The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD.

Background: Significant deficits in emotional recognition and social perception characterize patients with schizophrenia and have direct negative impact both in inter-personal relationships and in social functioning. Virtual reality, as a methodological resource, might have a high potential for assessment and training skills in people suffering from mental illness. Objectives: To present preliminary results of a facial emotional recognition assessment designed for patients with schizophrenia, using 3D avatars and virtual reality. Methods: Presentation of 3D avatars which reproduce images developed with the FaceGen® software and integrated in a three-dimensional virtual environment. Each avatar was presented to a group of 12 patients with schizophrenia and a reference group of 12 subjects without psychiatric pathology. Results: The results show that the facial emotions of happiness and anger are better recognized by both groups and that the major difficulties arise in fear and disgust recognition. Frontal alpha electroencephalography variations were found during the presentation of anger and disgust stimuli among patients with schizophrenia. Discussion: The developed program evaluation module can be of surplus value both for patient and therapist, providing the task execution in a non anxiogenic environment, however similar to the actual experience.

Background:Increasing evidence supports an association between psychological well-being and overall health, however, much remains to be understood about this association. Objectives: The current study addresses this issue by presenting a new perspective focusing on health perceptions. Additionally, it examines the impact of each of six dimensions of psychological well-being on health perception. Methods: Data for this study were collected from a sample of 1,155 Portuguese adults in various settings. Results: Findings reveal that psychological well-being dimensions' impact differently on prior, current, and health outlookperceptions. Furthermore, the dimension depressed mood influences current health perception; in turn, current health perception is the strongest predictor for psychological well-being. Discussion: Our results provide support for a bidirectional relationship between health perception and psychological well-being.Leite A et al. / Arch Clin Psychiatry. 2019;46(3):53-60

Objective: To study anxiety as a variable of the mid-and long-term psychological impact of presymptomatic testing for three autosomal dominant late-onset disorders -Huntington's disease (HD), Machado-Joseph disease (MJD) and familial amyloid polyneuropathy (FAP) TTR V30M -in a Portuguese sample. Methods: This cross-sectional study included 203 participants: 170 (83.7%) underwent pre-symptomatic testing for FAP, 29 (14.3%) for HD, and 4 (2%) for MJD. Of the 203 participants, 73 (36.0%) were asymptomatic carriers, 29 (14.5%) were symptomatic carriers, 9 (4.5%) were diagnosed with FAP and had a liver transplant, and 89 (44.5%) were non-carriers. Most were women (58.1%) and married (66.5%). The anxiety variable was assessed using the Zung Self-Rating Anxiety Scale (SAS). Results: The anxiety scores were higher for symptomatic carriers and for those who underwent psychological support consultations over the years. For symptomatic carriers, the mean scores were superior to 40 points, which reflects clinical anxiety. Conclusion: Although it was not possible to differentiate between the mid-and long-term psychological impacts, this study supports the conclusion that the proximity to the age of symptoms onset might be a trigger for anxiety.

People with severe mental illness (SMI), schizophrenia in particular, show considerable functional impairment in emotional recognition and social perception, which negatively affects interpersonal relationships and social functioning. Owing to its ecological validity, virtual reality (VR) has been observed to improve both assessment and training of emotional recognition skills of people with SMI. This article includes two studies: (a) a descriptive study on the Virtual Reality program for Facial Emotion Recognition (VR-FER) and (b) an empirical study that presents the results of the application of the VR-FER’s first module. For the second study, data were collected using two samples: a group of 12 people with schizophrenia and a reference group of 12 people who were mentally healthy. Data analysis comprised descriptive (mean, standard deviation) and inferential statistics (Mann–Whitney U test). Results showed that the first group presented a lower number of correct answers and a higher number of incorrect answers compared with the second group regarding facial emotion recognition (FER), thereby confirming the need to develop strategies to improve emotional recognition and social perception in people with schizophrenia. VR-FER is regarded a strategic training program for FER, using latest technology and following rehabilitation guidelines for SMI.