Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.

The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.

We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.

We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries.

People with type 2 diabetes treated in out-patient settings aged 18–65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of ‘upset’) between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables.

In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS.

This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.

Depression is among the most prevalent psychiatric conditions in general population. Previous reports established a link between suicidal attempts and major depressive disorder (MDD). There is a large number of risk factors which can participate in suicidal behavior. Many studies showed the role of personality dimensions such as borderline personality dimensions risk factors of suicidal behavior. The aim of this study was to assess dimensions of personality in inpatients who were hospitalized after suicidal attempt.

The sample consisted of sixty inpatients with MDD diagnosed with ICD X. There were thirty patients with suicidal attempt and thirty with no history of suicidal attempts. The assessment of personality dimensions was carried out by the Millon Clinical Multiaxial Inventory III (MCMI III).

Our findings have shown that borderline and masochistic dimensions were more frequently present in the group of patients with suicidal attempts. Compulsive dimensions were more present in the group of patients with no history of suicidal attempt.

Borderline personality dimensions with underlying impulsivity and low level of self-confidence might be potential risk factor for suicidal behavior, while the patients with a rigid system of organization and conscientiousness are less prone to suicidal behavior. Assessing personality dimensions is recommended in the process of psychodiagnostics and might be useful in preventive interventions.

Various studies have demonstrated that psychotic patients have poor performance on the Wisconsin Card Sorting Test (WCST), which serves as an indicator of the dorsolateral prefrontal cortex executive functioning. The aim of our study was to compare cognitive performance of patients suffering from chronic psychosis with the first episode patients.

Our sample consisted of chronic schizophrenic and schizoaffective patients in worsening phase, the first episode patients and corresponding healthy controls. All patients were tested by WCST in the second week after the hospitalization, were treated with SGA, and had PANSS score above 60.

The performance of the psychotic patients was equal to the performance of healthy controls in all variables of the WCST, except the average non-perseverative responses (NPR) (p=0.01). NPR score indicates a state rather than shift in a cognitive set, so we performed the analysis of the given working memory test per diagnosis of the patients. The results showed lack of significant difference in the WCST performance between schizophrenic, schizoaffective and healthy subjects, whereas the first episode patients performed significantly worse then controls in the following variables: categories, perseverative errors and conceptualization level (p< 0.05).

Our findings showed difference in cognitive functioning between first episode patients and chronic psychotic patients. Better cognitive performance of chronic psychotic patients could be explained by potentially beneficial effects of the SGA pharmacotherapy to the cognitive status. However, this finding may be also limited by its association with age and relatively modest PANSS scores.

According to CBT theory, belief system has an important role in etiology of depression. Absolutistic, rigid and irrational beliefs might have influence on development and persistence of depressive psychopathology. The aim of our study was to examine characteristics of irrational beliefs in the cognitive scheme of patients with Major Depressive Disorder (MDD).

The sample consisted of sixty inpatients diagnosed as MDD by using the ICD-X criteria. The assessment of irrational beliefs was carried out by Beck's Personality Belief Questionnaire (PBQ).

Our findings have shown that irrational beliefs related to histrionic, schizoid and paranoid cognitive system were the most prevalent in patients with MDD. We also found significant and high correlation between opposite way of thinking - histrionic beliefs pattern correlated with avoidant and schizoid beliefs patterns. Also, dependent belief pattern was in a significant correlation with avoidant, schizoid and paranoid beliefs. In addition to rigidity, absolutistic and imperative cognitive schemes, we also found ambivalent cognitive tendencies. The existing ambivalence could be an important factor in the maintenance of depressive symptoms.

Our study has shown high prevalence of irrational beliefs in MDD patients. By recognizing the exact cognitive biases underlying depression, it might be possible to direct the therapeutic interventions more specifically and provide a highly personalized approach in the treatment of patients with MDD. We also believe that there is a need for a psychotherapeutic work on irrational beliefs during remission, which might prevent relapses.

Recent studies showed that schizophrenic patients possess adequate attention resources to avoid Stroop colour interference but face difficulty when delays are imposed and multiple attention demands appear. The aim of our study was to use dynamic version of the Stroop interference test based on cognitive remediation techniques within a “training- interference task-test” procedure.

The observed subjects were chronic schizophrenic and schizoaffective patients in worsening phase and the first episode patients who were treated with SGA and having PANSS score above 60, as well as corresponding healthy controls. We trained subjects in Stroop colour interference task and immediately after the training applied different working memory task and subsequently tested the subjects (15 minutes (Stroop Colour task) and >24 hours (Stroop Word task)).

There was an improvement of the cognitive status of schizophrenic and schizoaffective patients similarly as in healthy controls in both the reaction time and response accuracy (p>0.05), whereas the first episode patients performed significantly worse than other two subgroups. This was revealed both in the training and subsequent Stroop Colour interference (Reaction Time: p=0.02, Error Code: p=0.04.

Our findings revealed that chronic schizophrenic patients show same level of achievement as healthy controls despite the demanding experimental design. Poorer results observed in the first episode patients could suggest the favorable effect of the SGA on cognitive functioning, or impose the role of their age. Carefully designed training of cognitive skills could be of high importance in preventing the cognitive deterioration of first episode psychotic patients.

Burnout syndrome is psychological experience that produces physical,emotional and mental symptoms and signs,which is commonly observed in health care professionals. The stress is considered as the key factor in development of this syndrome.

To assesses the burnout syndrome in general practitioners and anesthesiologists in Belgrade,Serbia,regarding that both occupations are considered as highly stressful.

The sample consisted of 50 primare care physicians working in primary health care and 50 anesthesiologists at a University hospital in Belgrade.The burnout was assessed using Maslach Burnout Inventory,which addresses thre general scales-emotional exhaustion,depersonalization and reduced personal accomplishment.

The findings supported our hypothesis that this syndrome is highly prevalent among health care workers,espacially among anesthesiologists.

The burnout syndrome is a frequent disorder among health care workers, especially among with high work demand,susc as general practitioners and anesthesiologists.Therefore,prevention strategies should be planned and carefully implemented.

It has been shown that abusive experiences in childhood may be related to specific behavior patterns manifested in adulthood, especially those that refer to negative parenting practices. The aim of this study was to assess the relationship between the use of punitive parental discipline and the childhood abuse trauma in parents.

Sixty six parents (30 males, 36 females, age 45.92±8.79 yrs, predominantly urban) completed the socio-demographic questionnaire, the Childhood Trauma Questionnaire (CTQ), and the punitive discipline self-report measure.

The frequency of use of punitive discipline between parents with and without the history of abuse was not significantly different (t=-1.298; p>0.05). The difference was not found neither among fathers (t=-0.047; p>0.05) nor among mothers (t=-1.951; p>0.05). Emotional abuse was the only type of childhood maltreatment related to the use of punitive discipline (r=0.393; p< 0.01). This relationship was found among both fathers (r=0.428; p< 0.05) and mothers (r=0.371; p< 0.05). In females, the use of punitive discipline was additionally related to the history of emotional neglect (r=0.379; p< 0.05).

The findings may emphasize the need for identification and modification of the parental discipline strategies in adult victims of child emotional abuse and neglect.