In the UK, almost 50% of illness diagnosed among working age adults is mental distress, depression and chronic anxiety being the two most prevalent illnesses. However, only 24% of those diagnosed receive appropriate interventions within the National Health Service (NHS). In light of this, third sector organisations, such as MIND, are left to fill the gap in providing therapeutic care. This paper reports on an evaluative study of what Mind offers as opposed to statutory services from a service user perspective.

An exploration of the differences in mental health care between statutory and non-statutory organisations.

To identify how service users experienced MIND's counselling service. To establish the benefits and disadvantages of mental health care within statutory and non-statutory services. To identify the impact of mental health care from non-statutory services.

This qualitative research project, adopted a case study approach. Using one to one narrative interviews, data from 12 participants, five males and seven females were collected. Following transcription, each narrative was analysed individually, with thematic analysis being used across all 12 interviews.

Six themes were identified; mindful of the gap; easing like sunday morning; magic moments; love is in the air; lighting up a future and changing the status quo.

Mind plays a significant role in enabling those with psychological problems to move towards building a better future. Findings suggest statutory services can learn important lessons from non-statutory organisations not least how best to provide cohesive, collaborative and compassionate mental health care for those in distress.

The authors have not supplied their declaration of competing interest.

Migration with its long-term changes and the resulting task to adjust to the new environment has been associated with an increased risk for mental health problems. This study aims to gain further insight on the relationship between the fours acculturations strategies (integration, assimilation, separation, marginalization) and severity of depression.

A total of n = 79 first generation Vietnamese outpatients from a psychiatric outpatient clinic for Vietnamese migrants in Germany were investigated regarding self-reported depressive symptoms (patient health questionnaire-9) and acculturation (Stephenson multigroup acculturation scale; SMAS).

Patients with an integration acculturation strategy reported lower severity of depression compared to marginalized patients, who reported the highest severity of depression.

The results implicate that the integration of both the mainstream society and the ethnic society might serve as a resource, whereas the rejection of both societies might increase the risk of depression.

The authors have not supplied their declaration of competing interest.

Vietnamese migrants under the influence of migration-related stressors (MRS) represent a vulnerable group within the mental health care system in Germany.

First study examining the relationship between the quantity of experienced MRS and the severity of self-reported symptoms of depression in a Vietnamese outpatient-sample.

137 first-generation Vietnamese migrants diagnosed with depression were asked to complete the BDI-II and 24 questions about stressful experiences related to the migration process. Linear regression models was performed to examine the influence of the MRS-quantity on BDI-II total score and on BDI-II subscales (Buckley et al., 2001).

A higher number of experienced MRS was found to be related to a higher BDI-II total score, as well as to a higher score on the cognitive subscale in particular. Regarding the cognitive depression-dimension the BDI-II items pessimism, past failure, guilt feelings, punishment feelings and suicidal thoughts were positively related to the MRS-quantity.

A dose-response-relationship was found, with a higher number of MRS being related to a higher severity level of self-reported depressiveness as well as to a higher level of cognitive depression-symptoms in particular. The increase in suicidal ideations in the light of MRS-exposure is in line with findings from other migrant populations. Therapeutic interventions may focus (more) on depressive cognitions as a result of recurring MRS-experiences. Special attention should be placed on suicidal thoughts being boosted by MRS.

The authors have not supplied their declaration of competing interest.

Equal access to health care treatment is a highly prioritized goal in most OECD countries. Timely access has become a priority too; in Denmark now with a 4-week deadline from referral to diagnosis. When mental health services become more centralized and allocation of patients to treatment further away from home become more common, it could have a negative impact on the goal of equal access.

To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.

A nationwide, Danish, register based, follow-up study on frequencies of contacts to out-patient psychiatric services, psychologist consultations supported by public funding and therapeutic talks by general practice.

Outpatient-psychiatric services were reached more often by patients in low SEP measured by income, but their frequencies of visits were less. Contacts to psychologists were less than half for patients in low SEP and less frequent too. Mental health service by GP showed low SEP associated with low contact. No difference in use of emergency or inpatient psychiatric services was found. Distance to provider showed interaction with SEP and contact to psychologist and frequencies of contact to outpatient psychiatrists. When distance increased by 5 km, contact to psychologist fell by 11% among lowest income group and frequencies of visits to outpatient psychiatrist fell by 5%.

Lower SEP is associated with lower mental health care utilization. Increased distance to provider increases inequity in mental health service utilization.

The authors have not supplied their declaration of competing interest.

Homeless people are more likely to have higher prevalence of psychotic disorders than general population. However, we know less about the prevalence of psychotic symptoms in this group.

To estimate the lifetime and current prevalence of psychotic symptoms and their correlates among homeless people living in the Paris metropolitan area.

We analysed data from 839 homeless randomly selected for the “Samenta” survey that studied mental health and addiction problems in this population. The mini-international neuropsychiatric interview was used to assess psychotic symptoms. Separate multivariate logistic regression analyses were conducted to estimate the associations of sociodemographic characteristics (age, gender, education level and migrant status), early life experiences (sexual abuse, physical and psychological violence, substance use) and psychiatric disorders.

The lifetime prevalence of psychotic symptoms was 35.4% (95% CI = 28.1–43.5) and the prevalence of current symptoms was 14,0% (95% CI = 9,8–19,6) with no significant difference between migrant and native groups, after exclusion of subjects with a diagnosis of psychotic disorder (n = 145). In multi-adjusted models, childhood sexual abuse was associated with an increased risk of lifetime or current psychotic symptoms (OR > 4, P < 0.05). Early life psychological violence was strongly associated with the risk of lifetime psychotic symptoms in natives (OR = 6.33; 95% CI = 2.10–19.0), whereas alcohol misuse in adolescence was related to lifetime or current psychotic symptoms in migrants (OR = 3.34; 95% CI = 1.20–9.37).

Homeless people are at higher risk of psychotic symptoms compared to the general population in France. Our findings are consistent with the hypothesis that childhood abuse is an important risk factor of the psychosis continuum.

The authors have not supplied their declaration of competing interest.

The admission experience survey (AES) is a reliable tool for measuring perceived coercion in mental hospital admission. We developed the Italian AES through translation back-translation and administered it to acutely hospitalized psychiatric patients.

To verify psychometric characteristics of the Italian AES. To Examine the AES factor structure.

n = 156 acutely hospitalized patients (48% women, 69% voluntary) were recruited in two university hospitals in Rome (Umberto I Policlinic, Sant’Andrea Hospital) and were administered the Italian AES. We conducted a principal component analysis (PCA) with equamax rotation.

Socio-demographic and clinical characteristics of the sample are reported in Table 1. The Italian AES had good internal consistency (Cronbach's alpha = 0.90); Guttmann split-half reliability coefficient was 0.90. AES total score significantly differed between voluntary and involuntary patients (5.08 ± 4.1 vs. 8.1 ± 4.9, P < 0.05). PCA disclosed a three-factor solution explaining 59.3 of the variance. Significant correlations emerged between AES total score and clinical variables (Table 2). Pearson's correlation coefficient disclosed a significant correlation between perceived coercion and psychiatric symptoms severity (BPRS total score).

The Italian version of AES and proposed new factor structure proved reliable.

The authors have not supplied their declaration of competing interest.

Sexual dysfunctions are more common in individuals with psychotic disorders and has a major impact on both quality of life and compliance.

The purpose of this study is to investigate whether a relationship between sexual dysfunction and level of treatment compliance in individuals with psychotic disorders.

The sample group of the study consisted of 173 in-patients who agreed to participate were selected by random sampling method. The permission was obtained from the hospital's ethics committee. In this study, to assess the sexual functionality Golombok-Rust inventory of sexual satisfaction male and female form and to assess the treatment compliance; medical treatment compliance rate scale is used.

When sexual problems and treatment compliance compared to gender, subscales of satisfaction (t = 4,423, P = 0.000), avoidance (t = 3.348, P = 0.001), touch (t = 2.165, P = 0.032) and overall total (t = 4.015, P = 0.000), although a statistically significant difference was found, there were no differences in treatment compliance. Aditionally, there is no relation between sexual problems and treatment compliance in men. It is also found that there is a weak negative statistical relation amongst treatment compliance and communication (r = −0.244, P = 0.027), avoidance (r = −0.270, P = 0.014), anorgasmia (r = −0.253, P = 0.022) and overall total (r = −0.249, P = 0.024) in women. According to these findings while sexual problems increase, treatment compliance decreases.

The level of compliance to the treatment and subscales of sexual problems; satisfaction, avoidance, and touch mean scores differ from each other. There was a weak negative correlation in between Women's compliance and sexual problems.

The authors have not supplied their declaration of competing interest.

War in Syria and related refugee crisis has caught worldwide attention for the past few years. The war is still continuing by the time of the writing of this abstract. War is one of the reasons of posttraumatic stress disorder (PTSD). Syrian people experience many traumatic events like witnessing death, torture and rape.

The aim of this research is to screen for PTSD among Syrian war victims.

A total of 150 (women = 52, men = 98) war victims between 18–65 years, inhabiting a Syrian camp near the Turkish border were screened with trauma response checklist for PTSD between March 11 and April 11 2015.

Significant amount of the interviewed participants were found to show symptoms of PTSD. Seventy-six percent (n = 114) of the participants had experienced a traumatic event. In total, 80.6% (n = 121) were experiencing distress. Seventy-eight percent (n = 117) had avoidance. Eighty-four percent (n = 126) had negative interfering thoughts. Eighty-eight percent (n = 132) were experiencing trauma associated disturbance. Answers from 78.6% (n = 118) of the participants indicated that they should be further referred to a specialist. The findings were not affected by gender or age.

We have found that most of the participants showed signs of PTSD. Our findings highlight the psychological impact of war on Syrian people. A definite diagnosis of PTSD can be made with detailed psychiatric examination, however given the amount of victims and available staff a brief screening instrument may help identify potential cases to be further evaluated. PTSD has life-long consequences and trauma can be passed through generations. International support for war victims should include psychological support and interventions.

The authors have not supplied their declaration of competing interest.

Children are at greater risk than adults for weight gain and metabolic disorders including hyperlipidemia and diabetes with newer antipsychotics. A web-based safety-monitoring program using a prior documentation model required submission of patient safety data (prior documentation) for insurance coverage at the pharmacy point of sale. This program launched in April of 2011, covering all NC Medicaid and Health Choice recipients under age 18. Clinical monitoring parameters and interactive educational features were developed with pediatric psychiatric experts and key mental health stakeholder groups.

Using a four-year run in period and a full 9 months of post implementation claims data, evaluate the rates of antipsychotic prescribing and safety monitoring before and after the implementation of the A + KIDS program.

Implementation of this program was associated with a consistent monthly decrease in overall antipsychotic use and increases in patient monitoring of glucose and lipid (Figure. 1, Table 1).

The prior documentation registry was effective in decreasing antipsychotic use and increasing safety monitoring. The impact of changing to more traditional prior authorization on the same clinical endpoints is currently under evaluation.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

It is commonly accepted that in most patients with schizophrenia external factors act on genetic predisposition to produce active psychotic symptoms. In fact, we showed that patients with schizophrenia have an abnormal brain activation and peripheral autonomic response to psychological stress. We sought to characterize the brain connectivity networks of such response in schizophrenia.

We studied the pattern of brain connectivity in relation to mental arithmetic stress paradigm in 21 patients and 21 healthy subjects aged 18 to 50 years, using 3T-fMRI. A period of 6 minutes of resting state acquisition (PRE) were followed by a block design with three 1-minute CONTROL task (one digit sum), 1-minute STRESS task (two digit subtraction) and 1-minute rest after task (POST). Pairwise Pearson correlations were calculated between 90 regions of interest. Data were analyzed with MATLAB and SPSS software.

Patients with schizophrenia showed a lower connectivity network between fronto-temporal limbic areas compared with control subjects during control and stress task. Moreover, we observed a great variability of link density during resting state in patients but not in controls, and it diminishes in response to task.

Patients present abnormalities in networks related to stress response showing an alteration in fronto-temporal connectivity, and a poor and random modulation of these networks at rest. Current and previous findings suggest abnormal fronto-temporal connectivity that ultimately would lead to psychotic symptoms emergency in response to an environmental stressor and, even, could be related to hypervigilance and misattribution feeding into the paranoid cognition characteristic of patients with schizophrenia.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Apathy is usually defined as a lack of goal-directed behavior. Although it is observed in about 30% of depressed patients, neurovascular mechanisms underpinning apathy remain little-known.

The main objective of this study was to compare the cerebral perfusion of apathetic depressed patients with non-apathetic depressed patients by arterial spin labeling (ASL), a quantitative and non-invasive perfusion magnetic resonance imaging (MRI) technique. The secondary objectives were to study their clinical profile and their correlation with cerebral perfusion data.

This study was conducted from a cohort of depressed patients in Rennes, France. Eighty-three depressed patients were included, of whom 22 were apathetic (AES≥42), 61 non-apathetic (AES < 42). Everyone got a clinical evaluation with scale screenings, especially for apathy (AES), anxiety (STAI) and anhedonia (SHAPS) as well as a cerebral MRI, including a pseudo-continuous ASL sequence.

Apathetic depressed patients were significantly less anxious and less anhedonic. Apathetic perfused better than non-apathetic in the inferior frontal gyrus (P = 0.022). We found a significant positive relationship between apathy and perfusion of the left frontal inferior gyrus (P = 0.05, r = 0.21). State-anxiety was positively correlated with perfusion of the cingulate cortex, the insula and the left amygdala. Anhedonia was positively correlated with the perfusion of the ventromedial prefrontal cortex, the cingulate cortex and the insula.

We have shown that the clinical and perfusional profiles of apathetic depressed and non-apathetic differ. This study suggests the existence of two distinct neurobiological networks for depressed patients; one involving motivational networks for apathetic patients, and another one involving emotional networks for more anhedonic patients.

The authors have not supplied their declaration of competing interest.

Although some magnetic resonance imaging (MRI) studies have investigated the existence of a relationship between clinical severity and neuroanatomical alterations in patients with schizophrenia (SCZ), the biological signature associated with illness severity in schizophrenia is still uncertain.

This study aims to investigate structural brain abnormalities in SCZ with particular regards to the identification of potential deficits associated to the severity of illness.

1.5 T MRI data were acquired for 61 subjects with SCZ and 59 matched healthy controls (HC). The patient group was divided in two subgroups based on clinical severity, one composed by 34 mild-to-moderately ill patients and the other one by 27 severely ill patients, and compared with matched HC.

The whole group of patients with SCZ had significantly reduced gray matter (GM) volumes in left inferior and middle temporal gyrus compared to HC (P < 0.05, pFWE corrected). Furthermore, compared to HC, patients with mild-to-moderate illness showed decreased GM volumes in inferior temporal gyrus (P < 0.05, pFWE corrected) whereas those with severe illness had reduced right cerebellum (P < 0.05, cFWE corrected). No differences were observed between the two subgroups of patients.

Our results showed significant GM volume reductions in left inferior and middle temporal gyrus in patients with SCZ compared to matched HC, confirming the role of this region in the pathophysiology of SCZ. Furthermore, we identified specific cerebellar gray matter volume reductions in patients with severe illness, which may contribute to stratify patients with SCZ according to their clinical phenotype expression, ultimately helping in guiding targeted therapeutic/rehabilitation interventions.

The authors have not supplied their declaration of competing interest.

Empathy is evolutionary preserved in social organisms and emotional face processing is one of its measures. Systems possibly active during empathic processing include perspective-taking, basic emotional contagion “mirroring” and “theory of mind” systems.

fMRI studies help clarifying neural correlates of empathic face processing; ALE meta-analysing fMRI studies allows identification of brain area activation/deactivation during empathy.

To identify brain areas most consistently involved in empathy.

We carried ALE meta-analysis of original studies focusing on cerebral activations during empathic face processing tasks and reporting data on Talairach or MNI space coordinates, converting the former in the latter. An 11-April-2016 PubMed search, using as keywords terms like empathy combined with functional magnetic resonance imaging (fMRI), produced 124 records of which 23 were finally included (568 participants, 247 males and 321 females; mean age 32.2 years). We followed the PRISMA statement. Whole-brain data were meta-analysed; significance was set at P = 0.0001, uncorrected.

ALE meta-analysis of data from 21 experiments (totalling 527 foci) on empathic face processing during experimental task conditions showed that emotional vs. neutral/control conditions significantly correlated with activations of left anterior cingulate cortex (BA 32), right precentral gyrus (BA 6), left amygdala, right superior frontal gyrus (BA 9), left middle occipital gyrus (BA 37), right insula (BA 13), left putamen, and left posterior cingulate cortex (BA 31).

Empathy is a complex process correlating with activation of different brain areas, which have been involved in emotional cue processing, self-other/same-different discrimination, perspective-taking, mirror neuron activation, emotional arousal and decision-making.

The authors have not supplied their declaration of competing interest.

Internet gaming disorder (IGD) is a type of behavioral addiction characterized by abnormal executive control, leading to loss of control over excessive gaming. Attention deficit and hyperactivity disorder (ADHD) is one of the most common comorbid disorders in IGD, involving delayed development of the executive control system, which could predispose individuals to gaming addiction. We investigated the influence of childhood ADHD on neural network features of IGD.

Resting-state functional magnetic resonance imaging analysis was performed on 44 young, male IGD subjects with and without childhood ADHD and 19 age-matched, healthy male controls. Posterior cingulate cortex (PCC)-seeded connectivity was evaluated to assess abnormalities in default mode network (DMN) connectivity, which is associated with deficits in executive control.

IGD subjects without childhood ADHD showed expanded functional connectivity (FC) between DMN-related regions (PCC, medial prefrontal cortex, thalamus) compared with controls. These subjects also exhibited expanded FC between the PCC and brain regions implicated in salience processing (anterior insula, orbitofrontal cortex) compared with IGD subjects with childhood ADHD. IGD subjects with childhood ADHD showed expanded FC between the PCC and cerebellum (crus II), a region involved in executive control. The strength of connectivity between the PCC and cerebellum (crus II) was positively correlated with self-reporting scales reflecting impulsiveness.

Individuals with IGD showed altered PCC-based FC, the characteristics of which might be dependent upon history of childhood ADHD. Our findings suggest that altered neural networks for executive control in ADHD would be a predisposition for developing IGD.

The authors have not supplied their declaration of competing interest.

Early life stressful events cause long-term neural changes that are associated with psychiatric disorders.

Early life manipulations focus on commonly the impact of remaining separate from the mother in a specific period of time. The maternal odor is required for pups to approach the mother for nursing. What happens when there is a mother that smell like a real mother but does not take care her own pups?

To investigate the fake mother effects on adult rat's behavioral changes, NMDR2B protein level changes in prefrontal cortex and hippocampus.

Wistar rats were used. Fake mother (n:13), early handling (n:12), maternal separation (n:14) and control (n:12) were the study groups. A fake mother is an object that smells like a real dam. When the real mother is separated from own pups fake mother stays with the pups for an hour. Manipulations were made during the postnatal first 14 days. Behavioral tests (social interaction test, elevated plus maze, novel object recognition test) were made between postnatal 62 and 78 days. NMDAR2B protein levels in prefrontal cortex and hippocampus were evaluated by using ELISA at postnatal 78 days.

In social interaction test, fake mother group exhibited less social behavior and more aggressive behavior than the other groups. Their long-term memory functions were the lowest. NMDAR2B protein levels in the hippocampus increased in rats that exposed to early stressful life events.

These results support that being raised by fake mother increases aggressive behavior and decrease social behavior in adulthood.

The authors have not supplied their declaration of competing interest.

Deficits in behavioral inhibition leading to impulsivity occur frequently in many otherwise different psychiatric diseases, mainly ADHD and borderline personality disorder (BPD). However, the research is complicated by using of different tests and their parameters. Further, the role of frontoparietal network in behavioral inhibition has been questioned recently.

The aims of our studies were:

– to present the influence of differences in inhibition tasks parameters;

– to describe neural correlates of behavioral inhibition in healthy people;

– to compare them with BPD and ADHD patients.

We implemented two different variants of Go/NoGo Task, one designed for behavioral research and the second for neuroimaging. Thirty healthy participants (37% of women, age range 15 to 33 years) underwent behavioral and fMRI measurement. Further, groups of patients with BPD, ADHD and their healthy controls underwent the Go/NoGo Task under both fMRI and EEG.

The results show differences in behavioral performance based on different task parameters. The fMRI results in healthy people show specific activation patterns within the frontoparietal network associated with inhibition trials (mainly inferior frontal gyrus, insula, cingulate gyrus, SMA, inferior parietal lobule). Further, we present differences between patients with BPD, ADHD and controls in BOLD signal and ERPs.

Go/NoGo Task design substantially influences the subjects’ behavioral performance. Our results with methodologically upgraded Go/NoGo Task design provide support for the inhibition frontoparietal brain network and its different activations in BPD and ADHD patients. The research was supported by Ministry of Health of the Czech Republic, grant nr. 15-30062A.

The authors have not supplied their declaration of competing interest.

Epilepsy is considered a complex neurological disorder with a great variety of clinical presentations that can resemble psychiatric disorders.

Disclose an unusual clinical case with psychiatric symptoms as the presentation of epilepsy.

Psychiatric assessments and retrospective review of the clinical file and literature research.

A 40-years-old Romanian woman presented to the psychiatry outpatient service with a history of persistent depressive mood and disturbed sleep for the past 3 years, complaining of a feeling that she described as “a snake squeezing around her body, starting in her left leg and spreading to the rest of her body up to the neck” associated with a sense of pins and needles, occurring during night time. She attended general practice, neurosurgery and psychiatry appointments. Her medical history included “gastritis” and lower left leg fracture and a pituitary microadenoma revealed in brain CT-scan. Blood work, including endocrine tests and brain-MRI were normal. Her symptoms initially led to diagnosis of: anxiety, somatization, Ekbom syndrome and depression. She was treated with antidepressives, antipsychotics and anxiolytics, without response. After careful reconstruction of the clinical history and further analyses of her complaints, the diagnosis of focal sensory jacksonian seizure was made. Levetiracetam introduction led to symptomatic remission.

Epilepsy includes a variety of neuropsychiatric symptoms. This case illustrates that epileptic patients may experience non-convulsive seizures that might be mistaken as primary psychiatric disorders. Neurologists and psychiatrists must be aware of this varied presentation while obtaining the medical history in order to investigate and manage this patient effectively.

The authors have not supplied their declaration of competing interest.

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Early invasion of the central nervous system might occur early in the course of the disease. Clinical manifestations may include acute meningeal syphilis, meningovascular syphilis, paretic neurosyphilis and tabetic neurosyphilis. Psychiatric symptoms are often the presenting symptoms of this illness and the correct diagnosis involves both a high degree of suspicion and adequate diagnostic tests.

The authors report a case of a patient, with no previous history of mental illness, initially admitted in a psychiatric unit with a clinical picture suggestive of a mixed bipolar disorder episode who has been diagnosed with neurosyphilis a year after.

Review of clinical records and complementary exams.

By the first admission, the patient presented with depressed and irritable mood, emotional lability, aggressiveness, grandiose and racing thoughts. Upon discharge, he was diagnosed with bipolar disorder and referred to ambulatory unit. The following year he starts presenting cognitive deficits and a progressive loss of autonomy in daily living activities, being referred to neurology evaluation. A year after the first admission, he is admitted in a neurology unit and diagnosed with neurosyphilis.

Current prevalence of symptomatic neurosyphilis in Western Europe is unknown. Atypical cases presenting with heterogeneous psychiatric and neurologic symptoms, with no previous history of mental illness, should raise a high index of clinical suspicion, since consequences for the patient's health might be severe if not properly diagnosed and treated.

The authors have not supplied their declaration of competing interest.