Geriatric psychiatry as a subspecialty is relatively new in our country. However, for a long time, psychiatrists in the Philippines have been treating elderly psychiatric patients.
GERIATRIC PSYCHIATRY

OBJECTIVES: The aim of this study is to assess the psychosocial needs of persons with disability of the Rehabilitation Sheltered Workshop (RSW) of the DSWD as well as screen for psychiatric illness.
METHODOLOGY: There were 38 persons with various disabilities enrolled at the RSW. They were interviewed and screened using the Self Reporting Questionnaire (SRQ).
RESULTS: About a third (34.21%) were married and 28.94% were single. Fifty percent were physically disabled i.e. amputees or with deformities of the extremities; 34.21% were blind the remaining 15.78% had a variety of disabilities e.g. deafness, facial deformity or speech impairment. The mean age was 45.5 years old. Based on the SRQ 38.64% of the visually disabled clients scored positive for mood/anxiety while 53.84% scored positive for psychosis; while 52.63% of the orthopedic clients scored positive for mood/anxiety and an even higher 73.68% scored positive for psychosis. For the other handicapped clients,33.33% scored positive for mood/anxiety and 50.00% scored positive for psychosis.
CONCLUSION: Majority (63.16%) of the 38 clients at the RSW were psychotic and only 44.73% were found to have mood/ anxiety symptoms, thus the need for psychiatric follow up as well as initiation of psychopharmacological and psychotherapeutic interventions for these clients.

OBJECTIVES:This study aimed at identifying psychiatric problems among patients who were diagnosed with breast cancer and scheduled for mastectomy.
METHODOLOGY:All the women who were diagnosed with breast cancer and were awaiting their scheduled mastectomy at the surgical clinic were interviewed using the Self-Reporting Questionnaire (SRQ) and the Zung Self Rating Depression Scale. Their sociodemographic and histopathological reports were also noted.
RESULTS:There were 21 women included in this study with mean age of 43.5 years. Majority (61.9%) were married and mostly high school graduates (42.8%) and unemployed i.e. 76.19% housewives. Most complained of breast pain (71.4%) while a third (38.1%) noted nipple discharge. Based on the SRQ,61.9% scored positive for mood/ anxiety and only 4.7% were found to be positive for psychosis. When rated according to the Zung Self Rating Depression Scale, 6 or 28.6% were noted to have marked depression and 5 or 23.8% had severe depression.
CONCLUSION:Since most women with breast cancer in this study have been found to be positive for mood/anxiety and depression, it is recommended that screening for psychiatry morbidity should be part of the standard care and a support group manned by mental health professionals should be established as part of the holistic management.

Objective: The aim of the study is to determine the pathways to care of children and adolescents with mental disorders between initial symptom recognition and psychiatric consultation and to examine the demographic and clinical factors influencing access to care. Methods: This is cross-sectional analytic study that entailed interview and/ or review of charts of children and adolescents with mental disorders evaluated at the Child Psychiatry section, Child Neuroscience Division of the Philippine Children's Medical Center from January 2002 to March 2006. Kruskal-Wallis Test and Mann-Whitney U Test were used to determine if there was significant difference in time intervals from symptom recognition to psychiatric consultation among the different groups of children and adolescents according to demographic and clinical factors. Results: Majority (56%) of the caregivers of the patients cited lack of concern over patient symptoms as the reason why it took a long time for them to seek psychiatric consultation. Twenty seven percent of caregivers claimed that they were concerned about their child's symptoms yet did not know where to consult. Institutionalized children and adolescents and those with psychosomatic symptoms had much shorter time interval. Psychotic patients had the next shortest time interval while those with hyperactive impulsive disorders had the longest time interval between symptom recognition and consultation. Surrogate parents also showed the shortest interval from symptom recognition to psychiatric consultation. Only 36% of cases reviewed were brought directly while 44% were initially brought to non-psychiatric PCMC trainees before eventual referral to psychiatry. Almost all (98%) of the psychiatric cases brought to non-psychiatric CNS fellow and a high proportion (92%) of those bought to non- CNS fellows and pediatric residents (88%) were subsequently referred to child psychiatry. Only half of the psychiatric cases reviewed were first seen by physicians outside PCMC and approximately one-third were first seen by psychologists before being brought to PCMC. Of all the professionals initially consulted the "herbolario" had the shortest time interval from symptom recognition to first attempt to seeking care. The mean time interval from symptom recognition to first attempt to seeking care of the cases reviewed was 20.7 months. The mean interval from symptom recognition to psychiatric consultation was 23.7 months. Conclusion: Knowledge of the pathway to psychiatric care and the different factors that influence this is vital in preventing delay in the diagnosis and management of children and adolescents with psychiatric problems. These children's mental conditions have an impact not just at the individual, but also on the familial and societal level. Impeding psychiatric assessment and intervention can lead to further deterioration in the functioning and intrapersonal relationships of these patients. Thus, it is very important to address factors that delay psychiatric consultation.
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Objective: The purpose of this retrospective study was to describe the status of the forensic cases referred to Davao Mental Hospital from January 1, 1988 to December 31, 2002. Methods: The populations that were included were new forensic cases that were initially seen as either outpatient or inpatient. The charts of the eligible subjects were reviewed and the data was collected, collated, and analyzed. Results: Of the 386 new forensic cases, only 249 were eligible for the study. The findings with regards to age and sex of those forensic cases were consistent with other studies done abroad. The data on socio-demographic profiles, clinical findings, and legal aspects were provided. The issue on possible predisposing risk for criminality as well as the relationship between mental retardation and crimes were discussed. The topics regarding diagnosis "no psychopathology at the time of examination" and "no final diagnosis" were evaluated and came up with recommendation to avoid coming up with the same findings in the future. The reporting system by the attending physician was also undertaken and the drawbacks for the limited number of complete psychiatric report as well as the inadequate corroborative information that are necessary for report making were tackled. The availability of the written court decision was taken into consideration as this will help in systematizing and debulking the records on file. Conclusion: This study showed that there were numerous forensic cases on file and there was a pressing need to update its status. There were several recommendations directed to the different sectors that catered to the mentally ill with forensic cases against them.

Substance abuse as well as its psychiatric consequences is prevalent in the Philippines. This causes an increase in admission rates in mental health institutions that describe these cases are rate. Objective: This study aims to determine the clinical profile of patients with psychoactive substance induced mental disorder and substance abuse co-morbidity. Methods: The medical records of patients admitted at the Community Center of Santo Tomas University Hospital from January 1995-September 2000 with the above diagnosis were reviewed. The data was analyzed using descriptive statistics. Results: Most patients were single, male, college undergraduate, unemployed and Roman Catholic. The mean age was 30 years old, living predominantly in Metro Manila. Most of them were smokers and occasional alcoholic beverage drinkers. More than 30% were diagnosed with substance induced psychotic disorder followed closely by co-morbidity with antisocial personality disorder and schizophrenia, respectively. The most common substance abused was methamphetamine "shabu" and the interval between the onset of symptoms and the psychiatric manifestations was 4-5 years. The presenting symptoms were restlessness, agitation and violent behavior. They also had paranoid delusions, auditory and visual hallucinations. The most common medication given was typical anti psychotics, specifically haloperidol, with a mean length of hospitalization of one month. Conclusion: Drug abuse was associated with a high risk for psychiatric co-morbidity, especially methamphetamine use, which is known to induce psychosis, responsible for agitation, violence and paranoia that would the require anti psychotic medication, and hospitalization.

OBJECTIVES: The goal of this study is to measure the auditory Event Related Potentials in Filipino patients with schizophrenia, their siblings and comparing them with normal controls. Specifically the P300 amplitude and latency measurements of schizophrenic patients would also be correlated to sociodemographic variables such as age, duration of illness and positive and negative symptoms of schizophrenia.
METHODOLOGY: Patients with schizophrenia after consenting to participate in the study were screened using the Positive and Negative Symptom Scale. The auditory event related potentials (ERP) of the parietal electrode of these patients and their siblings as well as a control group of healthy individuals from the community were measured and compared.
RESULTS: Comparison of P300 parameters among 20 patients with schizophrenia, 20 siblings and 20 controls using ANOVA showed that the P300 amplitude of schizophrenic patients was markedly reduced compared with the other 2 groups. P300 latency values were markedly prolonged in both schizophrenia and their siblings when compared to the control group. Analysis of the data revealed that P300 latency had a positive correlation with the duration of positive and negative symptoms. There was also an inverse correlation with positive symptomatology.
CONCLUSION: There was a decreased P300 amplitude and prolonged P300 latency in Filipino Schizophrenic patients. P300 parameters in schizophrenic patients were correlated to age, duration of symptoms and positive and negative symptoms.

OBJECTIVES: This study aims to determine the presence of anxiety, depression and obsessive compulsive symptoms among patients with hemifacial spasm.
METHODOLOGY: Eighteen patients with hemifacial spasm who were seen at a private outpatient clinic were included in the study. Demographic data, duration and severity of illness and screening for the presence of anxiety, depression and obsessive-compulsive symptoms were described. Age and sex matched control group were subjected to the same evaluation.
RESULTS: There were no significant differences in the levels of anxiety, depression and obsessive compulsive symptoms among patients with hemifacial spasm.
CONCLUSION: Psychiatric symptoms are not more prominent in patients with hemifacial spasm.

OBJECTIVES: This study will describe the demographic and clinical profile of forensic patients referred to VSMMC. It will describe the association between the ff: patients' mental disorder, their criminal offenses and the courts' decisions.
METHODOLOGY: This is a retrospective study of all forensic patients referred by the Judicial Courts for psychiatric evaluation from 1999-2003 to the VSMMC and whose residential address was in Cebu Province and its component cities. Data was obtained from the hospital's Outpatient Department records and from the Bureau of Jail Management and Penology after securing permission to review their files. Data was analyzed using the Statistical Package for Social Sciences (SPSS) software i.e. frequency, percentage, correlation coefficient and chi square test for independence.
RESULTS: Sixty-eight patients were included in the study. Majority of patients belonged to the age range of 20-39 years old (72.05%), mostly male (91.2%), single (67.65%), Roman Catholic (98.5%), from rural areas (83.8%) who reached either elementary (36.8%) or secondary (41.2%) levels but remained unemployed (77.9%). Majority (89.7%) of patients were diagnosed to have a psychotic disorder such as: Substance Induced Psychosis (41.2%), Schizophrenia (22.1%), Bipolar I (22.1%) and Brief Psychotic (4.4%). About a third of the cases (39.7%) were dismissed since these were less serious crimes such as illegal possession of methamphetamine HCl, theft, shoplifting and oral defamation; while 22.1% were convicted with serious crimes like murder, rape, homicide, and robbery. The correlation between patients' mental disorder and criminal offense committed was 24.496, while the correlation between the mental disorder and the judicial courts' decision was 21.937, both of which were statistically significant.
CONCLUSION: The mental disorder of the offenders had an influence on the type of crime committed and on the judicial courts.

OBJECTIVE:This research was conducted to determine whether children exposed to the violence of war such as those who lived through the civil war of East Timor in 1999, suffer developmental concerns and behavioral problems as evidenced by abnormal development quotients in at least 4 components of cognition and identification of inappropriate behavior. METHODOLOGY:This was a descriptive cross-sectional study conducted in 1999 on children who lived in Liquica District, 25 km away from Dili, the capital city of East Timor during the massacres that took place between April-September 1999 during civil war of 1999 and who at that time were 2-4 years old but by the time they were tested were 7-9 years old. Healthy children who qualified and whose parents or guardians consented underwent a physical exam that included taking their height and weight. Their parents or guardians were given a questionnaire that included demographic, personal, family and social data as well as the child's school performance, health, and developmental status. RESULTS: Of the 100 children included in the study 69% were found to have difficulties in problem solving skills and below average skills in adapting (63%) and auditory memory (51%). Behavioral problems were identified in 92% of children manifested as temper tantrums, aggressive as well as timid behaviors. Thirty-seven percent had poor school performance noted as being retained in the same grade level and a mean grade of less than 6. CONCLUSION: Majority of children exposed to violence of war presented with developmental i.e. cognitive delays, behavioral problems and school difficulties.