Peripartum Depressive Disorder (PPD) is a Peripartum Mental Disorder (PMD) characterized as a Major Depressive Disorder (MDD), wherein the manifestation of depressive symptoms initiates either during pregnancy or within the first 12 months following childbirth.

PPD impacts both maternal well-being and infant health, resulting in unfavorable outcomes during pregnancy and the postpartum period.

Non-Invasive Brain Stimulation (NIBS) is one of the rapidly expanding fields in medicine, using a range of techniques to modulate the brain.

This study aimed to summarize the latest evidence about the impact of NIBS (efficacy, tolerance, and safety) in PPD.

A review was conducted, drawing on reputable (PubMed and Web of Science databases).

Key brain stimulation modalities, such as Transcranial Magnetic Stimulation (TMS), Transcranial Electrical Stimulation (TES), and Electroconvulsive therapy (ECT) were analyzed in the context of PPD.

Preliminary findings indicate promising positive effect of NIBS in reducing symptoms associated with PPD.

In the postpartum, the favorable outlook on the effectiveness of NIBS implies that, when feasible, women diagnosed with mild to moderate PPD, especially those reluctant to initiate pharmacological interventions, should be presented with TMS or TES as an alternative therapeutic approach.

However, some doubts persist about the safety of NIBS regarding fetus and preterm birth.

NIBS constitutes a viable option for pharmacological and psychotherapeutic interventions, and it can also be integrated into comprehensive treatment regimens.

Future research include large-scale clinical trials and longitudinal studies is needed to address the efficacy, security, and long-term effects of NIBS.

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A number of studies have demonstrated that hyperthyroidism increases the prevalence of psychiatric disorders and the likelihood of depressive symptoms, anxiety and hipomania. Apathetic hyperthyroidism is a syndrome, which presents with symptoms of depression, apathy, somnolence or pseudodementia in the absence of the usual symptoms and signs of hyperthyroidism. This condition is more common in the elderly although it has also been described in young adults and adolescents.

In the majority of cases, treatment of hyperthyroidism results in an improvement in neuropsychiatric manifestations in parallel with an improvement of psychical (somatic?) symptoms and psychotropic medication is deemed unnecessary.

Approximately one-third of patients with Graves’ hyperthyroidism are prescribed psychotropic drugs. Sometimes to treat mental symptoms like psychosis or severe agitation, sometimes to treat mental symptoms remaining after amelioration of hyperthyroidism, and sometimes when the diagnosis of Graves’ hyperthyroidism has been missed and the patient is treated as having a primary psychiatric disorder.

To present a case of a patient with neuropsychiatric symptoms caused by thyroid dysfunction.

Case presentation and non-systematic review of existing literature on Pubmed using the following keywords: hyperthyroidism, psychiatric disorders, psychiatric symptoms, depression, psychosis.

We report the case of a 21-year-old female without history of psychiatric illness who presented to the emergency department with somnolence, apathy, cognitive impairment (answering “I don’t know” to most questions), poverty of speech, abulia, perplexity and delusional belief of ruin, in addition to physical symptoms namely alopecia and weight loss. According to her father, she was very active and dynamic person until two days prior, when he started noticing growing apathy, leading to job absenteeism. Urine analysis for elicit drugs was negative.

Investigation for organic disease was undertaken and the blood analysis revealed overt hyperthyroidism.

She was initially treated with aripiprazol. After thyroid dysfunction was identified, she was evaluated by an endocrinologist and started treatment with tiamazol and propanolol, presenting gradual remission of the psychiatric changes. Aripiprazole was discontinued and she was reevaluated in psychiatry consultation after about a month, with complete remission of psychiatric manifestations and normalized thyroid function.

Neuropsychiatric manifestations of thyroid dysfunction are often misdiagnosed as a primary psychiatric disorder. It is necessary to optimize the medical management of these patients in whom the psychiatric symptoms masks a curable organic cause.

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Autism Spectrum Disorders (ASD) is diagnosed when an individual displays irregularity in three key domains: social development, communication, and repetitive behavior/obsessive interests.

The theory of mind-blindness in ASD suggests that individuals on the autism spectrum exhibit deficiencies in the typical empathic process, relative to their mental age.

Empathy comprises two primary components: firstly, the capacity to attribute mental states to both oneself and others, and secondly, experiencing an emotional response that aligns with the mental state of the other person.

This study aimed to synthetase the latest evidence about the neuropsychiatric basis of empathy in ASD.

A review was conducted, drawing on reputable sources (PubMed and Web of Science databases).

A neural basis of empathy has built on a model first proposed by Brothers. It was suggested that social intelligence was a function of three regions: the amygdala, the orbitofrontal and medial frontal cortex, and the superior temporal sulcus and gyrus - the “social brain”. Abnormalities in autism have been found in the amygdala, the orbito and the medial frontal cortex.

Amygdala has been implicated primarily in fear perception of facial expressions, as well as in the recognition of other emotions such as sadness and “social” emotions. In addition to fear perception, the amygdala has also been implicated in related processes including eye gaze, affective memory, olfactory learning, and social judgment.

To date, findings on amygdala structure in autism have been mixed, with studies indicating reduced and increased volumes, as well as nonsignificant differences.

ASD is one of the most heterogeneous neurodevelopmental disorders, and cognitive theories as well as structural findings have linked likely frontal lobe abnormalities to the social and cognitive profiles of autism.

Future studies may elucidate existing data by taking advantage of new and infrequently used data acquisition technologies such as Transcranial Magnetic Stimulation.

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Impulsivity and compulsivity are natural behaviors controlled by brain mechanisms that are essential for survival in all species. Understanding these brain mechanisms may lead to targeted treatment strategies for these symptom domains when impulsivity and compulsivity become dysfunctional.

Pathological impulsivity and compulsivity characterise a broad range of mental disorders.

This study aimed to synthesise the latest evidence about the conceptualization of the impulsivity-compulsivity spectrum.

A review was conducted, drawing on reputable sources (PubMed and Web of Science databases).

The concept of impulsivity can be defined as a predisposition toward rapid, unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to the impulsive individual or to others. However, impulsivity is not always unplanned. Impulsive behaviours can be conceptualised as the core symptoms of a broad range of psychiatric disorders.

In contrast, compulsivity refers to repetitive behaviours that are performed according to certain rules or in a stereotypical fashion. Compulsivity is a tendency to repeat the same, often purposeless acts, which are sometimes associated with undesirable consequences.

Impulsivity and compulsivity may be viewed as diametrically opposed, or alternatively, as similar, in that each implies a dysfunction of impulse control. Each involves alterations within a wide range of neural processes, including attention, perception, and coordination of motor or cognitive responses.

The neurobiology of impulsivity and compulsivity may involve inhibitory neurotransmitters, excitatory neurotransmitters, the prefrontal cortex, and/or limbic dysfunction.

Impulsive and compulsive features may present at the same time or at different times during the same illness. Although both compulsive and impulsive disorders may be related to prefrontal cortex dysfunction, compulsive disorders would be related to hyperactivity and impulsive disorders to hypoactivity of the prefrontal cortex. Compulsiveness appears to be associated with increased frontal lobe activity, while impulsiveness may be associated with reduced frontal lobe activity.

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Incarcerated individuals are subject to a heightened risk of both mental and physical ailments. Hence, it is important to conduct regular assessments of their mental well-being and other potential health hazards.

The aim of this study is to examine the subjective experience of fear related to COVID-19 and the psychological consequences of the pandemic among a cohort of young adult male convicts.

A research design using an institutional-based quantitative cross-sectional approach was used. The data collecting period was from July to September 2022, during which data was gathered at a juvenile correctional facility located in the center area of Portugal. The researchers used questionnaires to gather data pertaining to demographic and health attributes, fear related to COVID-19, as well as measures of depression, anxiety, stress, and resilient coping.

The study included a cohort of 60 incarcerated males who had been imprisoned for a duration exceeding 2 years. The prevalence of stress was found to be the highest among offenders, with around 75% reporting this symptom. Anxiety was the second most often reported symptom, with 38.3% of inmates experiencing it, followed closely by depression, which was reported by 36.7% of the inmate population. The average score on the Fear of COVID-19 Scale was 17.38 ± 4.80, suggesting that participants generally reported mild levels of fear. A total of 38 subjects, accounting for 63.3% of the sample, had low scores in resilience. The participants’ responses indicated that their perceptions of mental health were within a fairly high range, with an average score of 3.62 ± 0.87. Similarly, their perceptions of physical health were also moderately high, with an average score of 3.73 ± 0.95. In terms of global health, participants reported a slightly lower average score of 3.27 ± 0.82 for the preceding month. The Pearson correlation matrix revealed statistically significant associations between fear of COVID-19 and characteristics linked to mental health, with the strength of these associations ranging from moderate to high (p < 0.001). The identification of predictive variables for fear of COVID-19 was accomplished by the use of a multiple linear regression model. Four predictors were identified in the study, namely age, perception of mental health, and overall levels of anxiety and stress. These predictors together account for about 49.7% of the variance in the outcome variable.

The findings of our research indicate a significant prevalence of stress among incarcerated individuals, accompanied by moderate levels of anxiety and depression. Our research has the potential to provide valuable insights for policymakers, mental health professionals, public health specialists, and other relevant stakeholders in the identification and effective management of pandemic-induced anxieties and mental health symptoms.

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The phenomenon of suicide and self-harm is one of the most intriguing and disturbing human behaviours. Suicide is global public health problem, with multiple and complex contributing factors. Global trend show a stabilizing or descending curves in the last years. The Portuguese atlantic archipelago of Azores has had an opposite trend that together with regional proctective and risk factors ought to be addressed for further tailored interventions.

Review of the up-to-date literature on this topic and present the recent suicide-related data in the Azores.

Unsystematic review of the most recent and relevant literature.

Epidemiology, risk and protective factors, preventive and treatment measures were described.

The Azores region has a ascending trend in the suicide mortality rate, opposing the portuguese trend. The azorean suicide mortality rate has a bimodal distribution and has higher values in every age group, except for the +75yo, when compared with the portuguese rates.

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Multiple complex factors contribute to the suicide phenomenon. Suicide protective and risk factors mostly overlap with mental disorders’ factors and those of other health and socio-economic conditions.

Azorean suicide rates are growing against the global and national descending trends.

Prevention and treatment strategies to be implemented regionally must be fine tailored, accounting for the most relevant factors in place, in order to be most effective.

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The emergence of new psychoactive substances (NPS) has had a substantial impact worldwide. NPS mimic the effect of “existing” drugs and are specifically manufactured so that the new substances fall out of regulatory frameworks. Although the structural changes might be minimal, NPS often have marked differences in potency and subsequent harm.

The population of the Azores archipelago has been particularly affected by the rapid growing and changing nature of this phenomenon, mainly caused by the introduction and spread of the “newly” synthetic cathinones as a inexpensive and easily available street drug.

Before any educational, public health and socioeconomic policy changes be proposed to accurately tackle the problem, the basic step of knowing how these substances have been affecting their users, specially their neuropsychiatric effects, must be taken.

This project aims to characterize the neuropsychiatric side effects caused by the acute intoxication of NPS with a psychostimulant profile, namely synthetic cathinones.

Description of the neuropsychiatric symptoms of intoxicated users of stimulant NPS that present to non-governmental organizations specialized in addictions and also to the psychiatry emergency department in Sao Miguel - Azores.

Review of the forensic records of the deaths by suicide in 2021 in Sao Miguel, looking for evidence of recent abuse of NPS or previous history of “NPS use disorder”.

Non-systematic review of the recent and relevant scientific literature on this topic.

The desired effects are increased energy, mood enhancement, euphoria, mental clarity, improved concentration, improved sociability, increased talkativeness, empathy inducing effects, amplification of sound and colour and prosexual effects. Nevertheless, in the case of intoxication, the frequent neuropsychiatric side effects tend to be agitation, agressiveness, irritability, altered consciousness, brief psychosis with paranoid delusion, visual and auditive hallucinations, transient mania, enhanced sensorial experiences, headaches, dizzyness, seizures, confusion and amnesia. Usually, the acjute intoxication period tend to be followed by a “crash” with depression, craving, anxiety, panic, suicidal ideation and behaviours. A third of the deaths by suicides in Sao Miguel Island in 2021, 7 out of 21, were in stimulant NPS active or recent users.

Review of the neuropsychiatric effects of New Psychoactive Substances with a psychostimulant profile. Further studies of this population of synthetic cathinone users in the Azores are due, namely studying their socioeconomic background, looking for risk and protective factors, and also the long-term side effects.

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People presenting first-episode psychosis (FEP) benefit from early intervention programmes, although they are scarce in low- and middle-income countries (LMICs). In Brazil, there are just a few of them unequally distributed across the country.

We aimed to describe the workings of the Ribeirão Preto Early Intervention for Psychosis Programme (Ribeirão Preto-EIP) – an outpatient service for first-episode psychosis patients residents in the Ribeirão Preto catchment area in Southeastern Brazil.

A retrospective cohort of all patients attended throughout four years (2015-2018) was analysed. We excluded patients who attended only the first consultation and those with an initial diagnosis other than a psychotic disorder. Data was obtained through retrospective analysis of medical records.

Our service had 358 new referrals during the four-year period, and 237 patients were followed on average (median) by 14 months. Most of the patients were male (64.1%), single (84.8%), with a median age of 23.5 years (age ranged from 9 to 86 years). Schizophrenia was the main diagnosis (43.4%), followed by substance-induced (25.7%) and affective psychosis (18.6%). Taking follow-up diagnoses as gold-standard, initial diagnoses of bipolar disorder and schizophrenia spectrum disorders had the highest positive predictive values, 83% and 81% respectively. Most referrals to our programme were made by tertiary care (63.7%), followed by secondary (28.5%) and primary care (7.8%).

Here we presented a large sample of FEP patients in a representation as trustworthy to the reality of our programme as possible. Our analysis suggest that Early Intervention Programmes can be successfully implemented in LMICs.

No significant relationships.

Digital Mental Health holds strategic potential in fulfilling populations’ mental healthcare unmet needs, enabling convenient and equitable access to mental healthcare. However, despite strong evidence of efficacy, uptake by mental healthcare providers remains low and little is known about factors influencing adoption and its interrelationship throughout the Digital Mental Health adoption process.

This study aimed at gaining in-depth understanding of factors influencing adoption and mapping its interrelationship along different stages of the Digital Mental Health adoption process.

This work adopted a qualitative approach consisting of in-depth semi-structured interviews with 13 mental healthcare professionals, including both psychologists and psychiatrists. The interviews were transcribed and analysed thematically, following Braun and Clarke’s method.

In this communication, we will describe how digital technology is currently used by clinicians to deliver mental healthcare. We identify potential factors influencing Digital Mental Health adoption and characterize the different identified stages inherent to this appropriation process: i) Pondering appropriate use; ii) Contractualizing the therapeutic relationship; iii) Performing online psychological assessment; iv) Adapting and/or developing interventions; v) Delivering Digital Mental Health interventions; and vi) Identifying training unmet needs. A discussion on how different factors and its interrelationship impact the adoption process will also be performed.

By characterizing mental healthcare providers journey throughout the Digital Mental Health adoption process, we intend to inform ecosystem stakeholders, such as researchers, policy makers, societies and industry, on key factors influencing adoption, so policies, programs and interventions are developed in compliance with this knowledge and technology is more easily integrated in clinical practice.

Delusional infestation (DI), also known as delusional parasitosis or Ekbom syndrome, is a rare disorder, characterised by fixed belief that the skin, body or immediate environment is infested by small pathogens, despite the lack of any medical evidence for it.

To describe and discuss two clinical cases of DI, in order to show two different ways of presenting in this entity.

Two case report and non-systematic review.

We present the case of a 76-year-old woman, without psychiatric history, with an DI with 5 years of evolution, referred to a psychiatric consultation by a dermatologist. The second case, is a 41-year-old woman with a history of multiple substance use disorder, with an DI with a month of evolution, who resorted to the emergency department. DI is not a single diagnostic entity. The classic form, as represented in the first case,is a primary form, which develops without any known cause or underlying disease, corresponding to a persistent delusional disorder. However, about 60% of patients have secondary forms of DI, in the context of substance misuse, some medications or in the course of physical or psychiatric diseases (e.g. stroke, delirium, dementia, depression, schizophrenia).

DI can occur as a primary delusional disorder or secondary to several other medical conditions. An in-depth clinical history is essential in order to make the correct diagnosis. A multidisciplinary approach is also important, to exclude any possible organic etiology, not forgetting that many patients may turn to other medical specialities first.

No significant relationships.

Multiple sclerosis (MS) is a chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system. This condition is enhanced by stress. In turn, stress symptoms are a risk factor for the onset and progression of MS. However, knowledge about predictors of stress in patients with MS is scarce.

This preliminary study aimed to verify whether the number of relapses, fatigue, physical disability (MS characteristics), experiential avoidance and self-judgment (emotion regulation processes) predict stress symptoms in patients diagnosed with MS.

A convenience sample of 101 patients diagnosed with MS and without other neurological diseases participated in this study. Participants completed the Depression Scale of the Depression, Anxiety and Stress Scales-21, Analog Fatigue Scale, World Health Organization Disability Assessment Schedule-12, Acceptance and Action Questionnaire-II, and Self-Judgment Subscale of the Self-Compassion Scale.

All predictors initially hypothesized and years of education have significant correlations with stress symptoms. Simple linear regression analyses showed that the variables significantly predicted stress symptoms and were, therefore, included in the multiple linear regression model. This model explained 51.8% of the variance of the stress symptoms and showed that years of education, the number of relapses, fatigue, and experiential avoidance significantly predicted those symptoms.

The promotion of mental health mental in patients with MS must develop functional skills to deal with stress induced by years of education (possibly responsible for the degree of awareness about MS and its consequences), recurrence of relapses and fatigue, and should minimize emotion regulation strategies focused on experiential avoidance.

Substance use disorders in adolescents are a growing problem worldwide. These disorders are often unrecognised, unvalued by families, society and clinicians and as a result underdiagnosed, with serious future consequences if improperly addressed.

Updated review of the recent literature on this topic.

Unsystematic review of the most recent and relevant literature.

Review of neurobiology, risk factors, co-morbidity, differential diagnosis, diagnostic criteria, evaluation and treatment of substance use disorders in adolescence.

Substance use disorder in adolescence includes a variety of behaviours related to the use of alcohol and/or drugs, for instance, inability to control substance use, impairment of function at school, home or work, interpersonal problems and hazardous use of substance. Further knowledge in identifying, early diagnosing and adequate intervention in adolescents’ substance use disorder may have paramount prognostic features.

No significant relationships.

Deficits in social functioning are a core feature of schizophrenia and are influenced by both symptomatic and neurocognitive variables.

In the present study we aimed to determine the reliability and validity of the Portuguese version of the Personal and Social Performance (PSP) scale, and possible correlations with measures of cognitive functioning.

One-hundred and four community and inpatients with schizophrenia were assessed using measures of social functioning and symptom severity alongside measures of executive function, processing speed and verbal memory.

The reliability of the PSP was found to be satisfactory, with a Cronbach's alpha coefficient of 0.789. Inter-rater reliability in the four domains of the PSP varied from 0.430 to 0.954. Low-functioning patients (PSP < 70) were older, had longer duration of illness, were more symptomatic and had worse cognitive performances, as compared to high-functioning patients (PSP ≥ 70). In a regression model, deficits in social functioning were strongly predicted both by symptomatic and neurocognitive variables; these together accounted for up to 62% of the variance.

The present study supports the reliability and validity of the Portuguese language version of the PSP and further supports the original measure. The co-administration of brief cognitive assessments with measures of functioning may lead to more focused interventions, possibly improving outcomes in this group.