The prevalence, severity and chronicity of abuse towards older men: Insights from a multinational European survey.

Background: Elder abuse is a growing public health question among policy makers and practitioners in many countries. Research findings usually indicate women as victims, whereas male elder abuse still remains under-detected and under-reported. We aimed to investigate the prevalence, severity and chronicity of abuse (psychological, physical, physical injury, sexual, and financial) against older men, and to scrutinize factors (e.

How to improve clinical practice on forced medication in psychiatric practice: Suggestions from the EUNOMIA European multicentre study.

Background: The decision to adopt forced medication in psychiatric care is particularly relevant from a clinical and ethical viewpoint. The European Commission has funded the EUNOMIA study in order to develop European recommendations for good clinical practice on coercive measures, including forced medication.

Methods: The recommendations on forced medication have been developed in 11 countries with the involvement of national clinical leaders, key-professionals and stakeholders' representatives.

Lifetime Abuse and Quality of Life among Older People.

Few studies have evaluated the impact of lifetime abuse on quality of life (QoL) among older adults. By using a multinational study authors aimed to assess the subjective perception of QoL among people who have reported abuse during the course of their lifetime. The respondents (N = 4,467; 2,559 women) were between the ages of 60 and 84 years and living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden).

Abuse of Older Men in Seven European Countries: A Multilevel Approach in the Framework of an Ecological Model.

Background: Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims.

Do patient and ward-related characteristics influence the use of coercive measures? Results from the EUNOMIA international study.

Purpose: This study aims to identify whether selected patient and ward-related factors are associated with the use of coercive measures. Data were collected as part of the EUNOMIA international collaborative study on the use of coercive measures in ten European countries.

Methods: Involuntarily admitted patients (N = 2,027) were divided into two groups.

Factors associated with refraining from buying prescribed medications among older people in Europe.

Aim: To evaluate the associations between refraining from buying prescribed medications and selected factors among older persons.

Methods: A total of 4467 people aged 60-84 years from seven European countries answered a questionnaire (response rate 45.2%).

Social support, socio-economic status, health and abuse among older people in seven European countries.

Background: Social support has a strong impact on individuals, not least on older individuals with health problems. A lack of support network and poor family or social relations may be crucial in later life, and represent risk factors for elder abuse. This study focused on the associations between social support, demographics/socio-economics, health variables and elder mistreatment.

Abuse and neglect of older persons in seven cities in seven countries in Europe: a cross-sectional community study.

Objectives: We aimed to investigate the prevalence rate of abuse (psychological, physical, sexual, financial, neglect) of older persons (AO) in seven cities from seven countries in Europe (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden), and to assess factors potentially associated with AO.

Methods: A cross-sectional study was conducted in 2009 (n = 4,467, aged 60-84). Potentially associated factors were grouped into domains (domain 1: age, gender, migration history; domain 2: education, occupation; domain 3: marital status, living situation; domain 4: habitation, income, financial strain).

Patient characteristics and symptoms associated with perceived coercion during hospital treatment.

Objective: Large numbers of psychiatric patients either are involuntarily admitted to hospital treatment or feel coerced despite a legally voluntary admission. For ethical and clinical reasons, their perceived coercion should be reduced as far as possible. There is however limited evidence on patient characteristics associated with perceived coercion during hospital treatment.

Causes of refraining from buying prescribed medications among the elderly in Kaunas, Lithuania.

Background And Objective: Accessibility to medications among the elderly is a source of concern in Lithuania and beyond. However, there are no studies carried out on this topic in Lithuania. Therefore, the aim of this study was to evaluate the causes of refraining from buying prescribed medications among the elderly in Kaunas, Lithuania.

How to improve clinical practice on involuntary hospital admissions of psychiatric patients: suggestions from the EUNOMIA study.

Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories.

Use of coercive measures during involuntary hospitalization: findings from ten European countries.

Objective: Involuntary treatment in mental health care is a sensitive but rarely studied issue. This study was part of the European Evaluation of Coercion in Psychiatry and Harmonization of Best Clinical Practice (EUNOMIA) project. It assessed and compared the use of coercive measures in psychiatric inpatient facilities in ten European countries.

Non-uniform effectiveness of structured patient-clinician communication in community mental healthcare: an international comparison.

Background: The effectiveness of psychosocial interventions in community mental healthcare has been shown to depend on the setting in which they are implemented. Recently structured patient-clinician communication was found to be effective in a multi-centre trial in six European countries, the DIALOG trial. In the overall study, differences between centres were controlled for, not studied.

Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?

Background: Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment.

Methods: Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with schizophrenia or related psychotic disorders.

What works for whom in a computer-mediated communication intervention in community psychiatry? Moderators of outcome in a cluster randomized trial.

Objective: An intervention to structure patient-key worker communication has been tested in a randomized controlled trial. The aim of this paper was to investigate effectiveness of the intervention in terms of moderators of effectiveness.

Method: A total of 507 patients with schizophrenia were included.

Structured patient-clinician communication and 1-year outcome in community mental healthcare: cluster randomised controlled trial.

Background: Patient-clinician communication is central to mental healthcare but neglected in research.

Aims: To test a new computer-mediated intervention structuring patient-clinician dialogue (DIALOG) focusing on patients' quality of life and needs for care.

Method: In a cluster randomised controlled trial, 134 keyworkers in six countries were allocated to DIALOG or treatment as usual; 507 people with schizophrenia or related disorders were included.

Effectiveness of a psychoeducational intervention for families of patients with schizophrenia: preliminary results of a study funded by the European Commission.

In spite of their proven efficacy, psychoeducational interventions for families of patients with schizophrenia are not being commonly applied in clinical practice. In this report, we present the preliminary results of a one-year follow-up study on the implementation and effectiveness of a psychoeducational family intervention in six European countries. Forty-eight professionals were involved in the study and provided the intervention for one year to 55 families of patients with schizophrenia.

Reinstitutionalisation in mental health care: comparison of data on service provision from six European countries.

Objective: To establish whether reinstitutionalisation is occurring in mental health care and, if so, with what variations between western European countries.

Design: Comparison of data on changes in service provision.

Setting: Six European countries with different traditions of mental health care that have all experienced deinstitutionalisation since the 1970s--England, Germany, Italy, the Netherlands, Spain, and Sweden.

The impact of routine outcome measurement on treatment processes in community mental health care: approach and methods of the MECCA study.

Three issues characterise the background to the MECCA study: A) Throughout Europe, most patients with severe forms of psychotic disorders are cared for in the community. The challenge now is to make processes in community mental health care more effective. B) There are widespread calls to implement regular outcome measurement in routine settings.