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The Ruminative Response Scale for Eating Disorders (RRS-ED) measures ruminative thought content specifically related to eating disordered themes, assessing two domains of rumination, brooding and reflection. This study aims to examine the factor structure of the RRS-ED in a Portuguese community sample, using correlated two-factor models, unifactorial and bifactor models and test for invariance across sex. A sample of 535 adults (179 male; 356 female) filled out the RRS-ED. A subsample (n=347) answered additional measures of repetitive negative thinking and eating psychopathology. The bifactor model of the RRS-ED provided the best fit, demonstrating a reliable general rumination factor. Also, the bifactor model of the RRS-ED was invariant across sex. RRS-ED showed moderate to strong correlations with negative perseverative thinking and eating psychopathology. Both domain-specific factors of RRS-ED were associated with higher levels of eating psychopathology. Findings indicate that RRS-ED is a reliable and valid measure to assess the ruminative response from the general population in Portugal, showing initial evidence that supports the use of a total score of RRS-ED as an overall measure of rumination, while specific factor scores should be reported with caution. Future studies are needed to replicate the findings and further corroborate the unidimensionality of the RRS-ED. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether visual acuity has the same importance as a factor of depression and anxiety comparing with other psychological variables, particularly perceived social support, in patients diagnosed with age-related eye diseases, with and without low vision. Design: Observational cross-sectional study. Setting: Patients attending outpatient appointments at the department of ophthalmology of a general hospital in Portugal. Subjects: Patients with age-related macular degeneration and patients with diabetic retinopathy attending routine hospital appointments were recruited for this study. Measures: Anxiety and depression were measured using the hospital anxiety and depression scale and perceived social support using the multidimensional scale of perceived social support. Visual acuity was measured with ETDRS charts. Results: Of the 71 patients, 53 (75%) were diagnosed with diabetic retinopathy, 37 (52%) were female and age (mean ± SD) was 69 ± 12 years. Acuity in the better seeing eye was 0.41 ± 0.33 logMAR. The mean anxiety score was 4.38 ± 3.82 and depression 4.41 ± 3.39. Clinically significant levels of anxiety were found in 21% (n = 15) of the participants and depression in 18%(n = 13). The total social support score was 5.29 ± 0.61. Significant multivariate regression models were found for anxiety (R 2 = 0.21, P = 0.016) and for depression (R 2 = 0.32, P < 0.0001). Social support was independently associated with levels of anxiety and with levels of depression. Gender was independently associated with levels of anxiety. Conclusion: This study suggests that patients' perceived social support might be more important than visual acuity as a factor of clinical depression and anxiety in a sample of age-related eye disease patients. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Summary 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 < 0.01 to P < 0.001; SPE: P < 0.05) and in males (BB: from P < 0.05 to P < 0.001; SPE: P < 0.05) and with insomnia symptoms ( P < 0.01). In females, bulimic behaviour was the only factor associated significantly with sleep difficulties (SDI, DIS; P < 0.01) and with insomnia symptoms ( P < 0.05). Although BMI was correlated negatively with sleep difficulties ( P < 0.05), regression analyses indicated that it was not associated significantly with them. Our findings support an association between eating behaviour and sleep disturbances in both genders, which may have treatment implications. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: To examine the factor structure of the Rutter Teacher Questionnaire in Portuguese primary school children. Method: The Rutter Teacher Questionnaire, a 26-item scale covering a variety of behavioral problems, was completed by teachers of 877 children, aged 6 to 11 years. Data were subjected to factor analysis using the principal components solution with varimax rotation. Results: The factorial analysis in total sample revealed three factors explaining 38.88% of the total variance, The factors contained items representing hyperactivity/conduct (Factor 1), anxious/depressive (Factor 2) and truancy/stealing (Factor 3). The highest correlations between factors scores were for Factor 1 and Factor 3. These Factors scores were higher in boys than girls and correlated with lower social class. All three Factors scores correlated with school performance. The comparison between separate factorial structures for the samples of boys and girls revealed a considerable overlap. Conclusions: The pattern of the items contained on Factor 1 appears to be related with the category of hyperkinetic conduct disorder used by the International Classification of Diseases-10. Results suggest that the Portuguese language version of the Rutter Teacher Questionnaire possesses good psychometric properties and may be considered a useful instrument for measuring children's behavior problems. [ABSTRACT FROM AUTHOR]

Introduction: The paradigm in mental health care is progressively moving towards a recovery-focused perspective. Thus, there is a need for validated instruments to measure recovery in bipolar disorder (BD). The Bipolar Recovery Questionnaire (BRQ) is the most used instrument to assess it. The aim of this study was to translate and perform a cross-cultural adaptation of the BRQ to European Portuguese (PT-PT) and to explore further associations of recovery with sociodemographic and emotional regulation, as well as recovery predictors to inform future research and clinical practice., Methods: The BRQ was forward-translated and back-translated until a consensus version was found, and a test-retest design was used to assess temporal stability. Participants were recruited in public hospitals and organizations supporting people with BD, either referred by their psychiatrists or psychologists or through self-referral. Eighty-eight individuals diagnosed with BD were recruited to complete a battery of Portuguese-validated self-report questionnaires to assess recovery (BRQ), clinical mood symptoms (Hospital Anxiety and Depression Scale), affect (Positive and Negative Affect Scale), well-being (brief Quality of Life for Bipolar Disorder; Satisfaction with Life Scale) and emotion regulation (Difficulties in Emotion Regulation Scale)., Results: The BRQ showed excellent internal consistency with a Cronbach alpha of 0.92, and test-retest exhibited good reliability (r = 0.88). Construct validity was confirmed through/by positive and moderate correlations with quality of life (QoL; r = 0.58) and positive affect (r = 0.52), and negative moderate correlations with depression (r = -0.64), and negative affect (r = -0.55). Both satisfaction with life (β = 0.38, p = 0.010) and recovery (β = 0.34, p = 0.022) impacted quality of life, supporting the BRQ's incremental validity. Depressive symptoms and emotion dysregulation accounted for 51% of its variance., Conclusion: The BRQ is a valid and reliable instrument to measure recovery in people with BD in the Portuguese population and is suitable for both clinical and research contexts.

Introduction: Stigma is associated with poor prognosis of illness and reduced help-seeking behavior, self-esteem and treatment compliance. The aims of this study were to study the reliability and construct validity of the King's et al Stigma Scale, and its association with Illness and Help-Seeking Behaviors scale (IHSBS) scores., Material and Methods: One hundred and forty mental health patients filled out the Stigma scale and the Illness and Help-Seeking Behaviors scale. The exploratory factor analysis of the stigma scale was performed, and its reliability studied. The correlation analysis was used and mean differences in Stigma Scale scores among IHSBS groups were explored., Results: The exploratory factor analysis indicated four factors (F): F1-Disclosure, F2-Discrimination, F3-Acceptance and F4-Personal Growth, which showed acceptable/good internal consistency (α from 0.70 to 0.91). Help-seeking behaviors were not associated with stigma. The levels of Discrimination were high in the group with global high-IHSB and in patients with medium/high illness behavior (IB) and health-related worries (HW). Additionally, Disclosure and overall stigma levels were higher in groups with high-HW and with medium-IB scores (when compared with the group with low-IB). The group with low-IB also had lower levels of Acceptance and Personal Growth when compared with the groups with medium-IB and high-IB, respectively., Conclusion: The Stigma Scale (27 items) is a valid, reliable instrument and useful tool to assess stigma in mental health patients.

Background: Although obsessive-compulsive (OC) symptoms are common in the perinatal period, measures to comprehensively assess their presence, frequency, interference and severity are lacking. The Perinatal Obsessive-Compulsive Scale (POCS) is the only self-report questionnaire with context-specific items. It includes items to assess perinatal-specific obsessions and compulsions, a severity scale and an interference scale., Objectives: (1) to analyze the validity and reliability of the Portuguese version of the POCS; (2) to find Obsessive-Compulsive Disorder (OCD) prevalence in postpartum and determine the POCS cut-off scores and its accuracy (sensitivity, specificity and predictive values) in screening for OCD according to DSM-5 criteria; (3) to describe the prevalence, content, severity, interference and onset of OC symptoms in the postpartum., Methods: 212 women in postpartum filled in a booklet, including the POCS Portuguese preliminary version, the Perinatal Anxiety Screening Scale and the Postpartum Depression Screening Scale; they were interviewed with the Diagnostic Interview for Psychological Distress-Postpartum., Results: Confirmatory Factor Analysis revealed that POCS presented acceptable fit indexes (χ 2 /df = 2.2971; CFI= 0.9319; GFI = 0.8574; TLI = 0.9127; RMSEA = 0.860, p < 0.001). The Cronbach's alphas were all > 0.800. The POCS cut-off point that maximized the Youden Index (J = 0.86, 95% CI [0.94-0.99]) was 20, corresponding to an Area Under the Curve of 0.970 ( p < 0.001; Standard Error = 0.031; 95% CI: 0.937 to 0.988). The prevalence of postpartum OCD was 3.30%. The severity of thoughts and behaviors was moderate to severe for approximately 15% of women. For thirty-five percent of women, the onset of symptoms was in the first three months postpartum., Conclusions: The Portuguese version of POCS has good validity, reliability and accuracy and may be considered ready for use in both clinic and research fields. POCS provides specific information regarding symptoms and individual patterns experienced by each woman, which allows normalization, destigmatization and personalized intervention.

Recent studies have documented the high prevalence of burnout among medicine and dentistry students, with potentially catastrophic consequences for both students and patients. Both environmental and personality factors play a part in burnout; perfectionism, a common trait in medicine students' personalities, has been linked to psychological distress and increasing students' vulnerability to burnout. Self-compassion, i.e., treating oneself kindly through hardship, has recently emerged as a buffer between perfectionism and psychological distress. While using a novel three-factor conceptualization of perfectionism (BIG3), this study aims to analyze if self-compassion has a protective role in the relationship between perfectionism and burnout, in a sample of medicine and dentistry students, through mediation analysis. We found that self-compassion significantly mediated the relationship between all three forms of perfectionism and burnout: as a partial mediator in self-critical and rigid perfectionism, as well as a full mediator in narcissistic perfectionism. Our findings underline self-compassion's relevance in burnout prevention and management, supporting its use as an intervention target in burnout reduction programs and strategies.

It is widely known that stress reactivity and social functioning impairment are important difficulties in people with psychosis. However, the specific impact of stress reactivity on social functioning and its underlying mechanisms are still less explored. Social rank variables, such as shame and self-criticism, have been pointed out as relevant in the development, maintenance of several types of psychosocial suffering and, specifically, in psychotic disorders. This study's aim was to explore the associations between external shame, self-criticism, social stress reactivity, and social functioning difficulties and understand the mediator role of shame and self-criticism in the relationship between social stress reactivity and social functioning. Seventy-seven participants with a psychotic disorder filled in self-reported measures of stress reactivity, shame, and self-criticism and were clinically evaluated for social functioning. To study the associations between variables in the study, Spearman correlation coefficients were used. The PROCESS macro was used to test the sequential mediation analyses. All variables under study were associated with each other, and social stress reactivity predicted social functioning difficulties through external shame, whereas self-criticism was not a significant mediator. The present study highlights the role of external shame in the pathway from stress reactivity to social impairment. These results inform recovery-oriented interventions and reinforce the relevance of considering social competitive mentality when working with people with psychosis. Further research is needed to clarify the role of self-to-self relationship in social impairment and to identify other mechanisms aimed at dealing with shame used by people with psychosis., (© 2019 John Wiley & Sons, Ltd.)

Objectives: To analyse the temporal and geographical diffusion of antivascular endothelial growth factor (anti-VEGF) interventions, and its determinants in a National Health System (NHS)., Setting: NHS Portuguese hospitals., Participants: All inpatient and day cases related to eye diseases at all Portuguese public hospitals for the period 2002-2012 were selected on the basis of four International Classification of Diseases 9th revision, Clinical Modification (ICD-9-CM) codes for procedures: 1474, 1475, 1479 and 149., Primary and Secondary Outcome Measures: We measured anti-VEGF treatment rates by year and county. The determinants of the geographical diffusion were investigated using generalised linear modelling., Results: We analysed all hospital discharges from all NHS hospitals in Portugal (98,408 hospital discharges corresponding to 57,984 patients). National rates of hospitals episodes for the codes for procedures used were low before anti-VEGF approval in 2007 (less than 12% of hospital discharges). Between 2007 and 2012, the rates of hospital episodes related to the introduction of anti-VEGF injections increased by 27% per year. Patients from areas without ophthalmology departments received fewer treatments than those from areas with ophthalmology departments. The availability of an ophthalmology department in the county increased the rates of hospital episodes by 243%, and a 100-persons greater density per km(2) raised the rates by 11%., Conclusions: Our study shows a large but unequal diffusion of anti-VEGF treatments despite the universal coverage and very low copayments. The technological innovation in ophthalmology may thus produce unexpected inequalities related to financial constraints unless the implementation of innovative techniques is planned and regulated., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

The aim of the present study was to investigate if disordered eating behaviors predicted the development of sleep disturbances. A total of 870 students participated at baseline, 592 one year later (T1) and 305 two years later (T2). The Eating Attitudes Test-40 was used to assess global disordered eating behaviors, dietary concerns (DC), bulimic behaviors (BB) and social pressure to eat (SPE). Sleep disturbances were assessed by two items related to difficulties initiating sleep (DIS) and maintaining sleep (DMS). A sleep disturbance index (SDI) was calculated by summing DIS and DMS scores. Results revealed that global disordered eating behaviors at baseline predicted DIS, DMS and SDI at T1 and T2. Students with increased BB and SPE scores at baseline were more likely to experience sleep onset and sleep maintenance difficulties in the long term. These results suggest that assessment and correction of eating behaviors might prevent sleep disturbances., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

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 role of perfectionism as a correlate and as a predictor of perinatal depressive symptomatology and disorder was examined. Three-hundred and eighty-six pregnant women (mean age = 30.08 years; SD = 4.205; range = 19-44) completed the Portuguese versions of the Multidimensional Perfectionism Scale, Beck Depression Inventory-II/BDI-II and three questions evaluating anxiety trait, life stress and social support perception. Diagnoses of depression were obtained using the Portuguese version of the Diagnostic Interview for Genetic Studies/OPCRIT system. Women who were depressed in pregnancy (ICD-10/DSM-IV) were excluded from the analyses. Self-Oriented Perfectionism and Socially Prescribed Perfectionism subcomponents (Conditional Acceptance and Others' High Standards) were significant correlates of depressive symptomatology/BDI-II in pregnancy. Others' High Standards was a significant predictor of postpartum depressive symptomatology/BDI-II, after controlling the other independent variables (depressive symptomatology and trait anxiety in pregnancy, life stress and social support perception in postpartum). None of the perfectionism subscales predicted postpartum depressive disorder (ICD-10/DSM-IV). Self-Oriented Perfectionism was an important correlate of depressive symptomatology in pregnancy and Others' High Standards and Conditional Acceptance were significant correlates of perinatal depressive symptomatology. Others' High Standards accounted for 0.8 % of the depressive symptomatology variance in postpartum after controlling the effect for other depressive symptomatology correlates. Perfectionism was not a risk factor for postpartum depressive disorder. Our findings improve the knowledge regarding the risk factors implicated in the development of postpartum depressive symptomatology/disorder, which is of utmost importance to develop adequate prevention and intervention strategies.

The aim of the present study was to estimate depressive disorder and symptomatology prevalence and incidence in perinatal period in a population-based sample. Three-hundred and eighty six Portuguese women (mean age=30.08 years, SD=4.21) were interviewed with the Diagnostic Interview for Genetic Studies and completed Beck Depression Inventory-II/BDI-II and Postpartum Depression Screening Scale/PDSS, in pregnancy and postpartum. OPCRIT polydiagnostic system generated ICD-10 and DSM-IV diagnoses. One-month prevalence in pregnancy was of 2.3%/ICD-10 and 1.3%/DSM-IV; in postpartum it was of 16.6% and 11.7%. Pregnancy incidence was of 0%/ICD-10 and .3%/DSM-IV and in postpartum of 7.5%/ ICD-10 and 4.9%/DSM-IV. Depression pregnancy point-prevalence found with BDI-II cutoffs ranged from 13.7% to 19.4% in pregnancy and from .8% to 13.0% in postpartum and with PDSS from 14.2% to 17.9% in pregnancy and from 3.9% to 12.7% in postpartum. In the same sample, different diagnostic systems generated different prevalence and incidence rates. Higher prevalence rates were found using self-reported questionnaires. ICD-10 generated higher prevalence and incidence rates than DSM-IV.

Introduction: In Portugal, the medical school selection process relies exclusively on past academic results, involving the most stringent criteria of all courses, with no attention given to the personality traits of the students. In a competitive context, perfectionism dimensions may be relevant to consider. Socially Prescribed Perfectionism (SPP) has been correlated with Neuroticism, while Self-Oriented Perfectionism (SOP) is strongly associated with Conscientiousness. These domains of personality have been linked (lower levels of Neuroticism and higher levels of Conscientiousness) to academic and professional success in Medicine. The premedical syndrome describes premedical students as overachieving, excessively competitive, cynical, dehumanized, overspecialized and narrow. Our main objective was to compare SPP and SOP levels between Medical and Humanities students, as they may be possible indicators of the premedical syndrome among Portuguese medical students., Material and Methods: The Portuguese version of the Multidimensional Perfectionism Scale was administered to 908 undergraduate students from Medicine and Humanities courses of Coimbra University. The sample covered students from the 1st to the 5th year of the courses but most of the students were from the 1st year (n=436)., Results: With respect to SPP, significant statistical differences were found, with Medicine students showing lower levels (mean 48.60+/-11.02; p=0.023) than Humanities students (mean 50.00+/-9.56). No significant differences were found in SOP., Discussion and Conclusion: Our results are reassuring, suggesting the lack of a negative impact of the medical school selection process in the personality traits of the students and the probable absence of the premedical syndrome.

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, and 1 year after (T1) and 206 2 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. Regression analysis revealed that SOP at baseline was predictive of Diet Concerns and overall eating disturbance (EAT total score), at T1 and T2. SPP was a significant predictor of Social Pressure to Eat at T1 and T2 and of Bulimic Behaviours only at T1., 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 and overall eating disturbance.

Pregnancy is essentially a physiological event, but neuroendocrinal and psychosocial changes are also important components of this experience. In this context, perceived stress may be enhanced by the activation of certain personality traits, like perfectionism, which in turn may be associated with more psychological distress (PD). The aim of this study was to investigate if perfectionism could be associated with more negative emotional outcomes (PD) in the transition to motherhood and to look at which of the perfectionism dimensions these consequences are specifically linked. The sample comprises 421 pregnant women (mean = 29.8, SD = 4.48 years) who completed measures of perfectionism and mood symptoms. A two-factor model with self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) dimensions and a three-factor model with SOP, SPP-others' high standards and SPP-conditional acceptance (CA) factors were explored. Correlations and linear regressions were calculated between perfectionism factors and mood variables. Results showed that higher levels of SPP factors were associated with increased anxiety, depression, anger, fatigue and confusion, with decreased vigour and with more severe depressive symptoms. Our results, in contrast with those from the study of Campbell and DiPaula (2002, In: Flett G, Hewitt P (eds) Perfectionism. Theory, research, and practice. American Psychological Association, Washington, pp 181-198), did not confirm a preferential association between SPP-CA and PD, revealing that both components of SPP were associated with PD.

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.

To develop a Portuguese short form, the Eating Attitudes Test-40 (EAT-40) was administered to a community sample of 922 female students and to a clinical sample of 63 females suffering from an eating disorder. With the EAT responses of the community sample a factor analysis was performed and items with factor loadings > or = 0.30 were selected. Internal consistency was computed for both the instrument and the factors. To study the discriminant capacity the proportion of symptomatic answers and the mean scores were compared between the clinical (N = 63) and control (N = 63) samples. Three factors were extracted: Drive for Thinness (14 items, alpha = .839), Bulimic Behaviours (8 items, alpha = .670), Social Pressure to Eat (3 items, alpha = .758). The short form is composed of 25 items and shows good internal consistency = 0.839. Symptomatic answers for all items (except one) and total mean scores were significantly higher (p < .001) in the clinical sample than in community sample., (Copyright 2007 John Wiley & Sons, Ltd and Eating Disorders Association.)

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.

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.

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., (2006 John Wiley & Sons, Ltd and Eating Disorders Association)

The present study investigates the association of mutations in the nuclear receptor NR4A2 in schizophrenic patients. The human Nur-related receptor 1, NR4A2, is an orphan nuclear receptor that can be constitutively active as a transcription factor and for which no natural ligand has yet been identified. Alone or with retinoid X receptor, RXR, NR4A2 influences the expression of several genes important for human brain development and regulation. In the absence of Nurr1 (the mouse homologue to human NR4A2), ventral mesencephalic dopaminergic mouse neurons evidence severe developmental failure, a condition that is lethal soon after birth. Nurr1 involvement in the dopaminergic system makes it a good candidate for study in neuropsychiatric disorders such as schizophrenia and Parkinson disease. Evidence by others support this hypothesis (1) mapping of the NR4A2 gene to chromosome 2q22-23, a region with suggestive linkage to schizophrenia and (2) identification of mutations in patients with schizophrenia (c.366-369delTAC, c.308A > G, c.-469delG), manic depression (c.289A > G), and familial Parkinson's disease (c.-291delT, c.-245T > G). To further extend these observations, we searched for all these mutations in 176 Caucasian Portuguese and 82 Caucasian Brazilian subjects with lifetime diagnosis of schizophrenia. The study failed to identify any of the described mutations in patients or controls. Nevertheless, these negative results do not exclude altered expression of nuclear receptors in schizophrenia or the presence of other mutations., (Copyright 2004 Wiley-Liss, Inc.)

Schizophrenia is a highly heritable condition, as demonstrated in family, twin and adoption studies. Candidate genes from the dopaminergic system have long been hypothesized to be involved in the etiology of this disorder. In the present study, we investigated the genetic association between polymorphisms in the D2 and D3 dopamine receptor (DRD2, DRD3) genes and schizophrenia. We examined 90 trios from Portugal, and negative results were obtained from association studies with both Haplotype Relative Risk (HRR) and Transmission Disequilibrium Test (TDT), as well as TRANSMIT. Therefore, we conclude that neither the DRD2 nor the DRD3 gene polymorphisms investigated are associated with schizophrenia in our sample.