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Starting in the summer 2023 and peaking in late 2023, large amounts of Sargassum were observed floating off the coast of Madeira Islands, Portugal. The analysis of the samples revealed the presence of the three most common morphotypes of the two known species of pelagic Sargassum: S. natans I, S. natans VIII, and S. fluitans III. This is the first record for the subtropical eastern Atlantic Ocean for S. natans VIII and S. fluitans III. Both species were found entangled, and even though the main purpose of the study was to document the occurrence of pelagic Sargassum in the Madeira archipelago, some associated fauna were also recorded: the crab Planes minutus (Linnaeus, 1758), the amphi-Atlantic shrimps Latreutes fucorum (Fabricius, 1798) and Hippolyte coerulescens (Fabricius, 1775), and the nudibranch Scyllaea pelagica Linnaeus, 1758. The last two are new records for the Madeira archipelago.
Obstructive sleep apnea (OSA) is a common sleep disorder in the adult population, often associated with an increased prevalence of comorbid conditions such as obesity and diabetes, but also several mental disorders that have been independently associated with worse hospitalization outcomes in a variety of situations. However, and despite such associations, there is a relative dearth of studies exploring comorbid psychopathology beyond depression and anxiety, and no studies seem to address the impact of comorbid mental disorders on the hospitalization outcomes of patients with OSA.
Objectives
This study aims to characterize and compare mental comorbidities among hospitalization episodes of adult patients with and without OSA held in mainland Portugal, regardless of the primary cause of admission, and to analyze the impact of such comorbidities on hospitalization outcomes.
Methods
An observational retrospective study will be conducted using an administrative database comprising de-identified routinely collected discharge data from all Portuguese mainland public hospitals. Inpatient episodes spanning from 2008 to 2015 will be categorized into two groups according to the presence of an OSA code (ICD-9-CM codes 780.51, 780.53, 780.57, 327.20 and 327.23). For both groups, mental disorders will be identified according to categories 650 to 670 of the Clinical Classifications Software (CCS) for ICD-9-CM. Descriptive, univariate, and multivariate analyses will be performed. Study reporting will comply with the RECORD statement guidelines.
Results
Out of 6,072,538 sampled episodes, 57,301 have an OSA code. Prevalence of any comorbid mental disorder is 30.4% in the OSA group, and 19.3% in the non-OSA group. For both groups, sociodemographic, administrative, and clinical variables will be characterized and compared, as well as the prevalence of each mental disorder category, yearly hospitalization trends, and most common primary diagnoses. Hospitalization outcomes, including length of stay, in-hospital mortality, and readmissions, will be compared taking into consideration the presence of CCS categories of mental disorders.
Conclusions
We expect to improve the understanding of the prevalence of mental comorbidities among hospitalized patients with OSA, including understudied mental disorders, and to elucidate their impact on relevant hospitalization outcomes, thus highlighting the need to recognize and treat this common association to achieve optimal outcomes.
Alcohol and illicit drug use are highly prevalent among the homeless population. Religiosity and spirituality (RS) have been widely associated with lower substance use. However, evidence of this relationship among the homeless is still scarce.
Objectives
To assess the association between RS and the use of alcohol and illicit drugs among the homeless population of a large Brazilian urban center.
Methods
This cross-sectional study was conducted in São Paulo, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (P-DUREL), religious-spiritual coping (Brief-RCOPE), and self-applied questions about current substance use (alcohol and illicit drugs) were evaluated. Adjusted Logistic Regression models were performed.
Results
A total of 456 homeless individuals were included, with an average age of 44.5 (SD=12.6) years. More than half of the participants used alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. The adjusted Logistic Regression models identified that aspects of RS were associated with a lower propensity for alcohol and illicit drug use, whereas negative religious-spiritual coping strategies were associated with a higher propensity for the use of both.
Conclusions
The prevalence of alcohol and illicit drug use among participants was high. Positive RS and religious-spiritual coping were significant protective factors against the use of these substances. Conversely, negative religious-spiritual coping strategies were associated with risk factors.
Epilepsy is one of the most common serious brain illness, with symptoms influenced by multiple risk factors and a strong genetic predisposition, rather than having a single expression and cause¹. Neuropsychiatric symptoms in epilepsy can encompass manifestations such as mood alterations, anxiety, sleep disturbances, psychosis, and behavioral disorders. While the motor and sensory manifestations of epileptic seizures are widely recognized, neuropsychiatric symptoms accompanying epilepsy are often underestimated. Therefore, it is essential to understand the most prevalent epidemiological profile of these patients to improve the diagnosis and management of these symptoms.
Objectives
Our goal was to evaluate the neuropsychiatric behavior of epilepsy patients in Brazilian over the past 3 years through hospitalization data in order to outline an epidemiological and behavioral profile.
Methods
A cross-sectional, descriptive, retrospective, and quantitative study was conducted on hospitalizations of individuals simultaneously diagnosed with epilepsy, schizotypal and delusional disorders, and mood disorders in all five regions of Brazil (South, Southeast, Midwest, North, and Northeast) between February 2020 and December 2022. Data from January 2020 were not available. The data used were collected through the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, gathering information regarding the nature of care, age range, gender, and ethnicity of the patients.
Results
The analysis covers the years 2020 to 2022, totaling 503,045 hospitalizations. In 2022, the highest number of cases occurred (≈ 37.55%), followed by 2021 (≈ 33.62%) and 2020 (≈ 28.81%). Urgent hospitalizations represented ≈ 90.85% of the total. The most affected age group was 30 to 39 years old (≈ 18.30%). Men were more affected than women (≈ 52.03% and ≈ 47.96%, respectively), and Caucasians accounted for ≈ 36.07% of the hospitalizations. The average length of stay was 19.1 days, and the mortality rate was 1.4%.
Conclusions
Thus, there is a gradual and annual increase in the number of hospitalizations during the observed period. While there is a minimal disparity between the affected genders, it is evident that the profile of male, caucasian, and adult patients is the most prevalent. Moreover, the predominantly urgent nature of hospitalizations points to an alarming scenario regarding this issue. From the analysis of the data obtained in the study, there is a clear need for interventions capable of reducing the prevalence of hospitalizations for neuropsychiatric symptoms in epilepsy patients in Brazil.
Neuropsychiatric disorders are the leading cause of disability worldwide, as seen in cases such as depression, anxiety, bipolar mood disorder and schizophrenia, which can be developed or exacerbated by the use of psychoactive substances. Most mental disorders have an early onset, often leading to early and/or permanent disability, increasing the need and cost of healthcare. Therefore, it is necessary to improve the identification of the epidemiological profile of these cases in the South of Brazil in order to enhance the diagnosis and reduce the costs associated with managing these disorders.
Objectives
The present study aimed to analyze statistical data regarding hospitalizations related to mental disorders caused by the use of psychoactive substances and alcohol in the southern region of Brazil, highlighting the pathological scenario and identifying the most prevalent profiles of these disorders in this region.
Methods
A cross-sectional, descriptive, retrospective, and quantitative study was conducted on hospitalizations of individuals diagnosed with mental and behavioral disorders due to the use of psychoactive substances and alcohol in the states of the Southern region of Brazil (Paraná, Santa Catarina, and Rio Grande do Sul) between February 2020 and December 2022. Data of January 2020 were not available. The data used were collected through the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, gathering information regarding the nature of the care, age range, gender, and ethnicity of the patients.
Results
The study covers the years 2020 to 2022, indicating a total of 81,608 hospitalizations, with the year 2022 having the highest number of cases (≈ 37.13%), followed by 2021 (≈ 33.30%) and 2020 (≈ 29.55%). The states with the highest number of hospitalizations were Rio Grande do Sul (≈ 54.90%), Paraná (≈ 29.29%), and Santa Catarina (≈ 15.79%). Urgent hospitalizations accounted for ≈ 87.29% of the total. The most affected age group was 30 to 39 years old (≈ 25.61%). Men were more affected than women (≈ 81.70% and ≈ 18.28%, respectively). Caucasians accounted for ≈ 64.29% of the hospitalizations. The average length of stay was 20.8 days, and the mortality rate was 0.32%.
Conclusions
There is a clear increase in the number of hospitalizations related to mental disorders caused by the use of psychoactive substances in the period from 2020 to 2022 in the southern region of Brazil, with the highest number of cases in the state of Rio Grande do Sul. The most affected population consisted of Caucasian men aged 30 to 39 years old. Furthermore, these results may be related to the increasing trend of psychoactive substance use among the Brazilian population and also the COVID-19 pandemic, which led to a period of underreporting due to social isolation.
Oxytocin (OXT) is a neuropeptide associated with social behavior and the modulation of neural circuits related to social cognition and emotion regulation. Schizophrenia is a mental disorder that causes impairment in different areas of social cognition, including empathy. A systematic review of the literature showed positive effects of exogenous administration of this hormone on the empathy of individuals without psychopathology, especially in the affective domain. Studies on the effect of OXT on empathy in patients with schizophrenia are very limited, being restricted to the cognitive domain.ations must be overcome in future studies. The effects associated with chronic use of the hormone should be the subject of future studies.
Objectives
to evaluate the effect of a single dose of intranasal OXT (24UI) on affective empathy in individuals with refractory schizophrenia and healthy controls.
Methods
a double-blind, randomized, placebo-controlled clinical trial was conducted. A convenience sample of 51 adult men (mean age 34.4 ± 7.6, >10 years of education) was recruited, 20 of whom were diagnosed with refractory schizophrenia according to the DSM-5 (exclusively using clozapine or clozapine + mood stabilizer and/or benzodiazepine) and 31 healthy controls. They were randomized into four groups and received OXT or placebo (PLA – vehicle: SCH-OXT (N=11), SHC-PLA (N=9), HC-OXT (N=15), HC-PLA (N= 16)). Before and after 50 minutes of administering the substance, they performed an affective empathy task (Multifaceted Emphaty Test – MET).
Results
the baseline levels of affective empathy of patients with schizophrenia were lower compared to healthy controls when faced with negative stimuli (p=0.003), but not positive ones (p=0.39). After the administration of OXT and PLA (post-pre), a small increase in empathy levels was observed in all groups, which did not reach statistical significance (positive stimuli: ΔSCH-OXT = 0.16±1.08; ΔSHC-PLA= 0.53±1.44, ΔHC-OXT= 0.02±0.67, ΔHC-PLA= 0.24±0.45, p=0.85; negative stimuli: ΔSCH-OXT = 0.20±1.31; ΔSHC-PLA= 1.16±0.79, ΔHC-OXT= 0.12±0.99, ΔHC-PLA= 0.31±0.57, p=0.11).
Conclusions
the acute effects of intranasal OXT did not favor improvements in the levels of affective empathy, either in patients with schizophrenia or in healthy controls, contrary to the hypotheses of this study. The limited sample size and context-dependent aspects of OXT may explain these findings. These methodological limitations must be overcome in future studies. The effects associated with chronic use of the hormone should be the subject of future studies.
Psychiatry Pitstop is a role-play-based program for medical students aimed to improve communication skills in the framework of mental health. The workshop involved amateur actors who simulated different clinical scenarios and psychiatry residents, who facilitated the sessions and provided constructive feedback following the Pendleton method. Psychiatry Pitstop was originally developed in the United Kingdom and it was expanded to Lisbon, Portugal, in 2019. The authors adapted the course to the Portuguese context, adjusting the number of sessions and altering the scenarios to match common clinical situations faced by junior doctors in Portugal. By now, we conducted four courses.
Objectives
Our study aims to describe the Portuguese adaptation of the program and to learn insights from the students feedback.
Methods
The course was assessed using satisfaction questionnaires, completed by the students after each session. These included a Likert scale ranging from 1 to 5, with items pertaining to Future Importance, Overall Quality, Theoretical Quality, and Practical Quality. Quantitative data was analyzed using Excel and standard descriptive statistics to summarize the results. The open questions invited students to articulate the main positive aspects, suggestions for improvement and future topics. A Natural Language Processing (NLP) software was used to evaluate open-ended responses and extract the main concepts.
Results
We obtained a total of 39 single-answers from 4 different courses. Evaluation results yielded a mean score of 4.7 for Future Importance, 4.9 for Overall Quality, 4.3 for Theoretical Teaching, and 4.9 for Practical Teaching. Notable positive aspects included students’ appreciation of the immersive interview environment, the dedication exhibited by actors and doctors, well-prepared case scenarios, and engaging interactions with participants. Suggestions for improvement encompass enhanced theoretical introductions, comprehensive topic coverage, universal participation in simulations, and expanded workshop days. Future prospects for the program include practicing interviews with other psychiatric diagnosis, addressing difficult patients, delivering bad news and covering topics related to sexuality, grief and moral dilemmas.
Conclusions
Our study shows that Psychiatry Pitstop adaptation to the Portuguese context was successful. Overall, the feedback from medical students has been consistently positive. Subsequent editions will draw upon the findings of this study to enhance overall program quality.
In recent years, mental health has gained prominence in public health, prompting thorough investigations into psychiatric condition trends. This study conducts a comprehensive epidemiological analysis of hospitalizations for Schizophrenia, Schizotypal, and Delirium Disorders in Rio Grande do Sul (RS) over the past five years. By revealing these patterns, it enhances our understanding of regional mental health dynamics and offers insights for intervention strategies, resource planning, and improved mental healthcare. The ultimate goal is to advance more effective and accessible mental healthcare in RS and beyond.
Objectives
This study aims to analyze the prevalence and epidemiological profile of hospitalizations due to psychiatric disorders to assist in the diagnosis and outcome of affected patients.
Methods
A cross-sectional, descriptive, retrospective, and quantitative study was conducted regarding hospitalizations for Schizophrenia, Schizotypal Disorders, and Delirium in the state of RS between January 2018 and November 2022. Data were collected from the Department of Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, focusing on the nature of care, age group, gender, and ethnicity of the patients. The information was aggregated over the five-year period based on the four mentioned descriptors and subsequently analyzed to establish a profile of hospitalizations during that period.
Results
The analysis spans from 2018 to 2022, encompassing a total of 28,345 hospitalizations. In 2019, there was the highest number of cases (22.21%), followed by 2018 (21.08%). Urgent care admissions constituted 85.34% of the total. The age group most affected was 35 to 39 years (11.8%). Men were more affected than women (60.18%), and the majority of hospitalizations were among the Caucasian ethnicity (75.12%). The average length of stay was 23.7 days, and the mortality rate stood at 0.26%.
Conclusions
The increasing trend in hospitalizations, peaking in 2019, highlights the need for preventive measures. Urgent admissions (85.34%) underscore the demand for accessible mental health resources. Men in the 35 to 39 age group are disproportionately affected, suggesting specific risk factors. The predominance of Caucasian ethnicity emphasizes the need for culturally sensitive care. A longer average length of stay (23.7 days) underscores treatment complexity, while a low mortality rate (0.26%) signals effective medical care. In essence, these findings inform tailored mental health policies to enhance service quality and prioritize patient-centered approaches.
The Personality Inventory for DSM-5 (PID-5) is an instrument that aims to assess pathological personality traits according to the alternative model proposed by the DSM-5. To validate the comparison of an instrument’s scores between different groups, it is necessary that the measure’s invariance be attested, in order to guarantee that the same underlying constructions are being evaluated between the groups. Differences between sex in relation to the predominance of adaptive personality traits were portrayed in previous studies, a fact that seems to be related to culture.
Objectives
This study aims to assess whether the PID-5 presents structural equivalence between sex (sex measuremet invariance) and whether there are differences between pathological personality traits in Brazilian men and women.
Methods
A community sample of 1110 subjects was assessed (71.2% women, mean age 34.6 (±15.8) years, 68.8% higher education). They were recruited through advertisements in different media and by the “snowball” method. Participants responded to the PID-5 in person. The cross-culturally adapted version into Brazilian Portuguese was used
Results
The PID-5 showed that its structure was invariant for sex at the configural level (CFI= 1.000; TLI=1.007; RMSEA<0.001), metric (ΔCFI=0.01; ΔTLI= 0.02; ΔRMSEA=0.02) and scalar (ΔCFI=0.006) ; ΔTLI= 0.006; ΔRMSEA=0.004), allowing comparisons. Regarding the domains evaluated by the PID-5, men showed more traits of Distancing, Antagonism, Disinhibition and Psychoticism (p<0.002), while for Negative Affectivity there were no differences between genders (p=0.06). In terms of facets, women showed higher indicators of lability, anxiety and impulsivity (p<0.01), while men showed perseverance, withdrawal, restricted affectivity, manipulation, dishonesty, grandiosity, attention seeking, insensitivity, irresponsibility, exposure to risks, unusual beliefs and eccentricity (p<0.04).
Conclusions
The findings reinforce the validity evidence of the DSM-5 trait model, which, through the PID-5, similarly evaluates such aspects between sex. Differences between genders were observed in relation to pathological personality traits, which bear similarities with differences observed in terms of adaptive personality traits. Specificities are observed at the cultural level, when, for example, the findings are compared with a Japanese university sample, reinforcing the role of culture at this level
Early-onset dementia (EOD) is defined as any type of dementia with an onset before the age of 65. Despite its profound impact on patients and their families, EOD has garnered less attention when compared to late-onset dementia (LOD), often resulting in its underestimation. In comparison to LOD, EOD commonly manifests with atypical and heterogeneous symptoms, encompassing mainly non-memory problems, ranging from language and executive impairments to behavioral-led dysfunction. Despite the importance of accurate data to organize appropriate healthcare, evidence regarding EOD patients in Portugal is lacking.
Objectives
The primary aims of this study include identifying the causes for hospitalization in EOD patients, diagnosed with dementia either as a primary or secondary diagnosis, and comparing them with inpatients aged 65 and older (LOD). Additionally, the study aims to analyze key hospitalization outcomes for both groups, including length of stay, in-hospital mortality, and readmissions. As a secondary aim, this study seeks to describe subtypes of EOD.
Methods
A retrospective observational study will be conducted following the RECORD statement. Data will be retrieved from an administrative database that gathers de-identified routinely collected hospitalization data from all Portuguese mainland public hospitals. Hospitalization episodes of inpatients younger than 65 years old, with a primary or secondary diagnosis of dementia (ascertained by ICD-9-CM codes 290.0-290.4, 294.0-294.2, 331.0, 331.1, and 331.82), will be extracted. Comparison patients will be selected by propensity score-matching from inpatients over 65 years with a dementia ICD-9-CM code (in any position), matched for Charlson Comorbidity Index (CCI).
Results
Descriptive and analytical statistics will be conducted to describe and characterize both group of inpatients. Variables such as age at admission, sex, place of residence, causes and type of admission, psychiatric comorbidities, length of stay (LoS), destination after discharge, readmissions, in-hospital mortality and hospital charges will be analyzed.
Conclusions
With this nationwide analysis of EOD hospitalizations, we aim to reveal critical aspects of this condition, including common causes of admission, diagnostic features and health outcomes, allowing for appropriate medical interventions and support tailored to the specific needs of this clinical group.
Immersive technologies have the potential to control cognitive and behavioural symptoms in people with dementia. A safe environment can be designed through a specific interactive scenario, according to the preferences and experiences of each user.
Objective:
Mapping neuro-emotional responses during the interactive scenario therapy experience in a case study, with dementia, using electroencephalography (EEG).
Methods:
A participant, 78 years old and diagnosed with moderate to severe Alzheimer's disease (female; Mini Mental State Examination score of 17 points; frontal assessment battery score of 8 points), underwent EEG analysis (EMOTIV EPOC X) using a protocol with interactive scenarios tailored to the participant's needs and preferences, the scenarios were designed from reminiscence strategies. The protocol included a stimulus that alternated between motor and cognitive activities (3 minutes), and breath-centered relaxation (1 minute). The scenarios used in this study were: setting up a living room; composing a cake recipe; shopping in the market to make a cake; looking for objects in the park; organizing a birthday party. These variables are provided, on a scale of 0 to 100, after processing by the algorithms of the EmotivPRO v3.0 software.
Results:
The values found in the EEG analysis will be described without stimulus and with stimulus respectively. Thus, engagement (68.57 to 71.86); arousal (57.86 to 49.86), focus (61.57 to 57.00), interest (54.86 to 49.57), relaxation (33.86 to 30.86), and stress (53.71 to 43.00). The EEG data showed an increase in engagement when the patient was stimulated (68.57 to 71.86). Relaxation also increased (30.86 to 33.86) when the stimulus was removed. The stress level, as analysed by the EEG, was also higher in the period without stimulus and reduced in the period with the stimulus (53.71 to 43).
Conclusion:
During a stimulus period in interactive therapy, there was an increase in engagement, which was related to an increasing focus during the stimulus. Lower values were observed compared to the period without stimulus, indicating a period of recovery after a period of concentration/arousal. Therefore, therapy with an interactive and familiar scenario, using a circuit of stimulus-breathing exercises, promotes a positive and adequate neuro-emotional response in a person with dementia.
This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.
The prospect of a medium-term approval of physician-assisted death in Portugal raises relevant ethical and deontological issues that need to be addressed, namely the framework of psychiatric assessments in this process. Such assessments are undermined by the lack of scientific precision in the methods used to determine decision-making capacity, making it possible for the final decision to be affected by psychiatrists’ personal beliefs. As such, outlining scientific evidence and legislation pieces defining the psychiatrists’ role and scope is of utmost importance to frame this debate.
Objectives
To synthetize the accumulated evidence worldwide regarding the psychiatrists’ involvement in the global process of physician-assisted death requests by reviewing scientific literature, published protocols, official reports and international promulgated or amended legislation related to hasten death practices.
Methods
PubMed, Scopus, Web of Science, PsycInfo and Google Scholar electronic bibliographic databases will be searched for eligible articles, as well as grey literature, using the following search terms: Psychiatry AND (Euthanasia OR (Suicide AND Assisted)). Official governments’ and countries health authorities’ websites will also be searched for relevant reports and legislation documents, as well as right-to-die organizations and akin associations. No language, date of publication, or geographical restrictions will be applied. The full text of potentially relevant results will be retrieved from the different sources for review after screening titles and abstracts. This two-stage process will be conducted independently by two researchers. Outcomes of interest will be the descriptions of psychiatric role in the process of physician-assisted death requests, assessment methods, and measurement techniques used.
Results
Given the fact that physician-assisted death is legalized only in a few jurisdictions, we believe the number of eligible results will be limited. Data will be extracted and a descriptive summary of the evidence will be provided. We anticipate finding a significant variability, but also to identify points of consensus. The findings will be published in a peer-review indexed journal and presented at national and international conferences.
Conclusions
To our knowledge, this is the first review of both, scientific published literature, and international legislation on the role of psychiatrists in physician-assisted death requests. We hope to provide an international overview to frame the public debate by pinpointing the most consensual assessment methodology, allowing to design an optimized assessment protocol before the implementation of the law in Portugal.
Home confinement was implemented worldwide as a response to the covid-19 pandemic. Therefore, almost all school-age children started to receive home-schooling from the beginning of 2020, it was necessary due to the length of the lockdowns. Being quarantined at home imposed an increase in psychological burden and the situation was aggravated because of school closure, lack of outdoor activity, aberrant dietary and sleeping habits, disrupting children’s usual lifestyle and promoting monotony, distress, impatience, annoyance, and varied neuropsychiatric manifestations.
Objectives
This study aims to understand the correlation between quarantine and psychosocial effects on school-age children.
Methods
An integrative literature review was developed in 3 steps: Development of the research question, search for scientific articles in the Pubmed database, and critical analysis of included articles. The search was conducted in September 2022, and articles between 2019 and 2022 were selected, for a total of 510 articles, of which 28 were used.
Results
The confinement caused by the coronavirus imposed an immediate and lingering psychosocial impact on children due to drastic changes in their physical activity, lifestyle, and mental excursions. Even a short-term shutdown of educational institutions and home confinement is indeed troublesome and anticipated to have detrimental effects on children’s physical and mental health and shatter the sense of normalcy that schools used to provide. Another important factor to note is that some children`s had to be detached from their parents due to several factors, this juncture caused ever-lasting psychiatric consequences including post-traumatic stress disorder, anxiety, psychosis, depression, delinquency, and even suicidal tendency.
Conclusions
Thus, frontline physicians must be aware of the psychosocial needs of the quarantined children. Hospital authorities need to make arrangements for children to communicate with parents via audiovisual devices. Government should invest in operational strategies to provide mental healthcare for the quarantined children.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. In Portugal, it is estimated to afflict 14.2% of the population over the age of 45 and is one of the most common causes of morbidity, with a significant social impact and excessive expenses. Moreover, COPD is associated with high levels of psychological distress and diverse psychiatric disorders that heighten the disease burden as they are associated with increased risk of exacerbations and frequent hospitalizations. Despite this overview, psychiatric conditions remain understudied compared to comorbid general medical conditions, and few studies have assessed their effect on COPD hospitalization outcomes.
Objectives
This study aimed to describe the occurrence of a vast array of psychiatric comorbid diagnoses in COPD hospitalizations and to understand their impact on hospitalization outcomes.
Methods
A retrospective observational study was conducted. All inpatient episodes from 2008 to 2015 of patients with at least 40 years and a primary diagnosis of COPD (ICD-9-CM codes 491.x, 492.x and 496) were selected from a national administrative database that included all hospitalizations in mainland public hospitals. From these sampled episodes, secondary psychiatric diagnoses were identified (ICD-9-CM codes 290.x-319.x). Age at hospitalization, sex, psychiatric comorbidities, length of stay (LoS) in days, admission type and date, destination after discharge, in-hospital mortality and hospital charges were analyzed.
Results
From a total of 66,661 COPD hospitalizations, 17,652 (26.5%) corresponded to episodes with a secondary psychiatric diagnosis. Patients with a comorbid psychiatric diagnosis were on average younger at admission (70.3 vs. 75.9 years, p<0.001), had a longer median LoS (9.89 vs. 9.33 days, p<0.001) and higher urgent admission rates (96.2% vs. 95.7%, p=0.009). There was also a significant association between discharge destination and psychiatric diagnoses (p<0.001).
Conclusions
These findings suggest that mental disorders have an adverse and quantifiable impact on COPD hospitalization outcomes. With this in mind, to provide optimal treatment for patients with both conditions, psychiatric disorders should become a matter of routine evaluation and follow-up.
Posttraumatic Stress Disorder (PTSD) consists of an intense, prolonged, and occasionally delayed reaction to a deeply stressful event. PTSD is associated with risk of suicide and chronic psychological impairment. The continued exposure to stress suffered by Healthcare Workers (HCWs) during the COVID-19 pandemic can be considered a mass traumatic event and contribute to higher rates of PTSD in this population.
Objectives
To study the rates of PTSD in a sample group of healthcare professionals working in a Portuguese general hospital and its relationship with a number of individual variables considered to be relevant by the existing literature on the subject.
Methods
We devised a survey to assess the prevalence of PTSD among HCWs in a general hospital and its relationship with sex, social support, profession, work experience in healthcare, time spent caring for COVID-19 patients and place in which the COVID-19-related activities were carried out. PTSD symptoms were assessed using the PCL-5, Portuguese version.
Results
A total of 226 HCWs were included in the study. Provisional diagnosis of PTSD was made based on the PCL-5 responses, considering DSM-5 criteria and the cutoff score of 33.
79 out of 226 (35.0%) HCWs had a provisional diagnosis of PTSD, and a significant association was found between PTSD and time spent working with COVID-19 patients and between PTSD and place of work, namely the COVID-19 Emergency Room and Intensive Care Unit.
Conclusions
Our results are in line with previous studies, highlighting the importance of a serious, wide, and honest discussion about mental health promotion among HCWs. The COVID-19 pandemic has been an undeniable source of stress for HCWs around the globe, and the consequences of this stress are beginning to manifest themselves. It is urgent that this reflection takes place, as it is of paramount importance that what we all have lived in the past years serves as a lesson, and not as a warning of a crisis doomed to repeat itself.
Decreased sound tolerance amongst individuals can be divided into two conditions: Hyperacusis and Misophonia. Hyperacusis is the perception of certain everyday sounds as too loud or painful. Misophonia is characterized by heightened emotional reaction to a sound with a specific pattern and/or meaning to an individual, with the context in which occurs being relevant. Scattered evidence from clinical research suggests that Hyperacusis and Misophonia can co-occur with a wide range of psychiatric disorders. These factors can have an impact on the severity of the symptoms and subsequently, in the clinical management of these patients. A better understanding these comorbid conditions is important as it could help to clarify its underlying mechanisms and ultimately, to improve the care of these patients. Despite this, no attempt has been made to synthesize the spectrum of such co-occurring disorders.
Objectives
To conduct a systematic review of the available evidence on the prevalence of psychiatric disorders in patients with Hyperacusis and Misophonia, and to explore which factors may influence prevalence estimates.
Methods
Preferred Reporting Items for systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) recommendations will be followed. The CoCoPop (Condition, Context and Population) framework was used to develop the review question. Pubmed, PsycINFO, Scopus and Web of Science electronic databases will be searched, as well as grey literature, using key-terms in accordance with the pre-established research question. Additional manual searches will also be conducted. Searches will be limited to human studies and no date, language or country origin restrictions will be applied. Outcomes of interest will be the occurrence of comorbid psychiatric disorders in patients with Hyperacusis and Misophonia that are reported according to validated assessment methods. Retrieved records will be screened for eligibility by two independent reviewers using a two-phase approach (title and abstracts screening and full-text review). The methodological quality of primary studies will be assessed using the Joanna Briggs Institute (JBI) – Critical Appraisal Tools, depending on study design, and data will be extracted independently using a standardized extraction form.
Results
Quantitative data will be synthetized and presented in text and tabular format. Studies heterogeneity will be verified and if feasible, a meta-analysis will be conducted.
Conclusions
It is expected that this systematic review will provide evidence of a significant prevalence of a wide range of psychiatric comorbidities in patients with Hyperacusis and Misophonia, supporting the importance of screening these patients for psychiatric disorders.
Psychiatric comorbidities are highly frequent in patients with epilepsy and are associated with negative outcomes. These comorbid conditions can lower the seizure threshold, increase the risk of treatment-resistant epilepsy, and reduce function and quality of life. Additionally, patients with epilepsy have an increased risk of premature mortality, including due to suicide. In this context, although hospitalizations are common in patients with epilepsy, little information on healthcare utilization associated with comorbid psychopathology is available.
Objectives
To characterize psychiatric comorbidities among all hospitalizations with a primary diagnosis of epilepsy and to analyze their association with key-hospitalization outcomes, including length of stay, in-hospital mortality, estimated hospital charges, and readmissions.
Methods
An observational retrospective study will be performed using an administrative database that comprises de-identified routinely collected hospitalization data from all Portuguese mainland public hospitals. All episodes of inpatients, discharged between 2008-2015, with a primary diagnosis of epilepsy (ICD-9-CM code 345.X) will be selected. Psychiatric comorbidities as secondary diagnoses will be identified, grouped into broader categories as defined by the Clinical Classifications Software for ICD-9-CM, and computed into binary variables. Descriptive, univariate, and multivariate analyses will be used.
Results
Descriptive and analytical statistics will be conducted to describe and characterize this sample of hospitalizations. Sociodemographic variables such as age at admission, sex, and place of residence will be characterized. Multivariate models will be used to quantify the association between psychiatric comorbidities and hospitalization outcomes, and results will be presented as crude and adjusted odds ratios.
Conclusions
With this nationwide analysis, we expect to better understand the additional burden of psychiatric comorbidities on epilepsy-related hospitalizations, including psychiatric diagnoses that have not been extensively investigated.
Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy and a severe threat to pregnant people and offspring health. The molecular origins of GDM, and in particular the placental responses, are not fully known. The present study aimed to perform a comprehensive characterisation of the lipid species in placentas from pregnancies complicated with GDM using high-resolution MS lipidomics, with a particular focus on sphingolipids and acylcarnitines in a semi-targeted approach. The results indicated that despite no major disruption in lipid metabolism, placentas from GDM pregnancies showed significant alterations in sphingolipids, mostly lower abundance of total ceramides. Additionally, very long-chain ceramides and sphingomyelins with twenty-four carbons were lower, and glucosylceramides with sixteen carbons were higher in placentas from GDM pregnancies. Semi-targeted lipidomics revealed the strong impact of GDM on the placental acylcarnitine profile, particularly lower contents of medium and long-chain fatty-acyl carnitine species. The lower contents of sphingolipids may affect the secretory function of the placenta, and lower contents of long-chain fatty acylcarnitines is suggestive of mitochondrial dysfunction. These alterations in placental lipid metabolism may have consequences for fetal growth and development.
Bipolar Disorder (BD) is one of the most challenging and severe psychiatric disorders. Considerable research in BD patients points to deficits in Facial Emotion Recognition (FER) as a potential BD endophenotype. Accordingly, such deficits have also been found in unaffected BD first-degree relatives, but no study has been conducted to synthetize this evidence.
Objectives
To conduct a systematic review of studies exploring FER deficits in first-degree relatives of patients with BD.
Methods
PRISMA 2020 recommendations will be followed. PubMed, Scopus, Web of Science and SciELO electronic bibliographic databases will be searched, as well as grey literature. Reference lists of the included studies will be hand-searched for additional eligible studies. Search strategy will include key-terms in accordance with the pre-established PICOS definition. No restrictions will apply regarding study design, setting, publication date nor language. Outcomes of interest will be FER deficits. Retrieved studies will be screened for eligibility by two independent reviewers using a two-phase approach. The methodological quality of primary studies will be assessed and data extracted independently using a standardized extraction form.
Results
will be described using narrative and tabular approaches. Studies heterogeneity will be verified and if adequate a meta-analysis will be conducted. Findings will be disseminated through a peer-reviewed publication.
Conclusions
It is expected that this systematic review will support the hypothesis that FER deficits may constitute a potential candidate for a BD endophenotype, which will not only improve the understanding of BD neurobiology, but also enable its identification in earlier stages, allowing timely treatments and better patients’ outcomes.