bluuebunny/crossref_metadata_2025 huggingface dataset:
P01-340-Title: comparing of psychiatric co- morbidity disorders in primary school students with adhd subtypes (attention deficit, hyperactivity, combined) in academic year of 2009–2010 in arak-iran
Authors: Salehi B. , Ebrahimi S. , Moradi S.M.
Published: May 2011

Introduction

ADHD is one of the most prevalent psychiatric disorders in children.

Objective

ADHD have co-morbidity with many other psychiatric disorders.

Aims

Aim of this study was Comparing of prevalence of three subtypes of ADHD with psychiatric Co- morbidity in primary school students of Arak-Iran.

Methods

This study was a descriptive analytic, cross- sectional one, which carried on 2000 (960 girls and 1040 boys)primary school students in 1st state of Arak in academic year of 2009–2010, which screened by Intelligence Raiven scale and 48 Canner’s questionnaire (parents and teachers)and if there were existed of any subtypes of ADHD, we have done K-SADS-E questionnaire(Schedule for Affective disorder and Schizophrenia -epidemiological version)for them, then data were analyzed by using descriptive- statistical methods and Logistic- regression for obtaining R. R.

Results

2.3, 3.5 and 2.7 percent of children have one of the subtypes of ADHD. The findings showed that prevalence of hyperactivity and attention deficit subtypes decreased while combined type increased by increasing age. The prevalence of two subtypes of hyperactivity and attention deficit in boys and girls were not significantly different but combined type was significantly different. Finally, there were differences between ADHD subtypes and Co morbidity of psychiatric disorders such as conduct, depressive,enuresis, tic, schizophrenia, oppositional, obsessive- compulsive, manic and social phobia, but these differences were not significant between girls and boys.

Conclusions

Prevalence of subtypes of the ADHD were different between age and gender but there were not significant differences between Co morbidity of ADHD subtypes and psychiatric disorders.
P01-344-Violence from the perspective of adolescent participants in a health promotion and education group
Authors: Scherer Z.A.P. , Abrahão E.S. , Abrahão-Curvo P. , Scherer E.A. ,   GREIVI – Grupo de Estudos Interdisciplinar Sobre Violência
Published: May 2011

Introduction

Adolescent violence represents a severe public health problem. Adolescents between 10 and 19 years old can get involved in violent acts as victims as well as perpetrators.

Objective

Get to know the senses and meanings attributed to violence from the perspective of adolescent participants in a health promotion and education group.

Aims

Enhance the understanding of the adolescent violence phenomenon.

Method

A qualitative and descriptive experience report was carried out at the Child and Adolescent Care Center in the interior of São Paulo State – Brazil. The 15 study subjects participated in weekly group meetings taking between one and two hours, during which the brainstorming creativity technique was used.

Results

According to the adolescent participants, violence means everything that causes pain, suffering and is related with physical aggressions, discussions, rape, scolding and humiliation, pedophilia and violent movies on television. They denoted special concern with physical violence between couples and siblings and with songs that defile mainly the feminine image.

Conclusion

Group activities that allow adolescents to reflect can enhance a more critical awareness of themes like violence. They can also stimulate the search for actions to improve the reality these subjects are inserted in.
P01-349-Female adolescents ‘health-information needs: a qualitative study
Authors: Shahhosseini Z. , Simbar M. , Ramezankhani A.
Published: May 2011

Introduction

Although much has been written about the health status of adolescents, little is known about adolescents’ perception of their own educational health needs. The purpose of this article is to describe the educational health needs of female adolescents to plan support services.

Methods

This qualitative study was conducted in Mazandaran province, a province in the north of Iran. 67 female adolescents between 12–19 years of age participated in 8 focus group discussion. Inaddittion, semi structured interviews were done with 11 key informants including:5 parents,3 teachers and school counselors,2 obstetricians and one midwife. Participants were selected based on purposeful sampling and with maximum variety. All tape-recorded data was fully transcribed and thematic analysis was done.

Results

Findngs of this research around the adolescents’ health-information needs emphasized on 5 overarching themes including necessary for education, need for appropriate content, need for suitable methods, need for suitable sources and appropriate age for education.

Conclusion

The results show that promotion of female adolescents’ knowledges about reproductive health and life skills is one of the most important health needs of them. Education of this issues via parents, schools and health care providers could promote the health status of adolescents.
Autism and violence
Authors: Touhami M. , Ouriaghli F. , Manoudi F. , Asri F.
Published: May 2011

Introduction

Autism is a disorder of the overall development and early onset before the age of 3 years, characterized by a deviant functioning and / or delayed in three areas: social interaction, verbal and nonverbal behavior.

The child may be aggressive, either to himself or to others. Communication difficulties hamper the social control of the aggression that is often disproportionate and can frighten the family.

In this work we are interested in the management of aggression for the autistic children.

Aims

identify ways of managing aggressive behavior for autistic children

Method

self-administered questionnaires provided to educators, psychologists, psychomotor therapists, working at Mohamed VI national center for handicapped people.

Results

43.3% of our sample exhibits behavioral problems which are « auto ou hétéroagressifs. We noted a male predominance. Precipitating factors were identified in 30% of cases and are mainly represented by the situations of failure and the changes in the environment of the autistic child. The management of aggressive behavior is based on several methods including the use of medications and behavioral approach.

Conclusion

The behavioral disorders are common among autistic children and are a major problem that families face. The aggressive management of the crisis is often difficult, and management remains uncodified.
From metabolism to psychiatric symptoms: Psychosis as a manifestation of acute intermittent porphyria
Authors: Bautista Garrido O. , Vázquez Caubet J.C. , Serván Rendón-Luna B. , Sáiz González M.D. , González Vives S.
Published: May 2011

Psychiatric symptoms may represent the main feature of some metabolic diseases. Acute intermittent porphyria (AIP) is the most common of the four forms of neuroporphyria. This is an heterogeneous group of hereditary illnesses with common alterations along the heme biosynthesis pathway. AIP mimics a variety of disorders, and it difficults a correct diagnosis. We report a case of confirmed diagnosis of AIP in a 19-years-old woman who was admitted to hospital due to a sudden acute psychosis. We have done also a complete bibliographic research about this illness and its relation to psychiatric symptoms.

In this case the differential diagnosis included schizophrenia and substance-induced psychosis. However, the presence of abnormal abdominal pain, port-wine color urine, sensory loss and muscular weakness gave us the clue for investigate AIP. Moreover, some anamnestic details about the use of anticonceptive pills, drug abuse and starvation increased our suspicion. Given the fact that the patient and her sister were both adopted, no family history was available.

The main laboratory findings supporting the diagnosis of AIP were a decrease in porphobilinogen deaminase (PBGD) activity in erythrocytes concomitantly with the detection of IVS7 (+33) G>T mutation of this enzyme’s gene.

Despite the prevalence of AIP is not high around Mediterranean countries, this possibility should be kept in mind in order to elucidate the origins of a not so low number of acute psychotic episodes. They can be effectively and specifically treated, as well as easily prevented by controlling porphirinogenic factors.
The importance of some life events to depresion of patients with cardio- surgery intervention (aorto-coronary bypass)
Authors: Damjanovik L. , Mitrev Z. , Ristova Dimova T.
Published: May 2011

Introduction

The cardiovascular desease is the great reason for mortality of the patiens. The comorbidity with the depression have a great influence of the incidence, morbidity and mortality. Some live events make the depression efects worse for the patient who take cardio-surgery treatment.

Aims

is to find the importance of some life events to depression of the patients with cardio-surgery intervention.

Methods

In this study there was 30 patients, hospitalised at Cardiosugery Hospital Filip II, Skopje for cardio-surgery intervention (aorto-coronary by pass), 38–79 age, both male and female. These psychiatric instuments were used:Hamilton depression scale (HAMD), (17 itema scale with max score 52 and minimal score 0) and Scale for living stres factors of Holms and Rahe.

Results

The average score of depression preoperation on HAMD scale is 16.77 ± 8.05, and the postoperation score were incresed to 21,25 and is high statistical significance (p < 0.01).The some events like death of member of the family, the illness, a big finansical changes significantly increace the depression (p < 0.01), but a newborn in the family, the holidays significantly decrese the depression on the participants (p < 0.05).

Conclusions

Multidisciplinary approach with the team of psyciatrists, psychologist of patient with cardiovascular desease make the despression efects small and the patients have good recovery.
Psychosomatic diseases and depression with general practice physicists
Authors: Ilic N.
Published: May 2011

The psychosomatic diseases belong to the group of the most spread disorders in the contemporary medical practice. Answer to the question--what is the spread of those disorders and depression with general practice physicists, we have looked for by means of a research performed in February 2008 in the Health Centers Nis and “Vozdovac”-Belgrade. As the research instruments, we have used an anonymous questionnaire about the psychosomatic diseases and depressivity self-estimation scale (ZUNG). Those papers were filled by 36 of physicists and general practitioners, male and female, aged 30-55 years. The thirteen of the total 36 polled doctors (36.11%) were found to be affected by psychosomatic diseases. Ten doctors suffer from hypertension (76.92%), two of them has ulcer (15.38%) and one doctor have diabetes (7.69%). Two of them are found not to be depressive (15.38%),three ones are depressive in remission (23.07%), four doctors are depressive with other disorders (30.76%),and four of them need depression medical treatment (30.76).

The depression in total number of polled doctors (36) is distributed as follows:

Four without depression (11.11%), eight with depression in remission (22.22%), eighteen with depression followed by other disorders (50%) and six of pooled showed depression that needs medical treatment (16.66%).

In the polled group, that offered psychosomatic illness, there is one third with depression that need medical treatment (30.76%)-this is two-times more (in percents) than of those in the total number of polled doctors (16.66%).
Delirium in hospitalized patients: A descriptive and retrospective study in the Clinical University Hospital of Valladolid
Authors: Sánchez Lorenzo I. , López Saracho I. , Ledo Rubio A. , Gómez Pizarro D.
Published: May 2011

Introduction

The syndrome confusional acute (SCA) is one of the most frequent mental disorders in patients hospitalized by medical diseases. It is characterized by acute onset symptoms fluctuating course, impaired attention, unorganized thinking, and altered level of conciousness. Though it is considered to be a reversible disease, often it is a sign of future deterioration of the cognitive functions.

Objective

To determine delirium prevalence and risk factors in a cohort of hospitalized patients. To know the characteristics of this population and the psychopharmaceuticals used.

Methodology

A descritptive and retrospective study was conducted, based on the review of 2642 medical records of hospitalized patients in the Clinical University Hospital of Valladolid between July, 2007 and February, 2010.

Results

893 (33,8%) presented delirium. 63,3% were men and 36,7% were women. The mean of age was 77 years. Turned out as significant predictive factors with highest percentages: cardiovascular disease (18,3%), traumophaty (15,1%). The principal motive of consultation was surgical pathology (48,1%). 30% presented cognitive deterioration also. They were medicated with tiaprizal (75%), olanzapina (24%), quetiapina (22,5%) and other medications.

Conclusions

The SCA is a frequent syndrome and has a negative impact on morbidity, as well as in resource use. It is possible to identify risk patients. The SCA can be the form of presentation of a physical serious disease or appear as a serious complication of a disease or of treatment. The treatment must divide in three principal aspects: prevention, treatment of the causal disease and symptomatic treatment of the delirium.
Medical consultations in psychiatric inpatients
Authors: Serván Rendón-Luna B. , Morón Nozaleda M.D. , Trebbau López H. , Machín Vázquez-Illá M. , Reyes Molón L. , Fernández Aurrecoechea J. , Marco Martínez J.
Published: May 2011

Introduction

Psychiatric illnesses have a high prevalence in the general population. Psychiatric illnesses affect the way other medical processes develop: age of onset, distribution by gender, type an evolution, and the training of the psychiatrists in caring for them.

Objetives

To describe the characteristics and the medical problems of patients who have been consulted by an Internal Medicine Liaison Unit while hospitalized in the Psychiatric Unit of a third level hospital. Comparison of the general profile of these patients and their consultations with that done to patients hospitalizad in the rest of the hospital.

Methods

Descriptive retrospective study from September 2007 to May 2010. Use of a centralized database created with of all the administrative and clinical details regarding the consultation. A p ≤ 0.05 has statistical significance.

Results

648 patients were identified (40,7% men). Mean age 52.4 years. Mean stay 3 days. 34,4% were solved in one visit. Mortality rate 0,3%. 94,1% of discharges were due to recovery, the rest were transfered to another service.

Distribution by major diagnostic groups: infectious 16,2%, cardiorespiratory 15,4%, mental illness 12,9%, metabolic 10,4%, tumoral 8,5%, digestive 8,2%, not defined 8,2%, hematologic 5%, others 15,2%.

Conclusions

The psychiatric patient is clearly younger and the female gender is slightly higher (59,3%) than in the control group. In this group the infectious and cardiorespiratoty illnesses predominate. The percentage of psychiatric consultations (34,1%; 648) over our global (1906) is impressive since the number of psychiatric inpatients is not proportional to this number.
Anxiety in patients before coronary angiography
Authors: Tel H. , Yazıcı Sayın Y. , Yılmaz M. , Tel H. , Güneş P.
Published: May 2011

Introduction

Coronary Angiography (CA) allows life saving diagnosis and treatment methods. However, because of its being an invasive intervention, it causes patient to live through fear and anxiety due to the process.

Objective

The present study was carried as a descriptive study in order to determine the anxiety condition in patients before coronary angiography.

Method

296 patients to be subjected to the coronary angiography were included in the study. The research data gathered with individual information form and State Trait Anxiety Inventory of Spielberger.

Findings

It was found that the anxiety points of the patients changed between 28 and 55 and the average anxiety score was 41.22 + 6.16. It was determined that the anxiety scores were high in the patients with a body mass index of 25 and above, using cigarette, having another chronic disease, previously diagnosed with heart disease, having someone in his/her family who has heart disease story, not being introduced to the angiography team before the operation, having angiography story, having angiography complication story and not having health insurance.

Results

It was found that patients lived through anxiety either at small or medium levels before coronary angiography. It is needed that the anxieties of the patients should be determined before the angiography and the approaches to decrease anxiety should be applied, the patients should be introduced to the angiography team before the operation.
The management of depression in oncology: State of play
Authors: Touhami M. , Ouriagli F. , Manoudi F. , Asri F.
Published: May 2011

Introduction

Many authors insist on the psychiatric accompaniment of patients in oncology. Today in developed countries, the role of psychiatrists has become a necessity in the context of a multidisciplinary working (psychiatrists, oncologists, radiotherapists…) The work of psychiatrists became necessary because of the prevalence of cancer and because of the development of therapeutic methods and specificity of the disease itself.

The objective of this work

The authors of this work focus on the current state of accompaniment and the role of psychiatrists in the care of patients regarding the structures of Oncology Nursing.

Materials and methods

The study was conducted at the National Institute of Oncology (INO) People interviewed: 50 doctors practicing in the INO.

Information was collected prospectively from a self-administered questionnaire completed by physicians

Results

40% of psychiatric manifestations appear after the diagnosis of cancer, 61% of oncologists reassure patients considering the symptoms as normal, 11.1% prescribe psychotropic especially anxiolytics.

Conclusion

The specificity of cancer requires the presence of psychiatrists in the service of cancerology
Association between albumin and social cognition in attention-deficit-hyperactivity-disorder (ADHD)
Authors: Grabemann M. , Zimmermann M. , Mette C. , Kraemer M. , Abdel-Hamid M. , Zepf F. , Wiltfang J. , Kis B. , Uekermann J.
Published: May 2011

Introduction

Albumin is a protein which serves as a transporter for a variety of metabolites and as a storage for a lot of substances. Although albumin cannot pass the blood-brain-barrier and thus influence the CNS directly, a negative relation between cognitive impairment and serum albumin level has been observed in studies of normal and pathological aging.

The aim of the present study was to investigate the association between albumin and social cognition in ADHD.

Method

20 adult patients with ADHD and 20 healthy controls participated in a double-blind within subjects crossover study. Participants completed the Moral-Judgment-Test, Tuebingen Affect Battery, the Movie for the Assessment of Social Cognition (MASC) and Cambridge Behaviour Scale (EQ). In addition, ADHD symptoms were assessed by the Wender Utah Rating Scale (WURS-K) and ADHD Self Rating Scale. Serum albumin levels were determined after blood withdrawal.

Results

In the patient group serum albumin levels were negatively associated with ADHD pathology measured by WURS-K. In addition, a low level of albumin was related with poorer performance in theory of mind, moral judgment competence and affective prosody tasks.

Conclusions

The results suggest that albumin is related to social cognition in younger patients with ADHD. This is, to the knowledge of the authors, the first investigation, in which the association between albumin and cognition has been investigated in ADHD. Thus the findings of the present study need replication and the neural mechanisms have to be explored in future studies. Further studies are needed to exclude a possible medication effect.
Two faces of rem sleep in normal and psychopathological development
Authors: Kirov R. , Uebel H. , Albrecht B. , Banaschewski T. , Rothenberger A. ,   Sleep in Child Psychiatric Disorders
Published: May 2011

Introduction

We have previously found an increased rapid eye movement (REM) sleep in children with attention-deficit/hyperactivity disorder (ADHD).

Objectives

To further investigate sleep characteristics in children with ADHD and their association with cognitive and neurobehavioral functions.

Aims

We asked whether and how REM sleep might have been associated with cognitive ability and neurobehavioral functions in children with ADHD compared with healthy children.

Methods

Twenty-three children with ADHD and 21 healthy controls underwent a two-night polysomnography and completed a number of standardized tests for cognitive and neurobehavioral functioning.

Results

Compared with controls, ADHD children exhibited a greater amount of REM sleep. In the ADHD group, the increased amount of REM sleep correlated positively with psychopathological scores (inattention) and negatively with performance intelligence quotient (IQ) (Fig. 1).

Fig. 1

[Kirov et al_Figure 1]

In contrast, in the healthy controls, the REM sleep amount correlated positively with performance IQ and negatively with psychopathological scores (inattention) (Fig. 2).

Fig. 2

[Kirov et al_Figure 2]

Conclusions

We conclude that REM sleep may have a bi-directional role in cognition and neurobehavioral functioning during childhood depending on the presence or absence of psychopathology.
Neurocognitive outcome after cognitive remediation in a 6-year-old girl with a history of perinatal stroke
Authors: Matos-Pires A. , Cardoso-Pereira N.
Published: May 2011

Perinatal Stroke involves an often poorly understood neurocognitive events affecting the fetus and the new born with a potential for serious intellectual outcome.

Our aim is to present a case study on the issue of neurocognitive defects on domains such as intellectual performance, attention and vigilance, executive functioning, visual perception, speed of processing, verbal learning and memory, and working memory on a 6 year old girl with perinatal arterial ischemic stroke.
A diminished serotonin level influences the performance in a modified AX-continuous performance task in adult ADHD
Authors: Mette C. , Grabemann M. , Zimmermann M. , Kraemer M. , Zepf F. , Suchan B. , Wiltfang J. , Kis B. , Uekermann J.
Published: May 2011

Introduction

Attention deficit disorder (ADHD) is a psychiatric disorder, which is characterized by deficits of executive functions (EF) and impulsivity. Whereas a variety of studies on the involvement of the dopaminergic system in ADHD exists, the impact of the serotonergic system to EF in ADHD in adults is underinvestigated.

Aims

To ascertain the effects of rapid tryptophan depletion (RTD) and the resultant reduction of the central nervous levels of serotonin on the EF of male adult patients with ADHD.

Methods

20 ADHD patients and 20 healthy controls completed the RTD test on one day and a placebo on another day in a double-blind within subject crossover design.- In addition, the subtest alertness of the TAP and a modified Version of the Continuous performance test (AX-CPT) with three stimulus conditions (AX, AY, BX) were administered.

Results

Statistical analysis revealed significant shorter reaction times, more errors and more omission errors in the ADHD group in the AX-CPT. The omissions error rate increased in both groups in the RTD condition but not in the placebo condition. Statistical analyses did not yield any significant differences between groups in the subtest alertness and no significant interaction of group and effect of the RTD condition could be observed.

Conclusions

In addition to higher impulsivity of patients with ADHD as reflected by shorter reaction times and higher error rates, the results of the present study imply an involvement of the serotonergic system as reflected by RTD in sustained and selective attention.
The effects of rutin on memory retrieval in normal rats
Authors: Nassiri-Asl M. , Zamansoltani F. , Javadi A.
Published: May 2011

Introduction

Various synthetic derivatives of natural flavonoids are known to have neuroactive properties.

Objectives

It has been reported that rutin (3, 3’, 4’, 5, 7-pentahydroxy flavone-3-rhamnoglucoside) has several pharmacological properties and it was found to be a neuroprotective agent.

Aims

To investigate the effects of rutin, a flavonoid that is an important dietary constituent of foods and plant-based beverages, on memory retrieval in rats.

Methods

We assessed the effect of rutin on memory retrieval using a step- through passive avoidance task. Control (saline, 0.1 ml/100 g body weight) and rutin (5, 10, and 100 mg/kg) were administered intraperitoneally (i.p.) one week before the start of training. Three retention tests were performed to assess memory in rats.

Results

Rutin (10 mg/kg) significantly increased the step-through latency of the passive avoidance response compared to the control in the three retention tests of the passive avoidance paradigm. These results indicate that rutin has a potential role in enhancing memory retrieval.

Conclusions

It is possible that rutin acts by several mechanisms, mediating a potential role in memory retrieval in rats. This result supports the potential beneficial effects of rutin as a dietary supplement on memory retrieval in a passive avoidance task.
Selective attention and inhibitory control in acquired blind individuals
Authors: Nejati V.
Published: May 2011

Background and aim

Blindness cause functional and structural change in brain. The aim of this study is evaluation and comparison of selective attention and inhibition in acquired blinds and matched sighted

Method

Forty five Acquired Blinds of war veteran and fifty six healthy volunteers participated in this cross sectional study. Auditory Stroop Test is used for evaluation of selective attention and inhibitory control. Independent T Test was used for comparing blind with sighted.

Results

Findings show significant difference between two groups so that sighted subjects have higher performance in accuracy and reaction time of all stage of stroop task.

Conclusion

We concluded that acquired blinds didn’t have any preference in selective attention and inhibitory control versus matched sighted.
Theory of mind & cognitive flexibility
Authors: Willinger U. , Schmoeger M. , Mueller C. , Auff E.
Published: May 2011

Theory of mind (ToM) refers to the capacity to attribute certain independent mental states, contents and processes to others - such as desires, concepts, intentions, beliefs and emotions (Wimmer & Perner, 1983). As there is a body of research with respect to the development of ToM in children, much less is known about adult mentalizing abilities, especially regarding the relationship between cognitive functioning and ToM. The present study aims to investigate a new instrument, called ToM-Stories and its relationship to the established ToM-Picture-Test (Bruene et al. 2005) and to cognitive functioning by using the Trail Making Test. Our ToM-Stories consist of brief stories, each describing a real life situation of various degree of complexity. All of them involve unintended misleadings in the sense of a false belief. Their comprehension requires mindreading at different levels of intentionality. The sample was composed of 79 adults, 45 (57%) women and 34 (43%) men, ranging in age from 18 to 88. Reliability analyses of the ToM-Stories yielded a Cronbach’s alpha of 0.79 (false belief-first order), 0.74 (false belief-second order), and 0.65 (false belief-third order). Correlation analyses showed moderate values between ToM-Stories and the Tom-Picture-Test (r = 0.496; p ≤ 0.0001) as well as the Trail Making Test B-A (r = −0.481; p ≤ 0.0001). The findings of the current study provide evidence that cognitive flexibility is an important competence in promoting representational understanding of the mind.
Working with cultural diverse persons involved in law and mental health - cultural competency training manual
Authors: Chow W. , Sadavoy J. , Wong J.
Published: May 2011

The goal of this presentation is to introduce a new “Cultural Competency Training/Manual (CCTP) for Law and Mental Health professionals Working with persons involved with law and mental health” sponsored by a grant from the Law Foundation of Ontario and department of psychiatry of Mount Sinai Hospital.

The manual is qualitative which includes conducting a literature review, facilitation of multi-stakeholder focus groups, and interviewed key stakeholders, consultation with clinical staff from the Mount Sinai Hospital and other Court Support programs, to address the key challenges in working with culturally diverse persons involved with law and mental health. In the oral presentation, we will present key themes on the challenges in dealing with culturally-diverse persons involved in law and mental health. The themes were consistent with the literature, evidence-based research, and validated by actual provider experience. They include language and communication, mistrust of mainstream services, racism and discrimination, resistance from persons involved with law and mental health and their families, and the need for cultural competency practices, such as interpretation, cultural understanding, community and systemic support. With these themes in mind, we will demonstrate the application of practical skills and cultural competencies using vignettes. A cultural competency model of working with culturally diverse persons involved in law and mental health and the five key responsibilities will be introduced. They include the following domains: language and communication, system support and navigation, education and advocacy, and collaboration.
The mental health needs of asylum seekers and refugees in Ireland
Authors: Datta A. , Frewen J.
Published: May 2011

Introduction

Asylum seekers and refugees (ASR) are commonly portrayed as opportunists who came to Ireland to fraudulently scrounge off the Irish public. Such views and the consequent exclusion and discrimination they experience can aggravate their mental health risks and reduce their willingness to seek professional help.

Objectives

To identify the mental health risks faced by ASR and outline specific measures to improve their situation.

Aims

Through available hardcopy and online literature

1/Assess and evaluate impact of asylum seeking and refugee integration process on ASR psychiatric problems in Ireland.

2/Assess and evaluate knowledge and understanding of ASR mental health status; effects of segregation from local communities due to living in isolated ‘centres’ and no employment entitlement; communication and cultural integration difficulties; impact of exclusion and/or (racial) discrimination; apprehension of alien mental health system and treatment process; differing outcome expectations held by ASR and mental health specialists; and fear of being stigmatised by peers.

Methods

Rigorous review of relevant and applicable hardcopy and internet literature in English language since 2000.

Results

ASR mental health problems associated are generally multi-dimensional. In addition to ‘normal’ stresses, many ASR are haunted by past hardships, experience exclusion and integration difficulties and endure a highly stressful asylum process.

Conclusion

ASR require additional, specifically targeted mental health assistance and services that respect and understand their particular needs. Mental health services should work with the asylum process and other relevant socio-economic sectors to develop programmes to tackle potential ASR mental health concerns.
Culture, vultures and the politics of post-neoliberalism a foot sodier’s perspective
Authors: Goel D.
Published: May 2011

Aims

To review the current status, directions and distortions in the field of culture and mental health, and their interface with politics.

Background review

Arising from the ruins of Adam Smith's shattered capitalist dream, shattered by the Great Depression, Keynesenian economics underpinned post-neoliberal thought and shaped politics, culture and science in ways few could have imagined.

Biomedical science did not remain immune, and mental health provided a soft target to political activists and reformers. Research evidence relating to ethnic variations in the prevalence, pathways to care and outcomes in schizophrenia, generated from epidemiological studies on migrant populations and a series of WHO-sponsored cross-cultural studies, has become enmeshed in the dialectic around alleged institutional racism in psychiatry, with deeply entrenched and highly adversarial posturing on both sides.

Method

Examine research evidence linking schizophrenia and culture, and how the politics of post-neoliberalism impacts scientific inquiry, with illustrations from different countries, and attempt to identify islands of credible research and outline possible future directions.

Results

Fragmented and often contradictory evidence in this area does not lend itself to coherent inferences, with the problem being compounded by allegations of institutional racism.

Conclusions

There are many unanswered questions:

•

Does cultural research improve clinical practice?

•

Or does it merely distract attention from core/ important secular issues?

•

Does it tend to demonise mainstream services and alienate ethnic minority patients?

•

Does what some term cultural gimmickry serve a hidden political agenda?

•

Has cultural research evidence lead to meaningful macro or micro-level interventions?
Adapting the SRQ for greek populations: a culturally-sensitive psychiatric screening instrument
Authors: Lyrakos G. , Kitsiou M.C. , Goudella A. , Spinaris B.
Published: May 2011

Introduction

There is a significant disagreement in the literature concerning the validity of psychiatric instruments in different cultures.

The objective of the study was to develop a culturally sensitive psychiatric screening instrument valid for Greeks in Greece and all over the world.

Methods

Forward and back translation was used for the greek version of the instrument. The sample was divided into three groups:

i) general population(69,4%);

ii) people in non-psychiatric treatment(12,9%);

iii) people in psychiatric treatment (11,7%).

They were interviewed with the Self-Reporting Questionnaire (SRQ), modified to include SRQ-F culturally specific items and physicians also completed an encounter form about the presence of mental health symptoms in participants.

Results

The study sample was composed of 631 Greek speaking adults, 502 females and 129 males, aged 18—67 (M = 30, SD = 11,5). Internal consistency for the overall score was very high (α = ,930). Item total correlations were between, 443 and, 692. Factor analysis revealed four factors accounting for the 54,22 of the total score variance. The factors were anxiety symptoms, depressed mood, somatic symptoms and psychotic symptoms. Content, construct, and criterion validity of each question led to 25 items. Independent t test revealed significant differences between psychiatric patients and control group in the total score (t = -17,795 p = ,0001), psychosis subscale (t = -12,622 p = ,0001) and somatic distress subscale (t = -17,712 p = ,0001).

Conclusions

The Greek SRQ was found to be a valid instrument which can be used in primary care to help general practitioners in the early recognition of mental illness.
Use of mental health services amongst ethnic groups - a service evaluation
Authors: Mothi M. , Nijabat K. , Mason O.
Published: May 2011

Introduction

London Borough of Waltham Forest is composed of an ethnically diverse population. In some ethnic groups, mental illness may prevent access, or influence non-attendance when referred to Mental Health Services.

Objectives

To examine referrals received by our service and first appointment attendance with respect to gender and ethnicity.

Aims

To assess the characteristics of referrals and first appointment attendance when accessing mental health services during August 2009 and compare with ethnic demographics of the borough.

Methods

We retrospectively analysed psychiatric referrals received. Data was collected from electronic patient record.

Results

Of the 159 referrals evaluated, 39% referrals were White, 13% Asian, 13% Black, 3% mixed and 4% other. Majority of referrals were from general practitioners. In 28%, ethnicity was not recorded. 60% were female and 38% male. 52% were referred for mood symptoms. 24% Whites attended their first appointment as opposed to 9% of Asians and 8% Blacks. While referrals reflected the wider population, there was a higher rate of non attendance amongst ethnic minority groups than Whites. Interestingly a higher number of females attended their first appointment compared to males. This may explain for lower number of female admissions compared to males.

Conclusion

We found several possible explanations for the above findings from literature which highlighted stigma as a major determining factor. Our trust has an Equality and Diversity Work plan to promote engagement of minority ethnic groups. However there seems to be a relative poverty in accessing services in our Borough.
Perceptions and beliefs about mental illness in romania
Authors: Todor I.
Published: May 2011

Negative stereotypes and stigmatizing attitudes against mentally ill persons have powerful historical roots in many cultures. The common perspective about these persons, who are unable to defend their rights, is that they are dangerous, violent and unpredictable (Arboreda-Florez & Sartorius, 2008). This paper presents a preliminary investigation regarding the public perceptions and attitudes about schizophrenia using an adapted version of the Opinions about Mental Illness Scale (Cohen & Struening, 1962). The participants were 350 university students and the following five attitudinal dimensions were investigated: authoritarianism (the opinion that people with schizophrenia are not able to respond about their acts and they should be controlled by the society), benevolence (an attitude that could be placed between tolerance and mercy), mental hygiene ideology (the opinion that mental illness is similar with other illnesses and it should be treated adequately by specialists), social restrictiveness (the opinion that mentally ill persons should be restricted in some social domains), and interpersonal aetiology (the belief that the real cause of a mental illness are the problematic interpersonal relations). The implications for the implementation of anti-stigma programs are discussed.
Can healthy lifestyle modify risk factors for dementia? findings from a pilot population-based survey
Authors: Andrade J. , Purshouse K. , Mukaetova-Ladinska E.
Published: May 2011

Introduction

Aspects of lifestyle are a key component to successful ageing and reducing the risk of cognitive impairment. Many developing countries, including India, currently have a much lower rate of dementia in people of the same age in the UK (Alzheimer’s Disease International 2008), in contrast to the higher prevalence rates of cardiovascular risk factors (reviewed in Misra and Kurana, 2009).

Objectives

Compare lifestyle choices in a developed and a developing country, that show contrasting dementia prevalence rates.

Aims

Identify protective factors that may reduce dementia prevalence.

Methods

A total of 251 participants at public meetings (123 in Newcastle and 128 in Chennai) on ageing completed a questionnaire voluntarily regarding their lifestyle, health status, 4-item GDS, and their subjective perception of their mental and physical health. The two groups had similar sociodemographic characteristics.

Results

Diabetes was three times more prevalent in the Chennai group (p = 0.001) but a significantly higher proportion of the Chennai population reported receiving treatment for diabetes (p = 0.012). Vegeterian diet was more frequent in the Chennai cohort (p = 0.000), as well as curry consumption (p = 0.000). The Newcastle group consumed more alcohol (p = 0.000) and practiced exercise less often (p = 0.005). Not surprinsingly, 95% of the Indian is religious, in contrast to 59.7% of the English (p = 0.000).

Conclusions

Type of diet, curry and alcohol consumption, and religious or spiritual beliefs, were the most significantly different, and may therefore confer protective advantages for dementia. Other explanations could be a higher proportion of uncontrolled diabetes and inactive people in the Newcastle sample.
The onset of dementia in patients with an acute ischemic stroke
Authors: Bacila C.
Published: May 2011

Introduction

Stroke is a disorder that has great prevalence, defined vascular territories and psychiatric signs generally emerge in association with specific cognitive deficits.

Objective

Dementia occurs frecquently after acute ischemic stroke. The incidence of dementia six months after stroke is about 42%. Fortunately, in recent years, more attention has been paid to organic disorders provoked by strokes, especially to dementia.

Aim

To follow up the occuring dementia after stroke and also to follow the various psychiatric disorders with the onset during or after an acute ischemic stroke.

Methods

Altogether 110 patients were recruited to this observational and non-interventional study, patients who were suffering from a psychiatric disorder after an ischemic stroke (according to DSM IV TR). The screening was followed by four visits during six months, when CGI, 17-HAMD, CROCQ and MMSE scales were used.

Results

Of 110 patients, 39,09% has been diagnosed with dementia. A number of these patients (n = 26) developed an onset like paroxistic disorder (60,46%), or an acute syndrom (20,93%) and 8 patients were considered “de novo” (with the onset of cognitive impairement after 60 days). There were various acute disorders occuring in the onset of dementia, that includes: amnestic syndrom, organic delirium, organic anxiety syndrom and a small number of patients (n=2) who developed mild cognitive disorder.

Conclusions

The literature considers vascular dementia occuring after an ischemic stroke and increasing step by step mnestic deficits; our study releaved a metamorphosis of various types of onset (anxiety, depression, delirium) or cognitive impairement could occurs after 30 days.
Vascular dementia - clinical case
Authors: Lopes R. , Moldes P. , Pinto A. , Fernandes L.
Published: May 2011

Introduction

Vascular Dementia (VD) is the second most frequent cause of dementia (20–30% of cases) with a similar percentage associated with Alzheimer’s disease (AD). Due to increased prevalence, its early diagnosis is of particular importance for prevention and correction of risk factors.

Clinical case

An 82-year-old Caucasian woman has been taken to the emergency department by her husband, presenting changes in behaviour defined by aggressiveness, delusional and paranoid ideation with 1M of progression. She had also suffered cognitive impairment (memory deficits, prosoprognosia, disorientation) and some functional decline. She also experienced isolation and reduced communication, anxiety, almost total insomnia, emotional lability, slurred speech, slowed gait and urinary incontinence.

Discussion

This elderly patient with multiple medical comorbidities (HTA, DM, chronic AF hypocoagulated, MI, Craneoencephalic trauma with a stroke episode) was admitted to the Department of Psychiatry and investigated with auxiliary diagnostic tests and neuroimaging. We found ischemic injury and haemorrhagic sequelae in the latter and in the neuropsychological assessment cognitive deficits were found (executive function, attentional, semantic memory and visuoespacial). Due to this findings and the rapid evolution of symptoms, the diagnosis was Cortical and Subcortical VD.

The patient was treated with a minor anxiolytic, a hypnotic inducer and an antidemencial, with improvement, after one week, of her emotional lability, behavioural symptoms and remission of delusional ideation. At discharge, she maintained slow gait, urinary incontinence, as well as attentional, mnesic and executive deficits, and she was partially oriented, in spite of anosognosia.

She was transferred to geriatrics and to a day center.
Trazodone in elderly patients with dementia: impact on caregiver burden
Authors: Pérez E. , García J.C. , Gandía R. , Bonete J.M. , Matarredona J.
Published: May 2011

Introduction

Trazodone is a Serotonin-2A Antagonist/Reuptake Inhibitor (SARI) that combines its ability as a 5/HT2A receptor antagonist with some serotonin reuptake blockade actions. Studies support its use in the treatment of behavioral disturbances in patients with Alzheimer's disease and frontotemporal dementia.

Objective

To evaluate the effectiveness of trazodone in behavioral symptoms and caregiver burden in elderly patients with dementia.

Methods

In 49 patients (males and females) older than 65 years with dementia (DSM-IV), trazodone was associated to the standard treatment in a single night variable dose (50–200 mg). On days 0, 14 and 42 neuropsychiatric disorders and caregiver burden (Neuropsychiatric Inventory-Nursing Home Version, NPI-NH) were assessed. On days 0 and 42 cognitive impairment was measured by the test Mini-Mental State Examination (MMSE). The Clinical Global Impression (CGI) was administered on the last visit. Statistical evaluation was done by SPSS 17®.

Results

38 patients completed the study. Global score NPI-NH was significantly reduced (p < 0.001). Sleep quality subscale improved significantly (p < 0.001). The MMSE was not modified. The caregiver burden showed a significant decrease (p < 0.001) on each visit.

Trazodone was well tolerated (main adverse effects were: hypotension (4.1%) and somnolence (2%). Patients evolution was positive (CGI).

Conclusion

Results of this study suggest that trazodone is an effective treatment for behavioral symptoms of dementia. Trazodone reduces caregiver burden without modifying the patient’s cognitive function.
Are platelet serotonin levels and platelet mao activity the biological markers for the progress of alzheimer’s disease?
Authors: Presečki P. , Muck Šeler D. , Mimica N. , Mustapić M. , Pivac N. , Mihanović M. , Nedić G. , Folnegović-Šmalc V.
Published: May 2011

Introduction

Alzheimer’ disease (AD) is a complex and progressive neurodegenerative disorder with unclear aetiology. Cognitive impairment and the behavioral disturbances in patients with AD might be associated with altered serotonergic system.

Objectives

Platelet serotonin (5-HT) levels and platelet monoamine oxidase type B (MAO-B) activity might be the biological markers for the progress of AD.

Aims

To determine platelet 5-HT concentrations and MAO-B activity in female patients with mild, moderate or severe stage of AD and sex and age matched healthy controls.

Methods

The study included 106 female patients with the diagnosis of probable AD (DSM-IV-TR and NINCDS-ADRDA criteria), subdivided according to the Mini Mental State Examination (MMSE) score in early (MMSE 26-18), middle (MMSE 17-10) and late (MMSE 9-0) phase of AD. Control group consisted of 102 healthy elderly women (MMSE 30-27). Platelet 5-HT concentrations and MAO-B activity were determined using spectrofluorimetric methods.

Results

Platelet 5-HT concentrations and MAO-B activity were similar between all patients with AD and healthy controls. Patients in the late phase of AD had significantly (p < 0.05) lower platelet 5-HT concentrations and MAO-B activity than patients in other phases of AD and healthy controls. The significant correlations were found between MMSE scores and platelet 5-HT concentrations, MAO-B activity and age.

Conclusion

The results suggest that platelet 5-HT concentration and MAO-B activity might be the peripheral biological markers for the severity and/or clinical progress of AD.