Objective: estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. Method: observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. Results: in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. Conclusion: anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it.

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IntroductionLate-onset psychoses are a heterogeneous group of disorders whose nosology has been controversial throughout history. Several methodological limitations have made difficult the comparison among studies and, as a consequence, the research interest has been little, leading to the absence of late-onset schizophrenia and paraphrenia in current official classifications.Aims and methodologyTo highlight the specific symptoms of late-onset schizophrenia as well as its differences with other psychoses though the study of a case report.ResultsA 70-year-old woman developed psychotic symptoms during the last seven years, consisting of auditory and olfactory hallucinations, telepathic phenomena and injury delusions, erotomania and thought control, with a high level of systematization and fantasy. She was admitted in an inpatient unit. She was treated with risperidone and the psychotic symptoms got better. At the time of hospital discharge, hallucinations and delusional thoughts had disappeared and no behavioral or emotional disorder was observed. Some weeks later, risperidone had to be substituted by paliperidone due to side effects, such as tremor, sialorrhea and parkinsonism.ConclusionsLate-onset schizophrenic psychosis is not as exceptional as it has been traditionally considered. One of the main problems is that current classifications do not include specific diagnostic categories for cases of late or very-late-onset psychoses. It would be necessary that future ICD-11 and DSM-V classifications will include different-age criteria when diagnosing mental disorders.

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