Browsing by Issue Date, starting with "2025-08-26"
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- Experience of conjugality among older people in long-term care facilities: a scoping reviewPublication . Bia, Florbela; Charepe, Zaida; Marques-Vieira, CristinaThis scoping review examines the underexplored impact of the transition to residential care on conjugal relationships among older couples in long-term care facilities (LTCFs). With an aging population and evolving care policies, understanding marital experiences in residential care settings becomes increasingly essential. Using the Joanna Briggs Institute methodology and the Population, Concept, and Context framework, a systematic search across six databases identified 17 studies from 529 articles. These studies were classified into three living arrangements: spouses in LTCFs with partners in the community, co-residing couples, and those addressing both scenarios. Findings reveal variations in living arrangements and the emotional complexity of these transitions, emphasizing the importance of maintaining marital bonds and relational identity. Influenced by institutional care policies and staff training, these outcomes highlight the need for longitudinal, quantitative and intervention-based research. Policy recommendations advocate relationship-centred care to promote privacy, marital continuity, and interventions enhancing marital well-being in LTCFs.
- A first case association of Lambert-Eaton Myasthenic Syndrome and first episode psychosis: a case reportPublication . Siopa, C.; Cordeiro, C.; Moura, B. M.Introduction: Lambert-Eaton Myasthenic Syndrome is an autoimmune neuromuscular junction disorder characterized by proximal weakness, autonomic dysfunction, and areflexia associated with antibodies against voltage-gated calcium channels. Psychotic symptoms can take place in many auto-immune neurological disorders, but their occurrence in myasthenic syndromes has rarely been observed. Objectives: We report a case of a 21-year-old female with primary autoimmune Lambert-Eaton Myasthenic Syndrome due to antivoltage-gated calcium channels antibodies subtype P/Q, who developed psychotic symptoms three years after motor symptom onset. Methods: The patient attended regular psychiatric follow-ups over three years. Results: With monthly administration, these psychotic symptoms improved after every cycle of intravenous immunoglobulin therapy. The patient displayed partial insight into the mental symptoms. Different causes of reversible psychosis were excluded, such as autoimmune encephalitis and paraneoplastic syndrome, though the patient tested positive for the anti-voltage-gated calcium channels antibodies subtype P/Q. Owing to muscle strength worsening and psychotic episodes, the patient was put on several treatments, including one admission to a Neurology unit. The patient then experienced psychotic exacerbation, leading to treatment with olanzapine at 20 mg/day. Psychotic symptoms persisted but were less severe, with greater intensity at night. After two years, the patient’s condition showed significant improvement, with olanzapine increased to 25 mg/day. Conclusions: This is, to our knowledge, the first described case of psychotic symptoms associated with Lambert-Eaton Myasthenic Syndrome. We speculate that voltage-gated calcium channel antibodies could have a role in developing mental symptoms. However, further hypotheses are discussed. Although the patient had received corticosteroid therapy before symptom onset, the timing and dosage make corticosteroid-induced psychosis unlikely. A primary psychotic disorder, such as schizophrenia, is considered improbable due to the atypical nature of the psychotic symptoms. This case underscores the need for further research on the neurobiological mechanisms linking VGCC antibodies to psychiatric symptoms.