Medical comorbidity in patients with schizophrenia and bipolar disorder is associated with poor psychiatric treatment outcome and,for inpatients, with increased length of stay (LOS) -either by increasing psychiatric symptomatology or by being the focus of medical attention.

To assess the impact of medical comorbidity that receives medical attention (as opposed to lack of concurrent medical problems or to stable comorbidity) on clinical outcomes and LOS within two psychiatric populations.

To estimate the prevalence of comorbid medical conditions in schizophrenia and bipolar disorder. To test for differences, primarily in LOS and psychiatric treatment outcome, between inpatients who received care for physical problems and those who did not need to.

This was a retrospective study of consecutive voluntary admissions of 106 patients suffering from schizophrenia and 110 patients suffering from bipolar disorder (type I or II). Our main independent variable was whether or not inpatients received treatment for a medical condition after referral from the attending psychiatrist. We used GAF and CIRS-SA assessments.

Most reported problems for schizophrenia patients were cardiovascular/respiratory (notably hypertension) and for bipolar patients endocrine/metabolic. Patients who received medical treatment did not differ in LOS or psychiatric outcome from those who did not receive, in either diagnosis group. 84% of bipolar patients who reported a psychiatric comorbidity received treatment for a medical problem.

Medical care for comorbid physical problems does not impact on LOS, diagnosis being a better predictor of the latter. In bipolar disorder significant medical burden appears to be drug-induced.

Beside the interpretation and processing of content of communication, an important part of psychiatric diagnosis is made on behavioral signs and symptoms. While the semantic assessment of the content of thinking through communication was enriched by the development of several psychopathological scales, schedule and structured or semi-structured interviews the assessment of non verbal parameters remains uncovered. Our aims was to analyses the non verbal parameters, by an automatic system conceived by Dr. Enatescu et colab., in patients with mood disorders.

The instrument we used are: original traductors, systems of calculation and programming belonging to the artificial intelligence which create new pattern of representation of the gait, gesture, sonorous background of the speech, the dynamic of the writing which can be represented or through a matrix or in a n-dimensional space on specific clusters or to some human typology or to some psychical disorders.

The non verbal parameters processed by computer were sensible altered along with switching in the depressive states of subjects. The informatics data has had both diagnostic value and screening value for the course of unipolar depression.

We demonstrate that there is the chances for a new semiology which have objective paraclinic value for psychiatry field of automate analyses, nonverbal behavior parameters having the name “Extraverbale Analysis”.

The studies about the comorbidity of major depressive disorder (MDD) and bipolar disorder (BD) have increased in the last years. The comorbidity with Axis I psychiatric disorders complicates the diagnosis, prognosis and treatment.

To analyze the prevalence of affective disorders associated with another Axis I psychiatric disorders to treat correctly from the beginning of the diagnosis and to improve the course of the disorder and the quality of life of these patients

The subjects who participated in the study were diagnosed of bipolar I disorder, bipolar II disorder and MDD, according to DSM-IV-TR criteria. The sample (n = 114) was divided into three groups: MDD (n = 58), BD (n = 31) and a control group of healthy subjects (n = 25). The diagnosis and stability were assessed using the MINI International Neuropsyquiatric Interview and the Hamilton Depression Rating Scale (HDRS).

BD had a significantly association with risk of suicide (38%), anxiety disorder (3.3%) and social phobia (12.9%). It was also reported a significant association between MDD and risk of suicide (71%), manic/hypomanic episodes (25.9%), anxiety disorder (37.9%), social phobia (25.9%) and generalized anxiety disorder (37.9%).

It is necessary for clinical practice an integrative model which takes into account the comorbidity of affective disorders to improve the response to treatment and the prognosis of these mental disorders

A recovery-oriented mental health service system should focus on empowering people with mental illness.

To analyse the feasibility of setting up a web-radio run by 13 subjects suffering from mental disorders.

The patients involved in the project attended a one-year preparatory course promoted by the Province of Reggio Emilia, before the factual setting up of “Radio TAB”. After six months, each patient was asked to fill in a qualitative questionnaire addressing motivation and personal competences; opinions on the preparatory course; the identity of the radio, objectives and values shared by participants, the satisfaction they obtained from the activities and their vision of the radio then and for the future.

• • great motivation for joining the project and holding on to it

• • the preparatory course was judged to be effective to acquire technical, communication and interpersonal skills;

• • expectations and objectives of participants were consistent with the values underpinning the radio and the outcomes of the project, suggesting good internal cohesion;

• • a well-defined vision of the radio as a result of the work emerged, which will hopefully lead to setting up an actual workplace in future.

The experience of “Radio TAB” could be a good example of empowerment strategies, encouraging individuals to autonomy, reintegration and sense of active citizenship.

Olfactory reference syndrome (ORS), first described by Pryse-Phillips in 1971, is a rare psychiatric condition whose defining characteristic is a preoccupation with the belief that one emits a foul or offensive body odor, which is not perceived by others. Although the existence of ORS is now widely accepted, current classifications do not explicitly mention ORS as an independent category, but consider it as a delusional disorder, somatic type. Nonetheless, given this syndrome's consistent description along time and cultures, and the associated substancial distress and disability, many authors debate the possibility of a new classification in order to establish its nosological status.

The aim of this paper is to show and discuss some troublesome and complex issues of diagnosis and management of patients with ORS.

Herein we report a case of a 38-year-old woman who presented with ORS.

Improvement in ORS can take place, in some extent, with a variety of different modalities of treatment, with the disorder responding to antidepressants and psychotherapy more frequently than to neuroleptics. Data on ORS are still limited and more research in this field is needed. Awareness of this particular diagnosis allows appropriate treatment to be administered.

Delusional disorder is an illness characterized by the presence of non bizarre delusions in the absence of other mood or psychotic symptoms.

Subtypes of delusional disorder are defined as erotomanic, grandiose, jealous, persecutory, somatic, mixed and unspecified. We will present a case of somatic subtype.

The core belief of somatic type of this disorder is delusions around bodily functions and sensation, the presence of an infection or a disease.

We report on a 40 years old female with delusional disorder who had a severe weight loss during last two years. Her weight was 60 kgr and she became 29 kgr. Her BMI was less than 12.

She was brought to a general hospital because of her severe malnutrition and somatic symptoms such as weakness, fatigue, dizziness. Her blood exams were abnormal because of starvation. She also had amenorrhea. After taking first aid treatment from general practicians she was transferred to our psychiatric clinic with their diagnosis anorexia nervosa.

Her mental status examination was normal with exception of the abnormal delusional belief that she had a serious gastroenterological disease and any food could cause her pain in stomach and other gastroenterological annoyances. She had visited at past many gastroenterologists and she had done many laboratory exams with no abnormal result. In differential diagnosis she was not anorectic because she did not like her skinny appearance and avoid looking herself at mirrors.

She was treated with olanzapine and gained weight.

In somatic type of delusional disorder the patient is totally convinced in physical nature of his disorder.

At the European Psychiatric Association's International Congress 2010, we reported on psychiatric staff confidence regarding emergency medical care in our poster: “How Well Prepared is a Psychiatric Ward for Dealing with a Medical Emergency?”. This work highlighted areas for improvement, including staff confidence and familiarity with equipment. Consequently, several aspects of practice were enhanced, including addressing training shortfalls alongside adopting a uniform layout for emergency trolleys. In order to identify improvement, the process was re-audited with a new qualitative component to gather staff opinion.

Our primary objective was to examine whether our interventions had improved staff confidence with regard emergency medical care. Our secondary objectives included exploring staff attitudes toward delivery of such care and to identify further areas for improvement.

Our primary aim was to evaluate the impact of our interventions on delivery of emergency medical care

Our original questionnaire survey was repeated and the results compared with those obtained previously. Additionally, a series of semi-structured qualitative interviews will be performed with staff to compliment the questionnaires.

Results will be available in February 2011.

Given that psychiatric patients often suffer from significant physical health problems, it is imperative that staff are comfortable in delivering initial emergency medical care. We anticipate our results will demonstrate modest improvement. Clinical governance is an ongoing process, therefore the most important conclusions to be drawn will be our recommendations for future work, which will encompass the next step in our efforts to improve delivery of emergency medical care.

Electroconvulsive therapy (ECT) is widely and effectively used to treat psychiatric disorders. When electrodes are placed on both sides of the head on temporal bones it is unclear whether ECT affect on hearing system because hearing system situated in temporal lobe. Whereas these electrodes are placed on temporal bone and hearing system in TEMPORAL LOBE this study was designed.

We studied the effects of electroconvulsive shock on hearing system. Audiometric tests were performed in 15 adult patients with major depression under treatment with ECT before and 24 h after ECT.

Hearing was decreased at 24 hours after ECT about 5 db. Right ear was affected more and the most changes were observed at 8000 khz.

It appears that electroconvulsive shock has early effects on hearing system. Further studies should be performed with more cases and Delayed effects should be investigated.

Pain management is connected to use of Opioids and analgesics at the emergency care units and interfere with ability of emergency care provider to manage patient if patient identified as drug seeking. Pain has been reported as the main reason for seeking emergency care; therefore, emergency care providers have great difficulty defining or accurately predicting those patients who present with factitious complaints to obtain pain medications, and fear of additions and abuse.

Was to investigate meaning and knowledge level of emergency nurses in Jordan in relation to drug seeking behaviors at the emergency units in Jordan.

A descriptive-correlational study used to collect data related to drug seeking from 305 emergency nurses using self-report questionnaires.

The analysis showed that emergency nurses in Jordan have wide variation and moderate level of agreement on meaning of drug seeking. Emergency nurses also lack the knowledge and ability to detect drug seeking patients, and lack the effective interventions required to manage drug seeking if identified. Although nurse had low level of knowledge and low level of management skills, the analysis also showed that there was a positive association between level of knowledge and management skills. Also nurses ‘knowledge had negative association with nurses’ age, number of years of experience in nursing, and number of years of experience in emergency units.

The study provoke attention to quality of pain management and interventions provided at the emergency units

The paper is to improve the quality of life and health of the peoples of the world by fostering and maintaining high standards of care in general practice/family medicine and other clinicians.

By comparing the general practitioners/family physicians with the other clinicians of specialities, summarizing the shortcomings of present health care services of clinicians of specialities, the proposals for promoting health care services and the working model of doctors around the world were suggested.

The article initiates that the values of general practice/family medicine should be fostered into other clinicians when all the clinicians take care of the patients in any conditions, critical or ordinary, by adopting to the values of general practice/family medicine. While the clinicians also take into account of their own specialities. The author outlines how the working model of doctors will be changed.

In applying these proposals, a healthy world and high quality of life of the peoples of the world will come soon after the working model of doctors is changed into right. So the quality of life and health of the peoples of the world can be promoted and enhanced.

Fifth patients with subarachnoid haemorrhage caused by intracranial aneurysms, whose the HUNT-HESS were grade 2∼4. According to the operation methods of a coaxial catheter in vascular intervention, author envisaged that insert some specialized utensils into subarachnoid cavity to carry out thrombolysis, intelligence mechanical shunt of cerebrospinal fluid through lumbar puncture under the DSA watching to achieve an aim of resuming cerebrospinal fluid (CSF) and rebuilding CSF circulation.

Seven consciousness disorder patients awaked in 8 to 26 hours after treatment by this technique, 15 patients were cured, no patient died and no any complication. Our observation suggests that the new technology restoring cerebrospinal fluid circulation on the treatment of subarachnoid haemorrhage with intracranial aneurysm is efficacy, worthy of further clinical observation.

There are many advantages to improve communication between primary care and Psychiatric services. In Ireland various models of liaison with primary care are still in early stages of experimentation in some parts. We devised a pilot project of consultation-liaison model in west of Ireland.

There are 11 general practitioners working in the catchment area. All of them were given information and five agreed to participate. Based on random allocation two general practitioners were placed in experimental group. Three other general practitioners were allocated to control group. All patients from these surgeries were enrolled in study. In experimental group face to face meetings between psychiatrist and general practitioners were arranged before and after seeing patients in clinics. Feedback and exchange of information took place during these meetings. Meetings were arranged on monthly basis for six month starting in December 2009. While in the control group communication and referral was through usual method of writing letters.

Assessment of data was based on comparison of outcome in two sets of patients and surgeries. We collected data regarding number of admissions, compliance with appointments, changes in medications, number of referrals to secondary care, number of discharges back to general practitioners. Results show quantitative benefits of collaborative model in the lines of more patients being discharged back to GP and less missed appointments. There was also trend of reduced admission rate but this was statistically not significant.