Compared with postpartum depression, validating self-reported questionnaires to detect depression during pregnancy has gained much less attention. Furthermore, it is not known whether it is appropriate to use the same cut-off point to detect depression in different trimesters of pregnancy.

One hundred and eighty-five Taiwanese women during pregnancy who completed the EPDS-T and the BDI-II were interviewed by psychiatrists with the structural interview, Mini-International Neuropsychiatric Interview (MINI), to establish DSM-IV diagnosis of major depressed disorder. We analyzed and compared the sensitivity, specificity, and validity of EPDS-T and the BDI-II against the MINI diagnosis in the second and third trimesters.

We identified 12/13 as the optimal cut-off of EPDS-T, at which the sensitivity of the scale was 83%, specificity 89%. The optimal cut-off of BDI-II was 11/12, at which the sensitivity of the scale was 74%, specificity 83%. The area under the curve (AUC) of the receiver-operating characteristic (ROC) analysis was 0.92 for EPDS-T and 0.84 for BDI. There were different optimal cut-off points of EPDS-T for detecting major depression during different trimesters: 13/14 for the second trimester and 12/13 for the third trimester. There was no different optimal cut-off point of BDI-II for different trimesters.

EPDS-T has a satisfactory sensitivity and specificity, and a better validity than BDI-II for detecting major depressive disorder during pregnancy in Taiwanese pregnant women. Although it is possible that different cut-off points should be used to detect depression in different trimesters.

This study aims to characterize the adults with ADHD in comparison to control individuals without a psychiatric diagnosis, in terms of symptoms of inattention, impulsivity and hyperactivity, presence of psychiatric comorbidity and socio-demographic profile.

Thirty-six individuals who were diagnosed with ADHD according to DSM-IV diagnostic criteria at the ADHD clinic for adults of the Marmara University Hospital, were included in the study. The control group consisted of 40 age and sex matched volunteers.

The socio-demographic characterization was done using a semi-structured interview. To evaluate the presence of psychiatric comorbidity, structured clinical interviews (SCID-I and II) were conducted by two general psychiatrists experienced in ADHD and trained in SCID administration. All groups were given SCL-90-R for general psychopathology assessment, Wender-Utah rating scale for childhood ADHD symptoms, and Beck DI for current depression rating.

The results of the study indicate that the adults with ADHD had poorer anger control (X2=8.904, p<.05). ADHD patients, in contrast to the control group, were more likely to have greater number of psychiatric diagnoses. (Wilks' Lambda= .597, p<.001 ; SCL90, F(71,1)=29.258, p,.001 ; SCID I: F(69,1)= 27.373, p<.001 ; SCID 2; F(69,1= 37.803, p<.001 ; BDI F(70,1)= 19.698, p<.001) The greater the number of comorbidities were more severe ADHD symptoms (SCID I: r=.621, p<.001).

The greater likelihood and the number of a psychiatric comorbidity are associated with more severe ADHD symptoms in ADHD patients. Functional impairment and treatment needs also increase as the number of comorbidities.

To examine the associations between tobacco use and a broad spectrum of mental disorders using longitudinal population based data over 20 years.

The data were derived from the Zurich Study – a longitudinal community study which started in 1979 with a stratified sample of 591 participants aged 20/21 years. Follow-up interviews were conducted at age 23, 28, 30, 35 and 41. Statistical analysis relies on logistic regression and longitudinal data analysis. The analyses focussed on smokers (having ever regularly smoked) and on strong smokers (having ever smoked more than 22 cigarettes per day).

In general, a lifetime diagnosis of mental disorders yields a heightened risk for smoking (OR ~ 4) and being a strong smoker (OR ~ 6) up to age of 40. The risk is particularly high in substance use, but also in dysthymia and bipolar diagnoses (OR > 15). At the other end of the scale are obsessive-compulsive disorder and bulimia with ORs almost similar to the general population. Simple phobia, agoraphobia, panic disorder and neurasthenia do not differ in terms of ever smoking, however their ORs are astonishingly high in strong smokers.

The risk of being (or having been) a smoker differs distinctly by mental disorder. This is most apparent in mood disorders. Moreover, in another group of disorders the amount of smoking interplays in a particular way. It seems unlikely that the causal linkage follows a consistent pattern.

The physical comorbidity of chronic psychiatric patients is affected not only by their psychiatric condition and treatment but also by the different access they have to health care facilities.

To record the medical morbidity of patients of the Psychiatric Hospital of Petra, Olympus, during its deinstitutionalization project.

The physical diseases of 196 chronic psychiatric patients (71.4% men), who were treated in long-stay wards or in community-based psychiatric facilities, were recorded during the autumn of 2003.

Circulatory and neurological diseases were the most prevalent between psychiatric patients, both affecting 62 (31.6%) patients. Hypertenstion, coronary heart disease, stroke and dementia were quite frequent, approximately as much as in the general population. Epilepsy and hypotension were markedly frequent, possibly due to association with their psychiatric condition and its treatment. It is remarkable that anemia was the most frequent physical problem (25.5%), while 13.3% of the patients had a history of bone fractures. 14.8% of the patients had gastrointestinal problems (mostly ulcers), 15.3% had endocrinological (mainly diabetes) and 8.7% respiratory conditions. Finally, incontinence, prostate hyperplasia and other urological diagnoses were found in 10.7% of the patients.

The (de)institutionalized psychiatric population seems to suffer by medical problems that are associated a) generally with their age and gender and b) specifically with their psychiatric condition and the side-effects of the corresponding medication. It is hoped and expected that the deinstitutionalization will help improve the treatment of the former without at least hindering the handling of the latter.

To estimate lifetime risk and ages of onset of mental disorders in the adult general population of Belgium.

For the World Mental Health Surveys of the World Health Organization, a representative random sample of non-institutionalized inhabitants from Belgium aged 18 or older (n=2419) were interviewed. The interview took place by means of the CIDI 3.0. Lifetime prevalence, projected lifetime risk, and age of onset were assessed.

Compared to lifetime prevalence rates, projected lifetime risk remains fairly stable for anxiety disorders, but is increased for mood and alcohol disorders: The lifetime risk for any mental disorder was 37.1%: 22.8% for mood disorders, 15.7% for anxiety disorders, and 10.8% for alcohol disorders. Prevalence estimates of mood and alcohol disorders were significantly higher in the cohorts between 18 and 34 years. Age of onset-distribution are presented for mood, alcohol and anxiety disorders.

This is the first study that assessed projected lifetime risks and ages of onset in the Belgian general population. A significant difference is noted between lifetime prevalence rates and projected lifetime risk. Median age of onset varies from disorder to disorder and younger cohorts had higher likelihood for developing mental disorders.

As a putative risk for mental disorders, particularly for schizophrenia, migration has reached an increasing interest. There are some evidences of high incidence rates of psychotic disorders in migrant populations. Most of the studies focus on inpatient, first-admissions samples. The aim of this study is to compare the rates of treatment for mental disorders between native-born and migrant patients in an outpatient setting.

A retrospective analysis of all patients (n= 3619) attended throughout the latest 3 years at an outpatient resource involving and area of 92234 inhabitants was carried out. Demographic variables (age, sex, country of birth) and clinical data (diagnosis at first contact and at follow-up, DSM-IV criteria) were collected. Patients were divided in two groups: natives (n=3486) and immigrants (n=133). Comparisons between both groups for the rates of any mental disorder and for syndromic diagnoses were performed.

Compared to native patients, immigrant patients showed higher rates of psychotic disorders (15.2% vs 4.2%, p<0.001, chi square; OR=3.6, 95% CI=2.1-6). As a striking finding, all of the “not specified” diagnostic categories (psychotic disorder NOS, bipolar disorder NOS, depressive disorder NOS, anxiety disorder NOS) were significantly more prevalent in the migrant group.

Among the patients referred to an outpatient mental health resource, a higher prevalence of psychotic disorders in migrants compared to native patients was found. The higher rates of not specified diagnoses in immigrant patients underlines the hazard of misunderstanding their symptoms and, therefore, to overestimate the prevalence of severe disorders in this group.

The objective of the present paper was to assess associations between parental agressive behaviour and agressive behaviour in adolescents, as well as to define the possible correlation between the parental agression and the psychopathology presented by the adolescents.

We surveyed 100 adolescents in the age from 14 years to 16 years and their parents. Adolescents and their parents fullfilled set of self-rating scales. Adolescents completed the Overt agression check-list, Beck depression inventory and the Scale for evaluation of bullying behaviour in their schools. Their parents also completed Overt agression check-list and Beck depression inventory.

Adolescents who presented themselves as bullies in school had more agression in their families than those adolescents who were not involved in school violence. Also adolescents whose parents had high scores on the Beck depression inventory and had autodestructive impulses had statistically higher scores on the Overt agression check-list compared with other group of adolescents whose parents were not depressed. We documented that 17% of adolescents were victims of school bullying. Those adolescents had statistically significant higher scores on the Beck depression inventory than the adolescents who were not involved in the school violence.

The present study revealed that the level of agression in families has influence on the agressive behaviour of adolescents in their schools.

We assessed the prevalence of lifetime suicidal ideation and associated psychosocial factors among Viennese secondary school pupils.

An anonymous self-report survey which assessed the major psychiatric risk factors of teen suicide, as well as demographic characteristics, was completed by pupils of three Viennese secondary schools (n=214).

Eighty-one (37.9%) secondary school pupil reported ever having suicidal thoughts, girls significantly more often than boys (48.5% vs. 29.1%, p=.004). Furthermore, lifetime suicidal ideation among Viennese secondary school pupils was associated with living in “broken-home” families, cigarette smoking, substance problem (alcohol/drugs), self-reported depression, and school type. After adjusting for confounders, we found that female gender, substance problem, school type and cigarette smoking were significantly associated with lifetime suicidal ideation among secondary school pupils in Vienna.

In context of suicide prevention, attention should be paid to the psychosocial factors associated with pupils' suicidal ideation.

There is little data about assessment of general health among Iranian adolescents. We aimed at studying the general health of 3rd grade high school students in Tehran.

In a cross sectional study representative sample of 3rd grade high school students were selected using multistage random sampling taking each school as cluster. The General Health Questionnaire (GHQ12) was administered to the students in absence of the teachers. Questions about physical activity and demographics were also included. The cut off value for GHQ score was determined using Receiver Operating Characteristic (ROC) curve against self reported general health taken as gold standard. The scores equal or higher than the cut off were assumed as high.Proportion of the students with high GHQ score was calculated by age and sex. Comparison of the proportions was made using Chi square test.

Of 4842 students studied 55% were 17 and 45% were 18 years old. It included 2444 (56%) girls.The cut off of 4.5 for GHQ score was obtained. The area under the curve was 0.89 (0.95CI, 0.85-0.89, p<0.001) with sensitivity of 0.86 and specificity of 0.69.The proportion of high GHQ was 46% and the girls had higher (49.8% versus 40.5%) (p<0.001). The high GHQ score in 18 years old was higher than that for 17 years old students (928,48.2% vs.1040,43.6%, p<0.005). Those who assessed their general health as"very good" had lower GHQ score than those who assessed themselves as "very bad" (410, 29.4% vs. 54, 84.5%) (p=0.000). Students with higher level of physical activity had lower GHQ score comparing with those with lower physical activity (490,35.4% vs. 660,63.5%) (p=0.000).

Proportion of minor mental disorders is high in Adolescents. Girls are more vulnerable to the mental disorders. Better mental health was associated with higher levels of physical activity.

Previous studies, based on clinic samples, report that enuresis in children is associated with behavior problems but the relationship between behavior problems and enuresis remains controversial. This population-based study investigates the prevalence and behavioral correlates of enuresis in a group of preschool children.

This cross-sectional survey involved 370 parents and their 5 to 7 years old children, all residents of Istanbul, Turkey. Parents completed the Child Behavior Checklist and sociodemographic data form. Fifty-three children with enuresis were compared to 303 nonsymptomatic children. Differences in the mean scores and the percentages of children falling beyond preselected clinical thresholds were compared across the groups.

The prevalence of enuresis was 14,9 and enuresis was more frequent among boys. Children with enuresis were reported by their parents to have greater social problems and total problem scores compared with control children (p = 0,019, p = 0,048 respectively). However there were no differences in the percentages of children falling beyond preselected clinical thresholds among the groups.

Enuresis is common in 5 to 7 years-old children. As a group, children with enuresis differ from children without enuresis on behavioral parameters, children with enuresis had the higher mean scores of behavioral problems than do controls, however clinically relevant behavioral problems did not showed differences between groups. Given the inconsistent research findings across studies, the longitudinal research and outcome effect studies could help determine whether there is a causal relationship between psychopathology and enuresis.

Andalusia is the most highly populated (7,849,799 hab.) region of the Spanish State. It has all the sanitary domains under its own Health Service (Consejería de Salud), and it has undertaken a deep reorganization of the psychiatric services, establishing a new model based on the mental health communitarian alternative that is already completely implanted. Rates of readmission are a method to assess the quality of care and an important tool in the planning of services of mental health.

The aim of this study is to establish if readmission rates are influenced by Human Resources in Psychiatric Community Devices.

Part of FIS Project PI05/90061 ‘Patterns of General Hospital Psychiatric Units Overuse’.

MBDS is a system of hospital register that gathers all the discharges produced in the andalusian hospitals. It is totally trustworthy from 1995, and we have processed data up to 2004.

Our Data Set register 101234 hospital admissions of psychiatric patients.

The number of admissions from patients who enter three times or more throughout the year has been: 22.66%(1995); 24.66% (1996); 31.01%(1997); 30.72%(1998); 34.07%(1999); 35.35%(2000); 36.92%(2001); 32.93%(2002); 31.20%(2003) and 29.36%(2004).

On the other hand, it has been an increase in Mental Health Human Resources Rates: 24.23-100.000 inhab-(1998); 24.19 (1999); 26.01(2000); 28.04(2001); 29.83(2002); 29.16(2003); 29.34(2004) and 29.90(2005).

Increasing human resources in psychiatric community devices do not change revolving-door rates in general hospital acute psychiatric units in a community mental health system.

South Tyrol is a province of Italy bordering on Austria with 500.000 inhabitants, comprising three different ethnic- linguistic groups (German, Italian and Ladin) whose suicide rate is two times higher than the Italian average.

Goal of the research: The following ecological research tries analyse the existence of some risk factors that differentiate South Tyrol from the rest of Italy explaining the greater number of suicides.

Between 1999 and 2006 almost 300 suicide cases were gathered and analysed with the descriptive interference method. The records have been elaborated considering different variables.

Among the results two records are of particular interest:

1. 1. A significantly higher risk of suicide in the German speaking population compared to the Italian one (the records of the Ladin speaking population are not significant).

2. 2. There is a higher suicidal tendency in the rural areas compared to the urban ones.

Such as in all epidemiological descriptive surveys there is no causal explanation for the instance that the German speaking group is characterized by a suicide risk which is 1,3 times higher than the Italian speaking group. It remains unanswered if the high number of suicide in the German speaking population is due to a selection variable; for example that the areas populated by the latter (mainly rural areas) present another variable (high alcoholism, different familiar cohesion, etc.) than the mother language. In this case the affiliation to a linguistic group would be considered a confusing variable among other causal factors.

Sudden Infant Death Syndrome (SIDS) is the main cause of infant death in the first year of life. SIDS has been linked to psychiatric disorders in three previous studies. We therefore aimed to investigate whether there is an association between Sudden Infant Death Syndrome (SIDS) and psychiatric disorders.

We used a case-control study design. Cases were women registered with a general practice on a UK primary care database with a live birth between 1987 to 2000 and a subsequent SIDS. Controls were women matched for general practice with a live birth born in the same index year as the matched SIDS, with infant survival for the first year of life. Conditional logistic regression analysis examined the effect of maternal psychiatric disorders and potential confounders. Results:169 linked mother-infant cases of SIDS were matched with 662 mother-infant controls. SIDS was independently associated with a history of depression in the year before birth and male gender. There was weak evidence of an association of SIDS with depression in the 6 months after birth.

Perinatal depression is associated with SIDS; women with perinatal depression need optimal treatment and advice on preventative behaviours to reduce the risk of SIDS.

There is an inequity in resource utilization among psychiatric in-patients. About 20-30% of them absorb 60-80% of the total resources allocated to this form of treatment. To develop interventions to contain this utilization pattern requires an agreement on a definition of who is a “heavy user”?

Using data from a random sample (n = 15000) from the annual Swiss Hospital Survey we compared different definitions of heavy service use as to their usefulness to map and quantify the effect of interventions targeted to reduce inequity of resource consumption.

To deal with heavy service use necessitates to take a look from different levels of service provision. To create a satisfactory definition that can be generalised across different service systems seems out of reach at an individual level. However, various inequity indices commonly used in economic sciences (e.g. Gini-index) are well suited to specify heavy service use from a systems level.

Quantifying the heavy service use from a systemic level allows for an estimation of the impact of services targeted to contain heavy service use.

Adolescence characterise frequent psychical crisis which are result of biological development, looking for own identity, changes in family relation and many socio-cultural influences. Bosnia and Herzegovina is a country with postwar society, currently going through transition period. Therefore various risk factors for drug abuse can be found here, such as: economical, social and health.

The main objective was finding how many adolescents had risk behavior and its subsequences.

Research has done in urban and rural areas of Sarajevo canton, involved 368 adolescents: male 170, female 198, aged 12-17 equal urban and rural distribution. In research used risk behavior questionnaire Q 2004 (K.B.Kelly 2000).

Out of total number of individuals in the study 25.8 percent was cigarette smokers, 39.4 percent consumed alcohol, 2.2 percent consumed marijuana.

Among group who use tobacco 33.7 percent have fight twice or more in the last two years; suicidal thoughts: 36.8 percent. Similar results were found among individuals who abuse alcohol: fighting 44.8 percentt: suicidal thoughts 32.4 percent. Among youngsters who abuse marijuana: fighting: 87.5 percent, suicidal thoughts 50.0 percent.

Bad score in school had 12.6% individuals who smoke, and 21.5% are truant. Similar results were among adolescents who drink alcohol: 10.3% had bad school performance and truant was 17.9%. Among marijuana group: bad score 12.5% and truant was 87.5%.

These results were compared with adolescents who don't abuse drug.

Adolescents tend to abuse psychoactive substances in developing countries. These results could be used to develop an appropriate prevention strategy.

Up to 45% of individuals who commit suicide contact their Primary Care physician (PCP) the month before. The objective is to study clinical characteristics of patients presenting death and/or suicidal ideation (SI) in Primary Care.

195 patients attending their PCP were evaluated using systematic sampling in three Primary Care Centres. Patients completed the PHQ and a Life Changes Checklist. Demographic data, both psychiatric and medical conditions and treatments, visits to their PCP, and days out of work (last year) were also collected.

24 patients had death or suicidal ideation for the previous two weeks (12,4%; IC95% 8,3-18,8%). Most of them (87,5%) had a mental disease, major depressive disorder (62,5%) and general anxiety disorder (50%). Patients with SI had more somatic symptoms (p<0,001), a greater number and score of recent life changes (p<0,001) and days out of work (last year) ((p=0,028) than the rest of the sample.

Compared to patients with any psychiatric disorder, patients with SI had more depressive symptoms (p<0,001) and a higher score in life changes in the 6-12 month period (p=0,044).

14 (58,3%) patients with SI had no previous psychiatric diagnosis and only 8 (33%) were receiving treatment.

In spite of a greater severity in depressive and other clinical characteristics of patients with SI most of them are not correctly detected and treated. Improving the rate of detection and treatment by the PCP of such patients would probably play a key role in the prevention of suicide.