bluuebunny/crossref_metadata_2025 huggingface dataset:
Translation of SCOFF Questionnaire and Validation of this French Version for the Screening of Eating Disorders in a Student Population
Authors: Garcia F. Duarte , Grigioni S. , Houy-Durand E. , Allais E. , Merygnac G. , Thibaut F. , Déchelotte P.
Published: March 2009

Objective:

To translate SCOFF questionnaire in French and evaluate its metrological features for the screening of eating disorders (ED) in a student French population.

Methods:

SCOFF questionnaire is composed by 5 questions and it has been developed for the screening of ED and Its French version isn't currently available. The translation and the transcultural validation were done using international criteria. The validation study employed the Mini International Neuropsychiatric Interview as the gold standard and the French version of SCOFF questionnaire (QD-TCA) paper and pencil form was applied to female students attending yearly evaluation in the Students Health clinic.

Results:

The sample was composed of 120 women with a mean age of 20 years (standard deviation - SD - 3.1 years, range 18-35). Thirteen cases (10.8%) of ED were diagnosed having ED (3 cases (2.8%) of anorexia nervosa and 10 cases (8%) of bulimia nervosa). Diagnostic threshold was calculated using the receiver operating characteristics (ROC) curve and fixated at two positive answers. The sensitivity of QD-TCA was of 92% with a specificity of 91.5%. Its positive and negative predictive values for ED were 57.1% and 99%, respectively. Similar results were obtained for AN and BN. Intraclass correlation-R was of 89%.

Conclusion:

The French version of SCOFF questionnaire developed by our team (QD-TCA) seems to be a reliable and practical eating disorder's screening tool in a moderate risk student setting.
Do Stressful Life Events Predict Eating Disorder Relapse?: Six-year Outcomes from the Collaborative Personality Disorders Study [P02-56]
Authors: Grilo C. , Pagano M. , Stout R.
Published: March 2009

Aims:

To examine the natural course of eating disorders (ED) prospectively over 6 years and to examine link between stressful life events (SLEs) and ED relapse among women with personality-disorders (PDs).

Method:

Subjects were 132 female patients with bulimia nervosa (N=40) or EDNOS (N=92) in the Collaborative Longitudinal Personality Disorders Study. EDs were assessed with the Structured Clinical Interview for DSM-IV Axis-I, and monitored with the Longitudinal Interval Follow-up Evaluation during follow-up. PDs were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV), and monitored with the Follow-Along version of the DIPD-IV during follow-up. SLEs were assessed with the Life Events Assessment (LEA). Follow-up assessments were conducted at 6- and 12-months and then yearly through 72 months. Proportional hazard regression analyses were performed to examine the link between time-varying levels of SLEs and ED relapse. Cox regressions controlled for the same covariates used in prior work: duration of ED, number of co-morbid psychiatric disorders, and time-varying status of PDs.

Results:

Of the 132 patients, 59% had remissions from ED, 68% of whom subsequently relapsed over the course of 6 years (BN and EDNOS did not differ in relapse). Total number of negative SLEs reported by ED patients significantly predicted subsequent ED relapse (HazardRatio=1.5, p< .05). The types of SLEs that predicted ED relapse were elevated work stressors (HazardRatio=3.0, p< .01) and elevated recreation stressors (HazardRatio=3.1, p< .05).

Conclusion:

Higher work stress and higher recreation stress represent significant warning signs for triggering relapse for women in remission from BN and EDNOS.
Childhood Risk Factors in Korean Women with Anorexia Nervosa: Two Sets of Case-control Studies with Retrospective Comparisons
Authors: Kim Y.-R. , Treasure J.
Published: March 2009

Objective:

The aim of this study was to investigate the characteristics of the risk factors for anorexia nervosa (AN) in East Asian subjects.

Method:

Two sets of case-control comparisons were conducted, in which 33 women with lifetime AN from Seoul, S. Korea, were compared with 42 women with lifetime AN from the UK and also with 90 Korean healthy controls in terms of their childhood risk factors. A questionnaire designed to conduct retrospective assessments of the childhood risk factors was administered to all participants.

Results:

There were no overall differences in the childhood risk factors between the Korean and British women with AN. The Korean AN patients were more likely to report premorbid anxiety, perfectionism and emotional undereating and were less likely to report having supportive figures in their childhood than the healthy controls.

Conclusion:

Our findings support the theory that AN is not a culture-bound syndrome. Larger epidemiologically based studies would be needed to validate these preliminary findings.
Subjective Health Complaints in a Sample with Morbid Obesity and the Complaints' Relation with Work Ability
Authors: Lier H.Ø. , Biringer E. , Eriksen H. , Tangen T.
Published: March 2009

Background and aims:

Obesity is associated with psychological, social and physical problems. The aim of this study was to examine the prevalence of subjective health complaints and their impact on work ability in a sample with morbid obesity.

Method:

Fortysix patients, 31 women and 15 men, aged 23 to 65 years (mean 43.7, s.d. 10.7), with BMI from 37 to 60 kg/m2 (mean 45 kg/m2, s.d. 5.02), on a waiting list for bariatric surgery participated. Subjective health complaints were measured by the 29-items Subjective Health Complaint Inventory. Five subscales were computed; Allergy, Flu, Musculoskeletal pain, Gastrointestinal problems and Pseudoneurology.

Results:

All participants reported subjective health complaints the last month, in particular they suffered from musculoskeletal (mean 8.2, s.d. 5.46), pseudoneurological (mean 4.7, s.d. 4.31) and gastrointestinal (mean 3.2, s.d. 5.46) complaints. Mean sickness absence the last year was 185 days (s.d. 163.32). Days of sickness absence were significant correlated with the Musculoskeletal (r = .35, p= .023) and Pseudoneurological (r= .40, p= .009) subscales.

Conclusion:

All patients reported subjective health complaints, with mean levels of symptoms considerably higher than in the general population. In particular, levels of musculoskeletal and pseudoneurological complaints were high, and these complaints were significantly related to work absence. It thus seems like subjective health complaints influence work ability to a significant degree in patients with morbid obesity.
Adversity and Suicide Attempts in Morbid Obese Adults: What’s the Reality?
Authors: Silva S. , Maia A.
Published: March 2009

Suicide is a common cause of death in eating disorders and suicide attempts are currently associated with binge eating and obesity. Research has shown that childhood adversities predispose to suicidal behaviour and other impulsive behaviours, such as compulsive eating. The aim of this work was to characterize the relation between childhood adverse experiences and adult suicide attempts and understand in morbid obese adults.

One hundred morbid obese (bariatric surgery candidates) filled out Life History Questionnaire (Felitti & Anda, 1998; translated by Silva & Maia, 2007), an instrument that evaluates the presence of 10 different forms of childhood adversity.

88% report at least one adverse childhood experience and almost 50% report at least five.

25% of the participants report at least one suicide attempt, almost 75% from this group more than one and 30% report an injury as a result of this attempt. In a logistic regression analysis, adversity had increased odds of suicide attempts (X2 (1) = 23.645, p< .000, odds ratio = 2.026).

Adverse childhood experiences and suicide attempts are prevalent in morbid obese adults. Adversity was associated with an increased risk of suicide attempts among bariatric surgery candidates. Taking in account that eating behaviour and suicide attempts can be conceptualize as impulse control problems resulting from adversity, these results should be taken in consideration in the evaluation of bariatric surgery candidates. It's also important to re-think all the selection criteria for inclusion in bariatric treatment, the follow-up of this patients and the philosophy of preventive programs.
Chronic Self-destructiveness in Anorexia Students
Authors: Wojciak R.W. , Cierpialkowska L.
Published: March 2009

The term self-destructiveness is related to human behaviours that lead to reduction of positive consequences and increase the probability of experiencing negative results. According to statistical data a growing number of acute self-destructive behaviours, like suicides, drug addiction and alcohol abuse has been observed in European population recently.

Apart from the acute self-destructiveness some authors have attempted to identify chronic self-destructive behaviours as the tendency to avoid behaviours that lead to positive consequences for oneself. The studies were performed on 15 anorectic women (diagnosed by EAT-26) and 39 non-anorectic women, aged 21,7 ± 1,0 years. All subjects were asked to answer on Kelley's test of chronic self-destructiveness modified to Polish conditions by Suchanska. The results were evaluated in the five-point scale and subsequently analysed with the use of t-Student's and Chi-square tests.

The results showed lack of tendencies to indirect auto-destructiveness in the studied subjects. However the were differences (chi-square=7,54; p< 0,05) in the distribution data showing that anorectic are more prone to such behaviours compared to non-anorectic (14% vs. 0%, relatively).

This work was supported by grant from the National Committee of the Science Research of Poland No 2 P06T 02330.
Knowledge of Attitude Toward Experience and Satisfaction with Electroconvulsive Therapy in a Sample of Iranian Patients
Authors: Malekian A. , Amini Z. , Barekatain M. , Maracy M.R. , Ahmadzadeh G.
Published: March 2009

Despite the wide consensus over the safety and efficacy of electroconvulsive therapy (ECT), it still faces unfavorable attitudes of patients and families. Little is known about how the experience with ECT affects the patients’ and their families’ attitude toward it. This study examined a sample of Iranian patients and their families regarding their experience with ECT and compared their knowledge and attitude toward ECT before and after this experience and their satisfaction with it. We surveyed 22 patients with major depressive disorder about to undergo ECT and 1 family member of each patient for their knowledge and attitude toward ECT and then surveyed them again after the trial of ECT to compare those variables while assessing their experience and satisfaction with ECT. Patients were rated using the Hamilton Depression Rating Scale and Mini-Mental Status Examination before and after the treatment. Before ECT, family members had a more favorable attitude toward ECT than patients, but after ECT, the patients’ attitude changed more positively. Both patients and their families had a poor knowledge of ECT before the ECT trial, but their total knowledge increased afterward, although not in the areas of indications and therapeutic effects. The majority of patients and their families found ECT to be beneficial and were satisfied with it. There was a high rate of perceived coercion to consent to ECT. Attention should be paid toward educating patients and their families about the ECT as well as informing them about their freedom of choice and right to refuse.
The Influence of HF-rTMS Treatment on Psychomotor Symptoms in Medication-resistant Depressed Patients of the Melancholic Subtype
Authors: Santermans L. , Vanderbruggen N. , Meers M. , Baeken C.
Published: March 2009

Aims:

Current evidence suggests that high frequency repetitive Transcranial Magnetic Stimulation (HF-rTMS) of the left dorsolateral prefrontal cortex (DLPFC) might be a promising treatment strategy for depression. However, due to rather modest clinical results, the efficacy of rTMS in depressed patients is still under debate. As melancholic depression seems to affect psychomotor activity, in this study, we wanted to evaluate whether HF-rTMS treatment affects psychomotor activity. We also wanted to examine whether the severity of psychomotor retardation could predict clinical outcome.

Method:

Our group consisted of twenty antidepressant-free unipolar depressed patients of the melancholic subtype. All were considered at least stage II treatment resistant. Depression severity was assessed with the Hamilton Depression Rating Scale (HDRS) and psychomotor symptoms with the Depressive Retardation Rating Scale (DRRS). All received 10 sessions of HF-rTMS delivered on the left DLPFC.

Results:

Forty percent of the patients showed a reduction of at least 50% on their initial HDRS score and were defined as HF-rTMS responders.

The severity of psychomotor retardation, as measured with the DDRS, did not predict clinical outcome. HF-rTMS treatment resulted in significant decreases in DDRS scores for responders as well as for non-responders. However: the better the clinical outcome, the higher the observed level of psychomotor improvement.

Conclusion:

Our results suggest that HF-rTMS might act on the ‘psychomotor’ level and this might add some further information as to why this kind of treatment can be beneficial for severely depressed patients of the melancholic subtype.
Sociodemographic Profile and Clinical Data of Suicide Attempters from the Emergency Room of the Central Hospital of Asturias (Northern Spain)
Authors: López J.L. , Al-Halabí S. , Díaz-Mesa E.M. , Bascarán M.T. , Bousoño M. , García-Portilla M.P. , Sáiz P.A. , Bobes J.
Published: March 2009

Objectives:

i.

To establish the sociodemographic profile of the subjects who attempted suicide in the Health Area IV of Asturias (Northern Spain);

ii.

To determinate the mental disorders more frequently associated with suicide attempts (SA);

iii.

To study the relationship between repetition of suicidal behaviour and severity of the SA;

iv.

To determinate the more commonly used methods for SA.

Method:

1,633 suicide attempters who attended the Emergency Room of the University Central Hospital of Asturias during the period 2003-2005 were included in the study. Evaluation of these patients was made using the WHO/Euro Multicentre Study Protocol. Psychiatric diagnoses were made following ICD-10 criteria.

Results:

Sociodemographic data: mean age (SD) = 38.66 (15.13); females: 62%; single: 39.8%; living with their family: 83.8%; lowest educational level: 67%; economically inactive: 33.8%. More prevalent psychiatric diagnoses were affective disorders (24.1%) and anxiety disorders (21.6%). Previous SA were present in 49.2% and 40% repeat the attempt during the monitoring period. Severity of the attempt (lethality of method and intentionality) was related with repetition of the behaviour during the monitoring period (p = 0.001). More frequent methods were overdose (74.8%) followed by cutting (18.5%).

Conclusions:

SA was more prevalent in a single woman with age between 30 and 50 years who suffering for affective or anxiety disorders. Many of the patients repeat the suicidal behaviour and this was related to the severity of the attempt. Individuals appear to use the methods that are available to them to attempt suicide.
Suicidal Attempts in Primary Care: Prevalence and Correlates in a Tunisian Area
Authors: El Kissi Y. , Amara G. , Bannour S. , Nasr S. Ben , Ali B. Ben Hadj
Published: March 2009

Aims:

This study aimed to determine prevalence and correlates of suicidal attempts in an adult primary care population in Sousse (Tunisia).

Method:

Sampling followed a stratified multistage probability cluster design from witch a representative sample of adult primary care population of Sousse was obtained. The sample was composed of 1249 subjects aged 18 years or more. Subjects were interviewed by trained clinicians using the Tunisian version of Composite International Diagnostic Interview 2.1.

General and clinical characteristics of subjects who had reported previous suicidal attempts were compared with those of the remainder using t test and Chi-2 test.

Results:

Mean age in our sample was 43.4 ± 17.62 years, with female gender (70.9%) and urban residency (67.8%) predominance. 62.3% of participants were married, 27.3% celibates and 10.4% divorced or widowed. 68.4% of them had low educational level and 70% were out of work during the last 12 months. Suicidal attempts were found in 2.9% of participants. They were correlated to less than 40 years age (p=0.036) and to the diagnosis of major depressive episodes (p< 10-3), recurrent major depressive disorder (p=0.005) and dysthymic disorder (p< 10-3). Among major depressive episodes, only severe ones were associated to higher prevalence of suicidal attempts (p< 10-3).

Conclusion:

Prevalence of suicidal attempts in Sousse primary care population was 2.9%. It was correlated to low age and to depressive disorders.
Depression, Cognitive Impairment, Somatic Complaints and Disability. Data from the “Faenza Community Aging Study”
Authors: Forlani C. , Atti A.R. , Ferrari B. , Dalmonte E. , De Ronchi D.
Published: March 2009

Aim:

To evaluate the relationship between depression, somatic symptoms, cognitive impairment and disability in an elderly population.

Methods:

216 subjects (65-84 years) were clinically examined for somatic symptoms, and underwent a mental health examination. Depression was defined by Geriatric Depression Scale scores >11/30; cognitive impairment by Mini-Mental State Examination scores < 24/30; functional status by Instrumental Activities of Daily Living Scale. Associations between depression, cognitive impairment or somatic symptoms and disability were evaluated by logistic regression analyses, estimating Odds Ratios (ORs) and 95% confidence intervals (95%CI) adjusted by sex, age, education.

Results:

Disability was common among depressed individuals (OR(95%CI)=3.60(1.63-7.96)) and among cognitively impaired subjects (OR(95%CI)=7.35(3.07-17.60)). An increasing number of somatic complaints increased the probability of functional impairment: compared with presence of 1-2 somatic symptoms, complaint of 3-6 and 7-12 symptoms were related to disability with OR(95%CI)=3.30(1.11-9.80) and OR (95%CI)=4.20 (1.17-15.09) respectively. Distinguishing pain, gastrointestinal, pseudo-neurological and general symptoms, only general somatic symptoms (palpitations, fatigue, sleep disturbances) were associated with disability (OR(95%CI)=1.81(1.25-2.62), independently by medical conditions (OR(95%CI)=1.57(0.98-2.52)). An additive effect toward disability was observed when general somatic complaints and cognitive impairment were co-existing (OR(95%CI)=23.68(5.50-101.86)). Including simultaneously cognitive impairment, somatic complaints and depression in the model, only cognitive impairment was still significantly related (OR(95%CI)=5.87(2.66-12.96)).

Conclusions:

Among many possible causes of disability in the elderly, an important role could be attributed to cognitive deficits.
The Use of Drugs for Mood Disorders in Italy: Preliminary Results [P02-95]
Authors: Carta M. , Aguglia E. , Balestrieri M. , Bocchetta A. , Drago F. , Faravelli C. , Morosini P.L. , Nardini M. , Hardoy M.C.
Published: March 2009

Background:

Some community surveys in Italy have shown that a proportion of subjects without lifetime psychiatric diagnosis (anxiety/depression) used antidepressants. The prescription of AD in bipolar depression appears to be another largely underestimated problem in the clinical practice and is difficult to recognise by means of traditional epidemiological methods (lay interview and structured diagnostic tools).

Objectives:

The purpose is to use defined and validated international semi-structured interview as diagnostic instrument administered by expert clinicians to evaluate appropriateness and amount of over and under prescription of psychotropic drugs in different Italian community areas. The focus is on general antidepressant use and use in subjects with bipolar disorder and in subsyndromal depression.

Methods:

Study design: Community survey. Study population: sample randomly drawn, after stratification by sex and age, from the adult population of Municipal records in 6 Italian Regions: about 4000 persons will be interviewed. Tools: Questionnaire on psychotropic drugs consumption, prescription, health services utilisation;diagnostic Structured Clinical Interview np version;Mood Disorders Questionnaire; Short Form Health Survey. Ethical aspects: a signed informed consent for each candidate. The study was approved by the ethical committee of theItalain National Health Institute.

Expected results:

The study aims to identify the frequency of over and under prescription of psychotropic drugs in different Italian regions and the determinants of prescription related to physicians, patients, comorbidity and symptoms and to establish the basis for a cohort prospective study to assess the future changes.
Evidence Supporting the Historical Context for Current Views on Unmet Need in Child and Adolescent Mental Health [P02-96]
Authors: Wilkes T.C.R. , Cawthorpe D.
Published: March 2009

Objective:

In over 60 years little has changed in children's mental health and the flag waving continues: It is time for action in the trenches. It is imperative to focus health policy on the need to provide basic mental health succor to children and their families. A failure to alter the situation related to children's mental health will no doubt have catastrophic consequences for our society. We review the level of progress made in reforming regional mental health services since 2002.

Methods:

Using population-based representation of regional service utilization capacity permits comparison of regional, provincial and national rates of child and adolescent mental disorder.

Results:

Regional services in the last 6 years have served at most approximately 1% of the 0-18 year old population annually. This rate represents an increase from about 0.6% in 2002.

Conclusions:

Rationing the scant professional resources that exist to serve children's mental health will become increasingly difficult. For example, it is estimated that three percent of 0-18 year-olds are estimated to suffer a debilitating mental problem. Implication for policy are that our results point to service gaps in need of immediate policy development to meet basic needs of children. Several strategies are considered.
Monitoring of the Metabolic Syndrome in Psychiatric Inpatients
Authors: Cordes J. , Regenbrecht G. , Agelink M.W. , Zielasek J. , Kahl K.G.
Published: March 2009

In this naturalistic observational study carried out in an inpatient treatment setting we as yet surveyed the parameters of the metabolic syndrome. A weekly monitoring procedure was implemented. The analysis included data of 350 patients over a time of 12 weeks. The last observation carried forward method was applied. Additionally we are evaluating the informative value of visceral body fat percentage as measured by a body composition analyzer. The patients showed a weight increase over the first 12 weeks (mean increase: 0.87 kg, p < .001) as well as an increase of the body mass index (mean increase: 0.45 kg/m2, p < .001). Accordingly, waist circumference (mean increase: 1.06 cm, p = .007) and visceral fat index (mean increase: 0.19, p = .007) increased. No worsening of fasting glucose and blood lipid concentrations was detected. Spearmens coefficient indicated correlations between visceral fat index and body mass index (ρ = .77; p < .001), waist circumference (ρ = .70; p < .001), and triglyceride concentrations (ρ = .39; p < .001). Correlations between visceral fat index and fasting glucose (ρ = .18; p = .019), and visceral fat index and total cholesterol (ρ = .16; p = .049) were weak but also significant. In contrast, the HDL cholesterol showed a negative relation with ρ < -.39 at each point in time (p < .001).

We conclude that psychiatric patients are at increased risk for the development of metabolic alterations during inpatient treatment. The possible underlying mechanisms of this interaction are discussed.
Psychiatric Inpatient Readmission in a General Hospital: Preliminary Report of a Two Years Observational Study
Authors: Guerreiro D. , Navarro R. , Telles D. , Martins P. , Trigo E. , Silva M. , Carvalho M. , Gois C.
Published: March 2009

Introduction:

Studying inpatient clinical population's features allows a better understanding of readmissions. Factors associated with higher levels of readmission may give clues concerning better treatment planning and follow-up.

Objectives:

To detect psychosocial and clinic factors associated with readmissions in an inpatient general psychiatric population.

Method:

107 patients consecutively admitted to an inpatient unit were characterized in terms of psychosocial, clinical, treatment and discharge plan features. Readmission was defined as the number of previous admittances in the last two years.

Results:

Patients characteristics: Average age 44 (SD: 16); 58% female; 10 (SD:5) years of education; average disease duration of 128 (SD:115) months. Main diagnosis: 30,8% schizophrenia; 14% bipolar I disorder; 13,1% major depression; 11,2% recurrent major depression; 5,6% cluster B personality; 3,8% bipolar II disorder and 2,9% schizoaffective disorder. From more to less frequent diagnosis implicated in readmissions were schizophrenia, schizoaffective disorder, recurrent major depression, bipolar I, bipolar II and major depression episode. Readmissions were not associated with inpatient treatment or disease duration, nor toxics or axis II diagnosis. Nonetheless, beginning a depot antipsychotic medication was related to an increase in previous admissions.

Conclusion:

These are preliminary results of a small sample, but they point towards the usefulness of a systematic evaluation of inpatient populations, mainly in what concerns complex clinical situations like major pathology readmissions.
Psychiatric Comorbidity in Children and Adolescents with High Functioning Autism
Authors: Herguner S. , Motavalli N.
Published: March 2009

Aim:

The present study aimed to investigate psychiatric comorbidity rates and patterns in a sample of clinically referred school-aged children with High Functioning Autism (HFA).

Method:

All cases were taken from children and adolescents who consecutively referred to Istanbul Faculty of Medicine, Department Child and Adolescent Psychiatry, Autism Unit. Participants were 30 children and adolescents (29 male, 1 female), aged 6-15 (10y 2m ± 2y 2m) year-old, who met DSM-IV criteria for Autistic Disorder and had a Performance IQ over 70 on WISC-R. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL).

Results:

90% (n=27) of the children had at least one comorbid psychiatric disorder, and 76.6% (n=23) had two or more. In 76.6% (n=23) of the cases at least one Anxiety Disorder was present, and in 63% (n=19) of the children criteria for at least one Disruptive Behavior Disorder was met. The most frequent Axis I psychiatric diagnoses were ADHD (60%), SP (53.3%), Oppositional Defiant Disorder (30%) and OCD (20%).

Conclusion:

A very high rate of psychiatric disorders was detected in a small group of clinically referred children and adolescents with HFA. These results underscore the importance of detailed assessment of behavioral and emotional problems in ASDs.
Children of Psychiatric in-Patients - Prevalence, Psychiatric Symptoms and Obstacles for Professional Support
Authors: Koelch M. , Schmid M. , Fegert J.M.
Published: March 2009

Aims:

Children of mentally ill parents are at high risk to develop psychiatric disorders. Psychiatric disorders often limit parenting skills and there are obstacles to accept professional help for the children. The study aimed to explore the prevalence of mentally ill parents in inpatient treatment, emotional and behavioural problems of their children, access to support for their children and obstacles for receiving support.

Method:

Inpatients of psychiatric hospitals of a county were examined by questionnaires (amongst other scales the Strengths and Difficulties Questionnaire (SDQ).

Results:

104 patients with children were detected, 81 patients with 165 children were enrolled. Most of the patients had more than one child and most of them had more than 3 prior inpatient treatments. Results in the SDQ indicated an up to fife fold increased number of children with emotional/behavioural problems compared to non-psychiatric samples. Even it 40% of the patients were dissatisfied with the care of their children during treatment, they seek seldom professional help. 51% have strong resentments against the youth welfare custodies. 55% quote that they cancelled or missed former inpatient treatments because of the inadequate nurturance of their children.

Conclusion:

Identification of children with need for professional support can be improved by using standardized questionnaires. Study results imply that psychiatrist should focus on parenthood of their patients and specialised offers of support are needed.
Is There Social Markers for Depression? Analysing the Portuguese Example
Authors: Mateus M. , Silva C. , Nogueiro O. , Redondo J.
Published: March 2009

Sociologists and anthropologists have long been engaged to study the changes in society, over time. This is particularly true since the end of the nineteenth century and beginning of the twentieth century, heights of history, that caused profound changes in the forms of relationships between men, in family scale and in the society itself. The industrial revolution, the exodus to the city, the emancipation of women, the world wars, the creation of the European economic community, the mass media and consumerism, have profoundly altered the social networks and engagement in which man lived since ancient times. The authors aim to address this issue, by trying to understand the behavioral changes that were needed to adapt to this new structure of society and in what way they were responsible for the loss of mechanisms of cooping, with the anti - social behaviour, with stress and depression.

The Portuguese example is finally exploited, given the most significant changes in the last century, as the fall of the monarchy, the instability of the early republic, the dictatorship, the colonial war, the April 25, the entry into the EEC.
Day Hospital and Then…follow-up Two and a Half Years After the Hospitalization
Authors: Pedrosa R. , de Sousa V. Teixeira , Marques J. , Martins A. , Domingues I. , Moura L. , Curral R. , Torres A. Roma
Published: March 2009

Psychiatry Day Hospitals deal with a wide spectrum of disorders, being responsible for a psychosocial intervention that intends to improve patient's quality of life. The Psychiatry Day Hospital Department of Hospital de São João has thirty-eight years of activity, and has been one of the first in Portugal. The aim of this Psychiatry Unit, composed by a multidisciplinary team, is to prevent relapses and rehospitalisations, promoting the patients’ social rehabilitation, building a bridge between inpatient hospitalization and their re-entry into the community.

The primary objective of this cross-sectional study was to evaluate important aspects of service's quality, such as the use of health resources and results in functional terms. The authors made the follow-up of the patients that had been admitted in 2005 (Jan 2005 - Dez 2005; n= 77). For this purpose, it was assessed the number of attendances to the Emergency Department and hospitalizations two and a half years before and after the treatment in Day Hospital. It was also compared their current employment situation to that which preceded the Day Hospital care.

This study was performed in clinical setting among a reduced sample, with the inherent limitations. It would be appealing to replicate this investigation in a larger population and including some other variables.
Choice of Psychotropic Drugs Used for Intentional Drug Overdose
Authors: Tournier M. , Grolleau A. , Cougnard A. , Molimard M. , Verdoux H.
Published: March 2009

Objectives:

To assess with which frequency subjects with intentional overdose of psychotropic drugs ingest their own psychotropic drug treatment, and whether prescription of a drug may be a factor influencing the choice of drugs used for the IDO.

Methods:

Demographic characteristics, psychiatric history, and currently prescribed psychotropic drug treatment were collected for all the patients (n=1654) admitted to an emergency department (ED) for IDO with psychotropic drugs (anxiolytics, hypnotics, antidepressants, antipsychotics and mood stabilizers) over a period of 18 months.

Results:

Two-thirds of the patients ingested during the IDO at least one of their own prescribed psychotropic drugs. Compared with the subjects who had ingested psychotropic drugs not prescribed for them, they were more likely to have a history of psychiatric hospitalization (OR 4.2; 95%CI 3.1-5.5), of parasuicide (OR 2.5; 95%CI 1.9-3.3), to be a psychiatric outpatient (OR 3.9; 95%CI 3.0-5.1), and to present with a serious IDO (OR 2; 95%CI 1.4-2.9). Independently from age and psychiatric hospitalization history (i.e. the seriousness of psychiatric disorder), they ingested during the IDO more often antidepressants (OR 4.4; 95%CI 3.0-6.4), antipsychotics (OR 2.9; 95%CI 1.7-4.8) and mood stabilizers (OR 4.1; 95%CI 1.6-10.7). No association was found with prescription for overdose of benzodiazepine or paracetamol.

Conclusion:

Prescription of the psychotropic drugs plays an important role in the choice of the drugs ingested for the IDO. It might make potentially “dangerous” drugs available for the patient. Physicians have always to balance the benefit of the treatment against the risk of drug overdose.
Personality Disoder and Their Judicial- Psychiatric-estimation of the Russian Federation
Authors: Vasyukov S. , Baeva A.
Published: March 2009

In modern Russian criminal law means diminished responsibility, that the subject is not capable to regulate meaningly legally significant behaviour at the moment of socially dangerous act. Such disability comes at presence if the subject has the chronic or time mental disorder, an aphrenia or other disease state of mentality. The specified clinical phenomena define medical criterion of diminished responsibility. Special interest represents disorders which in ICD- 10 concern to «Personality Disorders» (F60-F68). Here mental disorders which have no so-called remedial basis are meant, or in their structure it is impossible to note signs of weakening process. At the same time they not only qualitatively differ from the accepted norm, but also under known conditions possess that depth or expression that can be regarded as medical criterion of the formula of diminished responsibility. The research which has been spent in the Department of psychogenias and personality disorders of Institute of Serbsky included 80 men at the age from 20 till 45 years by which the diagnosis «Personality disorder» was established. It has shown that there can be 3 variants of influence on responsibility: they can cause full loss of liability; can essentially reduce the criminal liability; their presence can be neutral and not render influences on liability. The analysis of expert judgements shows, that in expert judgements about disability of the subject to regulate the behaviour meaningly it is necessary to estimate components both medical, and psychological criteria of diminished responsibility.
Expert Evaluation of «Another Unhealthy Conditions»
Authors: Danilova S.
Published: March 2009

Patients who have had chronic mental disorders, another unhealthy conditions, mental retardation are considered to be irresponsible. Special interest represent is disorders, which expect as “another unhealthy conditions”. Mental disorders consider without process basis (pathokinesis have has chronic or acute psychosis), dementia. Another unhealthy conditions is quality differences from mental standard, but it does happen expressive that does irresponsible.

56 men have been examined in the department of Personality Disorders and psyhogenias. Age: 20-60 years old. Disorders experts as “another unhealthy conditions” includes of the Classification ICD-10: Personality Disorders (F 60 - F 61), organic Personality Disorders (F 06.3 - F 07.9), mentally retardness of slight degree with breach of behaviour (F 70.1). Diagnosis of Paranoid Personality Disorder and Schizoid Personality Disorder were most common.

Analysis of expert evaluation is show that it is necessary to estimate psychological criteria of irresponsibility. Analysis of pathological symptoms, structure of personality and cognitive disorders, disposition of crime, situational and motivational factors are show that it is necessary to estimate a depth of mental pathology, disturbance of critical abless and defects of personality and intellectual functions to expects conclusions of irresponsibility.
Coping Strategies for Social Readaptation of Combatants
Authors: Fastovtsov G. , Oskolkova S.
Published: March 2009

According to research activities, those persons, who suffered military stress and developed post-traumatic stress disorder (PTSD), constitute a high-risk group of offending behavior in the time of peace.

Research objective:

Combatants were divided into 2 groups: those who committed (“persons under investigation” - N 1) and those who did not commit aggressive delicts and torts (“patients” - N 2).

Results:

Disadaptive (aggressive) forms of behavior occurred in “persons N 1” much more often in emotional sphere. The choice of strategies aimed on changing the situation prevailed in this group (cognitive sphere). The most distinct cognitive disorder noted in “persons N 1” was the decrease of their forecasting competency. In the groups studied, the choice of predominant strategies for overcoming social stress did differ for certain. Only 13% of “persons N 1” accepted impunitive way of reacting, while for “patients” this figure constituted 29.8%. Absense of confiding and trusting relationships, absense of usage of their efforts is more typical (p>0.05). Important factor helping to raise the level of social adaptation for “patients” include providing of affiliation (33.6%). In comparison to group of “persons N 1” they suppressed exhaustive emotions more seldom (9.7%) and were inclined to forecast real events more often. Thus, during organization of rehabilitation measures for combatants, it is necessary to consider coping strategies for overcoming social stress, as well as the level of transagression of structure of main motives and values, which may help to decrease the risk of criminal behavior for patients with PTSD.
Completed Audit of Physical Health Status of Patients with Severe Mental Illness in a Medium Secure Forensic Psychiatric Rehab Ward
Authors: George M. , Thakkar P. , Vasudev K. , Mitcheson N.
Published: March 2009

Aim:

An audit was conducted in September 2006 to determine whether the Physical health monitoring of patients on anti-psychotic medication was concurrent with the national guidelines.

This audit done in Dec 07 aimed to ascertain to what extent the recommendations were implemented and followed, thereby completing the audit cycle.

Methods:

The Audit was conducted in a 15 bedded medium secure forensic rehab ward.

As there was a lack of recording of the physical health status a monitoring sheet was introduced in the notes after the first audit. Age, Weight, Height, Smoking status, Blood Pressure, Diabetic Status, Blood Lipid Profile, ECG and the Medication regimen were noted for each of the patient.

Results:

Conclusion:

100% physical health monitoring was achieved and improvements in weight, CV risk, Total/HDL cholesterol ratio was noted 4 cases of significant QT prolongation and another 3 cases of prolactin elevation were detected because of the introduction of monitoring.
Forensic Psychiatric and Legal Aspects of Infanticide and Neonaticide in Russia
Authors: Kachaeva M. , Dmitrieva T. , Satianova L.
Published: March 2009

Aims:

To find out clinical and social factors contributing to specific female crimes - infanticide and neonaticide.

Method:

Clinical, descriptive statistical.

Results:

The problem of the murder of children by their mothers remains a burning issue in Russia. The most complicated for forensic psychiatrists are the cases when children were killed by not mentally ill mothers, especially in the situations when women killed their children within 24 hours of birth. Neonaticide reflects mostly social than clinical factors. The research has revealed that these women were young, single or separated and often exposed to psychogenic situations with high level of stress (financial and housing problems, concealment of illegitimate pregnancy). In accordance with the Criminal Code of Russia enacted in 1997 the special law governs infanticide and neonaticide. This law takes into account that:

1.

at the time of child murder the mental state of mother was affected by childbirth;

2.

the psychogenic situation which caused the crime.

In the cases of infanticide or neonaticide an offence punishable as if women had been guilty of manslaughter.

Conclusion:

Thus due to the new law these cases are dealt more leniently and it reflects more constructive and humane approach to such a complicated phenomenon as child murder.
Psihotic Disorders and Homicide in Family
Authors: Kovacevic R. , Kecman B.
Published: March 2009

Background:

The family is institution in which the life is born and rise. Homicide is cruel form of violence that is ruining and stopping the life. Those two, exclusive extremities, appear in one phenomenon- homicide in family.

Materials and methods:

This research is one part of comparative analytic prospective study, which last 10 years. In the Department of forensic psychiatry in Prison hospital in Belgrade we examined 266 perpetrators of homicide in family, 212 (79.70%) were male and 54 (20.30%) were female. Among those perpetrators we identified psychotic disorders in 77 mails (36.32 %) and 12 female (22.22 %). Thos groups committed 89 homicides in family with 99 victims.

Results:

We found statistically significant difference between males and females with regard to previous psychiatric treatment, alcohol abuses and intoxicated with alcohol at the time of the homicide. In male group with psychotic disorders, dominate schizophrenia (40, 26%) and paranoid psychosis (37, 66%), and in female dominate paranoid psychosis (50, 00%). Many perpetrators (41% male and 27% female) were not treated because of psychiatric disorder before, and psychiatric disorder diagnosed after the homicidal act.

Conclusions:

Among perpetrators of homicide in family there were two times more male than female with psychopathological symptoms. In both groups, psychoses are most usual diagnosis. The arm of future research should be recognizing factors that increased risk of violent behaviors and comparing those factors among person with and without mental disorders.
Treatment or Punishment for the Mentally Ill
Authors: Melamed Y.
Published: March 2009

A mentally ill individual who commits a crime stands trial. According to Israeli law, patients who committed crimes as a direct result of their illness, are not tried but are sent for treatment. The decision to hospitalize the mentally ill offender reflects humane concern for the patient. However, public safety must also be protected. When the patient"s condition improves, s/he no longer requires hospitalization, and by law, can be discharged. Thus, a patient who committed a serious offense may be released to the community much to the displeasure of society. Seemingly the patient "evades" punishment, though others claim that offenders must be punished.

There are three possible solutions:

a.

The patient should be hospitalized for as long as necessary, and thereafter, if s/he is still considered dangerous, should be sent to prison.

b.

The patient should be hospitalized for a period determined by the Court, and can not be discharged prior to the court determined discharge date.

c.

"Treatment years" model: The court determines "mandatory treatment years" for a patient who was not sentenced due to lack of criminal responsibility.

Thus, when necessary the patient is hospitalized, and when his/her situation improves, the psychiatric tribunal may transfer the patient to compulsory ambulatory care with the option for re-hospitalization when necessary. Non-adherence to ambulatory treatment, is treated as any other violation of court orders.

The law should find the middle road between treating the patient and protecting society coincident with punishment and determent of crime, when necessary.
Substitution Treatment and HCV / HIV Infection in a Sample of 31 German Prisons for Sentenced Inmates
Authors: Reimer J. , Stöver H. , Schulte B.
Published: March 2009

Injection drug use (IDU) and IDU-related infectious diseases such as hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections are highly prevalent among prisoners worldwide. However, little is known about the prevalence of IDUs and HCV/HIV and the availability of respective treatment options in German prisons. Data, provided by prison physicians of 31 prisons, representing 14,187 inmates, were included in this analysis. The proportion of IDUs among all prisoners was 21.9%. Substitution treatment was available in three out of four prisons (74.2%). Overall, 1,137 substitution treatments were provided annually with a wide range of treatment aims. The prevalence rate was 14.3% for HCV and 1.2% for HIV. Around 5.5% of all HCV-infected prisoners were in antiviral treatment annually, 86.5% of all HIV-positive subjects in antiretroviral HIV treatment.

Generally, substitution treatment, HCV and HIV testing and treatment are available. However, due to abstinence-oriented treatment aims substitution treatment is rarely available as maintenance treatment, and HCV/HIV treatment is mainly provided for patients with an existing treatment before imprisonment. The inconsistent data quality necessitate changes in prison related policy are needed, to improve surveillance and to generate aggregated data in German prisons. The selection process in this analysis might lead to overestimating the provision substitution - and antiviral HCV-treatment.
The QCAE: A Questionnaire of Cognitive and Affective Empathy
Authors: Reniers R. , Corcoran R. , Drake R. , Shryane N. , Völlm B.
Published: March 2009

Aims/objectives:

A lack of empathy is associated with callous-unemotional behaviour, violence, aggression, criminality, and problems in social interaction. Empathy is, though, inconsistently defined and inadequately measured. We therefore set out to produce a new and rigorously developed empathy questionnaire that would have clinical and public-health relevance.

Methods:

Sixty-five questions, themed around cognitive empathy (the ability to construct a working model of the emotional states of others) and affective empathy (the ability to be sensitive to and vicariously experience the feelings of others), were administered to two independent samples of healthy volunteers (N1=640, N2=383), which were used to explore and validate the factor structure.

Results:

Principal components analysis revealed five factors from thirty-seven items. Confirmatory factor analysis confirmed this structure. The hypothesised two-factor structure (cognitive and affective empathy) was tested by adding two second order factors, indicated by the five first-order factors, and provided the best and most parsimonious fit to the data (CFI=0.961, RMSEA=0.048). Cognitive Empathy encompassed Perspective Taking and Online Simulation; Affective Empathy encompassed Emotional Responsivity, Peripheral Responsivity and Emotional Contagion. Females scored significantly higher than males on Affective Empathy but not on Cognitive Empathy. The factors correlated significantly with measures of empathic anger, impulsivity, aggression, psychopathy, Machiavellianism and empathy as measured by the Basic Empathy Scale.

Conclusions:

The QCAE measures the distinct and specific components that make up cognitive and affective empathy. The factor structure was confirmed in independent samples and represents a valid tool for assessing cognitive and affective empathy and its subcomponents.