Dental anxiety is a common phenomenon influencing the relationship between a patient and a doctor as well as the course of treatment. The aim of the study was to assess the oral health status and hygienic habits among adult patients with respect to their level of dental anxiety.

In the study we included 117 consecutive adult patients referred to the Department of Conservative Dentistry and Pedodontics of Wroclaw Medical University. There were 58 women (49.57%) and 59 men (50.43%). The mean age of the patients was 36.57±16.76 years. The level of dental anxiety was assessed by Modified Dental Anxiety Scale (MDAS). To evaluate dental health status and oral hygiene the following indices were used: total number of decayed, missing and filled teeth (DMF/T) as well as surfaces (DMF/S), Approximal Plaque Index (API), Oral Hygiene Index (OHI) - Debris Index (DI) and Calculus Index (CI).

The higher was the level of dental anxiety measured by MDAS, the lower was the number of filled teeth (F/T) and the number of filled dental surfaces (F/S) and the higher was the Calculus Index (CI). There was no significant difference between dental anxiety measured by MDAS and age, gender or level of education; however, smokers had significantly higher anxiety level than non-smokers.

Dental anxiety has disadvantageous influence on oral health status. Low dental and periodontal health status may have many somatic as well as psychosocial consequences, both lowering quality of life of the patient.

Wilson's disease (hepatolenticular degeneration), is an autosomal recessive hereditary disease of human copper metabolism, being characterised by excessive accumulation of copper in the body particularly the brain, liver, kidney and cornea. The diagnosis of Wilson's disease is easily overlooked. About half the people with Wilson's disease (40%), have neurological or liver symptoms. Psychiatric symptoms due to Wilson's disease are present in 15% of patients.

To present the case of an adolescent admitted to Clinic of Psychiatry, University Clinical Center Tuzla, initially presented with psychiatric and neurological symptoms, diagnosed at etiologic cause on the basis of biochemical abnormalities of a copper metabolisam, treated with etiological therapy and obtained therapeutic effect.

An 18 years old boy admitted to Department of Psychiatry, University Clinical Center Tuzla, with prior history of behavioral disturbances in the form of disinterest in the surroundings, decreased interactions with family and with signs of aphasia. Neurological examination revealed drooling of saliva, tongue protrusion and generalized cogwheel rigidity.

Symptomatic treatment started with no therapeutic efficacy. After laboratory testings were done, findings showed low serum copper and ceruloplasmin levels, and with positive Kayser-Fleischer rings on ophtalmoscopic examination by slit lamp, and computerized tomography of the head indicate neuro-degenerative disease, Wilson disease has been diagnosed. After psychiatric observation and treatment started, patient was transferred to Department of Neurology, University Clinical Centre Tuzla. The patient responded very well to therapy with D - penicillamin, Clozapin, essential phospholipids, vitamins and pyridoxin. Regular follow up advised to evaluate the outcome.

Cognitive deficits, such as verbal memory dysfunction, are a core feature of schizophrenia. Yet the longitudinal course and associations of cognitive deficits with antipsychotic medication remain unclear.

Our aim was to analyze how lifetime antipsychotic dosage associates with the change of verbal learning and memory in individuals with schizophrenia during a 9-year follow-up.

Forty-two subjects with schizophrenic psychoses (22 males) from the Northern Finland 1966 Birth Cohort went through diagnostic interviews and cognitive assessment including California Verbal Learning Test (CVLT) at the ages of 34 and 43 years. Data of the subjects’ lifetime antipsychotic doses in chlorpromazine equivalents were collected from patient history records, interviews and national registers. The association between verbal learning and memory (immediate free recall of trials 1-5 and free recall after long delay) and dose-years of antipsychotics was analyzed by logistic regression model.

Higher dose-years of any and typical antipsychotics, but not atypical antipsychotics, associated statistically significantly to worse verbal learning and memory in cross-sectional analyses at age 34 years, even when onset age, sex, and severity of symptoms were controlled for. However, there was no statistically significant association between lifetime antipsychotic use and verbal learning and memory change between ages 34 and 43 years.

High lifetime antipsychotic dose did not associate to decrease in verbal learning and memory in schizophrenia in 9 years of follow-up. To our knowledge, this is a first report on association between cumulative lifetime antipsychotic use and change in cognition in a long-term naturalistic follow-up.

Some study suggest that unipolar mania could be a separate subtype, while there is no unipolar mania listing in DSM. We compared sociodemographic and clinical data of unipolar and bipolar mania.

In an analytical-observation study,through 850 patients with bipolar I disorder, in 10 years of illness duration, 240 patients were included. We evaluated demographic and clinical information and interview with patients and their families consistent with DSM, then we assessment the comorbidities and other clinical conditions and analysed our data by using the mann-witney test, chi-squar test and fisher exact test.

22.4% of 219 patients presented a course of illness characterized by unipolar manic episodes without history of major or mild depression. When this group was compared with 170 manic patients with a previous history of depressive episodes, we found significant similarities in most demographic, familial, and clinical characteristics. Just positive family history for MDD was higher in bipolar mania significantly (P< 0.005). Unipolar mania group reported more congruent psychotic symptoms (Pv= 0.005). Lastly in unipolar group total number of episodes is less than and manic episodes is more than bipolar. (Pv= 0.005).

There is no prominent differences between two groups and inform clinical and psychopathological have common characteristics in unipolar and bipolar mania. So, biologic, physiologic and anatomical bases of unipolar and bipolar mania could be similar. Literature on this topic is still insufficient, and it is necessary to ongoing unipolar manic studies in future.

Schizophrenia and mood disorders are chronic forms of mental illness. Quantum resonance spectrometer (QRS) test may be useful as a biological marker for the clinical diagnosis of psychiatric disorders of mental illness.

To evaluate reliability and psychiatric clinical value of quantum resonance spectrometer (QRS) in affective disorders detection.

We studied 1014 schizophrenic patients and 248 patients with mood disorders (including 93 major depression patients). Affective disorder symptoms of same subjects obtained from QRS test and psychiatrists’ diagnoses were compared. Also 3 affective disorder symptoms of renumbered 93 major depressive patients were discriminated using QRS.

Kappa values of affective disorder detection and diagnosed were more than 0.69 in all 3 symptoms of schizophrenia, and more than 0.65 in 6/7 symptoms of mood disorder. Same consistency could also be seen in Pearson R value, and ROC AUC. In the discriminated analysis, sensitivity, specificity, positive predictive value and negative predictive of hypothymia, anxiety, and irritability detected utilizing QRS are more than 0.66 compared with psychiatrists’ diagnoses.

The study is limited by no collected psychiatric rating scale data.

QRS in affective disorder detection seem to have a predictable value for outcome in schizophrenia and mood disorder, would become an objective identification and diagnosis instrument, and might promote psychiatric clinical diagnosis.

Although several lines of evidences suggest that the BDNF Val66Met polymorphism may be involved in the pathophysiology of schizophrenia, this association remains controversial. Here, we aim to investigate the genetic association between the BDNF Val66Met polymorphism and schizophrenia and to explore whether this polymorphism could influence the severity of clinical symptoms in schizophrenia patients in a Chinese Han population.

Genotyping of BDNF Val66Met polymorphism was carried out in 456 schizophrenia patients and 483 controls by the fluorescence resonance energy transfer method (FRET). The patients’ psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). The general clinical data of schizophrenia patients were analyzed.

There were significant differences in the genotype distribution and allelic frequencies of the BDNF Val66Met polymorphism between the schizophrenia group and normal control. Multiple linear regression analysis revealed that the BDNF Val66Met polymorphism explained approximately 16% for the variance of anxiety/depression symptoms in schizophrenia patients.

Our data provides evidence that the BDNF Val66Met polymorphism may be involved in the etiology of schizophrenia in Chinese Han population. Furthermore, the BDNF Val66Met polymorphism is a significant influencing factor on the severity of anxiety/depression symptoms in schizophrenia patients.

The large number of children with neuromotor pathology associated with mental retardation met in our clinic made us approach this topic. We have chosen this study in order to reveal the benefit of multidisciplinary treatment of these children.

• assessment of children with cerebral palsy and mental retardation aiming an appropriate and individualized therapeutic plan.

• to draw a warning regarding the needs of therapeutic methods of children with cerebral palsy and mental retardation.

We studied 75 children diagnosed with cerebral palsy and mental retardation, evaluated between 2010-2011 in National Medical Center of Neuropsychomotor Rehabilitation for Children Dr. Nicolae Robanescu in Bucharest. Our methods were: observation, clinical interview with parents and children, Hamburg test and Portage guide.

In our sample there were 30 girls and 45 boys, 46,66% from urban region, 53,33% from rural region, 53,33% with moderate mental retardation, 33,33% with mild mental retardation and 13,33% with severe mental retardation. Multidisciplinary therapeutic approach (kineto therapy, ergo therapy, psychological intervention and medication) led to improvement in motor and psychic skills. Periodical evaluation at 6 month contributed to an appropriate therapeutic intervention.

Data from our study confirms that early diagnosis and therapeutic intervention lead to improvement in skills of children with cerebral palsy and mental retardation and implicitly a better life quality. The approach of these children problems in a multidisciplinary team is determinant for obtaining better performances.

It is commonly accepted that in most patients with schizophrenia external factors act on genetic predisposition to produce active psychotic symptoms. It is known that patients with schizophrenia have an abnormal peripheral autonomic response to psychological stress. We sought to characterize the brain activity patterns of such response in these patients.

We studied the pattern of brain activation in response to a mental arithmetic stress paradigm in 14 patients and 14 healthy subjects aged 18 to 50 years, using 3T-fMRI. A period of 6 minutes of resting state acquisition were followed by a block design with three 1-minute CONTROL task (one digit sum), 1 minute STRESS task (two digit substraction) and 1 minute rest after task. Data were analyzed with SPM and SPSS software.

While controls showed bilateral activation of hippocampi, parahippocampi, insulae, amygdalae, anterior cinguli and basal ganglia during mental stress, patients displayed less left hemisphere activation, specifically in insula, orbitofrontal cortex and frontal cortex, along with activation of pons. Moreover, patients did not show activation of hippocampi, parahippocampi and amygdalae.

After stress healthy subjects recovered its basal pattern. However, patients showed sustained activation of right posterior cingulum and temporal pole, along with bilateral orbitofrontal cortex, frontal cortex, precuneus, cuneus and angular gyrus for the observation period.

Present results suggest that abnormal activation of limbic structures underlies extensively documented peripheral autonomic abnormalities in patients with schizophrenia. Abnormal fronto-temporal connectivity may be the pathophysiological link for these results.

Perfectionism trait is commonly viewed as a personality style characterized by striving for flawlessness and setting of excessively high standards for performance which is accompanied by a tendency to be overly critical of one's behavior. Perfectionists are more likely than non-perfectionists to experience several kinds of stress in a variety of forms. Thus, the link between perfectionism and stress in influencing emotional distress /psychopathology can be quit complex.

1. 1) to analyze the association between perfectionism dimension and stress vulnerability;

2. 2) to explore the relation between perfectionism dimension and other stress related mechanisms (for example, coping and social support).

217 students filled in the Frost Multidimensional Perfectionism Scale, the Questionnaire of Stress Vulnerability, and four items to evaluate stress related mechanisms.

We found positive associations between maladaptive dimensions of perfectionism and stress vulnerability (from r=.181, p< .005 to r=.661, p< .005). The adaptive dimensions of perfectionism are not significantly associated with stress vulnerability. These results confirm that only maladaptive perfectionists are more vulnerable to stress. Doubts about actions and concerns over mistakes (perfectionism dimensions) showed significant and positive association with all the dimensions of stress, and are negatively related with the social support.

Only the maladaptive perfectionists are more vulnerable to stress, find life events as more stressful and obtain less social support from others. Maladaptive perfectionism dimensions, in particular self-critical perfectionism might have an important role in stress generation.

Perfectionism has been a topic of increased interest in recent years. Findings from the literature have shown that perfectionism is associated in the development and maintenance of a wide range of psychopathological conditions.

1. 1) to analyze the psychometric properties of the Portuguese version of the Frost Multidimensional Perfectionism Scale (FMPS);

2. 2) to explore the associations between perfectionism dimensions and positive/negative affectivity.

217 students from two Portuguese Universities filled in the FMPS and the Profile of Mood States (POMS). A subgroup (n=166) completed a retest of the FMPS with a four weeks interval.

Scale reliability was good (Cronbach alpha = .857). Corrected item-total correlations ranged from .019 and .548, and were higher than .2 for most of the items. Test-retest reliability suggested a good temporal stability for FMPS total score (r=.765). A principal component analysis with Varimax rotation was performed and based on Scree plot, two robust factorial structures were suggested (four and six factors). The more maladaptive dimensions of perfectionism were significantly and positively associated with negative affect and negatively associated with positive affect. Depression and anxiety/hostility dimensions are both positively associated with concern over mistakes (respectively, r=.338, r=.360, p< .01), parental criticism (respectively, r=.180, r=.254, p< .01) and doubts about actions (respectively, r=.312, r=.189, p< .01). An unexpected result was the positive association with personal standards dimension (respectively, r=.178, p< .05; r=.204, p< .01).

The Portuguese version of FMPS showed good reliability and internal consistency. The perfectionism personality trait is associated with mood states.

Early environmental risk factors have a role in the development of violent behaviour in adulthood.

The aim of the study was to assess the impact of childhood trauma, expressed violent behaviour as a child, co morbid personality disorder and substance abuse on self reported interpersonal violence as an adult in suicide attempters.

A total of 161 suicide attempters were diagnosed with SCID I and II and assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6-14 years of age) and during adult life (15 years or older). A standard linear regression analyses was conducted with the two predictive KIVS subscales exposure to violence as a child and expressed violent behaviour as a child, Axis 1 mood and anxiety disorder diagnosis, co morbid substance abuse diagnosis, co morbid personality disorder diagnosis, age and gender as predictors of expressed interpersonal violence as an adult.

The regression model was significant with adjusted R square 0.22, F ratio 7.2, DF=7, p< 0.0001. Expressed violent behaviour as a child and personality disorder were significant predictors of expressed interpersonal violence as an adult. Broken down by gender expressed violent behaviour as a child was a significant predictor of violence as an adult in both men and women, whereas exposure to violence as a child and personality disorder predicted violence as an adult only in men.

It is important to take into account expressed violent behaviour in childhood in violence risk assessments.

Behavior disorders (addiction, eating disorders) which the teenagers suffer would come from a dysfunction from the early relations and an installation of mental representations of the attachment relations marked by insecurity, discontinuity and Separation Anxiety (SA). Quality of the early and current relations of attachment is going to influence the process of adolescence, which is connected to a second period of separation-individuation. Nevertheless, the SA of the adolescents remains a very rare and unknown diagnosis.

This study evaluated the relationship between cannabis abuse or dependence (A/D) and family functioning in adolescent cannabis users.

A sample of 336 adolescents filed up the questionnaires about frequency of their cannabis use, SA symptoms in adult populations, dysfunctional separation-individuation process in early adolescents, parental types perceived by the children and depression symptoms.

Cannabis A/D adolescents got significantly higher scores than non-cannabis A/D adolescents at the Anxiety Separation Adulthood (p < 0,005) and lower scores at the “care” subscale about parents representations (“mother” p < 0,01; “father” p < 0,001). The logistic regression analysis highlighted that SA disorders and care were significantly encouraging cannabis A/D.

The cannabis use would be a solution hindering the SA disorder's unbearable feeling. If a successful separationindividuation allows autonomy, the results have shown that cannabis would dress the individuation problem. Thanks to the substance the adolescent can express his personality and differentiate himself from the others by a marginal behavior.

Cognitive Adaptation Training Cognitive Adaptation Training (CAT) is a treatment that circumvents cognitive impairments by rearranging the environment to support, prompt and sequence appropriate behaviours. CAT has shown promising results, including improved social functioning. As yet, no reports have appeared on the use of CAT in combination with Assertive Community Treatment (ACT).

To evaluate the effect of CAT in comparison with ACT, focusing on social functions (primary outcome), symptoms, readmission, and quality of life of outpatients with schizophrenia.

To conduct a randomised clinical trial to test the effect of CAT compared to ACT on primary and secondary outcome.

From January 2009 to September 2010, 62 patients from three early intervention centres (where ACT was a principal part of the treatment) were enrolled in a randomised clinical trial. The effect of CAT was assessed at six and nine months.

The results indicated no significant difference between intervention group and control group at six and nine months for any outcome. The results indicated no significant difference on primary outcome GAF-F at six months (p= 0.32) or nine months (p= 0.34).

The results from this trial differ from previous CAT trials; this is the first trial without significant results in comparison with treatment as usual. However, the low number of patients in the trial may have resulted in accepting a false null hypothesis, giving a type II error. Further studies are needed to determine if some elements from CAT can make ACT more economically effective.

The previous neuropsychological studies have pointed to a significant understanding of the neurobiological correlates of Post Traumatic Stress Disorder with deficits in the functions of the intellect.

To establish the existence of intellectual changes in war veterans with developed PTSD and their relationship to PTSD.

War veterans are divided into two groups: Group A, war veterans with PTSD and “B” groups, veterans without PTSD. Were used:

1. - Wechsler's Adult Intelligence Scale (WB-F2)

2. - Trauma Questionnaire (UT-PTSD)

Questionnaire-socio-biographical data promjena u intelektualnom funkcionisanju.

The severity of stress and severity of post-traumatic stress disorder is directly associated with the intellectual functions. War veterans, who had more severe traumatic experience, with a strong and destructive PTSD compared to veterans without PTSD had significantly lower ratio of general, verbal and non-verbal intelligence quotient of mental efficiency, a high level of mental deterioration with significantly pronounced oscillations in intratest and insidetest variability. Veterans with PTSD showed significantly lower scores in the immediate memory capacity, efficient attention, concentration under conditions of mental activity, visual perceptual skills predicted exactly bit of trivial things, of associative elasticity of thinking and short-term learning abilities.

These results suggest that deficits in the intellect, are not primarily the result of low intelligence, of premorbid states, but it occurs under the devastating impact of PTSD, which influencing changes in certain centers in the brain and changes in intellectual functioning.

Our aim was to asses the severity of trauma experiences, cognitive impairs, depressiveness and anxiety of war veterans who suffered from posttraumatic stress disorder (PTSD).

A sample consisted from war veterans who were clinically treated because of PTSD (n=50) and healthy controls who accepted to participate voluntarily in this study (n=54) who were recruited in local association of war veterans. We used Harvard trauma questionnaire (HTQ) for assessment of PTSD, Hopkins Check Scale SBCL 25 for assessment of depressiveness and anxiety, and mini mental status (MINI) for assessment of cognitive impairs.

Mean age of tested subjects was 50.6 (SD=5.2) years, with no significant differences between groups: PTSD group was 50.3 (SD=6.0) years and no PTSD group was 50.9 (SD=4.4) years (df=1, F= 0.337, P= 0.563, ANOVA). War veterans who were treated from PTSD reported significantly more multiple trauma experiences 21.9 (SD=5.7) than their peers without PTSD 13.7 (SD=5.8)(F=52.213, P< 0.001, ANOVA). The score of severity of cognitive impairs was significantly lower of PTSD group. 22.6 (SD=3.7) than veterans without PTSD 26.6 (SD=2.1) (F=47.028, p< 0.001, ANOVA). War veterans with PTSD had significantly higher severity of depressiveness 3.0 (SD= 0.5) and anxiety 3.2 (SD= 0.6) than their peers without PTSD (1.4±0.4; 1.7±0.5, respectively) (F=241.979, p< 0.001; F=193.021, P>0.001, respectively, ANOVA).

War veterans who were clinically treated from PTSD reported significantly more trauma experiences, they were more depressive and anxious and also they were more severe cognitive impaired, than their peers who did not suffer from PTSD.

This research aims to evaluate psycho-emotional challenges for older adults and the relevance of person-centered therapy (PCT) for older adults.

Forty senior adults, aged above 65 years (M = 71.7; SD = 4.6) were assessed with the the Self-Esteem Scale (‘SES’) and the Mini-Mental State Examination (MMSE). Socio-demographic data, including gender (57.5% women), marital status (37.5% married) and education (39.2% mandatory school) were also assessed. Bivariate associations were performed.

Results yielded a set of five descriptive categories that captured the distinct ways older adults perceived psychoemotional challenges and that reflected the individual's perceived importance of PCT: ‘time perspective’, ‘the aging body’, ‘autonomy and control’, ‘cognitive endurance’ and ‘loss and reminiscing’. Regarding bivariate associations, results indicated that ‘autonomy and control’ was associated with the ‘aging body’ (r=.552, p< .001) and ‘cognitive endurance’ with ‘time perspective’ (r=.425, p< .001). This latter was also associated with ‘loss and reminiscing’ (r=.616, p< .001).

This study highlights the importance of PCT for older adults facing psycho-emotional challenges in old age. Interventions with older adults may benefit from clearly understanding older adults’ specific issues as an important component for promoting successful aging and reducing health disparities.