Intersubjective experience and phenomena addressed in psychiatric diagnosis are not available to standard scientific research. Many authors focused on intersubjectivity and the analysis of their work helps informing and clarifying how to address these facts.

This presentation aims to review the works of A. Shultz, C. Jaspers, F. Buytendijk, M. Heidegger, M Scheler (and others) on intersubjectivity in a phenomenological standpoint.

Approaching intersubjectivity from a phenomenological standpoint and its relations with current problems of psychiatric diagnosis and research.

Selective analysis of literature on phenomenological enquires of intersubjectivity in the field of Philosophy and Psychiatry

Research in psychopathology and psychiatry must neither treat intersubjective data as residuum nor try and reify data that resists reductionism and mechanistic explanations. Intersubjectivity is inherent to the meaning of psychopathological understanding and phenomena

There is need for new methods of enquire for many data in psychiatry. Researchers and clinicians must find new ways to deal with psychiatric objects and with relational data.

To illustrate the targets and the severity of the aggressive incidents in a forensic psychiatric setting.

The study was conducted in a forensic psychiatric setting at Psychiatric Centre Sankt Hans. It utilizes data from the three year period between 2008 and 2010. Staff Observation Aggression Scale Revised (SOAS-R) is used to examine all aggressive incidents during the period mentioned.

212 patients were admitted between 2008 and 2010. The majority being mainly men (98.6 %) with a diagnosis within ICD10 F20-F29 (79.7 %). In total there were 1507 recorded aggressive incidents of whom 63.2 % were registered with at least one aggressive incident. The most prevalent trigger of aggression was related to patients being denied something (45.9 %) and the staff is the primary target of the aggressions in 64.4 % of the incidents.

Mean severity score we found to be 10.12 (SD 4.84). According to the severity of the aggressions, we found 61.5 % of the reported incidents, with a severity score ≤ 9, symbolizing more severe aggression. We found abusive patient to be significantly more aggressive (OR 3.47 p = < 0.001), but no difference in the severity score between the abusive patient and the non- abusive patient was found (p = 0.28).

Aggression is a prevalent phenomenon in a forensic psychiatric setting in Denmark. The Majority of the aggressive incidents are characterized by being severe, but not necessarily related to abuse. The staff was the primary target of the aggressions.

To illustrate different perspectives on staff factors and aggression in forensic psychiatry.

The study was conducted in a forensic psychiatric setting at Psychiatric Centre Sankt Hans. It utilizes data from the three year period between 2008 and 2010. Staff Observation Aggression Scale - Revised (SOAS-R) is used to examine aggressive incidents during the period mentioned.

Out of 244 employees in a three year period and based on 1507 incidents, 91.6 % have registered at least one aggressive incident. The primary target for aggression was the staff in 64.4 % of the incidents.

74.8 % of the staff were women and the majority of the staff were RN and nurse-aids. According to gender differences we found no significant differences in reported incidents (OR 1.27 p = 0.818). Regarding the severity score there were no significant gender differences (p = 0.41). The length of employment has no impact on the severity score (p = 0.269). We found a minor but significant negative correlation (r = -0.262 p = < 0.01) between length of employment and the number of reported aggressive incidents.

Our findings show that the staff is the primary target of aggression, and the majority of the staff is experiencing aggression as part of the job. We found no significant differences related to the gender of the staff, but we found that length of employment has an impact on the numbers of reported aggressive incidents, indicating underreporting and possibly cultural adaptation to some extent.

Anxiety is a primary symptom in conditions of indefinite fear. Aim of the study is to objectivise the initial fear in patients who decided to take part in a chemo dialysis program because they suffer from chronic renal insufficiency (CRI) N:18.

In the study we examine 753 patients with CRI and who are in the program of chronic haemodialysis in Bosnia and Herzegovina (B&H) in the period 2001. g do 2010. g. The first group consists of patients with Balkan Endemic Nephropathy - BEN n = 348, and control group consists of n = 405 patients with other diagnoses of renal insufficiency (N18). The study is designed as a comparative study. Statistical analysis was done using descriptive and analytical methods.

Socio-demographic data show highly significant difference according to the place of residence between the BEN and N18 groups (c2 = 23.970) P < 0.01, difference in the incidence of renal comorbidity (c2 = 23.970) P < 0.01, family renal comorbidity (c2 = 23.970) P < 0.01, and migrations (c2 = 4.874) P < 0.01. BAI scale has highly significant differences between the two groups P < 0.001, and they are different by the degrees of incidence and significant by variables. HAMD scale has a group significance P < 0.001, and variables point to somatization, general anxiety and depression which is confirmed by general weakness of mental functioning - MMSE.

Anxiety appears in all tested dialysed patients. Structured anxiety with depression results in presuicidal risk

Using movies in psychiatric group therapy & rehabilitation classes provides ‘Entertainment, Education, Empowerment’ for the participants. We have provided such a setting where severely ill psychiatric inpatients. We aimed to describe the “Watching Cinema- Group Therapy” implementation for 500 inpatients in one year.

Selected movie clips were watched in the morning and group therapy session took place in the afternoon. The patients were instructed to watch the film closely, and if required, ask for certain scenes to be replayed for a better understanding. It was followed by review of the film.

We observed that these activities have encouraged the patients to talk about their beliefs, thoughts and feelings while discussing the characters and stories. We have also used as a reward for the patients who have therapeutic alliance. It motivated them to do something instead of being stayed in the room. Short movie scenes were more useful to follow up the films for the patients who have been administrated high doses of drugs.

It is the ingenuity and creative approaches of the educators and healers using movies in favor of behavioral health improvement. Movies are strong and important tools to be used for positive as well as productive means in treatment and teaching.

There currently are only a few clinical studies found in literature that assess acute psychosis in terms of its longitudinal clinical course, meaning whether it totally recovers, reappears later on or other types of psychotic episodes will appear.

To assess the clinical features of acute and transient psychosis after 10 years of evolution.

To emphasize the clinical stability of an onset diagnosis of acute psychotic disorder.

A sample of 40 subjects was assessed prospectively. They were admitted for the first time in Timisoara Psychiatric Clinic between 1999 and 2001 and have been diagnosed according to ICD 10 with acute and transient psychotic disorder (F23). The evaluation was performed at onset and after 10 years of evolution. Following parameters were analyzed: socio- demographic (age at onset, gender, educational, professional and familial status) and clinical (onset and current diagnosis).

After 10 years of evolution 67.5% of the subjects have experienced also other types of psychotic episodes and changed diagnosis during the illness course. 32.5% of the subjects followed a 1 to 2 years treatment and did not relapse so far.

Acute psychosis represent a heterogeneous group which can evolve to any other psychotic disorder.

Object of the study is self-destructive behaviour of young people in Bosnia and Herzegovina (B&H) in the period 2001- 2010. g. The aim of the study is exploration of the forms of self-destructive behaviour of young people in relation to poverty, adaptability and adolescence. Special aim is the analysis of self-destructive personalities.

Two adolescent groups from (B&H) were statistically processed. The test group consisted of n=125 subjects who had parasuicide before they were of legal age, and control group consisted of n=125 persons with somatic symptoms and parasuicidal behaviour. The design of the study is longitudinal. Statistical processing was done with: GDL, EPQ, HAMD, PIE, and the study is prospective, stratified by quality (number of attempts) of parasuicide.

Parasuicide has a growing trend of seriousness of self-destruction in the first group and increased somatization of anxiety and depression in control group. Parasuicidal destruction is reflected in suicide (7.7%), mental disorders (15.5%), social segregation (12.5%) and cases of good maturation (65%). Somatiform disorders are proven on Hamilton’s scale: body anxiety: t-test=0.78593, general body symptoms: t-test=0.73369, genital symptoms: t-test=0.8268, which are confirmed by Pluchic’s test.

Demonstrations of parasuicidal behaviour are found in both groups of respondents. Strong manifestations of self-destruction are clear in the test group, and in the control group they are expressed as masked forms of self-destruction. Both kinds of expression of the parasuicide are results of poverty, adaptability (PTSD), and personal difficulties in adolescence.

From adolescence, women have a 1.5 to 3 times higher risk than men of suffering from a depressive disorder. This risk increases in middle-aged of the life and even more in the transition period to menopause or perimenopause, when the depressive vulnerability becomes especially intense.

To know more about depression in perimenopause.

To provide practitioners with accurate information about this condition thus helping to better recognition and treatment.

a selective literature review on the topic is performed.

Hormonal, psychological and sociocultural factors have been suggested to understand the etiopathogeny of this condition. Treatment of depression in perimenopause is determined by the clinical severity and includes antidepressants, psychotherapy, and sometimes, hormone replacement therapy with estrogens.

Perimenopausal depression is an underdiagnosed and poorly treated problem, which generates a high level of suffering and deserves greater attention by clinicians and health systems.

Study followed appearance and treatment of depressive disorder at the patients with opiates dependency on methadone maintenance treatment.

Presenting frequency, time of appearance and pharmacology treatment of depressive disorder. Depression was verified by psychological testsing. Applied technics were: interview, MMPI, PIE, Mahover test, WAIS, Rorschach test.

The study covered 154 patients on methadone maintenance treatment. 45 (29%) patients had depressive disorder which required pharmacology treatment. Illness was more frequent at female patients comparing with male (35% to 27%). Patients mostly started to use antidepresive drugs approximately three months after they had stopped with heroine use. Sertaline was a drug of first choice used in 30 patients, then Fluoxetine in 7 patients. Improvement of patients’ condition has been indicated by patients’ own reports, higher level of their functionality (social, working functionality) and retest results (lower T score of D scale, MMPI; lower score of emocional dimension Deprivation, PIE).

Significant appearance of depression was noticed in heroine users on methadone maintenance treatment. Illness was usually diagnosed in period of stabilization, after establishing heroin abstinence. So it is recommended to pay attention on patients in period of stabilization and treat with antidepresives if it is necessary.

• Jeff W, Richard P. M, Wayne H. Methadone maintenance treatment and other opioid replacement therapies, 1997.

• Domenic A. C, Richard I S, Pharmacotherapy of Depression, 2008.

There is a significant prevalence of morbid obesity among the population in the United Arab Emirates (BMI>40kg/m2). This has been accompanied by a growth in bariatric surgery.

To study psychiatric co-morbidity in obese patients seeking Bariatric Surgery.

To identify baseline psychological characteristics such as symptoms of anxiety and depression that may potentially interfere or complicate the surgical procedure.

Eighty eight consecutive obese patients (F=69, M=19) seeking bariatric surgery were recruited at Tawam Hospital in Al Ain. Behavioral/psychosocial evaluations were conducted to screen for symptoms of anxiety and depression using Hospital Anxiety and Depression Scale (HAD). The impact on the degree of perceived disability was assessed on the four functional dimensions of the Sheehan Disability Scale (SDS). Statistical methods used Pearson Correlation to study correlation between scales and quantitative variables, while frequencies were determined for categorical variables.

The reported frequency of significant symptoms on the HAD were 26.7% for anxiety and 14.7% for depression. The average mean disability scores on the SDS were 21.3%. The relative frequency of disabilities on each of the 4 dimensions of functioning were 28.7%, 35.0%, 36.3%, 36.3% consecutively. Higher Depression scores were associated with marked disability on the dimensions of Social life, Family/home responsibilities and Religious duties (0.61, 0.38, 0.29 consecutively). Meantime, anxiety scores were associated with higher disability on social life, family/home responsibilities (0.39 and 0.3) but not on work/school or religious duties.

Anxiety and depressive symptoms are common among bariatric patients with morbid obesity in the UAE.

Multiple Sclerosis (MS) is an inflammatory demyelinating disease that affects the white matter of the central nervous system. It’s more frequent in women. The disease has clinical heterogeneity, but initial neuropsychiatric symptoms are common (60%). If these symptoms are not present at the onset, they will certainly develop throughout the course of the disease.

To describe the case of a central hospital psychiatric inpatient and it’s comparison with the international available literature.

Retrospective analysis of the clinical process.

Woman, 51 years old, functioning until 3 months ago. Hospitalized for behavioral changes with heteroaggressiveness (verbal and physical) and psychomotor agitation. History of relapsing-remitting type MS with 10 years of evolution, treated with 44μg Interferon beta 1a (subcutaneous). To the mental examination she presented with uncooperative and suspicious attitude, dysphoric and delusional mood, changes in thought content with auto-referential/persecutory delusions and delusional interpretations. The extended analytical study, CE-CT and MRI were not altered, as were the Internal Medicine and Neurology evaluations. There was complete regression of symptoms after Interferon beta 1a suspension and maintenance of low-dose neuroleptic.

This is a rare case of psychotic disorder secondary to the use of interferon beta 1a in patients with MS. The rarity of this case is well patented as there is no published report of psychosis secondary to use of subcutaneous formulation, although it is known that psychiatric symptoms may occur in less than 1% of patients using this drug.

The analyses of normal intrauterine psychic development, based on principle of reconfiguration of cross-functional connections, system organization and construction of psychic functions hierarchy, allowed marking out four groups.

1. 1) Sensory level of psychic development, serving for keeping the internal homeostasis.

2. 2) Perception level of psychic development, working out a certain range of automatisms.

3. 3) Level of bodily-spatial analyses, helping to master either inner or outer space.

4. 4) Voluntary level of psychic development, building not vertical but horizontal inter-hemispheric connections.

For every group of children we have marked out the diagnostic indications and stated the correction tasks. We propose the whole structure of sessions: sequence, periodicity, evaluation criteria for psychomotor correction. The correction method does not have a hard fixed structure, its application to children having Autistic Spectrum Disorder demands individual approach. It also has a range of contra-indications

The SHS is a brief four-item measure of global subjective happiness rated on a Likert scale from 1 (strongly disagree) to 7 (strongly agree). SHS is suited for different age, occupational, linguistic, and cultural groups, is easy to implement and its short form possesses measurement accuracy.

To test the psychometric properties of SHS.

To validate an easy to use and valid measurement, for primary care and during treatment assessment in psychiatric patients with emotional disorder(PPED) and general population (GP) in Greece.

Translation was performed using the multiple forward and backward translation protocol. Life orientation test (GrLOT-R), Depression anxiety stress scale (DASS) and Satisfaction with life Scale (SWLS), was also administered to check construct validity of SWLS.

856 adults participated, 218 (25.5%) males, 638 (74.5%) females. The total scale of the SWLS had a coefficient alpha of .756. Item - total correlations where from .223-.735. Factor analysis has supported a unidimensional model with 1 factor explaining 59.4% of the total variance. Mean scores differed significantly between GP (M=18.4±4.4) and PPED (M=15.2±4.2) (Mean differences=4.622 p< .001). There was significant negative correlation with stress (r=-.443 p< .001) anxiety (r=-.350 p< .001) and depression (-.416 p< .001) and positive with GrLOT-R (r=.574 p< .001) and SWLS (r=.678 p< .001).

The results of the current validation study suggest that the Greek translation of the SHS is both reliable and valid, with good construct and discriminant validity and psychometric properties close to those reported in the international literature.

We want to envisage the possibility of an intercultural clinic devoid of any theoretical rigidity.

We have based our research on the cathartic method in a way that constitutes the basic of the psychoanalytic clinic.

The research will have permit us to address the theoretical and practical requirements under cover of a particular clinic, based on the principle of interculturality.

Our clinical experience in Rwanda within the framework of the post-genocidal trauma clinic will have permit us to demonstrate the way in which relevant elements sometimes appear unexpectedly. Those meetings have an essential value where cultural difference made clinical work doubtful.

There are strong links between circadian disturbance and some of the most characteristic symptoms of clinical major depressive disorder (MDD). However there are no published studies of changes in expression of clock genes or of other neuropeptides related to circadian-rhythm regulation, which may influence recurrent susceptibility after treatment with antidepressant in MDD.

Blood samples were collected from twelve healthy controls and twelve male major depressive patients pre- and post- treated with escitalopram for eight weeks at 4-hour intervals for 24 hours. Outcome measures were the relative expression of mRNA of clock genes (hPERIOD1, hPERIOD2, hPERIOD3, hCRY1, hBMAL1, hNPAS2 and hGSK-3beta) and the levels of serum melatonin, Vasoactive Intestinal Peptide (VIP), cortisol, Adrenocorticotropic Hormone (ACTH), Insulin-like Growth Factor-1(IGF-1) and growth hormone (GH) in twelve healthy controls and twelve pre- and post- treated MDD patients.

Compared with healthy controls, MDD patients showed disruptions in diurnal rhythms of expression of hPERIOD1, hPERIOD2, hCRY1, hBMAL1, hNPAS2 and hGSK-3beta, along with disruptions in diurnal rhythms of release of melatonin, VIP, cortisol, ACTH, IGF-1, and GH. Several of these disruptions (hPER1, hCRY1, melatonin, VIP, cortisol, ACTH, and IGF-1) persisted after eight weeks escitalopram treatment, as did elevation of 24-hour levels of VIP and decreases in 24-hour levels of cortisol and ACTH.

These persisted neurobiological changes may play a role in MDD symptoms that are thought to contribute to recurrence vulnerability and in maintenance therapy for a long term.

Suicide by burning is considered like a violent suicide mechanism.

In our western countries, suicide by burning is relatively rare. But the number of cases seems to increase.

It is important to be able to differenciate suicidal, accidental and criminal burning. It could help physicians, particularly when a patient try to dissimulate a self immolation.

The aim of our study is to find criterias which can differenciate suicidal, accidental and criminal burning.

We collected all the cases of burning related deaths and burning wounds in alive patients, treated at the Forensic Department of the University Hospital Center of Tours, France, at the request of the Prosecutor, between 2000 and 2011. The aspects of death (suicidal, accidental, or criminal) were done by the police officers. In each case we studied sociodemographic and psychopathological datas.

We collected 53 cases, divided into three groups : accident (25), suicide (18), and crime (10). Mean age was 43,9. In cases of accidental burning, 73% had a psychiatric history, and 50% an alcohol abuse. In all these cases of suicide by burning, depression is the major diagnostic (69%).

In cases of accidental burning, we defined two specific groups. In cases of criminal burning, the victimes were aged between 20 and 40, and under alcohol during the offense. In cases of suicide by burning, the mean age is about 48, principally men, who use violent suicide methods. They have generally a documented psychiatric history.

Electroconvulsive therapy (ECT) was introduced in 1938 by Cerletti and Beni. This technique uses a small electrical current to produce a generalized seizure, under general anesthesia. In clinical practice, it is mainly used to treat refractory cases to previous treatment approaches. One of its main indications is major depressive episode, but it is also indicated for other conditions as severe manic phase, marked suicidal ideation, and schizophrenia.

To describe the case of a central hospital psychiatric inpatient and it’s comparison with the international available literature.

Retrospective analysis of clinical process.

Woman, 53 years old, psychiatric outpatient since she was 17, with a history of several hospitalizations since 2006, due to an affective disorder, transversely not clarified. She was functional until her last hospitalization for Major Depressive Episode. Over the last year, there was progressive worsening with deliroid ideas of ruin and somatic plus almost total inability to daily living activities. These symptoms were refractory to all therapeutic approaches, both pharmacological and psychotherapeutic. She underwent ECT, in a reference center with remission of those symptoms, being the patient functional at this moment.

Although throughout history ECT is embroiled in controversy, according to international bibliography, this is a technique of great therapeutic relevance and precise indications. It is noteworthy, that has been shown to be an effective and safe treatment for many psychiatric disorders, especially in cases refractory to other treatments, as evidenced by this case report.