National and international research has shown the association between depression and anxiety disorders with the risk of planned and impulsive suicidal behavior. Patients with depression may have severe anxiety or agitation associated with their depression with or without comorbid additional anxiety disorder diagnoses.

1. 1. Evaluate differences between self rated overall suicide risk of inpatients on a treatment resistant depression unit based on presence or absence of comorbid anxiety disorder.

2. 2. Evaluate association of pharmacogenetic testing results with self-ratings of suicide risk.

1. 1. To determine if suicide risk of psychiatric inpatients is higher in patients with depression and comorbid anxiety disorder.

2. 2. To determine utility of pharmacogenetic testing with suicide risk assessment and patterns of use in patients with treatment resistant depression at a large academic medical center.

This is a retrospective records review study of a sample of over 700 inpatients on a treatment resistant depression unit at the Mayo Clinic. Patients overall suicide risk self-assessments will be analyzed for differences in suicide risk assessment controlling for diagnoses, age, and sex. Pharmacogenetic testing results, including serotonin transporter and p450 2D6 testing results, will be analyzed for their association with suicide risk.

Statistical analyses results are pending at time of abstract submission.

At a population level, the interplay between anxiety disorders and depressive symptoms is felt to be key to understanding the progression from suicidal ideation to suicidal behavior. Factors complicating this at an individual patient level along with results of research study will be discussed.

rTMS is a non invasive technique, used for the stimulation of the Dorsolateral Prefrontal Cortex (DLPFC) by means of coil-generated magnetic fields [1,2]. The present study was aimed to assess efficacy and tolerability of augmentative low and high frequency rTMS in TRD patients, with current moderate-severe major depressive episode.

24 patients with a diagnosis of drug-resistant Major Depressive Episode (Unipolar or Bipolar Depression) were treated with 4 weeks of rTMS. Subjects were randomly assigned to one of the following treatments: right DLPFC, 1 Hz, 110% of motor threshold (MT), 420 stimuli/day; right DLPFC, 1 Hz, 110% MT, 900 stimuli/day; left DLPFC, 10 Hz, 80% MT, 750 stimuli/day, according to safety guidelines [3]. Analyses were performed using t-test and ANOVA.

3 subjects dropped out at the 1st or 2nd weeks of stimualtion. 21 patients completed the treatment, showing a statistically significant score reduction at HAM-D, MADRS, HAM-A e CGI-s (tr = 9.05, p < 0.005; tr = 7.93, p < 0.005; tr = 6.81, p < 0.005; tr = 4.37, p < 0.005). Response (reduction of HAM-D score of 50%) was achieved by 2 patients, one of whom considered remitter (HAM-D≤8). Partial response (reduction of HAM-D score between 25-50%) was obtained by 12 patients. No significant difference was observed in terms of efficacy between high vs low frequency. With respect to tolerability, only mild and transient side-effects were reported (discomfort, headache, insomnia). One patient withdrew because of hypomanic switch.

Both augmentative low and high-frequency rTMS appeared to be equally effective and well tolerated in the treatment of TRD.

Discussions about the limitation of the prescription and dispensing of buprenorphine hight dose (Subutex ®) emphasize the need for a systematic and formalized cooperation between the various contributors in health.

Describe the course of caring for patients addicted to Subutex followed at the outpatient service of Razi hospital.

A retrospective study was conducted on the records of patients who consulted the outpatient service of Razi hospital during a six-month period and whose diagnosis of dependence to Subutex was retained.

Twenty three patients were addicted to Subutex. 100% male. The mean age of the patients was 32.13 years. Almost 82.6% of patients had a low socioeconomic level and 78.3% of them did not have insurance. 16 were unemployed. A history of incarceration was found in 82.6% of patients. The duration of use of Subutex ranged between 2 and 168 months. Places of acquisition of this molecule were precised only by 26% of consumers. Fifteen consultants do not have any history of detoxification cure and 8 of them had 1 or 2 cures. In addition, 78.3% of patients reported being motivated to stop their addiction. Regarding collaboration of physicians, 8 patients (34% of the patients) were referred by generalist physicians, 7 patients by specialist physicians, 4 patients by emergency and 2 by psychiatrists.

The management of patients addicted to Subutex in our country is deficient. These results argue for the necessity of general measures of support dependent on psychoactive substances.

Social phobia is one of the most common psychiatric disorders. There is a lack of knowledge on the relationship between social phobia and cognitive functioning among older adults.

To examine cognitive functioning, prevalence and psychiatric comorbidity of social phobia in an elderly population.

A general population sample of non-demented 75-year olds (N = 768) and 85-year olds (N = 432) was investigated in 2005-2006 (75-year olds) and 2009-2010 (85-year olds) by psychiatric nurses. The procedure was identical with semistructured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria. Cognitive function was measured with the Mini-Mental State Examination, and eight different psychometric tests measuring short- and long-term memory, nonverbal memory, logical reasoning, visuospatial and executive ability.

The one-month prevalence of social phobia was 2.5% (N = 30), this was more common among women than among men (3.2% vs. 1.3%). Individuals with social phobia more often had major depression compared to individuals without symptoms of social phobia (33.3% vs. 4.3%). MMSE-score did not differ between individuals with and without social phobia. Individuals with social phobia had worse visuospatial and executive ability measured with Clock Test, compared to individuals with no symptoms of social phobia.

Our results indicate that social phobia is not unusual in old age and that comorbidity with depression is common. Social phobia does not have an impact on global cognitive functioning. Social phobia influenced visuospatial and executive ability but not performance on several other cognitive tests.

It has been shown that perfectionism constitutes a risk factor both for insomnia and postpartum depression.

To analyse the relationship between perfectionism, depressive symptoms and insomnia in the postpartum.

201 3-months postpartum women (M=12.27 ± .91 weeks postpartum) completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS) and Multidimensional Perfectionism Scale (MPS). Three MPS dimensions derived by factorial analysis with data from this sample were used: Self-Oriented Perfectionism/SOP, Social Prescribed Perfectionism-Conditional Acceptance/SPP-CA and SPP-Others Highs Standards/OHS. Women also answered 5 questions about sleep, considering the previous month, based on which three insomnia groups were formed: Good Sleepers/GS (women without insomnia symptoms or daytime impairment); Insomnia Symptoms Group (women with at least one insomnia symptom but no daytime impairment); Insomnia Syndrome Group/ISG (women with at least one insomnia symptom and sleep related daytime impairment).

Insomnia and PDSS were correlated (r = .39, pr < .01). SOP was not correlated with insomnia neither with PDSS total score. SPP-CA was significantly correlated with insomnia and with PDSS (rr > .25, pr < .01). SPP-OHS was only significantly correlated with insomnia (r = .14, pr < .05). SPP-CA mean scores were significantly higher in ISG than in GS (23.45 ± 3.032 vs. 18.98 ± 8.81, p = 002). Considering insomnia as a quantitative variable, linear regression showed that SPP-CA (β = .20, p = .005) and PDSS (β = .17, p = .021) were both significant predictors of insomnia, explaining 8.7% of variance (pr < .001). The mediation analysis revealed that SPP-CA partially mediated the relationship between PDSS and insomnia (IC 95% .008-.005).

SPP-C is a relevant correlate of postpartum insomnia.

Fatigue and depression are among the most frequent symptoms in multiple sclerosis (MS), affecting up to 90% of patients at onset or during the course of the disease. Repetitive transcranial magnetic stimulation (rTMS) has proven safe and efficacious for treating depression.

To perform a randomized, sham-controlled pilot study to evaluate effects of deep rTMS on fatigue and depression in patients with multiple sclerosis.

28 MS-patients underwent 18 sessions of deep rTMS over 6 weeks. 10 patients underwent sham stimulation, 9 patients stimulation of the left prefrontal cortex (PFC) (18 Hz, 120% motor threshold (MT)) and 9 patients of the motor cortex (MC) (5 Hz, 90% MT). Following the treatment, patients were observed for further 6 weeks. Effects on fatigue were evaluated with the Fatigue Severity Scale (FSS) Depression was assessed by Becks Depression Inventory (BDI).

There was no significant change of BDI or FSS in sham group, as well as in PFC group over all time points. However BDI in MC group showed a significant decrease already in early treatment phase (-25.74% ± 24.36%, p = 0.013) and continued decrease over treatment period with maximum in follow up phase (-39.23% ± 21.57, p = 0.001). In FSS, MC group showed a trend to decrease during treatment period and the effect becomes significant in follow up phase (-26,72% ± 16.30%, p = 0.001).

Our data suggests that deep rTMS may have positive influence on depression and fatigue. Intrestingly, comparable effects on both symptoms were observed in MC group but not in PFC or in sham group.

US primary care clinicians (PCCs) are increasingly assuming the medical management for psychiatric disorders. Clinical practice guidelines (PCGs) remain gold standard for professional care, yet physician adoption is not universal. We sought identification of methods to increase evidence-based mental health practices for the most commonly diagnosed pediatric behavioral condition, attention deficit hyperactivity disorder (ADHD).

Test two psychiatric interventions of different intensity levels, both designed to increase primary care clinicians’ use of PCGs for managing ADHD.

Increase PCCs’ use of PCGs for managing ADHD.

Participants: 70 North Carolina (NC) PCCs ; 70 case managers; 35 to 40 pediatric resident physicians; 420 pediatric government-insured patients ages 6-18 years (chart abstraction only).

Procedures: PCCs were randomized to:

1. (1) PCC training and follow-up support only; or

2. (2) PCC, case manager, and office staff training (collaborative) and follow-up support interventions.

Differences in knowledge, skills, attitudes, and ADHD assessment and treatment practices assessed by participant selfcompleted surveys at baseline, 6, and 12 months. Six of their patient charts were abstracted to determine the extent they followed American Academy of Pediatrics (AAP) treatment guidelines. NC Medicaid (government insurance) claims for children and adolescents of participating practices and a group of control practices were reviewed for diagnostic documentation.

For collaborative trained PCCs:

1. (1) increased use of ADHD symptom screeners and greater frequency of F/U visits;

2. (2) greater identification of children with ADHD, but decrease in the probability of receiving an ADHD medication

3. (3) lower rate of prescribing above dosing guidelines.

Specific phobia (SP) is prevalent in the population but its clinical relevance is unclear.

There are few prospective population studies of SP.

To study the prognosis of SP in a sample of elderly with special reference to SP as a risk factor for depression.

A representative sample of 70-year old men and women (N=558) without dementia were examined by psychiatric nurses, using a semi-structured interview based on the Comprehensive Psychopathological Rating Scale (CPRS). Symptom algorithms were used to diagnose SP and other disorders of mood and anxiety according to DSM-IV. At a 5-year follow-up 418 (74.9%) persons were re-examined.

The prevalence of SP had declined significantly from 10.2% to 6.1% at follow-up. Of those with SP at baseline, 28.6% met diagnostic criteria also at follow-up, 52.4% had sub-clinical symptoms and 19.0% had no symptoms at follow-up. The prognosis of SP was not influenced by psychiatric comorbidity or type of fear. SP at baseline increased the risk for depression at follow-up in a logistic regression model also including gender and other anxiety disorders.

Less than a third of those with SP meet criteria at a 5-year follow-up, indicating substantial fluctuation of symptom levels of SP. The marked reduction in prevalence of SP over time suggests that age in itself may have a positive influence on the prognosis. The increased risk for depression in this study calls for more prospective studies in younger samples.

To assess quality of life through self-administered KDQOL-sf (Kidney Disease Quality of Life - short form) by patients on hemodialysis (HD) classified according to age.

We randomly 159 hemodialysis patients and applied the KDQOL-sf between February/10 and March/11. We evaluated the quality of life based on scores below or above 50, on all scales, according to age < 60 years (n = 85) and ≥ 60 years (n = 74).

In patients < 60 years, the scales in which they had poorer quality of life were: physical function 47/85 (55.3%), Chronic Kidney Disease (CKD) burden 46/85 (54.1%), professional role 57/85 (67.1%) and sexual function 47/85 (55.3%). In patients ≥ 60 years, the scales with poorer quality of life were: physical functioning 47/74 (62.2%), physical function 51/74 (68.9%), general health 38/74 (51.3%), energy / fatigue 45/74 (60.8%), CKD burden 56/74 (75.7%), professional role 49/74 (66.2%) and sexual function 60/74 (81.1%).

While patients younger than 60 years have a quality of life decrease in 4 scales, patients with more than 60 years have worsened in 7 scales, with significant worsening of sexual function. We conclude that the quality of life is more impaired in the elderly undergoing HD.

To analyse variations in workers psychological distress, depression and burnout within a model encompassing the stress promoted by constraints-resources embedded in structures of daily life (workplace, family, social networks outside the workplace) and worker individual characteristics (demography, physical health, psychological traits, life habits, stressful childhood events).

Data were collected in 2009-2012 from a sample of 64 Quebec (Canada)workplaces, where 2162 employees were surved, for a response rate of 73.1%. Multilevel regression models were used to analyse the data.

Variables explain 31.8% of psychological distress (GHQ), 47.7% of depression (BDI) and 48.1% of burnout (MBI). Associations are not the same for each outcome. Skill utilization (BDI, MBI), decision authority (GHQ), abusive supervision (BDI, MBI), conflicts (BDI, MBI) and job security (GHQ, BDI, MBI) are related to the outcomes. For the family, being in couple (BDI, MBI), minor children (BDI, MBI), family to work conflict (MBI), work-to-family conflict (GHQ, BDI, MBI), strained marital and parental relations (GHQ, BDI) associated with the outcomes. Social support outside the workplace predicts both psychological distress and depression. Most of the individual characteristics correlated with the three outcomes.

The results of this study suggest expanding approaches in occupational mental health in order to avoid coming to erroneous conclusions about the relationship between work and mental health. Depression and burnout seem to share a similar explanatory structure, while psychogical distress appear mostly explained by non-work factors.

The diagnosis of bipolar disorder in children and adolescents has increased in clinical settings throughout the last two decades. Its prevalence is around 1.8% being similar in different countries. However, how it is diagnosed is still a challenge due to its variability of clinical presentations, overlapping with other more commonly psychiatric disorders and high rates of comorbidities. Therefore, it is still important to report cases in order to enhance our knowledge about this complex field of the mental health in childhood and adolescence.

To present clinical characteristics and follow-up of a 12 year-old adolescent who met DSM-IV criteria for bipolar disorder NOS.

To describe the clinical trajectory from the diagnosis to the outcomes of the mentioned case, focusing on the main symptoms and family functioning.

The combination of mood stabilizers, family interventions and individual psychodynamic therapy resulted in an improvement of the global functioning.

Even in a complex case of child bipolar disorder with early onset the treatment based on pharmacotherapy, individual psychodynamic therapy and systemic family therapy was able to provide satisfactory results.

There exists evidence about the presence of Childhood Trauma (CT) being implicated in pathogenesis of Delusional Disorder (DD).

Investigate de influence of CT in the cognitive biases (attentional bias, jumping-to-conclusions, personalizing attributional bias, need-for-closure and “self” discrepancies) and in the social cognition alterations (theory-of-mind and facial emotion recognition deficits) which have been postulated to be implicated in formation and maintenance of DD.

Childhood Trauma was measured using the “Childhood Trauma Questionaire” in 64 patients (n=64) diagnosed with DD by the SCID-I (DSM-IV-TR). The cognitive biases were evaluated using specific scales (“Emotional Stroop”, “Experimental Beads Task”, “Need-for-Closure Scale”, “Internal, Personal and Situational Attributions Questionnaire” and “Personal Qualities Questionnaire”). Social Cognition was evaluated using a theory-of-mind task (“Faux-Pas”) and a facial recognizing task (“Eyes Test”). The relationship between CT and those anomalies were examined using lineal regression models controlled by sociodemographic characteristics, premorbid IQ (“National Adult Reading Test”), delusion intensity (“Maudsley Assessment of Delusion Schedule”), depression intensity (“Beck Depression Inventory”) and neuropsychological function (attention, verbal learning, working memory and executive function; measured by a extensive neuropsychological assesment).

High scores in CT were significantly associated with low scores in Faux-Pas task after being adjusted by the delusion and depression intensity, executive function and antipsycothic medication dose.

The severity of Childhood Trauma in patients with DD is related to theory-of-mind deficits, a social cognitive function which has been implicated in the pathogenesis of the Delusional Disorder.

Delusions, hallucinations, aggression, and agitation affect more than half of patients with dementia. Antipsychotic drugs are used to treat these behaviors and symptoms. They are among the most frequently used psychotropic drugs in this disease, but their benefits are uncertain and concerns about safety have emerged. We assessed the current practice in use of antipsychotics medication in outpatients with dementia.

We conducted a retrospective cohort study involving patients older than 65 years who began outpatient treatment with antipsychotic drugs following a dementia diagnosis.

22 patients were included (16 female, 6 male) with mean age of 78.6 years. All patients consulted for behavioral problems. Most received typical aantipsychotic drugs (72,8%), while 36,4% received atypical antipsychotic drugs. 13 patients (59,1%) were receiving haloperidol. Improvement was observed in 54,5% of patients.

The comparisons of haloperidol with risperidone suggest no difference in efficacy for the treatment of global behaviour disturbance. On the other hand, use of haloperidol is, however, associated with a higher incidence of extrapyramidal and other side effects.

The treatment of elderly patients requires daily careful management and monitoring because of their polypathology, polymedication and of their greater sensitivity to the toxic effects of drugs. Overall, the study findings suggest that there is a need to monitor antipsychotic drug use by elderly patients in light of recent efficacy and safety data on atypical agents.

An allegiance to a school of psychotherapy may distort the findings of treatment effectiveness in randomized clinical trials (RCT).

To assess the influence of allegiance in treatment effectiveness.

Using a systematic approach across various psychotherapy studies we aim to identify if allegiance introduces systematic bias in the observed effects.

We considered meta-analyses of RCT of different types of psychotherapies in the Cochrane Database. Eligible articles included were those that had only RCTs and at least 1 study with allegiance of the experimenter. For each metaanalysis we calculated the relative odds ratio (ROR) of the allegiance studies vs. no allegiance odds ratios per meta-analysis and the summary ROR across all meta-analyses by using random effects models. Heterogeneity is quantified with the I2 metric.

A total of 30 meta-analyses including 240 RCTs were analyzed. Effect sizes of experimental intervention with psychotherapy allegiance (PA) has more favorable effect than experimental intervention without PA (sROR=1.31, 95% confidence interval (CI) 1.03-1.66, I2=53%). Subgroup analyses showed that this inflation is strongly type of psychotherapydependent (Cognitive Behavioral Therapy: sROR=1.07, 95% CI: 0.85-1.34, I2=19%; Supportive or counseling therapy: sROR=1.44, 95% CI: 1.01-2.05, I2=0%; and others: sROR=2.34, 95% CI: 1.03-1.66, I2=79%). Allegiance effect was also stronger where the therapeutic experimenter had both developed the therapy and supervised the therapist implemented the intervention (sROR=2.39 95% CI=1.15 - 4.99 I2=65).

PA can introduce systematic bias on effect sizes of various psychotherapy intervention trials in a similar way that conflict of interest does.

Repetitive transcranial magnetic stimulation (rTMS) is widely investigated and has been proved to have positive effect on treatment-resistant depression. The Food and Drug Administration has authorized rTMS to be used in this indication in several countries. However, patients do not all benefit equally from rTMS.

We therefore sought to identify the clinical and demographic factors associated with response and remission after rTMS in chronic and resistant depression.

76 patients suffering from unipolar or bipolar depressive episode received 10 high frequency rTMS sessions, one per day, over the left dorsolateral prefrontal cortex (10 Hz, 95% Motor Threshold, 5s on, 25s off). All patients were antidepressant-free or taking a stable antidepressant drug for at least one month.

Nearly half of patients had responded to the treatment (47.4%) and 16 went into remission (21.1%) by the end of the study (immediately after the last rTMS session). Morover, as shown by using simple and multiple logistic regressions, the age at which the first episode occurred and the initial level of state anxiety were associated with a higher response rate. A hyperthymic temperament and a greater trait anxiety were shown to be associated to a higher remission rate.

The results obtained suggest that unipolar and bipolar patients may react differently to rTMS. These two subgroups of affective disorders could benefit from specific, separate paradigms.

The incidence of depressive disorders in patients with skin diseases is about 30% compared with the prevalence of depressive disorders in somatic practice - up to 20% (Filaković P. at all, 2009). The comorbidity of depressive and anxiety disorders with allergic contact dermatitis and atopic dermatitis was spotted. The psychogenic factors and behavioural aspects have significant role in the etiopathogenesis of most dermatological diseases (Shenefelt PD, 2011).

A survey 46 patients with skin diseases - 28 (61%) atopic dermatitis and 18 (39%) allergic dermatitis, was conducted with psychometric scales (NAMD-21, Q-LES-Q). Skin disease duration was more than 12 months. The average age of the patients 36,4 ± 3,5 years.

In social aspect were obtained positive correlations with high demands at work (p ≤ 0.05), low social support (p < 0.02), a state of chronic stress at business (p< 0.002), persistent family problems (p < 0.05). Most patients demonstrated reduced social functioning and dissatisfaction with family relationships or relationships with a partner. Were identified: anxiety symptoms in 62% patients, somatovegetative manifestations of depression (appetite disorders - in 43%, 71% -of sleep disturbances, impaired concentration - 76%, irritability - in 91%), depressed mood - 39% and in 22% patients - anhedonia.

The business stress factors and interpersonal problems lead to probability of skin diseases occurrence.

Insulin-dependent diabetes, obesity and gestational diabetes are factors associated with macrosomia. Some psychiatric medications have well established side effects of weight changes in exposed pregnants. However, very few studies have investigated about the effects of lithium in fetal and neonatal anthropometry.

To investigate the effects of maternal use of lithium during pregnancy on fetal and neonatal growth.

A case-control study was conducted at the PERINATAL PSYCHIATRY PROGRAM CLÍNIC-BARCELONA. Case group consisted of 18 pregnant women on maintenance treatment with lithium monotherapy (n=13) or polytherapy (n=5) during pregnancy; control group involves 49 healthy women selected from an initial sample of 309. We evaluated sociodemographic data, lithium plasma concentrations in maternal blood and umbilical cord, fetal and neonatal anthropometry.

Women did not diabetes or obesity criteria pre-pregnancy and during pregnancy. Mean maternal age (SD) in lithium exposed cases was 33.5 (3.8) and 32.5 (4.1) in non-exposed pregnant. No statistically significant differences were found regarding sociodemographic variables and pre-pregnancy BMI. Caesarean section was required in 91.8% of lithium exposed mothers, whereas 8.2% of non-exposed women did not need it (p= 0.000). Fetuses exposed to lithium had greater abdominal circumference (p= 0.018) and femur length (p= 0.010) compared to non-exposed group. There were no differences in umbilical cord/maternal plasma lithium ratio between women treated with lithium monotherapy or polytherapy (1.11vs.1.03).

The fetuses exposed to lithium had a greater abdominal circumference, greater femur length and more caesarean section in comparison to non-exposed group. Fetal growth surveillance is recommended in pregnant treated with lithium.

Mood disorders have a multifactorial etiology comprising genetics and environmental aspects in a complex interplay between them. Depression and bipolar disorder have been increasingly diagnosed in children and adolescents in the recent years. A meta-analysis about the epidemiology of bipolar disorder in youth showed that the overall rate was 1.8%. Concerning depression in youth the lifetime prevalence varies from 3% in children to almost 20% in adolescents.

To describe a treatment and research program (PROACTH) for children and adolescents with mood disorders (depressive and bipolar disorder).

The program operates from Monday through Friday. Patients are referred to the program from primary care health services. On admission, patients were screened with standardized instruments. After that, the patients were submitted to pharmacological and psychosocial interventions. Finally, the follow-up period depends on each patient illness evolution. Also, the team encompasses child psychiatrists, systemic family therapists, psychologists and social workers.

The combination of pharmacotherapy and psychosocial interventions (individual psychotherapy and family therapy) led to a decrease of symptoms and a better psychosocial functioning.

In spite of the complex interplay between genetic and environmental factors usually found in children with mood disorders, timely and appropriate interventions are efficacious to achieve a favourable outcome.

Early onset dementia (EOD) is conventionally defined by age of onset less than 65 years. It is increasingly recognized as a real public health problem because it reaches potentially active people. Although little studied, it is not uncommon and has some clinical and etiological features.

The aim of our study was to evaluate the prevalence of early onset dementia in psychiatric consultation to examinate sociodemographic, clinical and etiological characteristics of this entity.

It is a cross-sectional study in external consultation of the psychiatric hospital Razi. We collected the records of patients seen between 01/09/2011 and 01/09/2012 and in whom the diagnosis of dementia was retained as the diagnostic criteria of DSM IV.

We compared the epidemiological, clinical, and evolutionary dementia, beginning before the age of 65 with late onset dementia (LOD) (after 65 years).

50 patients were included. The prevalence of EOD was estimated at 20% of all dementias. There was an over representation of men in the early onset group. MMS average score of our patients was 16. This score did not differ between the two groups but differed significantly according to the etiological diagnosis. Alzheimer's disease was the main etiology for both groups. Compared to late-onset dementia, the EOD is characterized by greater heterogeneity in the etiologic diagnosis.

The EOD and the LOD seem to have common characteristics, but some features of the EOD especially etiological, emphasize the value of a more comprehensive approach to the research of curable dementia.