Most students experience some level of anxiety during the exam. However, when anxiety affects exam performance it has become a problem. Test anxiety is a special form of anxiety, which is characterized with somatic, cognitive and behavioral symptoms of anxiety in situations of preparing and performing the tests and exams. Test anxiety becomes problematic when is so high that it interferes with test preparation and performance.

The objective of this study was to ascertain the presence of test anxiety in medical students and to analyze some aspects of test anxiety in medical students of different gender, different year of studying and possibility of falling the year of studying.

Study sample consisted of 198 students of Belgrade University School of Medicine of all grade years. The assessment of test anxiety was conducted by The Test Anxiety Inventory - TAI.

1. 1) Medical students generally present moderate level of test anxiety;

2. 2) female students have statistically significant more intense symptoms of test anxiety than male students;

3. 3) most intense symptoms are in III year and the least are at VI year of studies;

4. 4) there is no statistically significant difference in presence of symptoms of test anxiety between the students who repeated some year of studies and regular students.

There is considerable number of medical students who have intense symptoms of test anxiety and those students require help and support.

To establish the adherence of Assertive Outreach Service to the local protocol for the use of high dose antipsychotic (HDAT) medication. This audit cycle was started with an intention to minimise metabolic syndrome due to antipsychotic medication.

’Guidelines for the use of high dose antipsychotic (HDAT) medication’-February 2008. The following standards from the guidelines were measured from the sample:

1. 1. HDAT monitoring sheet should be completed for all HDAT patients

2. 2. ECG should be done for all HDAT patients

3. 3. Blood tests (LFTs and U&Es) should be done for all HDAT patients

4. 4. Physical examination should be done for all HDAT patients

5. 5. Consent should be obtained from all HDAT patients and filled on the monitoring sheet.

6. 6. Physical health risk factors should be filled for all HDAT patients

Out of 179 patients under the team, 17 patients were prescribed HDAT. All the data were collected from the case notes of all HDAT patients and entered into the HDAT monitoring sheets in January 2009 as a baseline assessment by Dr. Praveen Kumar and re-audited in June 2009 by Dr. Gaurav Mehta.

As evidenced by the results of audit in January 2009 and re-audit in June 2009, all the parameters were up to the standards in June 2009 except the physical examination not performed on all 17 HDAT patients as revealed inthe re-audit.

This is an analytical-descriptive study aimed at analyzing individual specifications of addicts who have gone to treatment centers of Tehran in the year 2008.

Investigation members were all addicts admitted to treatment centers of Tehran, investigation method was random sampling, investigation place was Behzisty rehabilitating drug addicts and NGOs, the number of all members was 256 and input assembling instrument was questionnaires comprising Demography and MMPI questionnaire. The results are derived from descriptive and deductive statistics and are analyzed by SPSS software.

The results demonstrate the fact that 19.1% of addicts are jobless, 38% are lessees, 2.3% are illiterate, 60.5% are single and 57.8% of them have an income of less than 2,000,000 Rials, reflecting the fact that unemployment has no relation with the tendency to addiction - Even those with high economic and educational position have a great tendency to addiction mirroring the failure of society's supporting. Based upon MMPI, the amount of exposition to danger in addicts consists of 7.81% in mania, 28.12% SC, 12.5% in paranoia, 33.98% in unsociability, 12.5% mysterious?,57.42% in depression and 22.26 in self-assumption of illness, reflecting disorder in their personality.

So, according to MPI, if the results of D, PD and SC in addicts are high and the L and K rates are low, treatment and consulting service is advised.

To evaluate the features of Frequent-Attenders (FAs) admitted to an Acute Psychiatric Unit of a general hospital in Bologna, Northern Italy.

Persons admitted between January 2008-June 2009 (N=110) were randomly selected thanks to the Hospital Information System. All participants’ admissions in the indexed period were recorded, the case-history of the first admission was reviewed gathering socio-demographic and clinical information. The International Classification of Disease (ICD-10) was used for diagnosis. FAs were defined for 3 or more admissions within 18 months (Botha et al. 2009).

Almost one out of three patients was a FA (N=34; 30.9%). The mean number of admission for each subject being 5.6±3.4 for an average length of stay of 56.2±62.1 days. In comparison to single users, FAs were more frequently men (67.6% vs. 46.1%; p=0.029), unemployed (79.4% vs. 29.2%; p< 0.001) and living in social-health facilities (29.4% vs. 9.5%; p< 0.024). FAs and common users were not different concerning compulsory/voluntary admission. Schizophrenia and other Psychotic Disorders were predominant among FAs (44.1%), followed by Substance Use and Personality Disorders (14.7%), but no differences were detectable between cases and controls in terms of discharge diagnoses. Conversely, the prevalence of concomitant organic diseases was higher in FAs (50% vs. 27.6%; p=0.020).Finally, the results of the Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals suggested that FAs had a lower insight/compliance (2.15; 2.50-29.66; p=0.001).

FAs have a higher mental-social disability. A targeted treatment might reduce the frequency of hospitalization.

107 persons (35-65 years old) working on chemical plant.

The tables Gorbova-Shulte, techniques «Proof test» B.Burbona and «10 words», a method of colour elections by Lusher, technique «State of health - Activity - Mood», a scale of uneasiness Spilberger-Hanin, a technique «Level neurotic and psychopathyz» were used.Conclusions about conformity or discrepancy of psychophysiological features of this or that examinee to certain kind of activity became on the basis of the complex analysis of results of psychodiagnostics.

Among all examinees of infringement of psychophysiological indicators cognetive functions, emotionally-strong-willed sphere and discrepancy to standard criteria for professional adaptation are fixed at 22 people (20,6%). Among persons at whom discrepancy to standard criteria at 14 people (13,1%) is fixed it is marked истощаемость mental activity; at 22 people (20,6%) - efficiency decrease mnestic functions; at 7 people (6,6%) - high level of emotional intensity with the tendency to increase; at 8 people (7,5%) - high level of alarm; at 5 people (4,7%) - high level neurotic and psychopatization (р < 0,05).

Timely revealing of deviations cognetic and emotional indicators from standard criteria, and also timely reaction, allows to fix group of risk with high probability of erroneous actions, to prevent and essentially to lower level of professional disorganisation of activity.

56 teenagers (12-13 years old), 34 (60,7%) girls and 22 e (39,3%) boys. From them 28 pupils were eyewitnesses of emergency and 28 persons were made by control group.

Children's questionnaire of neurosises, a questionnaire depression by Back, a scale of school uneasiness.

Clinically significant indicators are fixed on scales of infringement of behaviour - 6 persons (21,4 %), dream infringements - 3 persons (10,7 %), high level of alarm - 2 persons (7,1 %). Serious posttraumatic stressful frustration and stressful reactions to psychoinjuring event it has not been revealed. Similar control inspection has been spent on the basis of two comprehensive schools, 28 pupils of 7 classes have taken part in it. Clinically significant indicators are fixed on scales: behaviour infringements - 5 persons (17,8%), dream infringements - 3 persons (10,7%), high level of alarm - 1 person (3,5%), Posttraumatic stressful frustration are not revealed. Statistically significant distinctions between indicators control and experimental groups it is not registered (p < 0,05).

During the carried out research we had been established presence of a high threshold of sensitivity to occurring violent certificates and low level of empathy at eyewitnesses on emergency. Similar reaction to situation in this case grows out of influence of features of family education, together with influences of mass-media on mentality of the child.

90 sick of psychosomatic frustration with essential hypertension (32-48 years old).

:

1. 1) MMPI,

2. 2) Ljusher’s Color test,

3. 3) Technique of diagnostics of interpersonal relations of Leary,

4. 4) statistical methods.

At 73 persons (81,1%) the internal conflict caused dissonans of type of interpersonal relations “Authoritarianism-submission”, constant struggle against accruing is hostile-aggressive feeling has been revealed, at the same time there are difficulties of self-affirmation. In 48 cases (53,3%) prevalence I octant in personal pattern positively correlates with characteristics of sthenic type of reaction according to MMPI (profiles type 469-/0) and a method of colour elections (preference of bright colour standards on the first positions, the importance of positions of 4,2 and 3 colours). At 90 persons (100%) from a surveyed contingent high points on VIII octant (11-16) have been revealed, that speaks about hyperresponsibility presence (р ≤ 0,05).

Patients received complex therapy. The psychotherapy was applied individual, group and coordination. During group psychocorrection patients have seized methods of removal of an emotional pressure, intrapersonal conflicts have been resolved, at them the relation to success and failure situations has changed. Carrying out of group trainings at this sick essential hypertension with art therapies, creative visualisation, transaction analysis, and sychorelacsation therapies, is an effective complex of methods in correction and preventive maintenance of infringements in emotionally-strong-willed sphere.

The aim of the study was to register all incidences of mechanical restraint imposed upon patients hospitalized at an Acute Psychiatric Ward during the year 2008. Associations with social and clinical characteristics of patients were explored.

The study was conducted at one of the five open Acute Wards of the Psychiatric Hospital of Thessaloniki, All incidences of mechanical restraint were recorded. For each incidence the reason, the duration, the severity and procedural aspects were documented. Socio-clinical characteristics of all patients admitted to the Ward during the year 2008 were registered and possible associations with the implementation of coercive measures were explored.

During 2008 342 admissions were made to the D’ Acute Ward % involuntary. Overall, 157 incidents of mechanical restraint were documented (106 patients; 72 male, 34 female) and the most common diagnosis was ‘psychotic disorder’ (group 1). The main reason for the implementation of the measure was the patient not to leave the clinic However, it is interesting that a highly statistical significant difference was observed in the previous history of psychiatric disease between the two groups (Mann Whitney Z=-6.650, sig< 0.001).

Twenty years after the initiation of the psychiatric reform in Greece the Psychiatric Hospitals still are the main recipient of patients with severe mental illness who are sometimes forced to be hospitalized many miles away from their place of residence. This raises their distress, leads to overcrowded under-staffed Wards and affects negatively the use of coercive measures.

A research base should be of mental health and coping strategies in families of having patient with epilepsy, in Iran.

These families are at increased risk of stress and weakened family relationship, and to identify the variables that have a negative impact on a families and possible moderating influences on them.

This research was a descriptive study on 150 families of epileptics referring to the Iranian Association of Epilepsy Selected Using a Systematic sampling. All subjects were living with the epileptic person, were at least 16, all Iranian and it was at least six month after the beginning of the family’ epileptic members’ illness. For obtaining further information, a questionnaire consisting of three parts was used. The first part indicated the demographic specifications of the patient's family, the second part showed the General Health Questionnaires (GHQ), and the third part indicated stress coping strategies carversheier- weinrub questionnaires.

According to the acquired screen in the total mental health score, the majority of the epileptic patients’ family (56/7%) were not in an appropriate mental health condition. In this report contains depression (56/7%), social functional disorder (52%) somatic signs (61/3%) and anxiety and sleep disorder (6/7%). The majority of under research units based on acquired scores of general stress coping strategies, used this strategies in a medium level.

The result is that if there is more mental health in the family of the epileptic patient, they will use stress coping strategies in more suitable level.

To study kliniko-psychopathological features at persons about a syndrome of angry intestines.

47 patients with a syndrome of angry intestines at age from 18 till 40 years Have been surveyed.

method of a colour choice - Lusher, «the Clinical questionnaire for revealing and an estimation of neurotic conditions», the Scale of jet and personal uneasiness Spilberger-Hanin; a statistical method of research.

In RDC the universal system on differentiated diagnostics of organic and functional frustration is created. By results of diagnostics «the Clinical questionnaire for revealing and an estimation of neurotic conditions» indicators on scales: “Uneasiness” - 42 persons (89,4%,) «Neurotic depression» - 29 persons (61,7%), and «Vegetative infringements» - 32 person (68,1%) (р< 0,05) clinically significant level. «A scale of jet and personal uneasiness Spilbergera-Hanina»: high level of personal uneasiness at 36 persons (76,6%.). (р < 0,05). By results of psychodiagnostics by technique Lusher high level of uneasiness at 34 people (72,3%) is diagnosed; high level of an emotional pressure within 8-11 balls at 39 people (82,9%), decrease in working capacity at 18 people (38,3%). (р < 0,05)

Revealing at the patient of psychopathological symptoms, such as the alarm, depression, phobia and high personal uneasiness at an exception of organic disease of intestines, confirm the diagnosis «a syndrome of angry intestines» that allows to appoint adequate treatment.

To compare the current standards of clinical practice with the recommendations of NICE guidelines (CG 45).

NICE guidelines (CG 45) on Antenatal and Postnatal Mental health suggest that Healthcare professionals should discuss contraception and the risks of pregnancy including relapse, risk to the foetus and risks associated with the stopping or changing medication with all women of child-bearing potential who have an existing mental disorder and or who are taking Psychotropic medication.

A standardised questionnaire was answered by 50 female patients out of 60, attending New bridge unit in Birmingham for the Outpatient appointment in the month of November -2007. The age group was between 18 and 50. The questionnaire was handed out at the reception and Doctors encouraged patients to fill out the questionnaire. Confidentiality was not compromised.

12 (24%) patients were aware of contraception. 17 (34%) knew about the risks of relapse during pregnancy. 15 (30%) women recognised the risks of stopping or changing the medication and 13 (26%) agreed that the risks to foetus were informed to them. This indicated there was room for improvement.

To improve the standards of practice

1. · The Audit report that highlighted standards, was disseminated to all the clinicians through formal power point Audit presentation and through emails.

2. · The importance of passing on the relevant information to the patients was incorporated in Doctors Handbook for Junior Doctors.

To investigate whether the smoking ban has led to an increase in adverse events in adult psychiatry wards on the Wirral.

We compared the number of violent incidents reported on the adult psychiatry wards in the 6 months before and after the smoking ban. We also compared the number of emergency detentions (section 5.2 and 5.4 of the mental health act) implemented in the 6 months before and after the smoking ban.

There was a 36% reduction in violent incidents in the 6 months after the smoking ban compared to the 6 months before the ban (70 in the 6 months before the ban and 45 in the 6 months after the ban). There was a 64% reduction in emergency detentions in the 6 months after the smoking ban compared to the 6 months before the ban (25 in the 6 months before the ban and 9 in the 6 months after the ban).The number of admissions during each 6 month period that we looked at were very similar (288 admissions in the 6 months before the ban and 299 in the 6 months after the ban).

Prior to the smoking ban there were concerns that it would lead to an increase in the number of violent events and patients who required emergency detention (under Section 5.2 or Section 5.4 of the Mental Health Act). This study shows that there was a reduction in the incidence of adverse events following the smoking ban.

The chronic worldwide shortage of psychiatrists has impaired the delivery of first class mental health care (WHO 2008). This international project funded by a World Psychiatric Association grant proposes to examine and compare the effects of country-specific undergraduate and postgraduate factors involved in medical student choice of a psychiatric career. Phase 1 focussed on identifying published proven and novel modifiable factors to improve psychiatric recruitment.

We searched EMBASE, PsychInfo and Medline using the keywords ‘career psychiatry’, ‘medical education’, and ‘career choice’. All 206 papers retrieved using the combined search were reviewed and categorized thematically.

Findings are summarised under three themes:

1. · Pre-medical school factors: arts & social sciences qualifications, attitudes towards mental illness, high uncertainty tolerance, liberal political views, gender and life goals.

2. · Medical school factors: availability of psychology/sociology/special-studies modules, electives; length of clinical placement; exposure to motivated patients and effective treatment; quality of teaching and good role models; and conversely negative attitudes from other specialities.

3. · Post-graduate factors: availability of early clinical posts in psychiatry, work-life balance, remuneration.

1. · Studies have been limited by small sample sizes, unicentricity, and datedness, given the major reorganisations of mental health services and postgraduate training in many countries.

2. · During the next stage we will generate the first multicountry comparison, with sufficient power to detect differences in factors influencing a psychiatric career choice at personal, institutional and national level. We will focus on factors that may be modifiable by policy to positively influence career choice towards psychiatry.

Burnout is caused by high stress jobs and could induce somatic, psychological disorders and negative attitude to professional actives so this process is caused poor relationship with patient. Burnout should be considered in medical students by counseling centers of University for prevention of consequences. This study investigates burnout in senior medical students of Kashan University of Medical Sciences, Kashan,Iran(2008).

This research is a cross sectional study. In this study all of senior medical students (N=56) were answered to demographic questionnaire and Maslach burnout Inventory.

The findings showed that the majority of medical students (91.1%) had burnout and 16% of them had severe burnout. There was not significant relationship between burnout and sex, age, marital status P< 0.05.

Burnout was common problem in medical students and need to be helped. Therefore Medical Student should be encouraged to seek help and adequate facilities should be available.

Improving adherence in mental patients, growing up insight and reducing stigmatization.

Giving simple and clear messages to families and patients for learning about symptoms and the management of daily difficulties.

Three were the main pillars of our work: patients’ opinion, professional knowledge and families contributions. First, patients were questioned about “What is for you mental illness?” “May you explain your illness?” and the answers were completed with a collage/picture. Those opinions were evaluated by the group and the therapist. We already made reunions with a mental patients association and family groups to expose their opinions and daily life difficulties.

Analyzing drawing-collage characteristics, medical histories and reflections from patients and families, we achieved an individual management for patients. Families could expose doubts and suggestions about patients care. We offered a multidisciplinary management to develop insight and adherence.

“The other shore of mental illness” is a book with a psicoeducative propose about useful concepts of mental illness. It emerges from the professional need to approach to the other shore, families and patients’ opinions and feelings.

Drawing has been used as worktherapy, becoming a benefit for diagnosis and evolution in mental illness. In this book we used them as a means in the improvement of insight and adherence.

The work with families, patients and caregivers let therapists to attend the real difficulties in their daily lives.

The book would be not only a vehicle to reduce stigma, but also a reflection on avoiding discriminatory politicals in mental patients assistance.

Mental health policy in the English-speaking world emphasises the the importance of ‘recovery’ as a guiding philosophy. Translating this rhetorical consensus into reality has proved challenging, with some mental health service users reporting that the concept of recovery is being co-opted by professionals without substantive changes in practice. The aims of this talk are (a) to define personal recovery; (b) to present a theoretical framework for understanding personal recovery; and (c) to identify the four ways in which mental health professionals can support recovery.

The most widely cited definition of recovery will be elaborated, and key recovery domains identified from a systematic review of consumer narratives of recovery.

A new theoretical framework for recovery - the Personal Recovery Framework - will be presented, which identifies the centrality of identity, the contribution of clinical models to recovery (and how they can be toxic to recovery), and why hope is necessary. The framework identifies four approaches which mental health professionals can use to support recovery: fostering relationships, promoting well-being, offering treatments, and improving social inclusion. Examples will be given of how actual services around the world are undertaking these tasks to support recovery.

Developing recovery-supporting mental health services will involve a fundamental shift in power, values, attitudes, skills and behaviours. It will require system transformation, and genuine partnership between those using, working in and managing services.

Following the National Review of Mental Health Nursing in Scotland (2006), an action plan was developed to improve recovery focused mental health services. It was advocated that a method of sharing evidence based, positive and innovative practice in mental health be created. NHS Quality Improvement Scotland supported by the Scottish Government, was tasked to develop the database and successfully launched the PIRAMHIDS resource in September 2008, now providing the platform to share information at local, national and international levels.

PIRAMHIDS ensures equitable opportunity to share examples of practice from statutory, non statutory services and the voluntary sector. Contribution to the database is made easy by an intuitive online submission process. A quality assurance process is then followed in achieving publication approval. Submissions are passed to an external review body. External reviewers consist of professionals from a range of disciplines including Psychiatry, Mental Health Nursing, Occupational Therapy, Higher Education, service improvement, etc. The selected reviewers consider the submission in context of the publication criteria which includes:

• Practice summary:

  • Detail of practice deliverable

  • Evidence base-current/existing or potential to inform evidence

  • Challenges and resolves

  • Quality assurance considerations and impact assessment on the patient experience

PIRAMHIDS is the resource to share your practice. In addition there is an online forum encouraging networking, up to date mental health information feeds and direct links to other useful resources such as Integrated Care Pathways for mental health toolkit. Now accessed by thousands world wide, take the credit and share your care.

Contribute today.