Background:The purpose of this study is to determine, by classifying emergently admitted suicide attempter patients according to their Global Assessment Scale (GAS) scores, the characteristics of and factors associated with each group of patients. Methods:The subjects of this study were 1,317 suicide attempters who were seen at the primary/secondary emergency department of the Iwate Medical University Hospital and at the Iwate Advanced Critical Care and Emergency Center, during the period of 7 years from April 1, 2006.These subjects were classified into three groups, consisting of the low, middle and high score groups, and were analyzed by comparing these groups with each other in terms of background factors and psychiatric assessment of emergency psychiatry case cards.Comparison examination was performed among 3 groups, and multiple logistic regression analysis was performed by using investigation items and the three GAS score groups as explanatory and dependent variables, respectively Results: Factors associated with the low score group included being male, advanced age and unemployed, and high life event values.The odds of completed suicide in this group were more than 5-fold higher than in the other two groups.Past history of suicide attempts was extracted as a factor associated with the middle score group.Factors associated with the high score group included: being female; young age; having no history of regular psychiatric visits; having history of advice seeking prior to the attempted suicide; and complex motives. Conclusions:This paper determined characteristics of emergently admitted suicide attempters according to their GAS score levels, and proposed specific measures to be taken according to individual patients' GAS scores.It was suggested that in an emergency setting involving a suicide attempter, a global assessment of the patient and treatment given according to the assessment results may lead to the prevention of further suicide attempts.
Diabetes mellitus (DM) is a chronic debilitating disease, which can cause various psychological, emotional, social and psychosexual problems. Depression can be a risk factor as well as complication of diabetes because of its link with compliance issues, glycaemic control and increased risk of complications. Early recognition and treatment of depression can go a long way in improving the quality of diabetic patients and it can also improve medical outcome. The aim of the article is to get overview of the association of the two common disorders and knowledge of their association would add to the framework of the global campaign to reduce burden world-wide.
Background: As it is defined stimulants are the first choice in the treatment of ADHD patients but some patients cannot use it because of side effects or poor response. It seems we need to use drugs from antidepressant group like venlafaxine and bupropion that have the same effect and define which one is more effective. In this study these are answered. Therefore 40 children with ADHD between 7 to 11 years old were selected after psychiatric interview and received ADHD and Conner's rating scale. The first group took venlafaxine and the second group took bupropion. The two groups were evaluated as pre- and post-test by Conner's and ADHD rating scale. Result: Bupropion and venlafaxine were both effective on those children and their efficacy were compared in the entire sample and for boys and girls separately by using one-way analysis of covariance. There was no significant difference between the two groups in general and separately within males and females of the two groups. Discussion: This article shows that venlafaxine and bupropion are both effective on decreasing symptoms of ADHD. The response rates are the same in the two groups.
Moyamoya disease (MMD) in adult patients is commonly accompanied by vascular cognitive impairment (VCI). The mechanism behind is still unclear and has been related to its hemodynamic disturbances. Surgical revascularization seems to be the only efficacious way to maintain the cognitive outcome, while problems such as the selection of operation indications and timing, and the long-term efficacy still need to be solved. The purpose of this article is to review the related literatures in recent years and to summarize the results in our research on the mechanism and surgical intervention of VCI in patients with MMD.
Clinical vignette A 16 year old male wasdiagnosed with type 1 diabetes mellitus three months ago. His condition was uncontrolled with a hemoglobin A1c (HbA1c) of 9.0%. He has been meetingmonthly with his diabetes treatment team, but struggling at carbohydrate counting and managing insulin. The patient'smother has a history of depression,polysubstance abuse, and frequently failed to attendscheduled appointments. At the three month follow up visit, his HbA1c was 9.6%. He now reported sadness, low energy, and insomnia, decreased interest in sports or social contact, and feeling hopeless.
Brain research using postmortem brains has been pivotal to explore pathogenesis of neuropsychiatric diseases. Many of ambitious researchers have engaged in postmortem brain study, and have successfully revealed mysteries of human brains. For this, brain banks, i.e. research resources of postmortem brains, have had important roles, though there have not yet been universal consensus in ethics and law in running brain banks [1].
Autistic spectrum disorders (ASD) is now considered a multifactorial neurodevelopmental disorder, with increasing prevalence worldwide. Many evidences had showed a role of disturbed folate metabolism in increasing risk for autism, with methylenetetrahydrofolate reductase (MTHFR) being a pivotal enzyme controlling it. This study aims at examining two polymorphisms in MTHFR gene as they are linked to decreased enzyme activity. MTHFR C677T and A1298C polymorphisms are studied in Egyptian ASD children and their mothers in addition to control group. We examined MTHFR 677 C/T and 1298 A/C in 24 autistic children and their mothers and 30 control children and 42 control mothers. Genotype frequency of MTHFR 1298 AC/CC is significantly higher in autistic children; compared to controls. It was also significantly higher in autism mothers compared to control mothers with 3.2, and 2.1 increased fold risk for MTHFR 1298 AC, and AC+CC genotypes, respectively. No significant changes in C677T genotyping was found in neither autism children nor their mothers. Conclusion: These data supports an increased risk for ASD in association with MTHFR 1298 AC/CC polymorphism and hence a role of folate/methylation cycle disturbances is suspected in autism.
Objective: To determine psychological violence behaviors (mobbing) exposed by academic personnel working in Erciyes University, Turkey. Methods: A questionnaire-based cross sectional study was performed in June 2010 in Erciyes University. No sampling methods were used, questionnaires were delivered by mail to all academicians and 450 of 850 (53.0%) questionnaires were returned. We used the Mobbing Perception Scale (MPS) for data collection. Results: A total of 58.2% of the academicians experienced recurrent physiological violence at least once a week in the workplace and 16.6% stated that they were directly exposed to mobbing behavior every day (>1 point) in the past year, 44.7% reported “assault to their professional status”, 42.8% reported “assault to personality”, 39.9 % reported “isolation from work”, 13.0% reported “direct negative behavior”. The most commonly (30.4%) experienced behavior was; “groundless talk about the person in question”. Mobbing was not associated with demographic and professional variables. The main source of mobbing was the managers. Also 68.0% of the victims resorted to passive defense strategies, and only 2.5% took legal action. Conclusion: Workplace mobbing is a critical problem for academicians in our university. The level of directly mobbing behavior was substantially high. The most common threatening behavior was “assault to professional status”. The primary mobbers were the managers. A great of majority academicians had not been received professional help and they internalized the mobbing. The findings indicated that levels of awareness of mobbing have increased among academicians.
Background: We aimed to study the HRQL in patients with differentiated thyroid carcinoma (DTC) during hypothyroidism due to thyroxin withdrawal, which is induced routinely for iodine-131 (I-131) whole body scan and ablative treatment. Methods: Between September 2011 and March 2012, eligible patients with DTC who were referred to our institution for diagnostic or therapeutic radioiodine administration under hypothyroid conditions due to thyroid hormone withdrawal were asked to complete the psychological instruments rating their HRQL and psychological status. HRQL was studied using the Short Form (SF-36), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), the total mood disturbance (TMD) score, Beck Depression Inventory (BDI).One hundred and forty three hypothyroid patients with DTC (F=101, M=42, age=58.7 yrs) who were also on low-iodine diet were included in this study. Hypothyroidism was induced by withdrawal of thyroxin replacement in all patients. Results: The results of SF-36 showed that the HRQL was significantly impaired in hypothyroid patients during withdrawal of thyroxin (physical component scale: 44.3 ± 9.5, mental component scale: 40.8 ± 10.2, p ≤ 0.001). Depression scores were in the normal or non-clinically relevant range: 4.1 ± 3.8 on the HADS-Depression and 8.3 ± 6.6 on the Beck Depression Index. However, the mean score of 28.8 ± 25.2 on the POMS TMD was within normal range. Conclusion: HRQL is impaired in hypothyroid patients with DTC during thyroxine withdrawal before I-131 whole body scan and radioiodine therapy.
It has been demonstrated that childhood traumas are a risk factor for psychiatric disorders [1-3]. Studies have shown that childhood emotional and physical abuse, sexual abuse, substance abuse, and low self esteem contribute to sexual and interpersonal relationship problems [4-6]. Substance dependent people frequently show a history of significant childhood trauma [7-9]. There are also many epidemiological studies that show high rates of psychiatric disorders co-occuring with substance dependency disorders [10,11]. During the treatment of dependent individuals, our observations that families of dependent patients are more likely to have co-occuring psychiatric diagnosis and complaints about childhood traumas in family interviews is motivated us to make this study. Despite all the studies that show high rates of childhood traumas and co-occuring disorders, parents of substance dependent have not been well studied. We believe that this is a gap in the literature that should be remedied.
Background: This study was undertaken three years after the Yushu earthquake with the aim of exploring the differences in post-traumatic stress disorder (PTSD), anxiety symptoms between different groups. The survey was conveyed in Yushu Tibetan autonomous regions Ethnic School and the number of the participants was about one thousand. Method: T-test and chi-square test are mainly used to examine the correlation. In particularly, comprehend bivariate correlation analysis. Results: Three years following the disaster, 8.9% of participants reported PTSD and 49.3% displayed anxiety symptoms. A difference analysis of PTSD and anxiety symptoms across gender and grade subgroups suggested that there were no signi?cant gender differences in the anxiety and PTSD scores. However, there was a significant grade difference for anxiety symptoms. Conclusion: This study demonstrated the prevalence of PTSD was low among Tibetan adolescent. But the better of living environment and the customs habits did not change their anxiety level. This study may be useful for strengthening directing and evaluating mental health needs, as well as providing information on the psychological impact of the earthquake on this particular ethnic group in China.
Objectives: A great deal of research has been conducted into the possible involvement of neurotrophins such as brain-derived neurotrophic factor (BDNF) in the pathogenesis of Alzheimer’s disease (AD). We hypothesized that lower BDNF serum levels may be associated with cognitive decline. To test this hypothesis, we examined the differences in the serum BDNF levels in patients with AD and mild cognitive impairment (MCI) and normal controls. Method: We enrolled 56 subjects with AD, 29 subjects with MCI, and 24 healthy control subjects in the study. A total of 109 subjects agreed to blood sampling to evaluate serum BDNF levels. Serum levels of BDNF were measured using an enzyme-linked immunosorbent assay (ELISA) method. Results: The MCI group had higher BDNF levels as compared to the AD group (p=0.027). However, there were no significant differences between either the AD group or the MCI group and the control group. A significant correlation was observed between MMSE-K score and serum BDNF level. However, BDNF serum concentrations did not significantly correlate with age or level of education in the AD, MCI, and control groups. Conclusion: Our data suggest that BDNF serum levels are increased in subjects with MCI, supporting the hypothesis of an upregulation of BDNF in preclinical stages. BDNF levels might be involved in the pathophysiology of cognitive decline in elderly people.
Objective: This study investigated the emotional and behavioral problems of adolescents with diabetes. We also compared the emotional and behavioral problems according to the type of diabetes and glycemic control. Methods: Sixty-five adolescents with diabetes (type 1 diabetes; n=51, type 2 diabetes; n=14) and 83 healthy controls participated in this study. Glycemic control was assessed based on the mean HbA1c level, and the patient participants were divided into the following HbA1c groups: good (HbA1c<7.5%, n=17) and poor (HbA1c ≥ 7.5%, n=48). Emotional and behavioral problems were evaluated using the Korean version of the Youth Self-Report (YSR). Results: The YSR scores of the adolescents with diabetes were significantly higher than those of the healthy controls in terms of total problems, internalizing problems, externalizing problems, thought problems, rule-breaking behavior, aggressive behavior, and lower in terms of academic performance. The adolescents with type 2 diabetes had significantly more problems than those with type 1 diabetes; specifically, the adolescents with type 2 diabetes had more total problems, internalizing problems, anxious/depressed, social problems. No significant differences were found in the YSR scores between the good and poor HbA1c group. Conclusion: This study revealed that the adolescents with diabetes had more emotional and behavioral problems than did the healthy adolescents. The relationships among type of diabetes, glycemic control, and psychological problems might require further investigation.
Objective: The aim of this study was to investigate the reliability and validity of a version of the Barratt Impulsiveness Scale assessed by children’s parents. Methods: The test-retest reliability, split-half reliability, and homogeneity reliability were tested. Construct validity (including internal consistency and factor structure) and criterion validity were tested. The criterion validity examined the correlation with hyperactivity and impulsive factors of the CBCL and Conners’ scales and the score differences between the control and the diagnosed groups were compared. Results: The test-retest reliability was 0.825. The split-half correlation coefficient was 0.722. The internal factors consistency α coefficient of the scale was 0.387 for attention, 0.641 for motion, 0.643 for non-plan, and the total score was 0.794. The score was related with Conners’ hyperactivity and impulsivity factors and CBCL's corresponding factors. This assessed scale included six factors. The scores of the comparison group were significantly higher than those of the control group. Conclusions: The reliability and validity of the Impulsiveness Scale assessed by parents were ideal and consistent with psychometric requirements.
The present study examined the differences between native-born Israeli youth and immigrant youth, both dropouts and those that persevere with their studies, with regard to level of ego identity formation. The study was conducted among adolescents aged 13-18, of whom 191 (39.9%) were native-born Israelis and 288 (60.1%)-new immigrants. 239 of the adolescents were persevering students while 240 were dropouts. The comparison between native-born and immigrant youth revealed no difference in ego identity levels; however, when dropouts were compared to persevering students, the lowest level of ego identity was found among adolescents who dropped out of school, regardless of ethnic origin, age or sex.
The studies investigating antisocial personality disorder are mostly applied to subjects in prison.) In the literature, it is shown that 50% – 75 % of the prisoners are diagnosed as ASPD, and only 15% -25% of the patients can be defined "psychopathic". Comorbidity rates may change in different populations. In this study, we aimed to investigate comorbid disorders in a Turkish patient sample with the diagnosis of antisocial personality disorder (ASPD) who are not in prison and we investigated its relationship with psychopathy levels. 140 male subjects were included in the study. None of them had been in the prison on admission. They all had the diagnoses of ASPD according to DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-IV) diagnostic criteria. Socio-demographic data form, Structured Clinical Interview for DSM- Axis 1 Disorders and Axis 2 Disorders (SCID-I, SCID-II), and Hare Psychopathy Checklist-Revised (PCL-R) were applied. Most commonly seen comorbid disorders were as follows: substance use disorders (66,9%), alcohol use disorders (65,4%) and adjustment disorders (36,4%). In the high psychopathy group 'Current and Lifetime Alcohol and Substance Use Disorder" and 'Generalized Anxiety Disorder" were detected significantly more than those of the low psychopathy group. This study supplies important epidemiological data about ASPD comorbidity. Of note, none of the subjects were in the prison during the study. Psychopathy also seems like a predictor in comorbid situations.
Background: The study investigated whether perceived social support varied among children who have lost their parents to AIDS, those who have lost their parents to other causes, those who are living with HIV/AIDS-infected caregivers and children from intact families (comparison group).Method: This study employed cross-sectional, quantitative survey that involved 291 children aged 10-18 years in the Lower Manya Krobo District of Ghana and examined their social support disparities.Results: Multivariate linear regressions indicate that children living with HIV/AIDS-infected caregivers reported significantly lower levels of social support compared with AIDS-orphaned children, other-orphaned children and non-orphaned children independent of socio-demographic covariates. Children who have lost their parents to other causes and other-orphaned children reported similar levels of social support. In terms of sources of support, all children orphans and vulnerable children were more likely to draw support from friends and significant others rather than from the family.Conclusion: The findings indicate a need to develop interventions that can increase levels of social support for orphaned and vulnerable children within the context of HIV/AIDS in Ghana, particularly networks that include the family.
Background: Treatment fidelity tools are frequently used in clinical trials, promoting treatment consistency and therefore validity of trial findings. However, treatment fidelity procedures have not been included within international clinical trial guidelines such as the Consolidated Standards of Reporting Trials (CONSORT 2010). Aim: This study systematically reviews psychological clinical trials that incorporate Treatment Fidelity procedures and appraises their implementation using the Implementation of Treatment Integrity Procedures Scale (ITIPS). Method: Using the PRISMA Checklist as a guide for systematic review, a comprehensive search of the Medline, PsychINFO, Ovid, Cochrane Library, Scopus, PUBMED databases for the period 2004 to 2014 resulted in retrieval of 3186 potential articles. Thirty-two studies meeting inclusion criteria were analysed against the ITIPS. Results: Sixteen studies were assessed as ‘approaching adequacy’ in implementing Treatment Fidelity procedures as measured by the ITIPS scale, 8 studies were assessed as ‘adequate’ whilst a further 8 studies were deemed ‘inadequate’ against this assessment. Treatment Fidelity tools generally increased the intensity of the intervention or program within which they were used, resulting in improved levels of Treatment Fidelity. Conclusion: Current evidence supporting the inclusion of Treatment Fidelity tools is limited since there have been relatively few published studies examining the effectiveness of Treatment Fidelity tools. Further research into the efficacy, feasibility and measurement of Treatment Fidelity in implementing treatments is recommended, in tandem with additions to the CONSORT Guidelines to better support the inclusion of Treatment Fidelity procedures within clinical trials.
The human senses have long been unnoticed, despite their responsiveness being of great importance. The five human senses are of great importance for an individual’s experience of different purchase, frequency of purchase and consumption process. It is through the human senses that a customer can differentiate one brand from similar brands. Marketers have to market their brand or the dedicated point of sale (POS) along with the sensory attributes like touch, taste, smell, sight and sound that will generate the activation of emotions that make customers desire a given product. This is called “Sensory Branding”. Multi-sensory brand experience when more than one of the five senses contributes to the perception of sensory experience and how an individual reacts when a firm interacts. Multisensory convergence zones in the human brain indicate that one sense can be affected by relations with other senses.
Objective: To examine the relationship of a set of independent variables (age, qualification, experience, position, income and marital status) with occupational stress (Organizational Role Stress (ORS) & Burnout) among Animal Husbandry Personnel. Setting: Eight districts of Gujarat state, India Design: Descriptive cross-sectional Subjects: Two hundred and thirty six (236) Veterinarians and One hundred and forty six (146) Para Veterinarians of Animal Husbandry Department Outcome measures: The findings relate to the status of Burnout and ORS factors in case of Veterinarians and Para Veterinarians of Animal Husbandry Department. The statistical treatment established the various possibilities of ‘cause-effect’ relationship by applying Multiple Regression Analysis and Path analysis. Methods: The Pareek’s Occupational Stress scale and Maslach Burnout scale (MBI-GS) were used for data collection, while central tendencies, frequency, t-test, Co-efficient of Correlation (‘r’), Multiple regression analysis, Standard Partial Regression Co-efficient, Stepwise multiple regression analysis and Path co-efficient analysis were used for statistical analysis. Results: The data revealed that maximum respondents had education of graduation level with above 21 years service experience (62.0%) with monthly income in the range of Rs.20,001 to Rs.50,000 (69.6%). Majority of them were from age group of 36 to 50 years (59.5%). Maximum number of veterinarians and paraveterinarians had high IRD, RS, REC, RO, PI and RA. On the other hand, maximum respondents in case of RE were under low category. Considering Role Isolation, nearly 40% of veterinarians (39.83%) and paraveterinarians (38.36%) were under high category. Almost equal distribution of 33% each in low, medium and high categories of SRD was observed, in case of veterinarians. Length of service and age had negatively significant relationship with RS and PI, Age had negatively significant relationship with RIN. Similarly, length of service had negatively significant relationship with REC. Educational qualification had positively significant relationship with RE and monthly income had negatively significant relationship with PI. The data revealed that majority of veterinarians and paraveterinarians were having low level of Exhaustion and Cynicism. The Personal Efficacy was found to be high in both the categories of the employees. All the six demographic variables failed to establish significant relationship with three sub-scales of burnout viz., Exhaustion, Cynicism and Personal Efficacy. Conclusion: The results lead us to conclude that there is a need for more proactive HR policies to maintain and alleviate the role stress and burnout. It can be recommended that the organization needs to mandate a ‘stress audit’ for various categories of personnel. Counseling may also be provided on a case to case basis so that individuals may be helped with their cognitive restructuring.
