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The present study aimed to use an in vitro follicle culture (IVFC) biotechnique as a tool to evaluate the influence of whole flaxseed as a feed supplementation in the diet on the in vitro development of caprine early antral follicles (EAFs) and further embryo production. In total, 18 adult goats were homogeneously allocated into two diet groups: Control and Flaxseed. EAFs from both experimental groups (300–400 µm) were isolated and cultured in vitro for 18 days. After IVFC, recovered cumulus–oocyte complexes were submitted to in vitro maturation, and subsequently to IVF and in vitro embryo culture. The endpoints evaluated were follicular growth and morphology, oocyte recovery rate and diameter, sperm penetration, pronuclei formation, embryo development, and estradiol production. The addition of the whole flaxseed in the diet did not affect (P > 0.05) follicular growth and diameter. A higher (P < 0.05) percentage of oocytes ≥ 110 µm was recovered from the flaxseed treatment. However, the sperm penetration rate was higher (P < 0.05) in the control treatment when compared with the flaxseed treatment, but no differences were found regarding the rate of fertilization nor cleaved embryos. In conclusion, dietary flaxseed increased the recovery rate of fully grown oocytes, but it did negatively affect the sperm penetration rate, even though there was no further effect on the cleavage rate.
Frontotemporal Demential (FTD) is a neurodegenerative disorder evolving the frontal or temporal brain lobes. They have been described six variants. Behaviour variant (BvFTD) is the most common, and is characterized by changes in social behaviour and conduct, with loss of social awareness and poor impulse control. Hebephrenic schizophrenia (HSz), or disorganized schizophrenia, was recognized as a schizophrenia subtype, characterized by desorganized behaviour and a cognitive deteriorization. Subtypes of schizophrenia are no longer recognized as separate conditions neither in the Diagnostic and Statistical Manual of Mental Disorders, nor in the new International Statistical Classification of Diseases.
To review the literature about the concepts of hebephrenic schizophrenia and their similarities with the concept of frontotemporal dementia
Narrative review of the literature on PubMed/MEDLINE, using the keywords “hebephrenic szchizophrenia” AND “frontotemporal dementia”. Only articles in English were included.
Some authors described dificulty in establish a diferential diagnosis between HSz and BvFTD. HSz has an earlier onset. However, BvFTD is an early age dementia. The fenomenology of both diseases is similar, and schizophrenia was historical conceptualized as praecox dementia. Frontotemporal abnormalities are common neuroimagiological findings in schizophrenia. Clinically, FTD shows a profound alteration in personality and social conduct, emotional blunting and loss of insight. Memory, intellectual functions, executive and attentional abilities may be disturbed in both.
A diferential diagnosis between HSz and BvFTD is dificult to establish (clinically and imagiologically). The response to treatment is weak in both. It should be investigated the possibility they could be the same syndrome, onseting in diferent ages.
Skin-Picking Disorder (SPD) is psychiatric condition characterized by recurrent and excessive picking of the skin. There are several attempts to stop the behavior and it causes negative consequences such as dermatological complications and functional impairment.
The aim of this study is to describe a case report of SPD.
Data was collected retrospectively from case notes.
A 30 year-old male, married with 2 children, currently on sick leave, was admitted to the Day Hospital at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) with worsen skin-picking behaviour and functional impairment. During childhood the patient would “cut my toe nails the wrong way so that I could fix them”. By adolescence the patient suffered from acne and felt the need to “solve” them and take out the pus. Over the years the skin-picking behaviour spread to other areas of the body, mainly dorsal and chest areas. Before being admitted to the Day Hospital the episodes were daily and had 2-3 hours duration, using scissors and tweezers and evolving his family, asking his wife’s help with picking. He is being treated with fluoxetine 80 mg, risperidone 2 mg and N-acetylcysteine 1200 mg and Cognitive Behavioural Therapy. He is also participating in the Day Hospital activities that include occupational therapy, movement therapy, psychoeducation. After 2 months he has a few 20 minutes episodes per week, spends more time with his children and thinks about coming back to work.
SPD is a severe and debilitating illness that benefits from a multidisciplinary approach.
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality, giving rise to a variety of neuropsychiatric syndromes associated with great functional impairments, chronic disability and poor quality of life. Depending on diagnostic criteria, 20-90% of victims of TBI develop at least one neuropsychiatric manifestation in the first month, and about 40% present at least three symptoms during three months, with higher incidence in females. Survivors of TBI are at increased risk for development of severe, long-term psychiatric disorders. The aetiology of these disturbances remains unclear.
To review current knowledge on the neuropsychiatric consequences associated with TBI.
Non-systematic review of literature through search on PubMed/MEDLINE database for publications up to 2020, following the terms “traumatic brain injury” and “neuropsychiatry”.
Although the experience of neuropsychiatric symptoms may be temporary and may resolve in the acute period, many patients with TBI can experience psychopathology that is persistent or that develops in the post-acute period, regardless of injury severity. These symptoms can involve personality changes, psychosis, major depression, generalized anxiety disorder, post-traumatic stress disorder, maladaptive social behaviours, poor disability adjustment, reduced coping skills and cognitive impairment. Evidence remains insufficient to conclude the role of TBI-related neuropathological consequences in the development of post-TBI neuropsychiatric disorder. Non-organic factors are also implicated in its generation and maintenance.
Neuropsychiatric sequelae are common following TBI. Several of these syndromes are amenable to treatment. Further investigations are required to better understand the mechanistic aetiology of these conditions and the effectiveness of therapeutic modalities.
Psychiatric rehabilitation promotes recovery in individuals with mental disabilities. Its mission is to engage patients and families or caregivers in a collaborative treatment process. The vision of recovery is more likely to become a reality when patients and families are actively involved in treatment. Numerous factors have converged during the past decades to facilitate development and refinement of evidence-based approaches for strengthening families coping with mental disorders.
To review current knowledge on the importance of involving families in psychiatric treatment and rehabilitation, addressing effectiveness of family interventions, role of family coping skills in neutralizing stress and vulnerability, and family burden of mental illness.
Non-systematic review of literature through search on PubMed/MEDLINE database for publications up to 2020. Textbooks were consulted.
Given the unpredictability of major mental disorders, families assume responsibility for extensive monitoring and supervision of a severely and chronically mentally ill relative. Clinical, social, family and economic benefits are achieved by adding psychosocial family interventions to a comprehensive array of services required by patients. Family interventions are not stand-alone modalities: they are coordinated with pharmacotherapy, illness management, crisis intervention, clinical case management, skills training and supportive services. Family interventions show benefits, such as fewer psychotic/affective episodes of exacerbation or relapse by the patient, reduced hospitalizations and improved family morale and less emotional burden.
The new and effective family interventions do not stigmatize families as being ‘sick’ or in need of therapy to ‘straighten them out’. Family interventions are viewed as conferring added therapeutic protection to the patient and relatives.
In breeding programmes, the genetic selection process is based on the prediction of animal breeding values, and its results may vary according to the employed selection method. The current study developed an economic selection index for animals of the Angus breed; performed cluster analyses using the breeding values in order to evaluate the genetic profile of the animals candidates to selection, and compared the obtained results between the economic selection index and the cluster analyses. The evaluated traits included weaning weight, 18-month weight, scrotal circumference, fat thickness and ribeye area. Economic values were obtained using bioeconomic modelling, simulating a complete cycle production system of beef cattle breeds in Brazil, and the selection objective were the weaning rate and slaughter weight. The chosen selection index was composed of all of the traits used as selection criteria for the simulated production system. During the cluster analyses, the population was divided into two to four groups, in which the groupings containing potential animals were assessed. The animals of the grouping which was used for comparison with the selection index were identified, and most of the bulls that were included in the index were among the best in the analysed group. These results suggest that the cluster analyses can be used as a tool for the selection of animals to be used as parents for future generations.
In August 2019, public health surveillance systems in Scotland and England identified seven, geographically dispersed cases infected with the same strain (defined as isolates that fell within the same five single nucleotide polymorphism single linage cluster) of Shiga toxin-producing Escherichia coli O157:H7. Epidemiological analysis of enhanced surveillance questionnaire data identified handling raw beef and shopping from the same national retailer (retailer A) as the common exposure. Concurrently, a microbiological survey of minced beef at retail identified the same strain in a sample of minced beef sold by retailer A, providing microbiological evidence of the link. Between September and November 2019, a further four primary and two secondary cases infected with the same strain were identified; two cases developed haemolytic uraemic syndrome. None of the four primary cases reported consumption of beef from retailer A and the transmission route of these subsequent cases was not identified, although all four primary cases visited the same petting farm. Generally, outbreaks of STEC O157:H7 in the UK appear to be distinct, short-lived events; however, on-going transmission linked to contaminated food, animals or environmental exposures and person-to-person contact do occur. Although outbreaks of STEC caused by contaminated fresh produce are increasingly common, undercooked meat products remain a risk of infection.
Pelagic seabird populations have declined strongly worldwide. In the North Atlantic there was a huge reduction in seabird populations following the European colonization of the Azores, Madeira and Canary archipelagos but information on seabird status and distribution for the subtropical region of Cabo Verde is scarce, unavailable or dispersed in grey literature. We compiled and compared the historical and current distribution of all seabird species breeding in the Cabo Verde archipelago, updated their relative abundance, investigated their inland habitat preferences, and reviewed their threats. Currently, the breeding seabird community in Cabo Verde is composed of Bulwer’s Petrel Bulweria bulwerii, White-faced Storm-petrel Pelagodroma marina aedesorum, Cape Verde Shearwater Calonectris edwardsii, Cape Verde Storm-petrel Hydrobates jabejabe, Cape Verde Petrel Pterodroma feae, Boyd's Shearwater Puffinus lherminieri boydi, Brown Booby Sula leucogaster, and Red-billed Tropicbird Phaethon aethereus. One breeding species is currently extinct, the Magnificent Frigatebird Fregata magnificens. The relative abundance of Cape Verde Shearwater, Boyd’s Shearwater, Cape Verde Petrel, and Cape Verde Storm-petrel was determined from counts of their nocturnal calls in Santo Antão, São Vicente, Santa Luzia, Branco, Raso and São Nicolau. Cape Verde Petrel occurred only on mountainous islands (Santo Antão, São Nicolau, Santiago, and Fogo) from mid-to high elevations. Larger species such as the Cape Verde Shearwater and Boyd’s Shearwater exhibited a wider distribution in the archipelago, occurring close to the coastline but at lower densities on populated islands. Small procellariforms such as the Cape Verde Storm-petrel occurred at high densities only on rat-free islets and in steep areas of main islands where introduced cats and rats are unlikely to occur. The main threats to seabird populations in Cabo Verde range from predation by introduced predators, habitat alteration or destruction, and some residual human persecution.
OBJECTIVES/GOALS: Utilize polymer-based fiber scaffolds and machine learning methods applied to patient biomarker data to enhance and personalize T cell expansion and production for T cell therapy in chronic lymphocytic leukemia. METHODS/STUDY POPULATION: Scaffolds are 1) generated from a co-polymer blend of PDMS and PCL with controlled fiber diameters and pore size, 2) coated with activating antibodies to CD3 and CD28, and 3) used to stimulate T cells from both healthy donors and CLL patients. CLL patients have pre-annotated mutation burdens and clinical biomarkers. T cell populations will be analyzed for exhaustion markers and phenotypes before, during, and after expansion. Cell functionality will be measured by cytokine secretion, cell cycle analysis, and fold expansion, with respect to platform parameters, and analyzed with inputs of disease markers and exhaustion profile of isolated T cells using regression and random forest classifiers. RESULTS/ANTICIPATED RESULTS: We previously showed that engineering the mechanical rigidity of activating substrates can enhance and rescue T cell expansion from exhausted populations. Now we aim to study a broader range of compositions and geometry of scaffolds with respect to capacity to expand CLL T cells. Preliminary data with fiber diameters ranging from 300 nm to 6 um confirm the effect of geometry in modulating expansion. A biorepository of T cells from 80 CLL patients have been isolated concurrently. Anticipated results include correlating exhaustion profile of T cells with clinical biomarkers and identifying markers associated with expansion on panel of platform parameters. DISCUSSION/SIGNIFICANCE OF IMPACT: T cell therapy has shown particular promise in treating blood cancers, yet significant percentage of T cells isolated from patients undergoing treatments are unresponsive to activation. A powerful tool is to predict if and how patient T cells can be robustly expanded on a personalized approach.
The use of antibiotics as performance enhancers in animal feeding is declining, so Lippia gracilis Schauer essential oil (LGSEO) could be used as a potential substitute for the conventionally used growth promoters. The LGSEO contains components such as carvacrol and thymol, which kill and/or control pathogenic bacteria, increase population of beneficial organisms, act against oxidative processes and onto nutrient digestibility and absorption. The aim of this study was to investigate the action and the effects of LGSEO as a growth promoter in the diet of Japanese quail by examining their productive performance, intestinal microbiology, blood biochemical parameters, hepatic thiobarbituric acid reactive substances (TBARS) content and intestinal gene expression. A total of 252 two-day-old quail (Coturnix coturnix japonica) were assigned to 3 treatments in 7 replicates, using 12 birds per experimental unit. The treatments consisted of a basal diet, basal diet + LGSEO at 400 mg/kg of diet and basal diet + chemical antimicrobial (bacitracin methylene disalicylate) at 500 mg/kg of diet. The experimental period was 34 days. The highest feed intake (P < 0.01) was found in the group receiving the conventional antimicrobial, whereas the best feed conversion (P < 0.01) was shown by the animals receiving LGSEO. Escherichia coli growth was restricted in the quail receiving the growth promoters. Salmonella spp. growth was controlled by the treatment containing the conventional antimicrobial. There was no difference between the treatments (P > 0.05) for the concentration of aspartate aminotransferase and alanine aminotransferase enzymes in the blood or hepatic TBARS content. Birds receiving negative-control treatment exhibited a higher expression of sodium-glucose cotransporter (SGLT1), while those receiving the treatment with essential oil showed lower catalase (CAT) and glutathione peroxidase (GPX7) expressions compared to the conventional antimicrobial and control groups, respectively. Lippia gracilis Schauer essential oil is a powerful performance enhancer for Japanese quail by virtue of its abilities to improve their intestinal environment, balance the microbial population and reduce energy expenditure for oxidative processes.
Vascular Dementia (VD) is the second most frequent cause of dementia (20–30% of cases) with a similar percentage associated with Alzheimer’s disease (AD). Due to increased prevalence, its early diagnosis is of particular importance for prevention and correction of risk factors.
An 82-year-old Caucasian woman has been taken to the emergency department by her husband, presenting changes in behaviour defined by aggressiveness, delusional and paranoid ideation with 1M of progression. She had also suffered cognitive impairment (memory deficits, prosoprognosia, disorientation) and some functional decline. She also experienced isolation and reduced communication, anxiety, almost total insomnia, emotional lability, slurred speech, slowed gait and urinary incontinence.
This elderly patient with multiple medical comorbidities (HTA, DM, chronic AF hypocoagulated, MI, Craneoencephalic trauma with a stroke episode) was admitted to the Department of Psychiatry and investigated with auxiliary diagnostic tests and neuroimaging. We found ischemic injury and haemorrhagic sequelae in the latter and in the neuropsychological assessment cognitive deficits were found (executive function, attentional, semantic memory and visuoespacial). Due to this findings and the rapid evolution of symptoms, the diagnosis was Cortical and Subcortical VD.
The patient was treated with a minor anxiolytic, a hypnotic inducer and an antidemencial, with improvement, after one week, of her emotional lability, behavioural symptoms and remission of delusional ideation. At discharge, she maintained slow gait, urinary incontinence, as well as attentional, mnesic and executive deficits, and she was partially oriented, in spite of anosognosia.
She was transferred to geriatrics and to a day center.
Combination therapy of peginterferon and ribavirin for HCV has been recommended as a first choice for chronic hepatitis C. INF therapy has been associated with various IFN-related adverse events, such as psychological disturbances. Beyond that preexisting mental disorders are considered risk factors for INF-alfa-induced severe psychiatric side effects such as depression and/or suicidality, consequently many of these patients remain untreated even tough they fulfil the medical criteria for antiviral treatment of chronic hepatitis C.
The authors relate the case of a patient, 56 year's old, sent to infecciology consultation because she had alterations in abnormal liver function tests. She had a previous history of mental disorder with neurotic personality traits and she was treated with psychiatric medication.
She had treatment for chronic hepatitis C with peginterferon and ribavirin as well psychiatric and psychotherapeutic support.
A low sustained virologic response was obtained however the depressive picture has been difficult to handle so she had had already had a psychiatric hospitalization. There were several adverse life events that can not be forgotten as they certainly trigger and exacerbate the depressive symptomatology.
We assume that psychiatric patients have more depressive symptoms before and during treatment compared with patients without no psychiatric history. This shows that this patients have an increase need for treatment with antidepressants and that a close cooperation with a psychiatrist is always needed.
Depression is the world’s most debilitating disease, more prevalent in association with chronic diseases. We studied two different patient groups: with chronic renal failure in hemodialysis (H), responsible for 100 procedures/day and oncologic patients under chemotherapy (Q), with an admission rate of 659,788/year in Brazil. This study aims at investigating the presence of depression symptoms in both (H) and (Q). We associated sociodemographic and clinical variants with depression symptoms, measured the number of symptomatic patients under treatment and detected the group with the higher symptom scores. It is a cross-sectional study of the reference services in Barbacena, with 200 sample patients, prevalence 15%, power 80%, error 4%, significance 5%. We used the Beck Depression Inventory (BDI) and a sociodemographic one. Both were analyzed by the software SPSS-17, descriptive statistics, CHI Square Test, Fischer and Student’s t-Tests, 5% significance. Following data analysis we found 16,4% (H) and 12,2% (Q) with low or moderate symptoms; 1,5% (H) and 8,2% (Q) with serious depression symptoms. We observed that smoking and depression symptoms are linked, 66,7% (H). Weight, somatization, tiredness, sleep deprivation and decreased libido were found to be the most associated among the clinical variants. Although mental scores in both H and Q are similar it is necessary to differentiate symptoms caused by the underlying disease or depression, once none of the symptomatic patients received treatment; in (H), 8,96% of patients revealed suicidal thoughts and 60% of men suffered from erectile dysfunction.
To determine the relationship between smoking and: 1) exacerbation of positive symptoms of schizophrenia; 2) reduction of negative symptoms of schizophrenia.
31-year old man, smoker of 30 units-pack-year, with the diagnosis of paranoid schizophrenia since 2009, when he was admitted to the Centro Hospitalar Psiquiátrico de Lisboa. He was treated with risperidone, clozapine, quetiapine and ciamemazine, with reduction of positive symptoms and improvements in functional and social skills. There was persistence, however, of affective incongruity, discrete auditory-verbal hallucinations, attenuated feelings of passivity and residual delusion. During ambulatory follow-up the patient stated, concerning his habits of smoking, that: “when I am not smoking voices are feeble” (sic).
Studies show that some ingredients of cigarette smoke (mainly polycyclic aromatic hydrocarbons) have an accelerating effect on the metabolism of several antipsychotics (i.e. clozapine, olanzapine, members of the phenotiazine group, and haloperidol). Other studies suggest that nicotinic receptor agonists (such as nicotine) may have a therapeutic role in the treatment of cognitive impairments (i.e. dfisturbances in attention and in verbal, visual and working memories) in schizophrenia, and in turn, abstinence from tobacco can lead to deterioration of cognitive and psychomotor performance in this patients population.
1) Exacerbations of positive symptoms may be related to decreased effectiveness of certain antipsychotics in result of an accelerated metabolism induced by cigarette smoking.
2) Nicotine may reduce some negative symptoms of schizophrenia, including cognitive impairment.
Chitosan (CHI) is a natural biopolymer with antimicrobial, anti-inflammatory, antioxidant and digestive modulatory effects, which can be used in the ruminant diet to replace antibiotics. The aim of this study was to evaluate the effects of CHI on lamb growth traits, nutrients digestibility, muscle and fatty deposition, meat fatty acid (FA) profile, meat quality traits and serum metabolome. Thirty 30-month-old male lambs, half Suffolk and half Dorper, with an average BW of 21.65 ± 0.86 kg, were fed in a feedlot system for a total of 70 days. The lambs were separated into two groups according to the diet: the control (CON) group which received the basal diet and the CHI group which received the basal diet with the addition of CHI as 2 g/kg of DM in the diet. Lambs supplemented with CHI had a greater (P < 0.05) final BW, DM intake, final body metabolic weight (P < 0.05) and lower residual feed intake than the CON group. Animals fed CHI had a greater (P < 0.05) starch digestibility at 14 and 28 days, average daily gain at 14, 42 and 56 days, greater feed efficiency at 28 days and feed conversation at 14 and 42 days in feedlot. Most of the carcass traits were not affected (P > 0.05) by the treatment; however, the CHI supplementation improved (P < 0.05) dressing and longissimus muscle area. The treatments had no effect (P > 0.05) on the meat colour and other quality measurements. Meat from the CHI-fed lambs had a greater concentration (P < 0.05) of oleic-cis-9 acid, linoleic acid, linolenic-trans-6 acid, arachidonic acid and eicosapentaenoic acid. According to the variable importance in projection score, the most important metabolites to differentiate between the CON and the CHI group were hippurate, acetate, hypoxanthine, arginine, malonate, creatine, choline, myo-inositol, 2-oxoglutarate, alanine, glycerol, carnosine, histidine, glutamate and 3-hydroxyisobutyrate. Similarly, fold change (FC) analysis highlighted succinate (FC = 1.53), arginine (FC = 1.51), hippurate (FC = 0.68), myo-inositol (FC = 1.48), hypoxanthine (FC = 1.45), acetate (FC = 0.73) and malonate (FC = 1.35) as metabolites significantly different between groups. In conclusion, the present data showed that CHI changes the muscle metabolism improving muscle mass deposition, the lamb’s performance and carcass dressing. In addition, CHI led to an alteration in the FA metabolism, changes in the meat FA profile and improvements in meat quality.
The psychiatric conditions secondary to substance use (whether legal or illegal drugs) are well characterized and include psychosis, mania, depression and behavior changes.
We present a case of metformin-induced psychosis in a 79 years-old patient without any previous psychiatric history.
She was brought to emergency room after suicide attempt by hanging. She had a one-month history of altered behavioral and presented paranoid delusional though. Hallucinations were excluded. A detailed clinical evaluation excluded dementia, late-onset chronic psychosis and primary mood disorders with psychotic symptoms and revealed that symptoms initiate few days after the introduction of metformin to treat her diabetes. After Metformin suspension, total remission of psychotic symptoms was obtained in one week and patient return to previous functionality.
Psychosis secondary to metformin use is a very rare complication of oral antidiabetic drugs use but the awareness of this condition can lead to an earlier recognition and diagnosis.
Bipolar disorder (BD) commonly co-occurs with anxiety disorders (AD) and this comorbidity has been associated to worse clinical outcomes in BD patients. However frequency and clinical outcomes data might be biased once some of them had been originated from acutely ill bipolar patients as well as those in remission.
To assess AD in bipolar sample in order to know if this frequency vary according illness phase and identify possible clinical outcomes related to this comorbidity.
A population of 355 outpatients with bipolar I disorder were evaluated using structured instruments (SCID). The sample was split into four groups considering the illness phase and the presence of AD: euthymic without AD (euthymic/non- AD); euthymic with AD (euthimic/AD); non-euthymic without AD (non-euthymic/non-AD) and non-euthymic with AD (noneuthymic/ AD) groups. Clinical and socio-demographics differences between the groups were compared through bivariate analysis.
There was a progressive and significantly increasing in some worst clinical outcomes frequency, such as rapid cycling, suicide attempts, substance and alcohol use disorders, history of antidepressant use and decreased scores in all domains of QoL, from control group (euthymic /non-AD) through out intermediate group (non-euthymic/non-AD) until the group most affected (non-euthymic/AD). Both euthymic/non-AD and euthimic/AD groups did not differ.
We identified a group of severe bipolar patients that have worse clinical outcomes, and among them, the anxiety comorbidity. But, contrary to what has been stated, AD appears to be related with poor bipolar prognosis only when other severity clinical factors are presents.
Compared to the general population, people with schizophrenia have a substantially higher risk of premature mortality which translates into a 10–15 year reduction in life expectancy. The aim of this investigation was to determine if symptoms (including aggression, hallucinations or delusions, and depression) or the environmental and functional status of people with schizophrenia contribute to the high mortality risk observed in this patient group.
We identified cases of schizophrenia, aged ≥15 years in a large secondary mental healthcare case register linked to national mortality tracing. We modelled the effect of specific symptoms, activities of daily living (ADLs), living conditions, occupational and recreational activities (Health of the Nation Outcome Scale [HoNOS] subscales) on all-cause mortality over a 4-year observation period (2007-10) using Cox regression.
We identified 4270 schizophrenia cases (170 deaths) in the observation period. After controlling for a broad range of covariates, mortality was not significantly associated with hallucinations and delusions or overactive-aggressive behaviour, but was associated with subclinical depression (adjusted HR 1.5; 95% CI 1.1-2.2) and ADL impairment (adjusted HR 1.8; 95% CI 1.2-2.9).
Severity of symptoms, such as delusions and hallucinations, was less important in predicting mortality than subclinical depression and difficulties carrying out activities of daily living. The overall picture appears to be one where the highest all-cause mortality risk is in service users who are least visible to clinical teams.
The prevalence of psychiatric disorders in the general population in Portugal is estimated to be 30%. It is already known that many patients who present a psychiatric disorder do not seek a medical doctor, in part because they do not recognise their illness but also because of stigma associated to these disorders. Mental health promotion programs for schools are believed to help overcome these difficulties.
To analyse the knowledge on mental health issues and psychiatric disorders of Portuguese school students from the 7th to the 12th grade, and to assess their contact and interactions with patients who have a psychiatric disorder.
Five students from each class at Pedro Alexandrino high school were selected and they were asked to answer to a questionnaire. Data collected from the questionnaires was then statistically analysed.
The sample collected for this study included a total of 145 students, 60% male and 40% female, with a mean age of 15years-old. Global knowledge about mental health and psychiatric disorders among students was poor and it was primarily acquired through the media. A comparatively high percentage of students in our sample (46%) knew at least one patient with a psychiatric disorder, and in most cases those patients were from their family group or circle of friends.
Education on mental health and psychiatric disorders should be implemented at schools and within the context of health education, in order to promote mental health and also to help reduce stigma usually associated to psychiatric disorders.