bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental health policy in Greece: Implications into practice in the era of economic crisis
Authors: Grammatikopoulos I. , Koupidis S. , Petelos E. , Theodorakis P. 
Published: May 2011

IntroductionBudgets allocated for mental health make up a relatively small proportion of total health expenditures, although there is an increasing burden of mental disorders.ObjectivesTo review the mental health situation in Greece with regards to mental health policy through review of relevant literature.AimsTo explore the basic implications of the economic crisis from a health policy perspective, reporting constraints and opportunities.MethodsA narrative review in PubMed/Medline along with a hand search in selected Greek biomedical journals was undertaken, relevant to mental health policy.ResultsGreece is among the OECD countries with high health expenditure as a percentage of Gross Domestic Product (9.7% of GDP in 2008) but it doesn’t have a specified budget for mental health and is mostly depended in out-of-pocket expenditure (48%). The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management and poor incentives in the public sector. The lack of cost-effectiveness and the informal payments comprise a major source of inequity and inefficiency. Uneven regional distribution of psychiatrists exists and rural areas are mostly uncovered by mental health care facilities, as well as extramural mental health units and rehabilitation places, despite the current reorganization of the whole mental health care delivery system.ConclusionsThe core problem with mental health services in Greece is the shrinking budget with poor financial administration consistent with inadequate implementation of mental health policy. A clear authority with defined responsibility for overall mental health policy and budgetary matters is needed.
Mapping service development: A comparison of UK and US studies
Authors: Grant Hay A. , Woppmann A. , Walder N. , Szmukler G. , Schrank B. 
Published: May 2011

IntroductionReasons for differences in the effect sizes of studies on complex interventions, such as assertive outreach, between the US and the UK are a much debated topic. One possible explanation was suggested to be the potentially different quality of standard care in the two countries.AimsWe aimed to(i) empirically establish the comparability of research results on complex interventions for people with severe mental illness (SMI) from the UK and the US, and(ii) explore developments over time in standard care in both countries by comparing studies that use “treatment as usual” (TAU) as the control intervention.MethodsWe conducted a systematic review and meta-analysis of RCTs conducted in the UK or the US(i) involving people with SMI,(ii) comparing complex interventions with TAU, and(iii) using the outcome relapse or readmission to hospital.ResultsThe Risk Ratios for relapse/readmission were very similar and favouring experimental treatment both in the UK (RR 0.80, CI 0.73–0.88) and the US (RR 0.87, CI 0.79–0.95). The development of effects resulting from experimental interventions relative to those from TAU over time shows a slightly different pattern for the two countries.ConclusionsThe broadly similar total RR for relapse/readmission in both countries confirms the comparability of studies conducted in the UK and the US and suggests no significant overall difference in the quality of standard care. The chronological development of effects, however, reflects developments in TAU over time which differ between the two countries.
Psychatric morbidity among third year medical students at Ain Shams University, Cairo, Egypt
Authors: Ibrahim J. 
Published: May 2011

BackgroundMental distress among medical students is often reported. Different psychiatric disorders are found to be under recognized yet common and treatable among medical students. Various previous studies have shown that medical students are subjected to considerable stress over the last decades. The aim of this study was to determine the presence of clinically significant psychiatric morbidity among third year medical students, to explore the effects of the socio demographic background for these outcomes and to analyze gender differences regarding selected psychiatric morbidities.MethodsA cross sectional study is carried out among third year medical students from Ain Shams University. They were assessed using Social Classification Scale and Structured Clinical Interview for DSM-IV (SCID I) to assess psychiatric morbidity.ResultsResponse rate was 98.9%. Prevalence of psychiatric morbidity among our medical students sample was 59.9%. No significant statistical association between psychological morbidity and any of the socio demographic variables. The most prevalent psychiatric diagnosis was found to be depression (47.9%), followed by Generalized Anxiety Disorder (GAD) (44.9%) & Obsessive Compulsive Disorder (OCD) (44.4%). The least prevalent of which was Anorexia Nervosa (0.7%).ConclusionSignificantly high proportion of medical students (59.9%) had ongoing psychiatric condition and that proactive interventions should be addressed to encourage those medical students to seek help for their psychiatric problems. Counseling and preventive mental health services should be an integral part of the routine clinical facilities caring for medical students.
Qualitative evaluation of archived files of pasychiatric ward of Imam Hossein Hospital during years of 2007 to 2008
Authors: Kia A. , Ardestani S.M. Samimi 
Published: May 2011

IntroductionMedical records include information about the status and the hospital course of a patient and the instructions given to the patient. The accurate, accessible and up to date information can be used for further evaluation of the patient and also probable research projects.ObjectivesQualitative study of the archived patients’ files.AimsEvaluating the quality of the medical records at the psychiatric ward.MethodThe study was an observational descriptive study in which 400 archived files at the psychiatric ward of Imam Hossein Hospital during the years of 2007 and 2008 were qualitatively studied. The data was gathered by a data sheet and was analyzed using SPSS v. 15.0.ResultsAmong patient's demographic information, place of birth was not recorded in 82% of the files followed by birth date that was missing in 38% of the files. Case history, psychiatric formulations and progressive notes of patients were not appropriately recorded in 2.5% of the patients’ files. Finally, the summary sheets did not clarify the main complaint in 11.7% of the files and 7.5% of them lacked information to indicate dates of admission and discharge. Only 21.25% of the summaries defined initial and final diagnosis.ConclusionWith regards to the results and since there were incomplete data; the information could not be properly used as the raw material for researches. It seems that more supervision is needed to completely fill the files.
Mental health care pathways
Authors: Kingdon D. , Gregoire A. 
Published: May 2011

IntroductionThe term, care pathway, has been used to describe multidisciplinary/ multi-agency outline of anticipated care, placed in an appropriate timeframe, to help a patient with a specific condition or set of symptoms move progressively through a clinical experience to positive outcomes. In practice, a multitude of disparate projects have produced outputs ranging from pages of interconnected boxes and arrows with rather basic entries to thick and indigestible wads of paper. Certainly the idea of a ‘mental health care pathway’ accessible and used by the general public, service users, carers, primary and secondary care has seemed overwhelmingly complex and unworkable.Aims & objectivesTo make relevant service and clinical information available when and where in a person's progress or a clinician treatment path it was needed.MethodWebsite hyperlinks allow linkage within websites and to other websites with relevant information (e.g. ICD10, NICE guidelines, and Patient information leaflets). A development prototype funded by the UK NHS has been established to form the basis for a website to be launched in mid-2011 (www.mentalhealth.southcentral.nhs.uk).ResultsThe prototype contains links to evidence-based information on maintaining mental health and on ‘coping with problems’. Service Pathways describe detail of processes occurring in mental health care. Diagnostic care pathways start as broad categories [Kingdon et al, 2010] with links to diagnosis, medication (e.g. connects to the National Formulary) and psychological management sites.ConclusionsWeb technology allows information about mental health care pathways to be accessed more systematically and readily and has application internationally.
The correlation between acculturation stress and acculturation dreaming process
Authors: Lee S.B. 
Published: May 2011

AimThe purpose of this study was to test the correlation between acculturative stress scale and acculturation dream scale and to verify previous research outcomes.Methods165 Korean American undergraduate and graduate students (M age = 23.3, SD = 4.1) participated in this study. They submitted the most recent dreams and assessed acculturative stress scale. Total 165 dreams were coded by “Lee Acculturation Dream Scale” (Lee, Sang Bok, 2005: Psychological Reports, 96, 454–456). The hypothesis was that the group members having higher acculturative stressscale would have lower acculturation dream scale than the group members with lower acculturative stress scale.ResultsThe first generation Korean American students group (n = 80, M age = 23.4, SD = 4.2) had higher acculturative stress level and lower acculturative dream scale when compared with the second generation Korean American college student group (n = 85, M age = 23.6, SD = 4.3). The t-test on the two group comparison was significant on acculturative stress level (p < 0.001) and “Lee Acculturation Dream Scale” (p < 0.001). It was proven that day time acculturative stress situation had an effect on the night-time dreaming neurocognitive activities, i.e., unconscious acculturation process (Lee, Sang Bok, 2006: “Acculturation Scale for Korean American College Students,” Psychological Reports; Lee, Sang Bok, 2006: “Asian Values Scale - Comparisons of Korean and Korean-American High School Students,” Psychological Reports).ConclusionThe multiple domains of acculturative processes need to be explicated in terms of “multicultural hermeneutics” (Lee, Sang Bok, 2003: “Working with Korean-American Families - Multicultural Hermeneutics,” The American Journal of Family Therapy, 31, 159–178) and of real life experience mapping.
Depression in different welfare state regimes in Europe: The role of attitudes towards state responsibility for an adequate standard of living
Authors: Levecque K. , Van Rossem R. 
Published: May 2011

IntroductionRecent cross-national research by Levecque et al (Journal of Health and Social Behavior, in press) has shown that the health effects of social experiences are attenuated, boosted or even reversed by the sociopolitical context. More specifically, it was found that the link between economic hardship and depression varies between different welfare state regimes in Europe.ObjectivesCurrently, we assess whether this variation in depressing effect is totally attributable to differences in welfare state arrangements or whether welfare state attitudes play a significant role as well. Is economic hardship more depressing when the individual considers the state as the main provider for an adequate standard of living, or is the risk of depression higher when emphasis is put on self-provision and individual responsibility?MethodsAnalyses are based on data for 23 countries in the European Social Survey 2006–2007 (N = 41686). Multilevel linear regressions are performed. Depression is measured using the Center for Epidemiologic Studies Depression Scale (CES-D 8).ResultsWe find that experiencing economic hardship is significantly more depressing for individuals who consider the state as the main responsible for providing an adequate standard of living. This pattern is observed in all welfare state regimes and remains significant when controlling for gender, age, having a partner, educational level, social support and locus of control.ConclusionThe link between economic hardship and depression is dependent on both structural welfare state arrangements and welfare state attitudes.
PTSD as risk factor for alcohol-related disorders
Authors: Licanin I. , Fisekovic S. 
Published: May 2011

PTSD is highly correlated with alcohol and drug abuse.ObjectiveTo estimate impact of PTSD on frequency of various forms of alcohol induced disorder.MethodResearch conducted during 2006 at Psychiatric Clinic in Sarajevo. It included: first group (I) of 50 patients with PTSD and alcohol induced disorders and second (II) group of 50 patients with alcohol induced disorder without PTSD.ResultsComparing results these two groups, we found:Alcohol intoxication: I group 11 (22%) vs. II group 15 (30%)Alcohol withdrawal: 3 (7%) vs. 4 (8%)Psychotic disorder with hallucinations: 11 (22%) vs. 9 (18%)Psychotic disorder with delusions: 7 (14%) vs. 5 (10%)Delirium: 6 (12%) vs. 9 (18%)Amnesic disorder: 9 (18%) vs. 4 (8%)Blackouts: 1 (2%) vs. 1 (2%);Seizures: 2(4%) vs. 3(6%).ConclusionIt seems that PTSD frequently caused more severe clinical forms of alcohol disorders, which should be prove in larger sample. This could be considered in prevention alcohol and PTSD as well.
Factors that affect compliance in psyciatric therapy in patients and outpatients in a Greek psychiatric department
Authors: Lyrakos G.N. , Goudella A. , Spinaris B. 
Published: May 2011

IntroductionResearch shows that mental patients are usually the most difficult to be managed in terms of adherence to treatment. Antipsychotic drugs does reduce their symptoms, but at least half of people given these drugs do not comply with the treatment regimen prescribed.AimsTo explore the way that treatment options affects compliance in patients with mental disorders.Methods155 (61,5%) males and 97 (38,5%) females participated in the study. DASS42 and SQR29 questionnaires were administered to all patients in admission and at the end of the treatment. Good compliance to the treatment required low scores to both of them at the end of the treatment and the consent of the psychiatrist and psychotherapists who were responsible for each patient.Results172 of them had a good compliance, 32 medium and 26 did not comply at all.184 received pharmacotherapy, 21 CBT therapy and 26 combined therapy. Regression analysis indicates that better compliance to the treatment is significantly affected by CBT therapy (β = .44**), antidepressants (β = .37**), Typical antipsychotics (β = .25*) and sex (β = .24*) (*<, 05 **<, 0001). These variables accounted for 38 percent of the variance in compliance.ConclusionsIt seems that patients show better compliance to treatment when they are under psychotherapy and are receiving antidepressants and typical antipsychotics.
Health literacy and adherence to psychiatric appointments: Study of an urban academic center
Authors: Bizamcer A. , MacIntyre K. 
Published: May 2011

IntroductionHealth literacy (HL) measures the ability of an individual to use health-related information in order to make appropriate health-related decisions and to navigate the healthcare system. It influences a variety of behaviors such as breastfeeding, medication adherence, or the use of screening tests. Research has shown that it is related to the treatment outcome of conditions such as HIV and diabetes.ObjectiveIt is the assumption of this study that health literacy also plays a role in psychiatric patients’ adherence to treatment; in particular, to outpatient psychiatric appointments.AimsWe hypothesized that patients with different health literacy levels would have different adherence rates to outpatient psychiatric appointments.MethodsThe study was conducted in 2006 in the Outpatient Psychiatry Department (OPD) of Temple University School of Medicine in Philadelphia, Pennsylvania. All English and Spanish-speaking patients of the OPD (potential N = 150) were invited to complete the short version of the Test of Functional Health Literacy in Adults (sTOFHLA), yielding three HL groups: adequate, marginal and inadequate. We explored the demographic and clinical correlates of HL and compared the three literacy groups with respect to their adherence to appointments during a 12-month period.ResultsOur study showed that, for our patient population, HL was not significantly related to any of the demographic and clinical variables included in our analysis except appointment adherence.ConclusionPatients with lower HL had lower adherence to appointments. These findings invite further research to explore the significance of HL.
Implementing a national case-management training program in Portugal
Authors: Mateus P. , Xavier M. , Caldas-Almeida J. 
Published: May 2011

IntroductionIn Portugal, a new National Mental Health Plan has been launched with the following objectives: equal access to care, decentralisation of mental health services and integration of mental health services in the general health services. In order to change the operational model for mental health teams, a case-management training program has been launched by the Ministry of Health.ObjectivesThis study aims to evaluate:
a)the feasibility of implementing the program on a national level,b)the quality of the training program andc)the satisfaction of the trainees.MethodsThe study was carried out at 36 public mental health services in mainland Portugal. The professionals attended a case management course (SAMHSA procedures), in which they were trained by means of guidelines, demonstrative audios, scenarios and role-playing. The assessment was conducted with a questionnaire addressing logistics, program content, acquisition of skills, usefulness and overall satisfaction.Results135 professionals from the whole country have been involved. The trainees’ acquisition of competences was found rather satisfactory. Results of the training were impressive regarding satisfaction and motivation of the trainees (69% were highly satisfied). Dimensions such as organization (35% highly satisfied, 52% satisfied), program content (41% highly satisfied, 43% satisfied), practical skills gaining (35% highly satisfied, 58% satisfied) and usefulness (58% highly satisfied, 31% satisfied) were also very well rated.ConclusionsOf upmost relevance, it was possible to implement a case management training program at a national level, with no particular difficulties. The impact of courses on trainees was overall impressive.
Trajectory and predictors of depressive disorder among community older adults, in Quebéc: A one-year follow-up study
Authors: Mechakra-Tahiri D.S. , Dubé M. , Zunzunegui M.V. , Préville M. 
Published: May 2011

IntroductionPast research has demonstrated the high prevalence of depression in elderly. However, the most of studies followed the symptom trajectory of individuals diagnosed with depression in a clinical setting and few longitudinal studies have characterized the patterns of depression in older adults population-based.ObjectiveTo describe changing of depressive disorder in an elderly population-based over a 12-month period and to examine the influence of medical and psychosocial factors on the outcome.MethodsData come from a longitudinal ESA Study (Enquête sur la Santé des Aînés) of elderly community persons (n = 2752). Depression, including major and minor depression, measured using the DSM-IV criteria. Generalized estimating equations (GEE) were used to assess relations between participant characteristics at baseline and depression, 12 months later.ResultsAmong the 164 (5.9%) participants, who are depressed at baseline, 19.5% were continuously ill cases and 80.4% had recovered, 12 months later. Multivariate analyses showed that the risk of depression over the 12-month period was higher among for participants who were separated; living in rural region; with a great number of daily hassles, with high level of stress intensity, great number of chronic disease and with fair/poor perception of mental health.ConclusionResults support the hypothesis about medical and psychosocial factors as predictors over time of depression, in old persons. Using readily available prognostic factors (for example, high level of stress intensity, living in rural region, great number of chronic disease) could help direct treatment to elderly at highest risk of a poor prognosis.
Differences in antipsychotic combination (monotherapy versus polytherapy) between patients with schizophrenia and patients with other psychoses
Authors: Morales N. , Diaz M.C. , Ruiz J. , Portela M. , Martinez M.D. , Ruiz F.J. , Lloret J. , Lucas M. , Mayordomo A. , Fraguas D. ,   ISAMA
Published: May 2011

IntroductionAntipsychotic therapy is the cornerstone of the treatment of schizophrenia and other psychoses. Although clinical guidelines tend to recommend the use of antipsychotics in monotherapy, combination of two or more antipsychotics (that is, polytherapy) is a common habit in clinical practice.ObjectivesTo assess differences in antipsychotic combination profile between patients with schizophrenia and patients with other psychoses.MethodsA total of 241 patients (40.2% females, mean age 39.7+/−13.0 years) consecutively admitted during 2009 to a psychiatric inpatient ward with diagnosis of schizophrenia and other psychoses were assessed.Results145 (60.2%) patients were diagnosed with schizophrenia while 96 patients (39.8%) were diagnosed with other psychoses (schizoaffective disorder n = 35, delusional disorder n = 8, schizophreniform disorder n = 8, brief psychotic disorder n = 13, psychotic disorder not otherwise specified n = 27, and other psychoses n = 5). Out of the total sample, polytherapy was used in 150 (62.2%) patients. A total of 100 (69.0%) patients with schizophrenia were on polytherapy, compared to 52.1% of those with other psychoses (p = 0.008). After controlling for age and gender, the association between a diagnosis of schizophrenia and being in polytherapy remained significant (p = 0.046).ConclusionsPatients diagnosed with schizophrenia are more prone to be in polytherapy than those with other psychoses.
Effect of the worldwide crises on mental health
Authors: Ng K.H. , Agius M. , Zaman R. 
Published: May 2011

The events that unfolded towards the end of 2008 led to the worst global economic crisis since the Great Depression of the 1930s. While the economic and political implications have been studied in detail, the impact on health – especially that of mental health – has received much less attention. This essay aims to achieve a critical evaluation of causality (or lack thereof) between an economic crisis and mental health, using a combination of psychological theories, statistical review and common logic.From a theoretical perspective, establishing the value-laden concept of mental health is core to this evaluation. We reflect on Professor Warr's component-based model of mental health and how/whether the economic downturn relates to these ‘components’ individually. On the statistical front, an analysis of data from previous global economic crises reveals a close association between job-related insecurities and psychological morbidities.We found that both psychological theory and epidemiological data support causation between a recession and conditions like depression, anxiety and substance abuse. Further, we also explore the effects of the crisis on the family unit, society and international relations. This will highlight issues like child abuse, the psychological impacts on the socially deprived, and effects of the crisis on the developing world.We also review the effectiveness of efforts of different nature and magnitude to mitigate the effects of this downturn. All this will hopefully impact on our understanding of the causes of mental health problems in times of economic insecurity and assist in developing strategies to ameliorate them.