From the viewpoint of society, adolescence can be considered a transition phase into adulthood. For many psychoanalysts, the changes originating from the puberty process are accompanied with an “anguish of growth”. The crisis installed due to this process can be marked by something peculiar in the life of each one.

To discuss the clinical practice, looking towards an understanding of the peculiarities that mark the psychotherapy of an adolescent who lives through a cultural transition.

Case report referring to a clinically listening to a 15 years old adolescent who was born and raised in Japan, then moved to Brazil with her family when was 12 years old.

Adaptation to a different culture was what motivated the patient's mother to seek attention for her daughter. The family brings the image of an idealized Japan. The change did not only bring consequences to the daughter, but to the family that went through reorganization in the face of customs and material conditions. The new conditions ended up accentuating conflictive questions by the married couple and the difficulty of organizing the positions of the parents and children in family dynamics, interfering in the process of separation/ individualization of the adolescent. The patient found within a typical Japanese music group an outlet in which she could confront other discussions that stamp her identity.

Psychocultural transition has marked this phase in the life of this adolescent. Within a referential group of oriental culture, the patient has found support for these changes.

This study aimed to evaluate various associated risks between internet addiction (IA) and Attention deficit/Hyperactivity disorder (ADHD) children and adolescents by comparing ADHD group with and without IA problem.

78 ADHD children and their parents were performed designed general demographic questionnaire and standardized measurement including Chen IA Scale (CIAS), Swanson, Nolan, and Pelham, Version IV ADHD questionnaire (SNAP-IV), Child Behavior Checklist (CBCL), Adult ADHD self Rating Scale (ASRS), Symptom Check List (SCL-90) and were then divided into ADHD with IA or without IA group according to IA cutting point. Various associated risks included the BMI value, general demographic data, subtype, comorbidity, childhood common behavior problem, parental ADHD diagnosis, parental symptom, nail biting, and media exposure problem.

ADHD youth with IA problem was highly associated with overweight and playing computer game more than one hour. Stepwise logistic regression revealed that father of these ADHD children in this group were significantly younger, and children self having withdrawn tendency.

Father's younger age, overweight and withdrawal tendency on ADHD youth is risks associated with internet addiction problem and the presence of playing computer game more than one hour on ADHD child is at greater risk for developing internet addiction.

Although paediatric medulloblastomas are well described in surgical literature, there is relatively little in child-and-adolescent psychiatry literature on them. Anxiety as the primary presenting complaint of a brain tumour, is rarely reported among the paediatric population with primary cerebral malignancy.

To highlight the prudence of an initial skeptical attitude towards the cause of symptoms, and also the importance of a comprehensive physical examination in child psychiatry units.

A 14 year-old Chinese boy is described, who presented at the outpatient psychiatric clinic with a 3-month history of increasing anxiety, difficulties with social interaction, deteriorating academic performance, interspersed with about two episodes of nausea per week. Previously, he was known as an intelligent boy who enjoyed a good relationship with his classmates. He has no other focal neurological deficits, and no recent life events were reported. A CT scan of the brain done revealed a large tumour distending the fourth ventricle. Histology revealed medulloblastoma.

We will also briefly review the relevant literature.

After surgical removal of the tumour, patient is described to be more participative in social interaction and almost back to his premorbid personality.

Primary brain tumours may manifest only with psychiatric derangements. Somatic symptoms typically seen in anxious patients, such as nausea, may herald a more sinister underlying cause. We advocate further study on the relationship between anxiety and brain tumours, as well as urge an increased vigilance on the part of healthcare professionals in constantly utilizing a biopsychosocial diagnostic model in child-and-adolescent psychiatry.

The monoamine systems have been suggested to play a role for the biological background of ADHD symptoms. Thus, polymorphisms in e.g. the serotonin transporter (5HTT) gene have been associated with ADHD like phenotypes.

Furthermore, platelet MAOB activity has frequently been linked to impulsiveness-related traits.

Biological markers and candidate genes for psychiatric problems are often studied separately. We study ADHD symptoms with regard to the combination of platelet MAOB activity and 5HTT genotype.

To test the hypothesis that associations between ADHD like behavior problems and 5HTT-LPR polymorphism, would be more robust if calculations were done in combination with platelet MAOB enzyme activity.

The study group consisted of 156 adolescent twin pairs, i.e. 312 individuals. ADHD symptoms were scored with a structured clinical interview of both the twin and a parent using Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL).

Presence of a short 5HTT-LPR allele, in combination with high levels of platelet MAOB enzyme activity was associated with higher scores of ADHD like problems and disruptive behavior in boys. No such associations were found in girls.

This examination of ADHD scores in a non-clinical sample suggests that the effects of the 5HTT-LPR are moderated by platelet MAOB activity.

The aim of this study was to estimate physicians awareness to side effects in youth population treated with antipsychotics.

20 questionnaires filled up by polish child psychiatrists.

Information from author's questionnaire concerns side effects observed in antipsychotics medicated children, psychiatrists own preferences in safety monitoring strategies were analyzed.

Atypical antipsychotics are used in 25% of medicated children. Risperidon is the most popular antipsychotic in psychotic and non-psychotic indications (81%, 66%), afterwards olanzapine (54%, 30%) and quetiapine (34%, 24%). The most common indications for antipsychotics in children are: tics (55%), conduct disorders (53%) and schizophrenia (45%). Before drug initiation doctors check liver enzymes (GOT, GTP) (98%), hematology (98%), glucose level (95%), weight and height (91%), ECG (90%). The most common side effects observed are: weigh gain (63%), somnolence (59%), prolactin elevation (47%), attention deficits (43%).

In spite of lack of safety monitoring standards in youth population psychiatrists seem to be aware and careful in atypical neurolpetic treatment in children.

15-year-old schoolboy admitted to psychiatric hospital after acute psychotic episode. His symptoms started 2 years ago. After a few months he was diagnosed schizophrenia paranoid type. During 2 years he has been hospitalized many times because of persistent psychotic symptoms. He was treated using: risperidon, olanzapine, amisulpride, quetiapine, ziprasidone, perfenazin. All the drugs were ineffective, all were used in full doses, given no shorter than 8 weeks. Patient did not cooperate in treatment - he spits out or has hide the tablets, has to be controlled during drug supplies. He did not responded to long-acting injections of risperidon. Finally the treatment has been changed to new form of olanzapine in extended release injections started 210 mg i.m. every 14 days increased to 300 mg after 2 weeks. After 2 months of treatment (5 injections) reduction of positive and negative symptoms of schizophrenia was observed. Patients starts to socialize, attend school. He is on the drug now, the drug is well tolerated.

This descriptive study was performed with 1321 students selected from six middle schools (through random cluster) from schools in one area education of Sanandaj. For data Collection, Sarason test anxiety and demographic characters questionnaire was used.

Sampling was done before end year examination

In this study, 51/9% of subjects were girls and 48/1% were boy. 29/7% of units were in first degree; 28/2% second and 42/1% in third year degree. Also, 35/4% of boys and 37/8% of girls were 14 years old. Severity of test anxiety in 20/2% was mild, 44/9% moderate and 34/9% was severe. In this research, we found statistical differences between severity of test anxiety and gender (p = /.001).

The results showed high rate of test anxiety in middle school students. In our opinion, addition to gender effect on test anxiety levels, other factors such as stress of transition from one level to another level and access in special schools have significant role. Therefore, school coaches should attention to pathology and therapeutic methods for reducing test anxiety such as relaxation, systematic desensitization, immunization against stress and skills of reading correction in these groups.

Premenstrual syndrome (PMS) is a common disorder with prevalence rate of approximately 30%; its concurrence with psychiatric symptoms will make it a disabling condition that resists usual treatment.This study was enrolled to assess the co-morbidity of PMS andpsychiatric disorders in a sample of girls with PMS compared to those without PMS.

This study was conducted through a cross sectional method with 362 participants (166 with PMS and 196 healthy girls) who were selected randomly and completed the demographic questionnaire, premenstrual syndrome symptom daily record scale and the symptom checklist 90-revised (SCL-90-R).

According to the result of the independent t test, the mean score of all the psychiatric symptoms in the PMS group was significantly higher than those in healthy group (P < 0.001). According to SCL-90-R measurement, most of the participants in the PMS group were categorized as extremely sick for somatization (44%), obsessive-compulsive (59%), depression (58.4%), anxiety (64.5%), hostility (47%) and psychoticism (69.3%); most of the participants were diagnosed as having borderline severity of disorders for interpersonal sensitivity (44.6%) and paranoid (42.8%) and most of the respondents with PMS (46.4%) were diagnosed as healthy only for phobic anxiety.

There is a considerable relationship between PMS and different psychiatric symptoms that can complicate the diagnosis of PMS and its treatment for the health care providers. Therefore, all health care providers who are in contact with women in their reproductive age should be sensitive to mental health status in women with PMS.

Although the adverse impact of post-myocardial infarction (MI) depressive symptoms on prognosis of heart disease has been found, the link between coping strategies and post-MI depressive symptoms has yet been unclear. The aim of this study was to determine the relationship between coping styles and post-MI depressive symptoms.

In a cross sectional study one hundred consecutive patients following MI admitted to the CCU wards of hospitals in Isfahan were selected in respect of inclusive and exclusive criteria. The patients completed Jalowiec Coping questionnaire, Hospital Anxiety and Depression Scale and Norbeck Social Support questionnaire. Then the data was analysed by using MANCOVA and Covariance.

The findings indicated that 31% were the MI patients with depressive symptoms. The results of MANCOVA showed significant difference between two groups with and without depressive symptoms in coping styles (F = 2/185, P = 0.036). Also, the results of covariance indicated significant differences in coping styles including optimistic coping style (F = 3.754, P = 0.05) and supportant coping style (F = 6.66, P = 0.019). However, there was no significant difference in other coping styles between two groups.

The low tendency toward optimistic and supportant coping styles seem to play an important role in experiencing depressive symptoms among post-MI patients. Lock of optimism in dealing with life events is one of equivalents to hopelessness in Attribution theory explaining depression. Investigation of relationship between religious beliefs and effective coping styles would be worthwhile.

There is a lack of knowledge on outpatient treatment in mental health and its outcome. The major reason for this is that research on clinical decision making in health care has primarily focused on well-defined situations in physical conditions, while there has not been any research in clinical decision making in people with schizophrenia with its high demands on patient's treatment adherence and establishing stable therapeutic relationships.

This study is about clinical decision making in outpatient mental health care with specific focus on patients diagnosed with schizophrenia.

To identify the types of decision making between the patient and the therapist (paternalistic, shared and informed). Moreover, to investigate the patient's understanding of the decision making, involvement and analyse type of decision making as a possible predictor of adherence to treatment.

The study is an open, explorative study using a combination of both qualitative and quantitative methods. The study population consists of severe mentally ill outpatients diagnosed with schizophrenia. Data collection consists of both questionnaires, field observation and patient interviews.

Specifications of primary areas for further improvement in CDM is an expected result of the study. Recommendations will be extracted and formulated from the study data to implement elements of best practice in CDM in the routine care for people with schizophrenia in particular and severe mental illness in general. The explicit focus will contribute to the strengthening of patient perspective.

The National Board of Health and Welfare (NBHW) has developed a multi-dimensional performance assessment framework for open comparisons and assessment of health care. The framework includes the dimensions effectiveness, safety, patient-centeredness, timeliness, equity and efficiency.

To apply the framework to the area of psychiatric care in Sweden.

To identify disparities in the treatment and health outcomes of psychiatric patients in order to stimulate improvements.

More than 30 process and outcome indicators were developed using nationwide health data registers and were compared among regions or between patient groups.

Among other results the study shows large disparities in somatic care between patients with and without comorbid psychiatric disease (equity), low compliance to antidepressant treatment with small regional variations (effectiveness), decreasing suicidal rates (safety), regional variations concerning timeliness of care, lack of national data to asses patient-centeredness and no obvious relationship between costs of psychiatric care and outcome (efficiency).

The study indicates that the quality of psychiatric care in Sweden does not differ to any great extent between regions. However, there are large disparities in somatic care between patients with and without comorbid psychiatric disease. The framework is a useful starting point for assessing psychiatric care but improved reporting to existing registers and development of new data sources, particularly related to psychiatric health care outcomes, could lead to more adequate and comprehensive assessments including all the six dimensions of the framework.

The cardiovascular desease is the great reason for mortality of the patiens. The comorbidity with the depression have a great influence of the incidence, morbidity and mortality. Some live events make the depression efects worse for the patient who take cardio-surgery treatment.

is to find the importance of some life events to depression of the patients with cardio-surgery intervention.

In this study there was 30 patients, hospitalised at Cardiosugery Hospital Filip II, Skopje for cardio-surgery intervention (aorto-coronary by pass), 38–79 age, both male and female. These psychiatric instuments were used:Hamilton depression scale (HAMD), (17 itema scale with max score 52 and minimal score 0) and Scale for living stres factors of Holms and Rahe.

The average score of depression preoperation on HAMD scale is 16.77 ± 8.05, and the postoperation score were incresed to 21,25 and is high statistical significance (p < 0.01).The some events like death of member of the family, the illness, a big finansical changes significantly increace the depression (p < 0.01), but a newborn in the family, the holidays significantly decrese the depression on the participants (p < 0.05).

Multidisciplinary approach with the team of psyciatrists, psychologist of patient with cardiovascular desease make the despression efects small and the patients have good recovery.

Cardiovascular disorders are the first cause of death among over-80 year-old patients and cardio-surgery is sometimes the one therapeutic option. No scientific assessment of Quality of Life (QoL) or other psycho-socially relevant consequences has been carried out. Aim of the study was to quantify and describe QoL on over-80 patients after cardio-surgery.

Study 1 was a one-arm cohort study on 192 subjects who underwent cardio-surgery between years 2003 and 2005 and were interviewed by phone 5 to 7 years after by means of SF-36 and the Seattle Angina Questionnaire, matching these with socio-demographics and clinical pre/post operative variables. Study 2 was a pre-post study on 21 subjects who underwent cardio-surgery in 2009-2010, who were interviewed face-to-face before the interventions and 6 months after, including assessment of anxiety and depression via the HADS.

Study 1 patients reported satisfaction with treatment in 80%, freedom from cardiac symptoms in 62% and overall well-being in 78% of cases. Study 2 patients reported statistically significant improvement of QoL (SF-36 mean total score 57.1 vs. 73.5, p = .001), clinical conditions and anxiety-depressive symptoms (p = .001 both for HADS-anxiety and HADS-depression).

Assessment of QoL and anxiety-depressive symptoms should be included in routine evaluation of elderly surgical patients, though the present study also suggested the need for improvement of methodology of interview, being phone-calling and traditional self-assessment psychometric instruments particularly inappropriate for this patient population.

It is difficult for a single investigator to study the psychosocial changes that occur over the life span of an individual affected with a chronic illness like β-thalassaemia major. Therefore, a developmental epidemiological perspective is required to understand the chain of events and problems of psychological nature.

We aimed to construct the picture of developmental epidemiology for psychosocial aspects in families of β-thalassaemia major patients attending a tertiary care hospital in north India.

The accelerated longitudinal design was used. The sample consisted of 100 children with β-thalassaemia and their 150 parents, both groups were subdivided further so that each group represented the continuum of longitudinal course.

Overall 54 per cent of children had significant psychopathology. Within the parents groups, 10 per cent had adjustment disorder, 33.3 per cent depressive disorder, and 10 per cent had anxiety disorder and 11 per cent somatoform disorder. There was significant difference only in the domain of psychological health in all the three groups of parents with respect to the quality of life. Among children, quality of life improved with their progression of illness.

Growing up with β-thalassaemic family was analyzed. Such a design can test the hypothesized aetiological or developmental function of a targeted risk factor within a developmental path and may be used in studying the psychological impact of even other chronic illnesses over the life span of an individual for conceptual and holistic understanding.

The contribution of childhood trauma and dissociation to the unknown pathophysiology of fibromyalgia has been the subject of considerable debate.

To assess and compare the relationship of childhood trauma and somatoform dissociation between patients with fibromyalgia and rheumatoid arthritis both of which are characterized by chronic pain and disability.

Early life and prolonged trauma may affect brain modulatory circuitry of pain and emotions. The findings of relationship between traumatic events, dissociation and fibromyalgia can lead to a better understanding of the etiology and suggest new treatment modalities.

Thirty-one patients with fibromyalgia and 19 patients with rheumatoid arthritis were enrolled in the study. All participants were asked to fill in the Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire and Dissociation Questionnaire.

Physical neglect score was higher in fibromyalgia group than rheumatoid arthritis group (p < 0.05) although there was no significant difference between two groups in other subscores of childhood trauma and the rest of the dissociation scores. Total trauma scores were positively correlated with dissociation scores in fibromyalgia group whereas this correlation was not seen in rheumatoid group.

Among childhood trauma types, physical neglect seems to have a more important role in fibromyalgia than rheumatoid arthritis. Fibromyalgia may be related to early life stress or prolonged trauma, affecting brain modulatory circuitry of pain and emotions in genetically susceptible individuals.

The aims of the present study were to determine the rates of depression in patients with psoriatic (PsA) and rheumatoid arthritis (RA) attending a tertiary referral centre, and to investigate possible factors that are associated with depression in this population.

Interim data pertaining to depression (HADS), pain (British Pain Society Pain scale), quality of life (EuroQoL), physical function (HAQ-DI), inflammation (CRP) and emotional intelligence (Trait Emotional Intelligence Questionnaire - TEIQue-SF) were analysed from data from 100 patients (50 PsA and 50 RA).

Upto 30% of patients with PsA and RA were found to be depressed. Similarly, upto 25% of patients with PsA and RA fulfilled the criteria for caseness on the HADS A subscale.

None of these patients were on therapeutic doses of an antidepressant. There was significant correlation between depression scores and scores on quality of life, disability and emotional intelligence. Together, they explained almost 50% of the variance in depression scores.

The prevalence of depression is high in people with inflammatory arthritides. Disability, Quality of life and trait emotional intelligence seems to be important factors associated with inflammation and presence of depression in this population.