To explore changes in quality of life (ILC) in adolescents with attention-deficit/hyperactivity-disorder (ADHD) transitioning from Atomoxetine (ATX) or ER MPH (Medikinet retard) onto OROS MPH.

Post hoc analysis. 12 week, open label non-interventional trial in adolescents (ADHD; ICD-10 criteria) transitioning from ER MPH or Atomoxetine onto flexible dose of OROS MPHs. Effectiveness parameter were changes in IOWA Conners' parent rating scale, C-GAS, ILC adolescents and parents and questions focusing on afternoon activities.

57 adolescents were analyzed (median age 14 years, 84.2% male). Insufficient efficacy (77.2%), adverse events (3.5%) or a combination of both (19.3%) led to transition to OROS MPH. Mean dose of ER MPH prior was 34,3mg±19,3 and mean dose of atomoxetine was 53,2mg±17,9. Eight patients terminated the study prematurely. Median dose of OROS MPH at endpoint was 54mg/day. "Playing with other children", "doing household chores", "doing homework", "going to bed in the evening", and "ability to visit or receive visitors" improved (all p<0.001) as well as C-GAS (p<0.00001), Conner's parent rating scale, ILC parents and adolescent's (all p<0.001).

Adverse events (AE) with under OROS MPH treatment were reported in 45.6% of patients. AE ≥5% were involuntary muscle contractions not further specified (5.3%), insomnia (5.3%), and ineffective medication (5.3%).

Transitioning from ER MPH or ATX to OROS MPH in adolescents with ADHD was associated with an improvement in quality of life in adolescents and their parents and in daily functioning. Improved symptom control during late afternoon and early evening activities was apparent.

To explore changes in daily functioning (C-GAS) and quality of life (ILC) in children and adolescents with ADHD OROS®-MPH and their parents.

Full analysis. Open label non-interventional trial in children & adolescents with ADHD (ICD-10 criteria) treated with flexible dose OROS MPH for 3 months (42603-ATT-4001). Effectiveness parameter were C-GAS, ILC adolescents and parents and IOWA Conners' parent rating scale at baseline and endpoint.

598 patients with ADHD (ICD-10 criteria; Ø age 10.4 years ± 2.6; 84.8% male) were documented. 81.6% completed the observation. Mean OROS MPH dose at last observation was 33.5 mg/day (SD ± 13.3). Patients improved on C-GAS from 58.9±14.7 to 71.2±15.1 (p<0.001). IOWA Connors Symptoms decreased from 29.0 ± 10.5 to 18.5 ± 10.6 (p<0.0001). ILC improved from 18.8 ± 4.0 to 20.8±3.8 in children and adolescents (p<0.0001) and from 17.2±3.9 to 19.7±3.9 in parents (p<0.001). At endpoint, 76.8% of patients showed at least minimal improvement on CGI-C. Adverse events were reported in 28.8% of patients. AEs listed in ≥2% of patients were insomnia (7.7%), anorexia (3.9%), ineffectiveness (2.8%), headache (2.3%), nervousness (2.2%) and involuntary muscle contractions (2.2%). There were no significant changes in blood pressure or pulse.

Treatment with OROS®-MPH was associated with a clinically relevant improvement in daily functioning in patients with ADHD and Qol improved significantly in patients and their parents. Treatment with OROS®-MPH was well tolerated.

In order to assist in ameliorating suffering and improving health, psychiatrists engage with patient's experiences and behaviors and the social milieu within which these experiences and behaviors emerge and are expressed. How can psychiatric illnesses (complex biopsychosocial entities) be classified, comprehended, and treated?

Pluralogue.

Methodological pluralism must become standard practice in a psychiatry that aspires to stature as a scientific and humanistic discipline. The boundaries of such pluralism are constrained in ways that were first elaborated by Karl Jaspers and can be re-elaborated today. Jaspers already clarified that the methods of psychiatry are perspectival. Emerging from a particular vantage, each method reveals its evidence and at the same time conceals other evidence. Methods clash, complement, are mutually affirmative or disjunctive. Furthermore, the numerous methods of psychiatry are expressed within time - within a temporal horizon - leading us to ask if any is a priori divorced from its history. Can we claim that what is compelling today will not be illusory tomorrow? A scientific and humanistic psychiatry always deals with this challenge.

Psychiatry is a pragmatic, multiperspectival discipline. The methods of psychiatry are pluralistic. Each needs be clarified, with strengths and limits investigated in isolation and also through a sympathetic yet critical pluralogue. Jaspers mature existential philosophy, his notion of communication as a "loving struggle", and his clarification of truth all developed out his earlier experiences as a clinical psychiatrist. The psychiatrist who practices in 2008 deals with the same multifaceted psychiatric reality.

Challenging behaviours in dementia exceed the capability of many care home staff precipitating admission to hospital even though ninety percent of problematic behaviours occur as a response to care practices or environmental factors. Instead, the reasons should focus on when, where, why and with whom these behaviours occur. In 2006, a five-month pilot study within the Northern Health and Social Services Board (NHSSB) (Northern Ireland), using the Newcastle Model, a bio-psycho-social intervention received 20 referrals involving 11 care homes.

The Newcastle Model formulates challenging behaviour in terms of peoples' needs, which are assumed to drive their behaviours. The model is a hybrid of well-established ideas from various psychological models, but its distinguishing feature lies in the unique integration of teaching, supervision and intense support provided to staff in care homes.

The NeuroPsychiatric Inventory Caregiver Distress (NPI-D) measures frequency and severity of behaviours and level of distress this causes staff. This was administered pre and post intervention. At discharge staff completed an anonymous satisfaction questionnaire.

Following interventions four hospital admissions were averted which, based on the average length of stay, would have cost an estimated £81,500. NPI-D scores decreased and staff questionnaires were positive.

The potential of this pilot study was noted by the Institute of Healthcare Management Quality Awards scheme prompting the NHSSB to fund a Behaviour Sciences Nursing Service. This preliminary study will form the basis of a study that will evaluate the service using a quasi-experimental intervention – comparison non-equivalent design.

One hundred eight nine patients were enrolled according to the criteria of the International league Against Epilepsy (ILAE) for diagnosis of epilepsy. The patients were interviewed using a standard questionnaire, Quality of life in Epilepsy (QOLIE- 31-P).

Among 189 patients Total quality of life according to the score of QOLIE- 31-P was minimally 16.20 and maximally 87.5 and mean of (50 14.59 SD).the mean score for men was (50 16.11 SD; 16.2-85.35) and females (49.28 14.47 SD; 24.14-87.5), (no significant difference between sexes p Value= 0.549). The mean score in the monotherapy group (52.95 16.22 SD) (a significant difference to the poly therapy group (46.98 12.07 SD), (P Value=0.). There was no significant difference statistically with regard to age groups and educational status, but duration of the epilepsy less than one year had statistically significant better quality of life.

Differeces in studies may be due to stem form cultural differences and beliefs. The care of the epileptic patients must take into account the many factors influencing the quality of life in these patients.

The family is one of the most important factors can help to make independent the teenagers and increase their self esteem. depression of family decrease the family's attention to psychosocial need satisfaction (PSNS) of their teenagers specially in female's ones, so this research was carried out about depression of family and PSNS in female high school students of KASHAN, IRAN-2006.

A descriptive-analytical study performed on 762 female students of high schools of Kashan-Iran 2006 who were from All courses and different grades selected by multi-step random sampling from 50% of state and private schools separately (in high school and Art-school) of proportional to their population .After considering excluding and including factors, the researcher made PSNS Questionnaire (31questions) as well as demographic data were completed by students. χ2, Fisher exact test and T test were used to analyze the data .

The frequency of PSNS by parents were ;low 2/1%, moderate 25/7% and high 72/2% .There was significant relationship between PSNS by parents and depression in family(p<0/005, k2=40/62) .The rate of depression in family who had low PSNS was as twice as in family with high PSNS. PSNS of teenagers in family with depression was 56/7±16/46 and without depression ones was 69/34±13/54.

The parents' attention to psychosocial needs of teenagers is effected by depression of family, so it's recommended to cure depression of family in appropriate time.

to proceed on the primary care health level to a tracing on mental health in the geriatric population; to detect also depressive syntomatology in elderly without diagnosed psychiatric pathology.

Application of Tracing on Mental Health Scale (ER80) and of Geriatric Depression Scale (GDS-15) to a random group of consultation users from an urban health center with age ≥ 65 years.

/ Conclusions: In a total of 63 individuals, 50.8% were male, being the group between 70 and 75 years the most representative (34.9%), the majority were married (74.6%), with just four years of scholarity (46%) and retired (96.8%). In the analysis of the ER80, the mental disorder was detected in 22.2%, in 17.5% it was inconclusive due to data and in 4.8% questionnaires were excluded by the scale considers a falseness index (≥ 4). In the study of the GDS-15, a suspicion of depression (total ≥ 5) was verified in 49.2% and in 14.3% the result was inconclusive due to insufficient data. Results reveals that the general practitioner plays an important role in what regards to the precocious detection and primary prevention of psychiatric pathology in the elderly people, specially of the depressive syntomatology.

To evaluate socio-demographic, clinical, analytical and pharmacologic variables in psychiatric patients and to determine the prevalence of metabolic syndrome.

Descriptive transversal study of hospitalized patients at Sobral Cid Hospital, random chosen from hospitalized acute and chronic patients.

In a total of 51 individuals, 88.2% were male, 21.6% have between 40 and 50 years old (mean- 50.5 years), without known cardiac disease (92.2%), without tobacco (58.8%), alcohol (74.5%) or other substances consumer (92.2%), having 13.7% diabetes mellitus and 31.4% hypertension. The diagnostic group most prevalent was Schizophrenia, schizotypal and delusional disorders. The following parameters were determined: abdominal obesity (15.75), hypertrygliceridemia (25.5%), low HDL (70.6%), arterial hypertension (41.2%), high level of glycaemia (13.7%), elevated PCR (35.3%), BMI superior or equal to 25 (56.9%) and metabolic syndrome (19.6%). In relation to therapeutics 45.1% were medicated with antidepressives and 76.5% with antipsychotics (47.1% with atypicals).

It is fundamental that the assistant psychiatry identifies and orients patients with cardiovascular risk systematically, and also take into account those parameters when prescribing psychodrugs.

This study assesses the experiences of Internationally Recruited (IR) Consultant Psychiatrists focussing on the recruitment process and its adherence to the DH guidance.

Eighty-eight IR consultant psychiatrists from different countries were mailed a 13-item questionnaire assessing their experiences regarding various aspects of the recruitment process.

48% IR psychiatrists responded; 97% were from India. The recruitment process was generally satisfactory with perceived gaps in support from various stakeholders. Inconsistent experiences were reported regarding induction, mentorship, clinical responsibilities, and racial discrimination.

The recruitment process adhered to the good practice guidelines (DH) within the broad framework of clinical governance. It is important that any such future initiatives have in place appropriate supervision, mentorship, and a sufficient period of induction including exposure to the relevant systems and procedures to ensure good quality service with a view to minimise risk for patients as well as staff. There are limitations to the applicability of the results to the wider group of professionals.

UK studies have reported disproportionate detentions of Black and minority ethnic (BME) patients under the Mental Health Act 1983 (MHA). We conducted a systematic review to examine the evidence for greater detention of BME patients within psychiatric services in the UK and to examine evidence offered for these explanations, including racism in psychiatry.

Bibliographic databases were searched, descriptive analyses used to summarise studies and meta-analyses performed to produce pooled odds ratios. Possible sources of heterogeneity were investigated.

Meta-analysis revealed that BME patients were over three times (3.35), Black patients were nearly four times (3.83), and Asian patients are twice as likely (2.06) to be detained as compared to White patients, even when other predictors of detention were controlled. There was a striking lack of primary evidence to support most explanations to account for this excess.

While there is robust evidence that BME status is an independent predictor of psychiatric detention in UK, the causes of this remain unclear. Many potential explanations for greater detention such as length and severity of illness, pre-morbid personality, subjective experiences of receiving psychiatric care, lack of a social support system that can provide alternatives to detention and the relationship between local service structure and detention rates have not been studied. A simple ‘race-based’ explanation has possibly been detrimental to understanding the true reasons behind this excess and need to be explored in better designed studies using mixed qualitative and quantities methods.

The aim of the study was to evaluate sexual satisfaction during pregnancy using the Hudson's Index of Sexual Satisfaction (ISS) questionnaire.

One hundred and thirty seven couples who met the study criteria were recruited by voluntary participation. Participants anonymously completed a self-administered questionnaire (demographic questions, Hudson's Index of Sexual Satisfaction (ISS), Hospital Anxiety and Depression Scale (HADS)). Demographic data, ISS and HADS scores were analyzed and compared among trimesters.

Data of 38 couples for the first (28%), 40 for the second (29%) and 59 for the third (43%) trimesters of pregnancy were collected for the analysis. The median age was 28 (25 – 30 years) for women and 29 (26-32 years) for men. Women's ISS score was influenced by age of woman (b=0,12), woman's HADS score (b=0,25), and ISS score of the partner (b=0,55).

Women's HADS score (b=-0,18), women's ISS score (b=0,63) and men's HADS score (b=0,25) were factors influencing men's ISS score. Women's level of sexual satisfaction (ISS scores) didn't differ among trimesters. For men, the highest level of sexual satisfaction was reported in the third trimester.

Our results don't support previous observations that the level of sexual satisfaction decreased significantly throughout pregnancy.

Regarding to living of some elderly people due to different causes in nursing house, it's a must to Know affecting factors on mental health of this group. One of these factors is satisfaction with living in nursing house(NH). So we have studied relationship between that and mental health elderly people.

A descriptive-Analytical study with aim-centered sampling was performed on 56 elderly people residing on golabchi nursing house -Kashan 2007 in the event that had research units features (Normal IQ, able to understand the Questions and lack of serious mental disease and Alzheimer).The standard mental health Questionnaire (GHQ28) was used and the scores less than 23 was mentioned as health .some other like demographic factors, family residing in nursing house and …were assessed too. The descriptive statistics and χ2 were used to analyze the data.

There was no significant relationship between mental health with satisfaction with living in nursing house, gender, education, previous job, income source, economic situation, marital status and duration of residing in nursing house, although the rate of satisfaction in health group was 1/6 as unhealthy group and the rate of mental health was increased with increasing in duration of residing.

It may be promoting the rate of satisfaction with living in NH can help elderly people's mental health.

The family is one of the most important factors in psychosocial need satisfaction (PSNS) of teenagers specially in female's ones and father's role is more impressive and serious affair, so this research carried on about PSNS of female high school students and characteristics of their fathers KASHAN, IRAN-2006.

A descriptive- analytical study performed on 762 female students of high schools of Kashan-Iran 2006 who were from All courses and different grades selected by multi-step random sampling from 50% of state and private schools separately (in high school and Art-school) proportional to their population .After considering excluding and including factors, the researcher made PSNS Questionnaire (31questions) as well as demographic data were completed by students. χ2, Fisher exact test and T test were used to analyze the data .

The frequency of PSNS by parents were ;low 2/1%, moderate 25/7% and high 72/2% .There was significant relationship between PSNS by parents and father's age, education and job(p<0/05).%100 of students with younger fathers(less than 30) had high PSNS whereas in older ones (more than 45) it was %69/5, the rate of high PSNS in students with educated father and less educated ones was %84/4 and %55 respectively and in group with teacher fathers and worker ones was %81/3 and %65/5 respectively .

It is recommended to make program for teaching of paying attention to PSNS of teenagers for older and less educated fathers and low social class job ones in female student's high school.

Atomoxetine is often used in ADHD when other agents have been ineffective or are contraindicated. We report prescribing pattern, effectiveness and adverse drug effects associated with atomoxetine (ATX) in a Paediatric Neurodevelopmental Clinic. Naturalistic data are valuable to complement RCT data.

Retrospective case note review of ADHD subjects treated with ATX for any length from a single clinic. Data analysis includes co-morbidity, indications, dose, side effects, and response to treatment (CGI)

150 case notes reviewed. (Males 126, Females 24) .Mean age 12.3 yrs. (range 6.5 to 20.3 yrs) and dose 1.3mg/kg/day. Mean duration treatment 45 weeks (range 1 - 144).

Oppositional /Conduct problems 129(86%), Sleep Problems 100(67%), Learning Difficulty 55(51%), Internalising Symptoms 46(31%), Pervasive Developmental Disorder 32 (21%), Tics/Tourette's 19(13%), Epilepsy 9(6%). Main reasons for ATX initiation -full day cover 150(100%), sleep problems 97(65%), inadequate response or side effects with other medications 78(52%), parental preference 53(35%), internalising symptoms 31(21%), pervasive developmental disorder 31(21%), appetite/growth concerns 20(13%), tics/Tourette's 20(13%). CGI in those > 6 weeks treatment (n=129) - 25(19.4%) CGI-I, 33(25.6%) CGI-I 2, 18(12.4%) CGI-I 3, 47(36.4%) CGI-I 4, 8(6.4%) CGI-I 5. Adverse reactions reported include:-GI symptoms 21 patients, aggression 11, worsening ADHD 6, cold extremities/acrocyanosis 3, self harm 2, somnolence 2, palpitations/labile blood pressure 2.

Atomoxetine is a useful treatment in ADHD for many subjects including those with treatment failure, adverse effects or contraindications associated with other agents. This naturalistic data also demonstrates the importance of parental preference in treatment choice.

The Scottish Office Department of Health issued guidance in 1996 on ‘National Health Service (NHS) Responsibility for Continuing Health Care’ which is provided free of charge to patients whose complexity, nature or intensity of care needs (medical, nursing) are sufficient to fulfil certain criteria. Due in part to differing NHS guidance in England, there has been increased complaints to Health Boards and the Scottish Public Service Ombudsman (SPSO) about patients deemed not to fulfil the Scottish criteria.

To establish the level of knowledge amongst experienced psychiatrists about current Scottish regulations on NHS Continuing Care.

Following a pilot survey, a modified postal questionnaire comprising 19 structured questions was sent to 134 psychiatric consultants and specialist trainees in south-east Scotland in mid-2007, with a reminder to non-responders.

A 54% response rate increased to 66% following reminders. Of these, 82% were consultants and 88% had clinical responsibility for inpatient care within the past decade. Only 24% of responders were aware of the current Scottish guidance for NHS Continuing Care, with only 14% aware of the actual 1996 document. There was uncertainty regarding responsibility for both discharge and appeal processes although 8% had been involved with a formal complaint relating to NHS Continuing Care and 10% involved with the SPSO.

Clinical uncertainty abounds regarding the criteria in Scotland for NHS Continuing Care, despite guidance being issued over a decade earlier. There is urgent need for review of the criteria by the Scottish Government, with raised awareness among practising clinicians.

This study was examination by Telepsychiatry and E-consalting (telecommunication technologies with the aim of providing psychiatric services from a distance) of war related posttraumatic stress disorder (PTSD).

Many patients with PTSD have different symptoms. The authors' objective is to analize component of symptoms in PTSD.

The subjects were 50 male psychiatric patients by Telepsychiatry and e-consalting with war-related PTSD by videoconferencing via broadband ADSL and WADSL by 768 kbps. Posttraumatic stress syndrom-PTSS scale and 20-item Zung selfrating scale was used to assess state measures of symptom severity.

The symptoms of prolonged PTSS (posttraumatic stress syndrome) with duration between six moths and two years had been founded at 38 (76 %) and 12 (24 %) of patients had no PTSS: symptoms of depression had been found at 34 (68 %) patients. The enduring personality exchange after catastrophic expiriense (with duration more than two years), had been found at 7 (14 %) patients; symptoms of depression had been found at 17 (34 %) patients after two years.

Evolution of PTSD symptoms and continued examination and follow-up by Telepsychiatry service and e-consalting may be important in predicting the eventual development of depressive symptoms and precipitation of F 62.0 enduring personality exchange after catastrophic expiriense in the war related PTSD. Consequently, Telepsychiatry service and e-consalting it is able to serve not only PTSD but also wide range of other patient population.

Two thirds of all persons, who comit suicide have an appointment with their family physician (FP) in the preceding month. One third of them reports depressive thoughts and less than a fifth talks about his suicidal ideations and plans. FP are basically aware on the association of suicidality with psychiatric disorders i.e. deression. However, they hesitate to communicate about this topic mainly for insecurity. Additional factors might be that physicians themselves are prone to burnout or suicide more often than the general population.

Problem-centered semistructured interview following the grounded theory. Complete transcription of the interview tapes for analysis. Recording of demographic and practice data.

N=24 physicians were interviewed. They saw problems regarding time consuming contacts, stigma of compulsory admission, acceptance of suicidality especially in the older population. More problems would occur in non-depressed patients, especially in those suffering from chronic pain and/or addiction. Interview training was regarded as helpful.

This is the first qualitative study on the primary care management of suicidal patients. It shows e.g., that stigma of psychiatry also influences crisis management.

It is evidence-based that psychosocial interventions influence outcome of mental illness by improving social skills for life in community. The wellness program is manual-based step by step program and includes: the education about healthy life styles (the eating habits, physical activity), defining the goals and planning of activities. The aim of the study was to evaluate wellness program in term to improve the physical and mental health in persons with mental illness.

40 patients were included in study to assess the benefit of 12-week wellness program. The patients were treated by antipsychotics and/or antidepressants and six of them by a mood stabilizator. The groups met once a week during 12 weeks for 90 minutes. Data were obtained through the comparison of 12-Item of self-reviewing Satisfaction scale and body mass index (BMI) at the beginning and end of program. Wilcoxon signed-rank test was used for statistics.

Significant (p<0.05) improvement was recorded in self-esteem, energy, physical appearance, social life, physical activity, eating habits, free-time activities, self perception, quality of life in general. Significant (p<0.005) decline was recorded in BMI in 17 patients at the end of program.

The effects were obtained in three-quarters of tested Items implying significant improvement in the Satisfaction scale at the end of program. Although, the goal of program was not the reduction of body weight, the decrease in BMI points out that structured wellness program can be effective in improving the physical as well as mental health.

Life satisfaction is one of the most important indicators for mental health evaluation. The assessment of life satisfaction in Iranian elderly people is a must, so this study was carried out in order to assess the reliability and validity of the 13 item LSI-Z questionnaire in Kashan -Iran 2007.

The 13 item LSI- Z English Version was translated to Persian. demographic data and a question about total life satisfaction status was also assessed .The sampling was performed using convenience method. people aged ≥60 years old who conferred to health centers in kashan city in spring 2007 (n=75) were selected. After their consent informed, the questionnaires were completed. Reliability was determined via internal consistency using item-total correlation; cronbach's alpha and split-half. Construct validity was determined through known-groups approach; the samples were divided into 5 groups depend on their answers to the total life satisfaction status question, and then life satisfaction index-z scores were compared among 5 groups. The data were analyzed using pearson correlation coefficient, unequal spearman brown, Guttman, Cronbach's alpha coefficient and one-way ANOVA.

In 0-26 Scale, life satisfaction score was 13/68±5/47. The questionnaire reliability coefficient was 0/78-0/79. Item-total correlation confirmed its reliability too. LSI-Z scores were significantly different among the 5 known- groups (p=0/0001, f = 121/66); so the known-groups approach revealed that this tool is valid.

the 13 item LSI-Z Persian version for evaluation of life satisfaction in Iranian elderly people is valid and reliable.