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Insomnia disorder has known striking developments over the last few years. Partly due to advances in neuroimaging techniques and brain sciences, our understanding of insomnia disorder has become more fine-tuned. Besides, developments within psychological and psychiatric fields have contributed to improve conceptualization, assessment, and treatment of insomnia. In this paper, we present a list of promising 10 key “hot-topics” that we think in the next 10 years will continue to stimulate researchers in insomnia’s domain: increasing of systematic reviews and meta-analyses; improvement of existing self-report measures; increasing of genetic and epigenetic investigation; research on new pharmacological agents; advances in neuroimaging studies and methods; new psychological clinical approaches; effectiveness studies of e-treatments and greater dissemination of evidence-based therapies for insomnia; call for integrative models; network approach using in insomnia; and assessment of insomnia phenotypes. The breadth of all these topics demands the collaboration of researchers from different scientific fields within sleep medicine. In summarizing, in the next decade, it is predictable that insomnia’s research still benefit from different scientific disciplines.

The present study aims to characterize the prevalence, the pattern of medically prescribed and over-the-counter medication/supplements in Higher Education students, as well as to relate the consumption of sleeping medication with insomnia severity, sleep effort, sleep locus of control, anxiety, and depression. Data was collected from a sample of 2029 Portuguese Higher Education students, aged ≥18 years old, being approximately 75% women and 25% men. Thirty-one percent of the sample considered suffering from insomnia, 6% consumed sleeping medication prescribed by a physician, 4% consumed OTC (over-the-counter) medication/supplements, and 2% undergone psychotherapy. Among the Higher Education students with insomnia, 19% reported consuming sleep medication prescribed by a physician, benzodiazepines were the most prescribed drug class, and the General Practitioner the physician who prescribed most frequently. Twelve percent of students with insomnia consumed OTC medication/supplements, with Valerian being the most consumed substance. Among students with insomnia, only 8% undergone psychotherapy.

This study aimed primarily to compare the parent-reported sleep of children with ICD-10 hyperkinetic disorder (HKD) versus community children. Thirty children aged 5-13 years (83.3% boys) diagnosed with HKD by their child and adolescent psychiatrists took part in this study, plus 30 community children, matched for sex, age, and school year. Compared to the controls, the HKD children showed significantly later bedtimes, stronger bedtime resistance, longer sleep latency, shorter sleep; more frequent behaviors and symptoms concerning falling asleep into parents bed, needing something special to initiate sleep, nightmares, sleep talking, sleep bruxism, fear from darkness, bedwetting, and, most notably, loud snoring (26.7%); they also tended to show higher daytime somnolence. Attention deficit/hyperactivity disorder (ADHD)/HKD children may thus have more sleep-related problems than typically developing children. Alternatively, our results may reflect misdiagnoses; thus, special attention should be directed to comorbidity and differential diagnosis issues between sleep disturbances and ADHD/HKD.

Objective: To investigate the predictive/protective role of negative affect/positive affect in late pregnancy on the outcome of postpartum depression.Methods: A total of 491 pregnant women participated in the study. The participants were asked to fill out a series of questionnaires, which included the Profile of Mood States, the Beck Depression Inventory-II, psychosocial variables and socio-demographic characteristics and were asked to participate in a psychiatric interview. After delivery, 272 mothers participated again in the study and filled out a similar series of questionnaires.Results: Negative affect was associated with more intense depressive symptomatology, more self-perceived stress, lower self-reported social support, lower quality of life and perception of having a more difficult infant. By contrast, positive affect was negatively associated with these variables. Negative affect in late pregnancy increased the likelihood of experiencing postpartum depression (DSM-IV/OR = 2.1, 95%CI = 1.3-3.4, p = .003; ICD-10/OR = 2.1, 95%CI = 1.5-3.0, p < .001), while positive affect increased the odds of not having this condition (DSM-IV/OR = 2.0, 95%CI = 1.5-2.7, p = .042).Conclusion: In pregnancy, negative affect was a predictor of postpartum depression, whereas positive affect showed a protective role. Future studies are required to explore whether psychotherapeutic strategies focusing on decreasing negative affect and enhancing positive affect in the last trimester of pregnancy can reduce the risk of postpartum depression.

The aims of the present study were to develop three shorter forms of the Portuguese version of the Postpartum Depression Screening Scale (PDSS) as adapted and translated in Portugal, to analyse their psychometrics and to determine their cut-off points and associated conditional probabilities to screen for perinatal depression according to DSM-IV and ICD-10 criteria. In this study, 441 women in the third trimester of pregnancy and 453 in the third month of postpartum were interviewed for diagnostic purposes according to the Portuguese versions of the Diagnostic Interview for Genetic Studies and the Operational Criteria Checklist for Psychotic Illness. DSM-IV and ICD-10 classifications of depression were our gold standards for caseness. Three different shorter forms of the original Portuguese version of the PDSS were developed on the basis of reliability and factorial analysis. PDSS short versions, composed of seven and 21 (postpartum)/24 (pregnancy) items, presented significant reliability and validity and showed satisfactory combinations of sensitivity and specificity (≅80 %). The short forms of the original Portuguese version of the PDSS are valid alternatives to the 35-item version, given their equally precise screening performances, more concise structures and ease of completion.

BACKGROUND: The Eating Attitudes Test (EAT) is the most widely used instrument for evaluating eating disorders in adults and adolescents in a variety of cultures and samples. OBJECTIVE: The aim of this study was to analyse the psychometric properties of the Portuguese version of the Children's Eating Attitudes Test (ChEAT). METHOD: Nine hundred and fifty-six Portuguese secondary students (565 girls and 391 boys) answered the ChEAT. The test-retest reliability was obtained with data from 206 participants from the total sample who re-answered the questionnaire after 4-6 weeks. Psychometric analyses were carried out for the total sample and separately for girls and boys. RESULTS: Internal consistency and test-retest reliability were satisfactory. Principal components factorial analysis yielded four factors in the total sample, accounting for 42.35% of the total variance. Factor structure was similar in the total sample and in both genders. Factors were labelled: F1 "Fear of Getting Fat", F2 "Restrictive and Purgative Behaviours", F3 "Food Preoccupation" and F4 "Social Pressure to Eat". The concurrent validity, explored using the Contour Drawing Figure Rating Scale (CDRS) was high. DISCUSSION: The Portuguese version of the ChEAT is a valid and useful instrument for the evaluation of abnormal eating attitudes and behaviours among Portuguese adolescents. CONTEXTO: O Teste de Atitudes Alimentares é o instrumento mais utilizado para avaliar distúrbios alimentares em adultos e adolescentes em uma variedade de culturas e amostras. OBJETIVO: O objetivo deste estudo foi avaliar as propriedades psicométricas da versão portuguesa da Escala de Atitudes Alimentares para Crianças (ChEAT). MÉ;TODO: Novecentos e cinquenta e seis alunos do ensino secundário (565 moças e 391 moços) responderam ao ChEAT. O cálculo da fidelidade teste-reteste foi feito por meio das respostas de 206 participantes da amostra total que voltaram a responder ao questionário após quatro a seis semanas. As análises psicométricas foram realizadas para o total da amostra e para ambos os sexos separadamente. RESULTADOS: A consistência interna e a fidelidade teste-reteste foram satisfatórias. A análise fatorial em componentes na amostra total resultou em quatro fatores que explicam 42,35% da variância total. A composição dos fatores foi semelhante na amostra total e em ambos os sexos. Os fatores denominaram-se: F1 "Medo de Engordar"; F2 "Comportamentos Restritivos e Purgativos"; F3 "Preocupação com a Comida" e F4 "Pressão Social para Comer". A validade concorrente foi explorada com a Escala de Silhuetas Corporais (CDFRS) e foi elevada. CONCLUSÃO: A versão portuguesa do ChEAT é um instrumento útil e válido para a avaliação de atitudes e comportamentos alimentares em adolescentes portugueses.

OBJECTIVE: To evaluate the degree of absolute change, relative stability and state dependence of trait perfectionism in sleep disturbances in a sample of university students. METHOD: Participants completed the Multidimensional Perfectionism Scale and two items concerning sleep difficulties. The mean age at T0 (baseline) was 19.59 years (SD = 1.61, range = 17-25) and 62.5% of the sample were female. RESULTS: Absolute changes in self-oriented and socially-prescribed perfectionism were found. Relative stability was found for all perfectionism dimensions. Prior and concurrent sleep disturbances explained a significant amount of variance in perfectionism. Controlling for the effects of sleep measures, prior selforiented perfectionism and other-oriented perfectionism were the only significant predictors of subsequent self-oriented perfectionism and otheroriented perfectionism, at T1 and T2. Difficulties falling asleep at T1 and socially-prescribed perfectionism at T0 were significant predictors of socially-prescribed perfectionism at T1. CONCLUSION: Despite significant changes in perfectionism mean scores over the follow-up, the correlation analyses demonstrated that participants remained quite stable in regard to their relative levels of perfectionism. As concurrent difficulties initiating sleep also predicted concurrent socially-prescribed perfectionism, this seems to be one dimension of perfectionism with trait-state characteristics. OBJETIVOS: Avaliar o grau de mudança absoluta, de estabilidade relativa e dependência do estado do perfeccionismo nas perturbações de sono numa amostra de estudantes universitários. MÉTODO: Os sujeitos completaram a Escala Multidimensional do Perfeccionismo e dois itens sobre dificuldades em dormir. Os dados foram recolhidos em três momentos de avaliação, separados por um intervalo de um ano acadêmico. A idade média dos sujeitos noT0 era de 19,59 anos (DP = 1,61, variação = 17-25); 62,5% eram mulheres. RESULTADOS: Foram encontradas ao longo do follow-up mudanças absolutas para o Perfeccionismo Autoorientado e para o Perfeccionismo Socialmente Prescrito. Foi encontrada estabilidade relativa para todas as dimensões do perfeccionismo. As dificuldades de sono prévias e concorrentes explicaram significativamente a variância do perfeccionismo. Controlando o efeito das dificuldades em dormir, o Perfeccionismo Autoorientado e o POO prévios foram os únicos preditores significativos de Perfeccionismo Autoorientado e POO subsequente (T1 e T2). As dificuldades em iniciar o sono no T1 e o Perfeccionismo Socialmente Prescrito prévio (T0) revelaram-se preditores significativos dePerfeccionismoSocialmente PrescritonoT1. CONCLUSÃO: Apesar das mudanças significativas nas pontuações médias de perfeccionismo ao longo do follow-up, as análises de correlação demonstraram que os participantes permaneceramrelativamenteestáveisnosseusníveisdeperfeccionismo.Umavezque asdificuldades em iniciar o sono concorrentes serevelaram um preditor significativo de Perfeccionismo Socialmente Prescrito, o Perfeccionismo Socialmente Prescrito é a dimensão do perfeccionismo que possui características traço-estado.

This study investigates the association between sleep disturbances, body mass index (BMI) and eating behaviour in a sample of undergraduate students. The sample comprises 870 medicine and dentistry students from Coimbra University (62.5% females), aged between 17 and 25 years. The Eating Attitudes Test-40 was used to measure eating behaviour, and two questions were applied addressing difficulties of initiating sleep (DIS) and difficulties of maintaining sleep (DMS). A sleep disturbance index (SDI) was calculated from the sum of DIS and DMS scores. Body mass index (BMI) was determined from self-reported weight and height. The correlation analyses generally indicated that global eating disturbance, bulimic behaviour dimension and social pressure to eat were associated particularly with sleep difficulties. An association between diet concerns and sleep difficulties was less consistent. Regression analyses showed that bulimic behaviour (BB) and social pressure to eat (SPE) dimensions were associated significantly with sleep difficulties (DIS, DMS, SDI) in the total sample (BB: from P

The aim of the present study was to analyse whether the Portuguese version of the Postpartum Depression Screening Scale (PDSS) was a valid instrument for screening postpartum depression. For this purpose the following objectives were delineated: (1) to analyse PDSS psychometric properties; (2) to determine PDSS cut-off points and associated conditional probabilities for screening depression according to DSM-IV and ICD-10 criteria; and (3) to compare the performance of PDSS with the Beck Depression Inventory-II (BDI-II) in screening for postpartum depression. Four hundred eighty-six 3-months-postpartum women completed both questionnaires and were interviewed with the Portuguese version of Diagnostic Interview for Genetic Studies (DIGS). The Portuguese version of the operational criteria checklist for psychotic illness (OPCRIT) was used to obtain DSM-IV and ICD-10 diagnoses of depression, our gold standards for caseness. PDSS reliability and validity were very good and equivalent to those reported in other versions, including the original. PDSS was an accurate screening instrument for postpartum depression, showing satisfactory combination of sensitivity and specificity (80%). Compared to BDI-II it has the advantage of being more specific for the motherhood context. PDSS could be very useful for clinical and epidemiological purposes.

The purpose of the present study was to investigate the factor structure of the Beck Depression Inventory-II (BDI-II) in pregnancy and postpartum. Women were asked to fill in the BDI-II in their last trimester of pregnancy and at 3 months after delivery. A total of 331 pregnant women, with a mean age of 29.7 years (SD = 4.6), and 354 mothers, aged 30.6 years (SD = 4.6 years), answered the BDI-II. The first group was mainly nulliparas (65.6%) and the second group was mostly primiparas (57.4%). Factor analyses with principal components solution and varimax rotation were performed. Based on the scree test of Cattell a 2-factor solution and a 3-factor solution were explored. The 2-factor solution was identical in pregnancy and postpartum. Items loading in the Cognitive–Affective factor and in the Somatic–Anxiety factor were almost the same, though the Cognitive–Affective factor explained more of the BDI-II total variance in pregnancy, whereas in postpartum both factors explained similar total variances. The 3-factor solution of the BDI-II in pregnancy and postpartum slightly diverged. Besides the Cognitive–Affective and the Somatic–Anxiety factors, a third factor, Fatigue, was obtained in pregnancy while Guilt was the third factor identified in postpartum. This study reveals that the BDI-II 3-factor solution might be more appropriate to assess depressive symptoms in pregnancy and postpartum.

In this study, our aim was to explore the relationship between sleep quality/quantity, chronotype, pre-sleep arousal, arousability, stress, coping, neuroticism, extraversion, mood/affect, perceived health and sleep loss due to worry in college students. A total of 713 students (mean age 19.29 ± 1.256 years) completed a set of questionnaires that assessed sleep loss over worry (item from the General Health Questionnaire), other sleep–wake aspects (e.g., habitual sleep duration, sleep needs, sleep depth, subjective sleep quality, sleep latency, night awakenings, daytime sleepiness, sleep flexibility, sleep reactivity to stress), pre-sleep arousal (cognitive/somatic arousal), arousability, coping, neuroticism, extraversion, perceived physical/mental health, academic stress and positive/negative affect. Sleep disturbance due to worry was reported by 40.6 % of female and 19.2 % of male students. It was significantly correlated with perceived health and the majority of sleep–wake variables. Almost all correlations between the psychological traits under study and sleep loss over worry were significant. Results from the stepwise regression analyses, however, showed that only cognitive arousal (β = .353; p

Background: A long-standing epidemiological puzzle is the reduced rate of rheumatoid arthritis (RA) in those with schizophrenia (SZ) and vice versa. Traditional epidemiological approaches to determine if this negative association is underpinned by genetic factors would test for reduced rates of one disorder in relatives of the other, but sufficiently powered data sets are difficult to achieve. The genomics era presents an alternative paradigm for investigating the genetic relationship between two uncommon disorders. Methods: We use genome-wide common single nucleotide polymorphism (SNP) data from independently collected SZ and RA case-control cohorts to estimate the SNP correlation between the disorders. We test a genotype X environment (GxE) hypothesis for SZ with environment defined as winter- vs summer-born. Results: We estimate a small but significant negative SNP-genetic correlation between SZ and RA (−0.046, s.e. 0.026, P = 0.036). The negative correlation was stronger for the SNP set attributed to coding or regulatory regions (−0.174, s.e. 0.071, P = 0.0075). Our analyses led us to hypothesize a gene-environment interaction for SZ in the form of immune challenge. We used month of birth as a proxy for environmental immune challenge and estimated the genetic correlation between winter-born and non-winter born SZ to be significantly less than 1 for coding/regulatory region SNPs (0.56, s.e. 0.14, P = 0.00090). Conclusions: Our results are consistent with epidemiological observations of a negative relationship between SZ and RA reflecting, at least in part, genetic factors. Results of the month of birth analysis are consistent with pleiotropic effects of genetic variants dependent on environmental context. Refereed/Peer-reviewed

G.B. and S.N. acknowledge funding support for this work from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. P.H.L. is supported by US National Institute of Mental Health (NIMH) grant K99MH101367. Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from over 60,000 participants from the Psychiatric Genomics Consortium. We developed an analysis framework to rank pathways that requires only summary statistics. We combined this score across disorders to find common pathways across three adult psychiatric disorders: schizophrenia, major depression and bipolar disorder. Histone methylation processes showed the strongest association, and we also found statistically significant evidence for associations with multiple immune and neuronal signaling pathways and with the postsynaptic density. Our study indicates that risk variants for psychiatric disorders aggregate in particular biological pathways and that these pathways are frequently shared between disorders. Our results confirm known mechanisms and suggest several novel insights into the etiology of psychiatric disorders. Postprint

AM Vicente - Cross-Disorder Group of the Psychiatric Genomics Consortium Most psychiatric disorders are moderately to highly heritable. The degree to which genetic variation is unique to individual disorders or shared across disorders is unclear. To examine shared genetic etiology, we use genome-wide genotype data from the Psychiatric Genomics Consortium (PGC) for cases and controls in schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). We apply univariate and bivariate methods for the estimation of genetic variation within and covariation between disorders. SNPs explained 17-29% of the variance in liability. The genetic correlation calculated using common SNPs was high between schizophrenia and bipolar disorder (0.68 ± 0.04 s.e.), moderate between schizophrenia and major depressive disorder (0.43 ± 0.06 s.e.), bipolar disorder and major depressive disorder (0.47 ± 0.06 s.e.), and ADHD and major depressive disorder (0.32 ± 0.07 s.e.), low between schizophrenia and ASD (0.16 ± 0.06 s.e.) and non-significant for other pairs of disorders as well as between psychiatric disorders and the negative control of Crohn's disease. This empirical evidence of shared genetic etiology for psychiatric disorders can inform nosology and encourages the investigation of common pathophysiologies for related disorders.

Introduction Socially prescribed perfectionism has been associated with long-term sleep disturbances (Azevedo et al., 2010). Objective To investigate the association between perfectionism dimensions and insomnia in pregnancy. Methods 581 pregnant women, mean age 29.8 years (SD=4.5), average weeks of gestation 32.6 (SD=3.5), mostly married (75%) and nulliparae (64%) participated in the study. The multidimensional perfectionism scale (Hewitt and Flett, 1991; Soares et al., 2003) was used to assess total levels of perfectionism, self-oriented perfectionism (SOP) and dimensions of socially prescribed perfectionism (SPP): others high expectations (OHE) and conditional acceptance (CA) (Macedo et al., 2009). Insomnia symptoms and related daytime impairment were assessed with an insomnia questionnaire (Marques et al., 2011). Objective estimations of sleep were obtained through actigraphy in a small group (n=60). Results In comparison to good sleepers, insomniacs showed higher levels of SPP (M=53.4, SD=13.0 versus M=49.6, SD=12.3, p Conclusion Conditional acceptance is the SPP perfectionism sub-dimension particularly associated with self-reported insomnia and sleep alterations measured objectively with actigraphy in pregnancy. Financial support Portuguese foundation for science and technology (POCI/SAU-ESP/57068/2004).

Background Prior genome-scans of bipolar disorder have revealed chromosome 6q22 as a promising candidate region. However, linkage disequilibrium (LD) mapping studies have yet to identify replicated susceptibility loci. Methods We analyzed 1,422 LD-tagging single nucleotide polymorphisms (SNPs) in 83 genes to test single-marker and locus-wide evidence of association with bipolar disorder in the NIMH Genetics Initiative bipolar pedigrees and the Portuguese Island Collection (PIC) (N = 1,093 in 528 informative pairs). Both studies previously demonstrated significant evidence of linkage to 6q. SNPs were genotyped using an Illumina iSelect genotyping array which employs the Infinium assay. Evidence of single-marker association was assessed using the generalized disequilibrium test (GDT). Empirical estimates of gene-wide significance were obtained by permutation (via 100,000 gene-dropping simulations) of Fisher's combined test of P-values for each locus. Results No single variant yielded significant experiment-wide evidence of association, for either the combined sample or in each subsample. Our gene-dropping simulations identified nominally significant gene-wide associations with multiple loci, of which NT5DC1 in the NIMH subsample and CCNC in the PIC were the strongest candidates. However, no one gene consistently exceeded empirical significance criteria in both independent samples or survived Bonferroni correction for the number of genes tested. Conclusions Using a gene-based approach to family-based association, we identified gene-wide associations with several genes, though no single locus was significantly associated with bipolar disorder in both cohorts. This suggests that chromosome 6q may harbor multiple susceptibility loci or that complex patterns of LD in this region may confound approaches based on common SNPs. Published 2013. This article is a U.S. Government work and is in the public domain in the USA

Thyroid hormones are crucial during development and in the adult brain. Of interest, fluctuations in the levels of thyroid hormones at various times during development and throughout life can impact on psychiatric disease manifestation and response to treatment. Here we review research on thyroid function assessment in schizophrenia, relating interrelations between the pituitary-thyroid axis and major neurosignaling systems involved in schizophrenia’s pathophysiology. These include the serotonergic, dopaminergic, glutamatergic, and GABAergic networks, as well as myelination and inflammatory processes. The available evidence supports that thyroid hormones deregulation is a common feature in schizophrenia and that the implications of thyroid hormones homeostasis in the fine-tuning of crucial brain networks warrants further research., The present work was supported by Grant POCI/SAUESP/58757/2004 from the Portuguese Science Foundation (FCT/FEDER). NCS was supported by the fellowship SFRH/ BPD/51057/2010 by FCT.

Recent family and genome-wide association studies strongly suggest shared genetic risk factors for schizophrenia (SZ) and bipolar disorder (BP). However, linkage studies have not been used to test for statistically significant genome-wide overlap between them. Forty-seven Portuguese families with sibpairs concordant for SZ, BP, or psychosis (PSY, which includes either SZ or psychotic BP) were genotyped for over 57,000 markers using the Affymetrix 50K Xba SNP array. NPL and Kong and Cox LOD scores were calculated in Merlin for all three phenotypes. Empirical significance was determined using 1,000 gene-dropping simulations. Significance of genome-wide genetic overlap between SZ and BP was determined by the number of simulated BP scans having the same number of loci jointly linked with the real SZ scan, and vice versa. For all three phenotypes, a number of regions previously linked in this sample remained so. For BP, chromosome 1p36 achieved significance (11.54-15.71 MB, LOD = 3.51), whereas it was not even suggestively linked at lower marker densities, as did chromosome 11q14.1 (89.32-90.15 MB, NPL = 4.15). Four chromosomes had loci at which both SZ and BP had NPL ≥ 1.98, which was more than would be expected by chance (empirical P = 0.01 using simulated SZ scans; 0.07 using simulated BP scans), although they did not necessarily meet criteria for suggestive linkage individually. These results suggest that high-density marker maps may provide greater power and precision in linkage studies than lower density maps. They also further support the hypothesis that SZ and BP share at least some risk alleles. info:eu-repo/semantics/publishedVersion

Objectives The main objective was to investigate the association between perfectionism and eating behaviour in a non-clinical sample of adolescents of both genders. Method 997 middle and high school students completed the Portuguese versions of the child-adolescent perfectionism scale (CAPS) and of the eating attitudes test -25 (EAT- 25). Results In both genders, the perfectionism total score and the sociallyprescribed perfectionism (SPP) score were positive and significantly correlated with the EAT total score and with all EAT dimensions: Drive for Thinness (DT), Bulimic Related Behaviour (BRB), Social Pressure to Eat (SPE). In girls, self-oriented perfectionism (SOP) was also associated with the EAT total score and its dimensions, whereas in boys it was only associated with EAT total score and DT. In both genders SPP was a useful predictor of the EAT-25 total score and of all its dimensions. In which respects SOP, there were some gender differences showing that in boys this dimension should not be considered a predictor of eating behaviours. Conclusion These results confirm that high levels of perfectionism (SOP and SPP) are associated with abnormal eating behaviour in both genders. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.

The purpose of the study was to analyse for the first time the validity of a slightly modified version of the Portuguese Postpartum Depression Screening Scale (PDSS), to be used as a screening instrument for antenatal depression. Specifically, the aims were to analyse its psychometric properties, to determine PDSS cutoff points and associated conditional probabilities to screen for depression according to DSM-IV and ICD-10 criteria and to compare its screening performance with that of the Beck Depression Inventory-II (BDI-II). Five hundred and three pregnant women in the third trimester of pregnancy completed both questionnaires and were interviewed face-to-face with the Portuguese version of the Diagnostic Interview for Genetic Studies. The Portuguese version of the Operational Criteria Checklist for Psychotic Illness was used to obtain DSM-IV and ICD-10 diagnoses of depression, our gold standards for caseness. PDSS reliability and validity were very good and comparable to those obtained in the postpartum validation studies developed in Portugal and in other countries, showing satisfactory sensitivity and specificity combinations (≅80%). Compared with BDI-II, it has the advantage of being more specific for the motherhood context. Although developed for postpartum depression, PDSS is accurate to screen for antenatal depression, and it could be very useful for clinical and epidemiologic purposes.

To examine if perfectionism predicts self-reported sleep disturbances over time.The Hewitt-Flett Perfectionism Scale was used to assess self-oriented, socially-prescribed (SPP) and other-oriented perfectionism. Sleep disturbance was evaluated with two items: difficulty in falling asleep and waking up many times during the night. Out of 870 students who participated at baseline, 592 and 305 completed the same measures 1 year (T1) and 2 years later (T2), respectively.Subjects who reported insomnia at baseline, T1 and T2 (persistent insomnia) had significantly higher scores of baseline SPP (T1 M = 51.5, SD = 15.8; T2 M = 55.0, SD = 19.0) than subjects reporting, in all stages of the study, never/rarely having had sleep problems (T1 M = 41.9, SD = 11.4; T2 M = 42.2, SD = 12.3, P0.001 in both cases). Regression analyses showed that baseline SPP was the only significant positive predictor of difficulties in falling asleep at T1 and T2 (T1 partial R=0.187; T2 partial R=0.196, P0.001) and of difficulties maintaining sleep (T1 partial R=0.116; T2 partial R=0.244, P0.001).SPP was found to be the most reliable predictor of sleep disturbances over time, which constitutes a new important finding.

Objective: The main aims of this article are twofold. First, to assess perfectionism dimensions in obsessive-compulsive disorder and eating disorders in comparison with psychiatric control (depression/anxiety) and non-clinical control groups. Second, to examine if perfectionism is specifically related to these different clinical conditions. Method: Thirty-nine outpatients with obsessive-compulsive disorder, 24 outpatients with eating disorders, 65 outpatients with a diagnosis of depression and/or anxiety, and 70 non-clinical participants completed the Portuguese version of the Multidimensional Perfectionism Scale. Results: Compared to non-clinical subjects, individuals of all clinical samples had significantly higher scores on Multidimensional Perfectionism Scale total score, Self-Oriented and Socially-Prescribed Perfectionism. There were no significantly differences in Self-Oriented Perfectionism and Multidimensional Perfectionism Scale total score in all the three clinical samples. Subjects from the eating disorders sample had significantly higher scores of Socially-Prescribed Perfectionism in comparison to obsessive-compulsive disorder and psychiatric control samples. Conclusion: Perfectionism showed to be related with this broad range of psychopathologies. However, the differences between eating disorders versus obsessive-compulsive disorder and psychiatric control on Socially-Prescribed Perfectionism warrant further investigation in order to clarify the specificity of this perfectionism dimension in eating disorders. Descriptors: Personality; Obsessive-compulsive disorder; Eating disorders; Depression; Anxiety

The main purpose of the present research was to explore gender-related associations between sleep disturbance and perfectionism dimensions in a large sample of undergraduate students. Perfectionism dimensions have been assessed using the Portuguese version of the Multidimensional Perfectionism Scale (Hewitt and Flett, 1991 , J Pers Soc Psychol 60:456; Soares et al., 2003 , Rev Port Psicossom 5:46) and sleep disturbance with two items concerning difficulties initiating sleep and difficulties maintaining sleep. A total of 1163 undergraduate students of both genders between 17 and 25 years of age completed the scale. Results from correlational and categorial analyses indicated that socially prescribed perfectionism was the only dimension associated with sleep disturbance in undergraduate students of both genders. Males with the highest levels of socially prescribed perfectionism were approximately twice more likely to report sleep disturbances than those with less socially prescribed perfectionism. Similar results were found within the female sample. Implications for future research and clinical practice are discussed.

The neurogranin (NRGN) gene produces a postsynaptic brain-specific protein that regulates calmodulin-Ca(2+) availability in neurons. Acting downstream of the NMDA receptor and upstream of calcineurin and other proteins implicated in schizophrenia, NRGN is a good candidate for association studies in schizophrenia. NRGN expression is regulated during development and is modulated by thyroid hormones and retinoids, molecules essential for the proper development of the central nervous system. Given the genetic complexity of schizophrenia and the potential genetic heterogeneity in different populations, we studied a possible association of NRGN with schizophrenia in 73 Azorean proband-parent triads and in two independent case-control samples from the Portuguese-mainland (244 schizophrenic and 210 controls) and Brazil (69 schizophrenic and 85 mentally healthy individuals). Genotype distribution showed association of the rs7113041 SNP with schizophrenia in males of Portuguese origin, which was confirmed by the analysis of the proband-parent triads. This evidence, implicating NRGN in schizophrenia, introduces another player into the glutamatergic hypothesis of schizophrenia., Fundação para a Ciência e Tecnologia/FEDER (Portugal) grant POCTI/35837/MGI/2000 and POCI/SAU-ESP/58757/2004. D. Ruano is a recipient of a fellowship (SFRH/BD/8659/2002) from Fundação para a Ciência e a Tecnologia (FCT), Portugal

Objectives: The main objective was to explore which are the dimensions of perfectionism that are linked to disordered eating behaviour (EB) in a large non-clinical sample of both genders. Method: One thousand one hundred and sixty-three undergraduate students of the University of Coimbra completed the Portuguese versions of the multidimensional perfectionism scale (MPS) and the eating attitudes test (EAT-40). Results: In both genders, the MPS total score was associated with the EAT total score and all EAT dimensions (except for socially prescribed perfectionism in females). Self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) were associated with EAT total score, diet concerns (DC) and bulimic behaviour (BB) in females while in males the social prescribed perfectionism (SPP) was the useful predictor of EAT total score, BB and social pressure to eat (SPE). Conclusion: These results confirm that in general high levels of perfectionism are associated with abnormal EB. This was the case for both genders for SPP but for SOP for females only. The association for other oriented perfectionism (OOP) was greater for males than for females. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.

Several observations point to the involvement of disturbed lipid biology in schizophrenia. Reduced response to niacin flushing test, which involves vasodilatation induced by prostaglandin D2 (PGD2), is among the evidences, together with decreased CSF levels of lipocalin-type prostaglandin D2 synthase (PTGDS), the enzyme responsible for the synthesis of PGD2 in the brain. Since PTGDS is also a carrier for lipophilic molecules such as retinoids and thyroid hormones, altered PTGDS levels might influence both PGD2-mediated signaling, and vitamin A and thyroid hormone availability. To test whether genetic variants of PTGDS are involved in the etiology of schizophrenia, we searched for variants in the coding and regulatory regions of the gene. We identified four previously described polymorphisms. Using two case-control samples from Portugal and Brazil, none of the polymorphisms tested was associated with the disease. In addition, no transmission distortion was observed in an independent parents-offspring sample from the Azorean Islands. Our data do not support the involvement of the PTGDS gene in the etiology of schizophrenia., FEDER and Fundação para a Ciência e a Tecnologia (Portugal). Grant Number: POCTI/SAU‐ESP/58757/2004 and POCTI/35837/MGI/2000

It has been proposed that schizophrenia results from an environmental insult in genetically predisposed individuals. Environmental factors capable of modulating transcriptional activity and their carriers could link the genetic and environmental components of schizophrenia. Among these is transthyretin (TTR), a major carrier of thyroid hormones and retinol-binding protein (RBP). Retinoids and thyroid hormones regulate the expression of several genes, both during development and in the adult brain. Decreased TTR levels have been reported in the cerebrospinal fluid of patients with depression and Alzheimer's disease, and the absence of TTR influences behavior in mice. DNA variants capable of altering TTR ability to carry its ligands, either due to reduced transcription of the gene or to structural modifications of the protein, may influence development of the central nervous system and behavior. In the present study we searched for variants in the regulatory and coding regions of the TTR gene, and measured circulating levels of TTR and RBP. We found a novel single nucleotide polymorphism (SNP), ss46566417, 18 bp upstream of exon 4. Neither this SNP nor the previously described rs1800458 were found associated with schizophrenia. In addition, serum TTR and RBP levels did not differ between mentally healthy and schizophrenic individuals. In conclusion, our data does not support an involvement of the TTR gene in the pathophysiology of schizophrenia., This work was supported by Grant POCTI/35837/MGI/2000 from Fundação para a Ciência e a Tecnologia/FEDER. Dina Ruano is a recipient of a fellowship (SFRH/BD/8659/2002) from Fundação para a Ciência e a Tecnologia (FCT), Portugal.

The human p53 tumor suppressor gene (TP53) is considered as a candidate susceptibility gene for schizophrenia because of its functions in neurodevelopment. To test for an association between TP53 and schizophrenia, both the case–control study and the transmission disequilibrium test (TDT) were performed on genotype data from eight polymorphisms in TP53. Our samples included 286 Toronto schizophrenia cases and 264 controls, and 163 Portuguese nuclear families. In the Toronto case–control study significant differences of allele frequencies of the CAA Ins/Del ( p = 0.027) and the 16 bp Ins/Del ( p = 0.022) were detected. In TDT analysis we found significant differences for transmission of the CAA Ins/Del ( p = 0.017) in Portuguese schizophrenia families. Haplotype analysis also showed a significant association between TP53 and schizophrenia. These results provide further evidence that TP53 may play a role in the pathogenesis of schizophrenia.

Schizophrenia is a common, multigenic psychiatric disorder. Linkage studies, including a recent meta-analysis of genome scans, have repeatedly implicated chromosome 8p12-p23.1 in schizophrenia susceptibility. More recently, significant association with a candidate gene on 8p12, neuregulin 1 (NRG1), has been reported in several European and Chinese samples. We investigated NRG1 for association in schizophrenia patients of Portuguese descent to determine whether this gene is a risk factor in this population. We tested NRG1 markers and haplotypes for association in 111 parent-proband trios, 321 unrelated cases, and 242 control individuals. Associations were found with a haplotype that overlaps the risk haplotype originally reported in the Icelandic population ("Hap(ICE)"), and two haplotypes located in the 3' end of NRG1 (all P0.05). However, association was not detected with Hap(ICE) itself. Comparison of NRG1 transcript expression in peripheral leukocytes from schizophrenia patients and unaffected siblings identified 3.8-fold higher levels of the SMDF variant in patients (P=0.039). Significant positive correlations (P0.001) were found between SMDF and HRG-beta 2 expression and between HRG-gamma and ndf43 expression, suggesting common transcriptional regulation of NRG1 variants. In summary, our results suggest that haplotypes across NRG1 and multiple NRG1 variants are involved in schizophrenia.

Introduction Insomnia is considered to be the most prevalent sleep disorder (Morin and Benca, 2012). It is associated with physical and mental health problems (Taylor et al., 2003). Yet, the prevalence of insomnia in the postpartum period and its association with infant’s difficult temperament are less explored (Stremler and Wolfson, 2011). The objectives of the present study were: 1) to determine the prevalence of insomnia in postpartum and 2) to investigate the association between mother’s insomnia and their perception of baby’s difficult temperament. Materials and methods A total of 103 mothers (M = 31.9, SD = 4.10 years) participated in the study at 3 months after delivery. The vast majority was married (68%), 71.7% were primiparae, 59.2% had boys and 64.1% were breastfeeding. Mothers answered a sleep questionnaire about insomnia symptoms (lot of difficulties falling asleep; woke up many times during the night; woke up too early in the morning and was unable to go back to sleep again) and insomnia daytime consequences (sleep problem interferes a lot with life and activities; due to sleep poorly feels tired, irritable, excited, nervous or depressed during the day) experienced in the previous month. The Difficult Infant Temperament Questionnaire was applied to assess infant emotional regulation difficulties (baby irritable or fussy, cries excessively, difficult to comfort or calm down) and infant sleeping problems (gives bad nights and has difficulties falling asleep). Mothers‘ depressive symptoms were assessed with the Beck Depression Inventory (BDI-II). Results It was observed that 39.2% of mothers were good sleepers, 36.3% had at least one insomnia symptom, 22.5% experienced insomnia (at least one insomnia symptom and two related insomnia daytime consequences) and 2% referred sleep daytime consequences without insomnia symptoms. In comparison to the good sleepers group, the insomnia group reported that their babies had more sleeping problems (M = 2.3, SD = 2.0 vs. M = 4.0, SD = 2.6, p = 0.030). Differences between sleep groups were not observed relatively to infant emotional regulation difficulties. The association between mother’s insomnia and their perception of infant sleeping problems was not present when cases of severe depressive symptoms (BDI-II total score ⩾9, quartile 75) were controlled/removed from the analysis. Conclusion Results of the present study suggest that the association between mother’s insomnia in postpartum and the perception of baby sleeping problems is mediated by mothers‘ depressive symptoms. Acknowledgement AstraZeneca Foundation.

Introduction Factors associated with postpartum/PPT anxiety have been insufficiently investigated. Objective To identify correlates of PPT anxiety. Methods 201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS), Beck Depression Inventory/BDI-II, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables, Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology/LTHDS, Current insomnia, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding. Postpartum anxiety was measured with the Anxiety/Insecurity (AI) subscale of the PDSS. Results AI significantly correlated with LTHDS (rS=.32), LHI (rS=.18), Current insomnia (rS=.32), BDI-II (r=.76), SP (rS=.38), PSS (rS=.25), Perceived QOL (rS=.37), Health perception (rS=.29), Health problem in the postpartum (rS=.26), Negative Affect/NA (r=.66), Positive Affect/PA (r=.58), Conditional Acceptance/CA (r=.29) and DIT (r=.38) (all p M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p Conclusion Our findings are in accordance with previous research and contribute to the progress on this topic.

Introduction Postpartum depressive symptomatology is highly prevalent and has negative impact in the entire family. Objective To identify correlates of postpartum depressive symptomatology. Methods 201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale/PDSS, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables (marital status, work status, educational level, parity), Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology /LTHDS, Current insomnia, Sleep needs, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding. Results Total PDSS significantly correlated with LTHDS (rs=.35), LHI (rs=.22), Current insomnia (rs=.37), SP (rs=39), PSS (rs=.25), Perceived QOL (rs=.31), Health perception (rs=.28), Health problem or complication in the postpartum (rs=.16), Negative Affect/NA (r=.59), Positive Affect/PA (r=-.67), Conditional Acceptance/CA(r=.29) and DIT (r=.40) (all p M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p Conclusion These results are in line with previous findings and contribute to the progress on this topic.

Introduction A perceived difficult infant temperament has been associated to mothers depressive mood (Beck, 1996; McGrath et al., 2008). Objective To identify infant difficult temperament dimensions associated to mothers psychological distress. Methods 103 mothers (M= 31.9 years, SD=4.10; 68% married, 71.7% primiparae ) filled in the difficult infant temperament questionnaire (DITQ; Macedo et al., 2011), two items of the Brief infant sleep questionnaire (number of infant night wakings, duration of infants wakefulness during the night; Sadeh, 2004), the Beck depression inventory-II (BDI-II; Beck et al., 1996; Coelho et al., 2002) and the Postpartum depression screening scale (PDSS; Beck and Gable, 2000; Pereira et al., 2010) when their babies were 3 months of age. DITQ factor analysis with varimax rotation and reliability analyses suggested 2 temperament dimensions: emotional difficulties (irritable baby, cries excessively, difficult to calm down), F1; sleeping problems (baby who has sleeping problems, gives bad nights, has difficulties falling asleep), F2. Results DITQ-F1, DITQ-F2 and infants number of night wakings were positively and significantly associated with BDIII/ PDSS total scores. Infants eating problems were not associated with BDI-II or PDSS values. Controlling for mothers severe depressive mood, regression analysis revealed that DITQ F2 was the variable that explained BDI-II total score ( R 2 =.081; p =.011). PDSS total score was predicted by DITQ F2 ( R 2 =.050; p =.030) and number of infant night wakings ( R 2 =.074; p=.010). Conclusion Infants sleeping problems and infants number of night wakings contribute to mothers psychological distress in postpartum. Financial support AstraZeneca Foundation.

Introduction Positive affect (PA) is correlated to several positive outcomes and might be a constituent of happiness (Lyubomirsky et al., 2005). Objectives To investigate the correlates of PA in pregnancy and postpartum. Methods 397 pregnant women (T0) were also followed at 3 months postpartum (T1). At both time-points, they completed a questionnaire, the Postpartum Depression Screening Scale (PDSS), the Profile of Mood States (POMS), and were also interviewed with some sections of the Diagnostic Interview for Genetic studies (DIGS). Descriptive and correlation analyses were performed. Results T0/T1 PA scores were correlated (p Conclusions PA is a protective emotional trait, a good indicator of physical/mental health, and well-being in perinatal period. Mother's PA influences her perception of the infant temperament and may contribute positively to the dyadic interaction.

Introduction It has been shown that perfectionism constitutes a risk factor both for insomnia and postpartum depression. Objective To analyse the relationship between perfectionism, depressive symptoms and insomnia in the postpartum. Methods 201 3-months postpartum women (M=12.27 ± .91 weeks postpartum) completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS) and Multidimensional Perfectionism Scale (MPS). Three MPS dimensions derived by factorial analysis with data from this sample were used: Self-Oriented Perfectionism/SOP, Social Prescribed Perfectionism-Conditional Acceptance/SPP-CA and SPP-Others Highs Standards/OHS. Women also answered 5 questions about sleep, considering the previous month, based on which three insomnia groups were formed: Good Sleepers/GS (women without insomnia symptoms or daytime impairment); Insomnia Symptoms Group (women with at least one insomnia symptom but no daytime impairment); Insomnia Syndrome Group/ISG (women with at least one insomnia symptom and sleep related daytime impairment). Results Insomnia and PDSS were correlated (r = .39, pr .25, pr Conclusion SPP-C is a relevant correlate of postpartum insomnia.

Introduction Schizophrenia is a serious and common disease, one of the most disabling mental disorders in developed countries (Azevedo et al., 2010) and it is associated with high suicide attempt rates. A significant percentage of premature deaths is due to suicide and up to 50% of the patients attempt suicide during their lifetime, specially during the earlier course of the disease (Meltzer, 2003). Objectives In this study, the authors aimed to identify clinical factors (focusing on emotional reactivity and negative symptoms) and social-demographic variables associated to suicidal behaviour in Schizophrenia, in a large sample of Portuguese patients. Methods 508 patients with a diagnosis of Schizophrenia were selected according ICD-10 diagnostic criteria definitions, using the OPCRIT polydiagnostic system (McGuffin et al., 1991). Clinical and social-demographic variables were extracted from DIGS (Azevedo et al., 1993; Nurnberger et al., 1994). Suicidal Behaviour was assessed with the “Suicidal Behaviour Section” from DIGS. Results Suicidal behaviour occurred in 21.8% of the patients, with voluntary drug overdosing being the most used method. Although men showed to use more violent methods, the behaviour was more frequent in female patients. There was no association with the severity of delusions or hallucinations. The absence of formal thought changes, emotional withdrawal and affective blunting (meaning greater emotional reactivity) showed to be risk factors for the occurrence of suicidal behaviour. Conclusion This work may have relevant clinical implications due to its potential to guide the clinician in identifying a suicidal profile among his/her patients with Schizophrenia and delineating early intervention strategies.

Introduction Although developed for postpartum depression, the Postpartum Depression Screening Scale (PDSS; Beck & Gable, 2002) is accurate to screen for antenatal depression (Pereira et al., 2011). Nonetheless, as any screening instrument should be valid, short and easy it is important to develop a PDSS short form to use in pregnancy. Objectives To develop PDSS short version to use in pregnancy and to determine its cut-off points and associated conditional probabilities to screen for antenatal depression according to DSM-IV and ICD-10 criteria. Methods 441 pregnant women in their last trimester of pregnancy (M = 32.6 ± 3.47 weeks of gestation) completed the Portuguese PDSS adapted to pregnancy and were interviewed using the Mood Disorders Section/Diagnostic Interview for Genetic Studies. A factor analysis was performed to select the items (factor loadings > .60). ROC analysis was applied and cut-off points adjusted to the prevalence were determined. Results Four factors were extracted, making a total of 24 items selected to the short version (PDSS-24). For major depression/DSM-IV the cut-off point (CO) of 44, resulted in sensitivity 83.3%, specificity 78.9%, positive predictive value (PPV) 8.5% and negative predictive value (NPV) 99.7%; for depressive disorder/ICD-10 the CO of 42 determined sensitivity 85.7%, specificity 79.2%, PPV 11.9%, NPV 99.4%; for mild/moderate depression with somatic syndrome or severe depression without psychotic symptoms/ICD-10 the CO of 46 was associated to sensitivity 87.5%, specificity 82.2%, PPV 9.3% and NPV 99.7%. Conclusions The PDSS-24 is a good alternative to the 35-items version, equally valid, but more economic, faster and easier.

IntroductionScreening for perinatal depression is essential. The Postpartum Depression Screening Scale (PDSS; Beck & Gable, 2002) is a self-report instrument, composed of 35 items. The Portuguese version of the PDSS revealed to be a valid instrument to screen for perinatal depression (Pereira et al., 2010a,b).ObjectivesTo develop PDSS short version and to determine its cut-off points and associated conditional probabilities to screen for depression according to DSM-IV and ICD-10 criteria.MethodsParticipants were 452 women in their third month post-partum (M = 13.07 weeks post-partum; SD = 1.808). All women completed the Portuguese PDSS and were interviewed using the Mood Disorders Section/Diagnostic Interview for Genetic Studies. To select items for the short version the items that showed the highest correlations with their respective seven dimension scores were retained. ROC analysis was applied and both cut-off points and associated conditional probabilities adjusted to the real prevalence were determined.ResultsFor major depression/DSM-IV the cut-off point of 15, resulted in sensitivity of 77.8%, specificity of 88.9%, positive predictive value (PPV) of 21.7% and negative predictive value (NPV) of 98.9%; for depressive disorder/ICD-10 the cut-off point of 14 determined sensitivity 77.3%, specificity 84.0%, PPV 19.7%, NPV 98.6%; for mild/moderate depression with somatic syndrome or severe depression without psychotic symptoms/ICD-10 the cut-off point of 18 was associated to sensitivity 91.7%, specificity 94.5%, PPV 31.4% and NPV 99.8%.ConclusionsThe Portuguese short version of PDSS is a good alternative to the 35-items version, equally valid and precise, but more economic, faster and easier.

Aim:The objective of this study was to examine the sleep patterns of medical students and its associations with significant health behaviours.Methods:Sleep was assessed with a self-response questionnaire covering a wide range of sleep-wake habits and difficulties. A factor analysis with varimax rotation was performed with seventeen items of the questionnaire and four factors were extracted: Sleep Disturbance, Sleep Timing, Insufficient Sleep and Dreams/Nightmares. The questionnaire also included questions on coffee use, cigarette smoking, alcohol intake and physical exercise. The sample consisted of 212 females (M age=20.32 years, SD=1.26) and 128 males (M age=20.19 years, SD=1.23) third year medical students.Results:Habitual alcohol intake was reported by 6.5% of the students (males=14.8% vs females=1.4%; p=.000) and regular physical exercise by 37.9% (males=47.7% vs females=32.1%; p=.004); The mean number of coffee cups used per day was 2.16±1.16 (males M=2.18±1.35 vs females M=2.13±1.03; NS) and the mean number of cigarettes smoked per day was 3.69±5.71 (males M=4.41+6.55 vs females M=3.25±5.10; NS). Students who regularly practice physical exercise reported less Sleep Disturbance (p=.004). Habitual alcohol intake was significantly associated with Sleep Timing (p=.051) and Insufficient Sleep (p=.007). Significant correlations were also found between cigarette smoking and Sleep Timing (p=.000), Dreams/nightmares (p=.023) and Insufficient Sleep (p=.001). Coffee use was correlated only with Sleep Timing (p=.000).Conclusion:In this sample of healthy young adults habitual alcohol intake and cigarette smoking was associated with Insufficient Sleep and regular physical exercise was associated with less Sleep Disturbance.

Screening for postpartum depression has been considered essential. The Postpartum Depression Screening Scale (PDSS; Beck & Gable, 2002) is a self-report instrument, composed of 35 items placed in the specific context of new maternity. The aim of the present study was to determine, for the first time, PDSS cut-off points (adjusted to the real prevalence) and associated conditional probabilities to screen for depression in the post-partum, according to DSM-IV and ICD-10 criteria. Participants were 452 women, mean age=30.52 years (SD=4.176) in their third month post-partum (M=13.07 weeks post-partum; SD=1.808). All women completed the Portuguese version of the PDSS and were interviewed using the Mood disorders Section/Diagnostic Interview for Genetic Studies. ROC analysis was applied and both cut-off points and associated conditional probabilities adjusted to the real prevalence were determined. For major depression/DSM-IV the cut-off point of 69 (prevalence - 4.0%), resulted in sensitivity of 77.8%, specificity of 86.9%, positive predictive value (PPV) of 19.7% and negative predictive value (NPV) of 98.9%; for depressive disorder/ICD-10 the cut-off point of 67 (prevalence - 4.9%) determined sensitivity 77.3%, specificity 85.3%, PPV 21.2%, NPV 98.6%; for mild/moderate depression with somatic syndrome or severe depression without psychotic symptoms/ICD-10 (prevalence - 2.7%) the cut-off point of 80 was associated to sensitivity 91.7%, specificity 94.3%, PPV 30.6% and NPV 99.8%.In conclusion, the Portuguese version of the PDSS revealed to be a valid instrument to screen for depression in the post-partum.*Data for this study were drawn from a research project on Postpartum Depression and Sleep, FCT (POCI/SAU-ESP/57068/2004).

Aim:This study examines the relationship between the personality traits of Neuroticism and Extroversion and sleep patterns and others sleep behaviours in medical students.Method:Neuroticism and Extroversion were assessed using the Portuguese version of the Eysenck Personality Inventory. Sleep was assessed with a self-response questionnaire covering a wide range of sleep-wake habits and difficulties. A factor analysis with varimax rotation was performed with seventeen items of the questionnaire and four factors were extracted: Sleep Disturbance, Sleep Timing, Insufficient Sleep and Dreams/Nightmares. A total of 203 third year medical students (127 females, 62.6%) mean age 20.01 (SD=1.09; Range=18-24) participated in the study.Results:There were no significant gender differences in Neuroticism and Extroversion mean scores (Neuroticism: p=.454; Extroversion: p=.891). Extroversion was significantly correlated with Sleep Timing (p=.000), whereasthere was a trend for Neuroticism to be associated with Sleep Disturbance (p=.095). Concerning the relationship of Neuroticism and Extroversion mean scores with other Sleep problems, Neuroticism was found associated with concentration difficulties in the morning (p=.006), inadequate sleep duration (p=.001), sleep problems (p=.012), and use of sleep medication (p=.052). No significant associations were found with Extroversion.Conclusion:Neuroticism was significantly associated with sleep problems, use of sleep medication, inadequate sleep duration, and concentration difficulties in the morning. Extroversion was correlated only with later Sleep Timing.

Linkage disequilibrium and haplotype structure of five GABA A receptor subunit genes investigated for association with schizophrenia

IntroductionBipolar Disorder is a serious, common and disabling mental disorder which is associated to high morbidity and high suicide attempt rates.ObjectivesTo identify clinical and social-demographic variables associated to suicidal behaviour in Bipolar Disorder.MethodsThe samples comprises 124 patients (62.1% females) diagnosed with Bipolar Disorder (ICD-10 diagnosis following DIGS/OPCRIT). The variables selected to the analysis were extracted from DIGS and OPCRIT.ResultsSuicidal behaviour occurs in 27.1% of the patients; the most used method was voluntary drug poisoning; it's more frequent in females, with males using more violent methods - remaining results still unavailable.ConclusionsThis study identifies several clinical and social-demographic variables that can help the clinician to delineate a suicidal profile among his Bipolar patients, hence improving his ability to develop an early intervention plan and suicide prevention strategies.

Aim:To investigate the role of perfectionism in the development of disordered eating behaviours.Method:382 female university students completed the Hewitt & Flett MPS and the EAT-40 at baseline, one year after (T1) and two years later (T2).Results:Perfectionism at baseline was significantly associated with long-term abnormal eating attitudes/behaviours. Self-Oriented Perfectionism (SOP) and Socially Prescribed Perfectionism (SPP) were significant predictors of disordered eating behaviours. SOP at baseline was predictive of diet concerns, at T1 and T2. Baseline SPP was correlated with overall eating disturbance at T1 and T2. Regression analysis revealed that only SPP was a significant predictor of bulimic behaviours and social pressure to eat at T1, but not at T2.Conclusion:Our findings contribute to a more clear understanding of the association between perfectionism and eating disorders. SOP and SPP were prospectively associated with abnormal eating attitudes/behaviours and SOP was found to be predictive of diet concerns.