An important target of the antipsychotic treatment in schizophrenia is the regaining of the social functionality, correlated with the decrease of the positive and negative symptoms, the improvement of cognitive competence and social cognition.

We have done research on a lot consisting in 20 male patients, aging between 25-30 years, with paranoid schizophrenia diagnosis according to DSM IV and a maximum 3 years period of evolution of disease from the first psychotic episode. The lot we are studying consists of two subdivisions: 10 patients treated with Flupentixol depot in the last 12 months (20mg/14 days) and 10 patients treated with Risperidone long-action (37.5mg/14 days). Admission scores were PANSS ≤45 and >4 on CGI. 12 months later the patients were evaluated using the same scales and the Social Cognition and Object Relations Scale for the level of social cognition, the scores being correlated with others social risk factors.

The patients treated with Flupentixol depot presented a lower level of amelioration of positive symptoms and a dysfunction of the social cognition, while the patients treated with Risperidone longaction have shown the amelioration of the positive and negative simpthomatology and improvement of the social cognition.

The long action antisychotics present an increased adherence at the treatment, being by far a better treatment option then the standard medication. Risperidone long-action has a better action against positive and negative sympthoms and improves the social cognition in a significant way, compaired to the first generation antipsychotics.

The stigma of mental illness is a complicating feature of psychiatric treatment, especially in schizophrenia. A detrimental consequence is internalized stigma-the inner subjective experience of stigma resulting from applying negative stereotypes and stigmatizing attitudes to oneself. The empowerment and recovery oriented program of the day clinic might contribute to a reduction in internalized stigma. Until now the influence of day clinic treatment on internalized stigma has not been studied.

Data from two groups of patients had been collected at baseline and after five weeks. The experimental group attended the day clinic treatment (TKL-group, 20 patients), the control group waited for the day clinic treatment (KO-group, 20 patients). At both times the Internalized Stigma Of Mental Illness scale, the CES-Depression Scale, the WHOQOL-BREF questionnaire capturing the subjective quality of life and the Positive and Negative Syndrome Scale were applied. Furthermore, sociodemographic and clinical data were collected.

Changes during the five weeks within the TKL-group showed a significant reduction of internalized stigma and psychopathology and a significant improvement in quality of life. Within the KO-group it was only a significant reduction of depression. Significant differences between the two groups concerned changes in the quality of life and psychopathology with a clear advantage for the TKL-group. However, with regard to changes in internalized stigma, no significant differences between the TKL- and the KO-group could be observed.

Exploring a sample size of two groups each of 110 patients appears to be a feasible and valuable research plan with regard to internalized stigma.

The ‘MORES’ (MOdena RESidenze) project was a naturalistic study designed to assess clinical outcomes and to investigate psychosocial needs in two groups of patients currently admitted in two residential facilities characterized by different intensity of care (“low protection” vs. “high protection”).

32 patients (62%) in a Sheltered Housing (SH, low protection) and 20 patients (38%) in a Psychiatric Residence (PR, high protection) were assessed by means of a multi-dimensional and multiaxial system. Socio-demographic and clinical data were collected from patient charts. Clinicianadministered instruments (BPRS, GAF, CAN) and self-rating scales (LQL, VSSS, Empowerment Scale) were administered to all 52 patients. Chi-squared test and Mann-Whitney U-test were used to compare the two groups.

The most frequent diagnosis was Schizophrenia (n=41; 79%). No differences were found in socio-demographic and clinical characteristics between the two groups, as well as in psychometric scores. Scores at the BPRS, GAF, CAN and Empowerment scales revealed in both groups a medium-low degree of psychiatric symptomatology, low global functioning, high level of care needs (many of them satisfied, 73%) and a low level of empowerment, respectively. Self-perceived quality of life was poor (LQL: SH=4,57±0,31; PR=4,4±0,33), specifically related to the housing situation and VSSS (SH=3,81±0,85; PR=3,52±0,82) suggested poor satisfaction with mental health services.

Though no difference were found between the two groups, patients’ needs emerged clearly, suggesting need for further investigation to tailor more specific rehabilitation programs.

Stigma is a major stressor for many individuals with mental illness. Recent stigma models highlight the role of cognitive stress appraisal, emotional and cognitive coping responses, and their impact on outcomes such as self-esteem and social interactions. We tested this model, applying it to mental illness stigma.

In 85 people with mental illness, stigma stress appraisal and stress predictors (level of perceived stigma, rejection sensitivity, ingroup perception) as well as emotional reactions (anxiety, shame) and cognitive coping responses to stigma-related stress were assessed. In addition to selfdirected outcome (self-esteem, hopelessness), social performance in contact with outgroup members (i.e. members of the general public) was assessed by role-play and seating distance measures.

Higher levels of perceived stigma, rejection sensitivity and holding one's ingroup in low regard predicted high stigma stress which in turn was associated with anxiety and shame, but not with cognitive coping responses. Anxiety and shame predicted lower self-esteem and more hopelessness; the coping mechanism of ingroup comparisons predicted poorer social performance.

Our findings support the stress-coping model of stigma when applied to people with mental illness. Emotional reactions to stigma stress as well as coping responses predicted largely negative outcomes. Trade-offs between different stress reactions may render them helpful for some, but harmful for other outcome domains. Predictors of stress appraisal and poor outcomes could be useful targets for interventions that aim to reduce the impact of stigma on people with mental illness.

Meritocratic worldviews that stress personal responsibility, such as the Protestant ethic or general beliefs in a just world (“People get what they deserve”), are typically associated with stigmatizing attitudes and could explain the persistence of mental illness stigma. Beliefs in a just world for oneself (“I get what I deserve”), however, are often related to well-being and can be a coping resource for stigmatized individuals. Despite these findings in other stigmatized groups, the link between worldviews and mental illness stigma is unknown.

We measured just world beliefs for self and others as well as endorsement of the Protestant ethic in 85 people with affective, schizoaffective, or psychotic disorders and 50 members of the general public. Stigmatizing attitudes toward people with mental illness were assessed by self-report. Using a Brief Implicit Association Test, we also examined guilt-related implicit negative stereotypes about mental illness.

We found a consistent link between endorsing the Protestant ethic and more stigmatizing selfreported attitudes in both groups. Protestant ethic was associated with negative implicit stereotypes only among members of the public. Among people with mental illness, stronger just world beliefs for self were related to reduced self-stigma, but also to more implicit blame of persons with mental illness.

Meritocratic worldviews are associated with mental illness stigma. Just world beliefs for self among stigmatized individuals may reduce self-stigma, but could increase implicit blame among people with mental illness. This should be taken into account in interventions meant to reduce self-stigma.

It has often been claimed that mental illness stigma is a barrier to service use and treatment participation among people with mental illness (Corrigan 2004). Empirical findings to support this assertion, however, are scarce (Schomerus and Angermeyer 2008). We therefore studied stigma and stigma-related cognitions as predictors of service use over six months in people with serious mental illness.

At baseline, we measured the level of perceived stigma, self-stigma, group identification and perceived legitimacy of discrimination in 85 people with schizophrenia, schizoaffective or affective disorders. After six months, 75 participants reported whether they had used individual counseling/psychotherapy, mutual-help/peer-support groups, or psychiatric hospitalization after baseline assessment.

Controlling for baseline psychopathology and perceived stigma, low perceived legitimacy of discrimination, but not self-stigma or group identification, predicted use of counseling or psychotherapy. Participation in mutual-help groups was predicted by strong group identification. High self-stigma at baseline was associated with subsequent psychiatric hospitalization. Results were independent of diagnosis.

Cognitive stigma-related variables may predict use of outpatient mental health services, whereas self-stigma may be a risk factor for psychiatric hospitalization. Distinct aspects of stigma appear to predict use of different mental health services.

Similar to members of the public, people with mental illness may exhibit general negative automatic prejudice (e.g., general dislike) against their own group. However, it is unclear whether more specific negative stereotypes (e.g., danger or guilt) are automatically activated among diagnosed individuals and how such automatic stereotyping may be related to self-reported attitudes and emotional reactions.

We studied automatically activated reactions toward mental illness among 85 people with mental illness and 50 members of the general public using a Lexical Decision Task (LDT) as a measure of automatic stereotyping and a Brief Implicit Association Test (BIAT) as an index of automatic prejudice. Deliberately endorsed attitudes and emotional reactions were assessed by self-report.

In the LDT, but not the BIAT, diagnosed individuals showed less negative automatic reactions toward mental illness than members of the public. Among members of the public, stronger automatic stereotyping in the LDT was associated with more self-reported shame about a potential mental illness and more anger toward stigmatized individuals.

Reduced automatic stereotyping in the diagnosed group suggests that people with mental illness may not entirely internalize negative stereotypes. Automatic prejudice, on the other hand, among stigmatized individuals could reflect dislike of one's ingroup as well as associations with non-stigmatizing negative attributes such as the pain of having a mental illness. Among members of the public, automatic stereotyping may predict negative emotional reactions to people with mental illness.

Whereas some research suggests that acknowledgment of biogenetic factors in mental illness could reduce mental illness stigma by diminishing perceived responsibility (Corrigan et al 2003), other research has cautioned that emphasizing biogenetic aspects of mental illness could produce the impression that mental illness is a stable, intrinsic aspect of a person (“genetic essentialism”), increasing the desire for social distance (Phelan 2002).

We assessed genetic and neurobiological causal attributions about mental illness among 85 people with serious mental illness and 50 members of the public. The perceived responsibility of persons with mental illness for their condition, as well as fear and social distance, were assessed by self-report. Automatic associations between Mental Illness and Guilt and between Self and Guilt were measured by the Brief Implicit Association Test.

Among the general public, endorsement of biogenetic models was associated with less perceived responsibility, but also greater social distance. Among people with mental illness, endorsement of genetic models had only negative correlates: greater explicit fear and stronger implicit self-guilt associations.

Genetic models may have unexpected negative consequences for implicit self-concept and explicit attitudes of people with mental illness. An exclusive focus on biogenetic models may therefore be problematic for clinical practice and anti-stigma initiatives.

To describe the experience of group therapy with offender adolescents in an Institution for minor violators (“Fundação CASA”) and who have suffered from mental disorders related to psychoactive substance use.

“Fundação CASA” is an institution created to shelter minor offenders. In 2008 some were judicially referred for treatment to a University Hospital Psychoactive Substance Outpatients Service. An operative and informative group was formed, since they have not adapted to the already existing adult group. This group met weekly, aimed to prevent relapse and initially planned to last 6 meetings.

Soon there were 4 adolescents who had engaged with the group and requested to increase the number of sessions. Psychodynamic issues emerged during the sessions, which were well evaluated by all participants after 10 weeks, when the group had to be ended due to the completion of sentences of 3 participants. In 2009 only 3 of them were found. The first reported a relapse, but remains abstinent. The second started working as general assistant and remained abstinent. The third continued to consume crack and was arrested by the time he was 18.

This study showed the need for specific treatment for the group of juvenile offenders. Operative and informative groups create a communication space for drug users and other psychotic subjects. It permits group identification and allows the expression of mental suffering. Therefore this practice consists of a low complexity approach in an extremely vulnerable population, which is so prevalent in developing countries such as Brazil.

Work disabilities associated with mental disorders depend not only on illness, but social-economic conditions. People with mental disorders, in our country, try to solve financial status through premature retirement.

The aim of this paper was to analyze how we evaluate the work ability among adult psychiatric patients. Total number of patients required an estimate of work ability in our clinic during 2008 was 128. Median age was 48, 8 years, male prevalent (67, 9%).

In this sample the most number of patients were with substance use (25, 85%), affective (depressive) disorders (16, 32%) and schizophrenia (15, 64%). The suggestion for permanent work disability was made in 65, 71% patients; the reduced work ability in 21, 43%, disability for independent life in 8, 57%, some kind of public welfare in 1, 42%, while only 2, 86% were considered as ability for work. Highest rates of total work disability were observed among patients with alcoholism (26, 8%), psychotic disorders (23, 7%), dementia (14, 43%), mental retardations (10, 31%) and personality disorders (9, 27%).

In this role, psychiatrist is often placed between an attempt to supply financial safety or make difficult psychosocial rehabilitation and destigmatisation of mental ill persons.

The objective of this work is to check the assumption that changed social and economic factors causes change in some of the characteristics of non-psychotic clients treated in the daily hospital.

The investigation included 77 clients treated in the daily hospital in 1998 and 82 clients in 2008. Distribution of both groups was done according to the age, work status, duration of previous psychiatric treatment and diagnostic categories.

The result of the work indicates that the profile of a non-psychotic client changes showing an increase of the number of the clients over 50 (participated as 22.07% and 47.56% in 1998 and 2008, respectively). The increase of the number of unemployed of 9.09% in 1998 and 42.68% in 2008 was observed. The increase of number of the clients treated less than one year was also observed (23.37% and 50% in 1998 and 2008 respectively). There are no more significant percentage differences regarding affective disorders (32.46% in 1998 and 34.14% in 2008) and in the category of personality disorder and adults behavior disorder (9.09% in 1998 and 9.75% in 2008).

Neurotic stress associated and somatoform disorders were slightly increased in 2008 (50%) in relation to 1998 (40.25%), with significantly increased number of the clients in F 43 diagnostic category, from 7.79% during 1998 to 31,70% during 2008.

The results obtained point out that change in social and economic factors causes changes in the profile of non-psychotic clients in daily hospital.

To reflect on theory, implementation, practice and evaluation of FACT: the Dutch version of Assertive Community Treatment.

ACT is an EBM intervention for the 20% most severe mentally ill (SMI) outside the psychiatric hospital. From 2004 we started with a Dutch version: the FACT (Function ACT) model.

FACT teams are multidisciplinary teams serving all SMI outside the psychiatric hospital in a region/area of 50.000 inhabitants. The teams offer two kinds of care:

1. 1) clinical case managementteam and home care for the stable group and

2. 2) full ACT for patients in danger of crisis / recurrent psychosis or readmission.

The second group is on a digital whiteboard and is discussed every morning by the team to coordinate shared caseload and assertive outreach.

Interesting is the finding that the first and the second group have a large overlap in time: in 3 years >60% of the patients in the team has been the digital board.

In FACT we bring together care, crisis-intervention, treatment (and metabolic screening), recovery oriented support and care and CBT and IPS. We work in close cooperation with the psychiatric hospitals and sheltered living departments in ‘transmural’ care.

The number of FACT-teams in Holland is rapidly growing (> 80). The model appears to be able to serve all SMI in a certain region with good continuity of care. First findings are positive (very low drop out, more patients in remission, better satisfaction).

Certification started by the Centre for Certification ACT and FACT (see www.ccaf.nl)

Affective Temperaments (AT) in epilepsy is waiting for a clear understanding as antecedents of mood disorders. Recent studies suggest that perception of stigma (PS) correlates with high anxiety and depression scores in epilepsy patients.

In this study we investigated if there is association between AT, PS and depression in epilepsy.

Consequent 71 outpatients (40 women 31 men) with epilepsy were included in the study and examined using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A), Epilepsy Stigma Scale, SCID-I for DSM IV for the diagnosis of depression.

Depressive temperament (DT) scores were positively correlated with PS scores (r:0,247, p< 0.05) in whole group. PS scores were significantly higher in epileptics with MDD group (n:14) than epileptics without MDD(n:57) (t -3.052, p< 0.05). than the patients were divided into groups as patients with DT (n:10), patients with MDD (n: 9) and patients with MDD and DT (n: 5). In One Way ANOVA analysis there was difference between groups. By Tukey HSD the Perception of Stigma was not different between DT and MDD grup but DT+MDD group was significantly higher than DT group.

Recent studies suggest that a crucial part of inherited factors of depression is mediated by ATs and in some studies DT is founded to be related with recurrent depressive disorder. This study suggest that there may be an association between PS, DT and MDD alone but coexistence of MDD and DT is a higher risk for higher levels of stigma perception.

It is widely developed the idea of communitary attention of serious mental disorders, instead of being recluded in long stay hospitals. But tomake this project real it is needed a complex sociosanitay support: psychosocial rehabilitation units, protected dwellings…and nowadays some people are still discharged to long term hospitals.

The objective of this work is to demonstrate that clinical characteristics are not determinant and that the main reason that supports the decision is the insufficent social resources spread.

279 inpatients that entered a Psychosocial rehabilitation unit from January 2005 to April 2009 are selected. There are two comparison groups depending on the derivation to long term units. There are compared different variables taking the HoNOS scale as measurement tool. Ths stathistical comparison test used is the Fisher exact test.

HoNOs scale items:

1. 1 Disruptive behaviour

2. 2 Non-accidental self-injury

3. 3 Alcohol/drug taking

4. 4 Cognition

5. 5 Physical illness

6. 6 Hallucinations/delusions

7. 7 Depressed mood

8. 8 Other mental problems

9. 9 Relationship

10. 10 Daily activity

11. 11 Living conditions

12. 12 Activities/occupation

There is not statistical significance when clinical items of the HoNOS scale (item 1 to 8) are compared, instead of item 5 (p=0,001). There appears significance when comparing social items and specially item 9 (p=0,031),11 (p=0,002) and 12 (0,026).

Nowadays there is no difference in the clinical profile of inpatients when derivation. The fact of not having adequate living conditions is determinant in the decision of derivation, showing that socio sanitary resources are insufficient for an optimal communitary system.

Substance use or alcohol use were not a much concerned category in a far away district town 126 k.m away from state capital, Kolkata.

But the 2 drug de-addiction ceners those have a provision for a institutional therapy in such a rural Indian district remains almost full through out the year, here in Midnapore.

Here is a repressentation of a present scenario in those 2 drug deaddiction center namely UTTARAN meaning upliftment, and JANANI meaning motherly care, during the period march2008- feb09.

There patterns and profile are analysed to make a comparism in some other situation in other parts of the world.

All patients admitted in those 2 Drug-deaddiction centere were analysed trough their records & there were 2 visits to longitudinaly analyse the persons there in 1.1.09.There were 134 patients in 1st center & 122 patient's turn over in the 2nd center. There were mainly male persons in the age range of 22-56 years with a median age of 39 years. Alcohol use detained patients were majority(>64%), followed by Marijuana smokers(5%), and heroine addicted patient(>10%), followed by medicinal coughsyrup, glue, & benzodiazepin like nitrazepam.

There were co-morbid other Psychiatric illness like BPMD, hypomaniac, or depressive disorders, and Personality disorders, like Borderline personality Disorder & Asocial personality disorder.

There were divorce in 4% cases, jobless in >65% case. and their period of stay remains 3 weeks to 8weeks usually.

Recovery, or refraining from drug/alcohol after 3 monthhs is over 60%.

Treatment in Institutional-setting do the best &should present evrywhere.

This study aimed to determine the motivations for the consumption of alcohol by young adults in higher education.

In a cross-sectional study, of a quantitative nature, we have worked with a sample of 354 students (61.60% women), aged between 18 and 35 (M = 20.86 years, Dp = 3.52).

It was a daily consumption of alcohol in 28.6% of students. The motivations described as being associated with the consumption of alcoholic beverages are: because gives you pleasure (25.7%), to be happy (24.0%), for uninhibited (18.7%), to forget the problems of everyday life (13.3%), to relate to others who also drink (7.9%), to calm (7.4%), because they miss family and friends (6.8%), to forget problems / angry with her boyfriend or friends (5.9%).

Evidence presented here based guidelines for preventive and health promotion in the university context.

nowadays drug abuse and addiction is one of the most important health,social and political problems in the world. substance use among university students is a mental health concern. people with depression have high rates of comorbidity with other mental disorders and substance use disorders. the purpose of this study was to determine the prevalence of depression, substance use and the relationship between depression and substance use among student of guilan university of medical sciences(GUMS).

this was a cross-sectional study carried out on a representative sample of 254 students(n=167girls;n=87boys) of GUMS. The samples were selected randomly by stratified sampling. data was collected using a confidential multiple choice questionnaire detecting the frequency of various substance use. the beck depression inventory(BDI)were used to determine depressive symptoms. Data were analyzed by chi-square and exact fisher test using SPSS ver 16software.

results showed that the prevalence rate of each substance in use was: Opium (1.2%), Morphine (0.4%), cannabis (1.2%), Cocaine (0.4%), codeine (7.5%), Ritalin (2%), tramadol (4.7%) cristal (0.4%), Amphetamines (0.8%),cigarette (8.3%), alcohol(7.1%). according to BDI,(29.9%)of students had depression.there were significant differences between the prevalence of substance use with gender(p=0/0001),parent marital status(p=0/01)and depression(p=0/01).

This study demonstrated that the substance use among students is considerably high and specific interventions seem to be necessary in preventing or reducing the rate of substance use in students. Reading the result of this study,it is suggested that parents and universities authorities have a better over solving students emotional and social problems.

Alcoholism is a very common psychiatric problem, with a high morbidity and mortality. Psychiatric diagnoses that most often are associated with alcohol-related disorders include substance abuse, antisocial personality trasrtorno, affective disorders, anxiety and sleep disorders.

Our goal is to estimate the prevalence of anxiety and depressive symptoms in a population of patients in our mental health center.

To analyze data from a sample of 35 patients treated in mental health centers that meet diagnostic criteria for alcohol dependence according to DSM IV-TR. the study enrollment period was 6 months from January to June 2009. study design is observational, descriptive and transversal. The information was collected by clinical interview.

Comparison with normativesamples reflects that the alcoholics of the sample present more psychopathological symptoms than the normal populatio, but less than the psychiatric population. Furthermore, the severity of the alcoholism is related with the biggest presence and intensity of comorbidity.

The prevalence of depressive symptoms was 75% and anxious symptoms 65%, with variations in distribution by gender.

The prevalence of anxiety and depression measurement in the population to study is greater than in general population. there is needed further research that allow extending the results obteined in this present study.

Alcohol is the most widely psychoactive substance consumed in Portugal. The aim of this study is to describe the socio-demographics and clinical characteristics of alcohol abuse and dependence new patients of an Alcohol Unit in a University General Hospital.

We collected retrospectively data from all admitted patients to our Alcohol Unit between January and October 2009 with alcohol abuse or dependence diagnosis.

Fifty three patients were admitted during the period, 40 (75%) males and 13(25%) females. The mean age was 45.4 years (s.d.:10.6; median: 42), range between 24-67 years. Thirteen percent of patients were single, 26% divorced, 4% widowed and 57% married/with partner. Fifty-seven percent were employed, 30% unemployed and 13% retired. Twenty one percent of patients had known cardiovascular disease and 19% percent alcoholic liver cirrhosis. As Psychiatric comorbities 19% percent of patients had depressive disorders, 6% personality disorders and 6% other psychiatric disorders (anxiety and psychotic disorders). Mean AST value was 67.3 IU/L (s.d.:64.3), mean ALT 52.9 IU/L (s.d.:47.9), mean GGT 258.6 IU/L (s.d.:367.6) and mean MCV 92.3 um3 (s.d.:8.3). Forty percent of patients made an acute detoxification (77% as outpatient and 33% as inpatient). Fifty five percent of patients attended our psychotherapy group. Benzodiazepines (96%), antidepressants (25%) and naltrexone (22%) were the most used psychopharmacological treatments.

This study shows that there was predominance of male, married/with partner and employed patients in our sample. Alcohol biomarkers were high on the majority of patients, and there was also a high prevalence of medical diseases.

Quetiapine is a novel antipsychotic drug, which is efficacious in the treatment of schizophrenia and also helps reduce craving and consumption of stimulants and alcohol. Due to Quetiapine's promising receptor profile, we set out to examine its efficacy in relapse prevention treatment of alcoholic dependent patients suffering from craving and affective symptoms.

The three center pilot-RCT evaluated 40 alcohol dependent patients after withdrawal (Quetiapine vs. placebo). They were followed up for six months. We used operationalized questionnaires including OCDS-G, Form 90-CR, Form 90 short form-CR, PSQI, MADRS, STAI, BDI and FTND.

We tested the one sided hypothesis that it takes longer for the first severe relapse to occur using Quetiapine compared to a placebo. The primary outcome measure is time to first severe relapse. Further, we tested the two sided hypothesis that Quetiapine will prolong time until first consumption of ethanol, decrease the number of drinking days and increase the number of abstinence days, decrease the cumulative amount of ethanol, decrease craving, improve depression symptoms, improve anxiety symptoms, improve quality of sleep, avoid deterioration of safety variables and decrease nicotine addiction.

Our pilot study is designed to provide evidence for the efficacy of Quetiapine in alcohol relapse prevention. Alcohol dependent patients after withdrawal should display a decrease in persistant craving and should be less afflicted by sleep disorders, excitement or symptoms of depression or anxiety. The poster provides the rational for conducting this study and describes the study protocol including the subject's characteristics.