Keeping and maintaining mental health in a community or at a large in a soceity is a difficult,but promising task.Mental health is a dynamic state as that of state of health which is also going to be redefined than a state of complete physical, mental and soceial health. A positive mental health is not merely absence of any mental disorders, rather a flourishng environment where an individual can grow,work, and fulfil his dreams & aspiration & also nurcher own imagination in a fruitful manner.

Here it was a comparism between a rural and a community catchment area of 2 different places and mental health questionories were distributed among 2 high scool students who are derived fom 2 different socioeconomic status.

50 male & 50 female student of 2 catchment area in rural,as well in city school were collected in same proforma.Facilities in village school includes large playing ground,more joint family stucture & more choseveness.In city per capita income, library facility, playing facility,rcreationalsopes are more flourishly arranged.Mental disorders noted are early diagonosed and early intervenation done in city school.In rural scools all 12 known cases of some mentaldisturbances were takencare of in late.

From the questinary itself, from the reports of teachers and fellow student it shows mental health is more in positively maintanned state in city environment scools, as well early diagnosis & care.In rural settings good library and liberal friend ship & chosive pattern of family & soceity helps.

The purpose of this study was to demonstrate the possible implication of physical education in the process of hemispheric lateralization in childhood, and behind this in the acquisition of the speech and hand writing language.

The present study was taken on 116 pupils (av. = 6.4 yrs). Our goal was to emphasize if the ball games can play any role in the finalization of cerebral dominance. Using three tests of psychomotricity i.e. Tapping test, String test and Matorin test, we selected 18 ambidextrous pupils. Ten of them have a slightly greater performance of the right hand. These pupils were separated in two sample-groups:

• Sample I: 5 pupils involved in a regularly ball-games-program

• Sample II: 5 pupils who did not practice this program

This research has shown that children from sample I presented a greater performance and skill in achieving the speech and the hand writing language.

In a previous reported study we observed a comparable influence regarding performance and skill in achieving the speech and the hand writing language at pupils with borderline IQ. In this study the pupils performed a score between 89 and 120 at WPPSI III (Wechsler Preschool and Primary Scale of Intelligence).

We conclude that it may be taking in account the influence of these kinds of practice to influence the acquisition of the speech and hand writing language.

One of the most important prognostic factors in patients diagnosed with schizophrenia is the number of hospitalizations they need during their life. In this work we describe risk factors which determinate psychotic relapse.

Retrospective review of the clinical histories of patients diagnosed with schizophrenia who needed hospitalization during the year 2008 using Hospital Ramon Cajal's history software. Data were analyzed using the SPSS software 15.0 version.

1. - Socio-demographic: We collected a total of 57 patients, 60% were men and 77,2% were single who lived with their families. 52,8% only had Primary education and 14% had been to University. 38,6% were pensioner and 12,3% workers.

2. - Risk factors: 54,4% had abandoned their medication, 7% had had recent modifications in their medication, and 35,1% received long acting antipsychotic. 42,1% were identified as substance users.

3. - 40,4% had been diagnosed with schizophrenia more than three years ago; 57,9% had had less than 3 previous hospitalizations, and 54,4% need hospitalization the previous year.

Male under 30 years old have more risk of needing more hospitalizations. The main risk factor for suffering new psychotic episodes is the medication nonadherence, modifying medication only causes new episodes in few patients. Patients receiving long-acting antipsychotic agents suffer less psychotic relapse. Substance abuse among schizophrenia patients is a major complicating factor since almost half of the hospitalizations are related to it.

The aim of the present study was to assess the preventive and promotion activities in the mental health area in 12 Slovenian regions. In addition, some of sociodemographic and health indicators related to increased probability of mental health problems were analysed in order to estimate the amount of preventive/promotion programmes in the regions with highest threats to mental health.

301 mental health services have been assessed according to their promotion and preventive activities in the mental health area. Services were surveyed according to their implemented activities, prevention types, funding sources, target groups, addressed risk and preventive factors and available staff at services.

98% of assessed services were involved in one or more preventive and/or promotion activity. The selective primary prevention approach prevailed, whereas services mainly focused on major mood disorders and addiction. The most common types of activities were: individual / group counselling, lecture, workshop and media appearance, where the plan of support, interpersonal conflicts and organised lifestyle as addressed risk and protective factors predominated. In the preventive/promotion programmes were the most represented social workers, psychologists and volunteers. In the contrast with the scarcity of activities in Zasavska and Savinjska region, the most abundant choice of programmes was found in Osrednjeslovenska and Obalno-kraška region.

Our study indicated that considerable differences appeared between Slovenian regions in the view of diversity and extent of preventive / promotion activities since availability and variety of this activities were particularly scarce in the regions with highest threats to mental health.

Treatment-resistant schizophrenia is an old term, describing the form of schizophrenia that does not respond to a treatment dose of Chloropromazine, equal to 1,5 gr.

20 (n=20) patients have been studied, that were diagnosed with schizophrenia, and did not respond to any combination of typical or non-typical anti-psychotic drugs. These patients were 19-62 years of age, and were administered the BPRS and PANSS scales at start of the examination or the hospitalization, and during the 1st, 3rd, and 6th month evaluation. The said patients were treated with a combination of Amisulpiride, and Clozapine.

The patients received a dosage range of 400-1200mg for the Amisulpiride, and 300-900mg for the Clozapine. 18 patients (90%) responded to this treatment, and showed an improvement in the BPRS and PANSS scales, from the 1st month of treatment using a combination of Amisulpiride-Clozapine. Later, during the 3rd month of treatment, one of the patients discontinued the treatment, as she presented leucopenia (white cell count: 3250). The discontinuation of Clozapine treatment was decided. Clozapine was replaced by 20mg Olanzapine.

Despite the fact that the sample of patients was very small (n=20), it seems that the combination of Amisulpiride and Clozapine is effective for the treatment of patients showing resistance in pharmaceutical treatment and the combination of typical and non-typical neuroleptics.

Aripiprazole is a non-typical 2nd generation anti-psychotic drug, which acts on the majority of D-receptors of dopamine, as well as 5HT2 serotonineergic receptors.

240 (n=240) patients, age 20 to 75 years, have been studied during the years 1999 to 2009. 80 of these patients were male and 160 were female, treated with Aripiprazole. The subjects were diagnosed with major depressive episode with psychotic features, combined with SSRIs, SNRIs, and NaSSas. The severity of depression at the patients was assessed with the MADRS, SCL-90R, and BPRS scales, administered during evaluation and after 1, 3, and 6 months following the initiation of therapy. After 6 months, the patients were also submitted to the GAF (Global Assessment Functionality).

217 (n=217) patients (90,4% o the population) showed a decrease following evaluation with the scales MADRS, SCL-90R, and BPRS respectively. The MADRS and SCL-90R showed a considerable decrease of somatic symptoms, suicidal ideation, and luck of activity, while the BPRS scale showed a decrease of delirious ideas and hearing delusions that constitute common features of the disorder. Furthermore, the GAF had considerably increased after 6 months.

Based on the study above, Aripiprazole constitutes a basic choice for the treatment of Psychotic Depression. Given that the patient sample is relatively small, multi-focused studies are required in order to investigate in depth the original hypothesis.

The main objective of this work was to compare the emotional and behavioral problems reported by adolescents with and without psychotic-like symptoms.

The sample was composed of 1,713 non-clinical adolescents with a mean age of 14.7 years (SD = 1.7), of which 832 (48.6 %) were males.

The results showed that the participants with psychotic-like symptoms reported a higher number of emotional and behavioral problems compared to the participants who did not inform of said experiences.

The findings converge with data from previous studies of patients with schizophrenia as well as in schizophrenia-prone individuals, offering support to the dimensional models of psychosis, and have clear implications with a view to establishing primary prevention strategies for these high-risk individuals.

This paper outlines evidence from field work conducted in Sydney (a large capital city on the southern east coast of New South Wales, Australia) and in Alice Springs (a small town located in Central Australian desert in the Northern Territory, in the heart of Australia), among young adults living with mental distress. It aims to explore the efficacious effects of bringing young and elders together, in unconditionally supportive communities of belonging, providing mirroring and feedback in the journey of recovery and growth for both groups.

The paper applies case study profiling and autoethnographic practitioner reflection on work conducted between 2004-2009, in a PhD field group of 60 participants in an “open urban tribe”; and among all ages of the community involved with headspace youth mental health project in Alice Springs.

The paper describes positive impacts on both age groups from sharing in the practice of “working the business of life” together - in the indigenous sense of giving feedback, humour, witnessing and testimony, about individual's life choices.

The evidence arising from this work is that sharing perspectives, experiences, fears and triumphs, in environments of trust and safety, can lead to strengthening and growthful outcomes for all ages. The paper concludes that combining people of diverse ages, cultures and consciousnesses can have efficacious effects on all involved. This leads to further evidence for the author's All Fruits Theory, akin to Queer Theory only referring to diversity in consciousness rather than gender preference.

The schizophrenia has associated traditionally with major rates of comorbilidad physics. In addition the antipsychotic ones of the second generation are causers of the so called metabolic syndrome (increase of weight, dislipemia and diabetes) that favor directly the cardiovascular disease in our patients.

To develop a therapeutic plan to diminish the sobremortalidad and sobremorbilidad of our schizophrenic patients (according to different studies between 25-50 % of cardiovascular risk). To detect the factors of risk, which influence the metabolic Syndrome: a high level of cholesterol HDL, IMC, smoking and hyperglycemia.

To apply measures of prevention for the diabetes, for the arterial hypertension and the dislipemias.

Retrospective study is realized, checking the clinical histories of the patients beginning medication with aripiprazol for symptomatology psychotic and support the treatment at least 6 months later. We realized preventive specific measures in the patients including education to the patient, careful selection of the antipsychotic with substitution if there appear signs of metabolic syndrome.

39 patients that initiated treatment with aripiprazol, therapeutic doses. Of 39 patients 24 (61,54 %) is smoking, 18 (46,16 %) has an IMC> 25, 11 (28,39 %) hipertriglicerinemia, 5 (12,82 %) index of glycemia basal> 125 and 6 (15,38 %) with hipercolesterolemia.

The antipsychotic atypical alter the metabolic regulation. The treatment with aripiprazol suggests minor risk of metabolic syndrome, in relation to previous similar studies, with antipsychotic others. We think it performs vital importance the prevention of the overweight orientated to patients with the first psychotic episode.

Morphine withdrawal leads to cognitive deficits and an increase in corticosterone concentrations in plasma. Evidently glucocorticoid hormones influence memory. Therefore the current study evaluated the effects of metyrapone and mifepristone on memory deficit following spontaneous morphine withdrawal.

To evaluate memory novel object recognition task was used, which comprised of three sections; habituation, first trial and the test trial. In this method, the difference in the exploration time between a familial (F) object and a novel (N) object is taken as an index of memory performance (recognition index, RI ={N − F/N + F} × 100). Male NMRI mice weighing 25-30 g were made dependent by increasing doses of morphine (30-90 mg/kg) subcutaneously twice daily for three days; RI was assessed 4 hour after the last dose of morphine on the third day. Mifepristone and metyrapone were used subcutaneously (40 min and 90 min, respectively) before the first trial.

Memory performance was impaired in morphine dependent animals (RI= −14.8% ± 10.7, P< 0.05). Serum corticosterone concentration in 4 hr morphine withdrawn animals was 26.6 ± 0.9 ng/ml, which was 20% more than normal animals. Metyrapone 25 mg/kg, and mifepristone 50 mg/kg notably improved RI to 34.8% ± 10.8 and 25.4% ± 11.7 respectively, compared to vehicle group.

Conclusions: Therefore mifepristone and metyrapone by manipulating the corticosteroid function improves memory performance after withdrawal. These results show that increased glucocorticoid concentration is involved in memory deficit caused by morphine withdrawal.

The predictD study is a pioneering international study whose main objective was to develop a risk index for the onset of major depression in general practice attendees.

The aim of this exploratory study was to determine the opinion of primary care attendees and their general practitioners about how to implement primary prevention of major depression. The intervention consisted of informing primary care attendees about their risk level and risk profile for the onset of major depression.

The study participants were primary care attendees and general practitioners in urban health centres of 7 Spanish provinces. The methodology used was qualitative: there were 14 in-depth interviews (two from each province), 7 DAFO groups and 7 focus groups.

The results showed that attendees generally welcomed this precautionary measure. Some even proposed potential changes in their lifestyles to prevent depression, such as improving social relationships, taking things more calmly or doing more leisure activities, while others asked their GP for advice. The GPs were more resistant about informing primary care attendees, raising doubts about the validity-reliability of the instrument, their lack of education about what they should or should not advise their attendees, the danger of creating excessive fear in their attendees, or the barrier of lack of time in the office to do these activities.

Primary care attendees welcome this preventive measure more than their general practitioners.

This study examined how alexithymia subscales, depression and obsessive-compulsive personality(OCP) relate to eating disorder tendency (EDT) in non-clinical Japanese female adolescents.

A self-report questionnaire survey was conducted on 393 Japanese female adolescents (273 undergraduates and 120 college students, mean age=19.9yrs, SD=1.4).

A stepwise multiple regression analysis was conducted, indicating that “difficulty in identifying feelings”(DIF) (β=.17, p< .01) and “difficulty in describing feelings” (DDF) (β=−.15, p< .01), which are factors of alexithymia, depression (β=.30, p< .001) and OCP (β=.14, p< .05) predicted EDT. Depression had the strongest effect on EDT, with DIF the second strongest. Surprisingly, DDT had a significantly negative effect on EDT.

First, prevention and therapy of eating disorder should focus on depression, difficulty in identifying feelings, and obsessive-compulsive personality. Second, one aspect of discontinuity between clinical and non-clinical females with high risk of eating disorder was implied: Non-clinical females with high risk of eating disorder may tend to describe at least superficial feelings frequently, if not deep or real feelings with introspection. Further, the possibility of describing may work as a preventive factor for non-clinical females with high risk of eating disorder against suffering from clinical eating disorder.

Table 1:

Results of stepwise multiple regression analysis predicting EDT

Determine whether and how primary health care workers (PHCW) provide alcohol screening and brief interventions (SBI) and assess their interest in improving.

A questionnaire built built on WHO recommendations for alcohol prevention and harm reduction in primary health care was distributed to 130 primary health care workers (26.9% doctors, 73.1% nurses) in family medicine and emergency medicine departments in the Primary Health Care Facility Doboj.

The participation rate was 61% (79/130), of which 28 (35%) doctors and 51 (65%) nurses answered the questionnaire. 3 (10.7%) doctors and 3 (5.9%) nurses provide alcohol screening always, 15 (53.6%) doctors and 22 (43.1%) nurses sometimes, while 10 (35.7%) doctors and 25 (49%) nurses never do alcohol screening. None of the PHCW uses AUDIT, 1 uses CAGE, and others use clinical screening procedures. 12 (42.9%) doctors and 40 (78%) nurses never provide brief interventions. 22 (28%) PHCW are interested in providing alcohol screening, while 20 (71.4%) doctors and 15 (29.4%) nurses are interested in improving their SBI skills.

Primary health care workers do not provide routinely alcohol screening and brief interventions aimed at prevention and reduction of alcohol related problems. Those who do provide SBI do not follow WHO recommendations. There is a certain interest to improve, but the fact that 39% PHCW did not even answer the questionnaire is indicative. Motivation, training on SBI and follow-up of PHCW are needed.

Mild Cognitive Impairment (MCI) seems to represent an early stage of Alzheimer's disease (AD) and there is a great interest in the relationship between MCI and the progression to AD.

It has been demonstrated that patients with depression and mild cognitive impairment present a doubled risk of developing dementia of Alzheimer type as those with MCI only. Considering the importance of oxidative stress in MCI and Alzheimer disease, our current objective was to determine the level of oxidative stress in MCI patients with depression, compared with non-depressed MCI patients.

The patients were selected using Petersen criteria for mild cognitive impairment. The cognitive performance was assessed using MMSE (Mini Mental State Examination) and ADAS-cog (Alzheimer's disease Assessment Scale- cognitive subscale) and Geriatric Depression Scale for depression.

We assessed the levels of some enzymatic antioxidant defences like superoxide dismutase (SOD) and glutathione peroxidase (GPX), as well as lipid oxidation makers like MDA (malondialdehyde), from the patients peripheral blood.

The results were compared to an aged-matched non-depressed MCI group.

A significant decrease in the specific activity of both superoxide dismutase and glutathione peroxidase was found in MCI patients with depression compared with non-depressed MCI patients. Also, the concentration of serum malondialdehyde was increase in MCI patients with depression.

We conclude that patients with MCI and depression have an increased level of oxidative stress, compared with non depressed MCI patients. This could explain the increased risk of patients with depression and mild cognitive impairment in developing dementia of Alzheimer type.

To understood the influence of group psychotherapy to crisis frangibility and coping style in community residents,seek the methods and value of community psychological coping intervention,and provide the basis of psychological theory and practice for the work of community mental health.

The scale of crisis frangibility and BCQ were employed to evaluate and compare the mental state before and after intervention.

:

1. 1) Crisis frangibility of residents was negatively correlated with positive coping,positively correlated with negative coping.

2. 2) After group psychotherapy,scores of scale for crisis vulnerability and negative coping droped.

3. 3) Through the regression model analysis, the linear relationship between positive coping factor and the crisis vulnerable is closest.

Group psychotherapy in community is a effective method to reduce resident's crisis frangibility,and the setup of experimental model has provided the theory and the practice basis for development psychology counseling in community.

This study explores the effects of a group psychoeducations family intervention for individuals with schizophrenia and their family.

A cluster randomized controlled trial design was employed.A total of 97 patients with schizophrenia and their relatives were recruited from two street and divided into two groups.The groups consisted of a group psychoeducational family intervention group and a control group.A 12-month follow-up study was conducted.

The psychoeducational family intervention group attained a better knowledge gain related to mental illness and an increase in treatment compliance compared to the control group.Family attitudes toward the patient were positively related to the patient's clinical outcome.Family attitudes improved after 12 months of intervention.The clinical outcomes of family intervention group were enhanced and the relapse rate was significantly decreased as well.There was an increased readmission rate in the group family intervention may be due to better access to health care.Although there were no differences in overall social function,there were improvements in the specific components of marital role and care of self for the family intervention group.The patient's negative influence on society in the family intervention group decreased after 12 months of intervention.

The group psychoeducational family intervention played a important role in improving the relatives’ knowledge of mental health and attitudes towards the patients.The intervention promoted the patient's treatment compliance, decreased the relapse rate,improved clinical outcomes and social function.we think the group psychoeducational family intervention can provide the basis for future research and mental health practice in China.

The pharmacologic interface between psychiatry and neurology is AEDs as they are utilized to treat both epilepsy and psychiatric disorders. Further, AEDs are commonly utilized to treat pain disorders. Thus, AEDs are primarily prescribed for treatment of psychiatric and pain disorders, not for treatment of epilepsy. The choice of which AEDs neurologists will utilize in treatment of epilepsy is most often premised on the classic benefits/risks/alternatives equation; however, consideration should be given to psychiatric co-morbidities and which AEDs might best serve patients in both maximizing seizure control and minimizing psychiatric symptoms as patients with epilepsy (PWE) have a 50-80% lifetime prevalence of psychiatric disorders with a three-to-five-fold increased risk of suicide compared to the general population. This overview of AED treatment of psychiatric disorders with inclusion of labeled and off-labeled uses can serve as a guide for neurologists and psychiatrists in better treating psychiatric co-morbidities in PWE.

Literature review.

Of 16 AEDs reviewed, clinical studies have addressed > 30 possible uses; however only 5 AEDs (benzodiazepines, carbamazepine, valproate, lamotrigine, and pregabalin) have received FDA/EMEA psychiatric indications. Most studies are uncontrolled case reports, open-label case series, and underpowered randomized controlled trials with methodological flaws. Regardless of the limited approved indications and in some instances negative pivotal trials, AEDs continue to be utilized adjunctively or in monotherapy treatment for a plethora of psychiatric diagnoses.

AEDs are pivotal in treating psychiatric co-morbidities in PWE. Further placebo-controlled (augmentation and monotherapy) parallel-arm research with active-comparators is required in this complex field.

Glaucoma is a chronic, progressive optic neuropathy, with visual field defects (VFD) and progressive loss of the retinal ganglion cells, leading herewith to an affected light transmission to the suprachiasmatic nuclei. Progressed glaucoma has been therefore lately suggested to lead to a circadian misalignment and thus to several physiological consequences, including sleep and affective disorders.

The investigation of depressive symptoms and sleep disorders among glaucoma patients with and without VFD.

Patients with confirmed glaucoma diagnosis were recruited and divided in two groups: Patients with extensive VFD (glaucoma fere absolutum) and patients with no or minor VFD. The patients were assessed by self-rating questionnaires to depression (Beck's Depression Inventar), anxiety (State-Trait Anxiety Inventory), affectivity (Positive Affect - Negative Affect Scala) and sleep quality (Pittsburgh Sleep Quality Index).

88 patients have been recruited, of them 57% with VFD. The prevalence of depression was significantly higher in patients with VFD (p = .037). The VFD group also showed significantly higher trait anxiety rates (p = .027), but no significant differences concerning negative emotion. In addition, the subjective sleep quality in men with VFD was significantly worse than in the control group (p = .048), while VFD was significantly correlated with a longer lag time to fall asleep (p = .026).

This study verifies a high prevalence of untreated depression and sleep disorders among glaucoma patients with VFD, which could be an evidence for a circadian derangement. Subsequently, a psychochronobiological melatonergic depression treatment should be considered in this group.