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We present 63 new multi-site radial velocity (RV) measurements of the K1III giant HD 76920, which was recently reported to host the most eccentric planet known to orbit an evolved star. We focused our observational efforts on the time around the predicted periastron passage and achieved near-continuous phase coverage of the corresponding RV peak. By combining our RV measurements from four different instruments with previously published ones, we confirm the highly eccentric nature of the system and find an even higher eccentricity of
$e=0.8782 \pm 0.0025$
, an orbital period of
, and a minimum mass of
for the planet. The uncertainties in the orbital elements are greatly reduced, especially for the period and eccentricity. We also performed a detailed spectroscopic analysis to derive atmospheric stellar parameters, and thus the fundamental stellar parameters (
$M_*, R_*, L_*$
), taking into account the parallax from Gaia DR2, and independently determined the stellar mass and radius using asteroseismology. Intriguingly, at periastron, the planet comes to within 2.4 stellar radii of its host star’s surface. However, we find that the planet is not currently experiencing any significant orbital decay and will not be engulfed by the stellar envelope for at least another 50–80 Myr. Finally, while we calculate a relatively high transit probability of 16%, we did not detect a transit in the TESS photometry.
ABSTRACT IMPACT: Current practice guidelines offer a variety of treatment options for sternal reconstruction but complications and infections remain a serious surgical problem. This work seeks to provide a comprehensive picture of the com-morbidities and reconstructive methods that lead to success and improve patient outcomes. OBJECTIVES/GOALS: Patients that undergo cardiac surgery via the median sternotomy approach are at risk of wound complications that require repair. We seek to evaluate how outcomes of sternal reconstruction are influenced by patient comorbidities, flap usage and internal mammary artery grafts and methods of sternal closure. METHODS/STUDY POPULATION: We identified patients between 2005 and 2020 who underwent sternotomy followed by debridement and flap coverage at our institution. Comorbidities, method of reconstruction, demographic data, surgical history, and other factors pertaining to mortality and morbidity were collected. The data will then be analyzed to identify population characteristics using logistic regression variables to determine univariate and adjusted multivariable measures of association with mortality. We present the pre-liminary data analyzed using chi-square and one-way anova in R. RESULTS/ANTICIPATED RESULTS: In this study we present a preliminary characterization of one institution’s sternal reconstruction patient outcomes with a variety of reconstruction methods including pectoralis advancement flaps, omental flaps and latissumus dorsi flaps. Notable preoperative comorbidities include 50% of patients > age 60, 18% with diabetes mellitus, 18 % with diagnosed hypertension, 18% with COPD, and 9% with a smoking history DISCUSSION/SIGNIFICANCE OF FINDINGS: In an evolving cardiothoracic landscape, clinical characteristics of patients being treated for sternal reconstructive surgery present a moving target. Understanding current risk factors, preoperative management and timing for aggressive surgical treatment offers an opportunity to update treatment protocol and maximize successful outcomes.
Manuscripts pertaining to paediatric cardiology and CHD have been published in a variety of different journals. Some of these journals are journals dedicated to paediatric cardiology, while others are focused on adult cardiology. Historically, it has been considered that manuscripts published in journals devoted to adult cardiology have greater citation potential. Our objective was to compare citation performance between manuscripts related to paediatric cardiology and CHD published in paediatric as opposed to adult cardiology journals.
We identified manuscripts related to paediatric cardiology and CHD published in five journals of interest during 2014. Of these journals, two were primarily concerned with adult cardiology, while the other three focused on paediatric cardiology. The number of citations for these identified manuscripts was gathered from Google Scholar. We compared the number of citations (median, mean, and 25th, 75th, 90th, and 95th percentiles), the potential for citation, and the h-index for the identified manuscripts.
We identified a total of 828 manuscripts related to paediatric cardiology and congenital heart as published in the 5 journals during 2014. Of these, 783 (95%) were published in journals focused on paediatric cardiology, and the remaining 45 (5%) were published in journals focused on adult cardiology. The median number of citations was 41 in the manuscripts published in the journals focused on adult cardiology, as opposed to 7 in journals focused on paediatric cardiology (p < 0.001). The h-index, however, was greater for the journals dedicated to paediatric cardiology (36 versus 27).
Approximately one-twentieth of the work relating to paediatric cardiology and CHD is published in journals that focus predominantly on adult cardiology. The median number of citations is greater when manuscripts concerning paediatric cardiology and CHD are published in these journals focused on adult cardiology. The h-index, however, is higher when the manuscripts are published in journals dedicated to paediatric cardiology. While such publications in journals that focus on adult cardiology tend to generate a greater number of citations than those achieved for works published in specialised paediatric cardiology journals, the potential for citation is no different between the journals. Due to the drastically lower number of manuscripts published in journals dedicated to adult cardiology, however, median performance is different.
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding of Earth's sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments.
A synthesis is made of ten fields within climate science where there have been significant advances since mid-2019, through an expert elicitation process with broad disciplinary scope. Findings include: (1) a better understanding of equilibrium climate sensitivity; (2) abrupt thaw as an accelerator of carbon release from permafrost; (3) changes to global and regional land carbon sinks; (4) impacts of climate change on water crises, including equity perspectives; (5) adverse effects on mental health from climate change; (6) immediate effects on climate of the COVID-19 pandemic and requirements for recovery packages to deliver on the Paris Agreement; (7) suggested long-term changes to governance and a social contract to address climate change, learning from the current pandemic, (8) updated positive cost–benefit ratio and new perspectives on the potential for green growth in the short- and long-term perspective; (9) urban electrification as a strategy to move towards low-carbon energy systems and (10) rights-based litigation as an increasingly important method to address climate change, with recent clarifications on the legal standing and representation of future generations.
Social media summary
Stronger permafrost thaw, COVID-19 effects and growing mental health impacts among highlights of latest climate science.
Venlafaxine (V) is a SNRI metabolized primarily by the highly polymorphic cytochrome P4502D6 enzyme (CYP2D6) in O-desmethylvenlafaxine (ODV), the main active metabolite. Four CYP2D6 metabolizer phenotypes have been identified: poor (PM), intermediate (IM), extensive (EM) and ultrarapid (UM). Approximately 5-10% Caucasians are PMs; in these individuals metabolism of substrate is decreased and adverse clinical effects may be expected. The effectiveness of pharmacogenetic tests is controversial because the association between plasma levels of V/ODV and side effects is not attested.
We discuss the association between CYP2D6-genotype and Venlafaxine clinical effects.
We will recruit Caucasian patients aged 18 to 65, eligible for Venlafaxine treatment, satisfying DSM-IV criteria for major depressive episode, dysthymia or depressive adjustment disorder. Exclusion criteria will be: pregnancy, acute suicidality, alcohol/substance abuse, concomitant/prior antidepressive treatment in the previous 3 months. We will assess patients’ age, gender, DSM-IV diagnosis, Venlafaxine dose, concomitant pharmacological treatment, BMI, BP, tobacco use, liver and kidney functionality. Clinical response and side effects will be monitored using CGI, HAM-D and SIDE at T0 (onset), T1 (1 week later) and T2 (6 weeks later).
The patients will be analyzed for the presence of 16 CYP2D6-genotype variants by INFINITITTM CYP2D6 assay which utilizes AutoGenomics proprietary film-based microarray technology.
We expect to find out a correlation between CYP2D6-genotype, Venlafaxine dose and clinical response to treatment.
We will investigate whether a pharmacogenetic test prior to treatment can be useful in clinical practice to detect a proper Venlafaxine dosage or to switch to a different drug.
The immigrant population in Italy is currently increasing, particularly, foreigners in East Piedmont raised by 16,8 % last year. We aim to compare immigrant and Italian patients’ Emergency Room (ER) admissions due to psychiatric symptoms.
Of the 658 admissions we observed, 13.1 % of ER contacts concerned immigrants mostly coming from Russia, Albania, Morocco and Romania, consistently with migration streams in East Piedmont. Compared to the Italians, immigrant patients were younger (35.70; SD = 10.56 versus 44.78; SD = 16.57) and more frequently admitted for alcohol and substance abuse/withdrawal. Italians had a higher probability of having a psychiatric history including previous hospitalizations and contacts with Mental Health Services (OR = 2.60; CI 95 %: 1.64-4.12). The presence of social/relational problems associated with admission was significantly lower among the Italians (OR = 0.55; CI 95 %: 0.35-0.88).
Preliminary data suggest that ER utilisation by immigrants may represent their main way to primary health care. Monitoring ER contacts may provide relevant information for the development of culturally sensitive Mental Health Services.
We considered Italian and immigrant patients with psychiatric symptoms who were admitted to the ER Department of Novara during a period of 13 months. We compared sociodemographic (gender, age, education, occupational history, marital status, living circumstances) clinical-anamnestic (history of psychiatric illness, presentation symptoms, previous contacts with Substance Abuse/Mental Health Services, social/relational problems) and admission (type of admission, intervention and discharge) characteristics of the two groups (Italians versus immigrants).
Prostate and breast cancer share many similarities: high lifetime prevalence, increasing frequency, role of environmental factors, long survival also in metastatic disease and possibility of screening. The aim of this work is to evaluate the characteristics related to the patients, disease and treatment which can affect HRQoL at the beginning and after radiotherapy.
since June 2009, we have recruited patients, providing informed consent, before radiotherapy (T0). We assess demographic characteristic (age, qualification, work, marital status…); neoplastic staging and grading; radiation dose and other antineoplastic treatment (hormonal/chemio-therapy or surgery); concomitant medical disease and pharmacological therapy. We evaluate HRQoL by EORTC-QLQ-C30 and EORTC-QLQ-PR25 (prostate-specific) or EORTC-QLQ-BR23 (breast-specific). The protocol also includes HADS, Paykel Life Events Scale and EPQ-R. The work is ongoing and implies a follow-up at 6 and 12 months (T1/T2).
The majority of men have a localized disease with Gleason score between 6 and 8 and the median pretreatment PSA is 10.52 ng/mL; 70% will undergo adjuvant-RT; median age is 69.30 years. Women have a median age of 58.46 years, all underwent surgery and all have a localized disease and positive receptorial status. Global QoL is lightly higher in the man sample; both groups report a major deficit at Emotional Function and high levels of Fatigue. The personological characteristic more represented is “Extravertion”.
The results show an association between worse QoL, “Nevroticism” and high Anxiety levels only in the men sample at T0. At the moment, there is no significant relation in the women sample.
To study whether there are personality characteristics that discriminate between IPV women and non-abused control women, taking into account the effect of emotional state (depressive symptoms).
A total of 176 women victim of IPV and 193 non-abused control women were assessed with the Dimensional Assessment of Personality Pathology (DAPP-BQ; Livesley, 1990), the Beck Depression Inventory -II (BDI-II; Beck, 1996), and the Index of Spouse Abuse (ISA; Hudson & McIntosh, 1981). Women victim of IPV were recruited from Domestic Violence Centers, and non-abused control women were recruited from Primary Care Centers and Mental Health Services. A two way analysis of variance (IPV * Depression) were used for detecting differences in personality traits taking into account the effect of depression (BDI ≥ 17).
After controlling for depression, IPV victims scored higher than control women in submissiveness (F=6.41; p=0.01), cognitive distortion (F=4.35; p=0.04), intimacy problems (F=27.02; p< 0.001), suspiciousness (F=5.02; p=0.03) and self-harm (F=4.93; p=0.03), and lower in rejection (F=14.66; p< 0.001).
IPV victims showed high submission, low hostility, intimacy problems, suspiciousness, tendency to depersonalization or derealization, and suicidal ideation and attempts, as a result of chronic abuse. Some of these aspects could be explained by the presence of PTSD, more than by pre-existing personality characteristics. Traumatic and chronic stress can alter functional aspects of the brain and lead to the development of dysfunctional cognitive and behavioral characteristics that may be considered in the psychotherapeutic approach.
The impact of Idiopathic Parkinson Disease (IPD) in patient’s sexual health is still a matter of debate. Clinicians should have a concern about the sexual function of their patients with IPD.
To evaluate sexual health of patients with IPD.
We randomly select a group of IPD patients and a group of healthy controls. We used the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) to assess sexual function. To evaluate depression and anxiety we used Brief Symptom Inventory (BSI) and Beck Depression Index (BDI).
We had 83 IPD patients, and 69 controls. Male patients had lower total IIEF scores than controls (p< 0,001). The analysis of linear regression shows a relationship between the IIFE and the duration of the disease, the patient age and the BDI score (R=0,72; Adjusted R square=0,49, p< 0,001) when adjusted to the variables: realization of deep brain cirurgy of subthalamic nucleus (DBS-STN) stage of the disease, BSI score, dopaminergic treatment, treatment with antidepressives and antipsychotics. The IFSF didn’t show differences between the cases and the controls. Patients had higher BSI and BDI scores than controls (p< 0,001).
Male IPD patients had an impairment of sexual function predicted by disease duration, patient age and BDI scores. Sexual function should be assessed in these patients
Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.
78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).
ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.
ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.
The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.
- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.
- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.
To underline the importance of a correct diagnosis and management of catatonia and complications increasing its morbidity and mortality. Catatonia is a syndrome of altered motor behaviour, mainly classified as a form of schizophrenia. Recent literature suggests catatonia is an independent syndrome, frequent among patients diagnosed with mania/depression or accompanying many general medical conditions and neurological disorders.
We describe the case of a 58-year-old woman with NIDDM in antidiabetic oral therapy and history of schizophrenia, diagnosed when aged 20 and treated with Haloperidol (10 mg/day), Levomepromazine (100 mg/day) and Lorazepam (2.5 mg/day) who was admitted to our clinic for a condition characterized by mutacism, staring into space, muscular rigidity and bilateral arm cogwheeling, initially suggesting a neuroleptic malignant syndrome.
At hospitalization there was no fever, leukocytosis or CPK elevation. She quickly developed altered consciousness, autonomic dysfunction (hypertension, dysphagia, uncontrolled hyperglycaemia) and waxy flexibility finally recognized as a catatonic syndrome, according to DSM-IV-TR criteria. Multiple infections (urinary trait infection, teeth infections leading to sepsis) worsened her clinical condition. The first therapeutic strategy was suspending neuroleptics. Psychomotor symptoms, rated with the Catatonia Rating Scale (CRS), gradually resolved by intravenous administration of Lorazepam high doses (up to 12 mg/day). General medical conditions improved with specific antibiotic therapy, endovenous hydratation and parenteral nutrition. A physiatric rehabilitation program was started, with significative motricity improvement.
This report underlines the importance of the differential diagnosis between catatonia and similar conditions (such as NMS) and the fundamental role of multidisciplinary approach to complications.
UPD is a regional referral hospital psychiatric care unit, endowed with multidisciplinary equipment. It provides care to people with light/moderate/severe intellectual incapacity coexisting with mental disease and/or severe behavioral disorders. It offers attention to patients who need a protected therapeutical environment for correcting behavior disorders. It was opened in September 2008.
Description of:therapeutic goals, inclusion/exclusion criteria, admission protocol and psychotherapeutic/pharmacological interventions.
Analysis of inpatients's sociodemographic/clinical characteristics and preliminary assessment of therapy goals.
Retrospective study(13-month) of patients admitted to UPD of Leon Hospital from its inception to date. Data are collected from medical histories.
47 referrals have been received,5 of them have been rejected not to fulfill criteria. We’ve 16 patients on waiting list.32 incomes have been realized and 22 discharges have occurred.
19 of the incomes correspond to Mild,6 to Moderate,6 to Severe and 1 to Profound mental Retardation.
Regarding co-morbidity:22 patients presented serious behavioral disorder. From this group, 2 met criteria for autistic disorder, 5 had schizophrenia or unspecific psychotic disorders, 5 presented Personality Disorder and one ADHD.
10 patients did’nt present any important behavioral disturbance. From this group 2 were diagnosed with OCD,3 presented problems due to Alcohol and Substance-related Disorders,3 had Psychotic Disorders, one met criteria for Impulse Control Disorder and one presented Mood Disorder.
Before admission, 12 patients resided in specific handicappeds center, 5 intermittently at selected centers and in family, and 15 lived with family.
Psychotherapeutic intervention and treatment were useful in most cases. It was particularly helpful in treatment of behavioral disturbances. Now we must determine effectiveness in maintenance of improvement when they return to their community.
To evaluate the subjective well-being of a group of patients who were hospitalized at the Institute of Psychiatry (Novara), compared to the severity of illness.
Patients are evaluated at admission and discharge through self-administration of the SWN (Subjective Well-being under Neuroleptics) scale, which contains five subscales (emotional regulation; self-control; mental functioning; social integration and physical functioning) assessing patients’ psychophysical and emotional well-being, calculating a value for each subscale and a total score. The clinician fills in the CGI (Clinical Global Impression) for each patient, which provides a global judgement in three areas: severity of illness, global improvement and therapeutic effectiveness.
From June 2009, 51 patients were evaluated at admission and discharge: 26 diagnosed with psychosis and 25 diagnosed with personality disorders. Preliminary data suggest a meaningful improvement of the physical functioning in the psychotic group, a tendency to improvement of the social integration area in the personality disorders group. Among the psychotic group, the schizophrenic patients (n°=14) have shown an improvement in the self-control subscale.
Literature suggests that a high SWN score is associated with a better compliance and an early improvement of subjective well-being is a major predictor of the chance of remission. This study will allow to compare the subjective well-being evaluated by SWN with the clinical judgment of the CGI and above all if this can represent a predictor index for the compliance and the chance of remission.
Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories. The need for standardizing the involuntary hospital admission has been highlighted by all centers. In the final recommendations, it has been stressed the need to: providing information to patients about the reasons for hospitalization and its presumable duration; protecting patients’ rights during hospitalization; encouraging the involvement of family members; improving the communication between community and hospital teams; organizing meetings, seminars and focus-groups with users; developing training courses for involved professionals on the management of aggressive behaviors, clinical aspects of major mental disorders, the legal and administrative aspects of involuntary hospital admissions, on communication skills. The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure.
Alexithymia is a term to describe a state of deficiency in understanding, processing, or describing emotions. It expresses the cognitive-emotional state of vulnerable subjects who prone to suffer from psychosomatic illnesses. It’s characterized by difficulties in relationship and emptiness of feelings. It has been incriminated in genesis and maintenance of various psychosomatic pathologies, included psoriasis. Psychological stress is important in onset and exacerbation of psoriasis. We assume hypothesis that emotions that cannot be expressed through the appropriate symbolic language will be expressed through a symbolic somatic symptom.
A case study of psoriasis in a woman of 27 years without a previous psychiatric history. She was treated jointly by the service of psychiatry and dermatology. Methodology: We performed a detailed history in the course of the disease, summarizing vital changes and outstanding events of her lifetime in the different vital areas (family, work, school and sex life).
From the comprehensive revision of the ailments and pathobiography we can establish a clear relationship between physical-psychological symptoms.
Skin is an envelope that represents the boundary line between body-psyche. Skin and psyche interact in many ways. The skin reacts to feelings and perceptions. Psychosomatic patients feel extreme anxiety when they have to cope with separation and merger situations. They experience these situations as if they were to lose their physical limit. Broadly speaking, because of their alexithymia, they cannot process a painful emotion properly, and though they will express it through somatisation disorders and the development of diseases. In the case of our patient, the skin verbalizes her emotional silence.
DD represents a common issue in clinical practice, with relevant effects on symptoms, course and treatment of disease. It's often associated with negative outcome as a greater severity of symptoms and resistance to drug treatment.
To assess how the characteristics (sociodemographic, clinical and related to substance abuse) of patients discharged with DD have changed taking into account the FA occurred in three different five-year periods (1990–1994, 2000–2004, 2005–2009). We also compared the characteristics of patients discharged with only psychiatric diagnosis with those of patients with DD to look for possible risk factors for abuse among people with psychiatric illness.
We conducted a retrospective study of medical records of patients at FA to our Institute in three different periods. We divided the patients discharged with DD from those discharged with only psychiatric diagnosis.
Among the FA occurred in the periods examined we noticed an increase of DD cases (12% from 1990 to 1994, 21% 2000–2004, 28% 2005–2009). The incidence of each diagnosis was changed in several years, but each time the diseases more represented remain schizophrenic or affective psychosis and personality disorders. Alcohol is the most widely used psychotropic drug in each period. There is also a progressive increase in the abuse of cannabis, cocaine and in the incidence of multi-drug abusers. Compared with patients discharged with only a psychiatric diagnosis, patients with DD were more frequently:male, younger, unmarried, unemployed, with legal issues, grown up in a family with serious problems, and history of etero-aggressive episodes.
Due to continued increase in cases of DD, we want to highlight the importance of early identification of cases of comorbidity in order to provide adequate treatment and support.
Theory of mind represents the ability to attribute mental states to oneself and others and to use these mental representations to decide one's own and predict others’ behavior. In our study, ToM is investigated in a non-psychiatric setting: a university students sample.
The aim of this study is to evaluate the presence of subthreshold alterations in our sample and, on the other hand, if altered cognitive functioning can worsen study performance. Moreover it investigates a possible correlation between the faculty chosen and cognitive functioning. We considered 228 students attending the Faculty of: Economy (n = 26), Dental hygienists(n = 7), Law(n = 16), Medicine (n = 54), Pharmaceutics(n = 27), Physiotherapy(n = 15), Mathematics, Physics and Biology (n = 12), Midwifery (n = 14), Chemistry and Pharmaceutical techniques (n = 17), Liberal Arts (n = 3), Nursing (n = 37).
We administered the following tests to 228 university students: EYSENCK PERSONALITY QUESTIONNAIRE (EPQ-R): evaluating some personality dimensions including psychoticism, neuroticism, introversion, extroversion;SCL-90-R: self-evaluation scale of some symptom dimensions as somatization, obsessive-compulsiveness, depression, anxiety, anger, hostility, sensitivity, phobic anxiety, paranoid ideation and psychoticism; TEST OF EMOTION ATTRIBUTION: composed of 58 short scenes concerning seven emotions (sadness, fear, shame, disgust, happiness, anger, envy) that the student must identify.
TEST OF ToM: consists of 13 short stories describing social and family situations; the student must identify why the protagonist behaved in a certain manner.
The statistical analysis is still in progress. Preliminary data suggest that people with subthreshold symptoms belonging to the depression, obsessive-compulsiveness, anxiety and phobic-anxiety clusters show deficits of theory of mind. Data concerning the correlation between cognitive functioning and faculty chosen and between cognitive functioning and poor study performance will be examined in a further work.
Our results together with data from literature suggest the chance to apply this set of tests to screen deficit of Theory of Mind in a non mentally ill population.
Bipolar disorder is a chronic, debilitating psychiatric disease. The management of this disorder involves treating current episodes and preventing their long-term recurrence.
Many patients with Bipolar Disorder are hospitalized at some point in the course of their illness. Although most bipolar patients do not require extended inpatient psychiatric hospitalizations, short-term hospitalizations may be necessary during acute or potential crises.
Hospitalization is among the most expensive treatment options available, and it is therefore offered sparingly and generally only when no other treatment options will prove sufficient to ensure patient safety.
A hospital setting should be considered when safety is in question due to suicidal, homicidal, or aggressive impulses or actions, as well as inability to care for self. Other clear indications for hospital admission are the need for diagnostic procedures, history of rapidly progressive symptoms (especially psychotic phenomena), the rupture of patient"s usual support systems and a patient"s grossly reduced ability to take care of themselves.
The aim of this study is to characterize the inpatient treatment of bipolar patients admitted in the Hospital São João's Psychiatry Department. Data were collected from clinical files using an investigation protocol especially developed for this purpose. This protocol includes sociodemographic information, the referral source, the admission path, reason for hospitalization, current phase of disease, voluntary versus involuntary status, number of previous admissions, prescribed medications and length of stay.
To design a scale to measure perceived reasons to stay in violent partner relationships, and to carry out a preliminar analysis of its psychometric properties.
A 44 dicotomic items (true/false) self-report scale was designed (more a last open response question), elaborated according to published studies and open interviews with battered women. The questionnaire was administered to a pilot sample of 10 women to test its viability and comprehensibility. The questionnaire was then administered to a sample of 132 battered women. Exploratory factorial analysis was used to establish the underlying empirical structure. Internal consistency was calculated by mean of Cronbach's alfa coefficient.
The factor analysis identified two empirical factors: external factor (situational factor) and internal factor (psychological factors). Cronbach's alphas were 0.856 and 0.811, respectively.
The Block Escape in Intimate Partner Violence Scale is a reliable and easily comprehensible instrument mesuring percibed reasons of permanence with the aggressor. Its usefulness in both setting, clinical and social, will allow design with great effectiveness intervention strategies suitable for each case.
This study was supported in part by grant-58/05 from the Ministerio de Trabajo y Asuntos Sociales. Instituto de la Mujer.
To assess the use of SWN in the acute phase of psychiatric disease as a predictor of clinical outcome.
This study started in June 2009 and at the moment we have recruited 150 patients. The patients were divided into 4 groups according to their psychiatric diagnosis (schizophrenic psychosis, mood disorders, personality disorders, acute stress reaction) and each diagnostic group into three subgroups according to length of stay (T1< 7 days, T2 = 7–14 days, T3> 14 days). The subjective well-being indicators (subscales SWN: emotional regulation; self-control; mental functioning; social integration and physical functioning) and the severity of illness (CGI-S) were evaluated at admission and discharge.
At discharge there is a statistically significant difference in the SWN subgroups among the four diagnostic groups except for social integration and total score with equal CGI-S scores. Schizophrenic patients and personality disorders show a subjective improvement at T2; mood disorders at T3; acute stress reactions T1 = T2. CGI shows a statistically improvement regardless of the length of stay.
Preliminary data suggest that SWN represents a predictor of clinical outcome and remission and together with the clinical evaluation it can help clinician to settle therapeutic programs.