HVFX - PSI - Comunicações e Conferências
Permanent URI for this collection
Browse
Recent Submissions
- Neuroversion: a possible mechanism of action of ECT in acute maniaPublication . Silva-dos-Santos, Amílcar; Venda, Diana; Sales, MiguelThe first-line treatments for acute mania are lithium, antiepileptic moodstabilizers, and antipsychotic drugs. Electroconvulsive therapy (ECT) is reserved for drug-resistant patients, although it is the first-line treatment for severe or delirious mania with life-threatening physical exhaustion. Contrary to depression, there is a paucity of evidence for the use of ECT in acute mania. However, available literature indicates that ECT seems effective in treating acute mania, with response rates between 80% and 90%, even in drug-resistant patients. Yet, its electrophysiological and molecular pathways remain unknown. We present the curious case of a 63-year-old woman, followed at our psychiatric outpatient clinic for bipolar disorder type I, admitted to our inpatient unit in a manic state with psychotic features. Due to bradycardia episodes secondary to the psychiatric medication, she was submitted to ECT. After a single session, her symptoms improved, despite no evoked seizures. We compare this curious phenomenon to the well-known procedure of cardioversion and name it neuroversion e in other words, a possible normalization of brain activity and behavior triggered by a unique session of electrical stimulation. However, we acknowledge that further research, including randomized clinical trials, are needed to study this reported event.
- Sudden and Transient Block of Left Brain Hemisphere Activity in Catatonic Patients Undergoing Electroconvulsive Therapy (ECT)Publication . Melo, António; Bravo, Joana; Silva dos Santos, Amílcar; Gusmão, Ricardo; Lara, ElsaIntroduction: In the last 21 years, there has been an increase in studies on visual and quantitative EEG (qEEG). Although new findings have been reported, such as the extreme delta brush waves in anti-NMDA receptors encephalitis, there are still undocumented visual EEG alterations. In Psychiatry, these new findings are harder to detect because most patients do not undergo routine EEG. In this work, we report for the first time an EEG finding of a sudden and transient block of left brain hemisphere activity in two patients who underwent treatment with ECT. Methods: The EEG activity of the two patients undergoing ECT treatment was recorded using a Thymatron System IV device. Patient number 1: 23 year-old man with severe major depressive disorder with psychotic features and catatonia. Patient number 2: 48 year-old woman with bipolar disorder with mixed features and catatonia. Results and Discussion: The EEG recording of these two patients during their ECTs sessions showed a sudden and transient block (or arrest) of the left brain hemisphere activity. These findings are not attributed to background noise, electrode disconnection or device malfunction. Also, they were detected in two different patients. In patient 2 in two distinct admissions, two hospitals, utilizing two devices and by two different observers. After clinical improvement, these EEG alterations were not detected. Conclusion: To our knowledge, this is the first report of a sudden and transient block of the left brain hemisphere activity in psychiatric patients. Although the exact meaning of this finding remains unknown, a comparison can be made between this transient bradypsychia/block (arrest) of brain activity and bradycardia events in cardiology. We acknowledge the need for further studies to better understand these findings, particularly studies addressing different EEG abnormalities and the clinical traits they are associated with.
- Quantitative EEG (qEEG) in Patients with Bipolar Psychotic Depression and Unipolar Psychotic Depression under Electroconvulsive Therapy (ECT)Publication . Bravo, Joana; Silva dos Santos, Amílcar; Melo, António; Sales, Miguel; Mendonça, Pedro; Nagornova, Zhanna; Beljakov, Grigory; Shemyakina, Natalia; Lebedev, MikhailIn the last 21 years, there has been an increase in studies on quantitative electroencephalogram (qEEG) in psychiatry. Patients with unipolar and bipolar depression show different brain wave patterns. However, there is no consensus on the findings. In this study, we aimed to clarify some qEEG changes in patients with unipolar psychotic depression (UPD) and bipolar psychotic depression (BPD) during the ECT course. Methods: 10 patients undergoing treatment with ECT were considered. Of the 128 total ECT sessions, 34 sessions from six patients included had valid EEG recordings (3 patients with UPD and 3 with BPD, some with catatonic features). They underwent bifrontal ECT on a Thymatron IV device. EEG data were digitally recorded from two frontal leads with a Thymatron device and the Genie software. Data were analyzed with WinEEG soft package. EEG activity was divided into 4 phases: 1) background (resting state); 2) anesthesia; 3) ECT-induced stimulation/seizure, and 4) recovery. Regression analysis was performed for each phase through the sessions. The following EEG power spectrums were analyzed: delta (1.5-3.75 Hz), theta (4-7.75 Hz), alpha1 (8-9.75 Hz), alpha2 (10-13 Hz), beta1 (13.25-18 Hz), and beta2 (18.25-30 Hz). Results: Patients with psychotic unipolar depression showed an increase in the power spectrum of beta1 and/or beta2 in the resting phase over time (p < 0.05, linear regression). This increase was linked with clinical improvement. Patients with bipolar psychotic depression did not show this pattern. Conclusion: Clinical improvement in patients with unipolar psychotic depressionwas linked to an increase in the beta power spectrum. The same does not occur in bipolar patients. One possible reason for this finding might be that some bipolar patients have an increased basal beta activity. However, more studies are needed to assess the significance of our findings.
- Antipsicóticos injetáveis de longa ação clássicos vs atípicos: um estudo naturalísticoPublication . Sales, MB; Silva dos Santos, A
- Patient care transition in psychiatry and mental health (Transição entre níveis de cuidados e a adesão do doente)Publication . Silva-dos-Santos, A; Talina, M
- Antipsychotics in First-Episode Psychosis: Patterns of Use in a Sample of Portuguese PatientsPublication . Coentre, R; Talina, M
- Suicidality risk assessment in primary carePublication . Silva-dos-Santos, A; Rothes, I; Teixeira, A; Gusmão, R
- Ontem, hoje e amanhã O Trabalho da Equipa de Pedopsiquiatria do Hospital de Vila Franca de Xira – Intervenção em contexto de Grupos TerapêuticosPublication . Moura, M; Oliveira, AS; Ribeiro, JP
- Neuroimagiologia Estrutural no Primeiro Episódio PsicóticoPublication . Coentre, R
- Doença mental, homocisteína, risco cardiovascular e síndrome metabólicaPublication . Silva-dos-Santos, A