bluuebunny/crossref_metadata_2025 huggingface dataset:
Linking brain and culture: Universalism and differentialism
Authors: Cabanis M. , Martinez Mateo M. , Cruz de Echeverria Loebell N. , Krach S.
Published: May 2011

In 2009, Joan Y. Chiao, one of the leading experts in Cultural Neuroscience, labeled the research field as „a once and future discipline”. Ten years ago neuroscientists began to study cultural phenomena applying functional Magnetic Resonance Imaging (fMRI). Since then the number of publications and research grants related to this topic has tremendously increased. This was reason enough to examine the concepts of culture implicated, but rarely explicitly discussed, in these studies. Therefore we analyzed 42 English language manuscripts of original fMRI studies spanning from the advent of Cultural Neuroscience in the year 2000 to 2010 published in peer-reviewed journals (indexed in large databases [MEDLINE, PsychInfo, PubMed). Common to all of them were cultural comparisons between divided groups and communities, as e.g. black vs. white, easterners vs. westerners, Asian vs. Caucasian, Americans vs. Turks.

We reviewed the manuscripts with regard to the following aspects: type of comparison, the conveyed concept of culture using the classification by Reckwitz [normative, totality-oriented, differentiation-theoretical and the meaning- and knowledge-oriented], implicit valuation of the comparisons, and the artifact of the comparison. We extracted two main lines of reasoning:

1)

Universal models for the interaction between cultures and

2)

investigations pursuing a differentiation of divided cultural groups.

Both lines tend to simplify culture as an inflexible set of traits, specificities or biological diversities. We argue against the rigid understanding of culture, point out its disguised valuation and risks considering the Hackingian ‘looping effect’.
Is religion really important?
Authors: Da Ponte G. , Neves T. , Lobo M.
Published: May 2011

Introduction

Knowing the impact that religious beliefs can have on the etiology, diagnosis and course of psychiatric disorders will help psychiatrists better understand their patients, assessing when the religious or spiritual beliefs are used to cope with mental illness and when they may be exacerbating this disease.

Objectives

Alert to the importance of religion in clinical practice.

Methods

Relevant literature review.

Results

Several studies have demonstrated the influence of spirituality on physical, mental and health. In 1988, the World Health Organization (WHO) has given rise to the interest in further investigations in this area, with the inclusion of a spiritual aspect of the multidimensional concept of health. The spiritual well-being can be considered a protective factor for psychiatric disorders.

Although it is not possible to determine with accuracy, the mechanisms of interaction of spirituality on health, especially mental health, several studies suggest that exercise can influence the spiritual activities, psychodynamically, through positive emotions. Furthermore, these emotions may be important for mental health in terms of possible psychophysiological and psychoneuroimmunological mechanisms.

Anthropological sources suggest that beliefs in demons, black magic and evil spirits as cause of mental illness and distress are common. They may be less prevalent in western countries but even in Europe it's possible to see patients thought that their condition have been caused by evil and occult possession.

Conclusions

Clinicians should understand the negative and positive roles that religion plays in those with mental disorders and use this in clinical practice.
Medication adherence among Asian psychiatric outpatients: A systematic review
Authors: Fancher T. , Lee D. , Cheng J. , Yang M.S. , Larry Y.
Published: May 2011

Introduction

Little is known about medication adherence among Asians and Asian Americans in psychiatric treatment.

Objective

We conducted a systematic review of studies of Asian American and Asian patients with depression or schizophrenia to understand adherence rates and tools used to measure adherence.

Methods

A key word search of PubMED and PsycINFO, restricted to journal articles available in English or Chinese and published between 1960 and March 2010 was performed. Reference lists of studies meeting inclusion criteria were manually reviewed and content experts were consulted. Two investigators independently reviewed all identified publications for inclusion using predetermined criteria and a pilot tested data-abstraction form.

Results

Of the 1520 journal articles retrieved, 10 met criteria for inclusion. Adherence rates among patients with schizophrenia ranged from 5–71%; adherence rates among patients with depression ranged from 16–67%. Adherence rates varied among Asian sub-populations: Chinese patients’ rates ranged from 6–56%; Taiwanese patients’ rate was 46–61%; Asian American patients’ rate was 16%; Japanese patients’ rate was 56–71%; and Singaporean patients’ rate was 4.3%. Adherence was measured by: self-report; blood levels; refill rates; chart review; or physician/nurse or family caregiver report.

Conclusion

Medication adherence rates varied across clinical populations and country of origin. Nearly all of the rates are lower than many clinicians would consider acceptable. A critical step to research on improving adherence will involve reaching consensus on how to measure rates.
Vulnerability and diagnosis of psychosis among migrant patients in modena
Authors: Giubbarelli C. , Ferrari S. , Reggianini C. , Rigatelli M.
Published: May 2011

Introduction

The risk of psychotic spectrum disorders in Western countries seems to be higher among immigrants than natives. The higher vulnerability may be related to biological, psychological and social factors while cultural and diagnostic difficulties seem to delay an effective therapeutic intervention, with longer DUP (duration of untreated psychosis).

Aim of the study is to analyze the characteristics of psychotic patients of foreign origin with a particular attention to their use of mental health services.

Methods

We studied all migrant patients attended to 3 Community Mental Health Centres (CMHC) and to the Psychiatric Hospital (PH) of Modena over a period of a month.

The socio-demographic and clinical data were collected by means of a structured culturally-oriented form.

Results

63 patients of foreign origin attended to the Services. 46% of all diagnoses is a psychotic disorder (most frequent diagnosis being that of brief psychotic episode: 19.15% in CMHC, 22% in PH).

Psychotic disorders are prevalently present among Asian, South American and Eastern European populations.

Use of second generation antipsychotics is frequent in the CMHC (23.4% of all psychopharmacological treatments, p = 0.003) while combined therapies dominate in PH (42.86%). The DUP is on average 12 weeks in PH, 8 in CMHC.

Conclusion

We would confirm a high incidence of psychosis among migrant subjects, with a tendency to use emergency health services. Often there are difficulties in establishing a continuous and territorial therapeutic relationship, or to intervene in the early stage of onset.
Can’t take that song out of my mind… impact of psychiatry in music
Authors: Gago E. , Alves A. , Santos M. , Ribeiro A.
Published: May 2011

Introduction

As Aldoux Huxley said in his essay Music at Night (1931) ”After silence, that which comes nearest to expressing the inexpressible is music.”

Music has always played an important role in knowledge and communication among different cultures and it plays a very important role in young people culture, transmitting their worries and interests. The music world, especially rock, jazz and blues, has been related to drugs and alcohol. Themes related to drug and alcohol abuse and other mental disorders are frequent in the contents of songs, titles and even in the names of bands.

Objectives

The authors aim to show the relation between music and mental disorders.

Methods

The authors made a brief review of lyrics, song titles and names of popular bands of different music styles and times.

Conclusion

In many song lyrics and titles it is frequent to appear promotion of drugs and alcohol abuse as well as reference to psychiatric clinical terms as suicide, hallucination and depression.
Abridged cultural formulation of a clinical case
Authors: Garcia del Castillo I. , Caballero Martinez L.
Published: May 2011

Introduction

Cultural formulation (CF) of the DSM-IV is the cultural assessment tool promoted by the APA, not fully developed, that has limitations in clinical practice. An abridged cultural development, integrated into the overall clinical development of the case, might be more operational.

Objectives

Develop an abridged CF of a clinical case, focusing only on relevant cultural elements for the proper understanding of the case diagnosis and therapeutic approach.

Patients/ methods

A 43 year old woman from Hispanic Caribbean was admitted to a psychiatric unit, diagnosed with cycloid psychosis. She had been hospitalized twice before, with diagnosis of acute polymorphic psychotic episode. The three episodes seemed reactive to stress - loneliness, isolation, lack of protection - all on an abnormal development of personality with a clear overdevelopment of professional self versus other aspects of the self. The knowledge of sociopolitical conditions of her country, provided by a key informant, was necessary to deepen the narrative sense that the patient gave her disease.

Results

The diagnostic formulation including an abridged CF, made by introducing cultural elements, lead to a better understanding of the underlying psychopathology and sense of anomalous behaviour, develop an explanation of the disease acceptable to the patient and improve the therapeutic alliance, ensuring adherence to treatment and satisfaction with it.

Conclusions

Cognitive neuroscience and anthropological theories have to mix their methods to offer a more valid and reliable instrument than currently available. Future instruments must be compatible with work of a clinical psychiatrist and demonstrate cost-effectiveness of their use.
A study on comorbidities, knowledge and attitudes among patients of dhat syndrome
Authors: Jhanjee A. , Bhatia M.S. , Kumar P.
Published: May 2011

Introduction

Dhat syndrome is a commonly recognized clinical entity in Indian culture. It consists of vague somatic symptoms (fatigue, weakness, anxiety, loss of appetite, guilt, etc.) and at times sexual dysfunction (impotence or premature ejaculation), which the patient attributes to the passing of semen (Dhat) in urine as a direct consequence of his excessive indulgence in masturbation or sexual intercourse.

Objectives

To assess medical and psychiatric co-morbidities and prevalent knowledge and attitudes among patients of Dhat syndrome.

Methods

A cross-sectional study of 50 consecutive male patients with Dhat syndrome attending psychosexual clinic of a tertiary care hospital in Delhi was performed to ascertain co-morbid psychiatric and medical disorders and the prevalent knowledge and attitudes of subjects towards Dhat syndrome and its management.

Results

The commonest associated psychiatric illness was neurotic depression followed by anxiety neurosis. The commonest associated medical illness was urinary tract infections (UTI) followed by sexually transmitted diseases (STDs). Majority of subjects believed Dhat to be semen; that Dhat syndrome causes both physical and mental weakness and; that health tonics are required for successful management of Dhat syndrome. More than half of the subjects believed that masturbation causes Dhat syndrome. The study reveals a change in knowledge and attitudes of patients affected with Dhat syndrome in the last decade.

Conclusions

Dhat syndrome exhibits significant medical and psychiatric co-morbidity. The findings of this study need to be further evaluated in the immigrant population.
Evaluation of self-esteem with internalized stigmatization in the patients with mentally illness
Authors: Keser I. , Saygin N. , Turkan S. , Kulaksizoglu B. , Buldukoglu K.
Published: May 2011

Introduction

Internalized stigmatization means a internalized reaction in the person with mentally illness as a answer against the people reject and discrimination.

Objective

The peoples with mentally illness believe that most people reject and devalue people with mental illnesses, they may suffer a number of negative outcomes, such as demoralization, lowered self-esteem.

Aim

The aim of our study was to identify the relationship between the factors effecting the internalized stigmatization and self-esteem among patients with mentally illness.

Methods

In this study, we measured the prevalence of internalized stigma among 115 outpatients referring to the Psychiatry Service of Antalya Education and Research Hospital between 2009–2010 using Rosenberg Self-Esteem(SE) Scale, the Internalized Stigma of Mental Illness(ISMI) Scale, and Personel Datasheet.

Results

Of the patients, 53.9% had middle level of SE and the 22.00–70.00 ranging of ISMI, 30.4% of the patients were found to be 21–30 years-old. We found the increase of ISMI when SE was decreased in both of gender(p = 0.01, r = -0.67) and it was also found to be decreased of ISMI when the education level was increased in the patients(p = 0.004,r = -0.27). Recurrent hospitalization of the patients increased their ISMI points(p = 0.014, r = 0.23). There was no statistical relation between the living place of the patients and their ISMI points(p = 0.523).

Conclusions

Our results suggest that some factors effected internalized stigma and showed the relationship between the internalized stigmatization and self-esteem among patients with mentally illness. To decrease and prevent internalized stigmatization, a specific education should be provided to patients, families and society by health professionals.
Family dynamics in greek roma
Authors: Mentis M. , Kotrotsiou S. , Paralikas T. , Paschou A. , Mantzoukas S. , Bakouras S. , Kotrotsiou E. , Gouva M.
Published: May 2011

Introduction

Roma think highly of the family. Its function is influenced by Roma's distinguished cultural system and their system of values.

Aim

The objective of the present study was to investigate the relationship between family relationships, personal growth, family system maintenance and sociodemographic factors in Roma.

Materials and methods

145 individuals (105 male and 89 female), residents of the general area of Greece, participated in the present study. The measures used were: a) The Family Environment Scale (Form R-FES) and b) A questionnaire concerning socio-demographic information.

Results

The marital status correlated with the Cohesion in Roma family (r. = .225, P = .002), Expressiveness (r. = .188, P = .009), Conflict (r. = -.178, P = .013), Achievement Orientation, Intellectual - Cultural Orientation (r. = .184, P = .010), Family Organization (r. = .267, P = .000), Family Control (r. = -.178, P = .013), and Family Incongruence (r. = .200, P = .005). The sex correlated with the Achievement Orientation (r. = -.253, P = .000), Moral-Religious Emphasis (r. = -.275, P = .000), Family Organization (r. = -.172, P = .016), Family Control (r. = -.280, P = .000), and Family Incongruence (r. = -.182, P = .011). The work situation correlated with the Cohesion (r. = -.207, P = .004), Achievement Orientation (r. = -.173, P = .016), Intellectual - Cultural Orientation (r. = -.177, P = .014), Family Organization (r. = -.220, P = .002), Family Control (r. = -.180, P = .012), and Family Incongruence (r. = -.205, P = .004).. The state of residence correlated with Conflict (r. = -.213, P = .003), Independence (r. = .213, P = .003), Achievement Orientation (r. = .202, P = .005), and Moral-Religious Emphasis (r. = .191, P = .008).

Conclusions

In Greek Roma the different Relationship Dimensions and the Personal Growth Dimensions are influenced by certain demographic factors like the marital status, the work situation, the state of their residence (existence of bathroom, electricity) and also the possession of legal documents (ID).
The sang bok lee neurosynchronistic dream scales: an empirical exploration of jungian synchronicity
Authors: Lee S.B.
Published: May 2011

Aim

The purpose of this study was to verify the Jungian concept of synchronicity and to utilize lucid dreaming techniques for the selected dreamers to experience synchronistic dreams more frequently.

Methods

1248 dreams were collected from 416 Korean college students, Yongin, South Korea: 198 males (M age = 20.46 years, SD = 1.32) and 218 females (M age = 20.17, SD = 1.26). The collected dreams were coded by the Sang Bok Lee Neurosynchronistic Dream Scales. 36 dreams (2.88%) were evaluated as synchronistic and 10 dreamers were selected randomly and voluntarily: six females (M age = 20.19, SD = 1.24) and 4 males (M age = 20.47, SD = 1.35). Total twelve sessions for lucid dreaming technique training (one-hour session, twice per week, and six-week duration) were conducted and the trained dreamers reported their dreams during and after the twelve sessions.

Results

50 dreams that were collected during and after the lucid dreaming sessions were coded and found as significantly increased in terms of synchronistic dream frequency mode (9 dreams, 18%, when compared with the untrained dreamers: p < 0.0001). The results were empirically supported by “Lee Acculturation Dream Scale” (Lee, Sang Bok, 2005: Psychological Reports, 96, 454–456), “The Sang Bok Lee Neurocognitive Dream Orientations Scales” (2010, European Psychiatry), and by “Dreaming Brain and Acculturative Mind” (Lee, Sang Bok, 2010, European Psychiatry).

Conclusion

Lucid dreaming constitutes a future-oriented intentionality, adaptive function of brain/mind, neural plasticity, and a certain realization of the Jungian concept of synchronicity with measurable differences from untrained dreamers.
Communitarian campaign against the stigma of schizophrenia: “be on the stage”
Authors: Filipe N.S.L. , Clemente P.J. , Mateus S.I.S. , Lopes R.C.C.
Published: May 2011

The use of cultural approaches addressing stigma and discrimination promotes acceptance by raising consciousness. People with schizophrenia are often stigmatized by others.

Discrimination associated with common myths contributes to social exclusion and treatment delay, creating a barrier to recovery.This paper aims to present the development, implementation and evaluation of an anti-stigma campaign in the context of primary health care and local community using theatrical techniques.

In the Health Centre waiting rooms the invisible theatre technique was implemented, consisting in the performance of a previously rehearsed script without informing the public that it was a play, aiming to provoke debate and clarify problems related to social inequality and discrimination. The play script addressed common myths related to schizophrenia: People with schizophrenia are usually dangerous and violent; People with schizophrenia are unlikely to recover; Schizophrenia, as other mental conditions is a sign of weakness and not a true medical illness and others. In the local community, street performances were implemented based on image theatre techniques consisting in the use of living body imagery to address the myths described above.

Behavioural responses to the intervention were assessed using Likert type scale. Most of the people in both the settings were paying attention to the performances and dialogues. People watching street performances, however, were more active in expressing opinions or making specific questions related to the subject.

Further research on the impact of anti-stigma campaigns using theatre techniques is needed. These strategies may provide an effective approach to fight stigma in communitarian settings.
Geetopdesh: spirituality, cultural values and psychotherapy
Authors: Malhotra S.
Published: May 2011

In today’s age of globalization, growing materialism-unhealthy competition and distress, there is a felt need to explore the dimension of spirituality (Spiritual Intelligence). Spirituality and values can work as a soul for the science. In this regard, mythology and cultural heritage have a lot to offer. Revisiting scriptures and trying to understand the insights gained in the past era can add on to the knowledge and skills used in the practice of Psychotherapy. In todays fast pace life and age of globalization, utilizing such knowledge, insights and skills shall indeed be quite useful, both for personal growth and that of the patient. Today the challenge lies in inclusion, merging the cultural knowledge with current psychotherapeutic skills.

The paper shall focus on values derived from ‘Geetopdesha’ (’Geeta’, the Holy Book of the Hindus that incl. the preachings and guidance of Lord Krishna, an incarnation of the Administrator God Vishnu, to Arjun on the battlefield). It incorporates the philosophy of life and death, the never ending soul, cognitive psychotherapy, ‘Karm’ philosophy emphasizing on one’s duties and responsibilities.

Patients from different parts of the world can benefit from such insights and concepts that help in conflict resolution, enhancing motivation, self realization, increasing tolerance and acceptance thus aiding in reducing human suffering. It is of practical use in managing anxieties, phobias, fear of death, care of terminally ill and grief work. Combining relevant traditional approaches with the newer techniques is indeed a challenge in todays clinical practice of mental health professionals.
Children of homosexual parents
Authors: Moutinho A. , Pereira A.V. , Jorge G.
Published: May 2011

Like families headed by heterosexual parents, lesbian and gay parents and their children are a diverse group. Unlike heterosexual parents, however, lesbian and gay parents are often subject of discrimination because of their sexual orientation while facing adoption, custody or assisted reproductive technologies, based on stereotypes concerning children psychological development and wellbeing.

This work reviews empirical evidence regarding children with gay and lesbian parents. The results of existing research comparing children of homosexual parents with children of heterosexual parents are quite clear: common stereotypes are not supported by the data.
Prevalence of borderline personality disorder in immigrants in a psychiatric inpatient setting
Authors: Nielsen F. , Ziegenbein M. , Sieberer M.
Published: May 2011

Introduction

Information about the relationship between personality disorder and ethnicity or migration is sparse. The few studies regarding the prevalence of borderline personality disorder (BPD) in immigrants compared to an indigenous population are inconsistent.

Aims

The aim of the present study was to compare the frequency of a BPD diagnosis in psychiatric inpatients with and without an immigrant background.

Methods

2494 consecutive patients over a 3-year period at a psychiatric university hospital were reviewed. Data included socio-demographic and clinical variables and also information about an immigrant background. The psychiatric diagnosis was limited to information available from the digital documentation system of the psychiatric clinic and additionally from discharge letters. The diagnosis of borderline personality disorder was based on ICD-10 criteria.

Results

374 individuals (15%) of the study population had an immigrant background. The rates of BPD were 6.5% in the indigenous group (n = 2120) vs. 3.5% in the immigrant group (n = 374). The difference between the indigenous and the immigrant group regarding the rates of BPD-diagnoses was statistically significant (chi2 = 5.02, df = 1, p = 0.025).

Conclusions

The findings suggest that in a clinical sample BPD was diagnosed less frequently in the immigrant group than in the indigenous group. Therefore, our results do not support the concept of immigration as a risk factor for BPD. However, future investigations with a prospective study design and at epidemiological levels need to be conducted in order to get more precise information about the prevalence of BPD in different immigrant groups.
Ekbom syndrome - cultural aspects from a clinical case
Authors: Olari M. , Le Vacon G. , Follet M.
Published: May 2011

Introduction

Ekbom syndrome is a delusional parasitosis in which the patient has the delusion of infestation by parasites. This condition might occur in concordance with senile dementia or cerebrovascular disease, but it is also present in mood disorders or schizophrenia.

Objectives

To present a clinical description of a delusional parasitosis that appeared in a young nigerian women after she immigrated in France.

Aims

Our case is suggestive for showing that delusional parasitosis might develop in circumstances of social vulnerability such as the immigration and might have different cultural aspects.

Methods

We present the case of a 29 years old nigerian women that developed a delusional parasitosis 3 years after her arrival in France. The diagnosis was based on a carefully detailed clinical history, an MMSE was also applied. In order to exclude secondary causes an extensive laboratory evaluation was performed including: complete blood cell count, liver, renal and thyroid function tests, serum electrolytes and glucose levels, vitamin B12, folate, iron studies, coproanalysis, neuroimaging.

Results

The patient had all laboratory and neuroimaging tests normal. She presented a delusional parasitosis and she described an infestation with multiple intestinal worms. She was capable of describing them and their movements under the skin and also in all the organs. She described dracunculiasis and three more different species that are commonly present in Nigeria, she never mentioned lice or mites.

Conclusions

Ekbom syndrome is a delusion of hallucinatory mechanism that might have different cultural presentations and could be favored by social vulnerability such as immigration.
Family environment: differences between men and women greek roma
Authors: Mentis M. , Kotrotsiou S. , Paralikas T. , Paschou A. , Mantzoukas S. , Bakouras S. , Kotrotsiou E. , Gouva M.
Published: May 2011

Introduction

Roma attribute a great value at the family life. For them the family is the basic axis around which their community structures and their personal relationships are developed.

Aim

The present study aimed to evaluate the family relationships, the personal growth and the family system maintenance in male and female Roma.

Materials and methods

145 individuals (105 male and 89 female), residents of the general area of Greece, participated in the present study. The measures used were: a) The Family Environment Scale (Form R-FES) and b) A questionnaire concerning socio-demographic information.

Results

The mean age of men was 35.31 ± 11.21 years old, while the mean age of women was 32.43 ± 11.70 years old. According to the findings, the men scored higher in certain factors which were studied. In particular, they reported significantly greater Achievement Orientation (P=.000), Moral-Religious Emphasis (P = .000), Family Control (P = .000), Family Organization (P=.016) and Family Incongruence Score (P=.011).

Conclusions

Male Roma hold a special place in the Roma family, whereas the female's Roma place in the society of Roma in Greece is underestimated. Based on the measures used in the present study, the male Roma are characterised by greater ethics, religiousness, tendency to achieve their goals and generally to do things. Also, the male Roma seem to have a greater control over the family, in comparison to the female Roma.
Validation of patient health questionnaire in Greek-language sample
Authors: Pilipenko N. , Karekla M. , Feldman J.
Published: May 2011

Lack of validated measures creates obstacles for psychology research progress. The validation of widely used instruments can facilitate research and clinical work.

Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire (PHQ) is a cost-effective and psychometrically sound (Spitzer et al., 1999) instrument which is used for the diagnosis of specific psychiatric disorders according to the established diagnostic criteria. Unfortunately, despite its potential utility, PHQ has not been validated or used with Greek language populations.

The aim of this study is to conduct a PHQ validation in 520 Greek native-language participants in Cyprus. Appropriate self-report Greek-language measures were identified based on the convergence between the diagnostic specifications of these measures and PHQ diagnoses. The identified measures and the translated PHQ were used for data collection. Participants’ demographic and health information was also gathered.

Currently, the project is in its final stages of data collection, and will be completed by December, 2010. Preliminary results, suggest that a number of PHQ subscales have high internal consistency (e.g. Cronbach's alpha coefficient of .81 on Somatization, .83 on Depression) and correlate moderately with other diagnostic measures used (e.g. depression scale r = .43, p < .001 with BDI-II; panic scale r = .5, p < .001 with PDSQ panic scale).

Upon completion of data collection, PHQ factor structure, reliability, validity, sensitivity, and specificity will be further investigated. Item and correlation analysis will be confirmed.

Strength and weaknesses of PHQ subscales and the employed validation method will also be discussed.
The impact of social context on the acculturative process: acculturative stress in Latin American immigrants
Authors: Revollo H.-W. , Qureshi A. , Collazos F. , Casas M.
Published: May 2011

Introduction

The relationship between immigration and mental health may in part be affected by factors related to social context in general and in relation to specific ethnic groups in specific social contexts. A growing body of research is exploring the impact of neighborhood context on the well-being of immigrants. The specifics, however, have yet to be identified.

Aim

To analyze the impact of social context on stress and acculturative stress in a hospitalised Latin American immigrant sample.

Methods

The study was part of a larger project concerning stress, coping, and psychosocial well being in Latin American immigrants hospitalised in both internal medicine and obstetrics in a large public hospital in Barcelona (Spain). 290 participants were evaluated with the PSS-10 for general stress, the BISS for acculturative stress and a sociodemographic questionnaire elaborated ad hoc for social context.

Results

Neighborhood socioeconomic level is related to general stress and acculturative stress. A lower socioeconomic level is associated with higher levels of stress and acculturative stress. High levels of ethnic density of Latin American immigrants is moderately associated with lower levels of homesickenss and intercultural contact stress, but are not related with perceived discrimination.

Conclusions

Social context is an important factor that should be considered in the acculturative process of Latin American immigrants and its impact on their mental health status. A low socioeconomic neighborhood level increases levels of stress and acculturative stress, increasing the risk of psychosocial distress.

Own group ethnic density would appear to function as a protective factor.
Undergraduate elective experience in psychiatry - a personal account and literature review
Authors: Russell-Reddish H. , Temple P. , Beezhold J.
Published: May 2011

Introduction

The study was triggered by the first author's own experience on an undergraduate elective at the National Mental Wellness Centre in St Lucia. This was an eye-opening experience of psychiatry in a less economically developed environment. It highlighted disparities between practice in the developed and the developing world. Notably significant differences were apparent in facilities, epidemiology of presenting complaints, the interaction of cultural beliefs as well as the method of assessment and management.

Aims/objectives

To review the literature on the educational impact of electives in psychiatry.

Methods

A literature search using Ovid MEDLINE was conducted using the keywords’medical student’ AND’elective’ AND’psychiatry’. A total of 229 results were returned. These were then analysed for their relevance.

Results

Only one paper was found emphasising the importance of electives in psychiatry. This reported on one individual's personal experience. There also were reports highlighting the importance of undergraduate elective experience and the need to increase exposure to psychiatry to improve the uptake of postgraduate training programmes. There were no papers objectively assessing the educational quality or impact of a psychiatric elective experience.

Conclusions

An overseas elective experience was subjectively beneficial for the author but there is a lack of objective research to show the educational benefit of psychiatry electives on a wider scale. Further research regarding the educational benefits of electives in psychiatry is needed.
Acculturation stress in immigrant population, migratory mourning and associated comorbidities
Authors: Serrano Díaz de Otálora M. , Gómez-Arnau Ramírez J. , Martínez de Velasco R. , Andrada Meyer J.
Published: May 2011

Introduction

Migratory mourning has specific features and migration is itself a risk factor for mental health. Basic grieving relate to seven areas: family and friends, language, culture, land, social status, contact with the national group and physical risks, as well as general mourning the failure of the migration project.

Objectives

We intend to trace the process of acculturation seeking to distinguish its symptoms from those of most common psychiatric disorders.

Methods

We conducted a literature review using the National Library of Medicine and PubMed search system.

Results

Adaptation process traces a U-shaped curve. In the second stage called crisis stage may appear rejection or isolation, sadness, crying, sleeplessness, irritability, distrust, recurrent and intrusive thoughts, psychosomatic symptoms (headaches, fatigue, musculoskeletal pain), dissociative and somatoform symptoms. Stress reactions can occur with cognitive fatigue, role and personal shocks.

Ulysses syndrome has features in common with acute stress disorder or adjustment disorder. Differential aspects regarding DSM-IV are: multiple identifiable stressors of high intensity, long duration, cultural interpretations and association of dissociative and somatoform symptoms.

Main observed pathologies are: PTSD, schizophrenia and paranoia, somatization and affective disorders, whose clinical expression is primarily determined by cultural factors.

Conclusions

Professionals should know the different manifestations of mental illness in immigrant population to distinguish them from experiential reactions and to avoid upset psychiatrization and therapeutic nihilism. Ulysses syndrome seems closer to preventive health and psychosocial support areas.
Problem solving skill and Iranian nursing students
Authors: Seyedfatemi N. , Moshir Abadi Z. , Borimnejad L. , Haghani H.
Published: May 2011

Introduction

The ability to solve problems and make decisions creatively has become paramount to new nursing graduates, as these skills assist them with recognizing and evaluating situations that require prompt attention. This study was done to determine nursing student’s problem solving skills in various years of their four-year program.

Materials

This is a cross-sectional study. Three hundred and twenty two undergraduate nursing students in BSc nursing program participated in this study. The study setting was Nursing School of Iran University of Medical Sciences. The Problem Solving Inventory (PSI; Heppner & Petersen, 1982) was used to data gathering. The scale was divided into three subscales including: problem-solving confidence, approaching avoidance style, and personal control. Low scores were representative of a positive judgment and high scores indicated a poorer judgment of problem-solving abilities. Students involved in the study signed the study Informed consent.

Results

Findings showed that the mean score of problem solving skill was 89.5 ± 21.51. First year students were found to have a mean score of 89.13 ± 18.71, second year students had a mean of 91.57 ± 1.87. The mean score of third year was 91.52 ± 20.8 and for fourth year students was 84.18 ± 27.47. When these results are compared, no significant differences occurred among the student in different years, as well as no difference between nursing students in 3 subscales of problem solving was seen.

Conclusions

It is expected that Nursing school produce practitioners who have the ability to solve problems and make decisions.
Culturally defined community psychiatry in slovenia
Authors: Skoliber T. , Novak M. , Oravez J. , Švab V.
Published: May 2011

Introduction

Community psychiatry is to be acknowledged as evidence based psychiatric treatment in Slovenia with some decades of lag behind other EU countries. Nevertheless some community psychiatric programmes were developed by four Slovenian psychiatric hospitals, one of them covering the most deprived region regarding BDP and service provision region with 220000 population. Team work of psychiatrist, two nurses and social worker covers only several patients and families with most severe disability and social deprivation. Communication and cooperation with other community agencies is, regardless their scarcity, crucial. Community work has to be adapted to specific cultural environment defined by multiethnicity and prevailing protestant ethics that influence workers, patients and carers alike.

Case report

Revolving door patient with severe mental illness living in extreme poverty in suburb area was approached with family visits. Her mother also presented signs and symptoms of mental disorder and was strongly reluctant to treatment. A number of interventions applied targeted to their living circumstances. Their needs were different from those defined by health and social workers, which resulted in absence of any community care in previously. With personal involvement of team workers, consensus was made and continuity of psychopharmacological treatment with the patient was achieved after many years of non-compliance. Further steps were planned regarding their actual local and social circumstances.

Conclusion

Community psychiatric interventions need to be culturally and socially adapted to the needs of their consumers. The case presented is to reflect special cultural, individual and social particularities that define specific community psychiatric work.
Psychiatry without borders
Authors: Tarricone L.
Published: May 2011

The socio-economic changes of recent decades with the massive migration flows from third world countries and Eastern Europe to the more industrialized nations, including Italy, has led to a need for a meeting point between different cultures and has placed psychiatrists and health services in the position of having to revise their organizational models.

With this study we intend to analyze the mental health needs of non-CEE citizens in the context of a general hospital situation, and assess the impact of current laws.

A revision, made in the period 2006/2010 in SPDC in Campi Salentina, of the admissions and consultancy carried in the Emergency Unit for non-patients was carried out. Patients were divided by geographical area of origin, date of immigration, personal data and clinical diagnoses. The data show an increase of users patients coming from European countries, non-CEE geopolitical areas and North Africa in the first three years.

In the second two years, a reduction of admissions resulted because of a change in legislation. The clinical diagnosis showed a prevalence of clinical features of neurotic and adaptation of substance use for immigrants from Eastern Europe and pathology of the spectrum of mood disorders in patients from other continents. It is essential that the nature of the patient and their disease is considered in the context of socio-cultural dynamics to provide new knowledge, taking into account the size of collective psychopathology using a methodology that integrates the general cultural suffering from whatever country they come from.
Hikikomori; social withdrawal in Japan influenced by increased adaptation to economic changes and modernization while holding on to traditional values
Authors: Uchida M. , Uchida C.
Published: May 2011

Studies show that there may be more than 1 million Hikikomoris (individuals who withdraw in their rooms for over 6months,) in Japan, the majority being adolescent to young adult males living dependently on their parents. It is said that approximately 70% of them meet diagnostic criteria of a psychotic, mood, anxiety, developmental or personality disorder. It is noteworthy that while these psychiatric conditions seem to be universal, the very phenomenon of hikikomori is prominent only in Japan. Why only in Japan? The Japanese culture carries many social norms and structures that shape those diagnoses to present in this form. These include the expectation that children live with parents until marriage, the intense academic competition and the mother-son bond being more valued than the parents’ relationship as a couple. On top of that, Japan has experienced an increased adaptation towards western cultures while still holding on to the traditional virtues, as well as going through the huge economical bubble followed by the depression. The IT development has changed the communication around the world allowing people to chat and make transactions without interacting with anyone. The combination of changes and tradition is likely the major factor of Japan's hikikomori phenomenon.
Antidepressant treatment restores brain-derived neurotrophic factor (BDNF) serum levels and ameliorates motor function in parkinson's disease patients
Authors: Ricci V. , Pomponi M. , Martinotti G. , Bentivoglio A. , Loria G. , Caltagirone C. , Bria P. , Angelucci F.
Published: May 2011

Introduction

Depression is a common psychiatric disorder in Parkinson's disease (PD). It has been proposed that antidepressant drugs may bust brain production of trophic factors, such as brain-derived neurotrophic factor (BDNF) and glial cell derived neurotrophic factor (GDNF), an effect associated with improvement of clinical symptoms. However, BDNF and GDNF play also a role in the maintenance of dopaminergic neurons, which undergo to neuronal death during PD course.

Aims

Based on these findings we explored the hypothesis that PD depressed patients may have altered BDNF or GDNF serum levels and that antidepressant drugs may restore them and potentially have beneficial effects not only for depressive but also parkinsonian symptoms.

Methods

We measured by enzyme linked immunosorbent assay (ELISA) the serum levels of BDNF and GDNF in depressed PD patients, non depressed PD patients and healthy subjects and correlated them with clinical observations.

Results

We found:

(1)

BDNF serum levels were decreased in PD depressed as compared to non depressed patients and control subjects;

(2)

antidepressant therapy restored BDNF serum levels to those of controls; and

(3)

antidepressant therapy in association with Parkinson's therapy significantly ameliorated motor performance in PD depressed patients.

Conclusion

Our data suggest that PD patients are characterized by a reduction of BDNF serum levels and that depression may exacerbate this effect and worse PD symptoms. It is proposed that association between anti-parkinsonian treatment and SSRI could be a good therapeutic chance not only for treating depression in PD but also for improving PD symptoms.
Dementia in multiple sclerosis: report of a case with cortical grey matter involvement and frontal-type-like clinical features
Authors: Correia R. , Dias D. , Bastos-Leite A.J. , Rio E. , Curral R.
Published: May 2011

Background/introduction

Although multiple sclerosis (MS), a demyelinating disease of unknown aetiology, is primarily a white matter disease, it may also involve the grey matter, a feature not often demonstrated in vivo by means of magnetic resonance imaging (MRI). The involvement of cortical grey matter in MS may account for cognitive dysfunction and behavioural abnormalities.

Objective

The purpose of this report is to present the case of a patient with MS and clinical features mimicking dementia of the frontal type due to clear-cut cortical grey matter involvement in the left frontal lobe.

Case report

A 55-year-old woman with relapsing remitting MS developed a clinical picture characterized by frontal deficits (e.g. attention, verbal fluency, and speed processing), disinhibition, loss of insight, perseveration, abnormal eating behaviour, agitation, insomnia, and depersonalization phenomena. Neuropsychological evaluation also revealed abnormal performance on the Trail Making and the Stroop tests. Besides typical demyelinating lesions and “black holes”, MRI showed a striking pattern of left frontal opercular involvement including cortical thinning, focal knife-edge appearance of the gyri, and marked gliosis in the adjacent white matter.

Discussion

Cognitive deficits in MS are typically subcortical, due to the expected predominance of white matter lesions. Nonetheless, the involvement of grey matter structures may contribute to a different pattern of cognitive dysfunction. For example, hippocampal involvement has been linked to memory impairment. This particular case report additionally illustrates how cortical grey matter involvement in the frontal lobe may lead (not unexpectedly) to a clinical condition mostly characterised by frontal deficits and psychiatric symptoms.
Delirium in older adults: assessment scales review
Authors: Martins S. , Simões M.R. , Fernandes L.
Published: May 2011

Introduction

Delirium is characterized by the rapid onset of symptoms which fluctuate, with an altered level of consciousness, global disturbance of cognition, perceptual abnormalities and evidence of a physical cause (DSM-IV-R, 2002).

Aim

To review the characteristics and psychometric properties of thirteen Delirium scales available in research and clinical practice.

Methods

MEDLINE database was used to identify the delirium scales in use (1990–2010), using the keywords: delirium, confusion, questionnaires, scales, severity and screening. Only validation studies were included. Exclusion criteria were children and alcohol/drug delirium assessment scales. This study included seven screening scales: Confusion Assessment Method, Intensive Care Delirium Screening Checklist, Delirium Symptom Interview, NEECHAM Confusion Scale, Cognitive Test for Delirium, Delirium Observation Screening, Nursing Delirium Screening Scale and seven severity scales: Delirium Rating Scale, Memorial Delirium Assessment Scale, Confusional State Evaluation, Delirium Severity Scale, Delirium Index and Delirium-O-Meter.

Results

The majority of scales were based on the Diagnosis Statistical Manual Criteria as well as on a review of selected symptoms of Delirium informed by systematic clinical observation and formal brief assessment of mental status. In most of the studies, for psychometric analysis, the inter-rater reliability and validity with severity of Delirium assessment and cognitive screening tests were used.

Conclusion

Bearing in mind the recent review studies included, we can conclude that CAM is the most widely used instrument for delirium assessment.