Most people who commit suicide suffer from depression, but diagnostic categories and known personal and demographic factors do not adequately capture the distress that leads people to kill themselves. Mood Instability (MI) refers to sudden unpredictable fluctuations in mood often occurring within a day.

To determine whether MI predicts suicidal thoughts.

Hypothesis: That MI will predict suicidal thoughts even when negative affect (depression, anxiety, anger) are controlled.

Data from the Dutch Imigrant panel of the Longitudinal Internet Studies for the Social Sciences (LISS-I) (N = 1686) were used. MI was assessed with 7 items from the International Personality Item Pool of Big Five Indicators. The Chronbach's alpha was 0.86. Suicidal thoughts were assessed by a single question referring to the past week. Depression, anxiety and anger were represented by 21 items derived by factor analysis from the 31-item Emotional Expressiveness Module. Odds ratios using logistic regression modeling were calculated, adjusting for negative affect, alcohol and substance abuse, and demographic variables (age, sex, income).

MI predicts suicidal thoughts (Males OR: 1.14; 95% CI: 1.02-1.28 and females OR: 1.11; 95% CI: 1.00-1.23) along with negative affect. There was no interaction between MI and negative affect.

MI has been relatively neglected as a predictor of suicidal thoughts. It is likely that the unpredictable, sudden, severe descents in mood are particularly distressing and contribute to the feeling that life is intolerable. MI requires more attention in the assessment and treatment of suicide risk.

The present study aimed at examining the relationship between general health and reasons for living factors.

Descriptive correlational method was applied to this study. 100 female teachers were recruited from Babol city randomly as the research sample. Life Orientation Test (LOT) and General Health Questionnaire were tools used to collect data. The data obtained from respondents were transferred to SPSS spreadsheet for descriptive (mean and standard deviation) and inferential (Pearson's correlation coefficient and step wise regression analysis) analyses.

Results from the present research showed a significant relationship between the score of general health and reasons for living factors. Moreover, results of correlation matrix revealed the maximum correlation between general health and moral objections. Based on the smaller value of significance level (P=.021) obtained from the association of general health variable with survival/coping beliefs than that of shown in the table (P=0.05) and the correspondent correlation coefficient of -.223, we concluded with 95% confidence that a significant negative relationship existed between general health and survival/coping beliefs. Also, the amount of significance level of general health and responsibility to family was found to be smaller (P=.029) than the value shown in the table (P= 0.05) and correlation coefficient of -.207 was computed. As a consequence, it could be deduced with 95% certainty that there existed a significant negative link between general health and responsibility to family.

Results from regression analysis have indicated that general health variable can be predicted by reasons for living factors (Survival/Coping Beliefs (SCB), Responsibility to Family (RF), Child-Related Concerns (CRC), Fear of Suicide (FS), Fear of Social Disapproval (FSD) and Moral Objections (MO)). Moral objection, alone and with β= -.300, accounts for 30 percent of variance of general health.

Passing through the cancer increases the risk of depression. Also known that social support is an important predictor of a better adaptation and higher quality of life (QoL). Meanwhile, there are common cognitive distortions which may lead to inadequate perceive social support and deterioration in QoL. Correction of cognitive distortions through the use of cognitive behavioral therapy (CBT) should help to improve the functioning of cancer patients.

The first aim is establish correlation between cognitive distortions, level of depression, perceive social support and QoL. The second is examine the effectiveness of CBT among patients with breast cancer.

Longitudinal study included women with breast cancer and their partners. Experimental group consisted of 61 couples who had participated in ten-week CBT. A control group consisted of 56 couples, who did not benefit from any psychotherapy. The study used the following questionnaires: BDI, EORTC-QLQ-C30 (women) and BSSS (women and men).

At baseline there were no differences between women in the experimental and control groups. Women evaluated the support much lower than the average level of support declared by their partners. At post-test evaluation of support by men has not changed, but there observed an improvement in evaluation of support among women in CBT-group and a further deterioration in the evaluation in the control group. Simultaneously, an improvement in QoL and reduction in depressive symptoms were noticed in CBT-group.

Correction of cognitive distortions through the use of CBT should help to improve the functioning of patients with breast cancer.

The term suicide by cop is used commonly for police-involved shootings that could be considered suicides because of the subject's precipitated actions that demonstrate suicidal intent through words or behaviors. The notion that victims sometimes initiate physical conflicts in which they are injured or killed is studied for more than 50 years. This is first description of Suicide-by-cop in South-East Europe.

On October 28th 2011, MJ, a member of radical islamic movement, attacked the US Embassy in Sarajevo. He spent 50 minutes in plain sight firing from an automatic rifle (AK-47) at the U.S. embassy, seriously wounding a police officer before he was hit by a police sharpshooter.

Police may confront shootings motivated by suicidal subjects more often than reports indicate. Although suicide by cop is most commonly reported and studied in the United States, Canada, and more recently the United Kingdom it appears to be an international phenomenon.

Mevlid Jasarevic's case was an act of terrorism from the perspective of law. From the perspective of mental health professionals it was also Suicide-by-cop attempt. New information confirm our earlier made conclusion – MJ left movement, shaved beard and changed his outlook. There were some other reasons but terroristic for such attack.

To examine an effect of personality disorders on clinical features and disease course of cardiovascular diseases (CVD).

We’ve examined 358 inpatients (220 female, 138 male; mean age 57,6 ± 4,3years) with Arterial Hypertension (AH), Coronary Artery Disease (CAD) and Atrial Fibrillation (AF). Main methods were psychopathological, pathopsychological and clinico-instrumental.

Two groups of patients were determined. In the first group (216 patients, 64,8% female, mean age 56,9±2,1 years; mean CVD duration 9,2±3,1 years) clinical course of CVD is subjected to personality disorder's dynamics. Synergistic type of CVD clinical course is characterized by reactive somatopsychic lability, CVD manifestation at the time of stressful situation, CVD symptoms redoubling by somatoform disorders. CVD exacerbations correlate with psychogenic depressive phases and\or climacterial period. In most cases (76,1%) further CVD dynamics is characterized by hypochondriacal personality development. In the second group (142 patients, 70,4% female, mean age 57,6±1,4 years; mean CVD duration 9,2±2,2 years) clinical course of CVD doesn’t correlate with personality disorder's dynamics. Alternating type of clinical course of CVD is characterized by hereditary and somatogenic factors.

These data enable to explain ambiguous results about reciprocal influence of personality disorders and CVD received in many studies. Our findings are of great practical importance and show the necessity of differentiated approach in complex treatment of CVD.

Taking into account epidemiological data about growing frequency of acute and chronic disorders of maxillofacial area evaluation of psychopathological disorders in this group of patients is of great importance.

The purpose was to diagnose symptoms of psychopathological disorders in maxillofacial surgeons’ patients.

The study used psychometric method. The validated scales used were SAS, SDS, Holmes and Rahe stress scale, HCL-32-R1. We included all patients who have applied to the clinic of Moscow State Medico-Stomatologic University from January 2010 to March 2013 and who gave Inform Consent.

Study sample consists of 408 patients (206 men, 202 women), 18-71 years old. According to somatic status all patients were divided into three groups. First group (n=160) – patients with chronic somatic disease resulted in fixed deformity of maxillofacial area. 41,3% of patients had depressive symptoms, 31,3% had anxiety symptoms and 16,3% had hypomania symptoms. Second group (n=127) - patients with acute posttraumatic face tissue injury. 10,7% of patients had symptoms of depression, 20% of patients had symptoms of anxiety and 32,3% of patients had symptoms of hypomania.

Third group (n=121) – patients without evident somatic pathology wishing to perform surgical correction of appearance.51,2% of patients had depressive symptoms, 40,5% of patients had anxiety symptoms and 35,7% of patients had hypomania symptoms.

Our data suggest that 10-55% of maxillofacial surgeons’ patients have different symptoms of mental disorders (affective, anxiety). Further investigation needed to determine syndromal characteristics and nosological diagnosis and to elaborate psychopharmacotherapy and psychotherapy approaches.

Depression and apathy are common behavioral symptom of Alzheimer's disease (AD) and antidepressants, despite their role in improving depression have a minimum impact in improving apathy. Agomelatine has been shown to be effective in alleviating depression and reversing treatment emergent apathy.

The purpose of the current pilot study is to determine the efficacy of agomelatine in depressed patients with AD and comorbid apathy.

In this prospective 4 month study, twenty depressed elderly AD patients (age 65-85) who had been treated with SSRI and/or SNRI and shown a partial response to the antidepressant prescribed, in terms of apathy, were switched to agomelatine. Subjects were monitored for depression (Hamilton Rating Scale for Depression, HDRS), cognitive functions (Mini–Mental State Examination, MMSE) and apathy (Neuropsychiatric Inventory –apathy item, NPI-a).

Within groups, differences of HDRS, CSDD, MMSE and NPI-a scores at baseline, 2nd and 4th month of agomelatine treatment were estimated with repeated measure analysis of variance.

Following agomelatine, a numeric but not statistically significant improvement was observed in depression scores (8.2±3.5 vs 7.8±3.1, p=0.234, 7.8±3.1 vs5.8±2.3, p=0.421). A marked improvement in MMSE score was observed at both 2nd (22.2±4.9 vs 20.9± 5.4, p=0.05) and 3rd assessment(22.2±4.9 vs 23.9±4.9, p<0.05). Apathy score was also improved over the consecutive assessments (25.3±5.9 vs 18.6±3.9, p<0.05 and 18.6±3.9 15.5±4.3, p<0.05).

The present study demonstrated a good therapeutic response to agomelatine in elderly AD patients with depression and apathy symptoms in terms of alleviating apathy.

It is established the presence of seasonal variations in decompensation of patients with bipolar disorder. The purpose of this study is to assess whether other environmental factors such as Moon lighting or the distance between the Moon and Earth are associated with decompensation of this group of disorders.

We collected all the attention made ??to the Emergency Department of the Hospital de León for one year (July 2012 to June 2013). We identified patients diagnosed with Bipolar Disorder (F31.x). Consultations were correlated with the following astronomical data: Moon lighting, Moon Phase, Earth-Moon distance and growing or waning moon. Main variables to study were number of emergency consultations and income in hospitalization. It was used for analysis SPSS v20.

From a total of 1405 emergency consultations 96 patients were diagnosed with Bipolar Disorder, of whom 60 required hospitalization. The mean ratio of total number of consultations / total days in a particular moon phase was 0.2858 (95% CI: 0.2313 to 0.3403) with significant variations in the different phases. The mean ratio of total hospitalizations / total days in a particular moon phase was 0.1728 (95% CI: 0.1095 to 0.2361). The comparison of the mean lunar illumination between patients who required admission (mean = 56.7 + / -32.08) and those who were discharged (mean = 43.69 + / -32.39) was found near statistical significance (p = 0.058). There were no significant differences in the Earth-Moon distance or the waxing or waning state of the Moon.

No association was found between the Earth-Moon distance and the number of visits or hospitalizations in bipolar patients. The lunar illumination is higher in cases that required hospitalization and it is necessary conduct a study with a greater potency to establish or definitely reject this finding.

Patients with psychotic depression have a high rate of relapses and readmissions. There have been conflicting findings regarding the stability of the psychotic depression diagnosis.

The study is based on a sample of patients (diagnosis codes: F32.3x, F33.3x, F25.xx, F29), who had their first treatment episode in the hospital district of Satakunta between the years of 1996 and 2000. Their patients’ records were reviewed using an instrument to record background data, information on treatment episode and treaments, and symptoms. Additionally, data from national registers (hospital discharge register, reimbursement of medications and causes of death) was collected and followed until the end of 2008.

The sample included 181 subjects, 70 men (38.7%) and 111 women (61.3%). Out of the whole sample, 17.1% (n=31) had a diagnosis of schizoaffective disorder, 23.8% (n=43) a diagnosis of psychosis NOS and 59.1% (n=107) a diagnosis of psychotic depression. Patients with psychotic depression were significantly older (60.1) compared to schizoaffective (49.8) and psychosis NOS (36.5) patients (p<0.001). about two thirds of the patients (n=119) had at least two treatment episodes. A change in the diagnosis of the patient from the first episode to the last during the 12-year follow-up was observed in 34 (28.6%) out 119 subjects. Schizoaffective disorder (88.0%) was the most stable diagnosis, psychotic depression a moderately stable diagnosis (68.7%) among the readmitted patients. Only one case with psychosis NOS had retained the diagnosis.

In this sample, among the readmitted patients psychotic depression was a fairly stable diagnosis.

Previous studies suggested that migrants are at higher risk for psychosis [1] but that this risk is inversely correlated with the size of their ethnic group [2].

However, less is known about the influence of proportion of migrants in a population - a simple and readily available parameter - on the incidence of psychosis in the whole population - a measure of interest for mental health policies.

We prospectively collected data over 3 years in an urban area with a population of N=133000 at risk subjects. The area was divided in 80 geographical units classified in four categories (quartiles) according to the proportion of migrants in the latest census. For each of the geographic units we calculated the standardized incidence rates of affective, non-affective and total psychoses. We tested the hypothesis of unequal rates of psychosis according to migrants’ density quartiles using a Poisson model.

The proportion of migrants significantly influenced the incidence of total psychoses and affective psychoses. However, in this sample, an increase in migrant density was not linked to an increase in cases of psychosis over the entire spectrum of migrants’ density. A raise in the third quartile was followed by lower incidence rates in populations with the largest proportion of migrants (see figure)

More research is needed to confirm or contradict this result and test for different explanatory hypotheses.

The Lifeline’Talk With Us’ was founded in 2008 by Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Italy, to provide free and confidential emotional support to people in suicidal crisis.

In this study we evaluated the socio demographic profile of individuals who used the helpline during last year (2012–2013) and caller's intent to die at the end of the call.

To investigate suicide risk factors among the callers and the association with the socio-economic status.

Using a standardized form, we assessed suicide risk in a sample of 228 callers (120 female) focusing on Suicidal Desire, Suicidal Capability, Suicidal Intent.

The mean age of our sample was 41±14,8; most callers (52%) were female from north and central of Italy. Suicide risk factors in our sample were the following: feeling alone, loss of a significant relationship, economic problems, loss of a significant loved one by suicide. Suicide attempts were reported by 27% of participants whereas 16,8% of them referred suicidal ideation. Unemployment was found in 22% of the callers whereas 42% of them referred suicide attempts, and 25% suicidal ideation.

This study shows the importance to provide an accessible volunteer service for people who are in crisis, present suicidal ideation or reported prior suicide attempts. In particular, our service was very important for those who were in economic crisis, as demonstrated by our data. Improving the quality of the existing services, and promoting awareness that suicide prevention is possible are highly recommended.

The psychological autopsy aims to reach an understanding on the psychological aspects of a specific death.

Interview of relatives and friends require sensitivity to their emotional condition. Since Edwin Shneidman started to use this method, one of the most important questions is when to arrange the interview.

To evaluate family and friends satisfaction with the interview, in order to determinate when is the best moment to settle the psychological interview.

We studied the results of 271 suicides psychological interviews, and analyzed two variables: the satisfaction (measured using rating scale from zero to ten) and the time passed since the suicide.

The overall satisfaction was high (8´75), and the average time that we lasted to carry out the interview was 8´54 months.

When we analyzed the satisfaction through the months, we did not find differences in the values of the rating scale.

Although the best time to contact friends and relatives has been established to be between 2 and 6 months after the suicide event, in our study we did not find any relation between the timing and the satisfaction.

The results of this study show that the fact of when is the best moment to settle the psychological autopsy interview is still unclear.

A better konwlodge about this could improve the satisfaction of relatives and friends with the psychologial autopsy.

To examine whether positive and negative life events precede bipolar mood symptoms or whether bipolar mood symptoms precede life events in bipolar I and bipolar II outpatients.

173 bipolar outpatients with a diagnosis of bipolar disorder type 1 (BD I) or 2 (BD II) were assessed every three months for a total of two years. Life events were assessed by Paykel's self-report questionnaire. The NIMH monthly retrospective life chart method (LCM-r) was used to assess monthly functional impairment due to manic or depressive symptomatology. Mood symptoms were assessed every six months with the Quick Inventory of Depressive Symptomatology- Self Report (QIDS) and the Young Mania Rating Scale (YMRS).

Multilevel regression analyses (linear mixed-models) showed that negative life events are significantly associated with both subsequent severity of mania and depressive symptoms and functional impairment, whereas positive life events only preceded functional impairment due to manic symptoms and mania severity. These associations were significantly stronger in BD I patients compared to BD II patients. For the opposite temporal direction, we found that mania symptoms preceded the occurrence of positive life events and depressive symptoms preceded negative life events.

Life events appear to precede the occurrence of mood symptoms and functional impairment, and this association is stronger in BD I patients. Mood symptoms also precede the occurrence of life event, but no differences were found between BD I and II patients.

Recovery is an important concept in schizophrenia that has not been well defined or researched. It is crucial to determine its predictors.

To determine sociodemographic and clinical factors associated with remission and recovery in a population of patients with schizophrenia.

The design was an observational, cross-sectional and analytic study. We recruited all of the outpatients with schizophrenia or schizoaffective disorder (according to DSM IV-TR) who consulted psychiatry ward F from the 1/2//2013 to the 31/3/2013. Clinical and sociodemographic data for patients were gathered using an ad-hoc structured questionnaire. Clinical remission was defined according to criteria from the Remission in Schizophrenia Working Group (RSWG). Recovery was defined according to the following criteria from a Meta-Analysis by Jääskeläinen et al. (2013): a clinical remission (RSWG criteria) with a social remission (Global Assessment of Functioning score >=61) and no hospitalisation in the last two years.

Our sample comprised 44 patient (65.9% were females and 34.1% were males). Remission was achieved in 36.4% of the cases and was correlated with paranoid schizophrenia (p=0.024) and schizoaffective disorder (0.02) diagnoses. Recovery was achieved in 15.9% of the cases and had higher rates in females (p=0.4).

Better remission rates in paranoid schizophrebia and schizoaffective disorder is a finding which is broadly consistent with numerous previous studies. In opposite, the fact that female patients are more likely to achieve recovery remains controversial.

General practitioners (GPs) are well placed as gatekeepers for depression and suicidal ideation, but not properly prepared to detect and treat depression and suicidal behavior. Training programs aiming to increase the GPs’ capacity have been recommended as a useful strategy for suicide prevention. The current study aimed to increase the GPs’ attitudes toward depression and its treatment as well as attitudes toward suicide prevention and confidence in dealing with depression and suicidal ideation in daily practice.

In the context of a large European multilevel research project (OSPI-Europe) a standardized training program was developed and provided to 215 GPs in Germany, Hungary, Ireland, and Portugal. Core outcomes were assessed before training, after training, and at three months follow-up with the Depression Attitude Questionnaire, the Attitude toward Suicide Prevention scale, and the Morris Confidence Scale.

At baseline GPs showed moderately favorable attitudes toward depression and its treatment, fairly positive attitudes toward suicide prevention, and little confidence to deal with depression and suicide in their professional life. Importantly, the training program resulted in significant improvements in the GPs’ confidence to deal with depression and suicide and in their attitudes toward suicide prevention. After three months follow-up, training effects with respect to confidence could be sustained.

The OSPI-training program was able to reshape the attitudes of GPs toward suicide prevention and to boost their confidence in dealing with depression and suicide. Effects on the GPs’ attitudes toward depression and its treatment were less convincing. Recommendations are formulated for future training programs.

The subclinical behavioral and psychological characteristics of schizophrenic children have not been sufficiently investigated to present specific evidences. To elucidate the picture of them, and to find out indicators which predict later development of schizophrenia, childhood behaviors of the adult schizophrenia subjects were investigated in a questionnaire-based retrospective study.

Schizophrenia outpatients in his/her twenties and normal healthy subjects were investigated. All patients are diagnosed according to DSM-IV-TR as schizophrenia, and who present now mainly negative symptoms after passing an acute stage. By modified use of the CBCL (Child Behavior Checklist) as a retrospective assessment questionnaire, the parents of the patients and of control subjects rated their childhood (aged 6–8 years) behavior.

Among the eight CBCL syndrome subscale T-scores, those of’Withdrawan’,’Anxious/Depressed’,’Social problems’ and’Attention problems’ were significantly associated with schizophrenia, although any of these scores were not in clinical range. Patients also showed a significantly attenuated aggression. The hit-rate when classifying the schizophrenic and normal subjects by logistic regression analysis using the eight CBCL syndrome subscale T-scores totaled 87.8%.

The results suggested that subclinical behavioral and psychological characteristics of schizophrenia already exist in the patients’ childhood. With some assessment tool using obtained logistic regression formulas, the quite early screening for the risk of schizophrenia could be possible.

Adult Separation Anxiety Disorder (ASAD) is related to greater personal dysfunction and to a reduced sensitivity to conventional treatment, such as cognitive-behavioural therapy or anti-panic drugs, even considering severity of anxiety symptoms, number of co-morbid disorders, socioeconomical status, disease duration, and severity of agoraphobia.

To evaluate separation anxiety, psychiatric co-morbidity, levels of anxiety, character and temperament personality traits, and global functioning, in subjects with anxiety disorders attending a tertiary-level outpatient clinic.

To predict the outcome and customize treatment for anxiety disorders.

After symptom stabilization of one month (T0) 40 patients with anxiety disorders were assessed by means of SCI- SAS, SASI, ASA -27, MINI, HAM- A, TCI-R, GAF. Prospective evaluation is planned at T60 and T180.

According to preliminary cross-sectional data, higher scores of separation anxiety show statistically significant correlations with some domains of the TCI-R; in addition, patients with ASAD show greater psychiatric co-morbidity. No correlations were found between the presence of separation anxiety and levels of anxiety at HAM-A or GAF scores at baseline.

The prospective study of long-term response to treatment is ongoing and the sample will be expanded. The comprehension of anxiety symptoms appraisal in the framework of psychobiological personality characteristics is expected to influence the choice of both pharmacological and psychological therapeutic tools, particularly in patients showing higher levels of dysfunction.

According to the literature, consumption of cigarettes has been related to suicidal behavior. Furthermore, evidence suggests that increased consumption of cigarettes is associated with an increased risk of suicide.

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1. - To verify the association between the consumption of cigarettes and completed suicide.

2. - To confirm a higher consumption of cigarettes in completed suicide versus controls.

Completed old suicide and controls were recruited through the Institute of Legal Medicine of the province of Seville, Spain. After the physical autopsy was conducted, family members were asked for a posterior interview following the Psychological Autopsy methodology.

There were 412 subjetcs collected for this study; 270 completed suicide and 142 controls.

Only one third of suicides did never smoke whether almost half of controls did so (27.5% vs. 47.2%; c2=23.73; df:3; p<0.0001). We did not find any difference between the quantity of cigarettes used by those subjects that smoke daily in suicides (53.2%) and controls (44.5%). However this lack of association may be due to the type of controls. Controls were in a substantial percentage cardiac sudden death subject and smoking tobacco has been largely associated with cardiovascular disorders.-Almost 50% of controls had never smoked (compared to 27% of suicides).

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1. - There are fewer subjects that have never started smoking within the suicide subjects compared to controls.

2. - The number of cigarretes in those who smoke daily was not associated to any group. This results may be influenced by the characteristics of our control population.