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.

Several instruments have been developed to detect subjects who are at risk for mental disorders.

We aimed to address the predictive validity of several personality, schizotypal and mania scales for psychiatric hospitalisations.

As part of the 31-year follow-up survey of the Northern Finland 1966 Birth Cohort, Temperament and Character Inventory (TCI, temperament part), Physical Anhedonia Scale, Social Anhedonia Scale (SAS), Perceptual Aberration Scale, Hypomanic Personality Scale (HPS), Bipolar II scale (BIP2) and Schizoidia scale were filled in by 4,857 subjects. We dichotomized scores in the scales (highest 10% by gender vs. others). Also subscales of TCI and BIP2 were used as predictors. In a longitudinal study setting using hospital discharge register we followed those without previous hospitalisation (N=4,727; 2,092 males and 2,635 females) from 31 years for eight years and recorded hospitalisations due to psychotic, substance use, anxiety, mood and personality disorders.

In total 78 (1.7%) of subjects were hospitalized due to psychiatric disorder during the follow-up. Most of the instruments predicted several disorders. Mood lability subscale of BIP2 predicted (p<0.05) all diagnostic groups. Most specific predictors were SAS (Odds Ratio 3.84; 95% CI 1.44-10.28) and HPS (4.01; 1.52-10.60) for psychosis and novelty seeking subscale of TCI (3.00; 1.41-6.36) and energy/activity (2.68; 1.26-5.68) and social anxiety (3.90; 1.84-8.28) subscales of BIP2 for substance use disorders.

Scales measuring schizotypal or manic symptoms were good predictors for different psychiatric hospitalisations. Many of the scales predicted several disorders, only few scales predicted only one specific disorder.

There is no empirical research on the occurrence of postnatal psychiatric morbidity in Spanish population. To determine the prevalence rate of DSM-IV psychiatric disorders in postpartum Spanish mothers.

A two-phase cross-sectional epidemiological study. Women consecutively attending in the routine postnatal check-up (at six weeks after delivery) in the Department of Obstetric and Gynaecology of the Clinic Hospital during one year were included. In the first phase, 1453 women were screened with the EPDS. In the second phase, based upon EPDS outcomes, participants were stratified and randomly selected within each stratum for clinical evaluation with the Structured Clinical Interview (SCID) for DSM-IV to determine psychiatric status. Weighted prevalence and its 95% Confidence Intervals (95%CI) were obtained for DSM-IV diagnostic groups.

The overall 6-weeks prevalence rate for postpartum psychiatric disorders was 18.1% (95% CI 15.0-21.8). The most prevalent DSM-IV diagnostic group was mood disorders (9.8%; 95% CI 7.9-12.1), follow-up by adjustment disorders group (4.3%; 95% CI 3.0-6.3), anxiety diagnostic group (3.9%; 95% CI 2.5-5.8) and “other” disorders group (1.1%; 95% CI: 0.3-3.8%).

This results shows the heterogeneity of postnatal psychiatric morbidity. We found that DSM-IV diagnosis of mood disorders in postpartum women were more prevalent than anxiety disorders, in contrast with recent studies in postnatal community women. Clinical and research evaluation of mental health in postpartum women should include a full range of mental disorders.

This study has been supported in part by grant 13/00 from Ministery of Work and Social Affairs, Institute of Women, Spain.

Anxiety disorders are one of the most frequent disorders. The main goal is the estimate the half-year prevalence of Generalized Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD) in Slovak population.

The design of EPIA study is cross-sectional. The subjects in common population were identified by age,sex,education,region, nationality.We used anxiety section of MINI(Mini-International Neuropsychiatric Interview), part for GAD and SAD. Data were collected by trained interviewers (students of Comenius University in Bratislava). Different statistical methods were used for data analyses.

1251 subjects (a representative sample) were involved into the study, 48,2% men and 51,8% women. Mean age of whole sample was 42,82+-17,1 years. The 6-months prevalence of GAD was 4,0%, of SAD 1,7%. The prevalence of GAD and SAD was slightly higher in women than in men. Most participants with GAD were in age between 40 and 49 years. Participants with SAD were equally distributed in age group 18-39 years as in the age group 40-59 years. We compared our results with some similar findings in EU and USA.

The prevalence of GAD is slightly higher than in ESEMED study(GAD=2,8%). Prevalence of SAD is slightly lower. (ESEMED SAD=2,4%).

We investigated the links between familial loading, preadolescent temperament, and internalizing and externalizing problems in adolescence, hereby distinguishing effects on maladjustment in general versus dimension-specific effects on either internalising or externalising problems.

In a population-based sample of 2230 preadolescents (10-11yrs) familial loading (parental lifetime psychopathology) and offspring temperament were assessed at baseline by parent report, and offspring psychopathology at 2.5-year follow-up by self-report, teacher and parent report.

Familial loading of internalising psychopathology predicted offspring internalising but not externalising problems whereas familial loading of externalising psychopathology predicted offspring externalising but not internalising problems. Both familial loadings were associated with Frustration, low Effortful Control, and Fear. Frustration acted as a general risk factor predicting severity of maladjustment; low Effortful Control and Fear acted as dimension-specific risk factors that predicted a particular type of psychopathology; whereas shyness, high-intensity pleasure, and affiliation acted as direction markers that steered the conditional probability of internalising versus externalising problems, in the event of maladjustment. Temperament traits mediated a third of the association between familial loading and psychopathology. Findings were robust across different composite measures of psychopathology, and applied to girls as well as boys.

It is important to distinguish general risk factors (Frustration) from dimension-specific risk factors (familial loadings, effortful control, fear), and direction markers that act as pathoplastic factors (shyness, high-intensity pleasure, affiliation) from both types of risk factors. About a third of familial loading effects on psychopathology in early adolescence are mediated by temperament.

Prevalence data of aggressive behavior and its management in schizophrenia during acute episodes is scarce in Europe. The available data comes from studies conducted in small samples from single centers and do focus on pharmacological interventions.

To document the prevalence of agitation-hostility among patients and management strategies in Spain.

Cross-sectional survey during an hospital admission at specialized acute units. Selection criteria included patients with a diagnosis of Schizophrenia according to DSM-IV-TR criteria, attending the hospital for admission. Information regarding clinical profile, sociodemographic data, work status, severity of the disease by using the Clinical Impression of Severity Scale disease-specific (CGI-SCH) was collected. Aggression and hostility were recorded at admission by using the PANSS-EC subscore, and aggressive behaviors during the hospitalization period by the Overt Aggression Scale (OAS). Therapeutical management was also recorded at three time points, at admission during hospitalization and at discharge.

800 patients were recruited by 200 clinicians from 120 specialized psychiatric units across the country. Prevalence data for agitation-hostility in Spain is provided. For those patients showing aggressive behaviors during the hospitalization period, information concerning intensity and type of aggression is also described. Its associated management strategies are provided.

Prevalence data of agitation-hostility in patients in acute settings is valuable as well as understanding the routine practice applied to its management. This comprehensive work could represent a basis for the development of a consensus guideline for clinical practice at specialized acute units.

The Netherlands Study of Depression and Anxiety (NESDA, www.nesda.nl) is an ongoing study to: 1) describe the long-term course and consequences of depressive and anxiety disorders, and 2) to examine the demographic, psychosocial, somatic, biological and genetic determinants of this course. This presentation describes NESDA's rationale, sampling frame and methods.

The design is an 8-year longitudinal cohort study following 2,850 participants aged 18 through 65 years. The sample consists of 1600 persons with a current (6 month recency) diagnosis of depression or anxiety disorder, 850 persons at risk (because of high symptomatology, family or life-time history), and 400 healthy controls. Recruitment takes place in the community, through 65 general practitioners (using a three-stage screening procedure), and through 17 mental health care institutions in order to include patients reflecting various settings and stages of psychopathology. The 4-hour baseline assessment includes questionnaires, interviews, a medical exam, a computer task and blood (including DNA and RNA) and saliva collections. Follow-up assessments are repeated after 1, 2, 4 and 8 years.

Over 2500 respondents with more than 2100 current diagnoses of depression or anxiety disorders, were recruited in November 2006 (mean age = 41 years, 67% female). Expected end date of recruitment is in February 2007.

NESDA is expected to provide more insight into (predictors of) the course of affective disorders. NESDA is open for collaboration (including data utilization) with other European research groups, which we hope to stimulate by a presentation of its design and methods.

Alcohol abuse has long been considered an important factor of suicidal behavior. The solid body of research and empirical evidence suggests that hazardous pattern of alcohol consumption (binge drinking) lead to quicker and deeper intoxication, increasing the propensity for alcohol-related suicide. Purpose: To estimate the aggregate level effect of binge drinking on suicide rate.

Trends in age-adjusted, total and sex-specific suicide and fatal alcohol poisoning rate in Belarus from 1970 to 2005 were analyzed employing ARIMA analysis in order to asses bivariate relationship between time series.

According to official statistics, the suicide rate increased 1.8 fold (from 17.6 to 30.8 per 100.000 of population) and fatal alcohol poisoning rate increased 6.8 fold (from 4.9 to 33.5 per 100.000 of population) in Belarus from 1970 to 2005. The results of time series analysis indicate the presence of statistically significant association between two time series at zero lag for total population (r = 0.48; S.E. = 0.17), for males (r = 0.48; S.E. = 0.17), and females (r = 0.48; S.E. = 0.17).

This study supports the hypothesis that suicide and alcohol closely connected in culture with prevailing intoxication-oriented drinking patterns and adds to the growing body of evidence that a substantial proportion of suicide in Belarus is due to acute effect of binge drinking. The outcome of this study also suggests that alcohol-related suicide is mainly a male phenomenon.

The aims of this study was to identify patient characteristics associated with once-only contact with a community-based mental health service (CMHS), and to re-evaluate these patients 3 months after the contact.

A 33-month cohort of new episodes of care was followed-up to identify and interview once-only contact patients.

Of the 1,101 patients who met the study criteria, 165 (15%) were discharged after the first contact, 87 (8%) dropped out after the first contact, 440 (40%) were low users and 409 (37%) were high users of the CMHS in the 90 days after the first contact. A higher GAF score, less severe psychiatric diagnoses and lower socioeconomic status were the factors most associated with once-only contact at baseline. At follow-up clinical conditions of patients who had only one contact (both discharged and drop-out) had improved and, in most cases, they were in contact with other services. Drop-out patients, however, were more unwell and less satisfied with the initial contact.

Although there is no way of knowing the status of patients who could not be located, information from the people interviewed suggest that, for a group of patients predominantly without psychoses, dropping out of contact after the first visit is associated with being less satisfied with the services received at the initial contact. This dissatisfaction may had lead these patients seeking help elsewhere. Perhaps, some of these extremely low users are in need of a different or more specialized clinical treatment approach.

The epidemiology of mental disorders plays a significant role in the identification of the current status of mental health in society. As women play important role in protecting the mental health of the members of family and society. Therefore the mental health of the married women in Semnan has been studied.

In this study mental condition of the married women has been studied. To do this a questionnaire (Scle-90-R) counting questions about anxiety, depression and etc., via interview was completed by questionnaires. Sampling was done in the form of stratification in which population affiliated each health center considered as a stratification and appropriate with volume, a share from total sampling was allocated to it. At the end of 970 cases contributed with US data were analyzed by using spss10 frequency tables and statistical graphs.

In this research 91.8% (890 cases) were urban and 8.2%(80 cases) were rural. With the age mean 25.6±5.1 years were studied. In this study the common mental disorders which needed treatment were psychosis 9.1%, paranoid 7.3%, depression 6.8%. Meanwhile the common disorders needed the consultation were paranoid 21.3%, somatic complains 20%, depression 16.6%, sensitivity 16.5% and aggression 15.3%

Considering the high prevalence of the above disorders needing consultation and treatment, setting up the psychiatric and psychological sections for women is necessary in the health centers.

Prevalence, mental disorders, epidemiology, Scle-90-R.

Adolescence is a high risk period for the development of anxiety and depressive disorders. Very few studies have investigated the epidemiology of common mental disorders in adolescents attending school and using structured psychiatric interviews. The aim of the presentation is to report on the methodology used to assess the common mental disorders in schools of the region of Epirus in Greece, using a computerized version of the revised clinical interview schedule (CIS-R).

A two stage design will be used: Adolescents will first complete the 12- item general health questionnaire (GHQ-12) and then a stratified random sampling will be selected for the psychiatric interview. The latter will be delivered using a computer network version of the CIS-R

We used an open source program (phpsurveyor) to develop the computerized version of the CIS-R. We modified the program accordingly to include the full algorithm of the interview. Use of this interview to assess the common mental disorders was acceptable for adolescents and comparable with face to face interviews.

It is possible to use an internet-based structured interview to assess the common mental disorders in adolescents. Delivering this interview using the school-based computer laboratories may facilitate school-based epidemiological research.

Analysis data of sexual behaviour and sexual attitudes of adolescents in Serbia and Montenegro in context of traditional sexual upbringing and social transition.

The sample contained 203 participants, 101 males and 102 females, the age from 18-24, from Serbian language speaking area (Serbia, Montenegro, Republic Srpska). As an instrument of the research we used “Sexual Behaviour” questionnaire specially constructed for a National study of Serbian sexual behaviour. For our research we used questions about sexual behaviour divided in 5 parts: foreplay, coital behaviour, masturbation, sexual fantasy, sexual dreams, which we were statistically compared with 9 factors of sexual attitudes detached by factorial analyses.

Our findings showed that males have had significantly more coital experience than females (p<0,001), earlier beginning of coital activity (17,32±2,25yrs. vs. 19,78±2,73yrs, p<0,001), more sexual partners in general (5,4±7,6 vs. 1,7±1,5, p<0,001), more sexual partners in last month (1,7±1,7 vs. 0,7±0,7, p<0,001) more frequently masturbation (p<0,01), more dreams and fantasies about coital interactions, then females (p<0,001). But, males has less liberal sexual attitudes than females (p<0,001).

On the basis of received data, we concluded that sexual behaviour is in agreement with biological influences on genders and their social roles. We think that our findings showed hesitancy in adolescents to admit to having sexual experiences in context of social undesirable premarital sex. Regarding to contradiction of sexual attitudes and beginning of sexual activity we conclude that sexual attitudes are relatively changeable category then sexual behaviour, which is relatively stabile category.

In western countries, the majority of depressed patients are treated in primary care, and in developing countries, the majority of such population is not revealed. The main objective of this study was to find out the structure and prevalence of mental disorders at the mental health and multidisciplinary diagnostic Centers.

We work out appropriate documents to collect the clinical and epidemiological data. The mental disorders diagnosed according to ICD-10. There were investigated 148 patients at the Center “Stress” and 122–Center “Diagnostica”. The first group we conditionally named “psychiatric”, and the second one “diagnostic”. Baseline data on diagnosis, symptomatology and other independent variables was collected.

Of the 148 “psychiatric” patients the highest was the number of patients with depressive disorders (F 32, 33, 34) – 45 (27.6%), then the mental disorders due to brain damage, dysfunction and physical disease (F06,07) – 15.6%, and dissociative (conversion) disorders (F44) – 14.7%. Among 122 “diagnostic” patient the most frequent diagnosis was Neurasthenia (F48.0) – 24.6%, then depression (F32,33,34) – 24.5%, and mental disorders due to brain damage, dysfunction and physical disease” (F06,07) – 19.7%. So the rate of depressive disturbances was high in both groups. It was common for depressed people to present with somatic rather than psychological complaints.

Of people with a need for depression treatment, great majority reject it. Results of this study will contribute to a better understanding of depressive disorders in primary health care settings in Armenia.

To report on a first study on the characteristics of people with schizophrenia and a history of homelessness in The Hague, Netherlands.

Parnassia Psychiatric Centre is the sole mental health service provider for The Hague. We screened all 2723 electronic records of schizophrenia spectrum disorders patients at Parnassia in a recent year. We identified 112 patients with a homelessness history in the prior two years. We collected one-year data from the Parnassia Case Register on service use and clinical variables. In standardized interviews, we assessed clinical, substance use and homelessness histories of participants.

The majority, 76% (N: 85) was contacted. Among those contacted, 14% was excluded and 14% refused to participate. We found no significant difference on service use, demographic and clinical characteristics for participants (N:60) and non-participants (N:52). The majority (88%) is male, 45% never married, mean age is 39 and 27% is foreign born. Mean education is 9 years. Prescribed medication history is high (87%), and 44% reports periods of 3 to 12 months and 32% reports periods of more than 12 months of lifetime homelessness. Lifelong substance use histories are high: 64% cocaine, 36% heroine, 25% amphetamine; 63% cannabis, 53% alcohol. Current use is considerable: 32% cocaine, 10% heroine, 15% amphetamine, 52% cannabis, 34% alcohol. The majority (76%) reports an incarceration history. They have a high HIV rate, 2 out of 32 tested (6.3%) were positive.

These individuals need specialized services to address their dual diagnoses, risk of homelessness, and prevent HIV and imprisonment.

The increase in obesity has been described in the US as a major health problem. Recent European and Scandinavian studies indicate similar issues, yet little longitudinal data exists. Increased weight and BMI could indicate a lifestyle with a non-healthy diet and sparsely physical activity.

To study the prevalence of overweight and obesity in the general population of women aged 18-65 years in Norway 1991 (n=1849) and 2004 (n=1521).

Body Mass Index categories (kg/m2) were constructed based on self-reported height and weight. Questions on physical activity were added as well as items concerning pathological eating behaviors.

The main findings are presented in Table 1. We will also present results concerning the relationship between obesity and physical activity.

The overall overweight/obesity group has increased nearly 2.5 times from 1991 to 2004. A double increase in overweight, and a triple increase in the obesity 1 and 3 categories were found. These results are discussed in terms of changes in lifestyles and inactivity. In addition, suggestions are given on how to deal with this increasing health problem in the population.

Table 1

Obesity in 1991 and 2004.