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Introduction: Depressive symptoms are a common occurrence in people suffering from schizophrenia spectrum disorders (SSDs), representing a separate domain that interacts in peculiar ways with positive and negative symptoms. Nonetheless, available evidence on the relationship between depression and key clinical dimensions of SSDs is limited. Objectives: To increase the knowledge regarding depression in SSDs, we performed a cross-sectional study aimed to investigate the association of depressive symptoms with overall, general psychopathology, positive, and negative symptoms in individuals with SSDs. Methods: Adult people with SSDs were recruited from two psychiatric inpatient units in the northern area of the Metropolitan City of Milan from May 2020 to March 2023. Study participants with a Calgary Depression Scale for Schizophrenia score >6 were rated as depressed. Symptom severity was assessed by using the Positive and Negative Syndrome Scale (PANSS). Variables associated with depression at the univariate level were included into two multiple logistic regression models to analyse the association between depression and PANSS overall score as well as General Psychopathology, Positive, and Negative sub-scores. Results: A total of 231 subjects with SSDs were included. Among them, approximately one third (N=78; 33.8%) reported depressive symptoms. Multiple logistic regression models suggested that depression in individiuals with SSDs was associated with higher overall (p<0.001) and General Psychopathology (p<0.001) PANSS scores. Conversely, an inverse relationship between depression and positive symptoms was found (p=0.002). Negative symptoms were not associated with depression (p=0.210). Conclusions: Our findings suggest that people affected by comorbid SSDs and depression have more severe overall and General Psychopathology symptoms according to PANSS scores, as well as lower levels of positive symptoms. Further investigations are needed to evaluate the generalisability of these findings and to improve the clinical management of people with SSDs and depression. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

The epidemic of prescription and non-prescription opioid misuse is of particular importance in pregnancy. The Society of Obstetricians and Gynaecologists of Canada currently recommends opioid replacement therapy with methadone or buprenorphine for opioid-dependent women during pregnancy. This vulnerable segment of the population has been shown to be at increased risk of blood-borne infectious diseases, nutritional insecurity and stress. The objective of this study was to describe an urban cohort of pregnant women on opioid replacement therapy and to evaluate potential effects on the fetus. A retrospective chart review of all women on opioid replacement therapy and their infants who delivered at The Ottawa Hospital General and Civic campuses between January 1, 2013 and March 24, 2017 was conducted. Data were collected on maternal characteristics, pregnancy outcomes, neonatal outcomes and corresponding placental pathology. Maternal comorbidities identified included high rates of infection, tobacco use and illicit substance use, as well as increased rates of placental abruption compared with national averages. Compared with national baseline averages, the mean neonatal birth weight was low, and the incidence of small for gestational age infants and congenital anomalies was high. The incidence of NAS was comparable with estimates from other studies of similar cohorts. Findings support existing literature that calls for a comprehensive interdisciplinary risk reduction approach including dietary, social, domestic, psychological and other supports to care for opioid-dependent women in pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Erectile dysfunction (ED) and premature ejaculation (PE) are common disorders among italian male population aged between 18 and 65 years old (prevalence rate: 20–25%). Several studies demonstrate that the early treatment of the psychological conditions, frequently associated to ED and PE, can positively influence the prognosis. Aim: To evaluate the psychological correlates of sexual dysfunction using a standardized instruments.Methods. 46 male patients aged between 18 and 65 years old affected by EP (60,87%) and DE (47,83%) were administered the Cognitive Behavioural Assessment (CBA 2.0). Analysis of data was carried out using an automatic scoring and creating a graphic profile. Results: The 28,26% of the participants showed an high score (>95th percentile) at the STAI X-1 suggesting the presence of trait anxiety; the 39.16% of the subjects reported experiences of social and emotional maladjustment and concomitant introversive personality traits at EPQ schedule (85–@95th percentile at subscales E and P) and depressive mood at scale 8 (questionnaire D). Finally, the 32.60% did not present psychological conditions. Conclusions: According to the literature, our findings demonstrates an high frequency of psychological distress in patients affected by sexual dysfunction (67%). The use of CBA 2.0 migth represent an useful tool for the diagnosis and early treatment of this kind of population. [ABSTRACT FROM AUTHOR]

Introduction: The use of psychotropic medications in late-life is widespread although few population-based studies are available in literature. Aim: To evaluate drugs utilisation in elderly with special regard to psychotropic medications. Methods: 462 subjects (mean age 85.09±6.86 years, 53.2% women) were administered the Cambridge-Mental-Disorders of the Elderly-Examination and were clinically evaluated in order to investigate their mental health status (DSM-VI criteria) (Dementia N=88, Major Depressive Episode N=8, Generalized Anxiety Disorder N=66). Results: One out of three participants used five drugs or more (antihypertensive: 68%, antiplatelet: 44%, psychotropic: 26.1%). Among psychotropic agents, the most frequent were benzodiazepines (25.7%) particularly those with short half-life. Antidepressant treatment was also common (13.5%), especially SSRI (73%): sertraline and paroxetine were the most frequently prescribed (39.8%, 33.7% respectively) followed by citalopram and escitalopram (20.4%) and fluoxetine (8.2%). Less than 1% of the sample received tricyclic antidepressants, trazodone and mirtazapine. Out of 462 participants, 29 used typical antipsychotics: butirrofenoni (34.3%), phenothiazine (23.4%) and benzamides (23.4%). Atypical antipsychotic agents were not widely used, in particular only 3 subjects used risperidone and 2 amisulpiride. Finally, 1.7% used cholinesterase-inhibitor, 1.1% citicolina and 0.4% psychostimulants. Conclusions: One out of four community-dwelling elderly take at least one psychotropic drug; 38 persons used two psychotropic drugs or more. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence of non-fatal suicide behaviors (NFSBs) among patients admitted to an acute psychiatric ward in Bologna, Northern Italy. Methods: 30 attempters (mean age 45.10±16.12 years) consecutively hospitalized (May-July 2009) were compared to 117 controls randomly selected among patients admitted in the same ward for other reasons than NFSBs. Socio-demographical and clinical information were collected through the retrospective consultation of case-histories. Attempters were clinically interviewed and the Suicide Intent Scale (SIS) was administered. Clinical diagnoses were achieved using the International Classification of Disease-10th Revision (ICD-10) criteria. Associations between non-fatal suicide behaviors and covariates were evaluated by logistic regression analyses, estimating Odds Ratios (ORs) and 95% confidence intervals (95%CI). Results: Cases were more often women (63.3%), Italians (83.3%), unemployed (63.3%) and had a lower education (70.8%) than controls. Among attempters, most frequent diagnoses were personality disorders (56.7%) and mood disorders (50%); the 56.7% of cases was affected by concomitant organic disease (OR compared to controls:2.58; 95%CI=1.13-5.85). Stressful life-events were three-fold more frequent in cases than in controls; incongruous drugs assumption was the most common suicidal behaviours. A previous NFSB was highly prevalent in cases (46.7% p< 0.001) with a significantly association (OR:9.01; 95%CI=3.42-23.71) independent from socio-demographic features and diagnoses. SIS mean score was 11.6 ± 7.3 (low intention=53.3%, moderate intention=40%, high intention=6.7%. Increasing intention was associated with a longer duration of hospitalisation (p=0.005). Conclusions: NFSBs are associated with distinct socio-demographic and clinical profiles. Routine assessment of intentionality might help to identify subjects at higher risk of relapse. [Copyright &y& Elsevier]

Objectives: Cozart-test is a non-invasive instrument detecting recent use/abuse of drugs in oral fluid, largely employed in many environments including law enforcement. The present study aims to evaluate the prevalence of drug-use and its correlates in car-drivers in a wealthy area in Northern Italy. Methods: The study-population consists of 67 subjects recruited by policemen in Bologna and surroundings. An alcohol-test was administered to all the drivers. The Cozart-test was administered only to a persons with a positive result to the alcohol-test. A semi-structured interview was also administered together with a brief clinical assessment. Results: Drug-users were more frequently men (86,6%) of Italian origin (97%) and were often stopped nearby discos. A positive history of substance abuse was prevalent especially among subjects between 26 and 30 years of age (8,3%). Alcohol and Delta-tetrahydrocannabinol (THC) were the type of substances most commonly declared. Cozart-test resulted positive in one out of three participants. The Cozart-test largely confirmed the use of cocaine (17,6%) and two or more substance simultaneously (41,2%). Conclusions: According to the most recent literature, our findings suggest that cocaine and THC are the substances more frequently used within recreational setting, confirming the poor perception of risk by young people, looking mainly for the disinhibiting and entactogen effects of these psychoactive drugs. [Copyright &y& Elsevier]

Objectives: To evaluate the features of Frequent-Attenders (FAs) admitted to an Acute Psychiatric Unit of a general hospital in Bologna, Northern Italy. Methods: Persons admitted between January 2008-June 2009 (N=110) were randomly selected thanks to the Hospital Information System. All participants’ admissions in the indexed period were recorded, the case-history of the first admission was reviewed gathering socio-demographic and clinical information. The International Classification of Disease (ICD-10) was used for diagnosis. FAs were defined for 3 or more admissions within 18 months (Botha et al. 2009). Results: Almost one out of three patients was a FA (N=34; 30.9%). The mean number of admission for each subject being 5.6±3.4 for an average length of stay of 56.2±62.1 days. In comparison to single users, FAs were more frequently men (67.6% vs. 46.1%; p=0.029), unemployed (79.4% vs. 29.2%; p< 0.001) and living in social-health facilities (29.4% vs. 9.5%; p< 0.024). FAs and common users were not different concerning compulsory/voluntary admission. Schizophrenia and other Psychotic Disorders were predominant among FAs (44.1%), followed by Substance Use and Personality Disorders (14.7%), but no differences were detectable between cases and controls in terms of discharge diagnoses. Conversely, the prevalence of concomitant organic diseases was higher in FAs (50% vs. 27.6%; p=0.020).Finally, the results of the Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals suggested that FAs had a lower insight/compliance (2.15; 2.50-29.66; p=0.001). Conclusions: FAs have a higher mental-social disability. A targeted treatment might reduce the frequency of hospitalization. [Copyright &y& Elsevier]

Objectives: The aim of the present study is to evaluate the effects of Pet Therapy intervention on cognitive function, mood and perceived quality of life on elderly subjects (mean age 84.7 years; 95.2% women) living in a nursing home. Methods: Participants were 21 subjects affected by mental illness including dementia, depression and psychosis (diagnosis based on the International Statistical Classification of Disease - ICD-10). The Mini-Mental State Examination (MMSE) and the 15-items Geriatric Depression Scale (GDS) were administered to ten persons (pet-group) and eleven subjects (control-group) together with a self-perceived quality of life questionnaire. The pet-group underwent a dog-assisted educational intervention lasting 90 minutes, once a week for six weeks. MMSE and GDS mean scores were compared between and within groups by Student''s t-test. Results: The mean age ± standard deviation of the overall sample was 84.7±9.9 years. Mean schooling level was 4.0±3.4 years. Dementia was the most frequent diagnosis (47.6%), followed by psychosis (33.3%) and depression (19.0%). Both pet-group and control-group improved on GDS and MMSE. Within the pet-group, GDS symptoms decreased by 50% (from 5.9 to 2.7, p=0.013), whereas mean MMSE score increased by 4.5 (p=0.060). The between group comparison showed positive effect of Pet intervention on GDS (p=0.070). Furthermore, most of the participants reported an improvement of their perceived quality of life. Conclusions: According to the most recent literature, our findings suggest that Pet Therapy program can be efficient in improving depressive symptoms and cognitive function in residents of long-term care facilities with mental illness. [Copyright &y& Elsevier]

Aims: To evaluate the prevalence of MCI and its subtypes in the Faenza Project, using the Mini-Mental State Examination (MMSE). Methods: Subjects living in the municipality of Faenza were clinically assessed. The diagnosis of MCI was achieved according to international criteria using a double-step procedure: first, we excluded subjects with dementia, functional impairment and MMSE< 24, leaving 6,745 persons. Then, the performance in different cognitive domains was considered and scores less than 1.5 standard deviations below the age- and education-adjusted norms on MMSE were settled as cut-offs. Four subtypes were identified: amnestic MCI, single non-memory MCI, multidomains non-amnestic, multidomains amnestic MCI. Results: 2,720 (40.3%) participants met MCI criteria. Prevalence were 4% (amnestic MCI), 26.5% (single non-memory MCI), 4.4% (multidomains amnestic MCI), and 5.4% (multidomains non-amnestic MCI). Conclusions: MCI is common among Italian elderly. In our study prevalence are higher than reported in other population-based studies. The use of MMSE with different operational criteria, diverse sampling and assessment procedure might explain such discrepancy. The role of MMSE to identify persons with mild cognitive deficits deserves concerns. However, MMSE is largely used in both clinical practice and research and has been suggested as a useful screening tool for assessing the degree of cognitive impairment in the guidelines for the Report of the Quality Standards Subcommittee of the American Academy of Neurology. [Copyright &y& Elsevier]

Objectives: To describe the leading cause of re-hospitalization in an Acute Psychiatric Unit of a general hospital in Bologna, Northern Italy. Methods: All repeated admissions (>3consecutive admissions in 18 months) were recorded thanks to the Hospital Informatic System. Case-history were reviewed to collect information, diagnoses were based on the ICD-10. Results: In the indexed period, 392 admissions were registered for 152 patients (mean age 44; 46,1% women). At least one precipitating cause was present in 64% of admissions. The most frequent were psycho-social stress such as family conflicts, parental separations, relational problems, job or economic difficulties (39%). The co-occurrence of 2+ of such factors was common (20%). Tricky situation within the psychiatric rehabilitation service (20%), low compliance to treatments (7%), alcohol/drugs abuse (7%), and low insight (3%) were the remaining associated factors. All the re-admissions of patients with poor insight or reduced compliance were due to the same cause. Poor adherence to therapies was more frequent in bipolar disorder compared with other diagnosis (17%vs7%, p<0.005). In patients affected by personality disorders the contemporary presence of 2 or more factors was needed in 40% of admissions. Patients with schizophrenia showed the most hetherogeneous pattern of precipitating factors. Conclusions: Regardless of diagnoses, in almost a half of the admissions a single psycho-social stress is sufficient to lead to re-hospitalization; in personality disorders the contemporary presence of 2+ stressors is needed to overcome the capacity compensation of the patient. Low insight is frequently associated to re-admissions. Tailored treatments might reduce the frequency of re-hospitalization. [ABSTRACT FROM AUTHOR]

Introduction: The delusional misidentification syndromes (syndromes of Frégoli, Intermetamorphosis, Subjective Doubles and Capgras) are characterized by delusions of misidentification of other persons or of one-self. Aggressive ideas or behaviours often go with these delusions, but the problem received relatively little attention. Capgras’ Syndrome is characterized by the delusional belief that a well-known person has been replaced by a double. The delusion frequently involves significant others and takes place in a paranoid atmosphere with feelings of strangeness and unreality. We stress the importance of considering the potential dangerousness and homicidal acts directed towards family members of patients with Capgras’ Syndrome. Methods: We report a case with histories of paranoid schizophrenia and alcohol and cannabis intoxications who developed a Capgras’ Syndrome associated with homicidal behaviours toward his wife. Results: Our case met DSM IV-TR diagnostic criteria for paranoid schizophrenia, according to previous studies which show that paranoid schizophrenia is the most frequent mental disorder associated with delusional misidentification. The psychopathological analysis show that homicidal acts are connected to anguish of the ego disintegration and failure of defense mechanisms. Conclusions: According to the most recent literature, our findings suggest that Capgras’ Syndrome may be linked to a genesis of aggressive behaviours; alcohol and substance intoxications facilitates impulsivity and dissociation. The patients’ acting out directed toward family members occurs during a psychotic breakdown. Capgras’ Syndrome should always be evaluated in order to prevent violent acts. [ABSTRACT FROM AUTHOR]

Objectives: Even if medical and psychiatric co-morbidity often overlap, specific combined medical-psychiatric units do not exist in Italy and elderly who need urgent psychiatric care are usually admitted in the Acute Psychiatry Unit of general hospitals despite many difficulties. The aim of this study is to describe this phenomenon. Methods: 55 cases (>65 years) and 120 randomly selected controls (30-60 years), were picked-up among all patients hospitalized between 1st January-31st December 2008. Socio-demographic and clinical information were collected through the retrospective consultation of the case histories of all participants. Results: Cases were significantly different from controls in terms of psychiatric background, medical history and medical pharmacotherapy: mood disorders (38.2%) and positive medical histories (81.8%) prevailed among elderly as compared to adult controls (p< 0.001; p< 0.001 respectively). The use of drugs (other than psychotropic ones) was four-fold more frequent in the elderly (74.5% vs 16.6%; p< 0.001). Cases and controls used differently the service: elderly requiring more frequently medical pharmacotherapy (81.8% vs 27.5%; p< 0.001), specialist consults (38.2% vs 11.6%; p< 0.001), laboratory tests (76.4% vs 60%; p=0.04) and instrumental tests (chest radiography 9% vs 0.8%; p=0.01; brain neuroimaging 12.7% vs 2.5%; p=0.01).The multi-adjusted logistic regression analysis confirmed a different pattern of use of the acute psychiatric service for elderly as compared to adult controls. Conclusions: Elderly have peculiar medical histories and distinguishing management needs, notably in the medical field. Our data suggested the need of a new clinical approach concerning combined psychiatric-medical inpatient acute units in Italy. [Copyright &y& Elsevier]

Objectives: To describe the main features of the younger group of patients hospitalized (January 1st and December 31st) in the Acute Psychiatry Unit of a General Hospital in Bologna (Northern Italy), comparing their socio-demographic and clinical characteristics and their needs with those of the adult patients admitted. Methods: Retrospective consultation of case-histories concerning 111 subjects (60.4% men) randomly selected. Chi-square and independent sample T-test used to compare 33 cases (≤21 years) and 78 controls (35-49 years). Results: Young-cases had a higher prevalence of parental separation (31% vs 2.7%; p< 0.001) and were more frequently adopted (18.8% vs 0%; p=0.01). Psychomotor agitation or etero/self-aggressiveness (36.4%) and personality disorders (12.1%) were the most prevalent causes of hospitalization among the younger group, whereas psychosis (32.1%), mood disorders (19.2%) and alcohol-substances dependence (11.5%) were more common in controls (p< 0.001). Presence of unfavorable life-events was two-fold higher in cases than in controls (p=0.074). In particular, quarrels with family (40%) or friends (20%) and substance abuse (13.3%) occurred especially in young individuals. In adults, mournings/separations and rejection therapy were more frequent (p=0.017). Hospitalization''s features (type, length, number of laboratory and instrumental exams) were not significantly different among the two groups, except for frequency and number of interviews and childpsychiatrists and educators’ care provided that prevailed in cases. Conclusions: The young population admitted in our acute psychiatric ward has a complex sociorelational and clinical situation requiring a multi-professional management. The frequent need of care in emergent/urgent situation highlights the importance of further studies on this issue. [Copyright &y& Elsevier]

Aims: To evaluate anxiety syndrome prevalence and to investigate the association between anxiety and somatic morbidity in a population-based study of elderly: the “Faenza Project” (De Ronchi, 2005). Methods: 6987 cognitively intact subjects living in the Faenza area (mean age 71,88 years; 59,2% women) underwent semi-structured interviews and were clinically assessed in order to evaluate somatic and mental health status (ICD-10 criteria). Multi-morbidity was defined as the presence of two or more somatic diseases (hypertension, diabetes, dyslipidemia, cardiovascular, gastro-intestinal, endocrine diseases, psychiatric disorders, osteoporosis, Parkinson''s disease (PD) and stroke). The association between anxiety and somatic morbidity was calculated by Logistic regression analysis estimating Odds Ratios and 95% Confidence Intervals (OR, 95%CI), adjusting for age, education, gender, marital status, socio-economic status, smoking habits and alcohol consumption. Results: The prevalence of anxiety syndrome was 11,1% (8,6% women vs 2,5% men, p< 0.001). Taking into account possible confounders, anxiety syndrome was associated with depressive syndrome (OR,95%CI=4.55,3.73-5.54), osteoporosis (OR, 95%CI=1.37,1.13-1.65), Parkinson''s disease (OR,95%CI=4.18,2.55-6.85) and multi-morbitidy (OR,95%CI=1.75,1.46-2.10). When all these conditions were included simultaneously in the logistic model, however, only depressive syndrome and PD were still significantly associated with anxiety: OR,95%CI=4.10,3.22-5.23 and OR, 95%CI=3.02,1.73-5.28 respectively. Conclusions: The well known association between depression and anxiety is confirmed in our elderly population independently of other medical factors. Furthermore, a strong association between PD and anxiety resulted independently of co-occurrence of depression. [Copyright &y& Elsevier]

Introduction: Drop-out is a serious problem in ED which remains poorly understood. Aims: To describe socio-demographic and clinical factors associated with drop-out in order to prevent this phenomenon with individualized strategies. Methods: A semi-structured clinical interview was administered to 92 adult out-patients attending a third level centre for ED. Measures of psychopathology (EDE12th, BDI, STAI, MINI, SCID-II) were collected to achieve diagnoses. The study population included completers (CO) and drop-outs (DO) which consist of patients that did not complete the baseline assessment Failing in Alliance (FA) and persons who Failed in Treatment (FT). Results: The drop-out rate is 34,8%, including 17,4% of FA and 17,4% of FT. DO were less likely to have Anorexia Nervosa at Onset and Obsessive-Compulsive Personality Disorder, while serious Depressive Symptoms, Borderline Personality Disorder and Bulimia Nervosa predicted premature attrition. After multivariate analysis only the last three remain statistically significantly. Considering the period of drop out, we found that Bulimia Nervosa and Borderline Personality Disorder were independent correlated with FA respectively (OR=5,800; 95%CI 1,574–21,368) and (OR=5,782; 95%CI 1,135–29,449). Conversely FT had a higher probability to have serious Depressive Symptoms (OR= 12,289; 95%CI 1,187–127,207). Conclusions: Drop-outs in ED include two different subpopulations: failure in alliance (FA) and failure in treatment (FT) characterized by different clinical characteristics. Bulimia Nervosa and Borderline Personality Disorder were predictors of FA, whereas serious Depressive Symptoms were predictors of FT. [ABSTRACT FROM AUTHOR]

Background/aims: To describe the prevalence of drinking and smoking habits in an Italian population aged 75+. A research by “Istituto Superiore della Sanità” found that drinking alcohol involves one-third of elderly over 65 years. In Italy, smoking habit in population over 65 involves 23% of men and 11% of women. Material and methods: Cross-sectional study on a population of 462 subjects from the cohort of “The Faenza Community Aging Study” (De ronchi, 2005). All participants were interviewed with CAMDEX-R (Cambridge Examination for Mental Disorders of the Elderly - revised). Results: 56,7% of interviewed subjects drank alcohol (men 74.8%, women 40.8%; p< 0,005). Hundred and twentynine subjects (28,7%) were moderate drinkers (≥2 A.U./day). The 20% of the drinkers (6,2% of the total population) consumed ≥ 3 alcohol units per day. When we asked them if they consider themselves like heavy drinker, only 3,9%, (80% men) answer “yes”. The 56,9% (50,4% of the total and 58,3% women) of drinkers had symptoms of anxiety and 44,1% were affected by depression. Furthermore, among smokers the 51,1% had symptoms of anxiety and the 38% of depression. Discussion/conclusion: Drinking and smoking habits are an increasing attitude in elderly. These un-healthy habits might have severe implications and aggravate the clinical conditions in otherwise frail persons. Our data suggest to general practitioners and policy makers to be aware of this problem to actively investigate drinking and smoking habits in the general population, to launch preventive campaigns and to study aversion therapy. [ABSTRACT FROM AUTHOR]

Aims: To evaluate prevalence rate of suicidal ideation among Italian elderly and to investigate possible socio-demographic and psychopathological features of suicide attempters in a population-based study. Methods: 461 subjects (mean age 85 years; 52.9% women; 49.2% widow) were interviewed using the Revised Cambridge Examination for Mental Disorders in the Elderly. The presence of suicidal ideation was assessed by the Scale for Suicide Ideation. The association between suicidal ideation and its correlates was analysed by Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals (OR, 95%CI). Results: Eighteen (3,8%) persons refused to answer to questions concerning suicide thoughts. Only one participant declared to have attempted suicide (a 92 years-old men, widow, living on his own and complaining about depressive feelings). Overall suicidal ideation prevalence was 7.3%: wish to die (3.8%) and not worth living (13%). Gender, age, education, marital and socio-economic status were similar in subjects with and without suicidal ideation. Subjects with suicidal ideation had fewer family contacts, were less satisfied of their general health status and had a higher number of depressive and anxiety symptoms. However, when all these conditions were tested in the same model, only depressive symptoms were still significantly associated with suicidal ideation (OR, 95%CI=9.6, 3.3-27.9). Conclusion: The worldwide aging of the population deserves attention to psycho-geriatric medicine. Study on suicide in late-life are of interest to detect elderly at risk and to emphasize this increasing phenomenon. [Copyright &y& Elsevier]

Background: Patient involvement in the decision-making process is a key element for good clinical practice. Few data are available on patient involvement in psychiatry., Aims: To assess in a psychiatric out-patient context how psychiatrists involve patients in therapeutic decisions and to determine the extent to which patient and psychiatrist characteristics contribute to patient involvement., Method: Eighty transcripts from audiotaped first out-patient consultations, conducted by 16 psychiatrists, were rated with the OPTION (observing patient involvement) scale. Interrater reliability indices were obtained for 30 randomly selected interviews. Associations between OPTION scores and some clinical and socio-demographic variables were tested using t-test, ANOVA and Pearson's correlation coefficient where appropriate. The distribution of scores for each psychiatrist was assessed by intracluster correlation coefficients., Results: Interrater reliability and internal consistency of the OPTION scale in the psychiatric setting were satisfactory. The total score and the ratings for the single OPTION items showed a skewed distribution, with a prevalence of scores in the low range of abilities, corresponding to minimal attempts to involve patients or a minimal skill level., Conclusions: The OPTION scale proves to be a reliable instrument to assess patient involvement in a psychiatric setting. Psychiatrists showed poor patient involvement abilities parallel to previous findings in psychiatry and primary care. They need to be encouraged to share treatment decisions with their patients and to apply patient involvement skills. Further research is needed to establish which patient variables and clinical settings in psychiatry are more amenable to shared decisions, and how participation of psychiatric patients in treatment decisions will affect the outcome.