The clinical symptoms associated with chromosome 15q duplication syndrome manifest through a heterogeneous group of symptoms characterised by hypotonia, delay in motor skills and language development, cognitive and learning disabilities, autism spectrum disorder and refractory epilepsy. The late development of Lennox-Gastaut syndrome in patients with 15q11q13 duplication is a possibility that physicians should be aware of. We report the case of a 27-year-old man with a neurodevelopmental syndrome due to a 15q duplication, with intellectual disability, psychiatric disturbances, and an epileptic phenotype diagnosed as late-onset Lennox-Gastaut syndrome.

Introduction:The aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult and child and adolescence), and compare the data with the general population and other European countries. Material and Methods: A structured and anonymous questionnaire was sent by email to 159 portuguese trainees of adult psychiatry and child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analysed in SPSS v.19. Results: From the inquired population, 62 trainees (40,3%) partially responded, and 46 (29%) were complete responders -these entered the final analysis. There was a ratio of 2:1 (female:male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first degree relatives, 22% had attempted suicide and 13% completed suicide. Discussion:The results are worriying and may be associated with some factors to which this population is exposed. Conclusion: It is necessary further research to better understand this phenomenon, its causes and potential modifiers.

IntroductionPsychomotor agitation is a relatively frequent condition in Psychiatric Emergency Services. It consists in excessive motor activity and without purpose, with high tension and inability to maintain attention. It carries the risk of compromising the physical integrity of the patient himself or others, usually accompanied by hostility and destructive and / or aggressive behaviors.ObjectivesThe authors intend to describe the epidemiological characteristics and the approach of agitated patients in a Psychiatric Emergency Service.MethodsIt was randomly selected a sample of 52 patients who attended the Metropolitan Psychiatric Emergency Service at Centro Hospitalar São João - Oporto for episode of moderate to severe psychomotor agitation, from January 2012 to August 2012.The authors proceeded to retrospective data collection, including gender, age, diagnosis, the need of physical restraint, the psychotropic therapy instituted and the medical orientation of the patients.ResultsIn a sample where the average age of patients is 39.7 years and in which 54% are women, the most common diagnoses were psychosis and manic episodes.Physical restraint was required in 17% of patients and 48% accepted oral treatment. Diazepam and olanzapine were the most used drugs orally and haloperidol was the most frequent intramuscular / intravenous treatment.Hospitalization was required in 73% patients.ConclusionsWith the development of new psychotropic drugs, including benzodiazepines and antipsychotics, the need of physical restraint decreased. In agitated patients, immediate action is essential to enable effective and rapid control of symptoms, as most situations are serious and require hospitalization.

IntroductionSelf-harm is a major public health problem, being a frequent condition among youth and young adults. Psychiatric conditions, like borderline personality, depression, substance misuse and anxiety disorders, are commonly associated with self-harm. The effects of media and contagion are also important and the internet has an important role in divulging and sharing self-harm behaviors.AimsWe pretend to study the role the internet in potentiating or preventing self-harm behaviors.MethodsWe used combined literature searches in PubMed and B-on using the terms “self-harm”, “self injury”, “self mutilation” and “internet” and we also present a clinical case from our service.ResultsMost of the individuals that have self-harm behaviors may never present in psychiatric ward. Today, there is more information about self-harm available to the public domain than ever and web sites about self-harm include personal pages, forums, blogs, communities and even video-sharing sites. These web sites have supportive content that allow the users feeling that they are not alone, sharing feelings and narratives. However, most of them have potentially harmful material, including self-injury related tips, reinforcing messages and triggering material, normalizing or even glamorizing self-injury.ConclusionsMost of the websites normalize and promote self-harm behaviors. Only the better knowledge of these phenomena would allow the use of internet as an effective tool for self-harm prevention, especially for socially-isolated and vulnerable individuals.

Introduction: In Portugal, a reform to implement Long-term mental health care (LTMHC) started in 2017 allowing patients with severe mental illness receiving psychosocial rehabilitation to regain their autonomy and be reintegrated into their communities. Aim: To describe the first steps of the Portuguese LTMHC implementation and to assess the relationship between the LTMHC’s demand (referrals) and supply (vacancies and occupancy). Methods: We conducted a national retrospective observational study to analyse the LTMHC referrals, vacancies and occupancy between mid-2017 (LTMHC establishment) and December 2022. We described and analysed the associated indicators through time and geography, as well as performed a simultaneous regression model to evaluate the relationship between supply and demand. Results: There were 1,192 referrals to the LTMHC, of which 99 (8.3%) were made for childhood and adolescence structures. The maximum support residence (RAMa, ‘Residência de apoio máximo’), designed for patients with higher disabilities, had the highest number of referrals. Additionally, since the opening of vacancies in different institutions, residential structures became quickly saturated. On the other hand, domiciliary services were those with the lowest occupancy. Our estimates support that the vacancies (supply) are induced by the referrals (demand), and referrals are also related to the location of LTMHC facilities. Conclusion: LTMHC is still in the initial stage of development in Portugal, and it is expected to receive financial support through the Recovery and Resilience Programme. According to the occupancy rates and referrals made, residential structures seem to be a priority, being also important to explore the partial use of domiciliary services. The geographical distribution of vacancies can also be a concern, considering the important proximity to the community in LTMHC.