This longitudinal, community based cohort study assessed the mother-offspring transmission of BPD and examined whether maternal parenting styles and offspring temperament are associated risk factors.

At baseline 315 mothers and 414 offspring of the general population were investigated. Five years later the offspring were followed up and diagnostic interviews were carried out. BPD risk in children of BPD-mothers was compared to the BPD risk in children of healthy mothers. The contribution of an anxious-impulsive temperament in offspring and invalidating maternal parenting style to the prediction of BPD features was analyzed.

Offspring of mothers with BPD were 8.5 times more likely to exhibit the diagnosis of BPD than offspring of healthy mothers. Prediction analyses suggest that mother-offspring transmission of BPD may be partially mediated by reciprocal transactions between a vulnerable temperament and an overprotective maternal parenting style.

Given that offspring of mothers with BPD are not only at heightened familial risk of BPD but also other mental disorders, specificity of factors that are shared between mothers and their offspring is questioned. Early prevention needs to be provided to this high-risk group, especially if there are additional risk factors, as the transaction between vulnerable temperament and maladaptive parenting.

In recent years more attention has been paid to non-responders, i.e. patients who do not benefit from therapy, do not engage in treatment or terminate therapy prematurely.

It was to identify personality factors predicting psychotherapy utilization on the basis of personality pathology, affect regulation and interpersonal functioning.

Affectivity (AREQ), the interpersonal context (QORS) and character pathology (SWAP-200) were assessed.

Combination of instruments showed one stable factor predictive for non-engagement in psychotherapy, revealing an externalizing personality dimension, dominated by externalizing defenses, acting out, deficient super-ego functions, impairment in reflective functioning and in relating to others (n sample 1 = 129). Stability of the predictive power of this personality factor for therapy engagement could be shown and a replication in two other samples (n sample 2 = 95, n sample 3 = 94) confirmed the findings.

Further we examined the question if the externalizing mode of functioning is relevant for the course of psychoanalytic treatments.

In 38 psychoanalytic treatments, severity of symptoms (SCL-90-R), interpersonal problems (IIP), character traits and psychostructural functioning (SWAP-200) were investigated half-yearly.

For the first year denial of needs for closeness, and fears of an impulsive breakthrough of negative affects predicted dropout of therapy. During the second year externalizing defence, projection/projective identification, somatisation, hypochondria and dismissive interpersonal behaviour predicted break-ups.

The studies point at the necessity of interpreting affect-regulatory parameters, such as the externalizing parameter, from the very beginning and during the course of the treatment.

Adolescents with confused identity are a highly challenging client group. They respond to their adverse psychosocial environment with a variety of life-threatening behaviours.

Identity Exploration (IDEX) is a new approach which can be readily integrated into treatment modalities such as IPT (interpersonal), CAT (cognitive-analytic), DBT (dialectical) and SFT (solution-focussed) which are used for such cases.

To identify identity states, their clinical manifestations and presentations by type.

To provide clinical illustrations of each type, highlight where treatment interventions are possible within this paradigm, and report outcomes.

To set out the details of a twelve week group treatment programme. Elements of the programme are - knowing the origins of problems; getting to know self; enhancement of self-concept and self-esteem; discovering self confidence; being satisfied; dealing with rejection and disappointment; taking time out; cooperating and sharing; being kind to self.

Completion of IDEX instrument; qualitative assessment, using the Alston grid, to differentiate comorbid conditions which include ADD, juvenile bipolar disorder, reactive attachment disorder, developmental traumatic disorder and complex PTSD; process notes of group therapy sessions; CORE evaluation of outcomes.

The summary scores for the main parameters - empathetic identification, identity diffusion, conflicted identification and contaridentification - together with how they relate to the four identity states - Achieved, Foreclosed, Diffused and Moratorium - and outcomes will all be reported.

Identity Exploration is an easily administered tool which requires minimal training and which can be integrated into whichever treatment modality a therapist is trained in.

Meta-analytic studies found exposure to be the most effective treatment in PTSD. Results are less clear with regard to acute stress disorder.

To evaluate the additional effect of exposure therapy to supportive counseling.

The assessment of subjective measures and the heart-rate (HR) response to trauma reminders in the two treatment conditions.

Forty recent trauma victims with acute stress disorder were randomly assigned to three sessions of either prolonged exposure (PE) or supportive counseling (SC) with both groups also receiving psychoeducation and progressive relaxation. PE was administered imaginal and in vivo, both being therapist-assisted. Assessments were carried out before and after treatment and again after three months. Patients were shown ideosyncratic trauma-related pictures and autonomic responses assessed. Four years later, patients were asked by telephone whether they had required further treatment.

There were no significant group differences with regard to symptomatic improvement at the end of treatment. Before treatment both groups showed HR acceleration to trauma-related pictures. After treatment the PE group showed attenuation of the HR-response and a reduction of spontaneous skin conductance fluctuations (SF) whereas the SC group showed a decelerative (orienting) HR response and an increase in SF. Over the next four years 43% of the SC group and and 9% of the PE group required further treatment.

The data show that SC, unlike PE, fails to attenuate autonomic responses to trauma-related stimuli suggesting that the former treatment fails to reorganize the trauma network.

There is evidence that, besides limbic brain structures, prefrontal and insular cortical activations and deactivations are involved in the pathophysiology of panic disorder.

Using fMRI, this study investigated BOLD response patterns to stimulation with individually selected panic-specific pictures in patients with panic disorder with agoraphobia (PDA) and healthy controls. Structures of interest were the prefrontal, cingulate, and insular cortex, and the amygdalo-hippocampal complex.

21 PDA subjects (12 female, 9 male) and 21 matched controls were investigated using a Siemens 3 T scanner. Before, PDA subjects gave ratings on 120 pictures showing characteristic panic/agoraphobia situations (PA). 20 pictures with the individually highest ratings were selected. 20 matching pictures showing aversive but not panic-specific stimuli (A) and 80 neutral pictures (N) from the International Affective Picture-System (IAPS) were chosen for each subject. Anxiety and depression ratings were recorded.

Group comparisons revealed a significantly greater BOLD response in PDA subjects than in controls in the insular cortices, left inferior frontal gyrus, dmPFC, the left hippocampal formation, and left caudatum (p < .005), when PA and N responses were compared. Group comparisons for stimulation with A compared to PA showed activation of similar brain regions in both groups but with different peak coordinates.

Results indicate specific activation patterns to panic-specific picture stimulation in PDA patients. Distinct peak coordinates between PA and A differ between groups. This might implicate that the brain circuits underlying processing of aversive stimuli might differ in their function in PDA patients compared to healthy subjects.

Most available data about psychiatric mortality and invalidity concerns inpatients, although the majority of patients are treated as outpatients only.

It was the aim of this study to estimate the effect of anxiety disorders on early retirement and premature death in the working population with special emphasis on outpatients.

125.019 workes between age 16 and 58 were followed for an average of 6.4 years. Excess risks of death and permanent disability were calculated with multivariate Cox regression models.

Outpatient and inpatient treatment for anxiety disorders (OR 1.40 resp. OR 2.10) were associated with higher risks of early retirement. Males generally were more often affected by this bad outcome than females.

Further analysis showed decreased risks of premature death for outpatients with an anxiety disorder (OR 0.33). The effect tended to be most prominent during the middle decades of life and got smaller with older age, at which all-cause mortality approximated that of the control group. No significant effect on mortality could be shown for inpatients.

Patients with outpatient treatment for anxiety disorders have an elevated risk of permanent disability early in life, while all-cause mortality is lower. This beneficial effect can only be partly explained by different risk-taking behaviors. Different causes of death early in life and their connections with these disorders need to be discussed, too. Treatment should have a strong focus on preserving ability to work.

ADHD is a highly heritable neurodevelopmental syndrome with significant lifetime risk for psychiatric comorbidities. Several psychiatric conditions are significantly more common in patients with ADHD than in control subjects.

To evaluate the incidence of comorbid affective disorders, patients with adult ADHD who were first seen at the outpatient clinic of the Department of Psychiatry and Psychotherapy were evaluated for symptoms of major depression, brief recurrent depression, bipolar depression and anxiety disorders. Patients aged between 18 and 75 years were included into the study. All patients were evaluated according to DSM IV TR criteria. So far, from February 2007 until May 2010, 330 patients (192 males and 138 females) were included into the study.

The mean age of the patients at diagnosis was 33, 7 years for males (range: 18-75) and 35, 9 years for females (range: 18–64). Affective disorders were most frequently diagnosed as comorbid conditions in our patients and occurred in 26% of the patients in our sample. 13% had a minor depressive episode, 7% a major depressive episode and 6% were diagnosed with bipolar disorder. 21% of our patients were diagnosed with one or several comorbid anxiety disorders.

Most adults with ADHD are not diagnosed properly and therefore remain untreated although they are usually diagnosed and treated for comorbid psychiatric disorders. In the present study, we systematically analyzed comorbid anxiety and depression in a sample of adult ADHD outpatients in order to estimate the incidence of these disorders in an undiagnosed patient population.

In 2000 Gorman and colleagues published a widely cited revised version of their original neuroanatomical hypothesis of panic disorder from 1989. A “fear network” centered in the amygdala is supposed to be crucial in mediating fear-related responses. It is assumed that panic attacks result from a dysfunctional coordination of “upstream” (cortical) and “downstream” (brainstem) sensory information, resulting in heightened amygdalar activity with subsequent behavioral, autonomic, and neuroendocrine activation. The authors argue that many aspects of their revised neuroanatomical hypothesis are likely to prove incorrect, but hope it will stimulate research on anxiety disorders.

We reviewed neuroimaging studies on panic disorder to investigate in how far their results are in line with the neuroanatomical hypothesis and what inconsistencies emerge. Structural (CT, MRT), functional (PET, SPECT, fMRI, NIRS, EEG) and spectroscopic data (MRS) were considered.

To some extent studies investigating panic disorder found structurally and functionally altered brain areas that have been implicated in fear processing as supposed by the neuroanatomical hypothesis. However, inconsistencies regarding increased vs. decreased volume and increased vs. decreased activity in specific areas indicate aspects that cannot easily be explained by the hypothesis.

The neuroanatomical hypothesis is partially supported by empirical data that may have therapeutic consequences. However, inconsistencies should be a starting point to expand the hypothesis and modify some aspects. This may include the consideration of genetics, task-specificity and the definition of subgroups.

The present study has focused on the impact of training cognitive-behavioral strategies in reducing test anxiety among second-grade high school male math students.

This study has attempted to test the hypothesis that training cognitive-behavioral strategies can help a reduction on test anxiety among anxious students.

The subjects were 72 second-grade high school students who had obtained high scores on the test anxiety scale(sarason,1978) participants were selected by a multi-stage cluster sampling method from three high schools at Tehran after administering the self-report test anxiety scale as pre-test, the subjects were then divided into two groups of control and experimental with 36 students in each groupdid not receive any treatment then, both groups were asked to complete the test anxiety scale as post-test.

Analysis of variance (anova) with repeated measures was performed to analyze the data. the results revealed that there was a significant difference between the two groups and this difference was two the advantage of experimental group showing a significant reduction in test anxiety.

The results showed that training cognitive-behavioral strategies can reduce test anxiety.

Eccentric eating habits (EEH) represent various unusual eating habits that have been widely documented. The estimates about its prevalence range from 20 to 70% depending on the defining criteria. There is disagreement about the nature of EEH, whether it represents a pathology that may develop into an ED or just fussy habits.

To examine whether tendencies for EEH are a manifestation of an underlying tendency for EDs.

To test the hypothesis that a high level of EEH will be related to high scores on the Cognitive Orientation Questionnaire of Eating Disorders (COQ-EDs) which represents tendencies shared by the major EDs and assesses the underlying motivations for EDs.

Participants were 340 high school students (52% girls, 48% boys), 16–18 years old, from three different schools. They were administered the questionnaire of EEH, the COQ-EDs and the EAT 26 which assesses clinically significant EDs.

Analyses of variance showed significant differences in the COQ-EDs scores between three groups: high scorers on EAT 26, high EEH scorers and low EEH scorers, especially between the first and the last two. A stepwise discriminant analysis provided correct identification of group membership in 77.9% (versus 33% expected by chance).

The findings disconfirmed the hypothesis. EEH differs from tendencies for actual EDs. In the worst case they may be a mild form of EDs. It is doubtful whether it is necessary or desirable to treat EEH.

Impaired driving is a threat to road-safety. In order to target preventive measures, predictive factors of recidivism are needed.

We aimed to study relapse rates in subjects who were detected with impaired driving between 2000 and 2006 and followed up to the end of 2009.

We aimed to analyse predictive factors of recidivism after impaired driving.

Follow-up of 1787 Swiss residents (89% men, mean age 35), in whom impaired driving was detected by laboratory analysis regarding alcohol, drugs and medications between 2000 and 2006. Criminal records (2009) were used to collect recidivism data. Mean observation time was 4.13 (SD 1.7) years. Kaplan Meier methodology and Cox analyses were conducted to analyse predictors of relapse.

Within the observation period, 605 relapses were detected (33.9%). Men oftener relapsed than women, young oftener relapsed than elderly people. Most relapses were detected after driving under the influence of alcohol with BACs within prescriptive limits (48.5%). Based on Kaplan-Meier analyses the probability of recidivism was about 20% after two years less time driving licence was abstracted. According to Cox analyses, relapses were predicted by driving under the influence of drugs and by previous irregularities.

The present study underlines the importance of socialdemographic characteristics and previous irregularities for recidivism in road traffic. In terms of driving under the influence of alcohol it points out the difficulty of prescriptive limits for BACs and discloses a high risk for recidivism in terms of driving under the influence of alcohol and drugs.

The concept of quality of life has considerably important in evaluation of efficacy of therapeutic and rehabilitation programs in all medical fields, especially psychiatric disabilities therefore any intervention which cannot improve patient’s quality of life, their effectiveness is doubt. The aim of this study is evaluation of quality of life of chronic mental patients, before and after residence in rehabilitation center.

This study is quasi experimental that carried out on all of patients in rehabilitation center in Kashan(Iran). Demographic, Quality of Life and Global Function Scale questionnaires were used at the time of admission and next 6 months. Data were analyzed by paired T-Test and correlation tests.

The mean of function level was at the time of admission 31/47+/−7/5 and after of 6 months 36/52+/−7/15, that this difference was significant (p = 0/0001).

The mean of physical quality of life was 49/28+/−16/01 at the time of admission and after 6 months was 56/64+/−16/99, so the mean of mental quality of life at the time of admission was 37/20+/− 11/10 and after follow up 46/19+/−4/05.the mean of global quality of life was 42/75+/− 10/34 at the time of admission and after 6 months 54/59+/− 12/84, which this difference was significant.(p = 0/0001)

In this study relation between age and quality of life was significant. (p = 0/0001)

Results showed that various factors may have role in this change. Such as type of provided services, quality of treatment, emotional support of staff and family, homogenous group therapy, organized life.

Early maladaptive schemas (EMSs) are thought to act as templates for information processing that influence individuals’ emotional reactions to life satisfaction.

Thus,the main purpose of the present study was to predict Life Satisfaction with respect to early maladaptive schemas among Iranian college students.

The research population consisted of 1700 students. Three hundred undergraduate students (150 female and 150 male) selected by multiple cluster sampling method. Short questionnaire form of early maladaptive schema (YSQ-SF) and life satisfaction questionnaire were used in this study. For analyzing the data, Pearson correlation, Step wise regression and dependent t were used.

Results of correlation showed negative significant correlation between life satisfaction and early maladaptive schemas including emotional Depravation, Social isolation, Defectiveness/sham, failure, Dependence/incompetence

Vulnerability To harm illness, Subjugation, Self-sacrifice, Emotional inhibition, Unrelenting Standards /hyper criticalness and Insufficient Self-Control / Self-Discipline. Only three subscales Including Abandonment/ Instability, entitlement/ grandiosity, enmeshment/ undeveloped self, showed no significant correlation with life satisfaction. Result of regression analysis revealed that among 15 schemas, emotional Depravation, Defectiveness/sham and Dependence/incompetence schemas were best predictor of life satisfaction. In addition, the results indicated a significant difference between two groups of male and female students in subdivisions such as mistrust/abuse, failure, vulnerability to harm or illness, and unrelenting standards/hypocriticalness.

The findings of this study show that the assessment of EMS based on Young’s conceptualization of EMS can increase our understanding about students problems and interventions should be focused on changing these schemas.

The clinic of psychiatry and psychotherapy and the clinic of otolaryngology of the clinic of Nuremberg offer an interdisciplinary consultation for patients suffering from tinnitus aurium and comorbid major depression and/or insomnia.

Prediction variables are needed regarding the treatment of subjective ear noises by low frequency rTMS.

The aim of the present study was to examine

1. a) if rTMS responders and non-responders differ in significant parameters prior to the rTMS treatment

2. b) and if improvement of tinnitus complaints is associated with mood change.

From June 2008 to July 2010 109 outpatients with chronic tinnitus were treated with rTMS (1 Hz, 2000 impulses, intensity 110% motor-treshold, 10 proceedings, stimulation of left auditory cortex). Prior to and afterwards the proceedings clinical assessment regarding the severity of tinnitus (TQ) and depressive symptoms (BDI II, MADRS) took place.

Response to rTMS was defined as reduction in the TQ score of ≥ 5 points (54 responder, 18 female, 36 male; 55 non-responder, 16 female, 39 male). The samples did not differ in age (MR = 56,4, SDR = 13,3; MNR = 57,3, SDNR = 12,2). The subsamples differed significantly regarding depression symptoms before rTMS, as non-responder being more depressive than rTMS-responder (table 1; MADRS: p = 0.008 **; BDI II: p = 0.01**).

Furthermore there is a significant interaction between BDI and the response/non-response criterion indicating a higher decrease of depression symptoms in rTMS responders.

Serotonin (5-HT) is known to play a key role in a number of psychiatric disorders. The effects of abnormal 5-HT neurotransmission on the modulation of circadian rhythm have been proposed to be one of the mechanisms underlying these disorders.

Here we describe developmental characteristics of interneurones (IN) expressing 5-HT type 3A receptor (5-HT3AR) in mice. This receptor is a ligand-gated ion channel which activation leads to a rapid excitatory response in neurons.

The expression of 5-HT3AR during embryonic development in mice is mainly restricted to caudal ganglionic eminence (CGE) and entopedoncular area (EPA). We hypothesized that these regions are those specifically involved in the neurogenesis of the IN expressing 5-HT3AR.

To assess this hypothesis, we used homochronic in utero grafts. Cells were collected from CGE and EPA regions of transgenic mice embryos expressing Green Fluorescent Protein under the control of 5-HT3AR gene promoter. After in utero transplantation in non transgenic embryo, we examined at adult age the location of the grafted cells, as well as their morphological properties.

We observed that CGE-derived cells gave rise to IN that mostly populated the neocortex and the hippocampus, whereas EPA-derived cells integrated the amygdala, the pyriform cortex and the Ventro-Lateral Pre-Optic (VLPO) nucleus. Moreover, the VLPO EPA-derived cells are similar to “sleep active cells” found in this region and responsible of sleep induction.

These results lead to the better understanding of the IN expressing 5HT3AR development. Its activation is possibly implicated in triggering sleep mechanismes.

During the 90's, there was a dramatic increase (more than 200%) of the incidence of type 1 diabetes in the Polish pediatric population. During the first decade of onset of the disease, 48% of the prospectively monitored children developed psychiatric disorders.

To determine the influence of psychiatric co-morbidity on hospitalization for complications among children and adolescents with type 1 diabetes (T1DM).

One hundred seventy patients (age range: 8-18 years) with T1DM were evaluated using semi-structured diagnostic interview (K-SADS-PL). Current and past episodes of psychopathology were assessed according to DSM-IV criteria. The effect of psychiatric symptoms for number and times of hospitalizations due to medical complications per year was assessed by using General Linear Model. The mean time of observation was 4,0 ± 2,0 years.

The median number of days per year of acute hospitalizations was 4,0 (Interquartile Range 0.0-6.8) for group with co-morbidity and 2.6 (0.0–4.6) for group without; also the median of average number of hospitalizations was 0.4 (0.0–0.8) and 0.3 (0.0–0.5) respectively. Psychiatric co-morbidity was associated with number (beta = 0.19; p < 0.05) and duration of hospitalizations (beta = 0.16; p < 0.05) per year.

Young people with type 1 diabetes and psychiatric co-morbidity are at increased risk of hospitalization for disease complications. Interventions aimed at routine psychiatric screening followed by treatment may decrease the number of acute hospitalizations.

In Sweden there are three psychiatric disciplines, general psychiatry (GenP), forensic psychiatry and child and adolescent psychiatry (CAP). There are many similarities between GenP and CAP, but despite this, there is a virtual lack of information regarding possible early symptoms of mental disorders, and how they change during the process of maturing from childhood to adulthood.

An overall aim was to provide information about CAP-patients and their outcome as adults. This study describes and discusses the transition between CAP and GenP and illustrates the question if and which CAP-patients will proceed as patients within GenP.

1,400 patients, originally treated as in- and outpatients by CAP services were subsequently followed-up into mid-adulthood using official registries and hospital records.

At least a third of all CAP patients were later admitted to GenP. However, this group constituted only eleven percent of the corresponding age groups of GenP-patients. There seems to be a weak connection between diagnoses given to patients in CAP and later in GenP care.

At least three different pathways for becoming in need of GenP care as adults were identified. First, a “developmental trajectory” with early symptoms of parental neglect, later need of unspecific paediatric hospital treatment, school failure, behavioral problems and referral to CAP. Another way relates to the relatively uncommon development of psychotic disorders. However, the most common way relates to “adult problems” in the categories neurotic and stress-related disorders where the problems seem to have developed from accumulated stressful life-events.

To develop a school-based screening for adolescent risk behaviour and psychopathology and to investigate the predictive value of different adolescent risk behaviours in terms of suffering from psychopathology that requires mental health care.

A two-stage professional screening was developed and constituted in the randomized-controlled prevention trial “Saving and Empowering Young Lives in Europe (SEYLE). A school-based screening consisting of a self-report screening questionnaire and a semi-structured professional interview in case of being identified as at-risk were performed in a representative sample of almost 2,000 adolescents within the SEYLE sample of about 8,000 students from 7 European countries and Israel.

A very high percentage of students were detected to be at-risk by either showing risk behaviour or psychopathology or both in the first stage of the screening. From these students, only about one third came to the study center and took part in the interview. About half of of the interviewed students reached were referred to mental health care.

Risk behaviours are very common among European adolescents and may also have increased during the last years. Nevertheless, most risk behaviours are weak predictors for suffering from psychopathology that requires mental health care compared to psychopathology or suicidal behaviour theirselves. Although they are certainly unhealthy and badly influencing adolescent development risk behaviours seem to be an ubiquitous phenomenon during adolescence and cannot simply be regarded as signs for severe psychopathology.

Research about the continuity of mental health problems from childhood to adolescence and the influence of parenting practices on these is limited, but necessary for appropriate family counselling.

To examine the relationship between aspects of parental control, such as monitoring, physical punishment, and unlimited material provision, on the emotional and behavioural health of children up to adolescence.

A representative sample of 2695 Greek adolescents was followed-up from birth to 18yrs. Mental health problems at 7 and 18yrs were assessed by the Rutter A2 and YSR psychometric tools, respectively.

A strong correlation was found between behavioural problems in childhood and adolescence for both genders, while emotional problems were more likely to persist in boys. Age and sex-specific models revealed significant positive associations between frequent use of physical punishment during childhood and Total, Emotional, and Conduct problems in both genders, while parental monitoring was associated with higher scores on Conduct and Total problems mostly in boys at 7yrs. Parental monitoring was more strongly linked to psychological problems in adolescence, while the relationship between punishment and mental health problems was stronger in 7-year-olds than in adolescents. Material provision in childhood was not associated with the outcomes. The long-term effect of parenting strategies on adolescent mental health was mediated or confounded by mental health status at 7yrs.

Early interventions are necessary as mental health problems strongly persist from childhood to late adolescence. The adverse effects of unsuitable parental practices need to be recognised and improved.