To extensively review the European Court of Human Rights (ECHR) case law concerning psychiatric commitment, and to estimate the role of this supranational jurisprudence in the practice of contemporary psychiatry.

Using keywords to search the ECHR computerized database “HUDOC”, we reviewed all cases concerning psychiatric commitment registered between September 1953 and December 31, 2004. Four groups were identified: applications declared inadmissible; applications accepted but not judged by the Court; pending cases; and cases judged by the Court.

Of the almost 118,000 decisions taken by the ECHR in this time frame, we found 108 situations concerning psychiatric commitment. Forty-one of these applications were considered by the Court to be inadmissible. Twenty-four other cases were considered admissible but not judged by the ECHR. Three admissible cases were still pending at the end of 2004. The ECHR judged 40 cases, and found in 35 of them that one or several rights as guaranteed by the Convention had been violated.

The ECHR protects the human rights of persons subjected to involuntary psychiatric commitment by creating supranational law in the following areas: definition of “unsoundness of mind”; conditions of lawfulness of detention; right to a review of detention by a Court; right to information; right to respect for private and family life; and conditions of confinement, which address inhuman and degrading treatment. The respective number of applications submitted to the ECHR did not depend on when the Convention had entered into force in that country.

The possibility of an individual to access the ECHR depends on the degree of democracy in his country and on the access to legal assistance through non-governmental organizations or individual intervening parties.

– It is commonly assumed that reforms in the sector of psychiatric care have contributed to reducing the stigma attached to mental illness. In order to examine whether a relation between the psychiatric care set-up and stigmatisation of the patients exists we compared public attitudes towards mental patients in three countries at differing stages of progress in psychiatric reform.

– Population surveys on public attitudes towards mental patients were conducted in Novosibirsk (Russia) and Bratislava (Slovakia). The data were compared with those from a population survey that had recently been carried out in Germany. In all three surveys the same sampling procedure and fully structured interview were used. Public attitude towards mental patients was elicited using a perceived devaluation-discrimination measure.

– Psychiatric patients face considerable rejection in all three locations in question. Overall, the degree of perceived devaluation and discrimination was similar in all countries with a significant, but marginal tendency towards stronger devaluation of mental patients in Germany.

– Our results do not support a strong relationship between psychiatric reform and mental illness stigma.

– In the health sector, anywhere in the world nurses are one of the most exposed groups to violence. However, it is not obvious that psychiatric nurses (PNs) are more exposed to aggression and burnout.

– To determine the nature and effects of aggressive acts towards nursing staff in psychiatric and other medical services in Poland.

– Various questionnaires (Stress at Work Scale, General Health Questionnaire, Maslach Burnout Inventory, Work Satisfaction Scale), were distributed among psychiatric (N = 78) and non-psychiatric nurses (N-PNs) (N = 335). A 92.6% response rate was achieved.

– Significant differences were found between PNs and non-psychiatric counterparts with respect to their experiences of violence. The most frequently reported incident was verbal abuse, followed by threats and physical assault. Patients were significantly more frequent perpetrators in psychiatric wards than in others. The level of intra-staff aggression did not significantly vary between groups, neither did the level of work satisfaction and absenteeism.

– The frequency of violent acts and stress related to them point out the strong need for the development of preventive programs to address the issue of violence at work.

The study sought to determine whether an organized health promotion intervention during medical consultations improves the outcome for patients who meet the ICD10 criteria for anxiety or depressive disorders.

In 2001, physicians used the MINI to screen 9743 employees on sick leave and consulting physicians in 21 medical centres of a large company. A health promotion intervention was implemented in eight “active” centres. It took place immediately after diagnosis and consisted of explaining the disorders, delivering the test results and leaflets based on WHO recommendations, and advising patients to consult their personal physician, psychiatrist or occupational physician, if necessary. Its effectiveness, evaluated by symptom severity and outcome over 1 year, was assessed by comparing the eight active centres to 13 control centres (without the intervention).

Disorders were detected among 10.6% of the subjects, 29.4% of whom had no previous diagnosis of anxiety or depressive disorder. The intervention was associated with a positive effect on the 6-week and 6-month HAD scores. Total absence of disorders at 1 year was associated with age, sex, and intervention, among all identified cases (OR = 1.53), among those with at least one anxiety disorder (OR = 1.45), and among those with at least one depressive disorder (OR = 1.40).

Combining detection with organized provision of information including printed material improves patients' outcome and physicians' diagnostic abilities.

– To describe the utilization, geographical variations and adaptation of ECT in the Spanish context.

– A cross-sectional study, involving a questionnaire delivered to all hospitals with a Psychiatry Unit (PU) in Spain included in the National Hospitals Catalogue (N = 233). A descriptive analysis was made of the answers to the different questions, using an adequate denominator in each case: all PUs (n = 233), those units that prescribe and apply ECT (n = 174), or only those that apply the technology (n = 108).

– All PUs completed the questionnaire. Fifty-nine units (25.3%) neither prescribed nor applied ECT, while 108 (46.4%) prescribed and applied the technology, and 66 PUs (28.3%) only prescribed ECT. Those units with training responsibilities for psychiatry residents or pregraduate students, and those with a larger number of beds, were more inclined to apply ECT. The estimated ECT applied in the preceding 12 months totaled 2435 with an annual rate per 10,000 inhabitants of 0.61, and a range per Spanish Autonomous Community of 0.28–16.59.

– We now know a reliable rate and characteristics of the use of ECT in Spain, and the attitudes and opinion of PUs Spanish psychiatrists about it. We found a very important variability in ECT application rates among Autonomous Communities.

The 28-item version of the General Health Questionnaire (GHQ-28) developed by Goldberg and Hillier in 1979 is constructed on the basis of a principal components analysis of the GHQ-60. When used on a Spanish population, a translation of the GHQ-28 developed for an English population may lead to worse predictive values.

We used our Spanish sample to replicate the entire process of construction of the GHQ-28 administered in a primary-care setting.

Two shorter versions were proposed: one with six scales and 30 items, and the other with four scales and 28 items.

The resulting GHQ-28 was a successful adaptation for use on the Spanish sample. When compared with the original version, only 21 items were the same. Moreover, contrary to the English version, which groups sleep problems and anxiety in the same scale, a scale with items related exclusively to ‘Sleep disturbances’ was found.

– Earlier studies on the influence of pregnancy and postpartum period on the course of panic disorder have been inconsistent. The present study aims to quantify panic manifestations in these periods in large sample of women.

– Panic manifestations, including exacerbations and new manifestations of panic disorder, were assessed retrospectively in a sample of 128 women with panic disorder with or without agoraphobia, 93 of whom had had 195 pregnancies.

– Panic manifestations were fewer during pregnancy and more frequent in the postpartum period when compared with the control period. Women who had never been pregnant had significantly more panic manifestations than women with prior pregnancies. Breastfeeding and miscarriages did not have a significant effect. Women with postpartum panic reported more psychosocial stress events during this period.

– Possible reasons for postpartum panic and the protective effects of pregnancy are discussed, including psychosocial or hormonal factors and other neurobiological changes. Postpartum panic coincides with a sudden drop of hormones after delivery.