Clients’ satisfaction with mental health service is one of necessary conditions of good treatment outcomes. The aim of the study was to investigate satisfaction with treatment and it's dependency of users’ needs and their subjective quality of life.

The sample of 174 out-patients with schizophrenic, affective, anxiety, eating and personality disorders were assessed with the Brief Psychiatric Rating Scale (BPRS), the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), Manchester Short Assessment of Quality of Life (MANSA) and the Client's Scale for Assessment of Treatment (CAT).

1. 1. The mean result of CAT was 8,2 [SD=1,5] and the half of patients assessed their satisfaction with treatment between 7,2 and 9,2 (on 1-10 scale). Persons with eating and personality disorders were the least satisfied with services.

2. 2. The highest numbers of met/ total needs were connected with health and unmet needs with social area. Total unmet needs of persons with schizophrenic, eating, personality and affective disorders were significantly higher than among patients with anxiety disorders.

3. 3. Persons with personality, affective and eating disorders had significantly lowest subjective quality of life.

4. 4. Satisfaction with treatment had negative correlation with unmet needs (mostly health and service needs), intensity of depressive/anxiety symptoms and positive correlation with subjective quality of life.

1. 1. Social needs were the most often unmet from patients’ point of view.

2. 2. The higher unmet needs and more intensive symptoms of depressive/anxiety were, the less patients were satisfied with treatment and the lower they assessed their quality of life.

To derive small-area, or contextual, measures of the local social environment using benefits data from the UK Department of Work and Pensions and to investigate whether (1) the mental health status of individuals is associated with contextual measures of low income, economic inactivity, and disability, after adjusting for personal risk factors for poor mental health, (2) the associations between mental health and context vary significantly between different population sub-groups.

Data from the Welsh Health Survey 1998 were analysed in multilevel Normal response regression models of 24,975 adults aged under 75 years living in 833 wards in Wales (mean population 3,500). The mental health outcome measure was the Mental Health Inventory (MHI-5). The age-standardised ward-level benefits data available were the means tested Income Support and Income-based Job Seekers Allowance, and the non-means tested Incapacity Benefit, Severe Disablement Allowance, Disability Living Allowance and Attendance Allowance.

Each contextual variable was significantly associated with individual mental health status after adjusting for individual risk factors, so that living in a ward with high levels of claimants was associated with worse mental health. The non-means tested benefits that were proxy measures of economic inactivity from permanent sickness or disability showed stronger associations with individual mental health than the means tested benefits. All contextual effects were significantly stronger in people who were economically inactive and unavailable for work.

This study provides evidence for substantive contextual effects on mental health, and in particular the importance of small-area levels of economic inactivity and disability.

There is an excess of death from natural causes among people with major psychiatric disorders. Several reasons have been argued to explain this excess of death (Antipsychotic Agents, high nicotine dependence…).

Our objective was to examine and compare mortality rates in a historical cohort study of 166 psychiatric inpatients along one year.

Mortality rates were examined in our cohort of patients from January 1, 2003 to December 31, 2003.

11(6.62%) patients died along the year studied. Only 2 (18%) of the died patient were women. The main cause of mortality in our cohort of patients was cardiovascular diseases.

Inpatients with major psychiatric disorders appear to be at greater risk for cardiovascular mortality than those in the general population.

Several studies suggest that severe mental illness is associated with tobacco smoking.

In this study, we measure the frequency of tobacco smokers in a sample of 149 severe mental illness inpatients. We compare the tobacco smoking rate with the general population one and with other studies rates.

65 (43%) of the 149 patients were female and 84 (57%) male. The main diagnoses of the studied population was schizophrenia (80%).The main finding was that according to other studies, the percentage of smokers in our hospital 65 (43%) was consistently high and greater than in general population. Only 9 (13%) of the smokers group were women.

Tobacco smoking rate is higher in psychiatric inpatients than in general population.

Obesity and metabolic syndrome are public health problems worldwide, and present a risk to develop cardiovascular diseases. Previous findings mentioned that disruptions in the circadian clockwork may predispose to metabolic syndrome. Our aim was to find an association between seasonal changes in mood and behaviour and metabolic syndrome.

8028 participants (45% men) were interviewed face-to-face at home and assisted to a health status examination as part of a nationwide survey in Finland. Waist circumference, height, weight and blood pressure were measured and blood samples were taken for laboratory tests. They were assessed with the Seasonal Pattern Assessment Questionnaire (SPAQ) to measure seasonal changes in mood and behaviour, and the ATP-III criteria for metabolic syndrome.

Individuals with metabolic syndrome had bigger BMI (t=-42.7, df=3513, P<0.001), waist circumference (t=-47.2, df=6560, P<0,001), higher levels of glucose (t=-19.2, df=2339, P<0.001), total cholesterol (t=-13.2, df=6631, P<0.001), HDL cholesterol (t=48.5, df=5452, P<0.001), LDL cholesterol (t=-11.9, df=3800, P<0.001) and triglycerides (t=-37.5, df=2468, P<0.001). Global Seasonal Score (GSS) and seasonal changes in weight (OR=1.57, 95% CI=1.39 to 1.78) were risk factors to develop metabolic syndrome. Waist circumference correlated with seasonal symptoms, in particular with seasonal changes in weight (r=0.20, df=5986, P<0.001).

Seasonal changes were associated with metabolic syndrome. Assessment of these changes may serve as a proxy for this syndrome. Abnormalities in the circadian clockwork may predispose to seasonal changes in weight and metabolic syndrome.

To find out distribution of levels of mental and psychologic health within a certain age group and to determine main parameters of correlation of the above mentioned health categories among the population of Kazakhstan. A large number of researchers make precise distinctions between definitions of mental and psychologic health: the first is recognized as absence of mental disorders (biologic criteria); the latter – as a whole complex of personal qualities ensuring satisfactory adaptation of a person (psychologic criteria).

7968 respondents, aged 12 -55, underwent epidemiologic study with an aim to find out how levels of mental and psychologic health are correlated. Clinical-epidemiologic and clinical-sociologic methods were applied. There was used a special map of multilevel monitoring, which includes indicators and parameters, defining levels of mental and psychologic health.

In general, the research clarified all the difference between conceptions of mental and psychologic health; besides analysis revealed relevantly deeper crisis condition of psychologic health of population of Kazakhstan as compared to mental, as well as more dynamic reaction of a mobile level of a psychologic functional activity (psychologic health) to social and economic changes of the last decades. It is necessary to elaborate differenciated psychohygienic and psychopriphylactic approaches to the analysed health categories with more attention to psychologic.

To establish the main sociodemographic and clinical characteristics of a sample of inpatients admitted at the Brief Hospitalization Psychiatry Unit from the University Hospital of Valladolid, Spain during 2005.

Descriptive study of a sample of inpatients (n=160) admitted in 2005 by means of the discharge report. Sociodemographic variables include age, sex, civil status and both socioeconomic and education levels; clinical variables include diagnosis according ICD and DSM-IV criteria, substance use, duration of admission and pharmacological treatment.

The type patient is a male between 31 and 40 years or a woman between 51 and 60 years, single, with a middle socioeconomic and education levels. Substance use is frequently found in male patients, mainly concerning several substances. Mean duration of admission was about 13 days. Women usually are diagnosed of affective disorders and men of adaptive disorders associated with substance use; schizophrenia also appears more frequently in men.

The characteristic patient admitted at the Brief Hospitalization Psychiatry Unit from the University Hospital of Valladolid, Spain in 2005 is either a male between 31 and 40 years suffering from adaptive disorders and substance use, or schizophrenia, or a woman between 51 and 60 years diagnosed of affective disorders.

Multilevel models are invaluable in area-level research for investigating the impact of context on health outcomes. Frequently datasets are collected which include sparse levels of data and published studies of household-level effects on mental health often contain many single response households. This results in the household level being sparse. The effect of this sparsity on the validity of results from a multilevel model investigating mental health has not been investigated to date. The aim of the work is to determine the impacts of including and excluding a sparse household level in a multilevel analysis.

Three-level datasets were simulated with known variance structure in order to imitate individuals nested within households nested within areas. The relative importance of the household level, sample size and level of sparseness were all varied in order to assess their impact on multilevel modelling. An outcome measure was simulated based on the variance structure, as well as an individual-level predictor of this outcome. Hierarchical models were fitted to these data using the R programming language.

Variance component estimates for three-level null models were unbiased for most levels of sparseness. Under extreme sparseness conditions (average number of respondents per household < 1.5) the variability of the household and individual level variance components increased. Excluding the household level resulted in most of that level's variation being attributed to the individual level.

Sparseness can reduce variance component estimation precision and so caution should be exercised when interpreting these models.

Domestic violence towards women is frequently hidden and prolonged. Domestic violence is both a direct and an indirect risk factor for physical and mental health problems, and is associated with increased health care utilization. Intimate partner violence affects the person, his/her family, and society as a whole.

In a cross sectional case series study, 100 women with the experience of domestic violence, who were inhabitants of Bushehr Province, were evaluated in 1999. The sampling method was snow ball method. A questionnaire was filled out by interview. Physical, emotional (verbal abuse, criticism, threats, intimidation) and ethical violence (inhibiting birth control, and referring to physicians) were assessed.

49.4% of the women's spouses had lower than high school diploma educations. All the victims had experienced the three aspects of violence. The duration of violence was more than two years in more than half of them. 50.6 % of the women had experienced severe violence. All the women had symptoms of physical, behavioral, personal, social, and psychological problems. Social isolation (38%), headache (50%), nightmares (25%), misbehavior with children (39%), and irritability (32%) were the most common manifestations. Fearful of losing their children (23%), shamed by what is happening to them (19%) and loss of knowledge (17%) were the most common reasons that they kept it to themselves.

The women in our survey experienced high rates of severe lifetime violence. International, national, and municipal commitments are necessary to combat domestic violence.

The high prevalence of those called “revolving-door patients” continue supposing a high sanitary cost. The aim of this study was to identify factors associated with multiple admissions in a psychiatric unit.

The sample included all patients hospitalized in a psychiatric unit at the hospital “Virgen de las Nieves” in the city of Granada (southern Spain), during the time period between 1998 and 2006 (n=1873). There is no consensus in the literature with regard to the definition of the “revolving-door phenomenon”. Basing on prior studies (Woogh, 1990; Thornicroft et al., 1992), we defined "revolving-door patients” as those who had been hospitalized eight or more times in an eight-year period (an average of at least an admission per year).

The prevalence of revolving-door patients was 10% (186/1873). The condition of revolving-door patients was associated with male sex (OR=1.5; IC 95%: 1.1-2.1), with a marital status different from the married one (OR=1.8; IC 95%: 1.3-2.6), and with the diagnoses of schizophrenia (OR=3.3; IC 95%: 2.4-4.6), schizoaffective disorder (OR=3.8; IC 95%: 2.3-6.5), bipolar disorder (OR=2.1; IC 95%: 1.4-3.2) and personality disorder (OR=2.2; IC 95%: 1.3-3.5).

Male sex, marital status different from the married one and the diagnoses of schizoaffective disorder or schizophrenia may be a risk factor of readmission in a psychiatric unit. A better comprehension about the characteristics of these patients may help to establish more effective strategies to board the psychiatric community.

To determinate the prevalence of several mental disorders and its relationship with sex among patients admitted in a Psychiatric Unit.

The sample included all patients hospitalized in a Psychiatric Unit at the Hospital “Virgen de las Nieves” in the city of Granada (southern Spain), during the time period between 1998 and 2006 (n=1873). The tenth version of international classification diseases (ICD-10) was used to classify the mental disorders.

The principal diagnoses were psychotic disorders (36%), affective disorders (30%), substance-related disorder (8%) and personality disorder (7%). The prevalence of men was 57% and the prevalence of women was 43%. Male sex was significantly associated with substance-related disorder (OR=3.2; IC 95 %: 2.1-4.9), schizophrenia (OR=3.7; IC 95 %: 2.7-4.9) and mental retardation (OR=1.2; IC 95 %: 2.4-4.0). Female sex was significantly associated with bipolar disorder (OR=1.7; IC 95 %: 1.3-2.3), dysthymia and other depressive disorders (OR=2.4; IC 95 %: 1.9-3.1) and neurotic disorders (OR=2.3; IC 95 %: 1.4-3.7).

According with literature (Vogel et al, 1997) the principal diagnoses among patients hospitalized were psychotic disorders, followed by affective disorders. Previous epidemiological studies have shown similar prevalence of bipolar disorder among both sexes (Kessler et al, 1997; Kawa et al, 2005). Nevertheless, among patients with bipolar disorder who need hospitalization may be more women.

Mental disorders occurring in pregnancy need attention and specifically targeted treatments; if untreated, they may have severe consequences, for the woman, for her family, and mostly for the newborn. The woman is at higher risk for suicide; she may increase tobacco, alcohol and substances use, and may frequently develop postpartum depression (Halbreich, 2004).

We aimed to describe the prevalence of Axis I disorders (DSM IV-TR criteria) at the 3rd month of pregnancy in a large non-clinical sample of women.

Women between the 12th and the 15th gestational week were enrolled. A total of 1066 subjects (49.9%) of those eligible (N=2138) signed an informed consent and completed the baseline interview. Standard demographic information were collected and Axis I diagnoses were performed using the SCID-I (First et al, 1995).

Mean age was 32.3 years (±3.9); 280 women (26.3%) had a current Axis I Disorder. Mood and anxiety disorders were the most frequent current diagnoses: Major Depressive Episode (N=34;3.2%); Minor Depression (N=45;4.3%); Specific Phobia (N=114; 10.7%); Panic Disorder (N=43; 4%); Social Phobia (N=41; 3.8%); Obsessive-Compulsive Disorder (N=17; 1.6%); Anxiety Disorder NOS (N=29; 2.7%); Generalized Anxiety Disorder (N=20; 1.9%). Current comorbidity between depressive and anxiety disorders was present in 38 women (3.6%).

The sample size and the administration of the SCID, that provides more complete and reliable information about lifetime and current psychiatric history, than instruments used in previous similar studies (Andersson et al., 2003; Spitzer et al., 2000), represent major strengths of the study.

Mental illnesses are common, serious, brain disorders that seriously hamper an individual's ability to think feel and act.Studies have shown that risk of developing an illness is increased if another family member is similarly affected, suggesting strong hereditary component. (N.I.M.H.Report, 1997.)

Study sample consists of 721 mentally ill patients.Patients were diagnosed in the Outpatients Department of Psychiatry, Pakistan Institute of Medical Sciences Islamabad. Dept. of Psychiatry was visited from June 1998 to September 1999 for collection of data.

Study comprises 721 mentally ill patients. Bipolar (manic-depressive) patients are 62.97% (n=454) Personality disorders 26.21% (n=189) and schizophrenics are 10.89% (n=78).Ratio of females to males is 100♀♀: 100.27♂♂.

Mean age at diagnosis of mental illness in sample is 25.86 ± 0.40 years. Majority of patients fell in age cohort ranging from 10 years to 29 years. (n=477:66.16%).

The study shows total number of inbred marriages to be 400(55.47%) while outbred marriages are 321(44.52%). The coefficient of inbreeding (F) for mental illness patients is 0.0348 and that of control sample is F=0.0273.

There were 220 (30.51%) patients with positive family history 29(4.02%) with negative family history and 472 (54.66%) where occurrence of disease sporadic. Consanguinity is more in positive(23.35%) and negative group(3,30%) while in sporadic cases outbred cases are more in number(39.43%).

This study shows consanguinity as an important factor in the onset of mental illness and is a fertile base for further molecular genetic studies to locate genes contributing in the development of illness

To study the prevalence of anxiety and depression in a general hospital and to determine the ability of non-psychiatric residents to recognize the patients with clinically significant depression or anxiety.

This study was performed on a cohort admitted to Dr. Shariati Hospital in Tehran. Within 72 hours of admission, the patients were screened using the Hospital Anxiety and Depression Scale (HADS). Simultaneously, the residents who provided care for the patients were asked whether they believed the patients had significant levels of depression or anxiety. They were also asked to rate the degree of depression and anxiety of their patients in a 5 point Likert scale. Prescription of antidepressants and benzodiazepines during hospitalization was recorded by chart review. Assessments were completed for 401 patients.

According to HADS score, 136(34.25%) patients had probable depressive disorders(HADS-D score>7) and 157(39.75%) had probable anxiety disorders(HADS-A score>7). The residents only asked 26(6.4%) and 32(8.2%) patients about depression and anxiety respectively. Among the patients, only 10.2% with probable depressive disorders and10.8% with probable anxiety disorders were identified. No significant correlation was observed between HADS scores and the residents’ assessment of severity of depression and anxiety. Only 16.4% of the patients with probable depressive or anxiety disorders were given medication.

This study confirms the results of previous researches that had shown high levels of depressive and anxiety disorders among patients admitted to a general hospital. It also indicates that non-psychiatrist physicians overlook a marked proportion of depression and anxiety diagnoses identified by standardized instruments.