NICE Guidelines on Dementia (CG42) recommends that the Carers assessments should seek to identify any psychological distress and the psychosocial impact on the carer, including after the person with dementia has entered residential care. The assessment is offered by Health and social care managers.

The assessment includes

1. - Individual or Group Psycho education

2. - Peer support groups, tailored to the needs of the individual (for example, the stage of dementia of the person being cared for)

3. - Telephone support and internet information

4. - Training courses about dementia, services and benefits.

5. - Psychological therapies like CBT

6. - Practical support like transport, day care and Respite/short-break care

To identify the support received by the carers of patients suffering from Dementia.

A standardised questionnaire was answered by 25 carers attending the Outpatient clinics, Memory clinics, Day Hospital & Inpatients at Sandwell park Hospital, Hartlepool. The questionnaire contained 8 questions reflecting NICE guidelines. The audit was carried out between Nov 2008 and Jan 2009.

The standard was met up to 80% (20).

Everybody was aware of all the available support except five carers.

Three were not aware of the Psychological therapies and two were not aware of Training courses about Dementia.

1. . Dissemination of the report through Trust email to the Health and social care managers involved in the care of the carers in the catchment area.

2. . Educational meetings for the carers to be arranged

3. . Conduct the Audit in a year's time.

Valle Inclán Nursing Home is a multifunctional centre of Gerontology, that offers social and health services to elderly people, either with physical independence or with physical and psychic disabilities. Mental illness is studied from a multidisciplinary point of view, and these different therapeutic programs are implemented: psychological support for adjustment disorders, cognitive-behavioural therapy for mood disorders and overall medical examination of dementia. The total sample of patients that are studied is 445, chronologically distributed according the next data: N: 234 (2006), N: 264 (2007), N: 258 (2008) y N: 243 (2009).

To know the prevalence of the main psychiatric pathologies and to compare to data found in scientific literature.

To find data that can be used in order to improve the quality of medical care and psychosocial attention.

The prevalence of different psychiatric conditions treated by this mental health department, and the variation of these data for the last four years are showed. These data are compared with those in scientific literature.

Mental illness prevalence distribution is similar to the prevalence that is found in scientific literature. Dementia is the most prevalent pathology, and mood disorders are in the second place.

The decrease in the prevalence of mood disorders is probably on account of the implementation of specific psychotherapeutic programs. An increase in the prevalence of dementia can be explained by the improvement of screening of this illness and/or the increasing social request for admission to these nursing homes.

The frailty of elderly in Tenth Decade with stroke was considered a certainty for many years ruling, and the stroke in 90 year old was a paradigm of fragility in gerontology. However soon enough the existing data on the population in nursing homes.

The aim of this study was to evaluate the response to therapy SSRI antidepressants (fluoxetine 20–40 mg; sertraline 25–100 mg,; citalopram 10–40 mg) in a population of olds with depression after-stroke hospitalized in Nursing Home (RSA) at Catania (Sicily). We evaluated a total sample of 66 patients comparing the 13 patients 90yr-old with the 53 patients younger pertaining to the same RSA for stroke.

Stackable with somatic comorbidity and the post-stroke depression between the two populations, we founded:

1. 1. Both populations are responsive to antidepressant treatment with SSRIs

2. 2. The ninety recover more and more 'rapid cognitive impairment

3. 3. Both Populations improves the performances with rehabilitation recovering functional self-autonomy, albeit from different levels.

4. 4. The nutrient levels overlap in both populations and increased fragility biological of over 90-year old is evident for among of Prevalence and incidence of Delirium and Presence of Pressure Sores.

According to this data the response to antidepressants seems to be good and totally overlapped with the population most 'young studied as a reference.

This data also confirms that it is not age itself but the comorbidity of diseases present that make it’ a frail old man and that probably the frailty of the nineties is a biological myth.

Psychotic diseases in the elderly are underdiagnosed due to the limited use of medical resources. Advanced age makes psychoses of any cause less pure and differentiated, since old age adds a cognitive-impairment component to the basal psychotic defect.

We intend to estimate the prevalence of paranoid symptoms in older patients, and to study the many medical conditions associated with psychosis.

We conducted a literature review and we have performed a review of several clinical trials.

We found 12.1% of paranoid symptoms in the elderly with cognitive impairment. In absence of this factor, we found a prevalence of 14.1% for suspicion tendencies, 6.9% for paranoid thoughts and 5.5% for evident delusions. These figures were significantly higher in old black people.

We present a table of the main medical conditions that can produce psychotic symptoms. Some cases of apparently typical delusional disorder can appear as a long-term complication of some of these diseases. If organic factors are subtle and long lasting, the clinical may reproduce a fairly typical delusional disorder and may respond to treatment with neuroleptic drugs.

It seems possible that organic brain factors are more common that we believe, becoming essential a comprehensive study of the old psychotic patient. We should pay more attention to psychotic symptoms in elderly patients and avoid conclusions based on cross-evaluations. Diagnosis will be defined by evolution in most of the cases.

Social support among old people is particularly important because Event of life may endanger the supportive networks in this age-group the administered researches on old people have shown that:

Social support with more life satisfaction is less related to feeling of depression.

The aim of this study are the investigation of relationship between amount of depression and social support.

The sample of this study is composed of 100 old people that were selected randomly data about depression and social support were collected by depression inventory and social support scale.

The results show that: the amount of depression among old people is approximately 22% and women reported more depression depression among people who lost their spouse was higher than illiterate people and people with higher education reported more depressive symptoms depression had a negative.

Association with social support and old men in comparison with old women.

Reported more social support, especially from family.

Some of studies noted that: family support and performance affect the mental health in old people and suggested: old people with psychological.

Symptoms such as depression can benefit from family intimacy and wormth.

Mood disorders in the elderly are a relevant clinical problem associated with high prevalence and frequent co-morbidity with chronic somatic diseases.

Study of clinical traits of depression in elder persons with somatic disorders.

The investigation was entered by 582 persons (women = 391 (67,1%), men = 191 (32,9%)), mean age of women has constituted 67,5 ± 5,8 years, men - 62,1 ± 3,8 years.

Age in women 55 years and higher, in men - 60 years and higher, clinical level of depression according to Beck Inventory more than 22 scores.

Affective disorders were represented by symptom complexes that masked depression and complicated diagnosis. Clinical symptoms in the kind of anhedonia and complaints about anergia dominated (73,6%), whereas depression, melancholy have moved behind and have constituted 26,4%. Psychopathologic disturbances presented against the background of lingering chronically flowing neurological and somatic diseases (cerebral atherosclerosis, brain blood circulation impairment, IHD, HI, respiratory organs’ diseases) in 73,6 %. High risk of emergence of depressive disorders was noticed in widows with low level of education, living in rural area and in persons with somatic diseases. In 32% of probands we have revealed depression that correlated with marital status and feeling of loneliness (p > 0,005). In persons with high level of depression and experiencing feeling of loneliness, risk of suicidal behavioral was higher 2,1 as much.

Study of affective disorders in the elderly allows assessing co-morbidity of somatic and mental disorders, developing tactic of psychotherapeutic and psychopharmacological assistance rendering.

One of relevant challenges of psychogeriatric assistance is recognition of depression and cognitive disturbances in elder patients because clinical similarity of their manifestations masks nature of syndrome.

To study of clinical severity and nosological belonging of depressive syndrome against the background of accompanying cerebrovascular pathology with availability of cognitive disorders in elder patients under treatment at the specialized department of affective states.

Total number of observations has constituted 55 persons (males - 24, females - 31, mean age 66,3 ± 5,8 years). Criteria of inclusion: age older than 60 years, complaints about memory disturbances and decreased background of mood as a basic cause of seeking psychiatric assistance. We excluded patients with mental disorders of psychotic register, presence of substance dependence syndrome, dementia.

According to results of clinical-psychopathological investigation along with ICD-10 diagnostic criteria, nosological structure of revealed disorders has been represented by the following rubrics: organic affective disorder (F06.3) was diagnosed in 355 of patients; depressive disorders of rubric F3 were registered in 45% of patients, comorbid with organic asthenic disorder (F06.6) or with mild cognitive disorder (F06.7), in 15% of cases depression was leading syndrome within adjustment disorder also in combination with mild cognitive disorder, in 55 of cases depressive symptoms was regarded as secondary whereas predominating ones were cognitive and behavior disturbances within organic asthenic disorder (F06.6).

Thus, clinical assessment and nosological belonging of depressive syndrome combined with organic disorders in the elderly are an important factor mainly determining the choice of therapeutic strategy.

Hypertension is closely related with the anger control of the individual. While anger causes hypertension, the incapability to express anger in an appropriate way leads to depression. Depression is a mental problem occurring frequently in the old age period.

The present study was carried out in order to determine the anger and depression conditions in the old people diagnosed with hypertension.

418 old people diagnosed with hypertension and living in home with their families were included in the study. The data of the research were gathered with the individual information form, trait anger, anger types scale and depression scale for old people.

In the study, it has been understood that there are positive correletion between anger and depression in older people, and between hypertension during and depression (p < 0.05). It was found out that the anger mean score is high in old people who were male, using cigarette and alcohol; likewise, the depression score is high in older people who were women, widow, interdependent to someone in order to carry out daily life activities, illiterate and having poor economic conditions.

In old people with hypertension, depression increases as anger increases. As the hypertension diagnosis during of older people rises, depression rises, too. For this reason, it is needed to plan approaches for old people to recognize their anger, to ensure expressing their anger in an appropriate way and to prevent depression.

The problem of abuse of older people has to be approached from a multi-sector and multi-disciplinary perspective. The emphasis should be on new, deeper surveys, education of professionals, family members and other care takers.

Anemia (and especially mild forms) is a frequent laboratory finding in the elderly and is usually regarded in our everyday practice in psychiatry as an incidental innocent finding.

However, the growing body of literature proves otherwise.

Recent literature shows that anemia in the elderly has serious negative impact on mortality, morbidity and quality of life in this age group.

Despite the importance of this topic in mental health care, there is paucity or even lack of studies aiming to examine the magnitude of this problem in psychiatric hospitals and to suggest potential solutions for it.

In this small study, we aim to examine the prevalence of anemia in an inpatient psychiatric hospital, the types of anemia found, the investigations done and if any treatment was given.

Inpatient case notes were examined retrospectively for patients admitted to the Julian hospital from June 2010 to December 2010.

Anemia was defined according to the WHO criteria1 as a hemoglobin concentration lower than 12 g/dL in women and 13 g/dL in men.

Based on WHO criteria, most of our elderly patients were found to be anemic, with a significantly higher frequency in men than in women. The prevalence of anemia increased with increasing age, both in men and in women.

Anemia in elderly is a frequent, underappreciated and potentially morbid condition accounting for significant morbidity and mortality in this population.

As mental health professionals, we must work with our colleagues in medicine to translate awareness into action.

Brain-derived neurotrophic factor (BDNF) gene may be involved in the pathogenesis of schizophrenia by virtue of its effects on neurotransmitter systems that are dysregulated in psychiatric disorder. The common functional polymorphism Val66Met (or rs6265) within the BDNF gene has been reported to be associated with age of onset in schizophrenia. We investigated the relationship between BDNF polymorphisms rs6265 and rs11030101 and early-onset schizophrenia in the Chinese population.

The tag single nucleotide polymorphisms (tag SNPs) rs11030101 and rs6265 in the BDNF gene were genotyped in 360 early-onset schizophrenics and 399 controls subjects. Single nucleotide polymorphism association and haplotype analysis were performed.

There were significant differences in allele and genotype frequencies between patient and normal control subjects for rs11030101 (χ2 = 5.130407, df = 1, p = 0.023553; χ2 = 6.121, df = 2, p = 0.047). No statistically significant differences were found in allele or genotype between patient and normal control subjects for rs6265. Stratification of the study by gender of the samples yielded significant evidence for an association with the polymorphisms rs11030101 in female population (genotype-wise: χ2 = 7.758, df = 2, p = 0.021).

Our study indicates that the BDNF play major roles in the susceptibility to early-onset and female schizophrenia in the Chinese population.

The main purpose of this research was to investigate the simple and multiple relations between just (general and global) and unjust word beliefs with psychological state.

To this goal, 319 participants selected with the use of multi-stage random sampling method from the total population. Questionnaires which used in this research were: General Just Word Belief Scale, Unjust Word Belief Scale and SCL-90-R Scale were used. Pearson's correlation coefficient and stepwise regression analysis method.

Were used the results showed that there is negative significant relation between general just world belief with obsessive -compulsive (OC), interpersonal sensitivity (INT), depression (DEP), hostility (HOS) and paranoia (PAR), (p < 0.05, p < 0.01). Also results showed that there is negative significant relation between global just word belief with obsessive compulsive and depression, (p < 0.05). Results also showed a positive significant relation between unjust word beliefs with paranoia (p < 0.05).

The results of the stepwise regression analysis, showed that only depression has a significant power for prediction of general just word beliefs and score of additional items in SCL-90-R have significant power for prediction of global just word belief. Results of regression analysis showed that interpersonal sensitivity (INE) and paranoia have significant power for prediction of unjust word belief. Finally the results showed that only paranoia has a significant power for prediction of unjust word belief. The implications of the results have been discussed.

The paper aimed to study the relationship between self discrepancy and well-being in subjects suffering from social phobia. Previous research reveals that patients suffering from social phobia report a lower well-being and that self discrepancy have a positive correlation with well-being. So the question is which kind of self discrepancy decreases well-being through increasing social phobia.

To carry out this research 250 subjects were randomly selected based on Liebowitz’ s social phobia test given to a great number of university students. Subjects were asked to answer the tests on two domains of well-being and self discrepancy at the same time.

The results showed that “actualundesired” and “actualought” self discrepancy have more considerable effects on well-being respectively. Also, the direct effect of self discrepancy on well-being is more than the direct one.

These finding can be significant in treating social phobia and promoting well-being.

Liaison Psychiatry is primarily concerned with the detection and treatment of psychiatric disorders within the general hospitals. 1A study2 also highlighted the presence of only 45.5 core trainee posts in this speciality nationally.

To survey the liaison psychiatry service recently set up as a service provision at a psychiatry unit in North Derbyshire.

We retrospectively reviewed all case notes of patients who had been assessed from January 2007 to June 2009 by the consultation-liaison service.

A total of 136 patients had been assessed since this service began in September 2007. Majority of the patients (72%) were between the ages of 31 to 65 years, while the gender was equally distributed. 51% were referred from the medical ward and most of them had been referred by core trainee. 95% of the referral was during working hours and 74% of the patients were assessed within 24 hours. Their diagnosis was variable, for e.g. 29% had depression, 19% had substance misuse problems, 8% had psychosis etc. 66% of patients were managed by medication advice, psycho-education and referral to CMHT/GP.

Liaison psychiatry was established for service provision, but it is apparent that it fulfilled both clinical and educational needs, despite the challenges. Adequate experience can be gained with a well supervised service. The overall educational value of designing and implementing a new service as a trainee cannot be overstated; it is something which is difficult to learn in classrooms.

Although there are instruments for the assessment of DSM-IV mental disorders in primary care, there is no brief instrument to assess mental disorders in primary care according to the ICD-10.

The aim of the study was to assess the reliability of a new diagnostic interview, the TRIPS, designed for the assessment of anxiety-, mood-, and alcohol related disorders according to ICD-10 by non-mental health professionals.

At first, all Patients completed a screening questionnaire and were subsequently assessed by the staff of somatic departments of a Vienna General Hospital with the TRIPS. Within a week, patients were re-assessed by psychiatrists of the department of psychiatry with the Composite International Diagnostic Interview (CIDI).

Finally, 290 patients could be assessed with both instruments. With the CIDI, 106 out of 290 patients (37%) got any diagnosis of a mental disorder, 74 (26%) had a mood disorder, 64 (22%) an anxiety disorder and 10 patients (3%) an alcohol-related disorder.

Sensitivity of the TRIPS was 88%, specificity was 76% and diagnostic accuracy was 80% for any disorder, and 88%, 83%, and 84% respectively for any mood disorder, 72%, 88%, and 84% for any anxiety disorder, and 60%, 98%, and 97% for alcohol related disorders.

The results show that the TRIPS is a useful instrument with sufficient reliability to detect anxiety disorders and mood disorders in patients with somatic disorders by health professionals without psychiatric training. Due to the low base rate the test criteria for alcohol-related disorders cannot be interpreted sufficiently.