IntroductionAsthma is a major public health problem and its prevalence has increased in both developed and developing countries during the last few years. Once it is a chronic illness, it has also revealed psychological consequences. Moreover, recent studies have suggested an association between asthma (especially of severe grade) and mental disorders.ObjectivesThe authors pretend to make a brief review concerning psychiatric disorders among asthmatic patients.AimsTo understand and to be able to deal with the psychiatric disorders among chronic asthmatic patients.MethodsThe review was based on scientific documentation published in PubMed database, using the following terms as keywords: “asthma”, “depression”, “anxiety” and “panic disorder”.ResultsCompared to the general population, both anxiety and mood disorders rates are at least two times those observed in asthmatic patients. Moreover, certain psychiatric disorders rates, including panic disorder (PD) and major depressive disorder, are as much as six times more prevalent among asthmatics when compared to the general population. The association between psychiatric disorders and poor asthma control and asthma-related quality of life could occur through several pathways, such as behavioural pathways; cognitive or perceptual pathways; or through the direct physiological effects of depression and anxiety on the autonomic nervous system (ANS) and immune systems which increase asthma symptomatology.Discussions/ConclusionsThere is a close correlation between anxiety, PD and depression, and a poor controlled asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Gangliogliomas are rare tumors, comprising less than 1% of all brain tumors, predominating in the early decades of life, with strong association with long term intractable epilepsy. In 90% of the cases they are located in the temporal lobe and overall a good prognosis is expected.With this poster the authors report a case of a 38-year-old male patient, clinically stabilized with psychotropic drugs, who was diagnosed for six years with undifferentiated schizophrenia. Recently, he started with seizures which lead to the diagnose of ganglioglioma. Due to the need of surgical resection the psychotropic drugs were suspended. Consequently, the psychotic symptoms reappeared with more intensity and resistance to the treatment.A retrospective and detailed analysis of the psychiatric and neurologic diagnosis conducts to a thorough discussion over the possible associations between these two entities without excluding an eventual causality. The authors aim to review and discuss the relevance of this topic, highlightening the racional use of imaging studies in order to exclude organic diseases in patients with first episode psychosis.
Bariatric surgery is a therapeutic option to treat obesity in (carefully selected) patients with psychiatric disorders. About half of the patients referred for bariatric surgery have a diagnosis of (at least one) mental disorder and most of them are treated with psychotropic drugs. This procedure may modify the bioavailability of drugs and lithium is no exception. However, although absorption seems to decrease in most drugs, in the case of lithium, there is a high risk of toxicity. In this article, we describe the case of a 44-year-old female patient with lithium intoxication after bariatric surgery. We conducted a review of the published clinical cases in the scientific literature about lithium toxicity after bariatric surgery, and we propose potential preventive clinical solutions. It is essential to increase awareness of changes to the absorption of psychotropic drugs in the post-surgery period, particularly in the case of lithium. Regular postoperative clinical and laboratory monitoring of lithium serum levels is strongly recommended.
Gangliogliomas are rare tumors, comprising less than 1% of all brain tumors, predominating in the early decades of life, with strong association with long term intractable epilepsy. In 90% of the cases they are located in the temporal lobe and overall a good prognosis is expected. With this poster the authors report a case of a 38-year-old male patient, clinically stabilized with psychotropic drugs, who was diagnosed for six years with undifferentiated schizophrenia. Recently, he started with seizures which lead to the diagnose of ganglioglioma. Due to the need of surgical resection the psychotropic drugs were suspended. Consequently, the psychotic symptoms reappeared with more intensity and resistance to the treatment.A retrospective and detailed analysis of the psychiatric and neurologic diagnosis conducts to a thorough discussion over the possible associations between these two entities without excluding an eventual causality. The authors aim to review and discuss the relevance of this topic, highlightening the racional use of imaging studies in order to exclude organic diseases in patients with first episode psychosis.
For many years, psychiatric services were characterized by high rates of institutionalization and a strong focus on biological treatment. At present, aside from psychiatric hospitals, there are community mental health services introducing modern, community-based, and user-oriented services.Taking this into consideration, the main aim of this poster is to provide an overview of a community mental health service of Lisbon's Psychiatric Hospitalar Centre (E.T.C. -Espaço Terapêutico Comunitário) for severe mental disorders, highlighting its complexities and challenges.This poster also highlights the importance of recovery which requires symptom remission along with reduce interpersonal and social deficits and improved social adaptation and general life.For this purpose, the authors portray a community mental health service and describe the results of the Personal and Social Performance Scale (PSP), a validated scale for the Portuguese population, useful in the evaluation of personal and social functioning of patients, which allows a better understanding and evaluation of therapeutic strategies implemented during the intervention.Findings may suggest that these community structures may exert a great influence on social functioning of severely ill patients and that the recovery of people with chronic mental illness requires integrated support services. Therefore, the integration of health and social services is an essential element for the psychosocial rehabilitation and the administration of brief assessments with measures of functioning may lead to more focused interventions, possibly improving outcomes
Phytophthora cinnamomi is a major plant destructive pathogen with a wide range of hosts and is considered one of the main causes of Quercus spp. decline in the Southwest of the Iberian Peninsula. This study compares two inoculation tests, using simple and fast methodologies, in order to select the most aggressive isolate to use in future Quercus suber inoculation experiments. To evaluate P. cinnamomi intraspecific variability, cork oak excised shoots were inoculated with five isolates, obtained from Q. suber, Quercus rotundifolia and Castanea sativa stands. These isolates were used for in vitro inoculation of a Trifolium subterraneum cultivar available in Portugal in order to assess its usefulness as a "model plant" in rapid screening tests. This study revealed intraspecific variability of P. cinnamomi isolates to cause lesions in Q. suber excised shoots and in the number of T. subterraneum developing lesions on stem and leaves. However, there was no correspondence between the aggressiveness of the isolates in subterranean clover and in the cork oak. Only one isolate showed consistency in aggressiveness regardless of the host species. In conclusion, T. subterraneum is not a good "model plant" for the evaluation of P. cinnamomi isolates aggressiveness.
IntroductionMixed states have had growing importance since Kraeplin. They have long contributed to the concept of bipolar disorder. They are frequent, occurring in 1/3 of all bipolar episodes. Many severe psychotic mixed states are still misdiagnosed and mistreated as schizophrenia. Because they have such complex presentations, they represent a challenge to diagnosis and treatment.Objectives/ AimsThe authors' aims are to report a mixed episode; to describe its fast improvement only when lithium was introduced and to compare this result with the evidence in current guidelines.MethodsA patient clinical file was analyzed. Literature research was performed. Relevant chosen papers were selected.ResultsWomen. 33. Actress. Gradual depressive simptoms, after broke up with her boyfriend the month before. She became suspicious, showing persecutory ideias. She was thin, unable to sleep, her house was disorganized. On admisson she was agitated, her eyes sad, her face almost inexpressive, her speech disconected. She showed great instability: she seemed depressive, then loughed inexpectedly, suddendly became coprolalic. She was diagnosed borderline personality before. She has positive psychiatric family history (mother, psychotic depression). After valproate, bupropion and olanzapine her humor and judgment improved but she kept an unstable behaviour. Lithium´s introdution enabled a fast, sharp recovery and organized behaviour.ConclusionsDespite the prevalence of mixed states, research into the eficacy of treatments is limited. Current guidelines lack specific treatment recommendations and are sometimes inaccurate. Further studies are needed to complete our knowledge´s gap in the treatment of mixed states.
IntroductionFibromyalgia is a disorder characterized by chronic widespread pain and tenderness at palpation of specific points or associated symptoms of fatigue, un-refreshing sleep or cognitive dysfunction. Although his prevalence ranges from 2% to 6,4%, it remains a controversial and an exclusion diagnosis which causes are incompletely understood.Patients have been reported as being perfectionist, introspective, demanding and exhausting to manage. While such personality traits may appear to contribute to fibromyalgia symptoms, the links between them remain unclear.Objectives/AimsThe author’s goal is to understand the complex role of personality traits in clinical presentation and management of patients with fibromyalgia. Additionally we present an illustrative clinical case.MethodsA literature search was performed using the key words fibromyalgia, personality, trait psychology and retrieved papers were selected according to their relevance. The patient clinical record was reviewed.ResultsWe discuss whether the personality traits result from or cause fibromyalgia symptoms and present a case of a 47 years old woman with fibromyalgia who presents to psychiatrist with a depression syndrome. The personality assessment revealed anxiety, immaturity and impulsivity. A multidisciplinary approach was made with rheumatology, psychiatry and psychology. The patient was treated with antidepressants, mood stabilizers, muscle relaxant and opioid analgesics, as well as psychoeducation. Eighteen months later, the patient remains with pain and concentration complaints, having improved sleep and functional capacity.ConclusionsPersonality might be involved in various aspects of chronic pain, as seen in fibromyalgia, and be involved in triggering, maintaining and exacerbation of the fibromyalgia’s process.
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