ObjectivesPost-infarct Depression appears to 15-30% of the patients treated in the Infarction Units, according to the International Standards. It appears 24-72 hours following an Acute Infarction of the Myocardium.MethodsWe studied 300 patients treated in the Infraction Treatment Unit for a period of three months, within the framework of a Liaison Consultation Psychiatry program. 180 patients were men (60%) and 120 patients were women (40%). The average age of male patients was 52 years and the average age of female patients was 58 years. These patients were submitted to the Montgomery-Arnsberg Depression Rating Scale (MADRS) to evaluate Depression. According to the results of the Scale, these 120 patients presented depressive symptomatology, 45 patients presented mild symptomatology, 70 patients presented average symptomatology, and 5 patients presented heavy symptomatology.ResultsAll the above patients were treated with SSRIs. In particular, they received Fluoxetin, Sitalopram, Esitalopram, Fluvoxamine, Sertraline. The MADRS Scale has been evaluated on 15 days, 1, 2, 3, and 6 months following the initiation of therapy. 110 patients (91%) presented a significant reduction of MADRS Scale, while 10 patients (9%) showed resistance to the treatment and had to switch their treatment scheme with SNRIS or NASSAS.ConclusionsThe SSRIs constitute the most advisable treatment for post-infraction depression, due to their low side-effect profile. The rate of positive outcome for post-infarction depression treatment was especially high (91%) during treatment with SSRIs at a level consistent with the international literature reference.

ObjectivesTreatment-resistant schizophrenia is an old term, describing the form of schizophrenia that does not respond to a treatment dose of Chloropromazine, equal to 1,5 gr.Methods20 (n=20) patients have been studied, that were diagnosed with schizophrenia, and did not respond to any combination of typical or non-typical anti-psychotic drugs. These patients were 19-62 years of age, and were administered the BPRS and PANSS scales at start of the examination or the hospitalization, and during the 1st, 3rd, and 6th month evaluation. The said patients were treated with a combination of Amisulpiride, and Clozapine.ResultsThe patients received a dosage range of 400-1200mg for the Amisulpiride, and 300-900mg for the Clozapine. 18 patients (90%) responded to this treatment, and showed an improvement in the BPRS and PANSS scales, from the 1st month of treatment using a combination of Amisulpiride-Clozapine. Later, during the 3rd month of treatment, one of the patients discontinued the treatment, as she presented leucopenia (white cell count: 3250). The discontinuation of Clozapine treatment was decided. Clozapine was replaced by 20mg Olanzapine.ConclusionsDespite the fact that the sample of patients was very small (n=20), it seems that the combination of Amisulpiride and Clozapine is effective for the treatment of patients showing resistance in pharmaceutical treatment and the combination of typical and non-typical neuroleptics.

IntroductionThe Oswin unit located in the North East of England is commissioned primarily for offenders screened on the offender personality disorder (OPD) pathway based on measures of personality disorder being linked to moderate to high risks to other persons.ObjectivesThe Oswin Unit was re-designed in early 2014 meeting commissioning specifications to meet objectives based on access, measuring quality and reducing. The primary objective of this pathway is to ensure personality Disorder offenders have access to “community-to-community”, joint-up care and monitoring of risks. The Oswin unit implemented a re-designed service offering individuals formulation based assessments and risk management embedded in the OPD pathway. The overall objective of this project is to evaluate the effectiveness and risk amelioration of this hospital-based service.AimAs part of a broader service development and evaluation project, the cost-effectiveness of the current model of the unit was compared to that of the unit prior to the redesign of the service.MethodCollection of data on number of admission and length of stay and calculation of expenses per capita. Retrospective analysis of costs of care.ResultsAnalysis of comparative figures post-implementation of this new model of care found 41% more episodes of care. Cost-analysis indicated a saving of £200,000.ConclusionThe new Oswin Model meets commissioning objectives in offering access to hospital-based care and focused treatments for prisoners ‘stuck’ in prison pathways. This finding led to further investigation using thematic measures of quality of care to evaluate the effectiveness of this service and risk amelioration.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The concept of mentalizing has captured the interest and imagination of an astonishing range of people-from psychoanalysts to neuroscientists, from child development researchers to geneticists, from existential philosophers to phenomenologists-all of whom seem to have found it useful. According to the Thompson Reuter maintained Web of Science, the use of the term in titles and abstracts of scientific papers increased from 10 to 2,750 between 1991 and 2011. Clinicians in particular have enthusiastically embraced the idea, and have put it to innovative use in their practices. Mentalization-based treatment (MBT)-making mentalizing a core focus of therapy-was initially developed for the treatment of borderline personality disorder (BPD) in routine clinical services delivered in group and individual modalities. Therapy with mentalizing as a central component is currently being developed for treatment of numerous groups, including people with antisocial personality disorder, substance abuse, eating disorders, and at-risk mothers with infants and children (A. Bateman & Fonagy, 2011). It is also being used with families and adolescents, in schools, and in managing social groups (