The elderly persons continue to invest substantially in emotional relationships.

The overall objective of this research study was to investigate the attitudes of elderly persons towards family relations.

One hundred and ninety-seven healthy elderly individuals participated to the present study from different region in Greece. The age range was 66–93 years old. The questionnaire included: (a) the Family Environment Scale (Family Environment Scale, Form R-FES), (b) The Experience of Shame Scale (ESS), (c) the Other As Shamer Scale (OAS), (d) Quality of Life (SF-36).

Univariate and multivariate analysis was applied for the statistical analysis of the data, which showed that: the elderly persons who are satisfied with their lives in past, they exhibit lower overall price external shame feelings of emptiness (empty – OAS) (P = .002), they perceived reaction of others when they make mistakes (Mistakes – OAS) (P = .000), conflict (Conflict – [Form R-FES]) (P = .000). Elderly persons who are satisfied with their life in this time show higher levels of orientation towards active recreational activity (Active-Recreational Orientation – R-FES) (P = .000). Elderly persons who declared that family relation is important for them exhibit lower levels of feeling vacuum (empty – OAS) (P = .009), and higher levels of orientation for achievements (Achievement Orientation) (R-FES) (P = .010), social role (SF – SF36) (P = .000), Mental Health summary Scale (SF_MCS-SF36) (P = .000).

From the findings of this study, it is apparent how important is the study of the quality of life in old age.

The authors have not supplied their declaration of competing interest.

Anxiety disorders are among the most common mental disorders in Germany. Different sectors and disciplines participate in mental healthcare of these patients, but there is a lack of empirical evidence of the treatment outcomes in different settings.

The study focuses on analyzing the care pathways of patients with anxiety disorders and the effects of such pathways on critical events like sick leave, early retirement and mortality.

The analysis aims at developing recommendations for optimizing treatment with a view to minimize the rate of occurrence of critical events during the care pathway.

Secondary data of three statutory health insurance companies and of the German Pension Funds of the years 2005–2007. The analyses are based on 744,742 persons with at least one diagnosis of an anxiety disorder.

The analyses reveal a low rate of changes between primary and specialized care. There was a high number of care pathways (n = 2.608).The most common type was care by primary care physicians/somatic specialists only (60.5% of patients), followed by a treatment by a psychiatrist only (9.5%). Patients, who were only treated by general practitioners/somatic specialists, had significantly lower rates of sick leave and early retirement. This may indicate that cases with more favourable prognoses are found with this care pathway.

Analyses of care pathways using secondary data can contribute to identify potential for optimizing mental health care services and provide information about intersectoral interface problems, which should be considered in the quality management of mental healthcare.

The authors have not supplied their declaration of competing interest.

Social interactions have an important effect on the subjective well-being of individuals. However, in periods of financial crisis these interactions are reduced, affecting thus the mental health of the individuals as well.

To investigate the effect of the reduction in social interactions, as a result of the economic crisis, on the subjective well-being of non-insurance health care seekers in Greece.

Two hundred and sixty-six individuals participated in this study, 90 (35.6%) males and 163 (64.4%) females, with a mean age of 47. Analysis of data was conducted with Anova, using the SPSS software.

The findings showed that reductions in social interactions, caused by the financial crisis, led to significant reductions in the subjective well-being of individuals as well (F(1.259) = 13.276, P < 0.001 for social activities and F(1,258) = 14.531, P < 0.001 for peer socialization). More specifically, individuals whose social interactions were greatly affected by the financial crisis reported significantly lower subjective well-being than individuals who reported a medium effect (M = −2.952, SD = .764, P < 0.001). Furthermore, individuals who reported that the economic crisis had a great effect on their peer socialization reported significantly lower subjective well-being compared to both those who reported a medium (M = −1.868, SD = .658, P < 0.015) or low (M = −2.77, SD = .809, P < 0.001) effect of the crisis.

The results of this research showed that the financial crisis reduced the well-being of affected individuals through reductions in their social interactions. Further research is needed to investigate appropriate interventions to reduce the negative impact that the financial crisis has on the well-being of affected individuals.

The authors have not supplied their declaration of competing interest.

New guidelines aimed to minimize restraint in psychiatry clinics due to ethical reasons.

Further studies investigating factors affecting the decision of restraint and its potential benefits and harms are needed.

We aimed to determine current rates of restraint in psychiatric clinics and sociodemographic/clinical variables which may be related with restraint practices.

The study was conducted in 64-bed male and 28-bed female psychiatric inpatient units, between March 1–May 31 2015. Sociodemographic and clinical data forms were completed using case files and restraint records.

In a total number of 481 inpatients (351 males, 130 females), number of restrained patients was 98 (20.3%) (90 (25.7%) males, 8 (6.2%) females). There was no significant difference in sociodemographic characteristics between restrained and unrestrained patients, but duration of the illness and electroconvulsive therapy rates were significantly different. Substance abuse (44.4%) was higher in restrained male patients. Also, restraint rates were higher in patients having a diagnosis of substance-related disorder compared to other diagnoses. Restraints occurred most commonly in the first day (48%) of hospitalization.

The studies carried out in psychiatric hospitals suggested major differences in the rates and types of restraints among different countries and institutions. In our study, a higher restraint rate is obtained compared to other studies. Consistently with the literature, substance abuse was higher in restrained patients, and restraints occurred most commonly in the first day of hospitalization. Many factors including substance abuse should be considered to reduce restraint rates, which are still quite high in mental health hospitals in Turkey.

The authors have not supplied their declaration of competing interest.

Several community psychiatry projects have been developed in Lisbon; nevertheless, there are patients whose needs are not fulfilled by the existing structures. For this reason, our institution created a domiciliary care unit (PreTrarCa).

To assess if this program has an impact in admission rates, length of stay and follow-up appointments.

To improve the quality of care provided by PreTrarCA.

All active patients followed by PreTrarCA in 2015 were selected (n = 90); only those with F20 and F31 (ICD-10) diagnoses, admitted to the program after 2013, and who had information regarding duration of illness were chosen (n = 21). A control group with similar characteristics (age, gender, ICD-10 diagnosis, disease duration) was paired to our sample. Information concerning social/demographic data, disease duration, hospital admissions and appointments, before and after the patients started the program was retrospectively collected. All data and statistical analyses were performed via SPSS program.

Our patients were mostly female (n = 12); mean age 54,92; 10 and 11 had F-20 and F-31 diagnosis respectively. The test patients had fewer admissions (P = 0.027). No statistical significance was found concerning number of appointments, missed appointments or length of stay, between the groups before or after the patients had started the program.

Results suggest that domiciliary care may reduce costs associated with mental health care due to a decrease in admission rates. Our sample was paired to a similar group, which can account for the similar length of stay in both groups. Further studies should take into account other confounding variables.

The authors have not supplied their declaration of competing interest.

Intensive treatment in partial hospitalization unit may represent an efficient alternative to traditional inward hospitalization. However, there is evidence suggesting that this clinical resource may not be equally effective for every psychiatric disorder.

We aimed to study possible differences in the effectiveness of treatment in a partial hospitalization regime for different psychiatric disorders.

Three hundred and thirty-one patients were admitted to the Valdecilla acute psychiatric day hospital between January 2013 and January 2015. Clinical severity was assessed using BPRS-E and HoNOS scales at admission and discharge. Other relevant clinical and socio-demographic variables were recorded. For statistical comparisons, patients were clustered into 4 wide diagnostic groups (non-affective psychosis; bipolar disorder; depressive disorder; personality disorder).

We observed a significant difference in the status of discharge (χ2 = 12.227; P = 0.007). Thus, depressive patients were more frequently discharged because of clinical improvement, while patients with a main diagnose of personality disorder abandoned the treatment more frequently (23% vs. 4,0%)

When analysing the clinical outcome at discharge, we found that patients with a diagnosis of bipolar disorder showed greater improvement in BPRS (F = 5.305; P = 0.001) than those diagnosed of psychosis or depressive disorder. Interestingly, we found no significant differences between diagnoses in hospital re-admission in the following 6 months after being discharged.

Our results suggest that acute treatment in partial hospitalization regime may be more effective for bipolar and depressive disorder, and particularly less effective for those patients with a personality disorder.

The authors have not supplied their declaration of competing interest.

There have been a growing interest in the effectiveness of task-shifting as a strategy for targeting expanding health care demands in settings with shortages of qualified health personnel.

To explore the reasons for task-shifting and the healthcare settings in which task-shifting are successfully applied as well as the challenges associated with task shifting.

Literature searches were conducted on PubMed and Google Scholar using the search term – ‘Task shifting’ and Task-shifting’.

Reasons for task-shifting including: a reduction in the time needed to scale up the health workforce, improving the skill mix of teams, lowering the costs for training and remuneration, supporting the retention of existing cadres by reducing burnout from inefficient care processes and mitigating a health system's dependence on highly skilled individuals for specific services. Clinical settings in which task-shifting models of care have been successfully implemented, include: HIV/AIDS care, epilepsy and tuberculosis care, hypertension and diabetes care and mental healthcare. Finally, challenges which hinder the successful implementation of task-shifting models of care, include professional and institutional resistance, concern about the quality of care provided by lower lever health cadres and lack of regulatory and policy frameworks as well as funding to support task-shifting programmes.

The review brings to light important health policy and research priorities which can be explored to identify the feasibility of using task-shifting models of care to address the critical shortage of health personnel in managing emerging communicable and non-communicable diseases, including opportunities for expanding mental health care in conflict and under-resourced regions globally.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Data from electronic health records of adult Latino/a primary care patients (n = 29,887 person-years) were used to identify rates of SUD treatment in primary and specialty care. Treatment characteristics and receipt of adequate care were compared by gender and immigrant status.

Tobacco was the most frequently treated substance followed by alcohol and other drugs. Forty-six percent of SUD patients had a comorbid psychiatric condition. Treatment rates ranged from 2.52% (female non-immigrants) to 8.38% (male immigrants). Women had lower treatment rates than men, but male and female immigrants had significantly higher treatment rates than their non-immigrant counterparts. Receipt of minimally adequate outpatient care varied significantly by gender and immigrant status (female non-immigrants 12.5%, immigrants 28.57%; male non-immigrants 13.46%, immigrants 17.09%) in unadjusted and adjusted analyses.

Results indicate overall low prevalence of SUD treatment in the healthcare system. Low rates of minimally adequate care evidence the challenge of delivering integrated behavioral healthcare for Latinos with SUD. Results also demonstrate gender and immigrant status disparities in an unexpected direction, with immigrant women receiving the highest rates of adequate care.

The authors have not supplied their declaration of competing interest.

We aimed to review the distribution of diagnoses in children and adolescents evaluated by a child psychiatrist, in refugee camps in Diyarbakır, Cizre and Silopi province of Turkey.

Sociodemographic data, psychiatric complaints and distribution of psychiatric diagnoses of 38 children and adolescents living in refugee camps in Diyarbakır, Cizre and Silopi were evaluated. Psychiatric diagnoses were made according to DSM-5 criteria but some diagnoses as conversion disorder were also mentioned even tough they were not included in DSM-5.

The sample consisted of 22 female and 16 male children and adolescents. The mean age was 12.1 ± 4.5 and the range was 2–18 years. The mean duration of residency in the camp was 23.2 ± 3.9 days. The most common symptom was sleep problems. The most frequently seen psychiatric disorder was depressive disorder (36.8%) and at least two comorbidities were detected in 50% of children and adolescents. This diagnosis was followed by conversion disorder (28.9%), adjustment disorder (21.8%), acute stress disorder (18.4%), enuresis nocturna (18.4%), post-traumatic stress disorder (10.5%), separation anxiety disorder (10.5%), somatization disorder (7.8%), selective mutism (2.5%) and night terror (2.5%) respectively.

The study revealed that in refugee children and adolescents, starting from the early days of the migration period, various psychiatric symptoms and disorders might be seen. Therefore, it is essential to integrate psychosocial support units into the aid and support programs for refugees and quite important to observe and treat children in terms of psychiatric disorders, starting from the early days of the migration period.

The authors have not supplied their declaration of competing interest.

According to the Guiding Principles on Internal Displacement, internally displaced persons are persons who have been forced or obliged to leave their homes, in particular as a result of extreme situations, and who have not crossed an state border. As of May 21, 2015 UNHCR has information about 1,299,800 IDPs.

To study clinical features of neurotic disorders in IDPs.

We have a complex psychopathological and psychodiagnostic research 97 IDPs in volunteer center, located at the central train station in Kharkiv.

In total, 75.9% of IDPs observed have violations of adaptation: long-term depressive reaction (F 43.21) and predominant disturbance of other emotions (F 43.23). The men reactive alarm indicators (average – 37.7 ± 3.0), were higher than trait anxiety (average – 32.6 ± 2.9). On the contrary, women figures trait anxiety (average – 38.6 ± 2.9) were higher than reactive anxiety (average – 34.7 ± 3.0). Severity of depressive symptoms also slightly prevailed in women. The mean score on the Hamilton scale for men was 17.0 ± 2.3 points, women – 18.0 ± 2.3 points. Test results on a scale of quality of life showed no significant differences between men and women. We have developed a medical and psychological support system to correct the neurotic disorders in IDPs.

The majority of people who left the ATO zone have emotional disorders of different severity and require a further correction in the specialized medical institutions.

The authors have not supplied their declaration of competing interest.

A significant cortical thinning has been repeatedly observed in adult-onset first-episode schizophrenia patients compared to healthy controls, mostly in medial and inferior prefrontal cortices. However, it is yet unclear whether all these replicated alterations are related to any particular clinical feature.

This study aimed to investigate differences of cortical thickness in a sample of first-episode, drug-naive psychotic patients and age- and gender-matched healthy controls and explore clinical correlates of these parameters regarding negative symptoms.

High-resolution T1-weighted images were acquired from 23 antipsychotic-naive, first-episode psychotic patients and 26 age-matched healthy comparison subjects. Clinical features were measured with the negative subscale of the Positive and Negative Syndrome Scale (PANSS) at baseline and after a 2-month follow-up period.

No differences were found regarding age or gender when comparing patients and controls. We found a significant cortical thinning in the left medial orbitofrontal cortex and in the right lateral orbitofrontal cortex in patients compared to healthy age- and gender-matched controls. Regarding clinical performance, no correlation was found at baseline between left medial orbitofrontal nor right lateral ortitofrontal cortical thickness and scores of the negative subscale of the PANSS. However, at the 2-month evaluation clinical performances were significantly associated to the left medial orbitofrontal cortical thickness values.

Cortical thickness alterations in prefontal cortex appear to be present at disease onset and these alterations may relate to clinical outcome. However, our findings must be considered just as exploratory. Larger longitudinal studies may help characterize, replicate and consolidate these findings.

The authors have not supplied their declaration of competing interest.

The intuitive association between cognitive dysfunction in late onset depression (LOD) and the aberrant functional activity in the brain's default-mode network (DMN) has prompted interest in exploring the role of the DMN in LOD. The altered pattern of resting state voxel-mirrored homotopic connectivity (VMHC) in cognitive processes is not yet well understood in LOD.

The study was designed to examine the implicit coupling between the alteration of interhemispheric functional coordination and cognitive impairment in LOD. Thirty-one LOD patients and 37 matched healthy controls (HC) underwent neuropsychological tests and functional magnetic resonance imaging (fMRI) in this study.

Compared to HC group, attenuated VMHC in superior frontal gyrus, superior temporal gyrus, posterior cerebellar lobe, postcentral and precentral gyrus was observed in LOD. Neuro-behavioral relevancy approach revealed that the imbalanced interhemispheric functional coordination in bilateral cerebellum was positively correlated with the performance of trail making test in LOD (r = 0.367, P = 0.040).

Altered linkage pattern of intrinsic homotopic connectivity and cognition was firstly investigated in LOD, and it would provide a novel clue to reveal the neural substrates underlying the cognitive dysfunction in LOD.

The authors have not supplied their declaration of competing interest.

Neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed structural deviations of the corpus callosum in children and adolescents. However, little is known about the link between callosal morphology and symptoms of inattention or hyperactivity in adulthood, especially later in life.

We aimed to further expand this understudied field by analyzing a large population-based sample of 280 adults (150 males, 130 females) in their late sixties and early seventies.

We applied a well-validated approach capturing the thickness of the corpus callosum with a high regional specificity at 100 equidistant points. In addition to correlating point-wise callosal thickness with ADHD symptom measures within the whole sample, we tested for sex interactions.

There were significant sex interactions with respect to measures of inattention and hyperactivity, with follow-up analyses revealing significant negative correlations in males (see Fig. 1 – Top). In contrast, there were positive correlations with respect to hyperactivity only in females (see Fig. 1 – Bottom).

A thinner corpus callosum may be associated with fewer fibers or less myelination. Thus, the negative correlations, as observed in males, suggest an impaired inter-hemispheric communication necessary to sustain motor control and attention, which may contribute to symptoms of hyperactivity, impulsivity and/or inattention. The functional relevance and underlying mechanisms of the positive correlations, as detected in females, remain to be resolved.

The authors have not supplied their declaration of competing interest.

Increasing body of evidence suggest that patients with schizophrenia (SCZ) present dysfunction of the gamma band oscillations (GBO) during cognitive tasks. The current study aimed to explore the GBO activity in SCZ during a Sternberg task.

Twenty-eight chronic stabilized SCZ and 18 healthy controls (HC), were recruited. Ongoing EEG was recorded during the execution of the Sternberg task. Continuous EEG data were band-pass filtered (1–100 Hz) and corrected for eye blink and muscle artefacts by ICA. For each subject, the event-related-spectral-perturbation (ERSP) and the inter-trial-coherence (ITC) were computed at the Pz channel only for those stimulus-locked segments containing correct responses. GBO wavelet analysis was performed with two different increasing cycle ranges (3 to 5.8 and 12 to 22.6; frequency range: 30–90 Hz), to obtain the best information about temporal and frequency dynamics. Student's t test (with multiple comparisons FDR correction) was used to compare the groups.

During the manteinance phase (4000 to 4600 ms after the stimulus onset), SCZ presented a significant increase, respect to HC, in low GBO activity (range: 30-50 Hz;). In the other phases of the Sternberg task (encoding, probe presentation and response periods), no significant difference in GBO was observed between SCZ and HC.

These findings are in line with the evidence that GBO dysfunction in SCZ is present during selective phases of the working memory task. Future studies have to clarify the role of GBO dysfunction on the cognitive performance and the clinical utility of selective GBO modulation during cognitive rehabilitation.

The authors have not supplied their declaration of competing interest.

Taste perception is a complex phenomenon modulated by different factors, such as taste receptors and memory brain circuits. The palatability of the food, that activates the central reward pathways, also plays an important role in taste perception. It means that taste is able to influence the choice of food and then eating behaviour.

It is well known that people with anorexia nervosa (AN) have a lower sensitivity to reward stimuli and recent studies suggested that altered function of taste neural circuitry may contribute to restricted eating in AN.

The aim of this study was to evaluate, in patients suffering from AN, the activation of brain areas involved in taste perception and in central reward mechanisms to both pleasant and aversive taste stimuli and to correlate gustatory neurocircuitry activity with eating behaviours, temperament measures and/or sensitivity to reward and to punishment.

Fifteen underweight female AN patients and sixteen normal-weight healthy women underwent a functional MRI to measure brain areas activation to repeated stimuli of a pleasant taste (sucrose solution), alternated with an aversive taste (bitter solution), and water taste.

Compared to healthy controls, patients with AN showed a significantly reduced activation of left insula and left dorsolateral prefrontal cortex to sweet stimulus and reduced activation of right parietal cortex to bitter stimulus.

These results, if confirmed in future studies, may improve our knowledge about the pathophysiological mechanisms of AN.

The authors have not supplied their declaration of competing interest.

Brain amyloid-β protein (Aβ) deposition is a key pathology of Alzheimer's disease (AD). Cholinergic degeneration, including reductions in α7 nicotinic acetylcholine receptors (α7-nAChR), is also known as a pathophysiology of AD. Recent imaging studies have shown cognitively normal subjects with Aβ depositions, indicating a missing link between Aβ deposition and cognitive decline.

To clarify relationships among the Aβ burden, α7-nAChR availability, and cognitive declines in AD.

To measure brain Aβ deposition and α7-nAChR availability in the same patients with AD using positron emission tomography (PET).

Twenty AD patients and age-matched 20 healthy adults were studied. The α7-nAChR availability and Aβ deposition were evaluated using PET with [11C]MeQAA and [11C]PIB, respectively. Levels of specific binding were estimated by a simplified reference tissue method (BPND) for [11C]MeQAA and a tissue ratio method (SUVR) for using [11C]PIB. The values were compared with clinical measures of various cognitive functions using regions of interest (ROIs)-based and statistical parametric mapping (SPM) analyses.

[11C]MeQAA BPND levels were extensively lower in the cholinergic projection regions of AD. There was a significant negative correlation between [11C]PIB SUVR and [11C]MeQAA BPND in the nucleus basalis of Mynert (NBM). The NBM [11C]PIB SUVR was negatively correlated with the [11C]MeQAA BPND level in the anterior and posterior cingulate cortices, whereas the relation within the same region showed weak correlation. Also we found significant correlation between cognitive decline and [11C]MeQAA BPND levels in the NBM.

Aβ deposition-linked α7-nAChR dysfunction may account for cognitive decline in AD.

The authors have not supplied their declaration of competing interest.

The thought of greater loss of brain tissue in Deficit Syndrome (DS) i.e. subgroup of schizophrenia with enduring primary negative symptoms defined by Carpenter et al.; this has not been verified by recent studies.

Accumulated researches suggest that enlargement in Lateral Ventricles (LV) is related with current negative symptoms and poor prognosis. However, this has not been validated in DS.

Our aim is to study the association between the enduring negative symptoms and LV changes schizophrenia. We included both deficit and non-deficit patients for comparison with controls.

Forty-five patients (18 DS, 27 non-DS) and 37 healthy controls were recruited, evaluated for positive and negative symptoms, depression and extrapyramidal symptoms. Structural magnetic resonance imaging was performed. LV was assessed by MANCOVA (gender, age total brain volume as confounding factors) in 3-dimensional (3D) shape analyses. Correlations between clinical and imaging data were analyzed by Pearson correlation coefficient; P > 0.05 being significant.

LV of patients was found to be greater than controls, especially in regions adjacent to parietal and temporal regions but no significant difference between subgroups was detected. Enlargement in right LV by corpus callosum adjacency was found in DS. There was no correlation between negative symptoms and LV volume.

The idea of greater amount of LV enlargement in patients with predominant negative symptoms could not be observed in 3D analyses. New pathophysiological theories are needed for the explanation of negative symptoms, loss of functioning and poor prognosis rather than only commenting about tissue decrease/loss.

The authors have not supplied their declaration of competing interest.

Spectroscopy is a diagnostic method using MRI, to analysis tissue in vivo noninvasively. There are several studies with magnetic resonance spectroscopy (MRS) in patients with psychiatric disorders, especially schizophrenia and Alzheimer's type dementia, in their different developmental stage. Sometimes spectroscopy may allow brain metabolic changes to be observed before the onset of alterations in brain parenchyma. We do not know any documented case of spectroscopy performed on a psychiatry-targeted manner on our hospital. It is a noninvasive technique without added cost to the MRI and is available in our hospital. It seems interesting for us to combine two specialties like radiology and psychiatry in the field of a neuroimaging Project.

Our goal is try to establish a radiological anatomical correlate to brain molecular levels. It's a transverse and longitudinal prospective observational study in which subjects will be submitted to various psychiatric assessments by conducting a radiological examination that is the MRI and MRS to determine the regional metabolic pattern in the subjects explored.

Informed consent to all patients, aged more than 18 years, selected according inclusion/exclusion criteria that meet ethical principles. Patients are selected within the public health network of Sacyl Health Care System, Zamora Hospital, Spain.

Schizophrenia increased creatinine, choline and glutamate. NAA decrease in untreated patients and increased the same in patients with treatment Alzheimer: < increased NAA (N-acetyl aspartate) and increased MI (myo-inositol), their relationship has a high negative predictive value, ie if it is negative (the peaks are not increased) is discarded Alzheimer's disease. Early Dx/screening? Treatment?

The authors have not supplied their declaration of competing interest.

Although male and female patients with major depression (MDD) differ in psychopathology and other illness characteristics, a potentially confounding effect of gender has not been systematically controlled or investigated in most of the previous neuroimaging studies.

We investigated activation patterns during processing of ambiguous stimuli in MDD by functional MRI.

We aimed at examining potential activation differences between male and female patients.

A matching task was employed in which two stimuli with varying degrees of perceptual uncertainty had to be compared with respect to their sameness. Eighteen patients meeting DSM-IV criteria of MDD and eighteen healthy control subjects participated in this study.

Whereas on the level of behavioral performance no significant group differences could be detected we found distinct disorder- and gender-related differences in the brain activation. Patients activated significantly stronger in superior parietal, prefrontal and cingulate regions. Gender specific analyses revealed that the hyperactivity in the patient group was mainly attributable to hyperactivity in the male patients who activated significantly stronger than the female patients in an extensive fronto-temporo-limbic network, which partly overlapped with the network we found when comparing patients and healthy controls.

Our results indicate that male patients seem to be reliant on a significantly stronger metabolism in task-relevant regions to maintain an equal level of performance.

The present results provide evidence for gender-related differences in the functional organization of the brain in patients with MDD. Gender differences should be taken into consideration when investigating the neural correlates of MDD.

The authors have not supplied their declaration of competing interest.