Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries.

Medical students’ attitude toward psychiatry has been pointed as a predictor of recruitment. Several studies reported the positive effect a clerkship has on the student's attitude towards psychiatry. This effect is particularly visible in clerkships that promote students to participate in the direct delivery of care.

To evaluate the medical students’ perception of psychiatry, and the impact on their intention to pursue psychiatry as a future specialty.

Two self-report questionnaires (Balon,1999) were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship.

153 students were assessed. After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry.

However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students.

Clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality.

Cross-sectional population studies often suffer from unobserved individual heterogeneity (e.g. genetics or unobserved predisposition to adopt healthy lifestyle) contaminating the estimate of social inequalities on well-being. Accurate estimates of risk factors for impaired quality of life using large epidemiological studies may help to develop services for older people in the community.

We examined the effect of socio-demographic characteristics, lifestyle choices, smoking status and their impact on quality of life in non-institutionalised older people in six-year follow-up.

English Longitudinal Study of Ageing is current and ongoing longitudinal population studies in England over three waves (2002 = 9,953; 2004 = 8,411; 2006 = 8,411) were recruited. The study collected data on the personal, economic, psychological, and social circumstances of aging from a national sample of the non-institutionalised adults aged 50 years or more living in England. Quality of Life was measured using the CASP-19.

Determinants of quality of life using CASP-19 as the dependent variable were: female gender (beta = 1.19, p < 0.0001), younger age (beta = -0.56,p < 0.001), self-reported health (beta = -4.34, p < 0.0001), separation/divorce (beta = 0.81 p < 0.0001), monthly income (beta = -0.91, p = 0.01), accumulated wealth (beta = -0.094, p = 0.01), current smoker (beta = 0.34, p = 0.01 and socioeconomic ladder (beta = -0.115, p = 0.001).

Female gender, younger age, poor self-health reported status, family disruption, active smoking and income were predictors of impaired quality of life. Studies are needed in how to address these socio-economic related factors, social habits and smoking to improve the well-being of older people.

Compared to the general population, mentally ill patients might have additional risk factors for thrombembolism that can lead to sudden deaths. Several studies suggest a significant relationship between mental illness and death due to pulmonary embolism.

Our study evaluates the causal part that might have mental illness and different physical and medical treatments in the sudden deaths due to pulmonary embolism in mentally ill patients.

We conducted a retrospective study on the autopsies of patients admitted to Razi Hospital for psychiatric illness and who died during their stay in hospital from January 2000 to December 2010.

38 patients died during their stay at Razi Hospital during the studied period and had the origin of death identified by autopsy. Average age at the moment of death was 42,31 years, 58% were male, 40,5% suffered from physical illness before their admission to psychiatric hospital, 65% were tobacco-smokers. The most frequently found psychiatric diagnosis (41,7%) was Schizophrenia. First generation antipsychotics were mostly prescribed to patients (87,5%). Pulmonary embolism was the cause of death of 6 of our patients which equals 15,78%. Amongst these 6 patients, two suffered from Major Depressive episode with psychotic features, the remaining suffered from schizophrenia.

Several of the modifiable and non modifiable risk factors for thromembolism found in psychiatric patients and mentioned in literature are also found in our study. Identification of these risk factors is necessary to avoid premature death of mentally ill patients.

Fibromyalgia is characterized by diffuse musculoskeletal pain, fatigue, sleep disturbance, headaches, and cognitive and affective disturbance. The aetiological pathway is not clearly understood nor is there a clearly defined pathophysiological profile for the disorder that distinguishes it as a diagnosis.

To investigate the efficacy of 20 mg escitalopram monotherapy in management of depressive symptoms, pain, fatigue and sleep.

To demonstrate efficacy of escitalopram in improving depressive and pain symptoms as measured by primary and secondary outcome measures.

60 subjects were randomized to treatment or control group and evaluated at 4,8 and 12 weeks using MADRAS, McGill pain questionnaire, fibromyalgia impact score and sleep questionnaires.

Mean MADRAS score was significantly lower in the treatment group (14.96 ± 1.02 vs 18.12 ± 1.05; p = 0.03) as compared to the control group. When the change from baseline on MADRAS score was compared between the groups, the reduction was even more apparent in the treatment group (−12.49 ± 1.48 vs − 4.77 ± 1.54; p = 0.001).Mean FIBROMYALGIA score was significantly lower in the treatment group as compared to the control group (54.20 ± 2.09 vs 64.93 ± 2.14; p < 0.001). The reduction was much higher in the treatment group than the control group (−21.31 ± 2.94 vs − 2.79 ± 3.03; p < 0.001).

Positive statistically significant results for treatment group on all primary outcome measures of MADRAS and fibromyalgia impact score questionnaire.

To evaluate effect of Rosacea and Jasminum Sambac Sol essence on labor pain and duration of active phase.

In this randomized control trial study, which had done in Insurance hospital of Bandarabbas (2010), 240 healthy volunteer 17–35 years old primiparas during physiologic labor were involved. They randomly divided into three groups (Rosacea, Jasminum Sambac Sol, Routine physiologic labor). The essences were used in the environment by lightening the aromatherapy candle. The tools had three main parts of personal characterizes, check list of labor control chart, and Visual Analog Scale of pain score.

There were significant differences between duration of active phase in three groups (P < 0.05) and no significant differences between labor pains.

Aromatherapy during physiologic labor could promote clients’ satisfaction, useful for shortening of Lobar, which may be because of more relaxation.

To examine the pain relieving effect of breast feeding during DPT immunization injections in healthy neonates.

76 healthy 2– 4 months years old term infants, which had been brought to the health centers of Tehran University of Medical Sciences in West of Tehran for DPT vaccination by their mothers was involved in this randomized controlled trial study. (Their parents signed informed consent, Year 2008–2009) By randomized collection one group were breast-fed, 2 minutes before, during, and 15 seconds after the DPT immunization injection, and second group according to routine of clinic lied on the examining table during DPT Vaccination. Objective changes in appearance of Neonates were assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization till 15 second after it.

The equality between two groups according to age, gender and the time of feeding prior to vaccination were checked, there weren’t correlation. There were significant differences in Behavioral Pain Scores of two groups in all parts include: facial expression (4 items), cry (5 items), and movements (6 items). (P < 0.0001)

Regarding to significant difference in behavioral of Pain responds in two groups, it is suggested that, with simple and safe intervention of straight breast feeding, health care workers, and physicians reduce pain during immunization and muscular injections too.

We recently reported (EPA 2011) that one factor of the Eysenck Neuroticism Scale (EPI-N) represents Mood Instability (MI) that was a significant predictor of suicidal thoughts.

To increase our understanding of MI in psychological distress we examined a national sample with longitudinal follow-up:

1. 1. To determine whether factor analysis of the EPI-N scale yields a MI factor.

2. 2. To determine whether the MI factor predicts psychological well-being at follow-up.

British Health and Lifestyle survey (1984) (N = 6,124) individuals that completed both of the following questionnaires. 3,232 individuals were followed in 1991–92.

Eysenck Personality Inventory consists of 57 items that includes the EPI-N with 24 items. The General Health Questionnaire (GHQ) is a 30-item scale used to measure psychological distress in the community.

The EPI-N was factor analyzed and the extracted factors were entered as predictors of GHQ (1991) in a linear regression model, while controlling for baseline (1984) GHQ score and important physical health and socio-demographic variables.

We replicated the 3 factors of the EPI-N, the second factor represented MI. The other two factors represented mild symptoms of anxiety and depression. The 3 EPI-N factors (Including the MI factor), GHQ, hypertension and forced expiratory volume (1984) predicted GHQ (1991). Age, sex, marital status, occupational class, and household income were not predictors.

MI is the salient and distinct feature of neuroticism. MI may be a more clinically and empirically useful concept than “neuroticism” and is a fertile subject for clinical and basic research.

Paliperidone ER recommended therapeutic range is between 3 – 12 mg once daily. In this poster presentation we will describe a case in which, for self-medication, therapeutic efficacy was achieved at higher doses.

Mr. M.G. is a thirty-nine year old man that lives with his parents and has a diagnosis of borderline personality disorder (DSM-IV-TR) presenting paranoid ideation, instability, impulsivity, emptiness, sexual promiscuity, drugs consumption.

During the last hospitalization in his referral of Psychiatry unit (May 2011), routine blood tests were within normal range; at discharge in the community, Paliperidone ER 9 mg/day was prescribed. At the first out-patient visit, as the clinical picture appeared unchanged the psychiatrist continued with the same therapy. At the second check-up, severity of symptoms was reduced, and M.G. reported to have taken for more than a month, on his own initiative, the double dose of Paliperidone ER (18 mg per day divided into two daily intakes); as the therapy was effective and well tolerated the psychiatrist chose to continue with the same therapy at the same dosage.

After 4 months (September 2011) the clinical picture is further enhanced.

At each stage the client was assessed using: CGI (stage-one = 6,4,09; stage-two = 6,4,09; stage-three = 4,1,05; stage-four = 4,1,01), BPRS (95-94-62-41), HDRS (33-33-15-2), HARS (48-40-14-1), SOFAS (25-30-55-60), PSP (25-30-61-70); BPDSI: 476 at the admission, 163 actually.

This study highlights the case of the patient in achieving a significant improvement in symptoms at a dose of Paliperidone above the upper limit of the recommended range. Further studies are required.

In 2007 the Mental Health Act in England and Wales was amended and the definition of Mental Disorder was broaden. This change affected people with Personality Disorders who now can be admitted for hospital treatment without consent.

This poster reviews research on the different perspectives about the new law.

To clarify this subject by examining the attitude of contemporary psychiatry with regard to the interfaces between Personality Disorders and the new law.

MEDLINE and PsycINFO databases were searched for all English-language articles published between 2008 and 2011 containing the keywords “Personality Disorder” and “Mental Health Act” Additional key articles published before 2007 were reviewed. The most relevant articles were selected for review.

There is still no common consensus in regard to the benefit of compulsory admission to hospitals of people with Personality Disorders. Some of the most frequently encountered difficulties and ambiguities are around the definition of Personality Disorder, clear diagnostic criteria and lack of effective treatment.

Personality traits are associated with the vulnerability for developing psychopathology namely depression and anxiety disorders. How personality traits are reflected in the brain's structural and functional architecture is the main focus of personality neuroscience (DeYoung & Gray, 2009). Dimensions of human personality described by the Big Five personality trait taxonomy were already associated with specific neuroanatomic and neurofunctional correlates. However identifying brain correlates of a situation-independent personality structure would require evidence of a stable default mode of brain functioning associated with the different personality dimensions.

In this study, we investigated the neural correlates of the Big Five personality dimensions (Extraversion, Neuroticism, Openness/Intellect, Agreeableness and Conscientiousness) in what is probably the main brain resting state network - the default mode network (DMN).

Forty-nine healthy adults completed the NEO-Five Factor Inventory (NEO-FFI) and were scanned during a task-free fMRI acquisition.

Personality dimensions of Openness/Intellect, Agreeableness and Extraversion were positively correlated with the DMN and negatively correlated with the dorsolateral attention network. Neuroticism was found to be positively correlated with the right middle cingulate gyrus, while Conscientiousness did not correlate significantly with any of the typical DMN regions.

This study confirms previous data on the neuroanatomical correlates of the Big Five personality dimensions, and expands our understanding of this relationship by showing that different personality dimensions are associated with specific patterns of activation while the brain is in a default mode.

Caring to a dependent person can suppose a risk for the caregiver's psychological health (Pinquart & Sorensen, 2003). This risk is clarified by the individual differences in personality (Hooker, Frazier y Monahan, 1994). They are stable although non-definitive personal characteristics, and their variability in efficiency depends on context (Millon, 1994). The processes involved in caregivers’ adaptation can facilitate or not a good general psychological adjustment (Limiñana, Corbalán & Calvo, 2009).

To explore which caregiver's characteristics predict a better psychological adjustment.

To discriminate what characteristic of which is considered suitable to care of others contribute to caregiver's better functioning.

205 family and formal caregivers (mean age = 39.8; SD = 14.03; 83% formal caregivers) completed the Millon Index of Personality Styles (Millon, 1994), that assess normal personality and offers a Clinical Index, to evaluate psychological adjustment; and the CUIDA (Bermejo et al., 2008), a questionnaire of the adequate affective and cognitive variables to offer a good care of to others. Multiple linear stepwise regression was carried on.

Caregiver characteristics related to Independence and Altruism explained worse psychological adjustment, whereas Self-steem, Sociability and Emotional balance explained better personal adjustment (R2 = .596; F = 7.466, p < .001).

Some personal characteristics that could be important for caregiving could not facilitate a good psychological adjustment in some caregiving contexts. Personal adaptation, as defined here, depends on context.

A personality disorder is a sustainable pattern of perception, cognition and relationship with the environment and one's person, pervasive, maladaptive and inflexible, affecting important areas of the individual's life functioning. Specialized studies in the field describe a high rate of heritability of the personality disorders and the importance of these parent personality disorders in the development of the child, including the development of psychopathology.

The purpose of this study was to assess the frequency and type of personality disorder in parents of children with psychiatric pathology and to identify a relationship between personality disorders in parents and internalizing/externalizing problems in children.

The study was conducted on two groups of 30 children and their parents, the first batch of children with internalizing problems and the second with children with externalizing problems, hospitalized in the Pediatric Psychiatry Clinic from Cluj-Napoca during April-September 2011. We used as instruments for assessment the psychiatric interview, SCID-II and CBCL. Data processing was done with SPSS version 17.

We revealed a relationship between the avoidant, obsessive-compulsive, schizoid and depressive personality traits of the parents and psychiatric disorders in children.

Personality disorders are relatively common among parents of children with psychiatric diagnosis. For these reasons therapeutic relationship and plan for children should be made by taking into account the presence of the personality disorder of the parent.

The purpose of the study was investigation of personality traits and learning methods in distance education university students.

The statistical populations were 421 distance education and nongovernmental university students that were randomly selected and responded to Kolb learning styles inventory (LSI) and five - factor personality test (NEO - FFI). Data were analyzed with descriptive statistics (mean, variance and standard deviation) and inferential statistics with independent T test.

Findings showed significant differences in personality components in two groups. This means that distance education university students have more scores in Neuroticism, Extroversion and Openness to new experiences than nongovernmental university students. But there is not differencein learning methods in tow groups.

In contrast to prevailing pathology/symptom targeted treatements, Lifetrack therapy targets underlying Borderline Personality directly, through ‘Breakthrough Intimacy’ - closeness between committed couples far greater than their previous maximum experiences, without drugs, and often within 6 months - transforming borderline personality into a positively well-adjusted personality.

Lifetrack therapy works with couples (the patient, his/her partner in life) bringing them far closer than their previous maximum level, guided by their own daily self-rating on 41 parameters, that allow accurate graphic tracking via Internet of subtle changes in their personalities during each therapy session. This approach frees the therapist from transference (counter-transference) issues, which is the principal obstacle in treatment of borderline personality disorder. Working in three-way teamwork, the therapist actively helps the couple to achieve closeness far greater than their previous maximum level, overcoming waves of defense (spikes of anxiety, anger, physical-symptoms, depression, and psychosis) until it disappear by exhaustion, usually without medications, as couples undergo personality transformation.

The patients typically go through four distinct stages in the process of personality transformation, with stage-IV representing complete transformation. Of the 224 BPD diagnosis confirmed patients, 34% reached stage-IV, 16% reached stage-III, and 14% reached stage-II at the time of termination. 15% improved without going through typical four stages. However, 11% remained in stage-I and 16% remained in stage-0 at the time of termination. Patients with partners did 10 times better than singles (in improvement beyond their previous maximum adjustment levels according to their self assessment).