Mental Difficulties Research Articles

A Longitudinal Study Into Indicators of Mental Health, Strengths and Difficulties Reported by Boarding Students as They Transition From Primary School to Secondary Boarding Schools in Perth, Western Australia

This study examined indicators of mental health, as well as strengths and difficulties, as reported by same-age boarding and non-boarding students spanning four time points over a 2-year period as they transitioned from primary to boarding school in Western Australia (i.e., at the end of Grade 7, beginning of Grade 8, end of Grade 8, and end of Grade 9). It presents data taken from a larger longitudinal quantitative study, which included 76 male and 74 female boarding students while they were in Grades 7 to 9. Findings indicate that boarding students and non-boarding students reported significant increases in depression, anxiety, as well as emotional symptoms and hyperactivity over time, and reported significant decreases in prosocial behaviour. However, examining the boarder × time interaction, boarding students reported significantly higher levels of anxiety and stress at the end of Grade 8 compared to non-boarding students. No significant difference over time was found in depressive symptomatology between boarding and non-boarding students, whereas at the beginning of Grade 8 and end of Grade 9, boarding students reported significantly higher emotional symptoms than non-boarding students. These findings are discussed in terms of the boarding school context and possible considerations for prevention and practice are presented.

Correlating Multi-dimensional Oculometrics with Cognitive Performance in Healthy Youth Athletes.

There is a need for a practical objective measure to detect mild changes in cognitive performance as early signs of concussion in youth or other special populations. In this paper, we propose a novel correlation model that establishes the relationship between oculometrics extracted from raw eye movements during a mental workload task and cognitive performance. We assessed differences in cognitive performance in terms of age for youth athletes based on oculometrics pertaining to fixations and saccades. In this cross-sectional study, oculometrics were measured on 440 healthy youth athletes aged 7 to 15years. Oculometrics pertaining to fixations (fixation time, fixation size, and surface area of fixation) and saccades (total saccadic amplitude, average saccadic amplitude, and saccadic velocity) were measured and compiled into a multivariate oculometric database by age. We discovered that the combined power of fixations and saccades provided the strongest correlation with cognitive performance-a finding that is evident across all ages as well as all levels of mental workload difficulty. Specifically, the combined observations of fixation time, saccadic velocities, and saccadic amplitudes provided us an understanding of cognitive performance during different levels of mental workload difficulty across all age groups. This study is the first step towards establishing normative, multi-dimensional oculometrics for fixations and saccades in young athletes (7 to 15years) who are at risk for concussion in sports and recreational activities.

Why run the risk? Motivation for offences by patients with substance use and antisocial personality disorders which they rated as most risky to their own well‐being

Understanding motives for offending is important for the development and delivery of effective interventions. To explore associations between variables with motivational implications and the offence committed in the past year rated by people with antisocial personality disorder and substance use disorder as putting them and their status at most risk. Participants were 127 outpatients from a sample recruited for a pragmatic randomised controlled trial of an intervention for adults attending substance abuse treatment clinics in 13 municipalities in Denmark. Motives for offending were assessed on one occasion, using the Offending Motivation Questionnaire, aggression was assessed using the Buss-Perry Aggression Questionnaire and substance-related problems, including mental state difficulties, were assessed using the Substance Use Risk Profile. Attributing offending to provocation, excitement or financial gain differed substantially by type of offence, whereas attribution of offending to compliance did not. Personality scale scores were associated with attributing offences to provocation, excitement or compliance but not with financial gain. Motives for offending among substance users with antisocial personality disorder must be understood both in light of the type of offence and personality traits. Offending behaviour prevention strategies that draw on these distinctions, run in parallel to treatment for substance use, could improve reduction in recidivism. Copyright © 2017 John Wiley & Sons, Ltd.

Effects of prenatal alcohol exposure in a prospective sample of young adults: Mental health, substance use, and difficulties with the legal system

IntroductionFew studies have focused on the transition to adulthood in adults with prenatal alcohol exposure (PAE). In this study, we examine the occurrence of problem behavior at this transition, including mental health problems, substance use, and difficulties with the legal system. The sample is prospective and provides an opportunity to examine effects of a wide range of prenatal exposure. Adults with PAE were expected to show more problem behavior; the impact of level of exposure was examined as well. MethodThe sample was drawn from a predominantly low-income, African-American population. Mothers of the alcohol-exposed participants (n=123) and those in the non-exposed SES-Control group (CONT) (n=59) were recruited at a prenatal visit when information on alcohol and drug use during pregnancy was collected. A disability contrast group (n=54) was recruited at adolescence. The adults with PAE were assigned to three groups varying in physical and cognitive effects of exposure. This report is based on the adults' responses to interviews or questionnaires on problem behavior and laboratory tests related to substance use. ResultsAdults with PAE showed more problem behavior in all three areas than adults from the CONT group. For mental health problems, the exposed group showing cognitive, but not physical effects, had the highest scores; their scores were similar, however, to those of the disability contrast group on several scales. Results for outcomes on substance use and legal difficulties were less consistent, but, when significant effects occurred, the group that was exposed, but neither physically nor cognitively affected, was more likely to show negative outcomes. Males in this group were most involved in these behaviors. ConclusionEffects of PAE continue into early adulthood and affect mental health problems, substance use, and interactions with the legal system. Adults who are exposed, but less physically affected, seem to be the most involved in problem behavior. More research is necessary to examine environmental effects in conjunction with PAE on these outcomes and to provide a basis for developing potential interventions.

Impact of Psychosocial Environment on Young Children’s Emotional and Behavioral Difficulties

Objective: The impact of maternal psychosocial stress on young children’s mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4–6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children’s mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4–6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51–3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children’s emotional and behavioral difficulties.

“Back to Square One”: The Experience of Straddling Adolescence and Early Adulthood in Unemployed UK University Graduates With Common Mental Health Issues

We investigated the experiences of unemployed university graduates with common mental health issues. After conducting semistructured interviews with 12 unemployed bachelor’s degree graduates with common mental health issues, we used interpretative phenomenological analysis to generate three superordinate themes: “fall from grace,” “vulnerability,” and “life on hold.” Our focus in this article is life on hold and its constituent themes: “stagnation,” “moving backward,” and “feeling left behind.” Graduates struggled to complete the broader structural life transition from university student to the adult world of work, experiencing a nebulous state of straddling adolescence and early adulthood. This undermined their sense of adult maturity, leaving them vulnerable to becoming entrenched in their mental health-related difficulties. We discuss these findings in relation to the developmental perspectives of life-course theory, status passages, and separation–individuation in early adulthood, which raise important issues for the applicability of life-course frameworks for these graduates, who are a disadvantaged minority group.

한국노인의 사회적 자본을 위한 제 3의 장소를 찾아서

While overall population is experiencing mental difficulties with high mental disorder and suicide rates, the Korean old is worse than the rest of the population. The goal of his study is identifying physical features of existing communities that support social activities and social capital of elderly. Social capital, especially neighborhood related social capital in this study, shows how much people communicate and trust their neighbors. Transformation of Korean urban landscape with low-rise single- and multi-housing into with high-rise apartments could have resulted in less supportive environment for social activities. Pilot interviews showed that low-rise housing residents had higher level of social capital. Rather than housing type itself, public space and its connection to private area of house seemed to provide room for social activties.. Researchers examined the physical environment of the low-rise housing neighborhood and identified functional program such as corner stores, street elements such as plan pots, and spatial structure of streets as three components of spatial aspect of the social activities for elderly population. Given low economic capabilities and social culture of korean elderly the third place of the western culture such as cafe, restaurant, or bar might not work for them. Instead, neighborhood streets and alleys seemed to work as the third place for Korean elderly.

Adult ADHD: Risk Factor for Dementia or Phenotypic Mimic?

Attention-deficit hyperactivity disorder (ADHD) has historically been considered a disorder of childhood and adolescence. However, it is now recognized that ADHD symptoms persist into adulthood in up to 60% of individuals. Some of the cognitive symptoms that characterize ADHD (inability to provide sustained attention or mental effort, difficulty organizing or multi-tasking, forgetfulness) may closely resemble symptoms of prodromal dementia, also often referred to as mild cognitive impairment (MCI), particularly in patients over age 50. In addition to the overlap in cognitive symptoms, adults with ADHD and those with MCI may also share a number of behavioral and psychiatric symptoms, including sleep disturbances, depression, and anxiety. As a result, both syndromes may be difficult to distinguish clinically in older patients, particularly those who present to memory clinics with subjective cognitive complaints and fear the onset of a neurodegenerative process: is it ADHD, MCI, or both? Currently, it is unclear whether ADHD is associated with incipient dementia or is being misdiagnosed as MCI due to symptom overlap, as there exist data supporting either possibility. Here, we aim to elucidate this issue by outlining three hypothetical ways in which ADHD and MCI might relate to each other, providing an overview of the evidence relevant to each hypothesis, and delineating areas for future research. This is a question of considerable importance, with implications for improved diagnostic specificity of early dementia, improved accuracy of disease prevalence estimates, and better identification of individuals for targeted treatment.

Self-reported health and access to care among cancer caregivers: Analysis of the 2015 behavioral risk factor surveillance system (BRFSS).

6573 Background: Caregivers play a vital role in the support and treatment of cancer patients. Caregiver well-being can impact patient-perceived quality of care. The study objectives were to compare self-reported health and access to care between cancer caregivers and non-caregivers, and to determine the relationship of caregiving burden to self-reported health and access to care. Methods: We used data from the Caregiver and Core Modules of the 2015 BRFSS, an annual federal survey of health-related behavior, health conditions, and preventive service use. Caregiver burden was assessed by time (hours per week and duration of caregiving) and task (personal care and household management tasks). Measures of self-reported health and access to care between cancer caregivers and non-caregivers were compared using t-test or Chi-Square testing. Associations of caregiver burden with self-reported health and access to care were assessed with linear and logistic regressions. Results: 1,910 cancer caregivers and 84,412 non-caregivers were included. Compared to non-caregivers, cancer caregivers were more likely to report inability to see a physician due to cost (15% vs 9%; p < 0.001), depression (25.0% vs 17.9%; p < 0.001), and poor mental health (mean days per month 5.7 vs 3.1; p < 0.001). Compared to caregivers with low task burden, those with moderate or high task burden reported both more poor mental health days (moderate ß = 1.8, 95% CI 0.5 – 3.1, p = 0.008; high ß = 2.0, 95% CI 0.6 – 3.3, p = 0.004) and increased likelihood of cost barriers (moderate OR 1.6, 95% CI 1.03 – 2.5, p = .035; high OR 1.8, 95% CI 1.2 – 2.9, p = .008). Increased time burden was associated with more poor mental health days (moderate ß = 1.5, 95% CI 0.2 – 2.7, p = .02; high ß = 4.4, 95% CI 3.3 – 5.6, p < .001) but not cost barriers. No differences in insurance, personal health provider, medical check-ups, or self-reported poor physical health were identified. Conclusions: Cancer caregivers are more likely than non-caregivers to report poor mental health, depression, and difficulty seeing a physician due to cost. Caregivers with high caregiving burden are at increased risk of experiencing poor mental health and cost barriers to medical care.

Measurement of cognitive load in multimedia learning: a comparison of different objective measures

Different indicators are interesting for analyzing human learning processes. Recent studies analyze learning performance in combination with cognitive load, as an indicator for learners’ invested mental effort. In order to compare different measures of cognitive load research, the present study uses three different objective methods and one subjective method, reviewing the seductive details effect in a computer-based multimedia learning instruction. An experimental two-group design (N = 50) was used, with exposure to seductive details during learning as the between group factor. Eye movements were analyzed concerning the indicated cognitive activity and cognitive load was measured by the rhythm method (Park 2010; Park and Brunken 2015), the index of cognitive activity (ICA) (Marshall 2007), as well as by subjective ratings of mental effort and task difficulty (Paas 1992). Results confirm the seductive details effect for learning success with a decrease in retention and comprehension performance, an increase in total cognitive activity indicated by eye movements and significant higher cognitive load, indicated by rhythm method. The ICA values and the subjective ratings on mental effort and task difficulty show no difference in cognitive load between the groups. The results provide evidence of the suitability of different objective measures for a direct and continuous cognitive load assessment in multimedia learning. Further, the results show the benefit of combining different methods to gain detailed insight into information processing while learning with multimedia as well as a differentiated access to the single cognitive load factors.

Child Health Clinical Outcome Review Programme: Health Care Utilisation, Care Pathways and Educational Status in Children and Young People with Adolescent Mental Health problems with a focus on Self harm, Eating Disorders and Anxiety and Depression

ABSTRACT
 ObjectivesTo use routinely collected datasets and data linkage to identify patterns of healthcare utilisation by children and young people (CYP) with adolescent mental health (AMH) disorders across the four UK Nations, with a particular focus on self-harm, anxiety and depression and eating disorders. The analysis will focus on healthcare utilisation during transition from child to adult services and, where possible, on the interface between different care settings e.g. primary and secondary care and health and social care.
 In addition we will determine the extent to which routinely collected datasets can contribute to an assessment of the health needs and the quality of care that CYP with AMH disorders receive.
 ApproachData has been requested from the national data providers in each country:
 
 The Health and Social Care Information Centre - England
 The Secure Anonymised Information Linkage (SAIL) databank - Wales
 Information Services Division – Scotland 
 The Honest Broker Service- Northern Ireland
 
 As well as other sources:
 
 The Clinical Practice Research Datalink 
 The Paediatric Intensive Care Audit Network.
 
 A number of restrictions and information governance regulations have had to be negotiated and put in place in order to access and store the data in the SAIL Databank, Swansea University. Descriptive cross sectional analysis is underway to address the key questions.
 RationalThe project has arisen from the report ‘Overview of Child Deaths in Four UK Countries’ which found that 30-40% of 13-18 year olds were affected by mental health, learning difficulties or behavioural conditions. The diagnosis, management and services available for mental disorders in CYP are of growing concern and a source of controversy in the UK. Transitional care between child and adult services and the interface between primary and secondary/ specialist services, as well as, that between the NHS and other sectors is often disjointed. Thresholds for referral to Child and Adolescent Mental Health Services (CAMHS) are high and many adolescents are treated, at least initially, in primary health care systems.
 ImplicationsAnalysis of routinely collected health datasets has the potential to describe the nature and extent of health needs and health care utilisation for CYP with AMH disorders (self-harm, depression/anxiety, eating disorders). Furthermore the knowledge obtained from using routinely collected healthcare data, will inform future routine data collection across the UK for CYP with AMH disorders.

Risk of mental disorders and difficulties or conflict in relationships in young adults

IntroductionHigher risk of mental health problems has been linked with problems in relationships, including the experience of relational conflict with significant others and peers. Conversely, positive relations with others have been established as a key factor of psychological well being.ObjectivesWe hypothesized that psychological maladjustment will be related to the number, nature and severity of relational stressors. Furthermore, there would be a higher likelihood of risk of mental disorders for those who experience more relational hardships and of greater severity. Positive relations with others will protect from risk of mental health problems.MethodA total of 4461 university students completed a health and well-being survey, including the GHQ-12 (centesimal and 3-point cut-off scores), Ryff psychological well-being scale and a scale of 25 life stressors. Indexes of number and severity of difficulties in relationships were calculated with 10 items including romantic partners, friends, family, and classmates.ResultsCorrelations were significant. Logistic regression showed a risk effect for all stressors with OR values above 1.32. Overall perceived severity had the highest value (OR = 2.38, 95% CI = 2.16–2.61) and amongst the 10 stressors, gender related abuse/violence was also the highest (OR = 1.90, 95% CI = 1.73–2.09). Positive relations showed a protective effect (OR = 0.60, 95% CI = 0.56–0.54).ConclusionsFindings can inform health promotion, prevention and therapeutic interventions so as to improve the quality of personal relationship and conflict management skills, and to strengthen well-being associated with positive relations with others. Academic institutions committed to student welfare and the promotion of healthy environments should play a major role in young adults’ mental health.Disclosure of interestThe authors have not supplied their declaration of competing interest.

What is commonly missed in the suicidal risk assessments in the emergency room?

IntroductionSuicidal behaviour remains the most common reason for presentation to the emergency rooms. In spite of identifiable risk factors, suicide remains essentially unpredictable by current tools and assessments. Moreover, some factors may not be included consistently in the suicidal risk assessments in the emergency room by either emergency medicine physicians or psychiatrists.MethodStep 1 involved the administration of a survey on the importance of suicide predictors for assessment between psychiatry and emergency medicine specialties. In step 2 a chart review of psychiatric emergency room patients in Kingston, Canada was conducted to determine suicide predictor documentation rates. In step 3, based on the result of the first 2 steps a suicide risk assessment tool (Suicide RAP [Risk Assessment Prompt]) was developed and presented to both teams. A second patient chart review was conducted to determine the effectiveness of the educational intervention and suicide RAP in suicide risk assessment.ResultsSignificant differences were found in the rating of importance and the documentation rates of suicide predictors between the two specialties. Several predictors deemed important, have low documentation rates. Thirty of the suicide predictors showed increased rates of documentation after the educational intervention and the presentation of the suicide RAP.ConclusionThough a surfeit of information regarding patient risk factors for suicide is available, clinicians and mental health professionals face difficulties in integrating and applying this information to individuals. Based on the result of this study suicide RAP and educational intervention could be helpful in improving the suicidal risk assessment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Differentiating Different Types of Cognitive Load: a Comparison of Different Measures

Recent studies about learning and instruction use cognitive load measurement to pay attention to the human cognitive resources and to the consumption of these resources during the learning process. In order to validate different measures of cognitive load for different cognitive load factors, the present study compares three different methods of objective cognitive load measurement and one subjective method. An experimental three-group design (N = 78) was used, with exposure to seductive details (extraneous cognitive load factor), mental animation tasks (germane cognitive load factor), or the basic learning instruction (control group). Cognitive load was measured by the rhythm method (Park and Brunken 2015), the index of cognitive activity (ICA) (Marshall 2007), and the subjective ratings of mental effort and task difficulty (Paas 1992). Eye-tracking data were used to analyze the attention allocation and as an indicator for cognitive activity. The results show a significantly higher cognitive load for the mental animation group in contrast to the control and the seductive detail group, indicated by rhythm method and subjective ratings, as well as a higher cognitive activity, indicated by eye tracking. Furthermore, the mental animation group shows significantly higher comprehension performance in contrast to the seductive detail group and significantly higher transfer performance in contrast to the control group. The ICA values showed no significant differences in cognitive load. The results provide evidence for the benefits of combining eye-tracking analysis and the results of cognitive load ratings or secondary task performance for a direct and continuous cognitive load assessment and for a differentiating access to the single cognitive load factors.

From Traumatic Language to Posttraumatic Language: The Development of Language in Therapy According to the “Phenomenon of Hope” Model

ABSTRACTHope and language are part of the human development process starting from birth and continuing through all the stages of development. They are tools that help us to cope in complex situations. Environmental failure produces trauma, which damages the “self” and impairs the development of hope and language. The individual experiences “pessimistic hope” and “drained hope” and begins using “concrete language” and “pseudo-language.” Such profiles and languages indicate functional difficulties, including the inability to establish mature intimate personal relationships. When traumatic events such as those experienced in military combat compound childhood trauma (environmental failure), mental and functional difficulties buried by our defense systems may rise to the surface and worsen and chronic complex trauma may ensue. Psychotherapy for chronic complex trauma is complex. The therapeutic approach that is used in the “hope phenomenon” model includes five therapy stages that allow us to examine the effect of a trauma on personality and function. Here we examine the link between the five stages of therapy and the use of language. According to my experience, patients use concrete language and pseudo-language in the beginning of the therapeutic connection. As this connection and therapist-patient alliance evolves and deepens and the client and therapist move through the various stages, the patient then starts to use “plural language.” Concrete language and pseudo-language are used in the pessimistic hope and drawn hope stages, respectively, until a profile characterized by a realistic and mature hope emerges. This profile goes hand in hand with an ability to use plural language. This article examines the development of hope and language in a complex posttraumatic stress disorder (PTSD) patient who was treated using the hope phenomenon model. Consent for the therapy details to be used in this article was given by the patient.

Bioetički senzibilitet zakona o zaštiti osoba s duševnim smetnjama

A more and more obvious gap between the human spiritual development, which mostly stagnates, and often even regresses, and the technological development of society, which intensively and unstoppably grows, has been the initiation of numerous bioethical discussions that cover a wide range of topics, i.e. from a concern for a man and his health to a concern for nature and preservation of life in general. No matter the fact that numerous ethical discussions, which highlighted the last decade, have resulted with commonly accepted principles, several ethical issues were left without clear and unambiguous solutions. Within this context, the legal regulations expected to protect persons from unacceptable and harmful actions, but at the same time not to present an obstacle to scientific and technological development of society, have gained a special meaning. This is a significant challenge due to the fact that through statutory provisions we need to reach a balance between the freedom of scientific research and protection of a man. Although ethical dilemmas follow almost every field of human actions, bioethical contents are especially associated with the unimaginable technological achievements in medicine. Thereby, persons with mental difficulties, as one of the most vulnerable groups of patients, demand a highlighted bioethical sensibility within the meaning of humanity, understanding and enhanced awareness when ethically questionable medical procedures are applied on them, and especially when these patients are included in, sometimes even hazardous, biomedical researches. A basic protective mechanism for this category of persons in the Republic of Croatia is the Law on Protection of Persons with Mental Difficulties. The Law establishes a clear legal framework to proceed with actions designated for persons with mental difficulties, and certain legal provisions embodied within the Law could be considered a quite concrete answer to numerous ethical dilemmas. The analysis of these provisions discussed in this paper may be used as a relevant indicator of bioethical sensibility of the Law on Protection of Persons with Mental Difficulties.

Ustavnopravna zaštita prava osoba s duševnim smetnjama

In the last couple of years we have been witnessing numerous public and professional discussions of rights of people with mental difficulties and their position within the society. It is most likely that the fact that the Law on Protection of People with Mental Difficulties entered into force on 1st of January, 2015, has, among others, instigated interesting dialogues. Legislative actions resulted in enforcement of rights and recognition of a separate status of psychiatric patients on legislative level, nevertheless, the question remains whether the rights and freedoms of this particular category of citizens are in fact recognized in practice. Bearing in mind that the constitutional legal protection is the highest possible protection of rights and freedoms of all citizens, the Constitutional Court of the Republic of Croatia entire case law has been analysed covering the period of 1992 to 1st of November, 2017. The sample of 31 judgments and decisions analysing the constitutionality of restrictions of recognised rights of persons with mental difficulties has been individualised. A detailed analysis of the sample has revealed the constitutional standards to protect rights of persons with mental issues. The standards were compared with already established constitutional legal solutions in the European Court for Human Rights and the US Supreme Court case law. The final remarks reveal suggestions for improvement of the constitutional legal protection of persons with mental difficulties in the Republic of Croatia in the context of judicial activism.

Prava osoba s duševnim smetnjama u psihijatrijskim ustanovama u Republici Hrvatskoj

Nowadays, after reaching the numerous scientific conclusions in the field of mental health, it is evidently obvious that there is a direct link between the respect for rights of psychiatric patients and inpatient conditions on the one hand and patient treatment effectiveness, their deinstitutionalisation, and therefore, destigmatisation on the other. Nevertheless, in recent years, the reports delivered by the Ombudswoman and Disability Ombudswoman as well as numerous judgments of the European Court for Human Rights in cases of violation of rights of persons with mental difficulties are a clear warning about insufficient accommodation and treatment conditions in psychiatric institutions in the Republic of Croatia. Therefore, it proved justifiable to explore to what extent psychiatric patients exercise their rights as indoor patients and what are the conditions of their medical treatment. With this aim, the research was conducted at the Psychiatric Clinic „Vrapče“, Psychiatric Hospital Rab, Neuropsychiatric Hospital „Dr. Ivan Barbot“ Popovača and Psychiatric Hospital Ugljan, the only psychiatric hospitals in the Republic of Croatia with hospital wards designated for compulsory detention of mentally incapable defendants upon the decision of the criminal court. Two different questionnaires were disseminated, the Basic Questionnaire for Directors of Psychiatric Institutions and the anonymous questionnaire on the sample of 80 patients. The article presents the analysis of the results obtained from these two questionnaires.

POVERTY AND THE PREVALENCE OF MENTAL HEALTH ILLNESS AMONG MUSLIMS IN NIGERIA

This study is aimed at critically reviewing the issue of poverty, its relative economic factors (including low income and education), and impacts to common mental health illnesses and financial difficulties faced by Muslims in Nigeria. The paper also analyses the relationship between these two aspects - poverty and the prevalence of mental illness. The study used content analysis of secondary data obtained from journals, newspapers, magazines, annual report from the state and the Federal Government of Nigeria, as well as, from international and non-governmental organizations. Through the analysis of a number of studies focusing on explaining the factors, status, and condition of Muslims suffering from common mental illness, most common causes are found to be poverty and social economic problems, which contribute to various emotional and behavioral abnormalities. The paper revealed that, the pervasiveness of poverty is increasing among the Muslims in Nigeria and the cost of living is increasing continuously; mental health illnesses are increasing as cost of living is going higher. Corruption is perceived as one of the cause of poverty and increasing living costs in Nigeria. The study concludes that, as a means of contributing to the realization of the social objectives as well as alleviating poverty in the society, a number of institutional arrangements unique to the Islamic system are required to be put in place and sustained. This would include establishing the institution of zakat, Sadaqah, and Mirath (inheritance), among many others. Out of these, the scope of this paper has been confined to zakat only as it is one of the most important measures to overcome poverty.

Positive Effects of Cognitive Behavioral Therapy on Depression, Anxiety and Stress of Family Caregivers of Patients with Prostate Cancer: A Randomized Clinical Trial

Background:The family caregivers of patients with cancer mightexperience various physical, mental, and spiritual difficulties, the neglect of which can causeseriousproblems for theentirefamily. If caregivers are left without appropriate treatment and intervention, their level of physical and mental health will substantially decrease-they will, in other words, become “hidden patients.”Materials and Methods:The current study is a clinical trial of 80 family caregivers of patients with prostate cancer, who were allocated to control and experimental groups. The experimental group received 10 sessions of group cognitive behavioral therapy. The 21-item Depression Anxiety Stress Scales were completed before the intervention as well4 and 8 weeks after. Data were analyzed using descriptive statistics (means and standard deviations) andvariousstatistical tests.Results:The results showed thatthecognitivebehavioral intervention reduceddepression, anxiety, and stress among familycaregivers.Conclusion:Because of the positive impact of this intervention, its implementation in clinical care by nurses is recommended.