Heart disease mortality rates in persons with schizophrenia and bipolar disorder are greatly increased, compared to the general population. The objective was to assess the development during the period 1994 to 2006 of the heart disease mortality gap between persons with schizophrenia, bipolar disorder or other psychiatric disorders and the general population, evaluated in the light of rates of somatic hospitalization and invasive heart disease procedures.

Survival analysis was used to analyze heart disease mortality and somatic care trends in a cohort of all persons residing in Denmark.

Heart disease mortality in persons with schizophrenia remained on a high and stable level throughout the follow-up period, whereas cohort members without psychiatric disorders had declining heart disease mortality. The result is an increasing mortality gap with a significant mortality rate ratio trend equalling 1.12 with 95% CI (1.08, 1.15) for every second year. This was not the case for persons with bipolar disorder or other psychiatric disorders. Somatic hospitalization and invasive procedure were on a low level throughout the entire period, among persons with schizophrenia.

The reason for the widening of the mortality gap between persons with schizophrenia and the rest of the cohort members can be partly explained by the lack of improvement in treatment procedures, which is illustrated by the very low rates of invasive cardiac procedures. However, other reasons, such as antipsychotic-induced weight gain and difficulty following such advice as to stop smoking can also be part of the explanation.

To assess the efficacy of escitalopram, a selective inhibitor of serotonin reuptake, in the treatment of patients with fibromyalgia.

Ten patients with fibromyalgia were assessed prior to and after treatment with fixed-dose escitalopram 10 mg/d. Before initiation of pharmacotherapy, patients were interviewed with the Structured Clinical Interview for Axis I disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. The study lasted for 12 weeks, and patients were evaluated in weeks 4, 8 and 12. The primary outcome measures were the Fibromyalgia Impact Questionnaire (FIQ) total score and pain score. The anxiety and depression levels of the patients were measured with the Beck Depression, the Beck Anxiety, the Hamilton Anxiety, and the Hamilton Depression scales.

There was a significant improvement in the mean intensity of pain (P< 0.01) and in the disability caused by fibromyalgia (P< 0.01) from baseline to week 12 of treatment. The depression and anxiety scores also decreased significantly from baseline to week 12. The improvement in the FIQ scores did not correlate with the decrease of scores in both patient- and physician-rated depression and anxiety inventories. Change in pain scores also was not correlated with the change in depression and anxiety scores.

Escitalopram was quite promising in alleviating the pain and disability associated with fibromyalgia. This effect seems to be independent of its anxiolytic and antidepressant properties.

Islam is being practiced in Chechnya. There are data about alcohol abuse of a certain part of the population in the Muslim countries contrary to religious interdictions. Alcoholic psychoses reflect level of alcohol abuse among the population. The purpose of the present research was to reveal interrelation between dynamics of alcohol abuse, alcoholic psychoses, social changes during the different periods: the period of operations, the postmilitary period and that of active social restoration.

392 case records of patients with psychoses from 2002 till 2008 inclusively are studied. The age, duration and kinds of psychoses, rates of formation of dependence on alcohol advanced in years, average stay of the patient on a cot were estimated. The relation of the population to alcohol was established by questioning of 4,500 persons. All data were compared with the number of patients delivered in a drunken state for the same years. Processing was made by program SPSS 12.0 Windows

Average stay on a cot annually decreased from 38,09 till 18,27 days. Duration of psychoses has decreased from 8,52 to 4,24. Fluctuation of number of the hospitalized patients had a correlation with the social phenomena in a society. In the process of normalization of situation in the republic the ratio of number of alcoholic psychoses to total number of hospitalized alcoholic patients decreases. The interrogated majority's attitude to alcohol abuse is negative.

There is a direct interrelation between the level of social stress, alcoholic psychoses, seriousness of their course and alcoholism growth.

Our study concerned 100 medical and paramedical staffs practicing in the HEDI CHAKER HOSPITAL, Sfax

A structured questionnaire was used to collect socio-demographic, somatic, psychiatric and the tobacco consumption data.

We also used Hospital-Anxiety and Depression Scale (HADS) and Rosenberg's self-esteem scale.

The population was consisted of 100 staffs of the health, distributed in two groups

Group 1 (n = 50), regular or occasional smokers

Group 2 (n = 50), no-smoking witnesses

The mean age was 30 years. Sex-ratio (H/F) was 1.

The smokers were single in 60%. They began to smoke in an average age of 16 years. Their motivations to smoke were mainly: curiosity (44%), decreasing stress (28%), searching pleasure (16%) and doing as the others (12%).

The smokers, compared with witnesses, consumed more alcohol and reported more stress factors (divorce of the parents, the frequent quarrels in the family, financial difficulties).

In our study, low self-esteem and anxiety were statistically correlated to the tobacco consumption (p=0.00).

It emerges from this work that the addiction to smoking in the medical and paramedical staff is frequently associated with traumatic events, anxious disorder and low self-esteem.

These shares will promote to inform our population for possibility of psychiatrical science and practice, to form normal relation for psychic patients, to pay the attention of power and public for questions of mental health of population and to consolidate mental health of nation.

Although the world is suffering from an increasing burden of mental disorders, budgets allocated for mental health in the majority of countries make up a relatively small proportion of total health expenditures.

To review the mental health situation in Ireland with regards to mental health Policy and Planning through review of relevant literature.

To assess the extent of mental health problems in Ireland and discuss the obstacles and priorities in Mental Health Policy and Planning to achieving good mental health in Ireland.

To review available hardcopy and internet literature since WHO 2001 health report regarding current mental health situation, issues that are significant obstacles to implementation of mental health policy and what should be prioritised in order to achieve good mental health in Ireland.

In Ireland 24-25% of the population develop mental health problems at some point but only 7% of the health budget is allocated to mental health services. Mental health services are not equitable. There is a need for reorganisation of services and transitional funding. There are human resource shortages and lack of transparency and accountability especially around past expenditures.

The core problem with mental health services in Ireland is an increasingly shrinking budget with poor financial administration consistent with lack of or inadequate implementation of mental health policy. The stumbling block in mental health policy implementation is the lack of a clear authority with defined responsibility for overall mental health policy and budgetary matters.

Social phobia is the most prevalent anxiety disorder. It is accompanied by a deterioration of the quality of life and social adaptation. This has further impact that this disorder begins at a young age at the time where the topic has not yet acquired a stable socio-professional status.

The aim of our study was to assess the sounding of the social phobia among a population of 200 students.

It was a cross-sectional study, focusing on a group of 200 students from 5 universities in Sfax city, Tunisia.

We used:

1. - The Liebowitz Social Anxiety Scale for screening the social phobia,

2. - The Sheehan scale for the evaluation of the sounding on the social, professional and family life.

Thirty three per cent of this population presented a social phobia.

According to Sheehan scale, the disturbance in school, social and family life was mild to moderate (schooling: 3. 29; social: 2.95; family: 2.62).

Discussion and conclusion: Our study showed that the impact of the social phobia is lightweight at the family and social level but more important in the area of schooling. This suggests the necessity for screening and treatment of social phobia among students for a better socio-family insertion and especially for better academic achievement.

To assess trainees’ opinions on the quality of provided educational programs, as recently pointed out in several European countries.

The opinions of 198 Italian trainees in psychiatry on their training and their future career were assessed by means of the Questionnaire on Training in Psychiatry (QTP).

Recruited trainees were predominantly female (68%), with a mean age of 30.0 (± 3.0) years. Thirty-seven percent of them chose psychiatry because “it has always been a dream”, 20% by chance and 17% because they felt “keen on it”. Seventy-seven percent of residents interviewed would make the same choice again if they could turn back time.

Seventy percent of the respondents were “globally satisfied” with their training, especially in clinical psychiatry, psychopathology and psychopharmacology. Residents reported that training in psychotherapy, in psychiatric rehabilitation and in forensic psychiatry were the most neglected areas in their specialization course. Only 9% of them participated in exchange programs, finding them useful for their professional life and experience.

These results show that Italian psychiatric trainees are globally satisfied with the quality of their training. However, they feel that the training course in some neglected areas, such as psychotherapy, rehabilitation and forensic psychiatry, should be improved, and that exchange programs in other countries should be promoted.

Geographical separation of psychiatric units from general hospitals may significantly delay provision of optimal treatment for patients in a medical emergency. Following a ‘near miss’ event, we explored how well equipped our unit is for managing such cases. Our objectives were: To explore how confident staff are in dealing with medical emergencies

1. 1. To measure staff confidence levels in emergency care procedures

2. 2. To evaluate staff orientation by exploring how well staff could locate key equipment

Distribution of a questionnaire survey asking respondents to rate their confidence in various emergency skills, for example maintaining an airway. Staff were also asked to rate their confidence in being able to locate emergency equipment and medication when necessary. In addition, suggestions for improvement in provision of any aspect of emergency care were sought.

Following this, data collation was performed by various members of the multi-disciplinary team with scrutiny of current practice. Areas of change include layout of emergency trolley, revision of staff induction to emergency equipment and provision of easily accessible protocols for common medical emergencies. Following these changes, the questionnaire will be re-distributed and the datasets compared.

We anticipate that the survey will be completed by February 2010

This investigation will provide very useful, practical data on how well prepared for an emergency a typical psychiatric ward and staff are for providing immediate emergency care. This will have implications for induction and staff training policy, to ensure patient safety and provision of appropriate medical treatment.

Identification of dependence of dynamic of mental health of the family in the process of demographic reproduction with adaptive possibilities of family members.

Complex investigation of 249 families of patients with mental disorders has been carried out revealing new forms of family and identification of qualitative and quantitative parameters of family interrelations with scale of family adaptation and cohesion FACES.

Peculiarities of the contemporary family are as follows:

1. 1) family with one child predominates;

2. 2) number of birth beyond registered marriage increases;

3. 3) marriage consciously without children;

4. 4) process of nuclearization;

5. 5) open marriage;

6. 6) marital contract;

7. 7) alternative families emerge;

8. 8) number of lonely people and people consciously avoiding to get married increases.

Families according to degree of cohesion have been divided into balanced - 69% and imbalanced - 31% of families. According to degree of adaptability there were 39% of balanced families, 61% - imbalanced. We observe variability of families. For real cohesion disconnected level is typical, for adaptation - chaotic style. Thus, concordance of real and ideal images about the family is absent. Thereby we have identified potential possibilities of the families. Most of them pass onto balanced level of cohesion (5 types of families in total), remaining at the level of chaotic forms of adaptation when there are conditions for changes.

Mental health of the family at various stages of development of family system depends on adaptive possibilities.

The voluntary interruption of pregnancy (or voluntary abortion), authorized in Tunisia since 1973, has always been a public health problem, given the number of women affected each year.

The objective of this work was to develop, through a descriptive study, the profile of girls who aborted in the regional center of family planning (FP)of Sfax.

This is a descriptive study, conducted in the regional center of FP of Sfax, with 130 unmarried girls, who asked for abortion during the period from October 2008 to June 2009.

In our series, the girls had an average age of 25.4 years and the majority was between 20 and 29 years.

Most of them were from urban origin (63.1% versus 36.9% rural origin).

63.9% had a primary or a secondary education and 70.9% had low socioeconomic status.

More than half of the studied girls (55.4%) lived with their families. The rest lived independently or in dormitories.

The majority of surveyed girls’ parents (76.9%) lived together.

The existence of major family problems was reported at 65.3% cases, essentially family violence (49.3%) and financial problems (45.6%).

It appears from this work that the risk factors involved in most of the unwanted pregnancies with abortion are:

1. . The young adulthood with a longer period of celibacy.

2. . The urban origin.

3. . The low education level.

4. . The low socioeconomics status.

5. . The lacks of family communication.

6. . The existence of major family problems, mostly violence and financial problems.

The aim of this study was to clarify effects of Clozapine and its metabolites on insulin resection and expression of glucose transporter 2 (GLUT2) located in cell membrane of isolated rat's islets.

The cells of isolated rat's islets were prepared by a modified collagenase digestion methods. At 5.5 mmol/L glucose, the cells of islets was treated with 1mmol/L clozapine, desmethyl-clozapine(DCLO), clozapine N-oxide(CNO), respectively, blank control group was also set.

1. 1. After incubation 48h, the insulin in supernatant was assayed by radioimmunoassay.

2. 2. The cells of isolated rat's islets in each group were detected GLUT2 mRNA level with RT-PCR and its protein expression with Western-blot.

1. 1. Compared to control group, clozapine significantly inhibited insulin secretion (P=0.007< 0.01); DCLO has a tendency to inhibit insulin secretion after 48h of incubation, but no significant difference was found (P=0.154>0.05). There was no difference of insulin secretion between CNO group and the control group after 48h of incubation (P>0.05).

2. 2. The mRNA and protein expression of GLUT2 located in cell membrane of slets: clozapine group was significantly lower than control group (P=0.017< 0.05, P=0.035< 0.05), DCLO group was also lower than control group, but no significant difference was found (P>0.05), and no significant difference between CNO group and control group (P>0.05).

Clozapine can inhibit GLUT2 expression of cells of islets, and then hamper glucose transport through cell membrane, which was one of mechanisms to explain the effect of clozapine on insulin secretion.

People with severe enduring mental illness (SMI) are at least twice as likely to die from cardiovascular disease (CVD) than the general population, with 60% of excess mortality rate attributable to physical illness.

We report implementation in primary care of screening and intervention for cardiometabolic risk factors in SMI in Cheshire, UK. Data search was performed through the EMIS software provider.

453 patients (55.8% male 44.2% female) on the SMI Register in Cheshire, UK were screened for dysglycaemia (screening rate 57.3 %) and dyslipidaemia (screening rate 36.2%). There were no differences in BMI by gender, but a greater proportion of women (25% vs 20%) were obese (BMI ≥ 30 kg/m2). Fasting glucose was in the impaired fasting glycaemia range (6.1-6.9mM) in 6.5% of those screened and at or above the threshold for type 2 diabetes (7.0mM) in 17.3% of the group. Fasting serum cholesterol was high at >5mmol/L in 62.8% of those screened for whom the mean cholesterol was 6.2±0.8 mmol/L). Despite high rates of dysglycaemia and dyslipidaemia, systolic blood pressure was greater than 140mmHg in only 13% of those examined. 61% were active smokers.

Multivariate linear regression analyses revealed a direct relation between fasting glucose levels and BMI (beta = 0.22, p< 0.001) independent of age, gender, systolic blood pressure and fasting cholesterol and triglycerides.

There is scope for cardiometabolic risk reduction in patients with severe mental illness. Measures to encourage weight reduction and smoking cessation would be vital in risk reduction strategies.