Suicide attempts/thoughts are common among psychiatric inpatients and they are burden for the individual, the family and the health system. According to published reports, suicidality in Greece has increased significantly, because of the current economic crisis.

Examine the profile of psychiatric inpatients of the Psychiatric Department of the University Hospital of Crete(PD/UHC), presenting with suicide attempts/ thoughts.

Identify risk factors associated with attempted suicide or suicidal thoughts.

One hundred forty four out of 444 (33%) inpatients admitted in the PD/UHC between Nov 2011- Aug 2012 presented suicidal attempts/thoughts. Data were analyzed using the Pearson's chi-square test and multivariable regression models.

Major Depression, substance abuse, female gender and having a spouse were associated with suicidality in the entire group. Because there was an interaction between gender and having children, the analysis was stratified by gender. Risk factors for suicidality in men were having children (OR=2.26) and shorter time since onset of illness (OR= 0.96), and in women having a spouse (OR=2.47). Low income and unemployment were not significant predictors of suicidality.

Major Depression, substance abuse, female gender, family status and recent onset of illness appear to be risk factors associated with suicidality in psychiatric inpatients. Unemployment/low income, did not correlate with suicidality. Our findings do not support the popular belief of increased suicidality due to the current economic crisis. Finally, there is a need for further understanding of how family, its dynamics and potential stressors associated with it, may influence suicidality.

Psychotherapy requires clinical supervision. This is systematic guidance of a therapist by a supervisor. Inevitably, there is a question of training new high-quality therapists. This is related to supervision of their basic training. Beliefs and attitudes toward supervision in CBT could change during CBT training.

Our study was concentrated in mapping of the expectations from supervision of participants of CBT training in two different phases of training course (after 1st year of the training and after 4th year of the training) and expectation from supervision in participants of training in CBT supervision. As an assessment tool was used the Attitudes and Beliefs about Supervision Scale (ABSS). The expectations of probands with different experience in supervisor were compared to find out the similarities and the differences of the expectations.

The results showed that the students of Supervisory training (n=16) stress especially self-reflection and structure of supervision, Beginners in CBT training (n=36) stress counseling and planning of therapeutic strategies, and Advanced in CBT training (n=34) prefer higher understanding of transference and conter-transference and learning according the model. Surprisingly the self-reflection and therapeutic relation were evaluated as a most important by all groups.

Supported by grant IGA MZ CR NT 11047-4/2010.

Little evidence is available on the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immuno deficiency virus (HIV) in mentally ill populations. In April 2012 routine offering of testing for HBV, HCV and HIV of all individuals admitted at Broadmoor, a maximum secure psychiatric hospital, was introduced.

To elicit screening rates of, and to determine the prevalence of HBV, HCV and HIV in the inpatient population at Broadmoor Hospital.

To critically assess the identification process of blood-borne viruses (BBV) in order to improve patient care.

Retrospective data collection via the electronic patient record (EMIS) ascertained the proportion of the 198 inpatients offered screening and ultimately tested for HBV, HCV and HIV inclusive from April 1st 2012 to September 22nd 2012.

The proportion offered screening for HBV was 95% (189); for HCV was 94.9% (188) and for HIV was 92.9% (184). 129 patients were screened in each hepatitis group and 123 in the HIV group. Within the population of Broadmoor were three cases of HCV, one with HIV and zero with HBV.

This is a group at high risk for BBV infection and with a length of stay of up to five to six years it is important to identify those infected in order to instigate treatment and mitigate risk to both patients and staff. This study demonstrates rigorous screening for BBV is critical and will therefore necessarily impact on planning services for the future.

The scales for the assessment of depressive symptoms, translated and validated in Italian, lacks in the recognition of the psychopathological nuances of the disorder. The Bipolar Depression Rating Scale (BDRS) is a tool specifically built to reflect the characteristics of bipolar depression.

Screening criteria:

1. - aged 18–65 years

2. - diagnosis of BD (DSM-IV-TR) (125 patients) or

3. - diagnosis of MDD (DSM-IV-TR) (30 patients)

4. - manifestation of depressive symptoms

5. - no further psychiatric comorbidity on axis I and axis II (including abuse/addiction)

6. - no serious cognitive deficits

Psychometric battery:

• Bipolar Depression Rating Scale (BDRS),

• Hamilton Depression Rating Scale (HAM-D),

• Montgomery-Asberg Depression Rating Scale (MADRS),

• Young Mania Rating Scale (YMRS).

The analysis of the BDRS scores, according to the Kolmogorov-Smimov method shows a normal distribution; the α Cronbach's coefficient shows that the the scale, in its Italian version, has considerable validity and reliability (r = 0.82). The factor analysis was verified using the Varimax rotational method: after several tests, we found 2 subscales, one linked to mixed/depressive symptoms and a second related to (hypo)manic symptoms.

The BDRS is a valid scale for the measurement of depression in patients with Bipolar Disorder, with a notable internal consistency (Cronbach α 0.82), a significant consistency between items/total (Cronbach α from 0.80 to 0.82) and positive correlation with other scales (MADRS r 0.67, p < 0.001; HAM-D r 0.81, p < 0.001; YMRS r 0.46 p < 0.0001), including the Young Mania Rating Scale (better than the original validation sample Berk et al., 2007).

A suicide attempt is an major event that creates harm on both family and close relatives, that can be measured in terms of traumatic stress and medico-economic impact (costs). Each year, 3.750.000 French people are concerned by a suicide attempt of a relative (or close person).

Male or female, older than 16, being a relative of a suicide attempter (i.e. living in the same house as the suicide attempter). 171 families were included (171 suicide attempters and 171 « family informants »). These subjects were compared to IRDES datas on French population (Institute of Research and Documentation on Health Economy ; sample of 20.000 subjects, representing 95% of the French families). All subjects were reassessed by phone at 3 month and 1 year.

80% of the relatives declare “being fine” at 1 year; the 20% that declare being “not so well” are important to qualify, the sooner after the suicide attempt. An explicative model trying to evaluate the risk of being “not so well” at 1 year is possible ; this model is highly represented by the psychotraumatic impact of the confrontation with the suicide attempt.

On the economic plan, we can observe a great stability in healthcare contacts at 1 year (hospitalizations, GP or Specialists contacts, other kind of care contact…), contrasting with a big increase in medication use (× 2.37 in comparison with IRDES population); all the medication types being concerned, psychotropic and others.

The question of a self-medication partly unconscious is raised.

For our investigation we observed 167 patients with paranoid schizophrenia according to the criteria of ICD 10. Patients were randomized into 3 groups. Patients of 1st group (n = 52) received sertindole monotherapy 16–20 mg per day, patients of 2nd group (n = 67) received paliperidone 9–12 mg per day and fluvoxamine in combination with zuclopenthixole depot 150–200 mg per day.

Social functioning in patients with schizophrenia significantly improved in all three groups especially in group №3. We suppose that it was connected with activating activity of fluvoxamine.

Thus the results of the study indicate the significance of differences of dynamics of neurocognitive deficit in schizophrenia and the importance of choice of biological therapy for correction of neurocognitive deficit in patients with schizophrenia.The use of modern atypical antipsychotics and drugs which can influence on sigma-receptors can restore the social functioning in young patients with schizophrenia.

The rate of non-suicidal self-injurious behaviors (NSIB) is reported to be between 12–35% of adolescents. The previous studies revealed that around 9% of adolescents admitted to attempting suicide.

The aim of the study was to determine the lifetime incidence of suicidal ideations, suicide attempts (SA) and NSIB in girls diagnosed with Conduct Disorders (CD) who were educated and treated in Youth Sociotherapy Center (YSC).

42 girls aged 13–18 years suffered from CD participated in the study. All participants were residents of YCS due to previous educational and behavioral problems or juvenile delinquency. Based on psychiatric and psychological examination, medical and psychiatric history, the lifetime incidence of suicidal thoughts, SA and NSIB were estimated. The age of onset of symptoms and behaviors was also assessed as well as numbers of SA and NSIB.

Among the studied group 20 (47.6%) girls confirmed the occurrence of suicidal ideations, 9 (21.4%) patients SA and 26 (61.9%) NSBI during their lifetime. The median age of onset of both SIB and SA was 13 years. Median numbers of SA and NSIB was 4.4 and 12 respectively.

Adolescent girls suffered from CD are at high risk of early onset and recurrence of suicide attempts and nonsuicidal self-injurious behaviors.

The sample comprised 542 adolescents with 218 females (40,2%) and 324 males (59,8%). The mean age was 15,5 years. The main experimental group (46 adolescents) included only those respondents who had high levels of Internet addiction combined with the objective data from the questionnaire. The control group consisted of adolescents with no signs of Internet-dependent behavior of comparable age and sex (213 adolescents).

The group of adolescents with Internet-addictive behavior revealed the predominance cyclothymic, labile, asthenoneurotic, sensory, anxiety-pedantic, introverted, excitable, demonstrative and unstable types. We suggest that when characterological traits reach a level of accentuation, that becomes the factor associated with the formation of Internetaddictive behavior. The adolescents with problems of using the Internet show the general emotional instability, the tendency to experience the polar emotions simultaneously; they are excitable and have the aggressive style of communication. One of the main features of their characters is sensitivity to the danger, anxiety that caused the need to escape from the “harsh” reality. It could also be proposed that the adolescents with Internet addictive behavior separate emotions and cognitions, physicality and mentality. They isolate their own feelings and attach greater importance to the intellect. That cause the feeling of themselves as the subjects, more to do with information than with emotions, which could be poorly understood and classified.

The task of supervision is to increase the value of the therapeutic process in patient's best interest. There are many ethical questions rising in supervisors thinking about patients and also about therapist during CBT supervision.

The first aim was review the literature about ethics of CBT supervision and to compare the attitudes and belief about ethical questions in trainees of CBT a CBT supervision. The second aim was to find if there were any relations between ethical self-reflection and therapeutic skills of CBT trainee.

The first method was narrative review. A literature review was performed using the National Library of Medicine PubMed database, Scopus and Web of Science, additional references was found through bibliography reviews of relevant articles up to July 2011. Databases were searched for articles containing the following keywords: cognitive behavioral therapy, therapeutic relationship, training, supervision, ethics, self-reflection. The review also includes information from monographs referred to by other reviews. The second step was using the self-reflect questionnaire about ethical questions and assessment of the therapeutic skills of CBT trainees by their CBT trainers.

Strengthening ethical self-reflections in supervisees is valuable way of improving the development of ethical aspects of professional growth throughout all stages of their career. Training and supervision focused on self-reflection on ethical aspects are beneficial to both supervisees and their patients. Preliminary results show, that therapist with high level of ethical self-reflection are significantly better in therapeutic skills assessed by trainees.

Supported by grant IGA MZ CR NT 11047-4/2010.

Suicide seasonality with a peak incidence in spring or early summer has been consistently reported. Although a quite robust finding this spring peak of suicides is poorly understood. The effect of climate parameters such as sunlight, temperature, humidity etc. on hormones and neurotransmitters such as serotonin has been hypothesized to explain the seasonal variation in suicide.

To examine the amplitude of suicide seasonality in relation to sunlight duration and serotonergic medication.

By using Swedish Registers we gathered information including forensic data on antidepressive medication for 11,845 suicides during 1992 to 2003. Moreover, data for sunlight duration for the same period for all Swedish counties was obtained from the Swedish Meteorological and Hydrological Institute. The presence of suicide seasonality was estimated with a Poisson regression variant, in three groups, as defined by tertiles of sunlight duration.

In regions with low sunlight duration no statistically significant seasonality pattern was found for men independently of medication. In regions with middle or high sunlight duration an increased amplitude of seasonality was observed among men treated with SSRIs in a dose dependent pattern. Such a pattern was not observed among suicide victims on other antidepressant medication or those without an antidepressant. Women on the other hand showed a seasonal variation in suicide only in regions with low sunlight duration.

Suicide seasonality amplitude increases with higher sunlight duration especially in men treated with SSRIs. In women, the highest suicide seasonality was observed in regions with the lowest sunshine duration.

To analyze the quality of life (QoL) of war veterans in Bosnia and Herzegovina (BH) with posttraumatic stress disorder (PTSD), to analyze the interrelationship of certain segments of the quality of life and intensity of symptoms of PTSD and to analyze the interrelation of individual segments of the quality of life and overall functionality of the war veterans with PTSD.

The paper analyzed the 60 war veterans who were treated at the Department for Psychiatry Tuzla, in the period March-August, 2007, and who were diagnosed with PTSD. The control group comprised of the 60 war veterans employed as active military personnel in the Army of BH, who were not on the screening test showed that they have PTSD and who were not psychiatric treated. QoL was assessed with standardized scale The Manchester brief assessment of the QoL, and the level of severity of PTSD symptoms and the presence of PTSD at the time of the interview was assessed with Harvard trauma questionnaire, combined versions for Bosnia and Herzegovina and for Croatia.

The results of this survey indicate that the war veterans with PTSD had significantly worse QoL across all domains, as measured in almost total in relation to veterans who do not have PTSD. All individual symptoms and clusters of PTSD symptoms were negatively correlated with self-assessment of all segments of the QoL of war veterans.

The war veterans in post-war BH with PTSD had significantly worse QoL across all domains, related to veterans without PTSD.

Criminality is common among patients with severe mental disorders and/or substance use disorders (SUDs).

To study the incidence of imprisonment among psychiatric inpatients along with their diagnoses patterns and survival.

This is a nationwide register based study of all psychiatric inpatients admitted in Iceland between 1983 and 2007. The database contained information on discharge diagnoses, imprisonment and cause of death when relevant. Cumulative incidence of imprisonment was calculated using the Kaplan-Meier method. Using a nested case-control (1:3) design, survival was analysed with Cox-proportional hazard ratio model. Controls were similar regarding age, year of admission and discharge diagnoses. All analyses were done separately for men and women.

Men admitted at ages between 18 and 30 had 21% cumulative incidence of incarceration over a 20-year period. For women the corresponding figure was 6%. Most common discharge diagnoses of those serving a sentence in prison were SUD and/or personality disorder. Among men, adjusted hazard ratio (HR) for risk of death was 2.0 (95%-confidence interval (CI): 1.5–2.6) and for women 1.3 (95%-CI: 0.5–3.5).

Imprisonment is common among psychiatric inpatients. This group represents individuals with long-term problems and specific treatment needs. Mortality was significantly increased for men while there were to few women in the cohort to establish meaningful HR for risk of death.

Deficits in social cognition, especially in Theory of Mind (ToM) and empathy, may contribute in poor social functioning of patients with bipolar disorder (BD).

Previous studies have found impaired empathy in euthymic patients with bipolar disorder using self-report measures of empathy. However, evidence on the neuropsychological processes that underlie empathic abilities in BD is scarce.

The aim of the study was to assess empathy and ToM abilities in euthymic BD using both self-report and neuropsychological measures.

Fifty-seven euthymic BD patients and 53 healthy control subjects completed the Empathy Quotient, a self-report measure of empathy. A multi-level battery of ToM tasks was applied in all study participants, including First order false beliefs stories, Hinting task and Faux Pas Recognition Test (FP). Besides the ability to recognize Faux Pas, three specific components of ToM were assessed with FP: the affective ToM, the cognitive ToM, and the emotional perspective taking. The two groups were matched for gender, age and education.

Patients with BD reported significantly lower levels of empathy than healthy controls. There was no significant difference between the two groups in the First order false beliefs and Hinting task scores. Patients had significantly lower score than healthy controls in FP recognition and cognitive ToM. However, there was no significant difference between the two groups in affective ToM and emotional perspective taking.

Deficits in higher order ToM were found in the euthymic BD. These deficits might have important contribution to empathy impairments found, using self-report scales.

Internet-based therapy typically involves the interaction between a consumer and therapist via the Internet and incorporates the use of a structured Web-based treatment program for consumers to access in conjunction with therapist assistance (usually by email. Over the past decade, Internet-based treatments have been found effective for a variety of physical health conditions and mental health disorders, such as headache, encopresis, tinnitus, depression, panic disorder, social phobia, GAD and posttraumatic stress disorder.

The purpose of this open study will be to test the efficacy of therapist-assisted internet 12 module 4 month long selfhelp program based on cognitive behavioral approach (IB-CBT) with the treatment as usual (TAU) for bipolar affective disorder patients who are medicated with thymostabilisers.

Participants who recruit from the patients of the Psychiatric clinic Olomouc at time of start the maintenance pharmacological phase of the treatment of bipolar affective disorder will be randomized to the TAU (treatment as usual) and IB-CBT (12 modules of internet based CBT+ TAU). All participants will complete a clinical diagnostic interview, and a set of questionnaires to assess affective symptoms at four time periods (start of the maintenance treatment period and at follow up: 6 month, 12 month and 24 month. The study will be done in open conditions.

The results from the start of the maintenance treatment period will be present.

The existence of age-normal are causes the special features of sexual dysfunction. At a young age (18-30 years) is characterized by the development and formation of the sexual function. It is for this age period is characterized by the influence of media on the psycho-emotional state - admass, and as a consequence, the development of psychogenic sexual dysfunctions. Propaganda regular and undying of male strength is cause the formation of personality conflict.

35 patients were examined in this age range. Analysis of the data revealed that most patients were observed ejaculation disorder, (which was associated with increased sexual arousal) and erectile dysfunction, due to a number of reasons (personal characteristics, the nature of psychological trauma).

At a young age, there is an active search for a regular sexual partner. Unsuccessful attempts to prove their sexual viability leads to the formation of non-adaptive systems of personality that was the cause of sexual dysfunction. Is aggravated sexual dysfunction picture of perfectionism. The emergence of sexual dysfunction was also due to misconceptions about the norm of sexual activity. Thus formed resistant obsessive fear of impotence. Patients in this group rarely share their problems in sexual life with a partner, because they fear for their dignity and fear seem weak, vulnerable.

The development of sexual dysfunction is largely determined by personality traits of the individual. Thus, in patients aged under 30 years at the base of sexual disorders lying psychogenic factor. The degree of which depends on the personality characteristics.