The population of adult CHD patients is continuously increasing. The underlying CHD affects performance and prognosis, but also has a significant impact on quality of life, psychosocial behaviour, anxiety and emotional disturbances. This study analyzes these parameters of patients after one or more heart operations and the possible psychological effects of medical and psychosocial complications at the Department of Cardiology of the Kepler University Hospital Linz.

A total of 81 subjects participated in the questionnaire survey of the Institute of Cardiology and Clinical Psychology during their annual cardiological check-up. Of these, 80 participants were included in the study and three showed a mild CHD, 49 a moderate one, and 28 a severe one. This study has an exploratory design to assess possible stress factors and limitations in quality of life. For this purpose, a self-administered sociodemographic questionnaire and three standardised questionnaires were used. In summary, the quality of life of adult CHD is considered depending on the severity of the symptoms and compared with the healthy population. Differences in this regard are observed in individuals with lower symptom severity, who report higher psychological well-being. Sex differences are observed in physical role function and physical functioning.

Based on the results, regular repetitions of the study, as well as continuous psychological and psychosocial support, are necessary, since challenges are predictable with the increasing age of adult CHD patients and since the upholding of good quality of life and dealing with difficult life circumstances must be supported.

Neuroimaging studies in adults with borderline personality disorder (BPD) have reported alterations in frontolimbic areas, but cannot differentiate between alterations originating from disease and those occurring as side-effects of medication or other consequences of the disorder.

To provide a clearer picture of the organic origins of BPD, the present study reduced such confounds by examining adolescents in the early stages of the disorder. It also examined the extent to which alterations associated with BPD are specific, or shared more broadly among other psychiatric disorders.

Sixty right-handed, female adolescents (14-18 years) participated. 20 had a DSM-IV diagnosis of BPD, 20 had a different DSM-IV defined psychiatric disorder, and 20 were healthy controls. All groups were matched for age and IQ. Images were analysed using voxel-based morphometry.

No differences were found in limbic or white matter structures. Compared to healthy controls, adolescents with BPD displayed reduced gray matter in dorsolateral prefrontal cortex bilaterally and in left orbitofrontal cortex, but there were no significant differences in gray matter between BPD and other psychiatric patients. Like BPD patients, non-BPD psychiatric patients displayed significantly less gray matter in right dorsolateral prefrontal cortex compared to healthy controls.

These findings indicate that the prefrontal cortex is the earliest affected in the progression of BPD, but this does not distinguish it clearly from other psychiatric disorders. Alterations in limbic areas and white matter structures were not observed, but may play a later role in the progression of the illness.

Self-harming and suicidal behaviour are both well-recognized problems during adolescence. While prevalence rates are very high and still rising in most western countries, there is an extensive need for understanding childhood developmental aspects, personality factors and psychological correlates of self-harm and suicidality. Additionally, specific and effective prevention should be established regarding self-harming and suicidal behaviour as one of the largest concerns of public health during this period of life.

To investigate the prevalence and the associated psychological and social factors of self-harming behaviour in adolescents. To evaluate a school-based intervention aimed at reducing self-harming behaviour in adolescents.

In the years 2005 and 2010 we performed one population-based, cross-sectional study including a sample of 5,759 ninth-grade students and one randomized-controlled, school-based prevention study within the large EU-consortium (SEYLE) comprising a sample-size of 1,387 students on self-harming and suicidal behaviour in Heidelberg.

The data suggest that there is a strong link between social factors and occasional self-injurious behavior and, especially in repetitive self-injurious behaviour, that there is a strong association between self-injurious behaviour and suicidal behaviour as well as self-injurious behaviour and emotional and behavioural problems. Preliminary results of the randomized-controlled prevention study could reveal a decrease of self-harming behaviour in adolescents in the short-term as well as long-term-follow-up.

The results support a need to investigate the possible neurobiological underpinnings as well as social factors of self-harming behaviour within a longitudinal model.

The primary aim of our study was to determine the prevalence of deliberate self-harm in adolescents using an exact definition of DSH (intentional self-mutilative acts like cutting, burning and suicidal ideation, plans and attempts). Our second aim was to evaluate a wide range of internalizing (withdrawn, somatic complaints, anxiety/depression) and externalizing behavior problems (delinquency, aggression), as well as possible gender differences which may be associated with DSH.

Self-report cross-sectional survey. A representative sample of school students of the 9th grade (n = 5759, mean age = 14.98 (SD=0.73), 49,8% female adolescents) from the Rhein-Neckar-District in Germany has been investigated.

Moderate forms of intentional self-mutilative acts in the previous year was reported by 630 of 5759 (10.9%) school students. Additional 229 (4.0%) students reported repetitive forms of self-mutilation. With regard to suicidal behaviour 14.4% of the adolescents reported suicidal ideas and 7.9% one or more suicidal attempts during their life time. Compared with participants without a history of DSH, adolescents with DSH scored significantly higher on the YSR-subscales of somatic complaints, anxiety and depressive symptoms and delinquent behaviour.

Moderate forms of intentional self-mutilative acts and severe forms as well as suicidal behaviour were found to be associated with pronounced emotional and behavioral problems. In particular female adolescents are at higher risk for DSH in comparison to male adolescents. A better understanding of the associated psychiatric and psychosocial concomitants of deliberate self-harm is an important contribution for the development of prevention and intervention programs.

To develop a school-based screening for adolescent risk behaviour and psychopathology and to investigate the predictive value of different adolescent risk behaviours in terms of suffering from psychopathology that requires mental health care.

A two-stage professional screening was developed and constituted in the randomized-controlled prevention trial “Saving and Empowering Young Lives in Europe (SEYLE). A school-based screening consisting of a self-report screening questionnaire and a semi-structured professional interview in case of being identified as at-risk were performed in a representative sample of almost 2,000 adolescents within the SEYLE sample of about 8,000 students from 7 European countries and Israel.

A very high percentage of students were detected to be at-risk by either showing risk behaviour or psychopathology or both in the first stage of the screening. From these students, only about one third came to the study center and took part in the interview. About half of of the interviewed students reached were referred to mental health care.

Risk behaviours are very common among European adolescents and may also have increased during the last years. Nevertheless, most risk behaviours are weak predictors for suffering from psychopathology that requires mental health care compared to psychopathology or suicidal behaviour theirselves. Although they are certainly unhealthy and badly influencing adolescent development risk behaviours seem to be an ubiquitous phenomenon during adolescence and cannot simply be regarded as signs for severe psychopathology.

To investigate the prevalence of pathological Internet use (PIU) among adolescents in eleven European countries in relation to demographic and health-related risk factors and Internet accessibility using homogenous methodology.

Cross-sectional analysis.

The 7th Framework European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), is a Randomized Controlled Trial (RCT) evaluating preventive interventions for risk-behaviors among adolescents in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain with Sweden as the coordinating site.

11,956 adolescents (F/M: 6731/5225; mean age: 14.9 ± 0.89) recruited from randomly selected schools within the eleven study sites.

Internet users were classified by gender into three categories: adaptive, maladaptive and pathological, based on the Young Diagnostic Questionnaire for Internet Addiction (YDQ).

The overall prevalence of PIU was 4.4%. the rate was higher among males than females (5.2% vs. 3.8%). Students not living with a biological parent or relative had the highest risk for both maladaptive and pathological Internet use. Low-parental involvement and parental unemployment showed high relative risk for both maladaptive and pathological Internet use. PIU significantly correlated with the average number of hours spent online. No correlation was found between national levels of Internet accessibility and pathological Internet use.

Prevalence of PIU varied by gender. Youth in households without a biological parent and/or low level of parental involvement had the most significant health-related factors associated with PIU. National levels of Internet accessibility were not a risk factor for either maladaptive or pathological Internet use.

Peer relationships play a critical role in the development of adolescents, not only for the acquisition of social skills but also for the sense of personal identity and competence. Thus the quality of peer relationships influences actual and future mental health of the adolescent.

SEYLE (Saving and Empowering Young Lives in Europe) is a randomized controlled trial, funded by the EU, evaluating interventions for mental health promotion and suicide prevention. The study comprised 12,395 high-school students from 11 European countries.

We investigated the differences on psychological problems between students with poor and good peer relationships.

1,195 adolescents (mean age 15.3 ± 0.6; 68% females) from the Molise region constituted the Italian sample. Adolescents were identified as with poor peer relationships if they never or just sometimes get along with people of their age, feel that peers like having them in the group and feel that peers were kind and helpful. Psychometric measures were used to assess mental health problems such as depression (Beck Depression Inventory II), anxiety (Zung Self-Assessment Anxiety Scale), well-being (WHO-5) and suicidal ideation (Paykel Suicide Scale).

Adolescents who reported poor peer relationships scored significantly higher (p < .005) on the scales assessing depression, anxiety and suicidal ideation and significantly lower (p < .001) on the WHO-5.

Particularly in adolescence peer relationships may influence psychological well-being and vice versa mental health influences the openness to the others. So promoting mental health and contemporary improve social skills could lead adolescents to a better life.

Smoking among adolescents is still a major public health problem and a global concern. Early onset and long-term smoking are associated with physical and psychological health problems.

To identify risk factors and comorbidities for occasional and daily smoking among European adolescents.

In the context of the Europe-wide 'Saving and Empowering Young Lives in Europe” (SEYLE) study we surveyed 12,328 youths at the age of 13 to 17 from 11 countries. We applied questions from the Global School-Based Student Health Survey to determine nicotine consumption as well as other risk behaviors. Psychiatric symptoms were assessed by the Strengths and Difficulties Questionnaire, the Becks Depression Inventory-II, the Zung Self-Rating Anxiety Scale,the Deliberate Self-Harm Inventory and the Paykel Suicide Scale.

On average 30.9% of adolescents reported daily smoking and the onset of smoking was reported by 35.3% between the age of 12 and 13 already. Multinomial logistic regression model showed significant correlations between adolescent smoking and migration background, living in single parent households, no physical activity, parental smoking and physical fights. Further it revealed significant associations of adolescent smoking with alcohol consumption, illegal drug use, anxiety, conduct problems, hyperactivity, suicidal ideation, self-injury and internet-dependence.

Our data show that adolescent smoking is associated with psychosocial factors, especially family setting and parental behaviors. Further, smoking and psychiatric problems are highly correlated. Therefore, early preventive measures are necessary and essential not only for adolescents but also for their parents.

Previous research revealed substantial relations between the experience of childhood adversities and the development of borderline personality disorders (BPD) in adulthood. However, research about antecedents of adolescent BPD is still in its beginnings. Moreover, there is an ongoing controversy regarding transgenerational effects of childhood adversities and potential mediators.

We aim to investigate transgenerational effects of parental childhood experiences on the development of adolescent BPD within the next generation. Hereby, we are focusing on the investigation of differential effects of maternal and paternal experiences of childhood adversities on adolescent BPD and on underlying mechanisms.

We consecutively recruited 91 female inpatients (Mage = 15.6 years) from the Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, as well as 87 mothers and 59 fathers. Childhood adversities were assessed for parents and adolescents with the German Childhood Experiences of Care and Abuse Questionnaire, adolescent BPD by means of structured clinical interviews (SKID II).

Our results are in favor of a transgenerational effect of parental childhood adversities on the development of adolescent BPD. This effect turned out to be stronger for paternal than for maternal childhood adversities. Moreover, paternal childhood adversities revealed to be related to experiences of childhood adversities within the next generation.

Our results underline the importance of taking the family environment into consideration when developing prevention and treatment programs for adolescent BPD.

Truancy is a serious public health problem that affects adolescents from all countries around the world. It negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions. Young who are habitual truants are more likely to engage in at-risk behaviour like suicidal behaviours.

This analysis investigated the prevalence of truancy and suicidal behaviours in the Italian sample.

to reduce truancy among European adolescents improving mental health in European high schools.

the WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6±0,6; 64,4% females) was selected. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, suicidal behaviour and mental health issues was collected using a structured questionnaire.

6% has been absent from school for 7 days or more without a valid excuse during the past year (6.6% male); 20,3% as considered as truant student (three or more skipped days per month without a valid excuse in the past year). 4,6% have seriously considered taking own life during past 2 weeks have thought about suicide, and 1,2% tried to take own life in past 2 weeks. The analysis showed as correlation between skipped school and suicidal behaviour (p < .001)

Teens engaging in risk behaviours are at increased odds of depression, suicidal ideation, and suicide attempts (Hallfors et al. 2004). The preliminary We-Stay data confirm the prevalence of at-risk behaviours is higher among truant students.

Truancy negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions.

To implement and evaluate outcomes of three different kinds of intervention against truancy. A mechanistic intervention to stop truancy will be used as control.

To reduce truancy among European adolescents improving mental health in European high schools.

The WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6 ± 0,6; 64,4% females) was selected. The students were randomized into one of four different intervention arms. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, self-harm behaviours and mental health issues was collected using a structured questionnaire.

6% has been absent from school for 7 days or more without a valid excuse during the past year. 55,0% of the sample has smoked cigarettes; 7,2% drank alcohol 4 or more time during the week (13,9% male and 3,4% female). About the use of drugs, 17,4% of them used drugs at least once in a lifetime. 16% of the students started a fight at least once in a lifetime.

Truancy is often related to mental health problems and at-risk behaviours. The truancy has been the focus of a different policy initiatives, often ended in failure. Through the implementation of WE-STAY is possible to acquire more data on truancy prevalence and its correlated psycho-social and psychiatric aspects, as well as information on school and parents attitudes toward this phenomenon.

Major depression and sleep disturbances are closely related and often occur concomitantly. Many of the observed changes of sleep characteristics in depression are also present in healthy aging, which led to the premise that sleep in depression resembles premature aging.

Here, we aimed at quantifying the homeostatic and circadian sleep-wake regulatory components in young women suffering from major depression disorder and healthy young and older control women during 40 hours of sustained wakefulness.

After an 8-h baseline night 9 depressed women, 8 healthy young and 8 healthy older women underwent a 40-hour sustained wakefulness protocol followed by a recovery night under constant routine conditions. Polysomnographic recordings were carried out continuously. Sleep parameters as well as the time course of EEG slow-wave activity (SWA) (EEG spectra range: 0.75-4.5 Hz), as a marker of homeostatic sleep pressure, was analyzed during the recovery night.

Young depressed women exhibited higher absolute mean SWA levels and a stronger response to sleep deprivation compared to healthy young and healthy older women, particularly in frontal brain regions. In contrast, healthy older women exhibited attenuated SWA values compared to the other two groups and an absence of the frontal predominance of mean SWA during the recovery night.

Our data clearly show that homeostatic sleep regulation as well as sleep architecture in young depressed women is not equal to premature aging. Moreover, our findings demonstrate that young depressed women live on an elevated level of homeostatic sleep pressure.

According to previous studies the prevalence of adolescent depression is 4–8% both in the USA and Europe. the aim of the current study was to investigate the prevalence of adolescent depression separately in several European countries.

Data were drawn from the Saving and Empowering Young Lives in Europe (SEYLE) study, which included 11 countries (Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Israel, Romania, Slovenia and Spain) and Sweden served as the coordinating centre. Depression was measured by the Beck Depression Inventory-II (BDI-II). Adolescents with a score of 20 or greater on the BDI-II were defined as depressed. Multiple imputations were conducted to address missing data.

Out of 14,115 students who consented to participate, finally 12,395 adolescents (5,568 (44.92%) boys and 6,827 (55.08%) girls) were enrolled into the study. the mean age of the students was 14.81 years (SD = .83). Significant differences were detected in the ratio of non-depressed and depressed adolescents among countries (χ2(20) = 385.352 p = .000). the prevalence of depressed adolescents ranged from 7.1% to 19.4%. the prevalence of depressed adolescents according to country in increasing order is: Hungary: 7.1%, Austria: 7.6%, Romania: 7.6%, Estonia: 7.9%, Ireland: 8.5%, Spain: 8.6%, Italy: 9.2%, Slovenia: 11.4%, Germany: 12.9%, France: 15.4%, Israel: 19.4%.

Based on a screening tool our data underlines the importance of taking account country specific prevalence rates of adolescent depression.

Non-suicidal self-injury (NSSI) is an increasing phenomenon among adolescents. So far, comparable data on prevalence and psychosocial correlates are still rare due to different definitions, study samples, and measures.

To investigate the prevalence and associated psychosocial factors of occasional and repetitive non-suicidal self-injury (NSSI) and its relationship to suicide attempts in a representative adolescent samples from eleven European countries.

Cross sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in eleven European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9±0.89) recruited from randomly selected schools. Frequency of NSSI was assessed by a modified version of the Deliberate Self-Harm Inventory (DSHI) and the Paykel Suicide Scale. Additionally, a broad range of demographic, social and psychological factors was assessed.

Overall lifetime prevalence of NSSI was 27.6%; 19.7% reported occasional NSSI and 7.8% repetitive NSSI. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Suicidality, anxiety and depression had the highest odds ratios for both occasional and repetitive NSSI.

Results suggest high lifetime prevalence of NSSI in European adolescents, with significant country differences. A strong association of NSSI with both psychopathology and risk-behaviours, including family-related neglect and peer-related rejection/victimization could be found. These results, combined with the observed gender and country differences, support the need for a multidimensional approach to better understand the development of NSSI and facilitate culturally adapted prevention/intervention.

F17464 is a new highly potent preferential D3 antagonist, 5-HT1A and weak D2 partial agonist, with confirmed antipsychotic-like activity in animal models. In healthy volunteers, F17464 had a good safety and tolerability profile. A PET-scan study determined a high D3 occupancy rate up to 22 h after a single dose.

The primary objective was to evaluate the efficacy of 40 mg/day of oral F17464 in comparison to placebo.

This double-blind, parallel group, multicenter study included patients with acute exacerbation of schizophrenia treated for 6 weeks as antipsychotic monotherapy. Patients were hospitalised for the first 3 weeks of treatment, then continued as outpatients.

The 144 randomized patients had a baseline PANSS mean (SD) total score was 89.6 (9.5). The change from baseline of PANSS total score to Day 43 on the FAS (LOCF), showed a statistically significant difference in favor of F17464 over placebo: adjusted mean (SE) change −13.5 (2.1) on F17464 and −7.8 (2.2) on placebo with a treatment effect estimate −5.7 (2.7). The 20% or 30% response rate was statistically higher in the F17464 group (47.2% and 25.0%) compared to the placebo group (30.6% and 13.9%). The incidence of treatment-emergent adverse events was slightly higher in the F17464 group (70.8%) than in the placebo group (62.5%). There were no clinically-relevant hepatic, metabolic, or cardiovascular abnormalities. No EPS was reported under F17464.

This is the first D3 antagonist that proves efficacy. The results of this phase 2 study also demonstrate the favorable safety profile of F17674 when compared to placebo.

The authors have not supplied their declaration of competing interest.