Browsing by Author "Palma, M"
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- 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.
- Dar más notíciasPublication . Klut, C; Palma, M
- Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features.Publication . Palma, M; Ferreira, B; Borja-Santos, N; Trancas, B; Monteiro, C; Cardoso, GBACKGROUND: The aim of this study was to investigate the effectiveness of electroconvulsive therapy (ECT) in medication-nonresponsive patients with mixed mania and bipolar depression. METHOD: Forty-one patients with mixed mania (DSM-IV diagnosis of bipolar I disorder, most recent episode mixed) and 23 patients with bipolar depression (DSM-IV diagnosis of bipolar I disorder, most recent episode depressed) consecutively assigned to ECT treatment were included in this study. Subjects were evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS), the Brief Psychiatric Rating Scale (BPRS), and the Clinical Global Impressions-Severity of Illness scale (CGI-S). Assessments were carried out the day before starting ECT, 48 hours after completion of the third session (T1), and a week after the last session of ECT (T2). RESULTS: Both groups received an equal number of ECT sessions (mean +/- SD = 7.2 +/- 1.7 vs. 7.3 +/- 1.6). In both groups, within-group comparisons showed that there was a significant reduction in CGI-S score (mixed mania, p <.0001 at T1 and T2; bipolar depression, p < .01 at T1, p < .0001 at T2), MADRS total score (both groups, p < .0001 at T1 and T2), BPRS total score (mixed mania, p < .0001 at T1 and T2; bipolar depression, p < .001 at T1, p < .0001 at T2), and BPRS activation factor score (mixed mania, p < .0001 at T1 and T2; bipolar depression, NS at T1, p < .01 at T2). Between-group comparisons revealed that patients with mixed mania showed significantly greater decrease in MADRS score (p < .001) and a greater proportion of responders (CGI-S) than patients with bipolar depression at endpoint (56% [N = 23] vs. 26% [N = 6], p = .02). Patients with mixed mania showed a greater reduction in suicidality, as measured by MADRS score, than patients with bipolar depression (p < .02). CONCLUSION: In our study, ECT was associated with a substantial reduction in symptomatology, in both patients with mixed mania and those with bipolar depression. However, the mixed mania group exhibited a more rapid and marked response as well as a greater reduction in suicidal ideation. Response to ECT was not influenced by the presence of delusions.
- Empatia: ferramenta pró-social explorada num grupo terapêuticoPublication . Graça, J; Palma, M; Mendonça, C; Cargaleiro, I; Melo, JIntrodução: A empatia é um conceito multi- dimensional que engloba a capacidade de in- ferir um estado emocional e responder a emo- ções vivenciadas pelo outro, podendo ser assim categorizada em empatia cognitiva e emocional. É uma capacidade que se desenvolve pre- cocemente através, sobretudo, da interação com as figuras parentais. Não é exclusiva dos seres humanos e tem sido conservada evolutivamente, constituindo a base da moralidade, da socialização e do pacifismo. A desregulação empática, que pode ser avaliada psicometricamente, ocorre em perturbações mentais como a esquizofrenia, a perturbação afetiva, as perturbações de personalidade, entre outras. Métodos: Trata-se de um estudo exploratório prospetivo longitudinal que pretende avaliar a evolução da empatia, medida pelo Quociente de empatia, aos 0 meses e aos 9 meses e, secundariamente, a evolução desta em subgrupos demográficos e nosológicos. Foi utilizada uma amostra de conveniência de 22 doentes que frequentaram o Hospital de Dia do Serviço de Psiquiatria do Hos- pital Prof. Doutor Fernando Fonseca, EPE, entre setembro de 2011 e junho de 2012. No Hospital de Dia, para além das atividades regulares, foi desenvolvida a atividade terapêutica “Empatias” que consistiu no desenvolvimento de relações diádicas promotoras de empatia e num grupo te- rapêutico quinzenal com enfoque na tomada de perspetiva. Para a análise estatística foi utilizado o teste T-Student e o ANOVA. Resultados e Discussão: Não se encontraram diferenças significativas entre o QE aos 0 me- ses e aos 9 meses (QE=39,2 vs QE=39,7 pontos, respetivamente, p=0,813), tendo-se verificado uma estabilidade do traço empático medido através do QE nesta população. No entanto exis- tem algumas limitações, como a existência de fatores confundentes, o tempo curto de obser- vação e a ausência de validação da escala psico- métrica para a população portuguesa. Conclusão: Nesta população de doentes com perturbação mental compensada que frequen- taram o Hospital de Dia o traço empático mos- trou estabilidade longitudinal. A investigação na área da empatia é ainda exploratória e este estudo pretende ser um contributo para a ava- liação longitudinal da empatia, tendo em conta o papel desta na perturbação mental
- 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.
- Síndrome de Otelo na doença de ParkinsonPublication . Palma, M; Luis, A