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Letter to the Editor

Letter to the Editor


Preliminary results of an Acceptance and Commitment Therapy (ACT) brief group intervention for psychosis - read full article

By: Paula Castilho, Ana Margarida Pinto, Ricardo Viegas, Sérgio Carvalho, Nuno Madeira, and Maria João Martins

Acceptance and Commitment Therapy (ACT) is a contextual-behavioral therapy with promising results in various psychological disorders, including psychosis. This study aims to compare the potential benefits of a 4-session ACT group intervention with the interventions commonly offered in Portugal. ACT participants improved in a wider range of measures and 2 of the 3 patients improved significantly in both symptoms, cognitive processes and positive indicators of adjustment (without any deterioration). Future studies should explore the relationship between participants’ clinical profile and benefits from ACT interventions.

Keywords: Psychosis, Acceptance and Commitment Therapy, Brief group intervention, Reliable change index.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:6


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Letter to the Editor


Psychiatry and HIV infection: what changed? - read full article

By: Inês Souto Braz, André Bonito Ferreira, André Ribeirinho Marques, Sérgio Dinis, Isabel Nabais, Graça Gonçalves, and Sílvia Ouakinin

Background: The human immunodeficiency virus (HIV) infection is a chronic disease with significant comorbidity with mental disorders. Patients with mental health problems are at an increased risk of contracting HIV and infected patients are also at an increased risk of developing mental health problems, both cases contributing to a worse global prognosis. This cross-sectional study intends to characterize a sample of patients followed in a psychiatric department in order to understand the crucial role of Liaison Psychiatry in this area. 
Methods: Retrospective review of clinical records of patients followed between June and December of 2016 and assessment of multiple clinical and sociodemographic variables. 
Results: There were 117 psychiatric appointments for 69 HIV-infected patients. The average age was 51.6 (±9.86) years and the gender distribution was balanced. We found that 69.5% of HIV-infected patients presented affective or neurotic disorders (ICD-10), 73.9% were under antidepressant treatment and 72.1% under psychotherapy. Comparing HIV-infected patients with and without antidepressant therapy, we found that patients under antidepressant treatment had a longer duration of HIV infection (p=0.038). All patients presented stable immunological status. 
Conclusions: The paradigm shift of HIV infection—the transition to a chronic disease model—required an adaptation by healthcare providers. As depression is the most prevalent psychiatric condition in this population, its early detection is crucial in order to improve disease outcome and quality of life. 

Keywords: Psychiatry, HIV, Liaison Psychiatry, Depression.

International Journal of Clinical Neurosciences and Mental Health 2017; 4:6
DOI: https://doi.org/10.21035/ijcnmh.2017.4.6

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Letter to the Editor


Severe and enduring Anorexia Nervosa: a brief narrative review about the concept and its therapeutic options - read full article

By: Francisco Coutinho and Isabel Brandão

Anorexia Nervosa (AN) is a severe psychiatric disorder that can present in a chronic and durable form, often named severe and enduring AN (SE-AN), with little available literature considering therapeutic options in this subgroup of patients. We aimed to perform a bibliographic review considering articles about severe or chronic forms of AN published in the last ten years. According to the analyzed data, there are different definitions in the studies concerning SE-AN, however, many authors consider 7-years of disease as a threshold for diagnosing SE-AN. In the future, it will be important to have a standardized definition of SE-AN in order to characterize its preferential approach in large scale studies. Regarding therapeutic options, cognitive-behavior therapy remains a valuable option in these patients, despite the need of some adaptations considering the high probability of past failed psychotherapeutic approaches. Regarding biological therapies, there is now exploration of new possibilities such as the use of transcranial magnetic stimulation and deep brain stimulation in these patients. However, research towards these approaches is still in its beginnings, with need for further studies to characterize their possible role.

Keywords: Anorexia nervosa, Severe, Enduring, Chronic, Resistant.

International Journal of Clinical Neurosciences and Mental Health 2019; 6:3
DOI: https://doi.org/10.21035/ijcnmh.2019.6.3

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