The vast number of psychopathological syndromes that can be observed in clinical practice can be described in terms of a limited set of elementary syndromes that are differentially expressed. In the past, principal component analysis (PCA) has been used to identify such elementary syndromes (dimensions of psychopathology). Here, we show that elementary syndromes can be defined as modules within a network of interacting symptoms.

To examine the modular structure of psychopathology using network community detection (NCD) and principal component analysis (PCA) and to define critical areas of the network that could be primary targets for intervention.

192 heterogeneous psychiatric patients were tested on the Comprehensive Psychopathological Rating Scale (CPRS). PCA was performed on the bootstrapped correlation matrix of symptom scores to extract the principal component structure (PCS). An undirected and weighted network graph was constructed from the same matrix. Network community was optimized using a previously published technique.

NCD showed an optimal match (93.2%) with a 6-PCS of psychopathology. Some 6 network clusters were found, including ‘Depression’, ‘Mania’, ‘Psychosis’, ‘Psychomotor retardation’, ‘Behavioral disorganization’, and ‘Somatic anxiety’. The psychopathology network displayed a Small World structure. Nodes with singular network metrics were identified as possible targets for treatment.

We present the first comprehensive network graph of psychopathology: a ‘Psychopathology Web’. Clusters within this network represent elementary psychiatric syndromes. Individual symptoms with key roles in maintaining network connectivity were identified as possible targets for treatment.

Subjective well-being(SWB) is the scientific name for how people evaluate their lives, and since Thalassemia is an inherited blood disorder that requires lifelong adherence to a complicated and burdensome medical regimen, SWB could be easily underevaluated.

To measure the impact of SWB in adult patients with thalassemia.

To explore possible demographic, physical, and psychosocial correlates in SWB.

117 patients(23-60 years old, Mean age=37.2±9.3; 73% females) took part in the study. Satisfaction with Life Scale(SWLS-Ed Diener) was used for SWB, along with SF12 for health related quality of life, Depression Anxiety Stress Scale (DASS), life orientation test(GrLOT-R) for dispositional optimism and a questionnaire about sociodemographic characteristics. Statistical analysis was performed with SPSS 21.

16.8% of patients were substantially to extremely dissatisfied with their lives(SWLS=5-14). 16.4% were slightly below average(SWLS=15-19), 19.8% had an average score (SWLS=20-24) and the rest had a high(29.8%-25-29) and very high score(17.2%-30-35) respectively. There was a significant difference between males(M=20±7) and females(M=22.8±7.2)(t=-1.906-p=0.05). Multivariate analysis revealed that optimism(beta=-.403), stress(beta=-.415), spouse existence(beta=.155), and gender(beta=.228), explained 56.4% of the variance in SWB(adjusted R2=.564-p=0.026). Age, SF12, depression, anxiety and education had a Non Significant effect in the model.

Given these findings, almost half of thalassemia patients have average to low life satisfaction, something which implies that they are sometimes not functioning well because their unhappiness serves as a distraction. Talking to a psychologist or psychiatrist can often help the patient get moving in the right direction, although positive change will be up the person

The Montreal Cognitive Assessment(MoCA) is a psychometric tool measuring cognitive function that detects Mild Cognitive Impairment(MGI), a clinical condition which often results in dementia.

To measure the psychometric properties of the assessment.

To explore the discriminant validity and internal consistency of the assessment.

The study included 132 patients, 56(42.2%)men and 76(57.6%)women. Of them, 12(9.1%) had dementia, 54(40.9%)psychiatric diseases, 7(5.3%)vascular strokes, 3(2.3%)organic psychosyndrome, 17(12.9%) cases were to be investigated and 36(27.3%) were patients without psychiatric illness, who were evaluated under Liaison Psychiatry. The psychometric properties of MoCA were evaluated in comparison to the Mini-Mental-State-Examination(MMSE) and Golden Standard, which was the diagnosis of the treating physician. Statistical analysis was performed with SPSS21.

The total scale of MoCA had a coefficient alpha of .885 and all the subscales between .878-893. MoCA had a significant high correlation with MMSE(r=-.544 p =.001) and with age(r =-.544 p =.001). No significant differences were found between men and women (t=-.707 p>.05). There was a statistically significant difference between the assessments in moderate and severe cognitive impairment, where MoCA was more sensitive (99%) than MMSE (likelihood ratio=115.3 p =.001) in all diagnostic categories. The specicifity of MoCA was 93% due to fact that it was reduced in patients with organic psychosyndrome when the golden standard found no cognitive impairment.

MoCA is a brief screening tool of cognitive decline with higher specificity and sensitivity in detection of mild cognitive impairment in patients who scores in normal levels of MMSE.

Subjective well being (SWB) is really an umbrella term, that includes several different components and these components are somewhat independent, while Diabetes Mellitus (DM) is a chronic condition affected by many biopsychosocial factors.

To measure the impact of SWB in adult patients with DM

To explore possible demographic, physical, and psychosocial correlates in SWB.

293 DM patients(115(39.2%) males/178(60.8%) females), in two outpatients’ clinics in Athens-Greece took part in the study. Satisfaction with Life Scale(SWLS) was used for SWB, along with SF12 for health related quality of life Depression Anxiety Stress Scale(DASS), Life Orientation Test(GrLOT-R) for dispositional optimism and a questionnaire about sociodemographic characteristics. Statistical analysis was performed with SPSS 21.

internal Almost half of the patients(54.5%) scored below average(<24) in SWLS while 20% were highly satisfied (score 30-35) and 25% satisfied(25-29). No existing differences were present in SWB according to sex(t=1.605-p=NS). Multivariate analysis revealed that depression(beta=-.423), Physical component score (SF12-PCS) (beta=.317), fatigue(beta=.211), income(beta=.186), stress(beta=-.150) and pain intensity (beta=.139), explained 52.9% of the variance in SWB(adjusted R2=.529-p=0.001). Sex, education, marital status, anxiety, Mental Composite Score, HbA1c, insulin therapy, and diabetes complications had a NS effect in the model.

Our results indicates that SWB is affected equally from biological, psychological and societal variables, giving strong evidence to the biopsychosocial model of subjective health and suggests that multidisciplinary treatment with psychological screening should be applied in these patients in order to help and motivate them feel better.

Internet addiction(IA) has been proposed to separate into three subtypes, gaming, sexual preoccupation and email/text messaging and since use for social networking has increased significantly it may represent a fourth subtype in this model.

To examine the effect of more than two hours/day use of the social networking with facebook application, in relation to negative emotions of depression, anxiety and stress.

To estimate the possibility of this use in leading to negative emotions.

257 adults(17-68 years old, Mean age=33.1±10.1; 76(29.6%) males and 181(70.4%) females) took part in the study. An online form of Depression Anxiety Stress Scale (DASS) was used for measuring negative emotions as well as sociodemographic characteristics. Statistical analysis was performed with SPSS 21.

Statistical significant differences were found between males(x=14.8±8.4) and females(x=18.5±9.9) in stress(t=2.886 p=0.004). Multivariate analysis revealed that age(beta=.143) and social activity(beta=.123), explained 18% of the variance in depression(adjusted R2=.188- p=0.028). In stress and anxiety, social activity(beta=.177 and .130) and education(beta=-.170 and -.216), explained 23% of the variance (adjusted R2=.231-p=0.004) and (adjusted R2=.239-p=0.037) respectively.

Odds ratio of depression for those who used the Internet for more than two hours/day was: OR=1.0254(95% CI:0.5682-1.8504 p = 0.9337), for stress OR=0.7826(95% CI:0.4352-p= 0.4130) 1.4074 and for anxiety OR=1.1140(95% CI: 0.6200- 2.0018 p=0.7180).

Results suggested that social networking users who are initially free of mental health problems but use the Internet pathologically do not develop negative emotions as a consequence especially when they have social activities as a protective factor.

In the UK, 1/4 people are considered overweight or obese. National Health Service (NHS) employees are no exception with ½ workers affected. There are myriad factors that contribute to these statistics such as mental health, occupation and lifestyle.

Studies reveal that 35% of people with bipolar disorder are clinically obese, which is the highest percentage of any psychiatric illness. The suggested factors that may be contributing to this problem include co-existing eating disorders and treatment with medications that cause weight gain.

Religious periods i.e. Christmas and Ramadan are associated with weight changes. 50% of annual weight gain has been reported during the Christmas period. Conversely weight loss has been reported in Muslims who fast during the Islamic month of Ramadan.

To qualitatively illustrate how religious, psychosocial, physical and occupational factors can cause significant weight changes.

We provide an autobiographical narrative from a doctor- the primary author- employed by the National Health Service who suffers from bipolar disorder and who has experienced dramatic oscillations in his weight.

Ramadan provided the primary author with a platform to make major modifications to his lifestyle. He substantially reduced his carbohydrate consumption and also exercised 7 days/week. Dr Hankir lost 30 kg in weight over a 3 month period. His waist size decreased from 36 inches to 32 inches.

Fasting during Ramadan can provide an opportunity to lose weight as is evidenced in this case report, however structured and consistent lifestyle modifications are necessary to maintain sustained weight loss.

Quis custodiet ipsos custodes? Who will watch the watchmen?

The incidence of most psychiatric disorders is higher in doctors than in the general population. Surveys have revealed that up to 25% of doctors have depressive symptoms. Suicide rates are also high with 400 doctors in the US alone lost every year lost to suicide.

Doctors are notoriously bad at seeking help for their own psychiatric problems often only presenting when a crisis arises. Reasons for this include symptom concealment owing to fears of exposure to stigmatisation.

A stigma was a scar on the skin of ancient Greek criminals. It was a sign to all that these people were unsafe, unclean and unwanted. Stigma still persists today in the attitudes towards those who have mental health challenges. Nowhere is this more apparent than in the medical profession.

To take a stand against the stigma associated with mental health challenges in the medical profession and to debunk the many myths that abound.

The primary author composed an autobiographical narrative about his personal experiences with oscillations in his mood in attempt to illustrate the factors that influence disease detection, progression, treatment and outcome.

Mental health challenges do not prevent you from realising your dreams as evidenced in this case report. Dr Hankir received the 2013 Royal College of Psychiatrists Foundation Doctor of the Year Award. It is through making it more acceptable to share our experiences with low mood that the number of suicides among medics will fall.

A proinflammatory state in a subgroup of depressed patients has been reported repeatedly (e.g. increased interleukin-6 and tumour necrosis factor-alpha). COX-2 inhibitors down-regulate increased inflammatory markers and are therefore investigated as an add-on therapy in depression. Proinflammatory cytokines and/or kynurenine metabolites may predict the outcome of treatment with COX-2 inhibitors.

To prove or disapprove the hypothesis of a better therapy response in the group of add-on celecoxib to sertraline, particularly in patients with a more pronounced proinflammatory state at baseline. The aim is to find a biological predictor (cytokines and/or kynurenine metabolites) for treatment outcome.

This is a dual-center, randomized, double-blind, placebo-controlled, parallel group phase IIa study. It investigates the mean change in clinical outcome and in serum cytokine and kynurenine levels from baseline to endpoint (week 6) in patients with major depression (HAMD-17 ≥ 22) treated with sertraline plus celecoxib versus sertraline plus placebo for six weeks. 51 depressed patients of both gender, aged between 18 and 60 years without any recent inflammatory disease were enrolled. The study comprises six study visits (6x ratings, 3x blood collections) during six weeks of treatment and a follow-up visit 10 weeks after baseline. Cytokines were measured by Enzyme-linked Immunosorbent Assay (ELISA), kynurenine and its metabolites by High Performance Liquid Chromatography (HPLC).

The study was completed quite recently and the results are in progress.

The expectative in regards achieving better therapeutic adherence related to medication compliance in schizophrenia has been shown to be greater in patients treated with long-acting injectable antipsychotics.

The purpose of the present study was to investigate whether or not the schizophrenia treatment under evidence-based clinical practice conditions with Palmitate Paliperidone in comparison with conventional depots antipsychotics, will improve the patient evolution and prognosis in schizophrenia.

This 18 months study, the patient population consisted of 30 outpatients, all diagnosed with schizophrenia, who received treatment with Paliperidone Palmitate (n=15). A comparison was conducted with the same number of patients who received treatment with depot conventional antipsychotic.

All patients were evaluated every three months and the following scales were used for assessment and measurement: Positive and Negative Syndrome Scale (PANSS) Global illness Severity (Global Clinical Impression CGI), Treatment Satisfaction Scale, Remission Criteria (Andreassen criteria,) Personal and Social Performance (PSP) and the Subjective Well-being under Neuroleptic Scale (SWN-K)

At endpoint, we found statistical differences among both study groups: The Paliperidone Palmitate group showed significantly higher remission rates (p < 0.05) and treatment satisfaction scores (p < 0.05). Also an improvement in global clinical impression (p < 0.05), PSP (p < 0.05) and SWN-K (p < 0.05)

Paliperidone Palmitate group showed lower sexual dysfunction (p < 0.05) compared to conventional depot.

The presented data demonstrated that Paliperidone Palmitate was an efficacy and safety treatment and could improve the outcomes prognosis and the clinical course of the illness in schizophrenic patients when compared with conventional depot

Dyfunctions of prefrontal neuronal circuits contribute to the pathophysiology of depression. Previous studies showed increased functional MRI and EEG connectivity in patients with depression. In this study we investigated a large sample of patients with major depression (n=228) and healthy subjects (n=215).

Spectrotemporal dynamics during resting state with closed eyes were analyzed in sensor and source space to examine functional EEG connectivity (fcEEG) alterations between groups. Quantitative measures of delta, theta, alpha, beta and gamma power, hemispheric asymmetry, coherence, phase and current source density (CSD, eLORETA) analyses were calculated from artifact-free EEG recordings.

EEG theta power was increased in all brain regions in the group of patients with a focus in frontal regions and increased frontal theta and alpha power. Excessive coherence differences were detected in the delta, theta and alpha-bands in frontal, frontal-temporal and frontal-parietal regions. There were changes in phase differences in the delta, theta, alpha-bands between patients and healthy subjects. Differences in CSD were found for the delta, theta, alpha-band in the (rostral and subgenual) anterior cingulate cortex (ACC) with increased CSD in the patients.

The main finding of the present study was an increase in cortical slow-wave activity in sensor and source space in patients with depression revealing marked differences in prefrontal cortical networks. Functional delta, theta and alpha connectivity (coherence and phase) were altered with a predominance in the left hemisphere. Dysfunctions of the ACC, together with alterations in fcEEG may contribute to the pathophysiology of major depression.

Alcoholism is a family disease. Many studies confirm that family history of alcoholism is associated with the development of later alcohol dependence.

To analyse the family's impact in the development of alcohol addiction in children grown up in these families.

To create and distribute a questionnaire on family environment among group of alcoholic dependent and the control group and statistically analyse the results.

The research study was based on authors' anonymous questionnaire including questions referring to family structure, parents' divorce, prevalence of alcoholism of alcoholism in the family, parents' attitude towards alcohol and parent-child relationships. The study group consisted of 125 people, 83 men and 42 women, aged from 22 to 68 participating in treatment programs for alcohol addiction. The control group consisted of 231 people, 136 men and 95 women, aged from 17 to 65, with no history of alcoholism.

The study group participants stated less frequently that they had been raised by both parents (78% vs. 87%;p<0.05). In this group one of the parents significantly more frequently abused alcohol (43% vs. 19%; p<0.05) or both parents abused alcohol (15% vs. 1%;p<0.05). The participants claimed to be more often punished for their failures, abused physically/verbally and could less often depend on their parents.

Based on these result we concluded that patients addicted to alcohol were more often raised by a single parent, they were more likely to have alcohol-dependent parents and relationship with their parents were more often impaired.

Placebo effect has been a controversial and hot topic within psychoneuroinmunology. However recent studies have shed considerable light on the potential mechanisms of placebo responses and their role in health outcomes.

This study aims to provide a new and integrative look at the neurobiological mechanisms underlying the placebo effect.

A systematic review was conducted for articles published in peer-review journals in the last decade.

The two most evidence-based neural pathways for placebo effect: dopamine-related and endorphine-related; are fully explained and integrated in a comprehensive view.

The placebo effect represents an example of well-documented mind effect on the body. Implications for stress-related diseases are discussed.

The psychological modulation of stress-related disorders, such as type 2 diabetes is a well-established phenomenon in psychoneuroimmunology.

This study analyzes if health outcomes in a type 2 diabetes case are modulated by exposure to psychosocial stressors.

A single case study was conducted for a 38 year-old woman diagnosed with a history of unregulated type 2 diabetes.

Lack of control and predictability, lack of outlet for frustration, marital conflict, lack of social support and type A personality were associated with increase in clinical complications.

Results of this study point out the role of perceived intensity and chronicity of stressors in the health outcomes in our patient. In particular, interpersonal relationship, social support and personality played a key role in type 2 diabetes.

Because blind patients with schizophrenia are not so many, we don't have much information about their psychotic symptoms, neither about their treatment.

The hallucinations of blind schizophrenic patients could be different from unblind patients, due to impairment of their visual function.

Analysis of psychotic symptoms and antipsychotic treatment of blind schizophrenic patients could provide new information about their features and treatment.

We had two case studies, both diagnosed with schizophrenia, multiple episodes, currently in acute episode according to DSM V. Both patients were treated with olanzapine 10mg/day.

The psychotic symptoms of both patients had the same particularity, the presence of tactile hallucinations (both patients describe insects moving on and in the skin, with repeated attempts to remove them, producing secondary skin lesions). Both patients had a good response and remission of this symptoms after 14 days of treatment with olanzapine 10mg/day. The PANSS score had a reduction on hallucinatory behavior item from 5 to 1 for the first patient and from 6 to 2 for the second patient, for both after 14 days of treatment.

We presume that tactile hallucinations could be specific for these two cases. Treatment with olanzapine (an antipsychotic with a large receptoral spectrum) was a good choice in these cases.

A history of drug and alcohol use influences various aspects of inpatient care. It is important to ascertain the history of drug and alcohol use in new admissions. This knowledge ensures the appropriate detoxification of patients. It also allows the management of various risks such as the risk of violence, of escape, of drugs being brought onto the ward and of drug use amongst other patients. It can explain the lack of therapeutic progress in patients.

To ascertain whether new patients admitted to an acute ward on a medium secure unit in London are being asked about their drug and alcohol usage history.

To establish what proportion of 18 male inpatients on a medium secure unit have their drug and alcohol history documented in their admission notes.

The notes of all 18 patients on an acute ward in a medium secure unit were scrutinised. An audit tool was used to record whether the admission notes contained an entry about the history of drug and alcohol use.

There were 18 male patients. Four were under a section 3, four under a section 47, four under a section 48, one under a section 38, five under a section 37 of the Mental Health Act 1983. Only 5 of 18 patients had been asked about their history of drug and alcohol use on admission.

An important part of the history is being missed in a large proportion of new male admissions to a medium secure unit.

The psychological changes caused by trauma reflect the difficulty of overcoming the traumatic event. This study is a trial to approach the clinical and evolutionary aspects of post traumatic pathology through an observation of a recently hospitalized patient in our military psychiatric department.

Mr M., 28 years old, was surprised by the sound of distant gunshots. Going on site, he found six of his friends killed and his best friend dying. Developing severe symptoms of acute stress disorder, he was hospitalized and treatment by an antidepressant and anxiolytics has been established. Two weeks after, anxiety and nightmares decreased but repetition and avoidance syndromes did not improve.

Meanwhile, the patient was obliged to face major confrontations consisting of interrogations and legal proceedings concerning his conduct after the accident. He was suspended from his job and all his professional papers were confiscated. The patient developed consequently a major depressive episode; however, an important event occurred: the repetition syndrome disappeared. Thereafter, the mood disorder has improved and we have seen a more combative attitude from the patient.

In this case, how can we explain the relatively early disappearance of the repetition syndrome? Is it the confrontation with facts of reality even more traumatic than the trauma itself? The long-term evolution towards recovery or towards a new relapse will clarify us on this issue.