Sleep problems six-months after continuous earthquake activity in a Greek island.

Natural disasters, such as earthquakes, are traumatic events causing both acute and enduring stress to affected individuals. Psychosocial consequences include posttraumatic stress disorder (PTSD), reactions of anxiety and depression and sleep problems. The island of Cephalonia in Ionian Sea is characterized by its high seismic activity. More specifically, this activity has been considered to be the highest of the Balkan Peninsula and Europe in general. In January and February of 2014 a long sequence of earthquakes, which included two main shocks of 6.1 Richter and 6.0 R, struck the island. The epicenter of the earthquake was the city of Lixouri. A long series of aftershocks measured ≥ 4.0 R followed these main shocks. In total, the number of earthquakes that affected those living in Cephalonia between January 26 and August 2014 when the present study took place, was 2055. Several damages concerning buildings, monuments and churches, stonewalls, road networks and port facilities occurred, but there were no human casualties. The aim of the present study was to assess sleep problems, insomnia in particular in the affected population after the two severe earthquakes in the island of Cephalonia. The assessment was made through the Athens Insomnia Scale (AIS). Sleep problems were assessed for two time points, i.e., retrospectively one month before and six months after the earthquake. In terms of psychopathology, anxiety (STAI - State anxiety) and symptoms of depression (CES-D) were more pronounced in our study population than the expected norm in the community. Correlations with depression (Center for Epidemiological Studies-Depression), anxiety (State-Trait Anxiety Inventory - State Anxiety) and PTSD symptoms (Impact of Event Scale-Revised) were investigated. A significant increase of sleep problems pertaining to insomnia was found (p<0.001). The most frequent complaints were difficulty with sleep induction, awakenings during the night, and sleepiness during the day. Higher STAI - State anxiety, CES-D, and IES-R scores were associated with greater likelihood of having insomnia six months after the earthquake. No other significant associations were detected with several recorded sociodemographic parameters. In conclusion the local population exhibited sleep disturbances 6 months after the earthquake. Sleep problems and ensuing next day dysfunctioning appear to be dependent on the existing psychopathology but independent of sociodemographic factors, and are potentially the result of constant worry due to the continuing seismic activity. Therefore, mental health providers should recognize and manage disordered sleep after earthquakes, although further studies are required to investigate the long-term impact of natural disasters on sleep.

Adolescents' mental health during the financial crisis in Greece: The first epidemiological data.

Greek financial crisis has incurred adverse effects on the mental health of the population; however existing research is constrained in the adult population. Therefore, the present study aims to shed light on the mental health state of adolescents during the recession. In this context 2,150 adolescents were recruited from a random and representative sample of public and private schools in the greater Athens area. Mental health problems were assessed with the selfreport Strengths and Difficulties Questionnaire while additional questions enquired about students' socio-demographic characteristics. Findings indicate that roughly one out of ten adolescents scored above the cut off point for the total difficulties score, with the higher prevalence been recorded for the conduct problems sub-scale. More specifically, 7.7% of the sample scored above the abnormal cut-off point for the total difficulties score, 10.9% for emotional symptoms, 11.9% for conduct problems, 10.6% for hyperactivity and 4.8% for peer problems. Furthermore, adolescents who reported that during the previous month there was not enough food in their house displayed higher odds of manifesting mental health problems than adolescents who replied negatively in the particular query. On the grounds of these results, there is indication about the adverse effects of the financial crisis in the development of psychiatric symptomatology in adolescents in the Greek society. This is the first study providing epidemiological data on the current state of adolescents' mental health amid the recession in Greece, showing that the crisis impinges disproportionately on the most vulnerable socio-economic groups.

[Attenuated psychosis syndrome: A new diagnostic category for further study in DSM-5].

In recent years an increasing number of studies focus on the issue of early diagnosis and intervention. At the same time, a large number of special service units for early psychosis have been established around the world especially in Australia, USA, UK, Germany etc. Recently, similar units operate in Greece also. The Diagnostic Manual of Mental Disorders of the American Psychiatric Association in its latest edition in 2013 (DSM-5), introduced the category "Attenuated Psychosis Syndrome" (APS) for people with early psychotic experiences in the section: "Conditions for further study '. This new category has specific criteria and describes a situation, in which a person displays psychotic symptoms in an attenuated form, with quite unaffected reality testing, but not qualifying a diagnosis of schizophrenic spectrum. The clinical expression of APS should be differentiated with several well known psychiatric disorders such as: brief psychotic disorder, schizotypal personality disorder, major depression with psychotic features, adolescence adjustment disorders, drug use, etc. The "Attenuated Psychosis Syndrome" occurs mainly in adolescence and in young adulthood. The mean percentage of transition to psychosis for these individuals is estimated at 36%, three years after the onset of initial symptoms, while the risk of transition to psychosis, although smaller, seems to remain up to ten years later. For some other individuals, transition to other psychiatric disorders occurs, such as depression with psychotic elements, or bipolar disorder, while a significant number of them will not transmit to even more serious disorders. At the biological level, studies focused in brain's neuroimaging, suggest significant volumetric differences among people at high risk for psychosis who later develop psychosis compared to those who don't, while studies of psychophysiological indicators or / and genetic markers show promising results for the identification of relevant parameters indicating the transition to psychosis. Αlthough an heterogeneous population, people with APS, show significant difficulties in social, professional and cognitive level, that should be therapeutically addressed. In an attempt to improve the clinical status of these individuals, to delay or even to prevent a psychotic episode, a series of interventions have been used by psychiatrists. These interventions include: (a) administration of drugs, especially atypical antipsychotics or antidepressants in low dosage, (b) administration of non-pharmaceutical supplements (e.g. omega-3 ), (c) psychotherapeutic interventions, mainly cognitive behavior therapy and (d) a combination of the above. Many questions need to be answered such as, the period of therapeutic intervention, identification of indicators (biological or/and clinical) that may determine the most suited for the APS individuals therapeutic interventions or, that may foresee, to prevent the transition to psychosis. Thus, the continuation of research in populations of APS individuals in multiple levels is necessary.

[Impulsivity as an immediate factor between addictive disorders and Attention Deficit-Hyperactivity Disorder].

Impulsivity is a behavior in everyday life of mentally healthy individuals. But in some cases the degree of impulsivity begins to create negative effects on one's life and acquires pathological connotation. Two clinical entities in which can be observed a high degree of impulsivity is Attention Deficit Hyperactivity Disorder (ADHD) and Addictive disorders. In these disorders, both impulsive act and impulsive choice are observed. According to some researchers, genetic factors are involved in the control of impulsivity. The impulsive choice, in the sense of delay discounting, may be an intermediate phenotype or endophenotype that contributes to vulnerability with respect to specific disorders in which impulsivity plays a central and decisive role. Another group of researchers argue that ADHD is one of the expressions of a more generalized disorder, known as reward-deficiency syndrome. In this syndrome, it is included increased frequency of addictive disorders. On the other hand, some researchers argue that ADHD in adolescence does not increase the likelihood of developing dependencies, when it is not accompanied by comorbidity of conduct disorders. Regarding the use of substances, there have been conflicting views in relation to etiopathogenesis of impulsivity observed in the addicted patients and whether this impulsivity precedes or follows the onset of substance use. The element that links ADHD with impaired preoccupation with gambling and has been studied most is also impulsivity. Some researchers theorize that ADHD mediates with the element of impulsivity in the development of disordered involvement with gambling in some patients. The positive correlation between impulsivity and addiction to gambling arises, whether behavioral scales or questionnaires about personality have been used. Moreover the higher measured impulsivity of the patient, the more serious are the symptoms of dependence. Abnormalities in neurotransmitter systems have been found both in patients with dependence on gambling, as well as in patients with impulsive behavior. It seems that impulsivity in these players is part of their personality and not a transient behavior. The variety of views that exists and the debate surrounding this issue reflects the multidisciplinary nature of the phenomenon of impulsivity, when found in dual diagnosis of Attention Deficit/Hyperactivity Disorder and Addictive Disorder. It is important for patients with ADHD or any form of addictive disorder, presenting for treatment, to assess the degree of their impulsivity and to investigate the possible comorbidity with other mental health problems, in which impulsivity plays a central role.

Asperger syndrome and schizophrenia: Νeurodevelopmental continuum or separated clinical entities?

This article is an overview of the literature on Asperger's syndrome and schizophrenia and aim to discuss their similarities and differences. Eugen Bleuler who associated the terms "schizophrenia" and "autism" a century ago, viewed autism as a form of solitude of schizophrenic patients representing withdrawal from reality. Ever since, there has been confusion as to the boundaries between these conditions. Nowadays recent research, from a variety of perspectives-genomics, neurodevelopment, psychiatry, etc. has given new information on these conditions. It is easier to demarcate these two disorders at the extremes, but it is extremely difficult dissociating milder forms of both disorders. Asperger's syndrome (AS), is considered to be a continuous and lifelong disorder with strong heritability, present from early childhood. It is included within the category of autism spectrum disorders and it is usually diagnosed in childhood. Patients with Asperger syndrome are often diagnosed late or they are considered as having schizophrenia. Misdiagnosing Asperger syndrome creates severe problems by preventing effective therapy. A lot of clinical characteristics of Asperger's syndrome are also present in schizophrenia, such as impaired social interaction, disabilities in communication and restricted interests. On the other side some clinical features may facilitate the differential diagnosis, such as the younger age at onset, family history of pervasive developmental disorders, pragmatic aspects of language use, lack of imagination, ect. It is known that symptoms of Asperger's syndrome have some overlap with those of schizophrenia, but less is known about comorbidity between these two syndromes. It is still a question whether autism spectrum disorders in young children can increase the risk for the development of schizophrenia and other psychotic disorders, later in life. Both disorders are of neurodevelopmental origin and genetic factors are prominent. In both neurocognitive deficits as well as deficits in social cognition and social functioning are marked. The boundaries between AS and schizophrenia are still not clear even if this distinction is necessary for the appropriate treatment of the patient and his family. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Asperger's syndrome, schizophrenia, children and adolescents, differential diagnosis, autism spectrum disorders.

Comparing immigrant children with native Greek in self-reported-Quality of Life.

UNLABELLED: Research on an international and national context regarding immigrant children and adolescents' quality of life (QoL) is rather scarce. Few international studies have been conducted investigating the presence of psychopathology and providing evidence of behavioural and psychological problems in immigrant adolescents. Regarding immigrant quality of life, thus far investigation was directed mainly to adult immigrant individuals and not to their children. The aim of the present study was to investigate the quality of life (QoL) of immigrant children and young adolescents who live in the greater Athens area, and to compare them with their native Greek peers living in the same communities and attending the same schools. METHOD: Sixty three immigrant children, from Albanian and Eastern European origin (mean age 11.9 years) and 489 native children (mean age 11.33 years) were administered a QoL instrument specifically developed for children and adolescents: the Kid-KINDL® Questionnaire for 8-12 years old and the Kiddo-KINDL® Questionnaire for 13-16 years old. The dimensions examined in the KINDL® questionnaire refer to: physical wellbeing, emotional well-being, self- esteem, friends, family life and everyday life (school life). The Greek version is reported to show satisfactory values of validity and reliability. Administration of questionnaires was conducted at school after parent consent. Analysis included student's t-test, chi-square test, and multivariate linear regression analysis, as to investigate the relationship between KINDL® QoL dimensions' scores and nationality status, after controlling for gender and age. The results indicated that self-reported QoL scores of immigrant children were significantly poorer in comparison to native children in the domains of self-esteem and family life, as well as in the total QoL scores. In the rest of the QoL domains, similar scores were reported in both immigrant and their native classmates, that is in the dimensions of physical well-being, emotional well-being, friends and school. Investigating the effect of gender in KINDL® QoL parameters, after controlling for nationality and age, no evidence was found for differences between male and female children. Regarding the effect of age, older compared to younger in age children scored significantly lower in emotional well-being, self-esteem, and friends, school and total QoL. The results provide evidence of QoL deficits in self-esteem and family life in immigrant children. QoL deficits seem to increase in more areas as immigrant children grow older. Dimensions regarding self-perception and family may be interrelated, mutually influencing one another. It may be suggested that immigrant children seem to experience reduced self-esteem and distressful feelings within family interpersonal relations. As they grow older, distress seems to become more evident in emotional and social areas of QoL. Mental health interventions should take into account the multilevel impact of family interpersonal experiences on child's psychosocial development, as to design and deliver appropriate interventions supporting parenting for immigrant groups of individuals. Also, specialized mental health promotion programs need to be provided for adolescent immigrant individuals.

Predictors and characteristics of anxiety among adolescent students: a Greek sample.

In the Greek society, there is a strong cultural tendency to overestimate the value of University studies. So students are under high emotional pressure during the long lasting period of the preparation for the university entrance exams. The aim of the present study was to evaluate the level of anxiety in a general adolescent population of senior high school students in Athens, Greece. Also to examine the association between the anxiety's severity with various demographic and socio-cultural factors, as well as with academic performance, extracurricular activities, sleep duration and presence of somatic problems. The sample consisted of 696 adolescent students of three Senior High Schools (SHS) (391 girls and 305 boys). Two of the schools were general education institutions (GE1 and GE2, N=450), while the third was a technical one (TE, N=246). The school sample was selected to reflect the proportion between the two different types of SHSs in Athens as well as other major urban areas in Greece. The State-Trait Anxiety Inventory was administered and personal data were also collected. Statistical significance was set at p<0.05 and analyses were conducted using STATA 7.0. 567 adolescents lived with both parents and 121 with one or none of them. Father's educational level was low for 138, middle for 154, high for 195 and mother's was low for 135, middle for 417, high for 140. The average sleep duration was 7.5 hours per day (SD=1.3). The average time per week spent in school related activities was 7.94 hours (SD=7.56) and in extracurricular activities was 9.02 hours (SD=12.44). 107 adolescents reported somatic complaints in the last year The academic achievement was poor for 233, good for 264, excellent for 196 students. Adolescents with extracurricular activities for more than 11 hours per week had lower scores, both on State and Trait scales. More hours in school-related activities were associated with greater levels of Trait anxiety. Adolescents whose father had a high educational level had lower scores on State anxiety compared to those whose father had a low educational level. Adolescents who reported the presence of somatic problems had a higher score in Trait anxiety. A significant negative correlation was found between sleep duration and both State (r=-0.14, p<0.001) and Trait anxiety (r=-0.10, p=0.008) scores. Stepwise linear regression analyses confirmed the association of gender and of father's educational level with both State and Trait subscale scores. The association of somatic problems with Trait anxiety was greater for girls compared to boys. The hypothesis that there is exam-related anxiety in our sample was not confirmed. There were no differences between school years and GE and TE schools. Also there was not an association of anxiety level with academic achievement and the number of parents the adolescent was living with. This study shows that girls, especially those reporting somatic problems, and adolescents coming from families with low parental education, are particularly prone to higher level of anxiety and that extracurricular activities are linked to lower level of anxiety. These findings could contribute to the planning of preventive measures for student's anxiety.

[Attention-deficit hyperactivity disorder or bipolar disorder in childhood?].

Attention-deficit hyperactivity disorder (ADHD) is considered one of the most common neurodevelopmental disorders of childhood, characterized by inattention and/or hyperactivity-impulsivity. Even though a strict definition of this entity is constantly sought, ADHD is an often redefined and reconceptualized syndrome. Epidemiological studies show large differences in the incidence, pointing out that the effort of actual taxonomic systems to offer objective diagnostic criteria have not yielded substantial results. Bipolar Disorder (BD) with onset in childhood is distinguished from the adult form by the scarcity of affective symptoms. Very often, neither depressive mood, nor hypomanic euphoria are in the front line being covered by irritability with crises of violence. Children or adolescents have consecutive cycles, which include brief episodes of depressive, hypomanic, manic or mixed periods without free intervals. There was a delay in the recognition of this clinical picture. Τhe diagnostic criteria in the actual taxonomic systems are not separated from those of adults and according to some studies the disorder is under diagnosed mainly in European countries. The contemporary literature deals largely with the relationship ADHD - BD in young people because the two disorders share the same clinical picture with slight variations. Τhe differential diagnosis in favor of BD is mainly based on the presence of affective disorders in the family. The main questions raised are whether there is comorbidity, whether ADHD is overdiagnosed against BD or whether ADHD represents a prodromal manifestation of early onset BD. Children with comorbid ADHD and BD tend to express mostly a stimulant phenotype with a chronic course and have higher rates of antisocial conduct disorder. This particular phenotype suggests a symptomatic continuum between ADHD and early onset BD which is possibly responsible for the difficulties met in differential diagnosis and differences in the rates of comorbidity. It seems that the earlier the onset of BD more often it is combined with symptoms of ADHD which often precede mood disorders. The relationship between BD and ADHD is not just a nosological problem but has important implications for treatment. The confusion regarding diagnostic evaluation and the relationship of these two clinical entities is reflected in the proposed course of therapy particularly with regard tο pharmacotherapy. Τhe elevated rates of comorbidity between ADHD and BD observed in the USA, but not in other countries, are possibly due to the frequent use of stimulants.The dilemmas that arise for the diagnosis of ADHD, BD and their relationship refer to the difficulty of defining the limits of normal and abnormal in the mental health of children and adolescents and of the construction of a taxonomic system that respects the particularities of this developmental age spectrum. To achieve this goal, the search for objectivity in diagnostic criteria is not sufficient but one must also keep in mind psychodynamic factors that put children at the heart of their personal history.

Behaviour assessment and reading ability in second grade greek school children.

Studies on ADHD show high comorbidity with behavioural and learning disorders. However, the specific association of behavioural and attention factors with learning disorders is not clear. The aim of this study is to examine the relationships between hyperactivity, inattentionand reading ability in a non-referred sample in Greece. Data were collected from 201 pupils attending second grade in public school in an Athens district. The CBCL was administrated to parents in order to evaluate behavioural disorders, inattention and hyperactivity. Teachers completedthe CBCL and the Conner's scale. Reading ability was assessed by a reading test appropriate for second grade. Attention difficulties reported by the teacher were associated with lower readingskills, but hyperactivity and behaviour disorders were not. Correlations of reading skills with CBCL scores were very low, especially through parental ratings. Girls showed better reading skills and less"hyperactivity" than boys. There was consistency in teachers' ratings between the Conner's and the CBCL. Teacher-parent concordance on CBCL was very low or absent. Report of hyperactivity without report of attention problems was not associated with reading difficulties in a non-referred Greek sample of second grade schoolchildren. This observation must be considered when therapeutic and/or educational planning is undertaken.

[The psychopathology of bilingual children in a sample of a Community Mental Health Center].

Thoughts and views of one's internal self can be materialized via verbal symbols. Therefore literal people can use these verbal symbols as a means of recording their ideas and experiences in order for them to be passed on and read by others. Evidently the abovementioned mental operations can be reflected in speech and language. It is not yet known whether bilingualism is the sum of two monolingual situations or whether they coexist. The way each language is organized is also not known, neither are the psychological operations that may influence the organization of each language, memory and the relationship with each language. During childhood and adolescence, language is a very important tool via which one communicates, materializes emotional behavior and organizes oneself. Linguistic development and identity formation both follow a parallel and connected line in view of the internal psychological organization. However, in the bilingual person, this relationship is influenced both by the two different cultural stimuli and by the two different linguistic stimuli (i.e. language). However, in the case where children grow up in a bilingual environment there are some particularities and special issues affecting these children. Under such circumstances, the accomplishment of the feeling of coherence and stability of the self becomes an even more difficult task for the child. Nowadays, in Greek reality, the phenomenon of bilingualism tends to be associated with economic immigration. In the sample used, five fourths of children consist of children coming from families of economic immigrants. The composition of the student population in Greece is characterized by linguistic and cultural polymorphism. The presence and existence of a large number of immigrants has changed the setting in Greece in many regions of the country and in turn, the composition of the school population. Any public school allover in Greece consists, among others, of children coming from families of economic immigrants, including thus a random number of children speaking different languages. Without doubt, immigration affects the immigrating person as much as it affects the new group. Also, immigration adjustment and formation depends on the pre-existing characteristics of the immigrants as much as it does on the characteristics of the welcoming society. Research dealing with the issues of economic immigrants in Greece are limited and mainly come from schools. The focus of interest is aimed firstly on the psychopathology that can be linked to the phenomenon of immigration and secondly on the social consequences of the phenomenon. The formation of psychopathology is associated with immigration and the importance of psychological trauma and its consequences. However, the association between the creation of psychopathology, which is formulated in childhood/adolescence, and the bilingual environment together with identity formation, is not yet clear. The aim of this paper was to study the effect of the dual language environment on psychopathology formation among children and adolescents as it appears in everyday clinical practice and as it has been recorded at the Child and Adolescent Mental Health Unit of the Community Mental Health Centre of Byron and Kaissariani, Psychiatric Hospital, Athens University. Data deriving from the database of the Community Mental Health Centre were extracted from the files of 62 bilingual children, aged 0 to 18 years, who had visited the CMHC of Byron and Kaissariani in the period 2000 to 2005. The data selected concerned the sex, age, maternal language, diagnosis and the existence of economic immigration. Means deriving from the sample of bilingual children were compared to the means of the rest of the sample. (Pearson chi,2 Fishers exact test) Based on the results, four fifths of the sample was composed of children belonging to families of economic immigrants. The occurrence of Pervasive Developmental Disorders was triple among the sample of bilingual children compared to the sample of monolingual children. Among school-aged children the majority of diagnoses concerned Specific Language, Movement and Learning Disorders. On the contrary, during adolescence, there was a two-fold increase of psychiatric illness among bilingual adolescents compared to monolingual adolescents with conduct disorders being more prominent among males and mood disorders more prominent among females. Based on the extent and importance of the influence of the dual linguistic environment on children and adolescents as well as on the originality of the new situation in Greek society, further exploration of this area is believed to be necessary.

Factors affecting compliance with treatment in an outpatient child psychiatric practice: A retrospective study in a community mental health centre in Athens.

BACKGROUND: The literature review shows that treatment compliance in child psychiatric practice is a multifactorial issue that includes parameters such as the type of problem presented by the child, the family's functioning and the therapeutic team's organization and functioning. METHODS: In order to examine these parameters and their inter-relationship, epidemiological data from the files of 455 cases, representing the total number of cases admitted to our Centre between 1990-1994, were collected. We noted that the majority of patients (58.6%) failed to comply with treatment. RESULTS: The statistical analysis shows that the sex and age of the child, the socio-economic status of the family, the family's size, the parents' educational background as well as the referral source are unrelated to compliance. On the contrary, the type of problem presented by the child, the type of recommended treatment, the number of sessions attended and the season of admission are correlated with treatment compliance. CONCLUSIONS: Certain aspects of our team's techniques concerning the admission procedure, therapeutic contract and parental counselling have been re-examined and improved.

Achenbach's Child Behavior Checklist and Teachers' Report Form in a normative sample of Greek children 6-12 years old.

Achenbach's Child Behavior Checklist (CBCL) and Teachers' Report Form (TRF) were administered to 6-12 year old school children comprising a large random community sample (n = 1200) drawn from the whole of Greece. These are the first data on the TRF in Greece and the first nation-wide data on the CBCL. Appropriate cutoff points for the behavioral problems and competence scales of both questionnaires were obtained for boys and girls. These were considerably higher than USA cutoffs for the CBCL but not for the TRF. Analysis of scores in relation to degree of urbanization showed that it was not necessary to define different cutoffs in different strata. Parents' and teachers' ratings of the same child were most highly correlated for Externalizing and Aggressive behavior for boys and for Attention problems for both sexes.

The Conners-28 teacher questionnaire in clinical and nonclinical samples of Greek children 6-12 years old.

It is accepted practice in child psychiatry to use more than one source of information in assessing behavioural problems in children and adolescents. Employing standardized tools for these assessments allows cross-cultural comparisons and better interchange of the findings. Achenbach's Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) are two widely accepted instruments that were standardized in Greece within the framework of the European Network for the Study of Hyperkinetic Disorder. We studied the Conners-28 teacher questionnaire in a Greek community sample of primary schoolchildren aged 6-12 years. The factor structure showed to be similar to that originally reported from the USA. Discrimination between the referred and nonreferred sample was high, especially for the Inattentive-passive scale. Conners-28 scores were highly correlated with the TRF (scored by the same informant), much less so with the CBCL (scored by a different informant). Our study demonstrates the usefulness and applicability of the Conners-28 item questionnaire.

Age and cohort effects in adult handedness.

A systematic increase with age of the strong right-handers/mixed right-handers ratio, in normal adults, was found in Algeria, Greece, Italy, France and Spain. This age effect on adult handedness is not easily explained by variations in the social pressure against left-hand use, differential mortality, or information bias. There was no systematic decrease in the frequency of left-handedness with age. Left-hand writing among left-handers was common in the youngest age group and rare after 40 years of age.

The pharmacological effect of fractions obtained by smoking cannabis through a water-pipe. II. A second fractionation step.

The catatonic activity, prolongation of phenobarbital sleeping-time, convulsant action and disruption of nest-building activity was assessed in mice subjected to 4 cannabis pyrolysis products and their tobacco analogues. All but one of the cannabis fractions prolonged the pentobarbital sleeping-time and disrupted the nest-building activity of mice in a way not related to their content in the main cannabinoids. Nest-building activity seems to be the most valid assay we have used so far.

Hashish smoke interfers with Sidman avoidance in mice.

Hashish smoke has been proved to be active in the Sidman avoidance. Its activity is similar to that of hallucinogens.