Epidemiological evidence shows a concerning rise in youth mental health difficulties over the past three decades. Most evidence, however, comes from countries in Europe or North America, with far less known about changes in other global regions. This study aimed to compare adolescent mental health across two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil.

Four population-based cohorts with identical mental health measures were compared. In Brazil, these included the 1993 Pelotas Birth Cohort and the 2004 Pelotas Birth Cohort. In the UK, cohorts included the Avon Longitudinal Study of Parents and Children, and the Millennium Cohort Study. Mental health was measured in all cohorts using identical, parent-rated scores from the Strengths and Difficulties Questionnaire (SDQ). This was assessed in both countries over approximately the same time periods, when adolescents were aged 11 (2004 vs 2015 in Brazil, and 2003 vs 2012 in the UK), with follow-up analyses focused on outcomes in later adolescence.

Mental health problems were higher in the UK for adolescents born in the early 2000s compared to those born in the early 1990s. In Pelotas, the opposite was found, whereby problems were lower for adolescents born in the early 2000s compared to those born in the early 1990s. Despite these promising reductions in mental health problems in Pelotas over time, SDQ scores remained higher in Pelotas compared to the UK.

Our study represents the first to compare two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil, to understand how mental health problems have changed over time across the two settings. Our findings provide the most up-to-date insight into population-level rates of youth mental health problems in Pelotas, and shed novel insight into how these have changed over the last two decades in comparison to the UK. In doing so, our study provides a tentative first step towards understanding youth mental health over time at a more global scale, and presents a valuable opportunity to examine putative contributors to differences across time.

The Strengths and Difficulties Questionnaire (SDQ) is a widely used assessment tool for measuring the psychological well-being of children and adolescents. It consists of 25 items that assess emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship difficulties, and prosocial behavior.

The present study aimed to investigate the relationship between parental perceptions of difficulties and the results obtained from the SDQ.

Participants were recruited from the initial consultation of Child and Adolescent Psychiatry (N=132). Parents completed a questionnaire assessing their subjective perceptions of their child’s difficulties in various domains (home, school, learning activities, relations with friends) on a 4-point scale ranging from “no notion of difficulties” to “very severe difficulties”. They also completed the SDQ scale. Data were analyzed using SPSS software.

In this study, 74% of participants had scores on the SDQ indicating potential psychological difficulties. Additionally, 17.4% of participants had scores on the borderline between normal and abnormal results. 47% of patients scored above the cut-line for problems on the hyperactivity/inattention subscale, indicating higher levels of difficulties in this area. Conversely, only 3% of participants scored problematic scores on the peer relationship difficulties subscale. There was no statistical difference between sexes in terms of SDQ scores. A correlation analysis revealed a significant positive correlation (p < 0.01) between parental perceptions of difficulties and higher SDQ scores and the mean score on the SDQ scale was found to be significantly higher in patients who were rescheduled for another consultation following the evaluation by doctors, compared to those patients who received clinical discharge from the initial consultation (p-value 0,040).

This study provides valuable insights into the concordance between parental perceptions and objective assessments of difficulties in children and adolescents. Parents who perceived their child to have more difficulties also reported higher levels of psychological difficulties on the SDQ. This study highlights the importance of using tools like the SDQ to assess psychological well-being in children and adolescents. It also emphasizes the practical utility of the SDQ as a time-efficient assessment tool for use during initial consultations in child and adolescent psychiatry.

None Declared

Cognitive dysfunction has been reported in acute psychiatric patients for a long time and has profound implications for the management of severe mental disorders. The Screen for Cognitive Impairment in Psychiatry (SCIP) is a scale developed for screening cognitive deficits. This tool is simple and easy to administer.

To translate and to validate to Portuguese the SCIP.

The accepted back-translation method is employed for translating from English into Portuguese. One-hundred individuals in good health were characterized using demographic questionnaires and a neuropsychological battery. Subsequently, the new version of the scale was administered on two distinct occasions with a minimum one-week gap between them.

High internal consistencies as well as strong correlations with comparable neuropsychological tests were obtained.

The results obtained from the Portuguese version of SCIP are in line with those from the English version. Effectively, SCIP serves as a key instrument for the initial assessment of cognitive function. Its characteristics, particularly its conciseness and independence from a technological platform, allow it to be integrated into clinical practice. Our aim is to use this version and apply it to different pathologies, comparing patients with controls. This will allow us to study different patients and apply it to our population.

None Declared

Cancer causes an impact in the face of its news, whether due to feelings of anguish, stress and suffering due to the presence of the disease, which can be shared between patients, family members and loved ones. The news regarding the diagnosis generates, in addition to the psychological impact, financial difficulties, as the patient himself can often be responsible for a large part of the family income. Other complications are the difficulties in understanding the disease by the family members and/or the patient, denial of the disease in order to spare the patient from suffering and other loved ones, family conflicts related to the need to adapt to the new routine of daily life that the family should carry out aiming at the well-being of the patient and his treatment.

To evaluate the psychological impact and interpersonal relationships in patients with breast cancer treated in the city of Presidente PrudenteSP by a support association.

This is an observational, quantitative, analytical and cross-sectional study, in which 200 patients with malignant breast cancer will be invited.

The sociodemographic results found were: 62.5% white women, 65.6% aged between 45-65 years, 56.3% married, 46.9% have completed higher education, 56.3% had no family history of cancer, predominance of stages II, III and IV when discovered, 93.5% did not drink, 84.4% did not smoke. On the anxiety scale, 53.1% and 43.8% report getting tired easily and feeling like crying, respectively. On the social adequacy scale, 72.5% continued working only with some limitation during treatment, despite this, 41.4% had minor financial difficulties, 34.5% had difficulties expressing feelings with family members, 40.7% had a relationship well with family members with small arguments and finally 34.8% felt affection for the partner all the time, despite this 36.4% did not have sexual intercourse with them in the last month.

It was concluded, therefore, that when a family member gets sick, they all feel impacted, and each family will deal with the experience in a particular way, therefore, it is worth highlighting the encouragement of family participation in therapy sessions.

None Declared

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.

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.

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).

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.

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.

None Declared

Primary care visits of persons with dementia often bring together triads composed of patients, family carers and general practitioners (GPs), as previously discussed (1). Communication dynamics potentially affect dementia outcomes, not least because primary care is a health setting where these triad encounters often occur naturally. Our aim is to present further data from Portuguese primary care consultations with persons with dementia, their carers and GPs.

We refer to the conclusion of our study ‘Dementia in Primary Care: the Patient, the Carer and the Doctor in the Medical Encounter - Bayer Investigation Grant | NOVAsaúde Ageing 2018’ (1). Fieldwork was interrupted during the COVID-19 pandemic and resumed in 2022. Sixteen consultations with persons with dementia, their carers and GPs (purposive sampling) were audio- recorded and transcribed verbatim. Interactions were thematically analysed using NVIVO® software. The analytical framework combined codes derived from the transcripts with codes from the literature.

Dementia-related content took up less than half of consultations’ time, despite their considerable length (as compared to the average in primary care). Most GPs assessments lacked breadth, although efforts towards positive attitudes were present. Themes specifically related to social health in dementia were not (or were poorly) covered. Frequently, carers facilitated GPs’ assessment of dementia consequences, but their own needs were neglected. Patients’ self-expression tended to be limited.

Our findings suggest that doctor-patient interactions in many GPs’ consultations seemingly compromise patient-centred approaches. There are challenges regarding how to assess the biopsychosocial consequences of dementia in a context of fragmented care (2,3). Given the scarcity of evidence from live-recorded primary care consultations about triadic dynamics, our findings are important to guide further explorations.

One of the most common somatic responses of the human body to a mental health issue consists of alterations of the breathing rate. Typically, when an individual is under stress, tends to have a more rapid shallow breathing - instead of resorting to the diaphragm to help the air in and out the lungs, ends up conducting a thoracic breathing, leading to extended fatigue or dizziness.

The aim of this project is to assess the accuracy and efficacy of measuring the breathing rate through abdominal breathing movements, via the smartphone’s sensors, and applying it to personalize a digitized diaphragmatic breathing strategy. The main hypothesis under testing is that the digitization of this strategy with the personalization to the subject’s own response is efficient as a valuable tool for mental health coping.

A tool was developed and integrated with a mobile app that aggregates mental health coping strategies, based on the digitalization of positive psychology techniques. The tool included the diaphragmatic breathing exercise and the personalization to the user through biofeedback. Such biofeedback was based on the user’s abdominal movements and directly impacted the course of the strategy. The tool is under testing, counting so far with 25 subjects resident in Portugal.

The usability and effectiveness metrics of the solution will be assessed on the first contact of the subject with the app, and segmented by different subject profiles. Mental health metrics will also be assessed, namely anxiety levels - using the smartphone sensors and standard psychiatric scales. The results will be compared with a control group, in which the subjects will only perform the self-assessment, without using the breathing exercise.

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We have yet to draw conclusions from the project; however, we aim to achieve the first results in due time.

None Declared

The concept of motivation pervades our professional and personal lives. Motivation is almost impossible to be observed directly, it is a construct for the interpretation of a behaviour that “calls the attention”.

This work reviews the current available data on the phenomenological description of motivation and the abnormalities of motivation.

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “motivation”, “psychopathology”, “phenomenology”.

Abnormalities in motivation may involve diminution or exacerbation. Anhedonia is the absence of pleasure in relation to usually pleasurable activities, it occurs in depression and schizophrenia where the pleasurable intrinsic motivation that acts as incentive for behaviour may be lost. In mania it may be increased so that mundane activities become unduly fascinating and rewarding.

Countless theories have been proposed to explain human motivation but each sheds light on specific aspects of motivation, neglecting others. This diversity creates confusion because most theories have areas of conceptual overlap and disagreement. To facilitate the development of studies, an agreement should be achieved on an operational definition of motivation.

No significant relationships.

Neurocognitive deficits amongst patients with schizophrenia are considered one of schizophrenia’s central features. These deficits appear to be present from the first episode of psychosis (FEP) and certain cognitive impairments could be components of a genetic vulnerability to schizophrenia. Regarding research on cannabis and cognition in schizophrenia, different studies have assessed neurocognitive functions: memory, attention/vigilance, processing speed, verbal learning, executive functions, and verbal fluency.

The aim is to do a review of recent findings concerning the association of cannabis use with cognition in schizophrenia.

A literature review was conducted using the PubMed search database.

Patients with schizophrenia and concomitant cannabis use are associated with worse performance in immediate verbal learning, and in some studies with worse working memory performance. There is an improvement of verbal memory when they cease the cannabis’ consumption. Regarding attention capacity and memory types assessed, the results are controversial. In FEP, heavy cannabis use during the previous year correlates with slower processing speed. Also, FEP-patients with cannabis use but no family history of psychosis perform worse in executive functions, while those with a family history of psychosis perform better.

The studies of psychosis, cannabis and cognition differ in relevant aspects, which might be connected to the result variability. Therefore, before solid conclusions can be reached, it is important to carry out longitudinal studies to understand the changes in the cognitive variables, which can depend on the pattern of cannabis’ use (concurrent or prior to the FEP). Possible confounding variables that might be present should be acknowledged.

No significant relationships.

Seizures occur in about 3% cases of alcohol withdrawal. They usually appear within 48 hours after abrupt cessation, and are characterized by a reduction in seizure threshold secondary to adaptation to alcohol. More than 50% of individuals will experience a new seizure and in 5% of these cases, progression to a sustained epilepticus status can occur.

The aim is to do a review of the literature on alcohol withdrawal and the onset of seizures in individuals with alcohol addiction.

A literature review was conducted using the PubMed search database.

Alcohol is a central nervous system (CNS) depressant and chronic consumption causes neuroadaptation in order to maintain homeostasis. This adaptation involves the upregulation of excitatory neurotransmitters systems and the downregulation of inhibitory ones. When consumption is abruptly discontinued, the depressive contribution of alcohol to a previously established balance is disrupted, resulting in withdrawal symptoms associated to a generalized CNS’ hyperexcitability state.Critical episodes increase the risk of delirium tremens, a fatal condition in 20% of untreated cases. Thus, the treatment and prevention of seizure recurrences is essential: the clinical guidelines of the American Society of Addiction Medicine 2020, offer an action proposal. Pharmacological therapy after seizures is the preferential treatment: intravenous administration of fast-acting benzodiazepines (lorazepam and diazepam) is the first line treatment.

It is essential to monitor signs and symptoms that alert us to the appearance of seizures associated to alcohol withdrawal, effectively treat these cases, prevent recurrences, and provide a quality follow-up for these patients.

No significant relationships.

Body dysmorphic disorder (BDD) is a relatively common disorder characterized by a preoccupation with non-existent or slight defects in appearance. It was first described in 1886 by Morselli as dysmorphophobia.

This work reviews the current available data on BDD and its treatment options and describes a clinical case that reports an improvement in symptomatology after surgery.

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “body dysmorphic disorder”, “dysmorphophobia”. Clinical file consultation.

The usual treatment involves a combination of psychotherapy and pharmacotherapy. Antidepressant medication, mainly selective serotonin reuptake inhibitors (SSRIs) have been used. If the symptoms do not improve, a different SSRI can be considered or clomipramine, venlafaxine or second-generation antipsychotics can be useful.

The role of surgery remains controversial, several studies indicating that the symptoms typically worsen after an aesthetic procedure because the preoccupation shifts to a different body area. However a recent study reported 32 of the 41 patients that underwent surgery were highly satisfied with the outcome. In our clinical case, our patient, a 20-year-old female with non-delusional dysmorphic ideas about her nose initiated treatment with paroxetine with poor response and was, against medical opinion, submitted to a rhinoplasty. Three weeks after the surgery there was an improvement in preoccupation about her nose. More research should be made to clarify the role of surgery in this disorder that often lacks adequate therapeutical response.

No significant relationships.

Ever since the end of the 19th century that descriptions of acute and transient psychosis (ATP) have been found in the literature. Psychiatrists from different countries gave different names for these types of episodes, throughout the ages. Those early descriptions were an important part of the development of the concept of acute and transient psychotic disorders (F23: ICD-10).

This review aims to provide historical background of the development of different concepts to describe ATP.

Non-systematic review of literature on acute and transient psychotic disorders, bouffee delirante, brief psychotic disorder, atypical psychosis.

In 1876, K.Westphal introduced the term akute primäre Verruckheit, refering to a sudden paranoia associated with delusion ideas and hallucinations. In 1895, Magnan described Bouffée delirante, characterized by a recorrent, sudden psychosis with polymorphic symptoms. Later (1924), the term cycloid psychosis was introduced by K.Kleist: phasic psychosis with good prognosis. Different concepts appeared throughout history: psychogenic psychosis (Wimmer,1916); atypical psychosis (Mitsuda,1942), holodisfrenia (Barahona,1957). Nowadays, the classification systems include many of these concepts in the same categories: Schizophreniform disorder, Brief psychotic disorder (DSM-5), and ATP (F23 in ICD-10).

All throughout the History of Psychiatry, there was an evolution of concepts associated to ATP. They were strongly influenced by different time epochs. It is important to have context on the historical background of the concepts used in the contemporaneous Psychiatry. Diagnosis is challenging due to their heterogeneous presentation. There are not many studies available, because of ATP’s low diagnostic stability.

No significant relationships.

Uterine cancer is the most common gynecologic malignant neoplasm in developed countries. While depression is up to 3-5 times more common in patients with cancer than in the general population, literature is still limited regarding the relation between Endometrial Cancer and depression.

To analyze Depression among Endometrial Cancer hospitalizations in mainland Portuguese public hospitals (2008-2015).

A retrospective observational study was conducted using administrative data from all hospitalizations in Portuguese mainland public hospitals between 2008-2015. All women’s hospitalizations(≥18 years) with a primary diagnosis of Endometrial Cancer (ICD-9-CM 182.x) were selected. Secondary diagnosis of depression was identified with ICD-9-CM 296.2x, 296.3x and 311x codes. Surgical procedures codes 68.4x, 65.6x, 40.3x, 40.5x, 68.6x, 68.9x and 68.8x were used to divide the hospitalizations into surgical vs non-surgical. Groups were compared with Pearson Chi-square test and crude odds ratio(OR) was used to estimate the association between surgery and depression.

From 10227 hospitalizations with a primary diagnosis of Endometrial Cancer, 533 had a registry of depression(5.2%). Annual depression frequency rose from 2.0% (2008) to 8.3% (2015). Among patients with a record of depression, 73.2% had surgery. Women who had surgery were significantly more likely to have registered depression (p<0.001). The OR for depression in surgical vs non-surgical patients was 1.73 (95%IC:1.42-2.10).

Patients hospitalized due to Endometrial Cancer and submitted to surgery had almost two-fold more risk of having a registry of depression. This trend reinforces the importance of early depression screening of these patients, enabling the implementation of timely therapeutic strategies before and after surgery.

No significant relationships.

Cannabis-induced psychotic disorder (CIPD) is defined by the development of psychotic symptoms during or briefly after intoxication with cannabis or withdrawal from cannabis. The social measures and restrictions implemented following the COVID-19 pandemic might have had an impact on cannabis availability, as suggested by patients from our clinical practice, reporting a shortage of the substance.

To compare sociodemographic, clinical characteristics and admission rates of inpatient treatment for cannabis-induced psychotic disorder in COVID-19 pandemic period and pre-pandemic period.

Retrospective observational study of inpatient admissions for CIPD in a psychiatry inpatient unit of a tertiary hospital. The statistical analysis was performed using SPSS software, version 27.0.

Our sample included 120 inpatient admissions, corresponding to 80 patients. Compared to 2018 and 2019, in 2020 there was an overall reduction of 21.5% in inpatient admissions (n=618, 549 and 458, respectively). The number of admissions for CIPD in 2018, 2019, 2020 and 2021 up to september were, respectively, 29, 32, 10 and 31 (5.2%, 6.1%, 2.2% and 7.2% of respective annual admissions). We found no statistically significant differences regarding sociodemographic and clinical characteristics in patients admitted for CIPD during 2020.

These results suggest a disproportionate reduction of inpatient admissions due to CIPD in 2020, followed by an expressive increase in the number of admissions in 2021up to september. This might be related to cannabis availability returning to regular levels. However other factors must be considered, such as the delay of treatment due to reduced accessibility to health care.

No significant relationships.

Portugal has a Dementia Strategy that endorses care coordination in the community, but the strategy is not implemented despite there being a network of multidisciplinary primary care clinics that could support it. Recent research into barriers to dementia management in primary care has focused essentially on general practitioners’ (GPs) factors and perspectives. A comprehensive triangulated view on the barriers to dementia management emphasising teamwork is missing.

To explore the barriers to the implementation of the Portuguese Dementia Strategy by primary care teams, from the perspectives of service users and professionals.

Purposive sampling was used to recruit 10 GPs, 8 practice nurses, 4 social workers, 8 people with dementia and 10 family carers from 6 practices in different social contexts within the Lisbon metropolitan area. The analytical framework combined codes derived from the transcripts with codes from the available literature. Themes focused on the access to professionals/community services, care coordination within healthcare teams, and between health and community services.

Several system barriers were identified (undefined roles/coordination within teams, time constraints, insufficient signposting to community services) along with individual barriers (limited competence in dementia, unrecognised autonomy, limited views on social health and quality of life (QoL)), hindering users access to dementia services.

Enhanced competence in dementia, and nurse-led systematic care of people with dementia and their carers, are necessary. They can be effective in improving the QoL in dementia, but only if associated with better community support.