Mental health consequences of social decline due to unemployment, poverty and social exclusion should be adressed with locally and culturally responsive mental health services.

to influence development of mental health services in accordance with population needs.

to assess mental health needs of the local population.

Data on frequency of visits to psychiatric outpatient clinic, hospitalization and rehospitalization rates, benzodiazepine and antidepressant prescriptions as well as social status and social services´ use because od mental health disorders in the east north region of Slovenia are to be presented.

This is the region with one of the highest use of alcohol and BZD, with lowest income and high unemployment rate, rising in last years due to closing some large factories in the time of transition and economic crisis. The region also presents one of the highest sucide rates and high alcohol addiction problems.

Public mental health action regarding these problems is needed. Proposals for mental health needs assessment are to be suggested in this poster presentation.

Differences in prevalence rates between different ethnic groups in the Netherlands and Belgium have been demonstrated. But there is no data on treatment differences among ethnic groups in the Netherlands.

To obtain more knowledge on differences in mental health care among ethnic groups in the Netherlands.

To determine whether these minority groups will be more or less likely to be receiving psychotropic drugs.

A descriptive population study was performed using the Agis Health Database, containing data of approximately 1.5 million inhabitants of The Netherlands. Rates of prescriptions of psychotropic drugs from 2001 to 2006 and adjusted odds ratios for psychotropic drug prescriptions among native Dutch, Turkish, and Moroccan ethnic groups were calculated. These data were analyzed using logistic regression, adjusted for age, gender and socioeconomic status.

Among both the Moroccan and Turkish populations there was a higher risk of antidepressant drug prescriptions, antipsychotic drug prescriptions and a pronounced lower risk of ADHD medication en lithium prescriptions compared with the native population. Among the Turkish population the risk of anxiolytic drug prescriptions compared with the native population was increased.

Compared with the native population in the Netherlands, first and second generation Turkish and Moroccan immigrants had an increased risk of antidepressant and antipsychotic drug prescriptions and a decreased risk of ADHD medication and lithium prescriptions. Further research is needed to clarify if patients of different ethnic backgrounds with the same symptoms receive equal diagnosis and treatment.

The hypothalamic-pituitary-adrenocortical axis (HPA-axis) is involved in the regulation of the stress response. Dysfunction of this system is implicated in a variety of psychiatric and emotional disorders.

To explore the association between HPA-axis functioning, as measured by morning cortisol, and common psychiatric disorders and symptoms among a community sample of adolescents.

Data from a cross-sectional school-based survey of 501 school pupils, aged 15, were used to establish the strength of association between morning salivary cortisol and both diagnosis of psychiatric disorders and number of psychiatric symptoms. Analysis, conducted separately by gender, used multiple regression, adjusting for relevant confounders.

With one exception (a positive association between conduct disorder symptoms and cortisol among females) there was no association between cortisol and psychiatric diagnosis or symptoms. However, there was a significant two-way interaction between gender and conduct symptoms, with females showing a positive and males a negative association between cortisol and conduct problems. A three-way interaction showed that while the association between cortisol and conduct symptoms was negative among males with few mood disorder symptoms, among females with many mood symptoms it was positive.

Except in relation to conduct symptoms, dysregulation of morning cortisol levels seems unrelated to any psychiatric disorder or symptoms. However, the relationship between cortisol and conduct symptoms is moderated by both gender and mood symptoms. Our findings suggest research should concentrate on the moderated associations between cortisol, gender, and psychiatric symptoms.

The use of physical coercion and involuntary admission is one of the most controversial practices in medicine, it is now understood that perceived coercion is multidimensional and is associated with procedural justice and perceived pressures, and not simply related to the legal status of the patient.

We sought to determine the rate of physical coercion used and the perceived pressures and procedural justice experienced by the person at the time of involuntary admission and whether this influenced future engagement with the mental health services.

Over a 15 month period, people admitted involuntarily were interviewed prior to discharge and at one year follow-up.

81 people participated in the study and 81% were interviewed at one year follow-up. At the time of involuntary admission, over half of people experienced at least one form of physical coercion and it was found that the level of procedural justice experienced was unrelated to the use of physical coercive measures. A total of 20% of participants intended not to voluntarily engage with the mental health services upon discharge and they were more likely to have experienced lower levels of procedural justice at the time of admission. At one year following discharge, 65% of participants were adherent with outpatient appointments and 18% had been readmitted involuntarily. The level of procedural justice experienced at admission did not predict future engagement with services.

This study demonstrates that the use of physical coercive measures is a separate entity from procedural justice and perceived pressures.

The objective of this study was to determine the rate of observe patients Privacy by treatment team and its correlation with patient's satisfaction in an Emergency Department.

This was a cross-sectional correlation study that 260 hospitalized elderly patients in census method were recruited in Emergency Department of selected hospital of Tehran, Iran. Data were collected using a questionnaire included various dimensions in patients privacy and satisfaction. Data were analyzed using descriptive and analytic statistical methods by SPSS software.

Half of patients perceived that their privacy observed at poor to medium level. About 49.4% of patients reported that their privacy was observed at near to excellent to excellent level. Also about 1/3 of patients perceived that physical privacy and psychosocial privacy observed in medium level and their good information privacy. Satisfaction of 76.4% patients was low and medium. However satisfaction 50% of patients in physical privacy and 58.6% in information privacy was low. There is a strong correlation between level of privacy observed and satisfaction in various dimensions. There was significant correlation between some of the demographic variable and observes of privacy and satisfaction.

In regard to observe of privacy and satisfaction of the most of patients is not in good level thus it is need to specific attention of clinicians and educators to this point. Also interventions is need for better observe of privacy and patients satisfaction.

• • Ward rounds and clinical review meetings should reflect the recovery model for mental health and person centred planning. They play a pivotal role in hospital-based care. They should enhance the quality of patient care, improving communication and address service users’ concerns and problems.

• • They should involve users as fully as possible in the development and review of their treatment plan, allow proper planning and evaluation of treatment and facilitate multi-professional training and education.

• • This audit is designed to benchmark current practice against proposed standards outlined below.

To establish if the ward review practice in Prof. Benbow's team on Cedar Ward, Penn hospital is in line with the proposed standards and to consider whether the standards are appropriate.

• • The sample population includes patients or the cares involved in their care. Data was gathered by means of questionnaires and retrospectively from psychiatric case records between the period 01/001/2008 and 31/12/2008.

• • The questionnaires were both respondent and researcher completed. Open and close ended questions were used.

• • The findings showed satisfaction with the ward meeting process, but participants identified issues that could be improved upon.

• • Audit strength includes clearly defined standards and giving room for additional comments.

• • Limitations includes small sample size and poor response from patients and the carers.

The aim of the present study was to describe the population of juvenile sex offenders in the Canton of Zurich by a retrospective analysis of a consecutive sample of the police and judicial records between 2000 and 2008. Offence characteristics have been studied and compared to demographic and psychopathological factors of the adolescent offenders. Reoffence risk was assessed by the Juvenile Sex Offender Assessment Protocol (J-SOAP-II) and compared to sexual and general recidivism.

A youth-adapted version of the Forensic-Psychiatric Documentation System (FDPS) has been used for data collection. Recidivism has been assessed by the official crime database of the Canton of Zurich until October 2009.

Preliminary results show that the population of juvenile sex offenders is of heterogeneous nature. Intensity of sexual behavior and violence varies significantly in the sample (N = 351). Mostly the juvenile offenders have been arrested after committing one criminal act (56.4%). With exception of pornographic offences (35.9%), sexual coercion (32.8%) and sexual assaults against children (27.4%) were the most frequent crimes. Psychiatric assessments of the most serious juvenile offenders found frequent behavioral (43.6%) and emotional disorders (18.1%) but only one case of paraphilia. Results of risk assessment and recidivism are in preparation and will be added to the final presentation.

Juvenile sex offenders are a complex population and can not been compared to adult offenders according to offence characteristics and crime motivation. Developmental factors have to be included when assessing and treating juvenile sex offenders.

The study of psychic disorders and violence occupies a central place in the general and forensic psychiatry. A lot of various studies focused on grave crimes against personality, done by mentally diseased people have been carried out. A part of the studies are dedicated to the aggressive behavior of the schizophrenics - the risk of exercing violence turned out to be 3-5 times higher than in the general population.

Comparing of the clinicpsychopathological and socialpsychological characteristics between schizophrenic patients hospitalized voluntarily and those hospitalized non- voluntarily; setting up of:

1. 1. the factors forming the dangerous behavior with those patients;

2. 2. preventive ambulatory measures of the dangerous behavior.

Patients have been examined in the Regional hospital of psychiatry - Russe: 180 non-voluntary hospitalized schizophrenic patients and 110 schizophrenic patients treated voluntarily in hospital. The diagnoses of the specialists of psychiatry match the requirements of ICD 10. The objective assessment of the social functioning is included in the individual card of the research (assessed in a year,s time too). Also been used: PANSS (with additional questions towards the profile of the aggressive risk); a short version of the questionnaire of the WHO for an assessment quality of life.

The following factors are important when forming the dangerous behaviour: breaking up of the therapy for 1-3 weeks before hospitalization; obvious psychotic symptoms, personal changes; alcochol abuse; social disadaptation lack of social support, family rows and conflicts, material insecurity. The leading role of the social factors has been determined.

To make a critical review of the history, structure,facilities and practices as well as the laws governing the Nigerian juvenile justice system with a view to determine how well it can currently serve its intended purpose.

Information on the history, structure and current practices and existing laws were obtained from review of relevant literature and on-site visits to a juvenile remand home in South-West Nigeria.

The Nigerian juvenile system evolved during the British colonial era and was modeled after the British system. The few differences were mainly to accommodate local customs. However, over the years, the Nigerian juvenile justice system may have deviated beyond customary differences to include systematic ones. For instance record keeping is poor, and there are research evidence of widespread physical and emotional abuse of children while in custody. Also, a lot of young offenders are being processed in adult courts having being passed as adults by juvenile justice officers to avoid adhering to the legal requirements for their treatment. Furthermore, incarcerating forms of custodian care is the norm in Nigeria as non-incarcerating methods are not developed. The existing facilities are also in states of disrepair. Moreover The existing laws are obsolete and needs urgent review as some provisions runs contrary to children rights.Useful suggestions were offered.

The Nigerian juvenile system needs an urgent overhaul to be able to serve its intended purpose. The Government, Child mental health professionals and non-profit organizations all have a role to play.

To find out clinical factors which determine victimological behavior in adult persons with mental disorders who become victims of crime and to work out criteria of their competence to stand trial.

Psychopathological, psychological, statistical.

128 adult patients with different mental disorders were examined (organic brain disorders, mental retardation, schizophrenia, personality disorders). All were victims of crimes (rape, robbery, beating, fraud). According to Russian legislation persons who due to mental disorder can not understand the nature of the crime committed against them may not be put to trial. In such cases pretrial forensic psychiatric assessment must give a conclusion about capacity of a victim to give evidence. The study has revealed that the competence to stand trial is determined by severity of symptoms. The relation between psychopathologial symptoms and types of victimological behavior was revealed. Light symptoms determined psychological mechanism with provocative type of victim's behavior. In such cases victims could understand the nature of crime and give the evidence. Moderate and severe symptoms determined psychopathological mechanism and significant victimization of the patients with passive and aggressive types of behavior. Those victims could not understand the meaning of the crime and give evidence.

If the court decides that victim not competent to stand trial it can reduce revictimization of the patients avoiding traumatic experience of giving evidence in the court.

Substance abuse is associated with criminal recidivism. Substance abuse treatment has been found to correlate negatively with re-offending among treatment utilizers. However, for offenders with mental health problems and substance abuse, research on how substance abuse treatment affects re-offending is sparse.

The study aimed to examine the relationship between self-reported outpatient-based substance abuse treatment and self-reported a) re-offending, b) substance use and c) psychiatric problems among offenders with mental health and substance use problems.

Data were gathered from a naturalistic follow-up study with 208 participants, subjected to a court-ordered psychiatric assessment. This analysis covers 91 individuals who were followed-up after an average study period of 17 months. Among these, 68% had been sentenced to institutional imprisonment or forensic psychiatric care.

Offences, substance use and psychiatric problems declined between baseline and follow-up. However, the reduction was not associated with self-reported treatment utilization. Among participants who were sentenced to non-institutional corrections, more individuals had utilized outpatient-based treatment compared to individuals who were sentenced to imprisonment or forensic psychiatric care.

A definitive conclusion about the effect of treatment is difficult to draw. For instance, self-reported data may not reflect actual treatment consumption. However, one interpretation is that participants naturally recovered over time. Institutional correction might also have resulted in positive outcomes equivalent to outpatient-based treatment.

Murder-Suicide may be defined as extreme pattern of domestic violence. Research is hampered by the fact that with the death of the perpetrator the files are usually closed and an analysis of the cases is hardly possible. Knowledge about the circumstances of murder-suicide, however, is of special interest for the forensic-psychiatric expert when the perpetrator survives and the need for forensic assessment arises. Since forensic-psychiatric assessment is always based on comparison with similar cases we compared the files of surviving perpetrators of murder-suicide with those of lethal domestic violence.

All forensic-psychiatric expertises about surviving perpetrators of homicide-suicide which occurred in the region of Basle, Switzerland, between 1987 and 2006 (n = 6) were compared with those of perpetrators of homicide in a domestic environment (n = 20) in the same period.

There were comparatively more women but less foreigners among the perpetrators of homicide -suicide, their socioeconomic level was much higher and there were more children among the victims. The most frequent psychiatric diagnosis in both groups was personality disorder, but the range in the domestic murder group, however, went from no diagnosis at all to psychosis, i. e. assumed full criminal responsibility to assumed not guilty by reason of insanity. There was no case of not guilty by reason of insanity among the homicide-suicide group.

The disparities of these two patterns of domestic violence are much greater than we expected, which underpins the need for specific forensic assessment as well as preventive actions.

Drugs which affect the level of dopamine have also an impact on the level of prolactine and hence influence the sexual conduct of patients. Hypersexuality is a well known side effect of the treatment of Parkinson's' disease, whereas hyposexuality is a side effect of the drug-treatment of schizophrenia by classical and some atypical antipsychotics. The novel antipsychotic drug Aripiprazole, however, has a partial dopaminergic effect, causes no hyperprolactinaemia and might alter the sexual conduct of some schizophrenic patients.

Three case reports of patients with iatrogenic forensic-psychiatric relevant hypersexuality.

Case 1: Comparatively young Parkinson-Patient with sexual desinhibition, frequent visits in brothels contracting debts and sexual harassment towards women after treatment with Ropinirol.

Case 2: Chronic hebephrenic patient with homoerotic paedophilia, who only started molesting boys after changing medication from Olanzapine to Aripiprazole.

Case 3: Chronic-paranoid young schizophrenic patient with no criminal record who seriously assaulted a foreign woman short time after changing from Amisulpiride to Aripiprazole.

Hypersexuality as side effect of the treatment of Parkinson's disease is well known, it might be more important an issue, if the patient is young. Hypersexuality as side effect of the treatment with partial dopaminergic drugs should be considered in the drug treatment of schizophrenic patients.