The psychological modulation of stress-related disorders, such as type 2 diabetes is a well-established phenomenon in psychoneuroimmunology.

This study analyzes if health outcomes in a type 2 diabetes case are modulated by exposure to psychosocial stressors.

A single case study was conducted for a 38 year-old woman diagnosed with a history of unregulated type 2 diabetes.

Lack of control and predictability, lack of outlet for frustration, marital conflict, lack of social support and type A personality were associated with increase in clinical complications.

Results of this study point out the role of perceived intensity and chronicity of stressors in the health outcomes in our patient. In particular, interpersonal relationship, social support and personality played a key role in type 2 diabetes.

Because blind patients with schizophrenia are not so many, we don't have much information about their psychotic symptoms, neither about their treatment.

The hallucinations of blind schizophrenic patients could be different from unblind patients, due to impairment of their visual function.

Analysis of psychotic symptoms and antipsychotic treatment of blind schizophrenic patients could provide new information about their features and treatment.

We had two case studies, both diagnosed with schizophrenia, multiple episodes, currently in acute episode according to DSM V. Both patients were treated with olanzapine 10mg/day.

The psychotic symptoms of both patients had the same particularity, the presence of tactile hallucinations (both patients describe insects moving on and in the skin, with repeated attempts to remove them, producing secondary skin lesions). Both patients had a good response and remission of this symptoms after 14 days of treatment with olanzapine 10mg/day. The PANSS score had a reduction on hallucinatory behavior item from 5 to 1 for the first patient and from 6 to 2 for the second patient, for both after 14 days of treatment.

We presume that tactile hallucinations could be specific for these two cases. Treatment with olanzapine (an antipsychotic with a large receptoral spectrum) was a good choice in these cases.

A history of drug and alcohol use influences various aspects of inpatient care. It is important to ascertain the history of drug and alcohol use in new admissions. This knowledge ensures the appropriate detoxification of patients. It also allows the management of various risks such as the risk of violence, of escape, of drugs being brought onto the ward and of drug use amongst other patients. It can explain the lack of therapeutic progress in patients.

To ascertain whether new patients admitted to an acute ward on a medium secure unit in London are being asked about their drug and alcohol usage history.

To establish what proportion of 18 male inpatients on a medium secure unit have their drug and alcohol history documented in their admission notes.

The notes of all 18 patients on an acute ward in a medium secure unit were scrutinised. An audit tool was used to record whether the admission notes contained an entry about the history of drug and alcohol use.

There were 18 male patients. Four were under a section 3, four under a section 47, four under a section 48, one under a section 38, five under a section 37 of the Mental Health Act 1983. Only 5 of 18 patients had been asked about their history of drug and alcohol use on admission.

An important part of the history is being missed in a large proportion of new male admissions to a medium secure unit.

The psychological changes caused by trauma reflect the difficulty of overcoming the traumatic event. This study is a trial to approach the clinical and evolutionary aspects of post traumatic pathology through an observation of a recently hospitalized patient in our military psychiatric department.

Mr M., 28 years old, was surprised by the sound of distant gunshots. Going on site, he found six of his friends killed and his best friend dying. Developing severe symptoms of acute stress disorder, he was hospitalized and treatment by an antidepressant and anxiolytics has been established. Two weeks after, anxiety and nightmares decreased but repetition and avoidance syndromes did not improve.

Meanwhile, the patient was obliged to face major confrontations consisting of interrogations and legal proceedings concerning his conduct after the accident. He was suspended from his job and all his professional papers were confiscated. The patient developed consequently a major depressive episode; however, an important event occurred: the repetition syndrome disappeared. Thereafter, the mood disorder has improved and we have seen a more combative attitude from the patient.

In this case, how can we explain the relatively early disappearance of the repetition syndrome? Is it the confrontation with facts of reality even more traumatic than the trauma itself? The long-term evolution towards recovery or towards a new relapse will clarify us on this issue.

Violent behavior and association with alcohol abuse or other substance is a common problem in emergency psychiatry. Assessment, diagnosis, management and treatment of this symbiosis is very difficult. Such an association affects the severity of symptoms of mental illness, progress and prognosis.

To review the association of violent behavior with alcohol and substance abuse.

Improve assessment, management and treatment of patients with violent behavior, accompanied with alcohol and substance abuse in psychiatric ward.

Prospective cohort study, during 24 weeks. Psychiatric evaluation based on structural clinical interviews and questionnaires related to violent behaviors and risk factors were conducted to patients admitted in psychiatric hospital on UHC'Mother Tereza' Tirana.

According to our data, there are strong links between alcohol consumption, substance abuse and an individual's risk of being either a perpetrator or victim of violence. So 20% of males and 16% of female admitted to our service had reported alcohol consumption and substance abuse, (out of 159 male and 77 female patients) 66% of them had shown violence episodes. At the discharge from hospital 3.8% of men and 1.2% of female patients had diagnosis of axis I related to alcohol or substance abuse.

There is a close correlation between the Violence and abuse of Alcohol and other substances. The comorbidity affects the progress of treatment and prognosis of the disease. The abuse of alcohol and other substances is a good indicator to predict future violence.

Psychosocial treatments, broadly defined, refer to the use of human interactions for therapeutic purposes. Psychosocial treatments, in conjunction with pharmacotherapy, are increasingly utilized in treating schizophrenia. Reference is made to recent literature and research, showing that - although a number of current psychosocial treatment approaches address motivation to varying degrees, treating motivation as a primary target is needed to maximize functional outcomes in schizophrenia.

The paper describes a group-based intervention designed for persons with schizophrenia-spectrum disorders, to be administered as an add-on module to supplement ongoing psychosocial treatment in an outpatient setting in Moscow Research Institute of Psychiatry. The intervention is designed to enhance motivation to change maladaptive patterns of behavior, and to facilitate engagement in psychosocial treatments.

Individuals diagnosed with schizophrenia were recruited as they entered outpatient psychosocial rehabilitation programs. Patients completed interview-based measures of motivation. The conductor's work is, in first instance, to turn the group into an effective therapeutic tool.

Inclusion and exclusion criteria of patients, therapeutic team, setting, methodology, techniques, strategies and therapeutic factors - will be presented. We will discuss the modification of motivational enhancement techniques needed at different points in the treatment\rehabilitation process and the evidence for effectiveness.

Potential psychosocial treatment implications are suggested, especially those that emphasize motivational enhancement. Implications for the theoretical understanding and psychosocial treatment of intrinsic motivation in schizophrenia are outlined.

In bipolar disorder affective status is significantly associated with subjective well-being. That relationship is particular significant for depressive symptoms.

The purpose of the present study was to analyze whether it is appropriate the use of the Subjective Well-being under Neuroleptic Scale (SWN-K) among patients with bipolar disorder.

50 outpatients with bipolar disorder were recruited. Subjective well-being was evaluated using the SWN-K. Current symptomology was rated using the Hamilton Depression Rating Scale (HAM-D) and the Young Mania Rating Scale (YMRS).

In our sample, there is a strong inversely correlation (/r/ > 0.7. p <0.01) between the score on the HAM-D and the total score on the SWN-K. HAM-D and SWK are linearly related and that relationship is inverse, this strong inversely correlation is maintained between each subscales of the SWN-K and the HAM-D.

There is a modest direct correlation (0, 30≤ r ≤0, 70. p<0.01) between the total score on the YMRS with the total score on the SWN-K. Both variables are linearly related and this relationship direct. In each subscale of the SWN-K is detected this relationship with the YMRS.

According to previous studies, our results suggest that affective status is associated with subjective well-being in bipolar patients and this relationship is particular significant for depressive symptom. In contrast to previous studies, we found a modest but direct correlation between YMRS score and SWN-K. Further investigations are necessary in patients with acute mania in order to determine whether SWN-K is a good tool for it.

The psychological modulation of stress-related disorders, such as gastrointestinal complications, is a well-established phenomenon in psychoneuroimmunology. Recent studies of stress have highlighted the effects of chronic psychological and environmental stressors to health and well-being, but the evidence is still minimal.

This study analyzes health outcomes in a clinical case modulated by exposure to psychosocial stressors, focusing on gastrointestinal function, but also evaluating how those stressors are related to anxiety, depression and hypochondria.

A single case study was conducted for a 66 years-old woman diagnosed with gastric carcinoma. In addition, stressful life events and social support were registered.

Characteristics of stressors, such as intensity and chronicity, and type A personality were associated with increase gastrointestinal complications.

Results of this study point out the role of perceived stress in health outcomes.

Bipolar affective disorder in the elderly is a complex entity not only in its clinical dimension but also in its therapeutic management. Elderly patients are very sensitive to pharmacological secondary effects.

The objective of this study is to longitudinally analyze the pharmacological route of a sample of outpatients above 65 years old.

Review of clinical histories and data collection from a sample of 12 patients over 65 years old.

Most of the patients experienced at least three drugs prior to their current treatment. The fundamental reason for changes were intolerable adverse effects and, in one of them, irreversible (kidney failure). The trend is to replace drugs by atypical antipsychotic or antiepileptic ones. The prescription of gabapentin is not based on scientific evidence but with a positive response. The available literature is still limited to justify these decisions based on clinical experience, somatic background and tolerance of the patient.

Traumatic experiences are a decisive factor for the manifestation of dissociative symptoms and, in turn, dissociative symptoms are often part of severe psychopathology.

Given the lack of research in Portugal examining dissociation and trauma in patients with Schizophrenia and Bipolar Disorders, we intended to determine if these patients dissociate and what kind of traumatic experiences they had, to analyze associations between dissociation and trauma, and check if there are differences by gender and formal education.

We assessed, through Dissociative Experiences Scale and Traumatic Experiences Checklist, 30 patients (M ± SD age = 42.6 ± 12.38; range 20-65 years) with Schizophrenia (n = 22) and Bipolar Disorder (n = 8) from a Residence for mentally ill (Mini International Neuropsychiatric Interview confirmed diagnoses).

Twelve patients (40%) revealed pathological dissociation (M ± SD = 33.52 ± 17.74), scoring highest in DES absorption factor, and had more traumatic experiences between 7-12 years of age. Dissociation correlated moderately with traumatic experiences (?? = 0.40). Significantly, women had more dissociation and traumatic experiences (M ± SD = 34.55 ± 18.60; 2.14 ± 2.53) than men (M ± SD = 27.55 ± 16.48; 1.51 ± 1.91). There were no significant differences by education.

Many schizophrenic and bipolar Portuguese patients dissociate and had traumatic experiences in childhood, which is supported by the literature, but is necessary to replicate with bigger samples, and compare the two disorders to draw more conclusive interpretations. Nevertheless, therapeutic interventions should consider these aspects.

Adolescence is a critical period for dissociation, until more effective coping strategies are developed. Dissociate in a chronic manner is likely to interfere with the construction of a cohesive sense of self, and may potentiate later psychopathology. Adolescent Dissociative Experiences Scale/A-DES is yet to be studied in Portugal.

Analyze the psychometric properties of the A-DES 11-item format; compare between nonclinical with psychological disturbed adolescents/PDA; and determine the variables that associate with A-DES.

A sample of nonclinical (n = 69) and PDA (n = 45) aged between 11 to 18 years, 55.3% boys and 44.7% girls, education mean years 8.96 (SD = 2.74), completed the A-DES and the Youth Self Report/YSR.

The A-DES had a very good internal consistency (α = 0.94), presenting significant large correlations with YSR (r = 0.67). Confirmatory factor analysis suggested a 1-factor structure.

The mean scores (2.78 ± 1.82) were equivalent to other countries, and significantly discriminated (t = 6.02; p < 0.001; Cohen's d = 1.12) between the nonclinical (M = 2.06 ± 1.41) and PDA (M = 3.89 ± 1.84).

There were no differences between the sexes, but the younger, less educated, and institutionalized had more dissociative experiences (r = 0.21 to 0.30). Hierarchical multiple regression revealed that only YSR was statistically significant in predicting levels of A-DES (Beta = 0.64; p < 0.001).

The Portuguese A-DES version seems a valid and reliable screening for dissociation amongst adolescents.

The liaison psychiatrist often attends Bipolar disorder (BD) patients when they are admitted to a general hospital. There is little research and literature about special needs of these patients. It is important a detail examination of characteristic of the consultations carried out by liaison psychiatrist.

Analyse the demand for mental health liaison consultation for people diagnosed of Bipolar Disorder (BD).

Evaluation of clinical data obtained from the consultations attended to patients diagnosed of BD by a liaison psychiatry service from 2010 to 2012 in a general hospital.

The number of consultations attended was 824. 34 of them (4,12%) were patients diagnosed of a BD. Their mean age was 61,26 (DE 12,93). All the patients attended had previous psychiatric history. The 65% of them were receiving outpatient psychiatric treatment at admission. The departments that most frequently requested consultation were internal medicine with 26, 47% of the total ; Neurology and Surgery both with 14,7%; Traumatology, Digestive, Cardiology and intensive care with 8,82% each of them. A pharmacological intervention was carried out in 44% of cases while only 5,88% of patients required both pharmacological and psychotherapeutic interventions. In 50% of the requests an evaluation was the intervention.

We found a low percentage of demand of attention in patients with BP. This data are similar to studies. We should consider the possibility of inappropriate consultations among data analyzed. This might be related to lack of information for the management of people with BD in other specialties.

For our investigation we observed 167 patients with paranoid schizophrenia according to the criteria of ICD 10.

All patients received atypical antipsychotics. Patients were randomized into 3 groups. Patients of 1st group (n=52) received sertindole monotherapy 16–20 mg per day, patients of 2nd group (n=67) received paliperidone 9–12 mg per day and fluvoxamine in combination with zuclopenthixole depot 150–200 mg per day. Fluvoxamine was chosen because of its potential impact on sigma receptors.

the results of the study indicate the significance of differences of dynamics of neurocognitive deficit in schizophrenia and the importance of choice of biological therapy for correction of neurocognitive deficit in patients with schizophrenia. Also the study showed the possibility of correction of components of neurocognitive deficit in schizophrenia patients which was confirmed by objective psychological tests. The use of modern atypical antipsychotics and drugs which can influence on sigma-receptors can restore the social functioning in young patients with schizophrenia.

Chronically depressed patients show considerably impaired interpersonal features, which could be explained by a reduced Theory of Mind (ToM) ability.

The aim of this study was to examine whether chronically depressed patients are impaired in their ToM performance compared to a healthy control group in three different components of ToM: the social cognitive and social perceptual component as well as the ability to take someone else's visual perspective.

32 chronically depressed patients (DSM-IV) were compared to 32 matched healthy controls. ToM abilities were assessed by a cartoon picture story test (CT), the ‘Perspective task’ (PT) and the ‘Reading the mind in the Eyes’ test (RMET). In addition, information about depression severity, childhood trauma and executive functioning (working and logical memory) was assessed for both groups.

Patients mentalized significantly less frequently than healthy controls in the CT (Mann-Whitney-U=340,50, p<0,05). Furthermore, the CT was significantly correlated with the RMET (patients: r=0,46, p<0,05; controls: r=0,57, p<0,01). We didn’t find any significant difference between both groups in the RMET (p>0,05). In the PT, patients showed significantly lower scores than controls (t(35,68)=2,10, p<0,05). There wasn’t any significant correlation between the three ToM tests and severity of depression, duration of illness or childhood trauma (p>0,05).

Our results suggest that chronically depressed patients show deficits in their social cognitive ToM ability compared to controls, whereas their social perceptual ToM ability seems to be unimpaired. As to the capacity to take someone else's perspective, our results suggest that chronically depressed patients present significant deficits.

An early symptomatic response has been related with an early improvement in functionality, quality of life and subjective well-being.

The short version of the Social Functioning Scale (SFS) has been validated to get round the difficulty of lack of time in our clinical practice.

Evaluate functionality with SFS in a sample of schizophrenic outpatients treated with long-acting injectable antipsychotics.

20 outpatients with schizophrenia according to ICD-10 criteria. These patients were in treatment with long-term antipsychotic monotherapy during the past three months. Two treatment groups were established: paliperidone palmitate treatment group and another with the other long-acting injectable antipsychotics marketed in our country (constant release risperidone, olanzapine pamoate, zuclopenthixol, fluphenazine decanoate).

The severity of the disease was assesed by the CGI-S and function was assessed using the SFS. Antipsychotic medication was computed in equivalent mg of chlorpromazine (CPZe). Socio-demographic data were also collected.

Mean scores of SFS were: 25.91(SD 5.66) in paliperidone palmitate group and 27 (SD 6.78) in the other antipsycotics group. Mean score of CGIS were: 3.91 (SD 0.94) in paliperidone palmitate group and 3.33 (SD 1.41) in the other antipsycotics group. Mean score of CPZe was: 427.1 (SD 102,54) in paliperidone palmitate group and 580,59 (SD 332,54) in the other antipsycotics group.

We don’t find significant differences between the two groups. It should be noted observational design prevent us from make relevant inferences. It is likely that with a larger sample size these data can be modified.