Individuals with serious mental illness (SMI) are at considerably higher risk for morbidity and mortality than those in the general population. In these diagnoses – a refinement of intervention is required, the user perspective overall is still underrepresented.

In mental health Services there is an international trend toward recovery-orientated interventions, like Peer-support (PS) in formal mental health services. There is a raising but still insufficient evidence for it's benefits

In Germany this is the first try to implement and research peer support services area-wide in psychiatric facilities to provide a low-threshold service that aims individual recovery. This project forms a part of 'psychenet ', a project supported by the Federal Ministry of Education and Research of Germany during 2011 – 2014 and investigates the effect of peer support on psychosocial factors, functioning and hospital admissions.

In a controlled multi-centre-trial involving 10 hospital facilities in Hamburg − 216 in- and outpatients suffering from affective disorders, psychoses or personality disorders get randomized to either receive additional Peer-Support at most half a year aligned to individual requirements or treatment as usual. A mixed method repeated measurement analysis is conducted.

Subjects refill questionnaires and get rated by clinicians at three points of measurement: Entry of the half year of intervention, after the intervention and in a six month follow up. Psychosocial Outcomes, global functioning, and in and outpatient days were assessed. There is a significant positive Effect for the PS of the primary outcome. Results will be presented

Participants will be able to describe programs which illustrate the benefits of service-user support.

Drawing an analogy with immigrant and ethnic minority communities, the presenter will argue that there is a value in the mutual support found in identity communities of people who have experienced mental illness.

Ethnic minorities have multiple successful pathways towards social inclusion. They can choose to live, work and socialize in the dominant community, remain in their sub-communities, or move back and forth, choosing activities in each. People with psychiatric disabilities can be offered these same choices: we should not assume that integration into the broader community through mainstreaming is the ultimate goal.

Successful models that build on the value of the mutual support in communities of people with disabilities, such as social firms and the psychosocial clubhouse, will be cited. These models include business incubators that help community members develop micro-businesses and a user-friendly bank to assist in capitalizing such ventures. An economic development approach which identifies enterprises that can advance the economy of the service-user community and offer members work opportunities will be described.

Service-users should be given opportunities to appreciate the mutual support which comes from those with whom they share experiences, concerns, needs and goals, and not feel they must abandon this resource in order to integrate themselves into the broader community.

Electrodermal hyporeactivity has a high sensitivity (up to 97%) and high raw specificity (up to 98%) for suicide.

To evaluate prevalence, sensitivity and specificity of electrodermal hyporeactivity for suicide and suicide attempt, with and without death intent and with violent method or not, in adult patients with a primary diagnosis of depression.

The study will be performed at 20 psychiatric clinical centres in ten European countries. Patients with a primary diagnosis of depression, also in remission, will be recruited. Depressive symptomatology will be assessed through the Montgomery-Asberg Depression Scale. Previous suicide attempts will be registered and the death intent of the worst attempt will be rated according to the first eight items of the Beck Suicide Intent Scale. The risk of suicide will be assessed first according to rules and traditions at the centre and eventually revised considering the results of the EDOR Test (ElectroDermal Orienting Reactivity Test). Through headphones a moderately strong tone is presented now and then during the test. Sensors located within gold electrodes, on which two fingers are connected, are able to register the electrodermal response to those tones, measuring the skin conductance. Sensors also register blood volume variation. Recruited patients will be followed-up for one year. During this test period, information concerning possible suicide attempts or completed suicide will be acquired. Methods used and death intent will be also assessed.

It is expected that the test of electrodermal hyporeactivity detects a previously unknown neuropsychological dysfunction that is independent of the depressive state and can predict suicidality with a high sensitivity and specificity. The EDOR Test is optimized for detecting hyporeactivity and could be easily included into the everyday clinical practice.

To describe therapeutic features of 120 panic disorder (PD) patients treated with clonazepam, paroxetine, or clonazepam + paroxetine for 3 years and their follow-up for more 6 years.

A prospective open study randomized 120 PD patients to 2 mg/day clonazepam or 40 mg/day paroxetine. Poor responders were switched after 8 weeks to combined treatment with ∼2 mg/day clonazepam + ∼40 mg/day paroxetine. Tapered withdrawal of all treatments was performed after 3 years. Efficacy, safety, and cumulative relapse and remission were studied over the following 6 years, using panic attack (PA) count, clinical global impression-severity (CGI-S), and Hamilton anxiety scale (HAMA).

94 patients completed 3 years treatment. All were free of panic attacks since at least one year before undergoing tapered drug withdrawal. After two months of tapering, 80% of clonazepam patients were drug-free, versus 55% on paroxetine. No serious or severe adverse event were observed but PA/month, CGI-S, and HAMA worsened slightly. In annually studied patients the relapse rates were similar after the 3 treatments with an advantage of clonazepam over the combination (p=0.0035) and paroxetine (p=0.08, exact Fisher) at the first year after drug withdrawal. Cumulative relapses rate were 41%, 77%, and 94% at years 1, 4, and 6, but relapse therapy with either clonazepam or paroxetine was successful in nearly all cases.

PD is a chronic disorder, with many patients relapsing after 3 years treatment. Response to retreatment was excellent. Paroxetine and clonazepam were associated with similar long-term prognoses but clonazepam was better tolerated.

Social anxiety disorder (SAD) is a strong risk factor for the development of depressive disorders (major depressive disorder or dysthymia).

Identification of blood-based molecular predictors of a subsequent depressive episode in SAD.

Objectives: To screen SAD patient serum for biomarkers which predict the onset of depressive disorders over a 2-year follow-up period.

Multiplexed-immunoassay data obtained from 143 SAD patients without co-morbid depressive disorders, recruited within the Netherlands Study of Depression and Anxiety (NESDA), were investigated. The serum screen included 165 mainly immunological, metabolical and hormonal analytes. Predictive performance of identified biomarkers and clinical variables (e.g. Beck Anxiety Inventory) was assessed using receiver operating characteristics curves (ROC) and represented by the area under the ROC curve (AUC). Stepwise logistic regression was used to select an optimal set of patient parameters, combining predictive serum analytes and clinical variables.

A set of four serum analytes and four associated clinical variables reached an AUC of 0.86 for the identification of SAD individuals, who developed a subsequent depressive episode. Throughout our analyses, biomarker panels yielded superior discriminative performance compared to clinical variables alone.

We report the discovery of a serum marker panel with good predictive performance to identify SAD individuals prone to develop depressive disorders in a naturalistic cohort design. Furthermore, we emphasise the importance to combine biological markers and clinical parameters for disease course predictions in psychiatry. Validated biomarkers could help to identify SAD patients at risk of a depressive episode, thus facilitating early treatment and improving clinical outcome.

Using meta-analysis and physician billing data, the prevalence and efficacy of treatments for anxiety disorders in children and adolescents was elucidated.

To use billing data from the Calgary Health Region (CHR) to determine anxiety disorder prevalence rates. Meta-analysis was performed to compare treatment efficacy of two leading interventions for anxiety disorders in youth.

We sought to examine the prevalence of anxiety disorders in the CHR, and evaluate the efficacy of cognitive behavioural therapy (CBT) and attention bias modification (ABM) for the treatment of anxiety disorders in youth.

Physician billing data was used to identify 303 938 unique individuals diagnosed with an anxiety disorder. Effect sizes for CBT/ABM treatments were calculated for clinician and self-report measures and displayed in forest plots, allowing comparison of treatment efficacy.

The 16-year cumulative anxiety disorder prevalence rate was 28.8% in the CHR, while the annual rate increased from 1.5% to 2.1% from 1994 to 2009. There was no evidence of efficacy for the ABM treatment. 80% of the CBT studies showed efficacy of the treatment as rated by clinicians, but none showed significant improvement in self-report measures. Analysis revealed the ABM placebo was more effective than ABM, and significantly more efficacious than CBT.

The prevalence of anxiety disorders in the CHR increased by 40% from 1993 to 2009. Meta-analysis revealed no evidence of efficacy for ABM. CBT only showed efficacy in terms of clinician-rated measures; possible evidence of clinician bias. Ultimately, revision of current ABM methods is necessary.

Longitudinal alcohol consumption in early adulthood has been studied, but reports from later adulthood are scarce.

Finding longitudinal trends in alcohol consumption using prospective birth cohort data.

To investigate trends in self-reported alcohol consumption in adulthood.

In the Northern Finland Birth Cohort 1966 (N=5,621) alcohol use was studied with questionnaires at ages 31 and 46. Participants were classified into steady drinkers, increasers and decreasers based on the change in consumption (g/day). Multinomial regression analysis was conducted with educational, marital and employment baseline statuses and their changes, and baseline alcohol use as factors influencing the change in alcohol consumption.

70% of alcohol users were classified as steady drinkers, 10% as decreasers and 20% as increasers. In all, daily alcohol consumption rose over 30%, particularly among women. The unemployed, singles and low-educated consumed the most (P<0.01). Being a divorced male (OR 1.5; 95%CI: 1.0-2.1) or a long-term unemployed female (1.6; 1.0-2.6) predicted increase in alcohol use. The probability of decrease was higher among single men (OR 1.6; 1.0-2.4) and women (2.8; 1.7-4.4) at 31y, among men entering a relationship (1.9; 1.2-3.1), and among divorced women (2.4; 1.4-3.8) and entering a relationship (2.1; 1.3-3.5).

Alcohol usage among middle-aged Northern Finns is rather stable and increase is more exhibited than decrease. Gender differences in predictors existed: changes in relationship status predicted decrease in usage in women, whereas in men divorce predicted increase in usage and a new relationship predicted decrease. Long-term unemployment predicted increase only in women.

Adolescents with a problematic use of the Web reported less satisfaction also in interpersonal relationships and poorer onces with their parents (Liu & Kou, 2007). Other studies have shown that attachment plays a role in the way in which the person interacts with others in the network (Buote et.al. 2009).

This study was focused on the psychological profile of a sample of young Facebook users and on the relationships between the time spent on the Web, symptoms detected by the SLC-90, the state of attachment (Ca-Mir), and the self perception of attachment to parents and friends.

500 adolescents (F = 221, M = 214), aged between 13 and 18 years, were assessed by means of self rating questionnaires (BFAS Over-Bergen Facebook Addiction Scale, SPQ – Shorter Promis Questionnaire, MPIQ – Mobile Phone Involvement Questionnaire, UCLA – Loniless Scale, Self-Disclosure Online, IPPA – Inventory of Parent and Peer Attachment, SCL-90 – Syntom Check List, Ca-mir). On two subjects was performed EEG recording, during exposure to stimuli related to Facebook and to the Web.

A subgroup of young people were spending more time on the Web and were also reporting situations of mental and emotional vulnerability asociated with dysfunction in family relationships.

These results emerge from profiles of normality and risk, even multiples, which relate the quality of parent-child attachment relationship and the proper use of social networks and the Internet in general. Further investigations are needed to fully understand the brain dynamics behind these profiles.

Physical comorbidities are common in patients with mental illness and substance use disorder. Both regular use of alcohol and cannabis have been associated with adverse health effects. However, their physical comorbidities can also be explained by other unhealthy lifestyle choices, i.e. lack of physical activity, poor nutrition and smoking.

The aim of this study is to analyse baseline and follow up data after one and a half year of a 3-year interventional programme of improvement of physical health in patients with mental illness and comorbid substance use disorder.

All patients with mental illness and substance use disorder referred to Department M at Aarhus University Hospital Risskov, Denmark from 1 July 2013 and onwards are included in the programme. The study takes an active awareness and motivational interviewing approach to increase knowledge and understanding of physical health problems. The intervention includes health promotion activities, and physical health parameters are monitored. Further guidance on healthy food intake, smoking cessation and a physically active life is provided.

50 patients are expected to be participating in the programme after one and a half year. Preliminary results after one-year show that 89,7 % smoke cigarettes, their level of physical activity is low, which is seen in the extent of their sedentary behaviour. Further there are problems with insufficient food intake among patients.

This study indicates, that patients with mental illness and comorbid substance use disorder need guidance on a healthier lifestyle. They show an interest in this interventional programme.

Our knowledge about the effect of internet use on patients with psychotic disorder has not been fully investigated.

The main objective was to investigate the psychological characteristics associated with Internet use in chronically mentally ill, compared to the general population.

To explore the levelsof internet use in patients with psychosis and their association with self-esteemand interpersonal relationships.

The study involved 101 participants of which 30 were psychotic outpatients (meanage 39 years, SD = 11) and 71 (mean age 34 years, SD = 8) from the generalpopulation. Participants filled out a questionnaire of a) social-demographicand clinical parameters b) Diagnostic criteria Young's Internet addiction, c) Internet Addiction Test (IAT) questionnaire for the diagnosis of Internet addiction, d) The Scale in Interpersonal Relationships (ECRI) and e) The Greek version of Self-esteem Questionnaire (SES, Self-Esteem Scale).

We found significant statistical differences in terms of internetaddiction (Young's diagnostic criteria: 5/25 vs 6/65, p<.00001 and IAT: 7/23 vs 8/63, p<.00001) when we compared patients with psychotic disorder with general population. Especially, for psychotic patients logistic regression models found that self-esteem, avoidance and anxiety adulthood relationships statistically contributed to internet addiction, after adjustments(p=043, p=.015 and p=.021, respectively).

Our results found that a psychotic patient with difficulty ininterpersonal relationships and with low self-esteem is more likely to adopt an addictive behavior in the use of internet in comparison to the general population.

Somatosensory amplification, found in anxiety, depression and hypochondriasis, refers to the perception of normal somatic and visceral stimuli as being intense and disturbing. There is also some evidence that dysfunctional parental rearing styles associate with increased risk of suffering from somatic diseases and mental disorders in adulthood.

To measure somatosensory amplification in healthy adults and assess the type of parenting they received.

To verify whether a dysfunctional parenting style, as remembered and assessed by healthy adults, is linked to increased somatosensory amplification in adult life. Given that previous evidence suggested that depression and anxiety are also linked to increased somatosensory amplification, present study also controls for those symptoms in estimating the relationship between somatosensory amplification and parenting styles.

Two-hundred and thirty subjects were randomly selected from the general Greek population and asked to complete the Hospital Anxiety and Depression Scale (HADS), the Measurement Of Parenting Style (MOPS), the Remembered Relationship with Parents (RRP) and the Somatosensory Amplification Scale (SSA).

Our results showed that higher HADS scores as well as higher MOPS and RRP scores, indicative of anxiety, depression and perceived dysfunctional parenting respectively, predict a more intense somatosensory amplification. A multivariate regression model showed that increased somatosensory amplification associates best with an overcontrolling parenting style along with more anxiety, lower somatic health and lower educational status.

Our results show that a parenting style perceived as overcontrolling may result later, in adult life, in a more intense somatosensory amplification.

The term endophenotype was first used by Gottesman to describe a trait that may be intermediate on the chain of causality from genes to diseases. An endophenotype may be neuropathological, neurocognitive, emotional, neuro-physiological or neurobiological in nature. There is dearth of studies about the use of neurocognive dysfunction as endophenotype marker of BPAD, particularly from developing countries.

We aimed to evaluate neurocognitive dysfunctions as endophenotype markers of bipolar affective disorder (BPAD) in first degree relative of BPAD patients. We hypothesized that first degree relative of BPAD patients differ significantly in regard to neurocognitive dysfunction from matched controls.

A cross sectional study was carried out. Sample was drawn from first degree relatives (FDR) of patients of BPAD and controls. After assessment of neurocognitive function first degree relatives of BPAD were compared with controls on measures of attention, verbal working memory, auditory verbal memory, Visuo spatial working memory, visual attention and executive functions.

Results indicated that, first degree relatives of BPAD scored poorly on measures of neurocognition then controls. On conducting comparison over composite neurocognitive score 'we found that cognitive index in combination better discriminate the first degree relatives of BPAD from controls.

Neurocognitive dysfunction on measures of attention, verbal episodic memory, auditory verbal working memory, visuospatial working memory and executive functions significantly differentiated first degree relatives of BPAD patients from controls.

Whether burnout is anything other than a (job-related) depressive syndrome is unclear. A growing body of research suggests that the overlap of burnout with depression has been largely underestimated.

The aim of this longitudinal study was to examine whether burnout at baseline helped predict depression at follow-up when depression at baseline was controlled for.

A total of 627 French teachers took part in the two waves of this study, launched in 2012. About three of four participants were female and mean age at time 1 (T1) was 41. Depression was assessed with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). Using the PHQ-9, the severity of depressive symptoms can be graded and provisional diagnoses of major depressive disorders can be established. Burnout was measured with the Maslach Burnout Inventory. Participants completed the follow-up on an average 21 months after completing the initial survey.

Hierarchical multiple regression analysis showed that a model involving T1 burnout and depression as predictors did not explain more variance in depression at follow-up than a model involving T1 depression as the only predictor. Binary logistic regression analyses indicated that T1 burnout no longer predicted cases of major depression at follow-up when T1 depression was included in the tested model. All these results were obtained controlling for gender, age, and length of employment.

This study confirms that burnout overlaps with depression. Assessing burnout in addition to depression may not be as useful as assumed in the past.

Because randomized clinical trials in bipolar disorder include restricted study populations, the possibilities for generalizing to real-world bipolar patients are limited. Naturalistic long-term data can add valuable information about the diversity of treatment, outcome and risk factors in bipolar disorder.

After discharge from a psychiatric community hospital, 300 consecutively admitted ICD-10 bipolar I (n=158) and II (n=142) patients were followed-up naturalistically during for 4 years. Patients were assessed as to time to relapse, relapse in relation to index episode, prophylactic effects of prescribed medication, and risk factors for relapses such as prescribing attitudes, medication adherence, life events and alcohol use disorders.

204 (68%) of 300 patients relapsed within 4 years, with a mean of 208 days (SD=356.2) until the next affective episode. Relapses correlated in a statistically significant manner with the index episode. Using a Kaplan survival analysis, only lithium delayed time to the next affective relapse in a statistically significant way. Survival was reduced in a statistically significant manner when prophylactic medication was replaced by the psychiatrist or stopped by the patient. In a sub-analysis of this cohort life events (n=222) and alcohol use disorders (n=284) were associated with more depressive episodes in bipolar I patients.

Even though lithium seems more protective than other commonly used drugs, bipolar patients still suffer from a high relapse rate. Bad adherence, life events and alcohol use disorders are hereby major risk factors. The results urge for further and more holistic treatment approaches in bipolar disorder.

Negative impact of long-term lithium treatment on kidney and thyroid functions makes the important problem of such therapy. While kidney functions deteriorate in time-dependent manner after ten years of lithium therapy it is unclear whether a significant association exists between thyroid dysfunction and duration of lithium administration.

The aim was to compare thyroid hormones and antibodies in bipolar patients receiving lithium for 10-19 years with those receiving for 20 years or more.

The cross-sectional study was performed on 66 patients (21 male, 45 female) with bipolar mood disorder, receiving lithium for 10-44 (20+9) years. Thyroid stimulating hormone (TSH), free thyroxine (fT3) and free triiodothyronine (fT4) as well as thyroid peroxidase (TPO), thyroglobulin (TG) and TSH receptor (TSH-R) antibodies were measured.

Features of hypothyroidism were found in 10 (22%) female patients but not in male patients. A significant percentage of patients had abnormally high anti-TPO, and anti-TG antibodies (45% and 65%, respectively). There were no differences in thyroid function between 38 patients receiving lithium for 10-19 years and 28 patients taking the drug for 20 years or more.

The results confirm greater susceptibility of female bipolar patients for lithium-induced hypothyroidism. High anti-TPO and anti-TG antibodies suggest a possibility of autoimmune disturbance in these subjects. However, in contrast to lithium effect on kidney function, our results do not show an association between duration of long-term lithium therapy and thyroid dysfunction.

Data was analyzed from 271 patients with MS according IDF criteria, (aged 30 – 60 years). Current D and A were confirmed according to the criteria of ICD-10. All patients passed through: MMSE, HADS, HARS, HAM-A tests. GL and plasma indicators of lipid spectrum were assessed using NCEP criteria.

Subjects were divided into 2 groups, group A – with D and/or A (139) and group B -without affective disorders (132). Using Mann-Whitney test significant connection between changes in levels of indicators of lipid spectrum, the GL and affective disorders in group A were obtained. Subjects with D and A and mild cognitive impairment (MCI) had higher level of VLDL and LDL-C in comparison with only MCI subjects.

There is link between affective disorders and components of MS. Increased level of LDL and VLDL provokes comorbidity of MCI, depression and anxiety.