Diabetes Mellitus is one of the common chronic illnesses, which endanger patient's mental health.

We think there is a meaningful relationship between Diabetes and occurring the Mental diseases.

The present study was planned to assess the relationship between diabetic patients' mental health and coping strategies.

In this cross-sectional study 193 patients who were referred to diabetes clinic of Imam Khomeini hospital of Ardabil city in north western part of Iran were selected by available sampling method and assessed by GHQ-28 and Folkman-Lazarus questionnaires. Data were analyze by SPSS version 13 software ,using logistic regression analysis and independent t tests.

Results showed that 54% of diabetic patients are suspected to have a mental disorder and need more diagnostic assessments .Escape-avoidance (P < 0.001), confronting (P < 0.001) and plan-full problem solving coping strategies could predict the mental health in diabetic patients.

Inappropriate and emotion-based coping strategies against medical illnesses-such as escape-avoidance method as a predictor of diabetic patients' mental health-throw patients in vicious cycle of medical and mental illness.

In HIV infected patients with psychiatric disorders, the context of contamination should be assess as it could presented specificities that has to be known to recommend appropriate HIV test screening in this population and to ensure adequate treatment and care.

A large HIV screening test campaign took place in our psychiatric hospital during 5 years; from 2006 to 2011. Patients found HIV positive were selected and analyzed in terms of the context of their contamination, the diagnosis process and the characteristics of the medical care they had.

During the period, 2380 patients hospitalized could have been tested, from them 10 were found to be HIV positive (0.42%). Cases analysis show complex relationship between HIV infection and psychiatric disorders and raises issues of high risk of transmission in this population irrespective to their age or their way of life.

Our work highlights the recommendation of strong partnership with different medical department with multidisciplinary approach to ensure good quality of care in these complex situations. the psychiatric pathology should be better taken into account as it could influenced the course of the patient follow up and the treatment outcome. This could have an effect on epidemiological issue: reducing HIV transmission and on individual level in terms of vital prognosis.

Dissociative disorders are characterized by disturbances of integration of memory, perception, consciousness or identity. They were linked to psychological stress or trauma across various cultures. Dissociative amnesia and fugue, depersonalization disorder, dissociative identity disorder and dissociative disorder not otherwise specified (such as Ganser syndrome) belong to dissociative disorders in DSM-IV-TR. in contrast to DSM-IV-TR, ICD-10 also subsumes the conversion disorder under the category of dissociative (conversion) disorders.

This work's objective is establishing greater recognition of the neural correlates of dissociative disorders.

We review neuroimaging data pertaining to dissociative amnesia and fugue, depersonalization disorder, dissociative identity disorder (multiple personality disorder), Ganser syndrome and various forms of conversion disorder, which were obtained with functional and structural imaging techniques, including diffusion tensor imaging or magnetization transfer ratio measurements.

In addition to own imaging data from patients with dissociative amnesia and fugue, a comprehensive review of the scientific literature on the neuroimaging of dissociative disorders was performed.

Neuroimaging research data point to metabolic and sometimes even structural brain alterations in dissociative disorders, involving regions that are agreed upon to play roles in mnemonic processing, self referential processing (including body schema), perception, consciousness and/or emotional processing.

The use of functional and newer structural brain imaging methods has improved and will continue to further our understanding of the neural correlates of dissociative disorders and has provided evidence that environmentally-driven (stress-related) alterations of cognition, identity, body schema, perception, affectivity and behavior are accompanied by metabolic and even structural brain changes.

It is possible to find an organic cause just for 1/3 of patients admitted to hospital with chest pain [1]. for the other 2/3 we are dealing with Unexplained Chest Pain [2].

Many studies demonstrated that in a high percentage of people that suffer of UCP there are mental disorders and unfavourable social and psychological factors [3,4,5].

The aim of this study was to estimate prevalence and to outline the psychological, social, anxious, depressive and somatoform state of patients admitted to emergency ward.

We recruited 319 patients, 169 treated in Udine's Emergency ward for chest pain and a control group of 150 patients that went to their family doctor with other symptoms.

Each of them completed self-administered tests searching socio-demographic characteristics, anxiety, depression, somatization, alexithymia, stress factors and child abuse. After 3 months we selected, using the hospitals database, patients that had confirmed diagnosis of UCP.

Prevalence of UCP in patients treated in Udine's emergency room was 45,5% (n77). We found a statistically significant difference between patients with UCP and control healthy group in the somatization subscale of SCL90 (χ2 = 18,2; p < 0,0001) and anxiety subscale of HADS (χ2 = 21,5; p < 0,0001).

A high percentage of hospitalized patients in the emergency ward for chest pain did not receive diagnosis of an organic pathology. It's possible to find in these patients a greater tendency to somatization and presence of anxiety symptoms. This data is in line with what recent literature shows.

Multiple sclerosis is a chronic neurological disease characterized by a demyelinating process in the central nervous system.

Psychiatric symptoms, and especially mood disorders, occur more frequently in multiple sclerosis than in other chronic diseases.

To report the occurence, type, MRI abnormalities and management of a bipolar affective disorder prior to the onset of multiple sclerosis.

We report a case of a forty-one-years old man, who developed a manic episode induced by antidepressant treatment, four months before the diagnosis of multiple sclerosis.

This case report suggests that bipolar affective disorders may be the initial manifestations of multiple sclerosis.

The awareness of psychiatric manifestations in unset and acute relapse episodes of multiple sclerosis may be helpful for an early dagnosis and for treatment adjustment.

It is a well-known fact that psychiatric in-patients often suffer from severe somatic problems, like diabetes mellitus or cardiovascular disease. Risk factors for somatic problems are frequently found, like obesity and smoking. in the Netherlands there are no clear recommendations for a standard somatic screening of psychiatric out-patients. in 2008 a pilot study was performed by GGZ Breburg, to investigate whether performing a somatic screening discloses any unknown physical information. This study showed that at least one ‘aspect of somatic concern’ (ASC) was found in 79% of all included patients. 63% of these somatic problems were previously unknown. Somatic screening showed to be useful, but until now there are no clear guidelines or supportive instruments available.

Objectives and aims: the objective of this study was to investigate the additional value of physical examination in the process of the construction of a screener for somatic problems in new psychiatric out-patients.

Newly referred out-patients (n = 70) were somatically screened by a screening questionnaire and additional medical interview, laboratory examination and physical examination. When a somatic problem found, was previously unknown, the patient was referred to the general practitioner or a medical specialist.

At least one ASC was found in 81,4% of all patients. in 45,7% of all patients this somatic problem was newly found. 12% of all newly found somatic problems were solely found by physical examination.

Physical examination creates substantial additive information in the somatic screening of psychiatric out-patients.

Eating disorders (ED) are among the leading causes of disease burden, especially in women.

The overall aim is to explore role of parental social characteristics and family composition in the development of ED in adolescent males and females.

We investigated associations of parental socioeconomic position, family type, number of siblings and half-siblings and history of psychiatric disease in parents with the incidence of eating disorders at age 12–23 years.

The Stockholm Youth Cohort (N = 589,114) is a database created by record-linkage for all children and adolescents, 0–17 years, resident in Stockholm County during the period 2001–2007, their parents and siblings. Hazard rations were calculated using Cox regression. Cases of ED were identified in outpatient care.

A total of 3251 cases of ED (2971 females and 280 males) were recorded among 249,884 study subjects. There was an increased risk of ED in both male and female offspring of parents who had a history of alcohol and drug abuse or psychiatric ill-health. Higher parental education was a risk factors in females. Increasing number of full siblings had a protective effect (fully adjusted HR 0.91, 95% CI 0.87–0.96, per sibling) while increasing number of half-siblings appeared to increase risk of eating disorders in females.

Risk factors for ED seem to differ between females and males. While parental psychiatric health is related to risk of ED in both sexes, family socioeconomic position and relationships within family appear to be of more importance for influencing risk of ED in females.

find the relation between urine toxic metals of autistic children and severity of autistic symptoms. examine whether DMSA is beneficial for children with autism.

The participants were 44 Autistic Spectrum Disorder Saudi children (3–9 years) who were diagnosed according to DSM IV criteria. All were subjected to a parental semi-structured psychiatric interview and the Childhood Autism Rating Scale (CARS). the baseline urine samples were taken from autistic children and sent to the German laboratory for the detection of heavy metals. the children were assesed clinically immediately before and after the sixth month of DMSA intake. post DMSA was taken from each child for re-analysis months.

There was positive correlation of Aluminum, vanadium, mercury, uranium with some subscales of CARS. After treatment with DMSA, there was statistical significant difference in the mean level of mercury and lead before and after chelation. There was significant difference in the mean score of CARS before and after management with DMSA chelation regarding some subscales and the total score of CARS.

Is to examine possible environmental risk factors in children with autism spectrum disorder versus controls. Also, to assess the levels of trace elements and heavy metals in hair and urine in both autistic and control groups.

The participants were 25 Autistic Spectrum Disorder (ASD) Saudi children (3–9 years) according to DSM IV criteria.

A control group of 25 children was age and sex-matched. All autistic children were subjected to a parental semi-structured psychiatricl interview. the severity of autistic symptomatology was measured by the Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). Both groups were subjected to the Questionnaire on Exposure to Heavy Metals, Physical Symptoms, and Child Development. Hair and baseline urine samples were taken from both groups and sent to the Micro Trace Minerals Gmbh, Germany.

By comparing the ASD Group to the Control Group, we found a statistically significant difference in the mean hair levels of arsenic, cadmium, barium, cerium, lead, magnesium and zinc.

There were also statistically significant differences in the mean urine levels of Aluminum, Barium, Cerium, Mercury, and Lead, Copper and Germanium.

An agreement was found in both specimen (hair and urine) for barium and lead.

To assess the impact of lithium treatment alone or combined with other medications on TSH levels and WBC count in hospitalized bipolar and non-bipolar children, adolescents and young adults using data extracted from electronic medical records.

The study investigated serum TSH and WBC count in lithium treated hospitalized youth, aged 12–24 years. the study included 122 BP (N = 67) or non-BP (N = 55) disorder inpatients treated with lithium for mean duration of 173 days. TSH and WBC values were examined at baseline and at the end of the hospitalization. Subjects were divided into two groups for analysis: group 1 was treated with lithium as monotherapy and group 2 was treated with lithium combined with other psychotropic agents (polypharmacy).

The mean end-point TSH levels were significantly higher (3.16 ± 2.68 vs 1.52 ± 0.92 mU/L, P < 0.05) after lithium treatment. Sixteen children of the 54 (29%) had TSH values above the upper normal value of 4 mU/L at the end-point. A positive correlation was found between pre- and post-treatment TSH levels (Pearson's correlation: r = 0.568, P < 0.05). A statistical significant difference was also found in mean WBC's count (7195.3 ± 2151.88 vs 7944.1 ± 2096.53 count/mm3 cells, P < 0.05). No differences were detected between the monotherapy and the polypharmacy groups.

Lithium treatment is associated with significant increase in thyrotropin levels and WBC counts in youth. Higher-baseline TSH level is associated with higher TSH levels in lithium-treated subjects. Close monitoring of thyroid functions in lithium treated children and adolescents is recommended.

Little is known about the Quality of Life (QoL) in mothers of Arab children with Autism Spectrum Disorders (ASD):

The aim of the present study was to assess QOL among mothers with children affected with ASD:

Socio-demographic variables and ASD history were assessed using personal interview with a structured questionnaire. HRQoL domains were assessed using SF-36 questionnaire, while maternal mental health was assessed using Mini-International Neuropsychaitric interview (MINI-Arabic Version).

Mothers of children with ASD group showed significant deterioration along the physical and social domains of HRQoL compared to mothers of apparently healthy children. Deterioration in HRQoL showed a positive correlation with the level of severity of the children's symptoms and to coexisting behavioral problems and lower socio-demographic profile.

Results of this study provide preliminary evidence that mothers of children in need of social support and clinical interventions which are family centered, rather than child focused.

Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric disorder in childhood (estimated global prevalence 3–5%). ADHD symptoms and impairments frequently continue into adulthood, but data on lifelong impact are limited.

The Lifetime Impairment Survey aimed to evaluate the extent of lifetime impairment of individuals with ADHD in six European countries. We analysed the responses obtained from adults with/without ADHD regarding their current situation.

The survey was developed by a committee of ADHD specialists and implemented by a market research organization. Participants were recruited from a database of 487,533 volunteers, and answered questions on ADHD diagnosis and current experiences. Survey items were combined into scales/scores evaluating different areas of impairment. Mean scale scores for ADHD and controls were compared. Cross-country comparisons of impairment scales were also performed.

A total of 629 adults with ADHD and 736 controls participated. ADHD was diagnosed after a median of 22 months and after consulting a median of two physicians. Impairments reported by adults with ADHD were significantly greater (p < 0.001) than controls in most areas investigated, including work, social and relationship functioning, mood/temper control, rule-breaking behaviour, self-organization/planning, and financial difficulties. Analyses of variance showed that the country effect on impairment scores was generally negligible, explaining only 1–3% of the observed variance.

Compared with controls, the impairments reported by adults with ADHD suggest a continued impact of the condition on both personal and professional life; no substantial cross-cultural differences were observed.

By Shire Development Inc.

According to previous studies the prevalence of adolescent depression is 4–8% both in the USA and Europe. the aim of the current study was to investigate the prevalence of adolescent depression separately in several European countries.

Data were drawn from the Saving and Empowering Young Lives in Europe (SEYLE) study, which included 11 countries (Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Israel, Romania, Slovenia and Spain) and Sweden served as the coordinating centre. Depression was measured by the Beck Depression Inventory-II (BDI-II). Adolescents with a score of 20 or greater on the BDI-II were defined as depressed. Multiple imputations were conducted to address missing data.

Out of 14,115 students who consented to participate, finally 12,395 adolescents (5,568 (44.92%) boys and 6,827 (55.08%) girls) were enrolled into the study. the mean age of the students was 14.81 years (SD = .83). Significant differences were detected in the ratio of non-depressed and depressed adolescents among countries (χ2(20) = 385.352 p = .000). the prevalence of depressed adolescents ranged from 7.1% to 19.4%. the prevalence of depressed adolescents according to country in increasing order is: Hungary: 7.1%, Austria: 7.6%, Romania: 7.6%, Estonia: 7.9%, Ireland: 8.5%, Spain: 8.6%, Italy: 9.2%, Slovenia: 11.4%, Germany: 12.9%, France: 15.4%, Israel: 19.4%.

Based on a screening tool our data underlines the importance of taking account country specific prevalence rates of adolescent depression.

The essential characteristic of Selective Mutism is the consistent failure to speak in social situations where speech is expected, despite the capacity of speaking in familiar places or situations. the child usually refuses to speak at school, but speaks normally and well at home. Most cases start at preschool age and have transitory course.

Psychotherapeutical interventions and selective serotonin reuptake inhibitors are considered first and second line treatments, respectively.

The purpose of this current report is to describe the successful treatment of selective mutism in a school-age boy.

This is a case report about a multidisciplinary approach on a boy who stopped talking at the age of 3, and restarted talking by the time he was 8 years old, after 1 year of treatment.

This study showed the improvement of the patient after he changed from a group therapy only to a combined psychiatric + individual psychotherapy + phonoaudiological treatment + family orientation + educational work (school).

This case of Selective Mutism had better and faster results with a multifocused treatment than single therapies only.

The project “RESTAURANDO ESPERANÇA” (Restoring Hope) aims to tackle social exclusion between children and adolescents, deriving from drug use, associated with problems such as physical and sexual violence, school failure, mental health disorders, lack of access to appropriate education, health, housing, etc.- conditions characteristic of selective and unequal societies such as the Brazilian one.

The purpose of this current project is achieving adherence to the treatment of youth, promoting social inclusion, prevention and treatment against the use of alcohol and drugs, restoring their health and quality of life.

The GEAL/UFF and IPHEM Health Group, part of this Project, attends to a public between 10 and 18 years old, living at social risk and/or using alcohol and drugs.

The Pizzeria-School is a project that aims to train low-income young people.

In order to increase attendance and to provide a longer stay of youths in the Living Center, the Health Group and the Pizzeria-School have associated and that resulted in a new concept of therapeutic approach.

This association resulted in a group called “Kitchen's Talk” with a surprising adhesion and full attendance.

The “Kitchen's Talk” provides a less formal atmosphere and makes participants more comfortable during the group chat. At the end of the lesson, the encounter between the youth and their families, mediated by the therapeutic team, is celebrated with tasty pizzas, as a result of the work and the commitment of each individual, allowing the redefinition of values and the building of new family ties.

In recent years we've witnessed a rapid rise in the off-label use of atypical antipsychotics (AAPs) in child and adolescent psychiatry practice despite still limited evidence base for their efficacy and safety.

To investigate the patterns of use and frequency of side effects of AAP therapy in children and adolescents with psychotic disorders in Latvia.

Retrospective chart review of all inpatients with schizophrenia spectrum disorder diagnosis, treated in Children's Clinical University Hospital, Riga, Latvia from September 2008 till September 2011.

We identified 126 admissions (F/M ratio - 1,5; mean age - 13,83 (SD 2,69) years), 32 being first-admissions. Most frequent diagnoses were juvenile-onset (34,1%) and paranoid (23.8%) schizophrenia. in 91,3% cases patients received antipsychotic therapy (28,6% only AAPs, 11,9% only typical antipsychotics (TAPs), 50,8% a combination of both). Most widely used AAPs were Quetiapine - 34,9%, Risperidone - 26,2%, Olanzapine - 19,8% and Aripiprazole - 15,9%. Haloperidol was still used in 49,2% cases. in 58,7% cases patients also received anticholinergic medication, so reports of extrapyramidal side effects were anecdotal. in 31,0% cases (9 patients on AAPs, 30 on combined treatment) there was a significant (>400 mU/L) increase of serum prolactin level. in 15,9% cases there was a significant (>450 ms) elongation of QTc interval.

AAPs are rapidly substituting TAPs as the firsthand treatment for children with schizophrenic psychoses, but the rate of side effects is significant, with as much as 1/3 of those receiving AAPs developing hyperprolactinaemia, and 1/5 - a prolongation of QTc interval.