bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.