The state of the art in European research on reducing social exclusion and stigma related to mental health: a systematic mapping of the literature.

Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe-primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship.

[The spine and polytopic hyperostoses in gout and hyperuricemia]. / Die Wirbelsäule und polytope Hyperostosen bei Gicht und Hyperurikämie.

Investigations were made on a total of 92 patients with gout and hyperuricemia. 30% had no clinical signs of spinal involvement. The remaining 70% were examined radiologically and by xero-radiography. Examination revealed signs of erosion of vertebral bodies, spondylodiscitis, osteopenia, manifestations of Forestier's disease and changes on sacroiliac joints. In 35% of subjects there were polytopic hyperostoses including an increased incidence of calcifications around the large joints and periosteal appositions at the periphery, particularly on the finger and toe tips. The hypothesis was raised that massive calcifications and manifestations of hyperostosis and ossification of the ligaments and tendons (osteodesmosis) in gout may correlate with a latent glycide metabolism disorder like in Forestier's disease.

HLA antigens in vertebral ankylosing hyperostosis (Forestier's disease).

Vertebral ankylosing hyperostosis (VAH) represents a chronic spinal disorder that is often difficult to differentiate both from the inflammatory involvement of the spine like ankylosing spondylitis (Bechterew--AS) and from several forms of spondylosis or paravertebral ossifications of psoriatic spondylitis. Shapiro (1, 2) observed a significantly higher frequency of HLA antigen B27 in 47 patients with VAH; but this observation could not be confirmed by other authors. In our group of 46 patients with VAH, most of them males, there were no X ray signs of sacroiliitis. Compared with 1210 healthy blood donors, no significant difference was observed in the distribution of 31 HLA antigens of A, B, C locus.

Sacroiliac joints in chronic dermatoses.

In 34 patients with different chronic skin diseases (including eczemas, lichen ruber, erythrodermia, pyodermia, pemphigus erythematosus, vasculitis, parapsoriasis varioliformis, scleroderma adultorum Buschke, prophyria cutanea tarda, rosacea, dermatomyositis, erythematodes chronicus discoides and indurative tuberculosis), X-ray studies revealed sacroiliac-changes consistent with a low-grade inflammation. This oteoarthritis slightly differs from the patterns disclosed earlier by the same authors in psoriatic patients, lacking any clinical bone or joint symptoms. So far, it has not been possible to explain their nature, cause or development.

Arthritis of the sacro-iliac joints in patients with psoriasis.

In a series of 58 patients with psoriasis and skin involvement in the absence of any symptoms of an associated joint or bone disease, 49 individuals had definite signs of an arthritis of the sacro-iliac joints, while only slight changes were present in the others. The authors reached the conclusions that arthritis of the sacro-iliac joints occurs in all patients with psoriasis, without any exceptions; and thus not only in those who have simultaneous symptoms of bone or joint disease, which are well known in psoriasis, but equally in those in whom the clinical symptoms are missing.

[Xeroradiography in comparison to roentgen studies in gout, hyperuricemia and dyspurinia]. / Möglichkeiten der Xeroradiographie im Vergleich mit der Röntgenuntersuchung bei Arthritis Urica, Hyperurikämie und Dyspurinie.

In 24 patients with gout and in 15 patients with clinical oligo- and polyarthritic syndromes associated with hyperuricemia and dyspurinia xeroradiographic examinations of the clinically affected joints and soft tissues were carried out. In 32 cases comparisons were made with the classic x-ray examinations. In most cases the findings correlated, particularly the rarifaction of the bone structure including cystic changes of fingers and toes. In advanced cases, particularly in the hallux, erosions occurred and at the same time the changes in the soft tissues were recorded. Cystic changes in the larger bones were better estimated by the classical x-ray examinations. The soft tissues are shown better xeroradiographically. Xeroradiography has the advantage that it can record the structure of bones and soft tissue at the same time.

[Arthropathy of sacro-iliac joints in psoriasis (author's transl)]. / Arthropathien an den Sakroiliakalgelenken bei Psoriasis.

Roentgenographic studies of the sacroiliac joints were carried out in 117 psoriatic patients with associated symptoms of joint and/or bone involvement and in eleven psoriatic patients without signs of bone or joint disease. In all patients arthritis of the sacro-iliac joints with varying degree of severity was demonstrated. The sacro-iliac joint space remained open in patients without associated rheumatoid arthritis or ankylosing spondylarthritis. It was shown that the described method in the assessment of the sacro-iliac joints is fully justified.