The Right to Mental Health in the Digital Era

People with mental illness usually experience higher rates of disability and mortality. Often, health care systems do not adequately respond to the burden of mental disorders worldwide. The number of health care providers dealing with mental health care is insufficient in many countries. Equal access to necessary health services should be granted to mentally ill people without any discrimination. E-mental health is expected to enhance the quality of care as well as accessibility, availability and affordability of services. This paper examines under what conditions e-mental health can contribute to realising the right to health by using the avail- ability, accessibility, acceptability and quality (AAAQ) framework that is developed by the Committee on Economic, Social and Cultural Rights. Research shows e-mental health facilitates dissemination of information, remote consultation and patient monitoring and might increase access to mental health care. Furthermore, patient participation might increase, and stigma and discrimination might be reduced by the use of e-mental health. However, e-mental health 146 might not increase the access to health care for everyone, such as the digitally illiterate or those who do not have access to the Internet. The affordability of this service, when it is not covered by insurance, can be a barrier to access to this service. In addition, not all e-mental health services are acceptable and of good quality. Policy makers should adopt new legal policies to respond to the present and future developments of modern technologies in health, as well as e-Mental health. To analyse the impact of e-mental health on the right to health, additional research is necessary

Parenting styles and anxiety disorders in children – A study in an Albanian clinical population

IntroductionAbout 20% of children suffer from an anxiety disorder and symptoms may persist in adulthood. About 13 in every 100 children from 9 to 17 years old experience anxiety disorders, girls seem more vulnerable than boys. Theoretical models of anxiety emphasize the effect of parenting on development and maintenance of child anxiety.ObjectivesThis research aims to study the nature of correlation between parenting styles and anxiety in children who attend Tirana Child &amp; Adolescent Psychiatric Service.MethodsOne hundred and seventy-five children and 175 their parents filled Spence Children Anxiety Scale (SCAS) and Parenting Styles &amp; Dimensions Questionnaire (PSDQ) was found a significant correlation between parenting styles and anxiety in children.ConclusionsParental overprotection produces vulnerable children who become adults ready to give up in front of life difficulties therefore; it is necessary parents’ awareness in practicing a balance in their parenting styles, in order to reduce children's anxiety.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec

Relationship Between Brain Structural Abnormalities and Early Onset Psychotic Disorder–case Presentation

IntroductionContemporary structural models of several psychiatric disorders propose abnormalities in the structure and function of distinct neural networks. Clinical observations of affective and cognitive changes arising from cerebellar lesions and stimulation permit the hypothesis that the cerebellum may not be irrelevant in some neuropsychiatric states. There is evidence that patients with schizophrenia have altered corticocerebellar connectivity.ObjectivesTo evidence a case with early onset psychosis accompanied with brain structural abnormalities.MethodCase description.ResultsThe patient is 15 years old girl with an acute psychotic episode. For more than two months she had demonstrated odd behavior, getting around all the time purposelessly, abandoned school etc. She presented with disorders of perceptions, disorganized speech, insomnia and fluctuations in her mood and behavior. In her brain, MRI was found vermian atrophy, and CT was found hypocampal glyosis and dilatation of temporal corn.ConclusionsAlthough the structural mapping studies have been equivocal, the weight of evidence supports extending the study of cerebellar activity in schizophrenia. For example, the finding that unaffected first-degree relatives of probands with schizophrenia have reduced cerebellar volumes, along with the observation of reduced cerebellar volumes in neurolepticnaïve patients with schizophrenia, suggests that cerebellar atrophy may be a hereditary trait rather than a psychotropic associated epiphenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec

Stigmatization of mental health problems in Albania, ways of diminishing it

Background and aimMore recent definitions of stigma focus on the results of stigma – the prejudice, avoidance, rejection and discrimination directed at people believed to have an illness, disorder or other trait perceived to be undesirable.MethodsDuring this study, we used Attitudes to Mental Illness Questionnaire (AMIQ), which helped us to understand the differences in the acceptance by the population for 3 different types of diseases: addiction, diabetes and schizophrenia.Results(1) Alban has diabetes. (2) Besnik has schizophrenia.Conclusions(1) The patients with schizophrenia have higher levels of stigma compared diabetic patients or those alcoholics (Tables 1 and 2 and Fig. 1). (2) Statistical processing carried out concluded that have statistically significant differences between gender-stigma (P = 0.001), age-stigma (P = 0.0001) and education-stigma (P = 0.001) (Fig. 2). (3) Health care workers stigma is exactly the same as in general population (P = 0.01) (Fig. 2).Recommendations– Support recovery and social inclusion and reduce discrimination.– Do not label or judge people with a mental illness, treat them with respect and dignity as you would anyone else.– Do not discriminate when they come participation, housing and employment.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec

Child obsessive-compulsive disorder presenting with catatonic-like features: Case presentation

IntroductionAlthough catatonia was conceptualized as a subtype of schizophrenia, it is now recognized to occur most commonly in the course of other psychiatric disorders, in drug-induced disorders [1] or neurologic conditions [2]. Catatonia is rarely seen together with OCD and there are a limited number of case reports in the literature [3,4].ObjectiveWe describe the case of a 12 year boy who presented in our clinic with mutism, negativism, immobility, social withdrawn, rigid posture, refusal to eat.MethodWe performed a thorough psychiatric diagnostic assessment of the child as well as laboratory tests and MRI of the brain.ResultsThe child's first symptoms appeared 2 years ago: initially the child became socially withdrawn, spent most of time at his room, and became preoccupied with rituals of hand washing, walking back and forth, preoccupations with food contamination, became aggressive if someone would interrupt what he was doing, stopped going at school, and stopped calling his parents “mother” or “father”. Brain MRI showed lateral ventricular asymmetry and suboccipital cyst.ConclusionsThe child was put on therapy with lorazepam and sertraline. His obsessive-compulsive symptoms improved, and the apparent catatonic like features resolved and did not return over follow-up.DiscussionCatatonia is not uncommon among children and adolescents, and the relationship between OCD and catatonia is still misunderstood, but it may be an indicator of the severity of the OCD.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec

The side effects of risperidone depot in patients with psychotic disorders

Background and aimA long-acting form of risperidone is now broadly available for the treatment of schizophrenia and closely related psychiatric conditions. It combines the advantage of previously available depot formulations for first-generation drugs with the favorable characteristics of the modern “atypical” antipsychotics, namely higher efficacy in the treatment of the negative symptoms of schizophrenia and reduced motor disturbances [1].MethodsDuring this study, we observed side effects that appear in patients that are treated with risperidone depot. Patients were observed for a period of 3 months (October–December 2015) and the side effects were evaluated with Glasgow Antipsychotic Side-effect Scale (GASS). The data obtained were analyzed with SPSS, trying to prove the impact of variables such as: gender, age, diagnosis, dose and duration of treatment on the occurrence of side effects.ResultsThrough statistical processing, we reached the conclusion that there is a statistically significant correlation between duration of treatment and side effects (P value was 0.0001). Between two variables has a strong positive correlation (Kendall value was 0.766). Has a statistically significant correlation between the drug dose and side effects (P value was 0.026). Between two variables has a moderate positive correlation (Kendall value was 0.504). No statistically significant correlation between these variables: gender-side effects, diagnose-side effects and age-side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec

Depression episode in a patient with ataxic syndrome (case report)

IntroductionThe etiologic diagnosis of ataxic syndrome is a challenge itself, requiring a complete history, physical examination, and sometimes neuroimaging, as well as extensive laboratory evaluation but despite that in many cases, the etiology remains uncertain. But in this case report, we are focused on a complication due to this syndrome, depression episode in a patient suffering from an yet unknown etiology of ataxic syndrome.Case presentationAn 18.5 years old Albanian female visits for the first time the child and adolescent psychiatry clinic suffering from insomnia for at least 3 months, had difficulties in taking care of her personal hygiene, did not communicate to anyone, loss of appetite, spent 2–3 hours crying without reason and depressive humor. She also manifested tremor and gait abnormalities, which according to her medical history a year ago, in Italy she was diagnosed with ataxic syndrome, but the etiology is not yet specified. BECK Depression Inventory at the first presentation scored 47 points. The girl was hospitalized and treated in our clinic.ConclusionPatient suffering from ataxic syndrome have many neurologic complication with the passing of the years, but there has been little information or focus on the psychiatric ones and in the literature is described a syndrome called cerebellar cognitive affective syndrome with similar symptoms. In this case, we describe a patient with life-threatening situation due to her mental health condition and by treating the depression we noticed that the neurologic symptoms improved as well.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec