To understand those factors which facilitate or hinder resolution of Mental Health Crises in order to inform future development of Crisis Resolution and Home Treatment (CRHT) Teams.

Qualitative Interview study conducted by service users trained in research techniques. Home based interviews were conducted with 36 randomly selected patients who had used the services of one of nine CRHT teams across the East Midlands, United Kingdom, which serves a catchment population of 1.2 million people during a two week census period in October 2007.

Participants reported different levels of satisfaction with the treatment and professional responses they received. We identified three themes leading to successful resolution of mental health crises: being enabled to feel safe, to feel accepted and to feel understood. Participants did not identify specific treatment interventions such as medication or formal psychotherapy as important contributors to recovery. Unhelpful experiences included professional responses which resulted in participants feeling misunderstood or ignored, unsafe, vulnerable or anxious, or that they were being judged.

The quality of relationship between the patient and members of the CRHT team is critical to any therapeutic effect. Therapeutic effect is optimum when it is based upon an adult to adult relationship which can provide a holding function allowing the service user to feel safe, accepted and understood while the crisis resolves. These findings have important implications for commissioning and managing such teams, and theoretical implications for medical practice morewidely.

The aim of this work was to identify factors associated with homelessness status in patients admitted to the psychiatric emergency ward of a French public teaching hospital over the 6-year study period (2001-2006).

The study was based on a retrospective review of the psychiatric emergency ward's administrative and medical computer databases. Each emergency care episode had accompanying data including demographic, financial, clinical, and management information.

During this 6-year study, the psychiatric service recorded 16,754 care episodes concerning 8,860 different patients, of which 591 were homeless (6.7%) and 8,269 were non-homeless (93.3%). The mean ± SD number of visits to the psychiatric emergency service was higher for homeless (4.9±12.3) than for non-homeless patients (1.7±2.4) (p< .001). A total of 331 homeless patients (56%) had more than one care episode, versus 2,180 (26%) for non-homeless patients. Factors associated with homelessness included male sex, single status, and the reception of social financial assistance. Schizophrenia (43.7%) and substance use disorders (31.0%) were the most frequent disorders in homeless patients. Aggressive behaviour and violence were reported equally in homeless and non-homeless patients. Homeless patients were hospitalized less often after having received care in the emergency ward.

Although there is near-universal access to free mental health care in France, our findings suggest that the quality and adequacy of subsequent care were not always guaranteed. Multidisciplinary and collaborative solutions are needed to improve the management of homeless patients.

The Crisis Resolution Home Treatment team (CRHT) provides comprehensive care and support to individuals experiencing acute mental health difficulties in the community. It offers a same day assessment and provides an alternative to hospital admission by providing intensive intervention in the community. In case of hospitalisation, the CRHT can assist in minimising inpatient stay.

Handsworth and Ladywood are two major residential areas in Birmingham with high level deprivation and a population of approximately 9000. The study reviews the completeness and efficacy of CRHT intervention.

The study retrospectively examined 100 consecutive referred case notes during June and July 2008. That period was about four months prior to the start of the study which provided enough time for the completion of a home care episode. Data was gathered and assessed statistically.

62% of referrals were assessed on the same day and 27% within one day of referrals. 11% of referrals were new to psychiatric services. Referrals were from Accident and Emergency (32%), Community Mental Health Teams (22%) and general practitioners (8%). There were three and two assessors in 60% and 100% of cases respectively. A doctor was always present for all the assessments. Eighty-three percent of the referrers were notified of the assessment outcome the same day and 14% the following day.

The CRHT provides an effective care to psychiatric patients with acute needs. The organised nature of this service reduces hospitalisation and ensures that needs of patients experiencing acute mental health difficulties are met in the community.

To analyze, for all the pediatric consultations in 2008 in the emergency ward of the Pediatric Hospital of the University of Campinas, the clinical and demographic profile of the consultations in which there was a possible psychiatric diagnosis.

Review of all forms of consultations for children enrolled in the unit during 2008, selecting those with the possibility of a psychiatric diagnosis.

Of 21,811 consultations in 2008, 95(0.43%) included psychiatric complaints - 60(63.2%) girls and 35(36.8%) boys, aged 1-13 years(9±0.4). 70(73.7%) were white, 18(18.9%) mixed and 7(7.4%) black. A psychiatric evaluation was called for in 39(41.0%) cases. In 35(36.8%) sexual abuse was suspected. Other forms of violence were reported in 8(8.4%) cases. There were 6(6.31%) suicide attempts, 10(10.5%) cases of extreme agitation, 14(14.7%) consultations for extreme anxiety/dissociative symptoms, 5(5.3%) for depressive symptoms and 4(4.2%) for a psychotic condition. Twenty(21.1%) children were already using psychotropic drugs at the time of evaluation and in 29(30.5%) evaluations there were subsequent psychiatric interventions, with drug prescriptions in 11(37.9%). Nine(9.5%) children had clinical/pediatric conditions.

Children may need psychiatric care in emergency situations for various conditions. Despite the small percentage among the total number of pediatric emergency consultations, psychiatric evaluation, when necessary, can be useful and have an impact on diagnostic and therapeutic procedures. The plight of these children can be intense, demanding prompt and effective action. A psychiatrist can provide assistance that may help the pediatrician in the management of severe pathological conditions that affect the mental lives of children.

To examine associations between gender and diagnostic profiles of life events among patients admitted to a general hospital after attempted suicide.

Participants (n = 86) were patients consecutively admitted to a general hospital emergency care unit over the inclusion period of 26 months after an act of attempted suicide. They were interviewed within 2 days using the EPSIS protocol, the MINI and SCID-II interviews and a range of scales measuring life events (Brugha's scale) and alcohol abuse (AUDIT). Logistic regression was used in data analyses. Results are given in Odds Ratios with 95% Confidence Intervals.

Men reported more unemployment, [23.5(2.8-197.6)], loss of work, [4.7(1.2-17.3)], serious economic problems, [2.7(1.1-6.8)], problems with police and presented in court, [8.6(2.2-30.3)]. Major depression (MD) was associated with the separation from spouse due to interpersonal conflict [3.6(1.1-11.7)], however, when adjusted for gender, it tended towards significance only in men and was non-significant for women. Comorbidity of MD with anxiety disorders, alcohol abuse or borderline personality disorders were not associated with any specific life event.

Irrespective of diagnostic profile, life events related to legal problems and loss of job/work and marriage were significant for men who were admitted to a general hospital after a suicide attempt, irrespective of diagnostic profile.

Immigrant population has been growing up in Spain in the last decades. The immigration process constitutes a vulnerability factor for the development of psychological issues. Moreover, ethnicity determines a great variability in the symptomatic expression of psychiatric diseases. The objective of this study was to investigate the demographical characteristics and clinical profiles of immigrant patients that visit the emergency services of general hospitals.

An epidemiological study was conducted to evaluate profiles and demographical characteristics of immigrant population attended at the emergency services of the “Hospital 12 de Octubre” Madrid, during 2007. The data were acquired through a protocol developed for this study and applied to all foreign patients attended.

2976 patients were attended during 2007. Immigrant patients were 10% of the sample. There mean age was 29.46 years. 42.1% were men and 57.9% were women. The nationalities of the sample were as follow: 47.8% were Latin American, 23.7% Eastern Europeans, 16.1% were Maghribian and 4.7% were Africans. 48.2% were attended because of suicide attempt (the 59% of Latin Americans and the 54.5% of Eastern Europeans) and 14.3% had psychosis (the 42.9% of Africans and the 36.2% of Maghribians). 30% were diagnosed of a current Substance Use Disorder (the 16.9% of Eastern Europeans).

We found several clinical and demographical differences within the ethnic groups studied. Latin Americans and Eastern Europeans consult for suicide attempt, whereas Maghribians and Africans are attended for psychosis. Psychiatrists should consider cultural and ethnic factors when interviewing foreign population.

Revealing of clinical features of anxiety in victims of disaster for definition of the treatment and forecast.

Clinical, psychological testing, statistical. Clinical features of anxiety are investigated at 471 victims of disaster -- were staying in hostages (women -- of 68,4%, men -- of 31,6%) in the age of 18-60 years. Diagnostics of ASR was carried out according to diagnostic criteria МКБ-10.

Clinical variants of anxiety are allocated within the framework of ASR with: vegetative symptoms - 34,2%; asthenia - 52 (11,0%); emotional instability - 9,5%; somatoform symptoms - 8,7%; phobia - 11,3%; depressive symptoms - 17,0%; apathy - 3,1%); the others - 8,1%. On behavioural features with: hyperknezia - 60,9%; hypoknezia - 22,7%; mixed condition -- 16,3%. On current: undulant - 59,9%; constant - 30,8%; attack - 9,3%. After 1 year of dynamics of a mental condition has revealed formation of PTSD at 40,1% of injured, adjustment disorder at 24,2% anxiety disorder - at 18,7%, at 17,0% - recovery.

The least favorable forecast was marked at hostages with prevalence of somatoform symptoms (р≤0,001), emotional instability (р≤0,001) and apathy (р≤0,05). Favorable forecast -- at persons with vegetative (р≤0,05) and depressive symptoms (р≤0,05).

We have studied the treatment modes and therapies of patients with acute psychotic disorders, in a general hospital for 1600 beds.

Clinicopshycopathologic, clinicotherapeutic, and statistical.

1982 patients, 18-92 years of age, 64% of them males, have been examined.

All the patients have been primary admitted with acute somatic disorders:

• insult - 18%,

• skull injury - 21%,

• myocardial infarction - 23%,

• exogenic poisoning - 31%,

• parasuicides -4%,

• operations on the thoracic organs - 3%.

The mental disorders diagnosed were following:

• amnesic syndrome, organic - F04 - 29%,

• depression - F43.20 - 5%,

• organic hallucinosis - F06.0 - 12%,

• organic delirium - F05 - 33%,

• psychotic disorder - or drug induced - F1 - 21%.

After psychiatric examination by an attending psychiatrist, the patients have been moved to the resuscitation department where they have been treated up to their recovery.

None of the patients has been moved to the mental hospital.

The immigrant population in Italy is currently increasing, particularly, foreigners in East Piedmont raised by 16,8 % last year. We aim to compare immigrant and Italian patients’ Emergency Room (ER) admissions due to psychiatric symptoms.

Of the 658 admissions we observed, 13.1 % of ER contacts concerned immigrants mostly coming from Russia, Albania, Morocco and Romania, consistently with migration streams in East Piedmont. Compared to the Italians, immigrant patients were younger (35.70; SD = 10.56 versus 44.78; SD = 16.57) and more frequently admitted for alcohol and substance abuse/withdrawal. Italians had a higher probability of having a psychiatric history including previous hospitalizations and contacts with Mental Health Services (OR = 2.60; CI 95 %: 1.64-4.12). The presence of social/relational problems associated with admission was significantly lower among the Italians (OR = 0.55; CI 95 %: 0.35-0.88).

Preliminary data suggest that ER utilisation by immigrants may represent their main way to primary health care. Monitoring ER contacts may provide relevant information for the development of culturally sensitive Mental Health Services.

We considered Italian and immigrant patients with psychiatric symptoms who were admitted to the ER Department of Novara during a period of 13 months. We compared sociodemographic (gender, age, education, occupational history, marital status, living circumstances) clinical-anamnestic (history of psychiatric illness, presentation symptoms, previous contacts with Substance Abuse/Mental Health Services, social/relational problems) and admission (type of admission, intervention and discharge) characteristics of the two groups (Italians versus immigrants).

The first psychiatric intensive care unit (PICU) opened in the early 1970's in New York. This ward was designed to manage patient that did not respond to treatment in open psychiatric wards. There are about 15 PICUs in Sweden but the concept has not been specified by any public organs. In many county hospitals, both acute and intensive care units exists parallel.

Therefore, the aim of this study was to describe the core characteristics of PICU in Sweden and to describe the care activities provided for patients admitted to PICU.

Critical incident technique was used. In the study, eighteen caregivers at a PICU participated by completing a semi-structured questionnaire. Additional, in-depth interviews with three nurses and two assistant nurses also constitute the data.

Four categories were identified that characterise the core of PICU: the dramatic admission, protests and refusal of treatment, escalating behaviours and temporarily coercive measure. Care activities for PICU were also analysed and identified as controlling - establishing boundaries, protecting - warding off, supporting - giving intensive assistance and structuring the environment.

PICU were interpreted as a level of care as it is composed by limited structures and closeness in care.

To examine the effects of chlorpromazine for psychosis-induced aggression or agitation.

We searched the Cochrane Schizophrenia Group Trials Register (2008) for randomised control trials or double blind trials implying randomisation, comparing chlorpromazine with another drug or placebo for people thought to be acutely aggressive due to psychotic illness. For selected studies we extracted data and calculated relative risks (RR) and 95% confidence intervals (CI) on an intention-to-treat basis, based on a fixed-effects model.

118 studies were identified, two met inclusion criteria. One compared oral chlorpromazine with oral thioridazine and one intramuscular chlorpromazine with intramuscular haloperidol.Those allocated chlorpromazine did not remain on medication (RR 2.00 CI 0.94 to 4.26), or stay in hospital (RR 1.87 CI 0.70 to 4.95) longer than those allocated thioridazine. No differences were found for adverse effects.Those allocated chlorpromazine were no more likely to have one (RR 3.00 CI 0.13 to 68.26), 2-4 (RR 0.90 CI 0.52 to 1.55) or 5+ (RR 0.75 CI 0.20 to 2.79) injections than those allocated haloperidol. Two patients allocated chlorpromazine had, serious hypotension (RR 5.00 CI 0.26 to 96.13), one developed status epilepticus (RR 3.00 CI 0.13 to 68.26), no one allocated haloperidol had these effects

Overall the quality of evidence is limited and dated. Chlorpromazine was just as effective as similar medicines, but it may be associated with more side effects. Where better, more evaluated drugs are available it may be best to avoid using chlorpromazine. Carefully designed clinical trials are urgently needed.

Psychiatric morbidity of a community could be assesed by a community survey as to the incidence & prevalance of different disorders in a particuler period. A more scientific approach is for a cohort study for a long period of a geographic population.

Another simpler way to get a ready hand account of approximate prevelance&incidence of disorders could be viewed by analysing a clinics attendance patterns of psychiatric patients.Ofcourse it focuces on the tip of an iceberg.

A quick sample survey of prevelance & incidence of disorders those are being brought in that particuler day.

Here is analysis of this authors 105 cases, those were examined & treated in 2 rural clinics of a district Midnapore those are even 75 k.ms & 60 k.ms from the capitol city of Calcutta.72 cases in one clinic in morning session lasting from 6a.m-1-15 p.m & 33 cases in afternoon session in another clinic from 2.30p.m-6.30 p.m on 15th of november 2009 on a sunday.

Age group range varies from 5 years-78 years with a maximum no. in the age group of 21-55years range.Affective disorders predominately,depressive disorder inBPMD,MDD,Anxiety disorders, schizophrenia,Hypomanic psase in BPMD &Behavioral disorders associated with Mental retardation/low intilligence &other mental retardation,Hysteria,Senile dementia Of alzhiemers,vasculer &mixed are most diagnostic presentation.Students & youth with tension headache associated with anxiety disorders were in sizable number.Women patients in depression were mostly presented with pain in lower extremeties.

105 patients visited in one winter sunday with depressive patients in top is concluded.

Negative emotions such as anxiety and depression have been related to increased mortality in both healthy individuals and medical patients The method of treatment would be changed when the patients have psychological problem. In internal ward researcher observed many patients that them shown psychiatric disorder such as depression and anxiety. Therefore, this study has been done for evaluation of prevalence of anxiety and depression and comparison with a control group.

In this cross-sectional study, we checked 150 patients of internal medicine department and 150 patients, who have admitted to the A&E department as a control group. They have chosen by a Purposive accessible sampling method. A questionnaire form, namely “SCL-R-90” was filled by a group of nursing student. This is known as a standardized questionnaire in Iran. Data have been computed and analyzed by SPSS V.13 and we used t-student, Mann-Whitney tests and logistic regression methods. The results have been considered significant when the two tailed p-value was less than 0.05.

In internal ward 69.3% and A&E department 42% of patient have had depression (OR=3.5, 95%CI=1.9—6.5). Anxiety were observed in 50.7%of internal medicine patients and 12% of A&E's patients (OR=1.94, 95%CI=5.1 —23.7).

Prevalence of the depression and anxiety in internal ward patients was significantly higher in compare to A&E's patients. Therefore, it's necessary to consider these patients in order to diagnosing for the early treatment. Recommendation are made to further investigate by greater sample size and different setting in this field is warranted.

Severe mental disorders as bipolar disorder and schizophrenia often co-occur with chronic medical illnesses, especially cardiovascular disease and diabetes. Our aim was to estimate the prevalence of physical health problems in hospitalized patients and to determine the sociodemographic and clinical factors associated with physical comorbidity.

The medical records of all inpatients followed up between September 2007 and September 2009 were reviewed retrospectively.

144 patients were evaluted of which 59 (%41) had schizophrenia, 31(%21.5) had bipolar disorder and 54 (%37.5) had other disorders. 43 (%29.9) patients had at least one medical illness, hypertension being the most common (%30) followed by thyroid disorders (%16) and diabetes mellitus (%11). Diabetes Mellitus was detected only in bipolar patients (p=0.005). Females were affected more than males regarding physical comorbidity (p=0.009). Patients with physical comorbidity were older (42.9 vs 35.54 yrs) and had a longer duration of illness (16.2 vs 10.0 yrs). Their hemoglobin levels were lower, blood glucose, urea, thyroid stimulating hormone levels were higher than the patients with no physical illness and the differences were all statistically significant (p=0.05). There was no difference regarding length of hospital stay, drug compliance, previous neuroleptic use, family history for medical and mental illness.

Conclusions: Although it is generally accepted that many physical conditions have been associated with serious mental disorders, the exact nature of the relationship between them is still unclear. Further research is required to identify medical comorbidity risk factors in order to improve the physical health of these patients.

Boundary violations and boundary crossings have been constantly ignored in clinical settings due to its sensitive nature. Recent studies have identified several number of boundaries identified through quantitative and qualitative research. Large instruments have been developed for detecing boundary excursions in clinical settings. Rasch modeling offers a ground-breaking method for validating such large instruments.

The aim of this study is to introduce Rasch analysis features that enable to study large instruments like clinical boundary excursion questionnaire in a psychiatry setting.

An 88 item boundary excursion questionnaire was administered among 50 subjects during the period Jan-May 2008. Eligibility criteria for subjects included physicians, nurses and healthcare staff working in Psychiatry department at Rumeilah Hospital. Data was analysed using the Winsteps software.

The boundary excursion questionnaire showed high reliability. The instrument also showed high unidimensional construct according to rasch analysis with only few items violating the criterion for unidimensionality.

Rasch analysis provides signigicant amount of information to researchers regarding the presence of invariance and mesearurement of separation of items which are otherwise not detected in traditional analysis. The advantages of the using rasch map given large number of items are further discussed.

To determine the prevalence of DSM-IV psychiatric disorders in a representative sample of children and adolescents living in Santiago, Chile, as part of a national sample.

subjects from 4 to 18 years of age were selected in an aleatory stratified multistage fashion. As part of a national sample, 10 counties in Santiago were selected, then blocks, homes and the child or adolescent to be interviewed. Psychology graduate students applied the Spanish computer version of DISC-IV, as well as a questionnaire on family risk factors, socioeconomic index and service use.

a sample of 792 children and adolescents was evaluated, obtaining 76.7% of participation. Using the most stringent impairment algorithm, the prevalence for any psychiatric disorders was 25.4%, being 20.7% in boys and 30.3% in girls, mainly explained by anxious and affective disorders. Prevalence was higher in the 4-11 years of age than in the 12-18 (31.9% and 18.2% respectively). This difference was mainly accounted for by disruptive disorders. Prevalence of anxious disorders was the highest, but less associated with impairment, while most of the children and adolescents with affective disorders were impaired.

prevalence of psychiatric disorders in Santiago is high in this age group, and this study will be used for improving mental health services.

Depression seems to be an important clinical risk factor for the prediction of suicide attempts, similar to risk factors such as substance use disorders and borderline personality disorder. All of these factors share the same diathesis for increased impulsivity and suicidal ideation, which could explain comorbidity and suicidal behaviour (Pezawas L et al., 2002). Insufficient treatment of depression is one of the most important causes of suicide (Althaus D et al., 2007).

1. - The occur of suicidal behaviour (thoughts or attempts) - with focus on type of depressive disorder, age, gender, treatment and changes in the frequency of suicidal behaviour compared to a baseline

2. - The number of suicidal behaviour (thoughts or attempts) during depression

1. - Outpatient's files with depression from all Slovakia regions during 3 months in comparison with past

2. - Depressive disorder, n = 2570 (female 1800, male = 770) (DSM-IV), average age = 49 years

3. - 3090 questionnaires from 200 psychiatrists

1. - Every third patient with depression - suicidal thoughts and every tenth patient

2. - suicidal attempt (male more as female, NF)

3. - We observed the most frequent suicidal behaviour in patients with depression: 41 - 60 years (21 - 20 years)

4. - It was interesting: decreasing of consumption of hypnotics - decreasing of suicidal behaviour (SF), increasing of consumption of antidepressants - decreasing of suicidal behaviour (NF)

The eating disorders are a group of complex psychiatric disorders, severe and frequent medical complications.

symptoms occur along a continuum between the extremes of anorexia and bulimia nervosa. so, we found that more than half of patients develop anorexic and bulimic symptoms that many bulimic patients have a history of anorexia.

We analyzed sociodemographic and clinical variables of a sample of patients attending our clinic within the study period from January to September 2009.

We performed a retrospective descriptive study with data collected from the medical records of 42 patients treated in our mental health center within the study period, who met diagnostic criteria for eating disorders.

Regarding the demographics variables, most of the sample are women (96%), average age 23.5 years, single marital status (54.8%), from middle class (74.1%).

in relation to family history, 53.8% in any family member with pathologies, where mothers have the highest percentage. in personal ancedentes, we found that 35% had childhood obesity and anorexia in 14% of children.

the average age of disease onset was 15.6 years. 66.8% of the sample had had bulimic behavior and the majority (92%) compensatory behaviors.

The eating disorders are a group of chronic and severe. data analysis of our sample showed a profile similar to those provided by epidemiological studies: most women, single, between 10 and 25 years, middle class. Have symptoms frequently comorbid anxiety and depression.

There is no epidemiological study in France, that's why we make an epidemiological study on the prevalence of pathological gambling.

We wanted to study the prevalence of pathological gambling in a sample of 529 persons: 368 gamers of Pari Mutuel Urbain and La Française des Jeux, and 161 persons in the general population.

We used as instruments: SOGS for screening of pathological gambling, BIS-10 for impulsiveness's evaluation, HAD scale to assess anxiety and depression and ASRS for the evaluation of attention deficit disorder / hyperactivity disorder.

The results show that the rate of pathological gambling in general population is 1.24% (this result is similar to those found in other countries such as Quebec)

Men are overrepresented in the group of pathological gamblers (88.9%), also with consumption of alcohol and tobacco. Depression and anxiety are particularly high, 40% of JPs with an anxiety score significantly higher.

It would be necessary to establish follow-up studies of populations and patients as well as specific studies on people who frequent casinos, racetracks and Internet gambling. Almost 20% of players have a gambling problem or risk and these people do not consult despite their psychological problems, family, work, debts…