Depression is among the most common psychiatric disorders seen in primary care. Sexual dysfunction is often present in patients diagnosed with depression, but the temporality of the association is not clear. The aim of the present study is to ascertain sexual dysfunction for men and for women relative to diagnosis of depression in the UK patients' population providing an insight into these conditions.

A case-control design was used to assess the incidence of sexual dysfunction every year in the five year period pre- and post depression diagnosis. Depressed patients (8,221 in UK ffGPRD database) were matched by age, sex and time in the database to non-depressed patients. Significance tests were carried and risk ratios were calculated at each time-point in the 10 year follow-up.

The incidence rate of sexual dysfunction for cases (4.9 events/1000 person-years) and for controls (2.66 events/1000 person-years) were found to be significantly different (p ≤ 0.001). The incidence rate for the individuals sexual disorders (erectile dysfunction, premature ejaculation, and low libido were also significantly different.In addition, the risk ratios for the above conditions calculated by year in the five year period pre- and post diagnosis of depression were statistically significant from the date of diagnosis of depression. Further analysis was also undertaken to explore the observed patterns in the data.

Sexual dysfunction diagnosis differs significantly between cases and controls, particularly after diagnosis of depression. This raises questions regarding management of depression and its effect on sexual dysfunction.

Research on the effectiveness of different intervention strategies for stalking victims is scarce.

To present the “Mannheim Pilot Project on Stalking” that aims at linking-up different local activities for stalking victims.

An information centre at the prevention directorate of the police station and a cognitive group therapy for stalking victims were established.

Data of this research project are outlined.

Requirements of stalkees are better complied with. Group therapy reduces stress and enables victims to cope with their problems more adequately.

More research on the effects of different interventions strategies is needed.

The forensic psychiatric assessment of 98 schizophrenic patients (according to ICD-10) has been carried out. During our assessment psychopathic-like, neurotic-like disorders, depressive and psychotic symptoms were prevalent.

Structured and semistructured clinical interviwes and medical and criminal records investigation.

The outpatient care of observed patients must be strictly deontologically consistent. Most of the patients and their relatives have a certain psychological ideas about antisocial behaviour and causes of the disease. The doctor's attempts to make alterations may break his contact with a patient and increase the dissimulating tendences. Some patients were sure that relatives “dream” to get rid of them. Continuation of multifactor pathomorphosis in schizophrenia was determined.

The main causes of errors in diagnosis and therapy in schizophrenic patients were the previous treatment for combat related PTSD; alcohol and drug abuse or all of them as comorbid. Many patients and relatives were not prepared for necessary inpatient treatment and were unaware about new psychopharmacological therapy. Aggressive behaviour was the result of delirious protection which forces a patient to change his former social attitude or manifested as a postpsychotic condition as a form of adjustment to a “new health”.

The carried out research is helpful to formulate changed diagnostic criteria and aggressive behaviour rick/protective (clinical and social) factors system in schizophrenia patients. Out-patient care to schizophrenic patients seems to remain an object of discussion.

The atypical antipsychotic Risperidone is now available in a long-acting injectable form, risperidone consta (Risperidone Long-Acting Injection, RLAI). Patients in forensic psychiatry settings often have complex and difficult presentations marked by co-morbidity, poor concordance and treatment resistance. The potential role of RLAI in treating this patient group is not yet clear and this study aimed to investigate its use in an English high secure hospital.

The hospital pharmacy database was used to identify all patients prescribed RLAI during a four year period. Anonymised data for these patients was then obtained from the database and pharmacy casenotes.

24 patients were prescribed RLAI, the vast majority of whom had a diagnosis of schizophrenia. Mean length of treatment with RLAI was 281 days (range 2-925 days). 7 patients remain on RLAI (including 4 who were discharged to less secure settings). RLAI was stopped due to relative lack of efficacy in 13 patients, 9 of whom were subsequently treated with clozapine. In 1 case RLAI was stopped as it was no longer clinically indicated and for 3 patients data was not available. RLAI appeared to be well tolerated and there were no cases of it being stopped due to adverse effects.

In this small study of a highly specialised and complex group of patients RLAI was not associated with any serious adverse effects. A third of patients responded to RLAI such that they remain on it or were able to be discharged to conditions of lesser security.

The EUNOMIA international project focuses on the application of coercive measures in psychiatric treatment. The use of coercive measures to mentally ill people is a very sensitive topic. The type and frequency of this action is influenced by different cultural or legal traditions, general attitudes toward mentally ill people and the structure and quality of mental health care systems.

Presentation of the frequency and way of administration of coercive measures to psychiatric inpatients with acute mental illness in the Czech Republic.

All coercive measures used during hospitalization (restraint, seclusion, forced medication) were documented in detail in special form. The definition of coercive measures was following: Restraint - fixation of at least one limb for longer than 15 minutes. Forced medication – the use of restraint or high psychological pressure to administer medication.Seclusion -involuntary placement of the patient alone in a locked room.

We have evaluated the group of 202 involuntarily admitted patients and the group of 59 voluntarily admitted patients perceiving some coercion at admission.

Restraint, forced medication or/ and seclusion were used in 45,5% of involuntarily admitted patients. In 2/3 of these patients some coercive measure was repeated. In the group of voluntarily admitted patients coercive measures were used only marginally (5,1%).

The most frequent measure used was forced medication. Mainly typical antipsychotics and benzodiazepins were administered.

Presented results show the praxis with the use of coercive measures in the Czech Republic. The data were gathered within the EUNOMIA project.

Men and women who develop schizophrenia are at increased risk, compared with the general population, to engage in violence toward others and, in so doing, often lay waste to their own lives. The reasons for this finding remain obscure.

The present work aims to analyze the relationship between active symptoms of the disease, substance abuse and violence in schizophrenic patients admitted to a forensic ward in our country (Portugal).

A population of inpatients (male and female) from two forensic wards was studied as to personal and psychiatric history, substance abuse, social and cultural background, family history, symptoms at the time of the violent behavior and patient's insight.

The prevalence of offenses was the highest among male schizophrenic subjects with coexisting substance abuse, and more than half of the schizophrenic offenders also had problems with substance abuse. Most perpetrators were acutely ill at the time of the offence but only a small number was under mental healthcare.

Our results were consistent with those found in classic literature. We hope this will help us start a structured programme in our hospitals in which behavioral factors, substance misuse and social dislocation are managed together with the active symptoms of the disorder in order to prevent such violent behavior and to promote adequate treatment of schizophrenic patients.

The comorbid disorders for antisocial disorder were organic disorders mostly of perinatal origin and ADHD syndrome in childhood. For kleptomania there were non-psychotic affective states and personality disorders: schizoid, schizotypal, borderline and emotionally unstable of borderline type. The repeated theft in both groups served as habitual tool for emotional self-regulation since all the patients had dysthimic or dysphoric mood swings and unstable self-esteem. Their repeated criminal pattern responded to criteria of dependence syndrome listed in ICD-10 for substance abuse. We described them in terms of feeling of psychological dependence, distorted physical and psychological reactivity, and personality scarcity at the final stage of dependence when stealing behavior became serial, clichéd and followed by symbolic rituals. In antisocial personality disorder we observed tends to switching to more hetero-destructive behavior - pyromania, zoocides and sexual sadism served as substitution first and then developing the traits of addiction. In kleptomania auto-destructive kinds were more common (habitual self-mutilation, alcohol and drug dependence, exhibitionism, pedophilia, sadomasochism). Forensic psychiatric evaluation included assessment the urge to steal (impulsive, compulsive or obsessive) and degree of emotional disturbances as well as comorbid disorders (both underlying and substituting) to estimate the quality of volitional control.

The 550 adolescents commiting homicides or another grave agressive-violent crimes against personality were examined by complex clinical psychopathological, pathopsychological and instrumental diagnostical methods. A middle age of the patients -16,8.

In 37,3% of the patients organic personality disorders, in 35,4%- schizophrenia spectrum, in 21,3% - pathological formation of a character; in 6% -other nosological states were diagnosed. 67% of adolescents were the social orphans, severe relationships in families were authentic in 55% of cases, 32% were socially desadaptated, 56% revealed the risk of total desadaptation. In 58,5% of the sample different variants of abnormal mental development were presented.

An algorithm of estimation of agressive violent behaviour among the children and adolescents means a carrying out of complex phsychologo-psychiatric investigation in view of clinical psychopathological and psychological estimation of formation of agression in ontogenesis; dynamics of age development of crisis periods; the analysis of psychological, social and clinical components of agressive dehaviour, social functioning, estimation of behaviour and motivation of criminally significant period at fulfilment of socially dangerous act; analysis and synthesis of an expert research, instrumental diagnostic data with a formulation and substantiation of the expert judgement on criminal case (the proof of conclusions of expertise).

The period of adaptation in the places of imprisonment is accompanied by the complex of experiencing as a «prison syndrome».

Aim of the study is to find out predictors of adaptation in prison.

A cohort of 70 inmates was studied by psychiatrists in prisons of Russia, all of them had committed crimes of violence.

A “prison syndrome” reveals the state of depression, hopelessness, melancholy on a house and relatives with sense of guilt before them, disbelief in the forces, impossibility to find former status, passivity, apathy, decline of vital tone and drawings, sleep disorders, loss of interests. Factors of successfull (or unsuccessfull) adaptation could be divided into two groups: subjective and objective. Subjective are personality features: age, emotional reactivity, special features traits such as a resourcefulness, ability to manipulate by interests and necessities of people, physical force, vital experience, «experience» of criminal activity, amount of previous convictions and serving the punishments, participation in the former crimes, including the relation of condemned to prisons administration, to the educating measures, to the prisons mode, labour, studies and feature of conduct in the period of investigation, court. The objective factors are behaviours term on the sentence, article of the criminal law, belonging to the informal group, system of relations and microclimate in prison, physical and psychical health of condemned.

Immigrating to the USA is extremely frequent. Migrants come from different countries and different levels of society and some of them carry some form of mental illness. Imperial County has one of the 6 detention centers for the undocumented in the nation. Since 1996 this center has had the same psychiatric consultant to provide services to the detainees. This study was conducted to have better understanding of the clinical and social issues of this population.

Retrospective record review of all psychiatric consultations from 1996 to 2006. Statistical analysis with t-test and ANOVA.

A total of 2480 psychiatric cases were reviewed. The majority were from Latin America, especially from Mexico (p<0.001), followed by individuals from Asia including the Middle East and very few from Europe, Africa and Canada. The most common diagnoses included psychotic disorders (related and non-related to drug use) and bipolar disorders. Level of education was usually low, and over a third of the population had a criminal history. Remarkable differences were found on individuals who were subject to deportation after legally living 20 years or more in the country versus those who were detained while attempting to illegally enter the country.

Migration from emergent to developed countries is common and controversial in our planet. In the USA this phenomenon is frequent and demands the concurrence of government, community, law enforcement and financial efforts. The debate as to what services should be provided to these individuals by the destination country must continue.

The Act on medical care and treatment for insane or quasi-insane person who have caused serious incidents in Japan went into effect in July, 2005. It is critical to understand the current situation and the issue concerning medical care in this legal system for revision of the Act five years later. Therefore, this research aims to evaluate and analyze the information comprehensively collected from designated inpatient medical institutions and outpatient medical institutions from a technical standpoint.

The subjects of this research are 50 cases from designated inpatient medical institutions and 4 cases from designated outpatient medical institutions who have been registered as the subject of treatment under the Act. Static information at the time of the treatment starts and dynamic information, such as treatment evaluation usually created periodically in routine work, were the specific documentation for this research. From the information, variables required for analysis of improvement of medical care and operational situation of the Act were collected through the use of a database system.

Since the Act was enacted last year, this one year research remains as a short term monitoring targeting a few cases. In this report, evaluation and progress of treatment of the subject will be presented with the information relevant to the mental illness and the judicial system exposed by collected various kinds of data. From this information, we outline the current situation and issues in this legal system and shows the usability of the result from this monitoring research.

Clinical psychopathological, statistical analysis.

Decision of diminished responsibility in 70% of patients was connected with assessment of the severity of disorder, that were mainly psychopathic and organic syndromes non specific in relation to forensic psychiatric decision. There is a need in non-clinical parameter helpful to assess a tendency of psychopathological condition. The social adjustment indices found out to be such a parameter. The indices included: educational level; employment and its concordance with patient's education; registration at the dispensary (outpatient mental health clinic); number of inpatient treatment; marital status, family relationships, patient's position in a group of reference. The study has shown the lower level of social adjustment in the group of diminished responsible patients. They were more often registered at the dispensaries and had a history of inpatient mental health treatment. They were low educated and engaged in lower paid and low qualification job. More than 50% did not have family.

Thus, assessing the patients with clinically similar parameters it is necessary to take into account the social adjustment parameters to objectify the forensic psychiatric decision.

There is hardly any research work on the evolution of a psychiatric patient's competence throughout his/her stay in hospital. This (fact) prompted our team of professionals to consider the importance of studying this evolution and trying to determine the variables affecting the improvement of that competence.

Competence to consent to hospitalization has important clinical and ethical implications. However, there are no follow-up studies that evaluate the improvement on competence during psychiatric hospitalization. The authors sought to determine whether patients admitted to a psychiatric ward as incompetent to consent to hospitalization improve their competence during hospitalization.

A total of 160 consecutively admitted patients were administered the Competence Questionnaire (CQ), a structured scale designed to assess competence to consent to psychiatric hospitalization. CQ was administered both upon admission and at discharge. Severity and acuity of the psychiatric disorder were assessed with the Severity of Psychiatric Illness Scale (SPIS) and the Acuity of Psychiatric Illness Scale (APIS).

Of the 160 assessed patients, 70 (43.8%) were rated incompetent. 45 of these 70 incompetent patients completed the admission to discharge follow-up. 21 of these 45 patients (46.6%) remained incompetent at discharge. Participation in the treatment process was the only variable which predicted improvement on competence during hospitalization. Severity of psychiatric illness at admission did not predict improvement on competence.

Nearly half of the patients admitted incompetent in an acute inpatient ward remained incompetent at discharged.