Os transtornos afetivos são altamente prevalentes dentre os transtornos mentais, principalmente Transtorno Afetivo Bipolar (TAB) e Depressão Maior Unipolar (DMU), apresentando altas taxas de morbi-mortalidade. Estudos prévios de Ressonância Magnética (RM) têm identificado anormalidades estruturais cerebrais em indivíduos com TAB e DMU quando comparados a controles normais. Entretanto, nenhum destes estudos foi realizado a partir da comparação direta entre pacientes com DMU e TAB de início recente, nem comparou separadamente tais grupos com amostras representativas de controles assintomáticos provenientes de mesma região geográfica. No presente estudo, definimos a priori que regiões do circuito córtico-límbico-talâmico-estriatal estariam alteradas quando comparados indivíduos com TAB, DMU e controles normais diretamente entre si, em amostra de pacientes com quadros graves de sintomatologia psicótica e pareada com controles normais selecionados na mesma área geográfica dos pacientes. Foram selecionados 46 pacientes (20 com DMU e 26 com TAB) que tiveram contato pela primeira vez com serviço de saúde mental após início de sintomas psicóticos e 62 controles normais. Tanto pacientes quanto controles foram submetidos à RM em aparelho de 1,5 Tesla. Os diagnósticos foram baseados no DSM-IV e confirmados após 1 ano da realização da RM. As imagens foram analisadas pelo método automatizado de processamento denominado morfometria baseada no voxel (voxel-based morphometry). A comparação entre os grupos mostrou redução significativa de substância cinzenta regional em pacientes com DMU comparados aos controles (p<0,05, corrigido para comparações múltiplas) em duas regiões cerebrais selecionadas a priori: córtex pré-frontal dorsolateral (CPFDL) bilateralmente e giro parahipocampal posterior esquerdo. Na comparação direta entre pacientes com DMU e TAB encontramos uma redução de substância cinzenta de CPFDL direito em pacientes com DMU, como tendência a significância estatística (p<0,10, corrigido para comparações múltiplas). Nossos achados mostram que anormalidades volumétricas de CPFDL e região temporal medial estão presentes em pacientes com DMU em primeiro episódio psicótico, mas não em pacientes com TAB com gravidade de sintomas semelhante. / Affective disorders are highly prevalent mental disorders, mainly Major Depressive Disorder (MDD) and Bipolar Disorder (BD), with high morbidity and mortality rates. Previous morphometric magnetic resonance imaging (MRI) studies have identified brain volumetric abnormalities in samples of subjects suffering from MDD or BD. However, none of these have conducted direct brain volume comparisons between patients with recent-onset MDD and BD, nor contrasted them separately against representative groups of asymptomatic controls recruited from exactly the same environment. In the present study, we defined a priori that brain regions involved in cortico-limbic-thalamic-striatal circuits would present volume abnormalities when comparing subjects with MDD and BD with psychotic features, in their first contact with the health care system in Brazil, and a control sample of next-door asymptomatic neighbors. Forty-six patients (20 MDD and 26 BD) and 62 controls were examined with MRI, using an equipment of 1.5 Tesla. Diagnoses were based on DSM-IV, and confirmed one year after scanning. Image processing was conducted using voxel-based morphometry methods. Between-group comparisons showed significant regional gray matter deficits in MDD subjects relative to controls (p<0.05, corrected for multiple comparisons), involving two brain regions where abnormalities in mood disorder patients had been predicted a priori: the dorsolateral prefrontal cortex (DLPFC) bilaterally and the left posterior parahippocampal gyrus. In the direct comparison between MDD and BD patients, the right-sided finding of decreased DLPFC gray matter in the former group retained trend levels of significance (p<0.10 corrected). Our findings indicate that significant structural abnormalities of the DLPFC and medial temporal region are present in patients with MDD in their first episode with psychotic features, but not in BD subjects with symptoms of similar severity.

Introdução: Atualmente, muito tem se estudado a respeito de a esquizofrenia e do transtorno afetivo-bipolar (TAB) pertencerem a um continuum de sinais e sintomas que caracterizam o espectro da psicose, com etiologias que se sobrepõem parcialmente. O estudo comparativo de crianças filhas de pacientes com esquizofrenia e com transtorno bipolar pode ajudar na compreensão do quanto à vulnerabilidade para o desenvolvimento dessas patologias se assemelha e em quais momentos se diferencia. Os objetivos deste estudo foram comparar crianças e adolescentes em risco para esquizofrenia, para transtorno bipolar e um grupo sem risco para estes transtornos em relação a: 1) presença de problemas de saúde mental, diagnóstico psiquiátrico, competência social, quociente intelectual (QI); 2) associação entre presença de diagnóstico ou sintomas psiquiátricos nas crianças e a presença de diagnóstico psiquiátrico materno (esquizofrenia ou transtorno bipolar do humor), gravidade do diagnóstico materno, complicações obstétricas, nível socioeconômico dos pais, escolaridade da mãe. Métodos: Foi realizado estudo transversal comparando filhos de mulheres com diagnóstico de esquizofrenia e transtorno afetivo bipolar, segundo critérios do DSM-IV, e filhos de mulheres sem transtornos mentais graves, na faixa etária de 6 a 18 anos. Os instrumentos utilizados para avaliação da psicopatologia das crianças e adolescentes foram o Child Behavior Checklist (CBCL), Youth Self Report (YSR) e o Schedule for affective disorders and schizophrenia for school aged children-lifetime version (KSADS- PL). A psicopatologia das mães foi avaliada com o uso da escala Structured Clinical Interview for DSM-IV Disorders (SCID-I/P) e o funcionamento/gravidade destas mulheres com a Global Assessment of Functioning (GAF). Para a avaliação do QI e funcionamento social das crianças foram utilizados as escalas Wechsler Abbreviated Scale of Intelligence (WASI) e Children\'s Global Assessment Scale (CGAS) respectivamente. O nível socioeconômico foi avaliado com o uso da escala da Associação Brasileira de Empresas de Pesquisa (ABEP) e um instrumento contendo dados demográficos e de gestação e parto foi criado para ser utilizado neste estudo. Resultados: Foram incluídos no estudo 67 filhos de mães com esquizofrenia, 65 filhos de mães com transtorno bipolar e 63 controles. Os filhos de mulheres com transtorno bipolar apresentaram maior prevalência de problemas comportamentais que os outros grupos, com maior prevalência tanto de problemas de internalização quanto de externalização, e apresentaram maior prevalência de diagnóstico de transtorno de déficit de atenção e hiperatividade e de transtorno de conduta. Os filhos de mulheres com esquizofrenia apresentaram pior eficiência intelectual quando comparados aos jovens em risco para transtorno bipolar, e pior ajustamento social quando comparados aos controles. Foi detectada uma diferença na presença de comportamentos agressivos entre os gêneros no grupo em risco para esquizofrenia. Os meninos em risco para esquizofrenia apresentaram prevalência muito menor de comportamentos agressivos que as meninas deste grupo e que tanto meninas quanto meninos dos demais grupos. Os fatores que se associaram à presença de problemas comportamentais nestas crianças e adolescentes além do diagnóstico materno foram: gravidade da doença materna, moradia com a mãe, ter sofrido riscos pela presença de psicopatologia materna, nível socioeconômico, escolaridade da mãe, possuir pai com problemas com uso de álcool ou outras substâncias, intercorrências durante a gestação e parto, mãe não ter sido internada durante crise na gestação. Conclusões: Os filhos de mães com TAB apresentaram mais problemas comportamentais e diagnósticos psiquiátricos, enquanto os filhos de mulheres com esquizofrenia apresentaram mais prejuízos cognitivos e de competência social e funcional. Contribuindo, assim, para a discussão de que as duas patologias possam ser entendidas como entidades diagnósticas distintas na medida em que diferenças aparecem nos jovens vulneráveis a elas / Introduction: Nowadays a lot has been studied about schizophrenia and bipolar affective disorder being part of a continuum of signals and symptoms which characterize the spectrum of psychosis, with etiologies that are partially superseded. The comparative study of children who were sons of patients with schizophrenia and bipolar disorder can help understanding how much this vulnerability for these pathologies development is similar and in what moments it differs. The aims of this study have been to compare children and adolescents at risk for schizophrenia, bipolar disorder and a group without risk for these disorders in relation to: 1) The presence of mental health problems, psychiatric diagnosis, social competence, intelligence quotient; 2) The association between diagnosis presence or psychiatric symptoms in children and the presence of maternal psychiatric diagnosis (schizophrenia or mood bipolar disorder), severity of maternal diagnosis, obstetric complications, socioeconomic level, mother\'s educational level. Methods: A cross-sectional study has been done comparing the sons of women with schizophrenia and bipolar disorder, according to DSM-IV criteria, and sons of women without severe mental disorder, within the age group of 6 to 18. The instruments used for the evaluation of the children\'s and adolescents\' psychopathology were the Child Behavior Checklist (CBCL), the Youth Self Report (YSR) and the Schedule for affective disorders and schizophrenia for school aged children-lifetime version (KSADS-PL). The psychopathology of the mothers was evaluated with the use of the scale Structured Clinical Interview for DSM-IV Disorders (SCID) and the functioning/severity of these women with Global Assessment of Functioning (GAF). For the evaluation of the intelligence quotient and children social function were used Wechsler Abbreviated Scale of Intelligence (WASI) and Children\'s Global Assessment Scale (CGAS) respectively. The socioeconomic level was evaluated with the use of the scale from Associação Brasileira de Empresas de Pesquisa (ABEP) and an instrument containing demographic data and gestation/childbirth was created to be used in this study. Results: 67 sons of schizophrenic mothers were included in the study, 65 sons of mothers with bipolar disorder and 63 controls. The sons of women with bipolar disorder presented higher prevalence of behavior problems compared to the other groups, with a higher prevalence of both internalization and externalization problems, and they also presented higher diagnosis prevalence of attention deficit /hyperactivity disorder, and conduct disorder. The sons of women with schizophrenia presented worst intellectual efficiency when compared to youngsters with risk of bipolar disorder, and worst social adjustment when compared to the controls. A difference in the presence of aggressive behavior was detected among the genders in the group at risk for schizophrenia. Boys at risk for schizophrenia presented a much smaller prevalence of aggressive behavior compared to the girls in this group and also compared to boys and girls from the other groups. Besides the maternal diagnosis, the factors which were associated to the presence of behavior problems in these children and adolescents were: severity of the maternal disease, sharing residence with the mother, having suffered risk because of the presence of maternal psychopathology, socioeconomic level, mother\'s educational level, father who has a history of alcohol or other substance abuse, complications during gestation and childbirth, mother not being hospitalized when suffering a psychiatric crisis during pregnancy. Conclusions: The sons of mothers with bipolar disorder presented more behavior problems and psychiatric diagnosis, while the sons of mothers suffering from schizophrenia presented more cognitive, social and functional competence impairments. This conclusion corroborates for the discussion that both pathologies may be understood as distinct diagnostic entities insofar as differences appear in the youngsters who are vulnerable to them

Notre étude démontre que les sujets dépressifs unipolaires et bipolaires, présentent une difficulté de régulation des flux excitatifs découlant de la défaillance de la fonction pare-excitative, nommée dans notre travail, « défaillance du contenant psychique ». Nous la mettons en relief à partir de la cotation de trente protocoles de Rorschach à l’aide d’un indice de régression, élaboré pour notre recherche. Nous réalisons, en complément, une étude prospective des notes T à trente échelles et sous-échelles du MMPI-2 de ces mêmes sujets. Nous y relevons certaines constantes en note T, caractérisant en fréquence cette population dépressive, dont une constante en note basse à l’échelle Force du Moi. Nous utilisons ces résultats cliniques pour argumenter l’intérêt d’une prise en charge thérapeutique à partir d’un dispositif basé sur un tissage de médiations groupales, comme voie de restauration du contenant psychique internalisé et de sa fonction pare-excitative. / Our study demonstrates that unipolar and bipolar depressed subjects present a difficulty of excitement flows regulation, arising from the failure of the pare-excitations function, named in our research: "psychic container failure". We highlight this malfunction by the cotation of thirty Rorschach protocols, using a regression index, developed for our research. We carry out a prospective study in complementary from the notes of the scales and subscales of the Minnesota Multiphasic Personality Inventory 2 of these subjects. We identify the constants, low notes, and elevations, appearing frequently and significantly in this population, which is a constant low note to Ego Strength Scale. We use these results to point out the value of therapeutic support based on groupal mediations as way to restore the internalized psychic protective shield.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Fatty acids (FA) are constituent important of the neuronal phospholipids membranes and they carry out important functions in the development and function of the brain During the last decades changes were observed in the feeding habits of western countries, with an increase of the trans FA and omega-6 (n-6) and detriment of omega-3 fatty acids (n-3) consumption, contributing to increase the oxidative stress (OS) generation and development of neuropsychiatric disorders. The influence of FA supplementation containing n-6 (soybean oil-SO), trans (hydrogenated vegetable fat-HVF) and n-3 (fish oil-FO) on behavioral parameters and OS were studied in an animal model of mania. Rats were orally treated for 8 weeks with suspensions of SO, HVF and FO in place of drinking water, and treated with seven daily administrations of amphetamine (AMPH-mg/kg, ip) or vehicle, in the last week of oral treatment. Locomotor activity, vitamin C (VIT C) levels, protein oxidation and mitochondrial slices in striatum and cortex were evaluated. HVF supplemented rats showed an increase in the locomotor activity, higher levels of carbonyl protein in the cortex, and lower mitochondrial viability in the striatum and cortex, showing harmful effects per se. AMPH treatment increased the locomotor activity of all groups, but this effect showed greater intensity in the rats orally treated with HVF (456%). Similarly, AMPH increased the carbonyl protein levels in striatum (39.5%) and cortex (78%) of the animals orally treated with HVF, while SO and FO prevented it in the cortex. AMPH treatment decreased the mitochondrial viability in cortex and striatum of supplemented rats with all the FA; however the HVF group showed greater damage (46 and 44% of viability in the striatum and cortex, respectively). AMPH reduced the VIT C plasma levels of the HVF and SO groups (22.5 and 22.4% respectively), and this antioxidant parameter has not been changed in the FO treated rats. Here, we suggest that the trans FA contained in the HVF may increase the oxidative damages per se, leaving the rats more vulnerable to AMPH damage. FA n-3 contained in the FO showed subtle protecting effects, which were observed by preservation of the VIT C levels and lower levels of carbonyl protein in the cortex. Further studies should be conducted to evaluate the influence of the trans fatty acids consumption on neuronal activity, and consequently on the susceptibility to psychiatric disorders development among them the bipolar disorder. / Ácidos graxos (AG) são constituintes importantes das membranas fosfolipídicas neuronais e desempenham importantes funções no desenvolvimento e funcionamento do cérebro. Durante as últimas décadas foram observadas mudanças nos hábitos alimentares de países ocidentais, com aumento do consumo de AG trans e ômega-6 (n-6) em detrimento do consumo de ácidos graxos ômega-3 (n-3), cujas conseqüências podem estar relacionadas a um aumento dos danos oxidativos, facilitando o desenvolvimento de doenças neuropsiquiátricas. A influência da suplementação com AG n-6 (óleo de soja-OS), trans (gordura vegetal hidrogenada-GVH) e n-3 (óleo de peixe-OP) sobre parâmetros comportamentais e de estresse oxidativo (EO) foram estudados em um modelo animal de mania. Ratos tratados oralmente com suspensões de OS, GVH e OP, junto à água de beber durante 8 semanas, receberam nos últimos sete dias administrações diárias de anfetamina (ANF-4mg/kg, ip) ou veículo. Atividade locomotora, os níveis de vitamina C (VIT C) plasmático, marcadores de oxidação de proteínas e a viabilidade de fatias do estriado e córtex foram determinados. Animais suplementados com GVH mostraram um aumento da atividade locomotora, maior nível de proteínas carbonil no córtex, e menor viabilidade nas fatias do estriado e córtex, demonstrando efeitos prejudiciais per se. O tratamento com ANF aumentou a atividade locomotora dos animais de todos os grupos experimentais, porém este efeito mostrou maior intensidade nos animais que receberam a suplementação com GVH (456%). Semelhante, a ANF aumentou a carbonilação de proteínas no estriado (39.5%) e córtex (78%) dos animais suplementados com GVH, enquanto OS e OP preveniram o dano causado pela ANF no córtex. O tratamento com ANF diminuiu a viabilidade mitocondrial nos tecidos cerebrais de todos os grupos, entretanto o grupo suplementado com GVH apresentou maiores danos (46 e 44% de viabilidade no estriado e córtex, respectivamente). A ANF diminuiu os níveis de VIT C no plasma dos animais suplementados com OS e GVH (22.5 e 22.4%, respectivamente), e este parâmetro antioxidante não foi alterado nos ratos tratados com OP. Os resultados do presente estudo sugerem que os ácidos graxos trans presentes na GVH podem aumentar os danos oxidativos per se, deixando os animais mais expostos aos danos da ANF. A suplementação com ácidos graxos n-3 presentes no OP mostraram efeitos protetores sutis, representados pela preservação dos níveis de VIT C plasmático e menor oxidação de proteínas no córtex. Maiores estudos devem ser realizados para determinar a influência do consumo de ácidos graxos trans sobre a atividade neuronal, e conseqüentemente sobre a suscetibilidade para o desenvolvimento de desordens psiquiátricas entre estas, o transtorno bipolar.

Les troubles bipolaires (TB) sont des maladies psychiatriques dont le déterminisme complexe fait intervenir des facteurs génétiques et environnementaux de susceptibilité. Les efforts d’identification des facteurs génétiques ont produit des résultats discordants et les facteurs environnementaux restent mal connus. Notre équipe a contribué à identifier une forme à début précoce des TB (TB-DP), son caractère fortement familial en faisant un candidat pour faciliter l’identification de gènes de susceptibilité. Ainsi, nous avons réalisé un criblage systématique du génome dans le TB-DP suggérant une liaison avec les régions chromosomiques 2p21, 2q14, 3p14, 5q33, 7q36, 10q23, 16q23 et 20p12. Nous avons montré des associations entre le TB-DP et le gène SNAP25 (rôle dans les mécanismes d’exocytose, région 20p12) et entre les TB et le gène codant l’ASMT (rôle dans la synthèse de la mélatonine). Enfin, une étude d’association pangénomique suggère une association entre le TB-DP et deux gènes de la voie du phosphatidyl-inositol (PLEKHA5 et PLCXD3). Concernant les facteurs environnementaux, les traumatismes affectifs subis dans l’enfance (principalement les abus émotionnels) sont associés aux TB, influencent deux dimensions constitutives des TB (labilité affective et intensité des affects) et interagissent avec le 5HTTLPR pour moduler l’âge de début des troubles. Ces travaux illustrent la pertinence de se focaliser sur le TB-DP pour identifier des gènes de susceptibilité, la nécessité d’explorer plus finement les facteurs environnementaux (notamment les stress précoces) et de considérer les interactions gène-environnement afin de mieux appréhender le déterminisme complexe des TB / Bipolar disorders (BD) are psychiatric diseases with a complex determinism in which genetic and environmental susceptibility factors are involved. Attempts to identify genetic factors have produced conflicting results and environmental factors remain unknown. Early-onset bipolar disorder (EO-BD) is a clinical entity that is characterized by a strong familial aggregation ; a specific focus on this subtype might facilitate the identification of susceptibility genes. A genome-wide scan in EO-BD has suggested eight regions of linkage (chromosomal regions 2p21, 2q14, 3p14, 5q33, 7q36, 10q23, 16q23 and 20p12). We have demonstrated an association between EO-BD and the SNAP25 gene (located at 20p12 and involved in exocytosis). We have demonstrated an association between BD and the ASMT gene (involved in the synthesis of melatonin). Finally, a genome-wide association study has suggested the involvement of two phosphatidyl-inositol pathway related genes in the susceptibility to EO-BD (PLEKHA5 et PLCXD3). Concerning environmental susceptibility factors, childhood affective traumatic events (mainly emotional abuse) are associated with BD, might influence two core dimensions of BD (affective lability and affect intensity) and might interact with the serotonin transporter genelinked polymorphic region to modulate the age of onset of the disorder. These studies illustrate the relevance of focusing on the early onset subgroup of the disease to identify susceptibility genes, the need to further explore early stressors as environmental factors associated with BD and to investigate the complex relationships between these two kinds of susceptibility factors

Background Polypharmacy is often prescribed for bipolar disorder, yet medication non-adherence remains a serious problem. This study investigated the regularity in the daily dosage taken of mood stabilizers and second generation antipsychotics. Methods Daily self-reported data on medications taken and mood were available from 241 patients with a diagnosis of bipolar disorder who received treatment as usual. Patients who took the same mood stabilizer or second generation antipsychotic for ≥ 100 days were included. Approximate entropy was used to determine serial regularity in daily dosage taken. Generalized estimating equations were used to estimate if demographic or clinical variables were associated with regularity. Results There were 422 analysis periods available from the 241 patients. Patients took drugs on 84.4% of days. Considerable irregularity was found, mostly due to single-day omissions and dosage changes. Drug holidays (missing 3 or more consecutive days) were found in 35.8% of the analysis periods. Irregularity was associated with an increasing total number of psychotropic drugs taken (p = 0.009), the pill burden (p = 0.026), and the percent of days depressed (p = 0.049). Conclusion Despite low missing percent of days, daily drug dosage may be irregular primarily due to single day omissions and dosage changes. Drug holidays are common. Physicians should expect to see partial adherence in clinical practice, especially with complex drug regimens. Daily dosage irregularity may impact the continuity of drug action, contribute to individual variation in treatment response, and needs further study.

No description available.

Background The detection of early warning signs is essential in the long-term treatment of bipolar disorders. However, in bipolar patients’ daily life and outpatient treatment the assessment of upcoming state changes faces several difficulties. In this trial, we examine the effectiveness of a smartphone based automated feedback about ambulatory assessed early warning signs in prolonging states of euthymia and therefore preventing hospitalization. This study aims to assess, whether patients experience longer episodes of euthymia, when their treating psychiatrists receive automated feedback about changes in communication and activity. With this additional information an intervention at an earlier stage in the development of mania or depression could be facilitated. We expect that the amount of time will be longer between affective episodes in the intervention group. Methods/design The current study is designed as a randomized, multi-center, observer-blind, active-control, parallel group trial within a nationwide research project on the topic of innovative methods for diagnostics, prevention and interventions of bipolar disorders. One hundred and twenty patients with bipolar disorder will be randomly assigned to (1) the experimental group with included automated feedback or (2) the control group without feedback. During the intervention phase, the psychopathologic state of all participants is assessed every four weeks over 18 months. Kaplan-Meier estimators will be used for estimating the survival functions, a Log-Rank test will be used to formally compare time to a new episode across treatment groups. An intention-to-treat analysis will include data from all randomized patients. Discussion This article describes the design of a clinical trial investigating the effectiveness of a smartphone-based feedback loop. This feedback loop is meant to elicit early interventions at the detection of warning signs for the prevention of affective episodes in bipolar patients. This approach will hopefully improve the chances of a timely intervention helping patients to keep a balanced mood for longer periods of time. In detail, if our hypothesis can be confirmed, clinical practice treating psychiatrists will be enabled to react quickly when changes are automatically detected. Therefore, outpatients would receive an even more individually tailored treatment concerning time and frequency of doctor’s appointments. Trial registration: ClinicalTrials.gov: NCT02782910: Title: “Smartphone-based Ambulatory Assessment of Early Warning Signs (BipoLife_A3)”. Registered May 25 2016. Protocol Amendment Number: 03. Issue Date: 26 March 2018. Author(s): ES.

Abstract Background: The world population is aging and the number of older adults with bipolar disorder is increasing. Digital technologies are viewed as a framework to improve care of older adults with bipolar disorder. This analysis quantifes Internet use by older adults with bipolar disorder as part of a larger survey project about information seeking. Methods: A paper-based survey about information seeking by patients with bipolar disorder was developed and translated into 12 languages. The survey was anonymous and completed between March 2014 and January 2016 by 1222 patients in 17 countries. All patients were diagnosed by a psychiatrist. General estimating equations were used to account for correlated data. Results: Overall, 47% of older adults (age 60 years or older) used the Internet versus 87% of younger adults (less than 60 years). More education and having symptoms that interfered with regular activities increased the odds of using the Internet, while being age 60 years or older decreased the odds. Data from 187 older adults and 1021 younger adults were included in the analysis excluding missing values. Conclusions: Older adults with bipolar disorder use the Internet much less frequently than younger adults. Many older adults do not use the Internet, and technology tools are suitable for some but not all older adults. As more health services are only available online, and more digital tools are developed, there is concern about growing health disparities based on age. Mental health experts should participate in determining the appropriate role for digital tools for older adults with bipolar disorder.

In thesis on the topic "Social work methods used in clients with mental disorders and their effectiveness" I focus on the terminology. I am going to learn basic information about selected mental disorders such as schizophrenia, affective disorders, specifically bipolar disorder, neurotic disorders, specifically obsessive-compulsive disorder and lastly personality disorders, namely borderline personality disorder. Next, I am going to focus on the treatment possibilities of mental disorders, where I speak about the prevention and social worker approach. I continue with social survey and treatment&care for people with mental disorders. Finally, I am going to write about social work methods. The main goal of my thesis was to find what methods of social work are used at work with clients suffering mental disorders. Also if in practice are any methods used and what kind of method is used most often. My next goal was to find out the effectiveness of the methods used in social work. I used survey by a questionnaire. The survey contains 11semi-open questions. After that I concluded that methods of social work are provided to clients with mental disorders and all methods of social work for the mentally ill are used. That means work with an individual, family, group, community, psychiatric rehabilitation,...