bluuebunny/crossref_metadata_2025 huggingface dataset:
The needs of people with mental health problems and their carers’ burden - polish study
Authors: Ciałkowska-Kuźmińska M. , Piotrowski P. , Kiejna A.
Published: May 2011

Introduction

World studies show associations between social consequences of carers’ involvement and level of individuals’ met and unmet needs.

Objectives

In Poland not much interest has been put to studies of psychiatric patients’ needs and carers’ burden. Due to this fact most of care programmes have been developed on the basis of authors’ personal experiences or academic knowledge.

Aims

To obtain data regarding met and unmet patients’ needs and the impact on carers’ burden in Polish socioeconomic reality.

Methods

60 psychotic inpatients were examined with CSHI, BPRS and CANSAS. Their 60 direct carers’ personally completed IEQ, GHQ-12 and assessed own opinions about patients’ needs with CANSAS questionnaire. Patients unable to give informed consent, alcohol/drug dependent, mentally retarded/demented or with personality disorder were excluded along with patients below 18 and over 65 years of age.

Statistics included

The Pearson correlation coefficient, the Spearman’s rank correlation coefficient, Kendall’s tau coefficient.

Results

Results show significant relation between duration of the disorder and number of unmet needs assessed by individuals. Patients’ met needs are positively associated with carers IEQ results - subscales tension and worrying. Carers evaluation of patients’ unmet needs correlates with their IEQ results - subscales tension, worrying and urging. Overall number of patients’ needs indicated by carers correlates positively with carers’ results of IEQ subscale - urging.

Conclusions

The higher rate of patients’ unmet needs the higher burden they are imposed to. Results of the study are important in planning of interventions towards psychiatric patients and their direct carers.
Epidemiology of generalized anxiety disorder (GAD) and other anxiety disorders in the Czech Republic
Authors: Csémy L.
Published: May 2011

Introduction

The most frequently psychiatric ailments in Europe are anxiety disorders

Objectives

The goal of our study is to estimate the prevalence of general anxiety. disorder (GAD) and other anxiety disorders.

Methods

Personal interviews were conducted with a sample of 3,244 Czech citizens (between 18–64 years old). The Mini International Neuropsychiatric Interview (M.I.N.I.) had been used to estimate the prevalence of psychiatric conditions in respondents.

Results

In sum, 8.3% (95% CI: 7.6 - 9.0) of the respondents fulfilled the criteria for current anxiety disorder. Generalized anxiety disorder was the most prevalent of all anxiety disorders; comprising 3.6% (3.0% in males and 4.2% in females). The current prevalence for other anxiety disorders are: panic disorder 1.6%, social anxiety disorder 2.1%, OCD 2.2%, and PTSD 1.4%. Prevalence of anxiety disorders is higher in females compared to males (10.3% to 6.1%). Approximately 44% of respondents with anxiety disorders reported psychiatric treatment during their lifetime (4.9% inpatient treatment) in comparison to 13% without diagnosis of any anxiety disorder.

Conclusions

The results confirmed the extent of anxiety disorders in the adult population of Czech Republic. The fact that a majority of individuals who receive a diagnosis are never treated for mental health disorder denotes that early identification in a primary care level should be improved.
Criteria of evaluation of activity of psychiatric establishments at carrying out of the all-russia competition “for innovation in region of mental health”
Authors: Danilova S.
Published: May 2011

Competition

For innovation in region of mental health» has been conducting since 2008 in Russia. There are three nominations of Competition: psychoeducation, psychorehabilitation, psychoenlightenment. The missions of Competition are to celebrate humane, original, innovational works of doctors-psychiatrists, social organizations, to pay the attention of power and public for present interest problems of psychiatry, antistygmatization of psychiatry. The victor of Competition is a best region of Russian Federation. Dispensaries of psychiatry, hospitals of psychiatry, social organizations take part In Competition. The scale of evaluation of activity of establishments on 5 ball system has been developed. In a nomination psychoeducation such criteria as novelty of carrying out of psychoeducational programs, regularity in distribution of the information, concerning vital topics and psychiatry problems, formation of groups of support of families, carrying out of lectures, seminars for patients, relatives, experts, presence of own newspaper or magazine in establishment, the book edition, the feedback presented by responses, letters of thanks of patients, relatives on carried out actions are estimated. In a nomination psychorehabilitation following criteria are estimated: novelty of carrying out of psychorehabilitation actions, activity in carrying out of rehabilitation work, humanity in carrying out of rehabilitation actions, carrying out in establishments of exhibitions of works of patients, charitable trips, the response to carried out actions. In a nomination psychoenlightenment is considered representation by establishment of the information to television, the press about stigma in psychiatry and measures on its decrease, about public opinion about mentally sick, psychiatrists and psychiatry, about possibilities of a modern psychiatric science.
Coercive measures in italian inpatient units: results from eunomia study
Authors: Del Vecchio V. , Giacco D. , Luciano M. , Del Gaudio L. , De Rosa C. , Fiorillo A. , Maj M.
Published: May 2011

Introduction

The use of coercive measures in clinical practice represents a common, but understudied problem in Europe. In 2002–2005, the European Commission funded the study “European Evaluation of coercion in psychiatry and harmonization of best clinical practice” (EUNOMIA), coordinated by the Department of Psychiatry of the University of Dresden and carried out in 12 European countries.

Objectives

This study, carried out on the Italian EUNOMIA sample, aims to:

1)

assess the use of coercive measures in five Italian mental health inpatient units;

2)

identify the patients’ socio-demographic and clinical characteristics associated with the use of coercive measures;

3)

investigate the effect of coercive measures on the outcome of the patients.

Methods

The Italian sample included 294 admitted patients. Data were collected on coercive measures (physical restraint, seclusion and forced medication)

Results

Almost 30% of the patients received coercive measures during their hospitalization; in particular, 22% received forced medication, 9% were restrained or fixed by mechanic devices, 7% were seclused. The most frequent reason for prescribing coercive measures was aggression against others. Patients who received coercive measures were more frequently male, with higher BPRS scores and a worse social functioning. At three months after discharge, they showed higher levels of positive symptoms, and reported more negative opinions on the need of hospital admission and on the appropriateness of psychiatric treatments.

Conclusions

In Italy coercive measures are in most of the cases applied to the patients affected by more severe psychopathology and disability.
The effect of racial bias on the prescribing practice of a newly established psychiatric unit
Authors: Seretis D. , Apostolopoulos A. , Nikolaidou P. , Lembidaki M. , Douzenis A. , Lykouras E.
Published: May 2011

Introduction

Psychotropic medication prescribing can be a powerful indicator of racial bias. However, despite extensive research, mostly conducted with outpatients in developed western countries, findings are inconsistent.

Objectives

In response to prior studies reporting racial bias in inpatients with schizophrenia, comparing for doses of drugs between native and non-native inpatients, the authors investigated whether discrepancies in use of medication can be explained by negative ethnic bias.

Aims

To test for differences in prescribing for psychiatric inpatients fulfilling criteria for either schizophrenia and other psychotic disorders or major depressive or bipolar I disorder, focusing on use of drugs and including the use of SSRIs-SNRIs and mood stabilizers.

Methods

In a naturalistic study of consecutive voluntary admissions we overall controlled for 12 confounding variables. Prescribing practice was compared between the groups for five outcomes: Use of polypharmacy, use of typical antipsychotics, atypical antipsychotics, SSRI's-SNRI's and mood stabilizers.

Results

Use of polypharmacy and use of atypical antipsychotics were not associated with ethnicity. On the other hand, non-Greeks were less likely to receive SSRIs-SNRIs, less likely to receive mood stabilizers and more likely to receive typical antipsychotics, compared to Greeks.

Conclusions

Ethnicity did not seem to influence Greek psychiatrists’ prescribing. It appears that in this country, which has started receiving immigrants only recently, racial stereotypes are not firmly established. Other explanations are also discussed as ethnicity can influence psychiatric practice in many, often subtle ways. Future research might investigate racial bias in regard to disorders other than schizophrenia.
A prospective analysis of youth violence in adolescents: influence of depression, personality, social environment and media violence
Authors: Ferguson C.
Published: May 2011

Objective

Understanding youth violence remains a pressing issue of social concern. Identifying key risk factors for youth violence may help guide prevention and intervention efforts.

Aims

To examine the relative impact of varying social influences related to family, community, mental health, television and video games on youth violence in a multivariate format.

Study design

The current study involved a one-year prospective study of multiple risk and protective factors for youth violence in a Hispanic-majority sample of early adolescents. Multiple regression was used to examine risk factors from a multivariate format.

Results

Results find that current depression level was the most significant risk factor for youth violence. The influence of depression was most pronounced in individuals with preexisting antisocial personality traits. Risk and protective factors related to schools, neighborhoods, family environment or video game or television violence use were not predictive of youth violence.

Conclusions

Potentially, prevention efforts which focus on mental health issues may demonstrate the most positive effects. The degree of resources and rhetoric spent on other factors, particularly television and video game violence may conversely proove unhelpful in reducing youth violence.
Promoting mental health minimising mental illness and integrating through education (PROMISE)
Authors: Flores P. , Izquierdo R. , Leahy E. , Masferrer C. , Ryan P.
Published: May 2011

With the implementation of the European Green Paper on Mental Health, and the development of the Mental Health Pact, the strategic importance of Mental Health promotion and illness reduction as keystones of a European mental health policy and practice has never been greater.

The PROMISE project is a EU project and is financed by the European Commission, Directorate General for Health and Consumers, DG Sanco. It aims to develop and disseminate guidelines for generic training and education with respect to Mental Health Promotion and Illness Reduction. The best practice guidelines will specifically focus on the prevention of suicide, depression, and alcohol and drug abuse, and the promotion of healthy living.

A specific innovation is the involvement of mental health service users as non-traditional actors by developing multi-disciplinary training guidelines and training programs with a special emphasis on positive mental health, healthy living, diet and exercise project.

Project partners are all ‘multiplier’ organizations from 8 different European countries and have extensive previous expertise in their designated roles.

The role of Parc de Salut Mar, Barcelona PROMISE is: Identify best practice media guidelines for engaging press and media with the mental health promotion agenda through the use of positive role models. Monitor the implementation of the best practice guidelines through the design and development of local case studies in 7 sites across Europe.

Outcomes are an integrated and comprehensive set of training guidelines and model training programs accessed through an interactive website, endorsed by European level professional body and university networks.
Graduate medical education and effects on the recruitment of psychiatrists in Austria
Authors: Friedrich F. , Mczoch-Czerny M.-T. , Spiegel W.
Published: May 2011

Objectives

The recruitment of medical graduates into and retention within the specialty will be one of the major problems confronting psychiatry.

Aim

The aim of the study was to explore how many physicians intended to be psychiatrists and how many of those physicians practising as psychiatrists originally desired this area of expertise

Methods

For this cross-sectional survey, a self-administered questionnaire with 12 items was sent to all licensed physicians (n = 8127), based on the register of the Vienna Medical Chamber in June 2000

Results

2736 respondents (34%) completed the questionnaire validly. 50.3% (m: 43.2%; f: 58.6%) of all physicians in Vienna did not achieve their desired subject, whilst 86% of psychiatrists did so. These study results represent the highest percentage compared to other medical specialisations. Further, 6% of all physicians (m: 5%; f: 7%) initially defined psychiatry as their desired medical career regardless whether they attained this specialty later on or not. An average of 9% of all physicians changed their minds about their preferred specialty during their training.

Conclusions

Compared with other specialties the average number of physicians who practice a specialty different from the one desired is low in psychiatry. We think that this fact constitutes a favourable aspect with regard to recruitment of graduates for specialty training in psychiatry. Data found in this survey are similar to other studies conducted in German speaking countries, when focussing on psychiatry as desired career.
The validity of three different versions of the general health questionnaire among general hospital inpatients
Authors: Friedrich F. , Alexandrowicz R. , Benda N. , Krautgartner M. , Cerny G. , Wancata J.
Published: May 2011

Objective

Originally, the General Health Questionnaire (= GHQ) was designed to detect mental disorders among general medical outpatients and in community. The aim of the present survey is to compare the criterion validity indices of three different GHQ versions among general hospital inpatients when using different scoring methods.

Method

The GHQ-30 was filled in by inpatients prior to the research interview. For psychiatric case-identifiation the Clinical Interview Schedule was performed by three research psychiatrists.

Results

The final sample consisted of 993 inpatients. When comparing the three different GHQ-versions, no significant differences were found in OMR and ROC-AUC as well as in sensitivity (0,612–0,701) and specificity (0,601–0759). When comparing the four scoring methods no significant differences were found in sensitivity. By contrast, OMR and specificity showed better indices for the 20 item and 12 item GHQ versions when using the bimodal and modified Lickert scoring method. Further, the Lickert scoring method showed no significant differences to the other scoring methods for the GHQ-30, where as the modified Lickert and the bimodal method showed lower OMR and higher specificity compared to the chronic method.

Conclusion

Due to the results of this survey, the future use of the chronic scoring method for the GHQ has to be questioned when used for general hospital inpatients.
Factorial structure of the general health questionnaire (GHQ-30) among psychiatric and somatic patients
Authors: Frydecka D. , Malyszczak K. , Chachaj A. , Kiejna A.
Published: May 2011

Background

The Goldberg's 30-item General Health Questionnaire (GHQ-30) is used as a screening instrument for psychological distress in the general population. GHQ-30 has been widely used as a unitary measure, but several underlying factors have been identified in previous studies based on factor analyses.

Aim

To analyze the internal consistency and the factor structure of the Polish version of GHQ-30 in the group of somatic and psychiatric patients’ subpopulations. Differences in factor structure among those two groups might have important implications for how the test is used in those populations.

Methods

A total of 1473 patients (807 psychiatric and 666 somatic) were included into the study. A total score was calculated with Likert method. The principal factor analysis with orthogonal varimax normalized rotation was used for the factor extraction.

Results

The GHQ-30 was found to have high internal consistency. The factorial analysis conducted for the whole group, as well as for psychiatric and somatic patients separately, showed that two factors labeled as followed can be abstracted from the global scale: “depression and anxiety” and “interpersonal functioning and general coping”. These factors jointly account for 54,2% – 62,3% of the variance.

Conclusions

Results showed that GHQ-30 may be used both as a unitary measure using full-scale sores and allows to get more detailed information about individual's intra- and interpersonal functioning.
Dangerousness and mental disease in France: From stigmatization to prevention process
Authors: Gheorghiev C. , Lahutte B. , Boisseaux H.
Published: May 2011

Introduction

Although in close and old connections with psychiatry, dangerousness exceeds psychiatric field because of its transversal feature. By involving a potential attack of others’ integrity, dangerousness implies a social dimension.

Objective

The aim was to study social representations of mental disease, which are dominated by the specter of dangerousness and lead to its stigmatization, in order to outline a prevention prospect.

Method

The method was based on a review of literature of main French studies of social representations of mental disorder and mechanisms which lead to its stigmatization.

Results

The representations of psychiatry in general population are homogeneous and consensual, organized around the figure of the « mad », the « mentally ill » and the « depressive people ». Madness and mental disease are associated with the most violent behaviors and the use of psychoactive drugs. Two dimensions appear in the representation of the dangerous individual, one linked to a trained aggressiveness, the second to an impulsive aggressiveness, confirming the validity of the usual distinction between criminological and psychiatric dangerousness. Three main data are at the source of stigmatization : the fear of what is discerned like a threat, the anomaly through the difference which is carried, and the social regulation.

Conclusion

The struggle against mental disease stigmatization can be part of a prevention process allowing through the rehabilitation of the patient in the society the performance of a care which exceeds the simple treatment of the disorder.
Mental health policy in Greece: Implications into practice in the era of economic crisis
Authors: Grammatikopoulos I. , Koupidis S. , Petelos E. , Theodorakis P.
Published: May 2011

Introduction

Budgets allocated for mental health make up a relatively small proportion of total health expenditures, although there is an increasing burden of mental disorders.

Objectives

To review the mental health situation in Greece with regards to mental health policy through review of relevant literature.

Aims

To explore the basic implications of the economic crisis from a health policy perspective, reporting constraints and opportunities.

Methods

A narrative review in PubMed/Medline along with a hand search in selected Greek biomedical journals was undertaken, relevant to mental health policy.

Results

Greece is among the OECD countries with high health expenditure as a percentage of Gross Domestic Product (9.7% of GDP in 2008) but it doesn’t have a specified budget for mental health and is mostly depended in out-of-pocket expenditure (48%). The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management and poor incentives in the public sector. The lack of cost-effectiveness and the informal payments comprise a major source of inequity and inefficiency. Uneven regional distribution of psychiatrists exists and rural areas are mostly uncovered by mental health care facilities, as well as extramural mental health units and rehabilitation places, despite the current reorganization of the whole mental health care delivery system.

Conclusions

The core problem with mental health services in Greece is the shrinking budget with poor financial administration consistent with inadequate implementation of mental health policy. A clear authority with defined responsibility for overall mental health policy and budgetary matters is needed.
Mapping service development: A comparison of UK and US studies
Authors: Grant Hay A. , Woppmann A. , Walder N. , Szmukler G. , Schrank B.
Published: May 2011

Introduction

Reasons for differences in the effect sizes of studies on complex interventions, such as assertive outreach, between the US and the UK are a much debated topic. One possible explanation was suggested to be the potentially different quality of standard care in the two countries.

Aims

We aimed to

(i) empirically establish the comparability of research results on complex interventions for people with severe mental illness (SMI) from the UK and the US, and

(ii) explore developments over time in standard care in both countries by comparing studies that use “treatment as usual” (TAU) as the control intervention.

Methods

We conducted a systematic review and meta-analysis of RCTs conducted in the UK or the US

(i) involving people with SMI,

(ii) comparing complex interventions with TAU, and

(iii) using the outcome relapse or readmission to hospital.

Results

The Risk Ratios for relapse/readmission were very similar and favouring experimental treatment both in the UK (RR 0.80, CI 0.73–0.88) and the US (RR 0.87, CI 0.79–0.95). The development of effects resulting from experimental interventions relative to those from TAU over time shows a slightly different pattern for the two countries.

Conclusions

The broadly similar total RR for relapse/readmission in both countries confirms the comparability of studies conducted in the UK and the US and suggests no significant overall difference in the quality of standard care. The chronological development of effects, however, reflects developments in TAU over time which differ between the two countries.
Psychatric morbidity among third year medical students at Ain Shams University, Cairo, Egypt
Authors: Ibrahim J.
Published: May 2011

Background

Mental distress among medical students is often reported. Different psychiatric disorders are found to be under recognized yet common and treatable among medical students. Various previous studies have shown that medical students are subjected to considerable stress over the last decades. The aim of this study was to determine the presence of clinically significant psychiatric morbidity among third year medical students, to explore the effects of the socio demographic background for these outcomes and to analyze gender differences regarding selected psychiatric morbidities.

Methods

A cross sectional study is carried out among third year medical students from Ain Shams University. They were assessed using Social Classification Scale and Structured Clinical Interview for DSM-IV (SCID I) to assess psychiatric morbidity.

Results

Response rate was 98.9%. Prevalence of psychiatric morbidity among our medical students sample was 59.9%. No significant statistical association between psychological morbidity and any of the socio demographic variables. The most prevalent psychiatric diagnosis was found to be depression (47.9%), followed by Generalized Anxiety Disorder (GAD) (44.9%) & Obsessive Compulsive Disorder (OCD) (44.4%). The least prevalent of which was Anorexia Nervosa (0.7%).

Conclusion

Significantly high proportion of medical students (59.9%) had ongoing psychiatric condition and that proactive interventions should be addressed to encourage those medical students to seek help for their psychiatric problems. Counseling and preventive mental health services should be an integral part of the routine clinical facilities caring for medical students.
Qualitative evaluation of archived files of pasychiatric ward of Imam Hossein Hospital during years of 2007 to 2008
Authors: Kia A. , Ardestani S.M. Samimi
Published: May 2011

Introduction

Medical records include information about the status and the hospital course of a patient and the instructions given to the patient. The accurate, accessible and up to date information can be used for further evaluation of the patient and also probable research projects.

Objectives

Qualitative study of the archived patients’ files.

Aims

Evaluating the quality of the medical records at the psychiatric ward.

Method

The study was an observational descriptive study in which 400 archived files at the psychiatric ward of Imam Hossein Hospital during the years of 2007 and 2008 were qualitatively studied. The data was gathered by a data sheet and was analyzed using SPSS v. 15.0.

Results

Among patient's demographic information, place of birth was not recorded in 82% of the files followed by birth date that was missing in 38% of the files. Case history, psychiatric formulations and progressive notes of patients were not appropriately recorded in 2.5% of the patients’ files. Finally, the summary sheets did not clarify the main complaint in 11.7% of the files and 7.5% of them lacked information to indicate dates of admission and discharge. Only 21.25% of the summaries defined initial and final diagnosis.

Conclusion

With regards to the results and since there were incomplete data; the information could not be properly used as the raw material for researches. It seems that more supervision is needed to completely fill the files.
Mental health care pathways
Authors: Kingdon D. , Gregoire A.
Published: May 2011

Introduction

The term, care pathway, has been used to describe multidisciplinary/ multi-agency outline of anticipated care, placed in an appropriate timeframe, to help a patient with a specific condition or set of symptoms move progressively through a clinical experience to positive outcomes. In practice, a multitude of disparate projects have produced outputs ranging from pages of interconnected boxes and arrows with rather basic entries to thick and indigestible wads of paper. Certainly the idea of a ‘mental health care pathway’ accessible and used by the general public, service users, carers, primary and secondary care has seemed overwhelmingly complex and unworkable.

Aims & objectives

To make relevant service and clinical information available when and where in a person's progress or a clinician treatment path it was needed.

Method

Website hyperlinks allow linkage within websites and to other websites with relevant information (e.g. ICD10, NICE guidelines, and Patient information leaflets). A development prototype funded by the UK NHS has been established to form the basis for a website to be launched in mid-2011 (www.mentalhealth.southcentral.nhs.uk).

Results

The prototype contains links to evidence-based information on maintaining mental health and on ‘coping with problems’. Service Pathways describe detail of processes occurring in mental health care. Diagnostic care pathways start as broad categories [Kingdon et al, 2010] with links to diagnosis, medication (e.g. connects to the National Formulary) and psychological management sites.

Conclusions

Web technology allows information about mental health care pathways to be accessed more systematically and readily and has application internationally.
The correlation between acculturation stress and acculturation dreaming process
Authors: Lee S.B.
Published: May 2011

Aim

The purpose of this study was to test the correlation between acculturative stress scale and acculturation dream scale and to verify previous research outcomes.

Methods

165 Korean American undergraduate and graduate students (M age = 23.3, SD = 4.1) participated in this study. They submitted the most recent dreams and assessed acculturative stress scale. Total 165 dreams were coded by “Lee Acculturation Dream Scale” (Lee, Sang Bok, 2005: Psychological Reports, 96, 454–456). The hypothesis was that the group members having higher acculturative stressscale would have lower acculturation dream scale than the group members with lower acculturative stress scale.

Results

The first generation Korean American students group (n = 80, M age = 23.4, SD = 4.2) had higher acculturative stress level and lower acculturative dream scale when compared with the second generation Korean American college student group (n = 85, M age = 23.6, SD = 4.3). The t-test on the two group comparison was significant on acculturative stress level (p < 0.001) and “Lee Acculturation Dream Scale” (p < 0.001). It was proven that day time acculturative stress situation had an effect on the night-time dreaming neurocognitive activities, i.e., unconscious acculturation process (Lee, Sang Bok, 2006: “Acculturation Scale for Korean American College Students,” Psychological Reports; Lee, Sang Bok, 2006: “Asian Values Scale - Comparisons of Korean and Korean-American High School Students,” Psychological Reports).

Conclusion

The multiple domains of acculturative processes need to be explicated in terms of “multicultural hermeneutics” (Lee, Sang Bok, 2003: “Working with Korean-American Families - Multicultural Hermeneutics,” The American Journal of Family Therapy, 31, 159–178) and of real life experience mapping.
Depression in different welfare state regimes in Europe: The role of attitudes towards state responsibility for an adequate standard of living
Authors: Levecque K. , Van Rossem R.
Published: May 2011

Introduction

Recent cross-national research by Levecque et al (Journal of Health and Social Behavior, in press) has shown that the health effects of social experiences are attenuated, boosted or even reversed by the sociopolitical context. More specifically, it was found that the link between economic hardship and depression varies between different welfare state regimes in Europe.

Objectives

Currently, we assess whether this variation in depressing effect is totally attributable to differences in welfare state arrangements or whether welfare state attitudes play a significant role as well. Is economic hardship more depressing when the individual considers the state as the main provider for an adequate standard of living, or is the risk of depression higher when emphasis is put on self-provision and individual responsibility?

Methods

Analyses are based on data for 23 countries in the European Social Survey 2006–2007 (N = 41686). Multilevel linear regressions are performed. Depression is measured using the Center for Epidemiologic Studies Depression Scale (CES-D 8).

Results

We find that experiencing economic hardship is significantly more depressing for individuals who consider the state as the main responsible for providing an adequate standard of living. This pattern is observed in all welfare state regimes and remains significant when controlling for gender, age, having a partner, educational level, social support and locus of control.

Conclusion

The link between economic hardship and depression is dependent on both structural welfare state arrangements and welfare state attitudes.
PTSD as risk factor for alcohol-related disorders
Authors: Licanin I. , Fisekovic S.
Published: May 2011

PTSD is highly correlated with alcohol and drug abuse.

Objective

To estimate impact of PTSD on frequency of various forms of alcohol induced disorder.

Method

Research conducted during 2006 at Psychiatric Clinic in Sarajevo. It included: first group (I) of 50 patients with PTSD and alcohol induced disorders and second (II) group of 50 patients with alcohol induced disorder without PTSD.

Results

Comparing results these two groups, we found:

Alcohol intoxication: I group 11 (22%) vs. II group 15 (30%)

Alcohol withdrawal: 3 (7%) vs. 4 (8%)

Psychotic disorder with hallucinations: 11 (22%) vs. 9 (18%)

Psychotic disorder with delusions: 7 (14%) vs. 5 (10%)

Delirium: 6 (12%) vs. 9 (18%)

Amnesic disorder: 9 (18%) vs. 4 (8%)

Blackouts: 1 (2%) vs. 1 (2%);

Seizures: 2(4%) vs. 3(6%).

Conclusion

It seems that PTSD frequently caused more severe clinical forms of alcohol disorders, which should be prove in larger sample. This could be considered in prevention alcohol and PTSD as well.
Factors that affect compliance in psyciatric therapy in patients and outpatients in a Greek psychiatric department
Authors: Lyrakos G.N. , Goudella A. , Spinaris B.
Published: May 2011

Introduction

Research shows that mental patients are usually the most difficult to be managed in terms of adherence to treatment. Antipsychotic drugs does reduce their symptoms, but at least half of people given these drugs do not comply with the treatment regimen prescribed.

Aims

To explore the way that treatment options affects compliance in patients with mental disorders.

Methods

155 (61,5%) males and 97 (38,5%) females participated in the study. DASS42 and SQR29 questionnaires were administered to all patients in admission and at the end of the treatment. Good compliance to the treatment required low scores to both of them at the end of the treatment and the consent of the psychiatrist and psychotherapists who were responsible for each patient.

Results

172 of them had a good compliance, 32 medium and 26 did not comply at all.184 received pharmacotherapy, 21 CBT therapy and 26 combined therapy. Regression analysis indicates that better compliance to the treatment is significantly affected by CBT therapy (β = .44**), antidepressants (β = .37**), Typical antipsychotics (β = .25*) and sex (β = .24*) (*<, 05 **<, 0001). These variables accounted for 38 percent of the variance in compliance.

Conclusions

It seems that patients show better compliance to treatment when they are under psychotherapy and are receiving antidepressants and typical antipsychotics.
Health literacy and adherence to psychiatric appointments: Study of an urban academic center
Authors: Bizamcer A. , MacIntyre K.
Published: May 2011

Introduction

Health literacy (HL) measures the ability of an individual to use health-related information in order to make appropriate health-related decisions and to navigate the healthcare system. It influences a variety of behaviors such as breastfeeding, medication adherence, or the use of screening tests. Research has shown that it is related to the treatment outcome of conditions such as HIV and diabetes.

Objective

It is the assumption of this study that health literacy also plays a role in psychiatric patients’ adherence to treatment; in particular, to outpatient psychiatric appointments.

Aims

We hypothesized that patients with different health literacy levels would have different adherence rates to outpatient psychiatric appointments.

Methods

The study was conducted in 2006 in the Outpatient Psychiatry Department (OPD) of Temple University School of Medicine in Philadelphia, Pennsylvania. All English and Spanish-speaking patients of the OPD (potential N = 150) were invited to complete the short version of the Test of Functional Health Literacy in Adults (sTOFHLA), yielding three HL groups: adequate, marginal and inadequate. We explored the demographic and clinical correlates of HL and compared the three literacy groups with respect to their adherence to appointments during a 12-month period.

Results

Our study showed that, for our patient population, HL was not significantly related to any of the demographic and clinical variables included in our analysis except appointment adherence.

Conclusion

Patients with lower HL had lower adherence to appointments. These findings invite further research to explore the significance of HL.
Implementing a national case-management training program in Portugal
Authors: Mateus P. , Xavier M. , Caldas-Almeida J.
Published: May 2011

Introduction

In Portugal, a new National Mental Health Plan has been launched with the following objectives: equal access to care, decentralisation of mental health services and integration of mental health services in the general health services. In order to change the operational model for mental health teams, a case-management training program has been launched by the Ministry of Health.

Objectives

This study aims to evaluate:

a)

the feasibility of implementing the program on a national level,

b)

the quality of the training program and

c)

the satisfaction of the trainees.

Methods

The study was carried out at 36 public mental health services in mainland Portugal. The professionals attended a case management course (SAMHSA procedures), in which they were trained by means of guidelines, demonstrative audios, scenarios and role-playing. The assessment was conducted with a questionnaire addressing logistics, program content, acquisition of skills, usefulness and overall satisfaction.

Results

135 professionals from the whole country have been involved. The trainees’ acquisition of competences was found rather satisfactory. Results of the training were impressive regarding satisfaction and motivation of the trainees (69% were highly satisfied). Dimensions such as organization (35% highly satisfied, 52% satisfied), program content (41% highly satisfied, 43% satisfied), practical skills gaining (35% highly satisfied, 58% satisfied) and usefulness (58% highly satisfied, 31% satisfied) were also very well rated.

Conclusions

Of upmost relevance, it was possible to implement a case management training program at a national level, with no particular difficulties. The impact of courses on trainees was overall impressive.
Trajectory and predictors of depressive disorder among community older adults, in Quebéc: A one-year follow-up study
Authors: Mechakra-Tahiri D.S. , Dubé M. , Zunzunegui M.V. , Préville M.
Published: May 2011

Introduction

Past research has demonstrated the high prevalence of depression in elderly. However, the most of studies followed the symptom trajectory of individuals diagnosed with depression in a clinical setting and few longitudinal studies have characterized the patterns of depression in older adults population-based.

Objective

To describe changing of depressive disorder in an elderly population-based over a 12-month period and to examine the influence of medical and psychosocial factors on the outcome.

Methods

Data come from a longitudinal ESA Study (Enquête sur la Santé des Aînés) of elderly community persons (n = 2752). Depression, including major and minor depression, measured using the DSM-IV criteria. Generalized estimating equations (GEE) were used to assess relations between participant characteristics at baseline and depression, 12 months later.

Results

Among the 164 (5.9%) participants, who are depressed at baseline, 19.5% were continuously ill cases and 80.4% had recovered, 12 months later. Multivariate analyses showed that the risk of depression over the 12-month period was higher among for participants who were separated; living in rural region; with a great number of daily hassles, with high level of stress intensity, great number of chronic disease and with fair/poor perception of mental health.

Conclusion

Results support the hypothesis about medical and psychosocial factors as predictors over time of depression, in old persons. Using readily available prognostic factors (for example, high level of stress intensity, living in rural region, great number of chronic disease) could help direct treatment to elderly at highest risk of a poor prognosis.
Differences in antipsychotic combination (monotherapy versus polytherapy) between patients with schizophrenia and patients with other psychoses
Authors: Morales N. , Diaz M.C. , Ruiz J. , Portela M. , Martinez M.D. , Ruiz F.J. , Lloret J. , Lucas M. , Mayordomo A. , Fraguas D. ,   ISAMA
Published: May 2011

Introduction

Antipsychotic therapy is the cornerstone of the treatment of schizophrenia and other psychoses. Although clinical guidelines tend to recommend the use of antipsychotics in monotherapy, combination of two or more antipsychotics (that is, polytherapy) is a common habit in clinical practice.

Objectives

To assess differences in antipsychotic combination profile between patients with schizophrenia and patients with other psychoses.

Methods

A total of 241 patients (40.2% females, mean age 39.7+/−13.0 years) consecutively admitted during 2009 to a psychiatric inpatient ward with diagnosis of schizophrenia and other psychoses were assessed.

Results

145 (60.2%) patients were diagnosed with schizophrenia while 96 patients (39.8%) were diagnosed with other psychoses (schizoaffective disorder n = 35, delusional disorder n = 8, schizophreniform disorder n = 8, brief psychotic disorder n = 13, psychotic disorder not otherwise specified n = 27, and other psychoses n = 5). Out of the total sample, polytherapy was used in 150 (62.2%) patients. A total of 100 (69.0%) patients with schizophrenia were on polytherapy, compared to 52.1% of those with other psychoses (p = 0.008). After controlling for age and gender, the association between a diagnosis of schizophrenia and being in polytherapy remained significant (p = 0.046).

Conclusions

Patients diagnosed with schizophrenia are more prone to be in polytherapy than those with other psychoses.
Effect of the worldwide crises on mental health
Authors: Ng K.H. , Agius M. , Zaman R.
Published: May 2011

The events that unfolded towards the end of 2008 led to the worst global economic crisis since the Great Depression of the 1930s. While the economic and political implications have been studied in detail, the impact on health – especially that of mental health – has received much less attention. This essay aims to achieve a critical evaluation of causality (or lack thereof) between an economic crisis and mental health, using a combination of psychological theories, statistical review and common logic.

From a theoretical perspective, establishing the value-laden concept of mental health is core to this evaluation. We reflect on Professor Warr's component-based model of mental health and how/whether the economic downturn relates to these ‘components’ individually. On the statistical front, an analysis of data from previous global economic crises reveals a close association between job-related insecurities and psychological morbidities.

We found that both psychological theory and epidemiological data support causation between a recession and conditions like depression, anxiety and substance abuse. Further, we also explore the effects of the crisis on the family unit, society and international relations. This will highlight issues like child abuse, the psychological impacts on the socially deprived, and effects of the crisis on the developing world.

We also review the effectiveness of efforts of different nature and magnitude to mitigate the effects of this downturn. All this will hopefully impact on our understanding of the causes of mental health problems in times of economic insecurity and assist in developing strategies to ameliorate them.
Mental disorder- influence on education and professional abilities
Authors: Nikolic-Balkoski G. , Duisin D. , Batinic B.
Published: May 2011

Introduction

Mental illness has great influence on the possibility of regular education, employment, sometimes cause temporarily or definitive work disability.

Objectives

Current diagnostic criteria divide mental illness in two categories: psychotic disorders which consider more severe and nonpsychotic disorders as less severe disorders. Aims: The aim of this pilot study was to test the influence of quality of the mental disorder (psychotic/ nonpsychotic) on education completion and professional abilities.

Methods

Investigation involves 141 patients who were treated in two months period at CCS at the Psychiatric Clinic. Patients were divided in two groups according to ICD X criteria: group A- psychotic, group B- nonpsychotic disorders. Groups were equalized in sex and age. We compared groups in educational level (years of completed school), profession (employed, unemployed, retired, disability pension) and the age when the mental illness has begun.

Λ square test was used for the statistical analyses.

Results

Results showed that there were no statistical significant differences between groups in educational and professional performance. Groups differ only in the time of illness onset (earlier in group A).

Conclusions

A group, in spite of earlier onset of the illness and more severe simptomatology, is equally successful in education and professional performance, as B group. This may be the consequence of the great support of the family and the society. It also gives us hope that something is changing in relation to psychiatric patients and that stigma, shame and exclusion is not, or will not be everyday experience this group of patients.
Vancouver's inner-city youth: New approaches for a changing demographic
Authors: Patel M. , Mathias S. , Brown T.
Published: May 2011

Introduction

Inner-city youth suffer a high burden of mental illness and seek health care on an episodic basis (McCreary, 2001).

These youth tend to receive limited support services due to a lack of continuity of care as they move from child to adult services. Other barriers include homelessness and substance use.

The Vancouver Inner City Youth Mental Health Program (ICYMHP) is a psychiatry led initiative to provide psychiatric services and further collaboration between inner-city youth agencies providing care to at risk youth.

Aims

To introduce and review a collaborative model of care between psychiatric services and community based organizations.

To review the demographics, presentations and outcomes of youth assessed through the ICYMHP.

Methods

A chart review of all clients assessed through the program from its inception (November 2007) to May 2009 (18 months).

Results

Results from clients seen between November 2007 and June 2008 indicate an incidence of psychosis of 40% in men and 21% in women. Mood disorders were the primary diagnosis in 18% of men and 29% of women. Active substance misuse is high (71% of men, cannabis as drug of choice; 54% of women, methamphetamine as drug of choice). Length of stay at Covenant House nearly tripled for those under the care of the ICYMH versus the general shelter population, a positive outcome (21 days versus 9).

Conclusions

Inner-city homeless youth suffer from a high burden of mental illness. A collaborative model of care exists to improve health care quality and delivery to this population.