Eating disorders (EDs) and alcoholism are frequently co-occurring in the presence of other psychiatric and personality disorders. Eating-disordered patients are already at an increased risk for morbidity and mortality, so alcohol and other drug use pose additional dangers for these patients. Particular personality traits, such as impulsiveness, have been connected to both eating disorders and alcohol/drug abuse.

To present case-reports of EDs with comorbid alcohol abuse and a review study regarding the theme available in Medline.

Brief literature review.

Three case-reports are presented and literature of this theme shortly reviewed.

The authors present three cases of adult females followed up in our Department with EDs (restricting anorexics and bulimics) and alcoholism that have already tried many detoxifications with no success.

Literature research has demonstrated that there are several similarities between the physiological conditions and mechanisms of addictive conditions, such as EDs and Alcoholism. Restricting anorexics, binge eaters, and bulimics appear to be distinct subgroups within the eating-disordered population, with binge eaters and bulimics more prone to alcohol.

Personality traits such as impulsivity have been linked to both bulimia nervosa and substance abuse. Many researchers have proposed that an addictive personality is an underlying trait that predisposes individuals to both eating disorders and alcohol abuse. More studies are needed to understand psychobiological mechanisms of this comorbidity, and to develop treatments for individuals with comorbid eating disorders and substance misuse.

Analysis of credibility verbal statements represents an important part of forensic psychological evaluations. Currently there are several main methods for evaluating the content of verbal statement to estimate credibility of the statement.

The objective of the present study was to compare the main methods for credibility analysis of verbal statements in the Czech language. This is the first study in this area in the Czech republic.

We examined a group of non-psychiatric adult population with at least average intelligence and no cognitive impairments (n = 150) within classical credibility analysis setting - a part of the group (n = 75) exposed to a scene, the second part of the group (n = 75) was not exposed, but they were just told what happened. Further they were interviewed by independent psychologists. The methods of Statement validity assessment (SVA), Reality monitoring (RM) and Scientific content analysis (SCA) were used to detect those who experienced the situation and those who did not. The analysis of the statements was done in a double blind setting.

SCA and RM methods proved 85% (p < 0.01) success while SVA analysis only 65% (p < 0.01).

This pilot study supports validity of use of RM and SCA methods for analysis of credibility of verbal statements in adult non-psych iatrical persons in the Czech language, while in agreement with previous findings the method of SVA seems not to be suitable for adult persons.

Cocaine induced psychosis (CIP) is common but not developed in all cases. Many risk factors have been linked with CIP. A lifetime diagnosis of ADHD has been associated with the categorical presence of CIP.

The objective of this study is to determinate the relationship between impulsivity and impulsivity-realetd disorders (BPD, BN and ADHD) and CIP.

We study the presence of psychotic symptoms using a clinical interview for psychotic symptoms in a large sample of cocaine-dependent patients. Patients suffering from schizophrenia or bipolar disorders were excluded. Finally we included 287 patients in the study.

A structured interview about psychotic symptoms were systematically conducted. The Structured Clinical Interview for DSM IV Axis I and Axis II disorders were used in order to identify the comorbidity. CAADID-II (Conners’ Adult ADHD Diagnostic Interview for DSM-IV) were used in order to identify ADHD comorbidity. Barrat impulsivity scale were used for evaluate impulsivity.

BIS total were 63.78. We identify a significant association between CIP and BIS cognitive subscale p < 0.003 and BIS total p < 0.021. We also identify a significant association between CIP and adult ADHD in cocaine-dependent patients p < .0.002. We fail to identify association between CIP and BPD and BN.

CIP is related with BIS cognitive subscale and BIS total scores, and with ADHD comorbidity in cocaine-dependent patients. As well these findings could be useful for a clinical approach to the risks of psychotic states in cocaine-dependent patients.

Liaison psychiatry is the branch of psychiatry that specialises in the interface between medicine and psychiatry. The liaison psychiatrist uses a wide range of drugs and antipsychotics are among them.

To analyse the prescription of antipsychotics at the liaison psychiatry service of a general hospital.

This is a transversal study. All patients evaluated by the liaison psychiatry service of a general hospital from the 1/01/2012 to the 31/05/2012 were included.

The sample consisted of 128 patients (53’1% women; mean age 65’34±17’18). The majority of them were Spanish (92’2%). Internal Medicine was the service who asked for more psychiatric evaluations, followed by General Surgery (19’5%) and Nephrology (10’2%). The most frequent main complain was depression (46’9%), behavioural disorders (18%) and anxiety (10’2%). The diagnosis given were more often affective disorders (43’8%), delirium (11’7%), psychotic disorders (10’9%) and anxious disorders (9’4%).

Within the 128 patients, 34 (26’6%) did receive antipsychotics during the admission. We compared the two groups (antipsychotic group vs non-antipsychotic group) and obtained the following results: we found that the antipsychotic group more often had behavioural disorders (34’3%) and delusions/hallucinations (20%). A significant increase in delirium diagnose was to be seen (42’9%).

Antipsyhotics are the second most used treatment at the liaison psychiatry service. Patients who receive them are more often affected by delirium and to a minor extent by a psychotic disorder. The first generation antipsychotics such as haloperidol still are the first option. However, the use of second generation antipsychotics is increasing remarkably.

To investigate the effects sex and age on the methylphenidate HCl treatment in adult ADHD.

Sixty ADHD subjects were included into the study aging between 18 and 60 years. Levels of N-acetyl aspartate (NAA), creatine and choline in anterior cingulate cortex, cerebellum, striatum and dorsolateral prefrontal cortex were measured with magnetic resonance spectroscopy. Then, 10 mg oral methylphenidate HCl was given to the subjects and the same metabolite levels were measured after an interval of 30 minutes.

Twelve (20%) of the subjects were women and 48 (80%) of them were men. Age distribution of subjects is as follows: 15 were between 18–24 years, 26 were between 25–30 years, 19 were older than 30 years. No difference was determined between NAA levels before and after methylphenidate in both sexes. Creatine levels were determined higher after methylphenidate in women in prefrontal cortex and in men in cerebellum. Choline levels were determined higher after methylphenidate in women in striatum. NAA levels were determined higher after methylphenidate in prefrontal cortex of 18–24 years old age group and in striatum and cerebellum of 25–30 years old age group. Creatine levels in striatum after methylphenidate were determined higher in 18–24 years old age group than 25–30 years old age group. No difference was determined between choline levels before and after methylphenidate in each age groups.

It is thought that pharmacotherapy can be effective on brain metabolites and this effect can vary upon sex and age.

Current study shows that there may be a relation between specific personality and psychopathological traits of parents or foster caregivers and children development.

The objective of the present study was analyze whether there are any specific relations between personality or psychopathological traits of parents or foster care givers and any signs of child development.

We examined a group of children from biological families (n = 100) and a group of children from foster families (n = 100) - cognitive and socio-emotional development was evaluated. We also examined personality and psychopathology of both parents or foster.

We found statistically significant relation (p < 0.01) between slower intellectual development of children and depressive and neurotic traits of parents and foster care givers. This finding supports a hypothesis that depressive parent or care giver may substantially influence child development.

Irritable Bowel Syndrome (IBS) is characterised by persistent symptoms in the absence of structural abnormality.

To discover if people with IBS exhibit atypical patterns of attention to symbolic pain stimuli.

To investigate whether IBS is linked to enhanced engagement with pain words and slower disengagement.

Exogenous cueing was carried out with 20 IBS and 33 healthy participants. Participants responded to a dot following on the same or other side of the screen, allowing measurement of engagement and disengagement.

ANCOVAs were carried out. The IBS group engaged more with Pain and Social Threat words, and had greater difficulty in disengaging from Pain but not from Social Threat (see Figures 1 and 2). Difficulty in disengaging from Pain was linked to greater symptom severity.

Throughout the ages there has been an association between music and the various ways in which it can affect one's mood. More recently there have been scientific revelations on how music can affect the body, on a physiological level. There are correlations between physiological changes (neurotransmitters and hormones) and psychological states of being (fear, positivity). We present here some considerations on the relevance of this for mental health therapies.

To gather and evaluate research which has already been carried out regarding the effects of music on the body and mind.

To present an in-depth discussion on the ability of music to affect our physiology and correspondingly altering the psychological state. To then highlight some areas where this information may be relevant for potential psychiatric interventions.

Knowledge will be acquired in this area through literature review and prominent books on the subject.

Different types of sound vibration have been distinctly linked to certain psychological states such as focus, peacefulness, aggression, confusion etc, which have corresponding physiological changes brought about by neurotransmitters and hormones. This information coupled with an understanding of the study of psycho-neuro-immunology, indicates that music is a very powerful mover of psychology and emotions.

Music and sound vibration are potentially very powerful tools if understood appropriately. There is a deeply scientific basis for how music can affect the physical, psychological and emotional aspects of a person. Exposing service user to certain types of music could potentially provide an adjunct to conventional psychiatric intervention.

Evidence associates alexithymia with a range of psychopathology including, in particular, depression.

To investigate whether alexithymia is linked to enhanced levels of dysphoric salience in the individual's environment.

To determine whether item selection among individuals with lower and higher levels of alexithymia is sensitive to euphoric and dysphoric linkages.

A set of items was selected by each participant (N = 106), and for each item its perceived value established via the relation v(i, n) = (n - i)/(n - 1). A set of five affective saliences was elicited for each item.

Regression established that whereas perceived values for lower levels of alexithymia were associated with emotional comfort and past happiness, for higher levels they were associated with present sadness (Figures 1 and 2).

Fig. 1

Low alexithymia: Standardized dependence of perceived value on affective saliences (*p < .05)

Enhanced salience of present sadness in the judgements of those with higher alexithymia levels may play a role in depression.

Anticholinergic side effects of antipsychotic drugs has long been known. Although dry mouth and constipation due to the anticholinergic side effects are common, dry eye has not been reported in the literature as far as we investigate.

A 41-year-old, married, with two children, male patient. Outpatient clinic follow-up were performed for five years with a diagnosis of psychosis with complaints of suspiciousness, agitation, restlessness, drowsiness, emotional numbing, insomnia and feeling guilty. He was in remission with the treatment of olanzapine 5 mg/day. The patient was admitted with the complaints of eye blinking, eye burning sensation, sensitivity to light increasing over the past year.

We discussed treatments applied after the development of dry eye, clinical course and whether or not ocular dryness was due to the use of antipsychotic in a patient using olanzapine 5 mg/day for five years.

To our knowledge, antipsychotic-induced dry eye case has not been reported in the literature. We believe that our patient was a case of dry eye developed by antipsychotics.

Common side effects of antipsychotics as well as the side effects that are less common and less taken into account should be considered, they should be assessed in co-operation with other clinics and it should be noted that besides monitoring psychotic symptoms and signs, being vigilant in terms of the side effects and adverse events and following them is extremely important for the quality of life of patients.

To determine effect of massage and aromatherapy massage on Postmenopausal psychological symptoms.

In this Randomized Clinical Trial, 90 healthy volunteer menopause women, whom attended main referral gynecology hospital of Tehran University of Medical Sciences were involved in two Intervention and control groups (Year 2011) Aromatherapy massage received 30-min aromatherapy massage sessions with aroma oil, twice a week for four weeks, massage group, received same treatment with plane oil, and control group received no intervention. Tools have two main parts;

1. 1) Personal characteristics,

2. 2) Psychological symptoms scale, as obtained through psychological sub scale of Menopause Rating Scale, which was measured before intervention and at the end of interventions.

There were significant difference between participants’ pre-application and post-application psychological score in two intervention's groups (p < 0.001), whereas the score in the control group did not differ significantly. Also there were higher significant effect in aromatherapy massage (p < 0.001).

Results demonstrated that both aromatherapy massage and massage therapy were effective in reducing psychological symptoms during menopause, but the effect of aromatherapy massage was higher than massage therapy.

This study was supported by Tehran University of Medical Sciences (Vice Chancellor for Research), Year 2011–2012.

The Rorschach is a projective test frequently used in the forensic ambit for the information it can give in both the cognitive and affective areas. The purpose of our work is to identify the traits recurring in perpetrators of the “crime of impetus” through the examination of the psychometric indices of the Rorschach.

15 male subjects between 22 and 60 years (mean age = 43.2 ± 10.96 years) authors of murders, without previous psychiatric disorders, were tested; the control group was represented by 15 subjects without history of crimes. All protocols were collected and signed through the method “Scuola Romana Rorschach” and the scores of psychometric indices were compared between and within groups by Student's t-test.

From the cognitive point of view there were no significant differences concerning the sense of reality between the murderers and control samples (R+% = 75,87 vs 70,73; p = 0,241. F+% = 75,47 vs 76,93; p = 0,653), but the number of responses was lower than average (16,67 vs 25,27; p < 0,0001). The most significant differences in the murderers appeared in the G/M Index (G = 7,73vs9,35; p < 0,005. M = 2,37vs 1,00; p < 0,0001) and in the Impulsivity Index (0,96 vs 0,33; p=0,0002).

According to the most recent literature the Rorschach indices showed in the perpetrators of the “crime of impetus” the absence of mental disorders; however, the disproportion of the Index G/M and Impulsivity Index may indicate a “vulnerable anthropology” as a risk factor for impulsive crime in the presence of emotional stress.

It's known that adherence to treatment is a key factor in the treatment of addictions. The presence of comorbid substance dependence disorder and other psychiatric disorder is very high. Comorbid psychiatric disorders interfere with adherence to drug treatment and detoxification.

To analyze the percentage of patients who had a voluntary discharge to Hospital Detoxification Unit and to describe sociodemographic, clinical and diagnostic test characteristics.

We descriptively studied drug dependents patients admitted to our Detoxification Unit from June 2008 to August 2012. Data was gathered at admission on demographic (age), clinical (main abused drug, psychiatric comorbidities, polydrug users, binge consumption previous intake) and alcoholtest and/or urinalysis. Results from patients with and without voluntary discharge were compared.

The study sample included 469 patients (77.7% men, average age 38.3 ± 9). 10.7% of the patients had voluntary discharge. We found significant differences between voluntary discharge and the non-voluntary discharge group on younger people (37,6 vs 40,42,p < 0,05), on heroine as main drug of abuse (40% vs 13,4%, p < 0,0001) and psychiatric comorbidities (60,8% vs 39,2%,p = 0,02), being psychotic disorders (26% vs 13,6%,p < 0,02) and borderline personality disorder (56% vs 29,4%,p < 0,0001) the most significant. Also patients who had binge consumption previous intake (84% vs 56.6%,p < 0.0001) and patients with positive urinalysis(84% vs 58.2%,p < 0.0001) had more voluntary discharge. Patients with comorbid depressive disorders had non-voluntary discharge(6% vs 18.4%,p < 0.02).

Few patients had a voluntary discharge. Younger people, opiate dependence, having psychotic and borderline personality co morbidity, binge consumption previous intake and positive urinalysis might be considered as risk factors for voluntary discharge.

This controlled trial study, was performed on 152) healthy2- 4 months term infants, whom was brought to the health centers of west of Tehran for DPT vaccination and their parents filled in informed consent. (Year 2008–2010) By randomized collection infants divided to three intervention group (Breast feeding, Sucking pacifier and being in mothers hug, and each group had intervention 2 minutes before, during, and 15 seconds after the injection) and control group, whom lied on the examining bed as routine of clinics (38 in each group). Objective changes in appearance of Neonates were assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. Descriptive and inferential statistics were used. All ethical points were considered and approved by Research ethics committee of TUMS and had registered in Iranian Registry of Clinical Trials (IRCT).

Equality of age, gender and the time of feeding prior to vaccination were controlled. There were significant differences in Behavioral Pain Scores of four groups. (P < 0.0001) and routine group had highest pain score.

Breast feeding is more analgesic than pacifier use with maternal holding. Maternal holding had less effect, but had more significant effect than routine. It is suggested to use these simple interventions during infant's vaccination.

To evaluate the impact of the perception of body image on sexual activity of obese patients compared to a sample from the general population.

A cross-sectional case-control study. It involved 40 obese married patients (BMI ≥ 30 kg/m2) and 40 normal weight subjects of the general population. A questionnaire was presented with sociodemographic data, somatic and psychiatric personal histories and data on obesity. Besides, there were seven items assessing perception of body image and five items assessing the impact on sexuality.

The sex-ratio (men/women) of obese patients was 0.53. Obese women were less frequently satisfied with their body image than men (p = 0.002). Obese subjects were statistically more dissatisfied with their bodies than controls (p = 0.039). In Obese patients, avoidance of sexual intercourse was significantly related to dissatisfaction with body image (p = 0.025) and to the perception of unattractive body (p = 0.026). Sexual satisfaction was statistically correlated with the perception of a positive attracting body (p = 0.015). Sexual desire was statistically correlated to the satisfaction of body image (p = 0.019), positive perception of an attractive body (p = 0.017) and positive perception of a youthful body (p = 0.041). Sexual pleasure was correlated with the perception of an attractive body (p = 0.016).

The stigmatization of obese subjects leads to a weakening of the healthy perception of body and might be an obstacle to sexual fulfillment.

The concept of prodromal symptoms in schizophrenia is an old matter of debate. There have been reported several signs and symptoms that are considered to have a predictive value in a first psychotic episode, namely in the mood or anxious spectrums. However, these symptoms are not specific and can overlap with other disorders that have to be considered in the differential diagnosis.

To present a young adult with marked anxious symptoms, namely in obsessive-compulsive spectrum, and psychotic (subclinical) symptoms, questioning the extension of the comorbidity between anxious disorders and schizophrenia.

A case report is presented and a literature review of the theme is shortly surveyed.

The case report is about a 20 years old man, who have been developing for about two years obsessive thoughts of doubt concerning his sexuality, death and his mental health. Additionally, he described sensations of depersonalization, derealization and an intense distress that have been interfering with his function and daily activity. Several studies report substantial presence of anxious symptoms (including OCD symptoms) in schizophrenia, suggesting its early appearance in the development of the disease. Moreover, they can act as predictor of poorer outcome and may promote transition from psychotic symptoms to schizophrenia.

In schizophrenia prodromal stages, anxious symptoms may increase the risk and predict the development of psychosis disorder. On the other hand, the existence of mild psychotic symptoms can be present in neurotic disorders, witch compels clinicians to be cautious in the differential diagnosis that enclose these symptoms.

To evaluate effects of valerian extract on improvement of sleep quality in menopause women.

In this randomized, triple- blind, controlled trials 100 volunteer menopause women with age 50–60, who had insomnia and selected from 250 volunteers, had been visited in Public clinics of West of Tehran. Instrument includes demographic form and Pittsburg sleep quality index (PSQI). Samples randomly divided to two groups. Each group received twice a day for four weeks 530 mg of concentrated Valerian extract or 50 mg Starch as placebo in capsules.

Equality of personal characteristics and sleep quality before intervention were checked and there were no differences in two groups. Valerian led to significant decrease in average of PSQI in compared to placebo (Valerian before intervention: 9.8 ± 3.6, after one month intervention: 6.02 ± 2.6) (Placebo before intervention: 11.14 ± 4.3, after one month intervention: 9.4 ± 3.9) (p = 0.000). Also 30% of valerian group and 4% of placebo group had important improvement in sleep quality, which was decreasing of 5 score of PSQI. There were significant difference between two groups (p = 0.00).

Findings from this study add to the scientific evidence that support use of valerian in the clinical management of insomnia especially in menopausal women.