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":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors of alcohol initiation among Brazilian adolescents: assessing the role of attitudes, decision-making, communication, and resistance skills.","authors":"Juliana Y Valente, Sheila C Caetano, Miguel Henrique da Silva Dos Santos, Zila M Sanchez","doi":"10.47626/1516-4446-2024-3896","DOIUrl":"10.47626/1516-4446-2024-3896","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether attitudes toward drug use, as well as decision-making, communication, and alcohol resistance skills, act as predictors of alcohol use and binge drinking initiation among Brazilian students, considering sex differences.</p><p><strong>Methods: </strong>In a longitudinal sample of 1,103 seventh-grade students from 15 Brazilian public schools, we explored if attitudes toward drug use and decision-making, communication, and alcohol resistance skills at baseline predicted alcohol outcomes 9 months later.</p><p><strong>Results: </strong>Lower levels of resistance skills (i.e., ORboys = 0.29; 95%CI 0.12-0.70) and positive attitudes toward drugs (i.e., ORgirls: = 1.41; 95%CI 1.02-1.94) were predictors of alcohol use onset and binge drinking, independently of sex. Decision-making predicted binge drinking initiation, but only for girls (OR = 0.73; 95%CI 0.59-0.91). Negative attitudes toward drugs were a risk factor for alcohol use initiation, but only for boys (OR = 0.78; 95%CI 0.64-0.95).</p><p><strong>Conclusion: </strong>Our findings highlight the importance of understanding the predictors of alcohol initiation in adolescents, to inform which key components preventive programs should address in their activities to achieve the expected preventive outcomes.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243896"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984667","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}

{"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":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candidate genes related to spiritual mediumship: a whole-exome sequencing analysis of highly gifted mediums.","authors":"Wagner Farid Gattaz, Marianna de Abreu Costa, Angélica Salatino-Oliveira, Daniel Gaspar Gonçalves, Leda L Talib, Alexander Moreira-Almeida","doi":"10.47626/1516-4446-2024-3958","DOIUrl":"10.47626/1516-4446-2024-3958","url":null,"abstract":"<p><strong>Objective: </strong>There has been a call for neuroscientific studies of spiritual experiences due to their global prevalence, significant impact, and importance for understanding the mind-brain problem. Mediumship is a spiritual experience where individuals claim to communicate with or be influenced by deceased persons or non-material entities. We assessed whether mediums carry specific genetic alterations.</p><p><strong>Methods: </strong>We selected highly gifted mediums (n=54) with over 10 years of experience who engaged in mediumistic work for no material gain, performed whole-exome sequencing of these individuals, and compared its findings to those of first-degree relatives who claimed no mediumship (n=53).</p><p><strong>Results: </strong>We identified 15,669 variants exclusively found in mediums, likely to impact the function of 7,269 genes. Thirty-three of these genes were altered in at least one-third of all mediums but in none of their relatives. The inflammatory pathway was the most frequently affected (43.9%), with the translocation of zeta-chain associated protein kinase 70 kDa (ZAP-70) to the immunological synapse being particularly prominent.</p><p><strong>Conclusion: </strong>This is the first exome-wide investigation of genes possibly related to mediumistic experiences. We identified gene variants that were present in mediums but not in their non-medium first-degree relatives. These genes emerge as possible candidates for further investigations of the biological underpinnings that allow spiritual experiences such as mediumship.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243958"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053477","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}

{"title":"Effects of home-use transcranial direct current stimulation on clusters of depressive symptoms: an ancillary analysis of the PSYLECT study.","authors":"Matthias S Luethi, Lucas Borrione, Beatriz A Cavendish, Luana V M Aparicio, Stephan Goerigk, Matheus R F Ramos, Natasha K S Moran, Adriana M Carneiro, Leandro Valiengo, Darin O Moura, Juliana P de Souza, Mariana P Batista, Valquiria Aparecida da Silva, Izio Klein, Paulo Suen, José Gallucci-Neto, Frank Padberg, Lais B Razza, Marie-Anne Vanderhasselt, Paulo A Lotufo, Isabela M Bensenor, Felipe Fregni, Andre R Brunoni","doi":"10.47626/1516-4446-2024-3972","DOIUrl":"10.47626/1516-4446-2024-3972","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder is heterogeneous. While transcranial direct current stimulation (tDCS) is an effective treatment, its impact on symptoms remains underexplored. This ancillary study investigated the effects of home-use tDCS on depression symptom clusters.</p><p><strong>Methods: </strong>Data were used from the Portable Transcranial Electrical Stimulation and Internet-Based Behavioral Therapy for Major Depression Study (PSYLECT) study, in which 210 depressed patients were randomized to active (n=137) or sham tDCS (n=73) for 6 weeks. Items from the Hamilton Depression Rating Scale were grouped into symptom clusters using hierarchical clustering. Treatment effects were analyzed with mixed regressions. An alternative clustering solution was also evaluated using a larger sample.</p><p><strong>Results: </strong>Four clusters were identified: emotional, sleep, psychomotor, and psychosomatic symptoms. None showed significant group differences (sleep: p = 0.058, Cohen's d = 0.36, emotional: p = 0.976, d = -0.01, psychosomatic: p = 0.157, d = 0.27, psychomotor: p = 0.944, d = 0.01). The alternative clustering solution produced a similar sleep cluster, where tDCS led to significant reductions (p = 0.033, d = 0.41), but no differences were observed in other clusters (emotional: p = 0.707, d = 0.07, atypical: p = 0.537, d = 0.12).</p><p><strong>Conclusion: </strong>The association between tDCS and sleep improvement warrants further study. tDCS may be more effective for specific symptom clusters.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243972"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524168","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}

{"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":"10.47626/1516-4446-2024-3954","url":null,"abstract":"<p><strong>Objective: </strong>Due to the uncertainty whether atypical and typical antipsychotics have a stronger association with mortality among older people with schizophrenia, we examined the rates and causes of mortality in older adults with schizophrenia who take atypical or typical antipsychotics.</p><p><strong>Methods: </strong>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 between atypical vs. typical antipsychotics and mortality, adjusting for sociodemographic and clinical characteristics.</p><p><strong>Results: </strong>Of 313 older adults with schizophrenia, the 5-year all-cause mortality rates in patients who took atypical (n=192) and typical (n=167) antipsychotics were 36.4% and 24.3%, respectively. Following adjustment, no significant differences were found in all-cause mortality (AOR = 1.56; 95%CI 0.75-3.27; p = 0.24) or causes of mortality (all p > 0.05) between medication groups. Atypical antipsychotics were significantly associated with lower overall mortality in the subpopulation with baseline Mini Mental State Examination scores < 24 (AOR = 0.24; 95%CI 0.07-0.84; p = 0.025).</p><p><strong>Conclusion: </strong>Although atypical antipsychotics may not be associated with lower odds of overall mortality than typical antipsychotics in older people with schizophrenia, they might be associated with lower mortality among those with substantial cognitive impairment.</p>","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":"e20243954"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","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}

{"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":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has the time come to ban smartphones in Brazilian schools?","authors":"Paulo Marcos Brasil Rocha, Antônio Marcos Alvim-Soares, Maria Carolina Lobato Machado, Thales Pimenta de Figueiredo, Ana Paula de Alcântara Freitas, Débora Marques de Miranda, Marco Aurélio Romano Silva","doi":"10.47626/1516-4446-2024-4012","DOIUrl":"10.47626/1516-4446-2024-4012","url":null,"abstract":"","PeriodicalId":21244,"journal":{"name":"Revista Brasileira de Psiquiatria","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971946","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}