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Abstract Background Psychiatric re-hospitalisation is considered costly and disruptive to individuals. The perspective of the mental health service user is largely unexplored in literature. The purpose of our study was to explore service users’ experiences of psychiatric re-hospitalisation across six countries in Europe. Method Eight focus groups were conducted in Romania, Slovenia, Finland, Italy, Austria and Norway. Results A total of 55 service users participated in the study. All participants had been in receipt of mental health services for at least 1 year, and had experienced more than one psychiatric hospitalisation. The experience of re-hospitalisation was considered: (1) less traumatising than the first hospitalisation, (2) to be necessary, and a relief, (3) occurring by default and without progress, (4) part of the recovery process. Conclusions Psychiatric re-hospitalisation was considered inevitable by the study participants, in both positive and negative terms. Striking similarities in service user experiences were found across all of the six countries, the first experience of psychiatric hospitalisation emerging as especially significant. Findings indicate the need for further action in order to develop more recovery and person-centred approaches within hospital care. For psychiatric inpatient care to be a positive part of the recovery process, further knowledge on what therapeutic action during the hospital stay would be beneficial, such as therapy, activities and integration with other services.

Background: So far there is a scarce of studies dealing with the relationship between different aspects of aggressive behaviour and affective temperaments among various mood disorders. The aim of the present study was to explore in a group of patients with affective mood disorders the relationship between affective temperaments and aggression., Methods: 100 consecutive outpatients in euthymic phase of mood disorders (46 with bipolar disorder-type I, 18 with bipolar disorder-type II and 36 with major depressive disorder) were self-assessed with the Aggression Questionnaire and the short version of Slovenian Temperament Evaluation of Memphis, Pisa, Paris and San Diego - Autoquestionnaire (TEMPS-A)., Results: The factorial analysis of the TEMPS-A subscales revealed 2 main factors: Factor 1 (prominent cyclothymic profile) consisted of cyclothymic, depressive, irritable, and anxious temperaments and Factor 2 (prominent hyperthymic profile) which was represented by the hyperthymic temperament, and by depressive and anxious temperaments as negative components. Patients with prominent cyclothymic profile got their diagnosis later in their life and had significantly higher mean scores on anger and hostility (non-motor aggressive behaviour) compared with patients with prominent hyperthymic profile., Limitations: We included patients with different mood disorders, therefore the sample selection may influence temperamental and aggression profiles. We used self-report questionnaires which can elicit sociable desirable answers., Conclusion: Anger and hostility could represent stable personality characteristics of prominent cyclothymic profile that endure even in remission. It seems that distinct temperamental profile could serve as a good diagnostic and prognostic value for non-motor aspects of aggressive behaviour., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS)., Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or "Basic Stable Input of Care" (BSIC), coded by its principal function or "Main Type of Care" (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal)., Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making., Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

Background: TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire) is a self-rated instrument that measures five affective temperaments: depressive, cyclothymic, hyperthymic, irritable, and anxious. The aim of our study was to examine the psychometric characteristics of the Slovenian TEMPS-A and to ascertain if temperament profile is related to the professions chosen by Slovenian students., Methods: 892 Slovenian university students in six different professional fields (economics, geography, engineering, law, sports pedagogy and nursing) were included in our study., Results: Cronbach's reliability coefficients denoted acceptable internal consistency of the subscales. Principal component analysis revealed relatively good internal structure of the instrument. Nursing and geography students scored the highest on depressive temperament. Sports pedagogues as well as engineers demonstrated the most firm personality structure with distinctive hyperthymic temperament. Law students revealed the most irritable temperament, while nursing and law students scored the highest on anxious temperament., Limitations: Sample of Slovenian students is not representative for general population. The structure of the sample was crucial as well, as it comprised mainly of younger students who just started their study., Conclusions: The Slovenian version of the TEMPS-A proved to have relatively good internal consistency and internal structure. The questionnaire verified as a reliable and valid instrument and generally in line with previous studies. This study strengthens the perspective that professional areas could be associated with distinct affective temperament profile that could influence career decisions. The findings in students of economics, geography, and sport pedagogy are new as they have not been previously investigated by TEMPS researchers. The results open new possibilities for future research., (Copyright © 2012 Elsevier B.V. All rights reserved.)

A diagnosis of psychosis has tended to discount the considerable degree of emotional disorder associated with it, in a manner that may also inform psychological treatment options. Depression and anxiety are often associated with schizophrenia. Up to 40% of people have clinical levels of depression and anxiety symptoms could occur in 60% of patients with chronic psychotic disorder. Among emotional problems depression and depressive symptoms are well recognised and treated with success, whereas anxiety is a less known phenomenon and has not been studied as much as depression. Comorbid anxiety disorders or symptoms (social phobia, panic disorder, obsessive compulsive disorder, and post-traumatic stress disorder) occur in patients with psychosis in the same way as in patients who have only anxiety disorder. This comorbidity adversely affects outcome, and it may also reflect on processes underlying the development of psychotic symptoms. The present review highlights some major characteristics of anxiety and psychosis and also some aspects of coping and treatment strategies for anxiety in patients with psychosis.

The aim of our study was to examine availability and utilization of mental health services in the 12 Slovenian statistical regions by using the The European Service Mapping Schedule (ESMS) methodology. 251 mental health services were mapped according to their type as presented in schema of ESMS service tree. Marked differences between regions were noticed in patterns of service provision and utilization. In contrast with the scarcity of mental health services in the Zasavska and Notranjsko-kraska region, the Central-Slovenian region offered the most diverse and abundant choice of services of all statistical regions. We lack day and structured activity services offering work or work-related activities. Out-patient and community services are mainly medium intensity non-mobile services that offer continuing care.

Objective: It has been estimated that domestic violence is wide spread in Slovenia, but the lack of empirical data of domestic violence prevalence and its consequences, aggravate the precise knowledge on the extension of the phenomenon. The aim of the study was to assess the extensiveness and characteristics of domestic violence in the group of Slovenian adolescents., Subjects: 1297 young adolescents (age 13-15 years) from 65 Slovenian primary schools participated in the study., Methods: A questionnaire for domestic violence experience and help seeking screening, McMaster Family Functioning Scale, Buss/Perry Aggression Questionnaire and Trauma Symptom Checklist for Children (TSCC) have been applied., Results: 18.7% of participants experienced violence in their own family (38.3% males and 61.7% females). Different patterns of verbal violence, irritability and indirect violence predominated. In the most cases of domestic violence the adolescent's parents were involved as perpetrators and their close relatives (brothers, sisters). Victims displayed a significant profile that could be linked with their violence experience: dysfunctional family environmental, aggressiveness, anxiety, depression, anger and posttraumatic stress symptoms., Conclusions: Presented study confirmed that the phenomenon of domestic violence and abused adolescents is quite widespread in Slovenia and that in the future more attention on research and policy making level should be given to this phenomenon. Particularly the perceived gap between attitudes towards support and the actually given help could be the orientation for developing a better prevention strategies and screening procedures for domestic violence. A proper intervention and protection of the adolescent victims could effectively prevent the outburst of depression, suicide, behavioural problems and, spreading the aggressive behaviour patterns to the future generations.

Objective: Mental health promotion and mental disorder prevention can reduce the risk for mental and behavioural disorders and decreased social welfare and health costs. The aim of the present study was to map and analyse prevention and promotion activities and programmes in the mental health area in Slovenia., Subjects: The selection of services for a study was performed using the database of the Agency of the Republic of Slovenia for Public Legal Records and Related Services, internet and other accessible sources, Methods: The Slovenian translation of ESMS was used for mapping the services in the mental health area., Results: The initial sample from above mentioned sources contained 84 services working in the mental health area in 12 Slovenian statistical regions. At present 516 services were contacted and 172 did not comply with inclusion criteria. The 162 services from all 12 Slovenian statistical geographical regions have been mapped and their activities and characteristics analysed., Conclusions: The analysis of the approaches to mental disorder prevention revealed that the most frequent approaches were selective primary prevention in 27.9% and tertiary prevention in 28.2% of cases.

Objective: The purpose of the present study was to determine which aspects of motivational, cognitive and emotional functioning were impaired in a group of alcoholics after 8 weeks of abstinence. We also examined the clinical applicability of the BIS/BAS Scales (Carver & White 1994) used in order to identify a potential association between behavioural inhibition / activation tendencies and emotional and cognitive deficits in alcohol abstainers., Subjects and Methods: 33 right- handed middle- aged (mean age 45.0 years) male alcohol inpatients in treatment and 36 healthy volunteers without a previous drinking history, matched for age, education and handedness participated in the study. Both groups were assessed with the composite of tests in the following domains: motivation, attention, emotional processing, visuospatial functioning and working memory., Results: Alcohol abstainers revealed heightened BAS sensitivity, more pronounced depressive symptoms and attentional deficits compared to controls, while working memory and visuospatial abilities did not significantly differ between the groups. Elevated BAS sensitivity correlated with the length of abstinence, whereas BIS sensitivity associated with the presence of suicidal history and with selective attention difficulties., Conclusions: Our research confirmed several previous studies that some cognitive and visuospatial deficits could improve during alcohol abstinence, while motivational tendencies, attentional and emotional functioning take longer to recover. Application of the BIS/BAS Scales proved a useful instrument for assessment of the alcohol abstainers' rehabilitation process. In this regard, when planning treatment programmes for alcoholics, approach and withdrawal motivational tendencies, neuropsychological dysfunctions and psychiatric comorbidity should be considered.

LEK-8829 [9,10-didehydro-N-methyl-(2-propynyl)-6-methyl-8- aminomethylergoline bimaleinate] is an antagonist of dopamine D2 receptors and serotonin (5-HT)2 and 5-HT1A receptors in intact animals and a D1 receptor agonist in dopamine-depleted animals. In the present study, we used rats with unilateral striatal lesions with ibotenic acid (IA) to investigate the dopamine receptor activities of LEK-8829 in a model with innervated dopamine receptors. The IA-lesioned rats circled ipsilaterally when challenged with apomorphine, the mixed agonist on D1/D2 receptors. LEK-8829 induced a dose-dependent contralateral turning that was blocked by D1 receptor antagonist SCH-23390. The treatment with D1 receptor agonist SKF-82958 induced ipsilateral turning, whereas the treatment with D2 receptor antagonist haloperidol induced contralateral posture. The combined treatment with SKF-82958 and haloperidol resulted in a weak contralateral turning, indicating the possible receptor mechanism of contralateral turning induced by LEK-8829. Bromocriptine induced a weak ipsilateral turning that was blocked by haloperidol. The ipsilateral turning induced by bromocriptine was significantly potentiated by the coadministration of a low dose but not by a high dose of LEK-8829. The potentiation of turning was blocked either by SCH-23390 or by haloperidol. The potentiation of ipsilateral turning suggests the costimulation of D2 and D1 receptors by bromocriptine and LEK-8829, respectively, whereas the lack of potentiation by the highest dose of LEK-8829 may be explained by the opposing activity of LEK-8829 and bromocriptine at D2 receptors. We propose that the D2 and 5HT2 receptor-blocking and D1 receptor-stimulating profile of LEK-8829 is promising for the treatment of negative symptoms of schizophrenia.

The ergoline derivative, LEK-8829 (9,10-didehydro-N-methyl-(2-propynyl)-6-methyl-8-aminomethylerg oline), has been proposed as a potential atypical antipsychotic drug with antagonistic actions at dopamine D2 and serotonin 5-HT2 and 5-HT1A receptors (Krisch et al., 1994, 1996). LEK-8829 also induces contralateral turning in rats with 6-hydroxydopamine-induced unilateral lesion of dopamine nigrostriatal neurons. Turning is blocked by SCH-23390 (R(+)-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzaze pine), a dopamine D1 receptor antagonist. It has been suggested that LEK-8829 could have beneficial effects in parkinsonian patients suffering from psychotic episodes induced as a side-effect of antiparkinsonian treatment with dopamine D2 receptor agonists. Therefore, we now investigated the interaction of LEK-8829 with the dopamine D2 receptor agonist bromocriptine (2-bromo-alpha-ergokryptine) in 6-hydroxydopamine-lesioned rats. Treatment with either LEK-8829 (3 mg kg(-1)) or bromocriptine (3 mg kg(-1)) induced a vigorous contralateral turning response. The cumulated number of turns induced by the treatment with both drugs combined was not significantly different from the cumulated number of turns induced by single-drug treatment. The pretreatment with SCH-23390 (1 mg kg(-1)) did not have a significant effect on the bromocriptine-induced turning but significantly decreased the turning observed after the combined LEK-8829/bromocriptine treatment. We conclude that in the 6-hydroxydopamine model, the turning behaviour mediated by the LEK-8829/bromocriptine combination may be the result of opposing activity of both drugs at dopamine D2 receptors with concomitant stimulation of dopamine D1 receptors by LEK-8829. Therefore, LEK-8829 may have a potential for the therapy of parkinsonism complicated by dopamine D2 receptor agonist drug-induced psychosis.

1. Previous experiments have suggested a potential atypical antipsychotic activity of the ergoline derivative LEK-8829. In vitro experiments showed a high affinity to 5-HT1A, 5-HT2 and D2 receptors (the ratio of pKi values 5-HT2/D2 = 1.11) and a moderate affinity to D1 receptors. In vivo experiments showed antagonism of dopamine and 5-hydroxytryptamine (5-HT) receptor-linked behaviours. 2. In the present study, the rats with unilateral dopaminergic deafferentation of the striatum, induced by the lesion of the median forebrain bundle with 6-hydroxydopamine (6-OHDA), were used to determine the effects of LEK-8829 on turning behaviour and on striatal c-fos mRNA levels. 3. The administration of LEK-8829 induced a long lasting contralateral turning behaviour that was dose-dependent. It was found that the specific D1 receptor antagonist SCH-23390 but not the D2 receptor antagonist haloperidol or 5-HT1A antagonist pindolol, dose-dependently inhibited the turning behaviour induced by LEK-8829. 4. In an attempt to clarify the D1:D2 receptor interactions involved in the action of LEK-8829 in the 6OHDA model, we used in situ hybridization histochemistry to compare the effect of SCH-23390 pretreatment on striatal c-fos mRNA expression induced either by LEK-8829 or by the typical antipsychotic haloperidol. 5. LEK-8829 induced a bilateral striatal c-fos mRNA expression that was significantly higher in the denervated striatum as compared to the intact striatum and was completely blocked on both sides by pretreatment with SCH-23390. In contrast, haloperidol-induced striatal c-fos mRNA expression was limited to the innervated striatum and was not blocked by SCH-23390. 6. Our data demonstrate an intrinsic activity of LEK-8829 on D1 receptors that is potentiated in the dopamine-depleted striatum. We conclude, therefore, that the putative atypical antipsychotic LEK-8829 may prove useful as an experimental tool for the study of D1:D2 receptor interactions and could have beneficial effects in the treatment of drug-induced psychosis in patients with Parkinson's disease.