need a perseverant effort by many operators in order to promote their emancipation from institutional dependence.

The complexity of these cases, characterized by the persistence of a childhood disease, developed into a stables unstable mood chronic pathology till the late adolescence, suggests us a likely pathogenic relationship among BPD, BD and ADHD.

Internet is an important means of communication but its use must be monitored to prevent inefficiency in the working places and to become a behavioral disorder for workers.

The aim of this paper is to investigate the relationships between the use of Internet at work for non-work purposes (Cyberloafing) and factors such as gender, age, years of work at company, education, excessive use of Internet at home, company salary and certain psychological attitudes such as loneliness and lack of self-esteem.

A random sample of 409 workers (180 men, 229 women) was interviewed using a questionnaire with demographics, applications of Internet and Young's criteria of Internet addiction sections. We performed a binary logistic regression analysis using the SPSS 18 with depended variable the amount of time spent every day on using the internet at work for non-work purposes.

The following factors were found statistically significant predictors of the depended variable. Sex, Length of time for viewing Sports news at work, General Information, Buying pages, Playing games and Gambling. The mean age of the Cyberloafers was 35 years and the percentage of the workers who could use Internet at work for non-work purposes was 9.1%. The percentage of men who were using Internet at work for non-work purposes was 12.2%, whereas the analogues percentage for women was 6.6%.

Specific steps of monitoring the Internet use and organizing companies seminars for avoiding the dependence on the internet are recommended for maximum efficiency.

The present research aims to investigate what purpose[s] self-harm serves for male patients in a dangerous and severe personality disorder unit in Rampton high secure hospital. It is proposed that existing functional models of self-harm should be modified to suit this group due to environmental constraints and features of their diagnoses.

A model of self-harm was devised from interviews with patients, literature reviews and a pilot review of daily nursing notes, therapy notes and incident reports. The ten proposed functions for self-harm in this population were affect regulation, interpersonal influence, control, sensation seeking, psychosis, feeling generation, self-punishment, anti-suicide, revenge and the expression of aggressive intent. This was applied to data collected from incident reports and daily nursing notes on all incidents (n=386) of self-harm for all current patients (n=53) in the unit in December 2008, in order to establish the nature and context of the incidents, i.e. the location, time and method of self-harm, as well as the function of the behaviour.

The nature and context of self-harm was similar to that in other inpatient and secure settings, except the number of incidents, which did not vary according to time of day. The functions of self-harm were diverse, and there was evidence for those unique to this population.

Future research intends to develop a behavioural classification system for the assessment of motivations for self-harm that can be administered to staff and patients. The clinical impact of this work is discussed.

Delay discounting (DD) procedure has been used to probe the extent to which behaviour is insensitive to its long-term consequences. During the DD task, participants are offered a choice between a small reward, which is delivered immediately, and a larger reward, which can be obtained only after a delay. Several studies has been reported that drug addicts are insensitive to future outcomes in DD. Previous studies indicated that Methadone Maintenance Treatment (MMT) decreases risky behaviors such as illegal drug use, needle sharing and risky sexual behaviors. But, there is a serious question that could it change underlying cognitive processing of risky behavior or not?

In this study, we evaluated 266 opioid dependents (age: 31±9 years, education: 10±3 years) before MMT entry on DD. 78 patients (30%) has been completed at least three month MMT and re evaluated on DD. The Mazour model was fitted to data (V=A/(1+kD)) (K: delay discounting coefficient, D: delay) and least square parameter estimation was used to estimate delay discounting coefficient.

K was significantly reduced after 3 month successful MMT (0.12±.6 vs. 3.9±12.6) (P values=0.016). Successful patients in MMT had lower K in baseline but not significantly.

MMT could improve future time horizons in underlying cognitive processing of decision making. Based on this study, We could accept more favorably MMT as a real effective addiction therapy not just a substitution between street drugs and state drugs.

Neuroimaging studies in adults with borderline personality disorder (BPD) have reported alterations in frontolimbic areas, but cannot differentiate between alterations originating from disease and those occurring as side-effects of medication or other consequences of the disorder.

To provide a clearer picture of the organic origins of BPD, the present study reduced such confounds by examining adolescents in the early stages of the disorder. It also examined the extent to which alterations associated with BPD are specific, or shared more broadly among other psychiatric disorders.

Sixty right-handed, female adolescents (14-18 years) participated. 20 had a DSM-IV diagnosis of BPD, 20 had a different DSM-IV defined psychiatric disorder, and 20 were healthy controls. All groups were matched for age and IQ. Images were analysed using voxel-based morphometry.

No differences were found in limbic or white matter structures. Compared to healthy controls, adolescents with BPD displayed reduced gray matter in dorsolateral prefrontal cortex bilaterally and in left orbitofrontal cortex, but there were no significant differences in gray matter between BPD and other psychiatric patients. Like BPD patients, non-BPD psychiatric patients displayed significantly less gray matter in right dorsolateral prefrontal cortex compared to healthy controls.

These findings indicate that the prefrontal cortex is the earliest affected in the progression of BPD, but this does not distinguish it clearly from other psychiatric disorders. Alterations in limbic areas and white matter structures were not observed, but may play a later role in the progression of the illness.

Personality disorder, formerly referred to as a Character Disorder, is a class of mental disorders characterized by rigid and on-going patterns of feeling, thinking, and behavior. The underlying belief systems informing these patterns are referred to as fixed fantasies or “dysfunctional schemata” (Cognitive modules).

Patients and care providers have difficulty getting control of self-injurious behaviour. Nonetheless, there are patients who have succesfully stopped self-injury.

The aim of this study was to gain understanding of the process of stopping self-injury and to identify the determinants contributing to that achievement.

Semi structured interviews were conducted with twelve women with a long history of severe self-injurious behaviour who eventually succeeded in stopping that behaviour. The data were analysed based on of the Grounded Theory Method.

It was found that the process of stopping self-injury consists of six phases:

1. - the phase of connecting and setting limits: feelings perceived as unsafe are explored, and ways of strengthening feelings of safety are pursued. This sense of safety allows patients to reach out more to others and themselves;

2. - the phase of increased self-esteem with a further deepening of contact with the self;

3. - the phase in which patients “learn to understand” themselves: increased self-understanding makes patients realise they can control their own lives;

4. - in the phase of autonomy patients make active choices to increase control of their lives and immediate environment;

5. - the phase of stopping self-injury: learning and using alternative strategies other than self-injury to cope with unbearable feelings;

6. - the phase of maintenance focuses on preventing a relapse into self-injurious behaviour.

Contact was identified as key to all phases of the process

Interventions should focus on making contact, encouraging people who self-injure to develop a positive self-image and learn alternative behaviour.

We will present results of a systematic review of the effectiveness of methylphenidate in the treatment of adult ADHD. Furthermore, we will discuss the influence of methods on the results of meta analyses.

We searched Medline, PsycINFO and CCTR to identify randomised controlled clinical trials comparing methylphenidate with placebo in the treatment of adult ADHD. Studies were summarized with meta-analytic methods. Subgroup analyses were conducted with respect to parallel group vs. cross-over trials and self vs. observer ratings. The relationship between dosage and effect size was explored by weighted regression analysis. The results were tested for publication bias, and several sensitivity analyses were conducted.

Nineteen studies met the inclusion criteria of which 17 were included in the meta-analysis. The overall effect size was significant at d=0.42 different from zero, but this was only half the size expected on the basis of a previous meta-analysis. No significant differences could be observed in the subgroup analyses. The regression analysis showed no significant influence of mean daily dose on effect size.

These results contradict findings of a previous meta-analysis and challenge guideline recommendations. Differences between populations of children and adults and methodological issues in meta-analyses are discussed.