Background and aims: The aims of this study was to identify patient characteristics associated with once-only contact with a communitybased mental health service (CMHS), and to re-evaluate these patients 3 months after the contact.Methods: A 33-month cohort of new episodes of care was followed-up to identify and interview once-only contact patients.Results: Of the 1,101 patients who met the study criteria, 165 (15%) were discharged after the first contact, 87 (8%) dropped out after the first contact, 440 (40%) were low users and 409 (37%) were high users of the CMHS in the 90 days after the first contact. A higher GAF score, less severe psychiatric diagnoses and lower socioeconomic status were the factors most associated with once-only contact at baseline. At follow-up clinical conditions of patients who had only one contact (both discharged and drop-out) had improved and, in most cases, they were in contact with other services. Drop-out patients, however, were more unwell and less satisfied with the initial contact.Conclusions: Although there is no way of knowing the status of patients who could not be located, information from the people interviewed suggest that, for a group of patients predominantly without psychoses, dropping out of contact after the first visit is associated with being less satisfied with the services received at the initial contact. This dissatisfaction may had lead these patients seeking help elsewhere. Perhaps, some of these extremely low users are in need of a different or more specialized clinical treatment approach.

Background and Aims:Eating Disorders are strongly associated with psychological distress. We examined this association for anorectic and bulimic symptoms and obesity.Method:Cross sectional study of 2263 adolescents aged 15-18 years-old from 10 schools in Northwestern Greece. Subjects were screened using the 12-item general health questionnaire (GHQ-12). 873 subjects were selected for the second stage interview with the revised Clinical Interview Schedule (CIS-R) and asked for eating and dieting practices. Odds ratios adjusted for age and sex were computed for the association between eating disorder symptoms and scores on the CIS-R.Results:Eating disorder symptoms are prevalent among adolescents (Anorectic symptoms=15.8% ♀/♂=30/1, Bulimic symptoms=9.3% ♀/♂=2/1, Binge Eating symptoms=10.2% ♀/♂=1/1) and they are strongly associated with high psychological distress (CIS-R score≥18). The Odds Ratio (OR) of having a high score on the CIS-R for subjects with anorectic symptoms compared to healthy subjects was 3.7 (95% Confidence Intervals 2.1 – 6.5). For bulimia the OR was 12.9 (4.7 – 35.4) and for binge eating the OR was 7.2 (2.4 – 21.4). Obesity was not associated with higher psychological distress but it was found to influence satisfaction with body image and self reported physical health.Conclusions:The prevalence of eating-related symptoms defines a risk-population, much larger than the clinical significantly cases of eating disorders. The “eating related disorders” should be considered in a continuum in the one side of which lie obesity and on the other anorexia/bulimia nervosa, connected with the pre-morbid situations of Anorectic/bulimic symptomatology.“The research Project is co-funded by the European Union - European Social Fund (ESF) & National Sources, in the framework of the program "Pythagoras II" of the "Operational Program for Education and Initial Vocational Training" of the 3rd Community Support Framework of the Hellenic Ministry of Education.”

IntroductionThoughts of feeling life is not worth living could be the initial stage of a continuum that might end in a suicide.ObjectivesPsychiatric morbidity is quite prevalent among adolescents and has been associated with suicidal ideation.AimsOur aim was to test the association between thoughts that life is not worth living and psychiatric morbidity in a sample of Greek adolescents.MethodsA two-phase cross sectional study of 5614 adolescents aged 16–18 years old attending 25 senior high schools in Greece. A stratified random sample of 2431 subjects was selected for a detailed interview at the second phase. Psychiatric morbidity and thoughts of life is not worth living were assessed with the revised Clinical Interview Schedule (CIS-R). Odds ratios adjusted for age and sex were computed for the association between such thoughts and CIS-R scores.Results3,72% of the adolescents (girls:5,11%, boys:2,36%, p < 0.001) reported thoughts of feeling life is not worth living in the week before interview. Psychiatric morbidity correlated significantly with those thoughts (OR = 1.16, 95% Confidence Intervals: 1.14–1.19). The level of psychiatric morbidity was strongly associated with such thoughts with higher levels of distress showing a greater association (Table 1).[Table 1]ConclusionsPolicies aiming at preventing the overall burden of psychiatric disease in adolescence may reduce the frequency of thoughts that life is not worth living, which could eventually lead to a decrease in completed suicides.