ABSTRACTS - World Psychiatric Association

1991 in the province of Quebec, Canada. In one of the largest study on
this topic to date, the authors were able to identify a total of 840 consecutive
records of victims who were murdered in the context of familial
or domestic violence. These records were reviewed in detail and
compiled by the same two psychiatrists. The importance of obtaining
a clear understanding of familial homicide is underscored by indications
that a high proportion of those homicides are perpetrated by
individuals who suffer from a major mental illness. Spousal homicide
represented about half of the domestic homicide, followed in frequency
by filicide (22%), parricide (12%) and fratricide (2%). In contrast
to spousal homicide, where a similar proportion of victims died by
firearm or use of a sharp object, and parricide, where the majority of
victims died by sharp object, most victims of filicide (excluding fatal
battering) died by a method that caused minimal injury or pain.
PO3.129.
ETHICAL ISSUES IN PSYCHIATRIC CARE:
AN INDIAN VIEW
A. Mallik, D. Roy
Kothari Medical Centre and Appolo Hospital, Kolkata, India
No area of medicine is so concerned with ethics as the field of psychiatry.
In India, there is a wide variation of caste, creed and religion.
Hence, building a cooperative and trusting relationship with the
patients has always been an essential factor to enable psychiatrists to
foster the healing process. But, in reality, ethics in psychiatry is usually
wrongly stated or assumed in our practice. This is because psychiatry
remains a low priority compared to other branches of medical science
in India. Apathy and ignorance of family members of mental
patients, social stigma, unpredictable prognosis and variable treatment
modalities are the probable reasons. In India, a practicing psychiatrist
has to take more responsibility in management of mental disorders
in spite of workload, criticism by family members or vested
interested people. Harassment by over-enthusiastic patient party,
pseudo-social activists, politicians is inevitable and a practicing psychiatrist
needs careful consideration for such interference.
PO3.130.
DETENTIONS OF OLDER ADULTS IN A SCOTTISH
HEALTH REGION UNDER THE 1984 AND 2003
MENTAL HEALTH LEGISLATION – A COMPARATIVE
STUDY
G. Stevenson
Department of Psychiatry, NHS Fife, Scotland, UK
Mental health detentions in older adults (over 65 years) is an underreported
topic compared to working age adults, but the demographic
shift towards an older population is likely to alter this, and may influence
future mental health service configurations. This study compared
detentions of older adults in a Scottish health region under the previous
1984 legislation to those detained under the current 2003 mental
health legislation. Data were collected prospectively on all older adults
detained in Fife (with a population of 350,000) during a 12 month
period in 1994-1995 under emergency powers of the Mental Health
(Scotland) Act 1984, and for all older adults in the same health region
detained in 2008 under the replacement Mental Health Care & Treatment
(Scotland) Act 2003. The detaining medical practitioners were
interviewed, generally by telephone, following each detention, and a
structured questionnaire was utilised to record demographic information
of detainees, their previous mental health contacts, psychiatric
diagnoses, alcohol and drug usage, self-harming behaviours, violence
towards others, police involvement, and experience of the detaining
practitioner in the use of mental health legislation. Initial results show
a changing pattern of detentions of older adults in this Scottish health
region. Reasons for this are proposed and discussed in view of the
changes in Scottish mental health legislation.
PO3.131.
AN EVALUATION OF MENTAL STATUS OF STAFF
IN A TURKISH PRISON
G. Özgür, L. Baysan Arabacı, S. Yıldırım, S. Bozkurt,
N. Gördeles Beşer
Ege Üniversitesi Hemşirelik Yüksek Okulu, İzmir; Niğde
Üniversitesi Zübeyde Hanım Sağlık Yüksekokulu, Niğde, Turkey
This research was made to evaluate mental status of staff in a Turkish
prison. Thirty-three prison staff accepted to be included in the study.
Data were collected by an ad-hoc form and the SCL-90-R. The mean
age of staff was 42.5±4.5 years; 93.9% of them were male; all of them
were married; 54.5% of them were graduated from high school. The
mean Global Severity Index score was 0.7±.0.6. The level of distress
was higher in those whose age was 40 or higher, who were graduated
from high school, who worked 48 hours per week, who had been
working in a prison 20 years or more. The higher scores were found
on the subscale anger (1.1±0.9), obsessive-compulsive (0.9±0.6), somatization
(0.9±0.8), paranoid thinking (0.8±0.7) interpersonal sensitivity
(0.7±0.7).
PO3.132.
FIRST-EVER ADMITTED PSYCHIATRIC INPATIENTS:
CLINICAL CHARACTERISTICS AND REASONS
CONTRIBUTING TO ADMISSION
G. de Girolamo, F. Guzzetta, R. Miglio, G. Santone, A. Picardi,
B. Norcio, R. Bracco, for the PROGRES-Acute group
Health Care Research Agency, Emilia-Romagna Region, Bologna;
Department of Mental Health, Local Health Unit of Cesena;
Department of Statistics, University of Bologna; United Hospitals
of Ancona and Polytechnic University of Marche, Psychiatric
Clinic, Ancona; Mental Health Unit, Center of Epidemiology,
Surveillance and Health Promotion, National Institute of Health,
Rome; Department of Mental Health, Local Health Unit,
Trieste, Italy
First admission to a psychiatric facility represents a major personal
event for patients and their families, as well as a very expensive form
of psychiatric treatment. Aim of this study is to describe socio-demographic
and clinical characteristics of first-ever admitted patients and
to identify reasons contributing to admission. Data were obtained
from a national survey carried out in Italy in public (n=130) and private
(n=36) facilities admitting acute psychiatric patients (PRO-
GRES-Acute). Cluster analysis was used in order to identify homogeneous
patients’ groups. Three-hundred thirty-seven patients were at
their first admission. Median age at admission was 40; about 46% of
subjects were not receiving any treatment in the month preceding
admission. Social/work functioning problems, social withdrawal and
conflict with family members were the most common reasons contributing
to admission. Cluster analysis identified four patient groups
with notably different socio-demographic and clinical characteristics.
First admitted patients represent a highly heterogeneous group of
patients. Early intervention research should consider this sociodemographic
and clinical variety in order to better allocate resources
and develop special intervention programmes.
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