Cerebral palsy (CP), a long-term disease, may change parents' attitude towards ill child and may cause certain differences in everyday functioning between children with CP and healthy persons to increase. The aim of the study was to estimate the quality of sleep habits in children with CP.

93 boys and girls with CP aged 1-18 years participated in the study. A control group included 300 healthy children matched in age. The study was conducted using internally developed questionnaires of sleep disorders and sleep habits in the Department of Developmental Neurology of the Poznan University of Medical Sciences.

The health status of a child with CP was most frequently estimated as fairly good. In our study, 53.7% children with CP slept with another person in the same bed, 78,5 % of children slept in one room with other family members. Almost 53,3% of children with CP needed over 20 minutes to fall asleep, while in the CG only 35.0%; it was statistically significant difference. Day naps occurred in 41.9% of CP children and 27.7% of healthy ones. The statistical analysis shows a significant correlation between CP and the sleep habits.

The quality of sleep habits in children with CP was significantly different than in the CG children. Additional research on larger group of patients with CP is needed to correlate the prevalence of sleep disorder symptoms with motor impairment, Gross Motor Function Classification System (GMFCS) level and epilepsy.

The purpose of the study was to investigate the sleep habits and sleep disorders in children and adolescents with headache.

Three hundred children and adolescents with headache and 284 children without headache were investigated using a questionnaires developed by the authors.

In Our study we observed difference is all the more important as some phenomena like bed co-sleeping (27.7%) and watching TV (20.3%) during falling asleep and sleep disorders awakenings from night sleep (43.7%), sleep talking (48.3%), snoring (27.3%), bruxizm (23.3%), nightmares (16.7%), sleep terror (9.0%) are observed statistically more frequently in children with headache.

Sleep habits described by parents in the children with headache are significantly different than those in healthy. Sleep disorders are very common in the group of children with headache. There is a need of additional research to find correlation between the different types, frequency of headache and sleep habits and disorders.

The Emergency Department serves a population of over 300,000 people.This comprise a mix of different nationalities such as Irish, Other EAA citizens and non-EAA nationals.

Presentation to the Emergency Department after deliberate self harm is quite common.Although patient assessment do not reliably predict risk of future self harm(Hawthorn et al, 1995), they can identify treatable psychiatric disorders and other psychosocial problems.

All records of patients aged 16 years and over, presenting to the Emergency department with deliberate self harm between 1st January 2006 to 31st December 2006 were examined. The quality of assessments analysed using an audit protocol developed from the Royal College of Psychiatrist guidelines for assessment following self harm in adult (RCPsych Council report 2004).

A total of 319 patients presented within this period of which 284 case notes were traceable.Alcohol consumption prior to deliberate self harm was documented in only 75% of cases.

Also majority of precipitating factors for deliberate self harm were social issues but patients' social circumstances were assessed in only 57% of cases.

At the end of the assessments, over 70% of patients were discharged home, some without proper details of social support network. Also alcohol consumption need be assessed in all patients presenting with deliberate self harm (Royal college of Physician guidelines).

In conclusion, the assessments within this period fall short of the Royal College of Psychiatrist guidelines.

Describe and analyze the sequence of facts that families and patients have to cope with during the admission process at the hospital.

Based on a simple questionnaire applied to patients and relatives at the entrance of the hospital we obtain some interesting information about expectations and fears that may interfere in the relationship between users and staff. This information is very useful in order to plan not also the sequence of persons that may talk to the patient and/or their relatives but the content of the conversation to aim the best relationship and minimize stressors during hospitalization.

We list the main fears that appear in the process classified in four topics:

1. 1. Fears previous to admission

2. 2. Fears at first contact

3. 3. Fears in proper admission process

4. 4. Fears in relationship with the therapists

We also list main expectations in two topics:

1. 1. Relative's expectations

2. 2. Patient's expectations: related to diagnosis, therapeutic process, staff, structures and rooms of the hospital and other circumstances.

Fears and expectations of patients and relatives interfere in admission process but also in hospitalization and post discharge period.

It is very useful to know those fears and expectations in order to plan the hospitalization process.

This information is also useful to plan staff training and edit an information guide given at the entrance. This may also improve quality care parameters at Hospital.

Assess the sources of patients' knowledge of medication side effects and the effects of their knowledge on compliance with prescribed medication.

476 patients attending psychiatric services were randomly selected and asked to fill a questionnaire designed to assess parameters relevant to the objectives of the study.

Overall, 44% said they had learnt of side effects of their medication from multiple sources including doctors (52.31%), leaflets (54.2%), internet (14.29%), books (13.02%), chemist (11.34%), other patients (5.67%), friends/relatives (7.35%), self-help groups (2.94%) and other sources (4.2%). 8% said they were not aware of any side effects of the medicines they are taking presently.

13.44% of patients reported that they never find out about side effects of their medication before taking it for the first time with a high proportion of these being males (17.93%vs.10.69%, p = 0.0366). 46.2% reported that they have had concerns about taking medication because of their knowledge of side effects with females more likely to have such concerns than males (49.83% vs.40.76%, p = 0.0269). Finally, when asked if they would have taken the medicines prescribed for them now if they were told initially of all the side effects, 51.05% answered ‘more likely’, with a higher proportion of these being males (56.67% vs. 49.46%, p = 0.06)

Doctors and information leaflets are the leading sources of patients' knowledge about side effects of medication. The knowledge of side effects of medication has a potential to impact more on the compliance of female patients compared to males.

Culture is defined as the sum total of the way people think, feel, and act as members of a social group. Culture is learnt. Cultures can overlap and individuals can belong to several cultures. cross-cultural psychopharmacological studies have mainly focused on differences in the pharmacokinetics and pharmaco-dynamics of psychotropic medications among various ethno-cultural groups and research on many socio-cultural non-biologic contextual factors in psycho-pharmacotherapy is sporadic and often not widely known. In this paper, the authors review the relevant literature in all these areas.

Searching the recent thirty years studies on cultural issues in psycho-pharmacology in a wide area and then screening them systematically, fifteen relevant studies were selected and evaluated. Results were conceptually re-arranged and re-classified and are presented in the format of a narrative review.

In a general aspect, cross-cultural factors affecting psycho pharmacotherapy can be divided in two groups i.e. primary variables which directly influence pharmaco-dynamics and pharmaco-kinetics and confounding variables which indirectly interact with drug treatment, selection, usage and response. In another point of view, trans-cultural psychopharmacological issues are classified in the domains of patient variables, doctor variables and environmental variables, each including many different factors and considerations which are elaborated and discussed in the full-text of this material.

Recently, increasing prevalence of obesity has been elucidated for a major public health problem. Previous research propose that obesity may be significantly associated with psychological distress, considerable disturbances of sleep and health-related quality of life (HRQL). The aim of this study is to examine the psychological distress, subjective sleep quality and HRQL in a group of patient diagnosed with obesity.

A total of 57 obesity patients and 53 healthy control subjects were involved in the study and self-administered questionnaires was submitted to measure by using the General Symptomatic Index of Symptom Checklist (SCL-90-R), Pittsburgh Sleep Quality Index (PSQI), HRQL (Short-Form 36). Several clinical and socio-demographic data were also recorded.

HRQL was significantly reduced in obesity as compared to healthy controls. The obesity group exhibited greater psychopathology and suffered greater disturbed sleep quality than did controls. In particular, psychopathological distress was positively correlated with global PSQI scores.

Obesity is associated with psychopathological distress, poor subjective sleep quality and reduced perceived health status. Recognition of sleep disturbances in obese patients is also relevant to management, because effective strategies to improve sleep in this patient group might also lead to vast improvements in their psychopathological distress and perceived health status.

The purpose of this study was to assess the factors that influence attitudes of people neighbouring to residential care facilities that host chronic psychiatric patients formerly hospitalized in a psychiatric hospital, 2 years after their deinstitutionalization.

One member of at least 30 households neighbouring to 8 community-based psychiatric facilities (hostels and sheltered apartments) was interviewed by a group of specially trained social workers. The structured interview used was compiled specifically for the needs of this study.

Less than 25% of our sample had adequate knowledge of the term ‘deinstitutionalization’ and in particular people with higher education and that have been visited by a psychiatric resident. Nevertheless, their attitudes were in general positive. In a regression analysis, attitude towards deinstitutionalization was found to be positively correlated with having visited a psychiatric facility, years of education, and living near 4 out of the 8 psychiatric hostels [R-squared=0.20]. Female neighbours were generally more favourable, but this effect was only marginally significant. Attitude towards the psychiatric patient was best predicted by years of education, having visited a psychiatric hostel and living near 2 out of the 8 psychiatric hostels [R-squared=.21]. Age was generally negatively correlated with attitudes towards the patient [r=-0.23]. There were also significant differences among the attitudes of the various hostel neighbourhoods.

Apart from education, age, and gender the most important factors in influencing attitudes towards deinstitutionalization and patients are local. Choice of favourable locations for psychiatric facilities and cultivation of a positive neighbourhood climate are important.

The study of the impact of deinstitutionalization on a Psychiatric Hospital staff's perceptions regarding the sources of conflict at work, the presence of injustice, and their job satisfaction.

A questionnaire specially made for the purpose of this study was anonymously completed by the working staff two years before and two years after the closing of the chronic wards of their hospital.

The staff felt that there are more conflicts between nursing staff and patients as well as between colleagues themselves. The lack of staff was the greatest cause for conflict reported [t(346) =2.735, p<0.01], as was before the deinstitutionalization, while female gender, younger age [r=−0.117] and closer contact with patients were correlated with perception of more conflicts. The opinions about justice in the work environment were not significantly influenced by the deinstitutionalization, but by younger age [r = 0.150] and the female gender, as well. Finally, the staff reported higher levels of general satisfaction from their work [t(343) = 2.923, p<0.01] and especially that they felt safer in their new workplaces, than in the chronic wards of their hospital [t(349) = 1.976, p<0.05]. This effect was independent of gender, age or job type [F(5, 231) = 2.361, p<0.05].

This follow-up study verifies the previously found effects of the staff's demographic characteristics on perceptions of conflicts, justice and job satisfaction. The relocation of patients to community-based psychiatric facilities, which are smaller, with less staff and more responsibilities has created more opportunities for conflict; nevertheless has considerably increased the staff's job satisfaction.

There have been concerns about people with mental health problems living in the community in Iran experiencing harassment.

This study measures the prevalence and nature of harassment experienced by people with mental health problems and compares them with the general population.

Face to face interviews were conducted by trained interviewers to ascertain experiences of harassment. Interviews were carried out with 112 people with mental health problems and with 104 people from the general population.

Sixty-one per cent of people with mental health problems reported experiencing harassment, nearly ten times more frequently than those in the general population (7%). Among the people with mental health problems, being female, having higher levels of education, or being unemployed were significantly associated with experiencing harassment. The harassment commonly involved verbal abuse, often made reference to individuals' mental health problems and was primarily committed by family members.

A significantly higher prevalence of harassment was reported among individuals with mental health problems living in the community than in the general population sample. Mental health professionals should proactively ask their service users about their experiences in the home, and educational interventions are recommended, particularly for families of people with mental health problems.

This project was funded by Psychiatric and Psychological Research Center of Tehran University of Medical Sciences

There is a high prevalence of psychiatric disorders in dermatological patients.

To evaluate the prevalence of this problem and to find a set of variables associated with the presence of psychiatric disorder.

414 adults attending the outpatient clinics of a dermatological hospital or in inpatient ward were given a questionnaire comprising the DLQI and the 28-item General Health Questionnaire (GHQ-28).

In total, 414 questionnaires were given at admission. Of these Using a stringent cut-off threshold (5<) for psychiatric case identification with the GHQ-28, the overall prevalence of psychiatric morbidity was 51.3% . We found a higher prevalence of psychiatric disorders in married and low educated patients. Higher score of GHQ-28 accompanied with higher score of DLQI. High prevalence rates were observed among patients with vitiligo, psoriasis, pemphigus. There was not significant difference in psychiatric co-morbidity between men and women.

Our study has shown the situation that is actually faced by dermatologists in their everyday practice, where they are in an especial situation to detect psychiatric morbidity and to take appropriate measures. The GHQ-28, being easy for patients to compile and for physicians or nurses to score, may be a practical instrument to increase identification of patients with prominent psychological distress or formal psychiatric disorder in order to provide more appropriate intervention.

Dissociative disorders have comorbidity with conversion disorder, borderline personality disorder, depression and somatization disorder. Though dissociative disorders and medical illness comorbidity is not investigated enough, epilepsy, cronic pain such as headache, pelvic pain and backpain are frequent with childhood trauma and dissociative disorders. Few studies indicated that headache is more frequent in people with childhood trauma but the relationship between dissociative experiences and headache, childhood and other traumas is not investigated enough.

The aim of this study is to investigate the frequency of childhood trauma and dissociative disorders and the relationship between them among patients with cronic headache.

DIS-Q, SDQ, DES and Childhood Trauma Questionare is given to 90 patients presented to Neurology headache unit. Patients scored DIS-Q>2 or SDQ>30 or DES>25 are called for another session to apply DDIS and SCID-D.

46,7% of the patients had comorbid psychiatric illness. In this population the percentage of childhood trauma was 58,9% (34,4% neglect; 24,7% physical abuse; 22,6% emotional abuse; 10,8% sexual abuse). 21,1% of the patients had at least one suicide attempt; 17,8% had self destructive behaviour. DDIS was applied to 33 and SCID-D to 19 of 90 patients. Any type of dissociative disorders is diagnosed in 31 of 33 patients evaluated with DDIS.

We found high prevelance of childhood trauma and dissociative disorders among patients who present to neurology headache unit. These findings may indicate that childhood trauma can play a role in the development of dissociative disorders and somatic symptoms such as headache.

Clinical experiences.

Patients with haemophilia often experience high level of anxiety for the risk of bleeding and difficulty in coping with the situation. Comparison between the clinical data and the ESCHQoL Study results showed us, that patients with haemophilia initially tend to denial anxiety, which manifest itself more often through the body symptoms. Some of our patients experienced stigmatised behaviours during their childhood, which, of course is very traumatising.

The ESCHQoL Study results, especially the part, which evaluate the social and psychological problems of patients with haemophilia should be interpret with the caution. Clinical experiences in working with patients with haemophilia have shown that they have difficulties in expressing feelings. During the long-term psychological work with the patients they progresivelly start to open emotionally and the level and quality of their defence mechanisms start to change. As a consequence the management of haemophilia often improves.

Although there is growing interest in human health and psychological factors efficiency in chronic pains, specially in lowback pain, there has been limited studies of psychopathological aspects, such as somatization, interpersonality sensitivity, hostility and … with pain threshold. Pain is a affective, complex and cognitive phenomenon, which is highly common in a variety of medical conditions, and debilitate normal life. By the reason, the main aim of this study is to measure the relation of psychopathological variables, consistent with demographic factors with pain threshold and tolerance.

By multi stage sampeling of Tehran central branch of I.A university, 50 subjects (25 female, 25 male) in the age range of 22-26 years old, have selected. After testing by specific scales and electrical pain threshold-tolerance, (TENS), data analized by two-way analysis of variance.

There is statistical significant relation in pain and psychopathological variables.

This study consistently showed that not only personality characteristics, but also psychopathological aspects, specially anxiety, depression and hostality have relation with pain threshold and tolerance.

Since 2003 the national research program for solid organ transplantation in HIV patients is active at the Liver Transplantation Centre of Modena. HIV patients who enter this protocol are assessed by the CLP Service. The aim of the present study is to evaluate their psychiatric comorbidity.

An observational prospective study was conduced comparing ESLD patients with and without HIV. After the assessment, the psychiatrist compiled the TERS and the MADRS. Baseline (B) evaluation was made before the inclusion in the OLTx waiting list and the Follow-Up (FU) one was made 12 months later.

From January 2003 to December 2006 we assessed 553 patients: 39 (6%) with HIV and 361 (94%) without HIV. The two groups were homogeneous for gender (75% of male patients; p = ns) but not for age (46 ± 5 vs 56 ± 9; p = ns). Psychiatric anamnesis was negative in 176 (49%) patients without HIV and in 6 (15%) patients with HIV, p<0.001.

At baseline psychiatric comorbidity was present in 33 HIV patients (85%) and in 148 non HIV patients (41%), p<0.001.

At the follow-up MADRS highlights an improvement at all the items for HIV patients. In the non-HIV group score variation was: B = 7.10, FU = 8.15; in the HIV group: B = 10.20, FU = 4.09 (p<0.001).

The average score at TERS was higher in patients with HIV (43 ± 9 vs 35 ± 9, p = ns).

At B HIV patients with ESLD show a greater frailty to psychopathology but they quite improved during FU. The contrary happen in non-HIV group.

This study (A0081057) was designed to evaluate the long-term safety and efficacy of pregabalin treatment of fibromyalgia (FM).

In this 1-year, open-label (OL) extension of a 13-week randomized, placebo-controlled trial of pregabalin FM patients had the option of continuing pregabalin at doses of 150 to 600 mg/d. Efficacy was measured by the Short-Form McGill Pain Questionnaire (SF-MPQ), which included sensory and affective pain descriptors, Present Pain Intensity (PPI) index, and a Visual Analog Scale (VAS).

429 of 431 screened patients entered OL treatment, 249 (58%) completed, 70 (16.3%) discontinued due to an adverse event (AE), and 110 (25.7%) discontinued for other reasons. Median duration of treatment with pregabalin was 357 days (range, 1-402 days); 114 received pregabalin for ≥1 year. No clinically meaningful increases in dose were noted over the OL treatment period. Weighted mean dose was 414 mg/d in the first 3 months of treatment and 444 mg/d after 9 months of treatment. SF-MPQ sensory, affective, and total scores were improved relative to baseline, VAS pain score decreased 21 points (0-100 scale), and PPI decreased 0.9 point (0-5 scale). The most frequently reported all-causality AEs were dizziness, somnolence, peripheral edema, and increased weight, most of which were mild to moderate in intensity and of limited duration.

Pregabalin administered for up to 1 year was generally well tolerated by FM patients without evidence of dose increase over time. The sustained improvement in pain measures during OL treatment was consistent with that in shorter term double-blind trials.

To compare indices of quality of life of patients after aortocoronary bypass surgery depending on level of alexithymia.

We have examined 101 patients with verified diagnosis of IHD (44 – 65 years), exposed to aortocoronary bypass surgery (ABS). Level of alexithymia was identified according to TAS-26 scale. Indices of quality of life (QL) before and a year after surgical intervention were assessed according to general questionnaire of QL SF-36.

Comparative analysis of two groups of patients with IHD exposed to ABS with alexithymia (n=45; level of alexithymia according to scale TAS - 80,24±0,88) and without alexithymia (n=56; level of alexithymia according to scale TAS – 64,13±1,15) has been conducted. Mental status of patients in preoperative period and at the moment of catamnesis has detected as statistically significant differences according to frequency of anxious disorders. Level of anxiety according to Sheehan scale before operation in group with alexithymia has constituted 35,67±2,61 as compared with 28,34±1,99 in group without alexithymia; p=0,025613). At the moment of catamnesis statistically significant differences remained during reduction of indices of anxiety. A year after operation patients with high level of alexithymia had worse indices in association with relevant problems both of physical and mental health according to frequency of depressive and anxious-phobic disorders and number of not working persons (remaining disability).

We have revealed statistically significant role of alexithymia in prognosis of dynamic of psychoemotional and somatic status of IHD patients determining quality of life after aortocoronary bypass surgery.

Cutaneous Factitious Disorder (CFD) is rare but often chronic and recurrent illness that impairs patients' quality of life. Few are known about its underlying mechanism which often involves emotional factors such as anxiety and depression.

This study aimed to compare depression, anxiety and quality of life scores in patients diagnosed as CFD and in control patients with chronic dermatological diseases.

It's a case-control study held in dermatology and psychiatry departments of the university hospital Farhat Hached (Sousse, Tunisia). Twenty-five female patients diagnosed as CFD according to DSM-IV criteria were prospectively recruited. The control group consisted of twenty-five female patients with chronic dermatological condition. They were age and disease duration matched. Assessment was based on family and personal history, HAD-S anxiety and depression scores and SF-36 quality of life measures. Statistical comparisons were performed with Khi 2, Student and Fisher tests.

CFD patients had a mean age of 31 ± 8.62 years. They were more often celibates (p < 10–4) and had lower educational level (p=0.21) than controls. They also had more long family medical history (p=0.49), more personal psychiatric antecedents (p=0.29) and more previous suicide attempts (p = 0.10).

The level of depression and anxiety was the same between CFD patients' group and controls. However, quality of life measures were lower in CFD group (p<10–4).

In spite of a same level of depression and anxiety in the two groups, patients with CFD had a more impaired quality of life than those with other chronic dermatological condition.