Photo of the Psychiatry Unit (large part of the technical staff)

Description of roles and activities in the three major lines of work – teaching, research, and assistance to the community

The Psychiatry University Clinic and the Psychiatry Unit of CHLN are closely associated with, and are part of Santa Maria University Hospital, with a three-fold mission: provide assistance, teach, and carry out research. It is a unit that offers differentiated psychiatric care resorting to multiple techniques (biological and psychological) with intervention protocols specified according to technical and scientific quality standards. Mental health care is delivered at the level of prevention, secondary care, and rehabilitation. The unit also teaches undergraduate students of the Faculty of Medicine of the University of Lisbon, and offers postgraduate training to psychiatry interns. In addition, it offers internships in various fields of Psychiatry and Mental Health to Pedopsychiatry, General Medicine, and Family Medicine interns, as well as to Psychiatry interns from other hospitals. It has become a training centre for training psychologists.

The main research strands currently carried out at the unit are: 

• Temperament, Vulnerability to Stress and Affective Disease
• Biological aspects of bipolar disease
• Suicide attempts in adolescents
• Coping mechanisms for chronic medical disease
• Stress and psychoimmunology
• Psychological factors in morbid obesity
• Diabetes and Depression – new psychotherapeutic techniques
• Psychiatric cognition and pathology in elderly patients
• Initial stages of psychosis (biological and clinical aspects)
• Social functioning of psychoses
• Models of Institutional Psychiatry (focusing on depression in Institutions)
• Quality indicators of intervention at a Day Hospital
• Affective temperaments and alcoholism
• Psychopathology of obsessive delirious ideas
• Neurocognitive aspects of electroencephalography
• Psychopharmacological Experiments
• Genetic and psychosocial aspects of alcoholism
• Subtypification of dependent patients
• Gender violence and Child and Adolescent Victimization. Psychogenetic factors
• Approaches to the phenomenology of psychopathological processes
• Studies on the social and cognitive variables in drug-additions
• Psychophysiological indicators of cognitive and motivational forms: application to the Drug-addition Clinic
• Validation of psychosocial functioning scales (PSP) and quality of life in bipolar disease

The organizational chart of the Psychiatry Unit indicates areas of activity and units:

As part of its pedagogical mission, the goals it aims to attain in the training of future doctors are described below

As the objective is to teach quality Medical Psychology and Psychiatry, there is a wide variety of situations and places where this is performed.

The Psychiatry University Clinic teaches the following subjects to undergraduate students of the Integrated Master Degree in Medicine of the Faculty of Medicine of Lisbon: Introduction to Medicine, Psychology, Mental Health, Psychiatry I and Psychiatry II. It also teaches the elective subjects Drug-addition and Health and Psychosomatic Psychology. It is also involved in the Licenciatura Degree in Nutrition, teaching the subject of Psychology. It organizes the Master Degrees in Sexuality and Victimization of Children and Adolescents. It collaborates in the teaching of the Master/PhD degrees in Neuroscience, PhD in Voice Sciences, Language and Communication, and in the Master degrees in Bioethics, Forensic Medicine, and Sleep Sciences.

It collaborates with the Faculty of Psychology of the University of Lisbon in the subjects of Neuropsychology, Psychophysiology, and Child and Adolescent Psychopathology.

Teaching and assistance to Interns 

In 2010-2011, the Psychiatry Unit organized a cycle of studies on psychiatry research (basic research, advanced basic research, and clinical research) aimed at doctoral students and training interns, in collaboration with lecturers and researchers of the University of São Paulo, University of Porto Alegre, and the University of British Columbia (Vancouver).

The training programme of Psychiatry Interns includes the publication ‘Jornal Club’ (fortnightly), topics on Psychopathology (weekly), supervision in Psychopharmacology (fortnightly), and Psychotherapies (weekly)

Given current objectives, the materials resources and facilities involved are described below. 

The currently available facilities are manifestly insufficient given the number of undergraduate students. Several subjects are taught simultaneously. For example, in the first semester of the current academic year (2010/2011), the subjects taught are: Mental Health (year 3), Psychiatry I (year 4), Psychiatry II (year 5), and Mental Health Internship (year 6). In these subjects alone, we have a total of about 1050 students. It is only thanks to agreements with the Institute of Anatomy and the Training Centre that we are able to have large enough rooms for the practical classes, and this is clearly impossible in the two infirmaries with a maximum capacity of 48 patients that constitute the internment of the Psychiatry Unit. Even resorting to out patients, this task is difficult to manage, due to the pressure of clinical work. The number of academic internships in the area of Psychology adds to this figure – about 15 Psychology students stay at our facilities during the academic year. In addition, the number of postgraduate students is high: about 20 interns in specialist fields, and simultaneously, an average of 3-4 General Practice and Family Medicine interns (3-month internship), 2 Pedopsychiatry interns (6-month internship), 2 interns in Liaison Psychiatry (3-month internship), several Neurology interns, and in addition, we also have interns who come to do their electives (3 months) in Suicidology, Adolescence Studies, Food Behaviour Disorders, and Gerontopsychiatry, which are the most popular choices.

It is only possible to address all of these teaching needs thanks to the generosity and high commitment of a considerable number of guest lecturers. This is a situation that we very much hope will be gradually changed so that we can all truly be part of the spirit of the Medical Academic Centre. The number of hired part-time lecturers (guest lecturers on 30% or 40% of the time) is highly insufficient to meet the teaching needs of this field of knowledge.

The members of staff in this unit are listed below:  

At the level of partnerships with other institutions that are part of the Medical Academic Centre of Lisbon, the expected contribution of the unit is as follows:
The field of Psychiatry and Mental Health is undergoing change. The future programme of the Psychiatry Unit of CHLN and of the University Clinic of the Faculty of Medicine has to reflect on the directions and priorities of those changes, both in the area of providing assistance, and in scientific and academic terms. Key points of the change include:

– Rapid advances in Neuroscience and Clinical Psychiatry research;
– Availability of effective treatments for most mental diseases;
– Increasingly early intervention with the purpose of achieving more effectiveness in preventing the recurrence and chronicity of mental diseases;
– Changes introduced by the Mental Health Plan in the planning of care to patients with more serious mental diseases;
– The growing role that families and society in general play both as partners and as advocates of the conditions for clinical practice.

The Psychiatry Unit of CHLN is part of the university environment of the faculty of Medicine and will increasingly be part of the Medical Academic Centre. The vision of this University Centre, which includes HSM, FMUL and IMM, is one of a highly differentiated centre that stands out for the quality and specificity of its academic and clinical units. This is, thus, the biggest opportunity and challenge that we need to face and accomplish over the next years. The continuity and survival of a Unit that is part of a University hospital depends on it,

The vision, mission, and values of the Psychiatry Unit are aligned to the strategy of CHLN and of the Faculty of Medicine of Lisbon.

Director: Full Professor Luísa Figueira
afernandes@fm.ul.pt