Levels Of Psychiatric Symptoms Research Articles

Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey.

BackgroundInfertility is a major life crisis which can lead to the development of psychiatric symptoms and negative effects on the quality of life of affected couples, but the magnitude of the effects may vary depending on cultural expectations. AimWe compare the level of psychiatric symptoms, disability, and quality of life in fertile and infertile women in urban Turkey. MethodsThis cross-sectional study enrolled 100 married women being treated for infertility at the outpatient department of the Obstetrics and Gynecology Department of the Rize Education and Research Hospital and a control group of 100 fertile married women. All study participants were evaluated with a socio-demographic data screening form, the Hospital Anxiety and Depression Scale (HADS), the Brief Disability Questionnaire (BDQ), and the Short Form Health Survey (SF-36). ResultsThe mean anxiety subscale score and depression subscale score of HADS were slightly higher in the infertile group than in controls, but the differences were not statistically significant. The proportion of subjects with clinically significant anxiety (i.e., anxiety subscale score of HADS ≥11) was significantly higher in infertile women than in fertile women (31% v. 17%, χ2=5.37, p=0.020), but the proportion with clinically significant depressive symptoms (i.e., depression subscale score of HADS >8) was not significantly different (43% v. 33%, χ2=2.12, p=0.145). Self-reported disability over the prior month was significantly worse in the infertile group than in the controls, and 4 of the 8 subscales of the SF-36 - general health, vitality, social functioning, and mental health - were significantly worse in the infertile group. Compared to infertile women who were currently working, infertile women who were not currently working reported less severe depression and anxiety and better general health, vitality, and mental health. ConclusionsMarried women from urban Turkey seeking treatment for infertility do not have significantly more severe depressive symptoms than fertile married controls, but they do report greater physical and psychological disability and a poorer quality of life. The negative effects of infertility were more severe in infertile women who were employed than in those who were not employed. Larger follow-up studies are needed to assess the reasons for the differences between these results and those reported in western countries which usually report a higher prevalence of depression and anxiety in infertile patients.

Developing an Inpatient Group Psychotherapy Program: Challenges and Lessons Learnt.

In Iran, inpatient group psychotherapy has been limited to transient practices for research purposes or fulfilling personal interest of therapists. The goal of this paper is to share and explain the experience of developing an inpatient group psychotherapy program in Roozbeh Psychiatric Hospital, Tehran, Iran. After theoretical delineation and preparation of a draft of the program guideline, two pilot sessions were held. Based on this initial experience a final treatment guideline was prepared. Afterwards, the program was continued for more than 1 year in a female ward at Roozbeh Psychiatric Hospital. The output of this exercise was a guideline that covers important topics in development of inpatient group psychotherapy. It is concluded that inpatient group psychotherapy has its unique challenges. Of the most important challenges that can be mentioned in this regard are the participation of patients with significant differences in levels of psychopathology and psychiatric signs and symptoms, and high comorbidity with specific personality traits or disorders. Other challenges relevant to the structure of the group include items such as very limited time for working through and inevitable out-of-group contacts.

Relationship of Urologic Complications With Health-Related Quality of Life and Perceived Value of Health in Men and Women With Type 1 Diabetes: The Diabetes Control and Complications Trial/Epidemiology of Interventions and Complications (DCCT/EDIC) Cohort

OBJECTIVELimited information exists about the influence of urologic complications on health-related quality of life (HRQOL) in patients with type 1 diabetes.RESEARCH DESIGN AND METHODSWe studied 664 men and 580 women from the Diabetes Control and Complications Trial/Epidemiology of Interventions and Complications Study: mean ages were 51.6 ± 6.6 and 50.6 ± 7.2 years and duration of diabetes was 29.5 ± 4.8 and 29.8 ± 5.1 years, respectively. We assessed associations of sexual dysfunction, lower urinary tract symptoms (LUTS), and, in women, urinary incontinence (UI) with general quality of life (SF-36), perceived value of health (EuroQol-5), diabetes-related quality of life (Diabetes Quality of Life Scale [DQOL]), and psychiatric symptoms (Symptom Checklist 90-R).RESULTSIn both men and women, urologic complications adversely affected HRQOL and psychiatric symptoms, even after accounting for history of depression leading to treatment. Multivariable analyses accounting for the presence of diabetic retinopathy, neuropathy, and nephropathy also revealed substantial independent effects. In men, for example, the odds (95% CI) of a low DQOL score (≤25th percentile) were 3.01 (1.90–4.75) times greater with erectile dysfunction and 2.65 (1.68–4.18) times greater with LUTS and in women, 2.04 (1.25–3.35) times greater with sexual dysfunction and 2.71 (1.72–4.27) times greater with UI/LUTS combined compared with men and women without such complications. Similar effects were observed for the other measures.CONCLUSIONSSexual dysfunction and urinary complications with type 1 diabetes are associated with decreased quality of life and perceived value of health and with higher levels of psychiatric symptoms, even after accounting for other diabetes complications and depression treatment.

Autoeficácia para Prática de Atividade Física em Pacientes com Síndrome Metabólica

Introduction: Metabolic syndrome (SM) is characterized by a set of risk factors for cardiovascular disease, and the practice of physical activity (PA) is one of the recommended interventions. The practice of PA is under direct influence of the self-efficacy beliefs (SE). Therefore, the present study aims to investigate the SE in patients with SM and the implicated factors. Method: This cross-sectional study enrolled 62 men and women (30 to 59 years), who were diagnosed with MS. The participants were evaluated in terms of levels of psychiatric symptoms and stress, SE for PA, healthy habits and MS associated factors. Comparison (Student t-test, Mann Whitney or Chi-square) analyses were performed. Results: Results showed that most of the participants present a moderate PA SE, which seems to be related to the levels of stress and symptoms of depression. The number of participants practicing PA in the group Higher SE was bigger than those of the group Lower SE. Conclusions: The present results highlight the important of evaluating SE in participants before any intervention aiming at changing healthy habits and the important of developing interventions targeting psychological aspects.

Initial Validation of a Brief Pictorial Measure of Caregiver Aggression

In the present study, we report on the development and initial psychometric properties of the Family Aggression Screening Tool (FAST). The FAST is a brief, self-report tool that makes use of pictorial representations to assess experiences of caregiver aggression, including direct victimization and exposure to intimate partner violence. It is freely available on request and takes under 5 minutes to complete. Psychometric properties of the FAST were investigated in a sample of 168 high-risk youth aged 16 to 24 years. For validation purposes, maltreatment history was assessed using the Childhood Trauma Questionnaire; levels of current psychiatric symptoms were also assessed. Internal consistency of the FAST was good. Convergent validity was supported by strong and discriminative associations with corresponding Childhood Trauma Questionnaire subscales. The FAST also correlated significantly with multi-informant reports of psychiatric symptomatology. Initial findings provide support for the reliability and validity of the FAST as a brief, pictorial screening tool of caregiver aggression.

Mindfulness and Metta-based Trauma Therapy (MMTT): Initial Development and Proof-of-Concept of an Internet Resource.

Trauma and stressor-related disorders, including post-traumatic stress disorder (PTSD) and related comorbid disorders such as anxiety, depression, and dissociative disorders, are difficult to treat. Mindfulness-based clinical interventions have proven efficacy for mental health treatment in face-to-face individual and group modalities, although the feasibility and efficacy of delivering these interventions via the internet has not been evaluated. The present research developed mindfulness and metta-based trauma therapy (MMTT) as an internet resource to support the practice of mindfulness and metta (lovingkindness) meditations for self-regulation and healing from trauma and stressor-related disorders. In the present “proof-of-concept” study, research participants (n = 177) recruited online practiced mindfulness and metta meditations and related therapeutic exercises available via the website and rated their perceived credibility as interventions for improving self-regulation and well-being and reducing PTSD symptoms, anxiety, depressive, and dissociative experiences, as well as their experienced ease, helpfulness, and informational value. Results suggest that, independent of level of self-reported current and past psychiatric history and PTSD symptoms, participants considered the MMTT website as a credible and helpful therapeutic intervention for improving self-regulation and well-being and reducing PTSD, anxiety, depression, and dissociation. Overall, participants considered guided and non-guided meditation practices more helpful than a journaling exercise, and participants with increased PTSD symptoms preferred metta (lovingkindness) meditations less than other participants. We conclude that MMTT should be piloted in clinical trials as an adjunctive intervention to evidence-based treatments for persons with mood, anxiety, and trauma and stressor-related disorders, as well as more generally as an online resource to support self-regulation and well-being practices.

Overrepresentation of unaccompanied refugee minors in inpatient psychiatric care.

BackgroundUnaccompanied refugee minors (URMs) have high levels of psychiatric symptoms, and concerns for their access to mental health services have been raised. From the mid-2000s, an increasing number of asylum-seeking URMs, mainly adolescent boys from Afghanistan, have been referred to the Child & Adolescent Psychiatry emergency unit in Malmö, Sweden. The aim of the study was to compare inpatient psychiatric care between URMs and non-URMs.FindingsAll admissions in 2011 at the emergency unit were identified and divided into URMs (n = 56) and non-URMs (n = 205). On the basis of unique patients’ first treatment occasion, a group level analysis was performed on gender, age, treatment duration, additional treatment occasions/patient, involuntary care, involuntary care by gender, and ICD-10 principal diagnosis. To retrieve further sample characteristics, a questionnaire was administered to the physicians responsible for admitting patients in 2011.More URMs than non-URMs exhibited self-harm or suicidal behaviour in conjunction with referral. 86% of URMs were admitted with symptoms relating to stress in the asylum process. In the catchment area, 3.40% of the URM population received inpatient care and 0.67% inpatient involuntary care, compared to 0.26% and 0.02% respectively of the non-URM population, both comparisons p < 0.001. There were more boys in the URM group (95%) compared to the non-URM group (29%). A difference in use of involuntary care disappeared after adjusting for gender. No differences were found in diagnoses except for neurotic disorders (F40-48), which were more common in the URM group.ConclusionFrom an epidemiological perspective, URMs were overrepresented in inpatient psychiatric care.

Using community-based participatory research to identify health issues for Cambodian American youth.

Lack of data disaggregated by ethnic group and the widespread perception of Asian Americans as "model minorities" often masks the health needs of specific groups within the Asian American population. Limited research focuses on health and psychological well-being among Cambodian American youth despite risk of negative educational and behavioral outcomes as well as high levels of trauma and psychiatric symptoms among first-generation Cambodian refugee adults. This article describes the development of a health survey with Cambodian American youth using community-based participatory research (and illustrates how youth can actively engage in research to inform change in health-related programs and policies.

Empowerment in a Mental Health Institution

Objectives: To examine the association between empowerment and quality of life among adult forensic patients. Method: The Empowerment Scale and the Lancashire Quality of Life Profile were used to assess perception on personal empowerment and quality of life in 98 detained adult forensic patients in Prison Hospital of Tirana. Results: The proportion of adult forensic patients scoring above personal empowerment and the quality of life was significantly low in the detained group for the five factors of empowerment Hierarchical multiple regression models showed that self-efficiency-self-esteem, power-powerlessness, community activism, righteous anger, and optimism-control over the future were significantly low among detained adult forensic patients, indicating that detention contributed to increased symptom levels of psychiatric symptoms. Conclusions: For adult forensic patients, even brief detention is associated with a low perception on personal empowerment and a quality of life that interfere in rehabilitation plans. Governments should consider the many viable alternatives to incarceration of adult forensic patients, such as temporary placement in a supervised residential facility, to minimize the risks of psychological harm to this vulnerable population. DOI: 10.5901/ajis.2014.v3n6p229

Intelligence as a predictor of outcome in short- and long-term psychotherapy

Intelligence has been suggested as a suitability factor for short-term therapy whereas its possible effect on short-term versus long-term therapy still is unknown. The aim of this study was to compare the prediction of intelligence on the level of psychiatric symptoms and psychosocial functioning in psychotherapies of different lengths. A total of 251 outpatients from the Helsinki Psychotherapy Study, aged 20–46 years, and suffering from mood or anxiety disorders were allocated to two long-term and two short-term therapies. Intelligence was assessed at baseline with the Wechsler Adult Intelligence Scale (WAIS-R). Psychiatric symptoms and psychosocial functioning were assessed 5–10 times during a 5-year follow-up using two primary symptom measures (HDRS and HARS) and one primary measure of psychosocial functioning (GAF). Short-term therapy was more effective than long-term therapy during the first year of follow-up. During the second to fourth follow-up year no differences between short- and long-term therapies or the intelligence groups were found. At the fifth follow-up year, however, long-term psychotherapy showed a statistically significantly larger change in all three primary measures compared to short-term therapy among those with higher intelligence. No differences between therapy groups were noted in those with lower intelligence. People with higher intelligence may benefit more from long-term than from short-term psychotherapy. These findings should be confirmed.

Higher emotional and psychiatric sequelae amongst elderly early-stage cancer patients undergoing chemotherapy

symptoms. In order to provide adequate and appropriate psychosocial support for elderly cancer patients, there is a need to investigate the differential psychological impact that these patients face, in comparison to younger patients. Objectives: In the context of a local healthcare setting, the aim of this study was to (1) investigate if elderly patients had higher levels of psychiatric symptoms (depression, anxiety and distress) than younger patients; (2) examine the changes in the levels of psychiatric symptoms over a period of time; (3) investigate changes in the number of caseness of psychiatric morbidities for each patient population over the same period of time. Methods: 157 cancer patients from the National University Cancer Institute, Singapore, participated in this longitudinal study. 35% (n= 54) of the patients were aged 61 years and above (elderly). Selfreport questionnaires measuring distress (Distress Thermometer), and depression and anxiety (Hospital Anxiety and Depression Scale) were administered at 3 time points (baseline, 2 months and 5 months). An independent sample t-test was used to compare the levels of distress, depression and anxiety for both groups at baseline. ANOVAwas used to compare the measures both across time, as well as the elderly patients with the younger ones. Chi-square tests were used to analyse the prevalence of caseness in the two groups of patients. Results: Results indicated that for all symptoms at baseline, elderly patients did not report experiencing significantly higher levels compared to younger patients. For all patients, comparing baseline to 2 months, and baseline to 5 months, there was a significant decrease in the all symptoms, except for distress at 5 months which showed a marginally significant decrease. However, comparing between elderly and young patients over time, there was no significant difference in the levels of all symptoms. In addition, although marginally significant, the prevalence of caseness in the elderly patients was higher compared to the young patients, for depression at baseline (χ[1,118] = 3.577, p= .059) and for distress at 2 months (χ[1,73] = 3.273, p= .070). Apart from these two exceptions, there was no significant difference between elderly and young patients in the prevalence of caseness for all the symptoms at all three time points. Conclusion: This study has shown that elderly patients generally do not experience more symptoms of depression, anxiety or distress compared to younger patients. Instead, all patients exhibit a trajectory of decreasing symptoms over time. Attention should be paid however, to elderly caseness patients. Future research could investigate the profile of elderly caseness patients and the changes in symptom level over time, to allow for healthcare professionals to provide the appropriate psychosocial support for them. Disclosure of interest: None declared.

Cross-Sex Hormonal Treatment and Body Uneasiness in Individuals with Gender Dysphoria

Cross-sex hormonal treatment (CHT) used for gender dysphoria (GD) could by itself affect well-being without the use of genital surgery; however, to date, there is a paucity of studies investigating the effects of CHT alone. This study aimed to assess differences in body uneasiness and psychiatric symptoms between GD clients taking CHT and those not taking hormones (no CHT). A second aim was to assess whether length of CHT treatment and daily dose provided an explanation for levels of body uneasiness and psychiatric symptoms. A consecutive series of 125 subjects meeting the criteria for GD who not had genital reassignment surgery were considered. Subjects were asked to complete the Body Uneasiness Test (BUT) to explore different areas of body-related psychopathology and the Symptom Checklist-90 Revised (SCL-90-R) to measure psychological state. In addition, data on daily hormone dose and length of hormonal treatment (androgens, estrogens, and/or antiandrogens) were collected through an analysis of medical records. Among the male-to-female (MtF) individuals, those using CHT reported less body uneasiness compared with individuals in the no-CHT group. No significant differences were observed between CHT and no-CHT groups in the female-to-male (FtM) sample. Also, no significant differences in SCL score were observed with regard to gender (MtF vs. FtM), hormone treatment (CHT vs. no-CHT), or the interaction of these two variables. Moreover, a two-step hierarchical regression showed that cumulative dose of estradiol (daily dose of estradiol times days of treatment) and cumulative dose of androgen blockers (daily dose of androgen blockers times days of treatment) predicted BUT score even after controlling for age, gender role, cosmetic surgery, and BMI. The differences observed between MtF and FtM individuals suggest that body-related uneasiness associated with GD may be effectively diminished with the administration of CHT even without the use of genital surgery for MtF clients. A discussion is provided on the importance of controlling both length and daily dose of treatment for the most effective impact on body uneasiness.

Impact of dissociation and interpersonal functioning on inpatient treatment for early sexually abused adults

BackgroundLittle is known about the possible predictors of treatment outcome in early chronically sexually abused adults. The current study aimed to investigate what impact initial levels of dissociation and pre-treatment negative change in interpersonal functioning have on treatment response after 3 months of first-phase trauma inpatient treatment as well as after a period of 1 year the patients returned to their usual lives.MethodsThe sample comprised 48 inpatients with childhood sexual abuse histories and mixed trauma-related disorders who were examined at discharge and prospectively followed up for a period of 1 year under naturalistic conditions. Outcome variables were general psychiatric symptoms and interpersonal problems as measured with the Symptom Check List-Revised (SCL-R) and the Inventory of Interpersonal Problems (IIP) Circumplex.ResultsThe central findings were that pathological dissociation and deterioration in interpersonal functioning prior to admittance predicted general psychiatric symptom levels and interpersonal problems at the end of treatment and at 1-year follow-up. Pathological dissociation, involving memory and identity problems, alone predicted negative outcome at the end of treatment. The findings at 1-year follow-up indicate that it is not pathological dissociation in isolation that affects outcomes, but rather the interaction between dissociation and change in interpersonal functioning prior to treatment.ConclusionThese findings indicate the need of addressing dissociation and interpersonal problems in treatment planning and favor an integrated treatment approach for complex trauma patients. Future research should investigate whether and how this leads to better outcome, including long-term maintenance of gains after the end of treatment.

Changes in mental state associated with prison environments: a systematic review

To develop an understanding of the stability of mental health during imprisonment through review of existing research evidence relating physical prison environment to mental state changes in prisoners. A systematic literature search was conducted looking at changes in mental state and how this related to various aspects of imprisonment and the prison environment. Fifteen longitudinal studies were found, and from these, three broad themes were delineated: being imprisoned and aspects of the prison regime; stage of imprisonment and duration of sentence; and social density. Reception into prison results in higher levels of psychiatric symptoms that seem to improve over time; otherwise, duration of imprisonment appears to have no significant impact on mental health. Regardless of social density, larger prisons are associated with poorer mental state, as are extremes of social density. There are large gaps in the literature relating prison environments to changes in mental state; in particular, high-quality longitudinal studies are needed. Existing research suggests that although entry to prison may be associated with deterioration in mental state, it tends to improve with time. Furthermore, overcrowding, ever more likely as prison populations rise, is likely to place a particular burden on mental health services.

The impact of perinatal death on obstetrics nurses: a longitudinal and cross-sectional examination

Mental health and well-being among obstetrics nurses after perinatal death are understudied. Beyond the normal strain imposed on obstetric nurses, exposure to perinatal death may add significant stress. Two studies were conducted on obstetrics nurses. In study 1, obstetrics nurses were measured longitudinally, at baseline (with no recent history of exposure to perinatal death in the past 3 months), and 3 months after (2 months after two consecutive events of perinatal death have occurred 1 month after baseline). In study 2, a cross-sectional study was conducted comparing obstetrics nurses with a history of perinatal death (nurses from study 1) to obstetrics nurses with no history of exposure to perinatal death in the past 6 months. The results of study 1 showed that obstetrics nurses showed a higher level of psychiatric symptoms [posttraumatic stress disorder (PTSD), depressive, and psychosomatic symptoms] at time 2 (after exposure to perinatal death) in comparison to time 1. The results of study 2 showed a higher level of psychiatric symptoms (PTSD, depressive, and psychosomatic symptoms) in the exposed group in comparison to the non-exposed group. The effect of exposure to perinatal death is severe and needs to be addressed by developing intervention and preparation programs to help obstetric nurses cope with this critical incident.

KADINLARDA RUH SAĞLIĞINI VE AİLE İŞLEVLERİNİ ETKİLEYEN ETMENLER

Factors Affecting Mental Health and Family Functions of Women Objective: The aim of this study is to evaluate the factors affecting mental health and family functioning of women. Method: The population in the study consisted of all women in 432 families followed by 108 students at 3 rd and 4 th grades at Department whithin the Public Health Nursing course application in Province of three Health Centers in Mersin City between March to May 2009. The study sample consisted of women, who reside in these health center areas, 18-49 age groups, physical and cognitive health levels appropriate to answer applied forms, volunteered to participate in, do not have communication problems, chronic disease and psychiatric disease, not entered menopause, not married and have not children. The data were collected with questionnaire that include socio-demographic characteristics, “Brief Symptom Inventory” and “Family Assessment Scale”. In the evaluation of data analysis, percentage, Mann Whitney-U, Kruskal Wallis were used. Results: The Brief Symptom Inventory subscales of women the highest interpersonal sensitivity score was 1.01±0.86. The highest mean score of Women's Family Assessment Scale was found affective involvement 2.42±0.45 and Roles 2.31±4.96 respectively. It has been determined that the factors such as education level, marriage status, family type, spouse's education level, the number of people who live at home, presence of individuals with psychological problems in the family and migration to Mersin have affected women's level of psychiatric symptoms and had a negative effect on family functioning.

Psychodynamic interventions in cancer care I: psychometric results of a randomized controlled trial

This study aimed to assess the effectiveness of psychodynamic interventions in cancer care. Between 2006 and 2009, each consecutive outpatient of the Oncology Center of the University Hospital of Lausanne was invited to participate in a trial evaluating the effects of psychological support. Accepting patients were randomly assigned to an immediate intervention or a delayed intervention [4-month waiting list]. Patients who declined support were asked to participate in an observational group [OG]. Socio-demographic and medical data, anxiety, and depression [HADS], psychological distress [SCL-90], alexithymia [TAS] and quality of life [EORTC] were recorded at baseline, and at 1, 4, 8, and 12-months follow-up. Of the 1973 approached patients, 1057 were excluded, 530 refused, and 386 were included with 196 of them participating in the OG. Of the patients in the intervention group [IG] [N = 190], 94 were randomized to the immediate intervention and 96 to the delayed intervention group (dIG). IG patients were younger, predominantly female, and had more psychological symptoms compared with those in the OG. Although patients of the IG and OG showed significant improvement in quality of life from baseline to 12-months follow-up, other outcomes [anxiety, depression, psychological distress, and alexithymia] remained unchanged. The intervention was not effective with regards to psychometric outcome. The results have to be interpreted in light of the study design [untargeted intervention], the low levels of psychiatric symptoms, dropout of symptomatic patients, and the high prevalence of alexithymia.

Schizophrenia and the Sense of Self

Sense of self (SOS)--understood as the foundation upon which individuals experience their daily lives--has been increasingly investigated in schizophrenia. A disrupted SOS is thought to represent a platform for the experience of psychiatric symptoms, social cognitive deficits, and other abnormalities of consciousness. Few studies, however, have investigated the specificity of disrupted SOS to schizophrenia. The primary objective of the present study was to test the hypothesis that SOS is deficient in schizophrenia patients compared to both nonpsychiatric controls and patients with psychotic bipolar disorder. Using select scales from the Assessment of Self Descriptions, the present study assessed SOS from spontaneous narratives provided by schizophrenia patients (N = 50), bipolar patients with psychotic features (N = 17), and nonpsychiatric controls (N = 24). Our findings indicate that facets of SOS-in particular, certain aspects of agency and relatedness to others-are deficient in schizophrenia compared to nonpsychiatric controls and bipolar patients with psychotic features, even when overall level of functioning and psychiatric symptoms are accounted for. Implications of these results are discussed.

Psychiatric Symptoms Associated with Brief Detention of Adult Asylum Seekers in Canada

To examine the association between brief detention and psychiatric symptom levels among adult asylum seekers. The Harvard Trauma Questionnaire and the Hopkins Symptoms Checklist-25 were used to assess psychiatric symptoms and premigration trauma exposure in 122 detained and 66 nondetained adult asylum seekers in Montreal and Toronto. After a mean detention of 31 days, the proportion of asylum seekers scoring above clinical cutpoints was significantly higher in the detained than the nondetained group for posttraumatic stress (χ² = 4.117, df = 1, P = 0.04), depression (χ² = 13.813, df = 1, P < 0.001), and anxiety (χ² = 4.567, df = 1, P = 0.03) symptoms. Hierarchical multiple regression models showed that posttraumatic stress, depression, and anxiety symptom levels were significantly higher among detained asylum seekers than among the nondetained comparison group, taking into account previous trauma and demographics. Incremental F was significant for the addition of detention status for all 3 models, indicating that detention contributed to increased symptom levels. For asylum seekers, even brief detention is associated with increased psychiatric symptoms. Governments should consider the many viable alternatives to incarceration of asylum seekers, such as temporary placement in a supervised residential facility, to minimize the risks of psychological harm to this vulnerable population.

Considering Variables for the Assignment of Patients with Schizophrenia to a Case Management Programme

The elements and intensity of case management (CM) practices should be established according to patients' needs. Therefore, greater understanding of patients' needs in such community-based programmes is essential. This paper addresses this issue by characterizing two groups of patients receiving CM or a standard treatment programme (STP) and identifying the characteristics of patients receiving CM services. We recruited 241 patients with schizophrenia from 10 Adult Mental Health Centres in Barcelona (Catalonia, Spain). We analyzed the profile of new patients included in a clinical, non-intensive CM program against that of patients in a STP. CM patients, compared with STP patients, have a lower educational level and quality of life; greater use of health care services, and higher levels of psychiatric symptoms, disability and unmet needs. Community psychiatric visits, social services, education, physical health and needs were significantly associated with CM services. This study may help in identifying patients' needs and strengthening the CM programme.