bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer and serious mental illness: A qualitative exploration–findings
Authors: Millman J. , Galway K. , Santin O. , Reid J.
Published: June 2017

Introduction

Serious mental illness (SMI) is associated with poorer cancer outcomes. Reasons for such inequalities are unclear; those with this comorbidity receive fewer specialist interventions and die earlier than the general population. Further exploratory work is required.

Objectives

Exploring the experience of SMI and cancer from the perspective of those affected by this comorbidity and those caring for them professionally or informally.

Methods

Semi-structured interviews were conducted with ‘key patients’ living with SMI who had received a cancer diagnosis (n = 7), significant others who had supported key patients (n = 4) and healthcare professionals who had worked with at least one KP (n = 17). A panel of patients and professionals ratified interview guides. Interviews were analysed thematically.

Results

Mental health professionals were more confident in their knowledge of the needs of this population than oncology professionals, but were challenged by working with patients with major physical health needs. Key patients’ mental health appeared to remain stable after cancer diagnosis, and they expressed altruism towards others with comorbid cancer and SMI. Significant others and healthcare professionals were more likely to critique systemic aspects of care than were key patients.

Conclusions

Professionals feel challenged when working outside of their usual job role. Training needs include mental illness awareness in an oncology setting. Improved coordination and communication is required, encompassing significant others as well as professional groups. SMI may protect against the psychological impact of cancer. Key patients were keen to provide advice and support to others in similar situations. Further research is needed into these areas.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosomatic process in patients with dissociative mental disorders
Authors: Axenov M. , Perchatkina O. , Kostin A. , Nikitina V.
Published: June 2017

Present days are characterized by increased level of various psychosomatic disorders among different populations in economically developing counties. Moreover every mental disease contains somatic symptoms and these symptoms may interfere in whole picture, change the diagnostic schedule. In case of mild disorders patient's reaction to somatic disease was mostly hysteric: exaggeration of pathological sensations, suggestibility and self-suggestibility. Whole picture of the neurosis was very colourful, dynamical, with instable pathological manifestations, intention to draw one's attention.

Transition to long-term variant of dynamics mental disorder was accompanied by concentration on the smallest somatic sensations, seeking benefit from a disease state, “flight into the illness”, nosophilia. We identified prominent increase of hypochondriac symptoms in the group of patients with long course of dissociative disorders (33.4%) as compared with the group of acute and sub-acute course of the disorder (11.4%).

In patients with long course of dissociative disorders we observed accumulation of somatic pathology, in most cases one patient suffered from different somatic diseases. Increasing of rate of hypertension (31.33%) and different dishormonal disorders (37.5%) was the most prominent.

In psychological “portrait” of the patients with psychosomatic disorders we identified the great number of combinations of pathocharacterologic traits, creating the patient's “facade”, complicating interactions and compliance with physicians and psychiatrists.

Interactions between features of mental disorders and somatic disorders, psychological stress appear to us to be rather close. Presence of the somatic process leads to chronification of the neuroses, “flight into the illness”, decrease of dependence of clinical dynamics on psychogenics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of life and its relationship with illness representations in patients with obstructive sleep apnea syndrome
Authors: Gassara I. , Thabet J. Ben , Msaad S. , Yaich S. , Medhaffar K. , Omri S. , Maalej M. , Charfi N. , Zouari N. , Zouari L. , Kammoun S. , Maalej M.
Published: June 2017

Introduction

Obstructive sleep apnea syndrome (OSAS) is a highly widespread sleep-related breathing disorder that leads to serious impairment in quality of life (QOL).

Objectives

We aimed to assess QOL in patients with OSAS and to investigate its relationship with illness representations.

Methods

We performed an analytical cross-sectional study of 87 recently diagnosed OSAS patients. Apnea hypopnea index (AHI) was determined by an overnight polysomnography. Excessive daytime sleepiness (EDS) was assessed by the Epworth Sleepiness Scale (ESS). QOL was assessed by the 36-item short form health survey (SF-36). Illness representations were measured by the Brief Illness Perceptions Questionnaire (B-IPQ); High scores reveal a more threatening perception of the illness.

Results

Mean age of the participants was 55.7 years (SD = 11.6). According to the AHI, 70,1% of the patients had severe OSAS, and 16.1% had moderate OSAS. The mean score of the SF-36 was 40.2 (SD = 18.7). Overall QOL was impaired in 87.7% of the patients. There was a considerable decrease in both mental and physical QOL. EDS was associated with impairment in mental QOL. Illness representations were negatively correlated with overall QOL (r = - 0.45; P < 0.01). No relationship was found between QOL and illness severity.

Conclusion

The present study provides evidence that OSAS has serious influence on QOL of patients, which could be mediated by negative illness perception. So it is extremely important to know how OSAS sufferers perceive their illness to better understand their coping behavior and to improve their adherence to treatment and their QOL.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treating out of the box: A psychiatry for all!
Authors: Jouini L. , Homri W. , Mrabet A. , Zaouche R. , Labbane R. , Meddeb B. , Gouider E.
Published: June 2017

Introduction

Psychiatrists used to focus on some chronic illness such as schizophrenia and bipolar disorder. However, non–psychiatric chronic illness also need psychiatric follow-up. Indeed, the reciprocal impact of chronic illness and depression is becoming increasingly clear. There is evidence that living with a chronic illness can increase the risk for depression and that depression can impair the quality of life (QoL).

Objectives

We aim to assess the prevalence of depression in a chronic disease such as hemophilia and to evaluate the patients’ QoL.

Methods

Thirty-seven adults from the hemophilia treatment center were screened for depression using the Hamilton Scale for Depression. QoL was assessed using the norm based scores of the SF-36. When the group's score was below 47, the quality of life was below the average.

Results

The average age of our population was 26.5 years. 46% were married, 27% achieved a superior level of education and 30% were jobless. Good social and professional integration were reported in 70% and 76% respectively. 77% of our sample had depressive symptoms which were mild (30%), moderate (24%) or severe (13%). The physical and mental Component Scores (PCS and MCS) of the SF-36 scored 46.48 and 43.45 respectively. PCS and MCS were significantly lower in patients with depressive symptoms (P = 0.002/P = 0.048). However, depressive symptoms and SF-36 scores did not differ according to education level, marital and professional status.

Conclusions

Psychiatrists should be aware of the psychological impact of general chronic illness. Psychiatric consultations must be implemented in every general hospital.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association of blood pressure with anxiety and depression in a sample of primary care patients
Authors: Sacchetti A. , Mattei G. , Bursi S. , Padula M.S. , Rioli G. , Ferrari S.
Published: June 2017

Introduction

According to international scientific literature, and as summarized in the guidelines of the International Society of Hypertension, lowering of blood pressure can prevent cardiovascular accidents. Some studies suggest that hypertension, anxiety, and depression might be inversely correlated.

Objective

To investigate whether blood pressure is associated with anxiety and depression.

Methods

Cross-sectional design. Male and female primary care patients were enrolled, aged 40–80. Criteria of exclusion adopted: use of antidepressants or antipsychotics; previous major cardiovascular event; psychosis or major depression; Type 1-DM; pregnancy and hereditary disease associated to obesity. Anxiety and depression symptoms were assessed using HADS. Waist circumference, hip circumference, blood pressure, HDL, triglycerides, blood sugar, hypertension, albumin concentrations and serum iron were also assessed.

Results

Of the 210 subjects, 84 were men (40%), mean age was 60.88 (SD ± 10.88). Hypertension was found to correlate significantly to anxiety (OR = 0.38; 95% CI = 0.17–0.84), older age (OR = 3.96; 95% CI = 1.88–8.32), cigarette smoking (OR = 0.35; 95%CI = 0.13–0.94), high Body Mass Index (OR = 2.50; 95% CI = 1.24–5.01), Waist-hip ratio (OR = 0.09; 95% CI = 0.02–0.46) and the Index of comorbidity (OR = 16.93; 95% CI = 3.71–77.29).

Conclusions

An inverse association was found between anxiety and hypertension, suggesting the need to clinically manage these two dimensions in a coordinated way. Other findings are well known and already included in prevention campaigns. Further research is needed, also to better understand and explain the causative pathways of this correlation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence frequency of disabilities and psychological symptoms in patients diagnosed chronic obstructive pulmonary disease
Authors: Akhan L. Utas
Published: June 2017

Background

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality chronic obstructive pulmonary disease can cause intense psychological distress due to the caused problems that individuals experience in their lives. COPD is among a number of medical disorders associated with a high rate of depression and other psychological problems.

Objectives

In this study, it is aimed to evaluate the prevalence of psychological symptoms and disability in patients with chronic obstructive pulmonary disease.

Methods

The study includes 100 volunteers as a control group and 200 patients diagnosed with COPD who are being treated in a hospital for occupational diseases of the Turkish ministry of health. It is performed as definitive-cross-sectional between 12.03.2016–30.04.2016. In gathering the data; socio-demographic Information form, brief disability questionnaire and Beck depression scale and SCL 90 R scale are applied. The mean age of the COPD group is 49.2 ± 3.4 (25–78) and the control group is 45.1 ± 2.4 (27–60).

Results

In our study, depression was detected in 56% of cases with chronic obstructive pulmonary disease. Mean brief disability questionnaire score was found 7.28. Mild disability was found in 21%, moderate disability in 38% and severe disability in 29%. Moreover, It was also found that obsessive-compulsive and depressive symptoms were higher in COPD cases in comparison with the healthy group.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Does consanguinity increase the risk of mental illnesses? A population based study
Authors: Bener A.
Published: June 2017

The aim of this study was to assess the impact of consanguinity on risk for mental disorders especially in primary health care-PHC settings. It was decided to ascertain prevalence of common mental disorders and consanguinity. We set out to study the burden of commonest psychiatric disorders among consanguineous marriages at PHC using the WHO Composite International Diagnostic Interview (WHO-CIDI) and examine their symptom patterns and co-morbidity in Qatar. A prospective cross sectional study was carried out over a year between November 2011 to October 2012. A total of 2.000 Qatari subjects aged 18 to 65 years were approached; 1.475 (73.3%) gave consent and participated in this study. Prevalence of psychiatric disorders using the WHO Composite International Diagnostic Interview (CIDI, version 3.0) showed that six most common disorders were major depression disorders (18.3%), any impulse control condition (18.3%), any anxiety disorders (17.2%), any mood disorders (16.9%), followed by separation anxiety disorders (15.2%), personality disorder (14.1%). The mean age ± SD of the 1.475 subjects interviewed was 39.3 ± 9.8 years. The rate of consanguinity in the present generation was 31.5% [95% CI = 29.1–33.7]. There were statistically significant differences between consanguineous and non-consanguineous with regards to age, educational status, occupation status, household income as well as BMI, cigarette smoking and sheesha smoking. One-fifth of all adults who attended the PHC center 20% had at least one psychiatric diagnosis. The prevalence of the generalized anxiety disorders; social phobia, specific phobia, major depression, and personality disorders were significantly higher in consanguineous marriages than in non-consanguineous.

Disclosure of interest

The author has not supplied his declaration of competing interest.
The Senegalese accompagnant model in psychiatric care: How hospitalization with a relative may contribute to the therapeutic process
Authors: Ory B. , Benmansour S. , Pachoud B.
Published: June 2017

Introduction

The accompagnant model was set up at the Fann psychiatric hospital in Dakar in 1971 by prof. H. Collomb. It requires the patient to be hospitalized with a non-patient to accompany him/her at all time during the hospitalization. This model compensates for economic and human deficiencies, and also presents itself as a therapeutic tool in the treatment of mental illnesses.

Objectives

The contemporary use of the accompagnant model will be presented and its advantages and disadvantages assessed.

Aims

We investigate how the accompagnant model may have a role in the therapeutic process, and to what extent this model (or part of it) could be exported.

Methods

A qualitative study of the practice at Fann Psychiatric Hospital has been carried out, based on interviews with patients, professionals and accompanying persons.

Results

There is a striking consensus between patients, professionals and the accompanying persons about the advantages of this practice. It facilitates the encounter between professionals and patients, and reduces the risk of living hospitalization as a traumatic experience. The accompanying persons contribute to warrant the respect of human dignity, and to maintain a therapeutic dynamic through their participation in the development of a caring environment and their expectation of a recovery process. They help ensure continuity of care and medication after the hospital stay.

Conclusion

The accompagnant model emphasizes the role relatives may play during and after the hospitalization, in ways that could be compared with what is currently expected from family therapeutic education.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pitfalls of positivity–new perspectives on the futility of negating negativity
Authors: Vukovic V. , Nikolić-Lalić S. , Mitić J. , Golubović O. , Savić V.
Published: June 2017

The claim that “thinking positive” betters one's life has become pervasive in our contemporary culture. Proponents of this style of reasoning, including the head of the positive psychology movement, Martin Seligman, claim their goal is to create a field focused on human well-being and the conditions, strengths and virtues that allow people to thrive, and back their standpoint with a great number of studies.

However, critics of the movement have, first of all, pointed out flaws in some of the concepts and studies backing them, and second, performed experiments of their own which show not only that forced positive thinking doesn’t help, but can sometimes be harmful.

More worrisome than disputes in the therapeutic community is the tendency of mass media and our commodified society to abuse these approaches, the end result being a whole scope of popular psychology books which promise wealth, happiness and ideal partners to those prepared to “believe”, and the presence of a horde of self-appointed gurus promising easy answers and quick solutions. This is only a symptom of our contemporary postmodern condition, one well phrased by the Slovenian philosopher Žižek - “the commandment of the ruling ideology is ‘enjoy!”’.

From philosophers of negativity (Nietzsche, Schopenhauer) to psychotherapists dealing with automatic negative thoughts, we come to our proposed field of research in the “neuroscience of negativity”, a search for the biological underpinnings of positivity/negativity, focusing primarily on their relation to Cloningers’ dimensions of personality and mood disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Health-related quality of life of primary care patients with depressive disorders
Authors: Riihimäki K.
Published: June 2017

Background

Depressive disorders are known to impair health-related quality of life (HRQoL) both in the short and long term. However, the determinants of long-term HRQoL outcomes in primary care patients with depressive disorders remain unclear.

Methods

In a primary care cohort study of patients with depressive disorders, 82% of 137 patients were prospectively followed up for five years. Psychiatric disorders were diagnosed with SCID-I/P and SCID-II interviews; clinical, psychosocial and socio-economic factors were investigated by rating scales and questionnaires plus medical and psychiatric records. HRQoL was measured with the generic 15D instrument at baseline and five years, and compared with an age-standardized general population sample (n = 3707) at five years.

Results

Depression affected the 15D total score and almost all dimensions at both time points. At the end of follow-up, HRQoL of patients in major depressive episode (MDE) was particularly low, and the association between severity of depression (Beck Depression Inventory, BDI) and HRQoL was very strong (r = −0.804). The most significant predictors for change in HRQoL were changes in BDI and Beck Anxiety Inventory (BAI) scores. The mean 15D score of depressive primary care patients at five years was much worse than in the age-standardized general population, reaching normal range only among patients who were in clinical remission and had virtually no symptoms.

Conclusions

Among depressive primary care patients, presence of current depressive symptoms markedly reduces HRQoL, with symptoms of concurrent anxiety also having a marked impact. For HRQoL to normalize, current depressive and anxiety symptoms must be virtually absent.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Age at onset of eating disorders: A statistical validation of proposed cut-offs
Authors: Patriciello G. , Monteleone A.M. , Amodio R. , Calvanese M. , Volpe U. , Monteleone P.
Published: June 2017

Introduction

Despite age at onset (AAO) of eating disorders (EDs) has classically been described in adolescence; to date there is not an univocal definition. While initial studies described a bimodal distribution of AAO for ED, recently several studies didn’t confirm these findings.

Objectives

AAO thresholds definition for anorexia nervosa (AN) and bulimia nervosa (BN) with statistical validation of proposed cut-offs is highly needed, since AAO represents a crucial clinical feature.

Aims

We obtained data from subjects with AN and BN to perform a normal distribution admixture analysis to determine their AAO.

Methods

A total of 806 ED patients (792 females; 379 AN and 427 BN) were recruited. Diagnosis of AN and BN were ascertained according to the DSM-IV-TR criteria by means of the SCID – Patient Edition. AAO was assessed by a clinical interview performed by a psychiatrist matched with a systematic review of medical records. To test AAO subgroups, we used a normal distribution admixture analysis.

Results

A bimodal normal distribution of AAO with an early onset and late onset component was found for both AN and BN. Most of the subjects with AN (75.3%) and BN (83.3%) belonged to the early onset group. Both groups had a mean AAO of about 18 years. No significant differences were found concerning the AAO between groups.

Conclusion

Consider clinical history and course of AAO for EDs may be crucial for planning treatment. To our knowledge, this is the first study that applied a validated statistical procedure to identify AAO cut-off points for AN and BN.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
EMDR therapy on trauma-based restrictive eating cases
Authors: Yasar A.B. , Usta F.D. , Abamor A.E. , Erdogan Taycan S. , Kaya B.
Published: June 2017

Introduction

Eating Disorders (ED) affect an individual's physical and mental health with abnormal eating habits. Traumatic life events may underlie the development of ED as many studies document [1]. In the present study, we examined the effectiveness of EMDR therapy that was originally used to treat Post-Traumatic Stress Disorder (PTSD) [2], on restrictive eating symptoms associated with trauma. Cases B.Ö. (18) and B.S. (20) came to the clinic consecutively for resembling complaints about the sense of food sticking in their throat, breathing difficulties, raised heart beatings, unease to swallow, and choking fear. The patients revealed past traumatic events about being out of breath while swallowing their bites. Then, they have started to restrict their food intake and the types of food consumed, which led to emaciation with health problems, interrupted daily routines, and social isolation; meeting the diagnosis of avoidant/restrictive food intake disorder (ARFID) in DSM-5. Due to traumatic experiences, EMDR therapy was applied.

Discussion

After five EMDR therapy sessions, patients turned back to healthy eating habits, normal BMI, and effective daily life. As expected, EMDR therapy made significant improvements in the treatment of ARFID.

Conclusion

EMDR can be useful to treat ED with traumatic background.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What is commonly missed in the suicidal risk assessments in the emergency room?
Authors: Alavi N. , Reshetukha T. , Prost E. , Kristen A. , Groll D.
Published: June 2017

Introduction

Suicidal behaviour remains the most common reason for presentation to the emergency rooms. In spite of identifiable risk factors, suicide remains essentially unpredictable by current tools and assessments. Moreover, some factors may not be included consistently in the suicidal risk assessments in the emergency room by either emergency medicine physicians or psychiatrists.

Method

Step 1 involved the administration of a survey on the importance of suicide predictors for assessment between psychiatry and emergency medicine specialties. In step 2 a chart review of psychiatric emergency room patients in Kingston, Canada was conducted to determine suicide predictor documentation rates. In step 3, based on the result of the first 2 steps a suicide risk assessment tool (Suicide RAP [Risk Assessment Prompt]) was developed and presented to both teams. A second patient chart review was conducted to determine the effectiveness of the educational intervention and suicide RAP in suicide risk assessment.

Results

Significant differences were found in the rating of importance and the documentation rates of suicide predictors between the two specialties. Several predictors deemed important, have low documentation rates. Thirty of the suicide predictors showed increased rates of documentation after the educational intervention and the presentation of the suicide RAP.

Conclusion

Though a surfeit of information regarding patient risk factors for suicide is available, clinicians and mental health professionals face difficulties in integrating and applying this information to individuals. Based on the result of this study suicide RAP and educational intervention could be helpful in improving the suicidal risk assessment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Peculiarities of providing care in various emergencies
Authors: Shport S.
Published: June 2017

Air crashes

Attention is focused on providing care to the relatives (identifying the bodies of the perished, talking to investigators, filling out the requisite documentation, etc.), resolving social issues (organizing funerals, informing various services of what had happened, etc.).

Fires

Special attention is paid to the victims with burns at the inpatient facilities of hospitals.

Terrorist acts

Provision of care depends on the duration of the emergency and the number of people involved; in the case of a continual stress, in the phase of isolation the medical-psychological care is provided to victims’ relatives. At later stages–it is provided to the victims and their relatives.

Natural disasters

Are of a special nature, as they are always sudden and there exists a threat that a great number of people may become victims.

Organizational measures in the acute period of an emergency:

– coordinating the work of specialists of the local, regional and federal level;

– interacting with non-governmental organizations;

– setting up a 24-hour “hotline” service (“HL”) on the basis of a medical institution;

– deploying facilities for providing care to victims, their relatives, and to “secondary victims”.

Principles of medical-psychological care:

– urgent care must be provided jointly with psychiatrists/psychotherapists at the places, where the victims are located;

– individuals with the most severe stress reactions must be identified and observed by psychiatrists/psychotherapists;

– appropriate and prompt intervention should be made to relieve acute stress disorders;

– therapeutic interventions should not be a hindrance to victims’ participation in the urgent evacuation and interrogation expedients as well as completing social tasks.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Paranoidism and memory deficits: An epidemiological study
Authors: Calahorro C.M. , Guerrero Jiménez M. , Girela Serrano B.M. , Muñoz Negro J.E.
Published: June 2017

Background

The Green et al. Paranoid Thought Scales (GPTS) was developed to fulfill a need for a tool that was adapted to the current dimensional definition of paranoia, capable to assess dimensions of preoccupation, conviction, and distress, valid and reliable for the assessment of both clinical and healthy populations, and precise enough to detect subtle clinical change. It has recently been validated for the Spanish population (S-GPTS) with very good psychometric properties. Numerous studies suggest that patients with severe psychiatric disorders have impaired sustained attention and memory. A wide spectrum of executive deficits have also been described (goal-oriented tasks, recognizing priority patterns, planning, etc.) Very few studies have attempted to identify whether these same relationships between neuropsychological deficits and psychotic symptoms also occur in general population.

Methods

This is a cross-sectional study. We undertook a multistage sampling using different standard stratification levels and out of the 5496 eligible participants finally approached, 4507 (83.7%) agreed to take part in the study, completed the interview and were finally included in the study (n = 4507).

Results

Individuals with high cut off S-GPTS scores showed lower scores in working memory subtest verbal statistically significant(P > .05). While no significant difference was found among for immediate verbal learning subtest and high S-GPTS scores (P > .05654).

Discussion

This information can improve the clinician's understanding of patient's cognitive strength and weaknesses, put patients’ cognitive abilities into perspective for their diagnosis, and facilitate multidisciplinary treatment decisions as we improve our ability to distinguish clinical cases from non-clinical population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Health intervention in gender violence
Authors: Hernandez Anton R. , Noval Canga C. , De Uribe Viloria N. , Sevillano Benito I. , Espina Barrio J.A. , Marques Cabezas P. , Gallardo Borges L. , Segura Rodriguez A.I. , Gomez Garcia M. , De Cegama F. Uribe Ladron
Published: June 2017

Introduction

Male and female social roles were built on a historical inequality. Gender violence is a public health problem of the first order. We consider it important to conduct a study to improve diagnosis and interventions. From the Theory of Roles Moreno, each role has a complementary role that maintains the link. In gender violence predominates control, domination, submission and asymmetry of functions as dysfunctional elements of a relationship, which should be symmetrical.

Methodology

We reviewed 48 stories of women who come for abuse mental health team from 2013 to 2016. We analyzed the following aspects: socio-demographic data (age, nationality, marital status, education, jobs, dependent children); reason for consultation and number of queries; violence; roles, because of maintenance and interventions.

Results

Eighty percent Spanish. It occurs at all levels of education; 60% have children; 70% were derived from primary care for others reasons; almost 90% suffered psychological violence, 25% physical and economic, sexual only 3 women, 52.08% of women adopt a submissive role, passive-aggressive 20.83% and 25% ambivalent; maintenance of the violence is reinforced by the psychological dependence that occurs in all women (one in 45.83%).

Conclusions

Roles analysis is an effective method in the diagnosis of abuse and designing appropriate intervention. Psychotherapy, benefits of a psychopharmacological treatment that lessens the suffering and lets face their difficulties. It is important to ask about abuse at any level of care, because it contributes more to cover a hidden reality. The Psychological and economic dependence. They establish and maintain the mistreatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Social rituals as an early indicator of mental illness
Authors: Janca A. , Gaspar J.
Published: June 2017

Introduction

Social rituals refer to routine and expected social activities that are practiced in all communities in a culturally recognized manner (e.g., social greetings, eating customs, attention to dress, sleeping rituals etc.). Persistent departures from or disregard of these social rituals may be an early or prodromal sign of the onset of mental illness.

Objectives

(1) To develop and evaluate psychometric properties of a measure of social rituals entitled, Social Rituals Schedule (SRS); (2) to evaluate the reliability and cross-cultural applicability of this measure.

Methods

The SRS was administered to 30 psychiatric patients and their nominated relative/friend. The cross-cultural evaluations were conducted using focus groups of Ethiopian (n = 30), Australian Indigenous (n = 100), Iranian (n = 22), and Indian (n = 50) participants.

Results

The SRS demonstrated moderate to high inter-rater reliability and patient-informant concordance. The social ritual domains were found to be valid, well understood and applicable across the sampled cultures [1].

Conclusions

The concept of social rituals and the SRS instrument were demonstrated to be feasible, reliable and cross-culturally applicable tools for measuring changes in people's appearance and behavior that might be indicative of emerging mental illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Stigmatization of mental health problems in Albania, ways of diminishing it
Authors: Jupe T. , Elezi F. , Zenelaj B. , Myslimi E.
Published: June 2017

Background and aim

More recent definitions of stigma focus on the results of stigma – the prejudice, avoidance, rejection and discrimination directed at people believed to have an illness, disorder or other trait perceived to be undesirable.

Methods

During this study, we used Attitudes to Mental Illness Questionnaire (AMIQ), which helped us to understand the differences in the acceptance by the population for 3 different types of diseases: addiction, diabetes and schizophrenia.

Results

(1) Alban has diabetes. (2) Besnik has schizophrenia.

Conclusions

(1) The patients with schizophrenia have higher levels of stigma compared diabetic patients or those alcoholics (Tables 1 and 2 and Fig. 1). (2) Statistical processing carried out concluded that have statistically significant differences between gender-stigma (P = 0.001), age-stigma (P = 0.0001) and education-stigma (P = 0.001) (Fig. 2). (3) Health care workers stigma is exactly the same as in general population (P = 0.01) (Fig. 2).

Recommendations

– Support recovery and social inclusion and reduce discrimination.

– Do not label or judge people with a mental illness, treat them with respect and dignity as you would anyone else.

– Do not discriminate when they come participation, housing and employment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Analysis of geographical distribution of referrals to psychiatry from primary care
Authors: Mata Saenz B. , Muñoz Martinez V. , Nuevo Fernández L. , Lopez Lavela E. , Asensio Aguerri L.M.
Published: June 2017

Introduction

The distribution of the demand from primary care in the mental health units could be a way of facilitating the coordination and improving the attention to patients. For this reason, in our unit we have made a repartition of the areas among the different psychiatrists.

Objectives

To analyze if there was a correlation between the geographical origin of the patients or their primary care areas and the referrals, and between them and their attendance.

Methods

This is an epidemiological, analytic, prospective study of patients referred to our department. The following variables were collected: (1) referral protocol, (2) reason, (3) demographic data (origin, gender, age), (4) Primary Care area, (5) attendance to appointment, (6) diagnosis impression and (7) destination of referral. The SPSS 19.0 was used to analyze the data.

Results

A total of 1048 patients were sampled. A statistically significant relationship hasn’t been found between place of residence, primary care area or areas of distribution in the Unit and attendance (Chi2). If we analyze the population of each distribution, we can describe similar percentages depending on the size of these.

Conclusions

Although a different distribution and a relationship is thought between some areas and the attendance or the number of referrals, we didn’t find out them in our sample.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Who's lost in waiting?
Authors: Ossola P. , Jovanovic N. , McColl H. , Giordano V. , Webber C. Johnston , Steel M. , Ramjaun N. , Andlauer O.
Published: June 2017

Introduction

Early intervention services (EIS) can significantly reduce the rate of relapse, risk of suicide and number of hospital admissions for people with first episode of psychosis (FEP). However, care pathways in FEP can be complex, thus extending the period before patients commence appropriate treatment. Recently in the UK, guidelines have set a limit of two-weeks before patients with a FEP receive treatment at EIS.

Objectives

We explored the impact of this new policy on referrals to an EIS in the area City and Hackney, London, which has one of the highest incidence of psychosis in the UK.

Methods

Referrals from 6 months of 2015 have been compared with the data from the same period of 2016, once the waiting standard had been implemented.

Results

We observed more than a two-fold increase in the monthly number of referrals (9.4 in 2015; 20 in 2016) and this wasn’t due to a rise of inappropriate referrals (2.23% in 2015; 1.53% in 2016). Moreover the number of referrals doubled further when, in addition, the City & Hackney EIS went from a 18–35-year-service to an “ageless” adult service.

Conclusion

The recent focus on FEP in the UK might have increased awareness and reduced stigma, leading to the increment in referrals. Also, shortening the waiting time made the service more accessible for those that would have gave up in front of a longer waiting list. Interestingly enough a peak in the number of referrals has been observed from September 2016 when another standard was implemented.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Defensive psychiatry. An ethical perspective
Authors: Riolo A. , Babici F. , Tassi F.
Published: June 2017

Introduction

The legal dispute between doctors and patients is increasing. The “frivolous lawsuit” is spreading and the psychiatrist is being dragged to court in the dock. Guidelines and operational protocols become the bastions of the defensive psychiatry. Defensive psychiatry involves, for example, a larger number of hospitalizations, also involuntary admissions, and psycopharmacological prescriptions.

Objectives

We want to see if the issue of defensive psychiatry is perceived by psychiatrists as a risk in their clinical practices and what consequences may result in the relationship with the patient.

Methods

Through an audit and through a literature review get to define the defensive psychiatry.

Conclusions

Though there is much confusions and uncertainty in this field, the defensive psychiatry distorts the relationship with the patients and proposes the questions of social control.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Correlation between socio-demographic factors and profile of the rapist in Bulgaria
Authors: Stoimenova-Popova M. , Tumbev L. , Chumpalova P. , Veleva I. , Todorov A. , Valtchev V. , Popov P.
Published: June 2017

Introduction

Sexual abuse is of great public and high degree of public danger.

Objectives

The aim of this study was to evaluate the influence of specific socio-demographic factors among sex crime offenders.

Material

The subjects of study are 66 individuals in total, testified by expert psychiatrist and subsequently charged by law as of December 2010, up until today.

Methods

Patient record, providing information about different socio-demographic factors. Retrospective research of the available medical documentation. A statistician conducts data research analysis, using specialised software statistical packages for Statgraphics.

Results

The highest percentage of the participants are from the age groups between 15–24 and 45–54 years old. Both age groups consist of 18 people (27%). The two groups with the lowest percentage of sex offenders are the ones between 25–34 –6 (9%) and above 64–6 (9%). The biggest share have secondary education–26 (40%), followed by those with elementary education–24 (36%). The smallest percentage are those with higher education – 2 (3%). There is no statistically significant correlation between the research sample and their residence–34 (51%) live in a city and 32 (49%) – In a village. There is also not a significant difference in their ethnical origins. The biggest percentage of sex offenders have been raised by both parents – 54 (82%).

Conclusions

Sex offenders represent an exceptionally heterogeneous group, our study did not find significant correlation of socio-demographic factors and the profile of the rapist.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Agreement between psychiatric evaluations and court decisions concerning criminal responsibility
Authors: Tzeferakos G. , Papaliaga M. , Papageorgiou C. , Douzenis A. , Bali P.
Published: June 2017

Introduction

To our knowledge, a relatively small number of studies address the agreement between psychiatrists and court decisions concerning criminal responsibility among psychiatric offenders.

Objectives

The objective of the present study was to examine the agreement between psychiatric evaluations and court decisions in Greek penal cases.

Methods

Legal case files of 100 adult subjects, 90 male/10 female, 88 Greeks/12 foreigners were studied, and agreement was assessed by the κ (kappa) statistic.

Results

Seventy eight percent of the subjects had had contact with psychiatric services before the commitment of the crime. The most common diagnoses were schizophrenia spectrum psychosis (18%), antisocial/borderline/mixed personality disorder (15%) and substance use disorder (15%). In 30% of the cases criminal insanity/partial responsibility was attributed in the first-degree court. The presence of a psychiatrist (n = 63), attending, defense, prosecution or appointed by the court, significantly increased the possibility of such an attribution (41.3% versus 10.8%).

The highest agreement (κ = 0.780) was observed between court's decision and the evaluation of the psychiatrist appointed by the court, in the 35 cases in which such an expert was present (P < 0.001). Very significant agreement (κ = 0.805) was observed between the decisions of second and first-degree courts (P < 0.001). In 91% of the cases, the decisions remained unchanged.

Conclusions

Criminal insanity/diminished responsibility, were attributed in 30% of the reviewed cases. The presence of a psychiatrist already at the first-degree court is a prerequisite for such an attribution, especially when, he is appointed by the Court.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental health simulation training in psychiatric skills for police and ambulance service personnel
Authors: Attoe C. , Fisher M. , Vishwas A. , Cross S.
Published: June 2017

Introduction

UK healthcare policy has highlighted a shift in mental health services from hospital to community, stressing the importance of training for professions not traditionally associated with healthcare. Recommendations have been made to introduce training for the police force designed with experts. Similarly, the value of further training for ambulance clinicians in assessing mental health, capacity, and understanding legislation has been highlighted.

Aims

To investigate the effect of simulation training on the confidence, knowledge, and human factors skills of police and ambulance service personnel in working with people experiencing mental health conditions.

Methods

On completion of data collection from 14 training courses, approximately 90 police and 90 ambulance personnel (n = 180) will have completed the human factors skills for healthcare instrument, confidence and knowledge self-report measures, and post-course qualitative evaluation forms. A version of the hfshi for non-clinical professions will hopefully be validated following data collection. Results will also be compared by profession.

Results

Analyses have not been fully completed, although preliminary statistical analyses demonstrate promising findings, with increases post-course for human factors skills, confidence and knowledge. Furthermore, qualitative feedback initially illustrates valuable learning outcomes and interesting findings from comparisons by professions.

Conclusions

Mental health simulation training appears to have a promising impact on the confidence, knowledge, and human factors skills of police and ambulance personnel for working with people experiencing mental health conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological Effects of Working Night Shifts on Mental Health
Authors: Kchaou A. , Hajjaji M. , Masmoudi R. , Sellami I. , Masmoudi M.L. , Masmoudi J. , Jmal K. Hammami
Published: June 2017

Introduction

The medical and scientific communities are continually reporting that night work can increase the risk of certain disorders and have a negative impact on the overall well-being of employees.

Objectives

This study wanted to examine the impact of night work on physical and psychological well-being of hospital staff.

Methods

We carried out a cross-sectional study about a representative sample of hospital staff. We used validated self-reporting instruments: the Perceived Stress Scale (PSS) and the Subjective Well-being Scale (SWS). Data were analyzed using SPSS-20.

Results

Our study concerned 519 hospital staffs. More than half were male (53%) and 83.1% had worked in the same position for more than two years. More than half of the participants (51. 3%) considered themselves in very good health. Also 41.5% of participants had a well-being index reduced and 26% of personal had high perceived stress. Correlation analysis had shown that more than one guard at week was associated with high levels of perceived stress (P = 0.004) and well-being index reduced (P = 0.000). After adjusting for categories, more than one shift work at week was associated to well-being index reduced with odds ratios of 1.57 (confidence interval 95% [1.07 to 2.30]).

Conclusion

There is a clear correlation between night work, perceived stress and subjective well-being of different categories of hospital staff. Shift work interferences on health and well-being are complex and multifaceted in their origins and time manifestations, dealing with several aspects of personal characteristics, and working and living conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comprehensive Care for Inpatients with Mental Disorders: Working Towards Service Developments
Authors: Semenova N. , Kostyk G.
Published: June 2017

Introduction

Over the past 20 years, considerable progress was made in understanding the multiple and complex needs of patients with mental disorders and ways to organize comprehensive care. However, organizing care in inpatient, pathology-focused settings, where patients were seen increasingly as consumers of ‘inpatient psychiatric’ services is challenging.

Objectives and aims

Inspired by modern trends, we are more able to integrate recent developments in psychosocial treatments, broadly defined, into progressive treatment framework within inpatient setting.

Methods

Results of an audit of our service (psychosocial treatments) over the previous 5 years will be compared to published results of other services with a range of service delivery methods.

Results

Excerpts from mental health care practice in Moscow based Psychiatric Hospital No 3 named after VA Hilyarovsky – are provided. The pathways of care as well as the basic principles governing the treatment (careful attention to referral sources; optimal patient-treatment matching; and psychosocial, rather than medical supremacy) are outlined. Training and development is central to the effective and efficient working of any staff group. As part of the service developments, a number of inductions (on psychosocial treatments) were provided on regular basis to all staff joining the service.

Conclusions

Though the opportunity for future reform remains on the horizon, some of the strengths and weaknesses of our current health care practice will be presented.

Disclosure of interest

The authors have not supplied their declaration of competing interest.