Bipolar disorder usually begin at an early age and often need hospitalization. in this study, we aimed to investigate the clinical characteristics of patients with bipolar disorder

The data of 108 bipolar type I patients who were admitted to psychiatry clinic of a university hospital due to manic episode between 2007–2009 were examined.

45 of 108 bipolar patients (41.6%) episodes of mania was just across diseases. 18 of these 45 patients were diagnosed with first-episode mania. Percentage of these patients according to their diagnosis index episode, mania was 65.7%; hypomania was 15.7%; hypomania and depressive episode was 18.5%. The number of entrants as a manic episode was approximately 3 times as depression disease beginners. Maximum rate of admission to clinic was in November and December (14.8% and 10.1%). The distribution of hospitalization rate was 21.2% in winter, 25.9 and 24% in spring and summer, 28.7% in autumn. The mean length of hospitalization was 22.4 ± 16.0 days and patients were hospitalized 2.75 ± 2.34 times during their diseases. Patients had manic episodes average of 3.1 ± 4.4 times and depresif episodes average of 1.4 ± 2.5 times during their diseases.

There is no consensus regarding the types of seizures in first episode bipolar disorder. The first period of mania or depression is likely close to each other. in our study, the most prominent was mania with 65.7%. Major depressive periods usually begin in winter and autumn and improves in summer.

Sleep apnea (SA) is a common chronic disease that leads to higher morbidity and mortality; however, illness perceptions (IP) in patients with SA remain not well explored.

We aimed to assess the IP in patients with SA and to correlate them with the level of sleepness, the severity of the disease and the existence of a concomitant depression.

Sixty four untreated patients investigated for sleep apnea (mean age: 54 years, sex ratio = 2/3) participated in our study.

Excessive daytime sleepness (EDS) was assessed by the ESS, the severity of the disease by the apnea/hypopnea index (AHI) and the depressive symptoms by the HADs. Illness representation was measured by the Brief Illness Perceptions Questionnaire (B-IPQ); High scores reveal a more threatening perception of the illness.

In terms of cognition, our patients feel quite bothered by their symptoms (7/10) and enable to control their illness (1.3/10), but they believe that their treatment will be effective (7/10). Emotionnally, they feel pretty concerned (6/10) and negatively affected by their disease (6.1/10).

We also observed that the score of the B-IPQ (6/10 ± 1.5) was positively correlated to EDS (p = 0.004), the severity of the disease (p = 0.02) and the coexistence of a depression (p = 0.005).

Several factors seem to have an impact on the vision of the sleep-apnea's patients towards their disease and their life as well. The study of the IP seems interesting to better understand the coping behaviour of such patients so that their adherence to the treatment would be improved.

Several studies suggest mental disorders and substance misuse to be associated with a higher rate of violence and crime.

The aim of this study was to determinate the correlation between addictive behaviours and criminal offences in patients suffering from bipolar disorder.

Twenty-eight subjects with bipolar disorder were recruited from the forensic psychiatry service in Razi hospital and each one was compared with two patients suffering from bipolar disorder, correlated in gender and age and without history of criminal behavior. Data were analyzed using SPSS 11.5

The most frequent crimes committed by patients (about two thirds) were nonviolent (theft, pyromania, fraud, falsification of documents, damage to a property…).

The rate of criminal behavior was highest during manic episodes: 51, 7%.

Substance use was present in 66,7% of patients with history of criminal behavior against 30% in the comparative group.

This association was significant (p = 0,002). The odds ratio was about 5.

Our study suggests that comorbid bipolar disorder and addictive behavior may significantly increase the risk of criminality.

Sexual function is one aspect of physical functioning. Sexual dysfunction, no matter the etiology, could cause distress. in people with chronic renal failure, sexual problems have often been neglected in clinical practice and research. The aim of this study was to assess the sexual functioning of patients with chronic renal failure.

A total of 50 patients with chronic renal failure on hemodialysis were included in this study. The questionnaire included thirty items: sociodemographic data, clinical factors and history, sexual functioning before and after hemodialysis. Data were analyzed using SPSS 17.

Twenty seven per cent (27%) of the patients stated having no sexual activity at all. Eighty-three per cent (83%) of sexually active patients had sexual dysfunction. Sexual dysfunction in men was due to erectile failure, to loss of sexual interest, and to fatigue. Women reported essentially asthenia, loss of sexual interest and finally dyspareunia. These disorders appeared on average three years after being on hemodialysis.

The prevalence of sexual dysfunction was high among patients with chronic renal failure. This disorder needs special attention and management from doctors.

The debates about depressive disorder and cognition impairment are supported by controversial data.

We launched the study to investigate cognitive change in first onset depressive patients over a 6 year period.

A prospective cohort was performed. Participants included 206 cases of first onset depressive Chinese outpatient aged from 17 to 60 year old and followed from Apr. 2003-Feb. 2004 to Apr. 2009-Feb. 2010 in Shanghai. During the first 48 weeks, case management service was delivered. Participants were assessed by 17-HAMD and HAMA scale at baseline, week 12, week 32, week 48, and year 6. Cognitive changes were assessed using the WMS-RC, WAIS-RC, and WCST at baseline (n = 116), week 12 (n = 80) and year 6 (n = 24), 41 normal participants as control.

1. (1) During the first depressive onset, cognitive performance deteriorated comparing with those of control group (P < 0.01).

2. (2) At week 12,effective medication could relieve symptom and improve cognition function (P < 0.05), cognitive performance compared between patient and control with no obvious difference (P > 0.05). While patient group had a significantly larger proportion (whose Memory Quotient below 85) than control group did (χ2 = 5.66, P < 0.05).

3. (3) Using a general linear mixed model to estimate cognitive change,patients with more severe depressive retardation and lower education had a worse short-term memory over 6 years (estimate = -1.65, SE = 0.80, P < 0.05;estimate=1.63, SE = 0.30, P < 0.01), adjusting for demographics and medical status.

The first onset depressive patient has cognitive defects. Memory does not full recovery after symptom relief. Short-term memory impairment persists over 6 years with relative factors.

The aim of this study was to compare the sociodemographic and clinic characteristics of patients with bipolar disorder type I with and without history of depressive episode.

In this study the data of 108 bipolar type I patients who were admitted to psychiatry clinic of a university hospital due to manic episode between 2007–2009 were examined.

According to these data, 16 of 108 bipolar disorder type I patients (14.8%) had inhabited at least 4 manic episodes throughout their lives and there was no history of depressive episode although the disease had continued at least 4 years. with and without a history of depressive episode of bipolar type I patients have not been identified differ in terms of sociodemographic and clinical characteristics, but patients not having a history of depressive episode during their lifetime was found to be more than the number of hospitalizations.

Current information seem to be not sufficient to define unipolar mania as a separate nosological class. Largescale, prospective designs and illuminating the pathophysiology and etiology studies needs to be done in this issue.

Hypomanic Personality Scale (HPS) is a self-report questionnaire designed to identify high risk and vulnerable subjects to bipolar disorders in non-clinical samples.

To identify HPS factorial structure in a French non-clinical sample and to compare for different factors solutions described in the literature.

We carried out a survey within a student population with a French version of HPS. The factorial structure of HPS was tested first by a scree plot with simulation (using R “psy” library) in an Exploratory Factorial Analysis (EFA) with promax rotation. Secondly the number of factor was fixed for a Confirmatory Factorial Analysis (CFA) performed with AMOS.

A total of 347 students (mean age 23 years, 80% of women) were included in PCA (incomplete questionnaires were not included). Scree Plot with simulation revealed a 5 factors solution which accounted for 33% of the total variance. We also tested the 3 and 4 factors solution to compare respectively with factors solution obtained by Rawling et al. (2000) and more recently by Schalet et al. (2011). Our 4 factors solution was identical to Rawling et al. (2000) but the 3 factors solution was different from Schalet et al. (2011). Goodness of fit indices showed that the 5 factors solution “fits” our data better compared to other factorial solutions.

French version of the HPS showed a factorial structure composed of 5 factors in a non-clinical student population. However, this result needs to be confirmed with a more important and representative sample.

All children presenting to the Paediatric department at Ealing Hospital with self harm are admitted for joint assessment by the Ealing Child and Adolescent Mental Health Service (CAMHS) and Social Services within the next working day. This protocol is based on NICE guidance on the acute assessment and management of children presenting with self harm (NICE guidance 2004).

To conduct an audit of all self harm referrals to Ealing CAMHS and explore adherence to the existing protocol for referral of paediatric inpatients presenting with self harm to the CAMHS team.

A retrospective audit was conducted between the period 1st April 2011 to 31st March 2012.

67 self harm referrals were received. Presentations ranged as below:

Presentation Number

Self Poisoning 27

Cutting 5

Suicidal/self harm ideation 6

Attempted jump from height 1

Alcohol intoxication 26

Cannabis intoxication 2

57 cases were assessed; 40 jointly with Social Services. 55 cases were assessed within the next working day. 10 cases were not assessed however telephone contact was made and our service offered in 9. Ealing CAMHS followed up 22 cases. 4 were offered follow up by our service but declined. We had a 100% adherence rate to follow up with no repeat presentations.

To disseminate our findings to our Paediatrician colleagues and colleagues in social services and re-audit in 12 month's time. Our model is simple and can be adopted in other centres.

Violent conflict in Mollucas, Indonesia which started in 1999 had displaced more than 500.000 of the province's inhabitants and claimed more than 10.000 lives. The conflict was believed to be mainly a religious war between Christian and Moslem. Despite of the dangerous situation in the province, most of the inhabitants did not leave the province. After a short peaceful condition, another episode of conflict started in 2004.

This paper aims to investigate the difference of psychological distress and the risk factors of psychological distress of Internally Displaced Persons (IDPs) within the shorter period after the outbreak of conflict in 2004 and in the longer period.

Data were gathered from a longitudinal community based study conducted among internally displaced persons in Ambon island for two consecutive years in 2005 and in 2006. The number of IDP participants was 471 in 2005 and 399 in 2006. Data from 390 participants was analyzed.

There was a significant decrease in prevalence of psychological distress between 2005 and 2006, and the mean of psychological distress scores also was significantly lowered. in general the participants indicated improvement in mental health within one year interval of data collection time. Further investigation found different risk factors for psychological distress for shorter and longer period from the outbreak of the violent conflict.

This study explored the mental health of people affected by violent conflict in a more extensive way. Mental health initiatives were crucial in the process of rebuilding communities after devastating conflict.

Polycystic ovary syndrome (PCOS) is a common disease in women during the reproductive period. Studies have shown a reduction in the quality of life in patients with PCOS. But there is no consensus on which symptoms of PCOS influence the quality of life more.

In this study, we aimed to compare the quality of life, depression and anxiety levels of patients with PCOS to healthy controls.

53 reproductive-age women with PCOS and 53 healthy women who admitted to obstetrics and gynecology outpatient clinic of a university hospital were included in the study. For the evaluation of the quality of life of all patients, Polycystic ovary syndrome quality of life scale (PCOS-Q), Beck depression and anxiety levels of depression (BDI) and Beck Anxiety Inventory (BAI) was used.

While mean BDI scores were higher in patients with PCOS compared with control group, no significant difference was observed between the two groups in terms of BAI score. At the PCOS group; the total score of quality of life scale and the subscale scores of emotional deterioration, weight problems, infertility and menstrual disorders were significantly lower than the control group, but no significant difference was detected at the hirsutism subscale between the two groups.

PCOS has a negative impact on patients’ quality of life. To improve the quality of life of patients it should be taken into account the symptoms which are affecting the current state and the treatment should be planned toward this direction.

IDEA project is the outcome of Association for the Improvement of Mental Health programme and coordinated at Institute of Psychiatry, King's College London.

Are to explore experience of people treated in a mental health setting across nations, determine how inpatient experiences can be improved. Experience gained from interviews will be used to propose questionnaire for routine use, develop versions of interview for other services, inform a possible follow-up study.

30 consecutive patients are interviewed on day of discharge in own language. Semi-structured interview covers physical condition in institutions, experiences of treatments like medication, satisfaction with staff, privacy, dignity and whether rights were respected. Responses are summarized on several visual analogue scales and quantitative analysis will be performed. The scale will also be analysed by demographic indices within centres to see whether different groups have different experiences.

Qualitative responses will be analysed thematically, both within and between centres, identifying core themes for each domain and core themes for the protocol as a whole.

10 countries are participating, 577 interviews are completed. It is noticed a large disparity between institutions in regards to the amount of contact patients have with family, access to phone, quality of food, surroundings and view of medication and therapy.

It will be a better understanding of the size, structure and staffing of the institutions included in the study, which will help us with our observations about inpatient experiences by putting them in context and make recommendations to institutions.

A significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and affective disorders has been consistently reported in adults. Less data regarding the role of personality traits, and the influence of ADHD co-occurrence on clinical characteristics and outcome of mood disorders are currently available.

The sample consisted of 296 subjects, divided into three homogeneous groups according to demographic characteristics: 106 subjects diagnosed with major depressive disorder, 92 with bipolar disorders and 98 healthy controls. ADHD diagnosis was based on DSM-IV-TR criteria. Childhood and adult ADHD features were measured with the Wender Utah Rating Scale (WURS), the Adult ADHD Self-rating Scale (ASRS) and the Brown Attention Deficit Disorder Scale (ADD). The Hospital Anxiety and Depression Scale (HAD) and the Revised NEO Personality Inventory (NEO-PI-R) were also administered to the clinical groups, in order to investigate depressive/anxious symptoms and personality dimensions.

The prevalence of adult ADHD in subjects with bipolar disorders or major depressive disorder was 22.0% and 8.5% respectively (p < .001), compared to 3.1% in healthy controls. Significant associations between personality traits, depressive/anxious symptoms and ADHD features were found.

The present study emphasises the close relationship between affective disorders, especially bipolar disorders, and ADHD in adults. Our findings support the need to assess subjects with mood disorders in the clinical setting for possible co-existing ADHD and to further investigate personality traits to better understand the etiology of affective disorders and ADHD co-occurrence.

Atypical antipsychotics are frequently associated with increased risk of weight gain as side effect.

To compare body weigh alteration in psychotic disorder patients undergoing atypical neuroleptics therapy.

This study included 37 patients with mean age of 35,14 ± 1,57 years old, enrolled in a public mental health service with psychotic disorders related to the use of illicit drugs and schizophrenia.

Patients treated with atypical neuroleptics such as olanzapine (11) 0,28 mg/kg/day, clozapine (7) 1,56 mg/kg/day and risperidone (10) 0,031 mg/kg/day, were evaluated. Haloperidol (9) 0,072 mg/kg/day, as typical neuroleptics was also studied. Neuroleptics’ treatment period was 126,97 ± 20,93 days and the patients inicial body weight mean was 67,63 ± 2,13 kg.

Increase of body weight of 1,79 ± 0,72 kg was observed for patients receiving haloperidol, compared with olanzapine 10,37 ± 1,74 kg, clozapine 3,6 ± 2,10 kg and risperidone 1,21 ± 0,90 kg in the end of evaluation period.

These increase of body weight calculated in g/day were 31,68 ± 1,83 g/day for haloperidol, 99,54 ± 25,55 g/day for olanzapine, 27,44 ± 13,35 g/day for clozapine and 13,11 ± 1,40g/day for risperidone.

Increase of body weight index (BWI) at the end of the period of analysis was 0,66 ± 0,25 for haloperidol, 3,59 ± 0,63 for olanzapine, 1,52 ± 0,90 for clozapine and 0,40 ± 0,35 for risperidone.

These BWI increases identified per day were 0,011 ± 0,0038 for haloperidol, 0,034 ± 0,0085 for olanzapine, 0,011 ± 0,0057 for clozapine and 0,0039 ± 0,0055 for risperidone.

Although haloperidol, olanzapine, clozapine and risperidone act blocking serotonin receptors conducting to body weight gain, they probably act with different intensity degree of blockage.

Compulsory admission to psychiatric hospital in the United Kingdom (UK) is governed by the Mental Health Act (MHA). There have been concerns that the application of this legislation may be discriminatory, and that there is a trend towards increasing use of coercion.

To evaluate data on MHA assessments in order to determine overall outcomes; and whether there is evidence for a difference in outcomes based on variables such as age, gender, or ethnic group.

A database including around 99% of all such assessments was compiled from information recorded routinely at the time of the assessments by senior social workers who lead the assessments. This was analysed using SPSS statistical software.

There were clear statistical correlations with a number of variables including marital status, living alone and age. There was a slight but significant bias towards using shorter detention periods of up to 28 days for women, rather than longer up to six-month periods. However, despite this there was no overall evidence of gender bias.

This is the largest such study in the published literature and provides clear evidence of outcomes and trends in the use of coercive powers under the Mental Health Act in Norfolk, United Kingdom.