Scielo RSS <![CDATA[The European Journal of Psychiatry]]> vol. 25 num. 1 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<B>Towards a Europe of health</B>: <B>perspectives for future health policies</B>]]> <![CDATA[<B>Effectiveness of clinical assessment in Spanish forensic practice</B>: <B>detecting malingered psychological sequelae in victims of intimate partner violence</B>]]> Background and Objectives: According to Spanish legislation, the psychological harm suffered by the victim of a criminal act is determined by assessing its impact on the victim's mental state. Usually, the victim's pain and suffering is estimated by administering clinical scales. The aim of the present study was to explore the effectiveness of psychopathological assessment using commonly used scales in clinical practice and whose results are presented as legal evidence in a forensic context in order to detect malingered psychological sequelae (anxiety, depression and low self-esteem) in victims of intimate partner violence in forensic contexts. Methods: In the present study three scales based in a clinical setting and regularly used in a forensic context were administered (BDI, STAI and Rosenberg) to assess malingering of symptoms. The sample comprised 66 women: 36 students, and 30 real victims. The non-clinical sample was evaluated twice: the first time they gave sincere responses, and the second time they were instructed to answer as if they were victims. The real victims underwent testing in a forensic context. Results and Conclusions: The results of our research show that, even without previous knowledge of the scales, people can distort the test results by malingering symptoms that are normally accepted as sequelae of intimate partner violence, especially depression and low self-esteem; however, the results for anxiety, were less homogeneous. Although these tests are used extensively in clinical psychology, our study confirms that, just by themselves, they are not a reliable source of information in a forensic context. <![CDATA[<B>Posttraumatic stress disorders comorbid with major depression in West Bank, Palestine</B>: <B>a general population cross sectional study</B>]]> Background and Objectives: The prevalence of Post Traumatic Stress Disorders (PTSD) comorbid with Major Depressive Episodes (MDE) were explored in four areas of West Bank of Palestine in the aftermath of the second intifada. Methods: The sample consisted of 916 adult Palestinians representative of the general population. The interview was personal with the use of DSM IV criteria for PTSD and MDE (the SCID I modules). Results: The prevalence of chronic PTSD comorbid with lifetime MDE and chronic PTSD alone were found 18.7% and 26.5% respectively. Another 6.1% were diagnosed as suffering from lifetime MDE. Higher numbers of refugees were found to suffer from PTSD comorbid with MDE. The majority of respondents who reported previous suicidal behavior were comorbid cases of PTSD/MDE. The predictors differentiating between MDE alone and no diagnosis and between comorbid PTSD/MDE and no diagnosis were almost identical. Conclusions: This sample of adult Palestinians living under conditions of mass violence and continuous economic deprivation were found suffering from high rates of post PTSD and comorbid PTSD with MDE, a common finding among populations under serious traumatic exposure. <![CDATA[<B>Acting out and self-harm in children, adolescents and young adults and mental illness 18 years later</B>: <B>The Longitudinal Upper Bavarian Community Study</B>]]> Background and Objectives: To assess the predictive impact of childhood/adolescent/young adult acting out and self-harm in a community sample of 224 participants on mental illness 18 years later. Methods: Assessments focusseded on a baseline in 1980-84 and the results at a 18-year follow-up from 2001-2004. Self-rating scales as well as expert-rating interviews yielded data on acting out, self-harm, psychiatric diagnoses and psycho-social outcome. Results: The participation rate at 18-year follow-up was 82% of those of the baseline sample. Regression analyses showed these results: Acting out and self-harm predicted later mood disorders. Self-harm predicted later psychiatric treatment in the year preceding 18-year follow-up, and impairment in social functioning. Conclusions: Our data contribute to a better and broader understanding of the impact of acting out and self-harm in childhood/adolescence/young adulthood on mental illness and its consequences in adult age and underscore the need for early and intensive intervention at many levels to prevent the accumulation of psychological problems in this age. <![CDATA[<B>Clinical and functional outcome in a subject with bipolar disorder and severe white matter hyperintensities</B>]]> Background and Objectives: Neuroimaging studies have found higher rates of white matter hyperintensities (WMHs) in patients with bipolar disorder (BD) of all ages, although whether BD is associated with increased rates of WMHs independently from age and cerebrovascular risk factors is still matter of debate. The outcome of BD associated with severe WMHs is generally poor, but several authors have suggested that some factors could have a protective role in BD. The aim of the present study was to report the two-year follow-up of a woman with BD type I and severe WMH/PWMH lesions who was taking high concentrations of vitamin-D in her nutrition, as well as taking lithium and haloperidol as treatment. Case presentation: A 76-year-old woman was hospitalized for a mixed state BD. She had severe WMHs. She took lithium and haloperidol during the hospitalization and was euthymic at discharge as well as after two-years of follow-up. Her nutrition had a high concentration of Vitamin-D. Unfortunately, it was not possible to give her a second MRI. Conclusions: Although there was probable persistence of WMHs, the patient improved in both mood and quality of life. The possible protective effect of lithium and Vitamin-D is discussed. <![CDATA[<B>High 3D:5D ratio: A possible correlate of externalizing and internalizing problems</B>: <B>An exploratory study</B>]]> Background and Objectives: The second to fourth (2D:4D) digit ratio is a sexually dimorphic trait which has been studied to examine the association between fetal hormones and a variety of behaviors. Lower 2D:4D ratios, suggestive of exposure to higher levels of prenatal testosterone, have been associated with male-linked disorders, while higher 2D:4D ratios, suggestive of exposure to weaker prenatal androgen action, have been associated with female-linked disorders. Past research has concentrated on the 2D:4D ratio, whereas the relationship between other ratios, such as the 3D:5D ratio, and psychopathology has not much been studied before. Therefore, the aim of this study was to assess the correlation between the 2D:4D and 3D:5D ratio, and internalizing as well as externalizing symptoms, in a large non-clinical sample (143 boys, 150 girls) of white Caucasian children aged 7 to 13 years. Methods: Externalizing and internalizing symptoms were assessed with the Child Behavior Checklist (CBCL). Results: The 3D:5D ratio in boys and in girls was positively associated with scores on Externalizing Problems. Further, in girls only, the 3D:5D ratio was positively correlated to scores on Internalizing Problems. Conclusions: The 3D:5D ratio can be considered a correlate of externalizing and internalizing problems in children from the general population.