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Introduction: Before the COVID-19 pandemic, research had shown high (and variable) prevalences of the use of Complementary and/or Alternative Medicine (CAM; eg., 70%), in adults and children, dependent, neverthless, on the type of practice. Objective: To characterize adults’ experience with conventional and non-conventional health (self-)care practices during the COVID-19 pandemic in Portugal. Method: After obtaining the necessary authorizations, between 1/10-27/11/2021, a total of 104 adults living in Portugal answered to a Google Forms questionnaire on health (self-)care practices. Results: As for the last time the participants performed any health (self-)care practice: - 47,6% evaluated the results they obtained as good and 14.3% as very good; - 59.5% were satisfied with that practice; - 27.1% considered it a non-conventional practice and 20% were not sure. In terms of health (self-)care practices: 65.2% reported using conventional and non-conventional practices. Among those who have ever used any non-conventional practice: - 50% did it using a professional and 33.9% by themselves and using a professional; - 48.4% use it rarely; - 17.9% started using it more frequently since the start of the COVID-19 pandemic; - 93.8% had never done it against the recommendation of a (conventional) health professional. Since the beginning of the pandemic: 11.2% had at least one appointment with a non-conventional health professional; and 4.1% had more appointments with non-conventional health professionals than with conventional health professionals. Regarding negative experiences with non-conventional practices, 89.7% never had any. Conclusions: Since: (a) participants were mostly satisfied with their last health (self-)care practice/its results, predominantly a conventional practice, even though the majority use both types of practices; (b) when using non-conventional practices, only a minority use it by themselves and the majority with some frequency; (c) its (generally rational) use did not increase considerably with the pandemic; and (d) few negative experiences were reported, these preliminary results are not alarming. Nevertheless, they do suggest a need to increase health care professionals’, non-conventional users’ and non-users’ knowledge about these practices to ensure patients’ safety.

"Research has shown the frequent use of complementary and alternative medicine (CAM), its potentialities and risks. Aim: To characterize adults’ knowledge and practices of CAM in order to identify the need to develop lifelong learning programs. After obtaining the necessary authorizations, between 1/10-5/12/2021, 115 adults living in Portugal, mostly women with a higher education degree, working full-time, with a monthly income perceived as medium, answered a Google Forms questionnaire on health (self-)care practices (HsCP). Most considered their health as good (44.3%), being satisfied with it (53%). The majority: took some care of their health (60.5%; 28.1% a lot); had no physical (56.1%) or psychological (78.3%) health problem diagnosed by a conventional health care professional. Regarding the extent to which the participants had knowledge of non-conventional health (self-)care practices (NCHsCP), most (39.5%) knew little about it (10.5% had no knowledge). The majority: had already looked for information about NCHsCP (55.8%), was interested in having (more) knowledge about it (77.2%), and had someone close to them who used and/or was using some non-conventional practice - NCP (57%). Only 14.2% had done training in some NCP and 5.3% considered it impossible to reconcile conventional and NCHsCP. The majority (65.8%) stated that knowledge about NCP is important to them as (future) health professionals (not applicable to 26.3%). As for the last time participants performed any HsCP, 30.2% considered it a NCP (19.8% were not sure). In terms of HsCP, 66.7% reported using conventional and NCP. Among those who have ever used any NCP: 47.1% did it with a professional and 34.3% by themselves and with a professional; 45.8% use it rarely; 93.2% had never done it against the recommendation of a (conventional) health professional. Among those regularly (at least once a year) accompanied by one or more conventional health care professionals, 54% had never talked about NCP. Regarding negative experiences with NCP, 89.8% never had any. The minor children of 13.9% had done some NCP (not applicable to 60.2%). Among the health care professionals, 80.2% had no course during their training mentioning NCP; in their professional experience, 64.2% had knowledge of situations in which conventional and NCP were used simultaneously; in the context of their professional activity: 51.9% had recommended, and 40.7% had referred someone to NCP. Even though these preliminary results are not worrying, they suggest adults living in Portugal would greatly benefit from lifelong learning programs focusing on the potentialities and risks of CAM."

Depression is an important target of psychological assessment in patients with end-stage renal disease because it predicts their morbidity, mortality, and quality of life. We assessed the effectiveness of cognitive–behavioral therapy in chronic hemodialysis patients diagnosed with major depression by the Mini International Neuropsychiatric Interview (MINI). In a randomized trial conducted in Brazil, an intervention group of 41 patients was given 12 weekly sessions of cognitive–behavioral group therapy led by a trained psychologist over 3 months while a control group of 44 patients received the usual treatment offered in the dialysis unit. In both groups, the Beck Depression Inventory, the MINI, and the Kidney Disease and Quality of Life-Short Form questionnaires were administered at baseline, after 3 months of intervention or usual treatment, and after 9 months of follow-up. The intervention group had significant improvements, compared to the control group, in the average scores of the Beck Depression Inventory overall scale, MINI scores, and in quality-of-life dimensions that included the burden of renal disease, sleep, quality of social interaction, overall health, and the mental component summary. We conclude that cognitive–behavioral group therapy is an effective treatment of depression in chronic hemodialysis patients.

Adolescence is an important period during which the individual develops major concepts about himself and others, as well as skills to construct and maintain relationships. Stressful events during adolescence, like the death of parents and sudden routine changes, when associated with poor familiar and social support, may increase the risk for stress and depression. This is a case report of a 13 year old adolescent who was exposed to stressful experiences. It describes how those events may have contributed to the development of depressive symptoms. Twenty sessions of Cognitive-Behavior Therapy (CBT) were prescribed in order to reduce depressive symptoms and stress, and to develop coping behavioral skills. Training sessions were also conducted with the uncle (caregiver) in order to improve the relationship between the adolescent and the caregiver. Data suggests that a parent’s death, routine changes and inadequate parenting management were relevant to the development of stress and depressive symptoms. Those problems were also probably responsible for the development of externalizing behaviors. After CBT there was a reduction in the frequency of externalizing behaviors and depressive symptoms. There was also an increase of positive parenting skills. It is possible to suggest that traumatic events and inefficient parental skills increase the risk for psychiatric disorders during adolescence

BACKGROUND: Rapid demographic ageing will soon lead to large increases in the numbers of persons with dementia in developing countries. This study is the first comprehensive assessment of care arrangements for people with dementia in those regions. METHODS: A descriptive and comparative study of dementia care; caregiver characteristics, the nature of care provided, and the practical, psychological (Zarit Burden Interview, General Health Questionnaire) and economic impact upon the caregiver in 24 centres in India, China and South East Asia, Latin America and the Caribbean and Africa. RESULTS: We interviewed 706 persons with dementia, and their caregivers. Most caregivers were women, living with the person with dementia in extended family households. One-quarter to one-half of households included a child. Larger households were associated with lower caregiver strain, where the caregiver was co-resident. However, despite the traditional apparatus of family care, levels of caregiver strain were at least as high as in the developed world. Many had cutback on work to care and faced the additional expense of paid carers and health services. Families from the poorest countries were particularly likely to have used expensive private medical services, and to be spending more than 10% of the per capita GNP on health care. CONCLUSIONS: Older people in developing countries are indivisible from their younger family members. The high levels of family strain identified in this study feed into the cycle of disadvantage and should thus be a concern for policymakers in the developing world.