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Human aggression is highly prevalent and has a large impact on the lives of victims and society in general. Causes and mechanisms of aggression are manifold. One prominent component of aggression is the tendency to interpret ambiguous behavior of others as hostile, so called Hostile Attribution Bias (HAB). This systematic review investigated the association between HAB and aggression in adults. PsychInfo, Embase, PubMed and Web of Science databases were searched and 25 studies were included. These studies reported small to medium associations between HAB and aggression in adults. The association was present across different population samples, varying from students to forensic psychiatric patients. As most studies were cross-sectional and HAB measurements varied in quality, conclusions and implications for interventions are preliminary. This review provides an overview of existing research on HAB and aggression in adults, and highlights the importance of longitudinal studies and adequate HAB measurements for future research.

Human aggression is highly prevalent and has a large impact on the lives of victims and society in general. Causes and mechanisms of aggression are manifold. One prominent component of aggression is the tendency to interpret ambiguous behavior of others as hostile, so called Hostile Attribution Bias (HAB). This systematic review investigated the association between HAB and aggression in adults. PsychInfo, Embase, PubMed and Web of Science databases were searched and 25 studies were included. These studies reported small to medium associations between HAB and aggression in adults. The association was present across different population samples, varying from students to forensic psychiatric patients. As most studies were cross-sectional and HAB measurements varied in quality, conclusions and implications for interventions are preliminary. This review provides an overview of existing research on HAB and aggression in adults, and highlights the importance of longitudinal studies and adequate HAB measurements for future research.

Diplomska naloga se ukvarja s tem, kako so obravnavali koncept norosti v 19. stoletju. Tematiko osvetli tako z zgodovinskega kot s filozofskega vidika. S filozofskega vidika je v ospredju Foucaultevo raziskovanje na tem področju ter vpliv Freuda in psihoanalize, ki se pojavi ob koncu stoletja, z zgodovinskega pa podrobnejši pregled, ravnanja z duševnimi bolniki v psihiatričnih bolnišnicah. Ključno vprašanje, s katerim se ukvarja, pa je sama sprememba v obravnavanju duševne bolezni in duševno bolnih skozi 19. stoletje. The undergraduate thesis deals with the problem of how they examine concept of insanity in 19. century. It shows thematic both from historical and philosophical point of view. In philosophical point of view the main problem is Foucault's research in this area and impact of Freud and his psychoanalysis, which comes to life at the end of century, from historical point of view, the main problem is more detailed review of how they treated mentally ill in psychiatric hospitals. Key issue, with which the undergraduate thesis deals with is the change on how they examine mental ilness and mentally ill in 19. century.

Background\ud \ud This Commission addresses several priority areas for psychiatry over the next decade, and into the 21st century. These represent challenges and opportunities for the profession to sustain and develop itself to secure the best possible future for the millions of people worldwide who will face life with mental illness.\ud \ud \ud Part 1: The patient and treatment\ud \ud Who will psychiatrists help? The patient population of the future will reflect general demographic shifts towards older, more urban, and migrant populations. While technical advances such as the development of biomarkers will potentially alter diagnosis and treatment, and digital technology will facilitate assessment of remote populations, the human elements of practice such as cultural sensitivity and the ability to form a strong therapeutic alliance with the patient will remain central.\ud \ud \ud Part 2: Psychiatry and health-care systems\ud \ud Delivering mental health services to those who need them will require reform of the traditional structure of services. Few existing models have evidence of clinical effectiveness and acceptability to service users. Services of the future should consider stepped care, increased use of multidisciplinary teamwork, more of a public health approach, and the integration of mental and physical health care. These services will need to fit into the cultural and economic framework of a diverse range of settings in high-income, low-income, and middle-income countries.\ud \ud \ud Part 3: Psychiatry and society\ud \ud Increased emphasis on social interventions and engagement with societal expectations might be an important area for psychiatry's development. This could encompass advocacy for the rights of individuals living with mental illnesses, political involvement concerning the social risk factors for mental illness, and, on a smaller scale, work with families and local social networks and communities. Psychiatrists should therefore possess communication skills and knowledge of the social sciences as well as the basic biological sciences.\ud \ud \ud Part 4: The future of mental health law\ud \ud Mental health law worldwide tends to be based on concerns about risk rather than the protection of the rights of individuals experiencing mental illness. The United Nations Convention on the Rights of Persons with Disabilities, which states that compulsion based in whole or in part on mental disability is discriminatory, is a landmark document that should inform the future formulation and reform of mental health laws. An evidence-based approach needs to be taken: mental health legislation should mandate mental health training for all health professionals; ensure access to good-quality care; and cover wider societal issues, particularly access to housing, resources, and employment. All governments should include a mental health impact assessment when drafting relevant legislation.\ud \ud \ud Part 5: Digital psychiatry—enhancing the future of mental health\ud \ud Digital technology might offer psychiatry the potential for radical change in terms of service delivery and the development of new treatments. However, it also carries the risk of commercialised, unproven treatments entering the medical marketplace with detrimental effect. Novel research methods, transparency standards, clinical evidence, and care delivery models must be created in collaboration with a wide range of stakeholders. Psychiatrists need to remain up to date and educated in the evolving digital world.\ud \ud \ud Part 6: Training the psychiatrist of the future\ud \ud Rapid scientific advance and evolving models of health-care delivery have broad implications for future psychiatry training. The psychiatrist of the future must not only be armed with the latest medical knowledge and clinical skills but also be prepared to adapt to a changing landscape. Training programmes in an age in which knowledge of facts is less important than how new knowledge is accessed and deployed must refocus from the simple delivery of information towards acquisition of skills in lifelong learning and quality improvement.\ud \ud \ud Conclusion\ud \ud Psychiatry faces major challenges. The therapeutic relationship remains paramount, and psychiatrists will need to acquire the necessary communication skills and cultural awareness to work optimally as patient demographics change. Psychiatrists must work with key stakeholders, including policy makers and patients, to help to plan and deliver the best services possible. The contract between psychiatry and society needs to be reviewed and renegotiated on a regular basis. Mental health law should be reformed on the basis of evidence and the rights of the individual. Psychiatry should embrace the possibilities offered by digital technology, and take an active role in ensuring research and care delivery in this area is ethically sound and evidence based. Psychiatry training must reflect these multiple pressures and demands by focusing on lifelong learning rather than simply knowledge delivery.

The COVID-19 pandemic has raised significant concerns for population mental health and the effective provision of mental health services in the light of increased demands and barriers to service delivery [1]. Particular attention is being directed toward the possible neuropsychiatric sequelae of both COVID-19 and of the stringent societal mitigation steps deployed by national governments, concerns that are informed by historical increases in the incidence of psychotic disorders following influenza pandemics [2]. However, so far there has been scant attention paid to other important areas of psychiatry during COVID-19, including medico-legal aspects and human rights. In this paper, we discuss the legal implications for psychiatry of the COVID-19 pandemic and report a novel situation in which psychiatric patients may experience diminution of their statutory protections. We believe that this represents a paradigm shift in psychiatric care and that the consideration of the fundamental rights of psychiatric patients as “less important” than infection control measures compel mental health professionals to “advocate for … patients and their caregivers” in this time of crisis [1].

EgeUn###, Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. Method: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. Results: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: 1) To determine the efficacy of reboxetine in comparison with other antidepressive agents in alleviating the acute symptoms of depression. 2) To investigate acceptability of treatment with reboxetine in comparison with other antidepressive agents. 3) To investigate the adverse effects of reboxetine in comparison with other antidepressive agents.

Objective: The research was conducted in the psychiatry service to examine some demographic variables, internalized stigma and anger levels, as well as the relationship of these variables with each other. Methods: All patients who underwent inpatient treatment in the psychiatric service of a research hospital in the city, and the sample was formed by patients who underwent inpatient treatment in a psychiatric clinic between May and October 2018. The collection of data included Personal Information Form, Internalized Stamping Scale in Mental Illness and the Continuous Anger and Anger Style Scale. The data were collected by face-to-face interview technique and evaluated by the SPSS package program. Results: The total stamping of 89 patients covered in the research was 67.76±12.55 and the average anger score was 71.64±11.86. Correlation analysis between scales found a positive relationship between internalized stigma levels of patients and anger (p

Este trabajo describe mediante categorías sociológicas las etapas de la carrera del paciente mental. La información proporcionada por los familiares de tres personas que padecen de esquizofrenia en el municipio de Candelaria (Valle del Cauca) ha servido para analizar la manera como se organiza el proceso de construcción del paciente mental. El relato familiar de la enfermedad mental habla de la biografía, de la personalidad del paciente mental, intenta establecer las causas y describe con minuciosidad los síntomas, los signos, además de las transgresiones cometidas por las personas que padecen de esquizofrenia. This paper describes the stages by sociological categories of mental patient’s career. The information provided by relatives of three people with schizophrenia in the town of Candelaria (Valle del Cauca) has been used to analyze how the process of building the mental patient is organized. The familiar story of mental illness talks about the biography, personality, mental patient, trying to establish the causes and describes in detail the symptoms, signs besides the transgressions committed by people with schizophrenia.

Objective: We investigated the relationship between serum bilirubin levels and metabolic syndrome (MetS), and the longitudinal effects of baseline serum bilirubin concentrations on MetS in patients with schizophrenia spectrum disorders undergoing atypical antipsychotics. Methods: The sample of this study consisted of 131 patients with schizophrenia spectrum disorders. Waist circumference, blood pressure, and levels of triglycerides, high-density lipoprotein cholesterol, fasting glucose, and insulin were evaluated at baseline and at month six. Serum bilirubin levels were measured at baseline. Serum bilirubin levels of the patients with and without MetS criteria were compared. We also compared patients with high and low bilirubin levels (upper and lower 50th percentiles of serum bilirubin levels) in terms of MetS criteria, MetS frequency, and course of MetS. Results: Serum direct bilirubin levels were more consistently related to MetS and MetS-related variables. The waist circumference and triglyceride criteria for MetS were significantly related to low serum direct bilirubin at baseline; waist circumference and fasting glucose criteria, and insulin resistance were associated with low serum direct bilirubin at follow-up. MetS diagnosis and the presence of the waist circumference criterion were more frequent at the baseline and the follow-up in low bilirubin group. At the end of the follow-up period, the rate of reverse MetS was significantly higher in the high bilirubin group. Conclusion: Our results have suggested that serum direct bilirubin levels showed a more reliable and stable relationship with abdominal obesity for MetS components.in patients with schizophrenia spectrum disorders using antipsychotics. Further studies are required. Copyright © 2017, Korean College of Neuropsychopharmacology.

Background The adenosine A2A receptor forms a heteromeric complex with the striatal dopamine D2 receptor. We examined whether a specific polymorphism in adenosine A2A receptor (2592 C/Tins) is associated with tardive dyskinesia. Methods Tardive dyskinesia was assessed cross-sectionally in 146 Caucasian psychiatric inpatients from Siberia. Results Between-group comparisons of genotypic or allelic frequencies showed no statistically significant difference. Logistic regression analysis with the occurrence of tardive dyskinesia as dependent variable showed no significant association with age, duration of illness, gender, and genotype. Conclusion The interaction between the A2A and D2 receptors seems not involved in the development of tardive dyskinesia. Copyright (c) 2012 John Wiley & Sons, Ltd.

Background The adenosine A2A receptor forms a heteromeric complex with the striatal dopamine D2 receptor. We examined whether a specific polymorphism in adenosine A2A receptor (2592 C/Tins) is associated with tardive dyskinesia. Methods Tardive dyskinesia was assessed cross-sectionally in 146 Caucasian psychiatric inpatients from Siberia. Results Between-group comparisons of genotypic or allelic frequencies showed no statistically significant difference. Logistic regression analysis with the occurrence of tardive dyskinesia as dependent variable showed no significant association with age, duration of illness, gender, and genotype. Conclusion The interaction between the A2A and D2 receptors seems not involved in the development of tardive dyskinesia. Copyright (c) 2012 John Wiley & Sons, Ltd.

Aydemir O, Akkaya C. Association of social anxiety with stigmatisation and low self-esteem in remitted bipolar patients.Background: In remitted bipolar disorder, it is aimed to show the association between social anxiety, self-esteem and stigmatisation.Methods: From two university clinics, a sample of 150 remitted bipolar patients was included in this study. Patients were assessed with Liebowitz Social Anxiety Scale, Rosenberg Self-Esteem Scale and sense of stigmatisation subscale of Bipolar Disorder Functioning Questionnaire (Stigma) and were rated with Hamilton Depression Rating Scale and Young Mania Rating Scale for mood symptoms. Confirmatory path analysis was performed.Results: The mean age of the patients was 39.5, and 52.7% (n = 79) were female. Ninety per cent (n = 135) of the patients had bipolar I disorder. The mean duration of the illness was 13.4 years and the mean number of episodes was 7.8. The model was subjected to confirmatory path analysis and the goodness-of-fit index was calculated to be 0.909, the confirmatory fit index was found to be 0.902 and the root mean square error of approximation was 0.097. Self-esteem was negatively associated with stigmatisation (r = −0.746). Social anxiety was positively associated with self-esteem (r = 0.494). Social anxiety was negatively associated with stigmatisation (r = −0.381).Conclusions: In remitted bipolar patients, social anxiety is very high and this social anxiety seems to be caused by self-stigmatisation and low self-esteem.

Using the archival admissions records and the case history of a patient at a British asylum in the 1870s, the author compares two genres. The first of these is two medical certificates written and signed by two physicians attesting that the patient was of unsound mind and needed to be confined and treated. The second genre is the patient’s oral testimony to Parliament’s Select Committee on Lunacy Laws (1877), a narrative he delivered the year following his release from the asylum. Both genres are legal texts; however, it is the patient’s narrative of personal experience, as transcribed in the committee report, that allows the reader a glimpse of the misery imposed by confinement in a “lunatic” asylum. The two medical certificates have considerably more illocutionary force, however; as speech acts they most often resulted in confinement until the patient was determined to have recovered, was transferred to another asylum, or died.Utilizando el archivo de registros de admisión y la historia clínica de un paciente en un psiquiátrico británico de los años 1870, se comparan dos géneros. El primero consiste en dos certificados médicos escritos y firmados por dos psiquiatras certificando que el paciente estaba mentalmente incapacitado y necesitaba confinación y tratamiento. El segundo género se trata del testimonio oral del paciente ante el Parliament’s Select Committee on Lunacy Laws (1877), pronunciado al año siguiente de su alta. Ambos géneros son textos legales, sin embargo, es la narración de la experiencia personal del paciente, transcrita en el informe del comité, lo que permite obtener una visión de las miserias impuestas por el encierro en un sanatorio de lunáticos. Los certificados médicos tienen una fuerza ilocutiva considerablemente mayor, pero como actos del habla resultaban en la reclusión del paciente hasta que se determinaba su recuperación, su traslado a otro sanatorio o fallecía.

Objective To investigate the effects of hysterectomy and/or oophorectomy on sexual satisfaction. Methods Forty sexually active women underwent a hysterectomy and/or oophorectomy, for benign gynecological diseases. Patients were interviewed 15 days prior to their operation and again in the 3rd and 6th months after the surgical procedure. Depressive symptoms, anxiety symptoms and sexual satisfaction were measured by the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Golombock Rust Inventory of Sexual Satisfaction (GRISS), respectively. Repeated-measures analyses of variance (ANOVA) examined alterations in anxiety, depression and sexual satisfaction. Independent t-test and Mann-Whitney U tests compared the numerical data. Results The women had mild depressive symptoms before the surgery; however, these symptoms lessened between 3 and 6 months after the surgery. Similarly, the level of anxiety symptoms decreased during the postoperative period. Based on the GRISS cut-off point, it was found that the patients had problems in the sub-dimensions of frequency, communication, and avoidance in the pre-operative period. This pre-existing sexual dissatisfaction continued after the surgery, and sensuality and anorgasmia problems increased. Satisfaction, sensuality, avoidance and anorgasmia GRISS scores were significantly higher after the operation than before. Therefore, the patients' sexual satisfaction was decreased after the operation. Conclusions Patients were dissatisfied with frequency and communication, and they had high levels of avoidance before operation. In the postoperative period, sexual dissatisfaction increased. Although depression and anxiety decreased after the operation, we found that hysterectomy and/or oophorectomy had negative effects on sexual satisfaction. © 2011 International Menopause Society.

Objective: To investigate the prevalence of and risk factors for overweight and diabetes mellitus in long-stay psychiatric inpatients. Method: Statistical analysis of data collected from medical, laboratory, and pharmacy files. Results: 80% of the 256 patients were suffering from schizophrenia or other psychotic disorders. The prevalence of diabetes mellitus was 15%. The prevalence of a disturbed glucose tolerance was 14%. Severe overweight (BMI > 30) was positively associated with the use of clozapine (odds ratio (OR) = 2.7; 95% confidence interval (CI): 1.31-5.75), but negatively with the diagnosis schizophrenia (OR = 0.4; 95% CI: 0.22-0.88). Diabetes mellitus was associated with severe overweight (OR = 3.5; 95% CI: 1.57-7.69). Caucasian patients were at a lower risk for diabetes mellitus (OR = 0.2; 95% CI: 0.08-0.54). Conclusions: In residential psychiatric patients, diabetes mellitus is especially associated with overweight and non-Caucasian origin. In this survey, the use of clozapine was associated with overweight, but not directly with diabetes mellitus. Diabetes mellitus is highly prevalent, which calls for screening for diabetes mellitus at regular intervals.

To study the prevalence of early adversities in schizophrenia and unipolar depression, 2 groups of consecutive adult-onset inpatients with DSM-IV diagnoses of schizophrenia (n = 173) and unipolar depression (n = 305) were compared with an unscreened control group of volunteers from the general population (n = 310), with respect to their association with 4 types of childhood abuse and with early parental adversities (discord, separation, death, psychiatric caseness). Compared with general population, most types of early adversities (except sexual abuse and parental death) were significantly associated with both clinical groups. Compared with depression, all early adversities with the same 2 exceptions were significantly associated with schizophrenia; both frequency of abuse and number of types of abuse increased the risk of schizophrenia in a dose-response pattern, suggesting causality. These findings stress the role of social developmental factors in the etiology of schizophrenia.

Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale-originally designed to assess a positive response bias-are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ's MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ's discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. Overall, results suggest that a minimizing response bias-as detected by the MD subscale-has a small but significant moderating effect on the CTQ's discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables., National Institutes Health; Australia Research Council; New South Wales Department of Juvenile Justice, Australia

Resumen Introduccion Es importante distinguir la depresion unipolar de la bipolar, pues hay diferencias en el tratamiento y el pronostico. Dado que el diagnostico de las dos condiciones es netamente clinico, encontrar diferencias sintomaticas puede ser de gran utilidad. Objetivos Buscar diferencias en la experiencia subjetiva (de primera persona) entre depresion unipolar y bipolar. Metodos Estudio exploratorio de tipo cualitativo, de orientacion fenomenologica, con 12 pacientes (7 con depresion bipolar y 5 con depresion unipolar; 3 varones y 9 mujeres). Se utilizo una entrevista semiestructurada basada en el Examen de la Experiencia Anomala del Self (EASE). Resultados Estado de animo predominante: en la depresion bipolar es el apagamiento emocional; en la unipolar, la tristeza. Experiencia del cuerpo: en la bipolar, el cuerpo se siente pesado, francamente cansado y como un obstaculo para el movimiento. En la unipolar, la experiencia del cuerpo se parece a la pereza cotidiana. Cognicion y flujo de conciencia: en la depresion bipolar, en comparacion con la unipolar, el pensamiento se vive lentificado, como si tuviera que vencer obstaculos en su curso; hay mayor dificultad para comprender lo que se escucha o se lee. Perspectiva del futuro: en la depresion bipolar, la desesperanza es mas intensa y de mayor alcance que en la unipolar, como si se perdiera la posibilidad misma de la esperanza. Conclusiones Se encontraron diferencias cualitativas en el estado de animo predominante, la experiencia corporal, la cognicion y la perspectiva del futuro entre la depresion unipolar y la bipolar.

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Tardive dyskinesia (TD) is a potentially irreversible antipsychoticinduced movement disorder with a prevalence of about 20-30% in psychiatric patients chronically exposed to antipsychotics. A wellknown theory states that TD is related to oxidative stress induced neurotoxicity. Dehydroepiandrosterone (DHEA) is an endogenous antioxidant with neuroprotective activity. The biosynthesis of DHEA depends upon the activity of cytochrome P450c17a (CYP17). The gene that encodes for CYP17 has a (T34C) single nucleotide polymorphism which enhances CYP17 transcription and expression. Objective: To test the hypothesis that carriership of a more active CYP17 variant would result in higher DHEA(S) levels and protect against neurotoxicity which results in orofaciolingual TD (TDof), limb-truncal TD (TDlt) or both (TDsum). Methods: TD was assessed cross-sectionally by the use of the Abnormal Involuntary Movement Scale (AIMS) in in 146 Caucasian psychiatric inpatients from Siberia. TDof and TDlt were assessed with AIMS items 1-4 and 5-7, respectively. The DHEAs levels were tested with aid of the DHEA-S ELISA Kit, (DRG International Inc.). DNA extraction and fluorogenic 5′-exonuclease TaqMan genotyping assays were conducted according to standard protocols and blind to the clinical status of the subjects [1]. The statistical software 'R' was used for the calculations. For creating an overview of the clinical and demographic features of the study population, excel and the statistical SPSS software, release 17, for Windows were used. The deviation from the Hardy-Weinberg Equilibrium was tested by the chi-squared test for the Cyp17 polymorphisms. Results: In total 146 patient with clinical diagnosis of schizophrenia or schizotypal disorder (ICD-10: F20 and F21, respectively) were included of which 91 males and 55 females. Demographic and clinical details have been provided with elsewhere [1,2]. The genotype distribution in the total population and by gender shows that the female patients of this population are more often carrier of the Cyp17 CC genotype compared to male patients. The results of the logistic regression analysis of the influence of the Cyp17 T-allele and the level of DHEAS on the occurrence of TD, TDof and TDlt indicate that carriers of the Cyp17 genotype CC have a significant lower risk of developing TD compared to carriers of the Cyp17 genotypes TC or TT (p

Introduction: We report on dyspeptic complaints among patients hospitalized in the long-stay ward of a general psychiatric hospital. Methods: A representative sample of the patients was interviewed using a structured questionnaire. Results: Eighty percent of the patients reported one or more symptoms of dyspepsia, and 68% reported symptoms of reflux-like dyspepsia. Conclusion: Significant positive associations were found for dyspepsia complaints and clozapine (OR = 3.4), laxatives (OR = 4.4), and heavy smoking (OR = 2.3). © Georg Thieme Verlag KG Stuttgart.

Objective: To study the psychometric properties of the Turkish translation of the Depression Anxiety and Stress Scale (DASS-42) in a clinical group. Methods: Outpatients diagnosed with anxiety ( n = 138; mean age = 44.5 years; 74.6% female) or depression ( n = 112; mean age = 46.2 years; 77.7% female) from the psychiatric outpatient clinic of a public hospital were evaluated. A group of non-clinical volunteers ( n = 250; mean age = 37 years; 68% female) served as a community group for comparison. The participants completed the Turkish versions of the DASS-42, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Results: The structure of the DASS-42 was analyzed in the clinical sample using principal components extraction. The three-factor solution accounted for 56% of the total variance, with eigenvalues of 17.6, 3.0, and 2.6. The range of factor loadings was 0.55–0.85 for depression, 0.47–0.62 for anxiety, and 0.49–0.74 for stress. The Cronbach alpha values for the DASS depression, anxiety, and stress subscales were 0.94, 0.88, 0.94 respectively. The concurrent validity of the DASS was satisfactory. The non-clincal participants scored lower on all three subscales than the individuals in all of the clinical groups. Conclusion: The Turkish version of the DASS-42 appears to be an excellent instrument for measuring features of depression, hyperarousal, and tension in clinical groups.

BackgroundThe physical environment is presumed to have an effect on aggression and also on the use of seclusion on psychiatric wards. Multicentre studies that include a broad variety of design features found on psychiatric wards and that control for patient, staff and general ward characteristics are scarce.AimsTo explore the effect of design features on the risk of being secluded, the number of seclusion incidents and the time in seclusion, for patients admitted to locked wards for intensive psychiatric care.MethodData on the building quality and safety of psychiatric as well as forensic wards (n = 199) were combined with data on the frequency and type of coercive measures per admission (n = 23 868 admissions of n = 14 834 patients) on these wards, over a 12-month period. We used non-linear principal components analysis (CATPCA) to reduce the observed design features into a smaller number of uncorrelated principal components. Two-level multilevel (logistic) regression analyses were used to explore the relationship with seclusion. Admission was the first level in the analyses and ward was the second level.ResultsOverall, 14 design features had a significant effect on the risk of being secluded during admission. The ‘presence of an outdoor space’, 'special safety measures' and a large ‘number of patients in the building’ increased the risk of being secluded. Design features such as more ‘total private space per patient’, a higher ‘level of comfort’ and greater ‘visibility on the ward’, decreased the risk of being secluded.ConclusionsA number of design features had an effect on the use of seclusion and restraint. The study highlighted the need for a greater focus on the impact of the physical environment on patients, as, along with other interventions, this can reduce the need for seclusion and restraint.

BACKGROUND: The physical environment is presumed to have an effect on aggression and also on the use of seclusion on psychiatric wards. Multicentre studies that include a broad variety of design features found on psychiatric wards and that control for patient, staff and general ward characteristics are scarce.AIMS: To explore the effect of design features on the risk of being secluded, the number of seclusion incidents and the time in seclusion, for patients admitted to locked wards for intensive psychiatric care.METHOD: Data on the building quality and safety of psychiatric as well as forensic wards (n = 199) were combined with data on the frequency and type of coercive measures per admission (n = 23 868 admissions of n = 14 834 patients) on these wards, over a 12-month period. We used non-linear principal components analysis (CATPCA) to reduce the observed design features into a smaller number of uncorrelated principal components. Two-level multilevel (logistic) regression analyses were used to explore the relationship with seclusion. Admission was the first level in the analyses and ward was the second level.RESULTS: Overall, 14 design features had a significant effect on the risk of being secluded during admission. The 'presence of an outdoor space', 'special safety measures' and a large 'number of patients in the building' increased the risk of being secluded. Design features such as more 'total private space per patient', a higher 'level of comfort' and greater 'visibility on the ward', decreased the risk of being secluded.CONCLUSIONS: A number of design features had an effect on the use of seclusion and restraint. The study highlighted the need for a greater focus on the impact of the physical environment on patients, as, along with other interventions, this can reduce the need for seclusion and restraint.

Background The adenosine A2A receptor forms a heteromeric complex with the striatal dopamine D2 receptor. We examined whether a specific polymorphism in adenosine A2A receptor (2592 C/Tins) is associated with tardive dyskinesia. Methods Tardive dyskinesia was assessed cross-sectionally in 146 Caucasian psychiatric inpatients from Siberia. Results Between-group comparisons of genotypic or allelic frequencies showed no statistically significant difference. Logistic regression analysis with the occurrence of tardive dyskinesia as dependent variable showed no significant association with age, duration of illness, gender, and genotype. Conclusion The interaction between the A2A and D2 receptors seems not involved in the development of tardive dyskinesia. Copyright (c) 2012 John Wiley & Sons, Ltd.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:27:08Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:36:57Z : No. of bitstreams: 1 2-s2.0-84868110234.pdf: 454720 bytes, checksum: 0ef17d09aa08769b09b81c18347816e2 (MD5) Made available in DSpace on 2014-05-27T11:27:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-11-05 Uma revisão dirigida foi realizada nas bases de dados IBECS, LILACS e MEDLINE, até fevereiro/2011, para identificar intervenções farmacêuticas (IF) na atenção farmacêutica em saúde mental e os seus resultados. Para a busca utilizaram-se os descritores em saúde: Pharmaceutical Care, Pharmaceutical Services, Medication Adherence, Pharmacists, Mental Health, Mental Health Services, Mental Health Assistance, Community Mental Health Services, Mentally Ill Persons andMental Disorders. Identificaram-se 1686 publicações, das quais 21 contemplaram os critérios de inclusão. Após exploração do material, apenas cinco estudos tratavam-se de IF. Todos foram conduzidos no nível secundário de atenção, com abordagem individual, por meio do acompanhamento da terapia (3), intervenção educativa por cartas a médicos e pacientes (1), aconselhamento farmacêutico presencial e remoto e inserção de terapia com sistema transdérmico de nicotina (1). Os resultados, tais como promoção da adesão e resolução de problemas relacionados a medicamentos foram positivos para a terapêutica. No entanto, é necessário que as IF monitorem os parâmetros clínicos, as mudanças de hábitos, a melhora na qualidade de vida e os aspectos farmacoeconômicos a fim de avaliar os seus impactos. Palavras-chave:Atenção Farmacêutica. Assistência Farmacêutica. Adesão à Medicação. Farmacêuticos. Saúde Mental. ABSTRACT Pharmaceutical interventions in mental health services: a review A directed review was performed in IBECS, LILACS and MEDLINE databases, until February/2011, in order to identify the studies which developed pharmaceutical interventions (PI) in pharmaceutical care in mental health services and estimated their results. The search was carried out using the follow health science descriptors: Pharmaceutical Care, Pharmaceutical Services, Medication Adherence, Pharmacists, Mental Health, Mental Health Services, Mental Health Assistance, Community Mental Health Services, Mentally Ill Persons andMental Disorders. It was identified 1686 manuscripts, of whose 21 contemplated the inclusion criteria. After the content analysis of the eligible manuscripts, only five developed PI. All of them were conducted in the second level of health care, with individual approach, through: therapy follow-up (3), educational interventions by letters to physicians and patients (1), presence or remote pharmaceutical counseling and inclusion of therapy with nicotine transdermal patch (1). The data, such as adherence promotion and solving drug related problems, were positive for the therapeutic. However, it is necessary that the PI monitor the clinical parameters, the habit changes, the improvement in the quality of life and the pharmacoeconomic aspects, in order to assess their impacts. Keywords: Pharmaceutical Care. Pharmaceutical Services. Medication Adherence. Pharmacists. Mental Health. Mental Disorders. Departamento de Fármacos e Medicamentos Faculdade de Ciências Farmacêuticas Universidade Estadual Paulista, UNESP Departamento de Fármacos e Medicamentos Faculdade de Ciências Farmacêuticas Universidade Estadual Paulista, UNESP

Tardive dyskinesia (TD) is a potentially irreversible antipsychoticinduced movement disorder with a prevalence of about 20-30% in psychiatric patients chronically exposed to antipsychotics. A wellknown theory states that TD is related to oxidative stress induced neurotoxicity. Dehydroepiandrosterone (DHEA) is an endogenous antioxidant with neuroprotective activity. The biosynthesis of DHEA depends upon the activity of cytochrome P450c17a (CYP17). The gene that encodes for CYP17 has a (T34C) single nucleotide polymorphism which enhances CYP17 transcription and expression. Objective: To test the hypothesis that carriership of a more active CYP17 variant would result in higher DHEA(S) levels and protect against neurotoxicity which results in orofaciolingual TD (TDof), limb-truncal TD (TDlt) or both (TDsum). Methods: TD was assessed cross-sectionally by the use of the Abnormal Involuntary Movement Scale (AIMS) in in 146 Caucasian psychiatric inpatients from Siberia. TDof and TDlt were assessed with AIMS items 1-4 and 5-7, respectively. The DHEAs levels were tested with aid of the DHEA-S ELISA Kit, (DRG International Inc.). DNA extraction and fluorogenic 5′-exonuclease TaqMan genotyping assays were conducted according to standard protocols and blind to the clinical status of the subjects [1]. The statistical software 'R' was used for the calculations. For creating an overview of the clinical and demographic features of the study population, excel and the statistical SPSS software, release 17, for Windows were used. The deviation from the Hardy-Weinberg Equilibrium was tested by the chi-squared test for the Cyp17 polymorphisms. Results: In total 146 patient with clinical diagnosis of schizophrenia or schizotypal disorder (ICD-10: F20 and F21, respectively) were included of which 91 males and 55 females. Demographic and clinical details have been provided with elsewhere [1,2]. The genotype distribution in the total population and by gender shows that the female patients of this population are more often carrier of the Cyp17 CC genotype compared to male patients. The results of the logistic regression analysis of the influence of the Cyp17 T-allele and the level of DHEAS on the occurrence of TD, TDof and TDlt indicate that carriers of the Cyp17 genotype CC have a significant lower risk of developing TD compared to carriers of the Cyp17 genotypes TC or TT (p

Tardive dyskinesia (TD) is a potentially irreversible antipsychoticinduced movement disorder with a prevalence of about 20-30% in psychiatric patients chronically exposed to antipsychotics. A wellknown theory states that TD is related to oxidative stress induced neurotoxicity. Dehydroepiandrosterone (DHEA) is an endogenous antioxidant with neuroprotective activity. The biosynthesis of DHEA depends upon the activity of cytochrome P450c17a (CYP17). The gene that encodes for CYP17 has a (T34C) single nucleotide polymorphism which enhances CYP17 transcription and expression. Objective: To test the hypothesis that carriership of a more active CYP17 variant would result in higher DHEA(S) levels and protect against neurotoxicity which results in orofaciolingual TD (TDof), limb-truncal TD (TDlt) or both (TDsum). Methods: TD was assessed cross-sectionally by the use of the Abnormal Involuntary Movement Scale (AIMS) in in 146 Caucasian psychiatric inpatients from Siberia. TDof and TDlt were assessed with AIMS items 1-4 and 5-7, respectively. The DHEAs levels were tested with aid of the DHEA-S ELISA Kit, (DRG International Inc.). DNA extraction and fluorogenic 5′-exonuclease TaqMan genotyping assays were conducted according to standard protocols and blind to the clinical status of the subjects [1]. The statistical software 'R' was used for the calculations. For creating an overview of the clinical and demographic features of the study population, excel and the statistical SPSS software, release 17, for Windows were used. The deviation from the Hardy-Weinberg Equilibrium was tested by the chi-squared test for the Cyp17 polymorphisms. Results: In total 146 patient with clinical diagnosis of schizophrenia or schizotypal disorder (ICD-10: F20 and F21, respectively) were included of which 91 males and 55 females. Demographic and clinical details have been provided with elsewhere [1,2]. The genotype distribution in the total population and by gender shows that the female patients of this population are more often carrier of the Cyp17 CC genotype compared to male patients. The results of the logistic regression analysis of the influence of the Cyp17 T-allele and the level of DHEAS on the occurrence of TD, TDof and TDlt indicate that carriers of the Cyp17 genotype CC have a significant lower risk of developing TD compared to carriers of the Cyp17 genotypes TC or TT (p

XXa. viduryje prasidėjęs deinstitucionalizacijos bei bendruomeninio pobūdžio psichikos sveikatos priežiūros paslaugų plėtros procesas pareikalavo naujo – įgalinančio – požiūrio į psichikos liga sergantį žmogų ir jo galimybes savarankiškai gyventi bendruomenėje. Šis požiūris reiškia, kad psichikos liga sergančio asmens nuomonė ir poreikiai yra laikomi legitimiais priimant su psichikos sveikatos priežiūra, savo liga bei gyvenimu susijusius sprendimus. Tačiau nepaisant pastarąjį dešimtmetį Lietuvos psichikos sveikatos priežiūros sistemoje vykstančių pokyčių deinstitucionalizacijos link, psichikos liga sergantis pacientas išlieka pasyviu sveikatos priežiūros paslaugų gavėju, kurio poreikius apibrėžia sveikatos specialistai, institucijos ar artimieji, bet ne pats pacientas. Straipsnyje keliama prielaida, kad psichikos liga sergantis žmogus ir toliau yra traktuojamas kaip nesugebantis suvokti ir apibrėžti savo poreikių bei interesų. Toks požiūris į psichikos sutrikimus turintį žmogų iš dalies yra sąlygojamas ir palaikomas profesinio psichikos ligos diskurso bei praktikų. Psichiatrinėje literatūroje vyrauja (bio) medicininė psichikos ligos ir jos gydymo samprata, prioretizuojamas medikamentinis gydymas. Šioje sampratoje liga yra lokalizuojama individe ir tokiu būdu tampa jo elgsenos ir asmenybės vertinimo kriterijumi. Psichikos liga yra apibrėžiama kaip sąlygojanti sergančiojo realybės suvokimo jausmo praradimą, nesugebėjimą kritiškai įvertinti savo situacijos. Tai tampa pagrindu patologizuoti sergančiojo elgseną: pacientas laikomas nepatikimu, linkusiu manipuliuoti gydytoju, todėl paciento elgsena turi būti nuolat stebima ir kontroliuojama. Tokiu būdu yra pateisinamas paternalistinis požiūris į pacientą. Paternalistinio santykio įsišaknijimas psichiatrinėje priežiūroje sąlygoja psichikos liga sergančio žmogaus priklausomybę nuo sveikatos priežiūros sistemos ir tokiu būdu gali neigiamai įtakoti jo galimybes aktyviau ir savarankiškiau spręsti gydymo ir gyvenimo problemas. Second half of the 20th century has witnessed major changes in the way mental health care in the Western countries has been organized and provided for people suffering from mental illness. Deinstitutionalization and community care became common terms used to define a policy that aims to shift the locus of psychiatric care from large mental hospitals and custodial institutions into community. Deinstitutionalization of psychiatric care requires an empowering approach towards the mentally ill individuals and their capabilities to lead a self-dependent life in the community. Such an approach implies accepting the mentally ill health-care service users as credible individuals capable of taking responsibility for their actions and life. The aim of this article is to examine psychiatric conception of mental illness, treatment and the psychiatric encounter. The presentation largely draws upon analysis of Lithuanian psychiatric texts, although some foreign psychiatric literature is also used. The article starts with an introduction of a changing situation of the mental patient and proceeds to the analysis of the psychiatric discourse. The author argues that by conceptualizing mental illness as pathology located within the functioning of the individual body that affects the ability of a sick individual to apprehend the reality and to retain critical insight towards one’s health problem, psychiatric discourse may reproduce paternalistic approach towards the mentally ill individuals even in the deinstitutionalized settings. Such an approach may have certain implications for the individuals’ ability to lead an independent life in the community.

Objective: Antipsychotic induced weight gain is a major problem for second generation antipsychotics which may lead to diabetes and metabolic syndrome. Recent studies were mentioning that genetic factors might be relevant in antipsychotic induced weight gain. Aim of this study is evaluation of the association between IRS-1 Glyp972Arg polymorphism and olanzapine induced weight gain. Methods: Total of 95 patients whom were diagnosed as schizophrenia by DSM-IV criteria were included to study. Body weight, body mass index and blood glucose levels of all patients were checked at the beginning and six weeks after olanzapine treatment. Blood for DNA analysis were obtained from patients and analyzed as mentioned in literature. Data were evaluated with descriptive methods and Mann Whitney U test was used for comparison of two groups. Results: Eighty and four of patients had Glycine/Glycine and 11 patients had Glycine/Arginine genotype of IRS-1 Gly972Arg polymorphism. Despite the patients with Glycine/Glycine polymorphism gained more weight than patients with Glycine/Arginine polymorphism, the difference between Glycine/Glycine and Glycine/Arginine groups for weight change and body mass index change wasn't statistically significant. Conclusion: Our results showed no statistical relationship between the IRS-1 Gly972Arg polymorphism and olanzapine induced weight gain. However exploration of the other IRS genotypes and the antipsychotic-induced body weight change may help in the understanding of the mechanisms of antipsychotic-induced body weight gain.

Twenty patients who had become accustomed to a stable oral carbamazepine dose participated in an open, randomized, two-centre, cross-over study, in which ordinary tablets and Divitabs (a new sustained release preparation) were compared. Pharmacokinetic parameters, seizure control, effects on the behavioral state, and tolerability were considered. A smaller Area Under the Curve (AUC) during the Divitabs period was the only pharmacokinetic parameter with a significant difference (p

Twenty patients who had become accustomed to a stable oral carbamazepine dose participated in an open, randomized, two-centre, cross-over study, in which ordinary tablets and Divitabs (a new sustained release preparation) were compared. Pharmacokinetic parameters, seizure control, effects on the behavioral state, and tolerability were considered. A smaller Area Under the Curve (AUC) during the Divitabs period was the only pharmacokinetic parameter with a significant difference (p

Background People with mental disorders have a higher prevalence of physical illnesses and reduced life expectancy as compared with the general population. However, there is a lack of knowledge across Europe concerning interventions that aim at reducing somatic morbidity and excess mortality by promoting behaviour-based and/or environment-based interventions. Methods and design HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet country-specific needs, and (iii) at identifying best practice across Europe. Criteria for best practice will include evidence on the efficacy of physical health interventions and of their effectiveness in routine care, cost implications and feasibility for adaptation and implementation of interventions across different settings in Europe. HELPS will develop and implement a "physical health promotion toolkit". The toolkit will provide information to empower residents and staff to identify the most relevant risk factors in their specific context and to select the most appropriate action out of a range of defined health promoting interventions. The key methods are (a) stakeholder analysis, (b) international literature reviews, (c) Delphi rounds with experts from participating centres, and (d) focus groups with staff and residents of mental health care facilities. Meanwhile a multi-disciplinary network consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well as to hold resonance for community dwelling people with mental health problems. Discussion A general strategy on health promotion for people with mental disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider heterogeneity of mental disorders, the multitude of physical health problems, health-relevant behaviour, health-related attitudes, health-relevant living conditions, and resource levels in mental health and social care facilities.

Este artículo son unas notas acerca de la discusión sobre el carácter patológico o enfermo del chamán, propuesto por Devereux, fundador de la Etnopsiquiatría y su correspondencia con lo que llama Morin el carácter “demens” del homo sapiens sapiens. This article is notes about the discussion on the pathological or ill character of chamán, proposed by Devereux, founder of the Etnopsiquiatría and his correspondence and so the character calls Morin “demens” of homo sapiens sapiens. 35-50 franjve@yahoo.es Anual

El presente trabajo destaca la importancia de la palabra oral en el tratamiento psicoterapéutico que se realiza en Venezuela. La autora basa su afirmación en los datos de investigación que reunió en dos instituciones mentales de Mérida y Táchira. Los resultados muestran que estos pacientes todavía requieren un tratamiento amoroso, de seguridad y confianza en la relación con su terapeuta. Por otra parte, también destacó la necesidad de mejorar las condiciones humanas en las instituciones mentales y de trabajar por una concepción integral de estas enfermedades, como una manera de conocer mejor de qué se trata realmente una patología mental. La importancia de la colaboración antropológica en el diagnóstico y mejor comprensión de estas dolencias, servirá como apoyo a los médicos especialistas, pues siendo Venezuela un país multiétnico y multicultural, consideramos que las concepciones que tiene la población sobre la «locura», enriquecería el panorama médico- psiquiátrico venezolano. Se plantea además cómo la palabra oral puede ser un arma tanto positiva como negativa en la relación psicoterapeuta-paciente. The importance of verbal communication for psychotherapy in Venezuela is emphasized. The author bases this affirmation on data from research in the cities of Merida and Tachira. Evidence demonstrates that patients require evidence of loving care on the part of the therapist as well as the need for confidence and trust. Conditions in mental institutions must be improved. The fact that mental disease is a classifiable pathology requiring specific treatment must not be overlooked. Anthropological collaboration in diagnosis and improved comprehension is indicated for medics in their area of specialty. Venezuela is multiethnic and multicultural so that the general comprehension of «madness» is essential for the psychiatrist. The spoken word has the potential to both benefit and harm the mental patient. 231-244 luisapadrique@yahoo.es

This paper analyses mental patient’s rights. Mental patient has all political, economic, social and cultural rights. Mental patient with a mental illness has a right to appropriate, accessible and suitable medical aid provided free of charge at state health-care institutions. The paper further discusses such patients’ rights as the right to confidentiality with regard to information concerning their health. Involuntary hospitalization is studied in consideration of the constitutional right to liberty of an individual. Paper analyses criteria for involuntary hospitalization. The institute of guardianship is also discussed.

Background: Cytochrome P-450 2D6 (CYP2D6) and 2C19 (CYP2C19) are known to contain functional polymorphisms that can alter the metabolic rate of many antidepressants (AD) and antipsychotics (AP). Individuals with no metabolic activity and with increased activity may be at risk for an unsatisfactory drug response. Objectives: Aim of this study was to assess the influence of CYP2D6 and CYP2C19 phenotypes on the consumption of care in psychiatric patients. Methods: The study was conducted in a psychiatric hospital in the Netherlands, including all admissions from July 2001 until July 2010, of patients genotyped for (at least) the CYP2D6 ∗3 ∗4 and gene multiplication and CYP2C19 ∗2. Patients were classified as poor metabolizers (PM), ultrarapid metabolizers (UM), intermediate metabolizers (IM) and extensive metabolizers (EM). To study the consumption of care, several outcome measures were calculated for PM and UM and compared to EM. Results: 7377 admissions were analyzed, belonging to 3859 unique patients. The total duration of hospital stays with AP and/or AD treatment was longer for CYP2D6 UM than for CYP2D6 EM (66 versus 48 days, p