Traumatising experiences have been shown to be important in suicide ideation and attempt. A prolonged and continuous exposure to stressing interpersonal events can have more complex consequences. Therefore, the concept of Complex Post-Traumatic Stress Disorder (C-PTSD) has been emerging.

Our goal is to relate the symptoms of C-PTSD with suicide attempt and to evaluate the differences between C-PTSD and PTSD on those patients. Moreover, we compared our findings with a control population without prior suicide attempts.

Fifty patients that had been hospitalised in the Psychiatry ward following a suicide attempt were evaluated one week after the event with the ICD-11 Trauma Questionnaire (PTSD and C-PTSD). The same evaluation was performed on a control population without known suicide attempts.

There is a statistically significant relationship (P < 0.001) between the symptoms of C-PTSD and PTSD and suicide attempt, which effect is higher for C-PTSD. These symptoms are almost absent in the control group.

C-PTSD seams to be a more relevant risk factor for suicidal attempts. This aspect is important to define preventive and treatment programs and for suicidal attempts follow-up. The importance of traumatic events and of traumatic stress symptoms as moderator factors should be considered in future research.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

To determine the incidence of traumatic events in Ecuadorian women exposed to domestic violence and other complex social situations and their relationship with PTSD.

We applied a transversal descriptive study accomplished by the INEC (National Institute of Statistics and Census). The INEC recruited Ecuadorian women from 15 years old and more, the surveys were focused on this population. In total, 18,800 rural and urban housings were selected all over the country, 24 provinces. Date of the survey: November 16–December 15 of 2011. A, D and G were taken as references for guidelines following the criteria diagnosis of DSM V (Diagnostic and Statistical Manual of Mental Disorders) to determine a Traumatic Event.

The average age of the sample was 28 years old. The standard deviation was 21, ages: 15–25 years old: 14.265 (21.6%), 25–35 years old: 9.324 (14.1%), 35–45 years old: 8.132 (12.3%), 45–55 years old: 6.283 (9.5%), 55–65 years old: 4.302 (6.5%), > 65 years old: 23.745 (35.9%). Prevalence of the traumatic event (DSM-V) 4.6%. Women experienced any kind of violence 60.6%: 61.4% urban, 58.% rural. Types of abuse: psychological: 53.9%, physical: 38.0; sexual, patrimonial: 35.3%. Domestic violence 76.0% y other types of violence 24.0%.

Domestic violence rate is high, also, in this study, we determined that women face an important index of violence during their daily activities. Psychological abuse is the highest abuse, higher in the urban areas. These results based on acute traumatic events may predispose women to develop PTSD. The prevalence of traumatic events must be an alert to the Mental Health Organizations, not only in Ecuador but also in Latin American.

The authors have not supplied their declaration of competing interest.

Both clinical and subclinical psychosis is probably a consequence of underlying genetic and environmental interactions.

Defining differential impact of environmental/familial risk factors and psychotic experiences across the onset of clinical psychosis.

To assess mental health outcomes in a 6-year follow-up of a representative general population sample with a special focus on extended psychosis phenotype.

Addresses were contacted in multistage clustered area probability sampling frame covering 9 districts and 302 neighbourhoods (n: 4011) at baseline (T1) and 6 years after (n: 2142) (T2). Psychotic experiences were screened with Composite International Diagnostic Interview and probable cases were re-interviewed with SCID-I. Relations were tested using logistic regression models.

Of subclinical psychotic symptoms at baseline, 6.4% transitioned to clinical psychosis; 44.4% persisted, 90.2% transitioned to any DSM disorder. Of newly onset clinical psychosis at T2, 62.8% had subclinical psychotic expressions at baseline. The risk of developing clinical psychosis was greater in those with baseline subclinical psychotic experiences, alcohol–cannabis abuse, stressful-forensic event history and family history of mental disorders. Most of risk factors associated with psychosis proneness at T1 were also associated with clinical psychotic outcome at T2 (Table 1).

Psychotic experiences takes attention for the risk to develop psychosis due to underlying genetic and environmental interactions; also may be an important risk factor to develop any mental disorder.

The authors have not supplied their declaration of competing interest.

Conditions of depression and anxiety among employees’ leads to increased absenteeism and decreased social and professional function.

To test a collaborative model for contributing to mental health at work at the lowest interference and highest possible availability among Danish workers.

To investigate the effect of early detection and treatment in order to interrupt and improve conditions of clinical and sub-clinical levels of mental illness.

Self-reporting questionnaires were used for identification of clinical and sub-clinical cases of mental illness and for follow-up. Four questionnaires were distributed to all employees in six medium-large companies in Denmark (n = 1292) during a period of 16 months. Employees meeting the screening criteria were assessed diagnostically. Outpatient psychiatric treatment was offered to employees diagnosed with mental illness and preventive CBT-session to those assessed with sub-clinical conditions. Follow-up questionnaires were filled out after 6 and 12 months. Data were analysed using repeated measure mixed effects linear regression.

Of the 587 (55%) employees that returned the questionnaires, 58 were referred to either outpatient psychiatric treatment (n = 38) or preventive treatment (n = 20). Levels of psychopathology decreased significantly in both treated groups. Comparing with the pre-treatment period, a significant positive difference in change in psychopathology was detected for employees in psychiatric treatment. Measured up to healthy controls, the self-perceived level of stress also decreased significantly among employees in psychiatric treatment.

An integrated collaborative model for early detection and treatment was beneficial in order to interrupt and improve the course of mental health problems among Danish employees.

The authors have not supplied their declaration of competing interest.

Concern for medical doctors’ health has been widely recognized over the past ten years. EFPT is aware of the heterogeneity of support set up for doctors in distress, recognizing the need for further cross-Europe research.

The EFPT “HELP Project” was designed to investigate psychiatry trainees’ perceptions of and attitudes towards health seeking at a Europe-wide scale. Furthermore, it aims to determine what services are available in Europe specifically to support physicians’ health.

Multinational, cross-sectional survey conducted in 14 European countries between 2013 and 2014. Data collection was accomplished by an anonymous online or hard copy questionnaire. Completion implied consent to participate. Data was analysed using SPSS v20.0.

Of the respondent trainees, 57.7% were from developed economies; 46.2% under 30 years; 26.9% males. Ninety-eight per cent said they would have surgery in the public sector, versus 42.3% who agree to get treatment there for an eating disorder, depression (28.8%) or addiction (17.3%). Trainees from developing economies were significantly less confident in using public sector help for mental health difficulties. When asked for advice regarding the same problems in their fellow trainees, they said they would recommend public sector help. Specific services for doctors exist in the UK, Spain, The Netherlands and Switzerland, but most trainees said there were no services locally.

The EFPT believes specialised physician health services are needed to ensure doctors seek help when necessary, while avoiding feeling stigmatised or punished in doing so. The authors plan to create a ‘survival guide’ for European trainees in distress, with collated information about local services for doctors.

The authors have not supplied their declaration of competing interest.

Research shows that variables, such as depression, less functionality and health, less contact with family and others, may have a negative impact on life satisfaction.

To verify which variables correlate with satisfaction with life (SWL) and analyse which of them predict the evolution of SWL.

To examine correlates and predictors of SWL in institutionalized elderly.

This study involved a subsidiary longitudinal analysis of cross-sectional data gathered at Phase I (2010–2012; n = 493 elderly) and after 36 months at Phase II (2013–2014; n = 85) of Aging Trajectories Project from Miguel Torga University College.

At Phase I, higher scores in SWL scale correlated with having visits (r = 0.17; P < 0.01), specially from family (r = 0.20; P < 0.01), less depressive (r = –0.42; P < 0.001) and anxiety symptoms (r = –0.25; P < 0.001), less loneliness feelings (r = –0.37; P < 0.001), less functionality (r = 0.15; P < 0.01), and better general physical health (r = 0.25; P < 0.001). Age, sex, civil status, cognitive, and executive status did not correlate with SWL. SWL, depressive and anxiety symptoms, and loneliness feelings were stable through time, between assessment stages (P < 0.01). The worsening of depression and loneliness through time predicted the negative evolution of SWL (respectively, β = 1.16; P < 0.01; β = –0.69; P < 0.05).

These findings highlight the relevance of early detecting depressed mood and loneliness feelings in institutionalized elderly, and the importance of the treatment and the development of preventive interventions for this vulnerable population.

The authors have not supplied their declaration of competing interest.

Stigma towards psychiatry and mental illness significantly worsens the quality of life of psychiatric patients. Negative prejudices in medical students make it difficult for future doctors to send patients to mental health services and promote an increased risk of premature death.

Our aim is to assess stigma towards mental illness and psychiatry in medical students, and to study the influence of real-world experiences, such as having visited a psychiatric ward, having personally met a psychiatric patient or having friends and/or family members who suffer from a mental illness.

One hundred and thirteen Italian medical students completed the following tests:

– Attitudes Towards Psychiatry (ATP-30);

– Community Attitudes Towards Mental Ill (CAMI);

– Perceived Discrimination Devaluation Scale (PDD);

– Baron-Cohen's Empathy Quotient (EQ).

Having visited a psychiatric ward correlates with a better attitude towards psychiatry (P = 0.008), rather than towards the mentally ill. Having personally known someone with mental disorders correlates with less stigmatizing scores in CAMI: total score (P = 0.002), authoritarianism (P < 0.001), benevolence (P = 0.047) and social restriction (P = 0.001). Similar results emerged in those who have close relationships with a psychiatric patient. There is no statistical significance as to empathy.

The students who have visited a psychiatric ward have a less stigmatizing vision of psychiatry, while having personally known psychiatric patients favors a less stigmatizing attitude towards them. Those who have not had this experience, have a more hostile and intolerant vision of mental illness, and consider psychiatric patients as inferior subjects that require coercive attitudes and that would be better to avoid because socially dangerous.

The authors have not supplied their declaration of competing interest.

Stigma towards mental illness and psychiatry have a major impact on psychiatric patients’ quality of life; in particular, prejudicial beliefs make it more difficult for future doctors to send patients to mental health services, leading to a delay of necessary care.

Our aim is to evaluate the stigma towards mental illness and psychiatry, in a sample of Italian medical students. We studied the differences between the first-year students who have not attended the academic course in psychiatry, compared to the senior students who have attended the psychiatric lectures.

We tested 113 medical students, using the following questionnaires:

– Attitudes Towards Psychiatry (ATP 30);

– Community Attitudes Towards Mental Ill (CAMI);

– Perceived Discrimination Devaluation Scale (PDD), to assess the discrimination towards mental illness perceived in society;

– Baron-Cohen's Empathy Quotient (EQ), to measure empathy.

Among the 113 students, 46 have already attended the academic course of psychiatry and CAMI scores were less stigmatizing as total score (P = 0.014) and in authoritarianism subscale (P = 0.049), social restriction (P = 0.022) and ideology of mental health in the community (P = 0.017). However, there were no statistically significant differences in empathy, perceived discrimination in the society and stigmatization of psychiatry.

The 67 students who have not attended the academic course of psychiatry are more stigmatizing, considering psychiatric patients as inferior people that require coercive attitudes, socially dangerous and that should be treated faraway from the community. Studying psychiatry is therefore useful to reduce, in the future doctors, these prejudices toward mentally ill patients.

The authors have not supplied their declaration of competing interest.

Studies have shown that sport participation is connected with a more positive self-image and higher self-esteem in adolescents (Bowkers, 2006, Kirkcaldy et al., 2002), whereas sedentary behavior is associated with negative mental health characteristics (Primack et al., 2009).

The aim of this study was to investigate whether physical activity influences adolescents and young people's emotions, self-esteem and generally mental health.

Questionnaires were redacted by the research team investigating participants’ habits, emotions and health benefits concerning physical activities.

Questionnaires were administered to 150 adolescents, aged 18–20 years old in Technological Educational Institutes, colleges and fitness centers in Patras, Southern Greece during 2015's spring.

Eighty-seven percent of the respondents worked out in fitness centers or in natural environment. Most of them answered that exercise contributed to revitalization and euphoria feelings (63%), stress relief (78%), better self-image, and better health (49%). According to 63% of the adolescents, exercise improved their school performance and 61% of them felt that exercise affected positively mental health.

Present study's results underline physical activities’ benefits in students’ mental health, self-esteem, feelings and school performance being in line with other studies’ results [Biddle et Asare (2011), Ekeland et al. (2005), Brown et al. (2013)]. Restrictions refer mainly to small size sample.

The authors have not supplied their declaration of competing interest.

Participants were 5th- and 6th-grade children in two public elementary schools in Japan. The final samples were fifty-six children (25 boys and 31 girls). Participants completed a battery of three questionnaires just before (T1) and after (T2) an school-based universal prevention program for enhancing emotional coping abilities with others’ emotions, which was implemented in eight classes during one month. The questionnaires were utilized for assessing implicit positive and negative affect (IPA and INA), explicit emotional coping abilities to identify, understand, and regulate others’ emotions, and the adaptive status of children at school.

Hierarchical regression analyses showed that higher IPA at T1 was associated with higher explicit emotional coping and motivation for learning at T2. Also, higher INA at T1 was related to better peer relationship at T2. Moreover, higher IPA and INA at T1 were concerned with higher scores of classroom climate and approval at T2.

This study suggested that higher IPA leads to higher explicit emotional coping with others’ emotions. Also, it suggested that higher implicit affectivity (i.e., both higher IPA and INA) causes more adaptive status of children at school.

The authors have not supplied their declaration of competing interest.

Oxidative stress has been implicated in the pathophysiology of depression and anxiety disorders and may be influenced by antidepressant use.

This study investigated the association of oxidative stress, measured by plasma levels of F2-isoprostanes and 8-hydroxy-2′-deoxyguanosine (8-OHdG), reflecting oxidative lipid and DNA damage respectively, with major depressive disorder (MDD), generalized anxiety disorder, social phobia, panic disorder, agoraphobia and antidepressant use in a large cohort.

Data was derived from the Netherlands Study of Depression and Anxiety including patients with current (n = 1641) or remitted (n = 610) MDD and/or anxiety disorder(s) (of which n = 709 antidepressant users) and 633 controls. Diagnoses were established with the Composite Interview Diagnostic Instrument. Plasma 8-OHdG and F2-isoprostanes were measured using UHPLC-MS/MS. ANCOVA was performed adjusting for sampling, sociodemographic, health and lifestyle variables.

F2-isoprostanes did not differ between controls and patients, or by antidepressant use. Patients (current or remitted) using antidepressants had lower 8-OHdG (adjusted mean 38.3 pmol/L) compared to patients (current or remitted) without antidepressants (44.7 pmol/L) and controls (44.9 pmol/L, P < 0.001; Cohen's d 0.26). Findings for 8-OHdG were similar over all disorders and all antidepressant types (SSRIs, TCAs, SNRIs; P < 0.001).

Contrary to previous findings this large-scale study did not find increased oxidative stress measured by F2-isoprostanes or 8-OHdG in MDD or anxiety disorders. 8-OHdG levels were lower in antidepressant users, which suggests antidepressants may have antioxidant properties.

The authors have not supplied their declaration of competing interest.

It has been hypothesized that lowered antioxidant capacity, which leads to increased oxidative stress, may be involved in the pathophysiology of major depressive disorder (MDD) and anxiety disorders and might be altered by antidepressant treatment.

This study investigated the association of plasma uric acid, the greatest contributor to blood antioxidant capacity, with MDD, generalized anxiety disorder, social phobia, panic disorder, agoraphobia and antidepressants in a large cohort.

Data was derived from the Netherlands Study of Depression and Anxiety including patients with current (n = 1648) or remitted (n = 609) MDD and/or anxiety disorder(s) (of which n = 710 antidepressant users) and 618 controls. Diagnoses were established with the Composite Interview Diagnostic Instrument. Symptom severity was ascertained in all participants with the Inventory of Depressive Symptoms and the Beck Anxiety Inventory. ANCOVA and regression analyses were adjusted for sociodemographic, health and lifestyle variables.

Plasma uric acid was lower in those with current MDD and/or anxiety disorder(s) (adjusted mean 270 μmol/L) compared to those with remitted disorders (280 μmol/L, P < 0.001) or to controls (281 μmol/L, P < 0.001; Cohen's d 0.14). Within patients antidepressants were not associated with uric acid levels. Increasing symptom severity was associated with lower uric acid levels for both depression (β = –0.05, P = 0.001) and anxiety symptoms (β = –0.05, P = 0.004).

This large scale study finds that the antioxidant uric acid is lower in current, but not remitted, MDD or anxiety disorders and in persons with higher symptom severity, suggesting disturbances in redox homeostasis play a role in the pathophysiology of depression and anxiety disorders.

The authors have not supplied their declaration of competing interest.

The influence of the immune deregulation on the risk and psychopathology of schizophrenia is increasingly recognized in the literature.

To assess the association between serum IL-1RA on schizophrenia psychopathology.

We recruited 88 schizophrenia patients (38 males and 49 females, mean age 38.12 ± 12.67 years) and 88 healthy adult control subjects (68 males, 20 females, mean age 40.63 ± 7.99 years). Lifetime psychopathology was evaluated using Operational Criteria for Psychotic Illness (OPCRIT) checklist, while current psychopathology was assessed using Positive and Negative Syndrome Scale (PANSS). Serum samples were stored in aliquots at –80 °C. Serum levels of IL1-RA were measured using Immunoassay (ELISA).

There were statistically significant differences between schizophrenia patients and healthy controls (median ± interquartile range: 350,81 ± 227.04 and 888.74 ± 762.63, respectively [pg/ml]) (U Mann–Whitney test, Z = –7.99, P < 0.0001). There were no differences in serum IL1-RA levels between male and female among patients with schizophrenia (U Mann–Whitney test, Z = –0.22, P = 0.82) nor among healthy control subjects (U Mann–Whitney test, Z = –0.17, P = 0.86). Among schizophrenia patients, there was a trend-level association between IL-1RA serum level with negative symptoms (Spearman correlation coefficient, r = –0.23, P = 0.056), positive symptoms (Spearman correlation coefficient r = –0.22, P = 0.066), and on a statistically significant level with general symptoms (Spearman correlation coefficient r = –0.28, P = 0.018).

Serum IL1-RA level is higher in schizophrenia patients in comparison to healthy controls and it is associated with schizophrenia psychopathology.

The authors have not supplied their declaration of competing interest.

Alterations on the innate inflammatory response may underlie the pathophysiology of psychiatric diseases, but the mechanisms implicated remain elusive. Current antipsychotics modulate pro/anti-inflammatory pathways, but the specific mechanisms involved remain elusive. One attractive possibility is the regulation of the intracellular signalling pathways of the innate immune receptors Toll-like 3 (TLR3), which triggers antiviral and inflammatory responses.

To elucidate the regulatory role of paliperidone on maternal immune activation (MIA) induced alterations on TLR3 pathway and on the two emerging endogenous antiinflammatory/antioxidant mechanisms NRF2/antioxidant enzymes pathway and the cytokine milieu regulating M1/M2 polarization in microglia.

Pregnant mice were treated with the synthetic Toll-like Receptor 3 (TLR3) agonist Poly(I:C) in gestational day 9 and chronically treated with paliperidone (0,05 mg/kg i.p.) in adult offspring. Animals were sacrificed one day after treatment and behavioral test. Inflammation oxidative stress-related mediators were analysed at mRNA and protein level in prefrontal cortex samples. In addition, behavioral test t-maze was conducted.

Paliperidone prevented TLR3 pathway activation and the subsequent MIA-induced neuroinflammatory response. Also, paliperidone induced an increment in the activity and protein expression of nuclear NRF2, as well as increased mRNA levels of the antioxidant enzymes HO1, SOD and catalase in the MIA model. Otherwise, paliperidone increases the antiinflammatory cytokines levels TGFβ and IL-10 in favour of a M2 microglia profile and increased the levels of the M2 cellular markers ArgI and FOLR2.

The modulation of neuroinflammation and enhancement of endogenous antioxidant/anti-inflammatory pathways by current and new antipsychotics could represent an interesting therapeutic strategy for the future.

The authors have not supplied their declaration of competing interest.

Psychosis represents an uncommon but serious complication in the course of HIV infection, and always requires a careful differential diagnosis.

To provide an overview of psychosis in HIV-infected patients.

Literature review based on PubMed/MEDLINE, using the keywords “HIV” and “psychosis”.

Psychosis in HIV-positive individuals can be divided into psychotic disorders predating HIV infection and new-onset psychotic disorders in HIV-seropositive patients. The pathophysiology of psychosis in this population is complex and a multifactorial etiology is likely in most instances. The authors will analyze them and describe the differences of psychopathological pattern in first-episode psychosis between HIV-positive and HIV-negative patients. Antipsychotic agents are the treatments of choice regardless of the underlying diagnosis. However, they should always be used at the lowest possible dose for the shortest possible duration. Increased sensitivity to extrapyramidal reactions, high risk for dyslipidemia and hyperglycemia, potential interactions between HAART and some antipsychotic agents are also important considerations. Importantly, psychosis may be a harbinger of dementia. Cross-sectional studies have also suggested that psychosis may adversely impact the morbidity and mortality associated with HIV-infection.

Psychosis disorders may arise before or at any time during the course of HIV infection. A solid understanding of the complex relationship between psychosis and HIV allows for better evaluation and more effective treatment for psychotic individuals at risk for or infected with HIV. Thus, both HIV care programs and psychiatric care clinics should be made familiar with this important subject.

The authors have not supplied their declaration of competing interest.

Existence of integration, mutual relations of nervous and immune systems, which cellular elements are characterized by expressed phenotype and functional similarity, means the possibility of immune cells participation in the regulation of higher nervous activity.

Previously, we demonstrated the possibility of targeted regulation of animal's behavior by the transplantation of immune cells with definite functional characteristics. Based on the our previous research results in the present study, we investigated the modulating effect of the immune cells, treated in vitro with chlorpromazine on the nervous and immune systems functional activity in aggressive mice.

(CBA × C57Bl/6) F1 aggressive mice, exposed to 10-days chronic social stress, were undergoing the transplantation of immune cells in vitro treated with chlorpromazine. Animal's behavioral parameters, cytokines synthesis in the brain and immune cells before and after transplantation were estimated.

It was shown that aggression is associated with the increased production of spleen T-helper 1 cell-derived cytokines IL-2 and IFNγ, as well as decreased TNFα production by the spleen mononuclear phagocyte cells. These alterations were more pronounced following mitogen stimulation. Spleen cells, obtaining from aggressive mice, were treated in vitro with chlorpromazine and then injected intravenously into syngeneic aggressive recipients. The cell's transplantation led to the reduction of the recipient's motor activity in the “open field” and Porsolt swimming tests and normalized cytokines synthesis in the brain and immune cells.

Research results demonstrated the neuroleptic effect in aggressive mice, obtained by the transplantation of immune cells treated in vitro with chlorpromazine.

The authors have not supplied their declaration of competing interest.

Critical illness increases the risk of mental illness, including anxiety disorders. As critically ill patients exhibit high levels of inflammation and inflammation plays a role in mental illness, critical and mental illnesses may be linked by systemic inflammation.

To investigate whether anti-inflammatory drugs reduce the risk of subsequent anxiety disorders among intensive care patients requiring mechanical ventilation.

To assess the risk of anxiety disorders after intensive care requiring mechanical ventilation according to pre-admission use of non-steroidal anti-inflammatory drugs (NSAID), glucocorticoids, statins or combination. To compare risk in users with non-users.

This nationwide, registry-based, cohort study includes all patients receiving mechanical ventilation in Danish intensive care units during 2005–2013. Preadmission use of NSAIDs, glucocorticoids, statins or combinations will be identified from filled prescriptions. Risk of anxiety disorders in users and non-users of these anti-inflammatory drugs will be estimated using the cumulative incidence method, accounting for death as a competing risk. After propensity-score matching, risk in users and non-users will be compared using hazard ratios from a Cox regression.

N/A. The estimated number of patients is 100,000. Expected preadmission use is 14% for statins, 15% for NSAIDs, and 10% for glucocorticoids. The study will have 95% power to detect a 10% decrease in risk between users and non-users.

N/A. The study potentially will contribute knowledge about the pathogenesis of anxiety disorders and a mechanism linking critical illness and mental illnesses. If anti-inflammatory drugs reduce risk of anxiety disorders, this may guide trials.

The authors have not supplied their declaration of competing interest.

A family “constructs” an identity of its own derived from their assumptions about relationships and the social environment they live in. This identity transcends the individual while at the same time encourages individual differentiation. Family functioning is influenced from different factors like social context, qualitative characteristics, and from individual's medical or psychiatric condition.

To examined the effects of sociodemographic factors and individual psychopathology on the function of family in a non-clinical sample.

Cross-sectional study of participants and their families. The follow data collected:

• –demographics (age, gender, occupation, education);

• –description of the family (number of members, single parents family, adoption);

• –history of mental or physical illnesses;

• –Family Assessment Device (FAD);

• –Symptom Checklist-90 (SCL-90).

The sample constituted of 151 families, (453 individuals), in 48 families, 2 family members participated, in 56 families, 3 members participated, in 46 families 4 members participated and 1 family had 5 members participating. One hundred ninety-four (42.8%) were children and 259 (57.2%) were parents. The mean age of the children was 23.62 (SD: 6.35) and 68 (35%) were males. Mean age of the parents was 51.4 (SD: 8.2) and 117 (45.2%) were males. SCL-90 identified 183 participants as caseness. Multilevel analysis showed that individual psychopathology (caseness) was the only statistical significant factor for family dysfunctioning.

There is strong association between family dysfunction and psychopathology of a member. Dysfunctional families need further psychiatric evaluation of the members. Cause-effect cannot be concluded from this cross-sectional study.

The authors have not supplied their declaration of competing interest.

Recent studies have underlined the importance of considering the form of thoughts, beyond their content, in order to achieve a better phenomenological comprehension of mental states in mood disorders. The subjective experience of thought overactivation is an important feature of mood disorders that could help in identifying, among patients with a depressive episode, those who belong to the bipolar spectrum.

Patients with a diagnosis of bipolar disorder (BD) were compared with matched healthy controls (HC) on a scale that evaluates thought overactivation.

Validate the Italian version of a scale for thought overactivation (i.e. STOQ) in a sample of bipolar patients.

Thirty euthymic BD and 30 HC completed the Subjective Thought Overactivation Questionnaire (STOQ), the Ruminative Responses Scale (RRS), the Beck Depression Inventory-II (BDI-II) and global functioning (VGF).

The 9-items version of the STOQ has been back translated and its internal consistency in this sample was satisfactory (alpha = .91). Both the brooding subscore of RRS (b-RRS) (r = .706; P < .001) and STOQ (r = .664; P < .001) correlate significantly with depressive symptoms whereas only the first correlate with VGF (r = –.801; P < .001). The two groups did not differed in the b-RRS (HC = 8.41 vs BD = 9.72; P = .21), whereas BD where significantly higher in the STOQ total score (HC = 6.62 vs. BD = 14.9; P = .007).

Our results, although limited by the small sample size, confirm the validity of the STOQ and suggest that this scale could grasp a feature characteristic of BD, independently from their tendency to ruminate. The latter seems to impact more on global functioning.

The authors have not supplied their declaration of competing interest.