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IntroductionSleep problems are a common presenting symptom of elderly patients to Primary care physicians and Psychiatrists. Almost half of seniors over age 65 who live at home are dissatisfied with their sleep, and nearly two-thirds of those residing in nursing home facilities suffer from sleep disorders. Chronic and pervasive sleep complaints and disturbances are frequently associated with excessive daytime sleepiness and may result in impaired cognition, diminished intellect, poor memory, confusion, and psychomotor retardation.ObjectivesThe aim of this article is to sumarize and explore the facts envolving sleep disorders, discusses approaches to treatment and highlights new research in the area of geriatric sleep disorders.MethodsAn online bibliographic search was carried out on PubMed and Medline using the keywords “Elderly”, “sleep” and “Psychiatry”.ResultsManagement of sleep disorders is complicated by the risk of side effects of pharmacologic treatment approaches, and thus nonpharmacologic strategies are preferred when possible. Additionally, many of the pharmacologic strategies used in treating younger adults have not been studied adequately in the geriatric population, and more specifically in patients with underlying cognitive disorders, making treatment choices difficult.ConclusionsThis review has provided insights into the biopsychosocial impact of sleep disorders in the elderly, as this group pose unique challenges for diagnosis and treatment. Sleep changes in the elderly may have a far broader impact on geriatric health than originally thought, with implications for AD and delirium, and further research is needed in these areas as well.

IntroductionObsessive-Compulsive Disorder (OCD) is a disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions). Since the COVID-19 pandemic started, a lot of people developed fears of contamination or being infected.ObjectivesTo describe a clinical case and discuss the diagnosis of Obsessive-Compulsive Disorder in context of COVID-19 pandemic.MethodsThe data was achieved through patient’s and his family. For the literature review we searched the terms: “OCD” and “COVID-19 Pandemic”.Results45 years-old, male, single. He has a generalised anxiety disorder since 2010. At July 2020, the patient asked for help due to worsening of symptoms. Before the appointment, he was waiting outside because he didn’t feel comfortable in the waiting room. When he touch anything unintentionally, he wash his hands immediately. Since the COVID-19 pandemic began, he stopped working because he was too afraid of being infected. He started to think a lot about SARS-COV2 contamination, avoiding all public places, depending on his mother and friends to do basic daily tasks. His thoughts led to cleaning and hand-washing rituals, spending a lot of time. Those symptoms are egodystonic, have a huge impact on global functioning and are not explained by normative fear or protection measures. During 10 years of psychiatric follow-up he never showed obsessive-compulsive symptoms.ConclusionsThis case is an example of OCD onset during the COVID-19 pandemic in a patient with an anxiety disorder (without previous obsessive-compulsive symptoms). He has improved after paroxetine 60mg and risperidone 1mg daily, as well as cognitive behaviour therapy weekly.DisclosureNo significant relationships.

Introduction: Previous epidemiological studies clearly demonstrated gender differences in the patterns of mental illness. As a matter of fact, female suffer more from depressive and anxiety disorders, while male suffer more from addictive behaviour and psychotic disorders. Objectives/aims: The present study was elaborated by the Psychiatric Department Quality Commission of the Coimbra University Hospital in order to identify gender differences in socio-demographic and clinical characteristics of patients that were hospitalized from January to June 2011. Methods: We analyzed 417 clinical files and gathered socio-demographic information (gender, age, marital status and job) and clinical information (diagnosis and hospitalization's length). Statistical analysis was performed with SPSS program, using the chi-square's and Mann-Whitney's tests. Results: 53% of the inpatients were women. It was also observed that women were older (p = 0.021), more frequently married and widowed (p < 0.001), were less associated with compulsory admission (p < 0.001), had shorter hospitalizations (p = 0.024) and were more often diagnosed with adjustment reaction and bipolar disorder (p < 0.001), while men were younger (p < 0.001), more frequently single (p < 0.001), more frequently unemployed (p < 0.001), were more subject to compulsory admission (p < 0.001) and were more often diagnosed with addictive disorders and schizophrenia. Conclusions: These results are consistent with the existing literature and enable us to organize the services'conditions according to the needs of our psychiatric inpatient population.

According to the Portuguese Mental Health Law (PMHL), compulsory admission (CA) may be used whenever someone bears a "severe psychic anomaly" which is causing, or may cause, danger to his own juridical rights or to those of others, given that the subject refuses adequate treatment. A psychiatric evaluation, in emergency settings, might be ordered by a judge through a warrant and a report must be sent to the court about the clinical need of CA. Objectives: Assess the appropriate use of PMLH in what refers to its legal and clinical aspects in the emergency room. We explored social-demographic and clinical variables of the subjects submitted to CA and studied the relation between the patients subjected to psychiatric evaluation by court order and those were actually compulsory admitted. Methods: We studied retrospectively, the clinical files of 4537 patients who attended the psychiatric emergency of the Coimbra University Hospital between January and June, 2010. Results: 1,3% of all patients were compulsory admitted, two thirds of which were male, half were unemployed or retired. 1,7% were subjected to psychiatric evaluation by court order, about 50% weren't admitted compulsory. The majority of warrants were issued because of aggressive behaviour or behavioural changes. The most frequent diagnosis in CA were schizophrenia and delusional disorders. Conclusions: Understanding CA patterns helps to identify possible misuses of the law and may serve to recognize subgroups of patients in need of specific interventions to prevent the use of judicial processes concerning psychiatric patients.