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The Trail Making Test (TMT) is a useful measure of executive dysfunction in elderly subjects. This study aims to investigate the discriminative validity of the oral version of the TMT (OTMT), which can be administered to subjects with visual or motor disabilities, in elderly patients with Mild Cognitive Impairment (MCI; n = 30), Alzheimer's disease (AD; n = 30), and healthy controls (HCs; n = 25). The WAIS-R Digit Span Backwards Subscale, written form of the Trail Making Task, the Clock Drawing Test, the AD Assessment Scale-Cognitive Subscale, and the OTMT were also administered to all participants in order to examine the concurrent validity of the OTMT. The OTMT part B discriminated between patients with MCI, AD, and HC correctly. The OTMT completion time was not correlated with age, but was negatively correlated with education. In conclusion, the OTMT (mostly part B) is a valid and practical measurement tool for different levels of cognitive impairment, especially for patients with visual or motor disabilities for whom the classical written form is not feasible.

Introduction: Refugees have been shown to be a rather vulnerable population with increased psychiatric morbidity and lack of access to adequate mental health care. By expanding regional psychosocial and psychiatric-psychotherapeutic care structures and adapting psychiatric routine care to refugees’ needs, the state-funded project “refuKey” based in Lower Saxony, Germany, pursues to ease access to mental health care and increase service quality for refugees. A stepped-care treatment model along with intercultural opening of mental health care services is proposed. Methods: The project is subject to a four-part evaluation study. The first part investigates the state of psychiatric routine care for refugees in Lower Saxony by requesting data from all psychiatric clinics, participating and non-participating ones, regarding the numbers of refugee patients, their diagnoses, settings of treatment, etc. The second part explores experiences and work satisfaction of mental health care professionals treating refugees in refuKey cooperation clinics. The third part consists of interviews and focus group discussions with experts regarding challenges in mental health care of refugees and expectations for improvement through refuKey. The fourth part compares mental health parameters like depression, anxiety, traumatization, somatization, psychoticism, quality of life, as well as “pathways-to-care” of refuKey-treated refugees before and after treatment and, in a follow-up, to a non-refuKey-treated refugee control group. Results: RefuKey-treated refugees reported many mental health problems and estimated their mental health burden as high. The symptoms decreased significantly over the course of treatment. Mental health in the refuKey sample was strongly linked to post-migration stressors. Discussion: The state of mental health care for refugees is discussed. Implications for the improvement and the need for adaptation of routine mental health care services are drawn.

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Older GAD patients had more disturbances of sleep, less reassurance seeking behaviors, higher rates of depression and higher depression severity when compared to the young patients. Although older people seemed to have a lower severity of GAD, they had higher disability due to worries. Older patients worried more about their own health and family well-being, whereas young patients worried more about future and other's health.

The aim of this study was to investigate the dimensions of agitation in dementia patients using the Turkish version of the Cohen-Mansfield Agitation Inventory (CMAI-T). Materials and Method: The study included 100 patients diagnosed as dementia, according to the DSM-IV-TR. The CMAI-T was administered to the patients' caregivers via face-to-face interviews. The Standardized Mini Mental State Examination (SMMSE) was used to assess cognitive functions. The severity of depression and the functional state of the patients were assessed using the Cornell Scale for Depression in Dementia (CSDD) and the Functional Activities Questionnaire (FAQ). Principal component analysis and varimax rotation were used to determine the factor structure of the CMAI-T. Results: Factor analysis of the CMAI-T indicated a 3-factor structure: physically aggressive agitation, verbal agitation, and physically non-aggressive agitation. In 92% of the patients there was ≥1 agitation behavior during the previous 2 weeks. The CMAI-T total and factor scores were negatively correlated with the SMMSE scores, and positively correlated with the CSDD and the FAQ scores. Conclusions: The CMAI-T yielded 3 factors (physically aggressive agitation, verbal agitation, and physically non-aggressive agitation), which indicated the scale had construct validity. Agitation behaviors were associated with cognitive dysfunction, symptoms of depression and general level of functioning. Additional research is necessary to identify the predictors of these dimensions in different dementia samples, and to determine the efficacy of therapeutic interventions.

IntroductionGermany has always been an important host country for traumatized refugees and asylum seekers. Although, recently an increasing number of investigations about mental health of individual migrant groups have been published in Germany, there is a paucity of research concerning mental health of asylum seekers and refugees.Aims-objectivesTo investigate socio-demographic and clinical characteristics of traumatized refugees-asylum seekers who were applied to an outpatient psychiatry clinic in Germany.MethodA standardized data collection form (socio-demographics, diagnosis, suicidality, etc.) was filled by therapists for each traumatized refugee-asylum seeker who was applied to outpatient clinic of Klinikum Wahrendorff-Centre of Transcultural Psychiatry between April 2013 and October 2015.ResultsFifty-eight traumatized refugees-asylum seekers (F/M = 27/31, age: 34.7 ± 1.4) were assessed. 53 (91.4%) of them were assessed via interpreters. Thirty (51.7%) of them were staying in refugee-dormitories, 25 (43.1%) of them were living alone. They’ve been living in Germany for 19.9 ± 16 months (min: 1–max: 82). Psychiatric symptoms appeared before 29.9 ± 19 months. Time to reach to psychiatric care in Germany was 14.2 ± 11 months. Psychiatric diagnoses were posttraumatic stress disorder (PTSD): 12 (21%), depression + PTSD: 44 (76%), depression: 2 (3%). Fifty-three (91.4%) of them had suicidal ideation and 16 (27.6%) of them had at least one suicide attempt before.ConclusionsTraumatized refugees in this study have high rates of suicidal ideation and suicide attempts and it takes months to years for them to reach a psychiatric care. Therefore, strategies should be developed for early detection of PTSD symptoms in traumatized refugees and access barriers to reach a psychiatric care should be overcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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