Treatment adherence plays an importance role in the field of Mental Health, as therapeutic failure increases the number of relapses as well as hospital admissions.

To know if treatment failure is related to the type of mental illness suffered by the patient.

An interview was constructed to collect clinical data (diagnosis, prescribed drug group and drug group which has been altered, how this modifies the treatment and the reasons reported to alter the prescription)

-Marital status: 48,9% married/consensual union, 30,5% widowed, 19.1% single and 0.7% separated or divorced.

-Coexistence: no statistically significant differences were found in compliance among those living alone and those living together.

Group-diagnosis: Psychosis 12,9%, Affective disorders 39,3%, Anxiety disorders 5,0%, Personality disorders 0,7%, secondary to organic disease 15,7%, dementia 21,4%, Other 4,3%.

Compliance depending on diagnosis: Psychosis (83,3% Yes - No16,7%), Affective disorders (67,3% Yes - No 32,7%), Anxiety disorders (42,9% Yes - No 57,1%), Organic disorders (59,1% Yes - No 40,9%), dementia (56,7% Yes - No 43,3%), Other (Yes 50% - 50% No) Conclusions: A prioiri, cohabitation is an interesting factor in adherence, because living with relatives can lead to greater supervision, and hence greater compliance with treatment.

However,only diagnostic group seems to have a role in compliance. Of the analized sample, the group with greater adherence to treatment was “psychosis”.

Despite the emphasis that needs to be done in compliance with treatment of psychotic disorders, it is also necessary to enforce compliance in other disorders.

The use of coercive measures in clinical practice represents a common, but understudied problem in Europe. In 2002–2005, the European Commission funded the study “European Evaluation of coercion in psychiatry and harmonization of best clinical practice” (EUNOMIA), coordinated by the Department of Psychiatry of the University of Dresden and carried out in 12 European countries.

This study, carried out on the Italian EUNOMIA sample, aims to:

1. 1) assess the use of coercive measures in five Italian mental health inpatient units;

2. 2) identify the patients’ socio-demographic and clinical characteristics associated with the use of coercive measures;

3. 3) investigate the effect of coercive measures on the outcome of the patients.

The Italian sample included 294 admitted patients. Data were collected on coercive measures (physical restraint, seclusion and forced medication)

Almost 30% of the patients received coercive measures during their hospitalization; in particular, 22% received forced medication, 9% were restrained or fixed by mechanic devices, 7% were seclused. The most frequent reason for prescribing coercive measures was aggression against others. Patients who received coercive measures were more frequently male, with higher BPRS scores and a worse social functioning. At three months after discharge, they showed higher levels of positive symptoms, and reported more negative opinions on the need of hospital admission and on the appropriateness of psychiatric treatments.

In Italy coercive measures are in most of the cases applied to the patients affected by more severe psychopathology and disability.

Psychotropic medication prescribing can be a powerful indicator of racial bias. However, despite extensive research, mostly conducted with outpatients in developed western countries, findings are inconsistent.

In response to prior studies reporting racial bias in inpatients with schizophrenia, comparing for doses of drugs between native and non-native inpatients, the authors investigated whether discrepancies in use of medication can be explained by negative ethnic bias.

To test for differences in prescribing for psychiatric inpatients fulfilling criteria for either schizophrenia and other psychotic disorders or major depressive or bipolar I disorder, focusing on use of drugs and including the use of SSRIs-SNRIs and mood stabilizers.

In a naturalistic study of consecutive voluntary admissions we overall controlled for 12 confounding variables. Prescribing practice was compared between the groups for five outcomes: Use of polypharmacy, use of typical antipsychotics, atypical antipsychotics, SSRI's-SNRI's and mood stabilizers.

Use of polypharmacy and use of atypical antipsychotics were not associated with ethnicity. On the other hand, non-Greeks were less likely to receive SSRIs-SNRIs, less likely to receive mood stabilizers and more likely to receive typical antipsychotics, compared to Greeks.

Ethnicity did not seem to influence Greek psychiatrists’ prescribing. It appears that in this country, which has started receiving immigrants only recently, racial stereotypes are not firmly established. Other explanations are also discussed as ethnicity can influence psychiatric practice in many, often subtle ways. Future research might investigate racial bias in regard to disorders other than schizophrenia.

The crime committed by mentally ill offenders has continued to attract higher degrees of media interest and concerns over public safety.

To explore study participants’ views over public perceptions of mental illness, and psychiatric illness and violent crime link.

To study public percetions of mental illness.

The study was coducted using a qualitative research design, using audi-taped, semi-structured interviews of 8 University students and healthcare professionals. Qualitative research themes and categories were obtained through qualitative data analysis of interview transcripts.

Qualitative categories were obtained using open, axial, and selective coding of transcribed data. The analysis identified a public fear of mental illness displaying in rejection of mentally ill and through expressive communication using stigmatizing language. The study identified that the public sources of knowledge about mental illness are derived from family and peer contact and also through media exposure rather than formal learning opportunities in schools.

The study highlights the need for a public policy debate on harmful effects of social stigma of mental illness and further need for ongoing attempts to educate general public and policy makers. Three major categories emerged through this process are:.

1. 1. Negative media portrayal of mental illness

2. 2. Sufferer stigma and caraer burden

3. 3. Mental illness and Moral Panic

The study identified that an atmosphere of moral panic exists against mental illness and that this moral panic is reflected in media coverage of crime by mentally ill offenders.

Study confirms negative public perceptions and stigma of mental illness.

Understanding youth violence remains a pressing issue of social concern. Identifying key risk factors for youth violence may help guide prevention and intervention efforts.

To examine the relative impact of varying social influences related to family, community, mental health, television and video games on youth violence in a multivariate format.

The current study involved a one-year prospective study of multiple risk and protective factors for youth violence in a Hispanic-majority sample of early adolescents. Multiple regression was used to examine risk factors from a multivariate format.

Results find that current depression level was the most significant risk factor for youth violence. The influence of depression was most pronounced in individuals with preexisting antisocial personality traits. Risk and protective factors related to schools, neighborhoods, family environment or video game or television violence use were not predictive of youth violence.

Potentially, prevention efforts which focus on mental health issues may demonstrate the most positive effects. The degree of resources and rhetoric spent on other factors, particularly television and video game violence may conversely proove unhelpful in reducing youth violence.

Home visits are an essential component of community mental health care for their potentials in prevention and rehabilitative interventions. In the tradition of the Italian organisation, home visits are commonly carried out by psychiatric nurses, usually case managers for patients receiving them. Poor training and scarce integration to other clinical activities are common problems addressed by mental health professionals.

A written survey on attitudes, beliefs and reality of home visiting was submitted to all 95 mental health professionals working in the community mental health centres of the Modena District, North of Italy. The survey included the following sections: general information (including seniority of service); personal experience and emotions; description of “what actually happens”; opinions on training; comparison between reality and ideals.

Ninety-eight percent of contacted professionals responded to the questionnaire. Home visiting should be improved and better integrated according to 55% of respondents. Good integration with social services but poor planning and lack of periodical assessments of effectiveness were emphasized by respondents. Seniority of service was significantly associated to different opinions on aim (p = .043) and numbers of home visits (p = .02) as well as the specific mental health centre was strongly associated to different perceptions on quantitative load of home visits (p < .0001). Almost no perception of danger was addressed by respondents, particularly if older.

Home visit is a powerful tool for assertive community treatments in psychiatry and should be a focus for training and research.

Views on the causes and psychosocial consequences of schizophrenia of the Italian population, patients’ relatives and mental health professionals can influence detection and outcome of these disorders.

To investigate the opinions on schizophrenia in a sample of 614 lay respondents, 465 mental health professionals and 709 key-relatives.

The survey was conducted in 30 randomly selected geographical areas with the Questionnaire about Opinions on mental illness (QO).

The results show significant differences among the three groups as regards opinions about patients’ civil rights and social competence of patients with schizophrenia. In particular, the belief that patients’ behaviors are unpredictable is maintained by 18% of mental health workers and by 35% of family members and the general public. As regards causes, 68% of relatives, 20% of mental health workers and 34% of general public believe that schizophrenia is caused by psychosocial factors only. Forty-eight percent of the relatives affirmed that they are fully convinced of the usefulness of pharmacological treatment compared to 28% of professionals and 25% of the Italian population. With respect to civil rights, about half of the relatives is fully convinced that patients with schizophrenia should not have children compared to 17% of mental health workers and to 19% of the general public.

These results underline the need to conduct sensitization campaigns about schizophrenia focused on specific aspects of the disease, such as unpredictability, civil rights and opportunities to recovery of patients, taking into account the target population to which they are addressed.

Several studies indicate a significant longitudinal comorbidity of depression and chronic pain. Also, perceived stigma is a barrier to recovery. This study wanted to evaluate the correlations.

To investigate to what degree chronic pain patients suffer from depression and stigma fears 132 (66% females) consecutive in- and out-patients with somatoform pain disorders who presented at the Department of Psychiatry and Psychotherapy (MUV) were investigated using the Stigma Questionnaire by Link and the Beck Depression Inventory (BDI).

The aim of this study was to survey the attitudes of 132 patients with the diagnosis somatoform pain disorder, toward mental illness stigma and the influence of depressive symptoms.

The BDI was employed for measuring of the severity of depression and the modified 12-item version of Links Stigma Questionnaire to evaluate stigma perception.

Three third of the patients expect discrimination because of their psychiatric diagnosis and two third of the chronic pain patients also showed depressive symptoms. The overall results show a significant correlation between stigma perception and depressive symptoms.

Fear of stigma increases with depressive symptoms and both are a risk for treatment delay. Goal of future research should be the question how to reduce depression and fear of stigma in order to help them enter psychiatric treatment early and gain self-confidence and mental health back again.

The aim of the study was to explore how many physicians intended to be psychiatrists and how many of those physicians practising as psychiatrists originally desired this area of expertise

For this cross-sectional survey, a self-administered questionnaire with 12 items was sent to all licensed physicians (n = 8127), based on the register of the Vienna Medical Chamber in June 2000

2736 respondents (34%) completed the questionnaire validly. 50.3% (m: 43.2%; f: 58.6%) of all physicians in Vienna did not achieve their desired subject, whilst 86% of psychiatrists did so. These study results represent the highest percentage compared to other medical specialisations. Further, 6% of all physicians (m: 5%; f: 7%) initially defined psychiatry as their desired medical career regardless whether they attained this specialty later on or not. An average of 9% of all physicians changed their minds about their preferred specialty during their training.

Compared with other specialties the average number of physicians who practice a specialty different from the one desired is low in psychiatry. We think that this fact constitutes a favourable aspect with regard to recruitment of graduates for specialty training in psychiatry. Data found in this survey are similar to other studies conducted in German speaking countries, when focussing on psychiatry as desired career.

Originally, the General Health Questionnaire (= GHQ) was designed to detect mental disorders among general medical outpatients and in community. The aim of the present survey is to compare the criterion validity indices of three different GHQ versions among general hospital inpatients when using different scoring methods.

The GHQ-30 was filled in by inpatients prior to the research interview. For psychiatric case-identifiation the Clinical Interview Schedule was performed by three research psychiatrists.

The final sample consisted of 993 inpatients. When comparing the three different GHQ-versions, no significant differences were found in OMR and ROC-AUC as well as in sensitivity (0,612–0,701) and specificity (0,601–0759). When comparing the four scoring methods no significant differences were found in sensitivity. By contrast, OMR and specificity showed better indices for the 20 item and 12 item GHQ versions when using the bimodal and modified Lickert scoring method. Further, the Lickert scoring method showed no significant differences to the other scoring methods for the GHQ-30, where as the modified Lickert and the bimodal method showed lower OMR and higher specificity compared to the chronic method.

Due to the results of this survey, the future use of the chronic scoring method for the GHQ has to be questioned when used for general hospital inpatients.

The Goldberg's 30-item General Health Questionnaire (GHQ-30) is used as a screening instrument for psychological distress in the general population. GHQ-30 has been widely used as a unitary measure, but several underlying factors have been identified in previous studies based on factor analyses.

To analyze the internal consistency and the factor structure of the Polish version of GHQ-30 in the group of somatic and psychiatric patients’ subpopulations. Differences in factor structure among those two groups might have important implications for how the test is used in those populations.

A total of 1473 patients (807 psychiatric and 666 somatic) were included into the study. A total score was calculated with Likert method. The principal factor analysis with orthogonal varimax normalized rotation was used for the factor extraction.

The GHQ-30 was found to have high internal consistency. The factorial analysis conducted for the whole group, as well as for psychiatric and somatic patients separately, showed that two factors labeled as followed can be abstracted from the global scale: “depression and anxiety” and “interpersonal functioning and general coping”. These factors jointly account for 54,2% – 62,3% of the variance.

Results showed that GHQ-30 may be used both as a unitary measure using full-scale sores and allows to get more detailed information about individual's intra- and interpersonal functioning.

Although in close and old connections with psychiatry, dangerousness exceeds psychiatric field because of its transversal feature. By involving a potential attack of others’ integrity, dangerousness implies a social dimension.

The aim was to study social representations of mental disease, which are dominated by the specter of dangerousness and lead to its stigmatization, in order to outline a prevention prospect.

The method was based on a review of literature of main French studies of social representations of mental disorder and mechanisms which lead to its stigmatization.

The representations of psychiatry in general population are homogeneous and consensual, organized around the figure of the « mad », the « mentally ill » and the « depressive people ». Madness and mental disease are associated with the most violent behaviors and the use of psychoactive drugs. Two dimensions appear in the representation of the dangerous individual, one linked to a trained aggressiveness, the second to an impulsive aggressiveness, confirming the validity of the usual distinction between criminological and psychiatric dangerousness. Three main data are at the source of stigmatization : the fear of what is discerned like a threat, the anomaly through the difference which is carried, and the social regulation.

The struggle against mental disease stigmatization can be part of a prevention process allowing through the rehabilitation of the patient in the society the performance of a care which exceeds the simple treatment of the disorder.

Budgets allocated for mental health make up a relatively small proportion of total health expenditures, although there is an increasing burden of mental disorders.

To review the mental health situation in Greece with regards to mental health policy through review of relevant literature.

To explore the basic implications of the economic crisis from a health policy perspective, reporting constraints and opportunities.

A narrative review in PubMed/Medline along with a hand search in selected Greek biomedical journals was undertaken, relevant to mental health policy.

Greece is among the OECD countries with high health expenditure as a percentage of Gross Domestic Product (9.7% of GDP in 2008) but it doesn’t have a specified budget for mental health and is mostly depended in out-of-pocket expenditure (48%). The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management and poor incentives in the public sector. The lack of cost-effectiveness and the informal payments comprise a major source of inequity and inefficiency. Uneven regional distribution of psychiatrists exists and rural areas are mostly uncovered by mental health care facilities, as well as extramural mental health units and rehabilitation places, despite the current reorganization of the whole mental health care delivery system.

The core problem with mental health services in Greece is the shrinking budget with poor financial administration consistent with inadequate implementation of mental health policy. A clear authority with defined responsibility for overall mental health policy and budgetary matters is needed.

Reasons for differences in the effect sizes of studies on complex interventions, such as assertive outreach, between the US and the UK are a much debated topic. One possible explanation was suggested to be the potentially different quality of standard care in the two countries.

We aimed to

• (i) empirically establish the comparability of research results on complex interventions for people with severe mental illness (SMI) from the UK and the US, and

• (ii) explore developments over time in standard care in both countries by comparing studies that use “treatment as usual” (TAU) as the control intervention.

We conducted a systematic review and meta-analysis of RCTs conducted in the UK or the US

• (i) involving people with SMI,

• (ii) comparing complex interventions with TAU, and

• (iii) using the outcome relapse or readmission to hospital.

The Risk Ratios for relapse/readmission were very similar and favouring experimental treatment both in the UK (RR 0.80, CI 0.73–0.88) and the US (RR 0.87, CI 0.79–0.95). The development of effects resulting from experimental interventions relative to those from TAU over time shows a slightly different pattern for the two countries.

The broadly similar total RR for relapse/readmission in both countries confirms the comparability of studies conducted in the UK and the US and suggests no significant overall difference in the quality of standard care. The chronological development of effects, however, reflects developments in TAU over time which differ between the two countries.

There is a growing interest in establishing a relationship between several mental disorders and traumatic life events in childhood and adolescence.

It has been seen a high prevalence of these traumatic events when reviewing the clinical history of patients with mental illness.

Measuring the prevalence of traumatic events in a sample of patients with a diagnosis of psychotic disorder.

A retrospective descriptive study was made. The sample comprised 50 patients admitted to our psychiatric inpatient unit. These patients were separated into different categories according to clinical diagnosis and demographic variables. Data was obtained through clinical interview before their hospital discharge. We tried to detect the presence or absence of real or imaginary memories of traumatic events during their childhood or adolescence.

52% of patients had a diagnosis of paranoid schizophrenia. 64% reported a history of substance abuse in their family. 20% referred the experience of having suffered sexual abuse by a member of their family, and up to 44% of them by someone other than family. 22% reported having suffered some kind of physical abuse by their parents, and more than 70% reported having suffered some type of traumatic event in the school environment.

There is an important amount of traumatic events in childhood and adolescence in this sample of patients. However, concluding that such traumatic events could eventually produce severe psychiatric disorders is still quite controversial. In order to understand better the association between childhood trauma and severe mental illnesses more research is needed.

Mental distress among medical students is often reported. Different psychiatric disorders are found to be under recognized yet common and treatable among medical students. Various previous studies have shown that medical students are subjected to considerable stress over the last decades. The aim of this study was to determine the presence of clinically significant psychiatric morbidity among third year medical students, to explore the effects of the socio demographic background for these outcomes and to analyze gender differences regarding selected psychiatric morbidities.

A cross sectional study is carried out among third year medical students from Ain Shams University. They were assessed using Social Classification Scale and Structured Clinical Interview for DSM-IV (SCID I) to assess psychiatric morbidity.

Response rate was 98.9%. Prevalence of psychiatric morbidity among our medical students sample was 59.9%. No significant statistical association between psychological morbidity and any of the socio demographic variables. The most prevalent psychiatric diagnosis was found to be depression (47.9%), followed by Generalized Anxiety Disorder (GAD) (44.9%) & Obsessive Compulsive Disorder (OCD) (44.4%). The least prevalent of which was Anorexia Nervosa (0.7%).

Significantly high proportion of medical students (59.9%) had ongoing psychiatric condition and that proactive interventions should be addressed to encourage those medical students to seek help for their psychiatric problems. Counseling and preventive mental health services should be an integral part of the routine clinical facilities caring for medical students.

Dikmen Valley is a slum district where the Municipality of Ankara intended to start an urban transformation project. Dikmen neighborhood includes nearly 1000 houses which the Municipiality attempted to pull down suddenly at night in the winter of 2007.

Residents of Dikmen Valley resisted and managed to stop this attempt. Whole event was experienced as an acute trauma as well as a continuous experience of anxiety because of ongoing risk of another attack.

The aim of the present study was to investigate the psychological consequences of the whole process.

The study sample consisted of 201 individuals from 106 households, and a total of 178 individuals from 102 households was taken as comparison group from another slum neighborhood where residents did not experience any threat to their houses. The Beck Depression Inventory, the Spielberger Trait Anxiety Scale, and the General Self-Efficacy Scale were used for assessment.

Dikmen sample was found to have a statistically significant higher mean score of anxiety and depression compared to the comparison group. Dikmen had a higher level of general self-efficacy belief than the comparison group after controlling for depression and anxiety scores.

Although the traumatic process after an attack of pulling down and the threat of losing one's house resulted with a depressive state and anxiety in Dikmen residents, unexpectedly they had a high level of general self-efficacy. To the researchers’ observations, a social transformational process has been realized resulting with an overall high general self-efficacy level in Dikmen neighborhood.

Homosexuality is forbidden in Islamic countries. In Iran people who homosexual captures with police and in Islamic Law they are accuse and they transfer to prison. But Transsexual is accepted. So, people who are homosexual encourage changing their sexuality and identity with plastic surgery, and gaining new sexuality. Then government gets them Identification Card.

The aim of this study examines the view of Iranian counselors to working with Transsexual and Homosexuals clients.

For gathering data, use a questionnaire. A questionnaire was about the view of counselors to Transsexual and Homosexuals clients. For analysis data, use the descriptive statistical methods.

The results indicate that 60 percent of counselors disagree to working to homosexual people, 25 percent answered no Idea and 15 rest of them said they were accepted the homosexual clients.

To conclude, counselors did not interest in to working with homosexual clients, but when they are changed their sex with surgical operation and gain new Identity, counselors tend to working with them. But the reality is people who changed their Identity with surgical operation, after few months regretful and 35 percent of them attempts to suicide.