Estimate the prevalence of use of psychotropic medications in the cities of São Paulo (SP) and Rio de Janeiro (RJ);

Random sample of 3744 individuals, 15–75 years; CIDI 2.1 (depression and anxiety) and direct questions about use of psychotropic medications in the past year; prevalence estimation was performed by weighting oversampling in SP and standardization between cities by age; psychotropic consumption association with socio-demographic variables and diagnosis was performed by logistic regression.

The prevalence of psychotropic use was 8.95% in SP (CI:7.93–9 .97) and 9:54% in RJ (CI:8.49–10 .59). Antidepressants (4.72% and 4.33%) and tranquilizers (4.20% and 1.73%) respectively in SP and RJ where more common used. Psychiatrists in SP most often prescribed psychotropic (39%), in RJ general practitioners (48.8%) where more cited. Most antipsychotics (52%) and antidepressants (39%) in SP were donated by the government in RJ this figure falls to 8% and 7%. Female individuals with increasing age, separated or divorced with a psychiatric diagnosis in the past year, family history of mental illness and higher income were more likely to use psychotropic drugs. About 70% to 82% of individuals diagnosed with major depressive disorder or phobic disorder, did not use any psychotropic drug.

There was a decrease in the consumption of psychotropic drugs in Brazil in recent decades, with a change in the consumption of tranquilizers and antidepressants. There is a need for a better training and education of doctors and family assistance programs in recognizing symptoms of common mental health disorders.

In Egypt, the total number of persons with diagnosed and undiagnosed Diabetes is expected to increase more than double from 3.80 million to 8.80 million by the year 2025.compared with the prevalence of depression among normal subjects. These reports indicate that >25% of patients with diabetes reach clinical criteria for depression, a rate far higher than in the general population. the comorbidity of diabetes and depression is associated with adverse diabetic outcomes, compared with nondepressed diabetic patients.

To determine prevalence of depression among type II diabetic patients attending family health centers in Alexandria.

A sample size of approximately 303 adult diabetic cases of type II in the age category of (20–60) years old based on a prevalence of 27% of depression in diabetics, degree of precision of 5% and confidence level of 95%, will be randomly selected from the attendees of the studied family health facilities. Two days of the week will be selected randomly to visit the studied primary health care facilities till the allocated sample size is reachedAn interview questionnaire will be designed for depression assessment by using the Hamilton Depression Rating Scale (HAM-D) among type II diabetic patients.

40.18% (n = 135) of diabetic patients in our study showed moderate to severe depression, 12.2%(n = 41) showed mild depression while 47.62%(n = 160) showed normal values on HAM-D scale.Moderate to severe depression was present in 39.1% and 40.7% in males and females respectively.

Stigmatization of people with mental disorders often leads to impairment of quality of life (QoL) - lack of self-esteem and life opportunities, social isolation, decreased productivity, violation of human rights and inadequate health care. However, data comparing stigma and QoL between different psychiatric disorders is fairly limited.

To assess stigma and QoL of patients with affective disorders compared to patients with psychotic spectrum disorders and to assess the association of stigma to QoL.

A cross-sectional study. the patients from diagnostic groups F30–39 (n = 61) and F20–29, diagnosed according to ICD-10 criteria, in remission for at least six months at the time of testing, matched by age and gender were included in the study. A semi-structured socio-demographic questionnaire, Stigma Scale and World Health Organization Quality of Life Questionnaire (WHOQoL) - BREF were used in the study.

The QoL of patients from affective spectrum is significantly lower in some of its domains (overall perception of QoL, overall perception of health QoL, psychological domain) compared to the patients from psychotic spectrum. in addition, the affective spectrum patients scored higher on Stigma Scale, although not significantly. Furthermore, the scores on Stigma Scale showed strong, negative correlation with all domains of QoL.

The stigmatization strongly affects the QoL in psychiatric patients. Patients with affective disorders feel more stigmatized and perceive their own QoL as lower compared to the psychotic spectrum patients

Medical education is frequently stressful and could have a negative impact on mental health.

Characterize mental health of medical students from a positive and negative point of view and investigate the relations between these and sociodemographic factors, year of course, sedatives/tranquilizers use and psychological support.

Medical students of University of Beira Interior were invited to answer an online questionnaire with four sections:

• 1) Socio-demographic data

• 2) Mental Health Inventory

• 3) sedative/tranquilizers use in the last month

• 4) questions about pharmacologic and psychological support.

The results were analyzed on SPSS. the significant results were considered for p < 0,05.

A total of 272 (49.3%) students answered the questionnaire. the students of 1rst and 3rd year had significant low scores in psychological well-being scale. About 11% of the total had used tranquilizers in last month. the variables: female sex, 3rd year of course and the use of tranquilizers had significant negative impact on global mental health. 30% of students consulted at least once a mental health professional, 6% have regular follow-up and do pharmacologic treatment. About 10% of all students reported suicidal ideation in the last month.

Symptoms of distress appear to be particular important in female students and in the 1rst and 3rd years and it is necessary to understand the causes and the consequences of this situation. Targeted interventions that promote psychological well-being during the medical formation and identify students with symptoms of mental distress may be an effective way of dealing with this problem.

The responses of health care and social services to an increasingly aging population emerge as a social imperative in a scenario of demographic transition. the geriatric assessment includes the physical, mental, cognitive, emotional and social functions, allowing for, a concrete understanding of the realities and a better health planning.

To assess:

• A) The use and need for health services and social support by the elderly, related with their functional status in five areas (social resources, economic resources, mental health, physical health and activities of daily living);

• B) assessment of the use of and need for the services.

A) to provide information on the functional status and the use/need for services;

B) improve the quality of care, adapting the training of nurses to this new social and health reality.

Cross-sectional study. Randomly sample composed of individuals aged ≥75 (N ≈ 11279; n ≈ 1128) representative according to age and gender. Data collection using the QAFMI/OARS.

Innovative results should emerge in two areas: among the technicians and health policy makers. This study may represent, at a central level, a basis for the improvement of the planning of health and social policies; and, at a local level, a more inclusive planning by the health and social support entities.

Interventions at two levels will emerge from the work suggesting:

• A) health care data provision;

• B) resources allocation definition.

This allows for the social and health intervention policies, providing data which enables the coordination of the services aimed.

Compulsory admission is controversial and highly relevant to society. Nevertheless, epidemiological European data are scarce and of limited reliability and comparability. in several countries including Belgium and the Netherlands, the incidence of compulsory admissions seems to increase despite legislative amendments aiming to reduce coercion.

By pooling and analysing available epidemiological data, we estimated the incidence and evolution of compulsory admission in Belgium and the Netherlands within the 7-year timeframe of most recent available data.

We ran a systematic literature review including relevant epidemiological data, either published or from grey literature (e.g. unpublished governmental, regional or health care reports and databases). all data were (re)calculated into incidence rates per 100,000 inhabitants per year. Statistical testing (e.g. trend analyses) was performed when applicable.

Incidence of compulsory admission increased with 38% (Belgium, 1999–2006) and 39% (2002–2009, Netherlands), respectively (all p < .01), culminating in incidence rates of 45/100,000/y (Belgium, 2006) and 113/100,000/y (Netherlands, 2009). in between country differences can be partially explained by legal differences (type and duration of compulsory admissions). More fine-grained results, regional differences (e.g. urban versus rural areas), and incidence comparisons within a European context will be presented.

Our data suggest a significant increase of the incidence of compulsory admissions in both Belgium and the Netherlands. Uniformity and standardization in registration of compulsory admission throughout Europe is needed to enhance the comparability and quality of the data. Substantial differences in legal frameworks and the structure and organisation of healthcare further limit international comparability

Epidemiological data regarding compulsory admission are mainly limited to unpublished reports and databases, often gathered unsystematically with great heterogeneity in both definitions and data recording methods. the scarcity of scientifically validated and published data is in sharp contrast with the societal relevance of coercion. Therefore the Flemish Community implemented since 2007 a uniform data collection and recording method inspired by the Dutch registration, resulting in a database of incident cases of compulsory admission.

• (a) to investigate the epidemiology of compulsory admission in Flanders in terms of sociodemographic and psychiatric characteristics, past use of services, and temporal trends;

• (b) to compare Flemish epidemiological profiles with Belgian population-representative data (N = 7,821; 1997–1998) and data gathered from a Belgian university teaching hospital (N = 1,501; 2000–2010).

Data were systematically collected and quality controlled by a government agency, supervised by a scientific committee. all incident cases of compulsory admission were included prospectively (2007–2009, N = 10,607, response rate=100%). Descriptive statistics, advanced uni- And multivariate regression models and time-trend models were applied.

Epidemiological profiles of prevalence and incidence data comprising data from all three sources will be presented. Data will be disaggregated by sociodemographic profiles (e.g. gender/age comparisons), psychiatric disorders, severity estimates, correlates of compulsory admissions, and temporal trends in these disaggregation variables.

This is the first study investigating the epidemiology of compulsory admissions in Belgium using large and longitudinal databases. Our findings will be placed into an international context relating to implications for further epidemiological research, legislative issues, and methodological improvements.

Research suggests that urbanicity and lower socio-economic status are risk factors for psychosis.

To calculate the incidence and period prevalence of patients admitted with psychosis in Malta, and to examine differences between districts. To date, this is the first study of its kind carried out in the Maltese Islands.

One year prospective cross-sectional study, including all ICD-10 psychosis patients admitted to any one of the three psychiatric hospitals (n = 180).

Incidence of hospital admissions due to psychosis was 26.0 at risk per year per 100, 000 population. Period prevalence for 6 years was 41.9 per 100,000 person-years. Highest incidence: Southern-Harbour area (32.1, CI = 31.9–32.3), and lowest incidence: Western District (20.1, CI = 19.9–20.2). the period prevalence was highest in Gozo District (63.9, CI = 63.2–64.7). 5.2% of participants were irregular migrants, having an approximate estimate for incidence of psychosis of 400 per 100,000 person years at risk.

The high incidence of psychosis may be explained by the fact that Malta is the eighth most densely populated country worldwide. the district with the lowest socio-economic groups were found to have the highest incidence of psychosis, followed by the most densely populated district. Cultural factors, small genetic pool or readily available services could account for the high period prevalence in the Gozo district -a more rural area. Higher education in the Western district area could partially explain the lower incidence. Multiple Stressors and trauma may partially be the reasons for the much higher incidence rate in the irregular immigrant group.

According to various surveys, insomnia is found in 6–10% of the adults and more often when comorbid with a psychiatric disease.

To find out how many adults meet the ICSD-2 criteria for chronic insomnia and DSM-IV-TR ones for depressive, panic, anxiety disorder, somatoform or eating disorders, as well as alcohol abuse and adult ADHD.

To measure prevalence of chronic insomnia and common psychiatric disorders with validated screeners.

Adults, recruited via online adverts, were invited to fill in a battery of surveys consisting in the Romanian translations of the Sleep Disorders Questionnaire, Patient Health Questionnaire and Adult ADHD Self-Report Scale 1.1. Completion was online on Surveygizmo and analysis was performed with Excel 2007.

To date, one hundred sixty participants (114 females, 71%), aged 39 ± 13 were recruited. Chronic insomnia, somatoform disorder and alcohol abuse were suspected in 15% of the total respondents. Depressive symptomatology was found in up to 20%, anxiety and adult ADHD in 10%. Bulimia was likely in 3% (all women). Alcohol abuse was significantly more frequent among males (35% vs. 7%), while adult ADHD amongst females (10% vs. 6%). Moreover, except of chronic insomnia, bulimia and alcohol abuse, all of the screened disorders were more likely to be found in adults aged under 45. Adult ADHD, somatoform and depressive disorders were more likely to be comorbid with chronic insomnia in 20–40%.

With the exception of eating disorders, all of the screened conditions were rather likely to be found in this population.

Forms of psychiatric remuneration unlike daily taxes are of increasing interest to improve cost-effectiveness and quality of care, particularly for inpatient care. Accordingly, increasing rates of readmissions and long hospital stays are of critical relevance.

In 2009, the Canton of Zurich introduced a new remuneration approach in inpatient psychiatry. the aim is to reduce early readmissions and length of stay.

This study aims to evaluate the new remuneration system with respect to readmissions and length of stay.

We investigated data of about 40000 patients staying in psychiatric hospital between 2007 and 2010 in the Canton of Zurich. About 10000 of those patients were admitted to the University Hospital of Psychiatry introducing a new remuneration system in 2009. It consists of variable daily rates and a fix lump sum (on day 6) charging hospital stays within 28 days. We descriptively analysed readmission rates and length of stay in the respective hospital and compared those data to the rest of the Canton.

Preliminary findings show that the mean length of stay in the University Hospital of Psychiatry remained stable over time. Since 2009 there was a decrease of readmissions within 30 days in the respective hospital compared to the Canton.

Our results suggest that the new remuneration approach might reduce early readmissions. An effect on length of stay is not yet visible.

The present study attempted to assess the complex role of several suicide risk and protective factors in Ukraine.

Suicide rates, prevalence of alcoholism and alcoholic psychosis, prevalence of drug addictions, percentage of urban population and gross regional product for 26 provinces of Ukraine were obtained from the State Statistical Office of Ukraine and the WHO. Questions related to citizens’ religiosity and education were obtained from the European Social Survey. Structural equation modelling (SEM) was applied to research the complex theoretical structure of variables that might influence suicide mortality.

Religion presented strong statistically significant negative association with suicide mortality. the relationship between education and suicide was weak negative and not statistically significant. the relationship between the prevalence of alcoholism and alcoholic psychosis and suicide mortality was weak positive and statistically significant. Medium positive statistically significant association was revealed between the prevalence of drug addiction and suicide. the relationship between urbanisation and suicide mortality was medium negative but statistically significant among females only. No relationship was revealed between gross regional product and male suicide while the relationship with female suicide was slightly negative and not statistically significant.

Religiosity was found to be the protective factor most strongly linked to suicide mortality followed by urbanisation. Harmful role of drug addiction and alcoholism was confirmed. the role of education level and GRP is controversial. No striking gender differences were found.

Internet addiction is becoming a serious mental health problem in some countries, and has been proposed for inclusion in DSM-V. Social network sites (SNS) are proliferating and have attracted millions. However, there has been recent concern about potential abuse of social web, suggesting that “Facebook addiction” could be another subcategory of the spectrum of Internet addiction disorders. Unfortunately, there is sparse data to show whether SNS are of benefit or detriment to mental health.

1. Exemplify how excessive use of SNS may lead to dysfunction.

2. Summarize recent knowledge on the impact SNS may have on mental health.

We present a case of a 14-year-old adolescent who was referred to our institution due to excessive Internet/Facebook use, leading to some risky behaviors. Subsequently, we embark on a literature review about outcomes on mental health associated with SNS use.

We conducted a literature review of journal articles from EMBASE, MEDLINE and PSYCINFO, using the keywords “social network”, “Facebook” and “addiction”. Papers published from 2006 to 2011 were selected on the basis of relevant information contained in the title/abstract.

A brief summary of all relevant articles shall be presented in table format.

Nowadays Facebook is the most popular SNS, allowing users to real-time interaction and increased socialization, being used for personal, academic or work purposes. Personal information on SNS can be maliciously used by others, and may reflect user's habits, personality traits and psychopathology. Mental health professionals should be aware of Internet addiction disorders.

Information and computing technologies promise new virtual learning and communication opportunities within the real communities of health care professionals.

This research is interventional. in this study one questionnaire was distributed to nursing staff working in Psychiatry ward. the questionnaire was to assess the knowledge of the nurses with regards to essential information required for; nursing care for patients with Psychiatry problems, Anxiety Disorders, and Depression etc.

Their knowledge was then re-assessed following forward of-ten E- Newsletter via SMS mobile phone to the same nursing staff during a one month. the two results, before and after sending the information, was compared.

The findings of this study showed there was significant improvement in awareness and knowledge of the staff in thePsychiatry ward of Shiraz Psychiatry Hospital before and after sending E-newsletter containing the required information, via SMS. (p < .0/05)

According to the results of this research, development of mobile technology in all parts of our country can be used to forward the latest information to medical, paramedical professionals and to all employees and workers in these sectors, even in remote areas using this technology. the information can even be expanded based on request based on their needs.

The use of health information technology (HIT) to facilitate record-keeping and communication, and ultimately to improve quality, is increasing worldwide. While providing significant opportunity for improving the care provided to patients with psychiatric illness, this also raises privacy concerns, as it may put sensitive information at greater risk of improper dissemination. This presentation will explore the privacy implications of the increased use of HIT to the field of psychiatry.

• 1)To define the concepts of privacy, confidentiality, and security;

• 2)To outline mechanisms by which electronic information can be compromised;

• 3)To list categories of clinical information that may be deemed “sensitive”;

• 4)To present approaches for protecting privacy in an electronic environment;

• 5)To list consequences to psychiatric care from inadequate privacy protection, and conversely to discuss concerns if the flow of psychiatric documentation is excessively restricted;

• 6)To provide recommendations for clinicians.

• 1)To provide an overview of the privacy implications of HIT to psychiatry;

• 2)to encourage dialog amongst psychiatrists;

• 3)To prepare psychiatrists to contribute to HIT activities.

The information for this presentation is derived from the author's experience with HIT developments in the United States on behalf of the American Psychiatric Association; existing literature; and communications with practicing psychiatrists.

Not Applicable.

HIT is revolutionizing how healthcare is delivered and documented, and has significant implications for patient privacy. Psychiatrists need to be conversant in this area to ensure potential benefits to patients with psychiatric illness while minimizing the privacy risks.

Expectation bias (EB) occurs when an individual's expectations about an outcome influence perceptions of one's own or others’ behavior. in clinical trials, both raters and subjects may enter trials with expectations. Rater EB occurs when raters expect that subjects will improve over the course of the trial. Subject EB occurs when subjects themselves expect to get better. Rater and subject expectations can interact to create a therapeutic alliance.

To examine the impact of EB on placebo response and drug-placebo separation.

To identify methods for avoiding expectation bias in CNS clinical trials.

We review eight studies that illustrate the problem of rater and subject EB across therapeutic areas.

Studies examining rater EB suggest it can affect diagnosis and decrease IRR when subjects do not behave according to expectations. Studies of subject EB suggest subject expectations can increase placebo response and affect study outcome. Studies of the interaction of rater and subject expectations find placebo response increases with number of follow-up visits, and having a different rater for baseline, endpoint, and sequential visits may decrease placebo response.

Patient expectations, rater expectations, and rater-patient relationships can increase placebo response and decrease signal detection. Blinding raters to protocol details, including entry criteria and visit number, reduces expectations of improvement. Using different raters at baseline, endpoint and consecutive visits reduces the possibility that relationship bias could influence ratings. Utilizing remote, independent raters is one means to adequately blind and vary raters.

Inappropriate subjects may be enrolled in a study when enrollment pressures cause inflated baseline severity scores. An increasing number of studies now include methods such as blinded independent centralized ratings (CR) to ensure that appropriate subjects are entered into the trial. Post-baseline factors such as functional unblinding, expectation bias and rater drift can also affect outcomes.

Independent raters, blind to study visit, can minimize functional unblinding and expectation bias. Continuous calibration of CR can minimize rater drift.

To examine studies with both site ratings (SR) and CR to determine how critical post-baseline blinding and continuous calibration are.

A trial of acute schizophrenia used CR for the PANSS and SR for the BPRS on the same subjects.

A Parkinson's psychosis study used CR in the US and SR ex-US to assess subjects using the SAPS.

A GAD trial used CR of subjects enrolled by SRs’ SIGH-A evaluations.

In the schizophrenia trial, CR separated the active comparator and one of two test arms. SR separated the active comparator but neither test arm.

In the Parkinson's psychosis study, pimavanserin showed greater separation with CR than SR.

In the GAD trial, CR had lower placebo response than SR, independent of subject selection.

Data from several studies support the continued importance of rater blinding and independence, post subject selection. Results suggest that precision of ratings beyond baseline can increase the sensitivity of findings in a clinical trial, decrease placebo response rates and potentially eliminate Type II errors.

To evaluate dependence between a seniority as well as an exposure to the aggression demonstrated by patients in the workplace and a level of the aggression among the psychiatrists.

The study was conducted among 132 psychiatrists. Two questionnaires were used in the research: author's questionnaire assessing exposure of the doctors to the aggression in the workplace and Buss-Perry Aggression Questionnaire to evaluate a level of different types of aggression.

The study showed significant correlation between duration of the seniority and the level of verbal aggression, as well as the level of hostility in psychiatrists. There is also considerable impact of negative emotions present in relations with colleagues at the workplace such as: fear of being criticized, fury, envy and sadness, causing increase of general aggression among psychiatrists. Similarly, negative emotions that may appear in relations between psychiatrists and patients are showing a positive correlation with the level of general aggression developed by doctors.

The significant increase of general aggression among psychiatrists in conjunction with negative emotions present in relations with colleagues at the workplace show that negative atmosphere at workplace can cause aggressive behavior to patients. These negative emotions and also fear of the contact with the patient, anger directed to the patient or helplessness decrease with the doctors' age. It can be connected with increasing doctor's experience and self-confidence. the level of verbal aggression and the level of hostility decrease with duration of the seniority.