This research aims to explore a structural model of sense of coherence’ predictors in a cross-cultural older population.

Measures were completed using a variety of culturally appropriate methods, including mail-outs, self-administration and interviews. For the purposes of this study, the Sense of Coherence Scale, the Adjustment to Aging Scale, one measure of cognitive functioning - the Mini-Mental State Examination (MMSE) and demographics, were included. All variables prompted fewer than 1% missing values and complete data were available for 709 older adults (M = 82.4, SD = 6.45, (range 74–102)) from eight different nationalities. Structural equation modeling was used. Controlling for age, gender and country of origin, we assessed the level of sense of coherence of elderly people, and its predictors.

Sense of coherence is predicted, not only by self-reported spirituality, but also by adjustment to aging, among other variables. Sense of coherence was significantly associated with age progression (β = .426; p = .001) and perception of health (β =− .381; p = .001). All estimates were statistically significant (p<.01).

Specifically in late adulthood, changes may affect older adults’ worldview and thus their SOC. The older individual with a strong SOC has a greater ability to mobilize and exploit potential resources. In brief, this study stresses the predictors of sense of coherence in older age. Recommendations for future research on older adults’ sense of coherence and clinical practice are also presented.

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.

The “Saving and Empowering Young Lives in Europe” (SEYLE) has gathered 12,395 high school students in 10 countries (including 1007 students in the Lorraine Region). It has been funded by the FP7 European program and coordinated by the Karolinska Institute. Its main goals were to encourage teenagers to adopt healthier behaviors by reducing risk behaviors and suicidal behaviors, to assess the benefits from various prevention programs and recommend evidence based and culturally adapted mental health promotion programs for teenagers.

SEYLE is a randomized control trial evaluating 3 mental health prevention programs:

– a program training school staff to identify and refer students at suicidal risk (QPR);

– a mental health sensibilization program, aimed at the students (the Awareness program);

– a mental health professional screening program, through self-report questionnaires and clinical interview.

These prevention programs were compared to a minimal intervention control group. The students (aged 14–16 years old) filled a 127 items questionnaire at Baseline, M3 and M12.

The most salient results of this research have shown:

– the efficacy on suicidal behaviors of prevention programs in schools, in particular the Awareness program (the mental health sensibilization universal program);

– the existence of an invisible group of students at risk (highly sedentary students with poor sleep and media overexposure);

– a high prevalence of depressive (10.5%) and (5.8%) anxious symptoms as well as non-suicidal injuries (7.8%) in European adolescents.

This study has provided evidence of the efficiency of mental health awareness programs in schools to decrease the number of suicides and suicidal behaviors in teenagers and to better identify “at risk” students.

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.

Faut-il veiller sur une crise suicidaire dès lors qu’un sujet a été rencontré au décours d’une TS ? Nous prônons la simple idée de revenir un peu à distance, sur le compromis de sortie des Urgences qui avait été conclu avec le patient suicidant. Nous présentons ici la comparaison des parcours de soin dans l’année qui suit le geste, entre un groupe de sujet bénéficiant d’un dispositif de veille baptisé ALGOS et une cohorte témoin de suicidants.

Essai thérapeutique randomisé comparatif en deux groupes parallèles (ClinicalTrials.gov : NCT01123174). L’objectif principal était la réduction des conduites suicidaires à 6 mois, en comparaison d’un groupe témoin sans intervention spécifique. Un recueil exhaustif des consommations de soins directs (hospitalisations, consultations, arrêts de travail, etc.) était réalisé à 6 mois.

Vingt-trois centres d’urgence français de tous horizons (CHU, CHG, PSPH) ont inclus 1055 suicidants dans l’essai. À 6 mois, l’analyse en ITT était positive : (96/493) 19,5 % vs. (124/494) 25,1 % adverse outcomes, Khi square = 4,194 ; p = 0,041. Nous observions dans le groupe témoin, une différence significative dans le nombre de consultants en Rhumatologie, dans le nombre de séances chez le Kinésithérapeute (903 vs 419 dans le groupe ALGOS), dans le nombre de jours hospitalisations en MCO (Algos : 157,5 et Témoins : 316) pour un nombre d’hospitalisations quasi identique (Algos : 71 et Témoins : 73), une différence quasi significative du nombre de consultations auprès des assistantes sociales (moyenne Algos : 0,29 et moyenne Témoins : 0,17 ; p = 0,07).

Ce programme montre pour la première fois l’efficacité d’un dispositif de veille à 6 mois ; ce genre de dispositif se montrerait peu onéreux à mettre en place et ne génère pas d’augmentation des consommations de soin dans le groupe étudié, au contraire.

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.

Psychiatrie et médecine légale se côtoient devant les Assises. Si les meurtres au cours du sommeil sont rares (3 cas en 30 ans d’expertise pénale), ce phénomène est connu de longue date - 19e siècle (Fodéré, Lutaud, Brouardel, Briand, Chaudé, Casper).

– reconnaître et dépister les pathologies du sommeil capables de conduire à de tels drames souvent interprétés de manière erronée ;

• –  au regard des données neurophysiologiques, comprendre ces comportements moteurs nocturnes non REM à la frontière de la comitialité :

• –  L. Nobili–Milan,

• –  Tassinari–Bologne ;

• –  évoquer l’irresponsabilité pénale devant l’état hypnoïde, meurtrier en proposant l’article 122.1 ou 122.2 du Code pénal ;

• – – maintenir un esprit critique d’expert et s’entourer d’avis spécialisés (somnologique, neurologique, neurophysiologique) avant de conclure un rapport qui risque de conduire le prévenu à 20 ans de réclusion criminelle.

– à partir de trois dossiers de meurtre au cours du sommeil, d’une analyse électrophysiologique, de la littérature, deux pathologies émergent dans la transition sommeil (non REM)–veille :

– le somnambulisme,

– la confusion de l’éveil ;

– ces états meurtriers sont sauvages, violents, complexes, automates, inexplicables, sans motif conscient, avec au réveil une amnésie totale ou partielle ;

– le prévenu face à ces comportements se retrouve devant les Assises condamné alors que la doctrine devrait conduire à l’irresponsabilité.

– des critères médico-légaux ont été définis par Bonkalo au 5e Meeting international de Forensic Science–Toronto 1969 ;

– les actes impulsifs, insensés, survenant au cours de la transition sommeil lent-veille s’inscrivent dans le cadre des parasomnies caractérisées par des éveils incomplets ;

– les générateurs de ces comportements sont les mêmes que ceux de l’épilepsie fronto-limbique ;

– le cerveau est capable de générer des états dissociés avec éveil de certaines structures cortico-sous-corticales et sommeil du lobe préfrontal ;

– le sommeil et l’éveil peuvent se côtoyer dans le temps et l’espace sur le cortex.

– dans ce type d’affaire criminelle la répression prédomine ;

– l’expert aux Assises est souvent bafoué, voire humilié ;

– la méconnaissance des avocats, des magistrats, des experts, des jurés conduit à des décisions qui s’opposent au Code pénal ;

– pourtant dans son manuel de médecine légale, Lutaud (1886) rappelait : « Le somnambule endormi peut conduire à des actes criminels et n’en conserver aucun souvenir à son réveil. Il en résulte que, comme l’aliéné, il ne saurait être responsable des actions commises pendant son sommeil ».

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.