When other options fail, physical restraint is used in inpatient psychiatric units as a means to control violent behavior of agitated inpatients and to prevent them from harm. The professional and social discourse regarding the use of restrictive measures and the absence of the inpatients’ attitudes towards these measures is notable. Our research therefore tries to fill this gap by interviewing inpatients about these issues.

To assess the subjective experience and attitudes of inpatients who have undergone physical restraint.

Forty inpatients diagnosed with psychiatric disorders were interviewed by way of a structured questionnaire. Descriptive statistics were conducted via use of SPSS statistical software.

Inpatients reported that physical restraint evoked an experience of loneliness (77.5%) and loss of autonomy (82.5%). Staff visits during times of physical restraint were reported as beneficial according to 73.6% of the inpatients interviewed. Two thirds of the inpatients viewed the use of physical restraints as justified when an inpatient was dangerous. Two thirds of the inpatients regarded physical restraint as the most aversive experience of their hospitalization.

Our pilot study explored the subjective experience and attitudes of psychiatric inpatients towards the use of physical restraint. Inpatients viewed physical restraint as a practice that was sometimes justified but at the same time evoked negative subjective feelings. We conclude that listening to inpatients’ perspectives can help caregivers to evaluate these measures.

The authors have not supplied their declaration of competing interest.

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

Psychomotor agitation is the most common behavioural disorder observed in emergency and psychiatry departments. This syndrome is characterized by excessive or inappropriate motor or verbal activity and important emotional tension. Psychomotor agitation may be associated with medical conditions, substance intoxication/withdrawal and in a significant number of cases with schizophrenia or bipolar I disorder.

The objective of this protocol was to provide up-to-date guidance to identify, manage and treat patients with an episode of acute agitation, considering the consensus clinical knowledge, current ethical standards and available therapies. This protocol is aimed to be a patient-centric tool helping to anticipate and prevent the escalation of agitation symptoms.

The method followed to elaborate this document was through a combination of comprehensive bibliographical review (complied in the article “Assessment and management of agitation in psychiatry: expert consensus” by Garriga M. et al. (World J Biol Psychiatry, 2016), interaction with patients, and the clinical experience in our centre.

The elaboration of this protocol resulted in a document that contains guidelines to identify, manage and treat patients efficiently, ethically and safely. One of the novelties of the protocol is the addition of dichotomies based on the patients’ willingness to cooperate. The information is summarized in easy-to-use algorithms for non-specialized healthcare professionals.

This protocol may provide the basis of a new standardized treatment paradigm for psychomotor agitation which may help improve the patient's experience and therapeutic alliance with the healthcare professional and optimize resources in healthcare centres.

COI: The preparation of the protocol was funded by an unrestricted grant from Ferrer International. The company had no say on protocol content. Dr Vieta has received funding for research projects and/or honoraria as a consultant or speaker for from the following companies and institutions: AB-Biotics, Allergan, AstraZeneca, Bial, Bristol-Myers Squibb, Dainippon Sumitomo Pharma, Elan, Eli Lilly, Farmaindustria, Ferrer, Forest Research Institute, Gedeon Richter, Glaxo-Smith-Kline, Janssen, Lundbeck, Otsuka, Pfizer, Roche, Sanofi-Aventis, Servier, Shire, Solvay, Sunovion, Takeda, Telefónica, Institute of Health Carlos III [Instituto de Salud Carlos III], Séptimo Programa Marco (ENBREC), Brain and Behaviour Foundation (NARSAD) and Stanley Medical Research Institute.

Internet use has increased broadly worldwide. There are growing concerns about problematic Internet use (PIU) among youth. Among undergraduate students, excessive Internet use can adversely affect their interpersonal relations and academic achievements.

To estimate the prevalence of PIU among Zagazig university students, and to identify the possible associations between sociodemographic and Internet-related factors and PIU.

A cross-sectional study included a total of 732 undergraduate students, aged 17–34 years, from various colleges in Zagazig University. Participants were randomly selected and assessed for their internet use and abuse using the Internet Addiction Test (IAT), along with a semi-structured questionnaire for sociodemographic and Internet-related factors.

Maladaptive Internet use was found in 37.4% of respondents, and addictive Internet use was found in 4.1% of respondents. Logistic regression showed the predictors of PIU were: using the Internet throughout the day (OR 3.34, 95% CI: 1.75, 6.38), the number of hours spent daily using the Internet (OR 1.17, 95% CI: 1.10, 1.25), the number of days/week using the Internet (OR 1.28, 95% CI: 1.04, 1.58), accessing the Internet using multiple devices (OR 1.55, 95% CI: 1.21, 1.98), and accessing the Internet both indoors and outdoors (OR 1.57, 95% CI: 1.13, 2.19).

This is the first prevalence study of PIU at an Egyptian university. PIU was common among university students. Addressing this issue and its predictors could eventually help to enhance academic performance and achievement among those students.

The authors have not supplied their declaration of competing interest.

Psychotic spectrum diseases are one of the most expensive illnesses in our society. Being able to recover as much social and laboral activity as possible has to be the goal. Trying to achieve this objective, we face different problems, as for example therapeutic adherence.

Show the importance of an adequate treatment and adherence in order to keep the patient as much integrated in the society as possible, and in order to reduce the economic and social cost of the psychotic spectrum diseases.

Case report and bibliography review.

The patient of this case is a 34 year old woman with a schizophrenia diagnosis given after 4 hospitalizations in psychiatry units. She had 4 years of stabilization taking an injectable antipsychotic, in which she was able to study and keep adequate familiar and sentimental relationships. After being badly recommended to retire her medication for some who identified himself as member of the “new psychiatry”, she began with new delusions and hallucinations which had to be treated at the Hospital Psychiatry Unit. She was close to get a statal job related to her architecture studies, but she was not able to go to the exam due to the exacerbation of her illness. In the review we see that the average economic cost per schizophrenic patient in developed European countries such as Germany is, at least, 14000€ per patient.

Adequate treatment adherence is highly important to keep an adequate control of the illness in order to sustain the better social live and job function.

The authors have not supplied their declaration of competing interest.

Portugal is among the European countries with higher prevalence of mental disorders, associated with substantial unmet needs for treatment. Literature on the impact of the economic recession shows that an increased risk of mental health problems is likely to occur. Despite possible growing needs, the budget cuts at the health system level may have decreased the adequacy of care response. Understanding the impacts of the recession in psychological distress and in access and quality of care is imperative to set public health priorities.

Resorting to a qualitative approach, this study aims to explore the perceptions and experiences of primary health care users and professionals during the recession in the Lisbon Metropolitan Area.

Provide in depth information regarding the specific contexts and subjective experiences of key informants during the economic recession that started in 2008.

This study design resorts to focus groups with primary health care users and semi-structured interviews with health professionals. All interviews were recorded and transcribed verbatim. Inductive approach and thematic analysis were performed, using NVivo 10.

This study explores the views and insights of users and health professionals regarding their socio-economic context, mental health needs, changes in health services and possible solutions to alleviate the impact of the economic recession.

Being based on the perspectives of users and health professionals, this approach will complement epidemiological evidence for policy-making.

The authors have not supplied their declaration of competing interest.

Portugal is one of the European countries most affected by the Great Economic Recession. Mental health outcomes are likely to deteriorate during this period, with greater proportional impact among those more socially disadvantaged. Self-reported measures of financial difficulties and economic hardship are likely to be associated with psychological distress during this period.

To characterize the relationship between psychological distress and self-reported measures of financial difficulties and type of material deprivation during the Economic Recession in Portugal.

A follow-up epidemiological survey was conducted in 2015, with a probability sub-sample of 911 respondents of the 2008 World Mental Health Survey Initiative Portugal. Psychological distress was evaluated by the Kessler-10 scale. Financial difficulties were assessed by asking the responds if they had enough money for their daily activities. Type of material deprivation considered difficulties in acquiring essential goods, paying debts or buying other goods (clothes or leisure activities). Chi-square analysis were used to evaluate the association between psychological distress, financial difficulties and type of material deprivation.

A statistically significant association (P < 0.05) between psychological distress and financial difficulties was found. Among the respondents that reported not having enough money, 22% reported psychological distress. Regarding the type of material deprivation, a statistically significant association was only found for essential goods.

During the economic crisis, financial difficulties and material deprivation in essential goods were associated with increased levels of psychological distress, potentially widening social and health inequalities across the Portuguese population.

EEA Grants, Programa Iniciativas em Saúde Pública.

The authors have not supplied their declaration of competing interest.

All over the world, there is global emergency when it comes to respecting human rights in providing good mental health services. Morocco as an African and a developing country has always had a mental health policy defined by several glitches and failures, which had not helped him improve its mental health services quality. Nevertheless, huge improvements were achieved through time.

This report, aims to draw attention on how compulsory it is to think and act all together to promote mental health and provide patients with better health services in Morocco.

The National Human Rights Council conducted an information and investigation mission in Morocco's main mental health hospitals and facilities between March 27 and July 6, 2012.

Structures are insufficient and inadequate in terms of geographical distribution, architecture and equipment. There is a big shortage of medical and paramedical staff and little interest is given to vulnerable groups. Nevertheless, huge improvements have also been achieved through time with mental health issues becoming a cornerstone of the ministerial program, the involvement of the NGOs, the construction of newer facilities, the implementation of an information gathering system and the presence of a substance use policy.

Psychiatry in Morocco has come a long way since it was firstly implemented in the country as a medical specialty. Undoubtedly, a lot has been done but much more remains to be achieved. The current situation requires relevant actions and that clearly includes the implementation of a new mental health policy and the update of the legal framework.

The authors have not supplied their declaration of competing interest.

Children and Teenager's disability is an extremely important medical and social problem, being very characteristic of the state of public health in the country and the level of social well-being of society.

An epidemiological study of the structure of disability due to mental disorders in children and adolescent population of the Saratov region for the period from 2000 to 2014.

The analysis of the statistical data reporting forms “Information on the health care system” and “Information on the groups of the mentally ill” in the Saratov region in 2000–2014 by epidemiological, demographic and mathematical-statistical methods.

Number of children and adolescents (0–17 years), recognized as disabled by mental illness, increased both in absolute numbers (growth rate-12.86%), and the intensive indicators (49.88%). Increasing the number of disabled children and adolescents registered in schizophrenia, schizoaffective psychosis, schizotypal disorder, affective psychosis with delusions incongruent the affect. The most significant increase is observed in the group of chronic nonorganic and childhood psychoses. In epilepsy and mental retardation in the analyzed period was a slight decrease in total disability.

The most significant increase in disability in the group of chronic nonorganic and childhood psychosis, most likely due not only to a true increase in morbidity and disability, but also with a great attention of both the public and the country's health services to the problems of childhood autism and, as a consequence, greater detection of children with this category of disorders.

The authors have not supplied their declaration of competing interest.

The determining of the actual number of people with mental disorders and their spreading by nosology still remains actual, especially according to different regions.

The determining of the psychiatric services effectiveness in Saratov region on the basis of comprehensive analysis of its’ clinical, statistical and epidemiological characteristics.

The analysis of mental state indicators based on the example of adults’ schizophrenia Saratov region in dynamics for 10 years (2005–2015) in comparison with Russian Federation.

Over the past 10 years the number of clinically supervised patients with schizophrenia decreased at 0.9% in the city and 2.2% in region population. This is consistent with the tendency of schizophrenia morbidity in Russian Federation over the same period. The number of supervised adult patients with primary diagnosed schizophrenia in Russia remained at the same level and amounted to 10.8 per 100 thousand population. At the same time the noticeable fluctuations in the number of this patients’ category were observed in Saratov and Saratov region. Over the past 10 years, the proportion of patients with primary diagnosed schizophrenia disability in the class structure of mental disorders is quite high, averaging of 41.1% in Saratov region. Analyzing the number of patients with re-confirmed disabilities the gradual decline from 1846 to 755 people (at 59.1%) was found.

The mental health analysis of Saratov region population allows to suggest the long-term forecast of mental disorders’ morbidity, to analyze the level of disability due to schizophrenia, to develop recommendations for the optimal regional model of psychiatric services.

The authors have not supplied their declaration of competing interest.

The Burnout Syndrome Study screened for burnout in psychiatric trainees in 22 countries, along with associated factors. This paper reports the results of the PHQ-9 depression screen that formed part of the study.

It is well documented that physicians have higher rates of mental illness compared to the general population. Post-graduate medical trainees may work long hours and be exposed to stressful or saddening situations regularly. Their environment and workload means they may not exhibit appropriate help-seeking behaviours and be at significant risk of depression.

The study used a cross sectional, multi-country online survey. Participants were asked to participate via an email invitation. The participants were asked to complete the PHQ-9 questionnaire, which is validated as a primary care self-administered screen for depression. Mixed methodology was used when recruiting trainees to obtain the most representative sample possible from each country. Statistical analysis was performed using SPSS.

Complete data was obtained from 1980 trainees with an average age of 31.9 years and with 2.8 years of training. The prevalence of depression in psychiatric trainees varied by country from 50% in Latvia to 7.1% in Belarus. The average rate of depression was 20.8%.

Prevalence of depression in the US general population is estimated at 6.7%, making the prevalence of depression in trainees of 20.8% a sign that action needs to be taken to reduce depression rates in trainees.

The authors have not supplied their declaration of competing interest.

The Green et al. Paranoid Thought Scales (GPTS) was developed to fulfill a need for a tool that was adapted to the current dimensional definition of paranoia, capable to assess dimensions of preoccupation, conviction, and distress, valid and reliable for the assessment of both clinical and healthy populations, and precise enough to detect subtle clinical change. It has recently been validated for the Spanish population (S-GPTS) with very good psychometric properties. Numerous studies suggest that patients with severe psychiatric disorders have impaired sustained attention and memory. A wide spectrum of executive deficits have also been described (goal-oriented tasks, recognizing priority patterns, planning, etc.) Very few studies have attempted to identify whether these same relationships between neuropsychological deficits and psychotic symptoms also occur in general population.

This is a cross-sectional study. We undertook a multistage sampling using different standard stratification levels and out of the 5496 eligible participants finally approached, 4507 (83.7%) agreed to take part in the study, completed the interview and were finally included in the study (n = 4507).

Individuals with high cut off S-GPTS scores showed lower scores in working memory subtest verbal statistically significant(P > .05). While no significant difference was found among for immediate verbal learning subtest and high S-GPTS scores (P > .05654).

This information can improve the clinician's understanding of patient's cognitive strength and weaknesses, put patients’ cognitive abilities into perspective for their diagnosis, and facilitate multidisciplinary treatment decisions as we improve our ability to distinguish clinical cases from non-clinical population.

The authors have not supplied their declaration of competing interest.

Self-injury behavior among mental patients has been recognized for several years, yet our understanding of its mechanisms and its risk factors remains limited.

This study aimed to assess the prevalence of deliberate self-harm (DSH) among psychiatric inpatients and to identify its association with personal and clinical factors.

It was a descriptive and analytic study. It included 87 psychiatric inpatients followed in the psychiatry department “C” at the Hedi Chaker University Hospital of Sfax in Tunisia. Barratt Impulsivity Scale (Bis11) and the 28-items Childhood Trauma Questionnaire (CTQ) were used to assess respectively impulsivity and child maltreatment.

The average age of patients was 29.32 ± 8 years. Most of them were male (75%) and single. Fifty-nine percent of patients had previously attempted suicide. A history of DSH was found in 60.9% of cases. The most frequent trauma types were emotional abuse and physical neglect with respectively 58.7% and 69.8%. Factors positively correlated with DSH were: male gender (P = 0.026), father alcoholism (P = 0.024), history of suicide attempts (P = 0.017), borderline personality (P = 0.00) and history of emotional abuse (P = 0.008) or physical abuse (P = 0.04) or neglect (P = 0.004). Score “Bis11” was significantly correlated with suicide attempts (P = 0.00) and presence of childhood abuse (P = 0.00) or neglect (P = 0.01).

DSH seems to be a prevalent problem among psychiatric inpatients. It concerns mainly patients with a history of child abuse and impulsive behavior such as suicidal attempts underlying borderline personality disorder. Patients with these risk factors warrant specific attention in mental health services.

The authors have not supplied their declaration of competing interest.

Suicide is a serious and growing problem worldwide. According to the World Health Organization, for each death there are twenty attempts on record. Every year over 800,000 people commit suicide, that is, one in every forty. 45% of the people who commit suicide visit their Primary Health Care physician in the previous month. Seventy-five percent of suicides take place in countries with medium or low income and Argentine heads the suicide rate in Latin America. In the last twenty years the death by suicides rate in young people (aged 15–35) and has decreased in older age groups (+ 55), which historically presented the highest rates. In the inner zone of the province of Santiago del Estero, suicides have increased among teenagers [1].

To know suicide statistics in young people in the last decade so that a prevention scheme can be produced.

Descriptive observational study.

In the province of Santiago del Estero suicides occur more frequently among young people, aged 15–35, and the rate has increased significantly in the inner zone of the province.

The analysis carried out reveal that this problem in increasing in our province and it requires analysis and consensus in order to design a model of Primary Health Care Prevention.

The authors have not supplied their declaration of no competing interest.

Dissociative and conversion disorders are reported to have a present incidence of about 85–100per 1000 by different studies, which are very few. The present research is a part of a longitudinal study of 15 years but here; only 3 years are represented, which could be briefly analyzed.

Latest reports suggest a decline in incidence of hysteria (conversion and dissociation) and this research just tries to reconfirm.

All new patients attending a private psychiatry OPD in a small township of India at Lakhimpur Kheri in Uttar Pradesh, were screened to identify cases of dissociative disorder according to ICD 10, F44.2 and F44.3 from the 1st of January 2016 to 31st of October 2016 (10 months). These screened cases, only those presenting with fits of unconsciousness and possession, were analyzed and compared with the previous years for the same period.

Out of a total of 3671 patients seen, (2122 males and 1549 females) a total of 319 presented with the above mentioned symptoms (58 males and 261 females) about 87 per 1000 of psychiatric patients.

The results, when compared with two previous years for the same period were quite similar, 2015 getting incidence of 97 per 1000 and 2014, an incidence of 89 per 1000. The inference thus is that there does not seem to be any decline of incidence and the figure would be much higher if both conversion and dissociative symptoms are included – a really serious situation.

The authors have not supplied their declaration of competing interest.

Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes. According to literature, an excess of 5–8% of winter-spring births is found in individuals who later develop schizophrenia and bipolar disorder; this seasonal birth excess is also found in schizoaffective disorder (winter), major depression (March–May), and autism (March).

The objective of this study was to analyze the seasonal birth patterns of in-patients with psychiatric disorders.

Understand the relation between psychiatric disorders and season of birth during a 10 year period in a Portuguese University Hospital.

Analyze the birth date distribution of 2202 in-patients between 2007 and 2016 and compare with the psychiatric diagnosis.

Patients’ diseases analyzed by birthday season: 60% of patients with schizoaffective disorder were born in winter-spring, 48.4% of mental retarded patients were born in autumn, 37% of dementia patients in winter, 77% of patients with delusional disorder in winter-spring, 78% of patients with Cluster A personality disorder in spring-summer and 71% of patients with substance abuse conditions in autumn-winter. No seasonal birth excess was found for bipolar affective disorder, schizophrenia, alcohol abuse, major depressive disorder or Cluster B personality disorder.

Our sample data shows evidence for a potential link between season of birth and risk for schizoaffective disorder, dementia, mental retardation, Cluster A personality disorder, delusional disorder and substance abuse. The attempt to explain seasonal birth patterns in psychiatric illnesses could serve to clarify the etiological bases of such disorders.

The authors have not supplied their declaration of competing interest.

Screening questionnaires for mental health problems are useful tools for research and clinical practice.

To identify mental health problems and overall emotional functioning among general population samples in Kosovo as indicators for evaluation of needs for mental health services.

It is cross-sectional quantitative study. Participants from two samples: students (filled-out directly) and online respondents (n = 540; mean age = 24.84; SD = 8.29) were included in this study. All participants were asked to complete the Albanian translation of Mental Health Inventory (MHI-38). Data processing was done with SPSS 21.0 and Microsoft Excel 2007.

In total 11.2% of participants ranged at low level of mental health index. Regarding anxiety the high level is found at 51.3% and regarding depression high level is found at 24.5% of participants. A significant gender difference is found whereas females show greater depression (P = .022, r = .09), greater psychological distress (P = .000, r = .17) and lover mental health index (P = .000, r = .17), than males. A significant difference between samples is found whereas online sample show greater psychological distress (P = .000, r = .18), less anxiety (P = .001, r = .13) and lower mental health index (P = .000, r = .22) than direct sample.

The findings are quite intriguing. Future research is needed to find out more understanding on gender, anxiety, depression, psychological distress and mental health. Socio-cultural aspects can be of great importance to be examined. Despite this, needs for mental health services are inevitably and must be addressed properly.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The attitude to schizophrenic patients has always been considered a significant indicator of stigmatization of mental patients. The social aspect of stigmatization involves the social distance when speaking about the attitudes towards mental patients. The social distance is defined as “a various degree of understanding and feelings existing among the groups”.

The investigation included 120 participants divided into two groups. The first group included 60 participants; psychiatrists (38) directly involved in treating schizophrenia and 28 nurses working in wards where schizophrenic patients were treated. The second group of 60 participants included non-professionals divided according to age and gender to match the experiment group.

Investigating the correlation between the proclaimed attitudes to and social distance from schizophrenic patients: medical professionals and non-professional subjects.

Semantic differential scale was used to examine the personal attitudes towards a stigmatized group. To examine social distance, the modified Bogardus Social was used.

The results obtained using the Semantic differential scale to examine the attitudes did not show statistically significant score difference between the two groups of patients Bogardus Social Distance Scale score showed statistically significant difference (P > 0.03). A significant score on the scale of social distance can be recognized in both psychiatry professionals and non-professionals.

Stratification of items on the social distance scale shows a great social distance in the sphere of intimacy and slightly lower score on the level of social relations. The group having competent knowledge concerning the disease shows sophisticated way of hiding behind professional reasons.

The authors have not supplied their declaration of competing interest.