Primary deficit schizophrenia (DS) is characterized by enduring negative symptoms and represents a qualitatively different disease entity with respect to non-deficit schizophrenia (NDS). No studies investigated the association between the enzyme paraoxonase 1 (PON1) and DS and its phenomenology.

In this case-control study, Thai women and men, aged 18 to 65 years, were divided in DS (n = 40) and NDS (n = 40) and were compared to controls (n = 40). PON1 activities against 4-(chloromethyl)phenyl acetate (CMPA) and phenylacetate were determined. Moreover, subjects were genotyped for their PON1 Q192R polymorphism and immunoglobulin A (IgA) levels responses directed to Gram-negative bacteria were measured.

DS is significantly associated with the QQ genotype and the Q allele as compared with NDS and controls. PON1 activities are significantly and inversely associated with negative symptoms, formal thought disorders, psychomotor retardation, excitation and DS. The presence of the Q allele is associated with increased IgA responses to Pseudomonas aeruginosa, Morganella morganii, and Pseudomonas putida as compared with RR carriers.

The PON1 Q allele and lower PON1 activities especially against CMPA are associated with DS, indicating lowered quorum quenching abilities as well as lowered defenses against lipoperoxidation and immune activation. It is suggested that lowered PON1 activity in DS constitutes an impairment in the innate immune system which together with lowered natural IgM may cause lower immune regulation thereby predisposing toward greater neurotoxic effects of immune-inflammatory, oxidative and nitrosative pathways and Gram-negative microbiota.

The bipolar disorder, characterized by mania episodes, hypomania and depression is a serious recurring perturbation associated not only to severe sleep pattern disturbances but also to a significant circadian disruption. These fluctuations/changes have a great impact on quality of life and in the disease prognosis.

Review the main sleep pattern alterations/fluctuations observed in the bipolar disorder, their clinical impact and the involved pathophysiological mechanisms.

Complaints about sleep pattern changes may occur during any phase of the disease. These include frequent night-time awakenings, poor sleep quality, reduction of the total sleeping time (TST) and decreased latency and increased density of REM sleep. In the depressive phase, patients also reveal insomnia/hypersomnia, difficulty waking up and excessive daytime sleepiness.

Sleep pattern fluctuations are frequent in bipolar disorders and have a great clinic implication as a symptom. The corrections of sleep disturbances observed in bipolar disorder should be considered a therapeutic priority, since they prevent symptoms recurrence and smooth the socio-professional integration, thus providing greater success in patient’s rehabilitation and quality of life.

Centro Hospitalar Lisboa Norte's Psychiatric Day Care Hospital (CHLN-PDC) offers a psychotherapeutic oriented program.

To characterize the CHLN-PDC population and to determine if the subjects' HSM-PDC treatment leads to variation in the number of re-admissions to psychiatric wards.

Retrospective analysis of all patients admitted to the CHLN-PDC between July 1, 2008 and June 30, 2011, assessing for gender, age, diagnoses, time of admittance, and number of re-admissions in psychiatric wards, three years before and three years after the program.

During this period, 71 patients were admitted (17 males, 54 females), with an average age of 33 years old (no difference between genders). Mean duration of the program was 267 days (260 for females, 291 for males). The most frequent diagnoses were Depressive Episode (N=30), Personality Disorder (N=29, in general co-morbid to other diagnoses), Obsessive Compulsive Disorder (N=5), Generalized Anxiety Disorder (N=5), Schizophrenia (N=3) and Schizoaffective Disorder (N=3).

The number of admissions to psychiatric wards reduced from 86 before to 36 after the program. The reduction was more evident for patients with Bipolar Disorder and Personality Disorder. Patients who completed the full program remained in average 303 days, but re-admissions were reduced greatly when compared to those who did not complete the full program (increase of re-admissions).

The majority of patients were women, with no difference of age between genders. Most common diagnoses were Depressive Episode and Personality Disorder. The program, when completed to its fullest extent, lead to a decrease in the number of re-admissions.

With about 12 million people, Roma constitute the largest ethnic minority group in the EU. Children from Roma communities are much more likely to be out of school than their peers from majority communities, with a strong impact in global mental health status.

This paper reports the findings of an integrative review conducted to analyze recent empirical and theoretical literature on the factors of school absenteeism in Roma Children.

A comprehensive multi-step search (published 2004–2014) using databases such as SciELOand search engine such as B-on and EBSCO-host was performed. A sample of 8 final research reports met the inclusion criteria and was included in the review. A systematic and interactive approach was used to extract and reduce the data to draw conclusions.

The integrative literature review shows that there are three major groups of factors related to school absenteeism in Roma children – factors related to the children, factors related 8 to the school organization and factors related to the Roma families. These factors exist at the individual, community and institutional levels and are largely consistent with conceptual and empirical framework on mental health vulnerabilities factor’s

Schizophrenia (SCZ) patients are reported to present significant abnormalities in lipid and glucose metabolism, that increase the risk for cardiovascular disease and diabetes, possibly induced by antipsychotic therapy (APT) and lifestyle.

Characterize a sample of SCZ patients relating APT and biochemical laboratory profile.

We conducted a retrospective longitudinal study of SCZ patients’ records from Psychiatry Service of Hospital S.João (Porto, Portugal) from 2009 to 2011.

The study included 51 SCZ patients of which 82.4% (n = 42) were male, presenting a mean age of 39.3 ± 9.2 years. The most frequent subtype of SCZ was paranoid (90.0%). The average age of diagnosis was 24.5 ± 8.4 years old. Oral APT was prescribed to 48 patients. Depot APT were prescribed to 40 patients. Haloperidol and risperidona were in both cases the most frequent drugs. 50% of patients presented high total cholesterol values (≥200 mg/dL), 25% high LDL cholesterol (≥160 mg/dL), 81% low HDL cholesterol (≤40/50 mg/dL) and 44% presented high triglycerides results (≥150 mg/dL). 27% of patients presented impaired fasting glucose values (110 to 125 mg/dl) and 27% presented at least one plasma glucose result that meet the criteria for diabetes diagnosis (≥126 mg/dl). There was an overall increase in hepatic enzymes (54% ALT, 36% AST and GGT).

Hepatic metabolism of APT may explain elevated liver enzimes. Lipid and glucose profiles in our sample clearly indicate the need of monitoring SCZ patients, managing APT side effects and lowering risk. We encourage clinicians to record metabolic monitoring and to establish corrective measures (food, lifestyle and medication).

Anti N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an autoimmune disorder with a presentation that includes acute behavioral changes, psychosis, cognitive impairment and autonomic instability. In some cases, there are isolated psychiatric symptoms without neurological involvement.

To raise awareness of the disorder among psychiatrists, considering it a differential diagnosis in a first psychotic episode since a prompt diagnosis and treatment can dramatically affect the outcome.

To summarize the latest literature about this field and to present a case report.

A brief review of the latest literature was performed on PubMed using the keywords “anti N-methyl-D-aspartate receptor encephalitis”, “anti-NMDA encephalitis”, “psychiatric symptoms”.

A 20-year-old male was admitted to our inpatient unit with bizarre delusions of grandious and religious content, somatic hallucinations, sleep cycle inversion and strange behaviour. These symptoms had been present for 1 week and remitted after 10 days of treatment with risperidone. On follow-up, he developed anhedonia, apathy and blunt affect. Brain MRI showed multiple hyperintense changes in T2 and T2-FLAIR, highly suggestive of demyelinating lesions. The cerebrospinal fluid showed mild lymphocytic pleocytosis, mildly increased proteins, oligoclonal bands and anti-NMDAR antibodies of intrathecal production. He was treated with corticoids and the antipsychotic was discontinued. No neurologic symptoms were ever present.

This is an atypical case of anti-NMDAR encephalitis because of its isolated psychiatric presentation. Most patients develop neurological symptoms 2 to 3 weeks after onset of psychiatric symptoms. Monosymptomatic syndromes arise in less than 5% of patients.

The authors have not supplied their declaration of competing interest.

Mental disorders can have a major impact on brain development. Peripheral blood concentrations of brain-derived neurotrophic factor (BDNF) are lower in adult psychiatric disorders. Serum BDNF concentrations and BDNF genotype have been associated with cortical maturation in children and adolescents. In 2 large independent samples, this study tests associations between serum BDNF concentrations, brain structure, and psychopathology, and the effects of BDNF genotype on BDNF serum concentrations in late childhood and early adolescence.

Children and adolescents (7-14 years old) from 2 cities (n = 267 in Porto Alegre; n = 273 in São Paulo) were evaluated as part of the Brazilian high-risk cohort (HRC) study. Serum BDNF concentrations were quantified by sandwich ELISA. Genotyping was conducted from blood or saliva samples using the SNParray Infinium HumanCore Array BeadChip. Subcortical volumes and cortical thickness were quantified using FreeSurfer. The Development and Well-Being Behavior Assessment was used to identify the presence of a psychiatric disorder.

Serum BDNF concentrations were not associated with subcortical volumes or with cortical thickness. Serum BDNF concentration did not differ between participants with and without mental disorders, or between Val homozygotes and Met carriers.

No evidence was found to support serum BDNF concentrations as a useful marker of developmental differences in brain and behavior in early life. Negative findings were replicated in 2 of the largest independent samples investigated to date.

Both transposition of the great arteries (TGA) previously submitted to a Senning/Mustard procedure and congenitally corrected TGA (cc-TGA) have the systemic circulation supported by the morphological right ventricle, thereby rendering these patients to heart failure events risk. The aim of this study was to evaluate cardiopulmonary exercise test parameters for stratifying the risk of heart failure events in TGA patients.

Retrospective evaluation of adult TGA patients with systemic circulation supported by the morphological right ventricle submitted to cardiopulmonary exercise test in a tertiary centre. Patients were followed up for at least 1 year for the primary endpoint of cardiac death or heart failure hospitalisation. Several cardiopulmonary exercise test parameters were analysed as potential predictors of the combined endpoint and their predictive power were compared (area under the curve).

Cardiopulmonary exercise test was performed in 44 TGA patients (8 cc-TGA), with a mean age of 35.1 ± 8.4 years. The primary endpoint was reached by 10 (22.7%) patients, with a mean follow-up of 36.7 ± 26.8 months. Heart rate at anaerobic threshold had the highest area under the curve value (0.864), followed by peak oxygen consumption (pVO2) (0.838). Heart rate at anaerobic threshold ≤95 bpm and pVO2 ≤20 ml/kg/min had a sensitivity of 87.5 and 80.0% and a specificity of 82.4 and 76.5%, respectively, for the primary outcome.

Heart rate at anaerobic threshold ≤95 bpm had the highest predictive power of all cardiopulmonary exercise test parameters analysed for heart failure events in TGA patients with systemic circulation supported by the morphological right ventricle.

To identify risk behaviour patterns for chronic non-communicable diseases (NCD) in the Brazilian population and to investigate associated socio-economic and demographic factors.

Factor analysis was used to identify patterns considering the following risk behaviours: consumption of soft drinks/artificial juice, sweet foods, red meat with apparent fat, chicken skin; inadequate consumption of fruits and vegetables; alcohol abuse; smoking; absence of physical activity during leisure time; and time spent watching television. The χ2 test was used to compare ratios. All analyses accounted for weighting factors and the study’s complex sampling design effect. The socio-economic and demographic variables evaluated were gender, age, schooling level and macro region of residence.

National Health Survey, a household survey with national representation, conducted in 2013 in Brazil.

Individuals (n 60202) aged 18 years or over.

Four risk behaviour patterns were identified: ‘Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables’, ‘Saturated fat’, ‘Alcohol and Smoking’ and ‘Sedentary behaviour and Sugar’, explaining 52·01 % of the total variance. Overall, greater adherence to ‘Saturated fat’ and ‘Alcohol and Smoking’ patterns was observed among men and those with lower education level. The ‘Sedentary behaviour and Sugar’ and ‘Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables’ patterns had greater adherence among younger individuals, and the first was associated with higher education whereas the second with less education among individuals residing in the North and Northeast regions.

Risk behaviour patterns for NCD were heterogeneous, reflecting the socio-economic and demographic differences in Brazil.

A study conducted as part of the development of the Eleventh International Classification of Mental Disorders for Primary Health Care (ICD-11 PHC) provided an opportunity to test the relationships among depressive, anxious and somatic symptoms in PHC.

Primary care physicians participating in the ICD-11 PHC field studies in five countries selected patients who presented with somatic symptoms not explained by known physical pathology by applying a 29-item screening on somatic complaints that were under study for bodily stress disorder. Patients were interviewed using the Clinical Interview Schedule-Revised and assessed using two five-item scales that measure depressive and anxious symptoms. Structural models of anxious-depressive symptoms and somatic complaints were tested using a bi-factor approach.

A total of 797 patients completed the study procedures. Two bi-factor models fit the data well: Model 1 had all symptoms loaded on a general factor, along with one of three specific depression, anxiety and somatic factors [x2 (627) = 741.016, p < 0.0011, RMSEA = 0.015, CFI = 0.911, TLI = 0.9]. Model 2 had a general factor and two specific anxious depression and somatic factors [x2 (627) = 663.065, p = 0.1543, RMSEA = 0.008, CFI = 0.954, TLI = 0.948].

These data along with those of previous studies suggest that depressive, anxious and somatic symptoms are largely different presentations of a common latent phenomenon. This study provides support for the ICD-11 PHC conceptualization of mood disturbance, especially anxious depression, as central among patients who present multiple somatic symptoms.

Attention deficit hyperactivity disorder (ADHD) is frequently associated with poorer reading ability; however, the specific neuropsychological domains linking this co-occurrence remain unclear. This study evaluates information-processing characteristics as possible neuropsychological links between ADHD symptoms and RA in a community-based sample of children and early adolescents with normal IQ (⩾70).

The participants (n = 1857, aged 6–15 years, 47% female) were evaluated for reading ability (reading single words aloud) and information processing [stimulus discriminability in the two-choice reaction-time task estimated using diffusion models]. ADHD symptoms were ascertained through informant (parent) report using the Development and Well-Being Assessment (DAWBA). Verbal working memory (VWM; digit span backwards), visuospatial working memory (VSWM, Corsi Blocks backwards), sex, socioeconomic status, and IQ were included as covariates.

In a moderated mediation model, stimulus discriminability mediated the effect of ADHD on reading ability. This indirect effect was moderated by age such that a larger effect was seen among younger children.

The findings support the hypothesis that ADHD and reading ability are linked among young children via a neuropsychological deficit related to stimulus discriminability. Early interventions targeting stimulus discriminability might improve symptoms of inattention/hyperactivity and reading ability.