OBJECTIVES: 1 - Verify the prevalence of depressive symptoms in first to fourth-year medical students using the Beck Depression Inventory (BDI). 2 - Establish correlations between target factors and higher or lower BDI scores. 3 - Investigate the relationship between the prevalence of depressive symptoms and the demand for psychological care offered by the Centro Universitário Lusíada. METHOD: Cross-sectional study of 290 first to fourth-year medical students; implementation of the BDI, socio-demographic survey, and evaluation of satisfaction with progress. RESULTS: The study sample was 59% female and 41% male. Mean BDI was 6.3 (SD 5.8). Overall prevalence of depressive symptoms was 23.1%. The following associations were statistically significant (p<0.05): among students for whom the course failed to meet original expectations, who were dissatisfied with the course, or who came from the interior of the State (20.5%, 12.5%, and 24.4% of the total sample, respectively), for 40%, 36.1% and 36.4%, respectively, the BDI was consistent with some degree of depression. CONCLUSION: The study showed that there is higher prevalence of depressive symptoms in medical students than in the general population

IntroductionHikikomori, a form of severe social isolation, once characterized as a Japanese cultural-bond behavior with social and economic consequences, it is now being described in other countries. Its presentation mimics some clinical features of various classified mental diseases, such as prodromal phase of schizophrenia, personality disorders, Internet dependence, social phobia or depression, without fulfilling their defining criteria.Objectives/methodThis work aimed to do a brief review of this subject, describing one case that is probably the first ever reported in Portugal, comparing it with similar cases around the world.ResultsThe patient was a 22-year-old male, taken to psychiatry evaluation after 4 years of social withdrawal, avoiding or blocking any contact even with family members, which resulted in work and school impairment. He spent most of his days locked at his room, investing his time in particular interests and Internet use, only leaving to eat or do his basic hygiene. At that time, he presented no affective or psychotic symptoms and perceived his behavior as egosintonic. After six appointments with psychotherapeutic approach, he was able to get a job and improved his communication with the others, especially with family.Discussion/conclusionThis case fits most of the reports found on literature, in its presentation and clinical management. Hikikomori is not considered yet a disorder and further documentation of these cases is still needed to define its place in psychiatric nosology.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionNegative attitudes towards psychiatric patients still exist in our society. Persons suffering from mental illness frequently encounter public stigma and may internalize it leading to self-stigma. Discrimination occurs across many aspects of economic and social existence. It may represent a barrier for patients to receive appropriate care. Many anti-stigma campaigns have been taken to decrease people's prejudice, but its effects are not well documented.ObjectivesTo characterize anti-stigma initiatives and its effects on diminishing negative consequences of stigma.MethodsBibliographical research using PubMed using the keywords “stigma” and “mental illness”.ResultsDespite several approaches to eradicate stigma, it shows a surprising consistency in population levels. It was expected that focus on education would decrease stigma levels. The same was expected following concentration on the genetic causation of pathology. Most studies have revealed that education has little value and endorsing genetic attributions has led to a greater pessimism on the efficacy of mental health services, sense of permanence and guilty feelings within the family.ConclusionPublic stigma has had a major impact on many people with mental illness, especially when leading to self-stigma, interfering with various aspects in life, including work, housing, health care, social life and self-esteem. As Goffman elucidated, stigma is fundamentally a social phenomenon rooted in social relationships and shaped by the culture and structure of society. Social inclusion has been pointed as a potential direction of change.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionTinnitus is defined as the subjective or objective perception of a hearing sensation in the absence of a corresponding external stimulus. It is a very common medical symptom, and some studies show that 5 to 15% of adults had tinnitus in life. It is a condition that could be chronic and for some patients could be very debilitating. Anxiety and depression are common findings in patients with tinnitus. Tinnitus can also interfere with sleep and concentration and affect the quality of life of patients. The heterogeneity of the etiology, pathophysiology and clinical features of tinnitus probably exacerbate the variability of response to treatment of the population and the decision on the best treatment option could be complex.ObjectivesThe purpose of this study is try to understand how the psychotherapeutic interventions may be useful in the treatment of tinnitus.MethodsBibliographic research in Pubmed.ResultsCurrently there are no available effective pharmacological treatments. In some cases, surgical interventions may be effective with respect to ear pathology, but not to tinnitus. Most studies show that psychological interventions are needed to reduce the distress and the impact caused by tinnitus in patients’ lives and the cognitive-behavioral therapy is the primary therapeutic intervention in chronic tinnitus.ConclusionAlthough cognitive-behavioral techniques demonstrated to be effective in the treatment of the distress and impact caused by tinnitus, little is known about the mechanisms by which this technique achieves this effect, therefore most authors suggest that further studies should be conducted in this area.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe diagnosis of depressive disorders has suffered important modifications throughout DSM and ICD editions. The history of those modifications is an important subject to fully understand the current diagnostic criteria and classification, with milestones often set not by scientific or theoretical data but rather by political decision and conflicting interests.ObjectiveThe authors propose a review of how the concept of major depression has evolved along the several DSM and ICD editions.MethodsThe results were obtained searching literature included on the platforms PubMed, Google Scholar, PsycINFO and Psychology and Behavioral Sciences Collection.ResultsThe current diagnostic entity lacks validity and utility and that is an obstacle to both scientific research and clinical practice.ConclusionThe authors also discuss alternative models which may contribute to a paradigm shift more suitable to clinical reality and to provide a useful framework for all levels of research.Disclosure of interestThe authors have not supplied their declaration of competing interest.