PTSD is a disorder which occurs after a person is exposed to a trauma, or to threats of imminent death, characterized by symptoms such as intrusive thoughts, avoidance, and hyperarousal.

To observe the relation occurring between psychic trauma and psychopharmacotherapy in subjects exposed to trauma.

Among the DMH and the Department of Neuroscience and Imaging of Chieti, we recruited 50 subjects exposed to trauma. Rating scales (CAPS, HAMILTON-A e D, BARRAT IMPULSIVNESS SCALE) were handed out to each person; 38 subjects (Group A) never assumed psychiatric drugs before, the 12 left over (Group B) had used psychiatric drugs before: 11 of the latter (Group B) were diagnosed PTSD with comorbidity (9 mood disorders; 1 anxiety disorder; 1 borderline disorder); the only one remaining patient from Group B was suffering from bipolar disorder with psychotic symptoms even though he was never diagnosed with PTSD before. For this disorder came out after being exposed to trauma.

Among the 50 recruited subjects, those who develop PTSD (38%) take a drug therapy. Data analisys show a more significant relation between PTSD diagnosys and other comorbity treated with psychiatric drugs (Fisher exact two tailed p=0.0077), than with patients exposed to trauma do not develop PTSD.

The intake of drugs is often associated with comorbidity with other psychiatric disorders. The isolated exposure to trauma does not seem to generate the need for intake of psychiatric drugs.

Psychological diffusing takes place within the first hours after a trauma. At first, authors had hope it would be an efficient way to prevent post traumatic stress disorder (PTSD) but it is now considered as an ineffective intervention by many authors. Although, studies showed it could be more effective in military populations compared with civilian populations.

Objectives and aims

To evaluate the effects of defusing after a trauma in a military population.

Patients and Methods

A group of 5 active military soldiers who faced a mine explosion were included. They were referred to the emergency room in military hospital in Tunis with various benign lesions on the first day of trauma. A psychological diffusing was performed by psychiatrists from the psychiatry ward on this very first day. These patients were evaluated one month after in order to screen for PTSD.

All participants were male, aged 23 to 29. All patients met criteria for acute stress disorder on the first day. After one month, all 5 patients reported a significant subjective improving of their symptoms. Screening for PTSD was performed using the CAPS and found that 2 over 5 patients met criteria for PTSD. All 5 patients had residual symptoms. All patients were put on medications and a cognitive behavioral therapy is planned for them.

Psychological diffusing can sometimes be an effective intervention in military populations. Further research is needed with larger populations.

clinical examination, SMIL, Lusher-test, Test of neurotic disorders, Memory test.

Follow to our results, we make a list of Mental and behavioral disorders and gave criteria of general and special medical condition of mental health with which workers are not allowed to begin or continue their job to prevent harmful which could be done by exposure of job conditions on the workers. We gave the model of mental health examination follow the Russian Federation low in health.

It is well examined that hypothyroidism leads to cognitive losses and depressive moods. A well regulated thyroid metabolic status lowers those dysfunctions. After thyroid cancer and successful hormone replacement therapy cognitive and affective capacities can be re-established.

Do female patients' results in cognitive and affective testing in hypothyroidism after thyroid cancer differ from the same patients' results in euthyroid?

We assume the hypothesis that there is an improvement in cognitive performance and the depressive mood in euthyroidism compared with earlier hypothyroidism.

In this study during 20 months N = 24 healthy female patients' hypothyroid metabolic statuses after thyroid cancer and thyreoidectomy were examined as an inpatient and within at least six months later as an outpatient in euthyroidism. At both examination dates the patients filled in the Beck Depression Inventory (BDI) and a psychometric test battery (Rey-Osterrieth Complex Figure Test, D2-Test).

A Wilcoxon Signed-Rank Test indicate significant differences between hypothyroidism and euthyroid in favour of euthyroid in the BDI (M = z = – 3.56, p < .000), Rey-Osterrieth Complex Figures Test (cognitive reproduction, z = -4.20, p< .001) and the D2-Test (z = – 2.56, p = .011).

Our findings suggest that there is a relation between the hypothyroidism, depressive mood and fields of cognition (concentration and visual memory). It implies that a hormone replacement therapy should be initiated as quickly as possible for patients with hypothyroidism to re-establish their quality of life, performance and treatment compliance.

The need for integration of maternal mental health into primary health care (PHC) is well documented. However, research evidence suggest that maternal depression still remains uderrecognized and untreated. The help seeking bevaviour of mothers with depression remains an insufficiently investigated issue.

The present qualitative study’s objective has been to investigate, identify and interpret the help seeking behavior of mothers of young children experiencing depressive symptoms.

Our aim was to inform policies and practices so as to improve the detection and management of maternal depression within the primary health care, in particular in countries of weak PHC systems and limited resources.

Thirty semi-structured interviews were conducted to a purposeful sample of thirty mothers living in Athens. The selection of participants’ was based on socioeconomic status and depression severity. Qualitative content analysis was conducted independently by two researchers.

Two broad themes influencing mothers’ help seeking behavior were identified. Barriers and enablers related to PHC system aspects and psychosocial factors emerged. Barriers were associated to several aspects of the weak PHC system, such as the fragmentation of services, the lack of team based care, but also the perceived low quality and availability of community mental health services. The main psychosocial factors identified were stigma related issues, unfavorable attitudes toward mental health, and perceived social expectations regarding the mothering role.

Apart from the psychosocial factors, several aspects of the weak primary health care system could mediate the help seeking behavior of mothers experiencing depressive symptoms.

Modern cardiosurgery opportunities of highly qualified specialists help patients with congenital heart disease (CHD) to dramatically improve their health and life longevity, but at the same time a great number of patients still complain of weakness, fast tiredness, bad mood and low quality of life.

to identify psychosocial peculiarities of low quality of life of adult patients of younger age after congenital heart surgery.

The study involved 65 patients 18+1,8 years of age with surgically corrected CHD. The psychodiagnostics included the study of the quality of life and the identification of signs of anxiety and depression in the patients.

We identified gender differences in the quality of life of young adult patients with CHD, namely every day activities of men is significantly limited due to their physical condition which either precedes or follows the worsening of their emotional status, while women have rather high indices of life quality. Young adult patients with surgically corrected CHD display significant limitation of social contacts, decrease of communication levels due to the worsening of their physical and emotional condition. 42% of male and 50% of female patients displayed the symptoms of anxiety and/or depressive disorders.

The implementation of active and timely psychodiagnostics and psychocorrection measures to help adult patients with the inborn congenital heart disease after the surgery to improve their quality of life.

Even though the Internet is accessible to everybody, the studies show that it is mostly used by people younger than 35 and especially by those younger than 18. Over 60% of the adolescents spend about 1-3 hours a day while 77% of them say that they spend more time on the Internet than they used to.

The analyses of the behavior of the adolescents on the Internet.

To determine how the adolescents connect to the Internet, how much time they spend on-line and how they spend their time on Facebook.

The cross-sectional study included 145 subjects (43.4% of whom were female and 56.6% male) whose average age was 16.7 ± 0.46. The examinees attended the Electro-technical school, Agro-chemical school and the Grammar school in Nis.

All of the examinees access the Internet from their PCs while 41.4% of them also use their mobile phones in order to access the Internet. Less than a half (44.1%) spend more than 5 hours on the Internet. They spend about 3.81+-4.32 hours on Facebook and only 2.1% of them do not have Facebook accounts. 76.6 % of the examinees use mostly this social network for chating while a considerable percentage of them (14.6%) of them would spend more time on-line if they could.

Our results show that the adolescents spend most of their spare time on the Internet. The fact is that they belong to the group of vulnerable population, therefore the studies that deal with their behavior on the Internet are not only needed but also necessary.

The leading role in the development of chronic cerebral ischemia (CCI) is occupied by neurospecific protein S100.

To study neurotrophic protein S100 in patients with CCI with regard to genesis of development.

The content of protein S100 and autobody titers (AT) was measured in the peripheral blood serum of 160 patients with CCI, divided into 2 groups. Group 1 consisted of 80 patients with CCI of hypertonic genesis, group 2 included 80 patients with CCI of atherosclerotic genesis. Control group included 20 subjects.

In group 1 content of protein S100 was 0,76±0,09 nmol/l, in group 2 – 0,97±0,12 nmol/l. The differences in content of protein S100 in the both groups were reliable (P<0,001) in comparison with control group (0,50±0,06 nmol/l). Titer AT to protein S100 in group 1 was 1:427±0,8, in group 2 – 1:691±1,6, in control group – 1:210±0,2. There were noted reliable differences in contents of AT to protein S100 between control group and groups 1 and 2 (p<0,001), between groups 1 and 2 (p<0,01). The higher content of protein S100 and the highest titers AT was revealed in the patients from group 2.

The higher level of protein S100 and titer AT was found in patients with CCI of atherosclerotic genesis in comparison with CCI of hypertonic genesis, that indicate about chronic neurodegenerative process in brain in cerebral atherosclerosis.

Cerebral ischemia is the most frequent cause of the brain functions disorders accompanied by immune changes. The multiple studies show participation of the inflammation process in the atherogenesis and development of the chronic cerebral ischemia (CCI).

To study characteristics of the proinflammatory cytokines (TNF-α, IL-1β, IL-6) in the patients with CCI with regard to the genesis of the development.

There were studied 133 patients who were divided into 2 groups in relation to the pathogenesis of the CCI development. Group 1 included 65 (42,5%) patients with CCI developed predominantly on the basis of arterial hypertension (AH). Group 2 consisted of 68 (44,5%) patients with CCI, developed mainly in cerebral atherosclerosis. The control group of 20 (13,0%) healthy subjects was made for comparison of immunological examinations. The measurement of the cytokine contents (TNF- α, IL-1β, IL-6) in the peripheral blood serum was performed with IFA method with use of commercial tests – systems 'Vector – Best”, Novosibirsk, RF,2013.

The level of TNF-α in the blood serum in the patients of group 1 and 2 was increased 2,9 (6,3±0,76 pg/ml) and 2,12 times (4,6±0,48 pg/ml), respectively, in the control group only 2,15±0,23 pg/ml. In group 1 IL-1β was increased 1,8 times (11,4±1,10 pg/ml), in group 2 – 1,4 times (8,9±0,64 pg/ml). IL-6 in group 1 was 7,4±0,86 pg/ml, while in group 2 was 6,5±0,62 pg/ml.

In the pathogenesis of CCI of the hypertonic and atherosclerotic genesis the proinflammatory cytokines have important role.

Numerous organic pathologies may appear as single or first psychiatric symptomatology manifestations. That is why we must perform a detailed exploration in these type of patients; anamnesis, a physical examination and supplementary tests.

This poster describes the case of a 24 year old woman who unexpectedly manifests behavioural disorders(psychomotor disinhibition, myoclonus, opsoclonus), speech disturbances (inconsistent content) and a decreased level of consciousness.

We highlight the importance of a sequentially well arranged full assessment and conclude with an accurate diagnosis. Additionaly, we emphasize on differential diagnosis something we ought to take into account in these patients.

Bibliographic review of a clinical case of limbic encephalitis Review.

This poster describes the case of a 24 year old woman who unexpectedly manifests behavioural disturbances (psychomotor deshibición, myoclonus, opsoclonus), speech disturbances (Inconsistent content) and a decreased level of consciousness.

These symptom characteristics are consistent with those we found in our literature review on this pathology (PubMed) and in addition it highlights the important of bearing in mind the organic pathology while examining psychiatric patients.

Organic mental disorders are conditions that we should keep in mind while making an initial psychiatric assessment.

Paraneoplastic limbic encephalitis is a neurological condition that can present psychiatric symptoms, and that requires a complete organic diagnosis (biochemistry, blood count, urinary toxic, EEG, cranial CT and thoraco-abominopelvic, cranial MRI, CSF antibodies).

In order to perform a correct diagnostic it is crucial that we consider a couple of differential diagnosis.

The brain-derived neurotrophic factor (BDNF) is a neurotrophin related to the differentiation and survival of neurons as well as synaptic plasticity during brain development. It has been found reduced levels of BDNF in first-episode psychosis (FEP). There are contradictory results regarding its relation to psychopathology.

Establishing the relationship between serum BDNF levels in a group of 28 inpatients with FEP and psychopathology measured with the Positive and Negative Syndrome Scale (PANSS).

BDNF serum levels at admission, discharge, three, six, nine and twelve months were related with psychopathology measured with the PANSS (positive, negative and general psychopathology subscales). Data are present as mean.

At admission PANSS scores were high, decreasing progressively in the following determinations due to psychopathological improvement, although over the time remained higher scores on the negative than in the positive subscale. At admission: PANSS-positive 22.78; PANSS-negative 17.85; PANSS-general psychopathology 39.67; at discharge: PANSS-positive 8.51; PANSS-negative 11.07; PANSS-general psychopathology 20.11; at six months: PANSS-positive 8.04; PANSS-negative 10.91; PANSS-general psychopathology 19.56; at twelve months: PANSS-positive 7.80; PANSS-negative 10.95; PANSS-general psychopathology 19.75. There is a negative correlation between BDNF levels and PANSS negative scores at admission (r=-0.337), with a trend towards significance (P=0.079). This correlation disappears at discharge because of psychopathology improvement and is not maintained in the following determinations.

Lower serum BDNF levels may be associated with worse clinical symptoms, especially negative symptoms. Further studies with a larger sample are needed to replicate our results.

We have shown earlier that mice with active and passive behavioral types differed also in immune status and behavioral parameters could be regulated by the transplantation of immune cells with definite functional characteristics. Opiates are known to affect both – immune response and behavior. So, we investigated behavior and immune changes occurring during the formation of chronic morphine dependence in mice with opposite behavioral types and explored the possibility of their correction by the transplantation of immune cells from healthy donors.

mice with active and passive behaviors were undergoing chronic morphine exposure with abrupt withdrawal and intravenous transplantation of immune cells from syngeneic healthy donors with definite behavior status. The behavior and immune changes during these processes were estimated.

chronic morphine exposure leads to diverse behavioral changes in mice with different behavior status. Abstinence from morphine manifested by typical behavior parameters of withdrawal syndrome in mice, induced more than 50% suppression in the humoral immune response, inhibition of splenocytes proliferative activity, especially in mice with passive behavior and specific changes in spleen and brain cytokines synthesis. The transplantation of normal unfractionated or macrophage – enriched spleen cells with definite functional characteristics restored above-mentioned immune and behavior disorders.

behavior and immune changes following chronic morphine exposure depended on the initial behavior status of animals; the immune cells transplantation may correct both immune and behavior disorders in mice with morphine dependence, so it could be considered as a possible biological method in the treatment of drug abuse.

Recent literature suggests that over 70% of cases of antibody-mediated encephalitis present to psychiatry services with features of psychosis predominantly.

To investigate the seroprevalence of N-Methyl-D-Aspartate receptor antibodies (NMDAr-Ab) in patients with first episode psychosis (FEP)

Following ethical approval, all cases meeting entry criteria were invited to participate. Participants were interviewed with SCID to obtain a DSM diagnosis. NMDAr-Ab were identified in serum by cell based assay using co-transfected Human Embryonic Kidney (HEK)cells. Positive cases were reviewed by clinical neurology. Decision to treat with immunotherapy was made on a case by case basis.

85/115 (72%) of patients with FEP entered the study. 49 (58%) participants were male, mean age (SD) 37 (15.7) years. 42 (52%) were outpatients at the time of assessment. Four cases (5%) were serum NMDAr-Ab positive. 3 of these cases were male, age 48 (16.3) years. All four were admitted as inpatients with normal brain MRI imaging. One case (female, 55) was confirmed as NMDAr-Ab encephalitis based on case presentation, EEG demonstrating bilateral cerebral dysfunction and NMDAr-Ab in CSF. Immunotherapy treatment lead to clinical improvement. In remaining cases, EEG was normal and CSF negative. All 3 of these cases showed clinical improvement following psychiatric treatment as usual.

Our findings support the current estimates as to NMDAr-Ab prevalence in FEP. Increased awareness has lead to rapid treatment of florid cases of NMDAr-Ab encephalitis in our service. Additional seropositive cases are being followed with neuro-cognitive testing for any evidence of decline.

There is now an extensive body of data showing that depression is associated with a chronic low-grade inflammation. The obvious question is “What are the sources of this inflammation?” and “Could smoking be one of them?”

The aim of the study is to investigate the association between depression and inflammation, and to highlight the role of smoking in this process.

The study included 65 depressed patients and 30 healthy controls. Blood samples of both groups were used for the measurement of the high-sensitivity CRP (hs-CRP) and the interleukin 6 (IL6).

The mean value of hs-CRP was 2.02 mg/L among depressed patients and 1.42 mg/L among healthy controls (p=0.198).

Higher values of hs-CRP (>=3mg/L) were found among depressed patients (20%) than among healthy controls (3.3%) (p=0.033).

The mean value of IL6 was 4.12 ng/ml among depressed patients and 2.68 ng/ml among healthy controls (p=0.008).

Higher values of IL6 (>=4ng/ml) were found among depressed patients (29.2%) than among healthy controls (3.3%) (p=0.004).

The table below resume the relation between smoking and the elevation of inflammatory markers.

The causal relationship between smoking and depression is complex. Cigarette smoking increases the levels of inflammatory markers but did it leads to depression? Or did the depression increases smoking behavior? Or is there shared vulnerability factors for the both?

Immune dysfunction and pro-inflammatory states in particular have been implicated in the aetiology and pathogenesis of depression. While the onset of an episode and certain symptoms of depression appear well explained by this inflammatory model, the underpinnings of the episodic and progressive nature, as well as relapse and remission states in depression are not well understood.

To present a dynamic phase-specific model of immune dysfunction of both the innate and adaptive immune system in clinical depression.

In this presentation, results are presented on additional immune factors beyond pro- and anti-inflammatory cytokines that may effectively contribute to the neurobiology and the complex course of clinical depression suggesting a phase-specific involvement of the immune system in depression.

Considering neurobiological effects of immunomodulatory factors such as T cells, macrophages, microglia and astrocytes relevant to depression, the presentation will demonstrate a neuroimmune model of clinical depression underpinned by both innate and adaptive immune dysfunctions and by dynamic immunomodulatory processes during phases of depression. Such a dynamic neuroimmune model of clinical phases of depression shows that innate and adaptive immune factors or dysregulated in a dynamic way (acute vs remitted vs recurrent / progressive).

The presented phase-specific and dynamic model of clinical depression has implications for immunomodulatory and anti-inflammatory treatments of depression depending on the clinical and immunological phases. Caution is required for anti-inflammatory treatments since not all phases of depression are equally suited and some may be contraindicated for anti-inflammatory treatments.

Schizophrenia is a severe mental disorder characterized by breakdown of thinking process and a deficit of typical emotional responses. More recent attempts to demonstrate connections between schizophrenia and social isolation (SI) during early postnatal life. In both disorder T helper lymphocytes was loss the immune balance. The potent exogenous ligand of natural killer T cells (NKT) cells is a-galactosylceramide (α-GalCer)that can produce both T helper (Th) lymphocytes: Th1- (IFNγ) and Th2-type (IL-4, IL-10) cytokines. In this present study, we demonstrated immunomodulatory role of α-GalCer on brain cytokines of SI rats.

Four groups of male Wistar rats were reared post weaning in social or isolated conditions for 8 weeks. After First week of weaning, α-GalCer or normal saline delivered IP every week until last week. After the last weeks, all rats were decapitated and the brains removed. Rat brain was homogenized and lysed. The levels of IFN-γ and IL-4 were determined in brain supernatant using sandwich-base ELISA kit.

α-GalCer indicate significantly increased IFN-γ expression (p<0.001) also in α-GalCer-treated rats, level of IL4 reduced significantly than the social isolated condition(p<0.0001).

These data suggest that levels of IFN-γ and IL-4 were regulated differently depending on the physiological circumstance. In this regard Th1 and Th2 imbalance occurred on SI condition. Moreover, α-GalCer indicated modulation between levels of IFN-γ and IL-4 in post-weaning SI.