The goal of this study is to assess the differences in peak and medium velocity, peak and medium acceleration of eyeball movements after the administration of methadone.

Twenty-eight opioid addicts were examined. Patients admitted oculomotor impaired were excluded.

In this study, we made use of the Saccadometer Advanced (Advanced Clinical Instrumentation, Cambridge, UK), allowing the measurement of eye position with the time resolution of 1 msec (1000 Hz). The eye movement measurement is automated and synchronised with stimuli presentation. Before and after the administration of methadone two saccadic tests were carried out: Prosaccades Test (PT) and Antisaccades Test (AT).

The average of peak and medium velocity and the average of peak and medium acceleration of eyeball movements in the test AT were lower than in the PT test. After administration of a single dose of methadone the peak and medium velocity, peak and medium acceleration decreased in both tests (PT and AT). After administration of methadone prolonged the duration of saccades, and prolonged the duration of rising and falling slope of saccades.

It was found that methadone (μ-opioid receptor agonist) is associated with change of velocity and acceleration of eyeball movements.

The authors have not supplied their declaration of competing interest.

It is necessary to search for and to carry out effective treatments for chemical dependency – including behavioral addictions. One of the methods used in various disorders is a biofeedback HRV (BF-HRV). The aim of the study is to examine the impact of BF-HRV on people addicted behaviorally to gambling and chemically dependent patients on opioids.

Twenty-four opioid addicts were examined. We used emWave (HeartMath) with a heart rhythm monitor to learn stress reduction and emotional management skills. For a detailed analysis of the HRV data was used Kubios 2.0 software (Biosignal Analysis and Medical Imaging Group).

The average value of the three components of HRV, i.e. low (LF), medium (MF) and high (HF) frequencies of spectral energy FFT recorded during six consecutive sessions of BF-HRV were the following: 1st session LF 63%; MF: 17%; HF: 19%. Changing parameters in the next sessions: 2nd session LF −9.27%, MF: +0.50%, HF: +6.19%; 3rd session LF −11.11%, MF: +1.00%, HF: −10.07%; 4th session LF −14.27%, MF: −4.17%, HF: +18.77%; 5th session LF −15.02%, MF: −2.04%, HF: +17.07%; 5th session LF −15.02%, MF: −2.04%, HF: +17.07%; 6th session LF −20.86%, MF: −4.04%, HF: +24.90.

After the BF-HRV training decrease low and medium frequencies (LF-MF) and increase high frequency (HF). Recent studies suggest that LF-HRV is an index of cardiac sympathetic control and the LF/HF ratio is an index of sympathovagal balance.

The authors have not supplied their declaration of competing interest.

Tobacco dependence (TD) often coexists with alcohol dependence. Previous research documented that both biological and environmental factors influence simultaneous development of the two disorders. However, it has not been determined whether the same psychological and psychopathological factors affect TD in alcohol-dependent males and females.

The objective of the study was to assess risk factors for high severity of TD in alcohol-dependent individuals considering gender differences.

The study entailed two groups: male (n = 284) and female (n = 102) subjects entering alcohol addiction treatment programs in Warsaw, Poland. Standardized instruments were used to assess: severity of TD – Fagerstrom Test for Nicotine Dependence, personality traits – NEO-Five Factor Inventory to assess, consequences of drinking – Short Inventory of Problems, impulsivity – Barratt Impulsivity Scale, and Sleep Disorder Questionnaire-7 as a measure of insomnia.

In the studied sample, current smokers comprised 79.1% (n = 225) of male and 79.4% (n = 81) of female participants. Multivariate regression model showed that high negative consequences of drinking (P = 0.001) and low NEO Openness score (P = 0.009) were associated with high risk of TD in female alcoholics (corr. R2 = 0.223; P < 0.0005). Bivariate analyses showed that TD was associated with impulsivity, openness, agreeableness and neuroticism in male alcohol-dependent subjects. Insomnia was the only significant predictor for high severity of TD in the males (corr. R2 = 0.068; P = 0.002).

Different factors contribute to severity of tobacco dependence in male and female alcohol-dependent individuals entering addiction treatment.

The authors have not supplied their declaration of competing interest.

The objective of current study was conducted to determine whether low vitamin D level and BMD are associated with depressive symptoms as burden in Arab women during the menopausal and post-menopausal period.

A cross-sectional descriptive study.

A multi-stage sampling design was used and a representative sample of 1436 women aged 45–65 years were included.

Bone mineral densitometry measurements [BMD] (g/m2) was assessed at the BMD unit using. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.

Of the 1436 women living in urban and rural areas, 1106 women agreed to participate (77.0%). There were statistically significance differences between menopausal stages with regards to ethnicity, education level, systolic and diastolic blood pressure, parity, sheesha smoking and depressive symptoms. Overall, 30.4% of women were affected with osteopenia/osteoporosis in menopause and postmenopausal (24.4% vs. 35.7%; P = 0.0442). Osteopenia in menopause and postmenopausal (18.7% vs. 29.3%; P = 0.030) and osteoporosis (9.9% vs. 15.9%; P = 0.049) were significantly higher in post-menopausal women than in pre-menopausal women (P = 0.046). Similarly, vitamin D deficiency was more prevalent among postmenopausal women than menopausal women. The study revealed that vitamin D level, hemoglobin level, serum iron fasting plasma glucose, calcium, triglycerides, HDL cholesterol, LDL cholesterol, alkaline phosphate and magnesium were considerably lower in postmenopausal compared to menopause women (P < 0.001).

The study confirmed strong association between vitamin D level and BMD in Arab women during the menopausal and post-menopausal period.

The author has not supplied his declaration of competing interest.

The author has not supplied his declaration of competing interest.

Anxiety disorders are the most common mental disorders, and their prevalence is substantially higher in women than in men. Research has confirmed the existence of gender differences in several types of anxiety disorders.

The current investigation sought to determine whether any observable gender differences existed in anxiety for a nonclinical sample.

the sample consisted of 300 males and 300 female students from a secondary school in Kuwait. The genders were matched in age (males = 16.52 ± 0.90 & females = 16.37 ± 0.96, t = 1.93, P > .05). The inclusion criteria for all participants: sample of the population of Al-Jahra city, aged between 15 and 18 years old, school grades 10, 11, 12, and the social status of the parents (married). The Arabic version of Beck Anxiety Inventory (BAI) was administered to participants. BAI reliabilities ranged from .88 to .87 with a mean .87 (alpha) denoting good internal consistency. The convergent correlations in eight samples between BAI and Kuwait University Anxiety Scale KUAS (mean r = .52) for validity coefficients.

The results revealed that females (18.67 ± 11.11) had significantly higher mean anxiety than their male (14.52 ± 10.37) counterparts (f = 22.27, P < .000).

Therefore, we can conclude that female preponderance of anxiety has been a consistent finding within literature.

The author has not supplied his declaration of competing interest.

Thirty-five definite vestibuler migraine patients (according to Neuhauser criteria), 35 MO patients and 32 healthy controls were included. All patients were evaluated for their lifetime psychiatric disorders with Structured Clinical Interview for DSM–IV/Clinical version (SCID-I/CV). All three groups evaluated by:

– Hamilton Anxiety Rating Scale (HARS);

– State-Trait Anxiety Inventory (STAI), (STAI-X1) and the other trait anxiety STAI-X2);

– Beck depression inventory (BDI);

– Lifetime Panic Agoraphobic Spectrum Scale (PAS-SR);

– Penn State Worry Questionnaire (PENN);

– Separation Anxiety Symptoms Inventory (SASI);

– Adult Separation Anxiety Questionnaire (ASA).

Psychiatric diagnosis history (SCID-I); comparison of VM and MO did not indicate a significant difference (P < 0.05). VM and MO patients were significantly different than HC in terms of anxiety symptoms in “HAM-A, PENN, ASA, PAS-SR and PAS-SR subscales (P < 0.05)”. VM was significantly different than MO patients in BDE and PAS-SR (overall; separation anxiety, agoraphobia, reassurance seeking) (P < 0.05). The longer the history of migraine the higher was the anxiety points in both in VM and MO patients (P < 0.05). Headache and vertigo severity in VM patients were significantly correlated with the elevated anxiety and depression points (P < 0.05).

VM and MO patients significantly different in anxiety and mood disorder when compared with healthy controls. Our findings showed that VM patients were more vulnerable to psychiatric disorders. For that reason, multidisciplinary approach for the treatment of VM may facilitate the treatment process.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The influence of cognitions and the perceived self-efficacy on mental health has been studied for a long time. Some studies have linked the perceived self-efficacy and apprehensive cognitions with the severity of panic disorder with agoraphobia.

To study the relationship between self-efficacy and dysfunctional beliefs of patients with panic disorder with agoraphobia and severity of the disorder.

A systematic review of the literature was performed to examine the evidence of relationship between self-efficacy and cognitions with the severity of panic disorder. PubMed and PsycInfo databases were searched.

The studies conclude that a higher level of self-efficacy decreases anticipatory anxiety and negative emotional states in panic disorder with agoraphobia, reducing the severity of panic disorder. There is a temporal relationship between dysfunctional beliefs, self-efficacy and fear of a panic attack: changes in fear are preceded by changes in beliefs, changes in efficacy or changes in both beliefs and self-efficacy. Therefore, a higher level of self-efficacy and positive beliefs have been studied as a significant predictor of lower severity of the disorder and a greater improvement during treatment.

These results support the hypothesis that cognitive changes precede improvement and the importance of cognitive appraisals for anticipatory anxiety and severity of the panic disorder with agoraphobia.

The authors have not supplied their declaration of competing interest.

Patients with body dysmorphic disorder (BDD) are concerned about a slight or non-existent defect on their appearance, causing significant stress and interfering on their social and professional life.

Despite its prevalence and psychosocial impact, this disorder remains unknown by many clinicians.

Through a review of literature and illustration in our case report we will define: the symptomatology of this pathology, psychopathological models of the disorder and the etiopathogenic assumptions associated with it, in terms of risk factors and neurobiological correlations.

Patient 33 years old unmarried having been the victim of an AVP at the age of 25 years causing him a head injury above right eye for which he undergoes cosmetic surgery three times but the patient still not satisfied with installation of psychotic and delusional disorders requiring the use of antipsychotics.

The complexity of body dysmorphic disorder should not discourage clinicians to confront this disease. The management requires more than putting under medical treatment associated to psychotherapy, we also need a good relationship of trust and maintain effective working alliance.

The authors have not supplied their declaration of competing interest.

Illness anxiety disorder, or hypochondriasis, is one the most difficult and complex psychiatric disorders to treat.

To describe a case of a patient with illness anxiety disorder and summarize the most important aspects on this theme.

Interviews with the patient and literature review searching the PubMed/MEDLINE were performed.

A 42-year-old married man, dentist, Angolan citizen, who had recently arrived in Portugal, was referred to psychiatry assessment during his hospitalization in medicine service, after an exhaustive medical evaluation. He was excessively anxious and worried about having a severe heart disease because he has gradually become more aware of palpitations and chest pain. Although negative results of the examinations he was worried that “something has been missed”. After he had consulted several medical providers in Luanda, he decided to seek medical advice in Portugal. Patient believed that his symptoms exacerbated with activity and intake food, so he gradually restricted them. Due to his health anxiety, he stopped his work and lost 36 kilos. Shortly before the onset of the clinical picture, his daughter was hospitalized for the first time.

Illness anxiety disorder often begins in early to middle adulthood. Its core feature is the fear or idea of having a serious disease, based on the misinterpretation of bodily signs and sensations as evidence of disease, which persists despite appropriate medical evaluations and reassurance. This patient fulfills the DSM-5 criteria of Illness anxiety disorder and has a clinical profile similar to those found in literature.

The authors have not supplied their declaration of competing interest.

Psychogenic movement disorders are the result of a psychiatric rather than a primary neurological disorder. Astasia-abasia refers to the inability to stand or walk despite having good motor strength and conserved voluntary coordination.

Starting from a case report of a patient with an unusual gait disturbance the author intends to discuss the history and knowledge evolution on psychogenic gait disorders until the present time.

To debate the nosology, clinical features, diagnosis and treatment of psychogenic movement disorders.

Non-systematic review of the literature. Case presentation with the exhibition of a video showing the patient's gait.

A 48-year-old female was admitted to a psychiatry ward after attempting to commit suicide by cutting her throat. On day 3, she suddenly could not walk or stand without help. The neurological examination revealed some inconsistencies and all laboratory, electroencephalogram, and imaging studies performed were normal. After 2 weeks of treatment she started gradually getting better until the full recovery.

The gait disturbance presented might be regarded as a form of astasia-abasia. This term was first coined by Paul Blocq (1888) when he described a group of patients who showed inability to maintain an upright posture. Similar movement disorders were previously described as hysteria by authors like Charcot. Nowadays, these case descriptions would be likely considered cases of conversion or psychogenic gait disorder.

The etiology of these disorders is still not very well understood. These patients usually benefit from a multidisciplinary approach that includes psychiatry, neurology, physiotherapy, among others. Pharmacological and non-pharmacological treatments should address the underlying psychiatric condition.

The author has not supplied his declaration of competing interest.

Spielberger, Eysenck Personality Questionnaire (EPQ), the Hamilton Rating Scale for Depression (HRSD), the study of accentuation of personality by K. Leonhard.

One hundred patients with diagnostic categories: F41.0 – Panic disorder (episodic paroxysmal anxiety, F41.1 – Generalized anxiety disorder, F41.2 – mixed anxiety-depressive disorder who are on the examination and treatment at the psychiatric unit. A control group included 40 patients.

We performed the exploration of the peculiarities of clinical anxiety and patterns of therapeutic effect, based on the influence of short-term group and individual psychotherapy in the treatment of anxiety disorders, and evaluation the effectiveness of its recognition.

The development of the methodology of applying a short-term group and individual psychotherapy in the treatment of anxiety disorders based on combination relaxation, hypnosis, cognitive-behavioral techniques in combination on with short-term group therapy.

In fact, this is a new real model psychotherapy based on integrative principles. The high efficacy was shown in 82% patients, compared with 54% efficacy in control group patients.

We will offer a new comprehensive methodology in the treatment of anxiety disorders of neurotic case that will improve the therapeutic efficacy of the treatment process, reduce the time of treatment, reduce the period of drug therapy.

The authors have not supplied their declaration of competing interest.

to describe with prospective methodology the therapeutic response to clonazepam in the respiratory panic disorder (PD) subtype versus the non-respiratory subtype in a long-term follow-up.

A total of 67 PD outpatients (DSM-IV) were previously divided into respiratory (n = 35) and non-respiratory (n = 32) subtypes and then openly treated with clonazepam for 8 weeks. Those who responded were then treated for 3 years. Demographic and clinical features were compared in the two groups. The instruments used to evaluate response were the Clinical Global Impression, the Sheehan Panic and Anticipatory Anxiety Scale, and the Panic Disorder Severity Scale.

In the first 8 weeks of treatment (acute phase), the respiratory subtype had a significantly faster response on all the major scales. During the follow-up and at the end of the study (week 156), there was no difference in the scale scores, and the reduction in panic attacks from baseline to end-point did not differ significantly between the two groups. After the acute phase treatment, the patients could undergo psychotherapy. In the respiratory subtype, the disorder had a later onset, was associated with a high familial history of anxiety disorder. The non-respiratory subtype had significantly more previous depressive episodes. Clonazepam had a safe adverse event profile during both phases of treatment.

The respiratory PD subtype had a faster response to treatment with clonazepam at 8 weeks than did the non-respiratory subtype and an equivalent response after 6 months of treatment. The response of clonazepam is clearly maintained during the long-term follow-up.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

Epilepsy is a chronic disease often disabling, source of stigma and poor quality of life.

Determine the prevalence of anxiety and depression in patients with epilepsy and the associated factors.

We conducted a prospective, descriptive and analytical study among 20 patients followed for epilepsy in our department of neurology. The study was conducted from February to April 2015. We used a preestablished form to collect the socio-demographic and clinic profile of the patients. The assessment of anxiety and depression was made via the HADS “Hospital Anxiety and Depression Scale” and the perceived health status via GHQ scale “General Health Questionnaire”.

The average age of our patients was 35.9 years. The average GHQ score was 27.7. It was higher in women without a statistically significant difference. It was positively correlated with the number of attacks during the last 12 months (P = 0.042), poor treatment adherence (P = 0.007), the feeling of disability (P = 0.021) and the feeling of stigma (P = 0.008). Anxiety was estimated in 35% of cases and 45% were depressed. Depression was significantly associated to the celibacy (P = 0.012), the feeling of stigma (P = 0.038) and the GHQ score (P = 0.016). Anxiety was correlated with the absence of hobbies (P = 0.02) and the GHQ score (P = 0.008).

It is important to detect these psychiatric disorders and to manage generators factors to ensure a better quality of life and social integration for these patients with epilepsy.

The authors have not supplied their declaration of competing interest.

Melasma is a common disorder of acquired hyperpigmentation characterized by tan or brown macules and patches localized to photo-exposed areas of the face.

To study the psychological impact of melasma on Tunisian women.

We conducted a cross-sectional study on thirty patients with melasma who attended the dermatology department of the University Hospital in Sfax (Tunisia).

The questionnaire included socio-demographic and clinical data. We used four measurement scales:

– MELASQOL questionnaire;

– Rosenberg Self-Esteem Scale;

– Hospital Anxiety and Depression Scale;

– Body Image Questionnaire.

The mean age was 34.6 years. The majority was living in urban areas (90%), was married (56.7%) and had a profession (80%).

Sixty percent of patients were anxious and 16.7% were depressed. Both self-esteem and body image were respectively altered in 43.3% and 36.6%. The average score of MELASQOL was 31.77%. It was higher in single woman (36.8 vs. 28.4), younger than 40 years old (31.5 vs. 21.7), having a low socioeconomic status (45.2 vs. 29) and working in private sector (40 vs. 24).

The quality of life was more damaged in patients with disease duration less than five years (P = 0.024).

Anxious patients had higher MELASQOL scores than non-anxious (38.17 vs. 22.17; P = 0.008), as well as depressed patients (49 vs. 28.32; P = 0.009).

High MELASQOL scores were correlated with low self-esteem (P = 0.05) and altered body image (P = 0.04).

Although benign, melasma causes an important psychological impact such as anxiety, depression, low self-esteem and poor body image. These effects should be considered in the care plan.

The authors have not supplied their declaration of competing interest.

Dissociative disorders are among the most enigmatic and controversial psychiatric pathologies. In the last decades, great interest has emerged in understanding its pathophysiology, nonetheless, problems in recognition and management of these disorders are still challenging the psychiatric community.

We describe a paradigmatic case of a dissociative disorder illustrating the “choice” of dissociation as a strategy for coping with a traumatic reality.

Call attention to problems that interfere with the recognition, diagnosis and management of dissociative disorders.

Bibliographic research was conducted through the PubMed in the Medline library and clinical information was obtained through medical records and clinical interviews with the patient.

A 51-year-old Brazilian woman with no psychiatric history presented to the psychiatric outpatient care with apparent dissociative symptoms, these consisted of amnesia for episodes of agitation and aggressive behavior that occurred mainly at bed time. She had been previously on general practice and neurology consultations but none organic diagnose was made. Already in psychiatry, it was recognized that those symptoms developed together after a car accident and the beginning of a romantic relationship. It was also recognized that she has sexual dysfunction and a history of sexual abuse by a family member during her childhood, a known risk factor to dissociative disorders.

Skepticism and lack of understanding might be the reason for late psychiatric referral after the realization of various expensive and time-consuming medical exams. Improving the recognition of dissociative disorders will conduce not only to better clinical outcomes but also improve cost effectivity of medical interventions.

The authors have not supplied their declaration of competing interest.

Medical studies are considered one of the most stressful majors and the medical profession is one of the most at risk of burnout. Some studies indicate the presence of symptoms of burnout already in the early stages of career, or even before it started, i.e. during studies preparing for the profession. Medical studies may be such a case and it can affect the mental health deterioration and cause the occurrence of both burnout and neurotic symptoms.

Assessment of the impact of the course of studies on mental health of students and the risk of rapid burnout.

Estimation of the prevalence and severity of burnout and neurotic symptoms among medical student depending on the year of study.

Seven hundred and eighty-one medical students participated in the study. We used translated version of Maslach Burnout Inventory-Student Survey and Polish questionnaire – Symptom checklist S-III – for neurotic symptoms assessment.

There was no significant difference in MBI-SS subscales and symptoms checklist between first and last year of studies. Difference turned out to be significant when 1st and 6th year students with 3rd year – in Symptom checklist (P < 0.01 and P < 0.05, respectively), MBI-SS emotional exhaustion subscale (P < 0.01 for both) and depersonalization subscale (P < 0.01, significant only when compared with 1st year students).

Study revealed interesting pattern of burnout and neurotic symptoms, with theirs greatest severity at the beginning and the end of studies.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.