Browsing by Author "Madeira, N"
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- Circulating biomarkers in schizophrenia: a proteomics perspective.Publication . Santa, C; Coelho, JF; Madeira, N; Manadas, B
- Comunicação de más notíciasPublication . Ferreira, SR; Araújo, AI; Madeira, N
- Corticoterapia e Comportamento Suicidário – um caso clínicoPublication . Silva, S; Madeira, NOs corticosteroides são medicamentos muito usados no alívio de sinais e sintomas derivados de muitas doenças, incluindo as inflamatórias e autoimunes, e são os anti-inflamatórios/imunossupressores mais frequentemente prescritos em todo o mundo. Contudo, os corticosteroides podem também induzir efeitos adversos significativos. Consequências neuropsiquiátricas graves, incluindo psicose, mania, depressão, delirium, compromisso cognitivo, suicídio e tentativa de suicídio têm sido reportadas. Estes efeitos adversos ocorrem em até 60% dos doentes sob corticoterapia. Ainda assim, a previsão de tais efeitos é difícil, e os riscos variam com a idade, género, posologia, antecedentes psiquiátricos e alguns marcadores biológicos. Apresentamos um caso clínico de um doente sem antecedentes psiquiátricos, que faz uma tentativa de suicídio durante o tratamento com corticosteroides, e realizamos uma revisão da literatura usando a base de dados PubMed. A educação, tanto dos doentes quanto das suas famílias, acerca destes eventos adversos, e o aumento do nível de alerta por parte dos médicos acerca da sua ocorrência, poderá facilitar uma monitorização mais rigorosa. Quando a redução da dose de corticoterapia não for suficiente para o controlo da sintomatologia, será importante o tratamento sintomático com psicotrópicos.
- Corticoterapia e Comportamento Suicidário – um caso clínicoPublication . Silva, S; Madeira, NOs corticosteroides são medicamentos muito usados no alívio de sinais e sintomas derivados de muitas doenças, incluindo as inflamatórias e autoimunes, e são os anti-inflamatórios/imunossupressores mais frequentemente prescritos em todo o mundo. Contudo, os corticosteroides podem também induzir efeitos adversos significativos. Consequências neuropsiquiátricas graves, incluindo psicose, mania, depressão, delirium, compromisso cognitivo, suicídio e tentativa de suicídio têm sido reportadas. Estes efeitos adversos ocorrem em até 60% dos doentes sob corticoterapia. Ainda assim, a previsão de tais efeitos é difícil, e os riscos variam com a idade, género, posologia, antecedentes psiquiátricos e alguns marcadores biológicos. Apresentamos um caso clínico de um doente sem antecedentes psiquiátricos, que faz uma tentativa de suicídio durante o tratamento com corticosteroides, e realizamos uma revisão da literatura usando a base de dados PubMed. A educação, tanto dos doentes quanto das suas famílias, acerca destes eventos adversos, e o aumento do nível de alerta por parte dos médicos acerca da sua ocorrência, poderá facilitar uma monitorização mais rigorosa. Quando a redução da dose de corticoterapia não for suficiente para o controlo da sintomatologia, será importante o tratamento sintomático com psicotrópicos.
- De 'bouffée délirante' a perturbação psicótica aguda e transitória: revisitação do conceito a propósito de um caso clínicoPublication . Ribeiro, J; Oliveia, P; Pestana Santos, A; Silva, T; Madeira, N
- Death ideation in cancer patients: contributing factorsPublication . Madeira, N; Albuquerque, E; Santos, T; Mendes, A; Roque, MAdvances in cancer research and therapy have improved prognosis and the quality of life of many patients. However, previous epidemiological studies in oncologic patients have shown an increased risk of suicide. Suicidal thoughts, relatively well known in those terminally ill, may be just as important for cancer patients who are survivors or are living with the disease. Nonetheless, there is a relative paucity of data about suicidality in this setting. The authors conducted a prospective observational study to identify death thoughts and to explore the factors associated with suicidal ideation in cancer patients. A sample of 130 patients referred for psychiatric consultation was obtained following informed consent and authorization from the local ethics committee. A semistructured interview assessed sociodemographic data, psychosocial support, and information regarding the cancer process and its treatment. Psychometric instruments were used to evaluate psychopathology, namely the Hospital Anxiety and Depression Scale, the Beck Hopelessness Scale, and the Beck Scale for Suicide Ideation. Psychiatric diagnoses were obtained through the application of the Mini International Neuropsychiatric Interview. Death ideation was identified in 34.6% of patients, yet only 10% had active suicidal thoughts. Risk of suicide was associated with female gender, a psychiatric diagnosis (major depressive disorder, panic disorder, or dysthymia), difficult interpersonal relationships, associated pain, high hopelessness, and depressive and anxiety symptoms. Although suicidal thoughts are frequent in cancer patients at different stages of disease, most are transitory. Risk factors for suicidal ideation have been identified, such as depression, hopelessness, uncontrolled pain, and difficult interpersonal relationships. Further assessment is necessary to identify those at higher risk of attempting suicide, and underlying psychiatric disorders should be vigorously treated.
- Decrease in Stigma Towards Mental Illness in Portuguese Medical Students After a Psychiatry CoursePublication . Vilar Queirós, R; Santos, V; Madeira, NIntroduction: Stigma towards mental illness is considered a key obstacle to the provision of medical care to psychiatric patients. This is not only present in the general population but also among healthcare professionals. Therefore, medical students could be a target population for stigma prevention measures. The aim of this study is to assess the evolution of the attitudes of medical students from the Faculty of Medicine of the University of Coimbra towards psychiatric patients, before and after attending Psychology and Psychiatric courses. Material and Methods: Students from the third and fourth years of the integrated Master’s degree in Medicine in the Faculty of Medicine of the University of Coimbra were asked to complete four questionnaires. The surveys were distributed before and after the attendance of the courses. Results: There was a statistically significant decrease of the stigma scores (p = 0.025) between the two measurements (38.16 initially, 36.72 on the second moment). The baseline level of stigma was found to be negatively associated with empathy (rP = -0.477) and with the type of personality, with higher levels of openness to new experiences being associated with lower levels of initial stigma (rP= -0.357). Discussion: Overall, the students’ attitudes towards patients with mental illness were positive, with a decrease of the stigma value from the first to the second semester. This corroborates the hypothesis that education and contact with people with a mental condition could shape positive changes in attitudes and discrimination against those patients. Conclusion: Our results emphasise the importance of implementing programs inside medical schools in order to reduce stigma among future doctors.
- Défices Cognitivos na Perturbação Depressiva MajorPublication . Oliveira, J; Pestana-Santos, A; Madeira, N
- Depression: An unrecognized presentation of hyperthyroidism in old agePublication . Madeira, N; Santos, T
- Eletroconvulsoterapia no tratamento da psicose puerperalPublication . Madeira, N; Santos, T; Relvas, J; Pio-Abreu, JL; Oliveira, CVPuerperal psychosis (PP) is an exuberant clinical syndrome with an estimated frequency of 1 case per 1,000 childbirths that has been most consistently associated with the bipolar disorders spectrum. Available evidence is scarce, namely regarding management and treatment. The authors present the clinical case of a 28 year-old first-time mother, with no psychiatric history, who developed a florid psychotic syndrome in the first weeks of puerperium. Due to lack of improvement following pharmacological treatment, electroconvulsive therapy (ECT) was applied, with substantial and quick response. In this context, the authors reviewed current literature on the use of ECT for the treatment of puerperal psychosis.