Background: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. Aims: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. Method: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions ( Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. Results: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician’s interest in mental health topics. Conclusions: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.

A 46-year-old Caucasian male was involuntarily hospitalized in a Portuguese psychiatric unit due to manic and psychotic symptoms.The symptoms started abruptly 1 week prior to the hospitalization (Figure 1) and comprised irritability, psychomotor agitation, restlessness, purposeless activity, euphoric mood, affect lability, verborrhea and pressured speech, flight of ideas, grandiose and messianic delusions, disinhibition, verbal aggressiveness, total insomnia, excessive money spending, and the conception of several extravagant and unreasonable plans for the future.His medical history included latent tuberculosis (TB; diagnosed 10 years prior), ankylosing spondylitis (AS), and high blood pressure.

IntroductionThe challenges posed by the COVID-19 pandemic were many and daunting. Almost overnight, the lives of millions of people all over Europe was disrupted and people had to adapt to a completely new situation. Healthcare personal were amongst the ones most affected by it, whether by changes in their everyday work routine or by being the people directly in charge of responding to the demands of the pandemic. Trainees are an indispensable part of healthcare personal and, as a result, they were vastly affected by the pandemic.ObjectivesDiscussing the role of National Trainees Associations (NTAs) in pandemic times, including how they dealt with the new challenges, their successes and hardships, and their steps going forward.MethodsGathering of institutional information about the work of the Portuguese, Irish and Turkish NTAs during the COVID-19 pandemic. Critical appraisal of each of their contributions and projects.ResultsThere were impacts to trainees’ clinical work, formative activities and even personal lives. Amidst this turmoil, NTAs were precious institutions. Their objective is to represent the trainees of each country, looking for formative opportunities and linking trainees. During the pandemic, the work developed by the NTAs increase in importance, serving as a beacon of important information and as intermediaries in a number of discussions. They also aimed to minimize the impact on formative activities, whether by providing recommendations or by organizing some form of educational activity.ConclusionsWe provide some national examples – Portugal, Ireland and Turkey – and draw comparisons and lessons from each one.DisclosureNo significant relationships.

Background:Autoimune dementias are underrecognized clinical entities, frequently misdiagnosed as neurodegenerative or prion disorders. However, the prognosis is vastly different since immunotherapy can treat these conditions and restore functionality.Research objective:To reflect on autoimmune dementias, briefly presenting the autoimmune syndromes, how to diagnose them and some clinical cues to be attentive of.Methods:Literature search on Pubmed and Google Scholar.Results:The incidence and prevalence of autoimmune dementias are unknown, but autoimmune and inflammatory causes account for 20% of dementia in patients younger than 45 years of age.Autoimmune dementias are classified according to syndromic presentation, specific serologic markers, or histopathologic findings.Patients with autoimmune dementias usually present with an acute or subacute disorder of memory, thinking, or behaviour. Clinical clues that can help clinicians identify autoimmune dementias include six of the following: (i) rapidly progressive or fluctuating course; (ii) multifocal and diverse clinical presentations; (iii) personal or family history of autoimmunity; (iv) detection of inflammatory markers in the cerebrospinal fluid; (v) presence of a neural-specific autoantibody and (vi) favourable response to a trial of immunotherapy. Also, unsuspected cancer, new or recurrent, may manifest neurologically as autoimmune dementia.In evaluating patients with dementia and autoimmune disease, clinicians should be aware of the possible coexistence of these disorders.Conclusions:Recognition of clinical and serologic clues to autoimmune dementia allows early and sustained treatment. Misdiagnosis of a potentially reversible condition as a progressive neurodegenerative disorder can have devastating consequences for the patient and family.