Parental attitudes, taken in the three orthogonal dimensions of pleasure-displeasure, arousal-non arousal, dominance-submissive, contribute in creating the emotional climate in wich children's cognition and affectivity develop.

Parental attitudes can be measured via the Parental Attitudes Scales (PAD), a 46-item self-administered instrument counting three subscales.

To explore the psychometric properties of the Italian version of the PAD.

The PAD was administered to a sample of 163 Italian parents (77 males, 86 females) having children aged between three months and eight years and living in three different towns of Tuscany (Italy). Principal Component Analyses (PCA) were conducted and alpha coefficients were explored. The concurrent validity of the questionnaire was examinated by correlating the PAD scores with data from the Family Assessment Device (FAD) and the Positive Affect Negative Affect Schedule (PANAS).

Results from initial and PCA analyses suggested that several items of the questionnaire perform poorly and should be removed. Results supported a three-factor solution consisting of 36 items and accounting for 28,3% of the variance. Internal consistency for the short version of the PAD was high (Cronbach's Alpha = 0.81). The PAD scores showed statistically significant correlations with the PANAS and the FAD dimensions.

Findings suggest that a reduced version of the scale could better represent the construct measured by the PAD. Overall, the short versionof the questionnaire proved to be a valid and reliable measure of parental attitudes.

Children adopted from non-European countries are delayed in their general development but show less behavior problems compared to children adopted from European countries.

Financing is a critical factor in ensuring the optimal development and delivery of a mental health system. It is the mechanism by which plans and policies are translated into action through the effective and efficient allocation of resources.

1. 1. Analysis of the Ireland's mental health service financial model.

2. 2. Map mental health service delivery system to understand resource allocation.

3. 3. Review mental health policy and planning priorities in Ireland with respect to current financial model.

4. 4. Evaluate alternative financial models and their potentisl applicability to Ireland.

Analysis of financing model will facilitate and enable development of innovative recommendations to improve mental health service financial model and hence, by extension, mental health service delivery in Ireland.

Review of literature through electronic databases, hardcopy journals and other relevant sources. Analysis and evaluation of Irish financial model and assessment of potentiality of other possible models to improve Irish mental health service delivery.

Although a report on the financial management of the Irish Health system exists, there is no reliable study/report dealing exclusively with the mental health system. There is a lack of clarity and understanding as to the suitability of the current Irish financial model in optimising mental health service delivery. The current financial model risks perpetuating a two tier mental health system.

More work is needed to properly assess and evaluate the current Irish financial model. International best practices in financing mental health services should be adopted where relevant.

The influence of psychological factors on sports injuries has been demonstrated in numerous empirical studies. Athletes experience significant mood changes throughout rehabilitation, which may hinder rehabilitation early in the process.

Descriptive analytical case control study which includes fifty professional football players with lower limb injuries & another group of professional football players without any injury at all will be selected. All participants were subjected to Semi structured interview, Familial Sociodeconomic Status Scale, Semi-Structured Pain Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Life Satisfaction Scale, and Facing Daily Stressful Live Events Scale.

The group of football players with lower limb injuries shows statistically significant higher depression (p < .001), and higher anxiety (p < .001) compared to the other group of players. There was highly statistical significant difference regarding Life Satisfaction Scale (p < .001), and Facing Daily Stressful Live Events Scale. (p < .001).

Depressive and anxiety disorders were more prevalent among football players with lower limb injuries. Also, among the same group there was higher degree of life dissatisfaction, and more stress caused by life events.

Neurological Soft Signs (NSS) are minor neurological signs indicating non-specific cerebral dysfunction. They are divided into four categories: sensory integration, motor coordination, sequencing motor complex acts and primitive reflexes.

We sought to determine whether NSS were specifically related to schizophrenia.

1. 1) To compare NSS scores between patients with schizophrenia, bipolar disorder and controls.

2. 2) to assess the relationship of NSS scores with psychopathological measures and treatment (olanzapine equivalents).

We assessed neurological functioning by the Neurological Evaluation Scale (NES) in 67 patients diagnosed with schizophrenia (SCZ), 69 diagnosed with bipolar disorder (BD) and 50 healthy controls. Psychopathological dimension were assessed through the Positive and Negative Syndrome Scale (PANSS). Furthermore, we studied the correlation between NSS scores and psychopathological measures.Independent samples Student's t-tests and Post Hoc Tests were used to compute group differences. The correlations between NSS, treatment and PANSS scores were calculated using Pearson correlation coefficients.

Total NES and subscale scores were significantly higher in patients than in controls. SCZ patients performed worse than BD patients (p < 0,001). PANSS total scores were significantly related to NES scores (r = 0.63; p < 0,001). Antipsychotic treatment showed a significant correlation with PANSS total scores (p < 0,05), while no correlations was found with NES scores.

These findings support the hypothesis that neurological deficits measured through NSS could be a common endophenotype in schizophrenia and bipolar disorder, related to symptoms and independent from pharmacological treatment.

To report a case of a female patient, priorly diagnosed with bipolar I disorder, brought in our emergency department because of her risk taking behaviors probably from strong psychomotor agitation. On the third day of her admission to hospital she showed signs of fatigue, mild elevated body temperature, different grades of hematomas and complains of muscle pain, being tired, weak, powerless etc. On that day laboratory test revealed an increased Ck levels, AST, ALT, Creat.etc.

T.R.an 49-year-old woman was admitted in our hospital on July 2011.She was brought from her familiars and police forces because of her dangerous behavior towards them in public. In hospital she showed bizarre behavior, leaded from her psychosis mainly with delusional thoughts refusing eating and drinking, she was dysphoric, hyperactive, with racing thoughts and lack of insight. All this time she used filthy words accusing her familiars, biting and kicking everyone. Results of biochemical tests of first day were normal;

On the third day she appeared tired, with somatic complains, especially of her lower extremities, myalgia, joint pain, general weakness, anuria, different grades hematomas over her body, body temperature of 37.8, blood pressure 125/80 mmHg, Fc 104/min. Laboratory tests that morning revealed CK = 26 130 U/L,

Urea=281.3 mg/dl,Creatinemia=11.44 mg/dl,AST=962 U/L,ALT=1258 U/L,Amylase=157 U/L.

This results were changing hourly. On this conditions nephrologists consultation was needed. A diagnosis of rhabdomyolysis with renal acute failure was suggested. Treatment therapy consisted first with generous quantities of intravenous fluids than dialysis. Gradually the patient recovered, with better test results.

In the last decades, psychiatric training has undergone a major transformation due to the contribution of recent scientific developments in psychiatry. Nowadays, the information acquired during the Psychiatric training seems considerably variable in content and quality between different countries. However, data concerning access to information and also about the educational resources available to the trainees in Europe is very limited.

The ATIIPT survey aimed to evaluate Psychiatric trainees’ access to published, online, senior's or industry's information in Europe.

A short paper questionnaire constituted of 7 questions (Appendix 1) was created by the members of the EFPT Research Working Group and passed to each delegate of the 32 countries represented at the 19th EFPT Forum in Prague, Czech Republic, on the 2nd of July 2011.

According to the ATIIPT results, access to information among Psychiatric trainees in Europe is heterogeneous. The most available resources are books and websites, and the most preferable resource is journals. Most of the trainees find their resources sufficient, with the main obstacles being related to low availability of journals and books, lack of time and help from seniors.

Better access to information and more evidence in practice is warranted, since the introduction of novel approaches to access to information may create better psychiatrists in the future, encourage medical students to consider psychiatry as a potential career, and help reduce negative attitudes towards mental illness.

One-third of Americans are obese, with a body mass index (BMI) of 30 or greater; one-fifth have BMI's of 40 or greater. In 2004, bariatric surgery was performed on an estimated 140,000 individuals. Mental illness, most commonly depressive and anxiety disorders, is prevalent among obese populations. Psychological screening is an important component of the pre-surgical evaluation process; however, pre-surgical psychopathology does not consistently correlate with poorer weight loss outcomes.

A paucity of literature exists on the management of psychiatric conditions after bariatric surgery. Studies have suggested depression improves after surgery, but adjusting to life after bariatric surgery can result in the emergence, or recurrence, of symptoms.

This study is intended to stimulate discussion regarding the evolving field of bariatric psychiatry.

Three cases were studied retrospectively. All three received the Roux-en-Y gastric bypass for BMI's greater than 40 with no reported prior history of mental illness. They were admitted to the inpatient unit for suicidal ideation and co-morbid substance dependence.

Psychiatric management was highlighted by appropriate psychopharmacological treatment reflecting altered pharmacokinetics from the gastric bypass, potentially contraindicating side effects of medications, and preparations of the medications themselves. The management involved the exploration of unique psychosocial stressors, particularly dealing with the impact of surgery and factors contributing to co-morbid substance dependence.

Bariatric patients in the inpatient psychiatric setting present a unique situation in which surgery results in pharmacological and psychological considerations that must be examined and taken into account for the appropriate management of their condition.

While DSM-IV diagnostic criteria exclude autism for making autism diagnosis; there are some reports about their co-occurrence.

A clinical sample of children with pervasive developmental disorder was screened for ADHD according to DSM-IV criteria.

About 40% of them were with ADHD-combined type. The rates of other types of ADHD were lower than the rate of combined type.

There is a very high rate of ADHD in children and adolescents with autism.

Nowadays, self-esteem has become very important because it is thought to be essential to mental health. Yearly, a large number of students leave the university although they are smart and talented. This rate is reported about 15% in America (Zarei et al., 2010). Some factors that are influential in leaving university are low self -esteem, and test anxiety.

370 Students from the psychology, computer and sciences faculties were selected in a multi randomized manner. 38.1% male (n = 141) and 61.9% female (n = 229), they were handed to fill the five scale test of self-esteem (SET) questionnaire. Finally, questionnaires data, demographic information and the averages of one semester past have been used for analysis. In analysis of data, one-way analysis of variance, t and Post-Hoc and regression analysis are applied.

Results indicated that significant difference is observed in self-esteem among male and female students. However, male students for family self-esteem received higher scores than female students (t=−2/12), p < 0.05). The students of the faculties of sciences, psychology and computer showed significant difference in self-esteem. Academic self-esteem with r = 0.29 and family self-esteem with r = 0/14 on the meaningful level of P < 0.05 had a direct and positive relationship with the academic achievement of students.

According to the results there was significant difference between total score of various faculties’ self-esteem. In the vector of family self-esteem, there existed significant difference between male and female students. Plus, there were meaningful positive relationships between academic and family self-esteem with academic achievement.

Continuous advances in psychiatric research and increased service users’ expectations led to the need to develop a new international framework for psychiatric training. The assessment of early career psychiatrists’ (ECPs) views has been emphasized as an important step of this process. However, at the moment, only few national studies have investigated ECPs’ opinions on received training.

To assess:

1. 1) ECPs’ satisfaction with training and self-confidence in different psychiatric domains;

2. 2) availability of clinical supervision and educational opportunities during training.

The Early Career Psychiatrists Committee of the European Psychiatric Association - in collaboration with the European Federation of Psychiatric Trainees, conducted an online survey among European ECPs. The Psychiatric Training Questionnaire, a multiple choice-answer self-reported instrument developed for this occasion, was completed by 194 respondents from 34 European countries.

Most respondents (73%) were completely or partially satisfied with the received training. Highest levels of self-confidence were reported in clinical psychiatry (93%), pharmacotherapy (68%) and emergency psychiatry (67%); the most problematic areas for ECPs were forensic psychiatry (68%), psychotherapy (63%) and child and adolescent psychiatry (57%). Thirty percent of ECPs were not assigned to a tutor for clinical activities, 67% did not receive any psychotherapeutic supervision and only 19% participated in exchange programs.

ECPs are globally satisfied with the training received; however, they report the need to enhance training in psychotherapy, forensic psychiatry and child and adolescent psychiatry, to ensure adequate supervision to all trainees and to improve the opportunities for international exchange programmes.

In 1952, the American Psychiatric Association published the “Diagnostic and Statistical Manual of Mental Disorders”. Four revisions have come since then, adding new mental disorders, while others have been removed. The fifth edition is currently in progress.

Comparing the diagnosis given to patients admitted for the first time to an Acute Mental Health Unit, over a period of 10 years.

Systematic review of first admission patients in our Unit in 2000 and 2010, comparing initial diagnosis.

Of a total of 60 patients found in 2000 and 69 patients in 2010, we found these differences: firstly the increased number of admissions seen in 2010; secondly the initial diagnosis, being Schizophrenia the main diagnosis in 2000 and Bipolar Disorder the most prominent in 2010. There's also a larger prevalence of Psychotic episode secondary to drug abuse in 2010.

Since the introduction of DSM-criteria more than 30 years ago, the aim to validate the syndromes and finding of common etiologies have been difficult to reach. Despite many “proposed candidates”, no laboratory findings have proved to be specific to identify any of the syndromes of DSM. Epidemiological and clinical studies have shown high comorbidity amongst the disorders, discounting the hypothesis that the syndromes represent different etiologies. Besides, epidemiological data have brought the fact of high degree short-term diagnostic instability for many disorders.

In our study we’ve reached the conclusion that there appears to be a clear diagnostic variability during the last decade.

Self-mutilation is a heterogeneous phenomenon. The more severe cases are usually associated with psychiatric disorders or with nervous system lesions.

Systematic research is missing, though there are cases that could be life-threatening.

Report of a rare case of a man who was mutilating his hands by biting.

The patient was a 66-year old male who had been mutilating his fingers for six years. This behaviour started as serious nail biting and continued as severe finger mutilation (by biting), resulting in loss of the terminal phalanges of all fingers in both hands. On admission, he complained only about insomnia.

The electromyography showed severe peripheral nerve damage in both hands and feet due to severe diabetic neuropathy. Cognitive decline was not established. The CT scan revealed serious brain atrophy. His behaviour was not associated with any major psychopathology or traits of personality disorder. He was diagnosed as suffering from impulse control disorder not otherwise specified. His impulsive biting improved markedly when low doses of haloperidol (1.5 mg/day) were added to fluoxetine (80 mg/day). The encouragement of his social life and the use of a mouth guard, in addition to his drug regimen, helped the patient in stabilizing the therapeutic effect.

In our patient's case, self-mutilating behaviour was associated with severe diabetic neuropathy, impulsivity and social isolation. The administration of an antipsychotic plus an antidepressant proved to be beneficial, only when it was combined with psychosocial interventions.

The analysis of peripheral sensory processes can help elucidate causes and effects of developmental disorders.

This study was conducted in order to evaluate the evoked electrical activity of the inner ear in response to kinematic stimuli in individuals with Attention Deficit Hyperactivity Disorder (ADHD).

The signal developed at the ear drum during a 1.5 second acceleratory period of right contra-lateral roll rotation, at 15 degrees per second, was recorded using the EVestG method for 6 ADHD affected individuals and 30 healthy volunteers, aged 18 years or older. Signals were analysed using the Neural Event Extraction Routine, which utilises the complex Morlet wavelet to identify local field potentials. The inter field potential intervals (IFPI) were calculated as the time difference between adjacent field potentials. For each subject, mean IFPI was calculated and then the mean of means was calculated for the ADHD and control groups. Results from 1 ADHD subject and 1 control subject were excluded from further analysis due to incomplete data or sizeable movement artefact.

The ADHD group exhibited significantly shorter, right ear, mean IFPI than controls (student test, p < 0.05). Furthermore, controls displayed a significant asymmetry (student test, p < 0.05) between mean IFPI for right and left ear responses, this asymmetry was absent in the ADHD group.

This study provides an indication of abnormal inner ear responses to kinematic stimuli in the ADHD affected population, though further studies are required to validate these results.

To facilitate assessment of fatigue-related symptoms, we developed a customized global assessment scale based upon the original CGI. The CGI is subject to scoring variability that can obscure the assessment of the intended symptoms. In this study, CGI-severity and Patient Global Impression of severity (PGI-S) for Fatigue instruments were developed to focus on “targeted” symptoms of fatigue. We have demonstrated that the CGI-S and PGI-S for fatigue are reliable and valid, as used in a psychiatric population.

56 subjects consented to participate. There were two clinic visits during which the CGI-S and PGI-S for fatigue rating instruments were administered. The MGH cognitive and physical functioning questionnaire (MGH-CPFQ), a validated self-rated scale was also used as a validation instrument. The patient-rated MGH-CPFQ and PGI-Severity for fatigue preceded the clinician-rated CGI-S at screen and the CGI-S and CGI-Improvement (CGI-I) at the second visit.

Most subjects revealed mild to moderate levels of fatigue associated with a range of Axis I psychiatric disorders. Clinical and Patient Impressions of fatigue were well correlated. Both CGI-S and PGI-S for fatigue were well correlated with the CPFQ. At the second visit the CGI-S for fatigue revealed temporal stability in the test-retest assessment. The correlation between CGI-S and PGI-S remained high (r = 0.61) as did convergent validity for the CPFQ (r = 0.74 for CGI-S and 0.61 for PGI-S).

In this study, we have demonstrated that the customized CGI-S and PGI-S for fatigue are reliable measures of fatigue in this population of psychiatric patients.

The safety of trainees is a key concern within any psychiatric training scheme. The Royal College of Psychiatrists has suggested respective national standards.

To audit compliance with standards related to the safety of psychiatric trainees within a Mental Health Trust in the United Kingdom.

All trainees working within the Mental Health Trust were identified. A questionnaire was developed based on nationally suggested standards and sent to all trainees. To obtain the optimum response rate and ensure ease of distribution, a web-based survey tool was used.

44 responses to the questionnaire were received from 70 trainees (response rate 63%). Most trainees (62%, n = 26) had received information on local safety policies. Largely the participants (64.3%, n = 27) had guidance on maintaining personal safety, and 78% (n = 32) carried an alarm when in inpatient areas.

It is recommended that psychiatrists should not visit private dwellings alone if an emergency, and never at night. Most trainees (90.2%, n = 37) had not being asked to do an emergency assessment alone.

With regards to interview rooms both in and out of hours, most areas met the required standards.

Our survey showed that although most standards related to the safety of trainee psychiatrists were met, there was scope for improvements in induction, training and the use of monitoring arrangements and alarm systems in outpatient settings. The survey designed for this study has scope for replication in other psychiatric and non-psychiatric (accident and emergency) settings, where doctors’ safety may be a concern.