Revista Brasileira de Psiquiatria最新文献

{"title":"The association between maternal fears about their infant/ toddler during the COVID-19 pandemic and depression and anxiety: a birth cohort study.","authors":"Raquel Wermann Foschiera, Júlia Pustrelo Moro, Fabiana de Abreu Getulino, Marina Xavier Carpena, Francine Dos Santos Costa, Cauane Blumenberg, Rafaela Costa Martins, Thais Martins-Silva, Luana Patrícia Marmitt, Alejandra Goicochea, Rodrigo Meucci, Juraci Cesar, Christian Loret de Mola","doi":"10.47626/1516-4446-2023-3306","DOIUrl":"10.47626/1516-4446-2023-3306","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between maternal fears about their infant/toddler and depression and anxiety during the COVID-19 pandemic.</p><p><strong>Methods: </strong>In 2019, all mothers who gave birth in hospitals in Rio Grande, RS, Brazil were asked to respond to a standardized questionnaire (baseline). We followed them between May-June 2020 (first follow-up point), August-December 2020 (second follow-up point), and from October 2021 to March 2022 (third follow-up point), and asked them if they were: (1) afraid that their infant/toddler would become infected with COVID or get sick (yes/no), (2) afraid that they would contaminate their own child with COVID, and/or (3) worried about the pandemic's effects on their child's future. At baseline and at all follow-up points, we assessed depressive symptoms using the Edinburgh Postnatal Depression Scale and anxiety symptoms using the Generalized Anxiety Disorder Scale, creating symptom trajectories using group-based trajectory modelling. We used multinomial logistic regression to calculate adjusted relative risk ratios (RRR).</p><p><strong>Results: </strong>A total of 1,296 mothers participated. Worrying about the pandemic's effects on their child's future and the fear of contaminating their own child with COVID-19 increased the risk of raising depressive symptoms to a clinical level (RRR = 4.97, 95%CI 2.32-10.64 and RRR = 3.87, 95%CI 1.58-9.47, respectively) and anxiety to a moderate level (RRR = 2.91, 95%CI 1.69-5.01 and RRR = 1.86, 95%CI 1.03-3.35, respectively).</p><p><strong>Conclusion: </strong>Fear for their children increased maternal depressive and anxiety symptoms during the pandemic.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"491-497"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for executive function impairment in adolescence: an analysis of data from the 2004 Pelotas Birth Cohort study.","authors":"Júlia de Souza Rodrigues, Alicia Matijasevich, Luciana Tovo-Rodrigues, Tiago N Munhoz, Iná S Santos, Maria Pastor-Valero","doi":"10.47626/1516-4446-2023-3277","DOIUrl":"10.47626/1516-4446-2023-3277","url":null,"abstract":"<p><strong>Objective: </strong>To investigate risk factors associated with impaired attention-related executive functions (EFs) at age 11 and working memory at age 15.</p><p><strong>Methods: </strong>Data from participants of the population-based 2004 Pelotas Birth Cohort at ages 11 (n=3,582) and 15 (n=1,950) were analyzed. The study measured attentional control, cognitive flexibility, and selective attention using the Test of Everyday Attention for Children (TEA-Ch). Spatial working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). Logistic regression was employed to explore the relationship between perinatal and childhood exposures and EF impairment.</p><p><strong>Results: </strong>Low maternal education had a significant negative impact on EFs. At age 11, it was associated with decreased attentional control (OR = 3.04; 95%CI 2.09-4.43), and at age 15, it was linked to impaired spatial working memory (OR = 2.21; 95%CI 1.58-3.09). Additional risk factors included low household income, black or brown maternal skin color, high parity, prematurity, low birth weight, and multiple siblings. Breastfeeding, regardless of duration, was found to be a protective factor against impaired cognitive flexibility (OR = 0.38; 95%CI 0.22-0.65).</p><p><strong>Conclusion: </strong>This study underscores the lasting impact of perinatal exposures on EF development. Policies that mitigate the negative effects of risk factors and promote EF development, especially among vulnerable populations, are needed.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"470-481"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian Psychiatric Association guidelines on the integration of spirituality into mental health clinical practice: Part 1. Spiritual history and differential diagnosis.","authors":"Bruno Paz Mosqueiro, Marianna de Abreu Costa, André C Caribé, Fabrício H A Oliveira E Oliveira, Leandro Pizutti, Rogério R Zimpel, Leonardo Baldaçara, Antônio Geraldo da Silva, Alexander Moreira-Almeida","doi":"10.47626/1516-4446-2023-3056","DOIUrl":"10.47626/1516-4446-2023-3056","url":null,"abstract":"<p><strong>Objectives: </strong>To present evidence-based guidelines for clinical practice regarding religiosity and spirituality in mental health care in Brazil.</p><p><strong>Methods: </strong>A systematic review was conducted to identify potentially eligible articles indexed in the PubMed, PsycINFO, SciELO, LILACS, and Cochrane databases. A summary of recommendations and their levels of evidence was produced in accordance with Oxford Centre for Evidence-Based Medicine guidelines.</p><p><strong>Results: </strong>The systematic review identified 6,609 articles, 41 of which satisfied all inclusion criteria. Taking a spiritual history was found to be an essential part of a compassionate and culturally sensitive approach to care. It represents a way of obtaining relevant information about the patient's religiosity/spirituality, potential conflicts that could impact treatment adherence, and improve patient satisfaction. Consistent evidence shows that reported perceptual experiences are unreliable for differentiating between anomalous experiences and psychopathology. Negative symptoms, cognitive and behavioral disorganization, and functional impairment are more helpful for distinguishing pathological and non-pathological anomalous experiences.</p><p><strong>Conclusion: </strong>Considering the importance of religiosity/spirituality for many patients, a spiritual history should be routinely included in mental health care. Anomalous experiences are highly prevalent, requiring a sensitive and evidence-based approach to differential diagnosis.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"506-517"},"PeriodicalIF":3.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10339071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professor Ellis Alindo D'Arrigo Busnello: a humanist and a scientist with a passion for psychiatry and psychopathology. A great mentor of Brazilian scientific postgraduate programs in psychiatry.","authors":"Flavio Kapczinski, Antonio E Nardi","doi":"10.47626/1516-4446-2023-3332","DOIUrl":"10.47626/1516-4446-2023-3332","url":null,"abstract":"","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"465-466"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10339072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-urban disparities in fruit and vegetable consumption and cognitive performance in Brazil.","authors":"Natalia Gomes Gonçalves, Laiss Bertola, Cleusa Pinheiro Ferri, Claudia Kimie Suemoto","doi":"10.47626/1516-4446-2023-3316","DOIUrl":"10.47626/1516-4446-2023-3316","url":null,"abstract":"<p><strong>Objectives: </strong>Rural residents are exposed to many risk factors for poor diet quality, such as low socioeconomic status and food insecurity. However, the differences between urban and rural residents regarding the association of fruit and vegetable consumption with cognitive performance have not been explored. The aim of this study was to investigate the association of fruit and vegetable consumption with cognitive performance in urban and rural areas in a nationally representative sample of Brazilian older adults.</p><p><strong>Methods: </strong>The sample included 9,412 adults aged 50 years or older from the Brazilian Longitudinal Study of Aging (Estudo Longitudinal da Saúde dos Idosos Brasileiros [ELSI]). The association between consumption of fruits and vegetables and cognitive performance was evaluated using linear regression.</p><p><strong>Results: </strong>In 8,158 participants (mean age 61.6 ± 9.3 years, 54% women, 44% White, and 15% from rural areas), the mean frequency of fruit and vegetable consumption was 2.0 ± 1.3 times a day. Higher intake of fruits and vegetables was associated with better memory (ß = 0.031, 95%CI 0.014-0.049), verbal fluency (ß = 0.030, 95%CI 0.004-0.056), and global cognition (ß = 0.035, 95%CI 0.015-0.055) performance in urban, but not rural residents (p for interaction = 0.036).</p><p><strong>Conclusions: </strong>Higher frequency of fruit and vegetable intake was associated with better cognitive performance in urban, but not in rural areas in Brazil.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"498-505"},"PeriodicalIF":3.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS).","authors":"Lais B Razza, Miles Wischnewski, Paulo Suen, Stefanie De Smet, Pedro Henrique Rodrigues da Silva, Beatriz Catoira, André R Brunoni, Marie-Anne Vanderhasselt","doi":"10.47626/1516-4446-2023-3116","DOIUrl":"10.47626/1516-4446-2023-3116","url":null,"abstract":"<p><strong>Objective: </strong>Transcranial direct current stimulation (tDCS) has mixed effects for major depressive disorder (MDD) symptoms, partially owing to large inter-experimental variability in tDCS protocols and their correlated induced electric fields (E-fields). We investigated whether the E-field strength of distinct tDCS parameters was associated with antidepressant effect.</p><p><strong>Methods: </strong>A meta-analysis was performed with placebo-controlled clinical trials of tDCS enrolling MDD patients. PubMed, EMBASE, and Web of Science were searched from inception to March 10, 2023. Effect sizes of tDCS protocols were correlated with E-field simulations (SimNIBS) of brain regions of interest (bilateral dorsolateral prefrontal cortex [DLPFC] and bilateral subgenual anterior cingulate cortex [sgACC]). Moderators of tDCS responses were also investigated.</p><p><strong>Results: </strong>A total of 20 studies were included (21 datasets, 1,008 patients), using 11 distinct tDCS protocols. Results revealed a moderate effect for MDD (g = 0.41, 95%CI 0.18-0.64), while cathode position and treatment strategy were found to be moderators of response. A negative association between effect size and tDCS-induced E-field magnitude was seen, with stronger E-fields in the right frontal and medial parts of the DLPFC (targeted by the cathode) leading to smaller effects. No association was found for the left DLPFC and the bilateral sgACC. An optimized tDCS protocol is proposed.</p><p><strong>Conclusion: </strong>Our results highlight the need for a standardized tDCS protocol in MDD clinical trials.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"518-529"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10124202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian research consortium on obsessive-compulsive spectrum disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part II: Cognitive-Behavior Therapy treatment.","authors":"Maria Alice de Mathis, Priscila Chacon, Rodrigo Boavista, Marcos Vinícius Sousa de Oliveira, Pedro Macul Ferreira de Barros, Marco Antonio Nocito Echevarria, Ygor Arzeno Ferrão, Edoardo Felippo de Queiroz Vattimo, Antônio Carlos Lopes, Albina Rodrigues Torres, Juliana Belo Diniz, Leonardo Fontenelle, Maria Conceição do Rosário, Roseli Gedanke Shavitt, Renata de Melo Felipe da Silva, Eurípedes Constantino Miguel, Daniel Lucas da Conceição Costa","doi":"10.47626/1516-4446-2023-3081","DOIUrl":"10.47626/1516-4446-2023-3081","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD).</p><p><strong>Methods: </strong>A systematic review of the literature on CBT interventions for the treatment of adult OCD, comprising behavior therapy and exposure and response prevention (ERP) was done. The objective of this study is to present updated clinical guidelines to clinicians, providing comprehensive details regarding the necessary procedures to be incorporated into the CBT protocol. We searched the literature published from 2013-2020 in five databases (PubMed, Cochrane, Embase, Psycinfo and Lilacs), considering: study design, primary outcome measures, type of publication and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA).</p><p><strong>Results: </strong>We examined 44 new studies used to update the APA guidelines from 2013. High-quality evidence supports CBT including ERP techniques as the first-line CBT treatment for OCD. In addition, protocols for internet-delivered CBT have also demonstrated their efficacy for the treatment of adults with OCD.</p><p><strong>Conclusion: </strong>CBT based on ERP is a widely used treatment according to high-quality scientific evidence to treat adults with OCD.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10651938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The best of two worlds: Combining the DSM-5 and ICD-11 clusters of symptoms for posttraumatic stress disorder in a single screening scale.","authors":"Alina Vasconcelos, Michael Reichenheim, Elizabeth do Nascimento, Eduardo Lima, Christian Kristensen, Mauro Mendlowicz","doi":"10.47626/1516-4446-2023-3143","DOIUrl":"10.47626/1516-4446-2023-3143","url":null,"abstract":"<p><strong>Objectives: </strong>The most recent DSM-5 (2013) and ICD-11 (2018) diagnostic criteria for posttraumatic stress disorder (PTSD) encompass 20 and six symptoms, respectively, organized in different structures. This study aimed to investigate the dimensions of the Posttraumatic Stress Disorder Checklist 5 (PCL-5) according to the DSM-5's broader definition of PTSD and the ICD-11's narrower approach, as well as to explore an alternative restricted model that retains the core symptoms explicitly related to traumatic experiences.</p><p><strong>Methods: </strong>Data were gathered from Brazilian employees (n=1,101) who had directly experienced traumatic life events or had been exposed to them because of their work activities. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to evaluate the configural and metric structures of the models.</p><p><strong>Results: </strong>We estimated seven models of the latent structure of PTSD including the four-factor DSM-5 and three-factor ICD-11 PTSD models. Given the lack of evidence of their validity, an alternative 10-symptom model was tested. The final seven-item PTSD model considerably improved estimation of the PTSD construct. This solution showed reliable items with non-redundant content, acceptable fit indices, and satisfactory configural and metric properties.</p><p><strong>Conclusion: </strong>The more parsimonious one-dimensional model comprising the core PTSD symptoms has the potential to improve assessment of PTSD.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"423-430"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yanomami humanitarian tragedy: an urgent colonial heritage issue.","authors":"Marcelo G Lima, Thiago M Fidalgo","doi":"10.47626/1516-4446-2023-3321","DOIUrl":"10.47626/1516-4446-2023-3321","url":null,"abstract":"","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"459-462"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of hedonic perception of odors as a marker of treatment response to escitalopram: olfactory changes through an open-label antidepressant trial.","authors":"François Kazour, Boriana Atanasova, Thomas Desmidt, Valérie Gissot, Apolline Lefevre, Vincent Camus, Catherine Belzung, Wissam El-Hage","doi":"10.47626/1516-4446-2023-3107","DOIUrl":"10.47626/1516-4446-2023-3107","url":null,"abstract":"<p><strong>Objectives: </strong>To assess olfactory functions (threshold, identification, and hedonic valence) of depressed subjects before and after an 8-week trial of escitalopram and compare the results of responders and nonresponders.</p><p><strong>Methods: </strong>Fifty-two depressed subjects were recruited. Participants received escitalopram and were evaluated at two visits: baseline (V0) and week 8 (V8). They were categorized as responders (Montgomery-Åsberg Depression Rating Scale [MADRS] score reduction of > 50%) or nonresponders to treatment. Participants were evaluated with the Mini International Neuropsychiatric Interview (MINI) at V0 and, at V0 and V8, completed psychometric and olfactory assessments, including MADRS and the State-Trait Anxiety Inventory (STAI), as well as the Sniffin' Sticks® test (threshold and identification tasks). The hedonic valence of smell was assessed on a 10-cm linear scale after presenting two pleasant and two unpleasant odors. Forty-three participants completed the study (24 responders and 19 nonresponders). The Mann-Whitney, chi-square, and Fisher's exact tests were used to compare olfactory, clinical, and demographic variables between groups and within the same group at V0 and V8. The Spearman coefficient was used to calculate the correlation between clinical characteristics and olfactory variables.</p><p><strong>Results: </strong>The hedonic score of pleasant odors increased significantly between V0 and V8 only for responders (V = 61.5, p = 0.018), with no significant change in nonresponders (V = 90.5, p = 0.879). Comparison of olfactory performances between groups at V0 and V8 separately did not show a significant difference between responders and nonresponders to escitalopram. Olfactory threshold and identification scores were not different between V0 and V8 for responders or nonresponders.</p><p><strong>Conclusion: </strong>Depressed subjects have olfactory anhedonia, which appears to regress following a positive antidepressant response. Hedonic valence may be an indicator of cognitive changes associated with depression; improvement of this valence may indicate a clinical response to antidepressants.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"414-422"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10289817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}