Previous studies on depression reporting expert survey results have focused primarily on symptomatology (Cheung et al., 2007) or used a narrow selection of experts, e.g. only clinicians or social workers (Collimore Rector, 2014; Caan et al., 2006). The current study is the first to explore the whole range of interventions and psychosocial difficulties (PSDs) in depression, combining information from psychologists, psychiatrists, nurses, social workers and primary health care doctors.

The general objective of the ongoing project (part of <a href="http://www.maratoneproject.eu/">www.maratoneproject.eu</a>) is to provide comprehensive clinical recommendations on available interventions for PSDs in depression by means of a multi-informant approach.

This particular study aims to go beyond symptomatology and gather expert perspective on interventions for improving a wide range of PSDs in depression where literature might be scant.

The online survey will be available in 2015. Experts will rank the efficacy of existing interventions, specify the treatments effective for particular PSDs and report the determinants of efficacy according to their expertise. PSDs definition is based on World Health Organization's International Classification of Functioning, Disability and Health (ICF).

Preliminary results and expert data will be shown. We intend to attract part of our pool of experts during the 23^rd European Congress of Psychiatry.

Worldwide experts in the field of depression are invited to take part in this online survey. The future course planned out by literature focuses on potential personalization of interventions; therefore the current study is an excellent starting point in this direction.

Depression is an alarming burden in India causing substantial disability and cost to society. Recognizing depression is difficult because patients present predominantly with somatic symptoms or because attention is primarily focused on the co-morbid physical disorder. The cases of depression presenting in primary-care settings are either not identified or treated with inappropriate drugs or inadequate doses of anti-depressants.

To analyze current level of intervention done by non-psychiatrists to detect and manage depression in patients with chronic medical illnesses.

A panel of nine specialists (Cardiologists, Neurologists, Endocrinologists and Psychiatrists) discussed current Indian scenario of management of co-morbid depression by non-psychiatrists.

The panel agreed that

• Prevalence of co-morbid depression in India is not well-documented except for few regional studies.

• It is frequently witnessed but is hardly recognized or managed as a concurrent disease.

• There is a need to differentiate between depressive 'feeling” and 'disease”.

• The clinicians should increase duration of history-taking to include questions like, 'Do you feel sad/low? Are you disinterested?” in suspected cases.

• There is a need for developing Indian consensus to identify co-morbid depression, to decide when to start an antidepressant drug, in what dosage and duration with special focus on the when to refer to a psychiatrist.

Concrete steps are required towards large-scale data generation and development of Indian consensus on the management of co-morbid depression in patients with chronic medical illnesses for the non-psychiatrists to improvise patient health outcome.

Effective preventive strategies could reduce disability and the long term social and health complications associated with depression, but options are limited. Cognitive bias modification (CBM) is a novel, simple, and safe intervention that corrects the attentional and interpretive biases associated with depression.

To determine if CBM decreases the one-year onset of major depression in adults at risk.

This randomised controlled trial will recruit adults with subsyndromal depression living in Australia (parallel design, 1:1 allocation ratio). The intervention will be delivered via the internet over 52 weeks. The primary outcome of interest is the onset of a major depression according to DSM-IV-TR criteria. Secondary outcomes of interest include change in the severity of depressive (Patient Health Questionnaire, PHQ-9) and changes in attention and interpretive biases. Outcomes will be collected 3, 6, 9 and 12 months after randomisation.

Preliminary data on a subsample of 20 participants showed that the mean±SE PHQ-9 score of controls was 7.5±0.9 at study entry and 7.1±1.5 at week 6 (paired t-test=0.29, p=0.779), whereas the mean±SE score of active CBM participants was 7.4±1.0 and 4.4±1.1, respectively (paired t=6.00, p<0.001). The mean PHQ-9 difference between control and active CBM participants over 6 weeks was 2.6±1.5 points (t=1.79, p=0.090). One of 11 controls (9.1%) and 0/9 active CBM participants showed evidence of clinically significant depressive symptoms at week 6 (i.e., PHQ-9≥15).

By March 2015, 6-months preliminary data will be available on 165 participants.

A substantial obstacle to carry out a timely diagnosis and an effective therapy of depressive disorders (DD) is their combination with other forms of pathologies. Specific difficulties occur in diagnosis and treatment of DD with comorbid other mental disorders.

The aim of the study was to investigate typologies of DD with comorbid anxious disorders, alcohol dependence, and personality disorders.

A complex of methods included clinical-psychopathological and psychometric methods with application of the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. In the study 189 patients with DD (F32.0-F32.1) accompanied by anxious disorders (F41.0 and F41.1), personality disorders (F60.3 and F60.0), and alcohol dependence (F10.20) were examined. The control group consisted of 52 patients with DD without comorbid pathology.

It was demonstrated that patients with comorbid anxious disorders predominantly had senesthopathic-hypochondriac depression (42.9%, p<0.05) with an expressed somatization, somatic anxiety, and hypochondriac equivalents. For DD with comorbid personality disorders a clinical picture of depression was determined by a predominance of mournful (41.8%) and obsessive (32.7%) variants with anhedonia and obsessive-compulsive symptoms. Depression with comorbid alcohol dependence was characterized with a presence of asthenic-anergic (24.0%) and apathic-adynamical (21.3%) variants with expressed somatic-vegetative manifestations.

These results stipulate a necessity of using of differentiated approaches to pharmacotherapy and psychotherapy in patients with comorbid DD.

This makes the issues of epilepsy in elderly patients and of emotional and affective disorders more and more topical.

To study the structure of non-psychotic psychiatric disorders (NPD) in post-stroke elderly patients and in patients with symptomatic post-stroke epilepsy.

Two groups of 56 patients were studied. In Group 1 (37 patients: 21 men and 16 women), the stroke was complicated by the development of symptomatic post-stroke localization-related epilepsy. In Group 2 (19 patients: 7 men and 12 women), no paroxysmal states of the epileptic nature were found. The average age of Group 1 patients was 63.00 years, of Group 2 patients, 62.5 years.

In Group 1, affective d

epression-spectrum disorders were found more frequently than in Group 2 (Group 1 – 78.9%; Group 2 – 33.3%), whereas in Group 2, affective anxiety-spectrum disorders were found more frequently than in Group 1 (Group 1 – 21.1%; Group 2 – 66.7%). The average depression score in Group 1 and Group 2 was 34.81±2.73 and 28.57±3.07 on the BDI scale and 21.84 ±1.50 and 13.79±1.36 (p≤0.01) on the HRDS scale, respectively.

In Group 1, a considerable correlation dependence between the index of the impact of depression and anxiety on the manifestation of other psychopathological factors (up to .819**) and the General Severity Index (GSI) was found. In Group 2, a weak correlation dependence between anxiety and the GSI (up to .828*)

The study results have shown a high severity of depression in elderly patients with symptomatic post-stroke epilepsy.

Levels of mood instability (MI) appear to be high in people with depression, but temporal precedence and possible mechanisms are unknown.

We tested hypotheses that: i] MI will be associated with a diagnosis of depression cross-sectionally; ii] MI will predict new onset and maintenance of depression prospectively; iii] the association between MI and depression will be mediated by sleep problems at baseline, new onset alcohol abuse and life events 6 months preceding new onset depression.

We used data from the National Psychiatric Morbidity Survey 2000 at baseline (N=8580) and 18 month follow-up (N=2413). Regression modelling controlling for socio-demographic factors, anxiety and hypomanic mood was conducted. Multiple mediational analyses were used to test our conceptual path model.

MI was strongly associated with a diagnosis of depression cross-sectionally (OR: 5.28 (95% CI, 3.67-7.59) p< 0.001). MI predicted depression inception (2.43 (1.03 – 5.76) p=0.042) after controlling for important confounders. MI did not predict maintenance of depression. Quality of sleep and severe problems with close friends and family significantly mediated the link between MI and new onset depression (23.05% and 6.19% of the link respectively). Alcohol abuse and divorce were not important mediators.

Mood instability is a precursor of a depressive episode but does not worsen the course. Interventions targeting mood instability and sleep problems have the potential to reduce the risk of depressio

Wake therapy, during a whole night, followed by bright light therapy for 6 days has been shown in a number of studies to be effective in quickly alleviating depressive symptoms.

To evaluate the implementation of wake therapy followed by bright light treatment among inpatients with depression as an adjunct to treatment as usual.

Eligible patients with mood disorders were offered wake therapy (total sleep deprivation) followed by daily bright light therapy for one week (10,000 lux for 30 minutes). Results were registered prospectively and included patient experience, and both baseline and post-treatment Montgomery-Åsberg Depression Rating Scale (MADRS-S) and Insomnia Severity Index (ISI).

At present, four patients (all female ranging 24 to 60 years in age) have undergone wake therapy followed by bright light therapy. All patients received treatment with antidepressants along with the intervention. MADRS-S decreased by 12 points at average (range 0-22) for the four patients and ISI by 5 (range 2-12). All patients expressed gratefulness for the treatment and no severe side-effects were reported. At the conference, results from the first 10 patients will be presented

The first experience of the implementation of wake therapy followed by bright light therapy as an adjunct to treatment as usual has been positive. All patients improved and no side-effects were noted. The case-series will include at least 10 cases which will be presented at the conference.

To determine the prevalence of domestic violence in patients suffering from postnatal depression and to explore possible links associating the tow phenomenon.

Twenty five women suffering from postpartum depression (DSM-IV), admitted to the psychiatry department 'C” between 2012 and 2014, have participated in a retrospective, descriptive and analytic study. Patients have been interviewed with a semi-structured questionnaire and with the Woman Abuse Screening Tool (WAST).

The average age in our population was 24.3 years. Twelve women (48%) had an instructional level of primary school. Fifteen (60%) were multiparous with an average of 3.2 living child. Eleven of our patients (44%) reported abuse, especially emotional. Three of these patients committed suicide. Partners of abused women were unemployed in 9 of the cases (81%) and consumer of drugs in 8 of the cases (72%).

Domestic violence nourishes a panel of psychological and physical issues. Mental health professionals should be able to, early, identify victims of abuse in order to prevent such complications.

Major depression is associated with high risk of suicide. But it remains controversial whether the risk is higher in bipolar depression or unipolar one.

1. 1. To identify social, clinical and temperamental factors associated with high suicide risk among patients with unipolar or bipolar depression.

2. 2. To compare suicide risk in the two groups.

This cross-sectional study, in progress, is conducted on psychiatric outpatients in the University Hospital, in Sfax (Tunisia). We include subjects with major depressive episode in the context of bipolar disorder or major depressive disorder.

We use the Arabic version of the full-scale TEMPS-A auto-questionnaire and the suicidal risk assessment scale (RSD).

A total of 28 depressive patients were included. Compared to unipolar patients (20), bipolar patients (8) had more frequent previous suicide attempts (25% vs 10%) and had a higher suicide risk (50% vs 25%).

Among high-risk suicidal patients (16/28), 62.5% were males. The main stressful life events were: school failure (66.7%), early grief (55.6%) and family violence (44.4%). Psychotic and atypical features were found in 33.3% and 55.6%, respectively. Comorbidity with personality disorder was noted in 44.4% and with anxiety disorders in 22.2%. Cyclothymic (44.4%) and irritable (33.3%) temperaments were the most common.

Our results meet those of the literature. Suicide risk is associated with male gender and traumatic events in childhood. Bipolar depression, psychotic features, affective temperaments, as well as personality disorders, and anxiety increase this risk. Attention should be paid to all these factors in depressed patients.

Stimuli with features of an unfamiliarcultural background (out-group) might influence reaction, e.g. to emotion expressions. The Islamic headdress (niqab), as an out-group feature in Western cultures,leaves only the area around the eyes visible and thus additionally impedesidentification of facial features. Patients with psychiatric disorders, e.g.depression, have been shown to react more stereotypically to out-group stimuli.

The aim of our study is to examine the abilityof depressives in the identification of facial emotions with in- and out-groupfeatures.

Twenty five patients with depression (HAMD >10) and 25 healthycontrols were assessed. We employed a paradigm which consisted of six femalefaces with the emotion expressions happy, angry, sad and fearful. The faces were either covered by cap/scarf (in-group) or by niqab.

Only correct answers were analyzed. Patients with depression needed significantly longerto identify emotions than healthy controls. In both groups, anger was the emotionrecognized significantly faster, whereas reaction to sadness was slowest. Theinteraction of emotion item x stimulus type indicated a faster reaction tohappy faces in the cap / scarf condition and a faster reaction to sadness inthe niqab condition in both groups.

Results of our study replicaterecent findings of a general out-group / in-group effect in emotionidentification and can be interpreted as further evidence for acontext-dependent stimulus processing. Larger sample sizes and higher scores onHAMD might be needed to indicate a specific out-group / in-group effect indepressed patients.

B-vitamin insufficiency is associated with depression but it is uncertain if treatment with these is effective in prevention or treatment.

1. 1. To determine if daily supplementation with B-vitamins enhances response to antidepressants.

2. 2. Systematic review and meta-analysis of randomised, placebo-controlled trials of B-vitamins for depressive symptoms in adults.

1. 1. The B-VITAGE trial is a 52 week randomised, double-blind, placebo-controlled trial of citalopram together with vitamin B12, B6 and folic acid in older adult participants with major depression.

2. 2. Systematic review of 13 eligible trials of B-vitamin supplementation for the reduction, remission and prevention of clinically significant depressive symptoms.

Remission was achieved by 78.1% and 79.4% of participants treated with placebo (n=76) and vitamins (n=77) by week 12 (p=0.328), and by 75.8% and 85.5% at week 52 (effect of intervention over 52 weeks: odds ratio, OR=2.49; 95% confidence interval, 95%CI=1.12,5.51). The risk of subsequent relapse among those who had achieved remission of symptoms at week 12 was lower in the vitamin group (OR=0.33, 95%CI=0.12,0.94).

Short-term use of vitamins did not improve depressive symptoms in adults with major depression treated with antidepressants (standardised mean difference=-0.12, 95% CI=-0.45,0.22), but more prolonged consumption decreased the risk of relapse (OR=0.33, 95%CI=0.12,0.94) and the onset of clinically significant symptoms in people at risk (risk ratio=0.65, 95%CI=0.43,0.98).

Short-term use of B-vitamins does not appear to benefit depressive symptoms although longer use may enhance and sustain antidepressant response and decrease the risk of relapse or onset of clinically significant depression.

Comorbidity between depression and diabetes is a particularly common condition as underdiagnosed. Individuals with diabetes have about a 2-fold increased risk for major depression, affecting one of every 10 diabetic patients. Biological and psychosocial variables represent risk factors. Comorbidity with depressive disorders led to a worsening of diabetic symptoms, greater functional impairment and worse quality of life.

To evaluate the relationship between depression and HbA1c levels, biological and socio-demographic factors, quality of life and diabetes distress.

To demonstrate how depression in diabetic patients results in a worsening of clinical, treatment and social outcome.

72 patients with diabetes were recruited and matched into two groups (depressed, non-depressed). Socio-demographic data and HbA1c levels were collected. Diabetics patients were tested using Hamilton Depression Scale, Quality of Life Index and Diabetes Distress Scale (DDS).

Depressed diabetic patients had about a 4-fold increased risk for higher HbA1c levels (≥ 8%) (OD= 4.375). Depression was more prevalent in women than men (p< 0.05) and in retired (p < 0.05). Lower education level was significantly correlated with depression in comorbidity with diabetes (p < 0.05). Quality of life in depressive diabetic patients was poorer than patients without depression (p < 0.01). Depressed group showed higher levels in DDS particularly in Emotional Burden (p < 0.01), Regimen Distress (p < 0.01) and Interpersonal Distress (p < 0.05).

Depression in diabetic patients is significantly related to biological and socio-demographic factors and worse quality of life. Depressed demonstrates higher distress due to diabetes.

Robust relationships between personality and depression have been repeatedly reported, including a high negative-affectivity score and a low constraint score, as measured by harm avoidance (HA) and selfdirectedness (SD), respectively, as regards to Cloninger's biosocial model. However, the relationships between personality and fine-grained characteristics of depression (such as emotional and neurocognitive patterns, and the nature and intensity of depressive symptoms) have been poorly documented.

Therefore, the present study investigates the relationships between personality and specific symptoms and characteristics of depression.

We aim to help understanding the mediating processes involved in personality-depression relationships.

43 inpatients with a diagnosis of major depressive disorder (17 males, 20-60 year-old) fulfilled the TCI-R personality questionnaire, the Beck depression inventory-II and the PANAS-X emotion scale. Patients also completed a behavioral and electrophysiological testing including several alert tasks and an EEG at rest.

HA and SD are related to cognitive but not somatic symptoms of depression, and more particularly symptoms accounting for the negative attitude toward self. Interestingly, characters but not temperaments were related to the emotional pattern in depressed participants: high SD to less negative emotions and high self-transcendence to more positive emotions. Right frontal alpha asymmetry was related to HA, SD and positive emotions.

Despite several limitations, the present results shed some light on the mediating role of emotions and neurocognitive pattern in personality-depression relationships.

Neurocognitive impairment has been widely reported in major depressive disorder. Patients with major depressive disorder are known to present cognitive deficits, namely in verbal and visual memory, verbal fluency, attention, working memory. Some studies related these deficits with antidepressants, although those were also described in medication-free patients. Other studies suggested that in some groups of patients there may be significant residual cognitive deficits despite an overall positive treatment response with remission of depressive episodes.

The authors aim to contextualize cognitive deficits in patients with major depressive disorder and treatment options that could preserve/improve the cognitive functions.

Scientific literature search and review on the PubMed database with the keywords: 'major depressive disorder', 'cognition', 'neurocognitive impairment', 'memory', 'executive function', 'attention'.

Given the perception of impaired neurocognitive functioning in patients with major depressive disorder even in the remission phases, there has been an increased interest in attempting to treat those deficits during the last decade.

Studies suggest that different types of deficits are found in patients medicated with different types of antidepressants and medication-free patients. Some new treatment approaches have been used such as cognitive remediation therapy which is more frequently used in schizophrenia. Recent studies suggest that cognitive enhancing treatments could be an approach which should be further investigated.

Currently, the mechanisms underlying neurocognitive deficits in patients with major depressive disorder are not fully understood. Since these symptoms have a major impact on patients' lives this issue will remain an area of ??interest in the near future.

Art therapy is one of the least studiedmethods of psychotherapy.

Studied the effectiveness of art therapy in thecomplex treatment of patients with major depressive disorder (DDR).

Thestudy involved 150 patients of both sexes (87 women, 63 men) aged 18 to 55years, with major depressive disorder of varying degrees of severity.

Clinical examination, HDRS, HARS.

The study revealed that (70%) reduced thelevel of anxiety; y (75%) patients showed improvement in mood between sessions;77% of patients improved self-esteem, 80% of patients had sustained remission;68% – there was a positive outlook for the future; 65% reduced the level ofanhedonia and 80% of patients with marked regression of depressive symptoms. Patients with DDR with the current episode mild effectiveness of AT was high. Patients with DDR with the current episode of moderate severity was averageefficiency. In patients with recurrent episodes of DDR-severe AT efficiency wasminimal. Patients with melancholic clinical variants AT had enough positiveeffect already from the 4th session; with a disturbing one – art therapeuticeffect was observed after the first session, briefly, then resumed anxiety; withhypochondriacal option – AT had no effect and apathetic one effect was alsoabsent due to reduced motivation of patients.

Art therapy is an effective method ofpsychotherapy in an integrated treatment of recurrent depressive disorder, preferably at a dreary and alarming clinicopathological variants of recurrent depressive disorder and lesseffective in hypochondriacal.

Depression is the most common psychiatric disorder, with high severity and recurrence, low level of global functioning and quality of life, being the main cause of disability and burden of disease worldwide, with high direct and indirect expenses. Epidemiological data showed an almost double rate of prevalence for women.

The aim of the study was to evaluate trend of hospital admissions due to depression and differences according to gender in two areas from Eastern Europe: Province of Vojvodina (Serbia) and Dolj County (Romania).

This work presents a retrospective analysis based on the routine health statistics data which were collected from the inpatient health care facilities, including short-term and long-term hospitalization within ten years period (2004-2013).

During this period, in both areas was recorded an increasing number of admissions for depressive disorders, from 1,109 to 1,450 in Vojvodina, and from 1,214 to 2,270 in Dolj. The female/male ratio ranged from 1.5 in 2004 to 1.4 in 2013 in Vojvodina, and 1.7 in 2004, respectively 1.5 in 2013 in Dolj. The hospitalization rate per 100,000 inhabitants increased in both regions, but it is significantly lower in Vojvodina (from 54.8 to 75.8) compared to Dolj (165.3 to 343.7).

The results showed similarity in trends of hospital admissions for depression in both regions. In accordance with the literature data, women are more vulnerable when it comes to depression, however the difference between gender slightly decreases.

Depression in elderly despite treatment, care, family and social support, still remains a challenge and threatens constantly. Difficulties in this area are large, given that the manifestations of depression in elderly are presented with their specifications.

Presence of depression in elderly, difficulties, and the necessity for greater care of elderly threatened by depression.

This is retrospective study, performed in elderly house in Pristina-Kosovo. Here lives 86 residents, age 65-94 yrs. Over 70 years were 59 residents. All patients were examined by a psychiatrist for depression with the Beck scale and Geriatric Depression scale.

A considerable number of elderly, although had symptoms of depression like as inactivity, food refusal, neglect of cleanliness, escape from psychosocial activities, they were not treated in terms of depression, because they presented no problem for domestic order. Quite poor symptomatology and specific manifestation of depression in the elderly had not withdrawn the attention of treatments to their staff. There were presented many difficulties in research for those over the age of 70 years old, because of psychorganic problems, dementia and other chronic diseases.

Although life in the institution seemed quite organized, with profilized staff, as a psychologist, psychiatrist, social worker, nurse, dentist, physiatrists, there was a very large number of people with depression, psychosymtoms, some of them had lost the hope, confidence and mentioned the death. We distinguished five peoples which have manifested psychotic symptomatology, while others, over the age of 75 yrs have been in need of treatment with antidepressants.