Evaluate the attitudes of non psychiatrist doctors and residents working in Hôtel-Dieu de France hospital towards mental illness and medical students of Saint Joseph University.

A 25-question-questionnaire about the perception of severe mental illness, of psychiatric treatments, of psychiatrists, and of psychiatry as a future career, which was distributed to Saint Joseph University medical students over the 7 years via the delegates of each class, to the doctors via their secretaries in their clinics, and personally to the residents between the period of November 27 and December 28, 2007.

We have found negative attitudes towards mental illness in the studied population but positive attitudes towards psychiatric treatments, psychiatry, and psychiatrists with higher scores among doctors than students towards mental illness (p = 0.0073) and towards psychiatric treatments (p = 0.0016) but no significant difference between different groups in the scores of perception of psychiatry (p = 0.78) and psychiatrists (p = 0.42). No difference was found between males and females for none of the scores.

This study is the first of its kind to demonstrate that medical students’ attitudes are negative towards mental illness but positive towards psychiatric treatments, psychiatry, and psychiatrists during their first years of medical studies and stay the same after receiving a theoretical psychiatry course and after a clinical training in a psychiatric hospital and even when they become residents and that these attitudes become more positive when they become doctors.

Pereira et al. (2013) adapted to the antenatal period and validated a shorter version of the original 35-items Postpartum Depression Screening Scale (PDSS [1]), composed of 24 items, selected from the exploratory factor analysis matrix. In their study, the researchers considered this version a useful alternative to evaluate depressive symptoms in pregnancy, taking into account its reliability, concurrent validity and satisfactory combinations of sensitivity and specificity to screen for antenatal depression.

To confirm the four dimensions’ structure of the PDSS-24 using confirmatory factor analysis.

616 women (mean age: 32.29 ± 4.466) in the second trimester of pregnancy (mean weeks of gestation = 17.13 ± 4.929), with uncomplicated pregnancies, completed the PDSS-24 while waiting for their routine prenatal consultation at local health medical centers.

The 4-dimensional model of PDSS-24 presented good fit (χ2[242] = 893,275; RMSEA = 0.067, CFI = 0.934, TLI = 0.94, PGFI = 0.717; P<.001). The PDSS-24 Cronbach's alpha was α=0.90; all factors presented good/excellent reliability: Derealization and failure (a = 0.87); Concentration difficulties and anxiety (a = 0.81), Suicidal ideation (a = 0.94), and sleeping difficulties (a = 0.89).

This further validation study emphasizes that PDSS-24 in an adequate measure of antenatal depressive symptoms. To better distinguish it from the version to use in the postpartum (PDSS-21 [2]), from now on, we will denominate it perinatal depression screening scale-24.

The authors have not supplied their declaration of competing interest.

Fibromyalgia is an entity that affects approximately 2% of the population, mainly women.

According to many studies, approximately half of women with fibromyalgia have a history of traumatic events during childhood or adulthood.

Affective disorders before and after fibromyalgia diagnosis are particularly frequent.

Comprehensive review of the scientific literature (Medline, Psychoinfo, Medex) on psychiatric comorbidity in women diagnosed with fibromyalgia published over the last three years.

40-60% of women diagnosed with fibromyalgia report sexual abuse during childhood or adulthood; A higher percentage of women (over 70%) report other kinds of physical or emotional trauma.

Fibromyalgia has been linked to mood disorders in 50-70% of patients. More precisely, it appears in combination with major depression in 20% of cases. To a lesser but still noteworthy extent, women with fibromyalgia are also diagnosed with dysthymia, anxiety disorders, phobias or panic disorders.

Despite the common characteristics of these patients there is no such thing as a “fibromyalgic personality”.

As for comorbidity, mood disorders are highly prevalent, more specifically depression, even though no direct relationship has been established between them. Fibromyalgia symptoms are more acute in patients with comorbid psychiatric disorders.

There are increasing concerns regarding long-term psychotropic polypharmacy prescribed for foster care youth 3.5 to 5 times more often than in at-home youth (Kreider et al., 2014). Polypharmacy risks include weight gain, glucose intolerance and type 2 diabetes. (De Hert et al., 2011). In view of these risks, novel interventions are essential to safeguard foster care youth from overmedication.

To present guidelines for identification and management of polypharmacy in foster care youth.

To demonstrate a novel intervention to monitor and diminish polypharmacy and enhance psychiatric care in foster care children.

Polypharmacy is identified using LA County Juvenile Court Mental Health Service (JCMHS) Psychotropic Parameters* to review medication consent forms from treating psychiatrists. Polypharmacy triggers an in-person JCHMS consultation. *(Parameters 3.9 for JCMHS PMAF Review, Revised May 2015).

JCMHS Psychotropic Parameters (summary):

• – age 0–5 years:

• – 2 or > psychotropic medications,

• – Any antipsychotic (*except Risperidone in ASD);

• – age 6–8 years:

• – 3 or > psychotropic medications;

• – age 9–17 years:

• – 4 or > psychotropic medications;

• – All age youth:

• – 2 or > psychotropic medications in the same class (antipsychotics, antidepressants, stimulants, mood stabilizers, alpha agonists).

Psychotropic medication doses in excess of recommended (*LA County Department of Mental Health Parameters 3.8 for use of Psychotropic Medications for Children and Adolescents).

Approximately 25% of JCMHS annual psychiatric consultations were initiated by JCMHS parameters for polypharmacy. Corresponding consultations included education and recommendations discussed with treating psychiatrists regarding polypharmacy and optimal psychiatric management.

JCMHS Psychotropic Parameters is a useful tool to identify polypharmacy and enhance psychiatric care of foster care youth.

The authors have not supplied their declaration of competing interest.

To describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregivers.

Is selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers.

Most of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression. Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively.

There are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver's work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country.

The aim of our study was to investigate the impact of aerobic endurance training on cognitive performance, psychopathology and subjective well-being in paranoid schizophrenic inpatients.

37 inpatients who met the ICD-10 criteria for paranoid schizophrenia were randomly assigned to either a controlled endurance training (n = 20) or an occupational therapy program (n = 17). Before randomisation and prior to discharge psychopathological symptoms, subjective well-being and cognitive performance were assessed with a comprehensive neuropsychological test battery and psychometric measures. Patients in the aerobic endurance group received about four times per week a 30 minute training session. In the control group schizophrenic patients participated for an equivalent amount of time in an occupational therapy program.

All patients significantly improved in psychopathologic symptoms and subjective well-being. Additionally significant time effects in cognitive functions, except for attention, could be found in both patient groups. However, significant group by time effects could only be demonstrated for working memory, short term memory and verbal learning with an advantage for the sport group.

Concerning verbal memory functions patients could profit by aerobic endurance training in a clinical setting. As cognitive impairments, especially memory deficits are a core feature of schizophrenic illness aerobic endurance training should be an integral part of treatment programs for schizophrenic inpatients.

Mental health problems were shown by different studies to be both: results of and risk factors for unemployment. However, unemployed people with mental health problems often have difficulties in finding and using mental health services and therefore do not benefit from therapies. Because unemployed individuals outside the healthcare system are a hard-to-reach group, barriers to but also facilities for mental health services are poorly understood.

The aim of the study is to identify barriers and facilitators of help seeking and service use, based on experiences of unemployed people with mental health strains.

We conducted 15 qualitative semi-structured interviews with unemployed individuals, facing self-reported mental health problems or mental illness. Topics included individual experiences with help-seeking and mental health service use, with a focus on barriers and facilitators. Interviews were audiotaped and transcribed verbatim. Transcripts were analyzed using qualitative content analysis and major themes were identified.

Patients fear adverse reactions of psychiatric medication. They report to be treated as “different” by their social environment and health professionals, which leads to a lack of self-esteem and inhibits them in their help seeking efforts. Social support and desire for change on the other hand can be strong motivational factors in searching for help.

Perception of GPs towards mental health issues of their patients, and especially unemployed patients, has to be raised. Stigmatization of mental illnesses and help seeking should be reduced in practical context.

The authors have not supplied their declaration of competing interest.

Long term hospitalization are often caused by social reasons wich significantly affects the quality of the patients.

Comparing the quality of long-term hospitalized schizophrenic patients in relation to sex.

We have used following rating scale: a brief psychiatric assessment scale BPRS, QLS Quality of life scale, “Lancashir” profile quality of life scale LQOLP, a short questionnaire for the “needs assessment Cambersels” scale CANSAS. Analysis included 80 inpatients, 40 male and 40 female, with Schizophrenia according to ICD 10 criteria. All patients were hospitalized according to ICD 10 criteria. All patients were hospitalized in a Special Hospital For Psychiatric Illness G. Toponica more than two years.

Significant differences in quality of life between male and female patients about what is discussed in further study.

Research has shown that long-term hospitalizing has adverse effects on quality of life of schizophrenic patients of both sexes. His essential that the length of hospital stay should be reduced to the period reduced to the period for reduction of symptoms and provide the patient a stable life in the community after hospital treatment.

Lorazepam is a benzodiazepine derivative that is globally used for the therapy of anxiety and insomnia.

The objective of our work was to show that Lorazepam can be a cause of unexpected liver injury even though it is a rare entity.

We reported the case of a patient who had a Drug-Induced Liver Injury (DILI) under Lorazepam. We performed a literature review based on a PubMed search with the following keywords: “Lorazepam,DILI”.

A 20 year-old-Tunisian woman was hospitalized in the psychiatry department of the hospital of Nabeul in Tunisia for a brief psychotic episode.She had a DILI under Olanzapine, Chlorpromazine and Lorazepam, which conducted us to interrupt her treatments except for the Lorazepam(5mg/day). The hepatic tests went back to normal even under Lorazepam. Few days later, the liver enzymes increased again to reach very high levels. Extensive workup was negative for other causes of liver injury, including viral hepatitis A, B, C and E.; capillary electrophoresis of serum proteins was normal; Exhaustive immunological tests were performed searching for auto immune hepatitis(anti-smooth muscle antibodies, anti-LKM1, anti-LC1, anti-SLA/LP) primary biliary cholangitis(anti-mitochondrial antibodies, anti-GP210, anti-sp100) and other antibodies like antinuclear antibodies were negative. Liver biopsy showed polymorphic inflammatory infiltrate including some eosinophilic polynuclear cells and rare vaguely epitheloid macrophages, with necrotico-inflammatory foci in the lobules, all of which were consistent with DILI. Lorazepam was discontinued and within 10 days her liver enzymes decreased and completely normalized.

Lorazepam, with an unknown action mechanism, can be a cause of DILI.

No significant relationships.

One of the objectives of nursing education is helping nursing students acquire the knowledge, skills, and behaviors needed to deal with various problems.

The study is descriptive.

To determine the “problem solving skills” of the 1st-year and 4th-year students.

The study is a descriptive one. The study sample comprised a total of 153 students in their 1st-year and 4th-year in Department of Nursing, Cumhuriyet University, Turkey. The research data were collected by means of the “Personal Information Form” developed in light of the relevant literature review and the “Problem Solving Inventory” which was developed by Heppner and Peterson (1982) and tested in Turkey in 1990 by Taylan in terms of fist validity-reliability properties.

Of the first year students, 84.9% lived in a nuclear family, 61.6% lived in a city, 39.5% were first-born children. Of the fourth year students, 81.0% lived in a nuclear family, 67.2% lived in a city, 37.3% were first-born children. All of the students financial needs were met by their parents. There was no difference between the total “problem solving confidence” scores of the first year students (85.942 ± 16.649) and the fourth year students (81.866 ± 19.168) (p > 0.05). According to the sub-scales of the inventory, the first year students received higher scores than the fourth year students in “problem solving confidence”, “approach-avoidance behavior” and “personal control” (p > 0.05).

The education received by the students did not make a difference in the development of their problem solving skills.

In the UK, almost 50% of illness diagnosed among working age adults is mental distress, depression and chronic anxiety being the two most prevalent illnesses. However, only 24% of those diagnosed receive appropriate interventions within the National Health Service (NHS). In light of this, third sector organisations, such as MIND, are left to fill the gap in providing therapeutic care. This paper reports on an evaluative study of what Mind offers as opposed to statutory services from a service user perspective.

An exploration of the differences in mental health care between statutory and non-statutory organisations.

To identify how service users experienced MIND's counselling service. To establish the benefits and disadvantages of mental health care within statutory and non-statutory services. To identify the impact of mental health care from non-statutory services.

This qualitative research project, adopted a case study approach. Using one to one narrative interviews, data from 12 participants, five males and seven females were collected. Following transcription, each narrative was analysed individually, with thematic analysis being used across all 12 interviews.

Six themes were identified; mindful of the gap; easing like sunday morning; magic moments; love is in the air; lighting up a future and changing the status quo.

Mind plays a significant role in enabling those with psychological problems to move towards building a better future. Findings suggest statutory services can learn important lessons from non-statutory organisations not least how best to provide cohesive, collaborative and compassionate mental health care for those in distress.

The authors have not supplied their declaration of competing interest.

One of the partial solved issues in the treatment of depression is somatic pain. Most antidepressants can reduce the intensity of affective symptoms, but somatic pain, if present, is unfortunately, the last which disappears.

to estimate the clinical efficacy of SSRI (paroxetine) compared to venlafaxine XR, a dual action antidepressant, in patients with Major Depressive Disorder (MDD) and somatic pain.

Clinical open study including 48 patients (28-56 years), both sexes, with MDD (DSM-IV), mean scores MADRS=28 and somatic pains at baseline (at least 1 symptom moderate-severe)

MADRS, Depression Checklist (developed by University of Michigan Depression Center), CGI-Severity, CGI-Improvement, side effects, somatic conditions and relapse (follow-up: 6 month).

The patients were divided in 2 groups: Group A: paroxetine (40mg/day), 23 patients; Group B: venlafaxine XR (225mg/day), 25 patients. After 8 weeks: responders in Group A=56%, in Group B= 59%; partial responders: Group A=21% and Group B=15%, non-responsive: Group A=12% and Group B=11%. Drop-outs: Group A=11% and Group B= 15%. Somatic symptoms: 36% of the Group A patients and 28% of the Group B presented at least 1 somatic symptom with moderate to severe intensity. The 6 month follow-up period we evaluated the relapses in all groups and the outcome of the somatic symptoms.

1. 1. In MDD patients both paroxetine and venlafaxine XR demonstrated a good therapeutic effect.

2. 2. The somatic symptoms were less influenced by both antidepressants, till the end of the study.

3. 3. The group B was more responsive to these important aspects.

The Goldberg's 30-item General Health Questionnaire (GHQ-30) is used as a screening instrument for psychological distress in the general population. GHQ-30 has been widely used as a unitary measure, but several underlying factors have been identified in previous studies based on factor analyses.

To analyze the internal consistency and the factor structure of the Polish version of GHQ-30 in the group of somatic and psychiatric patients’ subpopulations. Differences in factor structure among those two groups might have important implications for how the test is used in those populations.

A total of 1473 patients (807 psychiatric and 666 somatic) were included into the study. A total score was calculated with Likert method. The principal factor analysis with orthogonal varimax normalized rotation was used for the factor extraction.

The GHQ-30 was found to have high internal consistency. The factorial analysis conducted for the whole group, as well as for psychiatric and somatic patients separately, showed that two factors labeled as followed can be abstracted from the global scale: “depression and anxiety” and “interpersonal functioning and general coping”. These factors jointly account for 54,2% – 62,3% of the variance.

Results showed that GHQ-30 may be used both as a unitary measure using full-scale sores and allows to get more detailed information about individual's intra- and interpersonal functioning.