The most obvious that could be conceived is that after an intersubjective crisis situation such as a genocide, the victims fall under a heinous dynamics and a desire of revenge against their torturers. It is thus potentially paradoxical in such a context to imaginate a harmonious bond, of deep attachment between the survivor and his attacker or his relative. However, the factual reality in the aftermath of the 1994 Rwandan genocide drama presents a different picture. Improbable families recomposed with the adoption of abandoned genocidaries children (in flight) by survivors.

Consider a healthy bond where the hatred in the trauma of the otherness seems as evidence becomes the most enigmatic paradoxes, that which comes the concepts of”hainamoration” in the trauma clinic.

The major question here is the one of the direction of this adoption for the survivors.

In other words, what whould be the real dimension of the relationship that is built between these abandoned children and the surviving victims of the destructive act of their parents ?

To understand the psychic mechanisms induced by the constraint of the Co-existance of two enemies after an intersubjective drama such as a genocid.

Consider a theoretical reflection in the service of trauma clinical and identify the paterns of the traumatic remission in such a context.

This study is based on our clinical experience in Rwanda after the 1994 genocid. The target populations here is the survivors of this genocid.

It is primarily based on psychopathology and psychoanalytic repositories from and maintains clinical observation.

’hainamoration’ as mutation and/or transformation of the primary hatred into’love’ allows the victim to better reflect and decide the fate of his trauma. From this, we reach to the second conclusion that, with the constant desire for revenge and hatred that drives the survivor, ’only love allows the enjoyment to condescend of desire’ (of this revenge).

Age-related health conditions are of great medical and social importance. Depression may occur as a result of vascular disease in a significant subpopulation of elderly persons. The mechanisms of interaction between cerebrovascular diseases and depression are widely discussed in the literature indicating a possible bidirectional relationship.

the present study is the psychiatric evaluation of elderly patients with vascular cognitive decline in terms of the diagnosis and assessment of depression.

Sixty-eight consecutive patients over 60 years of age diagnosed with vascular cognitive disorder underwent clinical psychiatric assessment and evaluation on The Mini–Mental State Examination (MMSE), Hachinski Ischaemic Scale (HIS), The Hamilton Depression Rating Scale (HAM-D-17) and The Hamilton Anxiety Rating Scale (HAM-A).

Depression of mild and moderate severity was diagnosed in 28 (41.2%) of the included patients. Varying presentations of depression in older adults included somatization, minimized feelings of sadness, more anhedonia and greater cognitive dysfunction, predominantly in complex attention and executive ability. Differential diagnostic difficulties arouse from co-morbidity, leading to clinical overlap.

Although an association between a subset of late-life depression and vascular disease is clear, significant gaps remain in our understanding of the precise linkages and interactions between these conditions. An important concern is weather the cognitive impairment is temporally related to depression, or depression is an associated feature, or both should be diagnosed. We suggest depression need to be considered in the evaluation of even subtle executive dysfunctions in cerebrovascular disease patients.

Cognitive deficits at young patients (children and adolescents) with eating disorders (anorexia nervosa) aren’t investigated sufficiently. Well known that the disease has different forms in children and teenagers and is accompanied by significant changes in cognitive activity. Joint clinical and psychological qualification of cognitive disorders, personality characteristics and quality of life of children and teenagers with eating disorders hadn’t done.

Diagnostic of cognitive deficits in children and teenagers with anorexia nervosa.

Clinical group (NAG) - 28 girls aged 8-16 years old (F50; F21). The patients were investigated in a hospital. Control group (CG) 18 girls of same age never attended by a doctor on mental disorders. Tests assessing cognitive processes: memory, attention, thinking.

We have found cognitive disorders in girls with anorexia nervosa. The obtained data specifies cognitive deficits in different higher mental functions. Memory: decrease in volume voluntary memory, immediate and delayed. differences between NAG and CG were statistically significant (p <0,01). Attention (reducing the rate and efficiency in the performance tests). Thinking: a structurally unstable decline the level of generalization and certain disorders thinking on the type of distortion of the synthesis and diversity - 0.05 level of significance of differences.

This study has identified the structure of cognitive impairments (memory, thinking, attention) in children and teenagers during the acute stage of the disease. General characteristics of cognitive impairment in anorexia nervosa in children reflects primarily acute condition, and only secondarily - projective, the specifics of the disease.

Eating disorders (ED) are severe psychiatric disorders affecting mainly teenage girls and young women. There is evidence that family aspects play important role in the etiology and outcome of ED. Aspects related to the patients’ father have been poorly studied.

To understand emotional experiences and life events of father of adolescent girls diagnosed with anorexia nervosa or bulimia.

Qualitative in-depth interviews were carried out with men, fathers of adolescent girls in outpatient treatment at a southern Brazilian general hospital.

Sample was composed mostly by men who spent their childhood in the countryside. All of them had lived with their parents at least until the adolescence. Contrary to what clinicians often hear from mothers of ED patients, subjects were concerned about their daughters’ health, wished to see them overcome ED and were well informed about the disorder. They reported that one of the most important events of their lives was their daughter birth. Subjects also reported feeling of powerlessness. They tended to blame the mother for the ED emergence or maintenance, but recognized some relation between the disorder onset and a certain distance in father-daughter relationship. They recognized that their aggressive temper might have interfered with family relationships.

Findings may contribute to understand life experiences and emotional characteristics of fathers of ED adolescents and this may help to keep them motivated to the treatment. This understanding can contribute to therapists to help fathers to regain their ability to care for their daughters, getting close to them again and improving father-daughter relationship.

We hypothesized an increase in dorsolateral prefrontal cortex (DLPFC) glutamate levels would occur after three weeks of repetitive transcranial magnetic stimulation (rTMS) treatment and a decrease in major depressive disorder (MDD) symptoms.

We report six cases (four females) 15–21 years of age with treatment-resistant MDD. Participants had a mean age of 18.7 years (SD ±1.95) and a mean IQ of 102.3(±3.39). Short echo proton magnetic resonance spectroscopy (1H-MRS) was used to quantify glutamate levels in the left DLPFC (4.5 cc) before and after rTMS treatment. rTMS was localized to the left DLPFC and applied for 15 consecutive weekdays (120% RMT, 40 pulses over 4 seconds (10 Hz), inter-train interval 26 seconds, 75 trains, 3000 pulses). Treatment response was defined as a greater than 50% reduction in Hamilton Depression Rating Scale scores (Ham-D). 1H-MRS data was analyzed with LCModel to determine glutamate concentration.

Following rTMS, treatment responders (N=4) showed an increase (relative to baseline) in left DLPFC glutamate levels (11%), which corresponded to an improvement in depressive symptom severity (68% Ham-D score reduction). Treatment non-responders (N=2) had elevated baseline glutamate levels compared to responders in that same region, which decreased with rTMS (−10%). Procedures were generally well tolerated with no adverse events.

rTMS is feasible and possibly efficacious in adolescents with MDD. In responders, rTMS may act by Induced elevations in elevating DFPLC glutamate levels in the left DLPFC, thereby leading to symptom improvement. Transcranial Magnetic Stimulation for Adolescent Depression (TMSAD).

Impulsivity is a frequently used explanation for acting without apparent forethought. Mood instability (MI) describes frequent repeated shifts in mood, often within a day. Both impulsivity and MI are related to depression.

We used data from the 1984/1991 British Health and Lifestyle Survey to examine relationships between MI, impulsivity, and depression.

Hypothesis: 1) both MI and impulsivity would be related to current and future depression, and 2) when MI was accounted for, impulsivity and depression would be unrelated.

Latent variables representing MI and impulsivity were derived from the Eysenck Personality Inventory neuroticism and extraversion subscales respectively, and a depression latent variable was derived from the General Health Questionnaire, by using factor analysis. Structural equation modelling was used to determine if impulsivity was related to depression after MI was accounted for.

Cross-sectionally, the correlation between impulsivity and depression (r = 0.22, p<0.001) became trivial in size (r = .05, p < .01) after the correlation between MI and impulsivity (r = 0.50, p<0.001) was removed from the structural model. Longitudinally, impulsivity no longer predicted future depression (β = −.04, p = .16) after MI was added to the structural model. These results indicate that any significant relationship between impulsivity and depression disappears when MI is considered.

The implication is that research and therapy might be more productively directed at MI instead of impulsivity.

Suicides are influenced by substance use especially the hazardous use of alcohol. This cross-sectional study in emergency setting evaluates hazardous drinking among people who attempt suicide.

1. 1. To study the prevalence of alcohol use among men who attempt suicide attending an emergency medical service at a tertiary care centre.

2. 2. To study the association between hazardous drinking and suicidal attempts among men attending emergency medical service.

3. 3. To assess the correlation between Intentionality and Lethality of suicide attempts and breath alcohol concentration levels.

4. 4. To study the association between suicidal attempt and psychosocial stress, socio-demographic variables and hazardous drinking among the men with suicidal attempt.

Patients will be screened for CIS-R, ICMR psychosocial stress scale, AUDIT, BSIS, LSARS. Correlation will be assessed between the scales. Descriptive statistics were used for all the variables in the study. Bivariate analysis were used to assess the association between lethality and pattern of alcohol use after adjusting for other factors identified in the univariate analyses.

Of the 100 men the mean age was 32 with a range (18 to 82). Of the participant 41% were daily drinker, 20% were social drinker. No association between severity of alcohol use and lethality, Beck Suicide Intention Scale, ICMR Psychosocial Stress Scale scores could be established. Among those who consumed alcohol mortality was three (4.92%).

Though there is no association between severity of alcohol use, psychopathology, stress and suicidal attempt. Recovery seems to be delayed among alcoholic group.

Most people who commit suicide suffer from depression, but diagnostic categories and known personal and demographic factors do not adequately capture the distress that leads people to kill themselves. Mood Instability (MI) refers to sudden unpredictable fluctuations in mood often occurring within a day.

To determine whether MI predicts suicidal thoughts.

Hypothesis: That MI will predict suicidal thoughts even when negative affect (depression, anxiety, anger) are controlled.

Data from the Dutch Imigrant panel of the Longitudinal Internet Studies for the Social Sciences (LISS-I) (N = 1686) were used. MI was assessed with 7 items from the International Personality Item Pool of Big Five Indicators. The Chronbach's alpha was 0.86. Suicidal thoughts were assessed by a single question referring to the past week. Depression, anxiety and anger were represented by 21 items derived by factor analysis from the 31-item Emotional Expressiveness Module. Odds ratios using logistic regression modeling were calculated, adjusting for negative affect, alcohol and substance abuse, and demographic variables (age, sex, income).

MI predicts suicidal thoughts (Males OR: 1.14; 95% CI: 1.02-1.28 and females OR: 1.11; 95% CI: 1.00-1.23) along with negative affect. There was no interaction between MI and negative affect.

MI has been relatively neglected as a predictor of suicidal thoughts. It is likely that the unpredictable, sudden, severe descents in mood are particularly distressing and contribute to the feeling that life is intolerable. MI requires more attention in the assessment and treatment of suicide risk.

The present study aimed at examining the relationship between general health and reasons for living factors.

Descriptive correlational method was applied to this study. 100 female teachers were recruited from Babol city randomly as the research sample. Life Orientation Test (LOT) and General Health Questionnaire were tools used to collect data. The data obtained from respondents were transferred to SPSS spreadsheet for descriptive (mean and standard deviation) and inferential (Pearson's correlation coefficient and step wise regression analysis) analyses.

Results from the present research showed a significant relationship between the score of general health and reasons for living factors. Moreover, results of correlation matrix revealed the maximum correlation between general health and moral objections. Based on the smaller value of significance level (P=.021) obtained from the association of general health variable with survival/coping beliefs than that of shown in the table (P=0.05) and the correspondent correlation coefficient of -.223, we concluded with 95% confidence that a significant negative relationship existed between general health and survival/coping beliefs. Also, the amount of significance level of general health and responsibility to family was found to be smaller (P=.029) than the value shown in the table (P= 0.05) and correlation coefficient of -.207 was computed. As a consequence, it could be deduced with 95% certainty that there existed a significant negative link between general health and responsibility to family.

Results from regression analysis have indicated that general health variable can be predicted by reasons for living factors (Survival/Coping Beliefs (SCB), Responsibility to Family (RF), Child-Related Concerns (CRC), Fear of Suicide (FS), Fear of Social Disapproval (FSD) and Moral Objections (MO)). Moral objection, alone and with β= -.300, accounts for 30 percent of variance of general health.

Passing through the cancer increases the risk of depression. Also known that social support is an important predictor of a better adaptation and higher quality of life (QoL). Meanwhile, there are common cognitive distortions which may lead to inadequate perceive social support and deterioration in QoL. Correction of cognitive distortions through the use of cognitive behavioral therapy (CBT) should help to improve the functioning of cancer patients.

The first aim is establish correlation between cognitive distortions, level of depression, perceive social support and QoL. The second is examine the effectiveness of CBT among patients with breast cancer.

Longitudinal study included women with breast cancer and their partners. Experimental group consisted of 61 couples who had participated in ten-week CBT. A control group consisted of 56 couples, who did not benefit from any psychotherapy. The study used the following questionnaires: BDI, EORTC-QLQ-C30 (women) and BSSS (women and men).

At baseline there were no differences between women in the experimental and control groups. Women evaluated the support much lower than the average level of support declared by their partners. At post-test evaluation of support by men has not changed, but there observed an improvement in evaluation of support among women in CBT-group and a further deterioration in the evaluation in the control group. Simultaneously, an improvement in QoL and reduction in depressive symptoms were noticed in CBT-group.

Correction of cognitive distortions through the use of CBT should help to improve the functioning of patients with breast cancer.

The term suicide by cop is used commonly for police-involved shootings that could be considered suicides because of the subject's precipitated actions that demonstrate suicidal intent through words or behaviors. The notion that victims sometimes initiate physical conflicts in which they are injured or killed is studied for more than 50 years. This is first description of Suicide-by-cop in South-East Europe.

On October 28th 2011, MJ, a member of radical islamic movement, attacked the US Embassy in Sarajevo. He spent 50 minutes in plain sight firing from an automatic rifle (AK-47) at the U.S. embassy, seriously wounding a police officer before he was hit by a police sharpshooter.

Police may confront shootings motivated by suicidal subjects more often than reports indicate. Although suicide by cop is most commonly reported and studied in the United States, Canada, and more recently the United Kingdom it appears to be an international phenomenon.

Mevlid Jasarevic's case was an act of terrorism from the perspective of law. From the perspective of mental health professionals it was also Suicide-by-cop attempt. New information confirm our earlier made conclusion – MJ left movement, shaved beard and changed his outlook. There were some other reasons but terroristic for such attack.

To examine an effect of personality disorders on clinical features and disease course of cardiovascular diseases (CVD).

We’ve examined 358 inpatients (220 female, 138 male; mean age 57,6 ± 4,3years) with Arterial Hypertension (AH), Coronary Artery Disease (CAD) and Atrial Fibrillation (AF). Main methods were psychopathological, pathopsychological and clinico-instrumental.

Two groups of patients were determined. In the first group (216 patients, 64,8% female, mean age 56,9±2,1 years; mean CVD duration 9,2±3,1 years) clinical course of CVD is subjected to personality disorder's dynamics. Synergistic type of CVD clinical course is characterized by reactive somatopsychic lability, CVD manifestation at the time of stressful situation, CVD symptoms redoubling by somatoform disorders. CVD exacerbations correlate with psychogenic depressive phases and\or climacterial period. In most cases (76,1%) further CVD dynamics is characterized by hypochondriacal personality development. In the second group (142 patients, 70,4% female, mean age 57,6±1,4 years; mean CVD duration 9,2±2,2 years) clinical course of CVD doesn’t correlate with personality disorder's dynamics. Alternating type of clinical course of CVD is characterized by hereditary and somatogenic factors.

These data enable to explain ambiguous results about reciprocal influence of personality disorders and CVD received in many studies. Our findings are of great practical importance and show the necessity of differentiated approach in complex treatment of CVD.

Taking into account epidemiological data about growing frequency of acute and chronic disorders of maxillofacial area evaluation of psychopathological disorders in this group of patients is of great importance.

The purpose was to diagnose symptoms of psychopathological disorders in maxillofacial surgeons’ patients.

The study used psychometric method. The validated scales used were SAS, SDS, Holmes and Rahe stress scale, HCL-32-R1. We included all patients who have applied to the clinic of Moscow State Medico-Stomatologic University from January 2010 to March 2013 and who gave Inform Consent.

Study sample consists of 408 patients (206 men, 202 women), 18-71 years old. According to somatic status all patients were divided into three groups. First group (n=160) – patients with chronic somatic disease resulted in fixed deformity of maxillofacial area. 41,3% of patients had depressive symptoms, 31,3% had anxiety symptoms and 16,3% had hypomania symptoms. Second group (n=127) - patients with acute posttraumatic face tissue injury. 10,7% of patients had symptoms of depression, 20% of patients had symptoms of anxiety and 32,3% of patients had symptoms of hypomania.

Third group (n=121) – patients without evident somatic pathology wishing to perform surgical correction of appearance.51,2% of patients had depressive symptoms, 40,5% of patients had anxiety symptoms and 35,7% of patients had hypomania symptoms.

Our data suggest that 10-55% of maxillofacial surgeons’ patients have different symptoms of mental disorders (affective, anxiety). Further investigation needed to determine syndromal characteristics and nosological diagnosis and to elaborate psychopharmacotherapy and psychotherapy approaches.

Depression and apathy are common behavioral symptom of Alzheimer's disease (AD) and antidepressants, despite their role in improving depression have a minimum impact in improving apathy. Agomelatine has been shown to be effective in alleviating depression and reversing treatment emergent apathy.

The purpose of the current pilot study is to determine the efficacy of agomelatine in depressed patients with AD and comorbid apathy.

In this prospective 4 month study, twenty depressed elderly AD patients (age 65-85) who had been treated with SSRI and/or SNRI and shown a partial response to the antidepressant prescribed, in terms of apathy, were switched to agomelatine. Subjects were monitored for depression (Hamilton Rating Scale for Depression, HDRS), cognitive functions (Mini–Mental State Examination, MMSE) and apathy (Neuropsychiatric Inventory –apathy item, NPI-a).

Within groups, differences of HDRS, CSDD, MMSE and NPI-a scores at baseline, 2nd and 4th month of agomelatine treatment were estimated with repeated measure analysis of variance.

Following agomelatine, a numeric but not statistically significant improvement was observed in depression scores (8.2±3.5 vs 7.8±3.1, p=0.234, 7.8±3.1 vs5.8±2.3, p=0.421). A marked improvement in MMSE score was observed at both 2nd (22.2±4.9 vs 20.9± 5.4, p=0.05) and 3rd assessment(22.2±4.9 vs 23.9±4.9, p<0.05). Apathy score was also improved over the consecutive assessments (25.3±5.9 vs 18.6±3.9, p<0.05 and 18.6±3.9 15.5±4.3, p<0.05).

The present study demonstrated a good therapeutic response to agomelatine in elderly AD patients with depression and apathy symptoms in terms of alleviating apathy.

It is established the presence of seasonal variations in decompensation of patients with bipolar disorder. The purpose of this study is to assess whether other environmental factors such as Moon lighting or the distance between the Moon and Earth are associated with decompensation of this group of disorders.

We collected all the attention made ??to the Emergency Department of the Hospital de León for one year (July 2012 to June 2013). We identified patients diagnosed with Bipolar Disorder (F31.x). Consultations were correlated with the following astronomical data: Moon lighting, Moon Phase, Earth-Moon distance and growing or waning moon. Main variables to study were number of emergency consultations and income in hospitalization. It was used for analysis SPSS v20.

From a total of 1405 emergency consultations 96 patients were diagnosed with Bipolar Disorder, of whom 60 required hospitalization. The mean ratio of total number of consultations / total days in a particular moon phase was 0.2858 (95% CI: 0.2313 to 0.3403) with significant variations in the different phases. The mean ratio of total hospitalizations / total days in a particular moon phase was 0.1728 (95% CI: 0.1095 to 0.2361). The comparison of the mean lunar illumination between patients who required admission (mean = 56.7 + / -32.08) and those who were discharged (mean = 43.69 + / -32.39) was found near statistical significance (p = 0.058). There were no significant differences in the Earth-Moon distance or the waxing or waning state of the Moon.

No association was found between the Earth-Moon distance and the number of visits or hospitalizations in bipolar patients. The lunar illumination is higher in cases that required hospitalization and it is necessary conduct a study with a greater potency to establish or definitely reject this finding.

Patients with psychotic depression have a high rate of relapses and readmissions. There have been conflicting findings regarding the stability of the psychotic depression diagnosis.

The study is based on a sample of patients (diagnosis codes: F32.3x, F33.3x, F25.xx, F29), who had their first treatment episode in the hospital district of Satakunta between the years of 1996 and 2000. Their patients’ records were reviewed using an instrument to record background data, information on treatment episode and treaments, and symptoms. Additionally, data from national registers (hospital discharge register, reimbursement of medications and causes of death) was collected and followed until the end of 2008.

The sample included 181 subjects, 70 men (38.7%) and 111 women (61.3%). Out of the whole sample, 17.1% (n=31) had a diagnosis of schizoaffective disorder, 23.8% (n=43) a diagnosis of psychosis NOS and 59.1% (n=107) a diagnosis of psychotic depression. Patients with psychotic depression were significantly older (60.1) compared to schizoaffective (49.8) and psychosis NOS (36.5) patients (p<0.001). about two thirds of the patients (n=119) had at least two treatment episodes. A change in the diagnosis of the patient from the first episode to the last during the 12-year follow-up was observed in 34 (28.6%) out 119 subjects. Schizoaffective disorder (88.0%) was the most stable diagnosis, psychotic depression a moderately stable diagnosis (68.7%) among the readmitted patients. Only one case with psychosis NOS had retained the diagnosis.

In this sample, among the readmitted patients psychotic depression was a fairly stable diagnosis.

Previous studies suggested that migrants are at higher risk for psychosis [1] but that this risk is inversely correlated with the size of their ethnic group [2].

However, less is known about the influence of proportion of migrants in a population - a simple and readily available parameter - on the incidence of psychosis in the whole population - a measure of interest for mental health policies.

We prospectively collected data over 3 years in an urban area with a population of N=133000 at risk subjects. The area was divided in 80 geographical units classified in four categories (quartiles) according to the proportion of migrants in the latest census. For each of the geographic units we calculated the standardized incidence rates of affective, non-affective and total psychoses. We tested the hypothesis of unequal rates of psychosis according to migrants’ density quartiles using a Poisson model.

The proportion of migrants significantly influenced the incidence of total psychoses and affective psychoses. However, in this sample, an increase in migrant density was not linked to an increase in cases of psychosis over the entire spectrum of migrants’ density. A raise in the third quartile was followed by lower incidence rates in populations with the largest proportion of migrants (see figure)

More research is needed to confirm or contradict this result and test for different explanatory hypotheses.

The Lifeline’Talk With Us’ was founded in 2008 by Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Italy, to provide free and confidential emotional support to people in suicidal crisis.

In this study we evaluated the socio demographic profile of individuals who used the helpline during last year (2012–2013) and caller's intent to die at the end of the call.

To investigate suicide risk factors among the callers and the association with the socio-economic status.

Using a standardized form, we assessed suicide risk in a sample of 228 callers (120 female) focusing on Suicidal Desire, Suicidal Capability, Suicidal Intent.

The mean age of our sample was 41±14,8; most callers (52%) were female from north and central of Italy. Suicide risk factors in our sample were the following: feeling alone, loss of a significant relationship, economic problems, loss of a significant loved one by suicide. Suicide attempts were reported by 27% of participants whereas 16,8% of them referred suicidal ideation. Unemployment was found in 22% of the callers whereas 42% of them referred suicide attempts, and 25% suicidal ideation.

This study shows the importance to provide an accessible volunteer service for people who are in crisis, present suicidal ideation or reported prior suicide attempts. In particular, our service was very important for those who were in economic crisis, as demonstrated by our data. Improving the quality of the existing services, and promoting awareness that suicide prevention is possible are highly recommended.