Behcet's disease (BD) is a heterogeneous, multisystemic, recurrent, inflammatory disorder with a chronic course and an unknown cause. Mental disorders (MD) occur quite often with BD. The influence of childhood experience, relations traumatic events with BD and MD, specificity of MD still have not investigated carefully.

55 BD patients (44 male and 11 female mean age 33,1±10,1) were included. ICD-10 criteria were used for MD diagnostic. Severity levels of stress, anxiety, depression found by PSS, HAM-A, MADRS.

Early traumatic childhood experiences observed in 29(52,7%) patients. Among this patients BD started before 18 years in 13(44,8%) cases whereas in patients without early traumatic childhood experiences in 7(26,3%). The severe stress factors were preceded first BD symptoms in 12(21,8%) cases, prolonged low-intensity stressors in 24(43,6%). Most patients 45(81,8%) self-reported connection between stressful life events and exacerbation of BD. MD were diagnosed in 47(86%) BD patients: dysthymia 19(34,5%), recurrent depressive disorder − 14 (25,4%), depressive episode (mild, moderate) − 8 (14,5%), generalized anxiety disorder − 4 (7,3%), adjustment disorder − 2 (3,6%). MD preceded BD in 20% cases. Depression scores showed a clinically normal level in 13 BD patients (23,6%), mild level in 34 (61,8%), and moderate level in 8 (14,5%). Mean severity levels of anxiety, stress were 14,3±5,4 and 16,1±5,9 accordingly.

The received data show, that individual history of stressful life events is important for the beginning of the rheumatic disease and MD in BD patients. Depression and anxiety spectrum disorders are the most common MD in BD patients.

A series of clinical studies demonstrated that QEEG (quantitative electroencephalography) prefrontal theta cordance value decreases after one week of treatment in responders to antidepressants and precedes clinical improvement. Ketamine, a non-competitive antagonist of NMDA receptors, has a unique rapid antidepressant effect but its influence on QEEG measures is still unknown. To date wasn’t studied predictive value of cordance in response to single infusion of ketamine in depressive subjects.

In a double-blind, cross-over, randomized, placebo-controlled experiment we studied the influence of ketamine (0.54 mg/kg) on theta cordance in a group of 27 right-handed hospitalized depressive patients on stable antidepressant medication. QEEG cordance values in theta frequency band were calculated according to UCLA algorithm.

Responders (n=11) to ketamine in compare to non-responders (n=16) showed significant difference in cordance values at the end of ketamine infusion (Spearman, p= 0.039). The cordance decrease, measured between the end of infusion and next day, positively correlated with ketamine antidepressant response (MADRS decrease) fourth day after infusion (two-tailed Fisher's Exact test, df=1, p=0.0076) with NPV 90.9% (95% CI 64.3%-99.5%) and PPV 62.5% (95% CI 44.2%-68.4%).

Our data indicate that ketamine infusion immediately induces similar changes as monoaminergic-based antidepressants do gradually after a series of downstream signalling steps. The reduction in theta prefrontal cordance could serve as a biomarker of sustained antidepressant response, a hypothesis that should be tested in larger depressive population.

Several factors influence the emotional behavior, including environment, genetic and the interaction between them.

The aim of this work is to investigate the interaction between environmental and genetic influences in the divergent behavior of Carioca High and Low Freezing (CHF and CLF) rats - a genetic model to study fear and anxiety. The Carioca rat lines were produced from selective breeding method, from animals with the highest and lowest levels of freezing behavior in the contextual fear conditioning, a model to study anxiety-like behavior.

To investigate the gene-environment interplay, we employed the cross-fostering procedure, which CHF rat pups were raised by CLF dams, and vice-versa, since pos natal day (PND) 1 until weaning at PND21. The litters were culled in 8 pups, and we fostered only 2–3 male pups per litter. We also maintained CHF and CLF control, no-fostered litters. On PND60, male animals of the four groups (CHF (n=7), CHF-CLF (CHF pups raised by CLF dams) (n=6), CLF (n=4) and CLF-CHF (n=3)) were exposed to the contextual fear conditioning.

The freezing behavior on the day after foot shocks was analyzed. A two-way ANOVA showed that, although CHF rats had a higher time in freezing in this task comparing to the CLF (p<0.01), as expected, no one cross-fostering effect was observed: CHF = CHF-CLF > CLF-CHF = CLF. On PND120, the same male rats were exposed to a 12-minutes-session, two-session extinction paradigm, in the same context. In these sessions, no foot shock was used. Comparing the freezing time in the context session on the conditioning paradigm to the freezing time on the first extinction session, we observed a significant decrease in this behavior for the CHF-CLF group, but not in the CHF group (p<0.05). This difference between groups was not observed between CLF and CLF-CHF animals. Our previous work has showed that there isn’t a memory deficit in the CHF animals.

This data suggest an existence of an early environment influence in the anxiety behavior extinction, but it was dependent of the genetic background.

Memantine has been registered worldwide for the treatment of moderate to severe dementia of Alzheimer's type (AD). However, both historical experiences and contemporary research showed its possible utility also in other types of dementia, including that of vascular origin (VaD) and Lewy body pathology-related (DLB/PDD). Maximum labelled dosing of memantine for patients with AD and the same was used in studies with VaD and PDD/DLB. Memantine seem to be well tolerated in AD patients, less is known considering other dementias.

Naturalistic observation of the group of 120 AD, 65 VaD and 30 DLB/PDD patients from the memantine initiation with a maximum one year observation period. Drop-out or dose reduction due to adverse effects where analyzed.

Considerably lower fraction of patients with other that AD diagnoses achieved maximum dose of 20 mg/day and needed dose-reduction due to adversity. Moreover, numerically more patients with DLB/PDD than both VaD and AD did not tolerate any dose of memantine; this difference, however, due to small numbers did not reach statistical significance. The most common symptoms which resulted in dose-reduction or drug discontinuation included agitation, excessive sedation and gastrointestinal complications.

Similarly to previously known observations with cholinesterase inhibitors, patients with dementia due to AD tolerated memantine better than those with other dementias. The phenomenon underlying mechanism is currently unknown. Nevertheless, despite obscure nature, it may have important pragmatic consequences and may lead clinicians to both greater vigilance and possibly targeting at lower memantine doses in patients with dementias other than AD.

of this study are evaluation the diagnosis rate of mental health clients in ED of general hospital, evaluation of rate of referrals to recommended.

The current study is aimed to analyze (a) the rate of mental health diagnosis in ED clients from general hospitals and (b) rates of referrals to recommended psychiatric services and other specific treatment.

This is an observational study performed within the EDs from five different East European countries: Romania, Serbia, Moldova, Bulgaria and Albania. The data collected from every ED include the number of recorded patients with psychiatric diagnosis, characteristics of these patients (age, gender, rural/urban origin, and professional status), number of recommended referrals to psychiatric settings and specific treatment and covers the 3 months’ period. The identification data were not collected from patients as for the ethical reasons.

estimate level of diagnosis of mental health disorders in ED patients in general hospitals in East European countries and find gaps in needs and services received in ED for mental health clients.

All countries involved in project are in the period of mental health services development and identification of the specific unmet needs for mental health clients in ED that can contribute for further strategy development based on study's findings.

Treatment-resistant schizophrenia (TRS) presents serious problems and unmet needs for clinicians, families, social, and legal services. Existing preliminary neurophysiological and clinical data confirm the hypothesis that ECT and dibenzodiazepine antipsychotics may have synergistic effects in TRS.

To evaluate efficacy and tolerability of two combination therapy options (ECT with clozapine [CLZ] and ECT with olanzapine [OLZ]) in TRS, as well as to differentiate clinical indications of the aforementioned methods in TRS.

80 TRS patients were randomised into four treatment groups: CLZ+ECT (n=19); OLZ+ECT (n=19); OLZ (n=21); CLZ (n=21), with dosage ranging 10–20mg OLZ and 200–900mg CLZ. ECT was administered 8-18 times in a twice weekly regimen. Patients (44 male, 36 female; mean age 32.2±11.6) were treated for 10 weeks and assessed using PANSS (total score [TS] and subscores), CGI and MOSES scales.

At the 10-week end-point, the number of responders (>30% PANSS TS reduction) in combination treatment groups was significantly higher compared to antipsychotic monotherapy: CLZ+ECT 53%, CLZ 14% (p<.05); OLZ+ECT 58%, OLZ 19% (p<.05); as was the mean PANSS TS reduction: CLZ+ECT 28.3%, CLZ 25.7% (p<.05); OLZ+ECT 37.6%, OLZ 26.3% (p<.01). Moreover, in combination groups the response threshold was generally observed 2–4 weeks earlier than in monotherapy groups.

Combining ECT with CLZ or OLZ improves and accelerates treatment response, and its efficacy is directly correlated with the number of ECT sessions. Specific indications include TRS with predominant catatonic, hebephrenic, negative and depressive symptoms. Combination options also demonstrated similar tolerability as CLZ and OLZ monotherapy.

The internet is an important source of information and exchange for patients and can exert considerable influence on their health-related behaviors. Internet-based therapy typically involves the interaction between a consumer and therapist via the Internet and incorporates the use of a structured Web-based treatment program for consumers to access in conjunction with therapist assistance (usually by email.

The purpose of this open study will be to test the efficacy of therapist-assisted internet 12 module 4 month long self-help program based on cognitive behavioral approach (IB-CBT) with the treatment as usual (TAU) for bipolar affective disorder patients who are medicated with thymostabilisers.

66 participants suffering with bipolar affective disorder, who recruit from the patients of the Psychiatric clinic Olomouc at time of start the maintenance pharmacological phase of the treatment of bipolar affective disorder will be randomized to the TAU (treatment as usual) and IB-CBT (12 modules of internet based CBT+ TAU). All participants will complete a clinical diagnostic interview, and a set of questionnaires to assess affective symptoms at four time periods (start of the maintenance treatment period and at follow up: 6 month, 12 month and 24 month. The study will be done in open conditions

The results from the start of the maintenance treatment period will be present. 31 paticipants finished psychoeducational program, 30 collaborated in TAU group. The comparison of both group according the rate of relapses and re-hospitalizations didnot significally differ in 6-moth follow up.

Supported by grant IGA MZ CR NT11047

Three methods are used to make a diagnosis: medical history, examination and laboratory-instrumental analysis.

With advances in modern medical technology, laboratory instrumental analysis is gaining increasing importance and trust, while classical methods are neglected: a thorough review of the medical history and a detailed examination.

To point out the significance of making a timely and correct diagnosis.

Report the case of 47 year old female patient with no previous psychiatric history. Her symptoms appeared suddenly in the morning, developed a clinical picture with psychotic symptoms. A CT scan of her brain, was normal findings. She went to a neurologist, who produced an orderly neurological report and recommended a screening test for psychoactive substances (PAS). The test was positive for heroin, morphine and benzodiazepine. Since she is disoriented and has incoherent speech and neologisms, she was hospitalised at the Psychiatry hospital. Abuse of the PAS was excluded because she used analgesic contains codeine. On the seventh day of her stay a CT scan of her brain was made and showed a large ischaemic lesion in the left temporoparietal area.

Laboratory-instrumental analysis is not without objective and subjective errors and must not guide the diagnosis without a sufficient clinical basis, and it must be preceded by a review of the medical history and an examination. A timely and correct diagnosis is important in order to provide adequate therapeutic treatment to a patient as soon as possible and in order to avoid needless hospitalisation in the psychiatry ward.

Post-partum depression is the most common complication of pregnancy in developed countries, affecting 10–15% of new mothers (McDonald et al., 2012). PPD can negatively impact a woman's wellbeing, maternal–infant interactions and child developmental outcomes from infancy through school age (Avan et al., 2010). Such conditions may be exacerbated by co-occurring anxiety symptomatology and perinatal stress (Brand, Brennan, 2009; Tambelli, Odorisio, 2013).

Nevertheless, empirical data show incongruent effects of perinatal maternal mental health upon mother-child relationship and the child's health. We believe that maternal representations may contribute to understand such differences.

On such basis, the purpose of our research was to evaluate the influence of maternal representations on emotional availability during a free play interaction in the context of perinatal depression and anxiety comorbidity.

We administered to 120 first time mothers (mean age= 33.57; s.d.=4.82) and their babies (mean age=6.55; s.d.=.63), the following measures: the Edinburgh Postnatal Depression Scale (Cox, et al., 1987); the State-Trait Anxiety Inventory (Spielberger, 1983); the Parent Stress Index – Short Form (Abidin, 1993) and the Maternal Representation Interview at Child's Birth (Tambelli et al., 2006). Finally, all mothers were video recorded during a free-play interaction with their child, assessed according to Emotional Availability Scales (Biringen, 2000).

Results showed significant different quality of maternal representations and mother-child interaction according to presence/absence of depression and/or anxiety.

The study shows the need to acknowledge the woman's emotion-regulation style that needs to be supported in the context of psychological malaise during the perinatal period.

110 patients who fulfilled the DSM-IV diagnostic criteria for a major depressive episode treated on an outpatient basis at the Eginition Hospital were assessed with the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale and the Global Assessment Functioning. The questionnaires were administered at the beginning of the medication period and thereafter every week over a 6-week period. Descriptive statistics are used for the presentation of the results.

Mean age ± SD of the sample was 52.5 ± 9,3 years. Mean score ± SD on the HDRS, HARS and GAF at the different time points of assessment are shown below.

Baseline (1) 1st week (2) 2nd week (3) 3rd week (4) 4th week (5) 5th week(6)

(mean±SD) (mean±SD) (mean±SD) (mean±SD) (mean±SD) (mean±SD)

HDRS 37.2±2.4 32.5±1.8 28.4±2.6 14.4±2.8 6.8±2.6 6.1±1.8

HARS 34.6±7.7 32.3±1.4 27.3±2.5 14.2±2.1 6.4±1.8 6.2±2.1

GAF 45.6±8.2 47.1±2.2 57.7±2.1 72.2±2.1 88.5±2.4 91.1±1.7

Psychopathology significantly subsided by the end of the study period; improvement was marked already from the third week of treatment.

The main finding of the present study was that monotherapy with agomelatine had a positive effect on symptoms of depression, anxiety, and global functioning in depressed patients.

DSM 5 (2013) solicits more empirical data on Internet Addiction (IA) before its inclusion in the Manual.

The objective of the present study was to deepen the relation between internet use and abuse among adolescents and attachment variables. AIMS The aim of the study was to define a psychological profile of adolescents that may enable to discriminate the variables that mark the border between internet use and abuse.

435 adolescents (F=221; M=214) aged 13 to 18 years (mean=15,25; S.D.=1,75) completed the following measures: BFAS -The Bergen Facebook Addiction Scale (Andreassen, et. Al. 2012); SPQ - Shorter Promis Questionnaire (Italian adaptaation Baiocco et.al. 2005); MPIQ - Mobile Phone Involvement Questionnaire (Walsh et.al., 2010); UCLA - Loniless Scale (Russel, 1996); Self Disclosure Online (Schouten et.al. 2007); IPPA – Inventory of Parent and Peer Attachment (Armsed e Greenberg, 1989; SCL-90 - Symptom Check List (Derogatis, 1980) Camir (Pierrehumbert 1996).

Data showed that ‘digital’ identity is common within the new multitasking generation of not-clinical adolescents, whereas internet abuse is linked to psychic vulnerability and to emotional neglect.

Attachment security, as manifested by secure perception of attachment to parents and friends, the capacity to express emotions, the ability to balance online and offline friendships and psychological wellbeing predict an adequate use of Facebook, preventing internet abuse.

Chronic pain is a prevalent condition worldwide. Opioids have beneficial effects when treating pain, but also involve risks. Opioid iatrogenic dependence(OID) is becoming more prevalent in western countries. Co-occurring psychiatric disorders are both among its predisposing factors and its complications.

To review factors predicting response to opioid treatment, especially those related with psychiatric comorbidities. We describe a case of OID as an example of the patient-type.

Attention needs to be paid to OID considering its growing health impact.

Throughout the case of a patient with chronic pain due to post-radiotherapic proctalgia, who suffered from depression and showed maladaptive personality traits, we describe a case of OID.

All patients assisted at our Pain Clinic have current or previous psychiatric disorders, and in almost half of the cases is major depression, as it happens in our case-example. Concomitant psychopharmacological treatment of opioid dependence and psychiatric comorbidities (including other drugs abuse/dependence) improves outcomes.

A global view of the opioid-consumer that includes comorbid psychiatric conditions is needed.

Studies show that children of oncologic patients resort more to psychiatric care and document the possibility that they face these episodes as traumatic events, easily developing PTSD if not properly signaled and followed.

The authors present the case of a boy who faced his father disease as a traumatic event, developing PTSD. They aim to describe the potential impact of parental oncologic diseases in children, as well as the benefits of acting preventively in those scenarios.

Report of the clinical case of a 14 years old boy who was admitted as an outpatient at the Department of Child and Adolescent Psychiatry after being referred by his General Practitioner for having initiated behavioral disturbances in reaction to his father oncologic disease, which led to a radical surgery of the face and neck with significant physiognomic changes. He has been followed in consultation, medicated with Risperidone 0,5mg and submitted to psychotherapy.

During approximately three months of treatment there was a wide improvement of the clinical condition with better acceptance of his father oncologic disease and of the physiognomic changes caused by the treatment. It is also noticeable the fading of his indignation against the medical community caused by the aggressive nature of the surgery.

This case shows a situation that would have benefited from a preventive intervention, because given the mutilating nature of the treatment, the adolescent should have been prepared to face his father's new appearance from a therapeutic perspective and not as a traumatic event.

Prevalence of violent behaviour within acute psychiatric services is about 10%.

To assess compliance of management of acutely disturbed patients with the National Institute for Health and Clinical Excellence (NICE) guidance for use of Rapid Tranquilisation (RT).

A sample of 24 patients admitted to local Psychiatric Intensive Care Unit (PICU) receiving RT during 2011 was assessed using retrospective analysis of records.

100% compliance was achieved in many of the criteria assessed, including recording the risk assessment and management plan appropriately.

None of the patients had up-to-date advance directive detailing their preferred strategies in case of violent incidents.

50% of patients had their baseline blood pressure, pulse, temperature and respiratory rate recorded and 33% at regular intervals.

25% were debriefed and none offered an opportunity to write their account of RT.

38% had their medication reviewed following RT.

46% were suffering from psychotic disorders; manic episode accounted for 25% of all patients.

54% of all (65% of men) received Zuclopenthixol acetate for RT and 46% the combination of Haloperidol plus Lorazepam; however, the combination of Haloperidol plus Lorazepam was used in 71.4% of women and 35% of men.

12.5% required a short period of seclusion.

All patients were detained under the Mental Health Act.

Training of the PICU staff in the NICE Guidance: The short-term management of disturbed/violent behaviour in psychiatric inpatient settings and emergency departments.

The study used psychometric method. The validated scales used were Leonhard Personality Inventory, NEO-PI-R, SAS, SDS, HCL-32- R1, Holmes and Rahe stress scale, SAF. We included all patients who have applied to the Institute of Plastic Surgery and Cosmetology from February 2012 to June 2012 and who gave Inform Consent.

Study sample consists of 123 patients (103 women), 18-70 years. In the group of cosmetologists’ patients (n=92; 76 women; mean age 44,6+-2,5 years) histrionic and anxiety-phobic personality traits predominated. Constitutionally determined or gained extroversion, expressivity, impulsivity and emotional instability were detected. Anxiety symptoms were detected in 32,4% of patients; depressive symptoms were detected in 35,8% of patients. In the group of plastic surgeons’ patients (n=31; 27 women; mean age 36,7+-1,8 years) pedantic, sticking and disthymic personality traits predominated. Introversion, high level of self-control and detachment were detected. Anxiety symptoms were detected in 22,9% of patients; depressive symptoms were detected in 21,7% of patients.

Our data give evidence of statistically significant differences in pathocharacterological and pathopsychological traits of plastic surgeons and cosmetologists’ patients. about one-third of these patients report about symptoms of depression, anxiety and hypomania. Complex diagnostic examination needed in order to determine nosological diagnosis and treatment strategies.

Fragile X syndrome is the most common inherited form of X-linked mental retardation. The aim of this study was to screen and identify fragile X syndrome-affected individuals in Tamil Nadu (South India) using DNA-based molecular analysis and chromosomal abnormalities.

Genomic DNA extracted from 47 (29 males and 18 females) individuals with mental retardation, including 47 controls, was analyzed using polymerase chain reaction, DNA gel electrophoresis and sequence analysis. Individuals with mutation were determined according to the CGG repeat size in the FMR1gene on chromosome Xq27.3. At same set of mentally retarded individuals, including controls 3ml of blood were collected in Lithium heparin tubes. The blood samples were incubated in 72 hours under culture conditions and harvested for Gbanding technique and results were guaranteed by SKY techniques.

The sequence analysis shows that the CGG repeat was found in fragile x site which expressed Fragile X syndrome highly when compared to healthy controls. The major Chromosomal aberrations (CA) like deletion, translocation and mosaic were also found. However, when compare with experimental subjects, the controls exhibited low levels of CA (P<0.05).

Results of this investigation suggest that, deregulation of the FMR1 gene might have responsible for fragile X syndrome of mental retardation, and CA among the individuals. Further investigation of this study helps to predicts the causes of this syndrome in molecular level (RNA based FMR1gene – Protein).

Children and adolescents make up one third of the world's population. Neuropsychiatric disorders are the most prevalent cause of health burden in this age group and are estimated to effect 10 to 20 per cent of children worldwide. Little is known about the prevalence of child psychiatric morbidities and associated risk factors in countries like Pakistan.

This is a prospective cross sectional study of 300 participants aged 6 to 18 years. Participants were recruited from a general psychiatric outpatient department over 12 weeks in Lahore, Pakistan. Information was collected on presenting complaints, possible risk factors and mental health disorders using the strengths and difficulties (SDQ) questionnaire.

Our preliminary results show that frequently reported presenting complaint were fits and alterations in consciousness (54%), disturbed behaviour (14%) and depressive symptoms (8.3%). The most frequent mental health disorder on SDQ was hyperactivity, followed by conduct. Emotional problems were least commonly reported. Male participants scored higher for conduct disorder. A history of epilepsy was reported by 35.3% of participants. Low socio economic status, low educational achievement and nuclear family setup were associated with higher rates of illness.

Our results show that fits and alterations in consciousness was the most frequently reported presenting complaint. Hyperactivity was most prevalent followed by conduct. The majority of child and adolescent patients attend general practitioners or general psychiatry out-patient departments. They are managed by practitioners who lack adequate training. Training these clinicians would help utilisation of limited resources.

The aim of the study was to identify sociodemographic, and clinical risk factors for suicide in the population of service-users (SUs) and nonservice users (NSUs) and gender-related characteristics of suicidal behaviour in a limited geographic region.

Data of 68 suicide cases (ICD-10 X60-X84) collected for residents on the Isle of Wight District between January 2006 and December 2009. All data were statistically analysed by using Pearson's chi-squared test and Yates’ correction for continuity.

The mean annual suicide rates were 5.65 per 100.000 for women and 19.28 for men. Significantly (p=0.0006) more men than women (male/female ratio 3:1) died as a result of suicide. Relatively (p=0.07) more women (56.2%) than men (32.7%), and significantly more (p=0.05) SUs (45.3%) than NSUs (13.3%) were unemployed. Significantly more (p=0.0006) SUs (64%) than NSUs (20%) had a history of suicide and relatively (p=0.06) more (50.9%) SUs than NSUs (20%) had attended the A & E. Depression as the most common Axis-I illness was diagnosed in 36% of all; but significantly (p=0.008) more in women (66.6%) than men (17.3%). Relatively (p=0.07) more women (56.2%) than men (32.7%) have contactacted serivces before their death. Suicide by hanging was the most common cause acounting for death of 71% of men and 50% of women.

80% of all suicides were conducted by people suffering from mental disorders. Depressive disorders in women and stressrelated disorders in men were the most common mental disorders. Treating mental disorders seem to be one of the key elements in suicide prevention.

Cognitive behavioral therapy emphasize the role of supervision during the training of the therapists Our study measured the trainees' expectations from the supervision and relation of the expectations with the therapeutic competencies.

Beliefs and attitudes toward supervision were assessed by the Attitudes and Beliefs about Supervision Scale (ABSS). It is 25-item questionnaire which measures the attitudes in 5 domains of therapy and supervision (therapeutic relation, skills, self-reflection, structure and process). Trainers and supervisors rate the level of competencies of trainees in Therapy Competencies Questionnaire (TCQ).

The trainees (n=50, mean age 34.8 + 7.3 years) prefer helping with self-reflection and understanding of therapeutic relation (mainly countertransference) during supervision slightly (but significantly) more, than supervison of classical CBT domains like skills, structure and process. There were not the correlations of the most of ABSS domains with the trainees' therapeutic competencies measured by CTQ with the exception of domain ‘skills’, which statistically highly correlate with some specific CBT competencies like skill to reward patient, using conceptualization and leadership of the social skills training,

The trainees of cognitive-behavioral therapy courses expect from the supervision helping in the understanding of the therapeutic relation (mostly counter-transference) and the improvement of the self-reflection and these expectations are higher than the expectations about supervision of skills and therapy structure. Nevertheless, on the other side, only level of expectations of the supervision of domain ‘skills’ highly correlate with the level of some competencies of the trainees rated by their trainers and supervisors.