Browsing by Author "Klut, C"
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- Alucinações musicais e esquizofrenia: a propósito de um caso clínicoPublication . Klut, C; Xavier, S; Graça, J; Cardoso, GAs alucinações musicais são um tipo de alucinações auditivas complexas. Trata-se de um fenómeno relativamente raro e etiologicamente heterogéneo. Como principais etiologias, têm sido apontadas a hipoacúsia, a patologia cerebral orgânica, a epilepsia, e as doenças psiquiátricas, incluindo a esquizofrenia. A propósito de um caso clínico, os autores revêem e discutem a etiologia e a psicopatologia das alucinações musicais. Parece tratar-se de um fenómeno sub-diagnosticado, cuja pesquisa activa poderá permitir uma compreensão mais completa do quadro clínico apresentado pelo doente.
- An OCD patient presenting with a cerebellum venous variant in a family with a strong schizophrenia loading: a case report.Publication . Palma, M; Borja-Santos, N; Trancas, B; Klut, C; Cardoso, GThe role of cerebellar pathology in psychiatric symptoms has long been recognized. Cerebellar pathology has been associated with obsessive-compulsive disorder pathophysiology, particularly with compulsive hoarding. Likewise, some cerebellum abnormalities have been described in schizophrenia, as well as in comorbidity between obsessive-compulsive disorder and schizophrenia. The authors report the case of a 32-year-old woman with obsessive-compulsive disorder and a cerebellum development variant in a family with a strong schizophrenia loading. This case emphasizes the probable role of the cerebellum in the pathophysiology of both obsessive-compulsive disorder and schizophrenia, and reconsiders the existence of a so called schizo-obsessive subtype of schizophrenia.
- Causes of Death in an Acute Psychiatric Inpatient Unit of a Portuguese General HospitalPublication . Barbosa, S; Sequeira, M; Castro, S; Manso, RT; Klut, C; Trancas, B; Santos, NB; Maia, TINTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis. Patients transferred to other wards during their admission were not included. RESULTS: Circulatory system diseases were the most prevalent causes of death, occurring in 2/3 of patients and include pulmonary embolism (n = 6), acute stroke (n = 3), cardiac arrhythmia (n = 2), acute myocardial infarction (n = 1), abdominal aortic aneurysm rupture (n = 1) and heart failure (n = 1). Two patients died with pneumonia and in four cases the cause of death was undetermined. Only one case of suicide was registered. DISCUSSION: Circulatory conditions were the most frequent causes of death in our inpatient unit. Albeit a relatively rare event, inpatient suicide does occur and, in addition to its complex consequences on staff, family and patients should remain a focus for continued prevention. CONCLUSION: Mortality studies are important for determining quality of health care and to create recommendations for preventive measures.
- Characteristics of frequent users of an acute psychiatric inpatient unit: a five-year study in Portugal.Publication . Graça, J; Klut, C; Trancas, B; Borja-Santos, N; Cardoso, GOBJECTIVE: This study examined demographic and clinical characteristics of frequent users of a psychiatric inpatient unit in Portugal. METHODS: Data (2004-2008) for 1,348 consecutive psychiatric inpatients were reviewed. Frequent users (N=137), who had at least three admissions in the study period, were compared with nonfrequent users (N=1,211) on age, gender, race-ethnicity, diagnosis, and compulsory admissions. Data were analyzed with chi square and Student's t tests. RESULTS: Frequent users accounted for 29% of admissions. They were significantly younger than nonfrequent users (39±14 versus 44±17, p<.001), and a larger proportion had compulsory admissions (28% versus 14%, p<.001). The frequent user group also had significantly higher rates of bipolar disorder (61% versus 46%, p<.001) and schizophrenia (29% versus 18%, p<.003). CONCLUSIONS: Understanding characteristics of frequent users can inform development of appropriate services. Research should address other variables related to frequent admissions, including socioeconomic factors, general medical and psychiatric comorbidities, and treatment compliance.
- Dar más notíciasPublication . Klut, C; Palma, M
- Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study.Publication . Cardoso, G; Graça, J; Klut, C; Trancas, B; Papoila, AINTRODUCTION: The aims of the present study were to assess demographic and clinical characteristics of patients after receiving a cancer diagnosis, and to determine possible risk factors for anxiety and depression. METHODS: All consecutive patients aged 18 or above, were assessed before starting intravenous chemotherapy for the first time with the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, and a Visual Analog Scale for pain. Demographic and clinical data were also collected. RESULTS: The patients assessed (n = 270) had a mean age of 59.4 (SD = 11.8) years, and 50.7% were women. Tumours were more frequently colorectal (27.2%), lung (18.8%) and breast (17.6%), and 68.9% were stages 3 or 4. A HADS Anxiety score ≥8 was present in 30% of the patients, a Depression score ≥8 in 24.1%, and a Distress score ≥4 in 44.4%. Independent risk factors for HADS Depression score ≥8 were being a woman (OR = 2.45; p = 0.004), being older (OR = 1.04; p = 0.005), and cancer stage 3-4 (OR = 2.24; p = 0.023) in the multivariable analysis; for Anxiety ≥8 they were being a woman (OR = 2.47; p = 0.002), having a past psychiatric consultation (OR = 2.83; p = 0.029), and cancer stage 3-4 (OR = 1.90; p = 0.047). CONCLUSION: These results suggest the need for greater awareness and a differentiated approach to patients at increased risk of anxiety and depression in the early stages of treatment and before starting chemotherapy.
- O estigma da doença mental: que caminho percorremos?Publication . Xavier, S; Klut, C; Neto, A; Ponte, G; Melo, JO estigma da doença mental tem sido alvo de crescente atenção nos últimos anos, com um aumento exponencial de publicações sobre o tema. Este fenómeno constitui para os doen- tes uma fonte de sofrimento, representando um obstáculo à concretização de projectos pessoais e à integração social plena, objectivo principal da prática psiquiátrica actual. Neste artigo, os autores fazem uma revisão selectiva do tema do estigma da doença mental, abor- dando as suas definições, origens, repercus- sões, vivências dos doentes e abordagens para o combater. A literatura revela tratar-se de um fenómeno complexo, cujas definições provêm de diferentes campos do conhecimento (socio- logia, psicologia e psiquiatria). O seu impacto na vida das pessoas com doença mental é evi- dente, condicionando perda de oportunidades, prejuízo da auto-estima e auto-conceito, quali- dade de vida, suporte social e empowerment e actuando como uma barreira ao desempenho dos papéis sociais habituais. O estigma pare- ce ainda comprometer o acesso a cuidados de saúde, não apenas ao tratamento psiquiátrico, mas também a cuidados médicos gerais, com aumento da morbilidade e mortalidade desta população vulnerável. Tem sido dedicado um considerável esforço à compreensão deste fe- nómeno e ao delinear de estratégias anti-estig- ma, que passam também pela sensibilização dos profissionais de saúde para o tema, tendo em vista a melhoria da prática clínica e qualidade dos cuidados prestados.
- Kraepelinian systematic paraphrenia as a recognizable disorderPublication . Borja-Santos, N; Trancas, B; Ferreira, B; Parente, J; Gamito, A; Almeida, S; Vieira, C; Luengo, A; Xavier, S; Klut, C; Graça, J; Ramos, J; Martins, M; Ribeiro, J; Neto, A; Palma, M; Luis, A; Cardoso, GObjectives: To demonstrate that systematic paraphrenia as defined by Kraepelin (the most consistent prototypic paraphrenia subtype) can be recognized and diagnosed. Subjects and methods: All patients admitted to a Portuguese psychiatric inpatient unit between September 2006 and October 2011, meeting the criteria for systematic paraphrenia based on Kraepelin’s definition, Munro’s operational criteria and the authors’ criteria, were evaluated by two senior psychiatrists. Results: Out of 27 evaluated patients, 16 (10 women and 6 men) were confirmed as having systematic paraphrenia, accounting for 0.83% of the total number of inpatients (1921). The mean age of onset was 34.3 years (SD = 8.9) and the mean duration of illness at observation was 19.5 years (SD = 12.3). Most (n = 13) had no family psychiatric history, were married (n = 11) before the onset of the disorder and none had previous sensorial deficit. Six were born outside of Portugal. Their academic achievements were only slightly inferior to the general population. Conclusions: Systematic paraphrenia can be recognized and diagnosed. Contrary to Kraepelin, the disorder seems to be more frequent in women. It does not seem to be associated with old age or heredity. This syndrome is internally consistent and its only similarity with schizophrenia is the positive symptoms’ dimension. It should also be distinguished from late paraphrenia.
- Psychoeducation for bipolar disorders’ patients: the “Porta Aberta” programmePublication . Klut, C; Xavier, S; Graça, J; Carreteiro, G; Melo, JPsychoeducation is currently considered to be a fundamental intervention in the management of bipolar disorders. A psychoeducation group programme for patients with bipolar disorders, aimed at euthymic patients just prior to their discharge from the acute psychiatric inpatient unit, named “Porta Aberta” (Open Door), has been implemented since 2007 at the day-hospital of our psychiatric department (Amadora, Portugal). In this article, the authors provide a brief review of the relevant literature on this subject and also assess the effectiveness of the “Porta Aberta” programme in reducing the average number and duration of readmissions; they determine whether individual characteristics (gender, marital status and disorder subtype) may influence outcome.