According to numerous studies, living with a chronic patient relates to higher depression and impaired state of bio-psychological health. The patients with chronic kidney disease live as a 'psychosocial dyad” with their spouse.

The main objective of the present study was to investigate the bio-psychological impacts of living with a spouse suffering from a chronic kidney disease.

The evaluation of the real and perceived state of health of the spouses of patients with chronic kidney disease.

The current study took place at the Department of Nephrology of University Hospital of Ioannina. The sample consists of 45 subjects (34 women, 11 men). In addition to a semi structured interview, the questionnaires used were: Patient Health Questionnaire (PHQ-9), Anxiety Test Questionnaire (GAD-3), The Zarit Burden Interview Questionnaire, The Health Related Quality of Life Questionnaire (EQ 5D), Other as Shamer Scale (OAS), a list of health problems and a questionnaire of social-demographic data.

The spouses had a mean age of 62,02±11,78. Most spouses report a satisfactory state of health (72,9%), but generally they postpone their own medical exams or routine surgeries. Their perceived burden of care increases as their economic state worsens (p=.015) and the increased burden relates to worse self -report state of bio-psychological health is (p=.000).

The spouses of renal patients experience the impact of living with a life-threatening disease. An effective health care planning should contribute to their own welfare.

The purpose of the study was to determine the occurrence rate and the variants of MD in LG outpatients in otorhinolaryngology practice.

30 LG patients (26 men and 4 women, mean age 48±8) were included to the study. MD were diagnosed in accordance with ICD-10 criteria. The severity of depression and anxiety were measured with MADRS and HAM-A.

The MD of anxiety-depressive spectrum were diagnosed in all investigated cases: depressive episode (mild/moderate; single/recurrent (n=13;43.4%); dysthymia (n=11;36.6%); generalized anxiety disorder (n=6;20%). The LG had manifested at the background of MD in most cases (n=26;86%). The chronic stress factors had preceded MD and LG in 90% and 36.6% accordingly. The profession and anxiety related vocal abuse has been revealed in 36.6%.

The preliminary results of the interdisciplinary study have shown close relation of LG with stress related MD of anxiety-depressive spectrum.

Adolescents with congenital heart disease are at increased risk for developingpsychological distress.

To assess the prevalence of depression and anxiety in adolescents withcongenital heart disease, and to identify the predictors related to thesedisorders.

This is a cross-sectional case-control study. A total of 60 adolescents withCHD aged from 12-18 years and 30 apparently healthy adolescents were recruited. All participants were assessed using a designed questionnaire, the Children'sDepression Inventory (CDI), the Revised Children Manifest Anxiety Scale(RCMAS), and the Mini International Neuropsychiatric Interview for Children andAdolescents (MINI-Kid).

Prevalence of depression was higher in adolescents with CHD compared to healthycontrol (18.3% vs. 3.3%, p= 0.048). Moreover, 30% of adolescents with CHD hadanxiety compared to 10% of the control group (p= 0.03). Multivariate analysisof risk factors showed that level of education and symptomatic cardiacfunctional class were the significant predictors of depression in adolescentswith CHD. Likewise, presence of more than one cardiac defect and having morethan one cardiac catheterization were the significant predictors of anxiety inadolescents with CHD.

Adolescentswith CHD are at increased risk of having depression and anxiety, especiallythose with low level of education, severe cardiac illness and having multiplecardiac catheterizations. Appropriate psychiatric assessment and earlyintervention can improve the quality of life of adolescents with CHD.

Our Department of Liaison Psychiatry from County Emergency Clinical Hospital Timisoara is providing psychiatric services since 2002, seeking to fully integrate psychiatric care in the routine management of patients with co-morbid somatic and psychiatric conditions.

To provide a comparison analysis of inpatient referral in May 2014 vs. a yearly comparator with 2003, and 2012 data, by hospital department and identified psychiatric pathology.

To determine if a professional mental health care intervention in general hospital provides evidences for changing mentalities over 10 years (2003/2012) vs. 2014.

We conducted a retrospective analysis of the inpatients evaluated in our department in 2003, 2012, respective May 2014.

Hospitalized patients distribution referred for liaison psychiatry consultation were the following (2003/2012/2014): Cardiology: 12.9/22.8/18.5%, Neurology: 9.8/16/19.3%, Diabetes and Nutrition: 13.8/14.7/15%, Endocrinology: 12.6/9.2/4%, Gastroenterology: 19/7/9%, Emergency Care Unit: 4.5/4.5/0.7%, Nephrology: 6.8/3.7/3.5%, Intensive care and toxicology: 4.7/2.6/5%, General Surgery: 5.5/2.6/3%, Orthopedics: 4/4.3/10%, Vascular Surgery: 3.8/4.3% in 2012/2014, Polytraumatology, plastic surgery and burns: 2.5/5.3/3.5%, Neurosurgery: 0.6/1.3/2%, Dialysis: 2/0.9/0.7%, Urology: 0.7/0.9/1.4%. Diagnosed psychiatric pathology had the following distribution (2003/2012/2014): dementia: 6.4/16.2/20.71%, organic delirium: 2.3/6.5/4.3%, other organic disorders: 15.4/4.8/5.7%, alcoholism: 7.5/5.8/5%, endogenous psychoses: 3.6/4.8/0.7%, mood disorders: 20/12/19.3%, anxiety disorders: 20/11.2/24.3%, adjustment/stress reactions: 12.8/8/12%, somatoform/conversion disorders: 2.6/8/5%, personality disorders: 0.3/3.6/1.4%, mental retardation 0.4/4/1.4%.

A significant growth in referral for psychiatric care was observed, especially in cardiology, neurology, surgical areas (where pain requires a complex control), and the integrated and collaborative care became a rule in our hospital both in emergency and complex care for chronic conditions.

Interferon-related depressive disorders are well known in literature. Despite this, few study have been able to identify reliable predictors of depression

Our aim was to examine the predictive value of several bio-psycho-social factors for the development of persistent clinically significant depression in patients affected by HCV treated with IFN. We also aimed at describing the clinical course, treatment and impact on quality of life of depression.

We conducted a cohort prospective study with assessments at baseline and at 4, 8, and 24 weeks with clinical interview and self-administered psychometric tests. We evaluated depressive symptoms with the Hamilton Depression Rating Scale, manic symptoms, anxiety, suicidal ideation, temperament, alexithymia and quality of life with other reliable instruments.

Preliminary results are available for 61 patients. Depressive symptoms increased significantly during IFN therapy to peak after 4 weeks. A third of patients still suffered clinically significant symptoms after six months. In a multivariate model, the onset of irritability (aOR= 6.5; p=0.03) and living alone (aOR= 7.4; p=0,06) predicted the persistence of depression after 6 months. The preliminary model displayed good levels of specificity and sensitivity.

Both psychological traits (irritability) and social factors (living alone) predicted the persistence of depression. These findings might prove useful to improve early detection of vulnerable patients and their mental health care in the real clinical world. Larger samples are however needed to confirm these findings.

According to data from the literature, depression and anxiety are frequent complaints among patients with lupus erythematosus. Their etiology may be a direct manifestation of attachment of central nervous system through the process of sickness, as well as secondary reaction to the suffering because of chronic disease. However, on the basis of available data it is difficult to close relationship between their existence, seriousness and cognitive deficits.

The comparison between cognitive functioning of women being treated for systemic lupus erythematosus and healthy women.

20 female patients aged 18-38 with SLE were tested. The Vienna Test System was used to assess cognitive function. All persons were also examined using a scale STAI assessing anxiety as a state and as a feature, and the Beck scale to evaluate the severity of depression. The control group consisted of 20 healthy women.

All patients with systemic lupus erythematosus participating in the study showed abnormalities of short-term memory, attention and reaction time in comparison with healthy members of control group. Positive correlations were also found between the results of cognitive test results and the intensity of depression and anxiety.

Antidepressive and atianxiety treatment should be an important element of the therapy of patients with lupus erythematosus.

Many multiple sclerosis (MS) patients suffer from psychiatric comorbidity, and 60% of patients of working age are on disability pension (DP). It is unknown how transition to DP affects MS patients’ mental health.

To investigate the risk for being prescribed psychiatric drugs before and after receiving full-time DP in MS patients compared to matched controls.

To examine the impact of transition of DP on MS patients' mental health.

Nationwide Swedish registers were used to identify all 3836 MS patients who were granted full-time DP in 2000-2012, along with 19,180 propensity matched controls also being granted DP in the same years. Patients and controls were organized into cohorts by year of DP, and adjusted odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated for being prescribed Selective Serotonine Reuptake Inhibitors (SSRIs), benzodiazepines and sleeping agents in 2006.

The risk for being prescribed psychiatric drugs increased in the years leading up to DP among both MS patients and controls. After DP, the risk for benzodiazepines increased among MS patients but was unchanged among controls (OR 1.72, 95%CI 1.16-2.57). MS patients had an increased risk for SSRIs after DP compared to controls (OR 1.76, 95%CI 1.44-2.15).

The risk for being prescribed psychiatric drugs after DP differs substantially between MS patients and other DP diagnoses. Possible reasons for the increased psychiatric illness among MS patients during and after transition to DP should be further investigated, as well as the role of DP as a rehabilitory measure.

Quality of life of Parkinson's disease (PD) patients is adversely affected by impairment of physical and psychological functions. Antiparkinson's drugs and disease progression may contribute to the development of secondary symptoms (motor fluctuations, dyskinesias, postural abnormalities, sleep disorders, psychiatric complaints, autonomic disturbances, etc) that may require additional medication to alleviate.

Determining local incidence of PD related psychosis will provide foresight into planning of service needs in our local cohort of patients.

The aim of this study is to determine the local incidence of psychosis in PD.

This is a retrospective cohort study looking at only PD cases diagnosed between January 2006 and December 2007 and recruited into the movement disorder database by the National Neuroscience Institute. The study period is defined as date of diagnosis through to December 2013, where the subjects undergo a variety of scaled assessments conducted during routine outpatient consultations. During the defined study period, a diagnosis of PD related psychosis will be defined as a score of 2 or more on the Thought Disorder subscale of the Unified Parkinson's Disease Rating Scale.

The proportion of patients in the study population who developed psychotic symptoms during the study period is comparable to existing literature.

This study allows us to better understand the local incidence of psychosis in PD patients. It provides groundwork for looking at whether regular screening for psychiatric symptoms in this patient cohort would be beneficial in the long term management of PD patients.

The assessment of quality of life (HRQoL) is a significant outcome indicator for patients with chronic diseases and treatments.Chronic hepatitis C is one of world's most important chronic diseases.

To carry out a systematic review of HRQoL during antiviral treatment with interferon and the new direct-acting antiviral agents (DAA), its baseline risk factors such a psychiatric history and HIV comorbidity, and its relationship with treatment efficacy.

A protocol based on the PRISMA&CONSORT guides was used. A comprehensive, computerized search (2004-2014) was conducted. Of 314 observational and RCT studies, 24 studies met the inclusion criteria. HRQoL tools used were SF-36 and EQ-5D. Studies showed a moderate to good quality. HRQoL changes from baseline and predictive variables were abstracted, and weighted means (SD) of HRQoL score changes in treatment groups throughout treatment from baseline were analyzed.

HRQoL decreased during any interferon treatment, especially the physical component. The DAA sofosbuvir showed no significant decline in HRQoL. HIV co-infection and a psychiatric history were risk factor for impairment during treatment with interferon. Previous non-responders did not recover in HRQoL to baseline scores at 24 weeks of follow-up. Cohort studies showed impairment 3 times greater than RCTs.

Any antiviral treatment impairs HRQoL. Interferon seems to have more impact than new treatments. Future studies using DAAs should assess HRQoL and its risk factors in depth. Clinicians should attempt a full evaluation of patients before starting treatment, in order to identify risk factors and take preventive measures.

Grant:Instituto Carlos III:FIS:P110/01827,and SGR2014/1135.

In spite of positive somatic outcomes of Coronary artery bypass grafting for treatment coronary artery disease, psychological distresses persist or appear for the first time after the operation worsening the patient's quality of life. Research studies show the interrelationships between psychological states and quality of life after CABG.

The purpose of this study is to examine the mental disorders, quality of life, and their relationship among patients undergoing CABG.

135 patients (101 men and 34 women) are randomly selected from the population of patients undergoing CABG at 3 medical centers in Tehran, Iran between December, 2009 and May, 2010. SCL-90-R and SF-36 are used to assess the mental disorders and quality of life, respectively. A structured interview is used to gather and investigate personal data and history of patients. Data analysis using Pearson correlation coefficient and t-tests are done.

This study demonstrated that the prevalence of GSI (General Severity Index) in CABG patients is estimated to be 22.96%, (38.34% for women and 17.6% for men), Depression with 44.22% prevalence is the most prevalent mental disorder followed by sensitivity, paranoia, hostility, anxiety, obsession, somatization, phobia, and psychosis. There is a significant, inverse association between quality of life and GSI (r=-0.4, P<0.01).

the prevalence of psychological distress is generally high among patients after CABG and indicate importance of evaluation and treatment of psychological distresses after CABG to prevent the decline of quality of life.

stigmatowards people with mental illness was found is to be the greatest barrier totreatment and recovery. Nurses were found facing several challenges in nursingpeople with mental illness, such as patients are more acute, demanding, andaggressive. These challenges may impact their role and practice. There is a little is knownabout the attitude of nurses toward people with mental illness.

This study aims atinvestigating the nurses' attitude towards people with mental illness and the socio-demographicfactors associated with attitude.

The data were collectedfrom 225 registered nurses using the Community Attitude towards Mental illness(CAMI) scale. The data were analysed by SPSS 20 software.

the results revealed that nurse's attitude towards people with mental illnesswere generally positive. Nurses' positive attitudes were associated with age, gender, years of experience, previous contact with people with mental illnessand position.

Positive nurses' attitude toward peoplewith mental illness is an important outcome indicator for the prospect to improvementwith treatment and prospect of recovery. The understanding of such a phenomenonmay also result in an increased possibility of provided care as well asrecovery and a better life for people with mental illness. Several suggestionsfor mental health practice, nursing education and future research werediscussed.

The our knowledge about the attitudes of the Romatowards health system has not been fully investigated.

To present theperceptions, the feelings and the beliefs of Roma people towards public healthsystem.

To investigate the attitudes of the Roma towards public health system

Participants were 361 Romani, living in the centralGreece area. The Others as Shamer Scale, Experience of Shame Scale, State/TraitAnxiety Inventory, Family Environment Scale and Symptom Check List wereadministered to collect the data along with a detailed questionnaire whichrecorded the social and economic factors that may affect the psychologicalcharacteristics studied. Perceptions and beliefs of Roma people towards publichealth facilities were recorded using the PBQ questionnaire that was designedand administered for first time in this study.

Feelings of abandonment and social discriminationcorresponded to higher scores of shame. The inability to understand medicalinstructions, the feeling of being different and the need to surrounded byrelatives while in the hospital are correlated with psychopathology and shameindexes whereas strong family structure corresponds to improved perceptionstowards public health system. As an attempt to classify the respondents inhomogeneous groups towards their responses in PBQ questionnaire we appliedcluster analysis and a three group solution is proposed. Lack of education andharder living condition characterize the cluster with the most negativefeelings towards public health system.

. The results ofthis paper may be useful in policy makers and persons looking to create interventionsin this minority.

Education about refugees’ mental health has so far been limited even for students and professionals within the health and mental health care system in Sweden. Further, there is lack of evidence about which training efforts are effective.

Evaluation of the outcomes of locally organised cross-cultural mental health training for staff in refugee reception and health care.

This naturalistic study aims a) to examine change in perceived knowledge and perceived barriers to their ability to do a good job among course participants before and after the course; b) Explore participants’ perception of barriers and success factors in encountering mental illness among refugees before and after the course.

A mixed method approach, with quantitative data from questionnaires (n = 232) and ten qualitative focus group interviews, was used.

After training, the participants reported that the hindering effect of lack of knowledge on their work decreased significantly from 2.81 (SD1.22) before, to 2.29 (SD1.00) (p < 0.001). Focus group interviews contributed to an understanding of this. According to findings from focus group interviews, after training, the participants shifted from emphasizing communication barriers towards empathy with refugees with mental ill-health.

Training resulted in an increased experienced capacity among participants to understand the social vulnerability of newly-arrived refugees with mental distress. However, the lack of collaboration and the structural barriers between the different organisations were not affected.

Purine metabolism may be affected in major depressive disorder (MDD). Increased enzymatic activity of the purine cycle has been observed in MDD. In MDD patients, purine metabolite levels also react to sertraline treatment.

To compare serum purine metabolites between: 1) MDD patients and non-depressed controls; and 2) remitted and non-remitted MDD patients.

To clarify the role of purine metabolism in MDD during active illness and recovery.

The sample comprised 99 MDD patients (DSM-IV, SCID interview) and 318 non-depressed controls (Beck Depression Inventory scores < 10) aged 20–71 years. Altogether, 78 patients returned for the follow-up; 33 were remitted and 45 non-remitted. Nine purine cycle metabolites were analysed using ultra performance liquid chromatography. Serum metabolite differences between the study groups were examined using logistic regression adjusted for age, gender, smoking, alcohol use, physical exercise and B-HbAC1. The follow-up analyses were adjusted for age, gender and physical exercise.

The participants’ likelihood of belonging to the MDD group increased 1.1-fold for each 1-unit decrease in serum inosine, 3.2-fold for each 1-unit decrease in guanosine levels and 2.2-fold for each 1-unit increase in xanthine levels. The remitted and non-remitted groups displayed no significant metabolite differences, but the remitted group showed a non-significant shift of values towards the values of the non-depressed group.

Increased degradation of purines and accumulation of xanthine may characterise MDD. Alterations in purine metabolism appear to only partially change during recovery. Nevertheless, recovery-related changes require further investigation in larger samples.

A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. Our one-month randomized controlled trial of very brief psychotherapeutic treatment (12 sessions/4 weeks) showed especially medium to large between effect sizes (BES ranging from .53 to .89) at 3 months follow-up.

This study aims at discovering the predictors of treatment response and remission at discharge and at 3 and 12 months follow-up.

The study was a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 167 consecutive adult inpatients with unipolar depression was recruited. Patients were randomly assigned to an adjunctive inpatient brief psychodynamic psychotherapy (IBPP) or psychiatric treatment-as-usual (TAU). The IBPP is a manualized very brief psychotherapeutic program in 12 sessions over 4 weeks. Response and remission were calculated on MADRS and QIDS-SR16. Variables included psychopathology (e.g., depression, symptom distress, diagnosis, comorbidity, suicidality, emotion regulation); history(e.g., childhood trauma, onset of the disorder); psychosocial role functioning (e.g., global functioning, social adjustment, Interpersonal functioning, quality of life); demographics; and therapeutic alliance (with the therapist, with the clinical team).

The two best predictors of response were (1) the treatment (psychotherapy) and (2) the alliance with the treatment team. Psychotherapy was the best predictor of remission.

Effective ways of treating depression in inpatient setting depend both on specific treatment programs and on general quality of the relationship with the clinical team.

To determine the prevalence of depression among patients diagnosed with brain tumours admitted to neurosurgery units at National Hospital of Sri Lanka, Colombo.

A descriptive cross sectional study. A sample of 50 inward patients with brain tumours at Neurosurgery units, National Hospital of Sri Lanka were interviewed using a self administered questionnaire to assess the presence and severity of depression (validated Sinhala version of Beck Depression Scale) which was followed by a clinical interview to confirm the results.

Twenty eight (56%) were males. Mean age was 45.7 years (Range 22-71). Most encountered tumour locations in the sample were frontal lobe (n=7, 14%), temporal lobe (n=6, 12%) and cerebropontine angle (n=6, 12%). Most common tumour types in the sample were meningiomas (n=15, 30%) and glioblastomas (n=6, 12%). 24% (n=12) of patients had mild depression; 18% (n=9) had moderate depression; 4% (n=2) had severe depression. 54% (n=27) of patients did not have depression.

A significant proportion of patients with brain tumours had depression. Every patient diagnosed to have a brain tumour should undergo psychiatric evaluation in the course of their treatment and if they have symptoms of Depression need to treat it vigorously.

Compassion is the capacity to be sensitive to pain and suffering of ourselves and others, accompanied by the commitment to alleviate it. Self-compassion has a positive effect on mental health (stress reduction and preventing recurrence of depression) and increases with the practice of mindfulness. For the general population several loving-kindness and compassion training programmes have been studied with promising results. At our outpatient center for integrative psychiatry, a novel compassion-focused training was developed: Mindfulness Based Compassionate Living training (MBCL) for patients who already followed a mindfulness training. MBCL consists of explicit exercises in loving-kindness and compassion, so that patients can deepen their skills in mindfulness and particularly in self-compassion in a safe way.

To examine the effects of MBCL training in a heterogeneous psychiatric outpatient population on levels of depression, anxiety, mindfulness and compassion.

The training consists of nine 1,5-hour sessions. Patients completed four questionnaires before and after the training (Beck Depression Inventory-II, Generalized Anxiety Disorder Scale, Five Facet Mindfulness Questionnaire, Self Compassion Scale).

Thirty-three patients participated in this pilot study (mean age 47,6 years; 82% female). MBCL training reduced levels of depression and anxiety, although results for anxiety were not significant. Levels of mindfulness and self-compassion increased significantly.

The outcome of this pilot study was judged very encouraging and MBCL training was therefore included in the treatment program of our center, enabling us to further investigate its effects as well as the underlying working mechanisms.