Many children experience severe anxiety symptoms that lead to impairment in daily functioning (Albano, Chorpita, & Barlow, 2003). Anxiety disorders are among the most common psychiatric problems experienced by children and they appear to remain stable and problematic for many youngsters throughout childhood and adolescence. About 13 of every 100 children and adolescents ages 9 to 17 experience some kind of anxiety disorder; girls are affected more than boys. Various parenting styles have been associated with the development of a wide range of anxiety disorders.

This study will look at correlations between parenting styles and symptoms among children with symptoms of anxiety disorders, at the Child/Adolescent Clinic of Psychiatry at University Hospital Center “Mother Teresa”.

Families participating in this observational study completed different parent and child questionnaires during the first study session. The child questionnaires asked for information regarding the child's feelings and family interactions. Parent questionnaires asked for information about their own personal feelings as well as the child's feelings, symptoms, and behaviors. Age range was between 6 to 17 years, 58% of them was female. Exclusion criteria were mental retardation, current or past diagnosis of autistic spectrum disorders, current or past diagnosis of psychotic disorders.

There was a significant statistical correlation between overprotective parenting and number, intensity and severity of anxiety symptoms.

Results of this study may contribute to the future treatment of children with anxiety disorders.

The role of general hospital in dealing with patients following suicide attempt has been discussed considerably lately.

Of the present study is the epidemiological record of referrals characteristics following suicide attempt.

36 of 256 patients referred to the specialist liaison team of the Psychiatric Department, 16-62(M = 33.6 ± 14.5) years old.

Psychiatric interview and record of demographic characteristics of the sample was used. Statistics analysis was undertaken using SPSS.16.

13 men and 26 women. 36 were pathological cases with drug poisoning, 1 deliberate self-harm case with the use of sharp object, 1 fall and 1 deliberate self-harm with the use of gun. 15 diagnoses by ICD10 were recorded, with the majority of the patients suffering from adjustment disorder (47.8%), while 7, 9% had no psychopathology. 5 were admitted in the psychiatric ward, 8 needed psychiatric follow up, 5 psychological support, 2 were prescribed combination therapy, 4 pharmacotherapy, 2 were transferred to outpatient special unit, to 5 no treatment was recommended, and 6 refused admission. There was statistically significant difference (t = 3.756 p = .001), between average ages of individuals committing suicide attempt with psychopathology (M = 42.1 ± 13.5) and no psychopathology (M = 26.8 ± 11.5), but not between genders (t = -.355 p = .725). Gender is irrelevant to psychopathology existence (x2 = 9.506 p = .301) and treatment (X2 = 4.625 p = .201). Increased attempts were observed for both genders and psychopathology existence but not statistically significant (x2 = .056 p-.832) and (x2 = .165 p = .303) respectively.

The major percentage of adjustment disorders agrees with the common percentages of bibliography. The wide range of interventions reflects the psychosocial model.

To assess alcohol abuse severity of soldiers who suffer from Post-traumatic Stress Disorder (PTSD) during the Bosnia- Herzegovina 1992-1995 war.

A stratified sample was composed of 4 war veterans groups: (A- who asked for psychiatry help during the war, n = 51; B- who continued psychiatry treatment and after the war, n = 51; C- who did not ask for psychiatry help at all, n = 62; Dindustry workers who were not involved in war activities, n = 50). We used DSM IV trauma questionnaire; questionnaire for alcohol dependency self-assessment.

During the war, 45.4% participants in A, 40.0% in B, 32.8% in C and 14.0% in D group, drunk alcohol more often than before war, while 20.8% of participants in A, 25.5% in B, 27.9% in C and 54.1% in D group drunk alcohol less than before war. Ten months after the war, 58.0% of participants in A, 31.6% in B, 20.0% in C and 20,0% in D group drunk alcohol more than usual, while 18.0% of veterans in A, 36.8% in B, 38.3% in C group and 37,8% workers in D group drunk alcohol less than usual. Upon departure to execute of combat missions to front lines war veterans from A group and B group drunk alcohol beverages significantly more than usual (51.7% and 40,5% respectively).

War veterans who bear traumatic experiences with difficulties, with more severe symptoms of PTSD were significantly more consumed alcoholic beverages during the war and the execution of combat missions.

Schizophrenia is a chronic severe psychiatric disorder with multiple environmental and genetic determinants. Several reports indicate the possible role of immune system dysregulation in the pathogenesis of schizophrenia. An accumulating body of evidence indicates an association of schizophrenia and its psychopathology with altered cytokine production. The variation of the level of cytokines might be partly due to their functional gene polymorphism.

The study was carried out to investigate the association of schizophrenia with the following cytokine polymorphisms: IL-2 (-330T/G), IL-6 (-174G/C), IFN-gamma (+874 T/A), TGF-beta (+869 T/C and +915 G/C).

We included 130 patients diagnosed with schizophrenia and 184 controls in our study. The patients were evaluated for lifetime psychotic symptomatology using the Operational Criteria for Psychotic Illness (OPCRIT) checklist. The patients having history of traumatic brain injury, neurologic disorders, substance abuse or immune related diseases were excluded from the study by detailed medical examination.

The polymorphisms were in HWE both in the cases’ and controls’ groups. In single marker analysis, we did not find an association for the tested polymorphisms.

Our data do not support the role of IL-2, IL-6, IFN-gamma and TGF-beta gene polymorphisms in the predisposition to schizophrenia in the Polish population.

National association of experts dealing with psychiatry in our country named Psychiatric Association of Bosnia- Herzegovina (PABH) was formally started with its work on March 17th 2008, as the first national associations in the post-war Bosnia-Herzegovina (BH). Since 2009 has been actively promoted and profiling as one of the best organized professional associations in BH. Recognition on the international level and the active role of the PABH substantially achieved in 2010 in the World (WPA), and from 2011 in European (EPA) Psychiatric Association. The Third Congress of Psychiatrists of BH with international participation is the first in a series of future Congresses organized by PABH with the full support provided by EPA and WPA.

To show importance of the roles of EPA and WPA for the future PABH achievements.

A retrospective review of the significance of the PABH collaboration with major psychiatric association both nationally and internationally through the documentation and archives of the PABH development.

The PABH is included in major psychiatric events in the country (active participation in the organization, logistics and scientific programme) and had strong collaboration with EPA and WPA, particularly on the national Congress in Tuzla 2012.

The PABH is the leading BH psychiatric association, an active member of the most important international organizations, with a continuous increase of the number of members who recognize the importance, relevance and quality of the PABH and further progress in its development and tendencies to harmonize psychiatric practice in the country and internationally.

Augmentation treatment has been the subject of several studies in treatment-resistant obsessive compulsive disorder (OCD). We hypothesized that medications with a dual action on the melatoninergic and serotoninergic systems may be of use in treatment-resistant OCD.

In this open label study we investigated the efficacy and safety of agomelatine augmentation in treatmentresistant OCD.

Twelve patients, aged 18–50, fulfilling OCD criteria, with no response to a 16-week or longer treatment with a selective serotonine reuptake inhibitor (SSRI) at the indicated dose, were assigned to receive agomelatine augmentation. Subjects were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and were screened for treatmentemergent side effects at baseline, week 8 and week 12 of treatment.

The overall Y-BOCS score fell during the duration of the study (all comparisons among baseline, 8th week and 16th week were statistically significant, p < 0.01). On the obsession Y-BOCS scale a drop was noted, which led to statistical significance at the 16th week of the study (p < 0.05). Regarding the compulsion Y-BOCS scale a drop was also noted, particularly from baseline to the 8th week of the study (p < 0.01). Dizziness (16.6%) and headache (8.4%) were the most often reported side effects of treatment.

Agomelatine could be efficacious and well tolerated as an augmenting agent in refractory to treatment OCD. Further controlled studies are warranted to explore the efficacy of agomelatine, as well as the potential role of circadian rhythm modulation both in the pathophysiology and treatment of OCD.

Since 3000 B.C. Man has been trying to classify mental disorders. However, there is still much to be done and the differential diagnosis of psychotic disorders remains one of the greatest challenges in modern psychiatry.

We aim to improve the differential diagnosis of psychotic disorders, namely by rethinking schizophrenia spectrum disorders as syndromes whose hallmark are not delusions or hallucinations.

We present the clinical report of a 57 year old woman admitted in our unit who was diagnosed with maniac type schizoaffective disorder. Her previous medical records documented different diagnosis, namely schizophrenia and bipolar disorder. Hence, we attempt to understand the evolution of classification systems, how clinical practice deals with these systems and how the future DSM-V and ICD-11 may correct existing flaws.

We demonstrate that the definition of psychotic symptom should be restricted to delusions and/or hallucinations, thus there is a need to rethink the core symptoms of schizophrenia spectrum disorders. Furthermore, the assessment of a patient should always take into account the longitudinal development of the disease, retrieving one of Kraeplin's concepts. We found conflicts between the existing classification systems and extraordinary shortcomings, such as a 50% chance of failure of DSMIV temporal diagnostic reliability.

Current clinical practice continues to give much emphasis to research on delusions and hallucinations - contradicting Bleuler's concepts - and neglecting other dimensions - cognitive dysfunction, disorganization and negative, affective and motor symptoms. The integration of these symptoms in stable diagnoses remains a challenge.

High rate of depression and suicide found in alcoholics. Low total serum cholesterol is related with suicidal behavior, impulsivity and depression. Alcoholics have elevated serum triglycerides and LDL cholesterol, but lower values of HDL-cholesterol.

To investigate the serum cholesterol levels and differences between secondary depressed and non-depressed alcoholics biochemical blood tests were performed.

A total group of eighty six non-cirrhotic male primary alcoholics, without malnutrition was recruited during inpatient treatment. After 4 weeks alcoholics were divided in the depressive (DA) group and non-depressive NDA group according the Hamilton Depression Rating scale- HAMD cut-off score under 8. Biochemical blood tests were performed for all participants on admission and retrospectively were analyzed. Differences between groups were tested by Student t-test.

There were not significant difference among groups for demographic and biochemical serum parameters. The DA group showed lower level of total serum cholesterol (5,9 ± 1.24) than NDA group (6.4 ± 1.20) on admission, with values between normal rang (3.63-6.7 mmol/l) p = 0.072.

The group of depressive alcoholics showed trend of lower level of total serum cholesterol on admission. It would be useful to investigate low serum cholesterol as possible predictive factor of secondary depression among alcoholics.

Suicide is a major global social and public health problem. Drug abuse is considered a significant risk factor for suicidal behavior. Research evidence suggests that some drug addicts may be more likely to engage in suicidal behavior.

The aim of this study was to describe the characteristics of drug-dependent individuals who committed suicide.

The social and demographic profiles of drug-dependent individuals who committed suicide in Belarus between 1995 and 2010 were investigated.

The use of illicit drugs has increased dramatically during last two decades in Belarus. Suicide is the fifth leading cause of death among drug-dependent population in this country. 92 suicide cases (84 males, mean age 34.9 ± 1.2 and 8 females, mean age 35.6 ± 1.4) among drug addicts in Belarus from 1995 to 2010 were registered. 92.4% of suicide victims used opiates. 53.3% of drug addicts had a criminal record. The majority of suicide victims (68%) suffered comorbid disorders. The most common disorders were viral hepatitis (30%), HIV (20%) and alcohol dependence (18%). 95.7% of drug addicts have committed suicide by hanging.

A number of risk factors for suicide such as opiates use, comorbid disorders and criminal activity among drugdependent individuals have been identified. It is important to identify those individuals with drug dependence that might be at particularly high risk for suicide.

Although the participant number in online role-playing games (MMORPGs) increase significantly, international validated instruments to assess excessive gaming are lacking.

Apart from sociodemographical data and behavioral gamer patterns, 3 different addiction scales were therefore tested in 453 French adult MMORPG gamers recruited during 10 consecutive months to determine characteristics, online habits and problematic overuse. The DSM-IV-TR substance scale (adapted for MMORPG and named DAS), the qualitative Goldberg Internet Addiction Disorder scale (GIAD) and the quantitative Orman Internet Stress Scale (ISS) were analyzed.

The 453 participating adult gamers were typically young adult graduates living alone in urban areas. For all scales, cyberdependence were high (respectively 27.5%, 44.3% and 32.5%). The DAS appeared as a pertinent discriminating instrument as DAS dependent gamers had a 3 times increased tolerance phenomenon, declared significantly more social, financial (OR:4.85), couple (OR:4.61), family (OR:4.69) or work difficulties (OR:4.42) than non-dependent gamers. Furthermore, they were 3 times more irritable, having more daytime sleepiness and more sleep deprivation to play.

The results highlight that the DAS did not overestimate proportion of online video gamers addicted and was associated with several behavioral disorders such as low mood, emotional changes, disturbance of sleep. This study confirms the necessity of setting up a relevant prevention program against MMORPG overuse (Achab et al., 2011, BMC Psychiatry, PMID: 21871089).

Delirium affects 11% to 47% of post-operative cardiac surgery patients and is associated with higher mortality and morbidity rates. However, the pathophysiology of this syndrome is largely unknown.

To investigate whether increased concentration of pre- and postoperative plasma cortisol predicts the development of delirium after coronary artery bypass graft surgery (CABG). Secondly, to assess whether the association between cortisol and delirium is stress-related or mediated by other pathologies, such as major depressive disorder (MDD) or cognitive impairment.

The patients were examined one day preoperatively with Mini International Neuropsychiatric Interview and Montreal Cognitive Assessment to screen for depression and cognitive impairment, respectively. Blood samples for cortisol levels were collected both pre- and post-operatively. The Confusion Assessment Method was used within the first five days postoperatively to screen for a diagnosis of delirium.

Postoperative delirium developed in 36% (41of 113) of participants. Multivariate logistic regression analysis revealed two groups independently associated with an increased risk of developing post-operative delirium:

1. 1) Those with pre-operatively raised cortisol levels and

2. 2) Those with a pre-operative diagnosis of MDD associated with raised levels of cortisol post-operatively. According to ROC

Raised peri-operative plasma cortisol concentrations are associated with delirium after CABG surgery. This may be an important pathophysiological consideration in the increased risk of post-operative delirium seen in patients with a preoperative diagnosis of MDD.

The subclinical behavioral and psychological characteristics of schizophrenic children have not been sufficiently investigated to present specific evidences .To elucidate the picture of them, and to find out indicators which predict later development of schizophrenia, childhood behaviors of the adult schizophrenia subjects were investigated in a questionnairebased retrospective study.

Schizophrenia outpatients (n = 50) in his/her twenties and normal healthy subjects (n = 200) were investigated. All patients are diagnosed according to DSM-IV-TR as schizophrenia, and who present now mainly negative symptoms after passing an acute stage. By modified use of the CBCL (Child Behavior Checklist) as a retrospective assessment questionnaire, the parents of the patients and of control subjects rated their childhood behavior.

Among eight syndrome scales of the CBCL, those of “Withdrawan”, “Anxious/Depressed”, “Social problems” and “Attention problems” were significantly associated with schizophrenia, although any of these scores were not in clinical range. The hit-rate when classifying the schizophrenic and normal subjects by discriminant function using all items of CBCL totaled 94%.

The results suggested that subclinical characteristics of schizophrenia already exist in the patients’ childhood. With some assessment tool using the obtained discriminat function, the quite early detection of schizophrenic children seems possible.

Social anxiety disorder represents a substantial public health problem because is a relative common mental disorder and has a high prevalence and lifelong chronicity. The fact that serotonergic agents is considered to be effective for its treatment suggests that patients may have an abnormal serotonergic neurotransmission. Selective serotonin reuptake inhibitors are effective in the treatment of social anxiety disorder and are currently perceived as the pharmacotherapy of choice.

We investigated the efficacy and tolerability of escitalopram in the treatment of generalised social anxiety disorder.

Patients with generalised social anxiety disorder were randomised to receive placebo (n = 61) or10-20 mg escitalopram (n = 60) in a 12-week, double-blind study. The primary outcome measure was the mean change from baseline to last assessment in the Liebowitz Social Anxiety Scale (LSAS) total score.

The study showed a statistically superior therapeutic effect for escitalopram compared with placebo on the LSAS total score (p = 0.005).There were significantly more responders to treatment for escitalopram than for placebo (68% v. 28%; p < 0.005). The clinical relevance of these findings was supported by significant reduction in the work and social components of the Sheehan Disability Scale and by the good tolerability of escitalopram treatment.

These data suggest that escitalopram was efficacious and well tolerated in the treatment of social anxiety disorder. Further studies are needed on larger groups of patients to certify these results.