bluuebunny/crossref_metadata_2025 huggingface dataset:
Intensity of Depressive Symptoms and Disorders of Working Memory and Executive Functions in Hyperthyroidism in the Course of Graves’ Disease and Toxic Nodular Goitre
Authors: Jabłkowska K. , Nowakowska K. , Adamiak G. , Borkowska A.
Published: March 2009

Current data show an association between thyroid diseases and cognitive dysfunction and depression. Depression may affect the clinical picture and the course of thyroid diseases, while also certain correlations are seen between depression and an increased risk of the incidence of these diseases.

The aim of this study was tracing associations among depression and hyperthyroidism in the course of Graves’ disease and toxic nodular goitre in particular stages of the disease and frontal cognitive function.

Eighty persons (63 females and 17 males) with diagnosed hyperthyroidism, their age ranging between 18 and 55 years, were qualified into the study, fifty (50) of them with Graves’ disease and thirty (30) with toxic nodular goitre.

Following performed hormonal evaluations, patients with overt or subclinical hyperthyroidism were identified, together with patients in euthyroidism.

The control group included thirty-one (31) healthy volunteers, matched with the study group, regarding their age, sex and education.

In the evaluation of working memory and executive functions, the Wisconsin Card Sorting Test (WCST) was used, while Beck Depression Inventory (BDI) was applied to determine the degree of depression symptoms.

The obtained results showed impairment of WCST performance in patients with Graves’ disease and with toxic nodular goitre. Any significant associations between the degree of depression symptoms and the efficiency of either working memory or executive functions were found.

Acknowledgements:

This research was supported by grant 502-16-683 Medical University of Lodz.
Mild Cognitive Impairment and Quality of Life
Authors: Mila C. , Podea D.M. , Chenderes R.M.
Published: March 2009

Objective:

The aim of this study is to evaluate the influence of cognitive enhancers on quality of life to patients with MCI.

Material and methods:

The study comprises a number of 40 elderly patients diagnosed with mild cognitive impairment. These patients were divided in two groups:

group A that comprises 20 patients diagnosed with mild cognitive impairment that were treated with piracetamum (daily dose: 1600mg),

group B that comprises 20 patients diagnosed with mild cognitive impairment that were treated with antioxidants Coenzima Q10 (daily dose: 15mg).

MMSE score between 28-21points is considered mild cognitive impairment. The inclusion criteria were:

patients over 65 years,

patients with mild cognitive impairment.

The exclusion criteria were:

patients with mild cognitive impairment due to major depressive disorder and schizophrenia,

patients with moderate and severe cognitive impairment.

The patients were evaluated with MMSE (Mini Mental State Evaluation) and GAF (Global Assessment of Functioning Scale) at the inclusion and after 6 months of treatment.

Results:

The average of MMSE scores in group A was 25.9 and for group B 25.5. The patients treated with nootropics have had a better outcome, cognitive performance improving with 2,6 points for group A and with 1,8 points for group B. Improvement of cognitive performance improve the quality of life of this patients, the GAF scores improving from 45.4 points to 67.3 in group A and from 44.8 points to 55.3 in group B.

Conclusions:

The patients treated with nootopics have had a better outcome regarding cognitive functions and quality of life also. Improvement of cognitive performance improve the quality of life.
Memory Disorder in Persons with Asperger Syndrome
Authors: Vidojevic I. Milacic
Published: March 2009

Aim:

Asperger syndrome (AS) is a term used to mark a subgroup of autism with no delay in language or cognitive development. Research reveal language and cognitive impairments in AS (uneven profile of abilities on Wechsler intelligence scales, pragmatic deficits, receptive speech, narrow attention and difficulty in shifting attention, etc). The objective of this study is to examine episodic memory of children with AS. 12 children with AS age from 7-16 years old, 11 males, 1 female participated in the study. All children had an IQ in the normal range.

Method:

Buschke Selective Reminding Test was used in the present study as a measure of episodic memory suitable for the age range of the children in the study.

Results:

scores gained by the children with AS comparing to the scores of the normally developing children indicate deviation on the measures of recall, long term storage, consistent long term retrieval and increased number of intrusions. Only 3 subjects scored within normal limits. Information produced on immediate recall was not lost over 30-minute delay.

Conclusion:

results shows dominant problem in organization of stored information.
Suicidal Behaviour and it Relation to Proximal Factors
Authors: Ahmadian M. , Nezam T. Shamshiri , Badvee I. , Homayuni A.
Published: March 2009

Introduction and aim:

The main purpose of the current study was to identification proximal risk factores including stressful life events, abuse specially emotional abuse, planning, methods and availability of methods for committing suicide.

Method:

This study has been run in a emergency settings over a period of 1 year and data gathered from a total of 120 participants including 52 male, 68 femal who had recently attempted suicide. The mean age of the samples was 22 (SD=3.9; max=33; min=18) and the mean level of education was 11 (SD=2.3; max=16; min=7). All participants completed the short form of WHO supremiss questionnaire (42 item version).

Data were analyzed using regression logestic and Chi square formula. The alpha coefficient reliability of this short form of WHO supremiss questionnaire was 0.67.

Results:

The results showed that the most common way to suicide (%58) was self-poisening (drug over doze with sedatives and anti depressants). The most common proximal risk factors were serious arguments with family or spouse, serious personal physical illness or hopelessness in a short period of time after an acute life event. Approximately %65 of this patients had a serious plan for suicide and Three fourth of patients had problems with their parents who neglect, over protect or abuse them.

Cunclusion:

The roles of different psychological stressors and vulnerability factores in attempted suicide will vary according to the time lapse from the stressor until the suicide attempt. understanding distal and proximal vulnerability factors involved in attempted suicide has important implications for both theory and practice.
HIV/Aids and Mental Illness Dual Diagnosis: Exploring Healthcare Professionals’ Perspective
Authors: Balzano R. , Guidi M. , Sepio D. , Martini L. , Puro V. , Girardi E. , Orchi N.
Published: March 2009

Aims:

A growing body of scientific literature emphasizes a strong linkage between HIV/Aids and serious mental illness. In the Italian context, specialized services for combined management of dual diagnosis are increasingly requested, and healthcare professionals (HPWs) have to face up the difficulty emerging by this new situation. To bridge these gaps, the present study aimed at studying the representations of dual diagnosis, analyzing HPWs’ experiences from their own perspectives, in order to understand their difficulty and create future good practices in healthcare services.

Method:

A quali-quantitative study was conducted with a multidisciplinary sample of professionals (N=91), drawn by HIV/Aids and Mental Health sites. Due to the exploratory nature of the research, data were collected from semi-structured interviews: HPWs were asked about their work experiences with HIV/Aids and Mental Illness. The interviews were fully audio-taped and verbatim transcribed. A computer-aided lexical correspondence analysis was conducted by a dedicated text-analysis software.

Results:

Data analysis showed out two main factorial dimensions: the first regarding the representation of the “Management of dual diagnosis within Health Services”, and the second one referring to the “categorization of HIV/Aids-Mental Illness co-morbidity”. Furthermore, four different Representational Conceptions were highlighted, corresponding to as many different ways HPWs use to represent/depict the aims of Health Service in relation to HIV/Aids-Mental Illness co-morbidity.

Conclusion:

This study reveals that socio-cultural meanings of dual diagnosis are not fixed; rather, they are ongoing co-constructed within the activities carried out by the HPWs involved in their specific health contexts in the exercise of their profession.
Using the DREEM-Italian Version to Evaluate the Recovery-Orientation of Pavia Rehabilitative Services
Authors: Boso M. , Barron E. , Secker J. , Pesenti S. , Morandotti N. , Orsi P. , Tarantola L. , Testori M. , Politi P.
Published: March 2009

We assessed the recovery-orientation of the Pavia Rehabilitation Services using an Italian Version of the DREEM (Developing Recovery Enhancing Environment Measure). A preliminary Italian Version of the DREEM was translated by the first author (MB) and a back-translation was carried out by a trained translator (MT). A third member of the research team (JS) resolved disagreements between the two versions by discussion and consensus with MB and MT. The final version was administered to the patients of the rehabilitation services of Pavia. 15 patients out of a possible 21 (71.4%) participated in the first interview. Demographic information including gender (53% male, 47% female), age range (26-35 years: 27%, 36-45 years: 33%, 46-55 years: 27%, 56-65 years: 6%, 66 years and over: 7%), ethnicity (Italian: 100%) was collected. 20% had been using mental health services for between 5 and 10 years, and 80% for more than 10 years. The section “elements of recovery and recovery enhancing services” scored 1.2 for “importance ratings for recovery elements” and 2.4 for “staff performance”, with a performance gap of 1.2. Mean scores for “organizational climate” and “recovery markers” were 2.3 in both sections. The mean score of 1.2 on the importance ratings shows that patients have a good understanding of recovery elements. The other scores reveal a fairly good recovery orientation of the service, but with a wide margin for improvements as indicated by the performance gap. The Italian version of the DREEM is useful; the results can promote reflections, discussion and learning within the staff.
Comparative Investigation of Maternal Health and Reha of the Mothers with Low Birth Premature Bilitation Infant, and Term Infants
Authors: Dabirzadeh S. , Kermani A. , Kermani S. , Kermani A.
Published: March 2009

Introduction:

The future of a society depends on children's health. Children's growth and health is directly influenced with mother's health. This study has targeted on defining and comparison of maternal health of mother's with low birth and premature with the one of mothers with term infants.

Materials and methods:

This descriptive analytic study was carried out on 200 mothers with low birth and premature infants selected by target focused sampling. The date were collated related to maternal health concerning weight, age, smoking, taken drugs pre delivery weight, times of pregnancy, anxiety due to crisis and maternal health care. The data were analyzed by descriptive and inferential statistics.

Results:

The findings related to mothers weigh before pregnancy showed that there was not a significant difference between most of the mothers with low birth and premature infants aged between 45 to 54 weight years and mothers with term infants of birth than 105kg (P< 0/01, DF= 182). Regarding maternal health in both groups there was a significant difference between taken drugs and duration and dosage, maternal health and anxiety.

And restlessness.

Since mothers play a major role in care of children and their own mental health influences their children physical and mental health, health team should play close attention to mothers mental physical and social health preservation in order to enhance their children physical and mental health as well.
Gender Differences in Family Burden Experienced by Caregivers to People with Intellectual Disability
Authors: Gutiérrez-Recacha P. , Martorell A. , Pereda A.
Published: March 2009

Background:

The term ‘family burden’ has been introduced to describe the adverse consequences of life with severely disturbed psychiatric patients. Its use has been extended to people with intellectual disability (ID). Literature has established a distinction between the intensity of worry and appraisals experienced by caregivers (subjective burden) and the real amount of resources (time, money, health, etc.) spent on the care (objective burden).

Aims:

To compare the possible effect of gender on the burden experienced by a group of caregivers to people with ID in Spain.

Methodology:

179 adults with intellectual disability clients of the Carmen Pardo-Valcarce Foundation's sheltered workshop in Madrid (Spain) were asked to participate in the present study along with their main caregivers. Burden experienced by caregivers was assessed with the ECFOS-II / SOFBI-II scale (Entrevista de Carga Familiar Objetiva y Subjetiva / Objective and Subjective Family Burden Interview). The tool has been validated for people with ID. It hasan introductory section plus 8 modules which assess different domains of burden.

Results:

Only two modules of the scale showed significant differences depending on the gender of the user. These modules refer to the need of assistance in everyday activities and motives for concern for the caregiver (p< 0.05).

Discussion:

In overall terms, caregivers experience the same level of burden when caring either for a son or for a daughter with ID. However, gender differences arise when considering specific domains, showing that social stereotypes can account for a higher level of subjective burden associated to female gender.
The Effectiveness of Little Bird Programme on Improvement of Mental Health and Decrease Parental Stress in Mothers of Autistic Children
Authors: Khorramabadi R. , Pouretemad H. , Dehghani M. , Mazaheri M.
Published: March 2009

This study was a trail of an intervention named Little Bird aimed to decrease parental stress and improve mental health in mothers of autistic children. The sample was 24 mothers of autistic children. The intervention compared across two groups, an intervention group and non-intervention control group. The result indicate that, compared with the control group, mothers in intervention group reported significant improvement in mental health and significant decrease in parental stress following the intervention, at the end of programme and 1 month follow-up.
Continuity of Care, Systems Integration and Patient Transitions: Central or Local Psychiatric Beds? The VELO-Project
Authors: Myklebust L.H.R. , Bjorbekkmo S. , Nymann A. , Molvik S. , Olstad R. , Sørgaard K.
Published: March 2009

Background:

Although scientifically controversial, continuity of care for patients with serious mental illness has long been a key-concept in the evaluation of deinstitutionalized mental health services. It is associated with systems integration, and particularly relevant in transitions from in- to outpatient status at the individual level. The theme is highlighted in a close to natural experiment that was part of the VELO-project, were two neighboring mental health service-systems diverge concerning their organization of in- and outpatient services.

Aim:

To investigate the significance of systems integration of inpatient and outpatient services on continuity of care for individual patients.

Method:

244 inpatients from the services case-registry (2005) were followed concerning their pattern of both inpatient and outpatient service use. The results were controlled for length of hospitalization, diagnosis and demographical variables.

Results:

Overall for inpatients, the low-integrated system shows significantly less outpatient activity than the high-integrated system. This pattern is not associated with differences in general service profile of the systems, and holds up for patients suffering from schizophrenia and anxiety, but not for affective disorders.

Discussion:

The results may be explained by differences in geographical and managerial organization of the two systems.

Conclusion:

High level of systems integration is important in reducing the risk of discontinuity of care for patients suffering from severe mental health problems. Level of integration may interact with differences in vulnerability for transitions of individual patients.
Relationship Between Developmental Problems and Family Functioning
Authors: Lopicic Z. , Perunicic I. , Djerkovic I.
Published: March 2009

Objectives:

A lot of theories point that developmental problems could be coused by many socio-psychological factors in children’s environment, especially in the family functioning. The purpose of the study is to investigate those factors.

Method:

The sample consisted of 60 children from a development counselling services and 90 children with no diagnosed disorders. The parents were administered: a questionnaire about socio-demographic characteristics (characteristics of family functioning in a primary family and in parents’ families; methods that parents use in upbringing and commitment of parents to the function of upbringing), GRADIR-test (measures family functionality).

Results:

We found statistically significant differences in family functionality between two groups of children. The characteristic of family functionality of children with developmental problems is that family relationships are more structured and emotional expression is reduced. By hierarchical regression analyses we found that statistically significant Betas that could predict developmental problems expresses a well functioning mother, aggressive, punishing father and a child with a weak impulse control.

Conclusion:

Our findings imply that families of children with developmental problems are well structured (rigid) and emotionally cold, fathers are aggressive and punishing and even though mothers are well functioning and shows healthy behaviour in upbringing, it seems that they don’t have as much influence as pathological patterns in family have.
Assessing Initial Patient’s Affective Disposition Towards the Hospitalization and the Treatment: A Validation Study
Authors: Pulido R. , Monari M. , Rossi N.
Published: March 2009

The present work shows some preliminary results of a longitudinal study aimed at validating a psychometric instrument - the Subjective Distance Scale (SDS) - developed to assess the patient's affective nearness/remoteness towards/from the psychiatric treatment in a Day Hospital program. 55 day hospital patients were assessed at different moments of the treatment: At admission they were evaluated by means of the SDS, the SCL-90-R (patient's psychiatric symptoms) and the GAS (patient's mental health level). Institutional therapeutic alliance was assessed one week from admission (IWAI-p) and finally, patient's psychiatric symptoms were retested (SCL-90-R) at the end of the treatment and 3 months from discharge. The main results reveal good psychometric properties of the SDS: its factorial structure partially confirms the dimensions theoretically hypothesised; its internal consistency - total and most of its subscales - reach adequate reliability levels; and related to its predicted validity, the scale correlates with some important aspects of the treatment, like the quality of the early institutional alliance, the symptomatic improvement and the stability of the improvements in time. New studies with larger samples and conducted in additional psychiatric settings are necessary to guarantee the validity and reliability of the scale before it could be used as a clinical screening instrument.
Coping with Loneliness when Death is Near
Authors: Rokach A. , Chin J.
Published: March 2009

The study compared the manner in which the dying, their caregivers, and the general population cope with loneliness. The patients were recruited in an oncological hospice in Israel, and despite being on their deathbed agreed to participate in the study. Thirty-seven cancer stricken patients, 78 caregivers, and 128 participants from the general population volunteered to partake in the study. They answered, anonymously, a 34-item yes/no questionnaire and were asked to endorse those items that described their strategies of successfully coping with loneliness. The dimensions of the coping strategies included: Reflection and acceptance which was defined as being by one's self and becoming acquainted with one's fears, wishes, and needs; Self-development and understanding, was defined as the increased self-intimacy, renewal, and growth; Social support network; Distancing and denial which was defined as denial of the experience and pain of loneliness through the use of alcohol or street drugs; Religion and faith; and Increased activity, the active pursuit of daily responsibilities. Results suggested the dying patient, his or her caregiver, and the general population cope with loneliness differently. Dying patients scored significantly lower than the general population on the Social support network and on the Increased activity subscales. The trend was reversed on the Religion and faith subscale. The present may be the first study to examine the manner in which the dying and their caregivers cope with loneliness. As such, more research is needed to replicate the present study, using larger samples.
Patients Satisfaction Within Community Mental Health Centres
Authors: Salčić D. , Mehmedbaić A. Bravo , Kučukalić A.
Published: March 2009

Introduction:

By the and of the war in Bosnia and Herzegovina process of psychiatric care reform has started by implementation of community mental health care concept. This way of mental health care organization is based on community mental health centres.

Aim:

Aim of this article is to assess the level of patients satisfaction with community mental health care provided within community mental health centers.

Method:

Research was conducted in three towns (Sarajevo, Zenica and Banja Luka) in Bosnia and Herzegovina in which the best possibilities for implementation of new organizational concept of care are existing. As research instrument adapted version of Patient satisfaction questionnaire within outpatient community mental health care was applied randomly with community mental health centers users.

Results:

In all targeted areas users of care expressed with high score their satisfaction with mental health professionals understanding for their situation and high level of trust toward mental health professionals. They were satisfied with time they spent with person who treat them, as well as with frequency of contacts with them, efficiency of therapy and efficiency of treatment in general. The level of satisfaction with the information regarding the treatment was optimal, but the lowest score for these items were registered in town Zenica.

Conclusion:

Results of the study, according to the level of patients satisfaction with services provided within community mental health centers, as a measure of their quality, indicates that focused community mental health centers provide services of good quality. It is neccessary to improve patients information regarding mental health disorder they are suffering from, as well as about treatment possibilities.
Psychiatric Consultation in Medico-Surgical Settings
Authors: Sirois F.
Published: March 2009

The author resents a frame for evaluating patients in various medical contexts and discusses principles of brief intervention. the frame relies on a basic assumption differentiating the approach of the mind from that of the brain whereby the subjective experience of the patient is compared with the reality process of medical procedures. In that specific context, psychiatric symptoms are seen as elaboration of the gap between the subjective experience of the patients and the objective medical assessment. Psychiatric evaluatiion is therefore subjected to that context where assessment of anxiety and coping mechanisms is paramount to search for the central psychic position from which the patient experiences the clinical episode. Principles of brief intervention are based on the interplay of psychic and external reality. Such principles are spelled out in ten different items along the clinical course of patients as to follow a short, stepwise path to help patients move from accommodating the external reality to their subjective experience to the other way around.
Correlation of Diagnosis, Risk Assessment and Involvement of a Care Co-Ordinator [CPA Status] in an English Community Mental Health Team
Authors: Agius M. , Kilsby A. , Zaman R.
Published: March 2009

Introduction:

The Care Program Approach [CPA] envisages that patients with serious mental illness who are deemed to be at risk [of self harm, harm to others, or serious deterioration of their condition] should have an appropriate assessment of needs, an appropriate care plan and should have an allocated care co-ordinator to implement the plan.

We investigated whether patients with Bipolar Disorder, Schizophrenia and Depression, who had recorded risk factors did indeed have an allocated care co-ordinator in a typical English Community Mental Health Team [CMHT]. This issue is of importance in describing ‘Treatment as Usual’ in a CMHT when comparing it to newer forms of management, such as assertive outreach teams.

Method:

We used a database held by a CMHT in order to assess whether all patients with the above diagnoses did indeed have an appointed care coordinator.

Results:

The results show poor correlation between diagnosis, presence of risk factors, and the appointment of a care coordinator. Interestingly, patients with bipolar disorder appeared more likely to have a care coordinator appointed than patients with schizophrenia. Patients with depression were least likely to have a care coordinator appointed.

Conclusion:

Lack of resources in the CMHT may account for the results. Another issue may be that, with treatment, patients may become less risk prone, but the work of the care coordinator may not be completed, and so the care coordinator may continue to be involved, thus being unable to move to other more needy patients in the team.
Perception of Primary School Teachers About Asperger’s Syndrome
Authors: Agyapong V. , Migone M. , Marckey B.
Published: March 2009

Objectives:

To assess the knowledge and perception of primary school teachers about Asperger's Syndrome (AS).

Methods:

Structured questionnaires about AS were posted to 90 primary school principals for them to distribute to teachers in their schools.

Results:

343 completed questionnaires were returned by 54 principals giving a response rate of 60%. Of these, 49% of the teachers reported that recognition and management of emotional and behavioural disorders was covered in their undergraduate training whilst 58% said they had ever taught a child with AS. 90% said intense absorption in certain subjects was a feature of AS, 84% recognised lack of empathy and poor social interaction whilst 58%, 64% and 69.7% respectively recognised pedantic repetitive speech, clumsy or ill-coordinated movements or odd postures and poor non-verbal communication as features of AS. 71% said children with Asperger's Syndrome should be taught in mainstream classes. However, only 10.5% of the teachers believed that main stream schools in Ireland are adequately resourced to cater for children with AS. 87.2% said they saw the need for a closer collaboration between schools and psychiatric services in the management of children with AS whilst 96.2% said they would like to receive in-service training on the management of children with AS.

Conclusion:

Most primary school teachers recognise the features of AS and want schools to have greater collaboration with psychiatric services regarding management of AS. An in-service training for teachers on the management of AS might be of benefit to children with AS.
Alopecia Areata in United Arab Emirate Adult Men’s Locals the Pattern and Profile
Authors: Almalmi M.
Published: March 2009

Background:

Alopecia areata (AA) is a recurrent nonscarring type of hair loss that can affect any hair-bearing area. Clinically, AA can present with many different patterns. Although medically benign, AA can cause tremendous emotional and psychosocial stress in affected patients and their families.

Objectives:

To study the pattern of alopecia areata in UAE adult men’s locals.

Patients and methods:

Twenty adult men united arab emirate local patients 20 to 40 years old presented with single or multiple hairless oval smooth skin lesions in the scalp and beared area. The duration was weeks or months. Skin and hair scraping and examined with 20% potasium hydroxide (KOH) for superfacial dermatophytosis was negative. There were no septic fossi. Most of the patients suffered or complained from anixiety neurosis, emotional stress, tention and social families problems. The treated with psychosocial reasssurance and interalesional injection therapy with Trimecinilone Acetonide (TA) vials for one set and they get better.

Results:

The clinical data, investigations, psychosocial analysis revealed that the twenty UAE locals had alopecia areata in the scalp or in the beared area. The most cuases were psychosocial.

Conclusions:

Alopecia areata in UAE adult men locals is very common hair and skin disorders. The psychological and social troubles play important role in the occurance. The governmental health departments as Dubai health organization (DOH), ministry of helath, (MOH) and Abu dhabi Health Authority (HAAD) in UAE must introduce psychological, social solutions, counciling and suporting for those patients.
Sexual Health in Parkinson’s Disease
Authors: Azevedo J. , Rosas M.J. , Esteves M. , Sousa C. , Vaz R. , Garrett C. , Palha A.
Published: March 2009

Introduction:

The changes in sexual health of patients with Parkinson's disease must be a concern to the clinicians. The effects in sexual health of patients submitted to functional cirurgy is still a matter of debate.

Objectives:

To describe and evaluate the sexual health of patients with Parkinson's disease following deep brain stimulation (DBS) of the subthalamic nucleus (STN).

Methods:

Patients with Parkinson's disease bilaterally implanted for DBS of STN and those only pharmacologically treated, will be evaluated. Sexual functioning will be assessed using the international erectile function indices (IEFI) and the female sexual function indices (FSFI). Depression and anxiety will be evaluated using the Beck depression inventory and the brief symptom indices. Relations between sexual functioning and modifications in the severity of disease (Hoehn and Yahr stage), reduction in levodopa equivalent daily dosage (LEDD), age, and duration of disease will be analyzed.

Results and conlusions:

We expect to find positive changes in the sexual health of these patients, given the fact of the procedure improve the overall burden of the disease by reduction of medication and motor symptoms.
Internet use by Patients with Psychiatric Disorders Searching for Medical Information
Authors: Balanzá V. , Tatay A. , Cepeda S. , Merino T. , Lloret M. , Laguna L. , Calabuig R.
Published: March 2009

Aims:

Despite the increasing use of the Internet to seek medical information, little is known about the web search for mental health information among psychiatric patients. We aimed to identify the patients’ demographic and clinical characteristics that better predict the search for medical information, as well as the most consulted aspects of psychiatric disorders.

Method:

Over a one-month period, a consecutive series of patients followed at one Spanish hospital psychiatric outpatient clinic completed a 13-item questionnaire about their personal Internet use.

Results:

Among the 144 participating patients (72% women), 61% reported having ever used the Internet, with lower search rates for general health (34%) and mental health (22%) data. There were no differences by sex, but Internet use was more frequent among younger and higher-educated patients, as well as among those with eating disorders and personality disorders. Patients were most interested in diagnosis and treatment facets. A model with age (exp.β=1.05; p=.001) and high-school education (exp.β=5.55; p=.004) predicted searching for general medical information and correctly classified 75% of the sample (R2=0.3; p=0.004). Age was the only variable predicting specific search about mental health (exp.β=1.05; p=.001), and correctly classified 76% of patients (R2=0.2; p=0.001).

Conclusions:

The results of this one-site pilot study went in the anticipated direction and suggest that possible differences in the access to Internet according to the diagnostic group merit further research with multi-centre, larger samples.
Autoimmune-Induced Pain Alters Affective Behaviors in a Model of Neuropsychiatric Lupus?
Authors: Ballok D.
Published: March 2009

As commonly seen in patients with neuropsychiatric systemic lupus erythematosus (NP-SLE), spontaneous disease onset in the MRL/MpJ-Faslpr/J (MRL-lpr) mouse model of NP-SLE is accompanied by increased autoantibodies, pro-inflammatory cytokines and behavioral dysfunction which precede neuroinflammation and structural brain lesions. Given that P2X purine receptors are important in peripheral "pain" signaling, the possibility that purinoception is involved in the development of aberrant affective behaviors was explored in the present study. Suramin, a P2X purinoceptor antagonist, was administered to lupus-prone mice from 5 to 14 weeks of age (60 mg/kg, i.p.). Novel object and sucrose preference tests were performed to examine behavior, and enzyme-linked immunosorbant assays for autoantibodies and pro-inflammatory cytokines were employed in immunopathological analyses. Suramin was found to attenuate markers of autoimmunity and inflammation, but was not immunosuppressive. Treatment did, however, prevent neophobic- and anhedonic-like deficits in MRL-lpr mice. More specifically, animals receiving the drug showed a profound 3-fold increase in their responsiveness to palatable solution (i.e. a reversal of anhedonia) and were less "distressed" by novelty. The present data supports the hypothesis that sustained activation of the peripheral immune system induces nociceptive-related behavioral symptomatology in lupus animals which is attenuated by the analgesic effects of suramin. It is proposed that anti-purine or cross-reactive autoantibodies cause neuronal hyperexcitability within "pain" pathways early in the disease process, which manifests as affective deficits. At a later stage of chronic lupus-like disease (following breakdown of the blood-brain barrier), fixed structural lesions in dopaminergic pathways likely account for and maintain impairments in emotionality.
Representation of HIV/Aids and Mental Health Co-Morbidity in Medical and Social Sciences Literature
Authors: Balzano R. , Sepio D. , Guidi M. , Puro V. , Girardi E. , Orchi N.
Published: March 2009

Introduction:

Aim of this article is to explore the ways in which, over the last 25 years, knowledge about HIV/Aids and Mental Health co-morbidity has been represented within medical and social sciences literature.

Methods:

The study has been conducted on the texts of 1101 published manuscripts abstracts within from 1984 to 2008, referring to 379 different journals and retrieved on PUBMED database. It was used the following database search string: ("mental health"[Title/Abstract]) or ("mental illness"[Title/Abstract]) AND (("aids"[Title/Abstract]) or ("hiv"[Title/Abstract]))). A Computer Aided Text Analysis was conducted with dedicated software: T-Lab (Lancia) using Cluster Analysis.

Results:

Cluster Analysis allowed to identify five different main dimensions: 1:(27,68%) Health-care Service organizational development; 2: (22,10%) Mental health as empowering precursor of infection risks. 3: (8,58%) Quality of life; 4: (19,17%). Therapies and treatments’ research; 5: (22,46%) Psychological issues, emotions and distress correlated to seropositive patients and their caregivers. Figure 1 it is a way to outline the five clusters literature trends over the time of 25 years.

Conclusions:

Our review could help to identify particular areas in need of change, to provide a baseline against which to assess future changes and to provide data for use in research health planning and policy analysis.
Fibromyalgia: Relationship Between Pain and Mood
Authors: Barreiro A. , Arroita A. , Ugarte K. , Arnaiz A. , Sarasola A. , Zallo E. , Agote J. Perez , Gandarias A.A.
Published: March 2009

Introduction:

Fibromyalgia is an entity with idiopathic etiology affecting 2-4% of population. It is a frequent cause of disability, its most usual symptoms being diffuse pain and fatigue. There is evidence that alterations in several chemical and hormonal factors could explain changes in pain perception mechanisms, accounting for some of the symptoms. However, the high incidence of comorbid psychiatric disorders tends to indicate there is an associated psychopathology in fibromyalgia patients, especially regarding affectivity. Some authors believe fibromyalgia could be considered an evolution of the concept of neurasthenia already defined by Beard in 1860.

Materials and methods:

Comprehensive review of the scientific literature (Medline, Psychoinfo, Medex) on fibromyalgia and pain mechanisms published over the last three years.

Results:

Mood regulation has been linked to pain perception through neurotransmitters and brain structures. Also, several studies state that depression changes the neuroendocrine, immune and processing regulation of pain.

However, some researchers believe there is enough evidence for a psychiatric approach to fibromyalgia, as there is a relationship between depression and fibromyalgia. Thus, fibromyalgia could be considered an affective disorder.

Conclusion:

Current research does not clearly show whether pain precedes affective alteration or the other way round, or whether mood and pain depend on common mechanisms.
Maintained Attitudinal Changes in Nursing Personnel After a Brief Training on Suicide Prevention
Authors: Botega N. , Silva S. , Reginato D. , Cais C. , Rapeli C. , Mauro M. , Stefanello S.
Published: March 2009

Aim:

To verify whether nursing personnel working at a general hospital change their attitudes after a brief training course on suicide prevention and if these newly acquired attitudes persist over a 6-month time.

Method:

317 nursing personnel attended a 6-hour training program. They answered anonymously pre- and post-training the Suicide Behavior Attitude Questionnaire (SBAQ) which comprises 21 visual analogue scale items divided in three factorial sub-scales. The scores on each SBAQ sub-scale (dependent variable) were compared along the time using ANOVA for repeated measures with rank transformation. The time of the measurement and characteristics of the nursing staff were considered as independent variables.

Results:

There have been positive changes in the attitudes and these gains were significantly maintained at the 6-month follow-up evaluation. Improvement was in the Feelings and Professional Capacity factorial subscales (p = 0.0001 and 0.01, respectively). There was no change on the Right to Suicide subscale.

Conclusion:

It was possible to demonstrate positive changes in the attitudes of nursing personnel as assessed six months after a brief training course on suicide prevention. As attitudes influence the effectiveness of the health care personnel interventions our findings may have important implications for the development of suicide prevention programs.
Validity of the Edinburgh Postnatal Depression Scale
Authors: Bunevicius A. , Kusminskas L. , Bunevicius R.
Published: March 2009

Depression is prevalent postpartum and is a major health problem. In this study we aimed to evaluate how precise the Edinburg Postnatal Depression Scale (EPDS) is in screening for depressive disorders postpartum. A random sample of 94 pregnant women was interviewed two weeks postpartum using the Composite International Diagnostics Interview Short Form (CIDI - SF) and filled in the EPDS. We evaluated:

a.

internal consistency of the EPDS by the means of Cronbach's alpha coefficient;

b.

area under the ROC curve, sensitivity, specificity of the EPDS against the CIDI-SF diagnoses of depressive disorders.

The internal consistency of the EPDS was at a level of 0.83. The optimal cutoff score of the EPDS for screening CIDI-SF diagnoses of depressive disorders was found to be 7 and more with area under the ROC curve at a level of 0.83, sensitivity of 92% and specificity of 73%. The EPDS has a good reliability for a screening instrument and has to be used a cutoff score of 7 and more for screening of depressive disorders postpartum.
Resident Burnout: What to do About it?
Authors: Castro L.C. , Pais V. , Cortinas A.
Published: March 2009

Background:

Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism and inefficacy. Resident physicians have intense work demands, limited control and high responsibilities in the workplace, making them more vulnerable to job burnout.

Aim:

To review studies in the medical literature that address the theme of burnout in residents and discuss relevant resources and interventions for residents with burnout.

Methods:

MEDLINE and PubMed databases searches for peer-reviewed studies, published between 1990 and 2008, using combinations of the Medline Subject Heading terms professional burnout and internship and residency.

Results:

The studies report high levels of burnout among residents. The reported residents’ strategies for coping with stress are diverse and include talking with family, significant others or other residents and practicing physical activity. Some studies investigated the role of stress management workshops for residents, reporting decline of emotional exhaustion levels in residents after the workshops.

Discussion:

The literature on resident burnout is still sparse. The reviewed studies suggest that residents from various specialties, internationally, experience burnout. Understanding resident burnout can be enhanced by more rigorous research, studying different intervention strategies. Burnout prevention and management can contribute to better personal outcomes and ultimately provide better patient care.
Psychiatric Emergency Service use in Coimbra University Hospitals: Results from a 6-Month Cross-Sectional Study Sample
Authors: Cerejeira J. , Firmino H. , Boto I. , Rita H. , Santos G. , Teixeira J. , Vale L. , Abrantes P. , Vaz Serra A.
Published: March 2009

Aim:

The Psychiatric Emergency Service (PES) is an important part of the mental health care system for the management of acute conditions requiring prompt intervention representing also a significant part of workload of specialists and trainees. The objective of this study was to characterize the clinical features of patients observed in PES of Coimbra University Hospitals.

Method:

During the first 6 months of 2008, demographic and clinical data were obtained for all patients observed by the first author of the study, together with a specialist in Psychiatry.

Results:

The sample consisted of 159 patients, 103 females and 56 males. Mean age was 45,9 ± 18,367 years. The majority of patients presented in the emergency room either alone (56,6%) or with a first degree relative (34,6%) by self-initiative and having a past psychiatric history (71,1%). Disturbing mood symptoms (depression, anxiety or both) were the motive of assessment in 58% of patients but several other causes were reported including behavioural symptoms, agitation, psychosis, drug or alcohol related disorders, sleep and cognitive disorders. Average Clinical Global Impression was 4,12 ± 1,177. After the psychiatric assessment, several diagnosis were made namely Major Depressive Episode (14,5%), Adaptation Disorders (13,9%), Schizophrenia and related disorders (13,8%), Anxiety Disorder Not Otherwise Specified (11,9%) and Drug or Alcohol related disorders (8,2%). Most patients were discharged without referral (50,3%).

Conclusion:

A significant percentage of patients went to the PES for conditions that could have been treated by a primary care physician or in an outpatient clinic setting.
Depression, Anxiety and Sleep Disorders in Patients with Chronic Rheumatic Pain
Authors: Cerejeira J. , Madeira N. , Miguel C. , Matos M. , Quartilho M.J.
Published: March 2009

Aims:

Chronic pain irrespective of its origin can be a major factor of significant distress inducing high levels of anxiety, depression and sleep disturbance. These symptoms can, by their turn, aggravate the perception of pain. The objective of this study is to characterize mood, anxiety and sleep pattern in patients with chronic rheumatic pain.

Methods:

Patients observed in the Psychosomatic Consultation of Coimbra University Hospitals from January 2008 with chronic rheumatologic pain were included in the study. They were prospectively assessed (twice in average) by a Psychiatrist for mood, anxiety, sleep, general status and levels of pain with standardized rating scales.

Results:

Thirty-two female patients were included in the study. Mean age was 51,22±7,37 years. Depression and levels of anxiety both correlated positively with Clinical Global Impression Scale but not with the level of pain reported by the patient. Moreover, although a significant proportion of the patients reported sleep disturbance, especially in the beginning and in the middle of the night, this was not correlated with levels of pain.

Conclusions:

This study suggests that chronic pain is not a predictor of depression and anxiety and does not fully explain the distress reported by patients with chronic rheumatic disorders. Assessment of other factors such as personality traits, coping styles and maladaptative health behaviours should be part of the routine intervention in these subjects.
Depression, Anxiety and Health Status in Patients with Multiple Sclerosis
Authors: Chylova M. , van Dijk J.P. , Rosenberger J. , Nagyova I. , Gavelova M. , Gdovinova Z. , Groothoff J.W.
Published: March 2009

Aims:

Multiple sclerosis (MS) is the most common cause of neurological disability in young adults and is frequently accompanied by symptoms of depression and anxiety. The aim of this study was to explore the association of depression and anxiety with health status in younger and older MS patients.

Method:

223 MS patients (67.3% female; mean age 38.9±10.8 years; mean disease duration 5.8±5.2 years) were divided into younger and older age groups (< 45 and ≥45 years). They completed questionnaires focusing on sociodemographic data, depression and anxiety (HADS), and physical and mental health status (SF-36). Functional disability (EDSS) was assessed by a neurologist. To analyse the data, a U-test and multiple linear regression analyses were performed.

Results:

A model consisting of age, gender, marital status, EDSS, depression and anxiety explained 46.6% of the variance in physical health status and 60.8% of the variance in mental health status (p≤.001). Depression was a significant predictor of physical health status in older MS patients and was associated with mental health status in both age groups (p≤0.001). Anxiety was related to worse physical and mental health status in younger MS patients, but not in the older ones.

Conclusion:

Depression in MS patients is associated with mental health status and with physical health status only in the older group; anxiety is associated only in younger MS patients with regard to their health status. Psychiatric diagnostics focusing on depression and anxiety might be important for treatment of MS patients in order to contribute to improving a patient's health status.