To determine the acceptability of mental health screening in Canadian pregnant women.

This cross-sectional survey used the Barriers and Facilitators of Mental Health Screening Survey. The study included pregnant women who read/spoke English. The survey was administered via computer-tablet to women recruited from prenatal classes and maternity clinics in Alberta. Analyses included descriptive statistics and multivariable regression.

Respondents (n=459, 92% participation) were largely 25-34 years old (89%), Caucasian (83%), and partnered (95%). Almost two-thirds of women indicated they expected to be asked about mental health, with 35% reporting their provider asked. The majority (99.8%) indicated that they could be honest with their provider about their mental health if asked and 99.3% of those asked reported they were comfortable with screening. Women indicated a strong preference for routine screening, but identified sporadic assessment as threatening. Women were more likely to report screening as positive if: 1) they had been treated previously for depression/anxiety; or 2) they identified barriers to screening as: a) feeling worried that their concerns were unimportant to their provider; or b) feeling that their provider did not have time to talk about mental health. Women were less likely to report screening as positive if they expected their provider to ask about their mental health.

Findings confirm women’s acceptability of routine prenatal mental health assessment. Results will inform decision-making regarding routine perinatal mental healthcare.

ADHD is one of the most frequent neurodevelopment disorders with variable persistence into adulthood. Adults with ADHD have been found to have a greater risk for other comorbid psychiatric disorders.

The aim of this study was to identify psychiatric disorders with higher rates of comorbidity with ADHD than would be expected from the base rates of those disorders in the population at large.

Systematic review of longitudinal prospective studies. Pubmed and PsycINFO search up to September 2014, using 'ADHD” and 'adult”, combined with 'comorbidity” or 'outcome” and 'longitudinal” or 'prospective” as search terms.

We found 8 studies that met our inclusion criteria. All of them have shown that ADHD persisted into adulthood in a significant percentage of children with ADHD. Elevated rates of antisocial personality disorder (ASD) have also been shown in all studies. Higher rates of major depressive disorder and substance use disorder across lifetime have been reported in four of those studies, with the others showing no differences between ADHD and control group. Three studies have shown higher rates of anxiety disorders and bipolar disorder. One study of ADHD girls has shown higher rates of eating disorders in females with childhood ADHD. Only one study evaluated other personality disorders than ASD, reporting elevated rates of passive-agressive personality disorder, histrionic personality disorder and borderline personality disorder in adults with childhood ADHD.

Only ASD showed consistent comorbidity with ADHD in all studies. More studies are needed to extract accurate conclusions.

We have previously shown that the burden of symptoms in patient with stress-related exhaustion is considerable. Beside from the exhaustion, most patients also fulfill diagnostic criteria for depression and anxiety and report large number of somatic symptoms.

To explore symptoms of exhaustion in patients with stress-related exhaustion, 5 years after seeking care.

How many patients with report symptoms of clinical exhaustion 5 years after seeking care? Can sex, age and/or initial level of mental symptoms (depression, anxiety or exhaustion) explain the long recovery?

This study comprises data from 105 patients (69% women, mean age 43 years) who fulfilled the criteria for Exhaustion Disorder. Shirom-Melamed Burnout Questionnaire was used to assess the symptoms of exhaustion five years after the patients initially sought care. Logistic regression was used to analyze plausible predictors of symptom duration.

As many as 41% of the patients still reported clinical level of exhaustion 5 years after initially seeking care. No difference was seen between men and women and neither burden of co-morbid depression and anxiety or age did significantly influence the recovery.

Symptoms of exhaustion was reported by almost half of patients with stress-related exhaustion five years after seeking care- This is unrelated to sex and age. Co-morbid depression and anxiety does not predict recovery. These long-lasting symptoms reported by these patients need to be further explored in order to explain why some patients still report markedly high burden of symptoms several years after seeking medical care.

Conduct problems and poor language development have been previously associated, however the direction of this association in early childhood remains unclear.

This study examined the longitudinal associations between conduct problems and expressive language ability from three to five years of age. Auto-regressive, concurrent, and cross-lagged paths were investigated while controlling for the contribution of parenting styles, maternal depression, children's cognitive ability, hyperactivity/inattention, and sex.

Children enrolled in the Millennium Cohort Study (MCS) (N = 17, 184), a population-based sample from the United Kingdom, were assessed at three and five years of age. Parent reports of conduct problems and standardized assessments of expressive language were analyzed using a cross-lagged modeling approach.

Conduct problems at three years was associated with poorer expressive language at five years and poorer expressive language at three years was associated with increased conduct problems by five years.

Overall, the results support reciprocal paths between conduct problems and poorer expressive language ability from three to five years of age. Interventions targeting conduct problems, language acquisition, and parenting in the first five years of life may yield the best results in the prevention of both conduct problems and poorer expressive language.

It has been estimated that around 10-20% of all pregnant women suffer from antenatal depressive or anxiety symptoms. These symptoms have been associated with multiple adverse child outcomes including obstetric problems, e.g. preterm delivery, Apgar score and low birth weight. Therefore, considerable health gains may be achieved if depression and anxiety during the perinatal period are adequately treated. Nevertheless, to date, no previous trials have published on the effects of Cognitive Behavioral Therapy (CBT) during pregnancy on child outcomes.

The ´Pregnancy Outcomes After a Maternity Intervention for Stressful Emotions´ (PROMISES) trial is a randomized controlled trial, which compares the effects of CBT vs. care as usual (CAU) during pregnancy among a group of women with (sub)clinically depressive and/or anxiety symptoms (n=226) on both maternal and child outcomes. Child outcomes comprise a range of obstetric outcomes including birth weight, Apgar score, and gestational age. Independent samples t-tests were performed to investigate differences in mean values.

No significant differences were found between the CBT- and the CAU-groups, in gestational age (39+0 vs 39+2 weeks+days, p=.99), birth weight (3447 vs 3509 grams, p=.24), or Apgar score at 1 (8.6 vs 8.6, p=.99), 5 (9.5 vs 9.6, p=.31), and 10 minutes (9.7 vs 9.8, p=.26).

Although CBT as early treatment of antenatal depression and anxiety is most likely to be effective for prevention of postpartum depression, CBT seems to have no effect on major obstetric outcomes.

'GLOBAL AWARENESS OF 'CHARLES BONNET SYNDROME'

I am the founder of a newly formed NGO by the name of The Trinidad and Tobago Society for Charles Bonnet Syndrome. An experience with a family member who suffers from Charles Bonnet Syndrome led me to become an advocate for this syndrome.

The Royal National Institute for the Blind (RNIB) outlines Charles Bonnet Syndrome as a common condition among people who have lost their sight and consequently see things that aren't really there, known as visual hallucinations.

People with CBS see the unimaginable and impossible!

Visual hallucinations impact negatively causing undue fear, nervousness and anxiety for victims.

There is no cure for CBS. According to Royal National Institute for the Blind (RNIB), the most effective form of treatment can come from knowing that the condition is not a mental health problem.

Dr. Dominic Ffytche and Thomas M. Cox recently concluded a CBS survey and outlined the need for education prior to hallucination to help reduce negative outcome.

Awareness of CBS globally

For medical professionals to consider the latest findings on CBS

Communication.

Removing the stigma of mental illness

Centuries have gone and Charles Bonnet Syndrome is still not known to many. Dr. Oliver Sacks calls it 'The Silent Multitude in his book 'Hallucinations.'

This abstract was prepared for those silent multitudes who wish to hear someone say 'It's ok, you are not losing your mind, it's called Charles Bonnet Syndrome.'

Cheron Faustin Holder

To obtainconsensus from non-consultant hospital doctors and consultants indeveloping a eLearning module for teaching non-consultant hospital doctorsabout delirium

1) A questionnaire to assess knowledge regarding deliriumwas administered to Medical NCHDs and toPsychiatry NCHDs. A 50 minute teaching session was provided to the PsychiatryNCHDs, which included an existing e-learning module for undergraduateson delirium developed in University College Dublin(UCD). Followingthis feedback was obtained regarding the module and what changes would berequired for it to meet the training needs of non consultant hospital doctors.

2) In the first step of the DELPHIprocess, feedback from medical consultants was obtained in relation to thethemes and topics to be included in the delirium e-learning module.

•In the first iteration of the DELPHI process, both NCHDs and Consultants identified relevant learning outcomes for an eLearning module on delirium for postgraduate medical trainees.

The next iteration of the DELPHI process will refine the themespreviously identified in order to achieve consensus among the NCHD andconsultant groups surveyed. This will be the basis for the design of aneLearning module about delirium.

The physical aspect of Maltese patients treated with antipsychotics

Patients with mental health problems are known to have more physical comorbidities resulting in reduced life expectancy when compared to the general population. The NICE guidelines (2014) has directed clinicians to monitor the physical health of patients with psychosis.

This study sets to determine whether management of physical health comorbidities of Maltese patients treated with antipsychotics is optimal.

The aim of this study is to screen for risk factors of poor physical health, features of the metabolic syndrome and other physical comorbidities amongst Maltese patients treated with antipsychotics.

Patients treated with antipsychotics were randomly enrolled in the study. Parameters measured included weight and waist circumference. Blood pressure and blood glucose monitoring was reviewed. Lipid profiles were checked for dyslipidaemia. Patients were questioned about physical comorbidities (particularly diabetes, cardiovascular diseases and respiratory problems), their smoking status, diet and level of physical activity.

Preliminary results indicate that the physical health of patients treated with antipsychotics in Malta is suboptimal and may be improved.

Patients treated with antipsychotics in Malta need better identification and management of their poor lifestyle choices and physical comorbidities. Simple interventions such as offering suitable advice, education and referring to appropriate specialists to treat identified physical problems may greatly improve patient's quality of life.

In 2007 the United Kingdom amended Mental Health Act legislation. This was driven by a public outcry over homicides perpetrated by mentally ill offenders. There was a very large and unsuccessful campaign against these changes led by the Royal College of Psychiatrists. One of the central objections to the changes was the belief that the amended Act would introduce new criteria for detention that would result in a rise in the number of detentions.

To measure whether there was any change in outcomes associated with the amended criteria for detention.

Data is routinely collected in the county of Norfolk on over 99% of all assessments for possible detention. Data covering the period 2001 – 2011 covering 11505 (7885 pre amendments and 3620 post amendments) individual assessments for possible detention was analysed as part of the Norfolk Mental Health Act Assessments Outcomes Study. Outcomes measures were the number of admissions and the number of detentions that followed from Mental Health Act assessments.

There was a highly significant 27% rise (p 0.000) in the proportion of people detained and a 16% fall (p 0.000) in the proportion of people admitted voluntarily following Mental Health Act assessments under the new amended Act.

The changes to the law appear to have led to approximately 33 people being detained every year in Norfolk who would not previously have been detained. If extrapolated to the whole of England this would amount to over 1500 additional annual detentions.

Assessment of psychological health of an individual is necessary and important for a number of national institutions to fulfil its functions. In Latvia it was a lack of such a clinical personality assessment test, which would comply with the internationally accepted scientific standards and contemporary trends in the field.

to develop 1) the theoretical concept, 2) initial item pool and 3) preliminary version of the Latvian Clinical Personality Test (LCPT).

based on thecombinedrational/theoretical and inductive/statistical strategy and emic-etic approach to develop a preliminary version of LCPT, and to perform the initial psychometric analysis of the LCPT.

in total 678 participants (70% clinical group) aged from 18 till 68 years completed the initial item pool of LCPT and demographical inventory; in addition clinical group participants were assessed with M.I.N.I (International Interview) by trained clinicians.

In the result of the performed analysis the preliminary version of LCPT was developed. The obtained results are very promising showing that the preliminary version of the LCPT has acceptable psychometric properties; content, construct and criterion validity of the LCPT preliminary version has been approved.

LCPT is a new clinical personality tests developed based on the DSM-V and aimed to measure a wide range of clinical and personality disorders. The preliminary version of LCPT consists of 10 Clinical disorders scales and Personality disorder scales. There are 3 additional validity scales: Disclosure, Desirability and Debasement.

A deeper understanding of how it is to live with dementia can be a good starting-point for caring and the organization of the care.

Understanding the lived experience of dementia from a lifeworld-theoretical framework, which has been put to practice from a hermeneutical perspective. The research question was: What is the lived experience of dementia for a couple where one of them is diagnosed with dementia?

Substantially it is caring science that has directed the research, and epistemological it is a lifeworld theoretical perspective that has directed the research towards the informant’s lifeworld. Interviews and observations have been used to collect data. The informants that have participated in the study have been 8 Portuguese couples with one partner suffering from dementia.

The couple’s existence is narrowed and controlled by the impact of the dementia disease and the existence is characterized of imbalance in responsibility and a sense of futility, hopelessness and homelessness.

By taking stand in the theory of intentionality in the care of the person with dementia, caregivers can help him or her to strain the intentional threads and gives the person a possibility to be rooted the world.

The recent DSM-5 criteria for delirium can lead to different rates of delirium and different case identification.

The aims of this study were to determine how the new DSM-5 criteria might differ from the previous DSM-IV in detecting rates of delirium in elderly medical inpatients and to investigate the agreement between different methods, including the DSM III, DSM III-R, DSM-IV and DSM-5 criteria.

Prospective, observational study of elderly patients aged 70+ admitted under the acute medical teams in a regional general hospital. Each participant was assessed within 3 days using the DSM-5, and DSM-IV criteria plus the DRS-R98, CAM and MoCA scales.

The studied sample included 200 patients. The prevalence rates of delirium for each diagnostic system/scale were respectively for DSM-5 n=26 (13.0%), DSM-IV n=39 (19.5%), DRS-R98 n=27 (13.5%) and for CAM n=34 (17.0%). Using tetrachoric correlation coefficients the agreement between DSM-5 and DSM-IV was statistically significant (rhotetr=0.64, SE= 0.1, p<0.0001). Similar significant agreement was found between the four methods.

DSM-IV identifies more delirium cases compared to any other method and DSM-5 is the more restrictive. These classification systems identify different cases of delirium. This could have clinical, financial and research implications. However, both classification systems (and their antecedents) have significant agreement in the identification of the same concept (delirium). Clarity of diagnosis is required for classification but also has implications for prediction of outcomes, further research looking at outcomes could assist a more in depth evaluation of the DSM-5 criteria.

The effect of perceived-stress on students' health is dependent on their coping abilities. One of coping strategies for dealing with stress is resilience. The aim of this study is to examine perceived stress and its relation with resilience in undergraduate Nursing students

In this cross-sectional study, 309 under-graduate nursing students studying at Tehran University of Medical Sciences during the first semester of 2012-2013 were selected by stratified sampling. Data were collected using the Perceived stress scale and Connor-Davidson Resilience Scale (CD-RISC) questionnaires. The data was analyzed using descriptive and inferential statistics by SPSS-Verrsion14.

Findings revealed that about 100% (99.3%) students reported that perceived stress moderately or high. Regarding relation between perceived-stress and resilience There were statistically significant relationship between these two variables (P≤ 001/0, r=-0.38).

According the study findings nursing school can provide facilities and opportunities for students to learn stress management strategies such as increasing resilience ability during 4 years educational program.

Gooddoctor-patient communication has been shown to have a positive impact on anumber of health outcomes in previous studies.

to assess the communications skills used by mentalhealth professionals(MHP).

This study explore the impact of clinical factors relatedMHP (communications skills) may have on treatment adherence of patients withmental health disorders (MHD).

In this crosssectional study we use a convenience sample of patients with MHD attending inthe mental health departments of three general hospitals in Lisbon greatarea. Data is being collected through individual interviews. We have appliedclinical and socio-demographic questionnaire and additional measures to assesssymptom severity, treatment adherence and attitudes towards medication. For MHP we used a optimism scale (ETOS) and Medication Alliance Beliefs Questionnaire (MABQ.

Two conveniencesamples were composed by 121 patients(mean age= 39.8; SD± 9.3) with MHDand 60 MHP (mean age 37.0; sd 8.4)working in a varietyof settings is being collected.69.4%(84) of patients said that MHP did notspoke about the way to deal with the possible side effects ofmedications and only 20%(12) of MHP, said that have a specific training incommunication skills.

Communication skills should be improved andphysicians should take a more active role in improving patient treatment adherence. Do not just prescribe medication, it is necessary to adapt the treatment to theprofile and characteristics of each patient, assessing risk factors andfacilitate the clarification of doubts. Successful collaboration requirestailoring strategies to individual patients rather than basing communication ongeneral assumptions.

To review specificities of and difficulties in psychodynamic psychotherapy training for psychiatry residents.

The Royal College of Physicians and Surgeons of Canada requires a minimum of 32 weeks of the PGY2-PGY5 psychotherapy experience. Most of Canadian universities organize training in supportive psychotherapy, cognitive-behavioral therapy and long-term psychodynamic psychotherapy for psychiatry residents. At the beginning of the PGY3 year, residents will begin supervised practice in psychodynamic psychotherapy for a minimum of one year. Residents may perceive psychodynamic psychotherapy as too complicated and they may require a more directive approach in supervision and guidance regarding psychotherapy technique and psychotherapy process. This is understandable because they lack personal/didactic analysis. Supervisor trained in psychoanalysis needs to take into account differences in supervision as a part of psychoanalytic training and psychiatry resident supervision in psychodynamic psychotherapy. Unlike the psychoanalytic training organized by psychoanalytic institutes, training in psychotherapy as a part of residency training is much less defined in terms of standards and expectations from both residents and supervisors. The profile of psychodynamic psychotherapists who serve as supervisors for residents may vary significantly with regards to their training, experience and personal style in supervision. Criteria for assessment of resident performance and his/her progress in training are not well established. Residency training committees and psychotherapy training committees should work on developing training standards of psychotherapy supervisions for residents.

In conclusion, psychodynamic psychotherapy supervision for psychiatry residents is a specific and modified type of psychotherapy supervision. There is a need for standardization of the long-term psychodynamic psychotherapy supervision.