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We investigate the nonlinear propagation of light beams with complex phase and intensity structures, including a Gaussian-embedded vortex, a Bessel vortex, and a Bessel-cosine necklace. We employ a colloidal suspension of bio-synthesized plasmonic gold nanoparticles, where a self-defocusing response is mediated by absorption at the laser wavelength (532 nm). We show that, by means of nonlocal nonlinearity, these structured two-dimensional beams with on-axis singularity can counteract the diffraction of the dark core and guide therein a coaxial Gaussian probe of different wavelengths (633 nm) and lower intensities. Angular steering of the confined probe is also demonstrated by tilting the propagation direction of the pump. [ABSTRACT FROM AUTHOR]

Introduction: Psychotic symptoms are a major source of morbidity in the elderly. Objectives: We conducted a study to determine their prevalence and correlates in search of plausible risk factors/prevention. Aims: Determine those objectives in a representative sample of non-demented community-dwelling elderly at the province of Granada, Spain. Methods: A cross-sectional study was performed in a 562 participants sample, aged 60–84 years, without dementia. We determined psychotic symptoms prevalence (SCID-I), quality of life (WHOQOL-OLD), subjective body complaints (GBB-24), perceived social support (MSPSS), anxious-depressive symptoms (HADS) and medication use with validated instruments. Results: Prevalences: Any psychotic symptom 13%, delusions 11.4% and either auditory or visual hallucinations 5,5%. Both delusions and hallucinations 3.9%. Women had more psychotic symptoms. Psychotic symptoms correlated negatively with lower quality of life scores (p<0.002). Psychotic symptoms correlates positively with higher scores in GBB-24 (p<0.05), depression subscale (p<0.02) and increased use of drugs (p<0.024). Delusions correlated positively with higher anxiety subscale scores(p<0.046). Discussion: This is the first specific study developed in a Spanish representative population. The prevalence of non-demented community-dwelling individuals is slightly higher than expected if compared with other non-demented community-dwelling Europeans. That may be due to hardship conditions in current Spanish elderly up-bringing and over-estimation by SCID instrument which is not specifically designed for elderly subjects. Psychotic symptoms are associated with female sex, poorer quality of life, higher subjective somatic complaints, medication use and higher anxiety and depression scores. Acknowledgments: We thank all the ABUEL STUDY GROUP for their collaboration. [ABSTRACT FROM AUTHOR]

There are currently over 600million people aged over 60 and it is predicted that, by 2025, the number will double and, by 2050 there will be over 2 billion people aged 60 and above and the number of over 60''s will be greater than the number of children under the age of 15. Co-morbid physical and mental health conditions are associated with an aging population and many of this population will suffer from stroke, hypertension, loneliness, depression, dementia, mobility and sight problems. The traditional approach of caring for people in hospitals is increasingly inappropriate for many of the elderly population and primary care is often the first point of contact for many people seeking access to health and social care. In 2008, the WHO and Wonca (World Organisation of Family Doctors) published a document about the integration of mental health into primary care across spectrum. We will be describing the principles and method of integration of mental health problems in old age into primary care using examples from the Australian and UK setting. Also we will examine the role non-governmental organisations can play in the process of integration. Caring for the elderly is rewarding and possible in the primary care setting. The current situation where many elderly people do not have access to an integrated health care system is unacceptable. Using data and a series of case vignettes we will illustrate that primary care has an important role to play within an integrated system. [Copyright &y& Elsevier]

We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint) in mentally ill inmates within two secure psychiatric hospitals (SPH) and three regular prisons (RP) in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP) were studied. Isolation (41.35%) was the most frequent coercive measure, followed by mechanical restraint (33.17%) and forced medication (25.48%). The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forcedmedication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures. [ABSTRACT FROM AUTHOR]

BackgroundSeveral studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the USA, limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further.MethodData were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data.ResultsThe analyses included 8318 attendees. Of participants reporting a spiritual understanding of life at baseline, 10.5% had an episode of depression in the following year compared to 10.3% of religious participants and 7.0% of the secular group (p < 0.001). However, the findings varied significantly across countries, with the difference being significant only in the UK, where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group [OR 2.73, 95% confidence interval (CI) 1.59–4.68]. The strength of belief also had an effect, with participants with strong belief having twice the risk of participants with weak belief. There was no evidence of religion acting as a buffer to prevent depression after a serious life event.ConclusionsThese results do not support the notion that religious and spiritual life views enhance psychological well-being. [ABSTRACT FROM PUBLISHER]

Purpose: Our aim is to examine which risk factors have a greater impact in women than in men on the risk of major depressive disorder (MDD) and whether factors differ between a possible recurrent MDD and a first onset of MDD.Methods: Prospective cohort study of general practice attendees in seven countries, who were followed up at 6 and 12 months (predictD). Absolute risk differences (interaction contrast) across sex for onset of DSM-IV MDD after 6 or 12 months of follow-up were estimated for 35 risk factors from 7101 participants without MDD at baseline.Results: A total of 599 participants (80% female) had an onset of MDD at 6 or 12 months. Most risk factors had a greater impact in women than in men on the risk of MDD and were not restricted to a specific class of risk factors. After we stratified for a history of depressive symptoms, we found that the impact of risk factors across sex was generally stronger on possible recurrent MDD than on a first onset of MDD.Conclusions: Our findings may partly account for the observed difference in incidence of MDD between men and women. [ABSTRACT FROM AUTHOR]

We report results from the PREDICT-Gene case-control study nested in a prospective cohort designed to identify predictors of the onset of depression among adult primary-care attendees. We tested the potential gene-by-environment interaction between 5HTTLPR genotype at the serotonin transporter gene and previous exposure to threatening life events (TLEs) in depression. A total of 737 consecutively recruited participants were genotyped. Additional information was gathered on exposure to TLEs over a 6-month period, socio-demographic data and family history of psychological problems among first-degree relatives. Diagnoses of depression were ascertained using the Composite International Diagnostic Interview (CIDI) by trained interviewers. Two different depressive outcomes were used (ICD-10 depressive episode and ICD-10 severe depressive episode). Both the s/s genotype and exposure to increasing number of TLEs were significantly associated with depression. Moreover, the 5HTTLPR s/s genotype significantly modified the risk conferred by TLEs for both depressive outcomes. Thus, s/s homozygous participants required minimal exposure to TLE (1 TLE) to acquire a level of risk for depression that was only found among l/s or l/l individuals after significantly higher exposure to TLEs (two or more TLEs). The interaction was more apparent when applied to the diagnosis of ICD-10 severe depressive episode and after adjusting for gender, age and family history of psychological problems. Likelihood ratios tests for the interaction were statistically significant for both depressive outcomes (ICD-10 depressive episode: LR X2=4.7, P=0.09 (crude), LR-X2=6.4, P=0.04 (adjusted); ICD-10 severe depressive episode: LR X2=6.9, P=0.032 (crude), LR-X2=8.1, P=0.017 (adjusted)).Molecular Psychiatry (2007) 12, 748–755; doi:10.1038/sj.mp.4001981; published online 27 March 2007 [ABSTRACT FROM AUTHOR]

Objective: To determine the association between functional impairment, as reported in a lay-administered structured interview (CIDI), and severity of depression, depressive symptoms and risk factors for depression. Methods: We undertook a cross-sectional study of 5442 consecutive attendees at general practices in seven Spanish provinces participating in the PredictD-Spain study on predictors of depression. Participants were administered the depression section of the Composite International Diagnostic Interview (WHO-CIDI 2.1), allowing diagnoses by the ICD-10 and DSM-IV classifications for depressive episodes. Impairment was measured using the CIDI question about whether symptoms seriously interfered with important areas of functioning, such as work or looking after the house and family. We measured a set of 39 known risk factors for depression. Results: Firstly, the 6-month prevalence of a depressive episode according to ICD-10 was 28.7% (1563) and of major depression according to DSM-IV it was 13.6% (742). Secondly, out of the 1563 patients with a depressive episode according to ICD-10, nearly half (47.9%; n=749) had no impairment in important areas of functioning. Conclusions: As the ICD-10 criteria for depressive diagnoses do not include the criteria that symptoms cause impairment in social, occupational or other important areas of functioning, a large number of false positive cases are included in reported prevalence rates; and secondly, the measurement of functional impairment, at least operationalized using a lay-administered structured interview such as CIDI, is not enough, in epidemiological research studies, to assess the clinical importance of depressive symptoms. [Copyright &y& Elsevier]