Revista Brasileira de Psiquiatria最新文献

{"title":"Risk of suicide in association with major depressive disorder among patients with dementia: a populationbased nested case-control study.","authors":"Jiun-Yi Wang, Yi-Ting Hsu, Chih-Yuan Lin, Chien-Hui Liu, Kun-Chia Chang, Chih-Ching Liu","doi":"10.47626/1516-4446-2024-3605","DOIUrl":"10.47626/1516-4446-2024-3605","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the association between major depressive disorder (MDD) and suicide risk in patients with dementia.</p><p><strong>Methods: </strong>A cohort of 625,218 individuals aged = 40 years with dementia was identified from Taiwan's National Health Insurance Research Database (NHIRD) between 2007 and 2018. After excluding prevalent cases in 2007, a nested case-control study enrolling 1,256 suicide cases and 5,022 matched controls was conducted. The frequencies of MDD-related outpatient or inpatient visits over a 7-year period preceding the event dates were calculated and analyzed for association using conditional logistic regression.</p><p><strong>Results: </strong>Dementia comorbid with MDD was associated with increased suicide risk (adjusted OR [AOR]: 2.67), particularly in individuals with = 1.0 MDD episodes per year (AOR: 2.85). A similar association was observed only in individuals aged = 65 years and males, with a pronounced risk of suicide in those experiencing = 1.0 MDD episodes per year (AOR: 3.08 for individuals aged = 65 years; AOR: 3.28 for males). Conversely, the risk increase was evident with > 1.0 MDD episodes per year in those aged < 65 years (AOR: 3.04) and females (AOR: 2.45).</p><p><strong>Conclusion: </strong>MDD is associated with suicide risk in patients with dementia. The strength of this association possibly varies with age and gender.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243605"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12679695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294252","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":"Online narrative therapy intervention improves post-traumatic stress disorder symptoms, perceived stress, anxiety, and depression in nurses: a randomized controlled trial.","authors":"Mengxin Xue, Ping Yu, Zhie Gu, Yanfei Sun","doi":"10.47626/1516-4446-2024-3740","DOIUrl":"10.47626/1516-4446-2024-3740","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of narrative therapy on post-traumatic stress disorder (PTSD) symptoms, perceived stress, anxiety, and depression in nurses.</p><p><strong>Methods: </strong>A total of 92 clinical nurses with positive PTSD symptom screening results were randomly assigned (1:1) to the intervention or control group. The intervention group received narrative therapy and a psychological stress leaflet, while the control group received only a psychological stress leaflet. PTSD, perceived stress, anxiety, and depression were measured before and after the intervention to assess the effect of narrative therapy.</p><p><strong>Results: </strong>After the intervention, the intervention group showed significantly lower PTSD symptom levels (p = 0.025), perceived stress (p = 0.033), anxiety (p = 0.004), and depression (p = 0.015) than the control group. Regarding the dichotomous PTSD, anxiety, and depression outcomes, there was a statistically significant decrease in the number of positive cases of PTSD (p = 0.030) and anxiety (p = 0.002), but no significant change in the number of positive cases of depression (p = 0.060).</p><p><strong>Conclusion: </strong>Narrative therapy is expected to alleviate PTSD symptoms, stress, anxiety, and depression among frontline clinical nurses, and healthcare managers should consider narrative therapy interventions to improve the mental health of their nursing staff.</p><p><strong>Clinical trial registration: </strong>ChiCTR2200058472. Registration date: April 09, 2022. Date of first recruitment: June 1, 2022.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243740"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352922","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":"Parenthood and all-cause mortality in older adults with schizophrenia: a multicenter 5-year prospective study.","authors":"Katayoun Rezaei, Sandra Abou Kassm, María Sofía Garcés-González, Marina Sánchez-Rico, Mark Olfson, Charles Ouazana-Vedrines, Valentin Scheer, Mahdi Fayad, Pierre Meneton, Frédéric Limosin, Nicolas Hoertel","doi":"10.47626/1516-4446-2024-3731","DOIUrl":"10.47626/1516-4446-2024-3731","url":null,"abstract":"<p><strong>Objective: </strong>The large body of literature examining the association between parenthood and mortality in the general population contrasts with a lack of such studies on older adults with schizophrenia. Identifying potential protective factors of premature death in this population is important to help guide prevention measures. Here, we examined whether all-cause and cause-specific mortality rates significantly differ between older parents and non-parents with schizophrenia during a 5-year follow-up.</p><p><strong>Methods: </strong>We used data from a 5-year prospective multicenter sample of older adults with an ICD-10 diagnosis of schizophrenia (aged 55 years or more) recruited in France. We performed a forward stepwise logistic regression to examine the association between parenthood and all-cause mortality, including only independent variables that best explain outcome.</p><p><strong>Results: </strong>Of the 323 older adults with schizophrenia, 133 (41.2%) were parents (mean age = 67.0, SD = 6.1) and 190 were not (mean age = 67.2, SD = 6.6). Following adjustments, parenthood was significantly associated with lower all-cause mortality compared to patients without children (21.1% [n=28] vs. 35.8% [n=68]; AOR = 0.50; 95%CI 0.27-0.94; p = 0.032); the association involved no significant sex differences.</p><p><strong>Conclusion: </strong>Parenthood could be a protective factor against mortality among older patients with schizophrenia who live in France. Further research is needed to understand the specific mechanisms underlying this association.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243731"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352923","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":"Short and long-term effects of cognitive behavioral therapy on sleep problems and psychotic symptoms in patients with psychotic disorders: a meta-analysis.","authors":"Mustafa Ugurlu, Gorkem Karakas Ugurlu, Esra Kabadayi Sahin, Gulsum Zuhal Kamis, Ali Caykoylu","doi":"10.47626/1516-4446-2024-3623","DOIUrl":"10.47626/1516-4446-2024-3623","url":null,"abstract":"<p><strong>Objective: </strong>Sleep problems are common in patients with psychotic disorders, especially schizophrenia. Although pharmacological methods are at the forefront of treatment, they have some drawbacks. Cognitive behavioral therapy for insomnia (CBT-I) is an option for the treatment of individuals with insomnia; in recent years, interest in its use in patients with psychotic disorders has been increasing. This meta-analysis aims to evaluate the effectiveness of CBT-I for sleep problems in patients with psychotic disorders.</p><p><strong>Methods: </strong>A systematic search of the PubMed, Scopus, and EBSCO (MEDLINE) databases was conducted to identify relevant studies. The inclusion criteria were randomized controlled trials (RCTs) and uncontrolled studies that focused on participants diagnosed with schizophrenia, schizoaffective disorder, delusional disorder, psychotic disorders not otherwise specified, bipolar disorders, or unipolar depression with psychotic features, who had had sleep problems for at least 1 month, and who were receiving treatment. The initial search yielded 246 studies, of which eight were ultimately selected for meta-analysis after screening and applying inclusion and exclusion criteria. Statistical analysis was conducted in the R software environment.</p><p><strong>Results: </strong>CBT-I significantly ameliorates insomnia and sleep quality in patients with psychotic disorders in both the short and long term. Additionally, CBT-I leads to significant improvement in psychotic symptoms in the short-term period and contributes significantly to improvement in mental well-being in both short- and long-term follow-up.</p><p><strong>Conclusions: </strong>CBT-I is an effective, valuable method for sleep problems in patients with psychotic disorders. Its widespread use for this purpose is recommended.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243623"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894186","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":"Emergency psychiatric care seeking among individuals who died by suicide in Fortaleza in 2022.","authors":"Ana Carolina Parahyba Asfor, Matias Carvalho Aguiar Melo","doi":"10.47626/1516-4446-2024-3635","DOIUrl":"10.47626/1516-4446-2024-3635","url":null,"abstract":"<p><strong>Objective: </strong>Suicide represents 1% of all deaths in the world, and it is more prevalent in developing countries. Because suicide mortality has been growing in recent years in Brazil, we investigated whether patients who committed suicide in 2022 in Fortaleza sought care in the state's only psychiatric emergency service before the act.</p><p><strong>Methods: </strong>This retrospective cross-sectional study used data from electronic psychiatric emergency records and reports from the state department of forensics.</p><p><strong>Results: </strong>A total of 292 deaths (25% women) were identified, representing almost 2% of mortality in Fortaleza that year. Only 2.7% of those who committed suicide during this period requested an emergency psychiatric evaluation in the 3 months prior to death. Of these individuals, 75% mentioned suicidal ideation. Most deaths (70%) were due to hanging.</p><p><strong>Conclusion: </strong>The majority of patients who committed suicide in Fortaleza in 2022 did not seek care from the psychiatric emergency service prior to the event; further studies are needed to investigate the causes of this behavior.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243635"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639696","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":"Leme Lopes: pioneering multiaxial diagnosis and the dilemma of subjectivity.","authors":"Larissa Junkes, Walmor J Piccinini, Antonio E Nardi","doi":"10.47626/1516-4446-2024-3990","DOIUrl":"10.47626/1516-4446-2024-3990","url":null,"abstract":"","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243990"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896975","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":"A case of recurrent priapism during prolonged clozapine administration","authors":"Kelly Acosta Gallardo, Nestor Andrades, Trino Baptista, Jose de Leon, Carlos De las Cuevas, Daniel Jose Salazar Juarez","doi":"10.47626/1516-4446-2024-4053","DOIUrl":"10.47626/1516-4446-2024-4053","url":null,"abstract":"","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20244053"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639660","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":"Maternal depressive symptoms trajectories and harsh parenting: the mediating role of maternal quality of life in the 2004 Pelotas Birth Cohort.","authors":"Alicia Matijasevich, Jessica Mayumi Maruyama, Luciana Tovo-Rodrigues, Iná S Santos","doi":"10.47626/1516-4446-2024-3652","DOIUrl":"10.47626/1516-4446-2024-3652","url":null,"abstract":"<p><strong>Objective: </strong>To study the impacts of maternal depressive symptoms trajectories and harsh parenting and explore if the maternal quality of life (QoL) mediates this association.</p><p><strong>Methods: </strong>We used data from the 2004 Pelotas Birth Cohort, a population-based longitudinal study from Pelotas, Brazil (n=3,285 mothers, complete cases analysis). We used the Edinburgh Postnatal Depression Scale (EPDS) to assess maternal depressive symptoms and calculated their trajectories from 3 months until the 11-year follow-up using a group-based modeling approach. Psychological and physical aggression were measured using the Parent-Child Conflict Tactics Scale (CTSPC). Maternal QoL was measured by the question \"How is your quality of life?\" Data were analyzed using path models in Mplus.</p><p><strong>Results: </strong>All maternal depressive symptoms trajectories increased the frequency of psychological and physical aggression at early adolescence when compared to the reference group. Mediation analysis indicated that maternal depressive symptoms led to low levels of perceived maternal QoL, which in turn was associated with increased use of harsh parenting. The proportion of total effect explained by maternal QoL ranged from 4.04% (0.00-5.58%) to 16.31% (10.88-19.10%).</p><p><strong>Conclusion: </strong>Our findings, within a longitudinal framework from a middle-income country, support existing evidence that maternal depressive symptoms are associated with harsh parenting. Our results also suggest that one mechanism underlying this association is lower perceived maternal QoL.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243652"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12677847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294249","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":"Patterns of drug combinations used by men who have sex with men in Brazil.","authors":"Rodrigo Nikobin, Julio Mella-Cobas, Maria Amelia Veras, Francisco Inácio Bastos, Jordi Casabona Barbarà, Valeria Stuardo Ávila, Dartiu Xavier da Silveira","doi":"10.47626/1516-4446-2024-3874","DOIUrl":"10.47626/1516-4446-2024-3874","url":null,"abstract":"<p><strong>Objective: </strong>The practice of using drugs to modulate experiences is a well-documented phenomenon worldwide, particularly among men who have sex with men (MSM). This study aims to describe patterns of drug combinations used by Brazilian MSM, embracing a detailed examination of the Brazilian context, which may inspire research elsewhere while enriching the global panorama on MSM drug use. By focusing on Brazilian MSM, the study sheds light on specific drug use combinations, which may help in the development of effective, culturally sensitive public health strategies.</p><p><strong>Methods: </strong>This investigation was conducted within the Latin American MSM Internet Survey, a pioneer online study addressing psychosocial and sexual health of MSM in the region. Conducted from January to May 2018, the survey garnered responses from over 18,139 Brazilian MSM. Using exploratory factor analysis through maximum likelihood estimation, the study identified distinct sub-groups of drug users among 15,499 participants after exclusion due to discrepant responses (Kaiser-Meyer-Olkin measure = 0.94 and Bartlett's test = 0.01), indicating adequate sampling and suitability for factor analysis across all substances.</p><p><strong>Results: </strong>The factor analysis revealed four primary drug combination groups among participants: Group One (Heavy Drug Users), Group Two (Party Drug Users), Group Three (Conservative Users), and Group Four (Classic Chemsex Users). Each group represents unique drug use patterns and preferences, from the use of potent stimulants to more socially accepted substances like tobacco and cannabis. Notably, Group One, identified as \"heavy\" drugs users, used particularly risky substances, including mephedrone, crack, crystal meth, heroin, and other synthetic stimulants.</p><p><strong>Conclusion: </strong>The findings reveal diverse and complex drug use patterns among MSM in Brazil. Understanding these patterns is essential for developing targeted interventions and support mechanisms for various sub-groups among MSM. Future research should focus on the health outcomes associated with these patterns and the social and psychological contexts of drug use.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243874"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010760","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":"Longitudinal gut microbiota composition during the perinatal period in women with different intensities of depressive symptoms.","authors":"Amanda S Mota, Luiz Gustavo Sparvoli, Pedro Augusto R Vanzele, Nathalia F Naspolini, Eric de Castro Tobaruela, Carlos T Yoshizaki, Rossana Pulcineli Vieira Francisco, Ana Maria S S Oliveira, Marco Aurélio Knippel Galletta, Vera Lucia C Tess, Carla R Taddei","doi":"10.47626/1516-4446-2024-3721","DOIUrl":"10.47626/1516-4446-2024-3721","url":null,"abstract":"<p><strong>Objective: </strong>Depressive symptoms during the perinatal period significantly impact mothers and infants. Emerging evidence suggests a connection between gut microbiota and mood regulation. This study investigated whether depressive symptoms are associated with changes in the gut microbiota of women during the perinatal period.</p><p><strong>Methods: </strong>Thirty-four pregnant women were screened for depression using the Edinburgh Postnatal Depression Scale (EPDS) and categorized based on symptom severity. Stool samples were collected during the third trimester and at two postpartum timepoints. All samples underwent 16S rRNA gene sequencing and quantification of short-chain fatty acids (SCFA) by gas chromatography-mass spectrometry (GC-MS).</p><p><strong>Results: </strong>No differences in SCFA concentrations were observed between groups (p > 0.05). However, postpartum women with moderate to severe symptoms (MS group) had a significant increase in Enterobacteriaceae abundance compared to women with mild or absent symptoms (AM group) (p < 0.05). The Bifidobacterium genus increased significantly in both groups over time (p < 0.05). The MS group showed a reduction in depressive symptoms during psychiatric treatment (p < 0.05).</p><p><strong>Conclusion: </strong>These findings suggest a link between gut microbiota and perinatal depressive symptoms. Further research using microbiome-targeted approaches is needed to understand the broader implications for maternal health.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243721"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294248","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}