Throughout the course of care, sexuality's patients with urological cancer can be distorded. The aim of the study was to determine the influence of urological cancer on quality of life and the impact of the disease on their psychological state and social lives.

This is a descriptive study that took place from July until mid-October 2012 in a urology department including 36 male patients with urologic cancer (bladder cancer…)

We used: SF36, HAD scale, Neuroticism scale.

We noticed that the average age of patients; 93.3% were married. The mean age of discovery cancer was 65.9 + / - 11.74 years.

Before starting treatment, erectile dysfunction has increased to 83.3% suggesting the involvement of a psychological effect, especially with the reached the urogenital tract and an unpredictable violation of their sexual life.

After treatment, erectile dysfunction was observed in 86.7% with a decrease in libido 96.7%, with psychological and organic effect.

Anxiety score ranged from 2 to 16; 23.3% of patients had a score above 10 and 40% of them have belong to level 3 of depression.

An average score of neuroticism was 146.53 + /- 20.44 with a maximum of 181.

The average score of SF36 was 61.05 + / -16.42 and we noted that 67.5% of patients had impaired quality of life.

A program to improve the care of patient with urological cancer is very important, because the dimensions of sexual health and his effect on quality of social life and psychology.

Recent neuroendocrinological studies have suggested that gonadal sex hormones play a significant role in the pathophysiology of schizophrenia. Low testosterone levels are also associated with negative symptoms in chronic schizophrenia. Patients receiving treatment for schizophrenia or schizoaffective disorder also show high rates of sexual dysfunction. Studies suggest that testosterone augmentation may play a potential therapeutic role in these patients.

To study a cohort of schizophrenia patients for the presence of hypotestosteronemia.

To establish that low testosterone hormone levels occur at a lower age in schizophrenia population.

We reviewed the total testosterone levels of all male schizophrenic patients seen in our office over a period of one year for a routine yearly physical. The blood was tested by LabCorp using the liquid chromatography/tandem mass spectrometry (L/MS-MS). Normal values using this sensitive method are between 348.0–1197 ng/dL.

There were a total of 61 male schizophrenia patients who had their testosterone levels tested during this period. Their ages ranged from 22 to 48 years. 23 (38%) out of the 61 men had serum testosterone less than 348 ng/dl, while 38 (62%) had testosterone levels between 348 ng/dl and 1197 ng/dl. None had testosterone levels above normal.

A significant number of our male patients with schizophrenia had hypotestosteronemia. Since gonadal sex hormones play a significant role in the patho-physiology of schizophrenia, testosterone levels should be routinely measured in the male patients. The role of testosterone supplementation in these patients needs to be further explored.

Teachers are potential partners in the referral and management of children with Attention Deficit Hyperactivity Disorder (ADHD) especially in resource constrained settings. However, their ability to play this role is a function of their knowledge of ADHD and their attitude towards children with the disorder. There is paucity of information on the attitude of Nigerian school teachers towards children with ADHD.

This study assessed the attitude of a sample of primary school teachers in Lagos, Nigeria towards children with ADHD.

Primary school teachers (n = 144) recruited from four mainstream schools in Lagos State were presented with vignettes describing school children with ADHD. Thereafter, they completed questionnaires which elicited their knowledge of ADHD and attitudes towards children with the disorder.

The responses of the participants indicated a high level of misperception about ADHD and negative attitudes towards children with the disorder. Only 9.0% and 16.7% of the respondents agreed that ADHD could be successfully managed with medications and psychological interventions respectively. One out of four (25.7%) teachers affirmed that they would avoid relating with a child with ADHD, while 35.4% would be unwilling to accept a student with ADHD in their class.

There is a high level of misperception about ADHD among Primary school teachers in Nigeria. This highlights the need for educational Interventions targeted towards improving the knowledge of teachers about ADHD. Furthermore, mental health literacy could be incorporated into the curriculum of institutions training primary school teachers.

To investigate the characteristics of the aggressive in-patient in a Danish forensic hospital.

The study was conducted in a forensic psychiatric setting at Psychiatric Centre Sankt Hans. It utilizes data from the three year period between 2008 and 2010. Staff Observation Aggression Scale - Revised (SOAS-R) is used to examine all aggressive incidents during the period mentioned.

212 patients were admitted between 2008 and 2010, the majority of which being mainly men (98.6%) with a diagnosis within ICD10 F20-F29 (79.7%). In total there were 1507 recorded aggressive incidents, and 63.2% of the patients were registered with at least one incident of aggression. Ethnic minorities were overrepresented in comparison to the background population (37.3% vs. 9.5%).

We found that Danish-born patients were more frequently aggressive compared to ethnic minorities (OR 1.8 p = 0.029), and that alcohol/substance abuse was a predictor of aggression (OR 3.47 p =< 0.001). According to age we found that the aggressive patient was significant younger compared to the non-aggressive patient (p = 0.043).

Aggression is a prevalent phenomenon in a forensic psychiatry setting. Patients with at least one aggressive incident as recorded in the SOAS-R are characterized by being male, Danish and abusing. In addition schizophrenia is the most frequent diagnosis in forensic psychiatry at Psychiatric Center Sankt Hans.

Patients with schizophrenia have higher cardiovascular morbidity and mortality compared to the general population. They also have high levels of cardiovascular risk factors: hypertension, smoking, raised glucose, physical inactivity, obesity and dyslipidaemia, Hypertension has significant negative effect on immediate delayed and recognition memory in these patients. However, its presence in institutionalized patients with schizophrenia has not been well studied.

To establish a high prevalence of hypertension in institutionalized patients with schizophrenia.

To confirm a high prevalence of hypertensive treatment in these patients.

Four residential institutions for patients with schizophrenia were chosen for the study. There were a total of 145 patients with schizophrenia. The first had 48 patients, males 30 and females 18, the second had 42 patients; 29 males 13 females, the third had 27 patients; 13 males and 14 females and the fourth had 28 patients; 15 males and 13 females. Compurterized print outs from the pharmacies and records from the institutions and office were reviewed.

Of the 145 institutionalized schizophrenia patients, there were 87 males (60%) and 58 females (40%). The average age was 55.76 years. Of these 145 patients, 82 (56%) were on treatment for hypertension and 63 (44%) were not. Of the 87 males, 47(54%) were hypertensive 40 (46%) normotensive. Of the 58 females, 35(60%) were on antihypertensive treatment and 23 (40%) were normotensive.

56% of our institutionalized patients with schizophrenia were on anti-hypertensive treatment. Due to close medical monitoring, awareness and treatment was one hundred percent.

Frequent attenders to the Accident & Emergency (A&E) can cause a huge burden on the services.

To screen this group of patients for any previous existing psychiatric background as well as to identify patients with Medically Unexplained Physical Symptoms (MUPS) in order to sign post them to the appropriate services and to create a joint management plan with the A&E department.

Not different from the objectives.

The list top 52 frequent attenders to two busy A&E departments in the North East of England for the period between Jan-Jun 2012, was obtained. Their records been verified on PARIS (the local Psychiatric Services Electronic Notes System) looking for at least one previous encounter with the services, if the patient was open to mental health and if the patient was care coordinated during that period. Diagnosis, history of substance misuse and significant alerts as well as housing were recorded. For the MUPS main reason for presentation was recorded. Joint care plan with A&E was also verified.

This group generated 851 attendance to A&E during this period. Mean attendance 16 (12-41). Nearly 80% of the sample had at least one encounter with the psychiatric services. 40% were actively open to the services. 18 patients were care cordinated. 30% had significant alert to harm others. 9 patients in total were classified as homeless.

Significant number of regular patients at the A&E department have psychiatric background. There was limitation in identifying MUPS due to anomalies in coding.

Analysis of barriers regarding the attendance of the health care system under consideration of cultural- and migrationrelated factors.

Cross-sectional survey with immigrants from Turkey (n = 77), Spain (n = 67), Italy (n = 95) and German resettlers from the former Soviet Union (n = 196), recruited on migration and addiction services of the German Caritasverband, the Arbeiterwohlfahrt and migrant organizations.

Spanish and Italian immigrants mainly search for help in their families and social environment. Immigrants from the former Soviet Union use home remedies and experience more linguistic difficulties as barriers for the use of health services, just like Turkish immigrants. Turkish immigrants reported feeling misunderstood regarding their cultural peculiarities by the expert staff as another main barrier. Other major influence factors were German language proficiency and the subjective wellbeing in Germany.

The consideration of cultural-related as well as linguistic factors in health care services is an essential contribution for improving health care of immigrants.

Description of a manic episode with psychotic symptoms in a patient by consumption of energy drinks.

Literature review of the relationship between energy drink consumption and the possibility of suffering a manic episode and description of a clinical case.

This case report describes a patient with no history of psychiatric interest suffers a manic episode with psychotic symptoms after consuming high amounts of energy drinks.

To my knowledge, this is one of the few cases that describe a manic episode in relation to the consumption of energy drinks, given this possibility, clinicians should consider asking about the consumption of energy drinks to young people without previous psychiatric history presenting a manic episode.

Patients with schizophrenia have higher cardiovascular morbidity and mortality compared to the general population. They also have a high levels of cardiovascular mortality risk factors: hypertension, smoking, hyperglycemia, physical inactivity, obesity and dyslipidemia, However, the presence of type 2 diabetes mellitus in institutionalized patients with schizophrenia has not been well studied.

To establish an association between type 2 diabetes mellitus and schizophrenia in patients living in residential homes.

To confirm a high prevalence of diabetes mellitus treatment in these patients.

Four residential institutions for patients with schizophrenia were chosen for the study. There were a total of 145 patients with schizophrenia. The first had 48 patients, males 30 and females 18, the second had 42 patients; 29 males 13 females, the third had 27 patients; 13 males and 14 females and the fourth had 28 patients; 15 males and 13 females. Computerized pharmacy print outs and records from the institutions and our office charts were reviewed.

Of the 145 institutionalized schizophrenia patients, there were 87 males (60%) and 58 females (40%). The average age was 55.76 years. 39(27%) of 145 patients were on treatment for DM; 106(73%) had no diabetes mellitus; 18 (21%) of 87 males had DM and 69 (79%) had no DM; 23 (40%) of 58 females had DM and 35(60%) had no DM.

Type II diabetes mellitus is extremely common (27%) in institutionalized patients with schizophrenia. Due to close medical monitoring, awareness and treatment is one hundred percent.

To introduce some questionnaires related to family environment such as FAD-GFS (The General Functioning Scale of the MacMaster Family Activity Device), SLE (stressful life events), FSQ (Family Stresses Questionnaire), FLQ (Family Life Questionnaire), EFQ (Everyday Feelings Questionnaire) and evaluate their validity and reliability.

Using cross-sectional design. The general questionnaire, FAD-GFS, SLE, FSQ, FLQ, EFQ were used to collect information about family environment from 504 parents of only children FACESII-CV and Index of General Affect were used as scale of criteria related.

The reliability and validity of FAD-GFS, SLE, FSQ, FLQ, EFQ is: Cronbach coefficient were 0.695 to 0.749; re-test reliability were 0.712 to 0.901; The scores of the scale in those questionnaires were correlated with each factor significantly and the coefficient of correlation is more than those between each factor of those scales. The correlation between the scores of FSQ, EFQ and the scores of Index of General Affect was-0.192, 0.539; The correlation between the scores of FAD-GFS, FLQ the score of total and three factor differently and the scores of family cohesion scores (FACESII-CV) was -0.423, 0.237, 0.514, 0.302, 0.210.

FAD-GFS, SLE, FSQ, FLQ, EFQ has good reliability and validity, in line with requirements of psychometric and is useful as a tool to evaluate the family environment.

The hardness of military service, the implementation of behavior of a person within the charter and the type of the personality are the important factors that led to the suicidal attempts during the adaptation period.

Current analysis were 95 militaries, who surveyed and treated at psychiatric and surgery department of Central Clinic Hospital of Armed Forces, after “unlucky” attempts of suicide (analysis for the period 2001–2011). Aged between 18–21.

64.1% of the suicidal attempts of militaries during the adaptation period was observed in the first 6 months. 18.2% of them registered in the first month. In general, 77.7% of surveyed have secondary or incomplete secondary education. On time of days the greatest rating of suicides 37,8% fell at evening time. There were no complications in hereditary mental illnesses among the 93.9% of surveyed (complications only in 6.0% of them). Depending on the daytime and the season, 53.3% of suicidal attempts was observed at noon and 27.7% of suicidal attempts registered in autumn and winter. Only 24.8% of suicidal attempts made by military officers (85.1% by soldiers).

Main causes of suicide among the conscripts are: severities during military service adaption owing to weak preinduction training, low mental attitude and motivation of soldier caused with the omission in education, the current situation in the family, targeting and mockery from fellow servicemen; heavy moral climate in some military units, increased physical and mental stress associated with understaffing personnel of military units, and other negative factors in military sevice activities.

Tuberculosis (TB) is an infectious disease whose presentation is dependent on host defenses, whereas neuroimmune disregulations are a feature of major depressive disorder (MDD). There are complex interactions between the immune and nervous systems; Tumor Necrosis Factor alpha (TNF-a) has been shown to play a role in the pathophysiology of both TB and MDD. These diseases are prevalent in Mexico, however there is scant research addressing their comorbidity and related immune mechanisms.

Evaluate differences in TNF-a levels and quality of life between subjects with TB and/or MDD.

Thirty-seven subjects (MDD = 10, TB = 9, TB + MDD = 8, controls = 10) were recruited. Instruments used were the SCID-I, Beck Depression Inventory, Hamilton Depression Scale and the World Health Organization Quality of Life survey. A blood sample was obtained from each subject to assess percentage of mononuclear cells positive for TNF-a, using an intracellular cytokines assay.

Highest mean levels of TNF-a were found in the comorbid TB + MDD group (X = 10.46, DE = 14.59) while the control group had the lowest levels (X = 3.26, DE = 4.93). However, when comparing all groups, no statistically significant differences were found. Mean quality of life scores were lower in the MDD (X = 65.6, DE = 5.4) and TB + MDD (X = 66.2, DE = 14.5) groups. When comparing all groups, there were significant differences between TB vs. MDD (p = 0.013), TB vs. TB + MDD (p = 0.004) and MDD vs. control (p = 0.0002) groups.

No significant differences across groups were found regarding TNF-a levels, while subjects with MDD and TB + MDD showed a worse quality of life.

The Integrated plan (IP) is an interdepartmental document in the implementation of which 25 relevant Ministries, departments, executive authorities and public organizations are involved. The coordinator and responsible executor is the Ministry of Health.

Of the IP to reduce the level of suicides among the population of the Republic of Belarus.

The main efforts are focused on the following areas: developing of normative documents regulating the rendering of aid to people in crisis situations; teaching the workers of educational, health and social institutions to identify depressions and suicidal signs at an early stage; implementation of multidisciplinary approach in rendering aid to patients in the crisis conditions; spreading information about the activity of suicide prevention services.

As a result of implementation of the activities of the IP, already in 2010 it was observed that the overall number of suicides committed in Belarus reduced for 9.6% in comparison to 2009. In 2011 the rate of suicides reduced in comparison to 2010: in general population - for 12.3%, from 2478 to 2170 cases, with the relative rate lowering from 26.1 to 22.9 cases per 100.000 of population. The rates are minimal in the last 15 years.

The implementation of the Integrated Plan of suicidal behavior prevention in 2009-2011 allowed to stabilize the suicide situation and to reduce the rates of suicidal activity of the population.

Polypharmacy, involving anti-psychotic drugs as well as drugs for co-morbid conditions is common. We report a patient on 31 different medications involving taking at least 40 pills a day.

To highlight the problem with excessive polypharmacy.

To report a case of extreme polypharmacy.

The medical and medication chart of one patient was reviewed due to extreme polypharmacy.

The female patient aged 67 was on the following 32 medications: Fexofenadine 180 mg, Amlodipine 5 mg, Asprin 81 mg, Bupropion-XL 150 mg, Citalopram 10 mg, Citalopram 20 mg, Clobetasol 0.05% cream, Clonazepam 1 mg, Rosuvastatin 10 mg, Divalproex-ER 500 mg, Ferrous Sulphate 325 mg, Furosemide 20 mg, HC Valerate 0.2% cream, Ibandronate Sod 150 mg, Lamotrigine 100 mg, Levothyroxine 50 mcg, Losartan Pot 100 mg, Meloxicam 7.5 mg, Metoclopram 10 mg, Oxycod/Apap 5-325, Plavix 75 mg, Polyeth Glyc 3350 NF Powder, Pot. Cl Micro 20 Meq, Promethazine DM, Omeprazole 20 mg, Os Cal 500 plus D, Quetiapine Fum 200 mg, Quetiapine 300 mg, Multivitamin Stovite One,Trazodone 100 mg, and Vitamin D 400 units. Overall, the patient was taking 38 - 41 pills per day, oral liquid medication 2-5 per day and applying two lotions for a total of 4 times per day.

This case illustrates extreme polypharmacy. Although all medications may be clinically warranted, co-morbid conditions and seeing different specialists can result in runaway polypharmacy. Non-compliance, drug-drug interactions and serious side effects can result from extreme polypharmacy. The cure can potentially become a disease.

Schizophrenia is a complex and heterogeneous disease. Several psychiatric conditions including depression, obsessive-compulsive disorder, panic attacks, aggressive and violent behavior and substance abuse are frequently associated with schizophrenia. Non-psychiatric comorbid conditions are also common in this population.

To evaluate the presence of non-psychiartic comorbid condtions in patients with schizophrenia.

This study looked at the medication history for non-psychiatric comorbid condtions in patients with schizophrenia.

Four residential institutions for patients with schizophrenia were chosen for the study. There were a total of 145 patients with schizophrenia. The first had 48 patients, males 30 and females 18, the second had 42 patients; 29 males 13 females, the third had 27 patients; 13 males and 14 females and the fourth had 28 patients; 15 males and 13 females. Medications were reviewed for the following comorbid conditions: hypertension, diabetes mellitus, asthma/COPD, hypercholesterolemia, arthritis, hypothyroidism, osteoporosis and miscellaneous.

Of the 145 institutionalized schizophrenia patients(87 males (60%) and 58 females (40%); aged 28 to 82 years), comorbid conditions being treated were as follows: hypertension: 82(56%); diabetes mellitus:39(27%); lung disease 37(26%); hypercholesterolemia 50(35%); arthritis 28(19%), hypothyroidism 11(6%), osteoporosis 7(5%) and others 50(35%). There were only 24(17%) patients who had no treatment for any comorbid conditions.

The vast majority (83%) of institutionalized patients with schizophrenia are on medications for multiple nonpsychiatric comorbid conditions. Psychiatrists need to be cognizant of this clinical complexity and the resultant polypharmacy in this population. Continuing care should be coordinated with a general medical practitioner.

Mental retardation can complicate the clinical course and outcome of bipolar disorder. How mental retardation affects the inpatient care of bipolar disorder warrants further investigation.

Information regarding demographic characteristic, pre-admission use of outpatient services, medical co-morbidities and indices of inpatient health resources use (length of admission, hospitalization expenses and use of psychotrophic medications) of all individuals diagnosed with bipolar disorder and mental retardation first admitted between 2000 and 2010 was extracted from a total population claims database in Taiwan and compared with those admitted during the same period due to bipolar disorder. Confounding factors affecting health utilization, including age, differences in hospital payment standard and medical cormobidity, were controlled by multivariate analysis.

451 and 13,513 bipolar patients with and without mental retardation were identified during the study period. For the index admission, bipolar individuals with mental retardation were younger, had longer hospital stay with higher total expenditures, and tended to be transferred for continual inpatient treatment. They also received smaller dosage of antipsychotics, lithium and benzodiazepines. Although the number of medical co-morbidity did not differ, the prevalence of hypertension and metabolic disturbances was lower among bipolar individuals with mental retardations.

The diagnosis of mental retardation was indeed associated with longer inpatient hospitalization and increased total cost of hospitalization expenses, despite being younger, with less metabolic imbalance and receiving less psychotrophic medications. Implications for the long-term course of bipolar disorder need to be confirmed by longitudinal follow-up studies.