Encephale
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The Verona Service Satisfaction Scale-French version (13) was translated and adapted from the Italian version of Verona Service Satisfaction Scale (27). The VSSS makes it possible to evaluate the satisfaction of people with serious mental illness with respect to the services. The original VSSS-54 contained 7 dimensions: 1) Overall satisfaction, 2) Professionals' skills and behaviour, 3) Information, 4) Access to services, 5) Services efficacy, 6) Relatives' involvement and 7) Types of interventions. According to factorial analyses carried out by Ruggeri et al., the dimensions Information and Access to services were aggregated. However, no factorial analysis was carried out in order to verify the six dimension-structure of the VSSS. From an international perspective, the study entitled "The European Psychiatric Services: Inputs linked to Outcome Domains and Needs (EPSILON)" achieved the standardisation of different questionnaires in several languages (2). A new version of the VSSS entitled "Verona Service Satisfaction Scale-European version" (VSSS-EU) was developed and is now available in the following languages: Italian, Danish, German, English and Spanish. In order to compare in different countries the satisfaction of people with serious mental illness with respect to services, we undertook from 1998 to ascertain the psychometrical properties of the French version of the VSSS. (13). Confirmatory Factorial Analysis (CFA) was carried out on the six dimension-structure of the VSSS-54F: 1) Overall satisfaction, 2) Professionals' skills and behaviour, 3) Information and Access to services, 4) Services efficacy, 5) Relatives involvement and 6) Types of interventions. For each dimension, consistency analysis (Cronbach's alpha) was computed in order to bring forth additional psychometrical properties of the VSSS-54F. ⋯ This study confirms with some adjustments the factorial structure of the VSSS. The results indicate five dimensions (25 items): Psychiatrists/Psychologists' skills and behaviour, Nursing staff/social workers' skills and behaviour, Information and access to services, Services efficacy, Relatives' involvement. Even if the Type of interventions dimension was not retained in the model, we suggest preserving it for eventual clinical evaluation based on each item. We also suggest, for future studies, the adaptation of the VSSS-54F to the European version, VSSS-EU. Indeed, the results of our study sustain the European version because the VSSS-EU is more focused since it separates the skills and behaviour of psychiatrists, psychologists, nurses and social workers (e.g. items 3a and 3b or items 22a and 22b). The next step in the validation process would be to measure Inter-rater and test-retest reliability as well as concurrent, convergent and discriminant validity of the VSSS-EU. Furthermore, a multicultural comparison of the VSSS-EU would be required if the instrument is used for interesting comparisons of survey.
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The increasing prevalence of the agitation states in the emergency department (ED) is a problem little studied on the epidemiological plan. ⋯ The management of the agitated patients in the ED requires the placing of protocols and of specific trainings as well as of adapted premises. The major prevalence of attacks imposes realization of epidemiological studies and the priority placing of a coherent politics, considering the potential and often real gravity of these behavioural problems.
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The high prevalence of psychoactive substance abuse or dependence among schizophrenic patients has now been well established. Mueser et al. stressed the need to assess the abuse of specific classes of substances and analyse the data accordingly. The objective of this study was to compare the socio-demographic correlates and the clinical features in a group of schizophrenic patients with a lifetime cannabis abuse or dependence according to the DSM III-R with a group of schizophrenic patients who had never presented any abuse or dependence. ⋯ The socio-demographic characteristics of cannabis abuse or dependence in schizophrenia are similar to those found in general population. Cannabis using schizophrenic patients were more likely to be younger and male than non users. The duration of hospitalization was significantly longer for the group with cannabis abuse. Prevalence of suicide attempts in schizophrenia is closely correlated to cannabis abuse.
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Polyunsatured fatty acids are made out of a hydrocarbonated chain of variable length with several double bonds. The position of the first double bond (omega) differentiates polyunsatured omega 3 fatty acids (for example: alpha-linolenic acid or alpha-LNA) and polyunsatured omega 6 fatty acids (for example: linoleic acid or LA). These two classes of fatty acids are said to be essential because they cannot be synthetised by the organism and have to be taken from alimentation. The omega 3 are present in linseed oil, nuts, soya beans, wheat and cold water fish whereas omega 6 are present in maize, sunflower and sesame oil. Fatty acids are part of phospholipids and, consequently, of all biological membranes. The membrane fluidity, of crucial importance for its functioning, depends on its lipidic components. Phospholipids composed of chains of polyunsatured fatty acids increase the membrane fluidity because, by bending some chains, double bonds prevent them from compacting themselves perfectly. Membrane fluidity is also determined by the phospholipids/free cholesterol ratio, as cholesterol increases membrane viscosity. A diet based on a high proportion of essential polyunsatured fatty acids (fluid) would allow a higher incorporation of cholesterol (rigid) in the membranes to balance their fluidity, which would contribute to lower blood cholesterol levels. Brain membranes have a very high content in essential polyunsatured fatty acids for which they depend on alimentation. Any dietary lack of essential polyunsatured fatty acids has consequences on cerebral development, modifying the activity of enzymes of the cerebral membranes and decreasing efficiency in learning tasks. ⋯ Some epidemiological, experimental and clinical data favour the hypothesis that polyunsaturated fatty acids could play a role in the pathogenesis and/or the treatment of depression. More studies however are needed in order to better precise the actual implication of those biochemical factors among the various aspects of depressive illness.
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We choose to discuss from the PTSD's point of view because this diagnostic reference is commonly used. We wish outline its restrictive sight which could prevent the professional from having a diagnosis of PTSD. We don't want to say there is a PTSD everywhere but it appears to us that a traumatic reading can be a precious advantage for the clinician to establish a real therapeutic relation with some patients. ⋯ With patients who suffered an infarct, the treatment of PTSD which prevents their recovery will help to go back to the way they lived before the event. It has been showed how important could be the PTSD detection on the severe burned people's pain control. Thus it seems to be crucial for the clinician to keep this diagnosis in mind alongside any other.