New dimensions of traumatic stress have surfaced since the inclusion of the PTSD classification in The Diagnostic and Statistical Manual of Mental Disorders-Third Edition (DSM-III) with its main focus on Vietnam Veterans. New Dimensions of traumatic stress entered the clinical/cultural equation with new populations, both military and civilian, subjected to massive disasters (hurricanes, floods, terrorist's attacks…) as well as those exposed to the potential of violence. The nearly four-year siege of Sarajevo and the constant fear of improvised explosive devices and suicide bombers among troops in Iraq and Afghanistan add another dimenstion of traumatic stress that falls outside the usually accepted “combat exposure” measure for a PTSD diagnosis. Our objective was to evaluate the scientific and clinical literature to see what assessment and treatment modalities are being employed to address this broader definition of traumatic stress.

We conducted a comprehensive review of journal articles and books published in English and the Slavic languages, the vast majority published within the past decade.

The search comprised of over 300 hits, mostly journal articles.

Assessment tools have been expanded to include co-morbid clinical and health diagnoses as well as pre-morbid factors. Related clinical diagnoses include major depression and panic attacks while health concerns run the range of immune deficiency disorders as those associated with traumatic brain injuries. Psychopharmacology inroads seem to focus on Serotonin agonists while cognitive-behavioral approaches dominate the psychotherapies. Targeted populations include coalition troops (male & female) and those involved in the Bosnian and Kosovo conflicts.

To develop and evaluate a culturally appropriate instrument for screening of mental health problems in Aboriginal people.

A ten-item screening instrument has been developed in collaboration with indigenous and non-indigenous health and mental health professionals. Subsequently, the instrument was evaluated in urban and rural parts of Australia for its cultural applicability, reliability and validity. The evaluation process included collection and analysis of both quantitative and qualitative data.

A novel instrument entitled “Aboriginal Here and Now Assessment” is based on the Aboriginal holistic view of health and covers ten culturally relevant physical and mental health domains including: general wellbeing, physical health, anxiety, depression, suicide risk, substance use, psychotic experiences, functioning, contextual issues and resilience. The instrument uses a visual severity scale and contains a symptom summary which can be used for providing a feedback to the individual.

There is a paucity of culturally appropriate instruments for screening and assessment of Aboriginal mental health problems. The newly developed tool appears to be culturally applicable for screening of mental heath problems in Australian Aboriginal people. The instrument is available for further evaluation across other indigenous populations around the world.

Alcohol use is a major public health problem and contributes to the burden of disease world-wide. The problem of alcohol use might defer among the natives and foreigners in a given cultural milieu.

To screen for the prevalence of alcohol use among the native Belarusians and foreigners.

1517 respondents (172 foreigners and the rest native Belarusians) from different cities in Belarus enrolled for the study. Standardized questionnaire containing the AUDIT, CAGE, MAST and other alcohol-related questions were administered to all respondents. The Student's t and Pearson, χ2 tests were employed for analysis of results.

Alcohol users were 90% native Belarusians and 62% foreigners. Problem drinkers were 16% native Belarusians and 30% foreigners. A significant increase (in approximately 2 times) in the rate of alcohol use after a 2-4 years stay in Belarus was noted among the foreigners (p< 0.05).

There is a significant difference in the pattern of alcohol use among the foreigners and native Belarusians. The rate of alcohol use and related problems is higher among foreigners, compared to the native Belarusians.

The pattern of alcohol use might differ among people of different ethnic groups. Differences in alcohol use and related problems among undergraduates of various ethnic groups - Belarusians, Arabians and Nigerians in Belarus were examined.

Altogether, 1345 Belarusian, 120 Arabian and 84 Nigerian undergraduates participated in a randomized anonymous study using the AUDIT questionnaire, including other alcohol related questions.

Overall, 91.1% Belarusian, 63.3% Arabian and 56.9% Nigerian alcohol users were identified. A total of 16.3% Belarusians, 32.5% Arabians and 22.7% Nigerians were problem drinkers. Beer was the most preferred alcoholic beverage among the general undergraduates’ population of all ethnicities.

Differences in the pattern of alcohol use and related problems exist among the undergraduate population of various ethnicities in Minsk, Belarus. The Belarusians had higher percentages of alcohol users, but relatively lower proportion of problem drinkers, compared to the Arabs and Nigerians. No significant differences were noted in the preference for alcoholic beverages among all ethnicities.

The influence of religion on the rate of alcohol use can not be overemphasized. In recent times, some studies have suggested that the inter-religion differences in alcohol use might be fading away. And that closer relationship might exist between the Christian and Muslim societies, especially in a population where alcohol use has become part of the life of people. We analyzed the prevalence of alcohol use and related problems among Muslims and Christians in Minsk, Belarus.

After the aims and objectives had been explained, 65 Christians and 70 Muslims agreed to participate in the anonymous and randomized study which was conducted among students at major four universities in Minsk, Belarus. All respondents were administered the AUDIT, CAGE and MAST questionnaire. Statistical analysis was performed using SPSS 16.0 version for Windows and the Pearson χ2.

The present study revealed that no differences in both the number of alcohol users and problem drinkers exist (according to the results of all three screening instruments) among the Christians and Muslims. Alcohol users were 67.7% Christians and 57.1% Muslims. Problem drinkers were 27.7 Christians and 34.3% Muslims.

This study is an exceptional one where for both Christians and Muslims, the percentages (as well as the average scores) of alcohol users and problem drinkers were the same on the AUDIT, CAGE and MAST.

Stacy and coauthors have noted that cognitive motivations of a person might be necessary for many behavioral patterns (drug or alcohol use etc). The expected consequences and perception determine whether the individual starts to use alcohol or not, regularly or misuse it, consequently leading to alcohol problems or not. Expectations and motives are the proximal factors in alcohol use. Many theories have been used to explain the pattern of alcohol use in the society. The self-effectiveness and motivational theories have been widely used to explain why people use alcohol. Alcohol users are mostly affected by the motives they prefer. For example, social factors are mostly associated with alcohol misuse. Alcohol use to reduce stress is associated with solitary drinking. As in many other countries, alcohol use is a major public health problem in Belarus.

To identify the motivational factors of alcohol use and related problems within the general students’ population in Minsk, Belarus.

We analyzed the results of 1599 students in Minsk, Belarus, using the AUDIT, CAGE and other alcohol related questions.

Drinking to reduce bad mood (16.4%, p< 0.000001); on days of wages (14.9%, p< 0.00001); for the sweet qualities of alcohol (24.8%, p< 0.05); to get drunk (26.7%, p< 0.0001) were reported by 87.5% alcohol users (of which 17.7% were problem drinkers) as the major motivational factors of alcohol use and related problems.

In 1956 Ledermann Sully suggested a hypothesis of alcohol use - the pyramidal hypothesis of alcohol use distribution. According to this hypothesis, the increase in social alcohol users in a given society leads to a disproportional increase in percentages of heavy users. In the same way, decrease in the number of social drinkers will have the greatest effect on heavy drinkers. In most western countries, where there are high percentages of heavy drinkers, the pyramid is broad. While in Asian countries where there are fewer heavy drinkers the pyramid is a narrow one. The pattern of alcohol use according to the Ledermann hypothesis among various ethnicities - Slavs, Arabians and Nigerians in Minsk, Belarus were examined.

1345 Slavs, 120 Arabians and 44 Nigerians in Minsk were administered questionnaire containing the AUDIT and other alcohol related questions. On the AUDIT, a score of 1-7 defines social drinkers; 8-19 - heavy drinkers; 20-40 - alcohol dependence.

Social drinkers, alcohol abusers and people with alcohol dependence in the general Belarusian population were Slavs - 74.8%, 13.8%, 2.5% respectively; Arabians - 29.2%, 20.8%, 10.8% respectively; Nigerians - 30.8%, 11.5%, 3.8% respectively. According to the Ledermann hypothesis, this study shows that the pattern of alcohol use by Arabs could be denoted with a narrow pyramid (pattern of alcohol use in most Asian countries) and a broad pyramid (pattern of alcohol use in most western countries) for both Slavs and Nigerians.

The DSM-IV Cultural Formulation (CF) is the most important method of cultural assessment, but has not been sufficiently developed.

Based on a case, a proposal is being done here of an Abridged CF trying to:

1. 1 Identify the main cultural factors.

2. 2 Link this abridged CF to the general clinical formulation.

3. 3 Show the effectiveness in arrive at a differential diagnosis and garner patients’ adherence

: A Moroccan 23 year-old woman was admitted in a Psychiatric Service and diagnosed of a manic episode and harmful consumption of drugs and at the discharge she quickly relapsed.

The incorporation of an Abridged CF on her second admission was crucial in building a better therapeutic relationship. There were different explanatory models acting in the case:

1. a) her family thought that she was “bewitched” or that the cause were “drugs”;

2. b) the clinicians’ explanatory model was that of biological predisposition to mania, triggered by her drug intake and other vulnerability factors.

This procedure made it possible to reformulate her psychiatric condition and to associate therapeutic goals to the aims of her and her family. It clearly promote a more favourable course and outcome.

A valid abridged CF could foster its broader use in clinical psychiatry, whereas a mandatory full CF runs the risk of being underuse and it would impoverish psychiatric practice and limit the acceptation of psychiatry as a universal brand of medicine.

Spirituality is recognized as a key facet of a person's sense of self and wellbeing. In the UK 73% of psychiatrists reported no religious affiliation compared to 38% of their patients. 92% of psychiatrists in Britain believed that religion & mental illness were connected & religious issues should be addressed in treatment.

Audit Spirituality Assessments conducted in new cases admitted to hospital and new cases seen in clinic over a 3 month period(July-September 2009) in adult/elderly services.

Demographic data was collected from electronic patient records and casenotes/clinic assessment letters were reviewed for evidence of taking a spiritual history. Guidance for how to take a spiritual history was sought from Royal College of Psychiatry guidelines and recently published journal article (Advances in Psychiatric Treatment.May 2007;13:212-219). Evidence of a brief screening of spirituality, followed by a more detailed assessment were recorded.

75 cases were reviewed of which 39 were male and 36 female. There was an even distribution of age within the sample over 7 decades from age 20 to age 90. Of the 75 cases, only 2 (2.7%) had a brief assessment of their spirituality whilst the larger majority (97.3%) had no assessment. No detailed assessment of spirituality history was conducted.

The results indicate that assessment of spirituality is very poorly conducted in this sample and there is need for development. Recommendations from the audit include facilitation of further training in religion and spirituality history taking and for such training to be encompassed within induction training of junior doctors.

There is no direct relationship between migration and mental health, certain risk (e.g. acculturative stress) and protective factors of psychosocial well-being are inversely related with psychopathology. Acculturation strategies have been found to be related to psychopathology however this relationship has been minimaly examined with psychosocial well-being. The objectives of this study are to examine the relationship between acculturative stress, acculturation, and psychosocial well-being.

The sample consists of 150 immigrant inpatients hospitalized in tertiary care between 18 and 65 years of age. Acculturative stress, acculturation, social adaptation, anxiety and depression, as well as sociodemogrpahic and attitudinal items were evaluated.

With general health situation controlled, the study found a negative relationship between acculturative stress and psychosocial well-being, as well as between the marginalization acculturation strategy and psychosocial well-being. A relationship was found between acculturation strategies and acculturative stress. There is no positive relationship between the integration acculturation strategy and psychosocial well-being, although the majority of the study participants preferred integration, followed by assimilation. The latter is associated with lower levels of acculturative stress and higher psychosocial well-being. Separation, on the other hand, is associated with lower levels of anxiety and depression, and with a higher quality of life.

None of the acculturation strategies demonstrates a clear advantage in relation to psychosocial well-being, however, marginalization appears to be the least adaptive. It may be useful to revise the notion of what constitutes the most adaptive acculturation strategy for an individual, taking into account his or her psychosocial well-being.

To study the role of skin color as a distinct social component of racial/ethnic cultural identity in the context of Brazilian higher education students.

From an existing database holding information on 1,306 students at a Brazilian public university, economic, academic and demographic differences relating to skin color were explored, as well as their experiences of discrimination and stereotypes held by Black and Brown minority groups of students. As they share many features, they were analyzed together, regarding quantitative variables, and compared to the White majority group. Blacks and Browns were compared to one another when there was any quantitatively significant difference between them and for their responses to open-ended questions about racial/ethnic identity, experiences of racism and discrimination.

Both Blacks and Browns share social markers of disadvantages in Brazilian society, which is accentuated in university populations. Black students show the worst social-economic status. Blacks also have a more established involvement with ethnic traditions and they report more experiences of discrimination than the Brown group of students.

Different factors influence the individual's cultural identity, which, in turn, leads to the development of particular perceptions, thoughts and attitudes. Blacks and Browns in Brazilian society share, besides African origins, similar indexes of social markers and both are socially disadvantaged, when compared to the White population. Nevertheless, they are not similar in other respects. This study found that self-declared Black students usually have a more developed sense of ethnicity and participation in themes related to Afro culture.

The frecuency on attempts or completed suicide between musicians is elevated. Diverse explanations have been adduced, not only the comorbid substance abuse and the high incidence of depression, but also the bohemian style of life and the effects of music and poetry of their songs on their psychological state.

The biographies and artistic productions of 30 musicians who died by suicide since 1968 are reviewed, in order to analyze several aspects like suicide methods and the relation with demographic and psychopathologic variables.

Suicide methods more used were the traumatic ones being the hanging the most frecuent, although if we analyze the sample according the gender there is predominance in overdose toxic method. About 85% had psychiatric antecedents or were in treatment when died. There is substance abuse in more of 50% of the cases like alcohol in the first place and others drugs. The 33% of the sample had an affective disorder. The average age of the consumption of the suicide was in youth (in their thirties).

The risk of dying by suicide in youth is elevated in the musicians. Even though there are an amount of studies, there are any definitely data that had confirmed the link between creative or artistic process and mental illness or suicide.

Suicide is always the result of psychopathology, even though there could be a few exceptions.

Substance abuse and psychiatric comorbidity are associated factors with the suicide risk in this group, in special alcohol and affective disorders respectively.

The Chinese community is the largest ethnic minority community in Northern Ireland. Previous research findings showed that they had a low uptake of mental health services.

This study aims to examine the help seeking behaviours of Chinese people when they experience mental illness.

About 96% of Chinese in Northern Ireland worked in catering business. Questionnaires (both in Chinese and English) were sent to ninety-one addresses occupied by catering businesses in Belfast. Focus group meetings were held with mental health workers and community leaders.

Twenty-four questionnaires were returned. 66.6% reported that they visited their GPs the previous year. Only one person visited the GP for a mental / psychological problem. Poor recognition of mental illness (41.7%) and mental illness stigma (25%) were the main reasons for not seeking professional advice.

Focus group meetings revealed that most Chinese people who came into contact with mental health professionals had severe mental health problems. 40% of their Chinese patients were referred by hospitals, 30% by GPs and another 30% by mental health workers.The community generally had little knowledge about mental illness, which often resulted in delay in seeking appropriate professional help.

Conclusion: Findings revealed that the Chinese do seek help from their GPs but may not see their doctors when they or someone they know actually become mentally unwell. Further investigation is needed to explore different ways to provide information about mental illness symptoms and mental health services for the community.

Dementia cases account for about1.2-2.8% of total OPD case attended in Calcutta Pavlov Hospital.Retrospectively it was evident on scrutiny of the records of the year2005-2009.Profiles of Dementia cases those attended between the periods 1.4.08-31.3.09 were analysed, with special regard to DLB type dementia, which resembles much with Alzheimer's dementia but with pakinsonian features, visual hallucination, fluctuating cognative function, h/o falls,syncope, transient loss of concsiousness.

Clinical evaluation of dementia with lewy bodies among the dementia patients and asses a probable % of DLB dementia in our situation obviousely without an autopsy verification.

Here a study of probable DLB dementia status in the dementia population.

22 dementia cases were recorded in the 2008-2009 period.12 females &10 male dementia case, age ranging from 66-79 with a median age of 71.5years,were analysed.20 cases were confirmed by CTScan only, and 16 cases those were lacking vasculer cause were subjected to MRI Scan.

Among the dementia cases Alzhiemers Disease type accounts for 10 cases (< 50%), followed by mixed vas. & Alzh. in 5 case,and then Vasculer dementia in 4 cases, rest 3 (>1.4%) were found clinically to be as DLB cases.

DLB cases were 2 in female & 1 in male, all inthe category of 70-77 years age group.They were presented with gradual decline of cognition, with brady kinesia, & rigidity and in 1 male case with tremmors with attentional deficit. MRI shows more atrophy in midbrain &tegmentum areas.

With more diagnostic advent DLB dementia % may rise in future.