The presence of mental illness in any of the parents can be a stressful factor in the child and be in certain way generator of disease. AIMS describe and quantify the psychiatric family history in patients who were consecutively referred to the outpatient department of children and adolescent psychiatry,mental health community center of collado villalba, Madrid

Obtain data of a series of cases filing a card of the 18-year-old minor patients who in September, October, November and December, 2007 come for the first time to our mental health community center.

The total number of patients were 114. There were psychiatric family history in 36,8% (N=42), the mother was or had been in psychiatric treatment in 28% (N=31)) of the cases, the father in 15% (N=17) and the brothers in 7 % (N=8), the most frequent diagnoses in mothers it were neurosis in 21 % (N=24), toxic abuse in 3,5% (N=4) and personality disorder in 1,8% (N=2), toxic abuse was the most frequent with 8,8% (N=10) in parents, followed by neurosis diagnosed in 4,4% (N=5), the most frequent diagnoses in brothers was the emotional disorder in 4,4,% (N=5). The mean age of parents was 41,34 (SE =6,34), in mothers was 38,43 (SE=6,59).

We have to consider the existence of some kind of psychiatric family history in the therapeutic plan of the patient.

Suicide is a serious public health problem. In 2005, 793 people were hospitalized in Madrid due to suicide attempt. However, most of the attempts do not require hospitalization and patients are discharged after the intervention in the emergency units. With the aim to implement local policies to prevent suicide, it is important to know the whole spectrum of suicide attempts that contact emergency units in Madrid.

To explore the incidence of suicide attempts assisted in the public health system in Madrid and to analyze their characteristics and the response of the health system.

Clinical reports of all patients attempting suicide were analyzed during 4 months in 4 general public hospitals (covering 44.7% of the whole population) in the Community of Madrid.

1009 suicide attempts committed by 921 people (66.2% women) were collected, with an incidence of 34.3 people per 100.000 in 4 months. 57 people (6.2%) committed more than one attempt (range 2 to 10, mean=2.5 ± 1.3). After the emergency intervention 71.9% of the patients were discharged, 25.3% hospitalized, 2.6% fled, and 0.2% died. Regarding suicidal ideation, 7.5% presented very high levels during evaluation, while 13.1% had high levels, 20.3% moderate and 47.3% had no suicidal ideation.

Compared with other European countries, our findings show moderate incidence of suicide attempts, most of which were mild, treated in the emergency units and derived to outpatient psychiatric follow-up. These results suggest places to develop and implement prevention measures.

Funded by Instituto de Salud Pública de Madrid.

The purpose of this study was to build a tool of evaluation of the strategies the children use during a dental care.

30 children (from 6 to 15 years old), 15 parents and 10 dentists participated in semi-directive conversations and in observations.

An analysis of thematic contents of the conversations and the observations allowed to kick away five categories of strategies and to classify them according to the moment of the meeting.

Questionnaires (behaviour, relation, cognition, emotion and somatic) were built. Once validated, these tools should allow to assess the strategies used by the child during a dental care and to individualize the way of treating them.

Ramón y Cajal Hospital is the reference hospital for area 4 (Madrid), which covers a population of more than 540.000 people. The psychiatric emergencies are one of the most frequent demands at the Emergency Department (ER)

• • Analysis of the cause of psychiatric demand and how it is made: who asks for help and who sends the patient to the hospital.

• • Analysis of the syndromic diagnosis, derivation and therapeutical attitude at discharge.

With data from sample of 145 patients attended by the emergency psychiatry staff between the 15th - 30th August 2008, we performed a descriptive analysis using SSPS 15.0 version in Spanish

• • Most common reason of consultation was nervousness (22%), being the patient the one who demanded evaluation (31,5%). Less commonly, the patient was sent from the local Mental Health Center (1,37%). Patients usually come accompanied by relatives (41%).

• • The most frequent syndromic diagnosis at discharge was “affective disorder” (23%),being usually derived to the local Mental Health Center (54%). Modifying the previous treatment after the consultation (37%) was nearly as frequent as leaving the previous one (35%).Starting a new treatment after consultation at the ER was rare (14%).

The profile of the patient attended by the psychiatry staff on duty in our hospital, is a patient who demands psychiatric evaluation, comes accompanied by relatives, consults for nervousness, is discharged with a diagnosis included in the spectrum of “affective disorders”, and is derived to the local Mental Health Center.

To evaluate aspects related to the psychiatric attendance in Campinas and population knowledge about mental disorders.

Participants of a public event were invited to answer a questionnaire about sociodemographyc aspects and knowledge about mental health.

The 88 questionnaires showed that there was uniform distribution between sexes and that 50 % of subjects were between 41 and 65 years. The most people have concluded the primary and secondary school. About religion, 55,7 % were Catholics and 26,1% protestants. The study showed that 23% of the subjects have looked for a psychiatrist in last year, the most at primary care health, but only 4,35% said there was no psychiatrist for them. Beyond the psychiatrist, psychologists and spiritualists are looking to solve mental disorders. People consider suicide idea as a disorder that must be treated by psychiatrist more than the eating disorders. “Listen voices that do not exist” was considered as reason to look for psychiatrist, being an opinion more prevalent between Catholics than protestants (O.R = 1.67). The people with first or second grade think that spiritual works produce mental disorders more than those who are graduated. (OR=3.97). When the information about mental illness is TV the people have more chance to believe that spiritual works can produce mental disorders (OR=1.67).

Psychiatric attendance is accessible for most people at primary health care in Campinas. The looking for psychiatrist comes with other professionals. The concept about mental disorders is influenced by level and source of information, sex and religion.

Suicide and smoking are immense, growing, associated global problems. Recent general population suicide rates and ratios by smoking status are unknown though in past reports, smokers had near three-fold hazard ratios of suicide among health professionals. So we assessed recent suicide rates and rate ratios in the general population of the United States (US) and Frankfurt, Germany.

US National Health Interview Survey interviewees from 1987, 1988, and 1990-94 with near complete follow up through 2002 (representing the US adult non-institutionalized population) and all suicides in 1999-2000 among adult residents of Frankfurt, their proxy respondents, control subjects, and census data were studied using survival time methods. Age was categorized in both samples as 18-30, 31-60 and 61+ years.

The respective US versus Frankfurt crude suicide rates per 100,000 were 13.8 (95% confidence interval (CI) 12.4-15.5) versus 17.7 (CI 15.0-20.5) overall, 7.9 (CI 6.4-9.9) versus 12.0 (CI 9.2-14.7) in never smokers, and 22.9 (CI 19.5-27.0) versus 32.0 (CI 24.5-39.6) in current smokers. Smoker suicide rate ratios relative to never smokers ranged from 2.1 (males) to 4.2 (females) in US groups and 1.5 (ages 61+ years) to 3.7 (ages 31-60 years) in Frankfurt groups (each p< 0.05).

In both the US and Frankfurt, Germany, large absolute and relative excesses of suicide are seen in smokers. Reducing the prevalence of smoking might greatly reduce suicide rates, especially in young and middle-aged adults and US females.

This study was funded by Pfizer, Inc.

This study aimed to examine the lifetime-prevalence of suicidal ideation, suicide attempts and depressive symptoms in a community sample of non-referred German adolescents.

The Self Harm Behavior Questionnaire (SHBQ) and the German version of the Center for Epidemiological studies- Depression scale (CES-D) were used to assess suicidal ideation, suicide threats, suicide attempts, and depression scores in a German school sample (n=665; age range:14-17; mean age: 14.81; SD: 0.66).

Lifetime suicidal ideation was reported by 239 (35.94 %) students, of whom 102 had planned an attempt and 41 had already started preparations. 104 (15.64 %) students reported, that they had at least once in their lifetime threatened others to commit suicide. Actually conducted suicide attempts were reported by 43 (6.47 %) students, of whom only five reported, that they had received medical treatment after their attempt. Depression scores were elevated in adolescents reporting suicidal ideation (mean CES-D score: 21.92; p< .0001) and suicide attempts (mean CES-D score: 22.86; p< .0001).

In accordance with international prevalence rates, suicidal ideation is a common phenomenon among adolescents. A small proportion of a school sample, with elevated levels of depressive symptomatology, reports suicide attempts. This fact highlights the need for awareness and prevention programmes within the school context.

Taking the prevalence of the sexual disorders -which in some studies is reported from 18% to 79% - into account and considering the fact that only a small percentage of the sexual patients refer to the physicians in order to treat their sexual problems. With regard to several problems which the veterans encounter in their personal and social lives, it seems that sexual disorders in these patients and their spouses are widespread.

In this research performed in the descriptive-temporal method, a questionnaire including all types of sexual disorders in men and women was provided and after standardization by 398 veterans and their spouses.

The results of this research are reported as follows; the prevalence of decrease the sexual desire in the veterans is 65/1%, the inability in erection 64/4%, difficulty in erection 60%, disorder in the continuation of erection 85/3%, and premature ejaculation 55%. In addition, the spouses of these veterans are encountered problems like the prevalence of the disorders in sexual desire with the rate of 25/4%, aversion of the sexual intercourse 7%, painfulness within sexual intercourse 8/8%, lack of excitement and vagina drought 10/3%, the disorder in orgasm 14/6%, and the inability in enjoying the sexual intercourse 14/3%.

The high level of prevalence of sexual disorders considered in this research clarifies the necessity and importance of the educational, consultation and the treatment programs for these groups and their spouses.

The epidemiology of mental disorders plays a significant role in the identification of the current status of mental health in society. As women play important role in protecting the mental health of the members of family and society. Therefore the aim of this study was epidemiologic survey of changes trend of mental disorders among the women in urban and rural regions in Semnan.

In this study mental condition of the married women has been studied. To do this a questionnaire (Scle-90-R) counting questions about anxiety, depression and etc., via interview was completed by questionnaires. Sampling was done in the form of stratification in which population affiliated each health center considered as a stratification and appropriate with volume, a share from total sampling was allocated to it. A at the end of, 970 cases contributed with us data were analyzed by using spss10 frequency tables and statistical graphs.

In this research91.7% (893cases) were urban and 8.3% (81cases) were rural. With the age mean 25.8±5 years were studied. The survey was shown that aggression, depression and psychosis have been increased individuals during the study. However anxiety, compulsive, inter personal sensitivity, somatic complains, paranoid and phobia have been decreased.

Considering the high prevalence of the above disorders, setting up the psychiatric and psychological sections for women is necessary in the health centers.

To assess with which frequency subjects with intentional overdose of psychotropic drugs ingest their own psychotropic drug treatment, and whether prescription of a drug may be a factor influencing the choice of drugs used for the IDO.

Demographic characteristics, psychiatric history, and currently prescribed psychotropic drug treatment were collected for all the patients (n=1654) admitted to an emergency department (ED) for IDO with psychotropic drugs (anxiolytics, hypnotics, antidepressants, antipsychotics and mood stabilizers) over a period of 18 months.

Two-thirds of the patients ingested during the IDO at least one of their own prescribed psychotropic drugs. Compared with the subjects who had ingested psychotropic drugs not prescribed for them, they were more likely to have a history of psychiatric hospitalization (OR 4.2; 95%CI 3.1-5.5), of parasuicide (OR 2.5; 95%CI 1.9-3.3), to be a psychiatric outpatient (OR 3.9; 95%CI 3.0-5.1), and to present with a serious IDO (OR 2; 95%CI 1.4-2.9). Independently from age and psychiatric hospitalization history (i.e. the seriousness of psychiatric disorder), they ingested during the IDO more often antidepressants (OR 4.4; 95%CI 3.0-6.4), antipsychotics (OR 2.9; 95%CI 1.7-4.8) and mood stabilizers (OR 4.1; 95%CI 1.6-10.7). No association was found with prescription for overdose of benzodiazepine or paracetamol.

Prescription of the psychotropic drugs plays an important role in the choice of the drugs ingested for the IDO. It might make potentially “dangerous” drugs available for the patient. Physicians have always to balance the benefit of the treatment against the risk of drug overdose.

To describe the types of psychotropic drugs ingested during intentional drug overdose (IDO) in subjects consecutively admitted to an emergency department and to assess which ones were a prognostic factor associated with increased morbidity during hospitalization.

Demographic characteristics, psychiatric history, current drug treatment, characteristics of the IDO were collected for 1654 patients admitted for IDO with psychotropic drugs (anxiolytics, hypnotics, antidepressants, antipsychotics and mood stabilizers). IDOs were a priori categorized as serious if associated with at least one of the following outcomes or technical events: death, hospitalization in the ED longer than 48 hours, respiratory support, use of vasopressive drugs, cardiac massage or dialysis. All types of psychotropic drugs were entered into a logistic regression model adjusted for age and gender. A stepwise selection was used to assess the types independently associated with serious IDO. Then, numerous confounding variables were entered one at a time in the final model.

Nearly all the patients ingested psychotropic medications during the IDO (88.4%), most often benzodiazepines (71.6%), and half used at least two various psychotropic products. Serious IDO was associated with tricyclics (OR 5.7; 95%CI 3.3-9.8), lithium (OR 4.3; 95%CI 1.6-11.6), carbamates (OR 2.7; 95%CI 1.8-4), anticonvulsants (OR 2.4: 95%CI 1.4-4.3), first-generation antipsychotics (OR 2.4; 95%CI 1.7-3.5) or selective serotonin reuptake inhibitors (OR 1.6; 95%CI 1.1-2.3).

Some drugs may be dangerous because of low toxic doses; prescriptions of short duration may be recommended. Moreover, for safety reasons, prescribers may prefer SSRIs to tricyclics and benzodiazepines to carbamates or phenothiazines.

Seasonal variance and climatic factors interrelated in incidence of psychiatric disorders and suicide have been attracting attention of resarchers for centuries. Still there are known just a few studies on the topic, once accomplished in remote times and parts of the world, which results might be found just controversial.

This pilot study analyses correlations in one year data on acute psychiatric admissions and suicides along with many objective physical parameters.

Used data are collected from two main psychiatric hospitals in Prague (1.5 mil. inhabitants), scientific institutes of Czech Academy of Science and Czech statistical office. Daily numbers of acutely admitted psychiatric patients during the year of 2005 (N = 3304) and suicides (N = 152) include persons of productive age, both gender, 18-65 years old. The daily admission rates, suicides and their distribution during the year and many climatic objective variables are treated with contemporary statistical methods.

Acute daily psychiatric admission rate seems to be significantly correlated with maximal daily temperature (x2, p= 0.05), quarters of the year (anova, p=0.003; x2, p=0.034), days of week (anova, p=0.001), weekends (t-test, p=0.0001), bank holidays (t-test, p=0.048).

Daily numbers of suicide do not significantly correspond with the variables meant above.

The strongest finding seems to be high risk of suicide in low air humidity condition: ODDS = 1.76.

Daily incidence of suicidality and acute psychiatric disorders differ in seasonal distribution and supposed relations to climatic factors. The study in wider complexity to be continued.

German psychiatric outpatient clinics have been established to treat the sickest among outpatients. They receive a lump sum per patient and quarter. This reimbursement is currently under scrutiny, because it can act as a disincentive for the care-givers and to the disadvantage of the patients. It was the aim of this study to elucidate the connections between individual aspects and concerns of the patients and the amount of care administered.

Clients of one of the largest health insurers, who visited a preselected outpatient clinic were followed for six months (p=339). All treatment activities were logged individually. Relevant sociodemographic data, the diagnoses, the individual needs and idiosyncracies, the course of the symptoms and case history were noted. Associations between the factors and utilization were tested by ANOVA and multiple linear regression models.

The regression model with the best fit (r2=0,48, p< 0,001) included five variables. Lower utilization is associated with living in nursing home (ß=-0,378; p< 0,001), higher age (ß=-0,273; p< 0,001), legal incapacity (ß=-0,306,p=0,002) and lower social functioning (ß=-0,187; p=0,033); higher utilization with inpatient days prior to outpatient treatment (ß=0,168; p=0,015). Treatment aims, isolated functional deficits, diagnoses and graveness of symptoms did not have a significant influence.

Outpatient clinics should address the needs of younger patients with the aspiration of an independent life despite of a grave psychiatric disorder. Treatments administered to nursing-home inhabitants are much less complex, although these patients are even sicker. A corresponding reallocation of financial resources is suggested.

There seems to be geographical differences in decisions about breast conserving surgery (BCS) in breast cancer patients. This study was to evaluate patients’ attitude to BCS and to assess the factors affecting cancer practice in West China.

A structured questionnaire was distributed to 184 patients, eliciting information about the patients’ characteristics, occupation, education, family life, recognition of illness, knowledge about BCS, the main means of gaining surgery information, selecting surgery approaches, preferences to breast reservation.

In all, 163 patients completed the questionnaire. The results indicated that only 7.4% of patients received BCS and 23% of the remaining patients desired to have BCS and the affecting factors were significantly associated with their family life, recognition of illness and the main means of gaining surgery information (P < 0.05). No associations were between BCS selecting and the other variables studied. The most frequent reasons for selecting BCS were keeping the female shape and improving quality of life (71%), the second most were postoperative recovery, minimal influence of physical function (47%) and patients’ knowledge about BCS (42%). The most frequent reasons for not selecting BCS were uncertainty about BCS results and worry about recurrence (81%), the second most was the elderly age unnecessary for BCS (40%).

The findings indicate that breast cancer patients in West China do not take BCS as the first choice as the best treatment method. It is warranted that further study of more patients, attitude of patients’ partners and physicians to BCS.