Browsing by Author "Gama Marques, J"
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- Catatonia in Anti-N-Methyl-D-Aspartate (NMDA) Receptor Encephalitis Misdiagnosed as SchizophreniaPublication . Ponte, A; Brito, A; Nóbrega, C; Pinheiro, S; Gama Marques, JAnti-N-Mmethyl-D-aspartate receptor encephalitis is an autoimmune disease of the central nervous system with prominent neurologic and psychiatric features. Symptoms appear progressively and sometimes with an exclusively psychiatric initial presentation. The patient's evaluation should be meticulous, and we should use all the diagnostic tests required for the exclusion of entities that can mimic this disease. We report the diagnostic investigation of a case of anti-N-methyl-D-aspartate receptor encephalitis in a patient with a previous diagnosis of schizophrenia with poor response to antipsychotics. The aim of this case report is to highlight the importance of close surveillance for neuropsychiatric symptoms, especially catatonia, and to recognize autoimmune encephalitis in the differential diagnosis of psychotic disorders with neurological symptoms and resistance or intolerance to antipsychotics. A prompt diagnosis will contribute to a faster onset of therapy and an overall improvement in prognosis.
- Comportamento Suicidário nos Internos de Psiquiatria em Portugal: Comparação com a Realidade EuropeiaPublication . Gama Marques, J; Roberto, A; Guerra, C; Pinto da Costa, M; Podlesek, A; Beezhold, J; Jovanovic, N; Moscoso, AIntrodução: O objectivo deste trabalho foi avaliar a prevalência de ideação suicida e tentativas de suicídio nos médicos internos de psiquiatria de adultos e de psiquiatria da infância e da adolescência em Portugal, e comparar os resultados com a população geral portuguesa e de outros países europeus. Material e Métodos: Enviou-se um questionário estruturado e anónimo, por e-mail, aos 159 internos de psiquiatria de adultos e de psiquiatria da infância e da adolescência do país, questionando antecedentes pessoais de ideação suicida e tentativas de suícidio, bem como antecedentes familiares de tentativas de suicídio falhadas e consumadas. Estas questões fazem parte do Estudo BoSS (Burnout Syndrome Study) realizado em 21 países. A análise dos dados foi feita através do programa informático SPSS v. 19. Resultados: Responderam parcialmente ao questionário 62 internos (40,3%) e 46 (29%) responderam ao questionário na totalidade, constituindo assim a amostra. O ratio feminino:masculino foi de 2:1 e a média de idade de 29 anos. A ideação suicida estava presente na forma passiva em 44% dos inquiridos e na forma activa em 33%; 4,3% referiu tentativas de suicídio prévias. Em relação à história familiar, registou-se 22% de tentativas de suicídio e 13% de suicídio consumado. Discussão: Os resultados obtidos são preocupantes e podem estar associados a factores específicos a que esta população está exposta. Conclusão: É necessária uma investigação mais aprofundada para se compreender melhor este fenómeno, respectivas causas e potenciais modificadores
- Homeless Outreach Psychiatric Engagement for Lisboa (HOPE 4 Lisboa): One Year of Marontology, and One John Doe Living with Diogenes SyndromePublication . Gama Marques, J; Chesi, D; Coelho, RO; Castanheira Costa, I; Santos Antão, C; Pedro, CA; Silva Santos, P; Xavier Diogo, JBackground: In Europe, psychiatric disorders seem to affect up to 50% of the homeless. In Portugal there were, at a certain time, circa 3,396 homeless people, half living in the capital city, Lisboa. Aims: The Homeless Outreach Psychiatric Engagement for Lisboa (HOPE 4 Lisboa) was created, in January 1st 2022, as a collaboration including staff from the local state asylum, medical school and town hall in Lisboa, Portugal, in order to provide better treatment for the super difficult cases of psychiatric patients living homeless in Lisboa. Method: During 2022, the HOPE 4 team made night rounds, every 15 days on Tuesday's night (20:30 to 23:30) trying to reach, at least, one dozen of homeless psychiatric patients, previously identified. Results: The HOPE 4 Lisboa interviewed 101 patients (53.4%) out of the 189 programed visits. From this group, 72 (72%) had already a previous psychiatric diagnosis. From those 101 patients, reports for 47 (47%) were sent for an eventual compulsory psychiatric assessment. From those 47 only 21 patients (21%) were admitted in the psychiatry ward. Finally we discuss the most super difficult patient we found, as a small case report: a John Doe living in complete Diogenes syndrome. Conclusions: there are still a few psychiatrists interested in treating homeless people completely or partially out of the classic mental health care systems. Some claim to be doing interstitial psychiatry, others street psychiatry, but we could also call it marontology.
- The European Portuguese Version of the Brief Negative Symptom ScalePublication . Santos, HC; Rodrigues, A; Ferreira, S; Martins, JM; Baptista, T; Gama Marques, J; Kirkpatrick, B; Prata, DNegative symptoms reflect a currently much-untreated loss of normal functioning and are frequently found in psychotic disorders. We present the first translation of the Brief Negative Symptom Scale (BNSS) to European Portuguese and evaluate its validity in a sample of Portuguese male patients with a psychotic spectrum disorder. The Portuguese BNSS showed excellent internal consistency, high convergent validity (i.e., strong correlation with the PANSS negative factor), and high discriminant validity (i.e., a lack of association with the PANSS positive factor). In sum, the present European Portuguese BNSS has shown to be reliable, thus extending this instrument's clinical availability worldwide.