Autism Spectrum Disorders (ASD) are neurodevelopmental disorders that affect people across their lifespan. Among those without an intelectual disability, the disorder may not become apparent until adulthood, when it usually presents with comorbidities.

As ASD symptoms are poorly recognized and assessed in adulthood, and the diagnosis is made easier by the application of appropriate evaluation scales, we intend to identify and describe all tools available for screening or diagnosing ASD in adults without intellectual disabilities, and report their psychometric properties.

Pubmed, PsycINFO and Embase database search up until September/2014, using 'high-functioning autism” or 'Asperger” and 'adult”, combined with 'questionnaire”, 'assessment”, 'instrument” or 'scale” as search terms.

We identified 14 instruments, including observational scales, interviews and self-report questionnaires, among which seven are specifically designed for adults. Time to administer and training required vary widely. Psychometric properties are generally good, although validation is scarce. Six instruments are designed for screening purposes: ASQ and its shorter version (ASQ-10), RAADS-14, ASDASQ, KADI and ASSERT. The remainder are intended to be diagnostic: ADI-R (with adaptations – deleted items), ADOS-G Module 4, AMSE, GADS, ASDI, RAADS, AAA and SRS-A.

Besides the time-consuming gold-standard instruments (ADI-R and ADOS-G), there are many instruments available for assessing ASD in adults. Nevertheless, lack of enough validation and comparison between these scales prevents making safe recommendations regarding their use.

Depression and anxiety are frequently reported by MS patients. Studies examining the association between depression, anxiety and personality in MS patients is very limited.

Our objective is to compare temperament and character, depression and anxiety in Relapsing Remitting Multiple Sclerosis (RRMS) patients with healthy controls and inquire into the association between these entities.

The aim of this study is to investigate the possible presence of spesific temperament and character profiles in RRMS patients.

Seventy one RRMS patients and 50 age and gender matched healthy controls were enrolled in the study. Diagnostic neurological examination, sociodemographic and clinical data including the type of MS, duration of the disease, number of relapses, current treatment and the duration of treatment were recorded. SCID-I, Standardized Minimental State Examination, Temperament and Character Inventory, Beck Depression Inventory and Beck Anxiety Inventory were administered.

Patients scored significantly higher in Harm Avoidance and lower in Novelty Seeking, Persistence and Self-directedness than the healthy controls. Depression, anxiety, temperament and character scores were not correlated with disability and the number of relapses.

Temperament and character, depression and anxiety seems to be independent of the disability and the number of relapses in RRMS patients.

In Portugal, after the integration, in 1992, of the Mental Health Services in General Hospitals and, later, with the publication of the Mental Health Act in 1998, there was a clear choice, in terms of health policy, for the deinstitutionalization of the mentally ill and for promoting the integration into their communities. In 1977, at the time called Mental Health Center of Viseu, inspired by the avant-garde currents of French sector psychiatry, pioneered through the creation of their Community Service, immediately reducing its capacity from 120 inpatients to 44.

To conduct a descriptive analysis of the patient population monitored by the team of the Community Service of Centro Hospitalar Tondela-Viseu.

An observational, cross-sectional study.

Descriptive analysis. Data collected from the clinical files and the database built by this service team, analyzed in the program EXCEL ® 2010.

The Community Service currently integrates 562 patients, about half of which are aged between 30 and 49 years. Most patients are male and the main diagnosis is schizophrenic psychosis.

The Community Services have progressively assumed a more relevant importance in the monitoring of individuals with mental illness, allowing their deinstitutionalization to happen and contributing to a more harmonious reintegration of these patients in their community.

This work aims to review ADHD’s definition, epidemiology, frequent psychiatric comorbidities, differential diagnosis – highlighting it’s similarities with BPD –, treatment, and outcome.

A review of relevant literature was conducted alongside online database research (PubMed and Medscape).

ADHD is a neurodevelopmental disorder defined by persistent impairing levels of inattention, motor hyperactivity and impulsivity that exhibit a negative impact in functioning. It is estimated to affect 5% of children and 2.5% of adults. As the affected individual grows it is likely that the symptoms of hyperactivity will decrease, but the inattention, poor planning, and impulsivity tend to persist into adulthood, compromising social, academic, and occupational functioning.

It may be difficult to distinguish between ADHD and personality disorders, especially BPD. However, BPD has characteristic features like fear of abandonment, self-injury/suicidal behavior, extreme ambivalence, feelings of emptiness, and stress-related paranoia/severe dissociation, that are not present in ADHD.

Despite some similarities in clinical presentation in adolescents and young adults, PHDA and BPD differ substantially in their treatment, impairment in functioning, and outcome, making it crucial to establish a correct diagnosis which will enable proper treatment.

Assessment of posttraumatic cognitions after accidents, paired with active identification of suicide risk and reasons to stay alive, can generate more effective management strategies of traumatic events. Aim. To comparatively assess posttraumatic cognitions in survivors of accidents with and without suicide risk. Participants and method. Authors assessed a sample of persons exposed to motor vehicle accidents, work – related accidents or burns, treated in the Rehabilitation Hospital Cluj – Napoca. Suicidal risk after trauma and in the 2 weeks prior to assessment were evaluated through Paykel Suicide Scale. Posttraumatic Cognitions Inventory was employed in order to assess various types of catastrophic cognitions. Results. Most patients included in the study did not exhibit suicidal risk after the exposure to trauma. Nevertheless, specific differences between the samples with and without suicide risk were ascertained, regarding the types of posttraumatic cognitions mostly endorsed. Discussion. Excessive suppression and excessive expression may prove equally detrimental after exposure to specific types of trauma, generating increased suicide risk. Conclusions. Certain catastrophic cognitions can be considered risk factors for suicide after trauma and addressing them in therapy can be beneficial for individualized short- and long-term trauma management.

Stigma against people with mental illnesses is oppressive and alienating; it prevents many from seeking help, denying them access to the support networks and treatment they need to recover. Diagnostic overshadowing occurs when symptoms of physical illness are attributed to the service user’s mental illness. This increases the risks of treatment delay and the development of complications. The situation may arise due to stigmatisation of the mental condition and negative attitudes among healthcare practitioners.

To review the literature on 'diagnostic overshadowing” in mentally ill patients.

A literature review was made by searching for articles in PubMED.

'Diagnostic overshadowing' appears to be common in general health care settings. Studies have shown that people with mental illness die earlier compared to the general population. Suicide is a big factor, accounting for 30 to 40 percent of early deaths. But 60 percent die of preventable or treatable conditions. Studies showed that patients with both a mental illness and a cardiovascular condition received about half the number of follow-up interventions, like bypass surgery or cardiac catheterization, after having a heart attack than did the 'normal” cardiac patients.

Diagnostic overshadowing remains a hurdle in delivering high quality psychiatric and medical healthcare to our patients. It is believed that diagnostic overshadowing contributes to the excess medical morbidity and mortality seen in individuals with psychiatric disorders.

Until the second half of the nineteenth century the word paranoia was used to mean 'out of mind”. Kraeplin has been determinant to change the conceptual history of paranoia, leading, with the contribution of other authors, to the emergence of delusional disorder in current classifications.

We intend to characterize delusional disorder and its clinical utility.

We describe and analyse a case of a man with the diagnosis of delusional disorder – persecutory subtype and make a bibliographic review about this disorder.

The delusional disorder has a prevalence of 0,03%. The key feature is the existence of an encapsulated delusional system without impairment of other mental functions. As expected our patient has personality traits characterized by suspiciousness, rigidity, an inappropriate sense of personal rights and a tendency to misconstrue the actions of others as hostile. His defense mechanisms are mainly denial, projection and reaction formation. The beginning of the disease was between 35-45 years. First time he was observed by Psychiatry he was taken by family and recently it was by court order. The differential diagnoses were excluded (paranoid personality, schizophrenia, dementia, other medical conditions, disorders induced by substances).

The cause of delusional disorder is unknown. The importance of personality traits, life events and genetic factors seems to be uncertain and probably variable. The typical lack of insight conditions the therapeutic adhesion and establishing the necessary adequate therapeutic relationship remain a big challenge.

998 consecutive adult PC patients (678 (67,9%) women and 320 (32.1%) men) were evaluated for psychiatric disorders, using MINI International Neuropsychiatric Interview (MINI). Information on the clinical diagnoses and treatment was obtained from the patient's medical records.

Major depressive episode (MDE) was found in 15.2%, anxiety disorders were found in 26.3% (generalized anxiety disorder in 18.1%, suicidality in 6.1% and alcohol misuse in 34.8%) PC patients, according MINI. Of all respondents, 266 (26.7%) were diagnosed as having at least one current MD (or MDE, or one of four anxiety disorders): 60 (18.8%) of men and 206 (30.4%) of women (p<0.001). The anxiety disorders were stronger associated with psychiatric treatment in women (OR=2.94; 95 CI 2.0-4.33), particularly in the category of cardiovascular diseases (OR=2.32; 95% CI 1.09-4.94), but there was also a significant association with diabetes mellitus in men (OR=5.54; 95% CI 1.6-19.18). The most common reasons for patients to seek a PC doctor consultation were cardiovascular diseases (31.5%), administrative/'no complaints” cases (17.6%), acute respiratory tract disease (10.4%), muscle-skeletal/connective tissue disease (6.9%).

Our findings suggest that MD are highly prevalent and co-morbid with each other, and with general medical conditions in PC.MD are prevalent and co-morbid in administrative/ “no complaints” PC attendees.

Perfectionism is characterized by the relentless pursuit of unattainable high standards. Burn-out syndrome is characterized by professional exhaustion and it was defined by Freudenberge, in 1974.

The authors intend to carry out a review about the association between perfectionism and psychiatric disorders. Also one note about the possible association between perfectionism and burn-out.

Review about the concept of perfectionism and its implications, including in the development of psychiatric illness.

There are several works on the concept of perfectionism and its implications. particularly in obsessive-compulsive disorder, depression, anxiety and eating disorders. There are constraints on the development of this pathology, such as cognitive ability and adaptation to life-events.

The increasing pressure on labor activity may, in individuals with this characteristic, contribute to the development of burnout.

It is essential the research and the applicatin of strategies for prevention and intervention in patients with perfectionist traces, susceptible to develop mental illness.

This study was aimed to discover the correlation between those getting tattoos and their psychopathology relating to their delinquent behavior and emotional problems.

Date for this study was collected from 19-year-old men who were receiving a physical examination for conscription at the Korea Military Manpower Administration. 400 data sheets were collected among them. All of sjubjects were evaluated on the following measures: sociodemographic variants, Juvernile delinquency scale, State-trait anger expression inventory, Beck depression inventory, State-triat anxiety inventory, and Positive affect and negative affect schedule.

In comparison with those without tattooes, those with a tattoo scored higher in the scales that were related to delinquency, anger, depression, and negateive emotion. Furthermore, there were positive correlations between the number of tattoos and the scores for the Juvenile delinquent tendency and behavior scale as well as on the State-triat anxiety scale.

Those with tattoos had experienced anger, anxiety, and depression more strongly in comparison with those without tattoos. These reults recommended that tattooed males should be evaluated more on their regrading psychopathology compared to those without tattoos.

Hypothyroidism is rarely associated with psychosis. This association has been reported since 1880 and described for the first time by Asher in 1949.

Case report: We report the case of a 60-year-old woman who presented at the age of 36 years a hyperthyroidism treated by benzylthiouracile, propranolol, and radioactive iodine. At the age of 49, she presented a hypothyroidism handled by a supplementation of thyroid hormones. The same year, she was admitted in psychiatric care for behavioral disorders, anorexia and insomnia. The diagnosis of hysteria was initially retained and the patient was lost sight of during 4 years. She was then re-hospitalized for psychomotor instability, delusions, insomnia, auditory and visual hallucinations, after she had stopped the treatment. Skin excoriations, caused by suspect cenesthetic hallucinations, were found in the examination. The diagnosis was chronic paranoid schizophrenia and the patient was treated with a long-acting antipsychotic associated to a supplementation of thyroid hormones. She was then lost from sight until 2014, when she was admitted for physical aggression, soliloquy, delusions of persecution auditory and visual hallucinations, and insomnia. The examination found significant dermal infiltration, a xerosis complicated with excoriations, a flushed face, macroglossia, hoarseness, difficulty in breathing and bradycardia . The biology revealed a rate of TSH=45.76uui/ml and FT4 <1pmol/l . Thyroid hormones have then been gradually introduced. The evolution was favorable with the disappearance of psychotic and somatic symptoms.

Though hypothyroidism is usually associated to a depressive symptomatology, it may, as shown by this case, be associated to psychotic symptoms.

Watkins and Moulds (2005) adapted the Positive Beliefs aboutRumination Scale (PBRS; Papageorgiou and Wells, 2001) to reduce confounds with mood states. The items keep the meaningthat recurrent thinking about feelings would be helpful, but direct mentions ofrumination, depression and negative mood or events were omitted.

To investigate thepsychometric properties of the PBRS-Adapted Portuguese version.

Acommunity sample of 552 university students (425 girls; 80.3%; mean age=19.72±1.147) answered the Portuguesepreliminary version of the PBRS-A, and the validated Portuguese versions ofother self-reported questionnaires: Perseverative ThinkingQuestionnaire/PTQ-15; Repetitive Thinking Questionnaire/RNT-10; The Metacognitions Questionnaire-30/MCQ-30;Profile of Mood States/POMS. To study the temporal stability, 242 (207girls; 85.5%) respondents answered the MCQ-30 again after approximately six weeks.

The PBRS-A Cronbach alpha was 'very good” (a=.80). All the itemscontribute to the internal consistency. The test-retest correlation coefficientwas high, positive and significant (.64; p< .001); there was not significantdifference between test and re-test scores [25.89±5.384 vs. 24.64±5.444, t (218)=4.014,p=.114]. Following Kaiser and Cattel Scree Plot criteria, only one factor wasextracted, meaning that the scale is unidimensional.

PBRS-Asignificantly, positively and moderately correlated with RNT-10, PTQ-15, MCQ-30and all their dimensions (all r>.35;p<.01) as well as with all the negative mood states from POMS (all r@.20; p<.01).

The Portuguese version of PBRS-Ahas good reliability and validity. As a transdiagnostic measure, it could be veryuseful to assess individuals with several emotional disorders, both in clinicaland research contexts.

The aim of our case report is to highlight the possible association of NF1 and psychotic symptoms, to underline the usefulness of a complete somatic examination when confronting with epileptic or mentally retarded teens experiencing an hallucinatory syndrome.

We report the case of a 17-years-old boy, with consanguineous parents and history of mental retardation and generalized epilepsy since the age of three, consulting for auditive and visual hallucinations and an heteroagressiveness since two months. Skin examination found signs of NF1.

Electroencephalography (EEG) showed no epileptic abnormalities and brain MRI showed no abnormalities than could explain the psychotic symptoms that are usually parts of the organic brain syndrome. A medication by 2 mg per day of Risperidone has completely eliminate the psychotic symptoms within two months and is continued for one year at least.

Neurological and psychiatric disorders are often intricate. Psychiatrists should have a better knowledge of both psychiatric and somatic manifestations of NF1 to not pass through the right diagnosis and to ensure to these patients better intellectual, academic and social skills.

To evaluate the presence of behavioural discrimination among the general public from Madrid city against people with mental health problems.

This RIBS scale (Reported and Intended Behaviour Scale) was used to evaluate the previously cited discrimination. Different sociodemographic variables were also included to be able to establish the possible Association between them and the scale reults. 100 participants from general population from Madrid completed this questionnaire. A descriptive and analytical analysis were carried out using the statistics programme spss v. 21.

In line with the results from previous studies, this analysis shows a high rate of behavioural discrimination against people with mental health problems. This situation may be a negative condition to the access of mental patients to mental health services. Besides, it may affect in a deleterious way to many others vital areas of the patient. Theese results reinforce the need of encourage anti-stigma programmes.

Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder of childhood characterized by inattention, impulsivity and hyperactivity. This condition affects 3% to 5% of school-aged children in the general population. It currently has a major problem about its social and especially school impact. It raises the question of his prognosis and his functional impact in adulthood.

The aim of ours works in to determine the different evolutionary terms to adulthood of hyperactivity attention deficit disorder.

Our study is a cross-sectional epidemiological survey of descriptive type covering all medical records of patients with a history of Attention Deficit / Hyperactivity Disorder (ADHD) in childhood.

We found 80 patients who had an Attention Deficit / Hyperactivity Disorder (ADHD) in childhood.

In 89.7% of cases were men, the average age at the first consultation in adult psychiatry service was 26 years. They were unmarried in 33%. They had a high school education in 28.2%.

The reasons for consultation were in 52% of cases, addictive behaviors (tobacco, alcohol, cannabis).

The ongoing medical monitoring was in 43.8%, irregular.

Patients suffering from ADHD, should benefit of collaboration between child psychologist and psychiatrist for a proper management of trouble and prevent the negative consequences in adulthood.

Thyroid disease may contribute to mental illness, and thyroid dysfunction in psychiatric illness is common. However, the exact mechanism underlying the link between thyroid abnormalities and psychiatry illness is unclear, and the routine use of thyroid tests to assess psychiatric patients remains debatable. There are no specific guidelines about witch tests should be routinely done, however psychiatrists should be aware that thyroid test abnormalities do not always denote thyroid disease, because there are many factors that interfere with these tests at newly admitted psychiatric patients.

To review evidence about the clinical utility and cost-effectiveness of thyroid screening in psychiatric inpatients.

Searches were undertaken in PubMed and other relevant databases using keywords such as 'thyroid screening', 'psychiatric' and 'inpatients'.

Recent data suggests that clinical utility of thyroid testing in psychiatric patients is low, but in some subgroups of patients thyroid tests may be useful. In fact, there are few studies of cost-effectiveness of thyroid screening in psychiatric inpatients. Therefore clinicians have to pay attention to indications of request thyroid tests, to the moment of thyroid analyses and that transient nature of abnormal thyroid tests results may be a reflection of multitude of factors.

The diagnostic yield of thyroid testing in psychiatric patients is low, and recent studies do not fully support routine screening for thyroid dysfunction in psychiatry inpatients. However, the benefits of thyroid screening of newly admitted psychiatric patients should be evaluated in prospective studies.

Several studies show a high prevalence of stigma related to mental illnes. This implicate the presence of prejudiced behaviours and false beliefs when treating with people with mental disorders. The literature reveals elevated rates of stigmatization in general population. Also, it is documented in general healthcare professionals and even in mental health workers or medicine students. This scene supposes an obstacle in several vital areas. The evaluation of stigma in medicine students become fundamental considering that they will be professionals soon.

To evaluate the attitudes towards mental illness in a sample of medicine students from Madrid.

The MICA (Mental Illness Clinician’ s Attitudes) scale v4 was used to evaluate the objective. Different sociodemographic variables were also included just like information about the clinical speciality the would like to choose. The posible association between theese variables and the scale reults was evaluated. 100 medical students in their 5°-6° year of the degree completed this questionnaire. The sample was collected from the Universidad Complutense de Madrid. A descriptive and analytical analysis were carried out using the statistics programme spss v. 21.

The results suggest that the rates of stigma between medical students from this sample are higher than desirable. That situation reinforce the need of encourage anti-stigma programmes which probably should include a longer contact between medical students and psychiatric patients.