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- Analysis of inequalities in access to healthcare in North-east PortugalPublication . Reis, Sara; Maldonado, Emanuela; Matos de Barros, João; Aroso Louro, Afonso; Guimarães, Manuel; Barroso, Bárbara; Fernandes, Hélder; Novo, AndréHealthcare accessibility stands as a multifaceted challenge, intricately woven with factors ranging from geographical location to economic status. Mental health, an indispensable aspect of overall well-being, is particularly susceptible to the inadequacies pervasive within global healthcare systems. Against this backdrop, schizophrenia emerges as a poignant example of the profound challenges faced by individuals navigating mental health disorders within healthcare systems. In the context of Portugal, while strides have been made in recognizing healthcare equity as a fundamental right, persistent regional disparities persist, underscoring the imperative for a coordinated effort to bridge these gaps. The interplay between geographical barriers and healthcare accessibility manifests as a critical determinant of health outcomes, particularly poignant in rural and remote communities where access to specialized care remains elusive. Objective: This article aimed to analyse the characteristics of the schizophrenia spectrum disorder population in the Bragança district and the disparities in their healthcare access. Methods: A cross-sectional, descriptive study was conducted on a sample of 274 patients provided by the Mental Health Department at the Unidade Local de Saúde Nordeste (ULSNE – Northeast Local Healthcare Unit), for sociodemographic characterization. The data were retrieved from the hospital’s database. The study was approved by the Ethics Committee of the Polytechnic Institute of Bragança. Results: The research enrolled 274 individuals diagnosed with schizophrenia, predominantly male (65.7%), with most falling within the 40-49 and 50-59 age brackets. Hospitalization frequency averaged 4.73 ± 6.74 instances, with men exhibiting higher rates. A significant correlation was found between medical monitoring and hospitalization frequency, particularly among patients with follow-up. Moreover, a notable discrepancy in healthcare accessibility was identified across municipalities, necessitating considerable patient travel for psychiatric consultations. Conclusion: The case study examined the challenges faced by patients diagnosed with schizophrenia spectrum disorders in the Bragança district. These findings highlight the urgent need for improvements in the existing healthcare infrastructure, including the expansion of medical services in underserved areas and the implementation of innovative solutions such as telemedicine.
- Virtual reality rehabilitation’s impact on negative symptoms and psychosocial rehabilitation in schizophrenia spectrum disorder: a systematic reviewPublication . Novo, André; Fonsêca, Jéssica; Barroso, Bárbara; Guimarães, Manuel; Louro, Afonso; Fernandes, Hélder; Lopes, Rui Pedro; Leitão, PauloSchizophrenia is a chronic psychiatric disorder with symptoms that can severely affect patients’ quality of life. While drug administration inhibits most of the positive symptoms, it fails to effectively treat the negative symptoms and in turn relies on rehabilitation therapies. With technological progress, virtual reality (VR) has been the target of recent studies in terms of mental health rehabilitation and has been shown to be a tool with ecological validity in order to introduce the individual to situations similar to their daily life. Methods: From July to August 2021, we conducted a systematic review with the purpose of understanding the impact of virtual reality rehabilitation on negative symptoms and psychosocial rehabilitation in the schizophrenia spectrum. The searches were performed in the databases Web of Science, Scopus, and PubMed. Results: In our search, we identified 201 results, where 108 duplicates were excluded, resulting in a final balance of 93. After reading and assessing the titles and abstracts, 66 studies were excluded. Of the remaining 27 reports, 23 were excluded for not meeting the previously defined eligibility criteria, resulting in the inclusion of four studies in this systematic review. Conclusions: The available data on the specific topic was limited and could have been more complete. However, in our review, we were able to identify statistically relevant results demonstrating the effectiveness of intervention. We could find medium to large effects, allowing VR to be an ally for rehabilitation of symptoms related to schizophrenia.