bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of the Integrated Long-term Program of Management of Patients after First Psychotic Episode in 5-year Follow-up [P03-221]
Authors: Zaytseva Y.
Published: March 2009

The study was carried out as prospective, longitudinal investigation of first episode patients having been treated in the integrative program in first episode clinic (1st group, 114 patients) and in routine care (2nd group, 109 patients) during 5-year follow-up. the integrated program included management according to the following principles: decrease of duration of untreated psychosis; using of services with initial or early transition to day treatment and at the following outpatient treatment stages; primary use of atypical neuroleptics in combination with psychosocial interventions; long-term follow up with individualized case management; family involvement in treatment and rehabilitation process. the efficacy was evaluated according to the comparative pairwise analysis using initial demographical and clinical characteristics of patients (34 pairs).

Comparing to the routine care, patients who have been treated in first episode clinic were more adherent to therapy regimen during the follow-up period, more than half of patients maintained the condition of complete remission. Moreover, patients of the 1st group were more likely to show help-seeking behavior and referred to services during the earlier stages of the exacerbation, therefore the relapse rates were decreased and 2/3 of patients were treated in outpatient settings. Symptomatic control of the illness contributed to social recovery in patients within integrated care. by the 5th year, only 1/5 of the cases of the 1st group were formally recognized as unemployable due to psychiatric disability. Significantly better clinical and psychosocial outcomes have been shown in comparison with the group of patients, treated in routine psychiatric services.
A Weak Association of the CLDN5 Locus with Schizophrenia in Chinese Case-control Samples
Authors: Wu N. , Zhang X. , Ye L. , Xu Q. , Jin S. , Wang Z. , Liu S. , Ju G. , Shen Y. , Wei J.
Published: March 2009

Background:

An increasing number of studies have described the relationship between velo-cardio-facial syndrome (VCFS) and schizophrenia. in a family-based study, we found that rs10314, a single nucleotide polymorphism (SNP) present in the 3’-flanking region of the CLDN5 gene, was associated with schizophrenia among a Chinese population. High false positive rate is a common problem with the association study of human diseases. It is very important to replicate an initial finding with different samples and experimental designs.

Methods:

A total of 749 patients with schizophrenia and 383 age and sex matched healthy control subjects in Chinese population were recruited. PCR-based RFLP protocol was applied to genotype rs10314 to see its disease association.

Results:

The χ2 goodness-of-fit test showed that the genotypic distributions of rs10314 were in Hardy-Weinberg equilibrium in both the patient group (χ2=1.12, P=0.289) and the control group (χ2=0.22, P=0.639). rs10314 was associated with schizophrenia with an odds ratio (OR) of 1.32 in the male subjects (χ2=5.45, P=0.02, 95% CI 1.05-1.67) but not in the female subjects (χ2=0.64, P=0.425, OR=1.14, 95% CI 0.83-1.57). the χ2 test showed a genotypic association only for combined samples (χ2=7.80, df=2, P=0.02). SNP rs10314 is a G to C base change. Frequency of the genotypes containing the C allele was significantly higher in the patient group than in the control group.

Conclusions:

The present work shows that the CLDN5 gene polymorphism is more likely to be involved in schizophrenic men than women, suggesting that this gene may contribute to the gender differences in schizophrenia.
Varenicline for the Treatment of Nightmares and Sleep Disturbance in Patients with Post-traumatic-stress-disorder (PTSD) - Two Case Reports
Authors: Lampen-Imkamp S. , Dillo W.
Published: March 2009

Aims:

Varenicline is a drug used for smoking withdrawal symptoms. It reduces cravings by binding to alpha4-beta2-nicotine-acethylcholine-receptors of the central nervous system. Side effects are nausea, headache, sleeping disorders. Patients with PTSD complain of depressions, social isolation, insomnia, nightmares and flashbacks. These symptoms often cause a severe drug abuse. We present two patients complaining of sleeping disorders caused by nightmares. These symptoms were significantly reduced under treatment with Varenicline due to a nicotine abuse.

Method:

Patient A was a woman with a history of sexual abuse in childhood. Besides a drug abuse of benzodiazepines she presented a nicotine addiction. She was increasingly affected by nightmares and insomnia. Patient B was a woman, who grew up in a children's protectory, where she was involved in violence. A PTSD was accompanied by alcohol and benzodiazepine abuse. The PTSD caused episodes of depression with suicidal ideation, nightmares and insomnia.

Results:

Both patients were treated with Varenicline for smoking cessation. After few days of treatment, they reported improved sleeping behaviours and diminished nightmares.

Conclusion:

Currently only few studies confirm the effectiveness of alpha1-receptor-agonists (Prazosin) in PTSD-associated nightmares. Our case reports demonstrated the effectiveness of Vareniclin in the treatment of nightmares and sleeping disorders in two patients. The treatment with Vareniclin lead to modified dreaming behaviours with positive, less threatening dreams. Therefore a placebo-controlled study to assess the effectiveness of Vareniclin in the treatment of nightmares is necessary.
The Influence of Depression and Obesity on Sleep Quality in Children/adolescents
Authors: Leibow M. , Abaro-Thomas L. , Devore S. , Doan M. , Pivonka-Jones J. , Hamai K.Y. , Randall K. Freier
Published: March 2009

Aims:

Limited to no literature exists on the association among sleep quality, obesity and depression in pediatric populations. This study aims to explore this association by examining the sleep quality of children and adolescents before and after a twelve-week comprehensive multidisciplinary pediatric obesity program.

Methods:

Archival data from the pediatric obesity program included 71 children ages 6-17 (M=10.24, SD=2.74 ) who had been assessed pre and post intervention using the Children's Depression Inventory (CDI), a Sleep Questionnaire, and physician derived Body Mass Index (BMI). On all measures, higher scores indicate presence of symptoms of depression, sleep difficulties, or obesity.

Results:

High scores on the CDI proved to predict poor sleep quality both at intake and exit. Hierarchical regression exhibited change in BMI from intake to exit and predicted sleep quality. As BMI decreased from intake to exit, sleep quality increased.

Conclusions:

The current study suggests that sleep quality is influenced by the level of depression in children and adolescents both at pre and post intervention measures. Both depression and BMI influenced sleep quality. When the effect of BMI was accounted for, depression significantly predicted sleep quality. The more depressed children/adolescents reported to be, the lower their quality of sleep. Thus, this study suggests the importance of sleep and depression in the treatment of pediatric obesity. This research supports the importance of a multidisciplinary approach to addressing pediatric obesity.
Personality Traits and Sleep Patterns/problems in Medical Students
Authors: Maia B.R. , Soares M.J. , Gomes A. , Marques M. , Pereira A.T. , Valente J. , Azevedo M.H. , Macedo A.
Published: March 2009

Aim:

This study examines the relationship between the personality traits of Neuroticism and Extroversion and sleep patterns and others sleep behaviours in medical students.

Method:

Neuroticism and Extroversion were assessed using the Portuguese version of the Eysenck Personality Inventory. Sleep was assessed with a self-response questionnaire covering a wide range of sleep-wake habits and difficulties. A factor analysis with varimax rotation was performed with seventeen items of the questionnaire and four factors were extracted: Sleep Disturbance, Sleep Timing, Insufficient Sleep and Dreams/Nightmares. A total of 203 third year medical students (127 females, 62.6%) mean age 20.01 (SD=1.09; Range=18-24) participated in the study.

Results:

There were no significant gender differences in Neuroticism and Extroversion mean scores (Neuroticism: p=.454; Extroversion: p=.891). Extroversion was significantly correlated with Sleep Timing (p=.000), whereasthere was a trend for Neuroticism to be associated with Sleep Disturbance (p=.095). Concerning the relationship of Neuroticism and Extroversion mean scores with other Sleep problems, Neuroticism was found associated with concentration difficulties in the morning (p=.006), inadequate sleep duration (p=.001), sleep problems (p=.012), and use of sleep medication (p=.052). No significant associations were found with Extroversion.

Conclusion:

Neuroticism was significantly associated with sleep problems, use of sleep medication, inadequate sleep duration, and concentration difficulties in the morning. Extroversion was correlated only with later Sleep Timing.
Sleep Patterns and Health Behaviours in Medical Students
Authors: Marques M. , Soares M.J. , Gomes A. , Maia B.R. , Pereira A.T. , Valente J. , Azevedo M.H. , Macedo A.
Published: March 2009

Aim:

The objective of this study was to examine the sleep patterns of medical students and its associations with significant health behaviours.

Methods:

Sleep was assessed with a self-response questionnaire covering a wide range of sleep-wake habits and difficulties. A factor analysis with varimax rotation was performed with seventeen items of the questionnaire and four factors were extracted: Sleep Disturbance, Sleep Timing, Insufficient Sleep and Dreams/Nightmares. The questionnaire also included questions on coffee use, cigarette smoking, alcohol intake and physical exercise. The sample consisted of 212 females (M age=20.32 years, SD=1.26) and 128 males (M age=20.19 years, SD=1.23) third year medical students.

Results:

Habitual alcohol intake was reported by 6.5% of the students (males=14.8% vs females=1.4%; p=.000) and regular physical exercise by 37.9% (males=47.7% vs females=32.1%; p=.004); The mean number of coffee cups used per day was 2.16±1.16 (males M=2.18±1.35 vs females M=2.13±1.03; NS) and the mean number of cigarettes smoked per day was 3.69±5.71 (males M=4.41+6.55 vs females M=3.25±5.10; NS). Students who regularly practice physical exercise reported less Sleep Disturbance (p=.004). Habitual alcohol intake was significantly associated with Sleep Timing (p=.051) and Insufficient Sleep (p=.007). Significant correlations were also found between cigarette smoking and Sleep Timing (p=.000), Dreams/nightmares (p=.023) and Insufficient Sleep (p=.001). Coffee use was correlated only with Sleep Timing (p=.000).

Conclusion:

In this sample of healthy young adults habitual alcohol intake and cigarette smoking was associated with Insufficient Sleep and regular physical exercise was associated with less Sleep Disturbance.
Sleep Pattern, Sleep Disturbances and Sleepiness in the Retired Iranian Elderly
Authors: Malakouti S.K. , Foroughan M. , Nojomi M. , Ghalebandi M.
Published: March 2009

Complaints of sleep disturbance increase with age and many studies have been reported on the relation of sleep problems with greater use of health services, physical and mental morbidity, functional decline and all cause mortality. This study aimed to examine the sleep patterns and sleep disturbances in Iranian older people and to see how their sleep quality relates to their health status. 400 men and women, 60 years or older, interviewed by trained psychiatrist regarding their physical and mental health status, then the Pittsburg Sleep Quality Index, the Epworth Sleepiness Scale, and General Health Questionnaire implemented on them. The gathered data analyzed by chi-square test, t-test, one-way analysis of variance and logistic regression. The results showed that the majority of participants (82.6%) suffered from poor sleep quality and approximately one third had sleepiness (29.2%) during daytime. Difficulty falling (p≤0.001) and maintaining (p≤0.01) sleep and feeling too hot at night sleep (p≤0.005) were significantly more prevalent in women, but men suffered more from leg twitching (p≤0.01). Being female (OR=2.52), and having GHQ scores more than 11 (OR=4.14) increased the risk of poor sleep quality considerably. Promoting sleep hygiene education and screening of mental health problems in primary health care services for older people are recommended.
No NREM Phase 3-4 (Deep Sleep) Among Benzodiazepine Abuse Patients in Methadone Maintenance Treatment (MMT)
Authors: Peles E. , Schreiber S. , Adelson M.
Published: March 2009

Aims:

As benzodiazepines (BDZ) abuse is highly prevalent among former heroin addicts, current MMTpatients, and poor sleep is highly prevalent complaint, we studied objective sleep patterns by polysomnography (PSG) and it relation with BDZ abuse.

Methods:

Urine results for BDZ (and opiates, cocaine, cannabis, amphetamines) which are routinely monitored, were taken at the month before PSG night. Pittsburgh Sleep Quality Index (PSQI), a self report questionnaire, questionnaire for pain (chronic pain defined if patient had current pain that lasted for ≥6month, of moderate or worse intensity), and DSM-IV-TR lifetime psychiatric diagnosis were studied.

Results:

Of 67 patients, 44(64.7%) were positive to BDZ. Patients included 86% males, 64.2% with any DSM-IV-TR axis I psychiatric diagnosis, 47% with chronic pain, with no differences between BDZ groups. PSQI scores and objective sleep efficiency were similar between yes and no BDZ groups (12.4±4.1 vs. 11.1±4.5, p=0.3, and 78±17.4% vs. 74±19.5%, p=0.4), but architecture differed notably. Specifically, 23(53.5%) of BDZ group had no non-REM deep sleep (phases 3+4) at all as compared with 4(16.7%) of the no-BDZ patients. REM phase was shorter among BDZ group (10.5±8.9 vs. 15.4±7.3, F=5.4, p=0.02). No other differences were found, and the absence of phase 3-4 was not related to methadone dose, treatment duration, or history of opiate abuse.

Conclusions:

Chronic / prolonged use of BDZ (which at times are prescribed for sleep), may disturb sleep, as shown to absolutely delete all restorative sleep phase. BDZ discontinuation is of important, but further studies are needed to establish the best way.
Prevalence of Insomnia in Nursing and Midwifery Students
Authors: Shamsaei F. , Cheraghi F.
Published: March 2009

Background:

Sleep is absolutely essential for normal, healthy function. Sleep disturbances are one of the most common under diagnosed and under treated health problems among the adult population. The disturbances in sleep and wake process caused physical and mental disorders.

Purpose of study:

The aim of the study was to assess the prevalence of sleeping problems to in the nursing and midwifery students.

Methods:

This research is a descriptive study. The participants consist of 321 individual were selected by census sampling. Data were collected by questionnaire that concluded 2 parts; A- demographic factors B- questions related to sleep disorders.

Results:

Outcome showed that nearly one-three of nursing and midwifery students suffered from insomnia. The percentage was significantly higher among women (37.1%) than among men (23.1%). The prevalence of insomnia was higher in nursing students (39.3%) than midwifery students (31.2%).

Conclusion:

Sleep disorders distracted the physical and mental health of students. It impacted on academic performance and decreased educational achievement of students. Emotional stress and anxiety are some factors of sleep disorders, with recognizing these factors, we can operate effective interventions.
Job Stress Associated with Managed Care Mental Health Services Among Social Workers in the USA
Authors: Acker G.
Published: March 2009

This study examined the complex interrelationships among work related stressors associated with managed care mental health services and burnout of social workers. The recent national trends in mental health care in the USA, driven by the rising costs of inpatient treatment have resulted in a reduced psychiatric inpatient census, increase in outpatient clients with severe and persistent mental illness (SPMI), new regulations and constraints, and increases in management activities and paperwork. The new economic decisions about mental health care have also resulted in changes in the work roles of social workers as well as other helping professionals (psychiatrists, psychologists), and in new ethical dilemmas, and disillusionment regarding mental health practice. A total of 591 social workers practicing in mental health agencies in New York State completed self-administered and anonymous questionnaire packets that included several measures: Level of conflict that workers experience when interfacing with managed care organizations (CMC), organizational commitment, emotional exhaustion, and turnover intentions. Results showed that CMC had statistically significant correlations with organizational commitment and with emotional exhaustion. The researcher discusses the role of social work schools and other related academic programs as well as agencies in offering new educational opportunities and training in order to improve workers’ skills which are necessary for communicating and negotiating with managed care organizations.
Traumatic Childhood Events and Potential Consequences in Adult Health
Authors: Amaral A.P. , Serra A. Vaz
Published: March 2009

Aims:

The objectives of the study were:

1.

Investigating the impact of early traumatic experiences in adult physical and mental health;

2.

Analysing the relationship between early traumatic experiences and adult vulnerability to stress.

Method:

The sample consisted of 552 adults of the general population. Individuals filled out a series of questionnaires inquired about physical and mental symptoms and early traumatic experiences. A correlational design was used.

Results:

In relation to mental health, observed that the higher the impact of the situation of rape, aggressive family and alcoholism in parents, during childhood, more psychopathological symptoms have in adulthood. When we regard to physical health, sexual abuse and aggressive family are the early experiences most relevant, they are related with the perceived state of health at present, 1 year ago and 5 years ago, and with the existence of chronic disease. We must also add that, greater the impact of living in an aggressive family, in childhood, greater the vulnerability to stress in adulthood.

Conclusion:

Given the results obtained, the main conclusion can be drawn from this study are: The higher the degree of impact of traumatic experiences in childhood, worse physical and mental health, and greater vulnerability to stress in adulthood.
Cumulative Effect of Life Events in Physical and Mental Health
Authors: Amaral A.P. , Serra A. Vaz
Published: March 2009

Aims:

This study examines the cumulative effect of life events in physical and mental symptoms. We have two main goals:

1.

Investigating the cumulative effect of life events in the health of the individual;

2.

Examining the relationship between the nature of adverse events and type of symptoms presented in terms of physical and mental health.

Method:

Data collection was performed in the general population, in 2 different moments: time 1 (T1) and time 2 (T2) spaced of nine months. The sample consisted initially by 552 individuals, and by 328 individuals at T2. A correlational design was used.

Results:

The number of life events, with impact on the individual, accumulated throughout the 9 months shows significant relationships with the physical and mental health in last evaluation. The hassles with impact for the individual are the events most relevant in terms of health. Certain circumstances of life are more closely related to mental health (changing the frequency of familiar meetings, the non-recognition of tasks, the workload increased). Others are more related to physical health (have been robbed or stolen, infidelity).

Conclusion:

Findings suggest the importance of hassles in the heath and some specificity in the relation with the life events and the physical and mental symptoms.
Posttraumatic Stress Disorders and Somatic Disease
Authors: Avdibegović E. , Delić A. , Selimbaić Z. , Hadibeganović K.
Published: March 2009

Numerous studies indicate that the exposure to traumatic vents and psychological trauma is a widespread. Studies also have properly documented and confirmed the presence of relationship between posttraumatic stress disorders (PTSD) and other health conductions. As PTSD might have a devastating effect on physical integrity and general health, the aim of this study was to show the prevalence of physical problems in patients with PTSD. The 217 patients with PTSD treated at the Department for traumatic stress disorders of the Clinic f Psychiatry Tuzla in the period from 2005 to 2008 were analyzed with regard to prevalence and type of physical problems. The PTSD was diagnosed according to DSM IV criteria while somatic diseases were diagnosed to ICD X. In group of patients that were examined there was almost an equal number of male and female. The average age was 49.44±8.85 years. With regard to educational level most patients completed secondary school. Regarding employment 75% patients were employed and exposed to psychological abuse at work. Out of 217 patients the PTSD in 67% was related to war traumatic experiences. With regard to somatic diseases mostly diagnosed were hypertension (45%), diabetes mellitus (43%), cerebrovascular diseases, hyperlipidemia, lumbo-sacral discopathy and thyroid gland diseases. Combination of PTSD and chronic somatic disease was common in patients treated at the department for traumatic stress disorders.
Bypassing Shame and Conversion Disorder
Authors: Bota R.G. , Preda A.
Published: March 2009

In this presentation we report a case of conversion disorder (partial aphonia) that was successfully treated with speech therapy. During the one year duration of this illness, the patient regained transiently (minutes) her normal speech on a few occasions independently of concomitant pharmacological interventions. Several hypotheses of the mechanisms of conversion disorder are reviewed as specifically applied to this case. The possible role of a pertinent shame mechanism to the conversion pathology is discussed.
Impact of Psychoeducation on Professional Stress Reduction within Prison Guards
Authors: Bravo-Mehmedbasic A. , Salčić D. , Kučukalić A. , Fadilpaić S. , Čaković L. , Mehmedika-Suljic E.
Published: March 2009

Aim:

Evaluation of psychoeducation effects on professional stress consequences within prison guards.

Method:

In the research were included 122 prison guards from three prisons in Bosnia and Herzegovina. All of them have been tested before and after psychoeducation was finished using following instruments: Index of reaction, STAI questionnaire, SAMAČA questionnaire.

Results:

Differences between first and second measuring of subjects included in this study in Sarajevo prison indicated statistically significant reduction of stress reactions, improvement of coping strategies and communication skills. In prisons in Zenica and Kula there are differences between first and second measurement in stress reactions reduction, improvement of coping strategies and overcoming of stress and improvement of communication skills as well, which are not statistically significant. In Kula Prison, significant differences between two measurements in attitudes of prison guards toward detainees were observed.

Conclusions:

Results of this study show that prison guards within prisons where are detained persons with long period of imprisonment (Zenica, Kula) are more exposed to professional stress, comparing to prison guards who are employed in investigation prison (Sarajevo). Psychoeducation resulted in positive effects and it should be obligatory included in prison guards training with the aim of decreasing of psychological consequences of prolonged professional stress to which they are exposed to. Psychoeducation should be on continuous basis and led by educated mental health professionals.
The Real Cost of Sickness-absence in Mental Health: A Cognitive Behavioural Perspective [P03-242]
Authors: Dovey A. , Wilday S.
Published: March 2009

The number of employees experiencing psychological problems related to occupational stress has increased rapidly in Western countries and mental illness is now cited as one of the top three causes of certified sickness absence.

Worldwide economic issues are now synthesising various cultural beliefs and behaviours and should Western factors have an influence then one could presume workplace mental health problems will increase worldwide. The presentation will focus on the literature pertaining to the potential function of sickness absence for the individual as well as the known maintenance factors for anxiety and depression from a CB perspective.The presentation will highlight that the basic CB premise of emotional disorder implicates the potential for an individuals response to symptoms to have a maintenance role in the course of both anxiety and depression. The potential impact of sickness absence for anxiety and depression via the loss of the benefits of employment (e.g. structure, activity and social contact) the potential for the development of sick role behaviour (e.g. reduced activity, social isolation) as well as the reinforcement of avoidant coping are considered significant.In conclusion the presenters propose that sickness absence for individuals with anxiety and/or depression can function as a maintenance factor for both disorders. The implications for the future use of sickness absence as a standalone intervention within this group will be discussed. The audience will have an opportunity to reflect on the potential effectiveness of cognitive behavioural therapy within the workplace
‘The Body Keeps the Score’ Revisited: Changes in Lipid Levels and Coronary Disease Risk in Army Veterans Suffering from Chronic PTSD
Authors: Kulenovic A. Dzubur , Kucukalic A. , Malec D. , Fisekovic S. , Suljic E. Mehmedika , Mehmedbasic A. Bravo
Published: March 2009

Aim:

To assess possible differences in plasma cholesterol, triglycerides, LDL-C, HDL-C, VLDLC, Index of arteriosclerosis and Established risk factor for arteriosclerosis and 10 year risk of coronary disease between veterans with combat experience with PTSD and veterans with combat experience without PTSD. To compare and analyze differences between groups in socio-demographic characteristics, trauma exposure, coping strategies and quality of life.

Method:

Plasma lipid parameters were determined and risk factors calculated for 50 subjects in the PTSD group and 50 subjects in the non-PTSD group. Groups were homogenized in gender, age, BMI, smoking status and somatic or psychiatric co-morbid disorders or the use of medications influencing blood lipid levels. Trauma exposure, coping strategies and quality of life were assessed with referenced psychometric instruments, socio-demographic characteristics with use of questionnaire.

Results:

Subjects in the PTSD group had significantly higher levels of all plasma lipid parameters except for HDL-C that was significantly lower. Risk factors were significantly higher in PTSD group. There was no significant difference in indices of exposure to combat trauma. Secondary traumatization was significantly more frequent in PTSD group. There were significant differences in socio-economic parameters, quality of life assessment and repertoire of coping strategies.

Conclusions:

The results of this study provide further evidence for the onnection of chronic PTSD and blood lipids abnormalities and cardiovascular risk factors. The results indicate the importance of posttraumatic environment factors and coping strategies for the occurrence and persistence of PTSD.
Predictors of Psychological Functioning in Sri Lankan Youth: Trauma Exposure, Perceived Availability of Resources, and Perceived Helpfulness of Religious Practices
Authors: Fernando G. , Miller K. , Garcia J. , Prasad J. , Suseema U. , Laurin D. , Gordon G.
Published: March 2009

The purpose of this study was to examine how exposure to the armed conflict and the tsunami, perceived availability of resources, and perceived helpfulness of religious practices would predict depression, anxiety, posttraumatic stress, and psychosocial functioning in a multi-ethnic sample of Sri Lankan youth. A sample of Tamil (174), Sinhalese (332), and Muslim (215) children (girls=391) between 12 and 19 years (mean age =14.4, sd =1.9), completed a survey including demographic questions and items assessing exposure to the conflict and the tsunami, the perceived availability of resources, and perceived helpfulness of religious practices. Scales assessing depression, anxiety, posttraumatic stress, and psychosocial functioning were also completed. Four hierarchical multiple regression analyses were conducted with exposure to the conflict and tsunami, perceived availability of resources, and perceived helpfulness of religious beliefs as predictors, and with depression, anxiety, posttraumatic stress and psychosocial functioning as outcomes. The results revealed that exposure to the armed conflict significantly predicted posttraumatic stress (R2 =.03, F [1,494] = 12.77, p< .001), while exposure to the tsunami predicted anxiety (R2 =.03, F [2,506] = 7.8, p< .001), and perceived availability of resources predicted depression (R2=.09, F [4,499] = 11.83, p< .001) and psychosocial functioning (R2=.098, F [4,506] = 13.67, p< .001). The results suggest that exposure to traumatic events should not be assumed to be the only or even the most important variable when considering the overall psychological and psychosocial functioning of children in developing countries and traditional cultures. Implications for interventions, policy, and future research are discussed.
Anger, Social Dysfunction and Psychopathological Distress in Hearing- Impaired Patients
Authors: Forghieri M. , Monzani D. , Galeazzi G.M. , Gherpelli C. , Rigatelli M.
Published: March 2009

It has been demonstrated that subjects suffering from hearing impairment present significant emotional reactions and socio-situational limitations when compared to controls (Monzani et al., 2008).

Aim:

To evaluate the relationship between hearing loss severity, anger expression, perceived handicap, social dysfunction and psychopathological distress in adult patients suffering from acquired hearing loss.

Method:

297 hearing impaired subjects were consecutively recruited by the ENT Clinic of the Modena and Reggio Emilia University from 1/1/07. Each patient were submitted to pure-tones audiometry and the pure tone average threshold (PTA) was calculated over 0.5,1, 2, 4 kHz. Socio-demographic data were collected (age, educational level, employment, marital status). Every patient was also administered the following questionnaire in their Italian validated version: Social Functioning Questionnaire, Brief Symptom Inventory, Hearing Handicap Inventory for Adults, State-Trait Anger Expression Inventory-2. Descriptive statistics were used to assess sociodemographic data; Pearson correlation coefficient was used to investigate relationships between test scores and hearing loss level.

Results:

Mean age was 53.79 (SD ±13.65); 44.8% were males. Hearing impairment level didn't significantly relate with objective social functioning level (p=.311), but with the subjective emotional and socio-situational perceived handicap (p=.000); moreover it significantly correlates with individual psychopathological tendency to phobic reaction (p=.006) and to anger general expression index (p=.021). Furthermore it directly relates with state anger (p=.021) and inversely relates with external expressed anger (p=.023).

Conclusion:

Anger felt but not expressed might be a key element in determining subjective social impairment in hearing loss patients and contribute to their well-known psychological distress.
Acute Effect of Blue Light Exposition on Well-being and Melatonin Secretion in Humans
Authors: Franke L. , Sülflow D. , Stark K. , Piazena H. , Uebelhack R.
Published: March 2009

Aim:

The aim of this study was to investigate the efficacy of blue light emitting diode units in suppression of melatonin secretion and to evaluate whether a single exposure can improve well being in healthy males and females (20/30) and in 15 women with premenstrual syndrome.

Methods:

All study participants were of morning-type with a regular sleep schedule. On control day 1, the subjects were kept under dim illumination (< 10 lx) from 19:00 to 22:30. On day 2, after 1.5h in dim light, the subjects were exposed for 60 min to blue light (12.15 μM/cm², TurboLite, Germany) following by 30 min dim light. Blood samples were collected every 30 min for melatonin assay. Zerssen's complaints scale was used to assess mental und physical well-being at 19:00 (pre-test) and at 22:30 (post-test) after dim illumination or blue light exposure. In addition a visual analogue scale (VAS) for sleepiness was applied.

Results:

Overall, blue light improved significantly mental and physical complaints from pre-test to post-test (reduction in sum score of the Zerssen's complaints scale by in average 30%) and reduced sleepiness, as measured by the VAS. There were gender-related differences, as well as differences related to the menstrual phase in females. Blue light reduced but not suppressed the gradual increase of melatonin in plasma with time mostly pronounced in the follicular phase.

Conclusion:

A single exposition with blue light of low radiant flux density, as applied in our study, seems to be helpful in reducing mental and physical distress.
Emotional Responses & Burn out Amongst Health and Social Care Workers During Earthquake Relief Work in Pakistan
Authors: Faruqui R. , Gul M.
Published: March 2009

Background:

South Asian earthquake of 8th October 2005 caused massive destruction of healthcare infrastructure in Pakistan. National and international health workers met the increased demand of health care provision. Initial consultation and discussion with professionals working in disaster-affected areas indicated a high level of physical exhaustion and emotional burn out amongst relief workers.

Method:

A qualitative consultation study based on semi-structured interviews was conducted during 2005- 2006. The objectives of the study were to identify peoples’ motivation and emotional reactions whilst providing services in disaster-affected areas. 30 professionals were consulted in total. All subjects had participated in health provision efforts in disaster-affected areas. Interviews were conducted in Karachi, Islamabad and Rawalpindi. A written record of interviews was kept to allow analysis.

Analysis:

The purposive sampling and ongoing thematic analysis of interview data enabled identification and further exploration of qualitative themes.

Results:

The emergent qualitative themes are presented in three sections:

1.

Sources of Motivation: Shared Experience, Doing Good, Fear and Gratitude, Positive Emotional Experiences.

2.

Sources of Distress: Feelings of Guilt and Impotence, Anger and Distrust, Physical Hardship, Poor Law and Order Situation, Conflict with Local Communities, Interpersonal and Inter-agency Conflict.

3.

Coping with Emotions: Work Strategies, Escape Activities, Religious Activities, Emotional Avoidance.

Conclusion:

Emotional experiences and motivating factors may play an important role in preventing or causing early ‘burn out’ in relief workers. This study highlights the importance of examining these factors in organization and conduct of disaster relief work.
Request for Asylum and Calls for the Recognition of a Psychiatric Illness Status - what are the Intrications?
Authors: Hristova-Ivanova P.
Published: March 2009

Applicants for asylum travel though a migrant’s journey, which is rewarding, but also psychologically difficult due to the trauma suffered in the country of origin, often as a result of political conflicts, war and diverse ethnic rifts, the separation from the native roots and the adaptation to a new socio-cultural context.

The migrant's insecurity of not quickly finding his bearings and stability in the host country could lead to transitional depressive symptoms, anxiety ruminations, nightmares and feelings of threat or rejection, which may be sometimes close to the experience of persecution.

These people have already been monitored by their general practitioner for several years.

During their journey, some are oriented towards psychiatric care. Usually their symptoms relate only to adaptation problems. Specific psychological support is offered when necessary.

However, it is ethically troublesome when these subjects appear at the psychiatric consultation with the request for the application of the various certificates for the recognition of a psychiatric disorder in order to support their request for asylum.

Such requests must be addressed impartially when they relate only to an adaptation problem where the migrant is susceptible, through termination, to resume the course of a citizen of the host country without necessarily attaining the status of a psychiatric patient.

The early psychiatrisation of migrants may discredit somewhat, through stigmatisation, their status as free subjects and not patients.

We illustrate our ideas with some clinical observations.
Antecedents of Spiritual Distress Experienced by Iranian Muslim Patients: A Qualitative Study
Authors: Karimollahi M. , Abedi H.A.
Published: March 2009

Introduction:

The World Health Organization (WHO) (1998) has proclaimed that the definition of health includes four Domains of well-being: physical, mental, social and spiritual. It is therefore suggested that nurses should prepare themselves to assist individuals and families, not only to cope with spiritual distress of illness and suffering but also to explore the meaning in these experiences. The purpose of this investigation is to explore the antecedents of spiritual distress experienced by Iranian Muslim patients in the context of Islam.

Methods:

Qualitative descriptive research was conducted using unstructured interviews with twenty-one patients and three relatives. The data analyzed using content analysis method.

Results:

Three main categories were found: failure in communication, non-holistic care and inability to worship.

Conclusion:

The results showed that the patient's spiritual well-being could be enhanced by communication, listening and giving information. Finally, it is clear that staff members have a great deal of responsibility for the patient's well-being, facilitating the relatives’ involvement based on their wishes and limiting the stress and difficulties experienced by the family.
Correlation Between Shift Work and Psychological Problems Among Hospitals Personnel of Ardabil University of Medical Science
Authors: Molavi P. , Karimollahi M. , Mohammadnia H.
Published: March 2009

Background:

Shift work can be propounded as a risk factor of psychological problems creation. This study has been executed to determine relation between shift work and psychological problems among hospital’s personnel of Ardabil University of Medical science.

Materials and methods:

This study is a retrospective case-control one and has been executed on 388 person of personnel of hospitals of Ardabil University of Medical Science (223 as case group and 65 as control group), that has been selected randomly. Requisite information was collected with three questionnaires. Including General Health Questionnaire (GHQ), personal questionnaire and standardized sleep state evaluation questionnaire and were analyzed by SPSS statistical software. Chi-square and analysis of variance tests were used to test investigation’s hypothesis.

Results:

Meaningful relation were found between these problems such as somatoform signs (p< 0.005) anxiety (p< 0.019) social action disorder (p< 0.001) and depression (p< 0.019) and shift work. At the same time result of comparison of sleep state in the case and control group showed that in all items s1sep1 taking nap throughout day, there is meaningful difference between two case and control group and this difference show that more sleep problems is found in case group as compared with control group.

Conclusions:

It is advised to reform irregular circulation of shift Work in hospitals and with due attention to work conditions of any hospital, a sought after shift work system be executed.
The Stressors of Nurses Working in Emergency Units
Authors: Molavi P. , Karimollahi M.
Published: March 2009

Background:

The comparison of stresses between nurses and dentists depicts that nurses more than other professions are prone to stress and the rate of suicide in female nurses 5-6 times and in male nurses 2-3 times more than general population. Researches also shows that neurotic disorders like drug abuse and depression is more common in nurses. This study aimed to determine stressors of nurses working in emergency units.

Materials and method:

All of nurses working in emergency units of hospitals of Ardabil medical sciences university (n=49) chosen for sample. The means of data collecting was questionnaire. Descriptive statistics used for data analysis.

Findings:

This study showed that the shortage an unavailability of necessary equipment (67.34%), patient's suffering (57%), patient's family interference with nursing care (53.06), shortage of nurses, unavailability of physicians in emergency situations, (51.12%) and working without adequate rest (42.17%)were the most important stressors of nurses working in emergency units.

Conclusion:

In the sum we can say that the most important stressors are the shortage and unavailability of necessary equipments. This is a management related factor so nursing managers can help to promote the nursing care quality using environmental changes.
Quality of Life Among the Navies at Six Months After the Tsunami in Phang-NGA Naval Base, Phang-NGA Province, Thailand
Authors: Kongsakon R.
Published: March 2009

Objective:

This study aimed to identify the health-related quality of life (HRQOL) among the navies or their spouses at 6 months after the tsunami disaster, to compare HRQOL with the 2006 Thailand normative data for Short Form - 36 (Bangkok)4.

Method:

A structured questionnaire modified from the 36-item Medical Outcome Study Short-Form Health Survey (MOS SF - 36), including demographic data, characteristics and amount of loss, social support, health information, and type of Tsunami exposure were recorded.

Result:

A total of 434 subjects participated in this study. Male was 77%. Married was 67%. Mean age was 33.56 ± 9.26 years old. The QOL scores among members of the Navy or their spouses were lower than the 2006 Thailand normative data (Bangkok) in almost all subscales except physical functioning, bodily pain, and social functioning. The major consequence of the Tsunami was mental health problems. A majority of the survivors who seriously experienced mental problems were female, low education, decreased income, loss of one's family members/loved ones, or property. Bodily pain was the only indicator subscale of QOL which was significant statistically associated with Tsunami exposure.

Conclusion:

The QOL measurement provided essential information that helped healthcare providers to identify survivors’ needs and outcomes. In addition, the changes in QOL over time after Tsunami disaster might be an effective guideline for health resources allocation. To improve their quality of life, these people required appropriate social support as well as physical and mental health care.
Stress Vulnerability and Mental Health in Eastern Europe Immigrants in Portugal
Authors: Monteiro A.P.
Published: March 2009

Introduction:

There are seldom mental health studies in Portugal about immigrant populations, particularly in groups belonging to non-Portuguese speaking minorities. The recent phenomenon of emergence of new migratory flows coming from Eastern Europe countries, which traditionally had no cultural or linguistic contact with the host country and the implications of this migratory process in the mental health status of this population, is the centre of this investigation.

Objectives:

This study aims to perform a socio-demographic characterization, identify the main health problems and health surveillance patterns of the immigrant population from Eastern Europe countries in Portugal. It also aims to assess the stress vulnerability and ths mental health status of this population.

Methods:

The study was conducted in immigrant local centres from January 31st 2005 to March 31st 2006 and focused on 566 Eastern Europe immigrants residing in several regions of Portugal, 296 males and 270 females. We used the 23 QVS (Vaz Serra, 2000); GHQ-28 (Goldberg & Hillier, 1979); SSQ6 (Saranson, Saranson & Pierce, 1987) and a Socio-demographic questionnaire.

Results:

From the 566 individuals in sample one; we conclude that this population is predominantly male, in active young age, with high academic qualifications.

Regarding mental health status, 10,4% of the inquired immigrants presented psychiatric pathology assessed by the cutting point of GHQ-28 and 54.9% presented stress vulnerability determined by the cutting point of 23QVS. We verified a statistically relevant correlation between stress vulnerability and the levels of mental health of the surveyed population.
Enhanced and Delayed Stress-induced Body Weight in Mice Lacking Functional Natriuretic Peptide-a Receptors
Authors: Mutschler J. , Grosshans M. , Jahn H. , Wiedemann K. , Spanagel R. , Kiefer F.
Published: March 2009

Genetic and environmental influences are both known to be causal factors in the development and maintenance of obesity. Stress related chronic stimulation of the hypothalamic-pituitary-adrenal (HPA) axis and resulting increased glucocorticoid exposure is known to be an important pathophysiological mechanism in the development of obesity. We show that the natriuretic peptide system, that mediates endocrine and behavioural responses to stress, plays a role in the control of long-term body weight in chronically ethanol drinking mice. In mice lacking functional NPR-A receptors, physical, and in particular psychological stress leads to enhanced and continuous increase in body weight in homozygote NPR-A mice. The effect of repeated stress on body weight appeared rapidly and persisted throughout life. Over a longer period of time without stress, body weights do not differ between the different genotypes. Moreover, we could demonstrate that NPR-A homozygote mice show significant higher corticosterone levels following stress. Heterozygote animals show an intermediate phenotype concerning body weights and corticosterone levels following stress. Alterations in the NPR-A receptor gene may constitute a genetic risk factor for stress-induced eating and obesity.