bluuebunny/crossref_metadata_2025 huggingface dataset:
Homicide and Schizophrenia: A Review of 14 Cases from 210 Forensic Examinations of Murderers [P02-151]
Authors: Richard-Devantoy S. , Bouyer-Richard A.-I. , Gigaux J. , Duflot J.-P. , Lhuillier J.-P. , Gohier B. , Garré J.-B.
Published: March 2009

Aim:

To establish the social, clinical and forensic differences between murderers with schizophrenia and murderers without any psychiatric disorder and to compare their respective relationship with their victim.

Method:

We identified the socio-demographic, clinical and criminological profiles of 14 murderers with schizophrenia from 210 forensic examinations of murderers, and compared their profiles with those of murderers without any mental disorder (n=73).

Results:

Murderers with schizophrenia are characterized by a specific socio-professional status (single, living alone and jobless). Previous psychiatric history was significantly more common in the schizophrenia group than in the group of persons without mental disorder, as it was the case as regards previous contact with the police.

Schizophrenic murderers generally commit, alone, a non-premeditated murder. They usually strangle their victim in a sudden attack, whereas murderers without any pathology usually premeditate their crime. 86% of perpetrators with schizophrenia have been in a delirium at the time they committed murder, among four main themes: persecution, thought insertion, mysticism and megalomania.

Victims of murderers with schizophrenia were family members in 21% of cases, acquaintances in 57% and a stranger in 14%. The victim was known to the perpetrator significantly more often in the schizophrenia group than in the no mental disorder group (86% versus 77%, p=0,002).

Conclusion:

The main difference between murderers with schizophrenia and murderers without any mental disorder is the psychopathology of the morbid process which underlies the homicide. The most schizophrenics’ homicide was more likely to be against intimates than strangers.
Acute Inpatients Units’ Old New Challenges: Compulsory Versus Voluntary Treatment
Authors: Rodrigues T. , Castro L.C. , Pereira J. , Pereira H.
Published: March 2009

Background:

Besides preventive, maintenance and rehabilitative measures, it is very important that Psychiatry Services develop acute care interventions that include hospitalization treatments. Compulsory treatment is mandatory when patients have a severe mental illness that deprives them from their judgement abilities in such a way that they deny their illness, refuse necessary treatment, and may endanger themselves and/or others.

Aims:

To compare socio-demographic and clinical features of patients treated in compulsory and voluntary regimen. To make a reflection on the most suitable model for the acute inpatient services.

Methods:

Retrospective study of socio-demographic and clinical characteristics of patients admitted in an acute inpatients’ unit of a Psychiatric Hospital - Hospital de Magalhães Lemos - in 2006 and 2007. We compared data of compulsory (CA) and voluntary admissions (VA), and discuss their respective main problems.

Results:

Among the total 577 inpatients admitted, 13% were compulsory and 87% were voluntary. Schizophrenia was the most prevalent diagnosis in both groups (51% CA vs 26% VA). By discharge, prescription of depot antipsychotics was higher in CA, and treatment with antidepressants was higher in VA. In CA, 8 (11%) patients had discharge against medical advice (escape) vs 12 (2%) in VA.

Conclusion:

Results might suggest that the current facilities and/or procedures are not sufficient to offer the levels of protection needed to provide the best environment for patients’ recovery.

In the context of the recent efforts towards the reorganization of mental health services, specific measures should be considered, including acute inpatients units exclusively designed for CA.
Utility of EEG as Diagnostic and Tarapeutic Approach in Examiners in Forensic Population-prevention of Criminal Recidiv
Authors: Talevska V.
Published: March 2009

Aims:

To define the importance for the difference between the EEG in patients with criminal behavior and in control group. To examine the relationship between the EEG of the patients with criminal behavior and diagnosis as well as the prompt registration of EEG changes.

Material and methods:

158 EEG investigations examined at the Psychiatric Hospital in Demir Hisar for 24 months with aggressive and criminal behavior.

Results and discussion:

In men normal EEG (69.44%) prevails. The means age of patients in examiner group with abnormal EEG is significant higher from the means age in patient's with normal EEG. There was the significant difference between normal and abnormal EEG and the diagnoses. There is not significant difference between the patient's behavior and EEG, and there was significant difference between EEG and its criminal factor. There was not relation between EEG and the patient's sex in control group. The difference between the means age (37.73 god.) in control group with abnormal EEG and the mean age of patients with normal EEG is significant. There was not significant relation between EEG and patient's diagnosis of control group. There was not connection between patient's behavior and EEG in control group. There was significant difference between EEG in examiner group and in control group.

Conclusion:

There was significant difference between EEG in control and in examiner group.

Suggested measures:

Easily diagnosis providing of psychiatric disorders with aggressive and criminal behavior with EEG -help and safety measures at examiners with criminal behavior.
Completed Audit Cycle on Lithium Monitoring on Older Adults in Northumbria Healthcare NHS Trust, UK
Authors: Nodiyal A. Ghosh , Ramsay G. , Wilson S.
Published: March 2009

Aims:

The aim of this study was to audit the practise of Lithium monitoring on all patients over the age of 65 years, over a one-year period in North Tyneside General Hospital, against the recommended standards, and re-auditing the following year.

Methods:

During the audit; data was collected from the medical notes of all patients prescribed Lithium, over 65 years in North Tyneside General Hospital. This was from January 2004 - January 2005. The standards used were the recommendations of The British National Formulary. The monitoring of urea, electrolytes, TSH and Lithium were recorded. The presence of an ECG, documentation of side effects, information leaflets’ distribution and patients lost to follow up were noted. Following the audit, recommendations were made and prescribing Consultants were informed. A re-audit was conducted on all patients on Lithium the next year from January 2006 - June 2006, using the same designed tool.

Results:

22 patient's notes were audited and 29 notes re-audited. 41% were males and 59% females in the audit, with similar distribution in the re-audit. 54% were between 65-75 years and 45% over the age of 75years in the audit. 41% and 59% respectively in the re-audit. Blood monitoring followed the standards in 86% in the audit and 95% in the re-audit. 32% had documentation of side effects in the audit, increasing to 72% in the re-audit. While 23% patients were lost to follow up in the audit, all were followed up in the re-audit.

Conclusions:

The re-audit encouragingly showed significant improvement in practise.
Behavioral Changes Induced by Angiotensin AT1 Receptors Blockade in the Rat Brain
Authors: Hritcu L. , Bild W. , Ciobica A. , Artenie V. , Haulica I.
Published: March 2009

Aims:

The brain renin-angiotensin system is involved in learning and memory, but the actual role of angiotensin II and its metabolites in this process has been difficult to comprehend. In the present study we assessed the role of the angiotensin AT1 receptors in certain behavioral effects of angiotensin II using their selective antagonist losartan and PD123319, intracerebroventricularly (icv) administrated.

Methods:

Male Wistar rats were divided into three groups: 1. sham-operated; 2. Losartan; 3. PD123319. All drugs were stereotaxically icv injected. Learning and memory tests began 2 weeks after the operation, and the ability of the rats to acquire the operant task was studied by means of Y-maze task and passive avoidance task, respectively. The anxiety state was measured in elevated plus maze.

Results:

Losartan and PD123319 significantly impaired spatial memory in Y-maze task, suggesting significant effects on short-term memory. In passive avoidance task, both angiotensin II antagonist, significantly decreased step-through-latency, suggesting significant effects on long-term memory. In elevated plus maze measuring anxiety, both drugs diminished anxiety state.

Conclusions:

Our results suggest the considerable involvement of the brain ATi angiotensin receptors in the cognition improving effects of angiotensin.
Wernicke-Korsakoff Syndrome: A Common Yet Elusive Diagnosis
Authors: Madeira N. , Santos T. , Pio-Abreu J.L.
Published: March 2009

In 1897, Murawieff proposed that a common cause was responsible for the two syndromes previously described by Carl Wernicke and Sergei Korsakoff. More than 100 years afterwards, the neuropsychiatric nosological entity known as Wernicke-Korsakoff syndrome remains one of the most significant, yet under-recognized, consequences of long-term alcohol abuse.

Prompt recognition and treatment of Wernicke's encephalopathy with parenteral thiamine can prevent permanent cognitive impairment, involving severe short-term memory loss - Korsakoff's amnesic syndrome. Such condition has devastating consequences for patients, not infrequently demanding long-term institutionalization.

Based on two clinical vignettes, the authors review some epidemiological, clinical and neuropathological features of Wernicke-Korsakoff syndrome, besides issues concerning differential diagnosis, treatment and prognosis.
The Portuguese who Could no Longer Speak French: Primary Progressive Aphasia (PPA) in a Bilingual Man
Authors: Simões S. , Rodrigues M. , Soares-Fernandes J. , Machado Á.
Published: March 2009

Introduction:

PPA is characterized by progressive language dissolution, with remarkable spare of other cognitive domains for at least two years, and should be considered in the differential diagnosis of dementia.

Clinical case:

A 56-year-old previously healthy man was seen for speech difficulties. He studied Portuguese for 4 years, and then went to live in France, where he learned French for 3 years. He returned definitely to Portugal when he was 42. Since early adolescence he was fluent on speaking, reading and writing in both languages. In the last 12 years he spoke French mainly when visiting his family. Three years ago he started showing disintegration of his second language preceding that of his native one. Upon examination he had laborious, effortful, nonfluent and agrammatic speech, with severe anomia and some repetition and complex-command comprehension difficulties. He could not name, understand or write any French word. The remaining neurological examination was near-normal to age and education level (MMSE - 25/30). Brain MRI showed left-side predominant frontotemporal cortical atrophy. PET scan revealed hypometabolism in the same area and the temporal lobe, anterior cynguli and dorsolateral frontal cortex.

Conclusion:

Our patient has nonfluent variant of PPA. Cases like this can give further insight into the neural network subserving language acquisition and dissolution. In proficient bilinguals, the main point on language dissolution in PPA seems to be the recency of use. The best way to confirm this would be to systematically characterize PPA patients on secondary language usage, attained proficiency and disintegration sequence.
A Case Report of Asperger Syndrom with Associated Visuo-Attentional Disorders
Authors: Tanet A. , Philippe A. , Cavezian C. , Chokron S.
Published: March 2009

In Pervasive Developmental Disorders, visual perception deficits, such as impaired face and object recognition, have been previously described. More particularly, Kracke (1994) as well as Pietz and colleagues (2003) reported prosopagnosia in individuals fulfilling criteria for Asperger Syndrome (AS). Moreover, anatomical or functional anomalies in the temporo-occipital areas have been observed in neuroimaging studies in autistic patients. Besides, this region is known to underlie visuo-attentional functions. Yet, the examination of such cognitive functions in autistic disorders is scarce, even in clinical practice.

This poster presents the case study of a teenager (male, 14 years) diagnosed with AS on the basis of his developmental history and current presentation: marked social abnormalities, lack of ocular contact, good language although with verbal and non-verbal communication difficulties, circumscribed special interests and motor impairments.

A neuropsychological and neuroophtalmological assessment of visuo-attentional cognitive functions revealed a visual field concentric reduction, signs of left unilateral spatial neglect, impaired visual pursuit, visuo-constructive apraxia and visual extinction. The anatomical MRI showed a mild enlargement of the left posterior ventricular horn (facing the occipital lobe), probably consecutive to a cortical atrophy (in the occipito-parietal parenchyma).

This case study emphasizes that visuo-attentional cognitive difficulties such as visual recognition deficit, visual field defect and attentional bias may be associated to behavioural signs of AS. In addition to previous descriptions in the literature, our case study leads us to consider that neuropsychological assessments of visuo-attentional functions in children with autistic symptoms may provide invaluable clinical and theoretical information.
Quality Improvement in Ambulatory Mental Health Settings
Authors: Cauterman M. , Woynar S. , Vergnaud S.
Published: March 2009

Eight ambulatory Mental Health Settings have been commited in a national pilot intervention aiming at improving the quality of the service they deliver from April 2006 to december 2007. This twenty months intervention allowed teams to set operational bjectives, to describe their organization, to implement an actions’plan and to evaluate their results.

The main operational objectives they chose were the following:

•

Delay for an initial appointment.

•

Delay for an appointment following a discharge from hospitalization.

•

Rate of non attendance.

The framework to analyse their organisation included a focus on Human ressources, on Operations, on Strategy and on Information Sharing.

The main findings were awide variations in performance from a setting to one another (median delay for a first appointment with a psychiatrist ranging from one to seven weeks, paid psychiatrist working time for a single appointment ranging from 0.6 to 2.5 hours...), lack of formalisation of processes (including major processes as intake, discharge from hospital...), the absence of objectives set by the managemers.

Actions’plans included very basical actions as setting dashboards and objectives, setting strategy to decrease non attendance, sharing diaries, reorganising meetings, mapping patient’ pathway.

Finally, some results were obtained as:

•

reduction of delays for first appointments (4 settings amongs 8);

•

reduction of delays for a appointment after hospital discharge (1 amongst 8).

Furthermore, this pilot intervention allowed to create and develop tools, method and experience for accompaining other settings. Ten new volunteers are involved since july 2008.
Institutional Therapeutic Alliance: Empirical, Clinical and Conceptual Remarks
Authors: Pulido R. , Monari M. , Rossi N.
Published: March 2009

The relevance of a good therapeutic alliance development between patient and therapists in the treatment success has been documented in more than 3 decades of empirical research. In the case of the treatment of severely disturbed patients, the alliance construction process involves particular characteristics determined, in part, by the patients inability to form safety bonds with others and because of, usually, various therapeutic figures are engaged in their treatments. The present work offers a general review of the most important empirical evidence about the therapeutic alliance process in institutional context treatments (i.e., hospitalization, therapeutic community), introduces the concept of Institutional Therapeutic Alliance (ITA) - clinical and empirical phenomenon that accounts for the working bond between the patient and the therapeutic staff perceived as a whole - and reports the major results of a longitudinal study conducted to assess the ITA and explores the relationship with treatment outcomes.

55 day-hospital patients take part in the research and were evaluated at admission, before one week, at discharge and after 3 months. The assessment battery included: Symptom Check List (SCL-90), Global Assessment Scale (GAS), Multidimensional Social Perceived Support Scale (MSPSS), Institutional Working Alliance Inventory (IWAI) and Subjective Distance Scale (SDS). The results show that ITA is positively correlated with symptomatic reduction at discharge and negatively associated with patient's re-hospitalization after 3 months.

The work concludes by discussing, from a clinical point of view, the promoting and obstructing alliance factors linked with the patient, the staff and their relationships.
Mental Health Status in Semnan University of Medical Sciences Employees
Authors: Saberian M. , Hajiaghajani S. , Ghorbani R. , Behnam B.
Published: March 2009

Background:

The mission of every University is to educate professionals to improve the quality of well being of body and mind of the society's members. To approach this important issue, Universities needs healthy employee to enable them to educate healthy qualified and well trained. This study was aimed to evaluate the status of mental health of Semnan University of medical sciences employees.

Material and methods:

This is a descriptive- analytical performed in a cross- sectional study. Samples were 414 employee. data were collected trough a self - reporting questionnaire (GHQ-28). Data were analyzed by spss and also mean, standard deviation, absolute & relative frequency were detected. Chi-square, Pearson & Spearman correlation coefficient at the level of 5% and logistic regression analysis was used for analysis.

Findings:

Total of 28.6% suffers from mental disorder. The most were working in treatment setting (41%). People aged 40-49 were 29.3 %, women were 37.4%, University undergraduate 40.7%, not married single 60%, 20 or more year work experienced 35.2%, had the most prominent mental disorder. Interpretation logistic regression showed that index of gender, level of education, and occupation has significant influence over mental disorder.

Conclusion:

The degree of mental disorder is 2.5 more than the statistics reported by WHO, but is similar with those reported in Iran. More investigation needs to better understanding the higher prevalence of mental disorder among women, university undergraduate, government employee and those working in treatment setting. The result of these studies can lead to find solution to resolve this problem.
How to Involve Undergraduate Medical Students in Psychiatric Research
Authors: Agius M. , Rashid Z. , Slattery C. , Kelly C. , Ryan D. , Wear H. , Pepper H. , Kilsby A. , Bradley V. , Davis A. , Gilhooley M.
Published: March 2009

The poster will address the important issue of how we can use opportunities in teaching our medical students how to take a wider view of psychiatry and learn to ‘think outside the box’ thus broadening their vision, enabling them to challenge presently held concepts, while at the same time learning the basic tenets of our profession.

Clearly, this is done by involving our students in clinical research based and audit based activities. However not all schools or teachers are comfortable with doing this, while the medical curriculum is broad, and there is a risk that students ‘only study for exams’.

Research based activities, including simple things such as using basic it skills to do a literature search for a review article or carrying out a useful clinical audit, using a unit held database, are however things which students can easily do, and these can lead to publishable case reports, posters, or ever articles in peer reviewed journals.

The poster will illustrate how we developed research activities with students at Cambridge University Clinical School. It shall discuss the advantages, difficulties, and indeed enjoyment of carrying out such activities.
Attitudes of Medicine and Nursing Students Towards the Sexuality of Older People
Authors: Azevedo J. , Palha A. , Esteves M. , Coelho M. Vieira
Published: March 2009

There is a paucity of research in attitudes of undergraduate students of medicine and nursing regarding sexuality of patients namely the older people. In previous studies we paid attention on staff attitudes of residential homes to aged people in what concerns with sexuality. With the same methodology, in this study it was evaluated the attitudes of undergraduate students of medicine and nursing and resident's on psychiatry towards the sexuality of older people.

Design:

A descriptive questionnaire survey using the attitudinal part of Aging Sexual Knowledge and Attitudes Scale (ASKAS).

Participants and setting:

Students of medicine and nursing of Oporto University.

We know from previous studies that little experience in the work with older people is predictive of negative attitudes towards sexuality. Nevertheless, in this sample we found a mean ASKAS score of 66 which reflects moderately positive and permissive attitudes toward later life sexuality. Medicine students were more permissive than nursing students (p< 0.01).

Conclusions:

Undergraduate students and psychiatry residents have positive attitudes toward sexuality of older people. Later life sexuality study should be included in the curriculum of undergraduate formation of doctors and nurses.
Validity and Applicability of the Mini International Neuropsychiatric Interview Administered by Family Resident Physicians in Primary Health Care in Brazil
Authors: Azevedo-Marques J.M. , Zuardi A.W.
Published: March 2009

Purpose:

To evaluate the “Mini International Neuropsychiatric Interview (MINI)” used by family resident physicians in primary health care (PHC) in Brazil.

Methods:

Training for administrating the MINI was given as part of a broad psychiatry education program, and was performed in PHC consultations. Interviews were held with 120 PHC patients. MINI was administered by 25 physicians, while the “Structured Clinical Interview for Diagnosis (SCID-I)” was administered by a psychiatrist. The physicians answered questions on the applicability of the MINI.

Results:

Concordance levels for the following diagnoses were analyzed: any mental disorder; depressive disorders in general, major depressive episode and dysthymia; anxiety disorders in general, generalized anxiety disorder and panic disorder; and substance abuse disorders. Kappa coefficients ranged between 0.65 and 0.85; sensitivity between 0.75 and 0.92; specificity, between 0.90 and 0.99; positive predictive values (PPV) between 0.60 and 0.86; negative predictive values (NPV) between 0.92 and 0.99; and accuracy between 0.88 and 0.98. The physicians considered MINI comprehensibility and clinical relevance satisfactory; the brevity of its administration was considered satisfactory for use with previous screening only.

Conclusions:

These good results may be related with more frequent, intensive, and diversified training in psychiatry. The MINI is a useful tool for general practitioners and should be part of the broad psychiatry education program offered to these professionals.
Validity of Questionnaires Administered by Community Health Workers and Auxiliary Nurses for Psychiatric Screening in Primary Health Care in Brazil
Authors: Azevedo-Marques J.M. , Zuardi A.W.
Published: March 2009

Aims:

To evaluate the validity of three questionnaires used by community health workers and auxiliary nurses for psychiatric screening in primary health care (PHC) in Brazil.

Method:

Training for administrating the SRQ-20, WHO-5 and COOP/WONCA Charts was given by a consultant psychiatrist to community lay workers and auxiliary nurses working in four PHC teams in university community health center. The questionnaires (administered by 14 community lay workers and auxiliary nurses) and a semi-structured psychiatric interview (SCID - administered by the consultant psychiatrist blind to the patients results on questionnaires) were held with 120 PHC patients who were at least 15 years old. Predictive validities of SRQ-20, WHO-5 and individual items of COOP/ WONCA charts in relation to SCID were calculated through area under ROC curves (AUC) and total accuracy. Concurrent validities between questionnaires were calculated through spearman coefficients.

Results:

For SRQ-20 (20 questions): AUC = 0.92; total accuracy on cut-off 7/8 = 85%. For WHO-5 (5 questions): AUC = 0.90; total accuracy on cut-off 11/10 = 85%. For COOP/WONCA chart “feelings”: AUC = 0.88; total accuracy on cut-off 2/3 = 85%. Sperman coefficients between SRQ and COOP/WONCA chart “feelings” was 0.74; between WHO and “feelings” was 0.67.

Conclusions:

Results of COOP/WONCA Chart “feelings” - an individual item of a questionnaire specifically developed for use in primary health care - were as good as more extensive questionnaires specifically developed for psychiatric screening purposes.
Preliminary Study of Mental Health Consultation-Liaison Activities with Primary Health Care Teams in University Community Health Care Center in Brazil
Authors: Azevedo-Marques J. , Zanetti A.C.G. , Galera S.A.F. , Zuardi A.W.
Published: March 2009

Aims:

This preliminary study describe the experience of mental health consultation-liaison activities delivered by a psychiatric community nurse and a psychiatrist with Primary Health Care (PHC) teams in a university community health center in city of Ribeirao Preto, State of Sao Paulo, Brazil.

Method:

This is a descriptive exploratory study, carried out from March to May 2008, from the record of the activities in weekly consultation meetings with four PHC teams.

Results:

The activities developed including discussions of issues and cases, joint consultations and home visits with PHC teams. Fifty-one joint consultations/home visits and twenty-six discussions of cases/issues were made. The clients were predominantly female and aged over 18 years; diagnoses of major depressive episode, generalized anxiety disorder and alcohol unhealthy use was common. Psychotic and bipolar disorders were also discussed and evaluated. The main complaints were related to: changes in sleep, appetite and energy; difficulty in relationships (including family and work); aggression and violence (including physical and sexual abuse); difficulty of adherence to treatment, and other psychiatric symptoms. The referrals were made mostly for ambulatory psychotherapy and ambulatory adult and child mental health specialized care.

Conclusion:

The joint activities between the specialized and PHC teams to enable full attention to health of patients and the development of interdisciplinary work. This work is challenging because it put on the agenda of health the borders between the levels of assistance, knowledge, practices and goals of different professional groups.
Affective Neuroscience: A Crucial Role in Psychiatry
Authors: Castro L.C.
Published: March 2009

Background:

Neuroscience has been a growing revolutionary field of scientific knowledge. The increasing recognition of the importance of emotional processes and subjective experience in several aspects of human behaviour parallel the growing amount of research in the field of affective neuroscience. Affective neuroscience studies the brain mechanisms subjacent to emotional behaviour.

Aim:

To discuss the relevance of affective neuroscience research in social and biological sciences, namely within psychiatric and psychological researches.

Methods:

Review of the literature. MEDLINE and PubMed databases searches for peer-reviewed studies, published between 1994 and 2008, using combinations of the Medline Subject Heading terms affective neuroscience, emotions, affective sciences and psychiatry, psychology, biological sciences, social sciences.

Results:

Several studies addresses brain functions and how emotions relate to genetics, learning, primary motivations, stress response and human behaviour. Some actual areas of research within affective neuroscience include: emotional learning, affective behaviour, emotional empathy, psychosomatic medicine, functional and structural biomarkers, emotional disorders and stress response, among others.

Discussion:

In Psychiatry, affective neurosciences find application in understanding the neurobiology of mood disorders, the neural control of interpersonal and social behaviour and the emotional systems that underlie psychopathology. Affective neuroscience reflects the integration of knowledge across disciplines allowing a broader understanding of human functioning. The field of affective neuroscience is an exciting field of future psychiatric research and it provides an investigational framework for studying psychiatric morbidity.
Guardianship Consultations in the Psychiatric Consultation Service in a General Hospital [P02-214]
Authors: Diefenbacher A. , Rottbeck R. , Burian R.
Published: March 2009

Objective:

Due to the implementation of the DRGs (Diagnosis Related Groups) in the somatic departments of general hospitals, an elevated demand for psychiatric consultations can be anticipated. It is a moot question whether psychiatric consultation services are adequate for such a surplus load. We investigated whether the proportion of psychiatric consultation requests for patient's capacity to consent and for guardianship is rising.

Method:

The DRGs were implemented in the somatic departments of the Ev. Krankenhaus Königin Elisabeth Herzberge (KEH) at the end of 2003. We compared consultation requests with the keywords “capacity to consent”, “capacity to enter contracts” and “need for guardianship” in the year 2002 with 2004.

Results:

Significantly more consultations with the keyword “guardianship” were requested in 2004 compared to 2002 (p=0.019). 56% concerned medical questions regarding capacity of consent. There was a slight, but increase in the requests social reasons.

The confirmation of the indication for the appointment of a guardian decreased inversely without statistical significance (80% in 2002 and 64% in 2004; Chi-Square p=0.058).

Conclusion:

The increasing demand of the consiliary-liason-service was confirmed in our investigation. It is possible that the implementation of the DRGs plays a role in the increase of psychiatric consultation request. As a trial to ease the growing burden, we developed a form which also enables colleagues from the somatic departments to apply for guardianship of their patients without psychiatric assistance.
Physician-Related Factors that Determine Clinical Decisions in Serbian Psychiatry
Authors: Divac N. , Gasic M. Jasovic , Tosevski D. Lecic , Maric N. , Stojanovic R. , Todorovic Z. , Prostran M.
Published: March 2009

In this study, we made an attempt to identify the physician-related factors that determine the choice of drugs in Serbian psychiatric practice.

The study was conducted at two major teaching psychiatric hospitals in Serbia. The structured questionnaire was used, and 41 psychiatrists were interwieved.

Physicians cited approximately four (of eight offered) categories of factors that determine the choice of drugs. Most often, these categories were: safety (adverse effects) (78%), proven efficacy of the drug (73%), recommendations of the relevant guidelines (65%), and reimbursement of the treatment costs by the mandatory health insurance (46%). About 65% of psychiatrists stated that they adhere to the national, or (where there are not national), relevant international therapeutic guidelines. When asked to cite which international or foreign guidelines in particular they used, approximately 50% failed to do so. The other half cited mostly the American Psychiatric Association (APA) Guidelines or National Institute for Health Care and Clinical Excellence (NICE) Guidelines.

The majority of the Serbian psychiatrists rely on the efficacy and safety of the drugs as major determining factors in the choice of therapy. However, substantial percentage of psychiatrists obtain indicators on drugs’ efficacy and safety from their personal professional experience. It is doubtful whether these indicators are valid, or just represent unproven prescribers’ habits. The majority of psychiatrists are willing to accept the relevant guidelines, and the effort should be made on the national level to further develop those guidelines and implement them into everyday practice.
The Contributes of Cerebellum in Higher Cognitive and Social Behaviour in Childhood
Authors: Dobi F. , Kabili E. , Elezi D. , Sotiri E. , Xhepa G. , Elezi F.
Published: March 2009

Many studies have confirmed the role of the cerebellum in the organization of superior brain functions in adults. Congenital cerebellar alterations are frequently observed in children with neurological diseases. These anatomical alterations are associated with neuropsychological or developmental disorders that often give rise to pictures of mental insufficiency of varying severity with behavioural changes even leading to autism.

Aim:

To evaluate of cerebellum role in cognitive and social organization also during development.

We report 25 children with different kinds of acquired cerebellar lesions (12 with hemispheric astrocytoma, 12 with vermis medulloblastoma, and 1 with hemispheric stroke) who showed different clinical patterns according to the lesion localization. All subject were studied by neurological examination and MRI. Neuropsychological assessment included:

•

observation of spontaneous behaviour;

•

Recording of spontaneous language;

•

Intelligence evaluation (WISC-test);

•

Language evaluation;

•

Memory evaluation;

•

Assessment of frontal lobe functions (categorical memory, sequential memory, language fluency, design fluency, flexibility of reasoning and problem solving).

Lesion in the vermis, mainly in the lower lobuli, caused different degrees of behavioural disturbances ranging from irritability to psychosis; lesions in the right hemisphere impaired language processing and symbolic sequencing, categorical memory and executive functions; lesions in the left hemisphere impaired speech prosody, visual sequential memory and design fluency.

These data confirm that the connections from the cerebellum to the associative cortical areas are operative very early and that the cerebellum has an essential role in cognitive and social organization also during development.
How to Improve the Visibility of Research in the Countries from the ‘Scientific Periphery’: A ‘Case Study’ [P02-220]
Authors: Kulenovic A. Dzubur , Puljak L. , Ivanis A. , Vukojevic K. , Zaletel-Kragelj L. , Donev D.
Published: March 2009

Case history and symptoms:

Small number of prestigious scientific journals publishes most of the world's scientific information. Although scientists in developing countries represent 25% of the world's scientific community national journals from this 'scientific periphery' are poorly visible: the Science Citation Index (SCI) included less than 2% of these journals in 1995.

Clinical presentation:

A vicious cycle of inadequacy for these journals: small number and poor quality of manuscripts submitted, inadequate review process, and imperfect English prevents them from reaching higher visibility and eventually escaping form anonymity. Key problems seem to be poorly designed and unoriginal research, lack of knowledge of research methods and data presentation.

Treatment:

1.

Teaching principles of scientific research in medical schools.

2.

Author-friendly editorial policy - a procedure where most of the articles received are pre-reviewed intramurally and improved by providing guidance to the authors, before being sent out for extramural review.

3.

Proactive board of editors - who seek interesting research and encourage researchers to communicate their results.

3.

Networking regional collaboration.

Treatment outcome:

In the case of Croatian Medical Journal (CMJ) that followed and partly developed the 'treatment' described, such policy resulted in significant formal success - inclusion of CMJ in the most selective international indexing databases (MEDLINE, Current Contents and Web of Science), open access status, decent visibility and attention of researches (impact factor 1.2). The original, active and efficacious approach of the editors of CMJ will be analyzed in this presentation.
In my Breast… in Your Hands… Psychological Distress Among Women Submitted to Breast Histological Biopsy
Authors: da Costa A. Ferreira , Guimarães R. , Samico S. , Coelho R. , Pimentel F. , Grangeia R.
Published: March 2009

It is almost consensual, the development of both anxiety and depression, among women diagnosed with breast cancer. Sometimes symptoms remain restricted to the time of diagnosis, but quite often they persist, and even increase after that. However, this same feature, among women with benign tumors, has not yet been well established.

Authors’ aim is to characterize the population of women attending a Breast Disease Diagnosis Unit, including: socio-demographic features, clinical conditions and screening for anxiety and depression. They also pretend to check out differences between the ones with benign and the others with malign disease.

For this purpose they evaluated 150 women, attending Breast Disease Diagnosis Unit of St. John Hospital (Oporto). All of them were first evaluated by a Psychologist, at the time of the histological diagnostic biopsy, and fulfilled a clinical specific protocol, as well as the Hospital Anxiety and Depression scale (HADS). Patients scoring for borderline (8-10) or pathological levels (» 11) were then reevaluated, after a three month period. Preliminary data shows that a high percentage of women with pathological levels of anxiety and depression symptoms (40%) were diagnosed with benign breast tumor.

First conclusion is about the need for a more attentive clinical behavior, also towards women with benign breast tumors. In fact it seems that they also have a high risk of developing both anxiety and depression.

This is an ongoing study, and the aim is to increase sample size and to better analyze and justify all possible variable correlations.
Evaluation of Hippocampal Neurogenesis in YAC128 Huntington’s Disease Transgenic Mice
Authors: Gil-Mohapel J. , Simpson J.M. , Pouladi M.A. , Hayden M. , Christie B.R.
Published: March 2009

Given the capacity of the adult brain to generate new neurons (a process called neurogenesis), adult neuronal stem cells have been proposed as an endogenous source of healthy cells for the treatment of certain neurodegenerative diseases. However, it is not completely understood to what extent this process is altered in neurodegenerative conditions such as Huntington's Disease (HD). An increase in neurogenesis in the subventricular zone (SVZ) of HD patients has been previously reported. On the other hand, we and others found a dramatic decrease in neurogenesis in the dentate gyrus (DG) of the hippocampus of the most studied HD transgenic mouse models, the R6/2 and R6/1 lines. We are now examining neurogenesis in a transgenic model that expresses the full-length huntingtin gene with 128 CAG repeats, the YAC128 mice. We are analysing how disease progression in the YAC128 model affects each stage of the neurogenic process (i.e., proliferation, survival, migration, and differentiation) in the two neurogenic regions (SVZ and DG). Proliferation will be evaluated in end-stage, symptomatic, early-symptomatic and pre-symptomatic YAC128 mice by immunohistochemistry for a variety of exogenous and endogenous cell cycle markers. Cell survival, migration and differentiation will be assessed by immuno-labelling of immature and mature neurons. Since hippocampal neurogenesis is thought to be involved in cognitive processes, a reduction in it might contribute to the cognitive deficits and/or depression in HD. Furthermore, these results will ascertain how well the HD brain might sustain neuronal transplant therapies.
Behavior Manifestations in Preschool Children
Authors: Golubovic Š. , Golubovic B.
Published: March 2009

In the sample of 943 preschool children aged between 4 and 7 (where the arithmetic mean is 5.72 decimal years and standard deviation .882) the assessment questionnaire was used in order to get the description of children's behavior as seen by their parents. The questionnaire contained 36 items for assessing behavior.

The aim of the research was to determine which forms of behavior characterize preschool children and how behaviors are manifested with relation to sex and the age of a child. The research shows that certain forms of manifestable behavior, such as aggressiveness, vivacity, restlessness are more often manifested in boys, while in the case of girls latent forms of behavior are more often manifested. The results achieved show that a number of behaviors, mostly externalized, change and manifest less frequently under the educational impact while growing up.

The early screening of problems related to the mental health of children, especially of those referring to the behavior and emotional problems, enables timely detection and early disorder intervention.
Internalizing and Externalizing Behaviour in Early Childhood: Relative Contribution of Executive Functioning, Social Cognition and Verbal Ability
Authors: Huijbregts S. , Swaab-Barneveld H.
Published: March 2009

Early internalizing and externalizing behaviour problems strongly predict later behaviour problems. We investigated cognitive correlates (executive functioning (EF), Theory of Mind (ToM), and verbal ability (Peabody Picture Vocabulary Task (PPVT) of internalizing and externalizing behaviour (assessed with Child Behaviour Checklist) in 229 3-to-6-year-old children. ToM and EF (r = .446, p < .001), ToM and PPVT (r = .308, p < .001), and EF and PPVT (r = .434, p < .001) were significantly related. Partial correlations, controlling for age, EF, and PPVT, showed that ToM was independently related to internalizing behaviour (r = -.125, p = .030), emotional reactivity (r = -.120, p = .035), anxious/depressed (r = -.141, p = -.016), and withdrawn/depressed (r = -.138, p = .018). Trends were observed for correlations between ToM and externalizing behaviour (r = -.105, p = .057) and aggression (r = -.087, p =.096), while the correlation with attention problems was significant (r = -.119, p = .036). Generalized Linear Models also showed significant differences on externalizing behaviour [Wald Chi-square = 17.8, p < .001] and aggression [Chi-square = 14.9, p = .001], between children with good and poor ToM-performance. In contrast, none of the EF-behaviour correlations remained significant after control for ToM and PPVT, and only the PPVT-withdrawn/depressed correlation remained significant after control for EF and ToM.

It is concluded that cognitive interventions for young children at an increased risk for continued behaviour problems might best be aimed at improving social cognitive abilities.
Spiritual Needs of Iranian Cancer Patients
Authors: Karimollahi M. , Rostamnejad M. , Abedi H.A.
Published: March 2009

Introduction:

Until the last 2 decades, spiritual care was a vital, but invisible, aspect of nursing care. Spirituality and spiritual care have entered the mainstream, and the literature in this area has burgeoned. In addition, there is minimal information in the literature documenting the expressed spiritual needs of patients in general and specific subgroups of patients in particular, thus this article aimed to present spiritual needs of Iranian Muslim patients. Therefore, this study is of significance to nursing in general and to transcultural nursing in particular because of the high priority associated with increasing the nursing knowledge through research that investigates and describes care practices in diverse cultures. This paper reports an investigation into the spiritual needs of hospitalized Iranian Muslim patients.

Method:

A qualitative study with a sample of 24 patients using semi-structured interviews. The sample selected from three different cities of Iran.

Findings:

Although not clearly distinguishable, we found two main spiritual needs include religious and existential needs in Iranian Muslim patients.

Conclusion:

With regard to holistic approach in Islamic philosophy, holism is a relevant concept in the care of Iranian patients.
MEDED - a Novel Interactive Manual to Enhance Psychopharmacologic Care in Children and Adolescents [P02-245]
Authors: Kutcher S.
Published: March 2009

Child and Adolescent psychopharmacology is a complex yet frequently necessary psychiatric intervention that requires the participation of the patient, the family, other caregivers, other health providers as well as physicians. Provision of up to date information about and education in the use of psychotropics is an essential component of good psychopharmacologic treatment. To date there have been no methods of addressing these needs within a collaborative care framework that meets the interests of all parties and optimizes the application of best available knowledge in the clinical care of child and adoelscents with mental disorders. MEDED (C) was developed by a group of pharmacists and child psychiatrists as an innovative tool to meet this need. It has been extensively evaluated in a variety of clinical settings in Canada with substantial positive results. This presentation will review the novel collaborative approach to pharmacotherapy that MEDED supports, the process of MEDED development, the contents of MEDED and research on its use to date. Clinicians and program directors will have the opportunity to learn how to obtain further information abot the use of this tool.
Socio-Demographic Profile of Out-Patient Clinic First Assessment
Authors: Moreno A. Chinchilla , Mateos L. Mateo , Larrégola M. Martín , Saez A. Diez
Published: March 2009

Introduction:

Ramon y Cajal Hospital is the referencial center for the mental health unit used in this study, whose outpatients are attended by psychiatrist consultants. First assessment is conducted by general practicioners, or other specialists. Once assessed, a decision must be made: to follow-up, carry out psychological therapies, refer to social workers or other resources.

Objectives:

To investigate socio-demographic and clinical profiles at the psychiatric outpatients unit as a result of an analysis of the first assessment data.

Methods:

We include 9 variables from 104 first assessments carried out in our center.

Results:

48,27 is the age range of our sample, with 58,65% female and 50,1 % married. Most referrals are requested by primary care, being only 14,42% by psychiatric ward units and other medical specialities. Anxiety is the primary reason for requiring psychiatric care (36, 54%) and affective disorders (35,58%), followed by psychosomatic events. With respect to diagnosis at first consultation, we found, as expected, that the most frequent disorders are anxiety (37,50 %) and depression (32,69%).71,15% of our patients needed a follow up by us and 8,65 % are discharged after the first assessment. The rest are reffered to other mental health resources.

Conclusions:

As a result of the analysis we found out that minor pathology is the most common reason for care in our centre, being refered mostly by general practicioners. So psycho educational programmes and continuous training in general medicine could be needed in order to improve mental health and to reduce costs of the mental health system.