The European Journal of Psychiatry

The SOV Regulation: A new criminal code regulation measured against the behavioural sciences

The so-called Psychopath Laws were introduced in The Netherlands at the beginning of the 20th century, with the purpose of ensuring the humane care and detention of disturbed criminals, and in so doing to prepare them for reintegration into society. In practice, however (especially in the early period following implementation of the legislation), all kinds of vagabonds, drunks and tramps were detained in order to bring them in line with the social order of the time - in other words, to keep them in custody so that they would no longer constitute a danger to society. These Psychopath Laws became, in fact, an instrument by which nuisance elements could be put behind bars. And once again we meet a similar 'nuisance criteria' in 2002, when the so-called SOV-Regulation came into force. This regulation has been incorporated into legislation governing the Legal Detention of Addicts (known in The Netherlands as the SOV Law), Statute Book 2001, no. 28. There are problems surrounding the question of whether the SOV regulation is actually used solely, or primarily, to put nuisance-element justiciables behind bars. SOV can only be effective if there are enough behaviour-expert arguments to support it. The field of behaviour-expertise is challenged to remain alert whereby justiciables are guaranteed the treatment they need.

Changes in the attitudes towards psychiatry among Spanish medical students during training in psychiatry

Background: To gain an understanding of the process of recruitment, studying changes in attitudes and views towards psychiatry among Spanish medical students during their fourth academic year. Methods: A 33-item questionnaire was administered to 48 medical students before and after having completed training in psychiatry. Comparative data analysis was carried out using the Wilcoxon test. Results: The comparison showed that there was a reduction in the number of students reporting that "psychiatrists abuse their legal power", that "for most specialists in this area, psychiatry was not their preferred choice" and that "those students interested in psychiatry are regarded as odd or peculiar". However, the view that "psychiatry is an expanding frontier of medicine" decreased among the students. The percentage of students considering psychiatry as a future career rose from 4.2% to 10.4% after training. Conclusions: The students' opinions change with the experience of training in psychiatry and become more realistic. Alongside these changes in attitudes, there is an increase in the proportion of students willing to consider psychiatry as a future career, which suggests that there is no reduction in vocations for psychiatry among Spanish students.

Frequency and characteristics of emotional disorders in patients after ischemic stroke

Emotional disturbances in stroke patients may unfavorably affect the process of rehabilitation and longterm outcome of the disease. The aim of the study was to assess the prevalence of emotional disturbances and their characteristics in our stroke patients, according to hemispheric lateralization of cerebral lesion (as recorded by CT), patient sex and grade of neurological handicap (as assessed by Rankin scale). The study included 50 patients (29 men and 21 women, mean age 65.52 ± 7.07 and 64.62 ± 11.83 years, respectively) who had suffered ischemic stroke 3 weeks to 6 months before the study. The Crown-Crisp experience index which consists of six scales: scales of anxiety, phobia, obsession, somatization, depression and hysteria, were used for detection of emotional disturbances. Results showed a high prevalence of emotional disturbances in the study group. Depression was most common (36 of study patients), followed by generalized anxiety (n=29) and phobic disturbances (n=33). According to hemispheric lateralization of the cerebral lesion, a more intense emotional response was found in case of right hemispheric lesions, however, the difference was statistically significant only on the scale of somaticized anxiety (p<0.05). According to sex, a more intense emotional response was recorded in women. The difference being statistically significant on the scales of anxiety (p<0.05), depression (p<0.05) and phobia (p<0.01). An increasing tendency in the prevalence of emotional disturbances was observed with the increasing severity of neurologic deficit (p<0.05). Study results showed a high prevalence of emotional disturbances after ischemic stroke, among which the most common is depression.

Social support and emotional exhaustion among hospital nursing staff

The role of three sources of social support (family as kin, co-workers as insiders, and supervisors as outsiders) on the emotional exhaustion were analyzed in a sample of 210 nurses at a general hospital in Seville, a city in the south of Spain. They were given an adaptation of the Nursing Stress Scale, (Gray-Toff & Anderson 1981), the Multidimensional Support Scale (Winefield, Winefield, Tiggemann 1992), previously adapted in a sample of nurses and the emotional exhaustion scale of the Spanish version of Maslach's Burnout Inventory (1997). After applying a hierarchical multiple regression analysis to the data, the results confirm the main effect of the three sources and the buffering effect in the case of outsiders and kin. It suggests the need to perform studies with wider samples, which allow the analysis of professionals' psychosocial characteristics and types of support, as well as demands in nursing job tasks.

Psychiatric care and immigration: Preliminary findings in a hospital in Madrid, Spain

This pilot study aims to investigate differences regarding access to psychiatric care, motives for demanding emergency psychiatric care, admission rates, rates of compulsory admission, and main diagnoses in immigrants and natives. Psychiatric emergency visits (n=1,126) and hospitalisations (n=225) were registered in a Spanish Hospital with a catchment area of 280.000 people (19.34% immigrants) between October 20th 2002 and April 30th 2003. Access to psychiatric care, motives for demanding emergency psychiatric care, admission rates, rates of compulsory admission, and main diagnoses in natives and immigrants were compared. Immigrants were more likely to be compulsory admitted, were under-represented in the emergency and hospitalization units, and were less likely to be readmitted. Motives for hospitalisation were also different. Immigrants seemed to suffer less drug abuse and more anxiety disorders than natives (possibly reactive conditions related to the stress of migration).

Prevalence of "organic brain syndrome" in a Southern European population in two different time periods: **The ZARADEMP Project**

Background: Comparative studies of dementia in different time periods are quite limited in the international literature, but might be useful to test environmental hypotheses. The aim of this study is to compare the prevalence of "organic brain syndrome", as a measure of dementia, in the elderly living in the same community in two different time periods and using the same methods. Methods: Representative samples of the elderly in the Zaragoza Study or ZARADEMP 0 (n= 1,080), completed the past decade, and now in Wave I of the ZARADEMP Project or ZARADEMP I (n= 4,803) were interviewed. The Geriatric Mental State (GMS) was the main case-finding instrument and the results were analysed using the AGECAT diagnostic package to generate diagnoses. Results: Adjusted, total prevalence of "organic brain syndrome" in individuals aged 65 years and older has not varied from the previous decade. It was 8.4% in ZARADEMP I , and 7.4% in ZARADEMP 0 (prevalence ratio, PR = 0.83; CI 0.65-1.07). Adjusted prevalence among men was lower in ZARADEMP I (3.6%) when compared to ZARADEMP 0 (5.5%), although the differences do not reach statistically significance (PR= 0.65; CI 0.41-1.05). However, in support of the working hypothesis, the differences were more marked, and we consider they reach statistically significant proportions in the age group 80-84 years. Conclusions: The prevalence of "organic brain syndrome" has not increased from the previous decade. On the contrary, the prevalence tends to be lower in men, and the differences reach stastistical significance in the age group 80-84 years. New analysis using diagnostic criteria of dementia in the same sample are required to confirm these findings.