Search results for: psychiatric morbidity

Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: D. Velayadum, P. Sthandiwe , N. Maharaj, T. Munien, S. Ndamase, G. Zulu, S. Xulu, F. Oosthuizen

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Introduction and aims of the study: It is the responsibility of the pharmacist to manage drug-related problems in order to ensure the greatest benefit to the patient. In order to prevent drug-related morbidity, pharmacists should be aware of medicines that may contribute to certain drug-related problems due to their pharmacological action. In an attempt to assist healthcare practitioners to prevent drug-related morbidity (PDRM), indicators for prevention have been designed. There are currently no indicators available for primary health care in developing countries like South Africa, where the majority of the population access primary health care. There is, therefore, a need to develop such indicators, specifically with the aim of assisting healthcare practitioners in primary health care. Methods: A literature study was conducted to compile a comprehensive list of PDRM indicators as developed internationally using the search engines Google Scholar and PubMed. MESH term used to retrieve suitable articles was 'preventable drug-related morbidity indicators'. The comprehensive list of PDRM indicators obtained from the literature study was further evaluated for face validity. Face validity was done in duplicate by 2 sets of independent researchers to ensure 1) no duplication of indicators when compiling a single list, 2) inclusion of only medication available in primary healthcare, and 3) inclusion of medication currently available in South Africa. Results: The list of indicators, compiled from PDRM indicators in the USA, UK, Portugal, Australia, India, and Canada contained 324 PDRM. 184 of these indicators were found to be duplicates, and the duplications were omitted, leaving a final list of 140. The 140 PDRM indicators were evaluated for face-validity, and 97 were accepted as relevant to primary health care in South Africa. 43 indicators did not comply with the criteria and were omitted from the final list. Conclusion: This study is a first step in compiling a list of PDRM indicators for South Africa. It is important to take cognizance to the fact the health systems differ vastly internationally, and it is, therefore, important to develop country-specific indicators.

Keywords: drug-related morbidity, primary healthcare, South Africa, developing countries

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Authors: Muhammad Tahir Khalily

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Aim: The purpose of the present study was to examine the effectiveness of alpha-theta brainwave Neuro feedback treatment for the internal self-exploration of individuals with conversion disorder. Method: A Purposive sample technique was used and data collected from Kalsoom International Hospital Islamabad and Al-Malik Medical Center Rawalpindi. 123 participants were examined, Male child = 5, female child = 6, male adult = 64, female adult = 48. This study retrospectively examined the symptomatic changes in clients with a range of psychiatric disorders particularly 13 (Male = 3, Female = 10) conversion disorder clients who have received Neuro feedback treatment. Results: Our results indicated a significant improvement (P < .001) in the amelioration of our clients’ symptoms which have enabled them to bring their emotional memories into conscious awareness for the peaceful resolution without self-detachment. Conclusion: Majority of the clients improved their psychiatric symptoms including the symptoms of conversion disorder and was discharged from therapy with the accomplishment of therapeutic goals.

Keywords: EEG, neurofeedback, conversion, therapy

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Authors: Jibran Abbasy, Rizwan Sultan, Ammar Humayun, Tabish Chawla

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Background: Hydatid disease caused by Echinococcus Granulosus affects liver in 70-90% of cases. Dogs are the definitive host while humans are the accidental host. Modalities used for its treatment are especially important for our population as the disease is endemic in many Asian countries. The aim of the study was to perform an audit of the various modalities used for treatment of hydatid disease of liver and the response to each modality in tertiary care center of Pakistan. Materials and Methods: Retrospective audit of patients diagnosed and treated for Hydatid disease of the liver at Aga Khan University Hospital from 1st January 2007 to 31st December 2014 was completed. All patients aged 16 and above were included. Patients who had extra hepatic disease and missing records were excluded. Outcome measures were morbidity, mortality and recurrence of the disease. Results: During the study period 56 patients were treated for isolated hepatic hydatid disease and were included. Mean age was 39 years with 48% being females and 52% males. Most common presenting complaint was abdominal pain seen in 53% of patients(n=41). Duration of symptoms was less than 6 months in 74% (n=38). Mostly right lobe was involved in 69% (n=38).Most common treatment modality used was surgery in 34 patients followed by PAIR in 14 patients while 8 patients were treated medically. At a median follow up of 34 months recurrence was seen in 2 patients treated with PAIR while no patient treated with surgery had recurrence with the median follow up of 20 months. While no morbidity and mortality were observed in PAIR, but in surgery 5 patients had morbidity while 1 patient had mortality. Conclusion: Our data is comparative to other studies in terms of morbidity, mortality, and recurrence. We had adequate follow up. In our study PAIR and surgery both are effective and have less complications and recurrence rate. Surgery is still the gold standard in terms of recurrence.

Keywords: echinococcous granulosus, puncture aspiration irrigation reaspiration (PAIR), surgery, hydatid disease

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Authors: Maria Malliarou, Efrossini Lyraraki, Pavlos Sarafis, Theodosios Paralikas, Styliani Kotrotsiou, Evangelia Kotrotsiou, Mairy Gouva

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Women with breast cancer have to adapt to physical malformations, side effects of chemotherapy, emotional insecurity, and changes in social roles. Inability to recognize the co-morbidity of psychiatric conditions can have an aggravating effect on patient compliance in therapeutic interventions, resulting in treatment delays and an impact on overall survival. The purpose of this study was to identify the quality of life of breast cancer patients undergoing external radiation therapy and to correlate it with depression and anxiety. Patients were asked to respond to an anonymous questionnaire with general demographic and clinical questions, followed by the EORTCQLQ-C30 questionnaire for assessing the quality of life of patients with breast cancer. Hospital Anxiety and Depression Scale (HADS) as well as the Depression, Anxiety and Stress Scale (DASS-21) was also administered. The statistical analysis of the data was done in IBM SPSS. Results indicated that the incidence of anxiety and depression in breast cancer patients is high both in HADS (37.5 % with mild to moderate depression and 62.5 % with significant to severe depression) and DASS - 21 (39.2 % mild to moderate depression and 60.8 % significant to severe) scales. The correlation of anxiety and depression with life quality was negative for HADS (r = -, 810, p = .000) as well as for DASS-21 (r = -, 682, p = .000). The psychological impact of breast cancer on patients is important. Its correlation with the quality of life may lead to better tolerance to treatment and better effectiveness of the therapeutic approach.

Keywords: anxiety, breast cancer, depression, quality of life

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Authors: Abir Dey, Shams Noman

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Introduction: Offshore Island is the remote and isolated area from the terrestrial mainland. They are deprived of their needs. The children from an offshore island are usually underserved in the case of health care because it is a remote area where the health care systems are quite poor compared to mainland. So, the proper information is required for appropriate planning to reduce underlying causes behind visual deprivation among the surviving children of the Offshore Island. Purpose: The purpose of this study was to determine ocular morbidities, knowledge, and barriers of eye care services among children in an Offshore Island. Methods: The study team visited, and all data were collected from different rural communities at Sandwip Upazila, Chittagong district for screening the children aged 5-16 years old by doing spot examination. The whole study was conducted in both qualitative and quantitative methods. To determine ocular status of children, examinations were done under skilled Ophthalmologists and Optometrists. A focus group discussion was held. The sample size was 490. It was a community based descriptive study and the sampling method was purposive sampling. Results: In total 490 children, about 56.90% were female and 43.10% were male. Among them 456 were school-going children (93.1%) and 34 were non-school going children (6.9%). In this study the most common ocular morbidity was Allergic Conjunctivitis (35.2%). Other mentionable ocular morbidities were Refractive error (27.7%), Blepharitis (13.8%), Meibomian Gland Dysfunction (7.5%), Strabismus (6.3%) and Amblyopia (6.3%). Most of the non-school going children were involved in different types of domestic work like farming, fishing, etc. About 90.04% children who had different ocular abnormalities could not attend to the doctor due to various reasons. Conclusions: The ocular morbidity was high in rate on the offshore island. Eye health care facility was also not well established there. Awareness should be raised about necessity of maintaining hygiene and eye healthcare among the island people. Timely intervention through available eye care facilities and management can reduce the ocular morbidity rate in that area.

Keywords: morbidities, screening, barriers, offshore island, knowledge

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Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

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Authors: Nidesh Sapkota, Garima Pudasaini, Dikshya Agrawal, Binav Baral, Umesh Bhagat, Dharanidhar Baral

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Background: Medical and Dental students are vulnerable to higher levels of Psychological distress than other age matched peers. Many studies reveals that there is high prevalence of psychoactive substance use and Psychiatric co-morbidities among them. Objectives: -To study the prevalence of substance use among medical and dental students of a Medical University. -To study the prevalence of depression and anxiety in medical and dental students of a Medical University. Materials and Method: A cross-sectional descriptive study in which simple random sampling was done. Semi-structured questionnaire, AUDIT for alcohol use, Fagerstrom test for Nicotine dependence, Cannabis screening test (CAST), Beck’s Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI) were used for the assessment. Results: Total sample size was 588 in which the mean age of participants was 22±2years. Among them the prevalence of alcohol users was 47.75%(281) in which 32%(90) were harmful users. Among 19.55%(115) nicotine users 56.5%(65), 37.4%(43), 6.1%(7) had low, low to moderate and moderate dependence respectively. The prevalence of cannabis users was 9%(53) with 45.3%(24), 18.9%(10) having low and high addiction respectively. Depressive symptoms were recorded in 25.3%(149) out of which 12.6%(74), 6.5%(38), 5.3%(31), 0.5%(3), 0.5%(3) had mild, borderline, moderate, severe and extreme depressive symptoms respectively. Similarly anxiety was recorded among 7.8%(46) students with 42 having moderate and 4 having severe anxiety symptoms. Among them 6.3%(37) had suicidal thoughts and 4(0.7%) of them had suicide attempt in last one year. Statistically significant association was noted with harmful alcohol users, Depression and suicidal attempts. Similar association was noted between Depression and suicide with moderate use of nicotine. Conclusion: There is high prevalence of Psychoactive substance use and psychiatric co-morbidities noted in the studies sample. Statistically significant association was noted with Psychiatric co-morbidities and substance use.

Keywords: alcohol, cannabis, dependence, depression, medical students

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Authors: Yichao Lv, Minmin Cai, Yanqiang Tao, Xinyuan Zou, Chao Zhang, Xiangping Liu

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Objective: This study aims to explore the network structure of personality traits and mental health and identify key factors for effective intervention strategies. Methods: All participants (N = 6,067; 3,368 females) underwent the Eysenck Personality Scale (EPQ) to measure personality traits and the Symptom Self-rating Scale (SCL-90) to measure psychiatric symptoms. Using the mean value of the SCL-90 total score plus one standard deviation as the cutoff, 854 participants (14.08%; 528 females) were categorized as individuals exhibiting potential psychological symptoms and were included in the follow-up network analysis. The structure and bridge centrality of the network for dimensions of EPQ and SCL-90 were estimated. Results: Between the EPQ and SCL-90, psychoticism (P), extraversion (E), and neuroticism (N) showed the strongest positive correlations with somatization (Som), interpersonal sensitivity (IS), and hostility (Hos), respectively. Extraversion (E), somatization (Som), and anxiety (Anx) were identified as the most important bridge factors influencing the overall network. Conclusions: This study explored the network structure and complex connections between mental health and personality traits from a network perspective, providing potential targets for intervening in adolescent personality traits and mental health.

Keywords: EPQ, SCL-90, Chinese adolescents, network analysis

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Authors: John Olav Bjornestad, Bjorn Tore Johansen

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The number of people suffering from mental illnesses is increasing, and such illness is currently one of the major causes of disability and poor health. The reason for this is most likely a lack of physical activity. The purpose of this study was to discover if physical activity was an effective mode of treatment for psychiatric patients at an out-patient treatment facility. The study included an exploration of whether or not patients having physical activity included as an integral part of their treatment (to a greater degree than do patients who are physically inactive) would achieve 1) an improvement in their physical condition 2) a reduction in symptomatic pressure and 3) an increase in their health-related quality of life. The intervention period lasted a total of 12 weeks. The training group completed a minimum of 2 training sessions per week with an intensity of 60-75% of maximum heart rate. The participants’ health-related quality of life (SF-36), symptomatic pressure (SCL-90-R) and physical condition (UKK-walking test) were measured before and after intervention. Twenty participants were pre-tested, and out of this initial group, nine patients completed the intervention program and participated thereafter in post-testing. The results showed that participants on average improved their physical condition, reduced their symptomatic pressure and increased their health-related quality of life over the course of the intervention period. The training group experienced significant changes in their symptomatic pressure (the anxiety dimension) and health-related quality of life (the mental health dimension) from the pre-testing stage to the post-testing one. Furthermore, there was a significant connection between symptomatic pressure and health-related quality of life. The patients who were admitted to the psychiatric out-patient clinic were in a physical condition that was significantly poorer than that of persons of the same age in the remainder of the population. Experiences from the study and the relatively large defection from it demonstrate that there is a great need for close follow-up of psychiatric patients’ physical activity levels when physical activity and lifestyle changes are included as part of their treatment program.

Keywords: health-related quality, mental health, physical activity, physical condition

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Authors: Ivory A. Rulona, Jarungchai Anton S. Vatanagul

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Background: Depression is common after stroke with quoted rates ranging from 18% to 61%. 8 Mood disturbance is common after stroke and may present as depression or anxiety. Psychological mood disturbance is associated with higher rates of mortality, long term disability, and hospital readmission. Objectives: To investigate the incidence of post-stroke depression in a tertiary hospital in Cebu City, Philippines and to determine its associated factors. The study is designed to be prospective, descriptive, cross-sectional survey. Participants: Adult patients seen and diagnosed to have stroke either infarct or hemorrhage within the period of January 1 to July 31, 2014. Results: A total of 100 patients with stroke were interviewed using the 17-item Hamilton Depression Rating Scale (HDRS) questionnaire. The average age of the respondents was 60.50 years old ±1.18, majority were males (55%), 83% were married, and 81% were employed. The most common co-morbidity was hypertension 78% followed by diabetes mellitus at 50%. Moreover, 39% of these patients had stroke in months, 26% in years, and 18% in weeks. The average functional capacity based on Modified Rankin Scale was 2.14+/-0.14. Among 100 patients, a total of 30 patients (30%) had depression: 2 (2%) very severe, 5 (5%) moderate and 23 (23%) had mild depression while 70 patients (70%) had no depression. Stroke located at the dominant hemisphere was not associated with severe depression (p=0.102). A similar trend was also noted among those with stroke at the right side (p=0.183), pons (p=0.634), bilateral (p=0.776), and midbrain (p=0.336). Conclusion: This study showed that majority of stroke patients were males with average age of 60.50 years. Hypertension was the most common co-morbidity. There was no association between stroke location and depression. The incidence of PSD was 30%.

Keywords: post-stroke depression, co-morbidity, disturbance, bilateral

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Authors: Hassan Shahmiri Barzoki

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Background: Posttraumatic stress disorder (PTSD) is an abnormal physiologic and psychological reaction in person with severe traumatic history. In recent studies, the relationship between PTSD and some other disease apparently unrelated to psychological situations, such as cardiovascular diseases, diabetes, and metabolic syndrome, has been revealed. Thus, the aim of this study was to survey the prevalence of metabolic syndrome and mental health in PTSD patients. Methods: The research design was retrospective cohort study. Subjects were consisted of 142 Iran-Iraq war veterans with PTSD (age: 40-60 years), and the control group was consisted of 153 veterans without PTSD. Data was collected using questionnaires, physical exams and laboratory tests. Results: Prevalence of metabolic syndrome was 45.1%in PTSD group and 17% in control group. In addition, blood pressure, triglyceride and fasting blood sugar in PTSD group were significantly higher than control group (p<0.05). Also, PTSD patients had significant high rates of psychiatric disorders. Conclusion: PTSD patients are more prone to metabolic syndrome and psychiatric disorders than control group.

Keywords: mental health, metabolic syndrome, post traumatic stress disorder, patient

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Authors: Eli Buchbinder

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Introduction. Language is the basis to our experience as human being. We use language in describing our experiences and construct meaning and narratives from experiences. Metaphors are a valuable linguistic tool commonly use. Metaphors link two domains that are ordinarily not related. Metaphors achieve simultaneously multi-level integration: abstract and concrete, rational and imaginative, familiar and the unfamiliar, conscious and preconscious/unconscious. As such, metaphors epistemological and ontological tool that are important in social work in every field and domain. Goals and Methods The presentation’s aim is to validate the value of metaphors through the first psychiatric breakdown is a traumatic for families. The presentation is based on two pooled qualitative studies. The first study focused on 12 spouses: 7 women and 5 men, between the ages of 22 and 57, regarding their experiences and meanings of the first psychiatric hospitalization of their partners diagnosed with affective disorders. The second study focused on 10 parents, between the ages of 47 and 62, regarding their experiences and meanings following their child's first psychotic breakdown during young adulthood. Results Two types of major metaphors evolved from the interviews in farming the trauma of the first mental breakdown. The first mode - orientation (spatial) metaphors, reflect symbolic expression of the loss of a secure base, represented in the physical environment, e.g., describing hospitalization as "falling into an abyss." The second mode- ontological metaphors, reflect how parents and spouses present their traumatic experiences of hospitalization in terms of discrete, powerful and coherent entities, e.g., describing the first hospitalization as "swimming against the tide." The two metaphors modes reflect the embodiment of the unpredictability, being mired in distress, shock, intense pain and the experience the collapse of continuity on the life course and cuts off the experience of control. Conclusions Metaphors are important and powerful guide in assessing individuals and families’ phenomenological reality. As such, metaphors are useful for understanding and orientated therapeutic intervening, in the studies above, with the first psychiatric hospitalization experienced, as well as in others social workers’ interventions.

Keywords: first mental breakdown, metaphors, family perspective, qualitative research

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Sasikala Govindaraj, P. Palanisamy, G. M. Natarajan

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Domestic sewage poses major threats to the aquatic environment in third world countries due to lack of technical and economic sources which can have significant impacts on fish. The tolerance limits to toxicants found in domestic effluents vary among species and their integrative effects may lead to reproductive failure and reduction of survival and growth of the more sensitive fish species. The mechanism of action of toxic substances upon various concentrations of sewage was taken aiming to evaluate locomotory, physiological, neurological and morbidity response of fish. The rapid biomonitoring assessment technique for qualitative evaluation of various industrial pollutants, behavioral responses of an air-breathing fish Pangasius pangasius were used as biomarkers for water quality assessment. The present investigation concluded that sewage is highly toxic to the fish and severely affects their physiology and behavior.

Keywords: air-breathing organs, behavioral, locomotory, morbidity, neurological, physiological, sewage

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Authors: Afshan Channa, Sameeha Aleem, Harim Mohsin

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First rank symptoms (FRS) are considered to be pathognomic for Schizophrenia. However, FRS is not a distinctive feature of Schizophrenia. It has also been noticed in affective disorder, albeit not inclusive in diagnostic criteria. The presence of FRS in Mania leads to misdiagnosis of psychotic illness, further complicating the management and delay of appropriate treatment. FRS in Mania is associated with poor clinical and functional outcome. Its existence in the first episode of bipolar disorder may be a predictor of poor short-term outcome and decompensating course of illness. FRS in Mania is studied in west. However, the cultural divergence and detriments make it pertinent to study the frequency of FRS in affective disorder independently in Pakistan. Objective: The frequency of first rank symptoms in manic patients, who were under treatment at psychiatric services of tertiary care hospital. Method: The cross sectional study was done at psychiatric services of Aga Khan University Hospital, Karachi, Pakistan. One hundred and twenty manic patients were recruited from November 2014 to May 2015. The patients who were unable to comprehend Urdu or had comorbid psychiatric or organic disorder were excluded. FRS was assessed by administration of validated Urdu version of Present State Examination (PSE) tool. Result: The mean age of the patients was 37.62 + 12.51. The mean number of previous manic episode was 2.17 + 2.23. 11.2% males and 30.6% females had FRS. This association of first rank symptoms with gender in patients of mania was found to be significant with a p-value of 0.008. All-inclusive, 19.2% exhibited FRS in their course of illness. 43.5% had thought broadcasting, made feeling, impulses, action and somatic passivity. 39.1% had thought insertion, 30.4% had auditory perceptual distortion, and 17.4% had thought withdrawal. However, none displayed delusional perception. Conclusion: The study confirms the presence of FRS in mania in both male and female, irrespective of the duration of current manic illness or previous number of manic episodes. A substantial difference was established between both the genders. Being married had no protective effect on the presence of FRS.

Keywords: first rank symptoms, Mania, psychosis, present state examination

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Authors: Alina Svechkina, Boris A. Portnov

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In line with a rapid increase in pollution sources and enforcement of stricter air pollution regulation, which lowers pollution levels, it becomes more difficult to identify actual risk sources behind the observed morbidity patterns, and new approaches are required to identify potential risks and take preventive actions. In the present study, we discuss a probabilistic approach to the spatial identification of a priori unidentified environmental health hazards. The underlying assumption behind the tested approach is that the observed adverse health patterns (morbidity, mortality) can become a source of information on the geographic location of environmental risk factors that stand behind them. Using this approach, we analyzed sources of environmental exposure using data on mortality rates available for the year 2015 for NUTS 3 (Nomenclature of Territorial Units for Statistics) subdivisions of the European Union. We identified several areas in the southwestern part of Europe as primary risk sources for the observed mortality patterns. Multivariate regressions, controlled by geographical location, climate conditions, GDP (gross domestic product) per capita, dependency ratios, population density, and the level of road freight revealed that mortality rates decline as a function of distance from the identified hazard location. We recommend the proposed approach an exploratory analysis tool for initial investigation of regional patterns of population morbidity patterns and factors behind it.

Keywords: mortality, environmental hazards, air pollution, distance decay gradient, multi regression analysis, Europe, NUTS3

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Authors: Abiodun M. Adeola, Hannes Rautenbach, Gbenga J. Abiodun, Thabo E. Makgoale, Joel O. Botai, Omolola M. Adisa, Christina M. Botai

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There was a surge in malaria morbidity as well as mortality in 2016/2017 malaria season in malaria-endemic regions of South Africa. Rainfall is a major climatic driver of malaria transmission and has potential use for predicting malaria. Annual and seasonal trends and cross-correlation analyses were performed on time series of monthly total rainfall (derived from interpolated weather station data) and monthly malaria cases in five districts of Limpopo Province for the period of 1998 to 2017. The time series analysis indicated that an average of 629.5mm of rainfall was received over the period of study. The rainfall has an annual variation of about 0.46%. Rainfall amount varies among the five districts, with the north-eastern part receiving more rainfall. Spearman’s correlation analysis indicated that total monthly rainfall with one to two months lagged effect is significant in malaria transmission in all the five districts. The strongest correlation is noticed in Mopani (r=0.54; p-value = < 0.001), Vhembe (r=0.53; p-value = < 0.001), Waterberg (r=0.40; p-value = < 0.001), Capricorn (r=0.37; p-value = < 0.001) and lowest in Sekhukhune (r=0.36; p-value = < 0.001). More particularly, malaria morbidity showed a strong relationship with an episode of rainfall above 5-year running means of rainfall of 400 mm. Both annual and seasonal analyses showed that the effect of rainfall on malaria varied across the districts and it is seasonally dependent. Adequate understanding of climatic variables dynamics annually and seasonally is imperative in seeking answers to malaria morbidity among other factors, particularly in the wake of the sudden spike of the disease in the province.

Keywords: correlation, malaria, rainfall, seasonal, trends

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Authors: D. Supaporn, B. Julaluk

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The purposes of this study were to study symptom cluster, functional status and quality of life of patients with chronic obstructive pulmonary disease (COPD), and to examine factors related to and predicting symptom cluster, functional status and quality of life of COPD patients. The sample was 180 COPD patients multi-stage random sampling from 4 hospitals in the eastern region, Thailand. The research instruments were 8 questionnaires and recorded forms measuring personal and illness data, co-morbidity, physical and psychological symptom, health status perception, social support, and regimen adherence, functional status and quality of life. Spearman rank and Pearson correlation coefficient, exploratory factors analysis and standard multiple regression were used to analyzed data. The findings revealed that two symptom clusters were generated: physical symptom cluster including dyspnea, fatigue and insomnia; and, psychological symptom cluster including anxiety and depression. Scores of physical symptom cluster was at moderate level while that of psychological symptom cluster was at low level. Scores on functional status, social support and overall regimen adherence were at good level whereas scores on quality of life and health status perception were at moderate level. Disease severity was positively related to physical symptom cluster, psychological symptom cluster and quality of life, and was negatively related to functional status at a moderate level (rs = .512, .509, .588 and -.611, respectively). Co-morbidity was positively related to physical symptom cluster and psychological symptom cluster at a low level (r = .179 and .176, respectively). Regimen adherence was negatively related to quality of life and psychological symptom cluster at a low level (r=-.277 and -.309, respectively), and was positively related to functional status at a moderate level (r=.331). Health status perception was negatively related to physical symptom cluster, psychological symptom cluster and quality of life at a moderate to high level (r = -.567, -.640 and -.721, respectively) and was positively related to functional status at a high level (r = .732). Social support was positively related to functional status (r=.235) and was negatively related to quality of life at a low level (r=-.178). Physical symptom cluster was negatively related to functional status (r= -.490) and was positively related to quality of life at a moderate level (r=.566). Psychological symptom cluster was negatively related to functional status and was positively related to quality of life at a moderate level (r= -.566 and .559, respectively). Disease severity, co-morbidity and health status perception could predict 40.2% of the variance of physical symptom cluster. Disease severity, co-morbidity, regimen adherence and health status perception could predict 49.8% of the variance of psychological symptom cluster. Co-morbidity, regimen adherence and health status perception could predict 65.0% of the variance of functional status. Disease severity, health status perception and physical symptom cluster could predict 60.0% of the variance of quality of life in COPD patients. The results of this study can be used for enhancing quality of life of COPD patients.

Keywords: chronic obstructive pulmonary disease, functional status, quality of life, symptom cluster

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Authors: Rachel Talbot, Nasuh Malas

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Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating ‘real problems’ and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Keywords: child and adolescent psychiatry, consult-liaison psychiatry, media, stigma

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Authors: Banca Patricia Pena Revuelta, Ramiro Gonzalez Avalos, Juan Leonardo Rocha Valdez, Jose Gonzalez Avalos, Karla Rodriguez Hernandez

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Probiotics are a promising alternative to improve productivity and animals' health. In addition, they can be part of the composition of different types of products, including foods (functional foods), medicines, and dietary supplements. The objective of the present work was to evaluate the effect of the feeding of Holstein calves supplemented with bacillus subtilis PB6 in morbidity and mortality. 60 newborn animals were used, randomly included in 1 of 3 treatments. The treatments were as follows: T1 = control, T2 = 10 g / calf / day. The first takes within 20 min after birth, T3 = 10 g / calf/day. The first takes between 12 and 24 h after birth. In all the treatments, 432 L of pasteurized whole milk divided into two doses/day 07:00 and 15:00, respectively, were given for 60 days. The addition of bacillus subtilis PB6 was carried out in the milk tub at the time of feeding them. The first colostrum intake (2 L • intake) was given within 2 h after birth, after which they were given a second 6 h after the first one. The diseases registered to monitor the morbidity and mortality of the calves were: diarrhea and pneumonia. The registry was carried out from birth to 60 days of life. The parameter evaluated was food consumption. The variable statistical analysis was performed using analysis of variance, and comparison of means was performed using the Tukey test. The value of P < 0.05 was used to consider the statistical difference. The results of the present study in relation to the consumption of food show no statistical difference P < 0.05 between treatments (14,762, 11,698, and 12,403 kg of food average, respectively). Calves group to which they were not provided Bacillus subtilis PB6 obtained higher feed intake. The addition of Bacillus subtilis PB6 in feeding calves does not increase feed intake.

Keywords: feeding, development, milk, probiotic

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Authors: Ravan Samadov

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Mentally disabled people are the most discriminated against among other disabled people and face much stronger negative attitudes across many cultures. The most complex and severe form of exclusion of these people is deprivation of liberty on the grounds of their disability. This problem was for many years overlooked to a great extent by the core human rights instruments. However, the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006, is considered a potential tool to successfully fill the gap. It is especially vital for the developing countries with the vast majority of disabled people of the world and the CRPD is presumed to be able to trigger drastic positive changes. Article 14 of the mentioned human rights treaty has brought into the international forum a new notion, as prohibits deprivation of liberty on the grounds of disability. It is to be understood as an absolute prohibition of deprivation of liberty on the grounds of disability, including mental disability, which manifests in the form of non-consensual psychiatric hospitalisation. The interpretation by the CRPD Committee indicates that this prohibition well embraces all types of non-consensual psychiatric hospitalisation – whether it is based on illness, impairment or disability. This prohibition also extends to such justifications as ‘dangerousness’, ‘need for treatment’ and ‘diminished capacity’. Moreover, providing due substantive and/or procedural safeguards does not render any legitimacy to application of deprivation of liberty on the grounds of mental disability. Logically, this new prohibition form was to be duly considered by different UN human rights bodies, and was subsequently to bring changes to their practices. However, the analyses of post-CRPD work of those bodies allows for asserting the contrary, as they have continued displaying the position which recognises deprivation of liberty on the grounds of disability to be legitimate. While such a position could be justified in the pre-CRPD time as stemming from the silence of human rights documents about it, the continuation of this course after the CRPD entered into force may call the integrity and coherence of the UN human rights treaty system into question. The non-coherent approaches of different UN bodies to this novelty give grounds for misinterpretation thereof, and hinder its due implementation by the States Parties. The paper will discuss the nature of the mentioned new prohibition and the controversial approaches to that notion by different UN human rights bodies.

Keywords: CRPD, deprivation of liberty, mental disability, non-consensual psychiatric hospitalisation, UN bodies

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Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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Authors: Mehmet Budak, Mehmet Fatih Ustundag

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Objectives: In this research, we studied the extent of exposure to physical violence and committing violence in patients diagnosed with schizophrenia in comparison to a control group consisting of patients with psychiatric diseases other than psychotic and mood disorders. Method: Between August 2019 and October 2019, a total of 100 hospitalized patients diagnosed with schizophrenia (clinically in remission, Brief Psychiatric Rate Scale < 30) were sequentially studied while undergoing inpatient treatment at Erenkoy Mental Health Training and Research Hospital. From the outpatient clinic, 50 patients with psychiatric disorders other than psychotic disorders or mood disorders were consecutively included as a control group. All participants were evaluated by the sociodemographic data that also questions the history of violence, physical examination, bilateral comparative hand, and forearm anterior-posterior and lateral radiography. Results: While 59% of patients with schizophrenia and 28% of the control group stated that they were exposed to physical violence at least once in a lifetime (p < 0,001); a defensive wound or fracture was detected in 29% of patients with schizophrenia and 2% of the control group (p < 0.001). On the other hand, 61% of patients diagnosed with schizophrenia, and 32% of the control group expressed that they committed physical violence at least once in a lifetime (p: 0.001). A self-destructive wound or fracture was detected in 53% of the patients with schizophrenia and 24% of the control group (p: 0,001). In the schizophrenia group, the rate of committing physical violence is higher in those with substance use compared to those without substance use (p:0.049). Also, wounds and bone fractures (boxer’s fracture) resulting from self-injury are more common in schizophrenia patients with substance use (p:0,002). In the schizophrenia group, defensive wounds and parry fractures (which are located in the hand, forearm, and arm usually occur as a result of a trial to shield the face against an aggressive attack and are known to be the indicators of interpersonal violence) are higher in those with substance use compared to those who do not (p:0,007). Conclusion: This study shows that exposure to physical violence and the rate of violence is higher in patients with schizophrenia compared to the control group. It is observed that schizophrenia patients who are stigmatized as being aggressive are more exposed to violence. Substance use in schizophrenia patients increases both exposure to physical violence and the use of physical violence. Physical examination and anamnesis that question violence are important tools to reveal the exposure to violence in patients. Furthermore, some specific bone fractures and wounds could be used to detect victimization even after plenty of time passes.

Keywords: fracture, physical violence, schizophrenia, substance use

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Authors: B. Kenny

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The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

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Authors: Nurlan Smagulov, Aiman Konkabayeva, Akerke Sadykova, Arailym Serik

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Introduction. Adverse environmental factors do not immediately lead to pathological changes in the body. They can exert the growth of pre-pathology characterized by shifts in physiological, biochemical, immunological and other indicators of the body state. These disorders are unstable, reversible and indicative of body reactions. There is an opportunity to objectively judge the internal structure of the adaptive body reactions at the level of individual organs and systems. In order to obtain a stable response of the body to the chronic effects of unfavorable environmental factors of low intensity (compared to production environment factors), a time called the «lag time» is needed. The obtained results without considering this factor distort reality and, for the most part, cannot be a reliable statement of the main conclusions in any work. A technique is needed to reduce methodological errors and combine mathematical logic using statistical methods and a medical point of view, which ultimately will affect the obtained results and avoid a false correlation. Objective. Development of a methodology for assessing and predicting the environmental factors impact on the population health considering the «lag time.» Methods. Research objects: environmental and population morbidity indicators. The database on the environmental state was compiled from the monthly newsletters of Kazhydromet. Data on population morbidity were obtained from regional statistical yearbooks. When processing static data, a time interval (lag) was determined for each «argument-function» pair. That is the required interval, after which the harmful factor effect (argument) will fully manifest itself in the indicators of the organism's state (function). The lag value was determined by cross-correlation functions of arguments (environmental indicators) with functions (morbidity). Correlation coefficients (r) and their reliability (t), Fisher's criterion (F) and the influence share (R2) of the main factor (argument) per indicator (function) were calculated as a percentage. Results. The ecological situation of an industrially developed region has an impact on health indicators, but it has some nuances. Fundamentally opposite results were obtained in the mathematical data processing, considering the «lag time». Namely, an expressed correlation was revealed after two databases (ecology-morbidity) shifted. For example, the lag period was 4 years for dust concentration, general morbidity, and 3 years – for childhood morbidity. These periods accounted for the maximum values of the correlation coefficients and the largest percentage of the influencing factor. Similar results were observed in relation to the concentration of soot, dioxide, etc. The comprehensive statistical processing using multiple correlation-regression variance analysis confirms the correctness of the above statement. This method provided the integrated approach to predicting the degree of pollution of the main environmental components to identify the most dangerous combinations of concentrations of leading negative environmental factors. Conclusion. The method of assessing the «environment-public health» system (considering the «lag time») is qualitatively different from the traditional (without considering the «lag time»). The results significantly differ and are more amenable to a logical explanation of the obtained dependencies. The method allows presenting the quantitative and qualitative dependence in a different way within the «environment-public health» system.

Keywords: ecology, morbidity, population, lag time

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Authors: Aline Giardin

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Introduction: This review addresses the relationship between physical education and mental health and its main objective is to discuss the meanings that circulate in Psychiatric Hospitalization Units and Psychosocial Care Centers (CAPS) about the presence of physical education teachers and the practices developed by Them within these services. Material and methods: It is based on the theoretical contribution of the Psychiatric Reform and is methodologically inspired by the Bibliographic Review. Objectives: The objective of this review was to identify the main scientific evidence on the effects of physical activity on the main psychological aspects associated with mental health during the hospitalization process. Results: It was observed that physical activity has beneficial effects in the psychological, social and cognitive aspects, being thus a fundamental aspect of the lifestyle in promoting a healthy and successful treatment. In studies evaluating the effects of physical activity on mental health, the most frequently evaluated outcomes include anxiety, depression, and health-related quality of life (eg, self-esteem and self-efficacy). Evidence from epistemological studies indicates that the level of physical activity is positively associated with good mental health, when mental health is defined as good mood, general well-being and decreased symptoms. Conclusion: It is necessary to intervene and a greater interest of the professionals of physical education in the treatment with the people with mental disorders so that the negative symptoms are modified, through the aid of the physical activity, by better quality of life, physical condition, nutritional state and A healthy emotional appearance.

Keywords: health mental, physical activity, benefits, treatment

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Authors: Sophia El Ouazzani, Amer M. Burhan, Mary Wickenden

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Background: Despite improvements in recent years, the Moroccan mental healthcare system still face disparity between available resources and the current population’sneeds. The societal stigma, and limited economic, political, and human resources are all factors in shaping the psychiatric system, exacerbating the discontinuity of services for users after discharged from the hospital. As a result, limited opportunities for social inclusion and meaningful community engagement undermines human rights and recovery potential for people with mental health problems, especially those with psychiatric disabilities from serious mental illness (SMI). Recovery-oriented practice, such as mental health rehabilitation, addresses the complex needs of patients with SMI and support their community inclusion. The cultural acceptability of recovery-oriented practice is an important notion to consider for a successful implementation. Exploring the extent to which recovery-oriented practices are used in Morocco is a necessary first step to assess the cultural relevance of such a practice model. Aims: This study aims to explore understanding and knowledge, perception, and perspective about core concepts in mental health rehabilitation, including psychiatric disability, recovery, and engagement in meaningful occupations for people with SMI in Morocco. Methods: A pilot qualitative study was undertaken. Data was collected via semi-structured interviews and focusgroup discussions with healthcare professional students. Questions were organised around the following themes: 1) students’ perceptions, understanding, and expectations around concepts such as SMI, mental health disability, and recovery, and 2) changes in their views and expectations after starting their professional training. Further analysis of students’ perspectives on the concept of ‘meaningful occupation’ and how is this viewed within the context of the research questions was done. The data was extracted using an inductive thematic analysis approach. This is a pilot stage of a doctoral project, further data will be collected and analysed until saturation is reached. Results: A total of eight students were included in this study which included occupational therapy and mental health nursing students receiving training in Morocco. The following themes emerged as influencing students’ perceptions and views around the main concepts: 1) Stigma and discrimination, 2) Fatalism and low expectations, 3) Gendered perceptions, 4) Religious causation, 5) Family involvement, 6) Professional background, 7) Inaccessibility of services and treatment. Discussion/Contribution: Preliminary analysis of the data suggests that students’ perceptions changed after gaining more clinical experiences and being exposed to people with psychiatric disabilities. Prior to their training, stigma shaped greatly how they viewed people with SMI. The fear, misunderstanding, and shame around SMI and their functional capacities may contribute to people with SMI being stigmatizedand marginalised from their family and their community. Religious causations associated to SMIsare understood as further deepening the social stigma around psychiatric disability. Perceptions are influenced by gender, with women being doubly discriminated against in relation to recovery opportunities. Therapeutic pessimism seems to persist amongst students and within the mental healthcare system in general and regarding the recovery potential and opportunities for people with SMI. The limited resources, fatalism, and stigma all contribute to the low expectations for recovery and community inclusion. Implications and future directions will be discussed.

Keywords: disability, mental health rehabilitation, recovery, serious mental illness, transcultural psychiatry

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Authors: Osagbai Joshua Eriki, Ngozi Agunwamba, Alice Hill, Lorna Almond, Maniya Duffy, Devashini Naidoo, David Ho, Raman Deo

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Aims: To evaluate the baseline eating pattern in a psychiatric hospital through quantifying purchases of food and drink items at the hospital shop and to implement a traffic light healthy eating labeling system. Method: A electronic till with reporting capabilities was purchased. A two-week period of baseline data collection was conducted. Thereafter, a system for labeling items based on the nutritional value of the food items at the hospital shop was implemented. Green labeling represented the items with the lowest calories and red the most. Further data was collated on the number and types of items purchased by patients according to the category, and the initial effectiveness of the system was evaluated. Result: Despite the implementation of the traffic light system, the red category had the highest number of items purchased by patients, highlighting the importance of promoting healthy eating choices. However, the study also showed that the system was effective in promoting healthy options, as the number of items purchased from the green category increased during the study period. Conclusion: The implementation of a traffic light labeling system for items sold at the hospital shop offers a promising approach to promoting healthy eating habits and choices. This is likely to contribute to a toolkit of measures when considering the multifactorial challenges that obesity and weight issues pose for long-stay psychiatric inpatients

Keywords: mental health, nutrition, food, healthy

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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