The authors intend to briefly review the literature regarding the progress of substance misuse rates and harms, the support available and reflect on the current national situation. We aim to better understand the changes in policies and services, and their impact to see what can be learned from the Portuguese experience.

A narrative literature review was carried out by the authors using the keywords “addiction” “drugs policy” “Portugal” “drug use”. The authors declare no conflicts of interest.

The end of the dictatorship in 1974, the reopening of borders, and the return of white Portuguese from former colonies, were all associated with a dramatic increase in substance misuse in Portugal. In the 1990's it is estimated that 0.5%-1% of the population was using heroin at the time, with extremely high rates of HIV and Hepatitis in intravenous drug users.

At the start of this period, healthcare services were poorly organized, resources for substance misuse services were limited, legislation was punitive, and there was a general understanding that drug addiction was a consequence of a moral failing. A change in paradigm occurred in the late 1990's and new legislation introduced in 2001, which along with the growth in services to support substance misusers dramatically reduced the rates and negative outcomes of substance misuse.

Of note, new HIV diagnoses due to injecting and overdose rates dropped significantly in the XXI century and decriminalization did not lead to an overall increase in substance misuse.

The pivotal shift in the understanding of the nature of addiction as an illness lead to a profound change in interventions to mitigate this overwhelming problem that affected Portugal by the end of the XX century. We hope that by sharing this experience this will improve interventions around the world to support substance misusers and public health.

Patient-Reported Outcomes (PRO) are directly reported by the patient without interpretation of the patient's response by a clinician or anyone else and pertains to the patient's health, quality of life, or functional status associated with health care or treatment. It can provide patients’ perspectives regarding treatment benefit and harm, directly measure treatment benefit and harm beyond survival, and are often the outcomes of most importance to patients. This study aims to analyze outcomes reported by Brazilian women diagnosed with breast cancer and rank the most important attributes for these patients.

Observational study composed of interviews and questionnaires applied to a convenience sample of women diagnosed with breast cancer. The instruments were developed taking into account the literature on the topic and the expertise of specialists. The questionnaire was built with close-ended questions using multiple-choice and a Likert scale, in order to rank the attributes and outcomes found in the interviews.

The total sample was composed of 65 women diagnosed with breast cancer. Twelve women were interviewed, in September 2020, to explore the main outcomes and preferences about their treatments, such as the most common side effects and the most impacted aspects of life after diagnosis and breast cancer treatment. Psychological, emotional, and sexual impacts were frequently described as aspects of life affected by the disease and its treatment. Fifty-three women, from all the five Brazilian regions, answered the survey applied in October and November 2020. Following an order of importance ranking, the following outcomes were chosen, respectively: overall survival, progression-free survival; and quality of life. The treatment effects that were considered less important, among this sample, were pain and adverse events.

Thinking about expanding the therapeutic quality of users, it is essential to take into account the experiences of patients. PRO is a trend in current research to achieve this goal, in order to influence the decisions of HTA agencies about the importance of valuing outcomes that affect patients' lives.

Generalized problematic internet use/GPIU has recently been associated with the impulsive-compulsive spectrum/ICS, but its mapping onto these behaviour dimensions is relatively unexplored.

To compare patterns of internet use and scores of BIG-5 personality traits, perfectionism and psychological distress between groups with low/high levels of GPIU.

475 university students (78.9% girls; mean age 20.22±1.695) answered the Portuguese versions of: GPIU Scale, Multidimensional Perfectionism Scale-13, NEO-FFI-20, Depression, Anxiety and Stress Scales and other questions about internet use. Chi-square and Mann-Whitney tests were performed using SPSS.

Individuals with high levels of GPIU (median+2SD; n=18; 3.8%) spent significantly more time/day in online activities, exceeding what they have planned; had no other hobbies and used social networks to meet friends; reported that GPIU interfered with affective/work relationships and academic performance (all p<.05). There were no significant differences in the purposes of the internet use (e-mail, social networks, shopping, videogames, multimedia, sexual, work…), unless for general information searching and betting games (both p<.05). High-PGIU group also presented significant higher levels of neuroticism, negative (but not positive) perfectionism, depression, anxiety, and stress (all p<.001).

Our results indicate that unlike the purposes of internet use, personality, perceived interference and the associated cognitive-emotional processes and symptoms (psychological distress) may help distinguishing between functional vs. dysfunctional internet use. Considering the preponderance of processes over contents and the presence of certain dimensions, such as perception of uncontrollability, interference and social isolation we add more evidence to consider PGIU as falling within the spectrum of impulsive-compulsive disorders.

No significant relationships.

The original Profile of Mood States (McNair et al. 1971) is composed of 65 items to measure six affect dimensions. There is a Portuguese shorter version (POMS-27) for the perinatal period (Bos et al. 2013), which reduced the number of items (adjectives) down to 27. Although briefer, it still covers relevant mood states with good psychometric properties, being considered a good alternative to use during this demanding and busy period.

To test if PoMS-27, composed of four dimensions (Depression, Anxiety, Vigour, Fatigue) and one second-order factor (Negative Affect, composed by the former two) is valid and reliable to be used with pregnant women from Brazil.

After confirming the items semantic equivalence and slightly adapt two adjectives from European to Brazilian Portuguese, 350 pregnant women (Mean age: 30.01±5.452; Mean gestation weeks=25.17±6.55), with uncomplicated pregnancies, completed the PoMS-27 and the Brazilian recently validated versions of Perinatal Depression Screening Scale and Perinatal Anxiety Screening Scale (PDSS; PASS; Barros et al. 2021). SPSS and AMOS software were used.

After deleting two items (20 and 22) and some errors were correlated, CFA indicated that the PoMS-25 four-dimensional model presented an acceptable fit (χ2=3.163; RMSEA=.079, CFI=.868, TLI=.849). The Cronbach alphas of the dimensions were: Depression (.82), Anxiety (.86), Negative Affect (.89), Fatigue (.80) and Vigor (.50).

Within this psychometric study we found useful, valid and reliable measure of negative and positive affect for Brazilian pregnant women. From now on we will denominate it Profile of Mood States-25Br

The Internet Addiction Test (IAT) is a 20-item, self-reported questionnaire that measures the presence and severity of Internet addiction which is an increasing problem in adolescents. Although a Portuguese version IAT has been validated in adults, its psychometric properties have never been evaluated before, in adolescents.

To analyse the reliability and construct and concurrent validity of the IAT in a Portuguese adolescent sample.

772 adolescents (53.5% girls), mean aged 13.21±2.246, answered the Portuguese versions of the IAT and the Portuguese versions of validated scales to evaluate: Cyberbullying, Game Addiction, Agressivity and Anxiety, Depression Scales. To study the temporal stability, 377 (60.5% girls) respondents answered the questionnaires again after approximately four-six weeks. The total sample was aleatory splitted to realize the exploratory and the confirmatory factor analyses.

Exploratory and confirmatory factor analyses supported a second order two-factor structure - “Isolation and Social Commitment” and F2-“Negligence and Functional Commitment”. The χ2/df value was 2.260 and had a significant p value; it had the lowest RMSEA score = .074 (p< .001) and it had the highest TLI (.980) and CFI (.905). IAT mean scores were no different between genders [Girls=29.25±18.775 vs. Boys: 30.85±17.929, p=.405]. The Cronbach’s alphas were > .85. Pearson correlation between the test and the re-test was r=.660. The IAT, video game addiction (r=.434), Cyberbullying (r=.383), anxiety (r=.209) and depression (r=.263) were significantly correlated (p<.001).

The Portuguese IAT has good reliability and validity, showing to be an adequate instrument for measuring Internet Addiction symptoms in Portuguese Adolescents.

Burnout occurs in every stage of a medical graduation and career. In the first years of graduation, is affects 35-45% of medical and dentistry students. This has severe consequences, such as: higher levels of suicidal ideation, substance abuse, medical errors and medical neglect; lower levels of empathy and self-compassion - essential to the quality of healthcare. Students with certain personality traits (e.g., neuroticism and, particularly, perfectionism) are more vulnerable to emotional dysregulation when facing stressors of daily life. Our recent studies proved that mindfulness and self-compassion can attenuate the effect of perfectionism on psychological distress.

To present the rational, materials, methodology and preliminary results of our project COMBURNOUT, aimed to develop, implement and assess the efficacy of a mindfulness and self-compassion-based intervention to prevent burnout in medical and dentistry students.

Students with high levels of burnout, psychological distress and perfectionism will be randomly assigned to intervention (8 weekly sessions) or control groups. The sessions will be composed by psychoeducation about burnout, mindfulness and self-compassion practices, within and between sessions. The follow up will include three assessment moments until a year after the intervention.

We expect that the experimental group will present significantly lower levels of burnout, psychological distress and perfectionism, and higher levels of emotional regulation skills.

The facilitators training and the manualization are guaranties of standardization and sustainability. If the positive impact of COMBURNOUT is verified, we intend to provide the program to medical/dentistry students from all over the country.