Whereas some research suggests that acknowledgment of biogenetic factors in mental illness could reduce mental illness stigma by diminishing perceived responsibility (Corrigan et al 2003), other research has cautioned that emphasizing biogenetic aspects of mental illness could produce the impression that mental illness is a stable, intrinsic aspect of a person (“genetic essentialism”), increasing the desire for social distance (Phelan 2002).

We assessed genetic and neurobiological causal attributions about mental illness among 85 people with serious mental illness and 50 members of the public. The perceived responsibility of persons with mental illness for their condition, as well as fear and social distance, were assessed by self-report. Automatic associations between Mental Illness and Guilt and between Self and Guilt were measured by the Brief Implicit Association Test.

Among the general public, endorsement of biogenetic models was associated with less perceived responsibility, but also greater social distance. Among people with mental illness, endorsement of genetic models had only negative correlates: greater explicit fear and stronger implicit self-guilt associations.

Genetic models may have unexpected negative consequences for implicit self-concept and explicit attitudes of people with mental illness. An exclusive focus on biogenetic models may therefore be problematic for clinical practice and anti-stigma initiatives.

To describe the experience of group therapy with offender adolescents in an Institution for minor violators (“Fundação CASA”) and who have suffered from mental disorders related to psychoactive substance use.

“Fundação CASA” is an institution created to shelter minor offenders. In 2008 some were judicially referred for treatment to a University Hospital Psychoactive Substance Outpatients Service. An operative and informative group was formed, since they have not adapted to the already existing adult group. This group met weekly, aimed to prevent relapse and initially planned to last 6 meetings.

Soon there were 4 adolescents who had engaged with the group and requested to increase the number of sessions. Psychodynamic issues emerged during the sessions, which were well evaluated by all participants after 10 weeks, when the group had to be ended due to the completion of sentences of 3 participants. In 2009 only 3 of them were found. The first reported a relapse, but remains abstinent. The second started working as general assistant and remained abstinent. The third continued to consume crack and was arrested by the time he was 18.

This study showed the need for specific treatment for the group of juvenile offenders. Operative and informative groups create a communication space for drug users and other psychotic subjects. It permits group identification and allows the expression of mental suffering. Therefore this practice consists of a low complexity approach in an extremely vulnerable population, which is so prevalent in developing countries such as Brazil.

Work disabilities associated with mental disorders depend not only on illness, but social-economic conditions. People with mental disorders, in our country, try to solve financial status through premature retirement.

The aim of this paper was to analyze how we evaluate the work ability among adult psychiatric patients. Total number of patients required an estimate of work ability in our clinic during 2008 was 128. Median age was 48, 8 years, male prevalent (67, 9%).

In this sample the most number of patients were with substance use (25, 85%), affective (depressive) disorders (16, 32%) and schizophrenia (15, 64%). The suggestion for permanent work disability was made in 65, 71% patients; the reduced work ability in 21, 43%, disability for independent life in 8, 57%, some kind of public welfare in 1, 42%, while only 2, 86% were considered as ability for work. Highest rates of total work disability were observed among patients with alcoholism (26, 8%), psychotic disorders (23, 7%), dementia (14, 43%), mental retardations (10, 31%) and personality disorders (9, 27%).

In this role, psychiatrist is often placed between an attempt to supply financial safety or make difficult psychosocial rehabilitation and destigmatisation of mental ill persons.

The objective of this work is to check the assumption that changed social and economic factors causes change in some of the characteristics of non-psychotic clients treated in the daily hospital.

The investigation included 77 clients treated in the daily hospital in 1998 and 82 clients in 2008. Distribution of both groups was done according to the age, work status, duration of previous psychiatric treatment and diagnostic categories.

The result of the work indicates that the profile of a non-psychotic client changes showing an increase of the number of the clients over 50 (participated as 22.07% and 47.56% in 1998 and 2008, respectively). The increase of the number of unemployed of 9.09% in 1998 and 42.68% in 2008 was observed. The increase of number of the clients treated less than one year was also observed (23.37% and 50% in 1998 and 2008 respectively). There are no more significant percentage differences regarding affective disorders (32.46% in 1998 and 34.14% in 2008) and in the category of personality disorder and adults behavior disorder (9.09% in 1998 and 9.75% in 2008).

Neurotic stress associated and somatoform disorders were slightly increased in 2008 (50%) in relation to 1998 (40.25%), with significantly increased number of the clients in F 43 diagnostic category, from 7.79% during 1998 to 31,70% during 2008.

The results obtained point out that change in social and economic factors causes changes in the profile of non-psychotic clients in daily hospital.

To reflect on theory, implementation, practice and evaluation of FACT: the Dutch version of Assertive Community Treatment.

ACT is an EBM intervention for the 20% most severe mentally ill (SMI) outside the psychiatric hospital. From 2004 we started with a Dutch version: the FACT (Function ACT) model.

FACT teams are multidisciplinary teams serving all SMI outside the psychiatric hospital in a region/area of 50.000 inhabitants. The teams offer two kinds of care:

1. 1) clinical case managementteam and home care for the stable group and

2. 2) full ACT for patients in danger of crisis / recurrent psychosis or readmission.

The second group is on a digital whiteboard and is discussed every morning by the team to coordinate shared caseload and assertive outreach.

Interesting is the finding that the first and the second group have a large overlap in time: in 3 years >60% of the patients in the team has been the digital board.

In FACT we bring together care, crisis-intervention, treatment (and metabolic screening), recovery oriented support and care and CBT and IPS. We work in close cooperation with the psychiatric hospitals and sheltered living departments in ‘transmural’ care.

The number of FACT-teams in Holland is rapidly growing (> 80). The model appears to be able to serve all SMI in a certain region with good continuity of care. First findings are positive (very low drop out, more patients in remission, better satisfaction).

Certification started by the Centre for Certification ACT and FACT (see www.ccaf.nl)

Affective Temperaments (AT) in epilepsy is waiting for a clear understanding as antecedents of mood disorders. Recent studies suggest that perception of stigma (PS) correlates with high anxiety and depression scores in epilepsy patients.

In this study we investigated if there is association between AT, PS and depression in epilepsy.

Consequent 71 outpatients (40 women 31 men) with epilepsy were included in the study and examined using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A), Epilepsy Stigma Scale, SCID-I for DSM IV for the diagnosis of depression.

Depressive temperament (DT) scores were positively correlated with PS scores (r:0,247, p< 0.05) in whole group. PS scores were significantly higher in epileptics with MDD group (n:14) than epileptics without MDD(n:57) (t -3.052, p< 0.05). than the patients were divided into groups as patients with DT (n:10), patients with MDD (n: 9) and patients with MDD and DT (n: 5). In One Way ANOVA analysis there was difference between groups. By Tukey HSD the Perception of Stigma was not different between DT and MDD grup but DT+MDD group was significantly higher than DT group.

Recent studies suggest that a crucial part of inherited factors of depression is mediated by ATs and in some studies DT is founded to be related with recurrent depressive disorder. This study suggest that there may be an association between PS, DT and MDD alone but coexistence of MDD and DT is a higher risk for higher levels of stigma perception.

It is widely developed the idea of communitary attention of serious mental disorders, instead of being recluded in long stay hospitals. But tomake this project real it is needed a complex sociosanitay support: psychosocial rehabilitation units, protected dwellings…and nowadays some people are still discharged to long term hospitals.

The objective of this work is to demonstrate that clinical characteristics are not determinant and that the main reason that supports the decision is the insufficent social resources spread.

279 inpatients that entered a Psychosocial rehabilitation unit from January 2005 to April 2009 are selected. There are two comparison groups depending on the derivation to long term units. There are compared different variables taking the HoNOS scale as measurement tool. Ths stathistical comparison test used is the Fisher exact test.

HoNOs scale items:

1. 1 Disruptive behaviour

2. 2 Non-accidental self-injury

3. 3 Alcohol/drug taking

4. 4 Cognition

5. 5 Physical illness

6. 6 Hallucinations/delusions

7. 7 Depressed mood

8. 8 Other mental problems

9. 9 Relationship

10. 10 Daily activity

11. 11 Living conditions

12. 12 Activities/occupation

There is not statistical significance when clinical items of the HoNOS scale (item 1 to 8) are compared, instead of item 5 (p=0,001). There appears significance when comparing social items and specially item 9 (p=0,031),11 (p=0,002) and 12 (0,026).

Nowadays there is no difference in the clinical profile of inpatients when derivation. The fact of not having adequate living conditions is determinant in the decision of derivation, showing that socio sanitary resources are insufficient for an optimal communitary system.

Substance use or alcohol use were not a much concerned category in a far away district town 126 k.m away from state capital, Kolkata.

But the 2 drug de-addiction ceners those have a provision for a institutional therapy in such a rural Indian district remains almost full through out the year, here in Midnapore.

Here is a repressentation of a present scenario in those 2 drug deaddiction center namely UTTARAN meaning upliftment, and JANANI meaning motherly care, during the period march2008- feb09.

There patterns and profile are analysed to make a comparism in some other situation in other parts of the world.

All patients admitted in those 2 Drug-deaddiction centere were analysed trough their records & there were 2 visits to longitudinaly analyse the persons there in 1.1.09.There were 134 patients in 1st center & 122 patient's turn over in the 2nd center. There were mainly male persons in the age range of 22-56 years with a median age of 39 years. Alcohol use detained patients were majority(>64%), followed by Marijuana smokers(5%), and heroine addicted patient(>10%), followed by medicinal coughsyrup, glue, & benzodiazepin like nitrazepam.

There were co-morbid other Psychiatric illness like BPMD, hypomaniac, or depressive disorders, and Personality disorders, like Borderline personality Disorder & Asocial personality disorder.

There were divorce in 4% cases, jobless in >65% case. and their period of stay remains 3 weeks to 8weeks usually.

Recovery, or refraining from drug/alcohol after 3 monthhs is over 60%.

Treatment in Institutional-setting do the best &should present evrywhere.

This study aimed to determine the motivations for the consumption of alcohol by young adults in higher education.

In a cross-sectional study, of a quantitative nature, we have worked with a sample of 354 students (61.60% women), aged between 18 and 35 (M = 20.86 years, Dp = 3.52).

It was a daily consumption of alcohol in 28.6% of students. The motivations described as being associated with the consumption of alcoholic beverages are: because gives you pleasure (25.7%), to be happy (24.0%), for uninhibited (18.7%), to forget the problems of everyday life (13.3%), to relate to others who also drink (7.9%), to calm (7.4%), because they miss family and friends (6.8%), to forget problems / angry with her boyfriend or friends (5.9%).

Evidence presented here based guidelines for preventive and health promotion in the university context.

nowadays drug abuse and addiction is one of the most important health,social and political problems in the world. substance use among university students is a mental health concern. people with depression have high rates of comorbidity with other mental disorders and substance use disorders. the purpose of this study was to determine the prevalence of depression, substance use and the relationship between depression and substance use among student of guilan university of medical sciences(GUMS).

this was a cross-sectional study carried out on a representative sample of 254 students(n=167girls;n=87boys) of GUMS. The samples were selected randomly by stratified sampling. data was collected using a confidential multiple choice questionnaire detecting the frequency of various substance use. the beck depression inventory(BDI)were used to determine depressive symptoms. Data were analyzed by chi-square and exact fisher test using SPSS ver 16software.

results showed that the prevalence rate of each substance in use was: Opium (1.2%), Morphine (0.4%), cannabis (1.2%), Cocaine (0.4%), codeine (7.5%), Ritalin (2%), tramadol (4.7%) cristal (0.4%), Amphetamines (0.8%),cigarette (8.3%), alcohol(7.1%). according to BDI,(29.9%)of students had depression.there were significant differences between the prevalence of substance use with gender(p=0/0001),parent marital status(p=0/01)and depression(p=0/01).

This study demonstrated that the substance use among students is considerably high and specific interventions seem to be necessary in preventing or reducing the rate of substance use in students. Reading the result of this study,it is suggested that parents and universities authorities have a better over solving students emotional and social problems.

Alcoholism is a very common psychiatric problem, with a high morbidity and mortality. Psychiatric diagnoses that most often are associated with alcohol-related disorders include substance abuse, antisocial personality trasrtorno, affective disorders, anxiety and sleep disorders.

Our goal is to estimate the prevalence of anxiety and depressive symptoms in a population of patients in our mental health center.

To analyze data from a sample of 35 patients treated in mental health centers that meet diagnostic criteria for alcohol dependence according to DSM IV-TR. the study enrollment period was 6 months from January to June 2009. study design is observational, descriptive and transversal. The information was collected by clinical interview.

Comparison with normativesamples reflects that the alcoholics of the sample present more psychopathological symptoms than the normal populatio, but less than the psychiatric population. Furthermore, the severity of the alcoholism is related with the biggest presence and intensity of comorbidity.

The prevalence of depressive symptoms was 75% and anxious symptoms 65%, with variations in distribution by gender.

The prevalence of anxiety and depression measurement in the population to study is greater than in general population. there is needed further research that allow extending the results obteined in this present study.

Alcohol is the most widely psychoactive substance consumed in Portugal. The aim of this study is to describe the socio-demographics and clinical characteristics of alcohol abuse and dependence new patients of an Alcohol Unit in a University General Hospital.

We collected retrospectively data from all admitted patients to our Alcohol Unit between January and October 2009 with alcohol abuse or dependence diagnosis.

Fifty three patients were admitted during the period, 40 (75%) males and 13(25%) females. The mean age was 45.4 years (s.d.:10.6; median: 42), range between 24-67 years. Thirteen percent of patients were single, 26% divorced, 4% widowed and 57% married/with partner. Fifty-seven percent were employed, 30% unemployed and 13% retired. Twenty one percent of patients had known cardiovascular disease and 19% percent alcoholic liver cirrhosis. As Psychiatric comorbities 19% percent of patients had depressive disorders, 6% personality disorders and 6% other psychiatric disorders (anxiety and psychotic disorders). Mean AST value was 67.3 IU/L (s.d.:64.3), mean ALT 52.9 IU/L (s.d.:47.9), mean GGT 258.6 IU/L (s.d.:367.6) and mean MCV 92.3 um3 (s.d.:8.3). Forty percent of patients made an acute detoxification (77% as outpatient and 33% as inpatient). Fifty five percent of patients attended our psychotherapy group. Benzodiazepines (96%), antidepressants (25%) and naltrexone (22%) were the most used psychopharmacological treatments.

This study shows that there was predominance of male, married/with partner and employed patients in our sample. Alcohol biomarkers were high on the majority of patients, and there was also a high prevalence of medical diseases.

Quetiapine is a novel antipsychotic drug, which is efficacious in the treatment of schizophrenia and also helps reduce craving and consumption of stimulants and alcohol. Due to Quetiapine's promising receptor profile, we set out to examine its efficacy in relapse prevention treatment of alcoholic dependent patients suffering from craving and affective symptoms.

The three center pilot-RCT evaluated 40 alcohol dependent patients after withdrawal (Quetiapine vs. placebo). They were followed up for six months. We used operationalized questionnaires including OCDS-G, Form 90-CR, Form 90 short form-CR, PSQI, MADRS, STAI, BDI and FTND.

We tested the one sided hypothesis that it takes longer for the first severe relapse to occur using Quetiapine compared to a placebo. The primary outcome measure is time to first severe relapse. Further, we tested the two sided hypothesis that Quetiapine will prolong time until first consumption of ethanol, decrease the number of drinking days and increase the number of abstinence days, decrease the cumulative amount of ethanol, decrease craving, improve depression symptoms, improve anxiety symptoms, improve quality of sleep, avoid deterioration of safety variables and decrease nicotine addiction.

Our pilot study is designed to provide evidence for the efficacy of Quetiapine in alcohol relapse prevention. Alcohol dependent patients after withdrawal should display a decrease in persistant craving and should be less afflicted by sleep disorders, excitement or symptoms of depression or anxiety. The poster provides the rational for conducting this study and describes the study protocol including the subject's characteristics.

We have compared oxcarbazepine (OXC) with acamprosate (ACP) in relapse prevention in recently withdrawn alcohol dependent patients. Oxcarbazepine blocks voltage-sensitive sodium channels. Its metabolite reduces high-voltage-activated calcium currents in striatal and cortical neurons, thus reducing glutamatergic transmission at corticostriatal synapses. This reduction is of interest in the treatment of alcohol dependence, since acamprosate modulates NMDA receptors, resulting in an inhibition of glutamatergic transmission. Furthermore, OXC has revealed a mood-stabilizing effect in bipolar affective disorders.

In a randomized open label pilot study 30 detoxified alcohol dependent patients were followed up for six months to assess treatment outcome in pharmacological relapse prevention. 15 alcoholics were treated with OXC and 15 with ACP. We asked for the time until first and heavy relapse and for drinks on drinking days. We assessed craving (OCDS), the severity of depression (ADS) and the degree of state anxiety (STAI).

After withdrawal, time to severe relapse and time to first consumption of any ethanol by OXC patients was not longer than for ACP patients. Abstinent patients in both study groups showed significantly lower OCDS-G than relapsed patients. No undesired effects occurred when OXC patients consumed alcohol.

While the current sample size clearly limits further conclusions from this pilot study, it is noteworthy that OXC is well tolerated. Thus, in medication-based relapse prevention, OXC could have the potential of a promising alternative for alcoholic patients unable to benefit from ACP or naltrexone or who suffer from affective lability. OXC certainly merits a larger placebo controlled trial.

Research has shown that Quetiapine reduce the craving and consumption for stimulants and alcohol. Due to Quetiapine's particulars and the promising receptor profile concerning addiction medicine, we set out to examine the tolerability and efficacy concerning relapse prevention of withdrawn alcoholics suffering from additional symptoms.

Our case observations attempted to evaluate nine alcoholics after withdrawal suffering from persisting craving, sleep disorder, excitement, depressive symptoms or anxiety symptoms. The patients were treated with quetiapine as relapse prevention and we followed them up in our outpatient clinic.

Eight out of nine patients were abstinent under quetiapine over a period of 2 to 7 months. One of these patients relapsed after he stopped taking the preparation at his own initiative after 10 weeks. The ninths patient stopped taking the preparation immediately because of swollen nasal mucosae. All target symptoms disappeared in the patients after an average of [mean ± SD] 24.5 ± 18.1 days. The overall tolerability was considered to be very good, however initial sleepiness appeared in four patients.

Patients reported to be very satisfied with the medication. Reports about clearly reduced craving seem particularly worthy of attention. Although uncontrolled case observations can only be interpreted with caution quetiapine seems to deserve further investigation. A double-blind placebo-controlled study is in preparation to confirm these preliminary findings. Quetiapine may hold the potential for preventing alcohol relapse in alcoholics suffering from additional above mentioned symptoms, or as an alternative in alcoholics who do neither tolerate acamprosate nor naltrexone.

Study of the relationship between bupropion and the onset of psychotic symptoms.

Review of the literature about this subject and review of the patient's history.

Mr D. was a 20 years old patient attended in our psychiatric unit for psychosis due to drug abuse that was exacerbated after the beginning of the treatment with Bupropion.

He showed a depressive episode at the age of 17, being diagnosed of Personality disorder (Cluster B), and he had history of substance abuse including cannabis (habit described as occasional), cocaine (only once in the past) and MDMA (only the 31 December 2008).

The patient recognized an intake of MDMA on the 31 December 2008, after which he showed visual hallucinations and insomnia in the following 48 hours. From the 3TH to 7TH OF January no symptom was observed although he had cannabis in unspecified amounts, appearing abnormal behaviour around January 8TH. On the 11th, his GP prescribed Bupropion at doses up to 150mg/day for smoking cessation, appearing two days later psychotic symptoms that included hallucinations, soliloquies, unmotivated laughter and an exacerbation of behavioral disturbances.

The symptoms disappeared after a week of treatment with antipsychotics.

Bupropion causes inhibition of dopamine reuptake, which would have created, an excess of this neurotransmitter that could explain the appearance of the psychotic symptoms.

We consider it appropriate to include in the contraindications section of this product, the use of bupropion among patients with history of psychotic symptoms in the context of consumption of toxic substances.

Sample of alcohol and opiate female addicts (30 patients in each group) plus control group (30 women) with no psychiatric diagnosis were questioned with the Semi-structured interview Addiction Severity Index - ASI (T.McLellan, J.Cacciola 1982).

There is a statistically significant difference among the groups compared for hereditary factors in addiction. In the group of opiate female addicts, a positive hereditary factor is present in 62.5%, in alcohol female addicts - in 50.0%, and in the control group - in 13.3%.

Alcohol addicted subjects do not differ significantly from opiate addicted subjects in terms of living with someone who has a drinking problem. However there is a statistically significant difference between opiate addicted subjects who live with someone with a drug problem (62.5%) and alcohol addicted subjects (13.3%).

Heredity is an important risk factor in addiction. A problem with chemical addiction in families of addicts, as a rule, presents as a multi-generational problem. Opiate addiction, in particular, starts and is maintained in a relationship with either a close family member or a partner.

According to Russian official statistics the average life period in males is about 59 years while in females it is about 73. The average marriage age for males is 24.4 and 22.2 for females. Thus statistically average woman in Russia lives in widowhood more than 15 years.

16 females aged 43 - 76 who began alcohol abuse in the second life period after (or during) social stress were studied. Specially elaborated Alcohol Intake Motive Self-esteem (AIMSE) scale was used.

According to ICD-10 criteria alcohol intake in all females conformed to F10.1 - Alcohol Dependence, in 12 it conformed to F10.3 - Alcohol Withdrawal. Duration of alcohol misuse before first appeal to addiction specialist varied from 1 to 8 years (mean 3,3±1,2 years). Mean duration of addiction forming was 1,8±,1,1 years; mean daily 100% ethanol tolerance was 100-150 ml. The stress situation was:

1. 1) A long-term husband illness which terminated lethally (7 persons);

2. 2) An unexpected death of a husband or constant partner (5 persons);

3. 3) Relation rupture with a husband or partner (4 persons).

The highest scores in AIMSE-scale have been obtained in the motives “solitude”, “low mood”, ‘bad physical health” and “heed deficit from children and relatives”.

The data have shown the phenomenon typical to the late onset female alcoholism in Russia. “Widow” alcoholism occurs in women in the second half of their life, when emotional bereavement situation and solitude are main provoking factors.