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The reliability and validity of a Portuguese version of the Young Mania Rating Scale were evaluated. The original scale was translated into and adapted to Portuguese by the authors. Definitions of clinical manifestations, a semi-structured anchored interview and more explicit rating criteria were added to the scale. Fifty-five adult subjects, aged 18 to 60 years, with a diagnosis of Current Manic Episode according to DSM-III-R criteria were assessed using the Young Mania Rating Scale as well as the Brief Psychiatric Rating Scale in two sessions held at intervals from 7 to 10 days. Good reliability ratings were obtained, with intra-class correlation coefficient of 0.97 for total scores, and levels of agreement above 0.80 (P < 0.001) for all individual items. Internal consistency analysis resulted in an alpha = 0.67 for the scale as a whole, and an alpha = 0.72 for each standardized item (P < 0.001). For the concurrent validity, a correlation of 0.78 was obtained by the Pearson coefficient between the total scores of the Young Mania Rating Scale and Brief Psychiatric Rating Scale. The results are similar to those reported for the English version, indicating that the Portuguese version of the scale constitutes a reliable and valid instrument for the assessment of manic patients.

Objective This study aimed at evaluating the stability of the first psychotic episode diagnosis in the emergency context. Methods Fifty-nine patients were selected during a 15-month period and were followed for an average of 19.35 ± 6.12 months. The admission and discharge emergency diagnosis were compared with the longitudinal diagnosis, obtained by the application of Structured Clinical Interview for DSM-IV Axis I Disorders — clinical version at the end of the follow-up. Severity rating scales (Brief Psychiatric Rating Scale, Young Mania Rating Scale and Hamilton Rating Scale for Depression) were applied in the emergency assessment. Results Agreement between admission emergency diagnosis and longitudinal diagnosis was unsatisfactory ( k =0.25), whereas that between emergency discharge and longitudinal diagnosis was satisfactory ( k =0.57). Brief psychotic disorder diagnosis presented higher sensitivity rates but low specificity, comprising several false positives. Bipolar disorder had the highest rates of specificity. Conclusion Brief psychotic disorder may not be a useful concept in the emergency assessment. A short period of observation can improve emergency psychiatric diagnosis.

Panic patients were evaluated with two models of experimental anxiety that are believed to generate distinct emotional states: (1) a stimulated public speaking test (SPS), a presumed indicator of unconditioned fear, and (2) conditioning of skin conductance responses (CSCR) to a tone associated with an aversive white noise, an index of conditioned anxiety. Subjective states were evaluated through the visual analogue mood scale (VAMS) and a bodily symptoms scale (BSS). In the SPS test, panic patients showed higher baseline levels of VAMS-measured anxiety than controls. Unlike controls, panic patients failed to show increased anxiety before and during speech. Although baseline levels of arousal were similar in both groups, VAMS mental sedation decreased in controls, but not in panic patients during the SPS. Panic patients showed more discontent than controls throughout the whole experimental session. They also scored higher than controls on several items of the BSS. In the CSCR test, panic patients showed more spontaneous fluctuations of skin conductance than controls. Nevertheless, conditioning of skin conductance responses to the tone was similar in both groups. Therefore, panic patients seemed to process unconditioned fear abnormally.