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INTRODUCTION: Coronavirus disease 2019 was declared as a pandemic on March 2020. Research on its psychological effects is still lacking. Perinatal depression is a medical complication of pregnancy, especially in situations of stress. In this study, we aimed to investigate the presence of symptoms of depression in pregnant women during the lockdown period in Portugal. METHODS: This study consisted in a cross-sectional study among Portuguese pregnant women, who completed an online self-report questionnaire between 25th April and 30th April 2020. An anonymous online questionnaire was developed to assess depression and concerns related to COVID-19. This study was approved by the IRB of Hospital Dona Estefânia and performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. Eligibility criteria included pregnant women, ≥ 18 years and living in Portugal. The primary outcome was to evaluate the presence of depressive symptoms and its association to socio-demographic characteristics and to concerns related to COVID-19. RESULTS: A total of 1698 pregnant women were enrolled. The mean age was 31.9 years. 82.4% felt a negative impact of the pandemic in the surveillance of pregnancy and 43% felt insufficient support. 26.3% showed "possible depression" according to the EPDS. A regression analysis revealed the possibility of depression increased as the concerns about COVID increased and was lower for women with support. The possibility of depression was higher for women with psychiatric medical history. CONCLUSION: This study demonstrated a significant increase in clinically significant depressive symptoms in pregnant women during the lockdown. It also revealed some of the socio-demographic characteristics of women at risk for depression. If left untreated, depression tends to persist, affecting the woman and also the child. Our findings suggest that COVID-19 represents a serious challenge for this population and reinforce the urgent need for early detection and intervention on mental health issues during pregnancy, especially during the pandemic.

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INTRODUCTION: The Centro de Estudos do Bebé e da Criança in Hospital Dona Estefânia has organized a multidisciplinary model for children under three with suspected autism spectrum disorder, thus implementing the recent guidelines established by the Directorate General for Health. The aim of this study is to describe this model and case series. MATERIAL AND METHODS: A retrospective descriptive study of observed children with suspected ASD. They were observed according to the model of the Centro de Estudos do Bebé e da Criança and DC:0-5TM classification, between January 2018 and September 2019. RESULTS: The study included 178 children. The average age at the initial assessment was 27 months. From the total sample, 116 children concluded the diagnostic sessions (axis I): Autism Spectrum Disorder/Early Atypical (36%), Developmental Language Disorder (18%), Other (19%). Factors of axes II, III, IV and V of DC:0-5TM were determinant for clinical diagnosis in 26%. DISCUSSION: Of 116 children, 36% were diagnosed with Autism Spectrum Disorder. This highlights the diagnostic challenge posed by neurodevelopmental disorders in early infancy. The sample shows that the characteristics of the relationship with the caregiver (axis II), presence of physical conditions (axis III), psycho-social stressors (axis IV) and developmental trajectory (axis V) have a significant clinical impact. In the future, the initial assessment should take place well before the age of 27 months because of the impact on prognosis. CONCLUSION: This model is a pioneering approach in Portugal. It promotes a common approach of Child and Adolescent Psychiatry and Neuropediatrics/Developmental Pediatrics in early infancy. Moreover, it increases the diagnostic acuity of Autism Spectrum Disorders and early therapeutic intervention.

Introdução: O Centro de Estudos do Bebé e da Criança do Hospital Dona Estefânia desenvolveu um modelo multidisciplinar de atuação na suspeita de perturbação do espetro do autismo na primeira infância, aplicando a recente norma da Direção Geral da Saúde. Pretende-se descrever a sua apresentação e casuística.Material e Métodos: Estudo retrospetivo descritivo da série de crianças(< 3 anos), observadas por suspeita de perturbação do espetro do autismo, entre janeiro de 2018 e setembro de 2019, segundo este modelo e a classificação DC:0-5TM.Resultados: Foram observadas 178 crianças. A idade média da primeira consulta foi de 27 meses. Do total de crianças observadas, 116 concluíram as sessões diagnósticas (diagnóstico eixo I): perturbação do espetro do autismo/ perturbação do espetro do autismo atípica precoce (36%), perturbação do desenvolvimento da linguagem (18%), outros(19%). Em 26% dos casos, o quadro foi atribuído a fatores classificados em outros eixos.Discussão: O diagnóstico de perturbação do espetro do autismo foi colocado em 36%, demonstrando o desafio diagnóstico das perturbações do neurodesenvolvimento na primeira infância. A casuística demonstra ainda que as características da relação com o cuidador (eixo II), a presença de condições físicas (eixo III), fatores de stress psicossociais (eixo IV) e a trajetória de desenvolvimento (eixo V) têm um impacto clínico significativo. É desejável a antecipação da idade de sinalização pelo impacto no prognóstico.Conclusão: Este modelo é pioneiro em Portugal ao propor uma atuação conjunta de duas especialidades na primeira infância: pedopsiquiatria e neuropediatria/pediatria desenvolvimento. Este modelo de atuação melhora a acuidade diagnóstica e permite a intervenção terapêutica precoce.

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To contribute to the validation of the sensory and behavioral criteria for Regulation Disorders of Sensory Processing (RDSP) (DC:0-3R, 2005), this study examined a sample of toddlers in a clinical setting to analyze: (1) the severity of sensory modulation deficits and the behavioral symptoms of RDSP; (2) the associations between sensory and behavioral symptoms; and (3) the specific role of sensory modulation deficits in an RDSP diagnosis. Based on clinical observations, 78 toddlers were classified into two groups: toddlers with RDSP (N = 18) and those with "other diagnoses in Axis I/II of the DC:0-3R" (OD3R; N = 60). The parents completed the Infant Toddler Sensory Profile and the Achenbach Checklist. The results revealed that the RDSP group had more severe sensory modulation deficits and specific behavioral symptoms; stronger, although not significant, associations between most sensory and behavioral symptoms; and a significant sensory modulation deficit effect. These findings support the validity of RDSP.

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The main objective of this review is to provide a descriptive analysis of the biological and physiological markers of tactile sensorial processing in healthy, full-term newborns. Research articles were selected according to the following study design criteria: (a) tactile stimulation for touch sense as an independent variable; (b) having at least one biological or physiological variable as a dependent variable; and (c) the group of participants were characterized as full-term and healthy newborns; a mixed group of full-term newborns and preterm newborns; or premature newborns with appropriate-weight-for-gestational age and without clinical differences or considered to have a normal, healthy somatosensory system. Studies were then grouped according to the dependent variable type, and only those that met the aforementioned three major criteria were described. Cortisol level, growth measures, and urinary catecholamine, serotonin, and melatonin levels were reported as biological-marker candidates for tactile sensorial processing. Heart rate, body temperature, skin-conductance activity, and vagal reactivity were described as neurovegetative-marker candidates. Somatosensory evoked potentials, somatosensory evoked magnetic fields, and functional neuroimaging data also were included.

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INTRODUCTION: The concept of resilience refers to the possibility of individuals to develop positively when exposed to situations of adversity or stress. This is a complex process involving the interaction of vulnerability and protection factors. Researching resilience only makes sense when applied to populations considered at risk which, simultaneously, present adaptive attributes. That is what we find in Child and Adolescent Residential Institutions. There is a rising need of research in the area of institutionalized children. A better knowledge of these populations allows for the creation of more adapted and efficient prevention and promotion health programs. OBJECTIVES: To identify resilience factors and their association with psychopathology in children/ adolescents (C/A) of three residential institutions in Lisbon. METHOD: Data was collected from a sample of children/ adolescents, aged between 6 and 18, who had been institutionalized for at least a year, whose legal representatives had signed the "informed consent". The three Lisbon institutions were chosen by convenience. Children/ adolescents diagnosed with a Pervasive Developmental Disorder (DSM-IV-TR) were excluded. The instruments used for assessment (Check-list for Characterization of the children/adolescents, Institution and Community, and Child Behavior Checklist) were completed by the care provider that better knows the children/adolescents. RESULTS AND CONCLUSIONS: There are resilience factors in those children and adolescents who present no psychopathology which are absent in those who have psychopathology. We identified factors that appear to have greater resilience preponderance for the protection of children/adolescents, namely "positive self-esteem," "talents recognized by others" and "cognitive skills". Males have more psychopathology, along with a smaller number of resilience factors than females.

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