Relationship Between Self-reported and Clinician-rated Psychopathology in Youth Psychiatric Outpatients

Introduction

Psychopathology rating scales have been widely used. Studies evaluating the congruence between self and observer-reported ratings show inconsistent results.

Objectives or aims

Determine whether there was consistency between psychopathology as assessed by patients and clinicians’ assessment in outpatients observed in the Young Adult Unit of our Psychiatry Department (Coimbra Hospital and University Centre-Portugal).

Methods

Socio-demographic characterization was undertaken with young adult outpatients observed during nineteen months (1st January 2015–31st July 2016). Brief Symptom Inventory–53 items (BSI-53) and Brief Psychiatric Rating Scale (BPRS) were applied at the first clinical evaluation. Spearman correlation coefficient between General Severity Index (GSI) of BSI-53 and BPRS total score was calculated.

Results

During the mentioned interval 255 outpatients were observed: 64.3% females and 35.7% males; aged between 17 and 39 years old (average: 20.56; median: 20). Fifty percent were diagnosed with neurotic, stress-related and somatoform disorders (ICD-10 F40-48) and 14.1% with mood disorders (ICD-10 F30-39). BPRS and BSI-53 rating scales were administered to 55 patients: 72.5% females and 27.5% males; average age 21.2. A statistical significant correlation was found between BPRS total and GSI score.

Conclusions

Several factors can determine the accuracy of psychopathology self-assessment, including diagnosis and severity of illness. In fact, studies show strong correlation between self and observer assessment of depressive and anxious psychopathology, but no correlation in psychotic psychopathological dimensions. Therefore, the correlation found in this population can be explained by the fact that the majority of patients were diagnosed with neurotic, stress-related and somatoform and mood disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Socio-demographic and clinic characterization in youth psychiatric outpatients: An observational study

Introduction

Most mental disorders begin during adolescence and early adulthood (18–24-years-old), highlighting the importance of understanding the onset and progression of mental disorders among youths. Although progress has been made, namely by creating youth mental health transition services, gaps continue to exist. Locally, our recently constituted young adults unit aimed to minimize discontinuities in care.

Objectives/aims

To characterize a population of young adult psychiatric outpatients, regarding socio-demographic and clinic variables.

Methods

Socio-demographic and clinic characterization of young adult psychiatric outpatients observed during 1st January 2015–30th July 2016.

Results

Two hundred and fifty-five outpatients were observed: 64.3% females and 35.7% males, average age 20.56-years-old (median 20). Most lived in urban areas (59.4%), with their parents (27.8%), were students (80.4%), attending secondary school (36.1%). A total of, 27.5% were referenced by an emergency department, and adjustment disorders (ICD-10 F43.2) were the most frequent diagnosis (21.6%). Regarding suicidal behaviours and self-harm, 9.8% did self-cutting. A vast majority did not have previous psychiatric hospitalizations–only 5.9% outpatients had at least one. In total, 39.8% were medicated with antidepressants (1/3 of which in association with other drugs), and about 38.8% received cognitive-behavioural interventions. About 2/3 of patients (66.3%) remained in care and only about 1/6 (15.7%) were discharged.

Conclusions

Our typical youth psychiatric outpatient was of female gender, student, living with its parents. Adjustment disorders were the most frequent diagnosis, and antidepressants were the main psychopharmacologic option, often combined with other psychotropic drugs. In the future, psychotherapy interventions should be more widely available, namely group psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Substance use among youth psychiatric outpatients

Introduction

Portuguese young adults (15–34 years old) were more frequent engaged in substance abuse (1.2%) than the general population, according to the Portuguese substance use annual report (2014). Alcohol was the most frequent substance use on youth adults. Cannabis was the most frequent illicit substance used (23.9% of users were considered dependent), with higher prevalence than previously reported. LSD (0.4%) use was also higher among young adults than in previous studies. Cocaine (0.4%), heroine/opiates (0.4%), ecstasy (0.3%), and hallucinogenic mushrooms (1.1%) had their consumption lowered among young adults.

Objectives/aims

To characterize a population of young adult psychiatric outpatients, regarding substance use and associated risk.

Methods

Socio-demographic characterization of our young adult unit outpatient users between 1st January 2015–31st July 2016. Substance use was assessed with the Portuguese version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).

Results

A total of 255 outpatients were observed during the timeframe; 58 outpatients were assessed with ASSIST: 44 females (75.9%) and 14 males (24.1%), aged between 16–33 years old (average: 20.95; median: 19.50). For tobacco, 3.5% had high risk, 37.9% moderate risk and 58.6% low risk; 22.4% had moderate risk of alcohol, 13.8% moderate risk of cannabis, and 20.7% moderate risk of tranquilizers. For others substances (cocaine, stimulants, inhalants, hallucinogens, and opiates) the risk was low.

Conclusions

In our sample, alcohol and cannabis use had the highest risk, as reported in the National Annual Report; however, we observed a moderate risk for tranquilizers use. In future care planning, youth mental health should address tobacco and alcohol abstinence, and preventive measures regarding anxiolytics should be undertaken, such as banning sale without medical prescription.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Validation of the Portuguese Severe Respiratory Insufficiency Questionnaire for home mechanically ventilated patients

The aim of this study was to develop and validate the professional translation and cultural adaptation of the Portuguese Severe Respiratory Insufficiency (SRI) Questionnaire. The sample was composed of 93 patients (50 male patients, 53.8%) with a mean age of 66.3 years. The most frequent diagnostic groups were chronic obstructive pulmonary disease, obesity hypoventilation syndrome and restrictive chest wall disorders. The patients were asked to fill in both the SRI and SF-36 questionnaires. Factor analysis of the SRI questionnaire was performed leading to an explained variance of 73%, and resulted in 13 components. When analyzing the reliability, we obtained values for Cronbach's alpha above 0.70 for most subscales with the reliability of the summary scale being even higher (0.84). This professional translation and cultural adaptation of the Portuguese SRI Questionnaire has good psychometric properties which are similar, not only to the original, but also to other translations. These characteristics make this questionnaire applicable to the Portuguese population receiving home mechanical ventilation for severe respiratory insufficiency.

Immature Stages of Six Species of Adelpha Hübner (Lepidoptera: Nymphalidae: Limenitidinae) from Southern Brazil Coastal Forests

Six species of Adelpha Hübner from Balneário Barra do Sul (Santa Catarina) and Morretes (Paraná) were collected as eggs or larvae and reared in captivity, aiming to provide descriptions and photography of the immature stages and imagoes. The species studied were Adelpha radiata radiata Fruhstorfer; Adelpha serpa serpa (Boisduval); Adelpha plesaure plesaure Hübner; Adelpha thesprotia (C. Felder & R. Felder); Adelpha lycorias lycorias (Godart); and Adelpha capucinus velia (C. Felder & R. Felder). Two new records of host plants were provided, Tapirira guianensis Aubl. for A. radiata radiata and Heteropterys for A. capucinus velia. This study provides a summary of host plants and the seasonality of occurrence of immature stages of these species. Data were organized in photographic plates that could be useful for the identification process.

The influence of emotional stress on Doppler-derived aortic peak velocity in boxer dogs

Background

Subaortic stenosis (SAS) is a common congenital heart disease in Boxers. Doppler‐derived aortic peak velocity (AoPV) is a diagnostic criterion for the disease.

Objectives

To investigate the influence of emotional stress during echocardiographic examination on AoPV in normal and SAS‐affected Boxers. To evaluate the effects of aortic root diameters on AoPV in normal Boxers.

Dogs

Two hundred and fifteen normal and 19 SAS‐affected Boxers.

Methods

The AoPV was recorded at the beginning of echocardiographic examination (T0), and when the emotional stress of the dog was assumed to decrease based on behavioral parameters and heart rate (T1). AoPV0–AoPV1 was calculated. In normal dogs, stroke volume index was calculated at T0 and T1. Aortic root diameters were measured and their relationship with AoPV and AoPV0–AoPV1 was evaluated.

Results

In normal dogs, AoPV was higher at T0 (median, 1.95 m/s; range, 1.60–2.50 m/s) than at T1 (median, 1.76 m/s; range, 1.40–2.20 m/s; P < .0001; reduction 9.2%). The stroke volume index at T0 also was greater than at T1 (P < .0001). Weak negative correlations were detected between aortic root size and aortic velocities. In SAS‐affected dogs, AoPV0 was higher than AoPV1 (P < .0001; reduction 7.3%).

Conclusion and Clinical Importance

Aortic peak velocity was affected by emotional stress during echocardiographic examination both in SAS‐affected and normal Boxers. In normal Boxers, aortic root size weakly affected AoPVs, but did not affect AoPV0–AoPV1. Stroke volume seems to play a major role in stress‐related AoPV increases in normal Boxers. Emotional stress should be taken into account when screening for SAS in the Boxer breed.

Benign or malignant? Case report

INTRODUCTION

Necrotizing sialometoplasia (NS) is a disease in which the clinical and sometimes even histological features can be confused with those of a malignant tumor, but which is in fact a self-limited inflammatory lesion of the salivary glands.

CASE REPORT

The authors present a case study of a 43-year-old female patient who came to the ENT Emergency Department with a painful ulcerated lesion of the hard palate. The lesion was 8 days old and had appeared after an abdominoplasty. Given the clinical need to rule out a malignant neoplasm, a biopsy was performed: the histological result was NS.

DISCUSSION/CONCLUSION

The authors make a literature review and stress the importance of differentiating between NS and salivary gland neoplasia. Histology is essential in case of ulcerated neoformation of the oral cavity, to adapt treatment, avoiding unsuitable approaches.

[Validity and reliability of the Portuguese version of the Pain Coping Inventory]

OBJECTIVE

To analyze the validity and reliability of the Portuguese version of the Pain Coping Inventory (PCI) in order to perform a cultural adaptation to permit its use in Portuguese population of non-oncological chronic pain patients.

METHODS

The PCI was translated to Portuguese and then again to English; moreover a spoken reflection was made. 180 participants with clinical diagnosis associated to chronic pain (namely, fibromyalgia and rheumatoid arthritis) were asked to fill in the self-report measure. Procedures of exploratory factorial analysis, confirmatory factorial analysis, and internal consistency were performed.

RESULTS

Based on the methodological procedures, results have shown evidence of a factorial structure comprised by five factors which assess distinct chronic pain coping strategies namely, withdrawal, worrying, distraction, pain transformation, and reducing demands.

CONCLUSIONS

The Portuguese version of PCI has shown evidence of validity and reliability which supports the relevance of its use in both research and clinical context.

Noise-induced duodenal lesions: a light and electron microscopy study of the lesions of the rat duodenal mucosa exposed to low frequency noise

BACKGROUND AND AIMS

Non-auditory effects of noise, including digestive disorders have long being reported. Low frequency noise (LFN) is considered to be responsible to most of non-auditory effects of noise and is widely spread in modern societies. Only a few studies were designed to evaluate these noise-induced digestive alterations. The pathogenesis of duodenal ulcers and erosions is complex and noise may be an environmental co-factor. The aim of the present study was to investigate the morphological injury of LFN-exposed duodenal mucosa.

MATERIALS AND METHODS

Five groups of Wistar rats were exposed to continuous LFN, during increasing periods, since 1 to 13 weeks. A control group was kept in silence. Duodenal specimens were studied using light microscopy (LM), scanning electron microscopy (SEM) and transmission electron microscopy (TEM).

RESULTS

We disclosed several changes in LFN-exposed rats: on LM, mucosa showed superficial erosions of the epithelial layer, degeneration, picnosis and cell death, with no inflammation. On SEM, epithelium presented displacement of cells and unequal distribution of microvilli, with coalescence and fusion. On TEM, microvilli were irregularly distributed, damaged and fragmented. The terminal web was destroyed. Morphological alterations occurred early, after just 1 week of LFN-exposure, persisted with longer noise exposition and did not suffer any evolution. Changes were similar among all LFN-exposed groups.

CONCLUSIONS

LFN-exposed duodenal mucosa develops destruction of microvilli and terminal web, leading to cellular death and development of superficial erosions. These lesions of cytoskeleton structures could explain why cells with actinic and tubulinic structures like cilia and microvilli present severe destruction after LFN-exposure. These erosions are similar to those seen in dyspeptic patients.