Sofia Ramos Ferreira

Background: Psychotic disorders such as schizophrenia (SCZ) have been frequently linked with oxidative stress, with uric acid (UA) levels being of particular interest, although evidence remains inconclusive. A possible reduction of UA levels in early phases of SCZ, namely first-episode psychosis (FEP), has been hypothesized. In this systematic review, we aimed to analyze and summarize current evidence regarding UA levels in patients with early psychosis. Methods: We conducted a systematic review of case-control studies comparing serum or plasma UA levels in individuals experiencing FEP with those in healthy controls (HC). Results: Eight studies met the inclusion criteria, with a total sample of 950 individuals that included 520 FEP patients and 430 HC. A tendency for lower UA levels in FEP was described, albeit without definitive evidence, and decreased UA levels were restricted to certain ethnic populations. Conclusions: Our findings do not fully support the hypothesis of an oxidative stress response in early psychosis translatable with reduced UA levels in patients with FEP. Further research is warranted to elucidate the nature and magnitude of the relationship between oxidative stress, UA levels, and early psychosis.

Desde que a doença causada pelo vírus SARS‑CoV‑2 foi declarada uma pandemia pela Organização Mundial de Saúde, diversos países adotaram medidas de distanciamento social para limitar a disseminação do vírus. Apesar destas medidas serem mecanismos preventivos essenciais, podem promover sentimentos de solidão e influenciar o surgimento ou a exacerbação de perturbações psiquiátricas. O conhecimento atual sobre o impacto da pandemia COVID‑19 na saúde mental ‑ e, em particular, na saúde mental dos idosos ‑ é ainda escasso. Com esta revisão não‑sistemática da literatura pretendemos analisar o impacto da pandemia COVID‑19, com especial ênfase nas medidas de confinamento adotadas, na saúde mental da população geriátrica e, adicionalmente, rever medidas passíveis de mitigar esse impacto. É possível um aumento de perturbação mentais subsequente à pandemia COVID‑19, podendo ser particularmente relevante em idosos. Diversas recomendações para manter a saúde física e mental dos idosos têm sido sugeridas, com ênfase em medidas não farmacológicas.

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a rare condition characterised by neuropsychiatric symptoms, presence of antithyroid antibodies and significant response to steroid therapy. Postpartum psychosis (PP), although having a low prevalence, is a psychiatrical emergency with potentially serious impact in the mother and children. PP has an atypical presentation when compared with affective or psychotic episodes unrelated to pregnancy. Autoimmune dysfunction is frequent in the postpartum period and is closely related to PP. We report a case of a primiparous woman in her 20s with PP who did not respond to initial treatment with antipsychotics. After reassessment, SREAT was considered in the differential diagnosis. Neuropsychiatric symptoms improved dramatically after 72 hours of treatment with high-dose steroids treatment and the patient was discharged after 16 days. In women with PP, an autoimmune cause must be ruled out before assuming a psychiatry aetiology.

Aim: Patients in early phases of schizophrenia or mood disorders with psychotic symptoms have a wide array of metabolic abnormalities. We analysed the potential predictive value of uric acid (UA) levels and other metabolic parameters in first‐episode psychosis patients to differentiate between non‐affective and affective psychosis.Methods: Retrospective chart review of all patients referenced to a first‐episode psychosis unit (n = 149), between 2012 and 2017, with available UA levels. Patients included (n = 37) were compared according to the follow‐up diagnosis of schizophrenia or mood disorder.Results: Mood disorder patients presented higher UA levels (p = .030) and lower fasting blood glucose levels (p = .020) compared with schizophrenia patients. The remaining variables did not show significant intergroup differences.Conclusions: Findings in this first‐episode psychosis cohort support previous evidence suggesting higher UA levels as a predictor of affective psychosis and glucose dysfunction as predictive of schizophrenia. Further studies are needed to explore metabolic parameters as possible diagnostic predictors in first‐episode psychosis.