The aim of this study was to build a structural model to explore the predictors of adjustment to aging (AtA) in a community-dwelling older population.

A community-dwelling sample of 1270 older adults aged between 75 and 102 years answered a questionnaire to determine socio-demographic (sex, age, professional and marital status, education, household, adult children, family‘s annual income, living setting and self-reported spirituality), lifestyle and health-related characteristics (perceived health, recent disease, medication and leisure). Several instruments were used to assert psychological variables, namely AtA, sense of coherence and subjective well-being. Structural equation modeling was used to explore a structural model of the self-reported AtA, encompassing all variables.

Significant predictors are self-reported spirituality (β = .816; p < .001), perceived health (β = .455; p < .001), leisure (β = .322; p < .001), professional status (β = .283; p < .001), income (β = .230; p = .035), household (β = −.208; p = .007), sense of coherence (β = −.202; p = .004) and adult children (β = .164; p = .011). The variables explain respectively 60.6% of the variability of AtA.

Self-reported spirituality is the strongest predictor of AtA. This study emphasizes the need for deepening the variables that influence older adults’ AtA, in particular perceived health and further lifestyle-related characteristics, as being relevant for promoting aging well in later life, within a salutogenic context for health care.

A recent national survey highlighted the considerable treatment gap for depression (59.6%) in modern Singapore. Asians tend to focus on physical features of a disease than the psychological ones, which might contribute to the relative lack of disease pick up by physicians. Literature suggests a distinct clinical entity of depression among the elderly, with a different clinical presentation from adults.

This retrospective case series was undertaken to understand the clinical features and management decisions of elderly patients presenting with depression in Singapore.

To describe the demographics, clinical presentation, psychiatric and medical co-morbidities, and management decisions of depression in the elderly.

Inter-departmental referrals to the Department of Psychological Medicine of Tan Tock Seng Hospital from 1/1/2011 to 31/3/2011 for the management of patients ages above 64 with the diagnosis of depression were collated for case description.

A total of 40 inpatients ages 64 to 101 years (mean 75.7 years) were recruited. 15 (37.5%) were male and 25 (62.5%) were female. 22 (55.0%) have an existing diagnosis of depression. 28 (70.0%) of the patients were referred for review of symptoms of depression. The most prevalent symptoms were low mood (67.5%), followed by biological symptoms of depression (47.5%), and suicidal thoughts (37.5%). 23 (57.5%) of the patients were started on Selective Serotonin Receptor Inhibitors.

As the population of Singapore ages, clinicians should be mindful that depression often co-exist with medical co-morbidities, and the complex interaction amongst the two entities.

To study the prevalence of social support (SS) and it's relation with other psychosocial factors in female population of 25–64 years in Russia.

Under the third screening of the WHO’MONICA-psychosocial’ program random representative sample of women aged 25–64 years (n=870) were surveyed in Novosibirsk in 1994. SS were measured by Berkman-Sym test (indices of close contacts (ICC) and social network (SNI)). SPSS 11.5 was used for statistical evaluation (X2).

The prevalence of low levels of ICC and SNI in women aged 25-64 was 57.1% and 77.7%, respectively. More than 80% of women with low ICC (p<0.001) and SNI had high level of personal anxiety. Women with low ICC and SNI more likely had major depression (17.4% and 19.4%, respectively; p for all <0.01). It's necessary to notice women with high SS have no major depression. Rates of high vital exhaustion level increased in 3-times with decline of SS grade (p<0.05). There were tendencies of higher prevalence of hostility and sleep disorders (only for low ICC) in women with low SS. There was significant reduction in the work capacity within the last year in women with low SNI (p<0.05). But there was increasing of conflicts in family up to 67.9% with growth of ICC levels (p<0.05).

The prevalence of low ICC and SNI in female population 25–64 years in Russia is large. Women with low SS more likely have high anxiety, major depression, high hostility and vital exhaustion, poor sleep and high job stress.

To demonstrate how each BPD patient in therapy can be turned into an on-going research project by tracking progress (or lack thereof) of each patient through daily self-rating on 41 parameters. The author has treated 224 BPD patients, showing that characteristic BPD symptoms (such as high spikes of anxiety, anger, physical symptoms, depression, and psychosis) can be predictably eliminated by transforming personality through’Breakthrough Intimacy’ - closeness between committed couples far greater than their previous maximum experience, usually without drugs and often within 6 months.

Lifetrack therapy works with the patient and his/her partner in three-way teamwork, bringing them far closer than ever before, guided by their own daily self-rating on 41 parameters that allow accurate graphic tracking via Internet of subtle changes in their personalities and dynamic mental status during each therapy session. The therapist actively helps the couple to think, feel, and act in such ways that their closeness will increase, provoking and overcoming waves of symptom spikes (defense) until they disappear by exhaustion, as the couples undergo personality transformations.

42% of 224 patients (with or without partners) treated with borderline personality disorder reached a level of adjustment beyond their previous maximum level. Patients with partners (134) did 10 times better (66.4% vs 5.6%) than singles (90). 34% reached Stage-4 (complete transformation far beyond symptom elimination).

BPD should be treated with patients’ partners whenever possible, bringing them far closer than their previous maximum experience, guided by their own daily self-rating graphs.

To demonstrates through case examples that’Breakthruogh Intimacy’ - closeness between the patient and his/her parter 5–10 times grater than their previous maximum experience (according to their own daily subjective self-rating on 41 parameters via Internet) predictably transforms their personalities, eliminating psychiatric symptoms such as anxiety, anger, psychosomatic symptoms, depression and symptoms of borderline personality disorder - without medications and often within 6 months.

Working with the patient and his/her partner, therapy focuses on bringing the couple far closer than ever before, guided by the couples’ daily self-rating graphs.

Of the 1,170 patients treated over the last 20 years, 48% of patients with various diagnoses reached a level of adjustment beyond their previous maximum level. 31% reached a level more than twice, 24% reached more than three times, 20% reached more than four times, 16% reached more than five times, and 7.6% reached more than ten times their previous maximum level of adjustment according to their own daily subjective self-rating. Of those who failed to reach their previous maximum level at premature terminations, 75% showed significant improvement in their overall adjustment, and 77% showed significant reduction of their symptoms. However, 24% showed significant reduction of overall adjustment, and 22% showed significant aggravation of their initial symptoms at the time of their termination during the initial phase of therapy, when symptoms typically worsen.

To demonstrate how to routinely’cure’ depression - acute, severe, chronic, and treatment resistant - through’Breakthrough Intimacy’ - closeness between the patient and his/her partner far greater than their previous maximum experience.

Working in three-way teamwork, guided by couples’ daily subjective self-rating, the couple's personalities are transformed in such ways that depression disappears as it becomes unnecessary. Case examples with patients’ graphs will show how personality is transformed through 4 stages. All the tools necessary to practice this method by participants after the workshop are offered.

Of the 1,170 patients treated (most of them showing varying degree of depression) over the last 20 years, 48% of patients with various diagnoses reached a level of adjustment beyond their previous maximum level. 31% reached a level more than twice, 24% reached more than three times, 20% reached more than four times, 16% reached more than five times, and 7.6% reached more than ten times their previous maximum level of adjustment according to their own daily subjective self-rating. Of those who failed to reach their previous maximum level at premature terminations, 75% showed significant improvement in their overall adjustment, and 77% showed significant reduction of their symptoms. However, 24% showed significant reduction of overall adjustment, and 22% showed significant aggravation of their initial symptoms at the time of their termination during the initial phase of therapy, when symptoms typically worsen.

Depression is caused by existing personality of patient, which can be transformed through therapy, causing depression to disappear.

To demonstrates through case examples that couple therapy guided by a quantifiable model of personality and mental health can achieve personality transformation in relatively short period (often within 6 months), eliminating major symptoms such as anxiety, anger, psychosomatic symptoms, depression, and symptoms of borderline personality disorder - without medications.

Working with the patient and his/her partner, therapy is focused exclusively on bringing the couple far closer than ever before, provoking and overcoming waves of defense (symptoms) until it weakens by exhaustion and eventually disappear, liberating the couple from their existing personalities, allowing them to achieve far greater adjustment not only in their intimacy spheres, but also in self and achievement spheres.

Based on 1,170 cases treated, participation of partner in therapy improved results 4 (all cases) to 10 (BPD) times.

Couple therapy format should be used in treating all cases whenever feasible to maximize therapeutic results.

Previous studies demonstrated the role of early improvement of depressive symptoms and change of QEEG prefrontal cordance in the outcome prediction of antidepressant treatment in depressive patients.

The aim of study was to compare change of prefrontal QEEG theta cordance at week 1 and reduction of depressive symptoms at week 2 in the prediction of response to venlafaxine ER in patients with resistant depression.

All patients (n=43) were hospitalized at Prague Psychiatric Center and were treated with venlafaxine for 4 weeks or more. Depressive symptoms were assessed using MADRS at baseline, week 2 and at the end of study. EEG data were monitored at baseline and after week 1. Cordance was computed at 3 frontal electrodes in theta frequency band.

There were no significant differences between change of cordance at week 1 and reduction of depressive symptoms at week 2 in predictive ability in terms of AUC of ROC analysis (0.78±0.07 vs 0.74±0.08; p=0.75). Using ≥20% reduction of MADRS and reduction of cordance value as indicators of response we did not detect significant difference in their predictive parameters. The model combining both measures yielded value of AUC ROC analysis 0.86 (nonsignificantly better than individual predictors). Positive and negative predictive values of proposed models were 0.93 and 0.75.

Both parameters were identified as predictors with comparable ability to differentiate between responders and non-responders. This study was supported by a grant from Internal Grant Agency of Ministry of Health of Czech Republic No. NT 14287 and grant RVO-PCP/2013

Acute and transient psychosis, with all its heterogeneous forms, represent a group of psychoses that are still under the process of crystallization, being distinct from the major’typical’ psychoses: schizophrenia and affective disorders.

The assessment of functional, socio-biographic and evolutive aspects in a sample of subjects diagnosed with acute and transient psychotic disorder compared to a sample with paranoid schizophrenia.

To highlight the significant differences between the two types of pathologies regarding functional, socio-demographic and evolutive aspects.

We have selected two samples comprising 41 subjects. The first sample included subjects diagnosed with Acute and Transient Psychotic Disorder (ATPD) and the other subjects with Paranoid Schizophrenia. We have assessed the following features: the age of onset, educational level, professional and marital status - at onset and after 5 years of evolution and the total number of hospital admissions during this period. Also, all of the subjects were evaluated at the end of the study with the Global Assessment of Functioning Scale.

We have found significant differences only regarding educational level and professional status at the end of the study. Also, there were significant differences in terms of the number of hospital admissions during the study period in sense of a favorable balance for those with ATPD diagnosis.

The differences between the two diagnosis samples are not as significant as implied by the types of pathologies analyzed. Functional and socio-biographic aspects remain insignificantly different between the two types of psychosis.

The aim of this paper was to review literature concerning the relationship between suicide and substance abuse behaviours among adolescents, focusing on epidemiology, comorbidity and prevention programs.

we performed a Pubmed/Medline, Scopus, PsycLit, and PsycInfo search to identify to identify all papers and book chapters during the period between 1980 and 2013.

Adolescents with substance abuse disorder who attempt or complete suicide can be characterized as having mood disorders, stressful life events, interpersonal problems, poor social support, lonely lives, and feelings of hopelessness. The research supports the existence of a strong relationship between suicide and substance abuse.

Preventive programs should be based on risk factors associated with both suicide and substance abuse disorder. Management programs should combine different therapeutic strategies such as peer-to-peer education, school-based programs, psychotherapy and pharmacological treatment. Evidence suggests that targeted suicide prevention programs can be delivered which reduce the burden associated with substance abuse and suicide in youths.

To investigate factors differentiating old-old elderly who died by suicide (those aged 75 years and older) from middle aged (those aged 50-64 years old) and young-old adults who took their own lives (aged 65 years to 74 years), and from living psychiatric outpatients 75 years and older who had no suicidal behaviors in the last six months before assessment.

Cases for psychological autopsy interviews were 117 old-old elderly who died by suicide between 1994 and 2009. Comparisons were 97 youngold adult and 98 middle aged suicides, and 117 psychiatric outpatients admitted to the Department of Psychiatry of the University of Parma (Italy), between 1994 and 2009. Information for suicide decedents was gathered through proxy-based interviews, and data regarding living comparisons were extracted from medical records.

A high number of old-old elderly were widowed and lived alone before death; widowhood was more prevalent in the old-old elderly than in the younger suicide groups and the living psychiatric comparisons. Also, old-old elderly were more frequently characterized by the presence of life stressors in the few months before deaths when compared with psychiatric living comparisons 75 years and older.

Clinicians involved in the prevention of suicide in the older adults should pay particular attention to loneliness and lack of social support, two conditions that may push the individual to feel hopeless, especially in those individuals who are facing stressful life events.

It is well recognized that alcohol dependence is among the major risk factors that are associated with suicidal behavior.

This study was design to extend our understanding of alcohol-parasuicidal relationship by examining same of the socio-demographic and mental health characteristics of alcohol dependent women attempted to commit suicide.

The relationship between alcohol dependence and parasuicide was studied among patients admitted to a Gomel regional psychiatric hospital (Belarus). A total 48 female alcohol dependent in-patients (ADPS) and a comparison group of 151 non-alcohol dependent parasuicidal inpatients (NADPS) were investigated. The socio-demographic and mental health profile of each group was analyzed.

Risk factors for parasuicide were acute alcohol intoxication, social dysfunction and psychiatric symptoms. Results show that, compared with NADPS patients, those with an alcohol dependence were younger (34.1 vs. 36.6%; p<0.05), unemployed (54.2 vs. 29.1%; p<0.001), unmarried (72.9 vs. 59.9%; p<0.001), or with a past history of deliberate self-harm (29.2 vs. 20.5%; p<0.05). Consumption of alcohol at the time of the parasuicidal act was reported more commonly by ADPS patients (75.0 vs. 21.2%; p<0.001). Comorbid psychiatric disorders were presented in 64.4% of ADPS and in 93.2% of NADPS patients. The prevalence of affective disorders (10.6 vs. 2.1%; p<0.001), stress-related disorders (22.5 vs. 8.3%; p<0.001) and schizophrenia (9.6 vs. 2.1%; p<0.001) were higher among NADPS compared with ADPS patients.

These findings are consistent with previous researches indicating a causal role for acute alcohol intoxication in parasuicidal behavior among alcohol dependent individuals.

Dementia has a multifactorial etiology including social, environmental, behavioral and neurobiological factors. The validity and status of currentlydocumented dementia risk factors are often uncertain, based on few studies, or inconsistent. We combined quantitative and qualitative information to summarize and weight the most important dementia risk factors.

Identifying the major modifiable midlife risk factors for dementia is crucial to develop effective preventive strategies and improve healthy late life cognitive functioning.

The present study is part of the FP-7 funded In-MINDD (Innovative Midlife Intervention for Dementia Deterrence) project, which aims to identify the most important modifiable risk factors for dementia.

Dementia risk factors named by international dementia experts in a Delphi study were synthesized with information from a systematic literature review. The literature research conducted in PubMed used a search strategy modified from Plassman et al. (2010). This yielded 3,127 abstracts, of which 327 were included for further scrutiny based on title and abstract. The results were pooled with those from previous reviews to arrive at the final risk inventory.

The risk factors named by experts were among the best-documented risk factors based on previous literature and our systematic review. These include depression, hypertension, physical inactivity, diabetes, obesity, hyperlipidemia, and smoking. We also identified new candidate risk factors that need further validation: coronary heart disease, renal dysfunction, stroke, and inflammation.

This study provides strong support for somatic and lifestyle factors in the etiology of dementia and flags several important targets for prevention in midlife.

The main purpose of our research was to investigate the presence of type D personality along with other psychopathological aspects in patients with coronary heart disease from our region.

The study was of a cross-sectional nature involving the 84 subjects admitted in Timisoara Institute of Cardiology for a diagnostic of coronary heart disease. Personality D scale, SCL-90 and Sheehan Disability Scale, were administered in studied subjects. A control sample that consists in 84 healthy subjects was done, being both gender and age matched.

The presence of type D personality has significantly correlated with the presence of coronary heart disease just in one of two its subdimensions. Hence, the negative affectivity scores were significant higher in subjects with coronary disease comparatively with healthy subjects (t = 4.081, df = 166, p < 0.001). Pertaining to psychopathological dimensions of SCL-90 scale, all of these have been significant correlated with the presence of coronary heart disease (p < 0.001). Work, social and familial disabilities have had significant worse impact on subjects with coronary heart disease that scored higher on negative affectivity subscale. (rho = 0.607, p < 0.001; rho = 0.323, p = 0.003 and rho = 0.420, p < 0.001).

The negative affectivity was significant correlated with coronary heart disease in patients from our region. Also, negative affectivity was associated with higher disabilities in all assessed domains of existence. Somewhat expectedly, subjects with coronary heart disease have higher levels of different psychopathologies than healthy counterparts.

Postnatal depression is one specific psychiatric condition of vulnerable women being in postpartum period. We aimed to investigate the magnitude of postpartum depression in our region, together with its clinical and personality correlated features.

A cross-sectional survey was conducted on 80 women being between 6 to 8 weeks after delivery that were monitored in Ambulatory of Bega Clinic Timisoara. Several psychopathological scales were administered to quantify postnatal depression (Edinburgh Postnatal Depression Scale - EPDS) and anxiety (Beck Anxiety Inventory), along with anchored visual analogue scales pertaining subjective levels of worry toward the health status of mother and their infant. Dimensional aspects of personality were assessed by using the Karolinska Scale of Personality.

More than half of studied subjects have met the criteria for postnatal depression (cutoff score of 10 on EPDS) (N=43; 53,75%). Both, subjective and standardized levels of anxiety have correlated with the level of postnatal depression. Among the dimensions of personality significant correlated with postnatal depression we found the following: socialization (r = -0,523; p < 0,001); somatic anxiety (r = 0,578; p < 0,001); muscular tension (r = 0,463; p < 0,001); psychic anxiety (r = 0,303; p < 0,01); psychasthenia (r = 0,331; p < 0,01); suspicion (r = 0,236; p < 0,05); indirect aggression (r = 0,226; p < 0,05); irritability aggression (r = 0,242; p < 0,05).

In our region, postnatal depression represents a clinical reality that raises a multitude of clinical and therapeutic challenges.

The serotonin system is considered to contribute to both predisposition and course of addictions. A major, suggested link between low serotonin activity and alcohol drinking is impulsivity, which can be manifested by suicidal behavior. The objective of our study was to build a comprehensive model of mutual relationships between HTR2A T102C (rs6313) polymorphism, suicidality, impulsivity and relapse in alcohol dependence.

A sample of 254 alcohol dependent subjects were recruited in alcohol treatment centers and prospectively assessed at baseline and follow-up after 12 months. Information about demographics, psychopathological symptoms, history of suicide attempts and alcohol problems was obtained. The stop-signal task was performed and blood samples for genetic analysis were collected. Relapse was defined as any drinking during the follow up period.

The statistical analysis revealed a significant association between CC genotype in HTR2A T102C polymorphism and relapse. Other factors that turned out to be significantly associated with relapse were history of impulsive suicide attempt and baseline depressive symptoms, with genetic factor being the strongest predictor of relapse in multivariate model (OR=2.125). In addition we observed a significant association between CC genotype and behavioral impulsivity as well as history of suicide attempts. We also found a significant association between stop reaction time and lifetime history of suicide attempts.

Our results provide a consistent perspective of importance of 5-HT2A receptor associated with impulsivity, suicidality and relapse. Based on these findings we propose a more comprehensive model of mutual relationships between relapse, impulsivity, suicidality and HTR2A polymorphism.

Poor insight has been associated to positive and negative symptoms in schizophrenia. However, the impact of antipsychotic treatment on insight in delusional disorder (DD) has not well defined.

Our purpose was to investigate the impact of long-acting atypical antipsychotics (PPLAI, RLAI) on insight in DD patients.

We conducted a prospective and observational study by including 60 consecutive cases of DD outpatients, which were followed up for at least 6 months. Outcome variables: Scores in the first three items of the SUMD for Insight, PANSS for psychopathology, HRSD-17 for depression and PSP for functionality. The sample was divided into two groups according to the treatment received: oral or long-acting atypical antipsychotics (RLAI or PPLAI). T and Chi-square tests were used. Insight differences between both groups were investigated by applying Analysis of Covariance.

At baseline, DD patients treated with long-acting injectable antipsychotics had higher scores in awareness of social consequences. Although no statistically significant differences were found, after 6 months of treatment, patients receiving long-acting injectable antipsychotics showed a tendency of improvement of awareness of illness, awareness of the effects of medication and awareness of social consequences. Statistically significant treatment group*PANSS total score interactions were found for awareness for social consequences. After controlling for SUMD baseline and PANSS total scores, DD patients treated with long-acting antipsychotics showed an improvement of awareness of the effects of medications and social consequences.

Patients receiving long-acting injectable antipsychotics showed an improvement in psychotic symptoms and insight dimensions.

Recent evidence supports an association between oestrogen levels and severity of psychopathology in women with schizophrenia. However, few studies have investigated differences in the psychopathology of premenopausal and postmenopausal female delusional disorder (DD).

To investigate whether men, premenopausal and postmenopausal women differ in age at onset and psychopathology.

Psychopathological symptoms were assessed in 64 outpatients with DD (DSM-IV-TR), as part of the Study on the Development and Course of Delusional Disorder in mean-age and the Elderly (DEVCODEL Study), at baseline and after 6 months. Scores in the PANSS scale, PSP for functionality, HRSD-17 items, C-SSRS for suicide and the first three items of the SUMD Scale were outcome variables. ANOVA and Chi-square tests were performed. Psychopathological differences between groups were investigated by applying Analysis of Covariance.

68.8% of the sample were postmenopausal women. When compared to premenopausal women and men, postmenopausal women had a lateonset disease (p<0.001) and attended later our outpatient clinic (p<0.001). Furthermore, postmenopausal women showed lower scores in awareness of mental disorder and awareness of the achieved effects of medication, a tendency of higher scores in depressive symptoms and higher severity of suicidal ideation at baseline. After 6 months, men and premenopausal women had lower scores in the positive PANSS subscale (p=0.041) than postmenopausal women. These findings in psychopathology held significant after adjustment for age and accumulated years of disease.

Our results support the notion that postmenopausal DD women have higher severity in psychopathology in comparison with premenopausal women and men.