Introduction Involuntary admission is a controversial issue with legislation varying from country to country. Objectives Research on elderly individuals being involuntary admitted is limited. Aim Firstly at assessing whether involuntary admitted (IA) elderly individuals differ from voluntary admitted (VA) patients and secondly to assess whether IA should be treated in a different way. Methods 40 IA were compared to 39 VA with regard to demographic data, DSM-IV diagnosis as well as behavioral issues recorded with the Patient Staff Conflict Checklist Shift Report (PSCCSR). All patients were aged 60 and over and were admitted in the psychiatric departments of four general hospitals in Athens. The study period was 12 months. Results VA patients were more likely to be married, working and suffering from mood disorders, whilst IA patients presented with delirium. From the 20 items of the PSCCSR, differences were found only in two: IA presented more aggressive in the first few days of admission and VA had recent suicide attempt just before admission. Conclusions The patients’ characteristics as well as the psychiatric and nursing needs of VA and IA elderly individuals in an acute psychiatric ward do not differ. They tentatively support the argument that since IA and VA elderly psychiatric inpatients exhibit similar behaviour being kept under section for long periods is unwarranted.

Background/Aims: The brain-derived neurotrophic factor (BDNF) levels in serum and the central nervous system are altered in patients with schizophrenia, suggesting that changes in the expression of BDNF might contribute to the disease pathophysiology. Long duration of untreated psychosis (DUP) has been associated with poorer prognosis in patients with schizophrenia. Such a relationship of untreated psychosis to outcome may indicate a neurodegenerative process and may have important implications for understanding the pathophysiology of schizophrenia. Methods: In this study, we investigated the association between serum BDNF levels and DUP in a sample of drug-naïve patients in their first episode of schizophrenia (FEP). We investigated serum BDNF levels in a sample of 37 drug-naïve FEP patients and 21 matched healthy subjects. Results: The serum BDNF level in the sample of FEP was significantly reduced compared to the healthy subjects (18.87 ± 8.23 vs. 29.2 ± 7.73 ng/ml, t = 4.76, d.f. = 57, p = 0.01). A negative correlation was found between serum BDNF levels and DUP in the group of patients (r = –0.346, p = 0.036). Conclusions: Our findings indicate that low serum BDNF levels at the onset of schizophrenia were associated with a long DUP and this could reflect an acute neurodegenerative reaction during the untreated phase of psychosis.

The role of brain-derived neurotrophic factor (BDNF) is to promote and modulate the neuronal responses across neurotransmitter systems in the brain. Therefore, abnormal BDNF signaling may be associated with the pathophysiology of schizophrenia. Decreased BDNF levels in the brain and the serum of patients with psychotic disorders have been reported. In the present study, we assessed serum BDNF levels in a group of 14 drug-naive first-episode patients with schizophrenia (FEP), compared to 15 healthy controls. The serum BDNF levels in the sample of FEP patients was significantly reduced compared to normal controls (23.92+/-5.99 ng/ml vs. 30.0+/-8.43 ng/ml, F=5.01, df=1, p=.034). Negative correlations were shown between serum BDNF levels of the patients and the PANSS Positive and Negative subscale scores. Our findings indicate that BDNF levels at the onset of schizophrenia may reflect associated pathophysiological processes as well as the severity of positive and negative psychotic symptoms.

Background: Certain epidemiologic studies suggest that moderate alcohol consumption decreases the risk of coronary heart disease. However, long-term excessive alcohol drinking is considered a major cause for a significant incidence of heart disease. Identifying alcohol-related problems among inpatients with cardiac disease is important. Methods: In this study, 209 male and 137 female inpatients with cardiac disease were screened for alcohol-related problems using the CAGE questionnaire. Associations of alcohol-related problems with sociodemographic and clinical variables were also investigated. Results: Fifty-seven patients (16.5%) scoring positively on the CAGE questionnaire were considered as having alcohol-related problems. Logistic regression analysis revealed that alcohol-related problems were associated with sex (p = 0.00), age (p = 0.0497), and educational level (p = 0.0524). Men less than age 50, with cardiac disease and of lower education level should be considered at high risk for abnormal drinking. The probability increases from 5.2% for the whole sample to 41.9% for the group with these specific characteristics. Conclusions: The characteristics are useful for constructing a profile of the cardiology patient who is more likely to have alcohol-related problems. Early identification and vigorous and holistic treatment of these patients is important for secondary prevention of alcohol-related problems.