Addictive Potential of Social Media: A Cross Sectional Study in Portugal.

INTRODUCTION: The use of social media is an extremely popular activity, with an average time spent of two and a half hours daily. The number of users continues to rise, with 4.65 billion around the world in 2022, approximately 58.7% of the world population. A rising number of studies show that a minority of these persons will develop a behavioral addiction on social media. The aim of this study was to understand if the use of a specific social media platform predicts increased addictive potential. MATERIAL AND METHODS: A cross-sectional sample of 300 persons (aged 18 years-old or older, 60.33% female), completed an online survey including sociodemographic questions, data regarding the use of social media and the Bergen Social Media Addiction Scale (BSMAS). Linear and logistic regression models were performed to determine the risk for each media platform. RESULTS: Instagram® use was a significant predictor of higher scores on the BSMAS (B 2.51; p < 0.0001; CI 1.33 - 3.69). The use of other platforms including Facebook® (B -0.31), Twitter® (B 1.38) and Pinterest® (B -0.15) was not found to predict a higher risk of social media addiction. CONCLUSION: Instagram® scored a higher grade in BSMAS scale, with statistical significance, which could suggest a higher addictive potential. More research is needed to establish the direction of this relationship, since the cross-sectional study design does not allow inferences about directionality.

Introdução: A utilização de redes sociais é uma atividade bastante popular nos dias de hoje, com um tempo médio de utilização diária de duas horas e meia. O número de utilizadores continua a aumentar, perfazendo 4,65 mil milhões em 2022, aproximadamente 58,7% da população mundial. Um número crescente de estudos mostra que uma minoria destes utilizadores irá desenvolver uma adicção comportamental às redes sociais. O objetivo deste estudo é compreender se o uso de uma plataforma de rede social específica é um preditor de maior potencial adictivo. Material e Métodos: Uma amostra de 300 pessoas (idade igual ou superior a 18 anos, 60,33% sexo feminino), completou um questionário online, com fatores sociodemográficos, dados acerca do uso de redes sociais e a Bergen Social Media Addiction Scale (BSMAS). Foram feitas análises de regressão linear e logística para determinar o potencial de adicção de cada plataforma. Resultados: A utilização do Instagram® foi um preditor significativo para pontuações mais altas na BSMAS (B 2,51; p < 0,0001; CI 1,33 - 3,69). O uso de outras plataformas, incluindo o Facebook® (B -0,31), o Twitter® (B 1,38) e o Pinterest® (B -0,15) não pareceu ser um preditor de maior risco adictivo Conclusão: O Instagram® atingiu uma maior classificação na BSMAS, com significância estatística, o que pode sugerir um maior potencial adictivo. É necessária mais investigação para estabelecer a direção desta relação, visto que o desenho transversal não permite inferências sobre a direccionalidade.

Anti-NMDA Receptor Encephalitis Associated With an Ovarian Teratoma Presenting as First-episode Psychosis: A Case Report.

We report an unusual case of a 27-year-old previously healthy female who presented with a 15-day history of psychotic, cognitive, and unspecified somatic symptoms. She was admitted to the psychiatric ward of an early intervention in psychosis team and medicated with aripiprazole. The young age of onset, the rapid onset, the absent history of psychiatric disease, and the persistence of a marked memory deficit after the psychotic symptoms remitted strongly suggested a nonpsychiatric etiology and led us to hypothesize autoimmune encephalitis as the most probable diagnosis. An investigation was carried out for anti-N-methyl-D-aspartate (anti-NMDA) receptor antibodies in the patient's serum and cerebrospinal fluid, and both tests were positive. The patient was transferred to the neurology ward, where an endovaginal ultrasound showed an ovarian teratoma in her right ovary. She underwent laparoscopic surgery without complications. She was initially treated with intravenous immunoglobulin and methylprednisolone for 5 days, which resulted in marked improvement of her memory and attention performance. Anti-NMDA receptor encephalitis, first described in 2007 by Dalmau and colleagues, is a form of auto-immune encephalitis with prominent neuropsychiatric manifestations, particularly psychotic symptoms. At symptom onset, distinguishing the disease from a primary psychiatric disorder is challenging. This case report highlights the importance of early psychosis treatment teams considering the diagnosis of anti-NMDA receptor encephalitis when evaluating new referrals with a potential diagnosis of first-episode psychosis, particularly when young patients with no relevant personal or familial psychiatric history present with neuropsychiatric symptoms and a distinctive pattern of symptom fluctuation over time.

Suicide Attempt in a Patient with Sibutramine Associated Psychosis.

Sibutramine is a serotonin-norepinephrine-dopamine reuptake inhibitor, initially developed as a potential antidepressant and later approved for the management of obesity. Sibutramine use is also associated with psychiatric symptoms, namely mania, panic attacks, and, less frequently, psychosis. We report the case of a 32-year-old man, admitted to our hospital due to a suicide attempt in the context of sibutramine-associated psychosis. The symptoms remitted completely after discontinuation of sibutramine and a brief period of antipsychotic medication. The aim of this manuscript is to highlight the importance of the recognition of sibutramine-associated psychosis, to discuss the possible pathophysiology and the proper clinical and therapeutic management.

A sibutramina é um inibidor não seletivo da recaptação de serotonina-noradrenalina-dopamina, inicialmente desenvolvido como potencial antidepressivo e posteriormente aprovado para o tratamento da obesidade. O uso de sibutramina está também associado ao aparecimento de sintomas psiquiátricos como mania, ataques de pânico e, com menor frequência, psicose. Relatamos um caso de um homem de 32 anos, internado no nosso hospital devido a uma tentativa de suicídio no contexto de uma psicose associada à sibutramina. Os sintomas remitiram completamente após a descontinuação da sibutramina e um breve período de terapêutica antipsicótica. O objetivo deste artigo é destacar a importância do reconhecimento da psicose associada à sibutramina, discutir a sua possível fisiopatologia e o seu apropriado manejo clínico e terapêutico.

Concurrent catatonia and COVID-19 infection in a demented patient: A case report.

Catatonia is a complex neuropsychiatric syndrome that comprises motor, behavioral and autonomic abnormalities. It occurs in the context of general medical, neurological, and psychiatric conditions. The study of catatonia in the elderly is particularly challenging due to the higher somatic and cognitive comorbidity, polymedication and the higher prevalence of delirium. Catatonia remains underdiagnosed in this population, especially in those with dementia. We describe a case of an 82-years-old patient with mixed dementia, who developed catatonia for the first time, during her admission to our general medical ward due to SARS-CoV-2 organizing pneumonia. Besides the specific treatment for SARS-CoV-2 organizing pneumonia, catatonia was treated symptomatically with benzodiazepines and memantine with success. In general, catatonia in older patients tends to have a good prognosis if detected early, its cause treated, the symptoms managed, and complications avoided. We report this case to alert clinicians in medical wards to this condition, to improve its overall diagnosis and treatment rates.

[The Impact of COVID-19 in Older People in Portugal: Results from the Survey of Health, Ageing and Retirement (SHARE)]. / O Impacto da COVID-19 na População Idosa em Portugal: Resultados do Survey of Health, Ageing and Retirement (SHARE).

INTRODUCTION: In March 2020, the World Health Organization declared COVID-19 as a pandemic, and Portugal reported its initial cases. In this study, we aimed to determine the impact of COVID-19 on Portuguese individuals aged over 60 years old. MATERIAL AND METHODS: We performed a cross-sectional study using data from the Survey of Health, Ageing and Retirement in Europe (SHARE 8: COVID-19 Survey). We selected a sample of 1080 noninstitutional Portuguese individuals aged ≥ 60 years. RESULTS: The study sample consisted of 605 (56%) women and 475 (44%) men, with a mean age of 70 ± 9.1 years. In total, 80% of the participants experienced higher levels of anxiety, 73% felt more depressed and 30% experienced additional sleep problems comparedto the period before the pandemic. Interestingly, there were no statistically significant differences between the sexes or the two selected age groups (60 - 74 and over 75 years old) regarding the incidence of these changes. Only 23%, of those that were interviewed maintained their walking routines. In addition, only 8% of the participants continued visiting family members as frequently as before. While 8% of the participants were refused some form of medical treatment, 56% claimed that they experienced healthcare delays. However,only 15% of the participants reported that their health status worsened during the pandemic. DISCUSSION: The pandemic has had a significant impact on Portuguese individuals aged ≥ 60 years; which is in agreement with the findings of previous international studies. It changed the participants' routines and increased their anxiety and depression levels. Despite the deterioration of healthcare services, most participants did not experience worsening of their health status. CONCLUSION: In conclusion, a COVID-19 pandemic had a significant impact on the elderly population, particularly regarding their mental health.

Introdução: Em março de 2020, a COVID-19 foi declarada pandemia pela Organização Mundial da Saúde e Portugal registou os seus primeiros casos. Este estudo visou determinar o impacto da COVID-19 na população portuguesa maior de 60 anos. Material e Métodos: Trata-se de um estudo observacional transversal que analisa várias variáveis de saúde, comportamentais, sociais e económicas. Utilizaram-se dados do projecto Survey of Health, Ageing and Retirement (SHARE 8: COVID-19 Survey), seleccionando uma amostra de 1080 portugueses não institucionalizados e maiores de 60 anos. Resultados: A amostra englobou 605 mulheres (56%) e 475 homens (44%), com idade média de 70 ± 9,1 anos. No total, 80% dos participantes notou aumento da ansiedade, 73% sentiu-se mais deprimido e 30% considerou que o seu sono piorou em relação ao período anterior à pandemia. Não houve diferenças estatisticamente significativas entre os sexos ou as duas faixas etárias analisadas (60 - 74 e ≥ 75 anos) quanto à incidência destas alterações. No respeitante a saídas de casa, apenas 23% dos entrevistados manteve os hábitos de passeio e 8% manteve as visitas a familiares no seu padrão habitual. Relativamente ao acesso a cuidados médicos, a 8% foi negado algum tratamento e 56% queixou-se do adiamento dos cuidados. Apenas 13% referiu um agravamento do seu estado de saúde durante a pandemia. Discussão: Este trabalho mostra que esta pandemia impactou a população portuguesa com mais de 60 anos, o que está em linha com o reportado noutros estudos internacionais. Os hábitos alteraram-se, e a ansiedade e depressão aumentaram. Apesar da deterioração dos cuidados de saúde, a maioria dos participantes não notou agravamento do seu estado de saúde. Conclusão: Em conclusão, a pandemia por COVID-19 teve um impacto significativo na população idosa particularmente no que concerne à sua saúde mental.