28^th International Conference on Psychiatry & Mental Health November 20-21, 2017 Melbourne, Australia

Dr Rinku Gautam Joshi is an Associate Professor of Psychiatry in BP Koirala Institute of Health Sciences, Dharan, Nepal. Her interest is in Women’s Mental Health.

Statement of the Problem Non-compliance to treatment is an important area of concern in mental illness as it contributes to relapse and hospitalization of patients. One of the ways to improve drug compliance is to know the crucial factors responsible for poor drug compliance so that proper management strategies may be planned to improve patients’ compliance. Methodology & Theoretical Orientation Aims: To find out the prevalence and reasons of non-compliance in patients with schizophrenia and its association with socio-demographic variables. Methodology: Patients attending psychiatric services, who are diagnosed as Schizophrenia as per ICD-10/DCR were enrolled and socio-demographic details obtained. Patients were evaluated using the PANSS to assess severity of illness. Subjective reasons of medication non-compliance were assessed using ROMI scale.The relation between non-compliance and socio-demographic profile was analyzed and reasons for non-compliance were studied. Findings: In the study the mean age of patients was 30.78±12.53 yrs (mean ± SD). It was observed that 46.3% were compliant and 53.8% were non-compliant. A significant association was found between duration of illness and mean negative score. The main reason for non-compliance identified in the present study was denial of illness followed by no current need for medications which may be due to the lack of knowledge about the illness. Conclusion & Significance: More than half of the patients were non-compliant. The main reason for non-compliance was denial of illness and considering no current need for medications which may be because of lack of knowledge about the illness that signifies the importance of psychoeducation. Recommendations are made for starting support groups to tackle the problems of the family members in managing the patient effectively; and developing standard protocol for providing consistent medication adherence counseling for the mental health professionals, which will improve the compliance to medication and treatment.

Yizhen Yu is a Professor in School of Public Health, Tongji Medical College, Huazhong University of Science

Objectives: Accumulating evidence suggests that genetic and environmental factors may influence aggression susceptibility. Compared to some extensively studied candidate genes of aggression, very little is known about the OXTR gene. The objective of this study was to determine whether genetic variants in the OXTR gene were associated with aggression risk and whether the polymorphisms would show interactive effects with childhood maltreatment on aggressive behavior in Chinese adolescents. Methods: A total of 996 participants including 488 cases and 488 controls were selected in our study. Aggression, childhood maltreatment were measured by self-reported questionnaire. Buccal cells of all subjects were collected. Genotyping was performed using SNPscan. We explored both main effects of OXTR polymorphisms, as well as interactive effects between the polymorphisms and childhood maltreatment on aggressive behavior. Results: Participants who carried the rs237885 TT genotypes in OXTR gene had a higher risk of aggression compared to those who carried GG or GT genotypes under the recessive model (OR=1.40, 95% CI, 1.04–1.89) after controlling for potential confounders. In addition, we also found that the polymorphism had a synergic additive interaction with childhood physical abuse on the aggression risk. The synergy index (S), the attributable proportion due to interaction (AP) and the relative excess risk due to interaction (RERI) were 2.81 (95% CI, 1.37–5.77), 0.59 (95% CI, 0.33–0.84) and 6.69 (95% CI, 0.41–12.96), respectively. Conclusions: The present study provides evidence that genetic variants of OXTR may contribute to the susceptibility of aggression. Moreover, this is the first study reporting significant interactive effects of OXTR polymorphism and childhood physical abuse on aggressive behavior in Chinese adolescents.

Dr. Anwar Ahmed, is a full-time associate professor in the College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences. Ahmed earned his B.S. in Applied Statistics and Demography at Gezira University, his M.S. in Statistics and Ph.D. in Biostatistics from Virginia Commonwealth University. He has taught a variety of courses in biostatistics, epidemiology, and research methods. His research has led to more than 45 scientific publications in refereed journals, and he plans to continue to publish. His publications focus on public health issues relevant in Arab and African regions and globally

Background: Although stress during pregnancy has negative effects on children’s development and pregnant women’s health, no study has assessed stress and its predictors among pregnant Saudi women. Aim: The aim of this study was to assess the relationship between sociodemographic and self-reported oral health problems and perceived stress in a sample of pregnant Saudi women Materials & Methods: A cross-sectional study was carried out at King Abdulaziz Medical City in Riyadh, Saudi Arabia, on 438 pregnant women who attended the obstetrics/gynecology clinic. We collected data on their sociodemographic and oral health status. Stress was assessed using the perceived stress scale. Results: 33.4% of the sample reported high stress. The study revealed significantly high stress in women with no or low income, chronic disease, sleep deprivation, no teeth brushing, irregular eating patterns, gestational diabetes, and no family support (P < 0.05). Self-reported oral health problems were significantly associated with high stress (P < 0.05). A multiple linear regression model shows no teeth brushing, chronic disease, sleep deprivation, gestational diabetes, and gingival redness predicted an increase in stress by (3.6, 2.4, 2.1, 1.4, and 1.4, respectively)

Rodrigo Chiavaro da Fonseca is a medical student, interested in research since the beginning of college. Today he is working in multiple projects, such as “Evaluation of Biochemical and Molecular Parameters of the Brain and their Clinical Correlations in Individuals Who Committed Suicide”, “Brazil’s Suicide Rate from 2000 to 2014 Stratified by Genre and Age” and “Hospital Waste: Is it possible to minimize the environmental impact of a big university hospital?”. He is also teaching as monitor in “Promotion and Protection of Elderlies and Adults’ Health” class since 2016, August. Rewarded with the Award of Best Oral Presentation at the 36th Scientific Week of HCPA in 2016.

Background and objectives: Mental disorders being considered brain diseases open up new possibilities for research and treatment of psychiatric illnesses. This paradigmatic change in neurosciences and mental health care can affect directly the way patients perceive their diseases and are treated for them. It is necessary to assess attitudes and opinions of people suffering from these diseases to understand how this paradigm reflects the way patients recognize their condition. Methods: Patients were recruited from a tertiary care facility, specialized in the treatment of bipolar disorder in a University Hospital. Using qualitative based in-depth interviews, 13 patients and 6 family members were approached and were able to express their thoughts, impressions and what they did know about the relation between body organs and mental disorder. Results: In general, the brain was the organ most cited to be related to Bipolar Disorder, though not in isolation. Several other organs were also mentioned, including the kidneys, liver and blood. In addition, a strong association was made between the brain, mental diseases originating in the organ and the effects of poor brain function on other systems in the body. The proper functioning of the brain was associated with overall health, while poor brain function was related to general health problems and not only mental disorders. Conclusions: Bipolar disorder was considered by the participants a disease of the brain, but not only of the brain. It their view, brain diseases were systemic and could interfere in a complex way in health and sickness.

Yu-Kai Du has expertise in maternal and child healthcare. He has worked in Department of Maternal and Child Health, Tongji Medical College, Huazhong University of science and Technology from 1983. He has undertaken a number of National Natural Science Funds projects on vertical transmission of hepatitis B virus in the Chinese population. He has also held a number of social positions, such as the Director of Chinese Society of Rural Health, the Director of Standing of Hubei Society of Family Education and Hubei Society of Comprehensive Development of Children Secretary-general, the committee of Chinese maternal and child experts’ committee. Committee and the expert group of prevention mother-to-child transmission of HIV, China’s Ministry of Health.

Objective: Related social factors and neurotransmitter pathway gene polymorphism of child Attention deficit-hyperactivity disorder (ADHD) was investigated to provide evidence for ADHD prevention and control and clue for further ADHD genetic study. Methodology: In the case-control study, social information of 233 ADHD children and 711 health children were investigated by a self-designed questionnaire. Blood samples of 168 ADHD children and 233 health children were collected. Ten Single nucleotide polymorphisms (SNPs) of SLC6A3, DRD4, SLC6A2 and ADRA2A were tested. Findings: In multiple logistic regression, ADHD were related to male (OR=4.96,95%CI: 3.28-7.49), 6-9 years old (OR=1.77, 95% CI: 1.24-2.53), family month income ≤3000 yuan per capita (OR=1.85, 95%CI:1.31-2.61), preterm birth (OR=3.09,95%CI:1.15-8.33), mother general or poor mood (OR=1.67, 95%CI:1.18-2.36) and indirect smoking (OR=1.81, 95%CI: 1.20-2.72) during pregnancy, general or poor parents relationship (OR=1.92, 95%CI:1.31-2.82), father accompany with child <4 hours a week (OR=1.80, 95%CI:1.16-2.79), house decoration last year (OR=1.62, 95%CI:1.03-2.55) and child indirect smoking (OR=1.77, 95%CI:1.16-2.69). Adjusted for child sex and age, DRD4 rs747302, DRD4 rs3758653 and ADRA2A rs521674 polymorphisms were associated with ADHD, ADHD subtype and ADHD-ODD (all P<0.05). SLC6A2 rs168924 and DRD4 rs1800955 polymorphisms were related to ADHD and ADHD subtype (both P<0.05). There were significant associations between ADRA2A rs2484516 polymorphisms and ADHD-Inattention (P<0.05), between SLC6A2 rs40615 polymorphism and ADHD-Hyperactive + Combined and ADHD-ODD (both P<0.05), and between rs28386840 polymorphism and ADHD-ODD (P<0.05). Conclusion: Boy aged 6-9 years old and preterm children should be screened

Shaeraine Raaj is a Consultant Psychiatrist in Royal college of Surgeons Department of Psychiatry, Ireland.

Background: Phoenix Care Centre is the only Psychiatric Intensive Care Unit in Ireland. This mental health facility was open in May 2013. Phoenix Care Centre provides a tertiary service for patients who require an intensive care setting for the treatment of acute episodes of their mental illness within a locked therapeutic environment. Phoenix care centre covers a population of 1.8 million within the catchment areas of Dublin, Wicklow and the North East Region. Over the last 20 years a small group of patients has shown to be difficult to manage in a General Hospital setting. Risks leading to referral include significant aggression, risk of assault, actual assault and absconding. AIM: The aim of this study is to identify the referral pattern to a Psychiatry Intensive Care Unit in Ireland. To demonstrate the diagnosis, mean length of stay, gender and the indication for referrals over a 2 year period. Method: A Retrospective chart study was carried out over admission to the PICU in the preceding two years. All patients admitted between January 2014 and January 2016 to the PICU formed the study group (n=67). Information concerning patient’s characteristics was obtained at the time of admission. This included gender, mean length of stay, indication for referral and the ICD 10 diagnosis.

Nagoya University, Japan

Mental health is an important component for academic and social adjustment in college. The present study examined differences in the factors predicting mental distress among university students in Nigeria and Japan, based on the ecological model. A total of 716 undergraduates (391 Nigerians, 325 Japanese) from four universities in both countries took part in the study. Average age of participants was 25.63 and 20.08 years in Nigeria and Japan respectively. A self-report questionnaire assessed several predictors including individual characteristics via the BNSG scale; micro level factors via the UCLA Loneliness Scale and SPUSSS; exo-level factors via the MacArthur scale of subjective status; and macro level factors via social participation on the outcome measure of mental health via the GHQ-12. A four-step hierarchical regression was computed on the data from both countries and the findings from the final model revealed that the predictors accounted for 16.1% (in Nigeria) and 31.8% (in Japan) of the variance in mental health. Furthermore, in Nigeria, competence and loneliness were statistically significant predictors of mental health while for Japan, autonomy, competence, relatedness, loneliness and club participation had significant regression weights Further analyses to evaluate the structure of the final model from the two countries showed that autonomy (Z = -4.44, p<.01), relatedness (Z= 5.13, p<.01) and loneliness (Z= 2.57, p<.05) had significantly different regression weights between the countries. These findings suggest cross-cultural differences in the influence of ecological factors on mental health of undergraduates with implications for the mental health of college students in both societies.

Managing Partner, Ndalle Bois Sarl

Psychiatric mental health is critical to ensuring the health and wellbeing of individuals, families, and communities. While psychiatric mental health work continues to become increasingly complex and challenging, the demand for psychiatric nurses with evidence-based skills continues to grow. Psychiatric mental health nurses (PMHNs) are the primary providers of professional psychiatric mental health care services Human beings are social species which require safe and secure social surroundings to survive. Satisfying social relationships are essential for mental and physical well beings. Impaired social relationship can lead to loneliness. Since the time of dawn, loneliness is perceived as a global human phenomenon. Loneliness can lead to various psychiatric disorders like depression, alcohol abuse, child abuse, sleep problems, personality disorders and Alzheimer’s disease. It also leads to various physical disorders like diabetes, autoimmune disorders like rheumatoid arthritis, lupus and cardiovascular diseases like coronary heart disease, hypertension (HTN), obesity, physiological aging, cancer, poor hearing and poor health. Left untended, loneliness can have serious consequences for mental and physical health of people. Therefore it is important to intervene at the right time to prevent loneliness, so that physical and mental health of patients is maintained.