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Unlabelled: Medication compliance is one of the foremost problems affecting neuroleptic efficacy in psychiatric patients. It is a crucial point to dispone of useful instruments that allow us a fiable assessment of patients' medication adherence in order to plan more appropriate therapeutical interventions. The aim of our study was to validade the Portuguese versión of the Medication Adherence Rating Scale (MARS), a concise instrument for assessment of medication compliance in psychosis., Methods: A translation-backtranslation of the original scale was elaborated. The sample consisted of 77 psychotic patients according to the DSM-IV criteria. Feasibility and reliability were calculated., Results: The results demonstrated that the MARS has a good internal consistence (Cronbach α = 0,73) and reliability (Pearson's r = 0,76; p < 0,05)., Discussion: These coefficients were similar to those found by the researchers who developed this scale. The MARS scale has proven to be easily applied and may be deemed a valid and reliable measure of compliancy for psychoactive medications.

Besides intervention in prepsychotic period, early intervention in psychosis includes interventions done after the onset of the first-episode psychosis, namely psychopharmacological and psychosocial phase-specific intervention. The main aim is to reduce the duration of untreated psychosis (DUP) and to ensure that besides remission of the symptoms there is also a psychosocial recovery. Many centers set up an assertive and integrated early intervention program, involving an active search of patients with a treatment that includes antipsychotic medication, cognitive behavioral therapy, psychoeducation, family and vocational interventions. The authors of this review explain the concepts and main studies that support this kind of treatment in early psychosis. The results of published data show that is possible to reduce the DUP and improve the clinical and functional outcomes with this intervention. Critical period hypothesis proposes that deterioration occurs aggressively in the first 2 to 5 years of early psychosis, so it is crucial to intervene in this period to ensure a functional recovery. Cost-benefit ratio seems to be favorable to early intervention model, with reduction of in-stay period, which is an important component of the direct costs of psychotic illness. Early intervention service model organization is also reviewed by the authors of this research. The results of many studies show favorable outcomes for the integrative early intervention and so many countries included it in their political mental health directives and attributed funds for early intervention in psychosis.

Psychotic disorders, namely schizophrenia, are severe illnesses with their onset in adolescence or youth adult age and have a classic limited outcome. In recent years there has been some research about early intervention in psychosis which can be done in prepsychotic period (prodrome) and/or after the onset of full blown psychotic episode. The authors review the literature about the diagnosis, evaluation, and possible interventions in patients in prepsychotic period (prodrome). Identification of patients with ultra high risk of psychosis could identify patients with a risk of development psychosis in 40%. The main interventions, pharmacological and psychosocial treatments, and main published studies are explained. Prospective identification of these patients and their treatment could prevent the development of full blown psychosis, delay the onset or promote the recovery of the disorder. We must remember some ethical issues about this kind of intervention, namely the stigma and false positive individuals. The results from the research in this area are mainly preliminary, but these studies suggest that some interventions are effective and promising. In future we must have trials with more number of patients included and probably a refinement of the criteria of ultra high risk patients.

Lack of insight into mental disorder is a frequent phenomenon in patients affected by a psychotic disorder and can be an important predicting factor involving the course of the disease mainly regarding compliance with treatment. The aim of the present study was to validate the Portuguese version of the Marková and Berrios Insight Scale, a self-report instrument that allow us to evaluate insight into psychotic illness. After a translation-back translation process, the Portuguese version of the scale was administered to a sample of 83 psychotic patients (DSM-IV). The results demonstrated that the Marková and Berrios Insight Scale achieved a excellent viability, internal reliability (a = 0,80). These coefficients were similar to those found by the researchers who developed this scale. The Marková and Berrios Insight Scale has proven to be easily applied and deemed an useful and valid instrument in researches involving psychotic subjects.

Electroconvulsive therapy (ECT) is an efficient, safe and even life saving treatment for several psychiatric disorders, namely depressive disorder, bipolar disorder and schizophrenia. Many were the doubts with it utilization, namely until the 1980s. After that it became more accepted with the publication of guidelines for many international associations of Psychiatry. Even with the development of psychopharmacology, ECT is still used with very good results, namely with affective disorders. Nowadays it is used almost exclusive with refractory patients but many studies show its efficacy in all the phases of psychiatric disorders where is indicated. The authors' review, based on literature, the history, indications, mechanism of action, procedure and adverse effects of ECT. The recent development of many procedures of magnetic stimulation could put ECT as a secondary treatment but the efficacy of that technique in comparison with ECT is still to be demonstrated, and ECT remains the most efficient treatment of psychiatry disorders.