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1.
J Gambl Stud ; 39(3): 1099-1110, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35921003

RESUMO

Scratch cards-otherwise known as scratch tickets or instant lotteries-are a highly accessible type of lottery, due to its relative accessibility and affordability. In Portugal, the popularity of scratch cards has experienced substantial growth, with almost no regulatory reaction whatsoever. This study aims to describe the sociodemographic characteristics of scratch card gamblers, prevalent gambling habits, and their perceptions regarding scratch card gambling. This study also determines the constancy of pathological scratch card gambling, and the possible impact of regulatory measures. We found that about half of the participants studied were at risk of pathological gambling and scratch cards seem to have a clear potential for enticing higher spending in vulnerable consumers, compared to other forms of gambling games. Perception biases regarding gambling are frequent and almost no one afflicted seeks help. Regulatory measures are crucial to regulate potential problematic behaviors, specifically in high-risk persons. There is an urgent need to act, made clear by both present findings and numerous precedent warnings regarding scratch card gambling hazards.


Assuntos
Comportamento Aditivo , Jogo de Azar , Humanos , Jogo de Azar/psicologia , Viés , Inquéritos e Questionários , Portugal
2.
J ECT ; 37(2): e17-e19, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33181561

RESUMO

ABSTRACT: Electroconvulsive therapy (ECT) is a treatment of undisputed efficacy for severe and treatment-resistant psychiatric disorders. Notwithstanding extensive data on efficacy and safety, it is significantly underused, corresponding to one of the most stigmatized approaches in psychiatry. The list of problems for which ECT is potentially effective does not include obsessive-compulsive disorder (OCD), resulting in only a few available case reports in the literature in which OCD is the target of this specific therapeutic strategy. The authors describe a patient with refractory OCD for whom ECT was prescribed, with remarkable clinical response and functional improvement. The existence of a clear response to ECT in reported cases of OCD, albeit in a globally small number of patients, should make it essential to identify predictors of ECT response that could assist clinicians in assessing and guiding such cases, particularly those labeled as refractory to treatment.


Assuntos
Eletroconvulsoterapia , Transtorno Obsessivo-Compulsivo , Humanos , Transtorno Obsessivo-Compulsivo/terapia , Resultado do Tratamento
3.
J Ment Health ; 29(6): 701-705, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28686478

RESUMO

Background: Medical comorbidity is associated with worse psychiatric outcomes, reduced functioning and higher services use, including inpatient psychiatric care.Aim: We explored the relation between medical comorbidity and length of stay, adjusting for potential confounders.Methods: We retrospectively analyzed an administrative database comprising all inpatient admissions between 2005 and 2014 at the Department of Psychiatry and Mental Health at Vila Nova de Gaia/Espinho Healthcare Center, Vila Nova de Gaia - Portugal. Psychiatric diagnosis and medical comorbidity were coded according to single-level and multi-level classification schemes, respectively, as proposed by the Clinical Classification Software.Results: We included a total of 4613 psychiatric inpatient admissions. The prevalence of medical comorbidity was 25.4% and it was associated with an average increase of 3.5 days (p < 0.001) in length of stay, comparing to patients without medical comorbidity. After adjusting for potential confounders, such as age, sex and year of discharge, medical comorbidity was associated with a 13% increase in length of stay.Conclusions: Medical comorbidity has measurable effects in inpatient outcomes, such as the length of stay and should be a major focus for intervention, in ambulatory care but also during psychiatric hospitalization.


Assuntos
Pacientes Internados , Transtornos Mentais , Comorbidade , Hospitalização , Humanos , Tempo de Internação , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Estudos Retrospectivos
4.
J Ment Health ; 26(5): 426-430, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27841067

RESUMO

BACKGROUND: Stigmatizing references to schizophrenia have a negative impact on self-esteem, deter treatment seeking and diminish the effectiveness of treatment. AIMS: To analyze the reporting of schizophrenia in Portuguese newspapers. METHOD: We analyzed five high circulation Portuguese newspapers between 2007 and 2013. We selected all news containing the word "esquizofrenia" (schizophrenia). Several variables were collected. RESULTS: About 1058 news items contained the word schizophrenia. Schizophrenia was mentioned metaphorically in 40% of the cases and in the context of Crime in 22%. When used in a Criminal context, schizophrenia was mostly attributed to people who were the perpetrators of the crime (93%). When used metaphorically, schizophrenia had a negative connotation in 90% of cases. We found an increasing reporting of schizophrenia in the criminal news and serious crimes. CONCLUSIONS: Our results suggest the media has an active role promoting stigma, as well as passively broadcasting and thus passing on prejudices.


Assuntos
Jornais como Assunto , Psicologia do Esquizofrênico , Estigma Social , Humanos , Meios de Comunicação de Massa , Jornais como Assunto/estatística & dados numéricos , Portugal
5.
J ECT ; 32(2): 119-21, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26704129

RESUMO

OBJECTIVES: Electroconvulsive therapy (ECT) is a technique with proven efficacy in the treatment of severe psychiatric disorders. However, studies regarding its use as a maintenance therapy are scarce. The aim of the present study was to build knowledge in this area. METHODS: Data from 28 patients receiving maintenance ECT (M-ECT) were retrospectively collected and analyzed using a mirror-image design. Length of stay and readmissions were compared before M-ECT (control condition) and after M-ECT (experimental condition). RESULTS: Our results showed a decrease in both length of stay and number of readmissions after M-ECT, although the decrease in readmissions was moderated by a site effect. CONCLUSIONS: The present study results reveal the potential benefit of M-ECT. Further studies are urgently needed to establish its usefulness as an alternative treatment for severe psychiatric disorders.


Assuntos
Eletroconvulsoterapia/métodos , Transtornos Mentais/terapia , Adulto , Eletroconvulsoterapia/efeitos adversos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Projetos de Pesquisa , Estudos Retrospectivos , Resultado do Tratamento
6.
Front Psychiatry ; 13: 894524, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35845441

RESUMO

Suicide is a global health issue that needs to be addressed. The COVID-19 pandemic has resulted in an increased mental health burden. Stigma has obstructed efforts to prevent suicide as individuals who need urgent support do not seek appropriate help. The influence of stigma is likely to grow in tandem with the COVID-19 pandemic. The stigmatization of persons with mental illnesses is widespread worldwide, and it has substantial effects on both the individual and society. Our viewpoints aim to address the probable link between stigma and suicide in the wake of the current pandemic and propose ideas for reducing suicide-related stigma.

7.
Clin Psychopharmacol Neurosci ; 19(4): 695-704, 2021 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-34690124

RESUMO

OBJECTIVE: Lithium is a drug of choice in the treatment of bipolar disorder and refractory depressive disorders. However, previous research suggests lithium has a negative cognitive impact in recovery from electroconvulsive therapy (ECT) and a higher risk of delirium, so patients are often required to stop taking lithium before ECT, despite risk of relapse. We studied the cognitive impact of serum lithium levels in patients undergoing ECT. METHODS: This was an observational prospective study. Serum lithium levels, thyroid and biochemical parameters were measured prior to each ECT session. Time elapsed from the anesthetic induction to the electrical stimulus and then to the patients' reorientation was recorded, as well as the motor seizure duration and electroencephalogram (EEG) seizure duration. A statistical analysis using a linear mixed model was run while adjusting for confounding factors. RESULTS: Ten participants underwent a total of 86 ECT sessions (41% right unilateral ultrabrief pulse, and 59% bilateral brief pulse). A negative interaction between lithium levels and reorientation time was found among those doing bilateral brief pulse ECT. No association was observed in patients doing unilateral ultrabrief pulse ECT. No significant relationship was observed between lithium and both motor and EEG-assessed seizure duration. CONCLUSION: This study suggests that low to moderate serum lithium levels (< 0.7 mmol/L) might have no harmful cognitive effects in patients under right unilateral ultrabrief pulse and bilateral brief pulse ECT.

9.
Gen Hosp Psychiatry ; 35(4): 452.e5-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23317937

RESUMO

Valproate-induced encephalopathy (ViE) has been increasingly reported and several risk factors have been proposed. We report a case whereby a patient became encephalopathic while treated with valproate and upon initiation of risperidone. The underlying mechanism could be risperidone's interference with valproate's binding to albumin, raising free valproate levels, which would impair the urea cycle and reduce ammonia conversion, leading to a hyperammonemic encephalopathy. The present case suggests a causal link, although further studies will be necessary to establish this. Nevertheless, clinicians should be aware of this possible interaction and consider carefully before concomitant administration of valproate and risperidone, mainly in patients with other risk factors for ViE, so this complication can be avoid or promptly diagnosed and treated.


Assuntos
Antimaníacos/efeitos adversos , Antipsicóticos/efeitos adversos , Transtorno Bipolar/tratamento farmacológico , Hiperamonemia/induzido quimicamente , Síndromes Neurotóxicas/etiologia , Risperidona/efeitos adversos , Ácido Valproico/efeitos adversos , Adulto , Interações Medicamentosas , Feminino , Humanos , Fatores de Risco
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