He income hospital represents a rupture in the continuity of life of the patient. It would be advisable to determine those variables that help to reduce them. Some studies are running to a paper protector of the treatment injection in the relapses and number of hospitalizations.

Compare the risk of decompensation, measured in terms of income hospital or consultations to emergency, between patients to treatment injection versus oral.

He is a descriptive study which assesses the number of hospital admissions and consultations to emergency departments in the period of one year (between September 2015 and September 2016) of a sample of 28 patients registered as TMS and the results are compared with the type used for antipsicotivo treatment via.

We start from a sample of 28 patients, of which 17 are still a treatment intramuscular and 11 have all your guideline prescribed in oral. Patients injection treatment group needed to be admitted to a psychiatric inpatient unit at least on one occasionin the past year, 7 patients and 11 patients to oral treatment, only 2 patients wereadmitted and other 2 came once to your referral hospital emergency department.

Of the 17 patients to treatment with injectable ingresason or needed care urgently a 41.18%, facing the 36.36% of those patients to treatment by via oral. These results do not have a protective role of injectable treatment compared with decompensation measures according to need hospitalization or urgent attention.

The authors have not supplied their declaration of competing interest.

Personality was shown to play an important role for well being under academic stress. The purpose of the present study was to evaluate how temperament and character traits predict academic burnout in Korean medical students.

One hundred and seventy-eight Korean medical students completed the Cloninger's temperament and character inventory (TCI) at the beginning of semester and Maslach burnout inventory-student survey (MBI-SS) was also measured around the final exam when academic stress and burnout is at the highest. The correlation between TCI and MBI-SS was examined and stepwise regression analysis was performed to measure how well personality traits predict academic burnout level.

The MBI-SS total burnout score was correlated positively with harm-avoidance (r = 0.247, P < 0.05) and negatively with self-directedness (r = -0.296, P < 0.001) and Cooperativeness (r = -0.169, P < 0.05) scores. The regression analysis showed that the harm-avoidance (β = 0.269, P < 0.001) accounted for exhaustion score and the self-directedness explained the Total burnout score (β = -0.296, P < 0.001) and Inefficacy score (β = -0.284, P < 0.001). The Cynicism score was accounted for high Novelty-Seeking (β = 0.150, P < 0.05) and low Cooperativeness (β = -0.182, P < 0.05).

This study showed that the Cloninger's temperament and character might explain the burnout level from the stressful medical education. The temperament of novelty-seeking and harm-avoidance could provide the susceptibility to the academic burnout and the character of self-directedness and cooperativeness might determine the resilience to the negative influence of academic stress.

The authors have not supplied their declaration of competing interest.

behavioral health (BH) agencies have care linkages for youth including juvenile justice (JJ). However, there are few studies on youth care linkages. This study focuses on six sites with the objective of examining BH and JJ staff perceptions about information exchange on screening, assessment and treatment.

We developed an index to quantify BH and JJ staff perceptions of information exchange on youth screening, assessment and treatment. After Informed Consent, staff rated past year interactions from agree to disagree on a 7-point Likert scale. Chi-squares and T-tests were used.

All 64 staff consented 17 (26.5%) BH staff and 47 (73.5%) JJ staff. Significant differences included BH staff were more likely to be licensed (P < .001) and had a masters degree or higher (P = < .01). Professional experience ranged from 9.8 to 15.8 years. However, there were no statistically significant differences. BH staff was somewhat higher from 5.7 for “shared assessment results” to 6.8 for “been easy to talk to” while JJ staff were from 5.1 for “shared screening results” to 6.1 for “treated youth with respect”.

This pilot study found high rates of staffs agreement including ease of talking and listening, sharing screenings and assessments information, and helping begin, continue, and complete treatment. This high agreement was not expected with confidentiality restrictions and traditions. Future studies should target care linkages including letters of agreement, case conferences, and guidelines.

The study is supported by the National Institutes of Health.

The authors have not supplied their declaration of competing interest.

Psychiatric symptoms/disorders in brain diseases are not specific and may have the same clinical presentations as functional psychiatric disorders, so they can compromise early diagnosing of disease.

This paper's objective is to show (negative) influence of stigma in a diagnostic process of patients with predominantly psychiatric symptoms in their clinical pictures.

The subject is a 46 year-old female patient with no history of psychiatric disease. Her symptoms includes: confusion, disorientation, perseveration, visual and auditory hallucination, lack of motivation, inability to understand questions, developed following a 10-day long period of febricity. During the outpatient care, she has been examined by a neurologist, a specialist of urgent and internal medicine, and a psychiatrist. As the CT scan made in that stage was interpreted as normal, the patient was hospitalised in a psychiatric hospital. She was treated both with typical and atypical antipsychotics but no therapeutic effects have been reached. Thinking of organic etiology, advanced diagnostics have been made (MR, LP). MR scan showed lesion that is a characteristic for herpetic meningitis, which is also confirmed with positive serological tests.

In patients with a sudden onset of psychiatric symptoms, patients with unexpected changes in mental status or suddenly developed headaches, as in the therapy- resistant psychiatric disorders, it is important to keep in mind the possibility of the coexistence of brain disease. Removing the stigma from psychiatric patients is important in order to be able to give every patient the chance of getting the correct diagnose on time.

The authors have not supplied their declaration of competing interest.

Women's personal and political identities are significant in defining their roles and eventual contribution to society in contemporary society both in the private and public spheres.

This research study focuses on the effect of Islam on women's personal and political identities.

This research aims to highlight the existing ideology relating to women's treatment in regards their identities and public roles, and hence to contribute to women's emancipation.

This study utilizes quantitative and qualitative methods in analysing women in eight Muslim-majority countries, namely, Iran, Turkey, Egypt, Saudi Arabia, Jordan, Yemen, Cyprus and Kuwait, in the Middle East. For the quantitative data, statistical dataset was culled from Inter-university consortium for political and social research of the university of Michigan.

The overall results show that historical constructions of gender spheres are still palpable in the Islamic landscape. Woman's question is identified as a complex personal and social problem, and cannot be rejected as a valid search for gender sameness or equality. This study also shows the interpolation of Islam with other factors such as patriarchy, modernization, and state formations. Some Muslim scholars argue that Quran's fundamental mooring is geared towards equality between men and women, and women's enhanced status, and it is patriarchy that has confined women to the domestic sphere.

Gender is embedded within culture, and structures of power in families, communities, and states, which have gender in itself, as an organizing principle.

The author has not supplied his/her declaration of competing interest.

The concept of Bourdieu's habitus effects nurses’ approach to patients. Habitus is the site of nurses’ internalizations of the rules in the field of care work, where nurses acquire emotional habitus that corresponds to ethical values and feeling rules of care work. If nurses do not manage their emotions in accordance with the moral disposition, social suffering will be occur. Determining social suffering helps to understand how a tension between the field of care work and emotional habitus can violate nurses’ well-being and cause burnout.

To determine the emotional habitus of nurses’ with the high level of burnout.

Clinic nurses of Hacettepe university hospitals constituted the population of this study. Firstly, Nursing Information Form, Maslach Burnout Scale were applied to participating 350 nurses. Secondly, semi-structured thorough individual interviews were made with 39 nurses of 201 with the high level of burnout.

With content analysis emotional habitus, problem areas for emotional habitus, results of these problem areas, optimal behavior in expressing feelings of nurses and related to suggestions to gain these statements total twenty themes were reached. Nurses suggested proposals to gain optimal behavior in expressing feelings. These are individual development, obtaining professional knowledge, role modeling, experiencing. Also, nurses wanted to see value by patients and hospital administration and respect patients.

To prevent and cope with burnout; it has been proposed that awareness training programmes and course contents about emotional habitus, management emotions should be arranged.

The authors have not supplied their declaration of competing interest.

Nurses are required to manage their emotions, like being empathetic. Emotion management requires emotional self-efficacy and emotion labour, because learning how to it takes effort. If emotional labor is not managed effectively by nurses, burnout will occur among nurses.

To evaluate the emotional labor, emotional self-efficacy and burnout levels of nurses.

Clinic nurses of Hacettepe university hospitals constituted the population of this study. Nursing information form, emotional self-efficacy scale, emotional labour Scale and Maslach Burnout Scale were applied to participating 350 nurses.

It was found out that nurses went through high level “emotional exhaustion”, medium level “depersonalization”, low level “personal accomplishment” and had medium level emotional self-efficacy sense. It was determined that there was a positively relationship between emotional labor and its sub-dimensions surface acting and emotional effort and depersonalization levels, also there was same relationship between surface acting and emotional exhaustion. There was a negative relationship between emotional self-efficacy sense and emotional exhaustion and depersonalization but there was a positive relationship in personal accomplishments. There was a positive relationship between emotional self-efficacy sense between deep acting, emotional effort and suppression of real emotions. Additionally, discrepancies were found in burnout levels of nurses according to sociodemographic, their working and choice of profession characteristics (P < .05).

To prevent and cope with burnout; it has been proposed that awareness training programmes and course contents about emotional management, emotional self-efficacy and emotional labour should be arranged.

The authors have not supplied their declaration of competing interest.

An quiet environment is comfortable and peaceful. Also, healthy and safety environment is a human right. But, exposure to noise may cause negative effects on psychology and performance. Also, it is a problem in public hospitals, because, noise is an important issue for both nurses and patients.

The study was designed to determine decibel levels on the hospital's four unified clinics and compare noise effects to state anxiety levels of patients and nurses.

Information Form, Spielberger State-Trait Anxiety Inventory (STAI) were applied to participating 40 patients and 14 nurses. A measurement of the sound level of unified clinics was performed for two days in the morning and after lunch for two days.

The range of minimum to maximum decibel levels was significantly greater in nurses’ station (38.66 dB versus 82.48 dB) than patient rooms (24.61 dB versus 74.2 dB) (P < .05). 25 patients and 14 nurses stated that there was noise in the clinic. 19 patients and 10 nurses expressed that it caused a headache. The state anxiety levels were 39.29 ± 5.61 for nurses and 45.4 ± 4.86 for patients. The state anxiety level of patients were 44.83 ± 3.86 in 1. Clinic, 48.8 ± 4.37 in 2. Clinic, 43.82 ± 4.9 in 3. clinic, 44 ± 5.57 in 4. Clinic.

We should reduce the noise level to reduce the level of state anxiety. This study describes one reason to reduce peak noise levels on unified clinics. Standards applied across studies to measure and characterize acoustic environments are urgently needed.

The authors have not supplied their declaration of competing interest.

Researchers who plan to debate the nursing practice habits and nurses’ professional-individual self and identity can study out nurse habitus. Habitus affects how the nurses understand care needs of patients. Also, sociotropy-autonomy is important for both the personal and professional development of nurses. According to researchers, professional criteria are autonomy, commitment to the profession and unity consciousness.

The study was designed to investigate of nurses’ sociotropic-autonomic personality features levels in the context of emotional habitus.

Information form, sociotropy-autonomy scale were applied to 10 nurses. Also, semi-structured thorough individual interviews were made with them.

Seven nurses have voluntarily chosen their profession and the others are not. Nurses’ sociotropy levels were 59.2 ± 22. Sixteen and autonomy levels were 83.9 ± 22.41. According to the results of the MWU test (U = .0 P < .05), anxiety about disapproval of eight undergraduate nurse (MR = 4.5) is lower than two graduated from health school nurse (MR = 9.5). Five nurses stated that nursing is appropriate for their personal character. Six nurses stated that nursing influenced the positive development of personal character. With content analysis, similarities and differences between nursing identity and social identity, optimal behaviour in expressing feelings of nurses and emotional habitus themes were reached.

Nurse habitus is developed by both of individual and structural factors which are complex and diversity. So, it affects nurses’ career and motivation to provide services. That the researcher assesses them from this aspect affects positively the quality of care.

The author has not supplied his/her declaration of competing interest.

The drivers are a central component of traffic system, and their limitations, constraints, needs, motivation, level of alertness, and personality define their behaviours on the road. Understanding the determinants of the driver's behaviour is crucial to find solutions for the serious problem of road accidents.

This study aims to investigate the reliability and the construct validity of the Portuguese version of the driver behaviour questionnaire (DBQ; Reason et al., 1990; Portuguese version: Correia, 2014), using exploratory and confirmatory factor analysis (EFA and CFA) in a sample of Portuguese population.

Participants answered an online survey including socio-demographic questions and the DBQ. Inclusion criteria were: driving license and regular driving for at least three years and age lower than 75-years-old. The sample is composed of 747 participants [417 (55.8%) women; mean age = 42.13 ± 12.349 years; mean driving license years = 21.30 ± 11.338; mean years of regular driving = 20.33 ± 11.328]. The total sample was randomly divided in two sub-samples. Sample A (n = 373) was used to EFA and sample B (n = 374) was used to CFA.

The most acceptable model was the three-factor model found with EFA, excluding items 1 and 24 (χ2/df = 2.01; TLI = .86; CFI = .88; RMSEA = .05, P = .315). The internal consistency analysis resulted in: infractions and aggressive driving, α = .77; non-intentional errors, α = .73; lapses, α = .71; total DBQ score, α = .84.

These results suggest that the Portuguese version of the DBQ is a valid and reliable measure to assess self-reported driver behaviour in the Portuguese population.

The authors have not supplied their declaration of competing interest.

Glucocorticoids are widely prescribed for a variety of diseases and are known to cause neuropsychiatric as well as somatic side effects.

To review the incidence, clinical characteristics, course and treatment of neuropsychiatric effects of glucocorticoids.

We have described the case of a 86-year-old woman. She had no personal and no psychiatric medical history in her family. She presented wrist arthritis requiring high doses of an oral corticoid treatment (prednisona 20 mg/d). After a week, she started with symptoms characterised by persecutory and surveillance delusions. Organicity was ruled out. The patient got a progressive recovery after starting anti-psychotic medication and progressive reduction of the steroid drugs.

We have performed a literature review of the neuropsychiatric complications of glucocorticoids using the PubMed database.

Neuropsychiatric effects of glucocorticoids involve affective, behavioural, and cognitive manifestations. The incidence is variable, between 2 and 60% of patients who receive steroids. Although the effects of glucocorticoids are unpredictable, the administered dose is the most significant risk factor for the development of neuropsychiatric symptoms. Dosage reduction typically results in clinical recovery. Although the limited data on this subject, it is a problem that clinicians face on their regular basis. The administration of anti-psychotics or mood stabilizers may be beneficial in the prevention and treatment of this syndrome.

The neuropsychiatric effects of glucocorticoids are unpredictable and non-specific. More controlled trials are needed in order to perform evidence-based clinical guidelines for the treatment with glucocorticoids and for the prevention of neuropsychiatric manifestations.

The authors have not supplied their declaration of competing interest.

Aging is a very heterogeneous and dissimilar process, full of asymmetries. There is evidence that socio-economic differences determine disadvantages and inequalities in old ages. Older people face particular inequalities in healthiness especially with more complex and vulnerable long-term conditions, being more likely to need support from social care services.

To evaluate the quality of life (well-being) related to the health of the elderly according to socio-economic indicators.

Cross-sectional quantitative study was performed. A total of 316 elderly people (M = 74.78; SD = 9.78 years of age) was interviewed with the Portuguese version of the EQ-5D-3L scale for health-related quality of life.

The interaction between income and the type of residential follow-up (alone vs. accompanied) was not statistically significant [F (2.310) = .910, P < .407; Ƞp2 = .006]. Differences in health status index were statistically significant for income [F (2.310) = 5.518, P < .004; Ƞp2 = .034]. Post-hoc comparisons indicated that the mean score for those with insufficient income for their expenses (M = .39, SD = .27) was significantly different from those with income reaching their expenses (M = .50, SD = .25) as well as those with income covering their expenses sufficiently (M = .60, SD = .21). The main effect for the type of follow-up (alone vs. accompanied) did not reach statistical significance [F (2.310) = .224, P < .636, Ƞp2 = .672].

Income has an impact on health-related quality of life. Health in aging as a social phenomenon is not neutral to economic differences and is exposed to these structural disadvantages.

The authors have not supplied their declaration of competing interest.

University life is stressful for the student, which is characterized by disturbed emotional regulation or alexithymia. To face these stressful events he must use certain coping strategies.

Studying the prevalence of alexithymia and exploring coping strategies among medical students, and establish the relationship between these parameters.

It was a cross-sectional study of 97 students in Sfax university medicine (Tunisia). We used:

– a questionnaire containing demographic and clinical data;

– Toronto alexithymia Scale (TAS-20): a score ≥61 indicates alexithymia;

– WCC (Ways of Coping Checklist-r Folkman) with 3 factors: problem-focused, emotion-focused and social support coping.

The average age of participants was 24.07 years (±2.71); the sex ratio (M/W) was 0.4. They were smoking in 36.1% and sedentary in 43.3% of case. They had a nibbling activity in 57.7%. The average score of TAS-20 was 50. 92 10.46 and alexithymia was found in 16.5% of students. Alexithymia was significantly correlated with smoking (P = 0.003) and physical inactivity (P = 0.025). Most students (72.2%) opted for problem-focused ways of coping with a highest score at WCC = 29.21. A significant correlation was found between alexithymia and coping strategy with emotion-focused (P = 0.02). The TAS score was significantly higher among students who resort to this ways of coping = 26.11. (P = 0.002).

This study explored the role of alexithymia in stress management ubiquitous in university life. A high level of alexithymia could be a detrimental factor in stress management. Psychological support aimed specifically alexithymic dimension is indispensable.

The authors have not supplied their declaration of competing interest.

Romantic relationship quality (RRQ) and break-ups (RRB) among young adults have been associated with the onset of a first major depressive episode or suicide attempts. However, the size of these associations varies across studies and the relative weight of RRB versus RRQ needs to be understood.

To investigate (1) the size of the association between adolescent RRQ/RRB and psychopathology (i.e., depression, suicide ideation, deliberate self-harm, and suicide attempt); and (2) the role of potential moderators (e.g., gender, age, and nationality).

A meta-analysis of 20 manuscripts reporting on 21 studies (n = 19623) was conducted, focusing specifically on adolescents and young adults. Studies focused on physically abusive relationships were excluded.

A model combining relationship quality and break-up yielded a highly significant association between relationship measures and depression/self-harm but the strength of this relationship was modest (r = .229). The strength of the association between depression/self-harm and RRQ (r = .279) was statistically different from RRB (r = .145) (P = .006). Location (US vs. Non-US) had no effect. Age was not significant, B = -0.005, 95% CI [-0.026, 0.016], P = .647. Gender was a weak moderator (B = .160, 95% CI [-0.021, 0.340], P = .083).

The association between psychopathology and RRQ/RRB was statistically significant but relatively small. RRQ was a stronger predictor of depression compared to RRB. This association was slightly stronger for women than for men. Implications for practice and future research will be discussed.

The authors have not supplied their declaration of competing interest.

Fear of childbirth (FOC) is a problematic mental health issue during pregnancy and postpartum period. It is essential to identify the most effective approaches to reduce the problem.

Using meta-analyses, we aimed to examine the most effective intervention for reduction of FOC.

We searched the Cochran central register of controlled trials, PubMed, Embase and PsycINFO databases since inception till January 2016 without any language restriction. The reference lists of all included studies were checked for additional published reports and citations of unpublished research. We included randomised control trials and quasi-randomised control trials comparing interventions for treatment of FOC. Two review authors independently assessed trial quality and extracted data. The standardized mean differences (SMD) were pooled using random and fixed effect model. The heterogeneity was determined using the Cochran's test and I2 index and was further explored in meta-regression model and subgroup analyses. Egger's regression and funnel plot were used for assessing publication bias.

Ten studies totalling 3984 participants were included from two quasi-experimental and eight randomised clinical trials. Eight studies investigated education and two studies investigated hypnosis-based intervention. The pooled SMD of FOC for the education intervention and hypnosis group in comparison with control group were -0.46 (95% CI-0.73 to -0.19) and -0.22 (95% CI-0.34 to -0.10), respectively.

Interventions were effective on reducing FOC; however educational interventions reduced FOC twice as high as hypnosis. This result highlights the roll of antenatal education in enhancing childbirth expectations and experiences to enhance maternal and neonatal well-being.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

Most mental disorders begin during adolescence and early adulthood (18–24-years-old), highlighting the importance of understanding the onset and progression of mental disorders among youths. Although progress has been made, namely by creating youth mental health transition services, gaps continue to exist. Locally, our recently constituted young adults unit aimed to minimize discontinuities in care.

To characterize a population of young adult psychiatric outpatients, regarding socio-demographic and clinic variables.

Socio-demographic and clinic characterization of young adult psychiatric outpatients observed during 1st January 2015–30th July 2016.

Two hundred and fifty-five outpatients were observed: 64.3% females and 35.7% males, average age 20.56-years-old (median 20). Most lived in urban areas (59.4%), with their parents (27.8%), were students (80.4%), attending secondary school (36.1%). A total of, 27.5% were referenced by an emergency department, and adjustment disorders (ICD-10 F43.2) were the most frequent diagnosis (21.6%). Regarding suicidal behaviours and self-harm, 9.8% did self-cutting. A vast majority did not have previous psychiatric hospitalizations–only 5.9% outpatients had at least one. In total, 39.8% were medicated with antidepressants (1/3 of which in association with other drugs), and about 38.8% received cognitive-behavioural interventions. About 2/3 of patients (66.3%) remained in care and only about 1/6 (15.7%) were discharged.

Our typical youth psychiatric outpatient was of female gender, student, living with its parents. Adjustment disorders were the most frequent diagnosis, and antidepressants were the main psychopharmacologic option, often combined with other psychotropic drugs. In the future, psychotherapy interventions should be more widely available, namely group psychotherapy.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

HIV (human immunodeficiency virus) infection is related to several neuropsychiatric complications, such as dementia, encephalopathy, psychosis, as well as, opportunistic infections of the central nervous system (CNS). The discovery of antiretroviral therapy (ART) has limited these conditions and extended the life span of infected patients into a chronic illness, but it is also associated with neuropsychiatric adverse effects.

To review the literature on the most common neuropsychiatric complications of the ART, since it can be difficult to distinguish drugs toxicity, the effects of the virus, immune system and psycho-social events.

The authors have conducted an online search in PubMed with the terms: “Psychiatry”, “HIV”, “adverse effects” and “antiretroviral drugs” from 2011 until 2016. From the outcome were collected, analyzed and summarized the articles considered to be relevant.

The antiretroviral therapy (ART) are associated with a numerous adverse effects on the central and peripheral nervous systems, as well as, metabolic, gastrointestinal, cardiac, and other toxicities. The neuropsychiatric effects are common and highly variable, including depression, cognitive impairment and sleep disturbance. The nucleoside reverse transcriptase inhibitors and the non-nucleoside reverse transcriptase inhibitors are one of the two classes of antiviral drugs most frequently associated with neuropsychiatric complications.

The occurrence of new-onset conditions related to ART makes it difficult to determine the association between psychiatric disorders and ART adverse effects, and given the fact that patients commit to lifelong therapy, as well as, they can diminish quality of life; it makes these assessment important in treating these conditions.

The authors have not supplied their declaration of competing interest.