bluuebunny/crossref_metadata_2025 huggingface dataset:
Being informed and involved in treatment: what do psychiatric patients think? A review
Authors: Paccaloni Monica , Pozzan Tecla , Zimmermann Christa
Published: October 2011

Aims – A narrative review of studies on the information needs of psychiatric patients, the knowledge of their diagnosis and treatment expectations. Methods – A literature review, limited to studies between 1980 to 2003, was carried out using Medline and Psychlnfo databases. Results – Sixty five studies of interest were identified. Less than half of the psychiatric patients know their diagnosis and patients affected by schizophrenia are the least informed. Notions about aetiology and treatment are patchy, and the concept of ‘multifactorial cause’ seems unknown. Little knowledge emerged about drugs and side effects, expecially in the long term. Patients want to be informed, involved in decisions and their treatment programme. They feel that their psychiatrists are more interested in pharmacological aspects than in their personal problems. Conclusions – A better quality of communication, the involvement of patients in decision processes and meeting patients' information needs is necessary to improve therapeutic relationships, to encourage greater compliance with treatment programs and to reduce the stigma of psychiatric illness.

Declaration of Interest: none of the three authors has had any interest or received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work.
Attuned Practice: a service user study of specialist child and adolescent mental health, UK
Authors: Hart Angie , Saunders Alex , Thomas Helen
Published: October 2011

Aims – Best practice emphasises user involvement. This exploratory study addresses the views of teenage clients and their parents on service delivery in a specialist Child and Adolescent Mental Health Service (CAMHS) serving a population of 250,000. It aims to explore some of the complexities inherent in children's services when parents are integral to modes of treatment. Methods — Twenty-seven teenage clients from specialist CAMHS were recruited with their parents (n=30). All were white British, 11 boys and 16 girls, from a range of socioeconomic backgrounds. Focus groups were employed using a series of structured interactive technique to elicit information, preceded by home visits. Analysis of interview data followed standard approaches to qualitative data analysis. Descriptive statistics were generated from both home interview data and focus groups. Results – Three themes emerged: the core values implicated in establishing a therapeutic alliance; the style of therapy and mode of practice (i.e. its inclusiveness of different family members). Practice implications – Core therapeutic skills are of fundamental importance. Our paper supplements a model of organisational user involvement with a model of therapeutic user involvement for use in negotiating mode of practice. Conclusions – This exploratory study was a collaboration between service users, researchers and health professionals exploring three important themes of therapy and the complexities inherent in children's services. The process of eliciting views was therapeutic in itself leading to the formation of a parent-led self-help group. The design can be replicated in other specialist CAMHS to achieve attuned practice.

Declaration of Interest: none.
Systematic reviews and clinical decisions in psychiatry
Authors: Barbui Corrado , Hotopf Matthew
Published: October 2011

In psichiatria, ormai da alcuni anni, accanto alle revisioni classiche della letteratura, le cosiddette revisioni narrative, gli articoli cioè in cui gli esperti di ciascun settore passano in rassegna le conoscenze riguardanti un determinato argomento per trarne conclusioni utili alia pratica clinica, si è progressivamente affermato un nuovo tipo di rassegna della letteratura, denominato revisione sistematica. Questo è avvenuto a seguito dell'altrettanto forte affermazione dell'idea secondo cui le decisioni in medicina devono basarsi sulle evidenze scientifiche a nostra disposizione. Le evidenze scientifiche sono meglio dette prove di efficacia, e il termine che descrive questo movimento è medicina basata sulle prove di efficacia (Barbui et al, 2002). Secondo il paradigma della medicina basata sulle prove di efficacia (o evidence-based medicine, da cui la sigla EBM) le revisioni sistematiche rappresentano lo strumento piu idoneo per riassumere le prove di efficacia esistenti per ogni argomento. Scopo di questo editoriale è chiarire che cosa sono le prove di efficacia in medicina ed esemplificare come queste ultime vengono correntemente utilizzate nella preparazione e nel mantenimento delle revisioni sistematiche. Obiettivo ultimo è discutere il possibile ruolo delle revisioni sistematiche nel supportare il processo di acquisizione di competenze che permettano di prendere decisioni in ambito psichiatrico.
Costs and outcome of care in subjects with a severe mental disorder
Authors: Percudani Mauro , Gerzeli Simone , Massagrandi Raffaella , Jommi Claudio , Fattore Giovanni , Cerati Giorgio , Contini Agostino
Published: October 2011

Objective – The objectives of the paper are the following: i) to describe the activities and the costs of care for patients with severe mental disorders; ii) to evaluate the association between costs, clients' characteristics and outcome measures. Methods – Patients were administered the following instruments twice a year: BPRS, GAF, HoNOS, DAS II, VSSS-54, QPF. Use of psychiatric services and other resources were collected for each patient over a two-year period. Results – The average yearly cost per patient is Euro 3,300. First-contact patients cost twice as much as patients already in treatment. Service costs are associated to patients' age, marital status and working condition. Annual costs are also associated with the initial score of BPRS, GAF, DAS and HoNOS. In multiple regression analysis age, initial BPRS and DAS scores, as well as being a first-contact patient, are strongly positively associated to annual costs. Conclusions – These results highlight the importance of monitoring routine activities of psychiatric services and the flow of funds for psychiatric care in the Italian public health system.

Declaration of Interest: the research project was funded by a grant from the Lombardy Region Health Authority.
Social economic inequalities and mental health II. Methodological aspects and literature review
Authors: Tello Juan Eduardo , Bonizzato Paola
Published: October 2011

Objective- This study provides a framework for mental health inequalities beginners. It describes the methods used to measure socio economic inequalities and the inter-relations with different aspects of mental health: residence, mental health services organisation and main diagnostic categories.Method- Literature electronic-search on Medline, Psyclit, Econlit, Social Science Index and SocioSearch usingand relating the key-words inequalities, deprivation, poverty, socio-economic status, social class, occupational class, mental health for the period 1965-2002 (June). The articles selected were integrated with manual search (publications of the same authors, cross-references, working documents and reports of international andregional organisations).Results- Inequality is not an absolute concept and, mainly, it has been changing during the last years. For example, the integration and re-definition of variables that capture, in simple indices, a complex reality; the accent on social more than on economic aspects; the geo-validity and time-reference of the inequality's indices. Moreover, the inequalities could be the result of individual preferences, in this case, the social selectionand social causation issues will raise the suitability for a public intervention.Conclusions- Up to now, research has been mainly concentrated in describing and measuring health inequalities. For designing effective interventions, policy makers need to ground decisions on health-socioeconomic inequalities explanatory models.

Declaration of Interest

this work was partly funded by the Department of the Public Health Sciences “G. Sanarelli” of the University of Rome “La Sapienza” and the Department of Medicine and Public Health of the University of Verona.
Contemporary thinking about the role of genes and environment in eating disorders
Authors: Bulik Cynthia M. , Tozzi Federica
Published: October 2011

Objective – To review recent literature documenting how family, twin and molecular genetic studies of eating disorders have revolutionized our conceptualizations of anorexia and bulimia nervosa. Methods – We summarized extant litera-ture on genetic epidemiology of eating disorders. Results – Results of extant studies highlight the underlying biological vulnera- bilities associated with these conditions. Genetic research has also opened up new avenues and approaches for exploring how the environment exerts its influence on risk. Conclusions – We discuss state-of-the-science findings in the genetics of eating disorders, explore various mechanisms of gene-environment interplay, and discuss implications of this research for science, practice, families and individuals with eating disorders.
Cannabis use and risk of psychosis: an etiological link?
Authors: Verdoux Helene , Tournier Marie
Published: October 2011

Objective – The nature of the link between cannabis use and psychosis remains to be clarified. Method – The paper reviews the evidence suggesting that cannabis may be a risk factor for psychosis onset. Results – Cross-sectional and retro- spective epidemiological studies show that individuals with psychosis use cannabis more often than other individuals in the gener- al population. It has long been considered that this association is explained by the self-medication hypothesis, postulating that cannabis is used to self-medicate psychotic symptoms. This hypothesis has been recently challenged by several prospective stud- ies carried out in population-based samples, showing that cannabis exposure is associated with an increased risk of psychosis, pos- sibly by interacting with a pre-existing vulnerability for these disorders. A dose-response relationship was found between cannabis exposure and risk of psychosis, and this association was independent from potential confounding factors such as exposure to other drugs and pre-existence of psychotic symptoms. However, the diagnostic specificity is weak, as cannabis exposure may be a risk factor for the occurrence of a large spectrum of psychiatric disorders, ranging from schizophrenia to mood and anxiety disorders. Conclusion – Considering the growing number of adolescents exposed to cannabis, the impact of this substance on the population mental health should be further explored.
England's policy on severe mental illness
Authors: Jenkins Rachel
Published: October 2011

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La Gran Bretagna ha messo a punto una comprovata strategia sulla salute mentale che include dove e come le persone sono curate e con quali obiettivi. Ha assicurato che la politica sanitaria sia basata sull'epidemiologia dei disturbi psichici e che sia incentrata non solo sui disturbi psichici gravi, che necessitano di trattamenti specifici, ma anche sui disturbi meno gravi in medicina di base, nelle carceri e sul posto di lavoro ed inoltre sull'integrazione e interfaccia tra i servizi di salute mentale ed altre agenzie.

Ha basato la politica sanitaria su un quadro coerente di promozione della prevenzione della salute mentale (prevenzione primaria, secondaria e terziaria e prevenzione della mortalita) conduce questa politica quantificando l'esito in termini di salute mentale, nonche gli imputs ed i processi.
Which treatments are effective: an epidemiological perspective
Authors: Gelder Michael G.
Published: October 2011

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Scopo - Descrivere alcuni problemi che possono emergere quando i risultati degli studi clinici controllati sono utilizzati acriticamente nella pratica clinica quotidiana e mostrare come una prospettiva epidemiologica faciliti l'identificazione di questi problemi. Metodo - Una rassegna degli studi clinici controllati per illustrare i problemi di: a) nascosta distorsione nella selezione dei casi, nei singoli trial; b) distorsione nella selezione degli studi inclusi nelle rassegne e nelle meta analisi. Risultati - È nota l'esistenza di molti tipi di distorsione nella selezione. In particolare, gli studi clinici con risultati negativi, a paritá di qualita scientifica, hanno minori probability di essere pubblicati su riviste a larga diffusione rispetto agli studi con risultati positivi. Conclusioni - Ci sono dei rischi nell'applicare, in modo acritico, i risultati dei trial alia pratica clinica. Tali rischi sono evitabili adottando una prospettiva epidemiologica e cercando trial clinici che siano rappresentativi dell'intera popolazione dei trial stessi. Il Cochrane Collaboration è stato fondato per minimizzare le deviazioni nelle rassegne e nelle meta analisi. Il primo Cochrane Centre on Schizophrenia è stato istituito ad Oxford ed altri sono previsti.
Early intervention in psychosis: a new evidence based paradigm
Authors: McGorry Patrick D. , Killackey Eoin J.
Published: October 2011

Objective – Even in countries whose mental health services are comparatively well resourced, the care offered to those in the early stages of psychotic illnesses is not what it could be. Patients often have to progress to chronicity before receiving adequate interventions, by which stage there has been great potential for harm, not only through the psychosis, but also to the quality of life of the individual who has often missed or not completed adequately, several important developmental tasks. Further, evidence indicates that delay in treatment is positively associated with poorer outcome. This paper puts the case for early intervention in psychosis. Method – Based on the experience of the Early Psychosis Prevention and Intervention Centre in Melbourne, the paper reviews the evidence for and the criticisms of, early intervention. Using the concept of indicated prevention, it suggests ways in which clinicians can improve the interventions available to those experiencing the onset of psychosis and suggests that prepsychotic intervention may be possible. Results – Evidence discussed in this paper indicates that the development of mental illness is a major health issue in young people; that there is a positive correlation between duration of untreated psychosis and outcome; that it is possible to identify a proportion of those at high risk of developing mental illness; that through intervention it may be possible to reduce the transition rate to illness. Conclusion – Primary prevention is beyond the capacity of our present knowledge. Indicated prevention in the form of early intervention and optimal, sustained treatment is a paradigm for which there is increasing supportive evidence. It is a paradigm which is appealing to clinicians, patients, families and which has the potential to reduce the secondary impact of serious mental illness such as suicide, stigma, isolation and reduction in social status.
Prevalence of mental disorders in the Zurich Cohort Study: a twenty year prospective study
Authors: Angst Jules , Gamma Alex , Neuenschwander Martin , Ajdacic-Gross Vladeta , Eich Dominique , Rössler Wulf , Merikangas Kathleen R.
Published: October 2011

Background — In order to minimise retrospective recall in developing estimates of the prevalence of mental dis-orders in the general population, we conducted a prospective study of a cohort of youth from Zurich, Switzerland. Method — A 20 year prospective study of a community-based cohort aged 19-20 from Zurich Switzerland. The sample was enriched by subjects scoring high on the Symptom Checklist 90 R (Derogatis, 1977). A semi-structured diagnostic interview was administered by clinically experienced psychologists and psychiatrists. The six interviews from 1979 to 1999 assessed diagnoses and sub-threshold manifestations of major diagnostic categories (with the exception of schizophrenia) for the past twelve months, depending on the current DSM versions (DSM-IH, DSM-HI R, DSM-IV). Additional information on symptoms and treatment were collected for the years between the interviews. The reported prevalence rates are weighted for stratified sampling and cumulate the one-year rates of the six interviews. Results — The cumulative weighted prevalence rates for any psychiatric disorder were 48.6% excluding, and 57.7% including tobacco dependence. In addition 29.2% and 21.8%, respectively manifested sub-diagnostic syndromes. Overall there were no significant gender differences. The corresponding treatment prevalence rates were 22.4% and 31.1%, respectively for the diagnostic subjects and 6.9% and 6.1 %, respectively for the sub-diagnostic groups. The total treatment prevalence rate was 37.2% of the population (males 30.0%, females 44.1%). Conclusions — Our findings reveal that psychiatric disorders are quite common in the general population. When the spectra of mental disorders are considered, nearly three quarters of the general population will have manifested at least one of the mental disorders across their lifetime. Limitations — The data are based on a relatively small sample; a single age cohort, and the study was conducted in Zurich, Switzerland. These study features may diminish the generalisability of the findings.

Declaration of Interest: this work was supported by Grant 3200-050881.97/1 of the Swiss National Science Foundation, and Research Scientist Development Awards (MH 46376 and DA00293) from the US National Institutes of Health (Dr. Merikangas).
Assistenza psichiatrica e monitoraggio dei servizi. Il Registro dei casi di Verona-Sud 1987-1990
Authors: Balestrieri Matteo , Meneghelli Giuliano , Tansella Michele
Published: October 2011

Riassunto

Sono descritte con la stessa metodologia impiegata in quattro altre aree italiane sedi di Registro Psichiatrico dei Casi (RPC), le caratteristiche della catchment-area, del RPC, della struttura e dei principi del Dipartimento di Psichiatria di Verona-Sud. II monitoraggio della domanda su 4 anni evidenzia tassi di prevalenza un anno (1010/100000 residenti adulti), prevalenza un giorno (306/100000 residenti adulti) e di incidenza (219/100000 residenti adulti) inferiori a quelli dei RPC europei. II RPC di Verona-Sud monitora l'attività svolta in strutture e servizi a differente gradiente assistenziale (residenziale ospedaliera, residenziale non ospedaliera, semiresidenziale, ambulatoriale, domiciliare, ecc), secondo il principio della continuità dell'assistenza fornita ai pazienti. II rapporto tra prevalenza annua non ospedaliera e ospedaliera è nel 1990 di 2,5 a 1. II tasso di lungoassistiti e di 130/100000 adulti. La spesa globale del Dipartimento è aumentata di circa il 25%, con un incremento da parte di tutte le componenti dell'assistenza.

Parole chiave

servizi psichiatrici territoriali, registri psichiatrici dei casi, utilizzazione dei servizi.

The principles, structure, Psychiatric Case Register (PcR) and catchment-area of the Community Psychiatric service of South-Verona are described, using the same methodology employed in 4 other Italian PCRs. The monitoring of the demand over 4 years shows one-year prevalence rates (1010/100000 adult inhabitants), one-day prevalence rates (306/100000 adult inhabitants) and incidence rates (219/100000 adult inhabitants) lower than those of other European PCRs. South-Verona PCR records data of the activities made in a comprehensive psychiatric service, which has multiple structures and services, offering different degrees of care: residential in and outside the hospital, semiresidential, in outpatient clinics, domiciliary, etc. The 1990 ratio between non-hospitalized and hospitalized users is 2.5 to 1. The rate of long-term patients is 130/100000 adult inhabitants. All the components of the treatment contributed to the 25% increment of the costs of the South-Verona Psychiatric Service.
Stagionalità, condizioni lavorative e suicidio in Italia. Una rassegna delle ricerche epidemiologiche più recenti
Authors: Micciolo Rocco , Tansella Michele
Published: October 2011

Riassunto

In questo lavoro vengono riassunti i risultati delle ricerche sul suicidio condotte negli ultimi quattro anni dal gruppo del Servizio della Psicologia Medica dell'Universita di Verona. È stata analizzata; mediante l'analisi armonica, la stagionalità del suicidio in rapporto al sesso ed all'area geografica. Sono emerse differenze qualitative fra i due sessi (una sola, importante, armonica nei maschi e due nelle feminine), una maggiore stagionalità nelle zone rurali rispetto a quelle urbane ed un generale aumento della stagionalità passando dal Nord al Centro e al Sud. Per quanto riguarda i rapporti fra suicidio e disoccupazione, sono emersi due risultati principali: un maggior rischio di commettere suicidio fra i soggetti disoccupati (molto più evidente fra la popolazione maschile), una contrapposizione Nord-Sud con tassi di suicidio più elevati al Nord (particolarmente nella popolazione disoccupata) e con tassi di disoccu- pazione più elevati al Sud.

Parole chiave

analisi armonica, cluster analysis, disoccupazione, stagionalité, suicidio.

This paper summarizes the results of the studies on suicide performed over the last four years in Verona the Psychological Medicine Service. Seasonal variation in suicide in Italy has been assessed by means of harmonic analysis. While in males the only important seasonal harmonic was the first (one cycle per year), in females there was an important first harmonic and a second harmonic (two cycles per year). When thesetting (urban or rural) and geographical location (Northern, Central or Southern regions) were taken into account, a greater seasonality was found in the rural than in the urban settings and in the Northern than in the Southern regions. When the relationship between suicide and unemployment was evaluated, two main resultswere found: higher suicide rates among the unemployed (mainly in males); higher suicide rates in Northern regions (particularly among unemployed) and higher unemployment rates in Southern regions.
Struttura fattoriale della versione a 12 domande del General Health Questionnaire in un campione di giovani maschi adulti
Authors: Piccinelli Marco , Politi Pierluigi
Published: October 2011

Riassunto

Scopi- a) Indagare la struttura fattoriale della versione a 12 domande del General Health Questionnaire (GHQ-12) in un campione di maschi diciottenni; b) saggiare la capacità dei punteggi fattoriali standardizzati di discrimi- nare tra soggetti portatori o meno di un disturbo psichico secondo il giudizio dello psichiatra.Disegno- Un campione di 363 soggetti selezionati nel corso della visita militare di leva è stato invitato a completare il GHQ-12 e ad essere intervistato da uno psichiatra. Dati completi sono stati raccolti per 320 soggetti (88% del campione selezionato).Risultati- Due componenti con autovalore(eigenvalue)superiore a 1 sono emerse dall'analisi a componenti principali prima della rotazione, riuscendo a spiegare il 46.7% della varianza nei dati. La prima componente, sulla quale tutti i 12 items del questionario hanno rivelato un peso di segno positivo, è stata interpretata come una misura globale dello stato psicopatologico dei soggetti esaminati. La seconda componente è risultata bipolare, dal momento che su di essa tutti gli items «positivi» hanno presentato pesi di segno positivo, mentre gli items «negativi» hanno avuto pesi negativi; cio suggerisce che il GHQ è in grado di cogliere entrambe le componenti della salute mentale, la componente negativa (di cui sono espressione i sintomi) e la componente positiva (rappresentata dalla presenza di uno stato di benessere soggettivo). Dopo rotazione Varimax ciascun item del questionario pesava significativamente su uno solo dei due fattori identificati, fatta eccezione per l'item 12 il cui peso è risultato inferiore a 0,500 su entrambi i fattori. Il fattore A, caratterizzato dai 6 items «negativi» del GHQ-12, è stato denominato «disforia generale» ; il fattore B, definito da 5 dei 6 items «positivi» è stato chiamato «benessere/funzionamento sociale» . La migliore discriminazione tra soggetti portatori o meno di un disturbo psichico è stata offerta dai punteggi relativi al fattore «disforia generale» ; nessun vantaggio è stato invece ottenuto dalla combinazione dei punteggi riportati sui due fattori.Conclusioni- La compren- sione della struttura fattoriale del GHQ-12 potra fornire utili informazioni oltre a quelle offerte da un singolo punteggio di severità risultante dalla semplice somma delle risposte positive, spingendo la descrizione dello stato psicopatologico dei soggetti esaminati oltre la semplice distinzione tra «casi» e «non-casi».
Doctor-patient interaction: a comparison between analysis systems
Authors: Del Piccolo Lidia
Published: October 2011

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Scopo — L'intervista medica nel contesto della medicina generate ha importanti implicazioni sia sul piano diagnostico che terapeutico, mira ad un'accurata raccolta di informazioni biopsicosociali e, per essere ben condotta, implica l'applicazione di tecniche d'intervista centrate sia sul medico che sul paziente. L'analisi dell'interazione tra medico e paziente consente di valutare le tecniche d'intervista messe in atto dal medico e di individuare in modo phi preciso gli aspetti che possono essere migliorati. In particolare: 1) la revisione degli strumenti di analisi dell'interazione (IAS) adottati per descrivere la comunicazione tra medico e paziente, tenendo conto della rilevanza clinica, le strategie osservative adottate, l'attendibilita e il tipo di comportamenti analizzati; 2) la valutazione critica e l'analisi dei risultati delle ricerche svolte adottando gli strumenti considerati. Obiettivi — Gli strumenti di analisi dell'interazione considerati sono stati individuati a partire da alcune revisioni precedenti e utilizzando la ricerca Medline (HelthGate) sulle parole chiave indicate nella revisione. Risultati — Sono stati analizzati 17 sistemi di classificazione e 10 di questi sono stati descritti in ordine cronologico. Da un'analisi di tipo sociologico o psicolinguistico, si e passati, nel tempo, a un approccio specificamente impostato sulla consultazione medica e quindi a situazioni specifiche del contesto medico, quali l'ambito oncologico o ospedaliero. Conclusioni — Nello studio dell'interazione medico-paziente e importante individuare quelle categorie che risultano piu salienti per un'intervista «centrata sul paziente». Cio e rilevante non solo ai fini di una corretta individuazione dei pazienti con disagio emotivo, ma anche ai fini della corretta attribuzione del disagio stesso. L'attitudine ad ascoltare e la sollecitazione a parlare anche di tematiche emotive costituisce, infine, una forma indiretta di educazione del paziente, in quanto comprende che puo parlare con il medico anche dei suoi problemi psicologici e che cio puo avere una valenza terapeutica.
Prenatal determinants of schizophrenia: what we have learned thus far?
Authors: Bresnahan Michaeline , Schaefer Catherine A. , Brown Alan S. , Susser Ezra S.
Published: October 2011

The Prenatal Determinants of Schizophrenia (PDS) study was designed to examine early antecedents to schizophrenia. Based in the Child Health and Development Study cohort assembled in 1959-1967, over 12,000 cohort members were followed in the PDS study for psychiatric disorders. Using the extensive data and biological samples prospectively collected beginning during pregnancy, PDS investigators have examined the influence of prenatal exposures on risk of schizophrenia in adulthood. Here we describe a few key findings from the PDS with respect to prenatal infection, nutrition, and toxic exposures.

Declaration of Interest: Supported by the Lieber Center for Schizophrenia Research, and the following grants: NIMH 1R01MH 63264-01A1 (A.S.B.), NIMH 1R01MH-60249 (A.S.B.), 1R01MH-60249-03S2 (A.S.B.), 1K02MH65422-01 (A.S.B.), aNARSAD Independent Investigator Award (A.S.B.).
Mental disorder and the use of public psychiatric services in the foreigner population of the Canton Ticino
Authors: Testa-Mader Anita , Degrate Alessandro , Clerici Nathalie
Published: October 2011

RIASSUNTO

Scopo – Verificare se la popolazione straniera residente nel Canton Ticino differisce nell'utilizzazione delle strutture psichiatriche pubbliche e nel tipo di disagio psichico presentato, rispetto alia popolazione svizzera. Disegno Indagine compiuta sui soggetti di nazionalità svizzera e straniera, con più di 19 anni d'età, residenti nel Cantone Ticino, che hanno avuto nel corso del 1995 almeno un giorno di ricovero presso l'ospedale psichiatrico o almeno un contatto con gli ambulatori. Setting I servizi pubblici dell'Organizzazione sociopsichiatrica cantonale del Canton Ticino. Principali misure utilizzate – Sono stati calcolati per gli svizzeri, gli italiani e gli stranieri non italiani i tassi annuali standardizzati di prevalenza ospedaliera e ambulatoriale e i tassi di prima ammissione e primo contatto ambulatoriale, totali e per categorie diagnostiche (ICD–10). Risultati – Il gruppo degli stranieri non italiani presenta tassi annuali standardizzati totali di prevalenza ospedaliera e, soprattutto, di prima ammissione più elevati rispetto agli svizzeri e agli italiani; inoltre presenta, rispetto agli altri due gruppi, tassi di prima ammissione più alti per le sindromi schizofreniche (F2), negli uomini e per i disturbi psichici dovuti all'uso di sostanze psicoattive (Fl), nelle donne. Mentre nei primi contatti ambulatoriali gli altri stranieri presentano tassi più alti di sindromi nevrotiche, legate a stress e somatoformi (F4), negli uomini e di sindromi affettive (F3), nelle donne. Conclusioni – I risultati ottenuti sembrano confermare la presenza di livelli più alti di disagio psichico tra gli stranieri non italiani, soprattutto per alcune nazionalità, rispetto agli svizzeri e agli italiani. E possibile che la presenza di una consistente offerta di servizi psichiatrici da parte del settore privato possa aver sottostimato l'effettivo disagio psichico, soprattutto nel gruppo degli svizzeri e, in modo minore, in quello degli italiani.
Psychotropic drug use in an Italian psychiatric hospital: a two-year follow-up study
Authors: Brambilla Paolo , Monzani Emiliano , Alessandri Mariella , Frova Maria , Barbui Corrado , Erlicher Arcadio
Published: October 2011

RIASSUNTO

Scopo - Documentare la possibilità di migliorare la qualità delle prescrizioni di psicofarmaci in una coorte di pazienti ricoverati presso l'ex ospedale psichiatrico di Milano. Disegno - Studio prospettico con follow-up a due anni. La razionalizzazione delle prescrizioni psicofarmacologiche è stata realizzata seguendo criteri generali di uso razionale degli psicofarmaci. Nel corso dei due anni di studio sono stati registrati i cambiamenti nella terapia psicofarmacologica ed eventuali variazioni psicopatologiche rilevate mediante la somministrazione della Brief Psychiatric Rating Scale (BPRS). Setting - Tre reparti dell'ex ospedale psichiatrico «Paolo Pini» di Milano. Principali misure utilizzate - Numero di pazienti in terapia psicofarmacologica, numero di pazienti in politerapia, dosaggio di neurolettico in equivalenti di clorpromazina, and amento psicopatologico. Risultati - Sono stati reclutati 70 pazienti. Al follow-up si è verificata una riduzione del numero dei pazienti in terapia con neurolettici; il numero di pazienti in terapia con due neurolettici si è dimezzato, e nessun paziente assumeva tre neurolettici al termine dello studio. In aggiunta, si è ridotto l'uso di formulazioni depot. Per quanto riguarda gli altri psicofarmaci, il numero di pazienti in terapia con benzodiazepine si è praticamente dimezzato. A fronte di queste modifiche farmacologiche, non si sono evidenziati cambiamenti psicopatologici di rilievo, come documentato dall'and amento dei punteggi alia BPRS. Conclusioni - Questo lavoro evidenzia la possibilità di trasferire nella pratica clinica di routine indicazioni di uso razionale degli psicofarmaci. Viene inoltre suggerita l'utilità di un monitoraggio longitudinale di tutte le pratiche assistenziali e terapeutiche che quotidianamente vengono messe in atto.
The growing public health importance of common mental disorders
Authors: Araya Ricardo
Published: October 2011

RIASSUNTO

Le malattie non trasmissibili sono in rapida crescita ed i problemi mentali rappresentano una larga percentuale all'interno di questo gruppo. La maggior parte del carico dovuto alle malattie mentali grava sulla medicina territoriale e generale. Ci sono grosse disparità nei tassi di prevalenza tra i vari paesi e al loro interno. I paesi latino americani hanno mostrato in maniera omogenea tassi di prevalenza più alti degli altri paesi.
Advocacy in the mental health services field
Authors: Fontaine Nicole , Allard Elisabeth
Published: October 2011

Objective — Advocacy in the mental health services field is gaining importance since the traditional role of mental health hospitals is changing, particularly in North America and in Western Europe. This review will define advocacy, its goals and fundamental principles. It will then delineate the skills and strategies needed for any intervention on behalf of a patient or a group of patients. It will also deal with the issues and approaches most frequently raised and used, and finally, with the limits of advocacy. Method — The method used for this review was mainly a recension of the literature concerning advocacy throughout North America and Europe, having in view to see emerging the principal stakes and concerns related to this process. Results — Advocacy has a significant impact patients' awareness of their rights and their capacity to exercise them. It also prevents potential abuse of patients. On the other hand, some patients have an increased opportunity to cease treatment, and this could lead to serious medical consequences. There is also the possibility of retaliation from staff, as a result of being involved with an advocate. The combination of high quality care and effective advocacy is the best guarantee that a mental health patient will get the care he wants and needs with human dignity.
Satellite‐Observed Algae Blooms in China's Lake Taihu
Authors: Wang Menghua , Shi Wei
Published: October 2011

During the spring of 2007, a massive bluegreen algae (Microcystis) bloom broke out in Lake Taihu, one of the largest inland lakes in China. This freshwater lake is located in the Yangtze River delta (Figure 1), one of the world's most urbanized and heavily populated areas. The massive bloom event became an environmental crisis that prompted officials to cut tap water supply to several million residents in nearby Wuxi city in China's Jiangsu province. The outbreak, which the Chinese government identified as a major natural disaster, forced unprepared residents to rush to buy bottled water for their normal usage. This article presents results from an analysis of that event that demonstrate an application of satellite‐derived imagery for inland lake water quality monitoring, assessment, and management.
First Satellite Image of a Moving Pyroclastic Flow
Authors: Liew Soo Chin , Thouret Jean‐Claude , Gupta Avijit , Kwoh Leong Keong
Published: October 2011

Pyroclastic flows that emerge from the bases of collapsing eruption columns or lava domes are transient dynamic phenomena, rarely documented due to their very brief existence, which may be only minutes. Such flows are commonly reconstructed from their deposits. They have been photographed on the ground, but to the best of our knowledge, the pyroclastic flow described in this article is the first such flow in action that has been recorded on a satellite image. This provides an excellent opportunity to see the flow in action.
Cassini team issues atlas of Saturn's moon Dione
Authors: Showstack Randy
Published: October 2011

Working with images from NASA's Cassini spacecraft, the Cassini Imaging Team released an atlas charting Saturn's fractured, 1125‐kilometer‐wide moon Dione on 20 May. “We used the 449 existing highresolution Cassini images of Dione to produce a single carefully controlled global map,” according to Thomas Roatsch, a planetary scientist from the Institute of Planetary Research at the German Aerospace Center (DLR), in Berlin. He said lower‐resolution images taken by the Voyager spacecraft in 1981 helped with imaging the moon's north polar regions which are currently shrouded in seasonal darkness.
Glacier and Permafrost Problems in High South Asia: International Workshop on Cryosphere and Hazards for Hindu Kush, Himalayas and Tibetan Plateau; Kathmandu, Nepal, 31 March to 2 April 2008
Authors: Shroder John F. , Bishop Michael P. , Haritashya Umesh
Published: October 2011

An outgrowth of prior conferences that had to be held separately for political reasons [Bagla, 2006a, 2006b], a 3‐day workshop to discuss the impact of climate change on the glaciers and permafrost of high Asia hosted some 70 geoscientists from China, India, Nepal, Pakistan, and the United States and a few from Europe and Canada. The scientists concluded that a major need exists for better long‐term monitoring of glaciers in the region using satellite imagery coupled with direct observations in the field. Also emphasized was the lack of cooperation or lack of sharing of essential hydrological information between the commonly militarily opposed countries in the area. Even within each country, agencies do not necessarily share data with other agencies or with university scientists. For example, a ludicrous situation was noted wherein it is easier to obtain high‐resolution imagery and digital elevation models from scientists in opposing countries rather than domestically, where such data can be restricted or illegal to use. Such data hoarding potentially increases a population's risk because people who are trying to forecast hazardous droughts, floods, and landslides commonly cannot get appropriate information.
Hula hoop research
Authors: Anonymous
Published: October 2011

Plastic hoops covered with polyethlene sheets are being used in one of three experiments with mechanical evaporation barriers. The Illinois State Water Survey is conducting experiments in an effort to reduce evaporation which, in Illinois, can total 44 billion gallons of water on an average day. The current project involves covering portions of small lakes with hoops. A second technique involves the use of a chemical substance contained within a lattice of interconnected hoops.
NSF summer institute
Authors: Anonymous
Published: October 2011

An NSF Summer Institute in Geophysical Fluid Mechanics for teachers in engineering and science will be held, June 23–August 15, 1969, at Colorado State University. Courses may be taken for graduate credit. Interdisciplinary courses will be offered in the mechanics of geophysical fluids, turbulent transport phenomena, meteorology of fluid mechanics, Fourier analysis of geophysical data, and numerical analysis of geophysical flows.
New Columbia telescope
Authors: Anonymous
Published: October 2011

Columbia University's new Harriman Observatory in Harriman, New York, will maintain one of the largest telescopes in the eastern United States. The $68,000 instrument, a Cassegrain‐Coudé reflector type with a primary mirror 24 inches in diameter, will be used primarily for studies of stellar magnetics. A spectrograph will be housed in a building adjoining the telescope dome. The Harriman Observatory will also be used extensively for photometric studies.
Deceased
Authors: Anonymous
Published: October 2011

Dinsmore Alter, 80, on September 20, 1968; member of AGU since 1930.

Leo Otis Colbert, 84, on December 24, 1968; member of AGU since 1934; Life member, 1968.
Vetlesen prize and symposium
Authors: Anonymous
Published: October 2011

The Fifth Award of the Vetlesen Prize was made to Francis Birch and Sir Edward C. Bullard on the evening of November 25, 1968, at Columbia University in New York City. Distinguished scientists from the entire nation attended this brilliant occasion, which climaxed an all‐day symposium on drilling and coring the deep sea. AGU was represented by Executive Director Waldo E. Smith. Birch, of Harvard University, and Bullard, of Cambridge University, were jointly honored for their outstanding work in solid‐state physics and fundamental geophysics, which has contributed to our understanding of major tectonic processes.
IMP Joins Scripps Fleet
Authors: Anonymous
Published: October 2011

The Instrumented Mobile Platform (IMP), a 17‐foot, remote‐controlled, modified Ryan Firefish target boat has joined the fleet of research vessels serving Scripps Institution of Oceanography at the University of California, San Diego. IMP will be equipped with an echo‐sounder and will operate this spring along with Scripps' largest research ship, the Argo, as a ‘slave’ unit, obtaining ocean soundings between San Diego and Tokyo. Although IMP represents a second, fully manned ship, it eliminates the costs of such a second ship
Gordon Research Conferences
Authors: Anonymous
Published: October 2011

The Gordon Research Conferences for 1969 will be held in New Hampshire June 9–August 29, 1969, and in Issaquah, Washington, from June 23–August 29, 1969. The Conferences will include Chemical Oceanography, Chemistry and Physics of Space, Geochemistry, Environmental Sciences: Air, and Physical Metallurgy.
Water resources abstract journal
Authors: Anonymous
Published: October 2011

The Clearinghouse for Federal Scientific and Technical Information and the Water Resources Scientific Information Center (WRSIC) have launched a new semi‐monthly periodical. The new publication, called Selected Water Resources Abstracts, provides scientists, engineers, and water resources managers with information on the physical, life, and social sciences as well as related engineering and legal aspects of the characteristics, conservation, control, and use or management of water. The periodical is published and distributed by the Clearinghouse for WRSIC, part of the Office of Water Resources Research, U.S. Department of the Interior.
Fluid pressure and earthquakes
Authors: Evans David M.
Published: October 2011

During 1961, a deep well was drilled at the Rocky Mountain Arsenal northeast of Denver, Colorado, to dispose of contaminated waste water. The well is bottomed in 75 feet of vertically fractured Precambrian gneiss. In November 1965, I proposed [Evans, 1966] that injection of waste water into the fractured rocks beneath the well was related to a series of 710 small earthquakes recorded in the area from 1962 through 1965. I proposed that Hubbert and Rubey [1959] had devised a mechanism that explained how fluid pressure could trigger crustal movement (and earthquakes) beneath Denver. This was a simple and an adequate means of reducing the frictional resistance to the sliding of large overthrust blocks down very gentle slopes. The weight of such a block is jointly supported by solid stresses and pressure of interstitial fluids. As fluid approaches lithostatic pressure, the sheer stress required to move the block approaches zero.
Summary of the seismographic observation of the Matsushiro swarm earthquakes
Authors: Hagiwara Takahiro
Published: October 2011

The Matsushiro swarm earthquakes commenced in August 1965 and continued for more than three years. The Earthquake Research Institute, University of Tokyo, conducted tripartite observation using very sensitive seismographs in four places in the active area in parallel with an ordinary seismographic network set up in that area. The observation was continued throughout the entire period of activity. An outline of the activity of the earthquakes will first be reported
Scientists and politics: The President's Page
Authors: Landsberg Helmut E.
Published: October 2011

The ferment of the times is penetrating all sectors of our society. Scientific organizations are beginning to feel the impact. Many scientists feel that their voices should be heard in the political arena. This is a legitimate claim. But some also feel that the scientific societies should become involved. This requires a very close look.
New marine center
Authors: Anonymous
Published: October 2011

A fish protein concentrate recently produced from New England Hake is expected to feed thousands of children in less developed nations. A program to help these countries to further utilize resources from the sea has been announced by the University of Rhode Island. With a grant of $750,000 from the Agency for International Development, the University will establish a new International Center for the Development of Marine Resources. The center will concentrate initially on the problems of salt water fisheries and their potential usefulness in various countries.
JGR publication procedures
Authors: Vemuri V.
Published: October 2011

I would like to add a few more thoughts to what was already said by Juan G. Roederer regarding JGR standards in the May issue of E⊕S.

First, Roederer correctly pointed out some of the difficulties regarding submission, review, and publication of papers in a technical journal. However, there is a pitfall in demanding submittal of manuscripts through division heads. I know of occasions when bosses, particularly new assistant professors with research grants, have forced their way as co‐authors after a paper has been accepted for publication and have never even bothered to look at or understand the contents of the paper. How can JGR make sure that each of the co‐authors of a paper has made any contribution—regardless of its significance? A letter to that effect, as suggested by Roederer, is so easy to produce. Indeed, it is even possible to make the original author write that letter ‘of his own free will.’
Water‐related research for the Great Lakes region
Authors: Havlick Spencer W. , Wilson James T.
Published: October 2011

The need to mobilize and integrate water‐related research efforts in universities of the Great Lakes region is predicated on the growing body of literature documenting the water resources problems of the Great Lakes and the influenced service area that provides goods and services to the people of that region. The gravity of the water pollution problem in localized areas, the fluctuating lake levels, the specter of increasing water treatment costs and decreasing raw water quality for industries and municipalities, the lack of subregional or regional planning guidelines, and the scarcity of high quality water recreation areas all give special emphasis to the need for sophisticated and systematic research directed toward serving human needs.

The difficulty of such a research effort in terms of data collection, regional economic analysis, or organizational innovations that may be required must not be minimized. Models that need to be built will require several years for conceptualization, planning, and implementation.
Observations of the Crab nebula
Authors: Anonymous
Published: October 2011

Analyzing data obtained from observations of the Crab Nebula on June 4, 1967, G. J. Fishman, F. R. Harnden, and R. C. Haymes of Rice University, Houston, Texas, report the detection of hard Xradiation pulsations (>35 kev) from the pulsar NP0532*. These observations contain the earliest data thus far in which a pulsar has been detected. The pulsation period is in agreement with the range of values suggested by extrapolations of recent optical data from NP0532 back to the time of the observation. The hard X‐radiation pulse profile indicates a double structure similar to that which is seen at optical wavelengths.
Oceanographic study program
Authors: Anonymous
Published: October 2011

A two‐year international oceanographic study program was initiated this month in the central Mediterranean by Edward F. K. Zarudzki of the Woods Hole Oceanographic Institution. Joining Zarudzki will be Carlo Morrelli, Director of Osservatorio Geofisico Sperimentale, Trieste, and Raimondo Selli, Director of Instituto di Geologia e Paleontologia of the University of Bologna. The other American scientists will be Carl Bo win, Joseph Phillips, and How‐Kin Wong. Several members of the Massachusetts Institute of Technology geophysics groups will also join the cruise.