bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of paranoid symptomatology in the elderly and relationship to organic brain factors
Authors: Serrano Díaz de Otálora M. , Gómez-Arnau Ramírez J. , Martínez de Velasco R. , Artieda Urrutia P.
Published: May 2011

Introduction

Psychotic diseases in the elderly are underdiagnosed due to the limited use of medical resources. Advanced age makes psychoses of any cause less pure and differentiated, since old age adds a cognitive-impairment component to the basal psychotic defect.

Objectives

We intend to estimate the prevalence of paranoid symptoms in older patients, and to study the many medical conditions associated with psychosis.

Methods

We conducted a literature review and we have performed a review of several clinical trials.

Results

We found 12.1% of paranoid symptoms in the elderly with cognitive impairment. In absence of this factor, we found a prevalence of 14.1% for suspicion tendencies, 6.9% for paranoid thoughts and 5.5% for evident delusions. These figures were significantly higher in old black people.

We present a table of the main medical conditions that can produce psychotic symptoms. Some cases of apparently typical delusional disorder can appear as a long-term complication of some of these diseases. If organic factors are subtle and long lasting, the clinical may reproduce a fairly typical delusional disorder and may respond to treatment with neuroleptic drugs.

Conclusions

It seems possible that organic brain factors are more common that we believe, becoming essential a comprehensive study of the old psychotic patient. We should pay more attention to psychotic symptoms in elderly patients and avoid conclusions based on cross-evaluations. Diagnosis will be defined by evolution in most of the cases.
Depression and social support in old people
Authors: Shahbazi Z. , Ahmadi Gatab T.
Published: May 2011

Introduction

Social support among old people is particularly important because Event of life may endanger the supportive networks in this age-group the administered researches on old people have shown that:

Social support with more life satisfaction is less related to feeling of depression.

Objective

The aim of this study are the investigation of relationship between amount of depression and social support.

Method

The sample of this study is composed of 100 old people that were selected randomly data about depression and social support were collected by depression inventory and social support scale.

Results

The results show that: the amount of depression among old people is approximately 22% and women reported more depression depression among people who lost their spouse was higher than illiterate people and people with higher education reported more depressive symptoms depression had a negative.

Association with social support and old men in comparison with old women.

Reported more social support, especially from family.

Discussion

Some of studies noted that: family support and performance affect the mental health in old people and suggested: old people with psychological.

Symptoms such as depression can benefit from family intimacy and wormth.
Clinical features of affective disorders in the elderly
Authors: Popova N.M. , Shakhurova N.I. , Schastnyy E.D.
Published: May 2011

Introduction

Mood disorders in the elderly are a relevant clinical problem associated with high prevalence and frequent co-morbidity with chronic somatic diseases.

Objective

Study of clinical traits of depression in elder persons with somatic disorders.

Methods

The investigation was entered by 582 persons (women = 391 (67,1%), men = 191 (32,9%)), mean age of women has constituted 67,5 ± 5,8 years, men - 62,1 ± 3,8 years.

Criteria of inclusion

Age in women 55 years and higher, in men - 60 years and higher, clinical level of depression according to Beck Inventory more than 22 scores.

Results

Affective disorders were represented by symptom complexes that masked depression and complicated diagnosis. Clinical symptoms in the kind of anhedonia and complaints about anergia dominated (73,6%), whereas depression, melancholy have moved behind and have constituted 26,4%. Psychopathologic disturbances presented against the background of lingering chronically flowing neurological and somatic diseases (cerebral atherosclerosis, brain blood circulation impairment, IHD, HI, respiratory organs’ diseases) in 73,6 %. High risk of emergence of depressive disorders was noticed in widows with low level of education, living in rural area and in persons with somatic diseases. In 32% of probands we have revealed depression that correlated with marital status and feeling of loneliness (p > 0,005). In persons with high level of depression and experiencing feeling of loneliness, risk of suicidal behavioral was higher 2,1 as much.

Conclusions

Study of affective disorders in the elderly allows assessing co-morbidity of somatic and mental disorders, developing tactic of psychotherapeutic and psychopharmacological assistance rendering.
Effectiveness of the electric shock treatment on the old age patients
Authors: Shpak N. , Boldi I. , Maze-Launay I.
Published: May 2011

The authors analyse 17 cases of electric shock treatment performed in the over 70th years old patients. They observe the effectiveness on affective status, the cognitive performance and the patient's autonomy. These items and the treatment's tolerance are measured before and after the treatment by a standardized geriatric assessment.

The standardized geriatric assessment as an objective measure permit to put the target's indications and to monitorize the maintain of the benefits with electric shock treatment.
QOL in primary care of elderly mentally ill and their caregivers’ well-being
Authors: Tataru N. , Dicker A.
Published: May 2011

It is difficult to talk about quality of life of elderly with mental disorders. Thus, there appeared serious ethical challenges for psychiatry: to cut mental health costs and to provide care to as many as possible through all duration of their diseases, from the onset to the end-of-life. The psychiatrists have to face these challenges and treat the elderly with or without mental disorders from primary care to residential one, assuring them the best quality of life as it is possible. The goal of medical policy is to optimize the patients’ and their caregivers’ well-being. Multiple loses in old age are important in decreasing of quality of life and increasing of mental health problems in the elderly. They have more social and medical problems, which include depression and suicide. Caring for a family member with dementia can be both challenging and stressful. Primary care-staff need to develop the skills to detect and manage signs of caregivers stress. Health care professionals can promote well-being of the caregivers not only the patients’ well-being, educate them how to access help and manage their stress effectively. Recognition of the importance of the role of caregivers and finding the effective ways of supporting them, respecting their personal perception of the quality of this offer, improve the quality of primary care of elderly patients with mental disorders and also improve the quality of life of their relative or caregivers.
Discrimination of older people in Serbia
Authors: Todorovic N. , Milicevic Kalasic A. , Vracevic M.
Published: May 2011

Abuse of older people is a single or a repeated act or a failure to act happening in a relationship between two persons based on trust that causes pain or disturbance on the part of the older person. Red Cross of Serbia is the initiator and the founding member of Humanas (the network of 15 civil society organisations dealing with the issues of older people) and is spearheading a campaign of sensitisation of the public in relation to discrimination, neglect and abuse of older people.

Humanas has educated volunteers in Elder Abuse and Discrimination prevention.

A survey has been done in 8 cities in Serbia polling 250 older people of both sexes, age 65 or above. The survey results demonstrate that 44% of all the polled people are familiar with the existence of abuse. Alarmingly, as high as 32% of older people have been exposed to some form of abuse, with the most frequent form being verbal abuse (11.2%) The polled older people have stressed that they hate being called names, made fun of and called stupid or illiterate, within their families as well as in the general community. As for prevention, 52% of the polled older people think that ‘everybody’, meaning both public and civil sector should play a role in prevention.

Conclusion

The problem of abuse of older people has to be approached from a multi-sector and multi-disciplinary perspective. The emphasis should be on new, deeper surveys, education of professionals, family members and other care takers.
Anaemia in elderly in-patients in psychiatric hospitala serious problem or an innocent finding?
Authors: Yasir Hameed Y.A.M. , Beezhold J. , Everard M.
Published: May 2011

Background

Anemia (and especially mild forms) is a frequent laboratory finding in the elderly and is usually regarded in our everyday practice in psychiatry as an incidental innocent finding.

However, the growing body of literature proves otherwise.

Recent literature shows that anemia in the elderly has serious negative impact on mortality, morbidity and quality of life in this age group.

Despite the importance of this topic in mental health care, there is paucity or even lack of studies aiming to examine the magnitude of this problem in psychiatric hospitals and to suggest potential solutions for it.

In this small study, we aim to examine the prevalence of anemia in an inpatient psychiatric hospital, the types of anemia found, the investigations done and if any treatment was given.

Design and methods

Inpatient case notes were examined retrospectively for patients admitted to the Julian hospital from June 2010 to December 2010.

Anemia was defined according to the WHO criteria1 as a hemoglobin concentration lower than 12 g/dL in women and 13 g/dL in men.

Results

Based on WHO criteria, most of our elderly patients were found to be anemic, with a significantly higher frequency in men than in women. The prevalence of anemia increased with increasing age, both in men and in women.

Conclusions

Anemia in elderly is a frequent, underappreciated and potentially morbid condition accounting for significant morbidity and mortality in this population.

As mental health professionals, we must work with our colleagues in medicine to translate awareness into action.
Association of the brain-derived neurotrophic factor (BDNF) gene polymorphisms with early-onset and female schizophrenia in the chinese population
Authors: Yi Z. , Yu S. , Fang Y.
Published: May 2011

Background

Brain-derived neurotrophic factor (BDNF) gene may be involved in the pathogenesis of schizophrenia by virtue of its effects on neurotransmitter systems that are dysregulated in psychiatric disorder. The common functional polymorphism Val66Met (or rs6265) within the BDNF gene has been reported to be associated with age of onset in schizophrenia. We investigated the relationship between BDNF polymorphisms rs6265 and rs11030101 and early-onset schizophrenia in the Chinese population.

Subjects and methods

The tag single nucleotide polymorphisms (tag SNPs) rs11030101 and rs6265 in the BDNF gene were genotyped in 360 early-onset schizophrenics and 399 controls subjects. Single nucleotide polymorphism association and haplotype analysis were performed.

Results

There were significant differences in allele and genotype frequencies between patient and normal control subjects for rs11030101 (χ2 = 5.130407, df = 1, p = 0.023553; χ2 = 6.121, df = 2, p = 0.047). No statistically significant differences were found in allele or genotype between patient and normal control subjects for rs6265. Stratification of the study by gender of the samples yielded significant evidence for an association with the polymorphisms rs11030101 in female population (genotype-wise: χ2 = 7.758, df = 2, p = 0.021).

Conclusions

Our study indicates that the BDNF play major roles in the susceptibility to early-onset and female schizophrenia in the Chinese population.
Simple and multiple relations between just and unjust word beliefs with psychological state
Authors: Aalayi Z. , Ahmadi Gatab T. , Sadeghi Afjeh S. , Mesbah N.
Published: May 2011

Introduction and objectives

The main purpose of this research was to investigate the simple and multiple relations between just (general and global) and unjust word beliefs with psychological state.

Method

To this goal, 319 participants selected with the use of multi-stage random sampling method from the total population. Questionnaires which used in this research were: General Just Word Belief Scale, Unjust Word Belief Scale and SCL-90-R Scale were used. Pearson's correlation coefficient and stepwise regression analysis method.

Results

Were used the results showed that there is negative significant relation between general just world belief with obsessive -compulsive (OC), interpersonal sensitivity (INT), depression (DEP), hostility (HOS) and paranoia (PAR), (p < 0.05, p < 0.01). Also results showed that there is negative significant relation between global just word belief with obsessive compulsive and depression, (p < 0.05). Results also showed a positive significant relation between unjust word beliefs with paranoia (p < 0.05).

Conclusions

The results of the stepwise regression analysis, showed that only depression has a significant power for prediction of general just word beliefs and score of additional items in SCL-90-R have significant power for prediction of global just word belief. Results of regression analysis showed that interpersonal sensitivity (INE) and paranoia have significant power for prediction of unjust word belief. Finally the results showed that only paranoia has a significant power for prediction of unjust word belief. The implications of the results have been discussed.
The predicting well_being in social disorder based on self_discrepancy
Authors: Aalayi Z. , Ahmadi Gatab T.
Published: May 2011

Introduction and objectives

The paper aimed to study the relationship between self discrepancy and well-being in subjects suffering from social phobia. Previous research reveals that patients suffering from social phobia report a lower well-being and that self discrepancy have a positive correlation with well-being. So the question is which kind of self discrepancy decreases well-being through increasing social phobia.

Methods

To carry out this research 250 subjects were randomly selected based on Liebowitz’ s social phobia test given to a great number of university students. Subjects were asked to answer the tests on two domains of well-being and self discrepancy at the same time.

Results

The results showed that “actualundesired” and “actualought” self discrepancy have more considerable effects on well-being respectively. Also, the direct effect of self discrepancy on well-being is more than the direct one.

Conclusions

These finding can be significant in treating social phobia and promoting well-being.
P02-270 “Education, education, education-” adult liaison psychiatry (consultation-liaison): Can service development fulfil educational needs?
Authors: Abbasi Y. , Pang A. , Vishwanath S. , Sarkar S. , Broadhurst M. , Gardner R.
Published: May 2011

Introduction

Liaison Psychiatry is primarily concerned with the detection and treatment of psychiatric disorders within the general hospitals. 1A study2 also highlighted the presence of only 45.5 core trainee posts in this speciality nationally.

Aims & objective

To survey the liaison psychiatry service recently set up as a service provision at a psychiatry unit in North Derbyshire.

Methods

We retrospectively reviewed all case notes of patients who had been assessed from January 2007 to June 2009 by the consultation-liaison service.

Results

A total of 136 patients had been assessed since this service began in September 2007. Majority of the patients (72%) were between the ages of 31 to 65 years, while the gender was equally distributed. 51% were referred from the medical ward and most of them had been referred by core trainee. 95% of the referral was during working hours and 74% of the patients were assessed within 24 hours. Their diagnosis was variable, for e.g. 29% had depression, 19% had substance misuse problems, 8% had psychosis etc. 66% of patients were managed by medication advice, psycho-education and referral to CMHT/GP.

Conclusions

Liaison psychiatry was established for service provision, but it is apparent that it fulfilled both clinical and educational needs, despite the challenges. Adequate experience can be gained with a well supervised service. The overall educational value of designing and implementing a new service as a trainee cannot be overstated; it is something which is difficult to learn in classrooms.
The reliability of a brief diagnostic interview, the trips, for the assessment of psychiatric disorders according to ICD-10 in primary care and non-psychiatric medical settings
Authors: Berger P. , Sibitz I. , Freidl M. , Topitz A. , Katschnig H.
Published: May 2011

Introduction

Although there are instruments for the assessment of DSM-IV mental disorders in primary care, there is no brief instrument to assess mental disorders in primary care according to the ICD-10.

Aims

The aim of the study was to assess the reliability of a new diagnostic interview, the TRIPS, designed for the assessment of anxiety-, mood-, and alcohol related disorders according to ICD-10 by non-mental health professionals.

Methods

At first, all Patients completed a screening questionnaire and were subsequently assessed by the staff of somatic departments of a Vienna General Hospital with the TRIPS. Within a week, patients were re-assessed by psychiatrists of the department of psychiatry with the Composite International Diagnostic Interview (CIDI).

Results

Finally, 290 patients could be assessed with both instruments. With the CIDI, 106 out of 290 patients (37%) got any diagnosis of a mental disorder, 74 (26%) had a mood disorder, 64 (22%) an anxiety disorder and 10 patients (3%) an alcohol-related disorder.

Sensitivity of the TRIPS was 88%, specificity was 76% and diagnostic accuracy was 80% for any disorder, and 88%, 83%, and 84% respectively for any mood disorder, 72%, 88%, and 84% for any anxiety disorder, and 60%, 98%, and 97% for alcohol related disorders.

Conclusions

The results show that the TRIPS is a useful instrument with sufficient reliability to detect anxiety disorders and mood disorders in patients with somatic disorders by health professionals without psychiatric training. Due to the low base rate the test criteria for alcohol-related disorders cannot be interpreted sufficiently.
Theoretical considerations and clinical implementations of the somatoform disorders concept
Authors: Bobrova M.A. , Bobrov A.E.
Published: May 2011

The existing ICD-10 typology of somatoform disorders is often criticized. The alternative approach to pseudo-somatic complaints as an expression of anxiety-affective disorders still deserves much recognition among practicing psychiatrists.

To evaluate the validity of these views a group of 53 patients (24 men and 29 women) was studied with the help of clinical interview, symptomatic scales, personality and neuropsychological tests. Results of statistical analysis demonstrate that there are four relatively independent “core” variants of somatoform syndromes, which closely resemble ICD disorders: anxiety-depressive, psychovegenative, dissociative, and paranoid hypochondriac. These variants differ in symptomatology, levels of disturbance and prognosis.

The obtained data evidence that differences in clinical features of somatoform disorders are determined by specificity of cognitive styles, changes in sensory levels, dysfunction of brain antinociceptive system, higher integrative brain functions and personality/behavioral patterns. It also means that contradiction between empirically and operationally based approaches to somatoform disorders reflects the consecutive transition from phenomenological to descriptive and then - to bio-psycho-social paradigm in modern psychiatry.
Sleep-related painful erections: pitfall on the interface between neurology and psychiatry
Authors: Buda B.L. , Tóth G.A.
Published: May 2011

Sleep-related painful erections (SRPE) are characterized by penile pain occurring during nocturnal erections, without apparent penile pathology. Sleep loss caused by the disorder may result in severe anxiety, mood disorders, irritability, and excessive daytime sleepiness. Until now, the phenomenon of SRPE has not been well understood. The rarity of the published cases probably does not reflect the actual prevalence, which is presumably over 1 percent.

Because of the bizarre nature of the complaints, patients are often referred to a psychiatrist. The authors present the case of a 69-year-old patient, who, during frequent nocturnal awakenings, experienced hard-to-define burning, tingling sensations in symmetric hypogastric localisation. Sometimes the skin of both legs, and, occasionally, the arms and hands was involved, too. Initially, however, no definite erection-associated penile pain was present. Micturating quite a small amount just after awakening consistently resulted in immediate and complete relief. After two years, painful nocturnal erections reoccurring at stable intervals of 90–120 minutes during sleep developed to be the leading complaint. In default of urological or gastroenterological pathology, the patient has been referred to a psychiatrist. Quite futilely, mianserin and alprazolam, later sertralin and carbamazepine, respectively, were administered. Clozapine has also been tried out; however, it has to be rejected due to some adverse effects.

Finally, 10 mg baclofen in the evening resulted in complete and permanent remission. This is consonant with the literature data stating that only clonazepam, baclofen and clozapine are likely to have long term beneficial effects in SRPE.
Munchausen syndrome - diagnostic challenge
Authors: Coutinho B. , Felgueiras P. , Torres M. , Fonte A.
Published: May 2011

Introduction

The Munchausen syndrome describes patients with a particular form of factitious disorders: symptoms of illness or injury intentionally produced, for psychological reasons, in order to be hospitalized and even to be submitted to invasive interventions.

Clinical case

A 38 years-old woman, firefighter, was admitted, in Medicine Department for a transverse myelitis, (spinal thrombosis D5-D7 secondary to sepsis caused by a central venous catheter infection). Healthy up to 24 years of age, she is diagnosed Webber Syndrome-Christian and treated. Some years after appeared hypochromic microcytic anemia, whose initial cause was considered to be a rectal ulcer, with complete hematologic recovery after surgery. But some time after, there was recurrence of anemia, plenty diagnostic exams were performed and all inconclusive. Since one-year ago, she had the need to blood transfused weekly. Because of poor peripheral vessels, central venous catheter (CVC) was placed, then she developed serial infections by S. aureus with sepsis and is noticed that she got hematological recovered whenever hospitalized, leading the suspicion the catheter was being auto-manipulated. Currently she is paraplegic from D7 and when it was told her, that there was no neurological recovery, paradoxically she happily said “I already knew.” Against her will, the CVC was removed and peripheral accesses reestablished. So, for all of this, it was hypothesized Munchausen Syndrome.

Discussion

Treatment of Munchausen syndrome primarily consists in treating the self-induced illness before psychiatric help can be given. Unfortunately most patients refuse psychiatric help and leave hospital even before correct diagnosis is made.
Providing a psychiatry service to a general hospital in the absence of a dedicated liaison psychiatry team
Authors: Doherty A.M. , Rutledge E.
Published: May 2011

Introduction

The international literature has clearly set out the importance of having an appropriate consultation liaison psychiatry service in a general hospital. There is limited data available on the quality of psychiatric consultations in those areas which are without dedicated liaison psychiatry teams.

Objectives

To examine the psychiatric work in a general hospital, and to establish a baseline regarding demographics, type of referral, and management of referrals.

Aims

To assess the psychiatric needs of the hopsital with a view to introducing improved evidence-based treatments.

Methods

All referrals from medical and surgical teams and from the accident and emergency department over a 3 month period were prospectively reviewed. As there is no dedicated liaison service, the referrals are seen by the psychiatric registrar on call. The details were entered in a register and reviewed.

Results

160 referrals were received over the 3 months studied. 90% were from the area served by the psychiatric services based at the psychiatric unit in the hospital. The most common diagnosis was depression (27%). Alcohol was an important factor in 16% overall, and in 26% of referrals from the accident and emergency department.

Conclusion

In the absence of a dedicated liaison psychiatry service, the liaison work is done by the team members of the general adult and psychiatry of older age teams. As 31% of the referrals seen were not deemed urgent by the assessing psychiatrist, there may be a role for a liaison nurse in the triage of referrals to this service.
Comparison of depression and anxiety disorders in patients with psoriasis and control group
Authors: Golpour M. , Hosseini S.H. , Khademloo M. , Ghasemi M. , Koohkan F. , Ebadi A. , Shahmohammadi S.
Published: May 2011

Objective

Psoriasis is a common, genetically determined inflammatory and proliferative disease of the skin. Psychological stress can also exacerbate the disease. The goal of the present study was to compare depression and anxiety symptom in patients with psoriasis and control group.

Methods

One-hundred patients with psoriasis (case) referred to the dermatology department and 100 patients with Otolaryngology problems and dermatological healthy volunteers (control) who referred to the Otolaryngology department of Bouali Sina hospital in Sari/Iran in 2007 were studied. Demographic characteristics were recorded. Then the Beck Depression Inventory and Spielberger State-Trait Anxiety Scale I-II were administered to the patients in both groups. Data were analyzed using SPSS statistical software and descriptive statistical tests.

Results

From 100 patients in each studied group, 44 (45%) were men. Patients with psoriasis and controls had depression scores of 67% and 12%, respectively. The Beck depression scores of patients with psoriasis were significantly higher than scores of the control group (P < 0.05). Based on Spielberger State-Trait Anxiety Scale, anxiety was found in 45% of patients in case group and 18% of controls.

Conclusion

The results revealed that Psoriasis patients reported significantly higher degrees of depression and anxiety than controls. In addition, psoriatic women were more depressed than psoriatic men.
The association of the metabolic profile in diabetes mellitus type 2 patients with obsessive compulsive disorder and depression: New insights
Authors: Kontoangelos K. , Raptis A. , Papageorgiou C.C. , Papadimitriou G.N. , Rabavilas A.D. , Dimitriadis G. , Raptis S.A.
Published: May 2011

Introduction

The high comorbidity of depression in patients with diabetes mellitus type 2 has been established.

Objectives

The association between Obsessive Compulsive Disorder (OCD) and diabetes mellitus type 2 is poorly understood.

Aims

The aim of the present study was to assess the degree in which diabetes mellitus type 2 is accompanied by OCD.

Method

131 diabetic patients, 55 female and 76 male were randomly enrolled and during the first assessment was administered in all participants the Zung Self Rating Scale (ZUNG) and the Maudsley O-C Inventory Questionnaire (MOCI). After one year, while an intensive effort to improve the patients’ metabolic profile was performed, the diabetic patients that were initially uncontrolled (n = 31) were re-evaluated by the same psychometric tools. From those 31 patients 10 had managed to control their metabolic profile.

Results

MOCI and the sub-scale of slowness are statistically related with the diabetic profile (controlled-uncontrolled), with uncontrolled patients scoring significantly higher on the overall MOCI score and the factor of slowness of MOCI scale (p = 0.028). Regarding the association between the values of Glycosylated Haemoglobin (HbA1c) and the scores of MOCI it was found that they were significantly positively correlated in overall scores (p = 0,028) and in the subscale of slowness (p = 0,028). The analysis revealed a positive association between depression (p = 0.004) and obsessive compulsive disorder symptomatology (p < 0.001) and thepatient’s metabolic profile.

Conclusions

Diabetes mellitus type 2 is associated with obsessive compulsive disorder symptomatology and depression. Improvements in glycaemic control were found to decrease the severity of the symptoms.
Assessment of efficacy of specialized psychiatric assistance for patients with combined mental and somatic pathology
Authors: Lebedeva V.F. , Semke V.Y.
Published: May 2011

Objective and methods

Use of developed prophylactic and rehabilitative programs based on city primary care unit and psychiatric services of psychiatric institution has allowed improvement of quality of life, high clinical and economic efficacy of treatment of patients with combined mental and somatic pathology.

Results

According to data of catamnesis (2–9 years) in group of patients in need for course therapy according to addressing, recovery has been achieved in 46,2% of cases, stable clinical improvement - in 44,1%; in group of patients in need for systematic therapy and dynamic observation, recovery has been achieved in 24,7% of cases, stable clinical improvement - in 65,5%. The most effective measures were at initial stages of mental disorders. Differentiated gradual approach to treatment of combined mental and somatic disorders under conditions of general medical institution and principle of continuum of treatment measures have allowed reducing transient disability in 1,8 times, number of not based addressing and examinations per 1 patient in 2,3 times.

Conclusion

Integrative approach to medical assistance rendering for patients with mental disorders, revealed in general medical network is enough effective. Successful interaction of psychiatrists of primary care unit, internists, psychiatrists of dispensary and hospital was contributed by principles: collective character of decision making, continuum in resolution of issues of treatment-prophylactic assistance, observation of principles of medical ethics and deontology oriented at interests of patients, accomplishment of treatment-diagnostic assistance, necessary in such an amount that maximum therapeutic effect was achieved during rational use of medical resources.
Anti-NMDA-receptor encephalitis: aethology of psychiatric symptoms in young women
Authors: Marin Diaz-Guardamino E. , Larrañaga Rementeria L. , Hervella Garces I. , Aldasoro Carcedo T. , Fernandez Bilbao J. , Araluze Iturbe K. , Segarra Echebarria R. , Eguiluz Uruchurtu I.
Published: May 2011

Introduction

Anti-NMDA-receptor encephalitis is subacute disorder that has been recently described in young women and girls who often present neuropsychiatric symptoms as first clinical features; thus, it is common that they receive an initial assessment, diagnose or even treatment by a specialist in Psychiatry.

Objectives

Presenting a case of Anti-NMDA-receptor encephalitis that was observed at our hospital and the steps taken from its initial assessment by Psychiatry to the final diagnose and treatment by Neurology, our objective is to describe this disorder in order to make it known to the specialists in Psychiatry.

Methods

The case is that of a 14 year old girl who presents altered behavior, bizarre delusions and auditory hallucinations with subacute onset. In psychiatric assessment it is noted that the patient presents fever, slight and language impairment: Medical and Neurological assessment are requested. The steps followed to rule out other disorders are presented. SPECT and the detection of specific anti-NMDA-receptor antibodies in serum were necessary for an accurate diagnose.

Results

The detection of specific antibodies is necessary for the diagnose of Anti-NMDA-receptor encephalitis. NMDA receptors are ligand-gated cation channels with crucial roles in synaptic transmission and plasticity. Their alteration could be a pathogenic mechanism in disorders such as epilepsy, dementia and schizophrenia.

Conclusions

Anti-NMDA-receptor encephalitis is a recently described clinical entity that should be taken in consideration to rule out other causes of subacute onset psychiatric symptoms in young women and girls. Its well-defined set of clinical characteristics should become familiar to the specialists in Psychiatry.
Psychological distress in patients suffering from femoral head osteonecrosis, with and without white matter lesions: clinical characteristics and personality traits
Authors: Mouzas O. , Papaliaga M.N. , Zibis A. , Hadjigeorgiou G. , Angelopoulos N. , Malizos K.
Published: May 2011

Background

The aim of the present study was to investigate clinical parameters in relation to personality characteristics and psychopathology, in patients with non traumatic osteonecrosis of the femoral head (ONFH), with and without cerebral white matter lesions (WML).

Methods

Sixty seven patients participated in the study, 48 males and 19 females. The mean age was 37.6 years (SD 10.92, range: 15–61). Seventy five healthy individuals age and sex matched, served as controls. Socio-demographic information, clinical data and brain MRI findings were collected. The following self-report instruments were used: General Health Questionnaire (GHQ-28) and Defense Style Questionnaire (DSQ).

Results

The odds of being assessed with a psychiatric diagnosis upon interview were three times greater among patients with ONFH compared to healthy controls (p < .006). The presence of cerebral WML and secondary nature of ONFH were associated with intense symptoms of psychological distress and especially with somatic symptoms of depression and social dysfunction (p < .003). A specific personality structure was identified in patients with ONFH.

Conclusions

Patients suffering from osteonecrosis of femoral head, especially when white matter lesions are present, often present psychological distress and problematic personality organization. Therefore psychological support and/or psychiatric intervention can be beneficial to these individuals.
Studying the psychosocial adaptation, depression and anxiety leves of patients who experienced myocardial infaction
Authors: Çam O. , Nehir S.
Published: May 2011

Aim

This study was performed to determine psychosocial adaptation, depression and axiety levels of patients who experienced Myocardial Infarction (MI).

Materials and methods

A total of 86 patients who were admitted to Coronary Intensive Care Unit of Ege University with MI diagnosis between October and December 2009 and who visited Cardiology Polyclinic as outpatients were comprised the sampling of study. In data collection “Patient Introductory Information Form” involving sociodemographic characteristics of the patients, “Psychosocial Adaptation Scale”, “Beck Depression Inventory” and “Beck Anxiety Inventory” were used.

Findings

When the sociodemographic characteristics of patients were scrutinized it was identified that their mean age was 57.50 ± 10.43 years. 76.7% were males, 79.1% were married, 40.7% were elementary school graduates, 94% were living with their families. Since patients have experienced MI at early ages, singles or those are living alone, those have less income and those experiencing difficulty in coping with stress had increased mean psychosocail adaptation scores and mean depression scores and the difference was found statistically significant (p < 0.05).In patients who experienced MI, as the depression and anxiety scores increased, also the psychosocial disease-adaptation scores increased. Increased mean anxiety and depression scores will decrease individuals’ adaptation to disease (p < 0.01).

Conclusion

Consequently, during the process of reducing the negative effects exerted by heart failure, which is a chronic disease, on individual, family and community and increasing patients’ psychosocial disease-adaptation, nurses should consider patients’ individual and disease-related characteristics and provide support for them to develop their psychosocial adaptation.
Psychological status of patients undergone myocardial infarction: presentation of a case myocardial infaction (MI)
Authors: Nehir S. , Çam O.
Published: May 2011

In myocardial infarction, as well as psychological problems many serious physical problems may appear in individuals who experience a disease which will be a threat for death or bodily image.

Presentation

Mr. H’ cardiac disorder had onset in 2001. When Mr. H. who was discharged after placement of stent due to myocardial infarction has returned to polyclinic for control a psychosocial orientation scale was applied. His compliance to disease was fairly good.

There were anxiety, lack of social support, reduced income level and various psychosocial factors which progress up to fear. Mr. H. is a 54-year old married man and he is a secondary school graduate, and is working in a restaurant since his present financial situation is not efficient. He demonstrated behaviors of anxiety, panic, uneasiness, gabbing and restlessness and an increase in tendency toward violence, irritability, isolation from society and timid behaviors were observed. Patient had a history of difficulty in establishing friend-relationships and there was an anxiety caused by gabbing and difficulty in expressing himself. During interview his actions were restless and just like he wanted to leave right away. He had fears of being disgraced in front of strangers. He said he was afraid of being ostracized from public because he was stammering. Nurses taking place in health team to arrange training programs related to issues such as appropriate diet toward MI, regular intake of medications, quitting smoking, reducing weight, increasing social support, coping with stress and anger control facilitate individuals who undergone MI compliance to disease and decrease their anxiety.
Remission of manic disorder in a hepatitis c virus (HCV) infected patient receiving pegylated-interferon (PEGIFN) plus ribavirin (RBV)
Authors: Ortiz Sánchez-Expósito C.L. , Machín Vazquez-Illá M. , Gallego Deike L. , López-Ibor J.J.
Published: May 2011

Introduction

Pegylated-interferon (pegIFN) plus ribavirin (RBV) is for the moment the licensed therapy for chronic hepatitis C. Neuropsychiatric symptoms are frequent side effects due to the treatment with pegIFN, registered in 30 to 80% of instances, with mood rather than psychotic disorders usually observed.

Objective

A manic profile with psychotic symptoms in a HCV infected patient receiving pegIFN-RBV is presented to discuss management strategies and outcome.

Methods

A 47 year-old male patient, former IDU and alcohol abuser, without past psychiatric history, was under therapy for chronic hepatitis C (genotype 1a, HCV-RNA 6.2 log IU/mL, Child A5). After 14 weeks of pegIFN-RBV treatment the patient attends ER with insomnia, uneasiness, expansive mood, irritability, extravagant and disinhibited behaviour, and detrimental and self-referential delusion.

Results

The patient was admitted at the Psychiatric Unit to receive amisulpride (400 mg/12h) plus lorazepam (1 mg/8h), with psychotic symptoms regressing over following days. It was agreed that psychotropic drugs would be maintained at the same doses until the end pegIFN-RBV therapy, intended for 48 weeks.

Conclusion

Antipsychotic therapy may be effective and allows VHC infected patients with manic symptoms related to pegIFN-RBV therapy to continue their treatment.
Relationship between mental health and its impact on family’s aggressive students boys and girls
Authors: Rezaei A. , Ahmadi Gatab T.
Published: May 2011

Introduction

The main purpose of mental health, prevention of the occurrence of adversity and minor behavior disorders and health promotion, mental health is the best form.

Objectives

This study reviews the relationship between mental health and its impact on family aggression male and female students Payam Noor University is the center of Babol.

Methods

Descriptive study methods - is solidarity. Statistical Society study male and female students of Babol University of Payam Noor Centre in 89–88 school year are studying make up. Sample consisted of 100 male and female students to simple random sampling method chosen. Data collected in this study were two questionnaires: General Health Questionnaire (GHQ) and the aggression questionnaire (AQ) is. And to analyze the data and the correlation coefficient R. The T method through SPSS software was used.

Results

Results showed that families with mental health among students, male and female aggression significant relationship exists. The results also show that between family and mental health scores of aggressive students, and significant negative relationship is seen. Whatever the mental health students is more aggressive than they would be.

Conclusions

The Role of Family Mental Health Dreaming family undoubtedly provides mental health and prevents distractions behavior has a major role.
Problem solving skills of the 1st year and 4th year nursing students
Authors: Sayin Y. , Farimaz M.
Published: May 2011

Introduction

One of the objectives of nursing education is helping nursing students acquire the knowledge, skills, and behaviors needed to deal with various problems.

Objectives

The study is descriptive.

Aims

To determine the “problem solving skills” of the 1st-year and 4th-year students.

Methods

The study is a descriptive one. The study sample comprised a total of 153 students in their 1st-year and 4th-year in Department of Nursing, Cumhuriyet University, Turkey. The research data were collected by means of the “Personal Information Form” developed in light of the relevant literature review and the “Problem Solving Inventory” which was developed by Heppner and Peterson (1982) and tested in Turkey in 1990 by Taylan in terms of fist validity-reliability properties.

Results

Of the first year students, 84.9% lived in a nuclear family, 61.6% lived in a city, 39.5% were first-born children. Of the fourth year students, 81.0% lived in a nuclear family, 67.2% lived in a city, 37.3% were first-born children. All of the students financial needs were met by their parents. There was no difference between the total “problem solving confidence” scores of the first year students (85.942 ± 16.649) and the fourth year students (81.866 ± 19.168) (p > 0.05). According to the sub-scales of the inventory, the first year students received higher scores than the fourth year students in “problem solving confidence”, “approach-avoidance behavior” and “personal control” (p > 0.05).

Conclusions

The education received by the students did not make a difference in the development of their problem solving skills.
Pain and depression in general hospital patients
Authors: Sibitz I. , Berger P. , Freidl M. , Topitz A. , Krautgartner M. , Spiegel W. , Katschnig H.
Published: May 2011

Background

Symptoms of physical pain can indicate a current depressive episode. The study aimed to assess pain symptoms among physically ill general hospital patients and to explore if pain symptoms are more prevalent among physically ill patients with a depressive episode than among those without a depressive episode.

Methods

Pain symptoms were assessed by a modified version of the Patient Questionnaire (Spitzer et al1). Diagnosis of a current depressive episode was made by psychiatrists with the Composite International Diagnostic Interview (CIDI; ICD-10 version2).

Results

Of the 290 patients included in the study 247 (85.2%) indicated at least one pain symptom. About a fifth of the patients suffered from a current depressive episode. Physically ill patients with depression suffered significantly more often from pain and reported significantly more often three or more symptoms of pain than those without depression.

Headaches, stomach pain and chest pain were significant independent predictor variables for depression in a multiple logistic regression analysis controlled for age, gender and primary somatic diagnosis.

Conclusion

Patients in general hospital who suffer from pain symptoms should be checked physically and psychologically in order to detect a comorbid depressive episode.

1Spitzer RL, Williams JB, Kroenke K, Linzer M, deGruy FV 3rd, Hahn SR, Brody D, Johnson JG. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272:1749-56.

2Wittchen, H.U., Pfister, H., 1997. DIA-X-Interviews. Manual für Screening-Verfahren und Interview; PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung); Auswertungsprogramm. Frankfurt, Swets & Zeitlinger.
Cognitive impairment and altered emotional status related to type II diabetes mellitus
Authors: Tamasan S. , Reisz D. , Vasilian C.C.
Published: May 2011

The aim of the study was to reveal the cognitive and emotional status of diabetic inpatients with no formal neurological and psychiatric complains (N = 68, consecutively admitted in a 6 week period, February-March 2009 in our hospital). We collected and interpreted: demographic data, cognitive (MMSE, clock drawing test) and emotional state (MADRS, GDS, HADS, PANI) assessments, the HoNos scale for general functioning of patients, items related to diabetes treatment and complications. Demographics showed in average (years): age 63,5; education 8,7; diabetes evolution 10,4. We found undiagnosed: mild cognitive decline (average MMSE = 25), subsyndromal depression (31%) and clinical depression (33%), high levels of anxiety (63%) and sleep complains (81%). 54% of subjects reported significant life events in the past year, more often the newly diagnosed ones. The multivariate analysis showed that depression and cognitive impairment have a differentiated clinical pattern depending on the duration of the diabetes, age and education, while anxiety and sleep complains seem to be constant symptoms in diabetic patients. Surprisingly, cognitive and emotional states are linked more with education than with the complications and treatment of diabetes. The results do not clarify the dilemma of the etiopatogeny of psychiatric findings in type II diabetes patients but do confirm the high incidence of undiagnosed and untreated depression and cognitive decline. In order to promote a qualitative and efficient management for diabetic patients, regular neuropsychiatric evaluation has to became a standard of care for this population.