A skin-picking disorder case report: a psychopathological explanation

We describe the case of a 44-year-old woman, without known previous psychiatric history, hospitalized after a significant hemorrhage caused by self-inflicted deep facial dermal lesions (with muscle exposition). Psychopathological possible explanations of this case, as in similar reviewed ones, are related to frustration, aggression, and impulsivity.

Assessing treatment response to prophylactic lithium use in patients with bipolar disorder

ABSTRACT Objetive To identify potential clinical and epidemiological predictors of long-term response to lithium treatment. Methods A total of 40 adult outpatients followed in an university hospital, with confirmed diagnosis of bipolar disorder and with history of lithium use for at least a six months period, had their response to this medication assessed through the use of a standardized instrument. The ALDA scale is based on retrospective clinical data, in our study assessed through a thoroughly reviewed of the medical charts, and is used to evaluate the clinical improvement with the treatment (Criterion A), corrected by the acknowledgement of possible confounding factors, such as duration of the treatment, compliance and concomitant use of additional medications (Criterion B), in order to estimate the response that can be specifically attributable to lithium. Results Our study found an inverse relation between the number of mood episodes with psychotic symptoms and lithium treatment outcome. Conclusion The results reinforce the hypothesis that lithium seems to be less efficacious in patients with bipolar disorder who present psychotic symptoms.

Cyberbullying: caracterização do fenómeno em Portugal

Dissertação de mestrado em Crime, Diferença e Desigualdade

Comportamentos de risco na juventude: Uma perspetiva de género e interseccional

Tese de Doutoramento em Psicologia - Especialidade em Psicologia Social

Aortic stenosis. Gender influence on left ventricular geometry and function in patients under 70 years of age

OBJECTIVE: To verify if adaptive left ventricle (LV) characteristics are also present in individuals under 70 years of age with severe aortic stenosis (AS). METHODS: The study comprised 40 consecutive patients under 70 years of age with AS and no associated coronary artery disease, referred for valve surgery. Out of the 40 patients, 22 were men and 18 women, and the mean age was 49.8±14.3 years. Cardiac symptoms, presence of systemic hypertension (SH), functional class according to the New York Heart Association (NYHA), and valve lesion etiology were considered. LV cavity dimensions, ejection fraction (EF), fractional shortening (FS), mass (MS), and relative diastolic thickness (RDT) were examined by Doppler echocardiography. RESULTS: Fourteen (63.6%) men and 11 (61.6%) women were classified as NYHA class III/IV (p=0.70). There was no difference in the frequency of angina, syncope or dyspnea between genders. The incidence of SH was greater in women than in men (10 versus 2, p=0.0044). Women had a smaller LV end-diastolic diameter index (32.1±6.5 x 36.5±5.3mm/m², p=0.027), LV end-systolic diameter index (19.9±5.9 x 26.5±6.4mm/m², p=0.0022) and LV mass index (MS) (211.4±71.1 x 270.9±74.9g/m², p=0.017) when compared with men. EF (66.2±13.4 x 52.0±14.6%, p=0.0032), FS (37.6±10.7 x 27.9±9.6%, p=0.0046) and RDT (0.58±0.22 x 0.44±0.09, p=0.0095) were significantly greater in women than in men. CONCLUSION: It is the patient gender rather than age that influences left ventricular adaptive response to AS.

Gender in focus: (new) trends in media

(Excerto) Nowadays, the public discourses about gender equality are commonly accepted in Western society. In fact, we live in an era of “equality illusion” (Banyard, 2010) because the mainstream discourses incorporate gender in the agenda, conveying the message that feminist struggles are unnecessary today. At the same time, postfeminism (McRobbie, 2004) gains importance and demonstrates the intricacies of a neoliberal, highly individualist culture that subtly imprisons the freedoms that it is supposed to grant (Gill & Scharff, 2011).

Gender and media: where do we stand today?

Nowadays, the public discourses about gender equality are commonly accepted in Western society. In fact, we live in an era of “equality illusion” (Banyard, 2010) because the mainstream discourses incorporate gender in the agenda, conveying the message that feminist struggles are unnecessary today. At the same time, postfeminism (McRobbie, 2004) gains importance and demonstrates the intricacies of a neoliberal, highly individualist culture that subtly imprisons the freedoms that it is supposed to grant (Gill & Scharff, 2011). However, back in 1978, Gaye Tuchman used the expression “symbolic annihilation” to refer to how the media represented women. The author refers to a “symbolic annihilation” because sometimes it is so hidden and subtle that it becomes difficult to perceive – and to be fought. Much has improved since then; yet a lot remains the same. Over the past decades there have been marked changes in gender relations, in feminist activism, in the (media) communication industry and in society in general (Byerly, 2013; Carter, Steiner & McLaughlin, 2015; Gallagher, 2014; Gallego, 2013; Krijnen, Álvares & Van Bauwel, 2011; Krijnen & Van Bauwel, 2015; Lobo, Silveirinha, Subtil, & Torres, 2015; Ross, 2009; Silveirinha, 2001; Van Zoonen, 1994, 2010). Now, in a globalised and media saturated world, the gendered picture is, consequently, different. The contemporary grammar is marked by diverse and complex tensions (van Zoonen, 2010).

Gender, sex and sexuality in two open access communication journals published in Portugal: a critical overview of current discursive practices

The links between gender, sex and sexuality and their relevance are theoretically and politically problematic (Richardson, 2007). One of the difficulties in understanding their interconnections is that these terms are often used differently and ambiguously by different authors (and even by the same authors). This article reports the results of an analysis of the articles published in open access communication journals with known impact factor, edited in Portugal and published between 2005 and 2012. The diverse conceptualisations of those three basic concepts and of their (inter)relationships within communication research are identified. The complexity and the intricate (and often implicit) nature of both the meanings of these categories and their relationships underlie and justify our attention and further research. What the findings suggest about the current communication research into gender issues published in the two journals surveyed is that the ‘Gender differences discourse’ (Sunderland, 2004) is the most pervasive discourse (also) in academic practice. Additionally, they show that gender and sex are mainly taken for a fact, not a question that is worth being studied. The editors of these journals, as well as the scholars submitting manuscripts, need to be more aware of the traditional nature of the theoretical and methodological choices that they make regarding gender- and sex-related issues, as well as of the relative lack of attention to sexuality as a research subject.

24-h urinary free cortisol from mid-pregnancy to 3-months postpartum: gender and parity differences and effects

Background: Pregnancy and postpartum have been associated to several physiological changes;however, empirical evidence was almost exclusively obtained in primiparous women and few studies focus on hormonal changes in men and second-time parents. The main aim of this study is to examine 24-h urinary free cortisol from mid-pregnancy to 3-months postpartum, comparing women/men and first/second-time parents.Methods: Twenty-six women and 22 men (N = 48) were recruited from an antenatal obstetric unit in Porto, Portugal. 24-h urinary free cortisol was measured at the 2nd and 3rd trimester and at 3-months postpartum. Repeated measures analyses of variance were conducted, in order to analyze 24-h urinary free cortisol patterns of change over this period. Gender and parity were included in the analyses as potential modifiers, in order to compare women and men, and first-and second-time parents.Results: An increase from the 2nd to the 3rd trimester (p = .006) and a decrease from the 3rd trimester to 3-months postpartum (p = .005) were reported in all parents’ 24-h urinary free cortisol. The interaction effects for Time * Gender (p = .03) and Time * Parity (p = .02) were found. Women and first-time parents revealed higher levels, while men and second-time parents showed lower 24-h urinary free cortisol levels at the 2nd trimester than at 3-months postpartum.Conclusions: Findings appear to clarify the direction, as well as, the timing, gender and parity extension of 24-h urinary free cortisol changes from mid-pregnancy to 3-months postpartum.The same pattern of change in all parents’ 24-h urinary free cortisol from mid-pregnancy to 3-months postpartum is consistent with the proposed role of hormones in preparation to parenting.

Childhood history of abuse and child abuse potential: the role of parent’s gender and timing of childhood abuse

It has been suggested that being physically abused leads to someone becoming a perpetrator of abuse which could be associated to parents' gender, timing of the physical abuse and specific socio-demographic variables. This study aims to investigate the role the parents' gender, timing of childhood abuse and socio-demographic variables on the relationship between parents' history of childhood physical abuse and current risk for children. The sample consisted of 920 parents (414 fathers, 506 mothers) from the Portuguese National Representative Study of Psychosocial Context of Child Abuse and Neglect who completed the Childhood History Questionnaire and the Child Abuse Potential Inventory. The results showed that fathers had lower current potential risk of becoming physical abuse perpetrators with their children than mothers although they did not differed in their physical victimization history. Moreover, the risk was higher in parents (both genders) with continuous history of victimization than in parents without victimization. Prediction models showed that for fathers and mothers separately similar socio-demographic variables (family income, number of children at home, employment status and marital status) predicted the potential risk of becoming physical abuses perpetrators. Nevertheless, the timing of victimization was different for fathers (before 13 years old) and mothers (after 13 years old). Then our study targets specific variables (timing of physical abuse, parents' gender and specific socio-demographic variables), which may enable professionals to select groups of parents at greater need of participating in abuse prevention programs.

Perfil de habilidades motoras finas de crianças com e sem perturbação do espectro do autismo, na zona norte de Portugal: um estudo comparativo

Dissertação de mestrado em Educação Especial (área de especialização em Intervenção Precoce)

Avaliação de habilidades motoras globais em crianças com e sem perturbação do espectro do autismo na zona Norte de Portugal

Dissertação de mestrado em Educação Especial (área de especialização em Intervenção Precoce)

Anxiety and depression symptoms in women and men from early pregnancy to 3-months postpartum: parity differences and effects

This study aimed to investigate both anxiety and depression symptoms from early pregnancy to 3-months postpartum, comparing women and men and first and second-time parents. Methods: A sample of 260 Portuguese couples (N=520), first or second-time parents, recruited in an Obstetrics Out-patients Unit, filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the 1st, 2nd and 3rd pregnancy trimesters, childbirth, and 3-months postpartum. Results: A decrease in anxiety and depression symptoms from early pregnancy to 3-months postpartum was found in both women and men, as well as in first and second-time parents. Men presented less anxiety and depression symptoms than women, but the same pattern of symptoms over time. Second-time parents showed more anxiety and depression symptoms than first-time parents and a different pattern of symptoms over time: an increase in anxiety and depression symptoms from the 3rd trimester to childbirth was observed in first-time parents versus a decrease in second-time parents. Limitations: The voluntary nature of the participation may have lead to a selection bias; women and men who agreed to participate could be those who presented fewer anxiety and depression symptoms. Moreover, the use of self-report symptom measures does not give us the level of possible disorder in participants. Conclusions: Anxiety and depression symptoms diminish from pregnancy to the postpartum period in all parents. Patterns of anxiety and depression symptoms from early pregnancy to 3-months postpartum are similar in women and men, but somewhat different in first and second time parents. Second-time parents should also be considered while studying and intervening during pregnancy and the postpartum.

Exposición prenatal al alcohol y síndrome de hiperactividad con déficit de la atención: un abordaje conductual, farmacológico y bioquímico. Alcohol prenatal exposure and attention deficit with hyperactivity disorder: behavioral, pharmacological and biochemical approaches.

El Trastorno por Déficit de Atención con Hiperactividad (ADHD) es un síndrome conductual de origen orgánico, que se manifiesta principalmente en niños. Está caracterizado por distracción moderada a severa, períodos de atención breve, hiperactividad, inestabilidad emocional e impulsividad. Los tratamientos se basan "paradójicamente" en psicoestimulantes. Las sustancias mas empleadas son metilfenidato y anfetamina. La sintomatología indica un mal funcionamiento en los circuitos dopaminérgicos que sería el resultado de factores genéticos como ambientales, ya que es común encontrar ADHD en niños expuestos prenatalmente al alcohol. Los modelos animales son importantes para estudiar patologías de etiología desconocida, en este sentido, estudios de nuestro laboratorio indican que ratones deficientes en p35 son hiperactivos y responden paradojalmente a psicoestimulantes. Cdk5/p35 participa en el desarrollo neuronal, liberación de vesículas, señales dopaminérgicas, etc. Además resultados preliminares indican que la experiencia prenatal con una dosis etílica moderada durante la gestación tardía, es suficiente para incrementar los patrones de actividad locomotora, semejantes a los descriptos en los modelos animales de ADHD. De acuerdo a estas consideraciones hipotetizamos que la exposición etílica prenatal a dosis moderadas y durante un periodo acotado de la gestación tardía, resulta en un patrón conductual similar al descripto en modelos de ADHD. Asimismo, drogas psicoestimulantes pueden revertir dichos efectos. Por otra parte, proponemos que estas alteraciones son consecuencia de los efectos ocasionados por el insulto etílico sobre el equilibrio en el funcionamiento del sistema de neurotransmisión dopaminérgio mesolímbico/cortical. Teniendo en cuenta que la etiología del ADHD aun no se conoce, el desarrollo de modelos animales, que recapitulen características clínicas de este trastorno, constituye una herramienta muy poderosa para el estudio de los mecanismos celulares y moleculares que subyacen a este síndrome, por lo tanto, en este proyecto nos proponemos obtener evidencias acerca de las alteraciones originadas a partir de efectos deletéreos de la exposición etílica prenatal, que recapitulan el desarrollo de fenotipos conductuales y bioquímicos descriptos en modelos para ADHD. Específicamente nos proponemos determinar, por medio de experimentos conductuales, si la exposición a distintas dosis moderadas de alcohol durante un periodo acotado de la gestación tardía, son suficientes para generar alteraciones conductuales características de ADHD y establecer si metilfenidato y anfetamina, son capaces de revertirlas. Evaluar, mediante métodos bioquímicos, si este modelo involucra cambios en algunos de los componentes claves de la neurotransmisión dopaminérgica, tales como niveles de dopamina y sus metabolitos, niveles de expresión de tirosina-hidroxilasa, de receptores y transportador de dopamina, del complejo cdk5/p35, entre otros. Esperamos recapitular características análogas a las observadas en sujetos diagnosticados con ADHD y que el tratamiento con psicoestimulantes re-establezca los niveles de conducta normales. Mediante ensayos bioquímicos, esperamos encontrar mayores niveles de dopamina en tejido estriatal, acompañados con un aumento en los niveles de sus metabolitos y mediante western blot y ensayos de actividad esperamos encontrar mayor nivel de expresión en D1, menor de DAT y alteraciones en la normal actividad y expresión de cdk5/p35, que podrían explicar los resultados comportamentales esperados. Dada la alta prevalencia de ADHD y que estos jóvenes pacientes son medicados con psicoestimulantes, junto con la poca información sobre las respuestas neuroadaptativas del cerebro inmaduro, es importante investigar los mecanismos que subyacen las alteraciones neurofisiológicas de este trastorno. Estos abordajes experimentales resultan centrales para el desarrollo de terapias mas eficientes para el tratamiento de este síndrome.