Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder.

BACKGROUND: Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some cases may occur in the summer with remission in the autumn-winter. In this study the authors evaluated the association between seasonal changes in mood and behavior with psychiatric disturbance. METHOD: Descriptive, cross-sectional study. Participants, students attending higher education and vocational courses (N = 324), were evaluated with the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Screening Scale for Mental Health (ER80). RESULTS: Among the respondents, 12.7% showed seasonal affective disorder (SAD), 29.0% showed subsyndromal seasonal affective disorder (s-SAD) and 58.3% did not show significant seasonal affective symptomatology. As for psychiatric morbidity, 36.6% of subjects with SAD and 13.8% of those with s-SAD were considered "psychiatric cases" whereas for subjects without SAD this value was only 3.2%. CONCLUSIONS: There is a statistically significant association between psychiatric morbidity and seasonal affective disorder. This association corroborates the importance of the Seasonal Pattern Assessment Questionnaire in screening for seasonal fluctuations in mood and behavior related disorders, and the clinical need for recognition of these conditions, particularly associated suffering and disabilities.

Melkersson-Rosenthal Syndrome: A Case Report With a Psychosomatic Perspective.

Context • The Melkersson-Rosenthal syndrome (MRS) is a rare condition characterized by a triad of symptoms: (1) recurrent and/or persistent orofacial swelling, (2) recurrent facial paralysis, and (3) a fissured tongue. Although various contributing factors have been suggested, the etiology and mechanisms of the syndrome have not been fully elucidated. Objective • The aim of the current study was to examine for the first time some psychosomatic aspects of the syndrome and to evaluate the benefits of a brief psychotherapeutic process in which the research team worked to reintegrate the complex bio-psycho-social functioning of the patient. Design • The research team performed a case study. Setting • The study took place at the outpatient clinic for psychiatric services of the Alto Minho Local Health Unit (Viana do Castelo, Portugal). Participant • The participant was a 26-y-old woman suffering from MRS who received services at the clinic for depression. Her clinical history revealed that significant life events had acted as triggers for her syndrome, both at the start and during several exacerbations of her symptoms. Intervention • The intervention consisted of 15 weekly sessions focused on insight promotion. Outcome Measures • The case study measured changes in the patient's condition through her verbal self-reports about her physical and mental state, and the research team's clinical evaluation. Results • The treatment allowed remission of her depression and diminished the frequency of her relapses of MRS. Conclusions • The current case study offers the first report that describes how significant affective phenomena can act as triggers in the MRS. It also opens the possibility of providing psychiatric and psychological therapeutic interventions to help prevent relapses and exacerbations of that syndrome.

The needs of older people with mental health problems in a Portuguese psychiatric setting.

BACKGROUND: This study aims to identify met and unmet needs, according to the patient, the carer and the staff, and their relationship with socio-demographic and clinical characteristics in elderly people with mental health problems. METHODS: A sample of 306 elderly patients ≥65 years, of both sexes, diagnosed with mental illness (ICD-10 criteria), was recruited from inpatient/outpatient settings in a Department of Psychiatry and Mental Health, in northern Portugal. Patients were assessed with the Camberwell Assessment of Need for the Elderly/CANE. RESULTS: The majority of diagnoses were depression (33.7%), dementia (24.5%), and schizophrenia (12.7%). The patients' main unmet needs found were psychological distress (15.0%), daytime activities (10.5%), and benefits (6.5%). Patients reported significantly lower unmet and global needs than carers and staff (Z = -8.58, p < 0.001; Z = -11.07, p < 0.001, respectively). A larger number of global needs (met and unmet) were associated with the diagnosis of dementia, followed by schizophrenia, bipolar, and depressive disorder (p < 0.001), with inpatients reporting more needs than outpatients. CONCLUSIONS: Mental disorders were associated with a greater number of needs in elderly patients, which makes this assessment important as it includes the patients' perspective, when they are the focus of intervention, in order to decrease distress and make more beneficial use of services, especially in inpatient settings. These different perspectives are crucial when assessing and planning psychiatric and mental health services.

[MAST and AUDIT. Evaluation of psychometric characteristics in patients with alcohol dependence]. / MAST e AUDIT. Avaliação de características psicométricas em doentes com dependência de álcool.

INTRODUCTION/OBJECTIVE: To evaluate the correlation between scores on the MAST and AUDIT in patients hospitalized for detoxification from alcohol dependence and consider if the intensity of those scores reflect the severity of dependence and problems related to alcohol use. MATERIAL AND METHODS: Correlational study. Patients admitted for the first time for alcohol dependence treatment. In addition to a structured interview, the MAST and the AUDIT, SADD was used to assess the degree of alcohol dependence and the APQ to assess the problems related to alcohol consumption. RESULTS: The internal consistency (Cronbach's α) of the MAST was 0.77 and the AUDIT was 0.73. The correlation between the two instruments was moderate (R = 0.497, p < 0.001). Both presented moderate and significant correlation (p < 0.001) with the APQ and SADD. The set of items from AUDIT directed towards dependence led to a higher correlation with SADD than with APQ, the reverse being true with the set of items belonging to the dimension problems / adverse consequences. The two instruments have low correlation with the volume of alcohol consumption measured in g/d. CONCLUSION: Both the MAST and the AUDIT have a total score that reflects the severity of dependence and alcohol-induced disorders. In clinical populations, these instruments can be used as a continuous variable to record quantitatively the magnitude of the problems. The AUDIT, relatively to the MAST, has the advantage of representing a smaller number of items, making it easier to answer and quote. The AUDIT also has the advantage of presenting sets of items belonging to three dimensions (quantity / frequency, dependency, problems / adverse effects) that can be analyzed separately, allowing for the characterization and further specification of the situations under study.

Introdução/Objectivo: Avaliar a correlação entre a pontuação no MAST e no AUDIT em doentes internados para desintoxicaçãopor dependência de álcool e analisar a possibilidade destas pontuações refletirem a intensidade da gravidade da dependência e dos problemas relacionados com o uso do álcool.Material e Métodos: Estudo correlacional. Doentes internados pela primeira vez, para tratamento por dependência de álcool. Além de uma entrevista estruturada, do MAST e do AUDIT, foi utilizado o SADD para avaliação do grau de dependência do álcool e o APQ para os problemas relacionados com o consumo de álcool.Resultados: A consistência interna (α de Cronbach) do MAST foi 0,77 e a do AUDIT foi 0,73. A correlação entre os dois instrumentos foi moderada (R = 0,497, p < 0,001). Ambos apresentam correlação moderada e significativa (p < 0,001) com o SADD e o APQ. O conjunto de itens do AUDIT dirigidos para a dependência têm maior correlação com o SADD do que com o APQ, sucedendo o inverso com o conjunto de itens pertencentes à dimensão problemas/consequências adversas. Os dois instrumentos apresentam correlação baixa com o volume de álcool consumido avaliado em g/d.Conclusão: Tanto o MAST como o AUDIT apresentam uma pontuação total que reflete a gravidade da dependência e das perturbações induzidas pelo álcool. Em populações clínicas estes instrumentos podem ser utilizados como variável contínua, para registo quantitativo da magnitude dos problemas. O AUDIT, relativamente ao MAST, tem a vantagem de apresentar um número menor de itens, ser mais fácil de responder e de cotar. O AUDIT tem ainda a vantagem de apresentar conjuntos de itens pertencentes a três dimensões (quantidade/frequência, dependência, problemas/consequências adversas) que podem ser analisados separadamente permitindo uma caracterização mais especificação das situações em estudo.