There is little known about the extent to which men and women with mental disorders are at increased risk of being a victim of domestic violence. We therefore aimed to estimate the prevalence and risk of domestic violence victimisation among men and women with depressive and anxiety disorders, post-traumatic stress disorder, eating disorders, psychotic disorders, and among psychiatric service users.

We searched 18 biomedical and social sciences databases (including MEDLINE, EMBASE and PsycINFO) and supplemented the search by hand searching of key journals and reference lists of included articles, citation tracking, expert recommendations, and updating a systematic review on victimisation among people with mental disorders. We included cross sectional, cohort and experimental studies that reported on the prevalence and/or risk of adulthood domestic violence victimisation among people meeting either ICD or DSM diagnostic criteria for a mental disorder. Two reviewers independently extracted data and appraised study quality. Random effects meta-analysis was used to pool data where possible.

High quality papers reported a median prevalence of adult lifetime domestic violence in mental health service users of 30% (IQR 26% - 39%) in female inpatients and 33% (IQR 31%-53%) in female outpatients. There was an increased risk of experiencing domestic violence in all diagnostic groups and in men and women but there were few high quality studies for men.

Mental disorder is associated with a high prevalence and increased risk of being a victim of domestic violence in both men and women.

Sixty patients with pharmacoresistant anxiety disorder recommended for in-patient complex therapeutic program (combination of cognitive-behavioral therapy and pharmacotherapy) were evaluated during structured interview focusing on self-stigmatization with clinical psychologist. There were divided into 3 groups according level of self-stigmatization. the patients were treated in intensive 6 weeks cognitive behavioral therapy program combined with treatment of antidepressants.

Preliminary results show, that patients with high level of self-stigmatization improved less in complex therapeutic program than patients with low level of self-stigmatization.

IGA MZ CR NT 11047-4/2010

66 patients completed trial. Three patients refused the protocol. All patients finished minimum of 6 weeks of CBT and showed statistically significant improvement on S-Y-BOCS, CGI-S and BDI scales. the main predictors of achieving the response or remission were scores in S-Y-BOCS lower than 24, good insight, high resistance against symptoms, low level of dissociation, and aggressive character of obsessions. the negative predictors of achieving the response or remission were control/symmetry obsession and compulsions, and obsessive slowness/ambivalence.

IGA MZ CR NT 11047-4/2010

The aim of the study was to assess retrospectively the efficacy of the in-patients therapeutic program for in patients suffering with depressive disorder and comorbid personality disorder (40 patients) and depressive disorder without comorbid personality disorder (40 patients). the electronic and paper documentation of age matched patients with depressive disorder and personality disorder and patients with depressive disorder without personality disorder hospitalized between years 2008- 2010 in Department of psychiatry of University Hospital Olomouc were randomly choose and studied and assessed by blind assessor according prepared criteria measured the efficacy of the treatment. the other factors for the analysis are the age, gender, dose of medication, comorbidity, length of the treatment, CGI and number of hospitalizations during 2 years follow up.

Preliminary results show, that patients of both two groups significantly improved during the treatment period. the outcome of patients with personality disorders was worse in the assessment of clinical state at the end of the index episode treatment, longer time of hospitalization, higher dosage of medication and higher number of hospitalization in follow up.

IGA MZ CR NT 11047-4/2010

IGA MZ CR NT 11047-4/2010

The aim of the study was to assess the efficacy of the in-patients therapeutic program for in patients suffering with pharmacoresistant panic disorder. the therapy was conducted in a group setting and systematic CBT steps were adapted to each individual patient in the group. Pharmacological treatment underwent no or minimal changes during the trial period. Outcome measures included the Clinical Global Impressions-Severity of Illness scale (CGI-S), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Dissociative Experience Scale (DES). the primary outcome measure for treatment response was a rating of 25% improvement in BAI. A remission was defined by CGI-S scores 1 or 2.

67 patients with pharmacoresistance panic disorder entering into the study. Five patients drop out. 62 patients were treated with inpatients therapeutic program consisting from intensive CBT and pharmacotherapy. All patients finished 6 weeks of CBT and showed statistically significant improvement on BAI, BDI and CGI-S scales. the main predictors of achieving the response or remission were scores less than 20 in BDI, droping more than 5 point during the first week of treatment in BAI, not been married and low level of dissociation.

IGA MZ CR NT 11047-4/2010

There are two edifices left to represent one of the most impressive cultural monuments of mental homes in Middle-Europe. the destruction of these historical buildings is intended to establish a modern “Translational Research Centre”.

To outline the significance of the asylum in the history of psychiatric architecture.

To appreciate the first Bavarian mental home.

Study of literature.

The British philosopher Jeremy Bentham is considered to be the founder of the panoptical (“invisible from all around”) concept in architecture. Several panoptical asylums have been built in Great Britain. in France, Italy and Germany a unique exemplar was realized. as the entire ward could be checked from a central room, the possibility of optimal surveillance of the patients was given and the minimisation of staff was enabled. in contrast to the emergent industrial cities (e.g. Nürnberg, Fürth, Schwabach) Erlangen disposed of enough building ground. There, J.M. Leupold (1794-1874) gave a lecture on the new establishing medical department of psychiatry. Thanks to his advice the project of the first Bavarian mental home could be completed within 12 years. the cruciform floor plan was supplemented by cross buildings, which constituted a relevant modification of the panoptical system. Concerning the extension of buildings (1874-1879) the internationally appreciated “system of pavillons” was realized and could be used by university since 1903.

As the TRC-project may serve as a document for future medical progress, it is important to remember the “Kreis-Irrenanstalt Erlangen” as a milestone in the evolution of psychiatric architecture.

41 years-old; biological male; divorced; father of five children; university degree.

Regret following male-to-female sex-reassignment surgery (SRS) and facial plastic surgery; requesting sexreconversion operation.

Compulsive, high-risk sexual behaviour, triggered by traumatic life-events during puberty (death of father and departure of mother at the age of 14). Symptoms evolved throughout adolescence and adulthood with persistent identity diffusion, intense abandonment fears, feelings of chronic emptiness and guilt, mood swings, unstable and intense interpersonal relationships, impulsivity and self-destructive behaviour. Gender history and transition: No evidence of gender nonconformity, gender dysphoria, gender-role discomfort or cross-gender identification. Uncertainty regarding male's role and identity diffusion, persisting since puberty. An impulsive decison for SRS and facial plastic surgery at the age of 40 (performed abroad), without a recommendation letter, motivated by the urge to resolve identity confusion and diminish compulsive sexual behaviour. He subsequently acknowledged his male identity, which led to relief of symptoms and request for sex-reconversion surgery.

Gender history and clinical presentation confirmed that the patient did not sufficiently meet criteria for Gender Identity Disorder, but rather for Borderline Personality Disorder. the authors are highly aware that this topic is significantly connected to issues of the human right to free choice; however we would wish to impose a medical obligation for a rigorous psychiatric assessment for origin of gender identity diffusion and discomfort. Psychotherapy and pharmacotherapy should be the first treatment choices before any radical surgery interventions are undertaken.

41 patients suffering from bipolar disorder and 198 healthy controls were included in the study. Only patients in remission of the disorder, evaluated as 1 or 2 points of clinical global impression - severity scale, were included into the study. Patients were psychiatrically assessed and the state of the disorder was evaluated by experienced psychiatrist. All participants were assessed with the Dissociative Experiences Scale (DES).

The groups didn’t differ in demographic variables like age, gender and education. Patients had significantly higher mean score on the DES and pathological DES than healthy controls.

Our results suggest that the level of psychological dissociation in bipolar affective patients is higher than in healthy controls.

Grant IGA MZ ČR NT11047

Panic disorder is frequent psychiatric disorder characterized by sudden and unexpected onset of a panic attack, characterized by terror or impending doom, and associated with many somatic symptoms. Panic is considered as a state of hyperarousal, the EEG has had a prominent place in anxiety studies. sLORETA (standardized low resolution brain electromagnetic tomography) is now widely used research method investigating the electrical activity of the brain with zero localization error and ability to reconstruct multiple resources.

EEG may be useful toll in looking for predictors to therapeutic response.

The study aimed at finding electrotomographic differences between patients with panic disorder who respond to combined therapy.

We measured patients with Panic disorder. Diagnosis was confirmed by M.I.N.I. (MINI-international neuropsychiatric interview). Patients were treated both by psychotropics and CBT (cognitive behavioral therapy) for six week. The symptoms intensity was assessed using BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory). They were also examined by EEG. It was measured in rest state with closed eyes, using standard 10-20 montage with 19 electrodes. Measurements were carried out at the beginning and after 6 weeks of therapy.

We found decreased absolute power in alfa-2 (10.5 - 12 Hz) activity in anterior cingulated, and increased absolute power in beta-3 (21.5 - 30 Hz) activity in superior frontal gyrus.

Our findings suggest that cognitive behavioural psychotherapy can cause changes in brain activity.

IGA MZ CR NT 11047-4/2010

These findings demonstrate a lower autonomic power in panic disorder patients and tendency to increase it during the treatment.

Supported by: Project IGA MZ ČR NS10301-3/2009

Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar patiens in remission. We recorded cardiac activity and assessed HRV in bipolar outpatients in remission.

Ascertain if ANS decrease with the age of the patient; ascertain relation between activity of ANS and level of dissociation, and other components (age of patients, and age of disorder, dosage of psychotropic medication).

Autonomic nervous system (ANS) has been evaluated during orthostatic change in three positions (1- lie down 5 minutes, 2 - stand up 5 minutes, 3 - lie down 5 minutes). The functioning of the ANS has been measured by the diagnostic systems that are using the power spectral analysis which quantifies the heart rate variability (HRV) was assessed using time domain, frequency domain, and nonlinear analyses in 23 bipolar patients in remission.

We found highly statistically significant negative correlations between level of dissociation measured by DES and most of parameters of ANS. We found negative correlations between the age of the patient and activity of ANS, and negative correlations between activity of ANS and duration and onset of disorder.

Autonomic dysregulation is associated with bipolar disorder in remission and has relation to level of dissociation and probably to age of patiens and age of onset and duration of disorder.

Supported by: Grant IGA MZ CR NT11474

We describe step by step the cognitive-behavioral group therapy of patients with panic disorder. We are explaning the concept of cognitive model of panic disorder, vicious circle, cognitive reconstruction, control of breathing and exposure. We also present personal experience with group cognitive-behavioral therapy and possible complications that may occur.

The results of our research in this group concerning the efficacy of the program, changes in the heart rate variability during program and EEG changes (using sLORETA) are presented. We also try to point on possible complications that may occur during the therapy and coping with them.

Supported by: Project IGA MZ ČR NS 10301-3/2009

Short psychodynamic psychotherapy or systematic CBT was tailored according the needs of each patient. Pharmacology treatment remained mainly unchanged during the trial period. Outcome measures were: CGI, Dissociative Experience Scale (DES), Somatoform Dissociation Questionnaire (SDQ-20), BDI, BAI. The primary outcome measures were clinical response defined as 30% decrease in BAI and remission defined as a 1 or 2 points in CGI.

190 patients were included into the study and 15 dropped out. Altogether 175 patients completed at least 5 of 6 weeks of intensive psychotherapy program. Patients of all diagnostic groups showed significant improvement in CGI, BAI, BDI. At the end of the treatment 51.1% of the patients achieved clinical response and 42.3% clinical remission. The main characteristics present at the beginning of the trial increasing probability of achieving response or remission during the treatment were BAI score lower than 25, BDI score lower than 20, no comorbidity with personality disorder, no comorbid depression, no being divorced or widowed.

Therapeutic efficacy of the intensive psychotherapeutics programs for anxiety disorders was predicted with level of anxiety and depression, comorbidity with depression and personality disorders and marital status.

Supported by: IGA MZ CR NT 11047

The dual diagnosis of substance abuse and severe mental illness has been proposed by some authors to highlight the high frequency of such association. Our objectif was to determine the prevalence of dual diagnosis among mentally ill patients and and particularly Anxiety disorders patients. As a secondary purpose, to describe the profile of patient at higher risk to develop dual diagnosis.

683 mentally ill patients were recruited from el Mamoura Psychiatric Hospital, they were assessed by the Arabic version of 6 item K6 scale, those scoring above 13 were submitted to a structured clininical interview SCID-I module for Anxiety disorders, urine screening for drugs of abuse and complete history of substance abuse and other medical disciplines.

22% of the sample fulfill the diagnosis of dual diagnosis. 19.3% of the sample were schizophrenic, 17.42% among the later were fulfilling diagnosis of dual diagnosis. Results reveals higher risk for dual diagnosis in patients younger in age, single, low socioeconomic state and low level of education. Those having dual diagnosis tend to have early onset, longer duration of illness, poor compliance, higher rate of smoking and increased number of relapses. No difference among anxiety spectrum disorders regarding rate of dual diagnosis.

Double diagnosis is an important issue that needs more focus in mental health services. Awareness of mental health providers about dual diagnosis is highly recommended.

There's an increasing professional and popular interest in relation of spirituality and general health. Although mental health professionals have traditionally avoided concerns, evidence has been accumulating that people with mental illness attach significance to spiritual beliefs. In contrast, around 60% of psychiatrists report minimal interest in spiritual matters. Some authors found spiritual well being as an active relation with a higher power to be positively correlated to good mental health.

Cross sectional comparative study design, 60 patients during detoxification and 20 patients in rehabilitation program with open group psychotherapy after detoxification, demographic data were collected and participants were subjected to spirituality subscale from substance misuse program philosophy questionnaire Arabic version.

Response to the 6 questions of the spirituality subscale used to assess level of spirituality didn’t show difference among the three groups, those during detoxification, those less than 3 months abstinence and those more than 3 months abstinence in rehabilitation program with open group psychotherapy.

Spirituality is persistently high through out detoxification and residential rehabilitation program. Spiritually inspired psychological intervention may be of help during the whole course of management of opiates addicts.

There's an increasing professional and popular interest in relation of spirituality and general health. Although mental health professionals have traditionally avoided concerns, evidence has been accumulating that people with mental illness attach significance to spiritual beliefs. In contrast, around 60% of psychiatrists report minimal interest in spiritual matters. Some authors found spiritual well being as an active relation with a higher power to be positively correlated to good mental health.

Cross sectional comparative study design, 60 patients during detoxification and 60 patients in rehabilitation programs after detoxification, 20 in 12 step rehabilitation program, 20 in residential rehabilitation program and finally 20 in rehabilitation program with open group psychotherapy. Demographic data were collected and participants were subjected to spirituality subscale from substance misuse program philosophy questionnaire Arabic version.

Response to the 6 questions of the spirituality subscale used to assess level of spirituality didn't show difference among the three groups, those during detoxification, those less than 3 months abstinence and those more than 3 months abstinence in rehabilitation program. Results show that spirituality is high during detoxification and throughout rehabilitation programs regardless model of rehabilitation program.

Spirituality is persistently high through out detoxification and residential rehabilitation program. Spiritually inspired psychological intervention may be of help during the whole course of management of opiates addicts.

We compared the efficacy of 6 week therapeutic program in pharmacoresistant patients suffering with panic disorder and comorbid personality disorder (19 patients) and panic disorder and/or agoraphobia without comorbid personality disorder (43 patients). Patients were treated with CBT and psychopharmacs. They were regularly assessed every week on the CGI, BAI, BDI. Before and after treatment were used also Sheehan anxiety scale, Dissociative experience scale, Quality of Life.

A combination of CBT and pharmacotherapy proved to be the effective treatment of patients suffering with panic disorder and/or agoraphobia with or without comorbid personality disorder. The treatment effect between groups did not differ in rating scales, but there are more remitted patients in group without personality disorder.

Supported by: Project IGA MZ ČR NS 10301-3/2009

The object of this research is to determine the relation among characteristic specialty and happiness feeling in Talasemi persons. (Major).

The design of this research, is descriptive and correlation one. The society of research includes: All talasemi persons of major kind in which are treating in Amir kola Talasemi center in 2011 in which about 150 persons has been selected by simple collision sampling by the aid of Morgan table. We have used of Pierson correlation and multi-linear regression analysis in analyzing dates. Also, for gathering dates, referred persons completed five neo factors of characteristic questionnaire and oxford happiness questionnaire.

Based on regression findings, neo characteristic and happiness of talasemi person indicators is about 0.45 in which shows linear correlation among neo-characteristic and happiness variables in Talasemi persons in which there is meaningful relation among characteristic specialty. (Psycho-anger, extroverts, flexibility, agreeability, responsibility).

Among characteristic specialties, extroverts, flexibility, agreeability, responsibility, there is positive meaningful relation to happiness in which it means the less psycho-anger is equal to more happiness.