Seasonal variance and climatic factors interrelated in incidence of psychiatric disorders and suicide have been attracting attention of resarchers for centuries. Still there are known just a few studies on the topic, once accomplished in remote times and parts of the world, which results might be found just controversial.

This pilot study analyses correlations in one year data on acute psychiatric admissions and suicides along with many objective physical parameters.

Used data are collected from two main psychiatric hospitals in Prague (1.5 mil. inhabitants), scientific institutes of Czech Academy of Science and Czech statistical office. Daily numbers of acutely admitted psychiatric patients during the year of 2005 (N = 3304) and suicides (N = 152) include persons of productive age, both gender, 18-65 years old. The daily admission rates, suicides and their distribution during the year and many climatic objective variables are treated with contemporary statistical methods.

Acute daily psychiatric admission rate seems to be significantly correlated with maximal daily temperature (x2, p= 0.05), quarters of the year (anova, p=0.003; x2, p=0.034), days of week (anova, p=0.001), weekends (t-test, p=0.0001), bank holidays (t-test, p=0.048).

Daily numbers of suicide do not significantly correspond with the variables meant above.

The strongest finding seems to be high risk of suicide in low air humidity condition: ODDS = 1.76.

Daily incidence of suicidality and acute psychiatric disorders differ in seasonal distribution and supposed relations to climatic factors. The study in wider complexity to be continued.

German psychiatric outpatient clinics have been established to treat the sickest among outpatients. They receive a lump sum per patient and quarter. This reimbursement is currently under scrutiny, because it can act as a disincentive for the care-givers and to the disadvantage of the patients. It was the aim of this study to elucidate the connections between individual aspects and concerns of the patients and the amount of care administered.

Clients of one of the largest health insurers, who visited a preselected outpatient clinic were followed for six months (p=339). All treatment activities were logged individually. Relevant sociodemographic data, the diagnoses, the individual needs and idiosyncracies, the course of the symptoms and case history were noted. Associations between the factors and utilization were tested by ANOVA and multiple linear regression models.

The regression model with the best fit (r2=0,48, p< 0,001) included five variables. Lower utilization is associated with living in nursing home (ß=-0,378; p< 0,001), higher age (ß=-0,273; p< 0,001), legal incapacity (ß=-0,306,p=0,002) and lower social functioning (ß=-0,187; p=0,033); higher utilization with inpatient days prior to outpatient treatment (ß=0,168; p=0,015). Treatment aims, isolated functional deficits, diagnoses and graveness of symptoms did not have a significant influence.

Outpatient clinics should address the needs of younger patients with the aspiration of an independent life despite of a grave psychiatric disorder. Treatments administered to nursing-home inhabitants are much less complex, although these patients are even sicker. A corresponding reallocation of financial resources is suggested.

There seems to be geographical differences in decisions about breast conserving surgery (BCS) in breast cancer patients. This study was to evaluate patients’ attitude to BCS and to assess the factors affecting cancer practice in West China.

A structured questionnaire was distributed to 184 patients, eliciting information about the patients’ characteristics, occupation, education, family life, recognition of illness, knowledge about BCS, the main means of gaining surgery information, selecting surgery approaches, preferences to breast reservation.

In all, 163 patients completed the questionnaire. The results indicated that only 7.4% of patients received BCS and 23% of the remaining patients desired to have BCS and the affecting factors were significantly associated with their family life, recognition of illness and the main means of gaining surgery information (P < 0.05). No associations were between BCS selecting and the other variables studied. The most frequent reasons for selecting BCS were keeping the female shape and improving quality of life (71%), the second most were postoperative recovery, minimal influence of physical function (47%) and patients’ knowledge about BCS (42%). The most frequent reasons for not selecting BCS were uncertainty about BCS results and worry about recurrence (81%), the second most was the elderly age unnecessary for BCS (40%).

The findings indicate that breast cancer patients in West China do not take BCS as the first choice as the best treatment method. It is warranted that further study of more patients, attitude of patients’ partners and physicians to BCS.

The aim of investigation is the examination of the role of clinical and social factors in genesis of formation of adolescent aggression.

During 2000-2006 years 977 adolescents were examined by the complex psychological-psychiatric expertise. A middle age of the patients compiled 16,7 (±1,05).

Among the examined adolescents in 57,9% the organic disorder was principally diagnosed, 18,3% of them revealed the disorders of schizophrenic spectrum, 8,5% compiled the forming personal disorder, another nosological stations were qualified in 10,3% of adolescents. The analyses of the consummated acts showed that 61,2% of adolescents were accused in hard and very hard aggressive-violent acts against personality (murder, the infliction of leaden physical injuries with lethal exit and sexual delicts). 1/3 of adolescent delinquents were in the station of drunkenness during committing a crime. Nearly 50% were recognized irresponsible because of mental disorder. The study of microsocial factors elicited that more then 80% of adolescents were accomplished in conditions of parents deprivation, 65% of parents abused alcohol.

55% of the children had tendency to early forms of antisocial behaviour.

An essential role in formation of early aggression interpersonal relations perform, negative family influence is determinate and lead to social and psychological alienation of a child. Negative socialization of interpersonal relations comes out on the one hand through the open conflict with other people, contrariwise, trough transference of basis activity to such spheres as abuse of psychoactive substances that aggravate their exasperation and aggression.

Large discrepancies in psychiatric compulsory admission rates have been found in the different European countries. However, some trends seem to exist in most studies: compulsorily admitted patients are more frequently male, unemployed, with a lower level of education, are more likely to belong to racial minorities (mainly black), and the most frequent diagnosis is schizophrenia.

To compare demographic and clinical characteristics of patients voluntarily and compulsorily admitted to a Portuguese psychiatric unit.

Retrospective data of all the patients admitted to a psychiatric inpatient unit, from January 2004 to December 2007, were reviewed. The demographic and clinical characteristics of compulsorily and voluntarily admitted patients were compared.

In a total of 1434 admissions, 180 were compulsory (11.2%). Compared to voluntarily admitted patients, those admitted compulsorily were significantly younger (38.2 vs. 43.6 years), more frequently male (62.8 vs. 47.1%), and black (27.8% vs. 19.9%), received more often a diagnosis of schizophrenia (34.4 vs. 19.0%), and had a longer average length of stay (27.0 vs. 18.5 days). There were no statistically significant differences in the seasonality of admissions or the number of readmissions in both groups.

The results are similar to those obtained in other studies, except for a higher rate of compulsory admissions. That can be explained by, among other factors, the low socioeconomic level and high percentage of immigrants in the local population. The comparison with voluntarily admitted patients helps identify characteristics associated with the two groups.

Combatants were divided into 2 groups: those who committed (“persons under investigation” - N 1) and those who did not commit aggressive delicts and torts (“patients” - N 2).

Disadaptive (aggressive) forms of behavior occurred in “persons N 1” much more often in emotional sphere. The choice of strategies aimed on changing the situation prevailed in this group (cognitive sphere). The most distinct cognitive disorder noted in “persons N 1” was the decrease of their forecasting competency. In the groups studied, the choice of predominant strategies for overcoming social stress did differ for certain. Only 13% of “persons N 1” accepted impunitive way of reacting, while for “patients” this figure constituted 29.8%. Absense of confiding and trusting relationships, absense of usage of their efforts is more typical (p>0.05). Important factor helping to raise the level of social adaptation for “patients” include providing of affiliation (33.6%). In comparison to group of “persons N 1” they suppressed exhaustive emotions more seldom (9.7%) and were inclined to forecast real events more often. Thus, during organization of rehabilitation measures for combatants, it is necessary to consider coping strategies for overcoming social stress, as well as the level of transagression of structure of main motives and values, which may help to decrease the risk of criminal behavior for patients with PTSD.

An audit was conducted in September 2006 to determine whether the Physical health monitoring of patients on anti-psychotic medication was concurrent with the national guidelines.

This audit done in Dec 07 aimed to ascertain to what extent the recommendations were implemented and followed, thereby completing the audit cycle.

The Audit was conducted in a 15 bedded medium secure forensic rehab ward.

As there was a lack of recording of the physical health status a monitoring sheet was introduced in the notes after the first audit. Age, Weight, Height, Smoking status, Blood Pressure, Diabetic Status, Blood Lipid Profile, ECG and the Medication regimen were noted for each of the patient.

100% physical health monitoring was achieved and improvements in weight, CV risk, Total/HDL cholesterol ratio was noted 4 cases of significant QT prolongation and another 3 cases of prolactin elevation were detected because of the introduction of monitoring.

To find out clinical and social factors contributing to specific female crimes - infanticide and neonaticide.

Clinical, descriptive statistical.

The problem of the murder of children by their mothers remains a burning issue in Russia. The most complicated for forensic psychiatrists are the cases when children were killed by not mentally ill mothers, especially in the situations when women killed their children within 24 hours of birth. Neonaticide reflects mostly social than clinical factors. The research has revealed that these women were young, single or separated and often exposed to psychogenic situations with high level of stress (financial and housing problems, concealment of illegitimate pregnancy). In accordance with the Criminal Code of Russia enacted in 1997 the special law governs infanticide and neonaticide. This law takes into account that:

1. 1. at the time of child murder the mental state of mother was affected by childbirth;

2. 2. the psychogenic situation which caused the crime.

Thus due to the new law these cases are dealt more leniently and it reflects more constructive and humane approach to such a complicated phenomenon as child murder.

Dynamic transformation of paraphilia (connection of new paraphilia’s forms to already existing) has been connected with the psychotic symptoms, convulsive attacks and increase of negative symptoms of schizophrenia, epilepsy and dementia (r=0.87, p=0.02 - canonical analysis).

Abnormal sexual imaginations appear during manifestation of schizophrenia in puberty age. A syndrome of a metaphysical intoxication, delusional depersonalization coexisted with available sexual perversion. In sexually mature age of patients with schizophrenia, dynamic transformation of paraphilia was associated with increase of negative symptoms (in remission). Anabatic of schizophrenia correspond with a degree of aggression sexual perversion.

New forms paraphilia of patients with epilepsy appear after repeatedly transferred convulsive attacks.

In persons with other organic mental disorders, dynamic transformation of paraphilia was observed in cases of formation dementia against a background of the impairments of cognitive function, deterioration in emotional control, social behavior, motivation and prognosis.

Dynamic transformation of paraphilia corresponds with a clinic and dynamic of mental disease: schizophrenia, epilepsy and dementia.

Searchof psychosexual indicators of sexual violence.

Infant and juvenile victims of sexual offends (51 persons).

Sexological.

Psychosexual disorders associated with sexual violence were observed in 24%.

For children of 3-7 years set is significant:

1. Sexualization of behavior:

   • – french kissing with friends;

   • – interest to intimate parts of body;

   • – a frequent situating of fingers in perineum;

   • – inserting into genitals different subjects;

   • – seizing for a breast or genitals.

2. Description to strangers those sexual actions which with them were realized.

For children of 7-12 years set is significant:

1. Sexualization of behavior:

   • – tempting behavior with persons of an opposite sex with make a suggestion of sexual contact;

   • – imitation of sexual contact;

   • – masturbation in public place.

2. Unusual sexual knowledge for this age.

For male adolescents set is significant:

1. Psychosexual dissociation: platonic and erotic libido is heterosexual, sexual libido is homosexual.

2. Disorders of identity: feminine identity and hyper-role behavior only with coevals of own sex.

For female adolescents set is significant:

1. Psychosexual dissociation:

   • – love for the concrete coeval with lack of sexual desire to him;

   • – presence of physiological sexual reactions on without personality object (heroes of books, television movies, etc.).

2. Illegible erotic behavior and lack of sexual desire.

3. Sexual aversion, restrictions of verbal contacts with young men, victims terminate to use of formal female attributes.

Results may be used for differential diagnostics of sexual development's disorders of different genesis.

The family is institution in which the life is born and rise. Homicide is cruel form of violence that is ruining and stopping the life. Those two, exclusive extremities, appear in one phenomenon- homicide in family.

This research is one part of comparative analytic prospective study, which last 10 years. In the Department of forensic psychiatry in Prison hospital in Belgrade we examined 266 perpetrators of homicide in family, 212 (79.70%) were male and 54 (20.30%) were female. Among those perpetrators we identified psychotic disorders in 77 mails (36.32 %) and 12 female (22.22 %). Thos groups committed 89 homicides in family with 99 victims.

We found statistically significant difference between males and females with regard to previous psychiatric treatment, alcohol abuses and intoxicated with alcohol at the time of the homicide. In male group with psychotic disorders, dominate schizophrenia (40, 26%) and paranoid psychosis (37, 66%), and in female dominate paranoid psychosis (50, 00%). Many perpetrators (41% male and 27% female) were not treated because of psychiatric disorder before, and psychiatric disorder diagnosed after the homicidal act.

Among perpetrators of homicide in family there were two times more male than female with psychopathological symptoms. In both groups, psychoses are most usual diagnosis. The arm of future research should be recognizing factors that increased risk of violent behaviors and comparing those factors among person with and without mental disorders.

Freud point to the special typo of delinquents, cold «delinquents from feeling of guilt». They delinquent behavior is determinate with unconscious motivations, delinquency of this type cannot be solved by social repression.

This research is comparative clinical analytic prospective study in witch are compared different parameters in two examined groups. We studies 40 delinquents with neurotic disorders. All of them are examined on the Department of forensic psychiatry in Special prison hospital in Belgrade. In control group were 40 non-delinquents with neurotic disorders who are treated in the psychiatric hospital «Dr.Dragiâ Miôvić» in Belgrade. For this research, we construed special questionnaire that contains the sets of questions for analyze different variables. The results are work out by objective statistical methods, which are adapted for this research: methods of descriptive statistic and methods of statistical tests.

Delinquency of people with neurotic disorders cannot be solved only by social repression, but primarily by psychotherapy, that presents special type of general prevention of criminality.

The results indicate that previous psychiatric treatment is the most important factor that influence on delinquent behavior. The results indicate that the risk for delinquent behavior in the non-treated group of patients with neurotic disorders elevated for twenty times (O.R. 19, 96). Those results indicated that the most important prevention factor for delinquent behavior is creating therapeutic programs for treatment of delinquents with neurotic disorders in penal institutions.

Children abduction by one parent and their transport refers to a foreign country is a gradually increasing phenomenon worldwide as well as Greece. Data from the Greek Ministry of Justice show that the frequency of such incidences is up to one a day (360/year). Some but not all of these cases come to the attention of the International Social Services (Division of Greece).

Records of fifty (50) cases of inter family abduction were obtained. These were cases that took place during the year 2003. These records were studied and analysed. The majority of cases concerned abductions within the European Union. Permission from the Personal Data Protection service was obtained before the research.

It was found that fathers were predominantly the abductors (60%). Based on the medical records of the parents, the abductor had established psychopathology (fathers 51,1%; mothers 48,5%). The abducting fathers made significant use of violence (50%) compared to the mother abductors (20%). The legal procedures that ensued the abductions were particularly prolonged: The trial period until the reach of a verdict took an average of 3 years.

In the cases of children abduction by a parent, there is high correlation between the action and the psychopathology of the abductor. The need for establishment of services appropriate to face this multidisciplinary problem is imminent. The long time each case takes to be resolved has obvious implications for the mental health of the children and the parents involved.