To evaluate the type of intervention received by patients with SMI in two mental health care devices that look after this group: A Day Hospital (DH) and a Rehabilitation Unit (RU).

A sample of patients had attended the devices mentioned in the last year was selected and it was collected data on the number and type of interventions received (pharmacological, individual, family and group) through the Information System of Andalusia Mental Health.

Regarding DH, most interventions performed were type group (65.5%), followed by pharmacological interventions (26.1%), individual psychotherapy (6.4%) and interventions with families (2%). Similarly, in the RU was registered an 80% of group interventions, a 16.1% of pharmacological interventions, a 2.6% and a 1.3% of individual and family interventions, respectively.

While most of the proceedings are group interventions, it is expected due to the framing of this type of device, other types of interventions that contribute to an integral approach to SMI are also performed.

The authors intend to characterize the population of foreign patients admitted to Department L of Centro Hospitalar Psiquiátrico de Lisboa, Portuguese biggest Psychiatric hospital, and compare it with published data on the subject.

The authors identified all foreigner patients hospitalized in the Inpatient Clinic from 01/01/2010 to 30/06/2011. Clinical information was obtained from the case notes and statistically treated. Relevant literature collected from PubMed was reviewed.

A great heterogeneity of nationalities was found including 21 countries, the majority of which are a part of CPLP (Community of Portuguese Language Countries). Nearly all of the patients (91%) were in Portugal as immigrants, most being single and unemployed. Housing conditions are unstable. Psychiatric diagnoses show that schizophrenia is the pathology with more expression (27%), followed by major depression (16%) and bipolar disorder (15%). A significant number of patients have disorders due to psychoactive substance use (19%). After discharged from the hospital 77% where referred to outpatient services, but only half of those are still being followed-up.

Social and familial stability is an important factor influencing mental health. Most patients covered by this study experience familiar, professional and housing instability, making them a risk group. Schizophrenia and affective disorders are the most prevalent pathologies, which agrees with the prevailing idea that social distress is a risk factor to them.

Further studies should be held in order to characterise foreigner populations admitted to psychiatric clinics so that better therapeutic and follow-up measures can be carried out.

Immigrant patients (IMs) became more frequent users within the health care systems in European countries, recently. This evokes challenges to health and mental health care providers to meet the needs of this group.

To improve the delivery of care for IMs, we need to know more about the current situation within services. There is still a lack of cross-European data on the utilization of health services, the existence of good quality responses and their implementation. We are aiming to fill in this gap presenting data from the EU funded cross-national EUGATE study (see http://www.eugate.org.uk/).

We collected and analysed data on the availability of data registers and on service utilization by IMs, the provision of interpreting services, and the availability of multicultural staff in services for chronic mental ill people, accident and emergency departments (A&E), and primary health services (PHS).

Three districts in each capital of the 16 participating EU countries had been selected. in each districts, one A&E department, one service for chronic mental ill people and three PHS had been assessed, resulting in 240 data sets. all data has been analysed using SPSS ver.18.

There is hardly any data registers on the utilization of health services by IMs available. More than 50% of all services never provide any direct interpreting service, although there are differences between countries and the different kinds of services.

There is a need of quality standards among European countries to provide appropriate care for IMs across European countries.

Detailed knowledge about the mental health of immigrants in Europe is limited due to a lack of representative data. Part of the problem is the difficult accessibility to and the participation of immigrants.

The international research project “Mental Health and Immigration” (see: www.segemi.de) funded by the VW-foundation, is aiming to provide those missing data by conducting an epidemiological study on the prevalence and co-morbidity of mental disorders and psychosocial impairments as well as the health care utilisation of people with a Turkish immigration background living in Germany.

To increase the generally low participation rates two different strategies are used in Berlin and in Hamburg. After building trust- relationships to the Turkish communities in both cities, either a snowballing approach and a quota plan with recruitment in public places or representative sampling through the registration office plus onomastic method guided by a public campaign are carried out.

In order to assess the mental health state interviews with a Computer Assisted Personal Interviewing (CAPI) of the Composite International Diagnostic Interview (CIDI) are conducted in Turkish and German in Hamburg and Berlin.

Due to an ongoing data acquisition process at the time of the conference preliminary results in regard to participation rates, strategy differences as well as first results on psychosocial impairments and health care utilisation of people with a Turkish migration background will be presented. These data will be compared with national epidemiological data for German speaking citizens.

Our evaluation is related with the current state of psychiatric diseases and the associated parameters with social impact.

A sample of 219 patients has been studied during past 2 years. Statistic analysis is based on z-criterion as well as X2-test. P values of 0.05 were considered to be statistically significant.

The average number of patient is 35 years old, 57,53% male,42,47% female.the majority of patients with depression or psychotic syndrom are women. 55, 56% of patients are single 32, 22% married and only 6% are divorced. 41, 04% of the patients have University education, 38% high school education. Conversely, 48% of the patients with depression have university education. in our research only 20, 75% of the psychiatric diseases have hereditary predisposition. Nevertheless the rate for depression is higher (37, 84) than the general result

Psychiatric diseases results: the most common psychiatric disease is depression with 36%, stress and anxiety with 15%, 13% psychotic syndrome. the next is phobia, with 8%, substance abuse with 5%. Schizophrenia has only 2% of the patients. Moreover 10% of the patients were diagnosed with 2 psychiatric diseases.70%of the widowers have suffered from depression.

Therapeutic interventions to patients were made using psychotherapy, medication or both. the analogy of psychotherapy to medication is almost 1:2

The most patients, who have come for therapy to our association, were diagnosed with depression. Also female sex, hereditary predisposition, higher education and widowhood are significant factors for depression,in comparison other psychiatric diseases.

Dental anxiety is very prevalent in population and it could be linked with dental problems.

Authors' objective was to analyze basic demographic characteristics of urban non clinical sample in order to find which of them is the most related to dental anxiety and to analyze anxiety and phobic reactions which are related to dental interventions.

We have analyzed 401 individuals from the urban non clinical sample (44,1% women, mean age was 32 years, and 43,4% of parents with most prevalent secondary education). We have used dental Anxiety Scale and sociodemographic questionnaire.

Almost all individuals (99%) has got dental visit and 70 of sample has dental visit in previous year. Most of sample (75,8%) indicate that they do non have any or have minimal dental anxiety, but 10,9% participants indicate that they have high dental anxiety and fear. Most of the sample does not avoid dental visits but 9,9% of sample avoid dental visit because of dental anxiety.

Managing diabetes is an overwhelming task, particularly for the newly diagnosed patient. Many diabetics struggle to cope with the requirements of the disease and the complications that it causes. as a result, many diabetics suffer from depression which is the most common psychiatric disorder witnessed in the diabetic population.

To compare the levels the emotional states of anxiety, depression and stress in patients with diabetes mellitus (DM) to the general population and chronic patients with psychological problems.

To reveille the significant differences between those patients.

We conducted a survey in a random sample of 279 patients with diabetes Mellitus (DM), 109 psychiatric outpatients (PO) and 383 healthy adults (C), using the Depression Anxiety Stress scale (DASSI-42). Statistical analysis was conducted with SPSS 16 for windows. ANOVA test was used to reveille the statistical significance between the groups in anxiety, stress, depression and total Scale.

Patients with DM had a significant difference to the PO patients and C in anxiety (MDPO = −12.251 p < .001), (MDC = 1.303 p < .001). They also had a significant difference from the PO in stress (MDPO = −11.465 p < .001), depression (MDPO = −15.751 p < .001), and total DASS (MDPO = −39.566 p < .001). Patients with DM had no significant difference to the control group in the above domains.

Analysis shows that patient with DM who are under medical treatment experience anxiety in a greater level than the general population, but in terms of stress and depression they are in the same level to the general population.

According to the World Health Organisation 450 million people in the World has some form of mental illness. These diseases are in second place as a cause of disability in the European Union and their treatment costs 3–4% of the total income.

To research the public health indicators on mental disorder in Split-Dalmatia County in a support of health care planning and organization.

The data sources used were databases of Split-Dalmatia County, the Croatian Institute for Public Health and World Health Organization. the public health indicators are presented as absolute numbers, the shares (%) and rates.

The number of patients suffering mental disorders recorded in family medicine area has increased in the period 1998–2007.

Among all specialist examinations in County in 2007, concerning patients in the age group 20–64 years, the psychiatric examinations were most common (19.2%).

County hospitals records show that mental disorders are on 11th place as a cause of hospitalisation.

The average duration of hospitalization in the County hospitals in 2007 amounted to 8.2 days and average treatment in the department of psychiatry was 16.1 days.

Standardized mortality rates from these diseases show upward trend from 2000 onward.

Mental and behavioural disorders are classified as subject to public-health interests, a growing need for services in the field of mental health requires a reorganization of health service delivery system throughout the world to include our country.

Implementation science evaluates the processes that move evidence-based treatments into routine use.

In Portugal, a new National Mental Health Plan with a community model has been launched in 2007. in order to change the operational model for mental health teams, a case-management (CM) training program has been prepared by the Ministry of Health.

To evaluate the effectiveness of the “implementation process” according to: a) profile of mental health services, b) organisational culture, c) barriers, d) degree of implementation.

30 mental health services were assessed. the “implementation process” included a CM course (SAMHSA procedures). Implementation effectiveness and barriers were assessed by: Barriers and Facilitators Assessment Instrument (MAJ Peters, 2001) and Illness Management Fidelity Scale - IMR (Mueser, 2009).

Assessment of services showed: liaison with primary health care (50%), routine use of guidelines (57%), single clinical records (50%), training and continuous education plan (85%), research practice (21%). Regarding the professionals, 70% reported previous case management practice, but only 20% had a formal training in CM. the CM approach was fully implemented in 36,3% of the services, fairly implemented in 45,4%, but still not enough implemented in 18,3%. Main barriers identified were related with availability of time (61%), lack of dedicated facilities (61%), low motivation (38%) and absence of financial incentives (38%).

In Portugal several barriers still undermine the full implementation of CM. Implementation science may contribute to improve the delivery of evidence-based care.

Regarding mental health problems in Portugal the most vulnerable groups seem to exhibit a higher risk than in the rest of Europe. the organisational model remains excessively centred on doctors and on intra-hospital interventions. Investment in human resources has a central role in the new Portuguese Mental Heath Plan.

To evaluate the profile of the MH teams and its adequacy to the MH needs of the population.

National survey covering every public MH service.

Portugal (10 million inhabitants) has 2500 MH professionals in the public MH services, concentrated in Lisbon, Oporto and Coimbra. for less that half the population, these 3 cities have 72% of total psychiatrists, 74% of the child psychiatrists, 70% of psychologists, 71% of MH Nurses, 68% of all OT's and 75% of SW's.

The rural regions (10% of total population) have about 4% of total psychiatrists and child psychiatrists, undermining access to care.

Hospitals assisting the same number of population can have ratio asymmetries of number of psychiatrists/population between 1.3/100 000 and 12.6/100 000.▮

The scarcity of resources is a factor that hampered the improvement of MH services in Portugal. MH teams continue to rely on a small number of psychologists, nurses, social workers, occupational therapists and other non-medical professionals, with most teams maintaining the traditional model of delivery of care.

The management and financing model of the services represents a restraint to the development of MH services.

Since December 2007 all Western countries have fallen into a severe economic recession, that caused an increase in unemployment and a lowering of income. Main consequences on health reported from previous economic crises such as the ‘29 Great Depression, the Post-communist Depression in early 1990s or the East Asian financial crises in late 1990s were:

1. 1) Increase in overall mortality,

2. 2) Increase in day-time alcohol drinking,

3. 3) Increase in male suicides and

4. 4) decrease in traffic fatalities.

To review the consistency of Italian data regarding the effects on health of the current economic recession with reference to effects of previous crises.

PubMed was searched for literature. Data on mortality, alcohol abuse and self-harm behaviours were obtained from the website of the Italian National Institute of Statistics (ISTAT).

Overall mortality in Italy increased in years 2008 and 2009, this increase being more evident among women. Overall male suicides and attempted suicides increased in the same years as well. Male suicides potentially referred to economic reasons showed an alarming increase. Traffic fatalities decreased during the last decade. Contrary to the expectations, alcohol consumption diminished gradually after recession onset.

Italian data are consistent with expectations and previous findings. Other concomitant and not related events could be involved (such as decrease in traffic fatalities or steadiness in alcohol consumption, which might be related to the introduction of new laws), though it seems extremely suggestive that the socio-economic context has a deep impact on mental health of general population.

Income inequality has been shown to be associated with mortality across US states, i.e. more unequal states have higher mortality. Recent survey results have also shown a significant variation on depression prevalence across the US state, and depression has been shown to increase morbidity and mortality.

To measure the effects of income inequality on mortality taking in account depression prevalence.

To test whether the relation between income inequality and mortality found among US states is due to different rates of depression.

Data comes from the US Census Bureau (income inequality) and from the Center for Disease Control (mortality and depression prevalence). Simple and multiple linear regression models were estimated.

Income inequality is positively associated with mortality across US states (p = .039). Depression prevalence was strongly associated with mortality across US states (p < .001). in a multiple regression model including income inequality and depression prevalence, the effect of income inequality is no longer statistically significant (p = .79) while depression prevalence remains significant (p < .001).

Depression prevalence accounts for the inequality effect and is a powerful predictor of mortality variation across US states.

In Dublin, 2366 adults were homeless in the last census. Access to both mental health and primary care services may be more difficult for these patients and it has been shown that homeless mental health service users have low rates of GP attendance.

We aimed to look at General Practitioner (GP) involvement in the care of patients referred to a Dublin city mental health service for homeless people. the initial audit cycle looked at referrals from August 2004 to February 2005. the second cycle looked at referrals from August 2007 to January 2009. Notes were retrospectively reviewed looking in particular at these issues:

1. 1. Contact information about the patient's GP on the referral form

2. 2. GP contact following initial assessment

The contact our service made with GPs following the first cycle of this audit improved from 50% to 63%. Letters to GPs were sent in 48% of cases which shows an improvement from 36% but still falls short of the agreed standard of letters to all GPs. the breakdown of the figures for cases that did not have a letter sent to their GP highlights the difficulties involved in follow up of this patient group.

Close collaboration between mental health services for homeless people and general practitioners is vital in the management of this vulnerable patient group whose needs are complex. Audit is a continuous cycle and further, more frequent reviews of this subject are required to maintain and improve on these results.

Qualitative methodology as a tool to understand the subjective meaning of individual's experience, is becoming more popular in health sciences' research. Understanding Stigma, which represents a major source of disability of people with mental illness, is a challenge that conventional research methods can not properly address.

To explore major features of qualitative methods and their relationship with quantitative research, and to point out how Stigma about mental illness can benefit from this epistemology and methodology.

Review of relevant literature.

Qualitative research seeks to know “what, how and why?” instead of “how much and what frequency?”. the researcher tries to shorten the distance to what's being researched, through close participation and interpretation of the study participants' experiences, considering its subjectivity and multiplicity. This accounts for a solid internal validity, but does not allow for external validity, replication and generalization, which is the goal of post positivism paradigm through quantitative methods.

Because of its considerable strength in disclosing cultural issues, values, judgments, behaviors and social contexts, the use of qualitative methods on Stigma experience has allowed a better understanding of its meaning.

There is now widespread evidence and acceptance that addressing subjective experience is of great importance in substantial mental health research. Despite fundamental differences from quantitative methods, qualitative methodology has gained considerable relevance, and became an essential tool to better address challenges in mental health, taking a bio-psycho-social model into account, such as in Stigma experience

There is evidence that social support predicts self-esteem and related moods for individuals with psychotic disorders. There has, however, been little investigation of relative importance of specific components of social support.

Evidence from social psychology suggests that perceived relational evaluation (PRE) or the extent to which individuals see others as valuing them, is a particularly important determinant of self-esteem and mood.

The current study compared the importance of PRE and other types of social support, in predicting self-esteem and depressive mood, anxiety and anger hostility in a sample of patients in an early intervention program for psychotic disorders.

One hundred and two patients of the Prevention and Early Intervention Program for Psychoses (PEPP) in London, Ontario completed measures of PRE, appraisal, tangible and general emotional social support, self-esteem and mood. in addition, ratings of positive and negative symptoms were completed for all participants.

In general, perceived relational evaluation was the most important predictor of self-esteem and mood. These relationships were not a result of confounding with positive or negative symptoms.

The extent to which an individual perceives himself or herself as being positively valued by those in his or her immediate social environment is a particularly important component of social support in predicting self-esteem and affect of individuals with a psychotic disorder

Whereas depression as a risk factor for the incidence of activity limitations in the elderly has been confirmed, little attention has been paid to anxiety, despite its high prevalence, with or without comorbid depression.

In a community-dwelling cohort of 1581 participants aged 65 years and over, the association between trait anxiety symptoms (Spielberger State-Trait Anxiety Inventory, third highest tercile) and current DSM-IV anxiety disorder (GAD, PTSD, OCD, panic disorder, agoraphobia or social phobia) at baseline and 7-year incident activity limitations was determined using mixed logistic regression models. Repeated measures of activity limitations included by increased severity level: social restriction (neighbourhood and house confined), mobility (Rosow and Breslau scale) and limitations in instrumental activities of daily living (IADL).

Of the sample, 42% were male and 14.2% had an anxiety disorder at baseline. Adjusting for socio-demographic and health variables, past and present depression and anxiolytic drugs, trait anxiety symptomatology was associated with increased incidence of social restriction (OR (95% CI): 2.46 (1.45–4.16), p = 0.0008) and current anxiety disorder with an increased risk of incident IADL limitation (OR (95% CI): 1.86 (1.01–3.41), p = 0.046). Associations remained significant in participants free of depressive symptoms at baseline (OR (95% CI): 2.92 (1.41–6.05), p = 0.004; OR (95% CI): 3.21 (1.31–7.89), p = 0.011, respectively).

Despite high comorbidity between depressive and anxiety symptoms, both trait symptomatology and anxiety disorder are independently associated with increased incident dependency with a gradient of severity: trait anxiety symptoms associated with incident social restriction and anxiety disorder with incidence of IADL limitations.

In Japan, a lot of people used to be prejudiced against gay men, lesbians or bisexuals despite the fact that “homosexuality” as a category was eliminated from diagnostic criteria. Still, there is little investigation into the relations between individual's personality and the attitudes toward homosexuals.

A total of 164 heterosexual students of health and welfare (91 men and 67 women) with a mean age of 19.7 (SD = 1.0) years participated in the questionnaire survey. They were asked to complete the Index of Attitudes toward Homosexuals (IAH) and a short form of Five Factor Personality Questionnaire as well as an inquiry about their encounters with homosexuals.

Factor analysis of IAH resulted in three-factor solutions with factors identified as “avoidance of homosexual neighbors”, “avoidance of contacts with homosexuals” and “avoidance of approach from homosexuals”. Logistic regression analysis showed that “encounters with homosexuals” (=yes, OR = .15, 95%CI: .05–.46) and personality traits such as “extroversion” (OR = 1.12, 95%CI: 1.05–1.19), “emotionality” (OR = 1.14, 95%CI: 1.07–1.21) and “playfulness” (OR = .85, 95%CI: .79–.93) were predictors of “avoidance of homosexual neighbors”. Similarly, “avoidance of contacts with homosexuals” was associated with sex (=male, OR = 2.73, 95%CI: 1.38–5.42), “extroversion” (OR = 1.05, 95%CI: 1.00–1.11) and “playfulness” (OR = .92, 95%CI: .86–.98), and “avoidance of approach from homosexuals” was associated with sex (=male, OR = 6.90, 95%CI: 3.25–14.64), “emotionality” (OR = 1.08, 95%CI: 1.02–1.14) and “playfulness” (OR = .92, 95%CI: .86–.99). These results indicate that personality traits weakly but significantly influence the development of attitude toward homosexuals among Japanese adolescents.

Previous epidemiological studies clearly demonstrated gender differences in the patterns of mental illness. as a matter of fact, female suffer more from depressive and anxiety disorders, while male suffer more from addictive behaviour and psychotic disorders.

The present study was elaborated by the Psychiatric Department Quality Commission of the Coimbra University Hospital in order to identify gender differences in socio-demographic and clinical characteristics of patients that were hospitalized from January to June 2011.

We analyzed 417 clinical files and gathered socio-demographic information (gender, age, marital status and job) and clinical information (diagnosis and hospitalization's length).

Statistical analysis was performed with SPSS program, using the chi-square's and Mann-Whitney's tests.

53% of the inpatients were women.

It was also observed that women were older (p = 0.021), more frequently married and widowed (p < 0.001), were less associated with compulsory admission (p < 0.001), had shorter hospitalizations (p = 0.024) and were more often diagnosed with adjustment reaction and bipolar disorder (p < 0.001), while men were younger (p < 0.001), more frequently single (p < 0.001), more frequently unemployed (p < 0.001), were more subject to compulsory admission (p < 0.001) and were more often diagnosed with addictive disorders and schizophrenia.

These results are consistent with the existing literature and enable us to organize the services’conditions according to the needs of our psychiatric inpatient population.

In the complexity of suicide, qualification, that is, the education attainment the individual reached, has been only marginally investigated. the aim of this naturalistic study was to document the role of education achievement in completed suicides in the Italian population.

Data were extracted from the Italian Mortality Database, which is collected by the Italian National Census Bureau (ISTAT) and processed by the Statistics Unit of National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS) at the National Institute of Health (Istituto Superiore di Sanità).

We found Differences between qualification groups broken down by age bands. We may see differences between qualification groups in most age groups in both sex. We may see a mortality gradient in Italian people aged 15 to 64 years old, and in the Italian male population aged 75+ years (P < 0.001). While in people 15 to 64 years death by natural causes were more frequent than suicide in those with lower qualification, in those with higher qualification suicide deaths were more frequent than deaths by natural causes. Only in the very old male adults the situation is reversed, and suicide was more frequent than death by natural causes in those with 5 years of education or lower (85.1% vs. 80.7%), and lower in those with 6+ years of education (14.9% vs. 19.3%).

This study highlights that education achievement is related to suicide risk in the Italian population. Age and gender differences were identified in this research.

Estimate the prevalence of use of psychotropic medications in the cities of São Paulo (SP) and Rio de Janeiro (RJ);

Random sample of 3744 individuals, 15–75 years; CIDI 2.1 (depression and anxiety) and direct questions about use of psychotropic medications in the past year; prevalence estimation was performed by weighting oversampling in SP and standardization between cities by age; psychotropic consumption association with socio-demographic variables and diagnosis was performed by logistic regression.

The prevalence of psychotropic use was 8.95% in SP (CI:7.93–9 .97) and 9:54% in RJ (CI:8.49–10 .59). Antidepressants (4.72% and 4.33%) and tranquilizers (4.20% and 1.73%) respectively in SP and RJ where more common used. Psychiatrists in SP most often prescribed psychotropic (39%), in RJ general practitioners (48.8%) where more cited. Most antipsychotics (52%) and antidepressants (39%) in SP were donated by the government in RJ this figure falls to 8% and 7%. Female individuals with increasing age, separated or divorced with a psychiatric diagnosis in the past year, family history of mental illness and higher income were more likely to use psychotropic drugs. About 70% to 82% of individuals diagnosed with major depressive disorder or phobic disorder, did not use any psychotropic drug.

There was a decrease in the consumption of psychotropic drugs in Brazil in recent decades, with a change in the consumption of tranquilizers and antidepressants. There is a need for a better training and education of doctors and family assistance programs in recognizing symptoms of common mental health disorders.