IntroductionThe diagnosis of psychosis is based on the presence or absence of characteristic symptoms. The presence of such symptoms varies during the course and treatment, raising the question of diagnostic stability after a first psychotic episode.Aims and objectivesThe aim of this study is to evaluate the diagnostic stability after a first psychotic episode in the long term (five years after the first inpatient admission).MethodologyA retrospective study that included patients with first psychotic episode between 2007 and 2011 admitted to the inpatient unit of the psychiatry and mental health clinic of São João hospital center, Oporto, Portugal and re-evaluation of the diagnosis after five years.ResultsWe included 60 patients with a first psychosis episode, 22 of which were drop-outs after five years. Of the 38 patients evaluated, it was possible to see that after 5 years 68.4% (n = 26) maintained the same diagnosis during follow-up. In particular, the diagnosis of schizophrenia was kept in 83.3% of patients after 5 years (n = 15, 18 patients with the diagnosis of schizophrenia after first admission). Diagnosis of acute and transient psychotic disorder and psychosis not otherwise specified were the least stable diagnosis after 5 years.ConclusionsThe diagnosis after a first psychotic episode has important therapeutic and prognostic implications. The presence of characteristic symptomatology, with periods of partial or total remission between subsequent episodes emphasizes the need for regular monitoring, since this group of patients appears to be more vulnerable to changes in diagnosis over time.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe clinic of psychiatry and mental health of São João hospital centre (Oporto, Portugal) has implemented a psychiatric consultation to support college students since 2007. This consultation is open to all of the universities in the metropolitan area of Oporto.Aims/objectivesThis specific consultation aims to detect and intervene early in the treatment of psychiatric illness and to promote mental health in this specific population.MethodsRetrospective study conducted in the São João hospital centre, Oporto, Portugal. Patients attending university student's specific consultation between January 1st 2011 and March 31st 2016 were included. Data collection included sociodemographic variables, clinical diagnosis (ICD-10, WHO, 1992) and psychological scales (WAIS-III, BSI, HADS, SF-36 and NEO-PI-R). SPSS® software (v. 20.0, 2011) was used for statistical analysis.ResultsIn this study, 139 patients were included (66.2% female, medium age 23.1 years old). The majority of patients were medical, engineering or nursing students (respectively 20.9%, 18.0% and 17.9%). The most frequent diagnosis was adjustment disorders, anxiety disorders, mood disorders and personality disorders. 54.6% completed all the psychological scales.ConclusionsThe number of students with mental health issues is increasing. Early detection and treatment of these pathologies may allow improvements on the educational, economic and social levels, as well as in the quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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IntroductionHIV-infection is a very stigmatized, chronic disease with increased rates of psychiatric disorders, being major depression the most common.ObjectiveTo review the recent research related to depression in HIV-infected patients.MethodsLiterature review based on PubMed/Medline, using the keywords “HIV” and “depression”.ResultsHIV-infected patients have a chance 2-7 times higher of developing major depression, around the time of diagnosis or during the course of their illness. However, only fewer than 50% of the cases are recognized clinically. Several factors contribute to its under-recognition and under-treatment, such as the overlap between the neurovegetative symptoms of depression, the somatic symptoms of HIV disease, and the effects of comorbid diseases; the mistaken belief that depressive symptoms are expected in this group; the neuropsychiatric side effects associated with some antiretrovirals. Besides, major depression presents important diagnostic challenges due to biological, psychological, and social components associated with the infection. The authors will analyze the clinical presentation.Depression has been associated with a negative impact on quality of life, poorer HAART adherence, faster HIV disease progression and increased mortality risk. Importantly, however, appropriate psychiatric intervention can do it over. In fact, studies suggest that patients receiving SSRI treatments for depression have rates of adherence and CD4+ T-cell counts similar to non-depressed patients receiving HAART.ConclusionsThe high prevalence of major depression in HIV-positive individuals and its serious consequences if untreated, increase even further the importance of its effective identification and subsequent treatment in this group of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Background: For Bleuler, late-onset schizophrenia (LOS) was characterized by onset after age 40, symptoms similar to the classic form and absence of signs of organic brain disease. We aim to describe the current aetiology, diagnosis and treatment of LOS, emphasizing the differences between LOS and classic schizophrenia.Methods: Non-systematic review of original articles and systematic reviews regarding late-onset schizophrenia aetiology, diagnosis and treatment indexed to Pubmed, ISI -Web of Knowledge, Scopus and EBSCO published between January 1980 and December 2017, using the MeSH query: schizophrenia AND late onset disorders. Altogether, 62 articles were deemed relevant by two independent reviewers and included in the final selection.Results: 23% of the cases of schizophrenia have late-(> 40 years) or very late-onset (> 60 years), with higher incidence in females. Genetic factors, menopause, sensory deficits, vascular and neurodegenerative lesions, and age per se are risk factors. Higher educational levels and marital rates and greater cognitive reserve stand out. Well systematized persecutory and jealousy delusions and auditory hallucinations are common. On the contrary, negative symptoms are uncommon. Cognitive functions are well preserved in the first year, but high rates of dementia are described after fiveyear follow-up. Due to the protective effect of oestrogen, LOS appears to have a worse prognosis in postmenopausal women. Despite the anti-psychotic drugs available, most patients remain symptomatic. Conclusion:There is a significant overlap between early-onset schizophrenia and LOS/very-late onset schizophrenia-like psychosis (VLOSLP), but there are important differences mainly regarding risk factors and symptoms that cannot be overlooked. Seventy-five years after the first description, it is necessary to better define LOS/VLOSLP as a debate identity.