BackgroundCountries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations’ health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes.MethodsLiterature review of records identified through Medline, PsycINFO, SciELO, and EBSCO Host. Only original research papers, published between 2004 and 2014, peer-reviewed, non-qualitative research, and reporting on associations between economic factors and proxies of mental health were considered.ResultsOne-hundred-one papers met the inclusion criteria. The evidence was consistent that economic recessions and mediators such as unemployment, income decline, and unmanageable debts are significantly associated with poor mental wellbeing, increased rates of common mental disorders, substance-related disorders, and suicidal behaviours.ConclusionOn the basis of a thorough analysis of the selected investigations, we conclude that periods of economic recession are possibly associated with a higher prevalence of mental health problems, including common mental disorders, substance disorders, and ultimately suicidal behaviour. Most of the research is based on cross-sectional studies, which seriously limits causality inferences. Conclusions are summarised, taking into account international policy recommendations concerning the cost-effective measures that can possibly reduce the occurrence of negative mental health outcomes in populations during periods of economic recession.

RESUMO-Introdução: A escabiose é uma infestação cutânea parasitária comum nos cuidados de saúde primários, pediatria e dermatologia. Apesar de não ser ameaçadora da vida, tem elevada morbilidade e impacto na qualidade de vida. Nos países em de-senvolvimento, a escabiose está associada a altas taxas de sobreinfeção cutânea bacteriana, nomeadamente de impetigo. Objetivos: Rever os aspetos gerais da escabiose, com particular enfâse no diagnóstico e tratamento. Analisar a realidade epidemiológica nacional e internacional e as opções terapêuticas disponíveis em Portugal. Material e métodos: Revisão narrativa da literatura científica, incluin-do livros e bases de dados científicas (PubMed/Medline, Cochrane, UpToDate, IndexRMP). Discussão: A escabiose é uma dermatose com características clínicas muito típicas, nomeadamente, o prurido frequente, a aparência das lesões cutâneas e sua distribuição, e a presença de contexto epidemiológico. O tratamento eficaz do doente e dos contactos próximos é dependente de um reconhecimento atempado da doença, sendo fundamental evitar atrasos no diagnóstico, baixa adesão ao tratamento e sua aplicação incorreta. Con-clusão: Atendendo à eficácia e toxicidade das várias opções terapêuticas, a permetrina a 5% e a ivermectina oral são consideradas de primeira linha. Contudo, em Portugal, pela ausência de comercialização destas, o mais usado é o benzoato de benzilo. A explicação cuidadosa e correta do tratamento ao doente tem um papel essencial para o seu sucesso. Em Portugal, seria útil e aconselhável haver uma notificação dos casos de escabiose. ABSTRACT-Introduction: Scabies is a parasitic cutaneous infection, which is common in primary care, pediatrics and dermatology. Although it isn't life threatening it causes considerable morbidity and has a substantial impact in the quality of life. In developing countries it is associated with high rates of cutaneous bacterial superinfection, namely impetigo. Objectives: To review the general aspects of scabies, with a particular emphasis on the diagnosis and treatment. To analyze the national and international epidemiological situation and the available treatment options, particularly in Portugal. Material and Methods: Narrative review of the scientific literature, including textbooks and scientific databases (PubMed/Medli-ne, Cochrane, UpToDate, IndexRMP). Discussion: Scabies is a dermatosis with typical clinical characteristics, namely pruritus, type of cutaneous lesions and their distribution, and presence of epidemiological context. Efficacy of treatment of scabies patients and close contacts depends on a timely diagnosis, and diagnostic delay, low-adherence to treatment and incorrect treatment application should fundamentally be avoided. Conclusions: Given the efficacy and toxicity of the various treatment options, 5% permethrin and oral ivermectin are considered first-line. However, in Portugal, since neither are available, benzyl benzoate is most frequently used. A careful explanation of treatment steps and its correct application is essenti...

Coping is commonly associated with deliberate self-harm (DSH) in adolescents. This article reviews the published literature from 2000 to 2010, aiming to highlight the current evidence supporting this association. Eighteen studies met the inclusion criteria, a total sample of 24,702 subjects was obtained and 17% were DSH cases. Emotion-focused coping style and in particular avoidant coping strategies have consistently been associated with DSH in adolescents. Problem-focused coping style seems to have a negative relation. Most studies were cross-sectional, which seriously limits our conclusions on causality. There is a clear need for more systematic studies, performed in accordance with consensual methodology.

The study aims to determine the prevalence of self-harm (SH) and related psychosocial factors in a large sample of Portuguese adolescents. A total of 1,713 pupils, aged 12 to 20 years, completed an anonymous questionnaire in a school setting. In all, 7.3% reported at least 1 episode of SH: rates were 3 times higher for females than males. Almost half reported repeated SH, most commonly self-cutting. Anxiety, depression, and substance abuse were linked to SH, and particularly repeated SH. Anxiety, trouble with the police, and exposure to SH or suicide of others, were independently associated with SH in both genders. These findings indicate that SH is a public health concern in Portugal as in other European countries.

The authors conducted a revision of literature about the diagnosis, epidemiology, clinical aspects, laboratory and structural investigations and the treatment of this condition. Based on this revision work, the authors sketch some recommendations about the work-up that should be done when faced with this diagnostic hypothesis.

The results support previous data regarding a different pattern of coping strategies used by adolescents who harm themselves. The use of self-rating instruments and the cross-sectional nature of the study limit our results.

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