A subjetividade da experiência da doença

In the present paper we will explore the different levels of deregulation and expression of suffering induced by a somatic illness or by a disease in individual subjectivity. These levels are part of a singular functional and organizational structure of the self and personality.No presente artigo vamos explorar os diferentes níveis de desregulamentação e expressão de sofrimento induzido por uma doença somática ou por uma doença na subjetividade individual. Estes níveis são parte de uma singular funcional e organizacional estrutura do eu e da personalidade

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Mecanismos psicológicos de adaptação à infecção pelo vírus de imunodeficiência humana adquirida

O presente trabalho é um aspecto parcial da experiência de coordenação de uma equipa de Saúde Mental de apoio psiquiátrico a doentes infectados com o vírus HIV, no Serviço de Doenças Infecto-contagiosas do Hospital de Santa Maria (Director: Prof. Carvalho Araújo e Prof. Francisco Antunes). A uma amostra de 123 doentes (110 homens e 13 mulheres) seropositivos e com o síndrome de de imunodeficiência adquirida foi aplicado um inventário psicológico que visa avaliar os modos de lidar com a doença (Mecanismos de «coping»), e escalas de avaliação de perturbação psicopatológica (escala de depressão de Beck e escala AMDP condensada em itens psicopatológicos). O estudo das médias das respostas e a análise da variância (MULTINOVA, SPASS) revelaram diferenças significativas entre as sub-amostras (sujeitos seropositivos HIV e doentes com SIDA) no que se refere aos mecanismos de «coping» e ao padrão de perturbação emocional. As relações entre os mecanismos de «coping» e a perturbação emocional são analisadas com um modelo de correlação. Finalmente é apresentado, em síntese, um programa de aconselhamento psicológico aos seropositivos.ABSTRACT: This study concerns part of the experience in coordinating a team for psychiatric help of HIV infected patients of the Department of Infectocontagious Diseases of Hospital Santa Maria (Head of Department: Professors Carvalho Araújo and Francisco Antunes). A sample of 123 seropositive AIDS patients (110 Males and 13 Females) was psychological assessed in relation to different ways of coping with the disease. Scales for evaluating psychopathological disturbances were also used (Beck’s scale for depression and AMDP system of psychopathological items). The observation of mean answers and the analysis of variance (MULTINOVA, SPSS) has shown significant differences between the two sub-samples (seropositive subjects and AIDS patients), concerning both coping mechanisms and emotional disturbance. A correiation model was used in order to analyse the reiations between ways of coping and psychopathological symptoms. A synthesis of a counselling programme for the seropositive subjects is also presented

The Classification Systems in Psychiatry in a Phase of Crisis? Focus on DSM-5

Since the chaotic atmosphere of psychiatric diagnosis of the sixties, psychiatric classification systems followed several theoretical models. The first two systems – DSM-I and DSM-II – were influenced by psychoanalysis, predominant in USA hospitals. With the implementation of DSM-III, published in 1980, there was a shift towards a neo-Krapelinian paradigm with an emphasis in the medical model, defining psychiatric disorders as medical diseases. The ongoing criticism regarding the poor validity of diagnostic categories and the failure to identify neurobiological markers led to the idea that classification showed symptoms of crisis in the Kuhnian sense. The assumption that the moment had arrived for a scientific revolution in psychiatric classification led to a revision of DSM–IV and the development of a new system – the DSM-5. The final result showed a failure in this unrealistic and overambitious objective and the new system is an “hybrid” one with empirical similarities with the previous one

Assessment of depression and suicidal behaviour among medical students in Portugal

© 2016 Ricardo Coentre et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0Objectives: To examine depression and suicidal behaviour and associated factors in a sample of medical students in Portugal. Methods: We conducted a cross-sectional study design of 456 native Portuguese medical students from the 4th and 5th year at the University of Lisbon. Participants answered a self-report survey including questions on demographic and clinical variables. Statistical analyses were conducted using the chi-square test, with a Monte Carlo simulation when appropriate. Results: Depression among medical students was 6.1% (n=28) and suicidal behaviour 3.9% (n=18). Higher depression scores were noted in female medical students (χ2=4.870,df=2,p=0.027), students who lived alone (χ2=8.491,df=3,p=0.037), those with poor physical health (χ2=48.269,df=2,p<0.001), with poor economic status (χ2=8.579,df=2,p=0.014), students with a psychiatric diagnosis (χ2=44.846,df=1,p=0.009), students with a family history of psychiatric disorders (χ2=5.284,df=1,p=0.022) and students with high levels of anxiety (χ2=104.8, df=3, p<0.001). Depression scores were also higher in students with suicidal ideation (χ2=85.0,df=1,p<0.001), suicidal plan (χ2=47.9,df=1,p<0.001) and suicidal attempt (χ2=19.2,df=1,p<0.001). Suicidal behaviour was higher in medical students who lived alone (χ2=16.936,df=3,p=0.001), who had poor physical health (χ2=18,929,df=2,p=0.001), poor economic status (χ2=9.181,df=2,p=0.01), who are/were in psychopharmacology treatment (χ2=30.108,df =1,p<0.001), and who had high alcohol use (χ2=7.547,df=2,p=0.023), severe depression (χ2=88.875,df=3,p<0.001) and high anxiety levels (χ2=50.343,df=3,p<0.001). The results also revealed that there were no differences between students in the 4th and 5th years of medical school regarding rate of depression and suicidal behaviour. Conclusions: Since depression and suicidal behaviour are mental health problems affecting a significant proportion of medical students, medical schools should implement programs that promote mental health wellness, physical health and economic status between other factors.info:eu-repo/semantics/publishedVersio

Gender-related endocrinological dysfunction and mental disorders

In this paper, we review updated data on sex and gender differences in stress reactivity, concerning the hypothalamic–pituitary–adrenal axis, endocrinological dysfunction and vulnerability to major psychiatric disorders, in a stress-diathesis approach. Mainly schizophrenia and affective disorders are discussed, according to recent investigation, in terms of early determinants of stress reactivity, the interplay of genetic expression and gender role, their responsibility in biological modulation and their hypothetical contribution to explain gender differences in prevalence and clinical aspects of mental disorders

Hábitos de estudo e competências cognitivas em alunos do terceiro ciclo e secundário

Dissertação apresentada à Universidade Fernando Pessoa, como parte dos requisitos para a obtenção do grau de Mestre em Psicologia, ramo de Psicologia da Educação e Intervenção ComunitáriaAlguns problemas de aprendizagem são explicados pela ausência ou uso inadequado dos hábitos de estudo. Deste modo, a utilização destes hábitos tornam-se fundamentais uma vez que auxiliam no percurso de aprendizagem do aluno, através de um empenho e participação ativa (Silva & Sá, 2007). O presente estudo observacional transversal, centra-se na relação das seguintes variáveis: hábitos de estudo, competências cognitivas (memória, atenção e perceção), locus de controlo e rendimento escolar. Foi avaliada uma amostra constituída por 350 alunos, das escolas EB 123/PE Bartolomeu Perestrelo (Funchal) e ES/2,3 de Águas Santas (Maia). Os participantes tinham idades compreendidas entre os 12 e os 18 anos de idade (N = 350; M = 15,23 DP = 1,822), a frequentar o terceiro ciclo e ensino secundário. De modo a avaliar os participantes recorreu-se à elaboração de um Questionário Sócio-Demográfico, Inventário de Hábitos de Estudo de Pozar (1997), Teste de Perceção de Diferenças de Thurstone e Yela (1995), Inventário de Locus de Controlo de Levenson (1973), um exercício para avaliar a atenção, e um exercício para avaliar a memória, ambos os exercícios foram elaborados pela autora do estudo. A análise estatística de tratamento de dados consistiu na execução de uma análise de variância, one-way ANOVA e de uma análise de correlação de Pearson. A análise dos dados permitiu constatar que existe uma relação estatisticamente significativa entre a perceção e o rendimento escolar; entre o locus de controlo interno e as notas escolares de algumas disciplinas; e entre as escalas do IHE e as notas escolares de algumas disciplinas. Bem como, verificou-se a existência de diferenças estatisticamente significativas entre os alunos que possuem diferentes níveis de atenção e de memória face às notas escolares de algumas disciplinas; entre os alunos que possuem diferentes níveis de memória face ao locus de controlo interno; e entre os alunos que possuem diferentes níveis de atenção face a algumas escalas do IHE.Some of the learning difficulties are explained by the absence or inadequate use of study habits. Thus, the use of such habits becomes fundamental in the way it supports the student’s learning course, through commitment and pro-active participation (Silva & Sá, 2007). The current cross-observational study focuses on the correlation of the following variables: study habits, cognitive competencies (memory, attention span and perception), locus of control and school performance. A sample of 350 students was measured, from the schools EB 123/PE Bartolomeu Perestrelo (Funchal) and ES/2,3 de Águas Santas (Maia). The participants were aged between 12 and 18 years old (N = 350; M = 15,23 DP = 1,822), attending third grade and secondary school. In order to evaluate the participants, one had to resort to a Social-Demographic Questionnaire; Study Habits Inventory (1997) by Pozar; Testing Perception of Differences (1995) by Thurstone and Yela; Locus of Control Scale (1973) by Levenson; an exercise to measure attention span; and an exercise to measure memory. The latter two exercises have been developed by this study’s author. The statistical review of data consisted on executing a variance analysis, oneway ANOVA and a Pearson’s correlation coefficient. The data analysis has shown that there is a significant statistical relationship between perception and school performance; between internal locus of control and school grades of certain subjects; and between the scales of IHE and school grades of certain subjects. In addition to this, significant statistical differences have been found among students who possess different attention span levels and memory levels in relation to school grades of certain subjects; between students who possess different levels of memory in relation to the internal locus of control; and between students who possess different attention span levels in relation to particular IHE scales

The importance of measuring psychosocial functioning in schizophrenia

BACKGROUND: Schizophrenia is among the most disabling of mental illnesses and frequently causes impaired functioning. We explore issues of definition and terminology, and the relationship between social functioning, cognition, and psychopathology considering relevant research findings. METHODS: The present article describes measures of social functioning and outlines their psychometric properties. It considers their usefulness in research and clinical settings. Treatment aims and objectives are explored in the context of cognitive and social functioning. Finally, we identify areas for developing research and refining the measurement of social functioning. RESULTS: The definition and measurement of social functioning in schizophrenia remains a complex and disputed area. The relationships between symptoms, cognitive functioning and social functioning are complex but we are beginning to understand them better. Scales for measuring functioning in clinical practice must be brief and sensitive to change and the Personal and Social Performance (PSP) scale may offer several advantages in these regards. Brief cognitive assessments focusing upon the domains most commonly affected in schizophrenia, such as verbal memory and executive functions, should be coadministered with measures of functioning. CONCLUSIONS: The use of validated scales for schizophrenia that are sensitive to change over the course of the illness and its treatment, should allow for a better understanding of patients' functional disabilities, enabling better and more comprehensive monitoring and evaluation of both pharmacological and non-pharmacological treatment strategies