A total of 60 patients with functional non-affective psychoses were assessed 16 years after their inclusion in the WHO co-ordinated study on reduction and assessment of psychiatric disability. All patients at inclusion had a recent onset of a psychotic disorder. About one-third of the patients had a good outcome. The rest showed moderate to severe psychiatric symptoms and social disability. Comparison with other similar studies suggested that our results show a low mortality rate, high levels of clinical symptoms, high levels of social disability and a low percentage of institutionalized patients. These findings are discussed in the context of the high level of family involvement in patients' care, which could reflect a cultural factor.

Background:Alzheimer Dementia (AD) is known as the most common cause of degenerative dementias that decrease patient life expectancy, quality of life and increase caregivers burden. Objective: To determine the evolution of cognitive and non-cognitive symptoms under donepezil treatment and to evaluate the impact of these symptoms evolution over the caregivers.Methods:This prospective, open-label, trial included a group of 56 patients, 34 male and 22 female, mean age 72.4, diagnosed with AD according to DSM-IV-TR criteria. Patients received either donepezil (n= 30) or 1400 UI/day mean dose of vitamin E (n=26). We evaluated these patients monthly during 1 year using Mini-Mental State Examination (MMSE), AD Assessment Scale (ADAS), Hamilton Depression Rating Scale (HAMD)-17 items, Brief Psychiatric Rating Scale (BPRS)- 18 items, Global Assessment of Functioning Scale (GAF), Burden Interview (BI).Results:Patients presented significant better evolution under donepezil on cognitive symptoms as scores evolution on ADAS-Cognitive behavior subscale (+1.5+/-0.2 vs. +10.4+/-0.8, p<0.0001) and MMSE (-0.8+/-0.2 vs. –7.7+/-0.4, p<0.0001) reflected. The non-cognitive symptoms evolution was also better under donepezil treatment, as the ADAS-Noncognitive behavior subscale (+2.6+/-0.4 vs. +8.2+/-0.7, p<0.0001), HAMD (increases of 4.5 vs. 8.2, p<0.001) and BPRS (increases of 6.7 vs.14.2, p<0.0001) reflected. The evolution of GAF was better in the donepezil group (-10.5 vs. –27.5, p<0.0001) and the burden of caregivers was significant less in the same group (+10.2 vs. +30.8 on BI, p<0.0001).Conclusion:Donepezil is efficient in controlling both cognitive and non-cognitive symptoms in mild to moderate AD and therefore it decreases also the caregivers burden.

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Results: From 265 randomized patients,207 were eligible for the analysis and 175 patients answered the preference question. 106(61%) patients preferred ODT, and 48(27%) preferred OCT (p<0.001 adjusted for treatment sequence); 21(12%) expressed no preference. 90% of patients were rated as almost always compliant on both formulations. The adverse event profiles of ODT and OCT were similar: most common (>1%) adverse events were weight increase, hypertriglyceridaemia, and somnolence.Conclusions: Most of the patients who answered the preference question declared to prefer olanzapine orodispersible to conventional formulation. Given the importance of patient's preference as one of the factors for future compliance, olanzapine orodispersible tablet could be a good choice. P0238"Before" and "Beyond" the parallelism between phenomenology and neuropsychology H. Tsuda. Departmnent of Psychopathology and Psychotherapy, Faculty of Medicine, Nagoya University, Nagoya, Japan A phenomenological-psychopathological approach, which attempts to directly explicate the basic mode of existence of affected persons, had once attracted broad attentions. Even today the most basic phenomena of schizophrenia cannot be understood without considering this approach, which takes current philosophies into consideration.After the revolutionary work of Blankenburg, phenomenological psychiatry has attempted to elucidate the relation between transcendental constitution and ''naturalness (Selbstverständlichkeit)'' based on Husserl's notion of passive synthesis. However due care must be taken with regard to the current trend to lump together this synthesis with the latest neurophisiological findings.Wittgenstein's philosophy, which turned from solipsistic analysis to the analysis of the language game in our daily life, has also contributed to understanding the quasi-solipsistic feature of delusions (Sass). One can also disclose, referring to Wittgenstein and Spensor-Brown, the specific feature of the conflicts between schizophrenic individuals and their hallucinatory voices. It is as if these conflicts could not be remedied without introducing ''imaginary'' numbers for solving equations.It can be postulated that the ''other'' which once appeared and withdrew in the past, which one cannot retroactively conceive of, provides one with basic trust and the basic structural categorization of our world. However, in schizophrenic cases, this ''other'' appears in the real biography in the later stage, as someone who becomes the origin of trauma. Deleusian philosophy may make clear ''the logic of life'' of these individuals remaining in the pre-structured world and also may reveal the conditions of ''our'' experience from a ''schizophrenic'' perspective. 1 Department of Psychiatry, Santa Maria Hospital, Lisbon, Portugal 2 Faculty of Medicine, Lisbon, Portugal Background and Aims: We investigated which factors could influence insight in psychosis.Methods: 117 in-out patients recruited in the Psychiatric Service of Santa Maria Hospital, Lisbon (Portugal) diagnose...

dinThe construction specification and regulations (SNIP) call for calculating the stability and seismic stability of earth dams with consideration of the factors determining the behavior of earth materials under static and seismic loads.In calculations of earth dams the stability of the slopes is evaluated by the method of fixed surfaces of sliding (in particular, along cylindrical surfaces) under the assumption that the sliding mass of soil behaves as a rigid undeformable body (model of a consolidated slope). At the same time, consideration of a possible unstabilized state is carried out on the basis of Terzaghi's principle of effective stresses by determining the excess pore pressure.It is indicated in the SNiP for earth dams that when calculating the pore pressure from consolidation of soils in cores of earth-rock dams with a height of more than 70 m it is necessary to take into account the stress state of the structure.Calculations of the stress state must be performed for earth-rock and rockfill dams of classes I and II with a height of more than 70 m. The use of relations of the linear and nonlinear theory of elasticity is allowed in the calculations.At present a number of organizations, the All-Union Scientific-Research Institute of Hydraulic Engineering (VNIIG), Leningrad Polytechnic Institute (LPI), All-Union Planning, Surveying, and Scientific-Research Institute (Gidroproekt), etc., have developed computer programs for calculating the stability of dam slopes realizing the SNiP methods.In these methods the excess pore pressure is determined on the basis of the theory of consolidation due to seepage, but the total stresses are found, as a rule, without consideration of the real stress state in the sliding soil mass; furthermore, the degree of water saturation and change of saturationduring consolidation are often not taken into account when determining the pore pressure.We note that consideration of the air content in soils is extremely necessary, since even a small air content considerably reduces the pore pressure and accelerates the consolidation process, and, consequently, considerably affects the safety factors being determined.Calculations of structures on the basis of limitation of the absolute and relative displacements should provide their normal service and not allow a decrease of their service life. If we turn to the SNiP for earth dams, then it is recommended in it to determine the settlement of the crest for evaluating the amount of construction rise of the dam and amount of differential settlement of its various parts.In this case it is recommended to calculate settlements by the layer-by-layer summation method with the use of compression formulas. There are also known recommendations containing empirical formulas for calculating the possible amount of settlement.It is recommended to estimate the horizontal displacements of dams on the basis of analogues, and for preliminary estimates of horizontal displacements of dam crest it is recommended even to assume them to be equal to settlement of ...