A high prevalence of Self-Injurious Behaviour (SIB) and suicide attempts has been found in patients with Eating Disorders (ED) as well as in patients with a Borderline Personality Disorder (BPD). Since there is a high comorbidity of these two disorders the impact of BPD on the occurrence of self-harm in patients with ED is unclear. This study examined the occurrence and clinical relevance of SIB and suicide attempts in a large sample of 1638 female inpatients with ED, comparing patients with and without a comorbid BPD.

The sample consists of 632 patients with anorexia, 659 with bulimia nervosa and 347 with EDNOS according DSM-IV; 100 had a comorbid BPD. The assessment included the Eating Disorder Questionnaire, the Eating Disorder Inventory, the Self-Harm Behaviour Survey, the Traumatic Life Event Questionnaire, the Dissociative Experience Scale, the Barratt Impulsivity Scale and other.

The lifetime prevalence for the whole sample of SIB and for suicide attempts was 34% and 33% respectively. The risk for SIB doubled with the presence of a comorbid BPD and the risk for suicide attempts increased fivefold. The presence of BPD was associated with significantly severer psychopathology but neither SID nor BPD did compromise the treatment outcome.

SIB and suicidal behaviour are common and important issues in patients with eating disorders. A comorbid BPD increases the risk of SIB and especially of suicide attempts dramatically. This should be taken into account in primary care in order to identify this high risk group.

927 ED women completed standardized measures of social anxiety (SADS), eating behaviors (EAT-40, EDI-II, BITE), personality (TCI-R)and general psychopathology (SCL-90-R).

Regression analyses showed that EAT-40, EDI-Social insecurity and interpersonal distrust, TCI-Harm avoidance (HA) and low Reward Dependence (RD) highly explained (57%) social anxiety in this population.

This is the first and largest study to date examining the specific association of social anxiety with different eating and personality characteristics in ED controlling for confounds. The importance of temperament traits such as high HA and low RD to explain the co-occurrence of both social anxiety and ED is highlighted.

To examine the effectiveness of an Internet Based Therapy (IBT) for Bulimia Nervosa (BN), when compared to a brief psychoeducational group therapy (PET) or a waiting list (WL).

93 female BN patients, diagnosed according to DSM-IV criteria. An experimental group (31 IBT patients) was compared to two groups (31 PET and 31 WL). PET and WL were matched to the IBT group in terms of age, disorder duration, previous treatments and severity. All patients completed assesment, prior and after treatment.

Considering IBT, mean scores were lower at the end of treatment for some EDI scales and BITE symptoms scale, while the mean BMI was higher at post-therapy. Main predictors of good IBT outcome were higher scores in EDI perfectionism and higher scores on reward dependence. Drop-out was related to higher SCL-obsessive/compulsive (p=0.045) and novelty seeking (p=0.044) scores and lower reward dependence (p=0.018). At the end of the treatment bingeing and vomiting abstinence rates (22.6% for IBT, 33.3% for PET, and 0.0% for WL; p=0.003) and drop-out rates (35.5% IBT, 12.9% PET and 0% WL; p= 0.001) differed significantly between groups. While the concrete comparison between the two treatments (IBT and PET) did not evidence significant differences for success proportions (p=0.375), statistical differences for drop-out rates (p=0.038) were obtained.

The results of this study suggest that an online self-help approach appears to be a valid treatment option for BN, especially for people who present lower severity of their eating disorder (ED) symptomatology and some specific personality traits.

Eating disorders are major problems in many countries of the world. They are especially prevalent during adolescence and early adulthood, because society equalizes thinnes with beauty and attractiveness in women. It is not suprising that women tend to be preoccupied with losing weight and acheaving a slim body at young age.

The study examined the relationship among BMI, diet, body satisfaction, weight and eating behaviour. Research of the semple includes high school students of both sex from Banjaluka aged between 15 and 18 (female 360, male 250). A sample of adolescents was screened with eating attitude test (EAT-26). They also answered to the questions about self reported weight and height, diet and body satisfaction.

Comparing self report of body satisfaction and BMI we found a statistical significance (p=0,0001) and frequency of using diets (p=0,0001). EAT was compared with BMI (p=0,07) and body satisfaction was statisticaly significant (p= 0,0001). BMI was also important for using diets (p=0,01).

In the study we found relation between body satisfaction, BMI and frequency of using diets. It could be first the step in the development of eating disorders. BMI does not have influence on EAT score. It is necessary to use this knowledge in the feature to design preventive programs for individual risk of developing eating disorders and for directed interventions for changing socio cultural pressures on the behaviour.

Preliminary analyses suggest less increase in the prevalence of eating disorders among women between 1991 and 2004 than expected. More men than expected with symptoms of ED. Detailed prevalence numbers for the different eating disorders according to DSM-IV, age cohort analyses, as well as analyses on the relationships between eating disorders, physical activity, and obesity will be presented in April.

The objective of this study was to analyze clinical and personality differences in three groups of patients with eating disorders: binge eating disorder (BED), bulimia nervosa- purging type (BN-P) and bulimia nervosa-non purging type (BN-NP).

The participants were 102 female patients (34 BED, 34 BN-P and 34 BN-NP), mean age 28.7. Assessment measures included the following tests: EDI-2, BITE, EAT-40, SCL-90-R and TCI-R, and other clinical and psychopathological indices that were collected via semi-structured interview.

When compared all three groups, BED were the oldest group, showed more frequent familial history of obesity and current or lifetime obesity. Regarding psychopathology, BN-P patients showed the most pathological scores, followed by BN-NP patients and BED patients showing the least pathological scores. Specifically, BN-P patients showed statistically higher scores than BED patients on SCL-90-R Paranoid Ideation, EAT-40 total score, EDI-2 Impulsivity subscale, and BITE Severity subscale. No statistically significant differences were observed among groups, on personality traits. A two-step cluster analysis procedure was conducted, to determine the clinical proximity among the three diagnostic groups. The relationship between cluster classification and diagnosis was statistically different (p<0.001), so we can assume that the present classification maybe does not classify accurately eating disorders.

Even when BED patients present differential characteristics with respect to family and personal antecedents when compared to BN patients, clinical and psychopathological overlapping with BN-NP makes them similar. Likewise, our results suggest deficiencies in the current nosological system, since it does not group patients’ subgroups which are homogeneous enough.

Recent publications have drawn attention to the role of serotonin-2A receptors in mood disorders. Low doses of atypical antipsychotics, like the butyrophenone pipamperone, are suggested as an augmentation strategy in the antidepressant treatment of mood disorders, in addition to conventional antidepressant therapies.

Functional imaging studies with highly specific receptor ligands allow quick assessment of drug-receptor occupancy at different doses of drugs - here pipamperone at 5mg and 10mg doses - in a large animal model.

Three healthy drug-naïve female Beagle dogs, aged 7 years, were included.

Dogs were scanned before treatment and after administration of one dose of pipamperone of 5mg and 10 mg, 90 minutes prior to injection of the tracer. Acquisition was performed under general anaesthesia 90 minutes after injection of the tracer. The acquisition for both investigations was performed with a triple head gamma camera equipped with LEHR collimators. The images were reconstructed with HOSEM iterative reconstruction and application of a Butterworth-postfilter (cut-off 1,2 cycles/cm, order 8).

The mean binding serotonin-2A binding index before treatment in the frontal cortex was 1.47. In the 5 mg pre-treatment condition, the binding index was reduced to 1.29 and in the 10 mg pre-treatment condition, it was reduced to 1.04. Non-parametric statistics (Friedman related-samples test) yielded a p-value of 0.05.

Even in the very low dose range (5mg-10mg) of pipamperone, there was a significant and dose-dependent reduction in serotonin-2A binding index in the three dogs.

Early and focal atrophy of medial temporal lobes on magnetic resonance imaging (MRI) in patients with Alzheimer disease (AD) can be measured in several ways.

In 20 patients with probable Alzheimer disease and 29 cognitively normal elderly medial temporal lobe atrophy (MTA) was measured by volumetry using manual tracing of the hippocampus. The volume of the hippocampus was also rated into five categories expressed as MTA scores ranging from 0 (no atrophy) to 4 (severe atrophy) using a simple and quick semiquantitative method according to the published combined widths or the height of selected three mediotemporal structures.

In comparison to controls, AD patients had significantly smaller volume of either hippocampus (median volume of the hippocampus Hipp dx: 1,81 vs 2,23 p=0,001; Hipp sin: 1,60 vs 2,14 p=0,003; Hipp bilat: 3,40 vs 4,31 p=0,0004). The total MTA score of both sides were significantly higher in AD patients (median 4) than that in controls (median 1) (p=0,0004). Nearly 60 % cognitively normal seniors had the MTA score ≤ 0,5. A similar proportion of patients with AD (65 %) had the MTA score ≥ 2.

Hippocampal loss of tissue can be detected by visual rating and volumetry on MRI in patients with AD. Visual MTA rating is the easier and quicker method than more accurate and time consuming volumetry to support the diagnosis of AD on the brain MR imaging.

The project was supported by CNS MSMT 1M0517 and VZ MZČR MZ0PCP2005.

Cannabis is the world's most widely used illicit drug. It can impair verbal learning and induce psychosis, both acutely and possibly following long term use. But, where cannabis acts in the brain to impair verbal learning and induce psychotic symptoms is unclear. The aim of this study was to clarify how one of the main psychoactive ingredients of cannabis, delta-9-tetrahydrocannabinol (THC) acts on the brain to impair verbal learning and induce psychotic symptoms.

15 healthy males with minimal exposure to cannabis, were studied on 2 occasions approximately 1 month apart, following oral administration of 10mg of THC or placebo 1 hour prior to scanning, in a double-blind design. MR images were acquired on a 1.5T GE camera while subjects performed a Verbal paired associates task with separate encoding followed by retrieval conditions, with the conditions repeated in the same sequence 4 times. We examined the main effects of drug, task and drug- task interactions.

Administration of THC abolished the normal linear decrement in parahippocampal activation across successive encoding blocks and was associated with a trend for impaired word recall. Administration of THC also altered the normal time-dependent change in ventral striatal activation during retrieval of word pairs which was directly correlated with concurrently induced psychotic symptoms.

These results suggest that impairment in learning and verbal memory associated with cannabis use may be mediated through its action in the medial temporal cortex while psychotic symptoms may be induced through its action in the ventral striatum.

Language disturbances, such as impoverishment, disorganization and dysregulation, are a prominent feature of schizophrenia. Several neuroimaging studies have suggested the superior temporal gyrus (STG) as a likely anatomical substrate of language deficits in schizophrenia. The aim of this study was to verify a correlation between structural measures of STG and Heschl's gyrus (HG) and language dimensions.

An extensive language examination battery, which included narrative and conversational expressive tasks, and syntactic and pragmatic comprehension tests, was administered to 23 schizophrenia patients (mean age±SD= 40.30±11.60) and 21 normal controls (mean age±SD= 42.19±11.05). All subjects also underwent a 1.5T MRI session, and STG and HG were manually traced and volumes were obtained, bilaterally, using Brains2.

Specific language deficits were shown in subjects with schizophrenia compared to healthy individuals (p<0.001), particularly in verbal fluency, syntactic complexity, lexical diversity and metaphor/idiom comprehension. Interestingly, speech fluency significantly directly associated with left STG gray matter volumes in controls (r=0.46, p=0.03) but not in patients (r=-0.27, p=0.21). In contrast, complex syntax and word diversity significantly correlated, respectively, with left and right HG volumes in schizophrenia patients (r=0.45, p=0.02; r=-0.47, p=0.02), but not in controls (p>0.05).

This study confirmed a widespread impairment of language in schizophrenia. Interestingly, distinct language dimensions differently correlated with STG-HG volumes in patients with schizophrenia and controls, particularly with regard to verbal fluency and syntactic measures.

Bipolar disorder (BD) is characterised by emotional dysregulation; relatives of BD patients have a high rate of affective symptoms, and therefore abnormalities in emotional information processing are likely to be part of the genetic predisposition to BD. Examination of unaffected siblings of patients with BD can contribute to determining features of the BD phenotype which are related to familial predisposition as opposed to disease expression.

To identify the neural correlates of facial affect recognition in BD patients and their unaffected siblings.

Event-related functional magnetic resonance imaging (fMRI) EPI data was collected with a 1.5T scanner. Blood oxygenation level-dependent (BOLD) data was obtained from 41 BD type I patients, 22 of their unaffected siblings and 51 matched healthy controls during recognition of fearful, angry and sad facial expressions. A random effects analysis was implemented using SPM5 (http://www.fil.ion.ucl.ac.uk/spm).

BD patients showed reduced prefrontal cortex (PFC) activation, when compared to controls and siblings, with evidence of differentiation in location and laterality of activation maxima across different facial expressions. Regardless of valence, patients showed reduced extrastriate cortex activation. During angry faces, when compared to controls, siblings showed reduced activation in posterior cingulate gyrus, and during sad faces, enhanced activation in left ventral PFC and right parahippocampal gyrus.

Dorsolateral PFC (BA47) activation may represent a marker for genetic risk for BD. During sad faces, siblings showed greater activation of this region than HC, whilst BD patients showed reduced activation. This is consistent with previous findings implicating this region in BD.

The present functional magnetic resonance imaging (fMRI) study investigated neural changes in relation to mood biased processing in depression, before and after cognitive behavioral therapy (CBT) using an emotional Stroop task.

Sixteen unmedicated patients (mean age 40 years), fulfilling DSM-IV diagnosis for unipolar major depression underwent fMRI, prior to and after 16 once-weekly sessions of CBT. Sixteen matched healthy volunteers were scanned at similar time intervals. In an emotional Stroop task negative and neutral words were presented in various colors and volunteers had to name the color of words. Latencies were recorded to determine behavioral emotional interference effects. MRI images were acquired using clustered image acquisition. Whole-brain and region of interest analysis examined the neural basis of interference and mood biased processing.

At baseline patients displayed increased latencies during color naming negative words, in comparison to neutral words and in relation to healthy volunteers. After treatment, latencies did not significantly differ between groups. With regard to neural activity, depressed patients showed increased activation at baseline in amygdala, dorsolateral prefrontal cortex (DLPFC), and ventrolateral prefrontal cortex (VLPFC), which normalized after CBT. Additionally, hyperactivation in the rostral anterior cingulate at baseline was positively correlated with symptom reduction after CBT.

Evidence was found for an emotional interference effect during acute states of depression which improved following CBT. The neural basis is associated with increased activity in the amygdala, DLPFC and VLPFC which normalized after treatment. CBT seems to affect behavioral biases and neural circuits involved in processing negative information.