To describe the admissions due to dementia in an acute psychiatric unit in the last decade, in patients aged over seventy.

Medical records of all patients over seventy admitted in an acute unit of a Psychiatric Hospital in 1997 and 2007 are analyzed.

Over the last ten years, the percentage of patients diagnosed with dementia compared to the total number of patients over seventy admitted in this acute unit, has hardly decreased.

Despite the fact that in the last decade neurologists have widespread the use of various drugs in the treatment of dementia, the number of patients admitted to our psychiatric unit, in order to control the accompanying symptoms (delusions, abnormal conduct, etc), remains stable.

Moreover, given the progressive aging of the population and the consequent increase in the number of cases of dementia among the elderly population, perhaps the fact that the number of admissions in the unit has not increased is positive itself.

To describe the characteristics of the admission of those older than 70 in the past year, in an acute psychiatric care unit.

Medical records of all over 70 patients admitted in our unit during 2007 are reviewed to find out their diagnosis, how many are first admissions and their average stay time, and this is compared to general average stay time for this unit.

About 10% of patients admitted to this unit is more than 70. the most frequent diagnosis is depression, followed by bipolar disorder, dementia, psychosis and other diagnoses. Nearly half of all these patients are in their first admission. the average stay of these patients is twice that of the total patients admitted to this unit.

Despite the fact that in some places the number of admissions of elderly patients is not considered enough to justify the creation of specific units, objectively their admissions are frequent and their average stay time is much higher than usual. This is probably both the difficulty of drug treatment and social problems that sometimes hampers their discharging. as the elderly population is increasing, we believe that treating these people in specific units should be reconsidered.

To analyze the characteristics of the admissions of elderly patients in an acute psychiatric unit in recent years, to see if there have been any changes in the number, the average stay or in their referral from the hospital.

Details of all admissions in a psychiatric unit for acute patients aged over 65 since 1999 are collected by means of a computer system. the number of admissions, the average length of stay and where they go when discharged are taken into account.

In recent years the number of patients over 65 entering our unit has remained relatively stable. the average stay time remains high over all the studied years. It is proved that a large number of patients need to be moved to residences or other assistive devices when discharged.

Despite the increase in elderly population, the number of patients over 65 who enter this unit has not significantly increased. their average stay remains always high over the years. It is striking the number of patients who can no longer go home when discharged, once they have been admitted.

In meridional European countries such as Portugal, informal caregivers are almost always close relatives, either key-relatives (those more involved) or not. There are few systematic comparisons between the experience of key-relatives/primary caregivers (PC) and other/secondary caregivers (SC) in psychogeriatrics. We present some preliminary data from the FAMIDEM (Families of People with Dementia) survey.

Non-randomised cross-sectional study comparing two related samples of caregivers (PC versus SC) of 41 patients with DSM-IV dementia from outpatient practices in Lisbon (Portugal). Caregivers’ assessments included: Zarit Burden Interview, Caregiver Activity Survey (CAS), Positive Aspects of Caregiving, GHQ-12, Social Network Questionnaire and Dementia Knowledge Questionnaire.

Patients’ mean age was 78,7 years (SD 7,9). 24 (58,5%) were women and 58,5% had Alzheimer disease.PC were older than SC (p=0,000) and tended to live with the patient (p=0,000). They reported less emocional support (p=0,021) but higher objective burden-CAS (p=0,002). Regarding all other outcome variables, significant differences between groups were not found. Within the global sample, comparing spousals (n=23) and adult children/other relatives (n=59) yielded interestingly different preliminary results, eg higher GHQ-12 levels (p=0,010).

The experience of caregiving is possibly different regarding PC and SC, but further research is warranted in order to define who really is at risk. Being a spouse may be much more determinant, although most spouses are PC as well. for the moment, it seems prudent not to exclude SC from risk assessments. the final FAMIDEM results, even lacking generalizability, will probably provide interesting clues.

To investigate the relationship between psychological well-being and measures of active ageing in a British sample of older people. Active ageing is the process of optimising opportunities for health, participation and security to embrace quality of life as people age.

A national survey of quality of life and psychological well-being including 999 people aged ≥65 years living in private households in Britain commenced in 1999. in the most recent follow up of 2007, 323 survivors aged ≥72 years completed a postal survey regarding their quality of life and specifically the process of active ageing. A subset of 42 participants was also interviewed qualitatively in 2008 about their perceptions of active ageing. Psychological well-being at baseline was measured using the 12 item General Health Questionnaire (GHQ12) and correlated with measures of active ageing at baseline and in subsequent follow ups. Measures of active ageing included number and frequency of leisure and social activities, physical ability and access to support networks.

A significant positive relationship between psychological well being and measures of active ageing was found at baseline (p< 0.05). Measure of active ageing in 2007 were also correlated with psychological well-being at baseline (p< 0.05). Qualitative interviews in 2008 provided additional insights into this relationship.

Results suggesting a strong relationship between psychological health and ageing actively. Good psychological health may allow the elderly to maintain an active and fulfilling lifestyle and reduce isolation and dependence, which in turn may protect against some aspects of poor mental health.

Today, about 10% of the world population are older than 65 and even it is about 30% in some of society. According to growing of population in the word and in Iran and also high prevalence of psychiatric disorders in this group, demographic and epidemiological studies are necessary.

From 1422 subjects 59 years or older, who were live in Ekbatan district of Tehran, 313 subjects were chosen randomly. Finally 204 subjects were enrolled and completed the questionnaires of GDS-15, GHQ and CES-D. from study sample, 104 subjects were selected randomly and interviewed by CIDI to validate psychiatric disorders.

According to our study, 53.4% of subjects were women and 46.6% of them were male and 63% of the population were between 60-75. the life time prevalence for all psychiatric disorders were 35% and the period prevalence were 17.5%. 25.2% of subjects had only one psychiatric disorder and 6.8% and 2.9% of them had two and three or more psychiatric disorders, respectively. the most prevalence of psychiatric disorders were Major depressive disorder, Dysthymic disorder, OCD and PTSD, respectively. Some subjects had not engaged in treatment.

The results of this study revealed that the psychiatric disorders in Iranian geriatric population are common. It seems that these results can be helpful for mental health services.

Delusional misidentification syndromes are widely present in several psychiatric and neurological disorders in the geriatric population. Numerous studies witness growing evidence of organic background in different misidentification syndromes and reduplications.

The authors present a case of a patient with dementia, vascular type where clonal pluralization of the Self appeared as a secondary interpretative delusion after a hallucinatory type of autoscopic experience. the 86-year-old patient was referred to our department because he was talking continuously to his so-called ‘twin’. He considered his experience as a miracle to be investigated by a special medical staff. We discuss the distinctive characteristics of the presented case from other delusional misidentification syndromes and from other psychopathologic and neurological symptoms.

In the presented case the linear evolution and the interpretative aspect of the arising delusional misidentification phenomena were predominant. Overviewing the broad spectrum of concepts on delusional misidentification syndromes, we emphasize the importance of those approaches which enhance the disappearance of the classical functional-organic dichotomy on the double phenomenon and which try to clarify the neurocognitive background of delusional misidentifications.

To estimate the prevalence of depression and of depressive symptoms among older people living in retirement homes within Penacova county. to estimate the percentage of elderly depressed people receiving adequate treatment. to study associations between recorded clinical variables and depression.

We visited all the retirement homes of Penacova County to interview institutionalized men and women older than 64 years, applying a semi-structured protocol that included GDS (geriatric depression screening scale), MMSE, pain scale, Clock Drawing Test, Barthel Index and BSI (Brief Symptom Inventory).

We included 78 subjects (22 Men and 56 Women) with a mean age of 81.3 years. among them 29 were illiterate, 34 had < 4 years of education, 13 had 4 years of education and 2 had a university degree. 56 were widowers and 49 were born in Penacova. the mean GDS value was 17.27. 19,2% were not depressed, 46.1% were depressed and 34,6% were severely depressed.

These results suggest that depression is a common problem affecting older people living in retirement homes. A significant percentage of depressed patients were not adequately treated. This study highlights the importance of screening this population for depression.

Recent studies suggest that the metabolic syndrome and inflammation affect cognitive decline in old age due to vascular risk factors that might cause leukoaraiosis. It is not known which components of the metabolic syndrome are mostly involved.

There were included 60 subjects aged 65-90 years divided in two groups: group A-30 subjects diagnosed with metabolic syndrome according to NCEP-ATP-III criteria; group B-30 subjects used as control for the study group. Inflammation was assessed by measuring the C-reactive protein (CRP) plasma levels. Cognitive assessments included general cognition exam using Mini-Mental State Examination. the subjects underwent head CT-scan in order to observe the presence of the leukoaraiosis. the mild cognitive impairment (MCI) was considered when the MMSE score was between 28-21points.

In group A 25 of the subjects presented MCI, while in group B only 13. in group A hyperglycemia was most strongly associated with cognitive function being identified in 80% of the subjects, followed by inflammation (CRP levels>1mg/L), present in 76.6% of the subjects. the subjects from group B presented hyperglycemia in 20% of the cases and high CRP levels in only 16.6% of the subjects. Leukoaraiosis was present in 60% of the subjects in group A, and in 23.3% in group B.

Subjects with metabolic syndrome had a poorer cognitive performance than subjects without metabolic syndrome at general cognition exam. in those subjects with metabolic syndrome hyperglycemia and inflammatory status were most frequently encountered when considered the association with cognitive impairment and was noticed a higher incidence of leukoaraiosis.

The work reported in this paper was supported by grant PNCDI2-41-057/2007 from the Romanian Ministry of Education and Research.

Despite the well established genetic basis of schizophrenia, the relationship between genes and the disorder itself is still elusive. Individual endophenotypes, which reduce the complexity of genetic analyses, allow statistical approaches with quantitative trait methodologies. P200 abnormalities of event-related potentials have been reported in schizophrenia with conflicting results. the present study aims to characterize the P200 in first-episode patients and to compare it with that of first-degree relatives and controls.

ERPs were recorded at 19 sites with an auditory oddball for 21 first-episode patients with schizophrenia (mean age=25.14; SD=6.20), 41 of their first degree relatives (mean age=47.65; SD=15.53) and 19 healthy controls (mean age=26.32; SD=7.16). Potentials were averaged for frequent stimuli and P200 amplitude and latency measures were obtained.

Analysis of midline electrodes revealed significant group effects for P200 peak amplitudes (F(2, 78)=3.315, p=.042), but not for peak latencies. Post-hoc analyses revealed that patients with schizophrenia present significantly lower P200 amplitudes (M=2.466; SD=1.564) than controls (M=5.037; SD=2.500) at Pz (T(38)=3.851, p=.003). No other significant differences were found.

The results obtained do not straight-forwardly support the P200 peak amplitude nor peak latency as an endophenotype of schizophrenia. However, the trends of our results may suggest that the P200 amplitudes of relatives may present intermediate values between healthy controls (with higher amplitudes) and patients (with lower amplitudes). Further statistical analyses will be required in order to disentangle the effects of possible confounding variables.

Parental pychosis can have a major impact on the household and studies indicate that they increase the risk of children developing behavioural, social, emotional and educational problems (Royal College of Psychiatrists, 2004). to our knowledge, there is scarce information available about the mental health status of the sons and daughters cared by psychotic inpatients. Potential interventions that mental health services could adopt by screening this at risk population are missed.

To assess the mental health status of the children cared by the psychotic inpatients admitted to an acute mental health ward in Porto. to determine the number of children that fulfill criteria of mental illness and of those at risk. to refer this population to a specialist clinic.

Prospective study: we will screen the sons and daughters of all the inpatients admitted with psychosis between the 1st September 2008 and the 30th November 2008 to a busy acute inpatient ward at Hospital Megalhães Lemos, Porto. We will use the Robert Goodman Strenghts and Weaknesses Questionnaire for the 18- year old and below and the SCL-90 for the adult population. the population that fulfills criteria for mental health problems and the ones that are identified as at risk will be referred to a specialist clinic and followed-up by an experienced psychiatrist.

To identify and quantify a vulnerable population at high risk of developing mental health problems and offering an early intervention may proove to have an important impact in the household wellbeing.

In some different studies, a high prevalence of interpersonal trauma especially childhood abuse as well as posttraumatic stress disorder (PTSD) has been found in patients with several mental illness (SMI): schizophrenia, schizoaffective and bipolar disorder.

The aim of this study was to determine the prevalence of the traumatic life events and PTSD in a sample with SMI.

We enrolled adults patients with schizophrenia, schizoaffective disorder or bipolar I disorder. We excluded patients who score 3 or more in conceptual disorganization, hallucinations and/or unusual contents of the Brief Psychiatric Rating Scale (BPRS) and 4 or more in another item of this scale. Interventions: sociodemographic date and Traumatic Life Events Questionnaire and Distressing Event Questionnaire.

78 patients (52.6% men) with a mean age of 40 years. Diagnostic of the sample: 47.5% schizophrenia, 41% bipolar disorder and 11.5% schizoaffective disorder. Traumatic life events in the childhood: physical abuse, 22.1% (22.5% males and 21.8% females); psychological abuse, 26.9% (14.6% males and 40.5% females, p< 0.05); sexual abuse, 28.2% (21.9% males and 35.1% females).Some abuse in childhood, 48.0% (38.1% males and 62.2% women, p< 0.05).

Sexual abuse in adulthood: 25.6% (43.24% females and 9.7% men, p=0'05).

PTSD, 12.9% (8.3% males and 20.7% females).

Almost the half of the patients have biographical history of traumatic life events in the childhood. These traumatic events are significantly more prevalent in females. in adulthood, almost half of women had suffered sexual abuse.

A fifth part of the women with SMI have comorbidity with PTSD.

Modern computers often use programs that incorporate a programming technique called Object Oriented Programming (OOP), allowing users to manipulate complex ‘computational objects’ such as menus, screen windows, etc with very little effort, say the click of a mouse. OOP deals with structures called objects and allows time and computational effort saving devices such as inheritance, polymorphism and encapsulation. We examine whether the brain itself may use OOP and if representation of objects suffers a breakdown in schizophrenia.

Previous models fail to provide a unifying explanation with a computational basis that could explain the psychopathology in schizophrenia. METHODS Using the object oriented programming language JavaTM we designed a system of self-objects named ‘hand’, ‘action monitor’ etc interacting with non-self objects ‘scissors’, ‘hammer’, ‘wall’, etc. in computational experiments, we allow the ‘action monitor’ to fail; the features of disparate objects are allowed to merge, some features of an object are allowed to be shared with other objects, etc.

By transposing only a few lines of code, it is possible to duplicate various features of the psychopathology of schizophrenia.

Our model can demonstrate overinclusion (overabstraction), concrete thinking (underabstraction), loss of ego boundaries (conjoining of disparate objects), delusions (misattribution of object function), lack of insight (poor monitoring of object activity) and passivity (loss of monitoring and misattribution of object activity).

The brain must use the OOP model in its computations. Failure of object representation and manipulation must lie at the core of the psychopathology of schizophrenia.