Revista Brasileira de Psiquiatria最新文献

Parental pattern, childhood trauma, and impulsivity contribute to the severity of crack cocaine addiction: a cluster analysis. 父母模式、童年创伤和冲动对快克可卡因成瘾的严重程度有影响：聚类分析。

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-16 DOI: 10.47626/1516-4446-2024-3645

Daniela Benzano Bumaguin, Joana Corrêa de Magalhães Narvaez, Jaqueline B Schuch, Deborah Daitschman, Sergio Kato, Lisia von Diemen, Felix H P Kessler

{"title":"Parental pattern, childhood trauma, and impulsivity contribute to the severity of crack cocaine addiction: a cluster analysis.","authors":"Daniela Benzano Bumaguin, Joana Corrêa de Magalhães Narvaez, Jaqueline B Schuch, Deborah Daitschman, Sergio Kato, Lisia von Diemen, Felix H P Kessler","doi":"10.47626/1516-4446-2024-3645","DOIUrl":"10.47626/1516-4446-2024-3645","url":null,"abstract":"Objective: To determine severity clusters (groups) of substance use in crack cocaine users by the severity scores of the sixth version of the Addiction Severity Index (ASI-6) and compare the groups detected in relation to risk factors as parental styles, childhood maltreatment, and impulsivity.Methods: A cross-sectional study was conducted with 531 male adults with Substance Use Disorder, admitted to a hospital treatment unit for addiction in Southern Brazil. In order to detect more homogeneous groups of individuals, the approach used involves the K-means clustering using ASI-6 scores to create clusters or groups of individuals with similar severity in different areas. Parenting styles were assessed using the Measure of Parental Style, childhood trauma was assessed using the Childhood Trauma Questionnaire, and the patients' impulsivity was measured using the Barratt Impulsivity Scale 11. Poisson Regression was used for association analysis.Results: Two distinct clusters (groups) were identified, which differed significantly across all composite scores (p<0.001). These associations were further confirmed through Poisson Regression analysis. The more severe cluster showed significantly higher scores for maternal abuse (p=0.026), sexual abuse (p=0.003), motor impulsivity (p=0.014) and unplanned above the 75th Percentile (p=0.032) compared to the less severe group. Other parenting styles, types of trauma and impulsivity were not significant different between the groups.Conclusions: The division into severity clusters contributes to the proposition of more targeted treatments. More research focusing on outpatients would be important to reinforce the impact on preventing early life factors and treating impulsivity.","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potential Adverse Events of Fluoxetine: A Real-world Study Based on FAERS Database. 氟西汀潜在不良事件：基于FAERS数据库的真实世界研究

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-16 DOI: 10.47626/1516-4446-2024-3879

Xuezheng Gao, Xiangjun Zhou, Zhiqiang Du, Qin Zhou, Ying Jiang, Haohao Zhu

{"title":"Potential Adverse Events of Fluoxetine: A Real-world Study Based on FAERS Database.","authors":"Xuezheng Gao, Xiangjun Zhou, Zhiqiang Du, Qin Zhou, Ying Jiang, Haohao Zhu","doi":"10.47626/1516-4446-2024-3879","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3879","url":null,"abstract":"Objective: This study aimed to mine and analyze adverse event signals of fluoxetine using the FAERS database.Methods: This study focused on suspected drug adverse reaction reports from the first quarter of 2004 to the second quarter of 2023, with fluoxetine as the primary suspected drug. Four signal mining and analysis methods were employed to comprehensively assess adverse event signals.Results: A total of 19,932,732 reports were collected, of which 22,884 were primarily suspected of fluoxetine. Through analysis, 862 PT signals involving 27 SOCs were identified. Among the reported patients, female patients (58.81%) reported a higher proportion than males (26.84%), and the age group of 18 to 45 held the largest percentage. Adverse event signal strength related to pregnancy and neonatal conditions was notable, including Foetal exposure during pregnancy, Exposure during pregnancy, and neonatal health-related adverse events showed higher signal strength, such as Atrial septal defect, Premature baby, Ventricular septal defect, and Maternal drugs affecting the fetus.Conclusion: Although Fluoxetine has been extensively approved and applied, its use in pregnant and planning-to-conceive women should be approached with caution.","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of recurrent priapism during prolonged clozapine administration 氯氮平长期服用期间反复勃起1例

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-16 DOI: 10.47626/1516-4446-2024-4053

Kelly Acosta Gallardo, Nestor Andrades, Trino Baptista, Jose de Leon, Carlos De las Cuevas, Daniel Jose Salazar Juarez

引用次数: 0

It is unlikely that major depression severity correlates with white matter lesion volume. 重度抑郁症的严重程度不太可能与白质病变体积相关。

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-16 DOI: 10.47626/1516-4446-2025-4121

Josef Finsterer, Joao Gama Marques

引用次数: 0

Cannabis use patterns and different phenotypes in relation to other drugs use: latent class analyses from the Sao Paulo Megacity Mental Health Survey. 大麻使用模式和与其他药物使用相关的不同表型：来自圣保罗大城市心理健康调查的潜在类别分析。

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-16 DOI: 10.47626/1516-4446-2024-3833

Camila Magalhães Silveira, João Maurício Castaldelli-Maia, Erica Rosanna Siu, Maria Carmen Viana, Yuan-Pang Wang, Laura Helena Andrade

{"title":"Cannabis use patterns and different phenotypes in relation to other drugs use: latent class analyses from the Sao Paulo Megacity Mental Health Survey.","authors":"Camila Magalhães Silveira, João Maurício Castaldelli-Maia, Erica Rosanna Siu, Maria Carmen Viana, Yuan-Pang Wang, Laura Helena Andrade","doi":"10.47626/1516-4446-2024-3833","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3833","url":null,"abstract":"Cannabis is the most widely used substance in Brazil. This study examined subtypes of individuals who use cannabis based on usage characteristics and correlates with other substance consumption and harms. Data are from the São Paulo Megacity Mental Health Survey (N = 5,037). Latent class analysis (LCA) was performed considering age of onset, use frequency , tobacco consumption, heavy episodic drinking (HED), alcohol use disorder (AUD) and substance use disorder. Logistic regression assessed class correlates, and further analysis compared socio-demographic, health and behavioral indicators. A 4-class model was optimal for 496 individuals. The 'Polydrug' class (26.2%) and the 'Former' class (5.9%) showed earlier onset and highest frequency of cannabis use, with strongest harm associations. 'Polydrug' class had higher odds of other drug use (OR=3.0), tobacco use (OR=2.5), HED (OR=1.8), and AUD (OR=1.5), compared to lighter-use groups. About 30% of those who use cannabis are at increased risk for negative outcomes, particularly those with early, frequent, and polydrug use patterns. Brazil's public health should prioritize targeted prevention on the risks associated with early and frequent cannabis, and polydrug use. Addressing this at-risk group is essential for harm reduction and a health-focused approach.","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

No changes in plasma Brain-Derived Neurotrophic Factor (BDNF) levels in Treatment-Resistant Depression patients submitted to Convulsive Therapies. 接受抽搐治疗的难治性抑郁症患者血浆脑源性神经营养因子（BDNF）水平无变化。

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-16 DOI: 10.47626/1516-4446-2024-3983

Leonardo Afonso Dos Santos, Eric Cretaz, Helena Bellini, Adriana Munhoz Carneiro, José Gallucci-Neto, Leda Leme Tallib, André Russowsky Brunoni

{"title":"No changes in plasma Brain-Derived Neurotrophic Factor (BDNF) levels in Treatment-Resistant Depression patients submitted to Convulsive Therapies.","authors":"Leonardo Afonso Dos Santos, Eric Cretaz, Helena Bellini, Adriana Munhoz Carneiro, José Gallucci-Neto, Leda Leme Tallib, André Russowsky Brunoni","doi":"10.47626/1516-4446-2024-3983","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3983","url":null,"abstract":"Background: Convulsive therapies are often effective for Treatment-Resistant Depression (TRD), although their mechanisms of action are unclear. Increases in Brain-Derived Neurotrophic Factor (BDNF) levels are observed after Electroconvulsive Therapy (ECT), but more recent evidence calls this claim into question. Moreover, Magnetic Seizure Therapy (MST), a new convulsive technique, has not yet been studied regarding possible neurotrophic modulation.Methods: We performed plasma BDNF measures before and throughout treatment of adult patients (18 to 65 years old) diagnosed with TRD and submitted to treatment with convulsive therapy (ECT or MST) in the arms of the EMCODE project.Results: We enrolled 31 participants (mean age = 38.4 years, SD = 11.88), 14 (45.16%) were submitted to ECT and 17 (54.84%) to MST. Notable improvements in depressive symptoms were observed in both groups, with no significant difference between them (p = 0.1046). Meanwhile, no significant changes in BDNF plasma levels were observed for any technique, pre and post-treatment (MD = -93.01 pg/ml, 95% CI -545.88 to 359.86), or over time (Coefficient = -67.95, SE = 37.75, p = 0.072).Conclusion: The findings suggested no significant changes in plasma BDNF following convulsive therapies, challenging the notion of BDNF as a biomarker for treatment-resistant depression.","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges and future directions of Transcranial Direct Current Stimulation for Depression: insights from a systematic review and meta-analysis. 经颅直流电刺激治疗抑郁症的挑战和未来方向：来自系统回顾和荟萃分析的见解。

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-16 DOI: 10.47626/1516-4446-2024-3989

Pedro Henrique Rodrigues da Silva, Marie-Anne Vanderhasselt, Giuseppina Pilloni, Leigh Charvet, Frank Padberg, Marom Bikson, André R Brunoni, Lais B Razza

{"title":"Challenges and future directions of Transcranial Direct Current Stimulation for Depression: insights from a systematic review and meta-analysis.","authors":"Pedro Henrique Rodrigues da Silva, Marie-Anne Vanderhasselt, Giuseppina Pilloni, Leigh Charvet, Frank Padberg, Marom Bikson, André R Brunoni, Lais B Razza","doi":"10.47626/1516-4446-2024-3989","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3989","url":null,"abstract":"Depression is a common and debilitating disorder affecting millions. First-line treatments fail to achieve remission in about one-third of patients, highlighting a critical treatment need. Transcranial direct current stimulation (tDCS) has emerged as a novel treatment for depression. Therefore, the aim of this review was to provide a comprehensive overview of the last decade of tDCS trials for depression and propose future research directions. To compile studies of the past decade, we conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) of tDCS for depression. A total of 21 RCTs were included, presenting a moderate effect for active tDCS compared to placebo. We also provided a description of study designs, stimulation parameters, and patients' characteristics. Following, we proposed possible strategies to enhance clinical effectiveness and reduce variability in results, including 1) optimization/personalization of tDCS via spatial and temporal target localization; 2) optimized methodological strategies, including home-based, accelerated tDCS protocols and novel trial designs; and 3) investigate patient profile to identify features that can predict treatment response. In conclusion, tDCS holds promise as a treatment for depression, but variability in trial parameters and outcomes underscores the need for its further optimization. Refining and standardizing protocols may enhance its effectiveness.","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transdiagnostic Clinical Staging in Youth Mental Health: A primer for clinical practice. 青少年心理健康的跨诊断临床分期：临床实践的入门。

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-15 DOI: 10.47626/1516-4446-2024-3979

Letícia Müller Haas, Pedro Mario Pan, Ian B Hickie, Letícia Sanguinetti Czepielewski

{"title":"Transdiagnostic Clinical Staging in Youth Mental Health: A primer for clinical practice.","authors":"Letícia Müller Haas, Pedro Mario Pan, Ian B Hickie, Letícia Sanguinetti Czepielewski","doi":"10.47626/1516-4446-2024-3979","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3979","url":null,"abstract":"Clinical staging models are tools used in healthcare that have the potential to enhance diagnostic precision, improve treatment decisions, articulate more personalized care pathways, and optimize service models. In youth mental health, clinical staging has been increasingly applied to conditions where progression from non-specific symptoms to full-blown syndromes, such as schizophrenia, bipolar disorder, and depression, is possible. However, novel transdiagnostic staging models have also been proposed, recognizing the limitations of current classification systems and the substantial overlap of symptoms, particularly early in the illness course. Models incorporating an appropriate developmental and transdiagnostic lens may offer significant advances for research and clinical practice, supporting early intervention and secondary prevention. This narrative review critically examines theoretical premises and empirical applications of transdiagnostic clinical staging models in youth. Peer-reviewed studies were identified in PubMed using search terms related to clinical staging, focusing on sociodemographic, cognitive, and clinical factors investigated in youth samples (12-30 years). Evidence is synthesized in three main sections: progression, extension, and stage-based treatment. Additionally, a stage-based care model and directions for future research are presented. Early findings partially support important assumptions for the model, suggesting stage-related differences in cognition and functionality. Furthermore, new extension features have been recently proposed, including substance use, circadian disturbances, and physical illnesses. The long-term outcomes of stage-based interventions remain an open question. While the transdiagnostic clinical staging model offers a promising alternative for classifying youth psychopathology, further empirical validation is essential before its widespread implementation.","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response: to "Prevalence of Antidepressant Use in Brazil: A Systematic Review with Meta-Analysis". 回应：“巴西抗抑郁药使用的患病率：荟萃分析的系统回顾”。

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-15 DOI: 10.47626/1516-4446-2024-4031

Frederico Giovanetti, Gustavo Goulart, Rafael Bertoni, Vanessa Venâncio, Chaiana Esmeraldino Mendes Marcon

引用次数: 0

Association of Typical and Atypical Antipsychotics with Mortality in Older Adults with Schizophrenia: a 5-year multicenter prospective study. 典型和非典型抗精神病药物与老年精神分裂症患者死亡率的关系：一项5年多中心前瞻性研究

IF 3.6 3区医学

Revista Brasileira de Psiquiatria Pub Date : 2025-03-15 DOI: 10.47626/1516-4446-2024-3954

Raphaëlle Haddad, Marina Sánchez-Rico, Katayoun Rezaei, Sandra Abou Kassm, Carlos Blanco, Mark Olfson, Frédéric Limosin, Nicolas Hoertel

{"title":"Association of Typical and Atypical Antipsychotics with Mortality in Older Adults with Schizophrenia: a 5-year multicenter prospective study.","authors":"Raphaëlle Haddad, Marina Sánchez-Rico, Katayoun Rezaei, Sandra Abou Kassm, Carlos Blanco, Mark Olfson, Frédéric Limosin, Nicolas Hoertel","doi":"10.47626/1516-4446-2024-3954","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-3954","url":null,"abstract":"Objective: Uncertainty exists over whether atypical and typical antipsychotics differ in the strength of their association with mortality among older people with schizophrenia. Here, we examined whether mortality rates and its causes significantly differ between older adults with schizophrenia taking atypical or typical antipsychotics.Methods: In a 5-year prospective multicenter study of patients aged ≥55 years with an ICD-10 diagnosis of schizophrenia, we used a multivariable logistic regression model to examine the association of atypical versus typical antipsychotics with mortality, adjusting for sociodemographic and clinical characteristics.Results: Of 313 older adults with schizophrenia, the 5-year all-cause mortality rates in patients taking atypical (N=192) and typical (N=167) antipsychotics were 36.4% and 24.3%, respectively. Following adjustment, there were not significant differences in all-cause mortality (AOR=1.56; 95%CI=0.75-3.27; p=0.24) or in death causes (all p-values>0.05) between patients taking atypical or typical antipsychotics. Atypical versus typical antipsychotics were significantly associated with decreased overall mortality in the subpopulation of participants with a baseline MMSE score<24 (AOR=0.24; 95%CI=0.07-0.84; p=0.025).Conclusions: Use of atypical antipsychotics compared to typical antipsychotics may not associated with different odds of overall mortality in older people with schizophrenia, but might be associated with reduced mortality among those with substantial cognitive impairment.","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0