Assessment of patients’ subjective experiences is an important approach of qualitative research in mental health care. It also strengthens the patient-centred view on mentally ill people. Here we focus on the admission to a psychiatric hospital.

Subjective experiences of psychiatric admissions were recorded with a semi-structured interview in 72 fairly representative in-patients. Patients’ satisfaction with treatment was recorded with the ZUF-8 questionnaire. Additionally, 52 in-patients on nine wards were interviewed in focus groups.

From the patients’ point of view, the most important aspects of the admission were staff, ward atmosphere and fellow patients. Violence and coercion played only a minor role. In the face-to-face interviews, assessments were generally positive. The results of the patient-satisfaction-questionnaire (ZUF-8) showed a tendency to positive ratings as well. In focus groups, also negative experiences and criticism were reported.

Patient's subjective experiences of an admission to a psychiatric hospital could be well assessed. Future surveys should be conducted anonymously to minimize social desirability bias. Focus groups yield an important extension of individual interviews.

To study the differential psychopathology of ADHD according to the Conners and ICD/DSM criteria.

Studying hyperactivity, attention and impulsivity features in children in relation to sensory processing difficulties, specific cognitive impairment and anxiety.

An extensive developmental questionnaire and old notes are also used to detect cognitive style, rate of development, communication and learning needs

86/136 63% (208-209) children with a learning disability are assessed according to the Conners rating scale. An additional 21 are assessed for attention deficit without the use of the Conners. 27/86 meet the criteria of an attention deficit syndrome according to the Conners. 6/21 are meeting the criteria of ADHD according to international diagnostic criteria (total 33 cases). 13/33 cases display ADHD features of response inhibition and general utilisation behavior. 5 with a hyperactivity syndrome respond tosensory material such as a bean bag, a slow rhythmic voice and a squiggly cushion. 18 cases have no attentional difficulties on preferred activities. Four attentional cases resolve with tailored educational input. One case of ‘typical ADHD’ recovers at resolvement of abuse. 9 display ADHD features as a form of communicating distress. Of the twenty cases 17 are meeting the criteria of an autistic spectrum disorder.

This study needs expanding, under experimental conditions and with multiple researchers to optimize blinding. However, this unfinished pilot demonstrates that ADHD criteria do not cater for qualitative differences in presentation and etiology. This has very serious treatment and ethical implications.

1. 1. To find out and compare man's and female reaction to the stress caused by divorce and their capability to overcome stress.

2. 2. To find out to the aid what professionals more often persons during divorce rely.

3. 3. To find out as during divorce of the man and the woman perceive functions of the social worker.

The divorced men and women who visit groups of rendering of mutual aid in Kaunas (Lithuania) archdiocese the Family center and in НРС day time the center “Solija” were investigated. In research have taken part 62 exploratory, 32 from them were women and 30 men.

The most part exploratory has specified, that after divorce feels alone, divorce has changed their life, and that after divorce their quality of a life became worse. Stress caused by divorce of the man and the woman overcome differently. From stresses caused by divorce of the man overcome withdraw in itself, and women openly showing the feelings. To the majority exploratory men and women, psychologists have helped to overcome the stress caused by divorce.

1. 1. Comparing men and women during from divorce, the majority of men feel rage on representatives of an opposite floor.

2. 2. Comparing men and women during from divorce, the majority of men feel lonely.

3. 3. With stress during divorce of the man and the woman overcome differently.

4. 4. Comparing men and women, during divorce, the women capable after divorce to search the professional help, it is more.

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.

To provide a comprehensive review of past and current implementation of coercive measures in Italy.

Literature review (cross-referencing in PubMed, Embase, and Index Medicus) concerning the application of coercive measures in Italy. Description of the past and current regulations as well as of the routine implementation of coercive measures in Italy has been also empirically summarized.

The Italian 1978 reform law on mental health care clearly established that medical treatment and tests are mainly voluntary. Only under special circumstances, the medical authority can order a patient involuntary admission and the physician is obliged to provide necessary tests and medical treatment. However, even if coercive measures are usually placed without patient's consent, the first objective should remain to protect patient's interest and rights, in accordance to the Italian Constitution. In Italy, there are no officially recognised protocols on coercive measures for acute inpatient care and each psychiatric ward adopts its own rules and internal norms.

In Italy, patients with aggressive or dangerous behaviours are approached by the staff according to a “de-escalating” model, in which physical and mechanical restraint should be adopted only when any other therapeutic options previously failed. Proposals aimed to improve the implementation of coercive measures in clinical practice will be provided.

The study of the correlation between the insight of the patients attended by a Regional Mobile Psychiatric Unit, and various clinical and sociodemographic variables. The evaluation of the insight included the compliance of the patient to the treatment, his awareness regarding his illness as well as to the therapist notion concerning the way the patient was coming in terms with his disease.

45 psychotic patients aged 17-67 were studied. Spearman rank correlation, x2 statistical test and stepwise multiple regression analysis were used in order to determine the relation between the variables at the beginning as well as at the end of the 5-year study.

• • The subjects who had no insight of their disease prior to research were not prescribed. During the intervention, the patients’ insight as well as their compliance to the prescription was improved. However, this correlation did not remain significant at the end of the study.

• • The diagnosis of the patients as well as the family history of a mental disease was related to the degree of their insight before the intervention.

• • The more socialized a patient was before the intervention, the more insightful he was not only before, but also after the intervention.

• • The more motivated a patient was regarding his leisures on his free time after the intervention the more insightful he was before the intervention.

• • The patients’ insight was positively correlated to the duration and the number of the previous admissions prior and after the intervention respectively.

Evaluation of QOL, stress and coping strategies of people with psychiatric disorders after a one-year training course for social and occupational reintegration.

The main elements of the study focused on the SVF 120 (Stress Processing Questionnaire) and PLC (Quality of Life with Chronic Disease questionnaire).

In total a number of 20 people were enrolled in the study. Mean age of the participants was 33.4 years. The reintegration programme showed a retention rate of 100%. The PLC questionnaire showed no statistically significant results (p>0.050). The SVF 120 showed a slightly better score after one year regarding social encapsulating (p= 0.056) and trivializing (p = 0.021). After the one-year training course 60% of the participants could be reintegrated in an occupational activity and 40% could achieve a better social status.

Our results showed that participant of the programme used stress coping strategies morte than before the course. Reintegration data make clear that training courses of people with psychiatric disorders can achieve valuable results.

Evaluating the effectiveness of training courses for basic qualification for occupational re-entry, empowerment and self-determination.

Participants with psychiatric disorders attended a one-year course on basic qualifications and empowerment for occupational re-entry. The main elements of the course were empowerment topics and training of self-determination. On behalf of the psychiatric disorders data sets were collected in a narrative manner.

A total of 28 people were enrolled in the study. 57.2% of the participants were male and 42.8% female. Male mean age was 34.2a and female 33.3a (p>0.050). Among other psychiatric disorders 45.5% of the participants showed problems with alcohol. Before the programme 100% of the participants were jobless. The retention rate after one year was 9.1%. 27.3% could be placed in kind of a occupational training. The same rate of participants could get into a job after the one-year course. Participants judged self-determination significant higher after the one-year course. Training costs amounted to 4.867Euro/Person/year.

A high percentage of the study participants could be re-integrated into the working market. Basic qualification and empowerment programmes could be an effective tool for people with mental disorders regarding social and occupational issues.

The objective of our study is to determine the relationship between cyber addiction and temperament in a population of young students.

Our population was composed of 60 students belonging to 2 different colleges.

For data collection, we used:

1. - A data sheet containing demographic data, reasons for Internet connection …

2. - The test of Dr. Young to detect users suffering from an addiction to the Internet.

3. - The TEMPS-A: to assess the affective temperaments.

Our sample was formed by 60 students’ devised into 2 groups:

1. - 30 Students were cyber addicts.

2. - 30 Students witnesses.

The mean age was 22.6 years, with extremes ranging from 19 to 30 years.

The reasons for connection to the Internet were in:

1. - 43.3% to deepen knowledge.

2. - 28.3% as a hobby.

3. - 16.7% to expand the circle of friendship.

Cyber addict's students had a cyclothymic temperament in 50% cases, 26% were hyper mood, 13% were anxious and 11% had a depressive temperament.

In our sample, cyber addiction was significantly correlated with cyclothymic temperament (p = 0.024).

Accordingly, patients suffering from Internet addiction should be given a specific addiction treatment and monitoring taking into account the temperament.

This paper reports and reflects upon 50 years’ evolution of social psychiatry in the UK context, including internal debates, and parallel policy and service developments in the “outside”, nonhealth world. It reviews the history and development of the therapeutic community approach since the immediate post-war era, summarises the current position in emerging UK policy, and looks to the future with new conceptual tools to describe current initiatives in public mental health and community-oriented mental health.

A review and analysis of historical, research and “grey” literature (ie: especially government policy pronouncements), including discussions with clinicians and policy makers over future trends.

Two new conceptual frameworks are emerging - the “Psychologically Informed Planned Environment” and the “Enabling Environment” - which between them both embody and encourage current new thinking on the health and well-being contexts of community cohesion, and the introduction of enlightened management for enhanced well-being in hospitals, prisons, schools and workplaces, housing projects and places of faith.

From the remnants of the post-war therapeutic community movement, a new terminology is emerging to address the demands of community psychiatry for the 21st Century. Recognising the social determinants of health and the challenge to health inequalities, and the health and well-being contexts of social capital and community cohesion, this framework raises quasi-philosophical questions over shared values, and highlights the necessity to work with reflective practice and collective accountability for an inter-dependent world.

Development of Quality Indicator for Rehabilitative Care (QuIRC), experiences of Polish partner in implementation of the toolkit and preliminary assessment of care standards in psychiatric institutions. Research constitutes a part of international project funded by European Commission.

Polish language version of QuIRC has been tested in 20 psychiatric units across 3 districts in Poland. Selected facilities differed in employment profile, living standards as well as location and service users turnover. Managers of participating units were interviewed using the refined tool with 145 items regarding domains indentified during previous phases of the DEMoB.inc project. Each participant was questioned by a single researcher during face-to-face meeting. Lacking answers were completed on basis of service users’ medical files and account departments’ documents when necessary.

Manager of only 1 out of 21 units refused to participate in interview. QuIRC usage was simple but time-consuming. The most common hardships in data collection referred to numbers of staff and trainings the employees participated in. It might be due to round-the-clock care in Polish units and common work in the shift system. Moreover ward managers in Poland in vast majority of the units were medical doctors and the facilities’ economics was often obscure for them. Development of web version of the toolkit will facilitate its implementation in research projects but as well internal assessments for units’ own purposes.

The Delphi exercies carried out in Poland constituted part of DEMoB.inc project founded by EC and conducted within 10 European countries. Polish part of Delphi exercise fulfils major method's assumptions and aims to define items of long-term psychiatric care in recovery model of treatment.

Delphi method has not been widely applied in research across Poland. Method is characterized by defined panel of experts (EP), information flow, regular feedback and participants’ anonymity. Delphi has proven prognostic potential in health care, social sciences, new technologies and policy forecasting. However informality of EP selection and limited complex forecasts with multiple factors and downward responses-rate tendencies in following rounds constitute its crucial shortcomings. Criticized basic statistics has been lately overcome by implementation of sophisticated fuzzy logic theory. Three stages Delphi exercise has been carried out in four groups of respondents: service users, carers, advocates and professionals. Wide range of EP representatives has promoted indication of diverse elements of care within partner sites.

Polish mental health care network varies from developed European countries. Out of 11 initially appointed domains only 2 (SPHRandA; SMA) have been underrepresented. Advocates achieved significant consensus in the largest number of items: 23 out of 104 which covered 9 domains whereas professionals in the lowest number: 11 out of 130 which covered only 4 domains. Moreover domains supported with advocates’ opinions fully overlapped with domains pointed by service users. The surprising outcome might be due to diversity of professions in “professional group”, differences in occupational responsibilities and work experience.

Folie á deux is a rare mental syndrome, firstly described by Falret in France on 1997, and renamed in the DSM-IV as shared psychotic disorder, and in the ICD-10 as induced delusional disorder; in which a paranoid or delusional belief is shared by two people with a very close relationship, and usually belonging to the same family. Social withdrawal is a common characteristic of both persons during the initial stage of the disorder.

A 16 years-old adolescent boy, born in Russia, and having this syndrome is presented in this study. After his arrival to Spain, he lived with his father with important social isolation for six months, and he begun to report delusional ideas with mystical-religious and ufological content. His father was diagnosed as having a delusional disorder with the same contents. Both patients received behavioural-cognitive therapy (CBT) with the aim of modifying their delusional beliefs, even that they went on living together. No antipsychotic medication was needed.

Clear changes were observed in their delusional system, particularly in the degree of conviction, as well as in distress, thought interference, and anxiety, and also an improvement was observed in the understanding of their beliefs, and in their social relationship with peers.

Social withdrawal as well as cultural differences associated to their immigrant condition played a critical role in the establishment of the induced delusional disorder, and CBT modified the delusional system, even father and son continued living together.

Health problems are often associated with activity limitations and participation restrictions (ICF, WHO, 2001). An example are problems at work or sick leave. The research question has been whether in these cases activity limitations and participation restrictions refer only to the workplace, or whether and to which degree other areas of life are similarly affected.

Type and degree of participation restrictions in different domains of life were assessed in 382 primary health care patients (aged 18-65) with the IMET, a questionnaire which measures participation restrictions across several domains of life. Additionally, the patients were interviewed about health-related problems at work. IMET scores were compared between patients with and without health related problems at work.

27% of 299 presently employed patients were suffering from workplace problems. These patients had significantly longer durations of sick leave than patients without problems at work and also reported significantly more problems in functioning in general daily activities.

Workplace problems are a frequent topic in primary health care and related to sick leave. Health related problems at work are indicative for problems in functioning in other areas of life as well. Participation restrictions in non-work areas can be early indicators for participation problems at work.

In this workshop, Dr. Nakajima will discuss position statements that the American Psychiatric Association (APA) has taken concerning gay and lesbian issues and mental health.

A review of position statements by the American Psychiatric Association and European psychiatric organizations about gay and lesbian mental health issues.

The APA was the first psychiatric organization to delete homosexuality as a mental illness from its nosology, DSM-II back in 1973. When homosexuality was deleted the APA also passed a resolution affirming the civil rights of gay men and lesbians. These position statements in 1973 were the first of a long number of positions statements that the APA has taken concerning mental health issues for gay men and lesbians. In 1987 the APA voted against keeping egodystonic homosexuality in DSM-III R and currently there is no diagnoses related to homosexuality in DSM-IV. The APA has also taken position statement concerning adoption and co-parenting of same-sex couples as well as discrimination of gay and lesbians in the US military. In the past few years the APA has developed position statements against therapies to change sexual orientation, which is sometimes referred to as “conversion or reparative therapy,” and in support of same sex marriage. Some European psychiatric associations including Norway's and the United Kingdom's have followed the APA in passing position statements against conversion therapies.

We will discuss the importance of Psychiatric Organizations to make formal position statements to advance the mental well being of lesbians and gay men.