A large number of meta-analyses demonstrates that psychotherapy is beneficial for most forms of psychopathology. Yet, there is considerable disagreement as to what makes psychotherapy effective. Currently, there are two major assumptions: the specific ingredients assumption and the common-factor model. However, this dichotomy is based on conceptual inaccuracies.

The presented Taxonomy Project attempts to contribute to a clearer definition and conception of common psychotherapeutic factors by analyzing their differential associations to psychotherapeutic techniques.

A comprehensive literature search was performed to identify the common factors discussed in psychotherapy research. 22 common factors were extracted from the literature and defined. Psychotherapy experts then rated the degree of associations of different common factors to a set of psychotherapeutic standard techniques in a web-based survey. Hierarchical regression analyses using mixed models, principal component and cluster analyses were performed to analyze these associations.

Mixed-effects models indicate that common factors differ by their differential associations to specific psychotherapeutic techniques. Common factors, therefore, could be defined by their idiosyncratic profiles of associated techniques. In addition, based on these differential associations 4 superior classes of common factors operating in effective psychotherapy can be identified by principal component and cluster analyses.

At present, research addressing therapeutic change processes in psychotherapy is suffering from a terminological “jungle” and fundamental misconceptions. It is likely that this conceptual impreciseness hinders the exact analysis of the psychotherapeutic change processes and, thus, progress in psychotherapy. The presented taxonomical endeavor is a promising first step towards a clarification of the important construct ‘common factors’.

In an empirical study, we addressed the temporal properties of personality disorders (PD) and their treatment by schema-focused psychotherapy. We explicitly investigated ‘enduring patterns’, assumed to be the core of PD, and the ‘change mechanisms’ of psychotherapy process. The goal was to introduce a method by which psychotherapeutic change mechanisms of PD patients can be modeled in the temporal domain. 69 patients were assigned to a specific schema-focused behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline PD. Both treatments offered 30 bi-weekly group sessions of 100 min duration each. The statistical approach focused on using time-series panel analysis of the patient-assessed factors Clarification, Bond, Rejection, and Emotion. These factors derived from repeated session-report data obtained after each session. The method provided a detailed quantitative representation of therapy process via the time-lagged associations of these factors. It was found that clarification played a core role in schema-focused psychotherapy, reducing rejection and regulating patients’ emotion. This was also a change mechanism linked to therapy outcome. The introduced process method allowed to highlight the mechanisms by which treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Limitations are that time-series analysis explores Granger causality, an approximation of causality based on temporal sequence. In principle, yet unlikely, causal effects of unobserved variables may go unnoticed. In conclusion, the chosen methodology can explicate mechanisms of action in psychotherapy research and illustrate the enduring patterns underlying PD.

We now know that a single gene mutation may present with multiple phenotypes, and vice versa, that a range of genetic abnormalities may cause a single phenotype. As a result, our traditional approach to determining disease nosology - eliciting symptoms and signs, creating clusters of like individuals and then defining a disease on those criteria - though it has served medicine and therapeutics well in the last century and a half, is now outdated. Under that traditional model, the collection of data is subjective, depending as it does on patient-doctor interactions, and that may be why it has not generated fundamental breakthroughs in our understanding of the pathophysiology of psychiatric disease.

What lies ahead? It is time to radically overhaul our epistemological approach to brain disease. We now know a great deal about brain structure and function. From genes, through functional protein expression, to cerebral networks and functionally specialised areas defined via physiological cell recording and microanatomy, we have accumulated a mass of knowledge about the brain that defies easy interpretation. Advances in information technologies, from supercomputers to distributed and interactive databases, now make integration of very large and diverse datasets and advanced data-led analysis possible. This is the new nosology, which we must strive to refine to progress understanding of psychiatric brain disease.

There has been developed over the last few years a novel meta-empirical model for translational cross-validation among neuroscience and psychiatry (Stoyanov, 2007, 2011, Stoyanov, Machamer, Schaffner, 2010). Following critical analysis of the current neuroimaging methodology we have defined several shortcomings in their study designs. Those shortcomings concern the temporal gap between the administration of the psychological assessment tools and brain scan, named temporal discordance (i); insufficient reliability and specificity of the findings as potential biomarkers (ii) and lack of convergent validity (iii). Hence mere statistical correlations are established instead of explanatory connections. Contrastingly our model regards the clinical assessment tools (e.g. psychological inventories) and the underlying neurobiological processes as convergent validity operations. We therefore suggest that the functional brain imaging should be performed simultaneously with the administration of the clinical assessment tools. Real time complementary translational ‘bridges’ between the clinical phenomenology and causal brain mechanisms might be established: for instance certain depression score in MMPI may correspond to specific biochemical anomalies in the brain function. Such translational approach has various projections in psychiatric classification and therapy. It can be implemented in the construction of novel ‘prototype’ diagnostic units and the evidence-based drug choice. In practical terms, once the procedure of simultaneous cross-validation is applied to a clinical tool, it can replace the high-technological functional brain scan in further studies and so to serve as a ‘pharmaco-psychological’ test for drug choice in psychiatry. By analogy therapeutic drug monitoring might be optimised reflecting the biological processes, underlying mental disorders.

Empathy became a fashionable phenomenon to study with the functional imaging techniques of modern neurosciences. To many, neurosciences (in particular the theory of mirror neurons) are providing the scientific proof that empathy is a “real” phenomenon.

The studies addressing the empathy for human pain will be used here to discuss the relation between the concept of empathy as it was conceived in philosophy and psychology at one side, and the experimental results at the other side. It will be shown that the conception of empathy has changed across centuries, moving from a philosophical standpoint to a psychological one, and eventually to current neurophysiology. Even in modern neuroscience the definition of empathy widely varies in the various studies; it oscillates between an automatic and preconscious phenomenon to one influenced by drives, beliefs and expectations.

In conclusion, this review shows that modern neurosciences do not provide a simple neurological basis for the classic concept of empathy (seen as a unitary and stable phenomenon). On the contrary, they contribute to reshape the original concept, which now tends to be subdivided in different features related to different patterns of brain activity, with both top-down and bottom-up arms.

Under current taxonomy clinical research in neuroscience is trying to identify brain differences in psychiatric groups. Current research is top-down, meaning the use of phenomena to identify structural and chemical changes. Emphasis has been made that psychiatry needs a stronger phenomenology before real neuroscientific inquiry can begin and that the phenomena currently used have frail consistency. Others insist that this attempt to correlate mental symptoms and diseases with brain changes would provide different epistemic ground for Psychiatry and new means to diagnose diseases. In fact there is a third problem - disorders in Psychiatry can have a different coherence in each epistemological paradigm and we need to show why is the neuro-scientific paradigm so important. We’ll discuss this topics under current conceptualization of mental symptoms as hybrid objects some are cultural while others biological objects (some seem pervasive to current taxonomy). We hope to show that even these last ones are subject to cultural changes and we might be tracing these cultural changes rather then real symptoms

Mood episodes have a complex taxonomy and DSM-IV and ICD-10 listings show apparently correlated polymorphic symptoms and features. The attempt to be objective could be considered frail in these disturbances as most criteria refer to subjective experience and some rely in common-sense vocabulary (e.g. feelings of emptiness). This presentation will also show how our current classification scheme sometimes does not respect phenomenological boundaries (e.g. Masked depression and Borderline Personality Disorder). We’ll also mark how this category isn’t well defined and how that might be a necessary requirement for any coherent reductionism. We hope to present difficulties and merits of current mood disorders psychopathology and taxonomy in relation with neuroscience research.

Building forth on earlier work in which I have argued for the self-relational nature of human psychopathology, this presentation will investigate whether self-relatedness is also fundamental for the study of the neuronal mechanisms that underlie human psychopathology.

Self-relatedness refers to the self-referential structure of human experience and action. It is concept with some philosophical importance, because it helps to avoid an unattractive instrumentalist (and ultimately Cartesian) view of the brain, in which the brain is either seen as the executive organ of a hidden player (the ego) (dualism) or as the engine of the complicated machinery we call man (materialistic monism). It will be shown how self-relatedness is implied at two levels of investigation in neuroscience:

1. (1) The level of first order attitudes and experiences such as basis moods, affective dispositions and body memory; and

2. (2) The level of second order processes that are implied in (self) regulation, integration and insight.

To support this hypothesis I will build forth on the work of neuroscientists and philosophers like Damasio, Edelman, Thompson, Noë, Jack & Roepstorff. Differences and similarities between the concepts of self-relatedness and of self-organization will be pointed out.

The relationship between technology and human being is not new and man has always tried to overcome the topological limits of the human body and mind by modifying human characteristics to facilitate the ease and speed of accessing action/knowledge. However, since at least three centuries, modern technology has exerted a deep influence on human behaviour, at different levels. In the last fifty years, the digital technology has changed even more significantly the access to information, the human relationships, the timing of everyday life. Thus, it is not surprising that the science which studies the human behaviour has been affected by such recent technological changes in many ways. The aim of this presentation is to review the most cogent changes, induced by recent digital technology, in routine psychiatric practice, also encompassing the modern technological aids for treatment and research in psychiatry. To these aims, a literature review, covering the scientific articles published in last thirty years, was conducted and a general evaluation of how and how much digital technology has impacted psychiatry is made. Finally, a brief account of new diagnoses related to the misuse of technology is summarized and specific hints aimed to optimize professional use of digital technology in psychiatry are provided.

Access to adequate mental health care services is one of the identified problems within EU mental health services. Asylum seekers, refugees and migrants experience major difficulties due to language and cultural barriers. The treatment of such patients is costly due to use of interpreters with consequent longer treatment time, less efficacy and decreased patient and provider satisfaction. A telepsychiatry project was conducted to improve access to culturally-appropriate care providers (i.e. culturally competent, bilingual clinicians) by the use of videoconferencing. A self-completed retrospective questionnaire survey was conducted with asylum seekers, refugees and migrants. The service was free of charge for the patients involved. Over a period of 34 months, 61 patients participated in the pilot project. The patients’ residency status was: refugees (n = 45), asylum seekers (n = 12), migrants (n = 3) and domestic (n = 1). A total of 318 telepsychiatry sessions (lasting 35–45 min) was conducted, with an average of 5.2 sessions per patient. Nine languages were spoken during the study period (Danish, Arabic, Farsi, Somali, Kurdish, Polish, Bosnian, Serbian and Croatian). 52 patients completed the questionnaire. Patients reported high level of satisfaction and willingness to use telepsychiatry again and recommend it to others. They preferred telepsychiatry via their mothertongue, rather than interpreter-assisted care.Technology has a vital role to play in enhancing accessibility to and efficacy of psychiatric services in provision of high qualified mental health care.

Immigrant women, especially the newcomers, are particularly at risk for developing mental disorders. The main risk factors are the stress from the immigration and the acculturation process. Some aspects of this process may affect physical and emotional well-being. Other risk factors could be the lack of social support, the presence of financial worries, job and housing frailty, the social isolation and separation from the extended family, the difficulty of access to the basic services for social, cultural and language barriers, the discrimination and the unfamiliarity with medical practices. An inability to communicate in the language of the new country may impede access to social and mental health services. Immigrant women have lower levels of social support, and it is this lack of support, rather than immigrant status per se, that is related to higher levels of reported stress. It appears, in conclusion, that immigrant women may constitute a high-risk group for mental disorders. The results suggest that not only are there important barriers to accessing mental health care for recent immigrant women, but it can also be challenging for mental health care workers to deliver such needed care. Understanding some of these barriers and challenges from the perspective of mental health care providers is an important step to remedying gaps and obstacles in the community mental health system.