bluuebunny/crossref_metadata_2025 huggingface dataset:
Movies and mental illness stigma - A European cinematic perspective
Authors: Pavlovic R.Y. , Pavlovic A.M.
Published: May 2011

Introduction

Mental illness remains highly stigmatized in society. Cinematography is a potent source of psychiatric images. Research has concentrated on mental illness portrayals in Hollywood; neglecting European cinematic perspectives.

Objectives, aims, methodology

We systematically examined European cinematic depictions of psychiatric illness and treatment. Award-winning European films were screened for psychiatric content using the International Movie Database. Two assessors independently viewed shortlisted films and compared findings. Stigma markers were derived from Link. Attributes, affective responses, attitudes and behaviours towards designated mentally-ill characters were identified through content and dramatic character analysis.

Results

40 films between 1964 and 2009 were identified. Psychopathologies included schizophrenia, delusional disorder, epileptiform psychosis, depression, somnambulism, learning difficulties, autism, sado-masochism and transsexualism. Frequent attributions were ‘odd’, ‘inappropriate’, ‘dangerous’, ‘unstable’, ‘frightening’ or ‘perverted’. Core affective responses comprised a cluster of ‘shame’, ‘pity’, ‘disgust’ and ‘fear’. Attitudes and corresponding behaviours occurred on a spectrum of ‘benevolent’, ‘ambivalent’, ‘distant’ and ‘hostile’. Stigmatisation of psychiatric treatment included portraying home treatment within traditional societies as misguided; institutional confinement as common; and medication as dominating daily routine. Religious dimensions to psychiatric illness and care were depicted positively and negatively. Anti-stigma themes included redemptive sacrifice or artistic genius in madness; madness as a natural manifestation of industrial alienation; and madness as unjust political labelling. Stigmatising reactions were depicted as cruel; even driving sufferers to gain sympathy through faking suicide. Psychiatrists were often characterized as empathic. One film charted humane Italian psychiatric reforms.

Conclusion

European cinematic psychiatric perspectives are complex; both propagating and deconstructing stigmatising stereotypes.
Human rights in mental health: Changing attitudes through raising awareness
Authors: Poštuvan V. , Constantinescu P.-M. , Jilek V. , Digil A. , Radusinovic D.
Published: May 2011

Introduction

Individuals with mental health problems, especially those hospitalized in mental health institutions, are particularly vulnerable to violations of their Human Rights. There are a number of special laws and regulations in different European countries and on the international level regarding the rights of people with mental health problems, however there are many instances in which their rights continue to be violated. In order to respect their Human Rights, it is necessary to study and to address the negative attitudes that the general (or even professional) public may hold toward the people with such problems.

Aims

This research aims to reveal and compare the attitudes toward mentally ill people in different countries (Romania, Czech Republic, Nigeria and Serbia). Also, within the project we will develop a workshop to address these attitudes.

Methods

The Opinion about Mental Illness Scale (OMI) for measuring attitudes was used. We used the pre-post study design to evaluate changes of attitudes because of the involvement in the intervention workshop. Students in the area of psychology, medicine or similar or general public took place in 90-minutes workshop, which was developed from the stories of people suffering from mental illnesses (e.g. schizophrenia), and their family perceptions and attitudes.

Results and conclusions

The pilot study showed a great acceptance of this kind of interventions among students. Besides, the structure of the workshop, the response of the audience, participation rate and first results of the evaluation will be presented.
Cross sectional study of psychiatric comorbidities among adolescents with obsessive compulsive symptoms
Authors: Rady A. , Salama H. , Hamza M. , Ketat A.
Published: May 2011

Background

Obsessive symptoms among children and adolescent age groups are increasing, an observation made by mental health professions working with this age group. Our epidemiological study is targeting secondary school students to estimate the prevalence of obsessive symptoms, obsessive compulsive disorder and to evaluate psychiatric comorbidities among students with obsessive compulsive symptoms.

Materials and methods

The study is a cross sectional carried on 1299 secondary school students, the sample size was chosen based on an estimated OCD prevalence of 2% in literature. Equal samples were recruited from the 3 educative zones in Alexandria Governorate. Obsessive compulsive symptoms were assessed by the Arabic version of Lyeton obsessive inventory child version LOI-CV. Students scoring above 35 were subjected to the Mini International Neuropsychiatric Interview for children MINI-KID Arabic version to assess psychiatric comorbidities. OCD patient students detected by MINI-KID were assessed by psychiatric interview to confirm fulfilling criteria of OCD according to DSM IV - TR criteria.

Results

The sample was equally distributed according to gender with 51.7% and 48.3% of males and females respectively. The prevalence of obsessive compulsive symptoms was 15.5%, while that of obsessive compulsive disorder was 2.2%. Comorbidity with other psychiatric disorders was high for substance abuse 18.9%, Dysthymia 16.4%, social phobia 15.9%, Major depression 13.9%, Generalized anxiety disorder 12.9%.

Conclusion

The prevalence of obsessive compulsive symptoms is high among adolescent age group, there is high Comorbidity between obsessive symptoms and psychiatric disorders particularly substance abuse, mood disorders and non OCD Anxiety spectrum disorders.
Prevalence of cognitive impairment in Brazilian frailty elderly
Authors: Ferreira A.S. , Raposo N.R.B. , Barbosa E.M.S. , Gattaz W.F.
Published: May 2011

Introduction

Accelerate aging is a worldwide problem. In underdeveloped countries, it is occurring without adequate planning and is attributed due to falling mortality and fertility, which contributed to increase life expectancy. However, aging was not accompanied by improvement in living conditions and health assistance. Poor sanitation and diet, low incomes and education levels contributed to increasing the prevalence of chronic diseases in elderly.

Objectives

Data obtained in other countries could not represent the national population; objective was to describe a Brazilian frailty elderly sample.

Aims

Determine cognitive impairment prevalence in Brazilian frailty elderly.

Methods

1952 frailty elderly were analyzed. Social data, tobacco and alcohol consumption were verified and mini-mental state examination was applied from February to August in 2010.

Results

Female elderly was predominant (68.8%). They were almost married (47.5%), followed by widow (37%), single (8.1%), divorced (7.4%). White people were predominant (69.2%); black (14.6%) and brown (16.2%) were presented at the same proportion. 823 frailty elderly (64.9%) studied until 4 years; 7.7% studied between 4–8 years; 1.9% went to college and 25.6% were illiterate. Only 10.6% were smokers and 2.8% drank alcohol. The majority (79.4%) were younger than 80 years-old. Cognitive impairment prevalence were 17.2% in illiterate; 15.2% in elderly who studied until 4 years and lower, 5.3%, in the group who studied between 4–8 years.

Conclusions

The prevalence of cognitive impairment was dependent on years of study and we presented data obtained in a Brazilian sample. These data can be used to compare cognitive impairment in different countries.
Social-economic profile of a Brazilian frailty elderly sample
Authors: Ferreira A.S. , Barbosa E.M.S. , Raposo N.R.B. , Gattaz W.F.
Published: May 2011

Introduction

Frailty elderly is defined as the person older than 80 years old or between 60–80 years old and who has polipathologies; polipharmacy; total or partial immobilizations; fecal or urinary incontinence; postural instability; cognitive or functional impairment; frequently hospitalizations. Since they are complex patients, the knowledge about their social-economic profile contributes to the success of health professionals’ assistance, because it directly influences on each person health.

Objectives

Determine the social-economic profile of a Brazilian frailty elderly sample assisted in a public service.

Aims

The knowledge about social-economic profile can guide the assistance and health promotion campaigns.

Methods

126 frailty elderly were interviewed. A validated Brazilian questionnaire (ABIPEME) of social-economic profile was answered. Sex, civil status, age and who answered the questionnaire were also obtained.

Results

Female elderly were predominant (67.7%). They were almost married (56.3%), followed by widow (35.7%), single (4%), divorced (4%). 46 frailty elderly (36.6%) were younger than 69 years old; 37.8% were between 70–79 years old; 22.6% were between 80–89 years old and 3.0% were older than 90 years old. 95 frailty elderly (75%) were able to answer all the questions. The majority belonged to poor class (42.2% to poor and 18.3% to very poor); 36.6% belonged to low medium class; only 3.0% belonged to medium class; nobody belonged to rich class.

Conclusions

The low social-economic condition of frailty elderly can contribute to chronic diseases in these population, due mainly to a poor diet, inadequate access of medicines and a low quality of life.
Functional impairment prevalence in Brazilian frailty elderly
Authors: Ferreira A.S. , Barbosa E.M.S. , Raposo N.R.B. , Gattaz W.F.
Published: May 2011

Introduction

Health life expectation could be defined in many ways. The notion of health life can considered, for example, physical, mental or social well-being; disease consequences; functional impairment; successful aging. Functional independence in daily activities is a key aspect on frailty elderly quality of life. This independence is related with elderly social and leisure activities, which improves their physical and mental health and brings sense to their life.

Objectives

Data obtained in other countries could not represent the national population; the objective was to describe a Brazilian frailty elderly sample.

Aims

Determine functional impairment prevalence in Brazilian frailty elderly.

Methods

8769 frailty elderly were examined. Social data, tobacco and alcohol consumption were verified and the functional activities questionnaire was applied from May, 2009 to August, 2010.

Results

Female elderly was predominant (68.1%). They were almost married (47.3%), followed by widow (37.9%), single (9%), divorced (5.9%). White people were predominant (69.9%); black (14.9%) and brown (15.2%) were presented at the same proportion. Only 13.1% were smokers and 4.3% drank alcohol. The majority (78.7%) were younger than 80 years-old. Functional impairment prevalence was 9.5% in the 60–69 years old group; 18.9% in 70–79 years old group; 36.8% in 80–89 years old group and 61.3% in 90–99 years old group.

Conclusions

The prevalence of functional impairment increased with aging and we presented data obtained in a Brazilian sample. These data can be used to compare functional impairment in different countries and to stimulate elderly independence during their aging.
The role of marital status, literacy, and urbanity in suicidal behavior by burns in the province of Khorasan, Iran
Authors: Alaghehbandan R. , Lari A. Rastegar , Joghataei M.-T.
Published: May 2011

A prospective study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Khorasan, Iran, from March 21, 2005 to March 20, 2006, to examine marital status, urbanity and literacy among these patients. Data were obtained through interviews during the course of hospitalization. A total of 130 patients with suicidal behavior by burns were identified (incidence rate of 2.9 per 100,000). Females had a higher rate of suicidal behavior by burns than males (4.2 vs. 1.6 per 100,000, P < 0.001). The rate of suicidal behavior by burns was higher among single persons than married persons(4.3 vs. 3.5 per 100,000). The rate of suicidal behavior by burns among the rural population was slightly higher than the urban population (3.2 vs. 2.7 per 100,000). The high rate of suicidal behavior by burns among young, married women in Khorasan is a social tragedy.
A prospective population-based study of suicidal behavior by burns in the province of Ilam, Iran
Authors: Alaghehbandan R. , Lari A. Rastegar , Joghataei M.-T. , Motavalian A.
Published: May 2011

The aim of the study was to examine epidemiologic characteristics of suicidal behavior by burns requiring hospitalization in the province of Ilam, Iran.

A prospective population-based study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Ilam, Iran, from March 21, 2005 to March 20, 2006. Data were obtained from patients, family members, and/or significant others through interviews during the course of hospitalization.

A total of 51 patients with suicidal behavior by burns requiring hospitalization were identified during the study period, representing an overall incidence rate of 12.5 per 100,000 person-year (P-Y). Females had a higher rate of suicidal behavior by burns than males (18.0 vs. 7.2 per 100,000 P-Y) (P < 0.001). The age-specific rate of suicidal behavior by burns peaked at age group 20–29 years. The rate of suicidal behavior by burns was slightly higher among married persons than single persons, although not statistically significant (13.5 vs. 9.8 per 100,000 P-Y) (P = 0.25). The rate of suicidal behavior by burns among the rural population was significantly higher than the urban population (17.9 vs. 9.3 per 100,000 P-Y) (P = 0.02). The most frequent precipitating factor for suicidal behavior was marital conflicts.

The high rate of suicidal behavior by burns among young, married women in Ilam is an alarming social tragedy. Despite substantial efforts toward improving health and human rights, persistent conditions allow violence against women in Iran and that these women continue to turn to the desperate remedy of self-burning.
Using the CES-D scale in a large cohort study and dealing with missing data: Application to the French E3N cohort
Authors: Resseguier N. , Verdoux H. , Clavel-Chapelon F. , Paoletti X.
Published: May 2011

Introduction

The CES-D scale is commonly used to assess depressive symptoms (DS) in large population-based studies. Missing values in items of the scale may create biases.

Objectives

To explore reasons for not completing items of the CES-D scale and to perform sensitivity analysis of the prevalence of DS to assess the impact of different missing data hypotheses.

Methods

71412 women included in the French E3N cohort returned in 2005 a questionnaire containing the CES-D scale. 45% presented at least one missing value in the scale. An interview study was carried out on a random sample of 204 participants to examine the different hypotheses for the missing value mechanism. The prevalence of DS was estimated according to different methods for handling missing values: complete cases analysis, single imputation, multiple imputation under MAR (missing at random) and MNAR (missing not at random) assumptions.

Results

The interviews showed that participants were not embarrassed to fill in questions about DS. Potential reasons of nonresponse were identified. MAR and MNAR hypotheses remained plausible and were explored.

Among complete responders, the prevalence of DS was 26.1%. After multiple imputation under MAR assumption, it was 28.6%, 29.8% and 31.7% among women presenting up to 4, to 10 and to 20 missing values, respectively. The estimates were robust after applying various scenarios of MNAR data for the sensitivity analysis.

Conclusions

The CES-D scale can easily be used to assess DS in large cohorts. Multiple imputation under MAR assumption allows to reliably handle missing values.
Revisiting goa's mental health
Authors: Ribeiro A.E. , Santos M.
Published: May 2011

Despite Goa's privileged economic and environmental position, research has demonstrated that mental health is in fact a major public health issue in this Indian state.

Besides learning difficulties, child abuse, and high suicide rates, depression and anxiety seem to affect more than one third of the patients in primary care attenders. Medically unexplained physical symptoms are common clinical features, frequently misdiagnosed by the primary care physicians. Alcohol consumption has always been an integral part of Goan lifestyle, with alcohol dependence being a major public health issue. Drug abuse, in particular heroin and more recently LSD and ecstasy, are of concern in the coastal areas, and foreign influence might not be the only explanation for this fact.

Goa has one of the most extensive health systems in India. Private psychiatry is also relatively well represented, and fortunately there are some NGOs working in this field, providing care in areas where government services have been inadequate.

Despite those facts, the majority of persons with mental health disorders have never come in contact with mental health care providers. Persons prefer to consult non-mental health professionals, and frequently continue to seek help from Religious and Spiritual Leaders, Informal Counsellors, priests and Gurus with healing powers. Many of such practices are unregulated, expensive and potentially dangerous.

Priority mental health issues in Goa include sensitizing health workers to mental illnesses, and improving access to care in existing health services.
Social determinants of mental health and policy implications
Authors: Rocha I.
Published: May 2011

Introduction

WHO has defined the social determinants of mental health (2008) as “social justice is a matter of life or death. Affects how people live, their propensity for disease and risk of premature death”. Underlies that health is not only determined by biological, but by social factors that can be divided into: Economic, Gender and Cultural.

Objectives

The author proposes to do a literature review focusing on a consensus on the social determinants of mental health, and the implications on the policies of various countries.

Aims and methods

We performed a literature review using textbooks and research papers (Medline, Pubmed, 1997–2010).

Results

Topics about Social Determinants of Mental Health often establish, the social gradient, situations of stress, childhood development, poverty, drug dependence, conditions at work, unemployment, social support, food, transportation policies, gender and cultural determinants.

The Global Movement for Mental Health should play an important role in public health activities, focusing on global mental illness. To do this effectively, the mental health professionals need to confront global poverty, its relationship with the political and economic developments as well as the consequences for common mental illnesses.

Conclusions

In a public health perspective, evidence of the mechanisms of this relationship can be used to consider a variety of primary and secondary preventive strategies with regard to mental health.
Survey of special needs in physically disabled people: A qualitative research
Authors: Farhoudian A. , Soleimaninia L. , Sadeghi M. , Jafari F. , Savari M.E. , Zafarghandi M.B. Saberi
Published: May 2011

After sanction of “the rights of disabled people convention” United Nations Organization have been stressed more on dealing with this group’s needs. Therewith, most of countries in the world have been committed in this field. Therefore with consideration of importance of identifying the needs in disabled people and making policies for them, this study conducted in order to identify the special needs in physically disabled people. This article is a part of a qualitative research with grounded theory method. 15 physically disabled people of Tehran were selected through a purposeful sampling participated in study. The main method for collecting data was semi-structured interview that continued until theoretical saturation of information. Data was analyzed with Strauss & Corbin coding manner or continued comparison and the assessor’s viewpoints method is used for validity promotion of data.

Totally, most important domains of special needs in disabled group were: family and relatives, education, movement and transportation, building and places (houses and public places), social participation and occupation, treatment and rehabilitation services, and people’s attitude toward their problems.

The results indicated that for promoting social participation and function independency in disabled people, should be emphasis on “equality of opportunities” in society rather than “disability”. Thus, public systems and services should be available equally for all, such as physical environments and places, housing, transport system, educational and vocational opportunities, and socio-cultural life like equipments for sport and amusement. Then, physically disabled people can reach to a life with more quality and same with others.
Poverty and mental illness: An unbreakable cycle?
Authors: Santos M. , Ribeiro A.E.
Published: May 2011

Mental condition is determined by a multiplicity of factors, such as biological, individual, social, economic and environmental. Mental and behavioural disorders are estimated to account for 13% of the global burden of disease, according to the World Health Organization. Despite this evidence, mental health is a neglected and an under-researched area of public health, particularly in low-and-middle-income-countries (LMICs).

Recent studies found an association between common mental disorders (CMD), such as depression and anxiety, and poverty. However, investigation on several specific poverty indicators has revealed a much more complex scenario.

A recent meta-analysis showed that variables such as education, food insecurity, housing, social class, socio-economic status and financial stress are consistently and strongly associated with CMD. In turn, the disabling effects of mental disorders impair the ability of persons to self-sustain, reflecting a relationship between poverty and mental disorders that has been likened to a vicious cycle.

The authors emphasize the need for improvement of LMICs mental health policies.
Review of studies of ADHD: Long-term outcomes with and without treatment
Authors: Shaw M. , Caci H. , Hodgkins P. , Kahle J. , Callamaras N. , Woods A.
Published: May 2011

Introduction

As awareness of ADHD has increased worldwide, interest has grown beyond the constellation of ADHD symptoms, to include long-term impact on people's lives and society in general.

Objectives

Examine the results of studies of long-term life consequences of ADHD.

Aims

To identify areas of life affected long-term by ADHD and differences in outcomes with and without ADHD treatment.

Methods

Following Cochrane guidelines, 12 databases were searched for studies published in English (1980–2010). Limiting criteria maximized study inclusion while maintaining high study rigor: (1) peer-reviewed, (2) primary study reports, (3) including a comparator condition, and (4) reporting long-term outcomes (mean 8 years, range 6 months-40 years from study start for prospective studies; subjects in adolescence or adulthood for retrospective or cross-sectional studies). The fully-defined electronic search yielded 4615 citations. Manual review based on titles and abstracts yielded 340 studies included in this analysis of outcomes.

Results

The majority of studies (86%, 243 of 281; studies of untreated ADHD only) showed that untreated ADHD has substantial negative long-term outcomes, encompassing nine broad-ranging areas of life: non-medicinal drug use/addictive behaviour, antisocial behaviour, academic achievement, occupational achievement, public services use, self-esteem, social function, obesity, and driving outcomes. In contrast, most studies including ADHD pharmacotherapy and/or non-pharmacotherapy (94%, 46 of 49) showed that compared with baseline or untreated ADHD, long-term outcomes improved or stabilized with treatment of ADHD.

Conclusions

ADHD has notable negative long-term consequences, and this negative impact may be reduced with treatment of ADHD. Supported by Shire Development Inc.
Training in child and adolescent psychiatry (CAP) in Europe: 2010–11 survey by the European Federation of psychiatric trainees CAP working group
Authors: Simmons M. , Pacherova L. , Barrett E. ,   EFPT Child and Adolescent Psychiatry Working Group
Published: May 2011

Introduction

The education and training of doctors specialising in Child and Adolescent Psychiatry (CAP) varies substantially across Europe. There is a paucity of information available about training quality. This prompted an initial training survey led by Dr E Barrett (2010) which was expanded upon by the CAP working group in the 2010 EFPT international forum in Dubrovnik to create ‘country reports’ for 2010–2011.

Objectives

The objectives of this study were to collect information relating to key aspects of CAP training programmes in Europe in a systematic way in order to start a ‘Training Database’ that can be held centrally by the EFPT. Information will be added to the database every year following EFPT annual international meetings.

Aims

We aim to better understand the training structures in CAP across europe to help inform best practice standards for training.

Methods

A pro-forma word document was emailed to all EFPT CAP contacts: there were 20 contacts emailed.

Results

So far we have a response rate of over 60% and we are continuing to collect and collate relevant data. This survey highlighted a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.

Conclusions

This survey highlights a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.
Quality of life of patients residing in long-term care psychiatric community settings
Authors: Stinga M. , Moti E. , Papageorgiou E. , Ioannou T. , Paraskevopoulou V. , Papanikolaou K. , Voura N. , Angelidis G.F.
Published: May 2011

Introduction

In the context of psychiatric reformation, the long-term mentally ill have moved from institutionalized care to outpatient-based mental health services and community-based rehabilitation settings.

Objective

Quality of Life (QoL) constitutes a critical outcome of mental health programs and services and is a multidimensional subjective construct.

Aim

Exploring the perceived QoL of long-term psychiatric residents and, identifying possible associations between sociodemographic variables, psychiatric history, cognitive function (MMSE), physical comorbidity and type of residential care.

Method

104 patients residing for over six months, to community based rehabilitation settings subjected to the PHPO (5 sheltered apartments, 7 hostels, 2 boarding houses) were encountered. QoL of participants was assessed using the self-fulfilling, 36 item Short-Form Health Survey (SF-36) at a given point of time.

Results

The majority of the residents expressed good levels of satisfaction in all subscales of the SF-36, with mean values of Physical Component Summary (PCS): 34.90 ± 13.92 (range: 0–50) and Mental Component Summary (MCS): 67.89 ± 20.09 (range: 25-100). Statistical significant differences were recorded concerning the PCS and age (p = 0.000), MMSE scores (p = 0.000), educational level (p = 0.017), marital status (p = 0.049) and type of residential home (p = 0.012). MCS was statistically significant associated with age (p = 0.032), MMSE scores (p = 0.007), socioeconomic status (p = 0.008) and type of residential home, too (p = 0.040). No differences were found concerning psychiatric diagnosis or physical comorbidity.

Conclusions

Community care models provide subjective positive life satisfactions to the majority of the chronically mentally ill. Thus, besides the care giver's management, independent variables play an important role to perceived QoL.
Comparison of burnout syndrome, anxiety and depression in nurses of psychiatric ward and other wards
Authors: Toobaee S. , Tadioni G.R.
Published: May 2011

Background

Burnout is a syndrome consisting of physical and mental exhaustion and depersonalization. Work burn out may be caused by job specification and environment. Medical and paramedical staff because of their job is at high risk and burn out is more common in this group.

Methods

In this research 104 nurse including 52 nurses from psychiatry ward and 52 nurses from other hospital wards were randomly selected and evaluated for signs of burn out, anxiety, depression. We applied maslach (MBI) questionnaire to assess the prevalence of burn out, beck questionnaire for prevalence of depression and Hamilton questionnaire for anxiety.

Results

The results showed no significant differences in the average grades of work burn out, depression, anxiety among the nurses serving psychiatry wards and other hospital wards.

Conclusion

As a result being in contact with psychiatric patient cannot essentially lead to anxiety and depression in their caring nursed and so psychological disorder are not transmissible.
The helps toolkit - a tool to promote the physical health of residents in psychiatric facilities across Europe
Authors: Weiser P. , Becker T. , Kilian R.
Published: May 2011

Introduction

People with a mental disorder are at increased risk for physical illness and therefore their risk of premature death is raised. An unhealthy lifestyle, living conditions, medication side-effects and a lack of physical health monitoring are regarded as the main causes of high somatic morbidity. But up to now only little research has addressed the physical co-morbidity in mentally ill. At present, there are no specific policies to improve the health status of residents in mental health care facilities.

Objectives / methods

Against this background a multi-disciplinary network of experts from 15 European countries was set up. Working together with researchers, stakeholders, professionals, networks, practitioners, and relevant organizations, the HELPS network developed a “physical health promotion toolkit” for routine application in a wide range of mental health care facilities across Europe. The HELPS toolkit intends to empower patients and staff to identify the most relevant risk factors in their specific context and subsequently select the most appropriate action out of a range of defined health promoting interventions. In doing so, the toolkit takes into account the heterogeneity of mental disorders, the high number of somatic problems, aspects of lifestyle, environment, medical care system, personal goals of patients and their motivation for health behavior.

Results / conclusions

The poster presents the HELPS toolkit. It illustrates the individual components of the tool and the processes of its implementation and evaluation. First results of the pilot study concerning the feasibility of the toolkit will be presented and discussed.
Dual diagnosis (DD) at first admission (FA) in three different periods: An epidemiological study
Authors: Zeppegno P. , Porro M. , Lombardi A. , Feggi A. , Torre E.
Published: May 2011

Introduction

DD represents a common issue in clinical practice, with relevant effects on symptoms, course and treatment of disease. It's often associated with negative outcome as a greater severity of symptoms and resistance to drug treatment.

Objectives

To assess how the characteristics (sociodemographic, clinical and related to substance abuse) of patients discharged with DD have changed taking into account the FA occurred in three different five-year periods (1990–1994, 2000–2004, 2005–2009). We also compared the characteristics of patients discharged with only psychiatric diagnosis with those of patients with DD to look for possible risk factors for abuse among people with psychiatric illness.

Methods

We conducted a retrospective study of medical records of patients at FA to our Institute in three different periods. We divided the patients discharged with DD from those discharged with only psychiatric diagnosis.

Results

Among the FA occurred in the periods examined we noticed an increase of DD cases (12% from 1990 to 1994, 21% 2000–2004, 28% 2005–2009). The incidence of each diagnosis was changed in several years, but each time the diseases more represented remain schizophrenic or affective psychosis and personality disorders. Alcohol is the most widely used psychotropic drug in each period. There is also a progressive increase in the abuse of cannabis, cocaine and in the incidence of multi-drug abusers. Compared with patients discharged with only a psychiatric diagnosis, patients with DD were more frequently:male, younger, unmarried, unemployed, with legal issues, grown up in a family with serious problems, and history of etero-aggressive episodes.

Conclusions

Due to continued increase in cases of DD, we want to highlight the importance of early identification of cases of comorbidity in order to provide adequate treatment and support.
Analysis of correlations among theory of mind, symptoms and personologic traits in university students
Authors: Zeppegno P. , Gogliani A. , Antona M. , Gili S. , Ponzetti D. , Torre E.
Published: May 2011

Introduction

Theory of mind represents the ability to attribute mental states to oneself and others and to use these mental representations to decide one's own and predict others’ behavior. In our study, ToM is investigated in a non-psychiatric setting: a university students sample.

Objectives

The aim of this study is to evaluate the presence of subthreshold alterations in our sample and, on the other hand, if altered cognitive functioning can worsen study performance. Moreover it investigates a possible correlation between the faculty chosen and cognitive functioning. We considered 228 students attending the Faculty of: Economy (n = 26), Dental hygienists(n = 7), Law(n = 16), Medicine (n = 54), Pharmaceutics(n = 27), Physiotherapy(n = 15), Mathematics, Physics and Biology (n = 12), Midwifery (n = 14), Chemistry and Pharmaceutical techniques (n = 17), Liberal Arts (n = 3), Nursing (n = 37).

Methods

We administered the following tests to 228 university students: EYSENCK PERSONALITY QUESTIONNAIRE (EPQ-R): evaluating some personality dimensions including psychoticism, neuroticism, introversion, extroversion;SCL-90-R: self-evaluation scale of some symptom dimensions as somatization, obsessive-compulsiveness, depression, anxiety, anger, hostility, sensitivity, phobic anxiety, paranoid ideation and psychoticism; TEST OF EMOTION ATTRIBUTION: composed of 58 short scenes concerning seven emotions (sadness, fear, shame, disgust, happiness, anger, envy) that the student must identify.

TEST OF ToM: consists of 13 short stories describing social and family situations; the student must identify why the protagonist behaved in a certain manner.

Results

The statistical analysis is still in progress. Preliminary data suggest that people with subthreshold symptoms belonging to the depression, obsessive-compulsiveness, anxiety and phobic-anxiety clusters show deficits of theory of mind. Data concerning the correlation between cognitive functioning and faculty chosen and between cognitive functioning and poor study performance will be examined in a further work.

Conclusions

Our results together with data from literature suggest the chance to apply this set of tests to screen deficit of Theory of Mind in a non mentally ill population.
Polypharmacy in psychiatric inpatients: Data from amsp (arzneimittelsicherheit in der psychiatrie), a european pharmacovigilance system
Authors: Konstantinidis A. , Letmaier M. , Grohmann R. , Stephan P. , Engel R. , Kasper S.
Published: May 2011

Introduction

Psychotropic polypharmacy is widely used in routine clinical practice although there is still a substantial deficit in established knowledge about combination and augmentation treatments. Polypharmacy is related with a higher risk of adverse drug reactions and incompliance.

Methods

On two reference days per hospital and per year, the following data are recorded for all patients on the wards under AMSP surveillance: all drugs applied on that day with the daily dosage for psychotropic drugs, ICD diagnosis, age, and sex. Data is stored at the study center in Munich. We evaluated data from 2000 (N = 5669) and 2007 (N = 8346).

Results

From 2000 to 2007 inpatient prescriptions including three or more drugs increased significantly from 59.4% to 69.3% (chi2: 144.913; df:1; p < 0.001). Furthermore the percentage of inpatients being prescribed three or more psychotropics increased significantly from 36.5% in 2000 to 47.97% in 2007 (chi2: 180.01; df:1; p < 0.001).

Investigating further, which inpatients, diagnosed according to ICD-10, tend to be treated with more than two psychotropics, we found that this was more common in inpatients, who had an F2., F3. or F9. ICD-10 diagnosis. Especially inpatients with a bipolar disorder (F31.) showed an extremely high rate for psychotropic polypharmacy with three or more psychotropic drugs, with rates of 63,8% in 2000 and 75,2% in 2007.

Conclusion

Polypharmacy is still gaining ground. Our results show that psychotropic agents are commonly used in combination; therefore further studies evaluating assumable positive results of psychotropic combinations are needed.
L-methylfolate augmentation of selective serotonin reuptake inhibitors (SSRIS) for major depressive disorder: Results of two randomized, double-blind trials
Authors: Papakostas G. , Shelton R. , Zajecka J. , Rickels K. , Clain A. , Baer L. , Schoenfeld D. , Nelson E. , Barbee J. , Lydiard B. , Mischoulon D. , Alpert J. , Zisook S. , Fava M.
Published: May 2011

Introduction

Two randomized, controlled trials of L-methylfolate augmentation of SSRIs for major depressive disorder (MDD) were conducted using a novel study design (sequential parallel comparison design- SPCD).

Objectives/aims

To evaluate the efficacy of L-methylfolate augmentation using the Hamilton Depression Rating Scale.

Methods

In study one (TRD-1), 148 outpatients with SSRI-resistant MDD were enrolled in a 60-day, SPCD study, divided into two 30-day periods (phases 1 and 2). Patients were randomized 2:3:3 to receive L-methylfolate (7.5mg/d in phase 1, 15mg/d in phase 2), placebo in phase 1 followed by L-methylfolate 7.5mg/d in phase 2, or placebo for both phases. Study two (TRD-2) involved 75 patients and was identical in design to TRD-1 except for the dose of L-methylfolate (15mg only).

Results

In the TRD-1 Study, L-methylfolate 7.5 mg/d was not found to be more effective than placebo. In phase 1 of the TRD-2 Study, 37% of patients on L-methylfolate 15mg/d responded and 18% of placebo patients responded, while in phase 2 among placebo non-responders, the response rates were 28% on L-methylfolate 15mg/d and 9.5% on placebo. When phases 1 and 2 were pooled according to the SPCD model, the difference in response rates was statistically significant in favor of L-methylfolate (p = 0.0399). The rates of spontaneously reported AEs and rates of study discontinuation appear r comparable between L-methylfolate and placebo in both studies. Rates of study discontinuation were also comparable

Conclusions

These studies suggest that L-methylfolate 15 mg/d may be a safe and effective augmentation strategy for inadequate response to SSRIs.
Do we follow prescribing and administering guidelines?
Authors: Popescu F.
Published: May 2011

This audit was done in July 2010 in an Geriatric Psychiatric Unit. Data collected from 45 drug cards with a total of 368 prescriptions, both psychotopic and non-psychotropic, regular and PRN prescriptions.

The aim was to analyse ?% of prescriptions on drug cards are meeting Birmingham and Solihull Mental Health Trust guidelines in both medics prescribing and nurses administering.

Prescribing guidelines:

Ø drug: generic name, capitals, dose amount, dose unit, frequency, route of administration

Ø patient: full name, address, date of birth (D.O.B.), patient id (P.I.D.), allergy status, team, ward

Ø prescribing doctor: signature, printed name, date of prescription

Ø In general: legibility and black ink

Administering guidelines:

• At administration of the drug, the practitioner must, sign with initials in the appropriate column of the official prescription sheet or introduce the correct code.

The results:

2 tables can′t attach

SIGNATURE AT ADMINISTRATION by the nurses

•

Signed 95%

•

Signed + code 18.5%

•

Administered by the nurses but not signed by dr. 0.5%

Recommendations:

1.

Medics and nurses teaching

2.

Introduction of the prescribing guidelines in the junior doctors trust induction handbook

3.

Notes with prescribing /administering guidelines

4.

Special print name box on the drug card

5.

Introducing electronic prescribing to avoid missing allergies

6.

Re-audit December 2010

The first four recommendations have been already implemented.

The audit has been registered with the Clinical Governance Department. By the time of the presentation of the poster with your permission in March, the audit cycle will be closed.
Hormones in the immediate postpartum period as a risk factor for postnatal depression, at two months postpartum
Authors: Leonardou A.A. , Boufidou F. , Zervas I. , Nikolaou C. , Lambrinoudaki I. , Papageorgiou C. , Christodoulou G. , Papadimitriou G.
Published: May 2011

Introduction

Postnatal depression is a serious disorder affecting 10–20% of postpartum women. It has a negative impact on the whole family system and on the child's development.

Objectives

It is important to identify possible risk factors for PND, due to its frequency and severity. It has been hypothesized that the hormonal fluctuatios of the immediate postpartum period could be a risk factor for the appearance of PND.

Aims

This study aimed at inquiring the possible correlation of hormonal parameters in the 1st week postpartum with the appearance of PND.

Methods

95 postpartum women were recruited, in the process of validating the Greek EPDS. Of them, 40 consented to give blood on the second postpartum day, so that the plasma levels of TSH, T4, T3, FSH, LH, Progesterone, Estradiol, Prolactin and Cortisol were measured. 81/95 women consented to be reassessed at 8 weeks postpartum, and 10/81 were diagnosed with depression, major or minor. Plasma levels of the hormones were correlated with the diagnosis of PND and with the EPDS.

Results

Women who suffered from PND did not differ from the non-PND subjects in the levels of all measured hormones. There was a statistically significant negative correlation of the levels of prolactin with the EPDS on the second postpartum day (p < 0.001, correlation coefficient -0.56).

Conclusions

Our study failed to show a definite correlation of the hormonal levels in the immediate postpartum period with PND. In other studies the role of hormones in the appearance of PND remains as well questionable.
Depressive disorder among married children and adolescents
Authors: Afridi I.M.
Published: May 2011

Introduction

Depression is a common condition that does not spare any age, gender and group. Marriage, an important life event, that too in early age in relation to this disorder, is the focus of this study.

Objective

To assess married male and female cases with age< 18 years for depressive disorder.

Methods

This study was conducted in psychiatric out-patients at Neuro-spinal & medical Institute, Karachi. 564 cases below 18 years consulted. Among them 44 married cases fulfilling the including criteria were selected. They were assessed on semi-structured proforma. Criteria of ICD-10 were applied for diagnostic purpose. Ethical issues were taken care off. Results were analyzed through SPSS.

Results

Forty four cases (7.8%) were married among total 564 cases < 18 years. Among them 15 (34%) were males and 29 (66%) were females. Their age ranged between 9-< 18 years with mean ages ± SD was 16.1 ± 1.8 years. Most of the females (51.7%) were illiterate while 46.7% of the males were students of primary classes. Most were from joint families with family members of up to 18 members. According to ICD-10, 33.3% of the males and 62.1% of the females were suffering from depressive disorder.

Conclusion

Early marriage is still prevalent (7.8%) among of children and adolescents in this part of the world. Depressive disorder was almost double among females below 18 years.
Depression frequency in Urmia University of medical sciences, Iran
Authors: Aghakhani N. , Eghtedar S.
Published: May 2011

Background

A depressive disorder is an illness that involves the body, mood, thoughts, and behaviors. It affects the way a person eats, feels, sleeps and thinks about things. A research about depression in Urmia University of medical sciences was done to propose some methods for solving of problems of the students. This study aimed to identify the presence of depression among medical students

Methods

This study designed to determine prevalence of depression in student of Urmia, Iran. A descriptive cross-sectional study was conducted on 700 undergraduate medical and basic students in Urmia University of medical science, west Azerbaijan Province, Iran. BDI questionnaire has been used for data gathering.

Results

Mean score of students was 10.4 ± 0.8 and 52.6% of students scored under the threshold of Beck depression inventory questionnaire indicating depressed. 2% of them have a major depression. Results didn’t observe any significant relationship between ages, education, sex, rank of birth, duration of education. Depression level in Urmia medical science university was very high that can affect on the quality of education and social behavior of the students.

Conclusion

It is important to research the causes of depression and plan to omit them. Establishment of consulting and recreation and problem solving centers that they will have in the future can be helpful.
Depression and anxiety following open heart surgery: Mediation of coping, spiritual struggle and interleukin-6
Authors: Ai A. , Appel H. , Kronfol Z.
Published: May 2011

Introduction

Factors pertaining to religion and spirituality have been linked with well-being and adequate coping. Few studies have investigated negative aspects of religious coping, such as spiritual struggle.

Objectives

Based on multidisciplinary literature and previous findings, our study's objectives are to estimate the parallel psychophysiological pathways from pre-operative distress to post-operative depression in patients undergoing open heart surgery.

Aims

The study's aims are to examine the association in depression, anxiety, and how coping, spiritual struggle and interleukin-6 play a role in patients following open heart surgery.

Methods

Plasma samples for interleukin-6 (IL-6) were obtained before open heart surgery. Patients’ history and demographic information obtained through interviews 2 days before surgery. Follow up interview for mental health and religious were conducted before and after surgery.

Results

The results showed that a link between spiritual struggle and IL-6 mediated the indirect effects of pre-operative anxiety on post-operative depression. Anxiety had positive indirect effects on post-operative hostility. Further, hope played a protective mediating role to moderate the undesirable influences of the spiritual struggle-IL-6 link and maladaptive coping on post-operative mental health attributes.

Conclusions

Our study estimated important psychophysiological pathways from pre-operative distress to post-operative maladjustment. To our knowledge, this model is the first analysis to demonstrate the significant mediating effect of the spiritual-IL-6 link, alongside that of positive religious copping and other maladaptive coping, in this population.