Trends in Psychiatry and Psychotherapy最新文献

{"title":"Does a lifestyle-based intervention improve sleep quality in individuals with major depressive disorder? A randomized controlled trial.","authors":"Maria Luiza de Morais Barros, Vagner Deuel de O Tavares, Geovan Menezes de Sousa, Geissy Lainny de Lima-Araujo, Felipe B Schuch, Brendon Stubbs, Raissa Nóbrega de Almeida, Jaime Eduardo Hallak, Emerson Arcoverde, Nicole Leite Galvão-Coelho","doi":"10.47626/2237-6089-2025-1120","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1120","url":null,"abstract":"<p><strong>Background: </strong>Major Depressive Disorder (MDD) is a leading cause of global disability, contributing to substantial individual, social, and economic burdens. While antidepressant therapy remains the cornerstone of treatment, complementary lifestyle-based interventions, such as multimodal exercise and mindfulness, have shown promise in alleviating mood symptoms. However, their specific impact on sleep quality, a critical therapeutic target in MDD, remains underexplored.</p><p><strong>Methods: </strong>In a 12-week randomized controlled trial, 88 patients with MDD were assigned to three groups: pharmacotherapy alone (control group-CG), pharmacotherapy plus home-based multimodal exercise (exercise group-EG), or pharmacotherapy plus home-based mindfulness training (mindfulness group-MF). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) at baseline, week 5, and week 12.</p><p><strong>Results: </strong>A Linear Mixed-Model (LMM) was performed, and significant group-by-time interactions were observed. At baseline, the EG exhibited lower PSQI scores compared to the MF (p=.002, d=.75) and CG (p=.001, d=.83). At week 5, the EG continued to show superior sleep quality relative to mindfulness (p=.018, d=.64) and CG (p=.001, d=.89). At week 12, the MF also demonstrated better sleep quality than the CG (p=.002, d=.80). All groups improved over time, with exercise yielding rapid benefits and MF showing progressive, sustained improvements.</p><p><strong>Conclusion: </strong>Lifestyle-based interventions enhance sleep quality in MDD when combined with antidepressant therapy. Multimodal exercise offers immediate improvements, while mindfulness provides gradual, long-term benefits. These findings underscore the value of adjunctive lifestyle interventions in MDD management and highlight the need for further research into their long-term efficacy and potential synergistic effects.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased use of psychiatric drugs in Brazil over the years: evidence from a country-wide dataset.","authors":"Alana Castro Panzenhagen, Augusto Cezar Sartori Maffini, Raul Dantas, Ken Shimomura, Maria Letícia Rodrigues Ikeda, Daniel Pens Gelain, Flávio Milman Shansis, José Cláudio Fonseca Moreira","doi":"10.47626/2237-6089-2024-0914","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0914","url":null,"abstract":"<p><strong>Objectives: </strong>Stressful events can impact the incidence of psychiatric disorders and, therefore, psychiatric drug use. However, it is not clear whether psychiatric drug use is stable or not across the Brazilian population over time. The aim of this study was to investigate trends in psychiatric drug sales in Brazil over the years, using sales data from private-sector pharmacies as a proxy for psychiatric drug consumption.</p><p><strong>Methods: </strong>This is a non-interventional pharmacoepidemiological study using routinely collected health data from 2015 to 2021. The primary outcome was the amount of psychiatric drugs sold, corresponding to an individual or entity purchase recorded in the national system.</p><p><strong>Results: </strong>We found an overall annual increase in psychiatric drug sales in the last few years (Z = -2748·7, p = 2·2 x 10-16). Antidepressants and antipsychotics are by far the top seller psychiatric drugs. The south and southeast regions of Brazil and the state of Pará simultaneously show high levels of psychiatric drug sales, COVID-19 confirmed cases, and per capita income. We have raised hypotheses that might help explain the variations in psychiatric drug consumption. We provide evidence of a growing psychiatric drug sale over the years, likely reflecting an increase in psychiatric disorders or symptoms.</p><p><strong>Conclusion: </strong>The trend reported here indicates an association between increased psychiatric drug sales and recent socioeconomic and health crises, including the COVID-19 pandemic, but causality cannot be established. This is possibly just the beginning of a major nationwide challenge that deserves attention going forward so that effective measures are implemented.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Acceptance and Commitment Therapy for Patients with Cardiovascular Disease\": the Role of Group Dynamics Integration, Digitalization, and Follow-up.","authors":"Al Halik, Budi Astuti, Farida Agus Setiawati","doi":"10.47626/2237-6089-2025-1138","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1138","url":null,"abstract":"","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the relationship between excessive internet use and sleep quality and the implications of this relationship: a systematic review.","authors":"Simone Gazale, Natia Horato, Antonio E Nardi, Anna Lucia King","doi":"10.47626/2237-6089-2025-1086","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1086","url":null,"abstract":"<p><strong>Background: </strong>The internet has become an important element in people's lives. The increasing use of smartphones and other electronic devices has promoted an increase in digital interactions, resulting in significant problems in the field of mental health. However, one of the implications of excessive internet use is impaired sleep quality, especially among users who use the internet before bed.</p><p><strong>Methods: </strong>We searched the PubMed, Web of Science and PsycINFO databases to identify articles that addressed the association between excessive internet use and sleep quality. Studies in which participants had a previous diagnosis of insomnia or used psychoactive substances were excluded.</p><p><strong>Results: </strong>The initial search resulted in a total of 3269 articles, 25 of which met the inclusion criteria. The results suggested an association between excessive internet use and sleep quality.</p><p><strong>Conclusions: </strong>Excessive internet use significantly compromises sleep quality, directly affecting users' mental and physical health. This study highlights the importance of strategies that promote digital education to raise awareness about the risks of excessive use of screens.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent Class Profiles and Factors Associated with Willingness to Change in Open Drug Scenes in Three Brazilian Cities.","authors":"Clarice S Madruga, Katia I S Barreto, Martha Canfield, Danilo Seabra, Fernanda M Garbosa, Claudio J Silva, André Miguel, Quirino Cordeiro, Ronaldo R Laranjeira","doi":"10.47626/2237-6089-2025-1058","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1058","url":null,"abstract":"<p><strong>Introduction: </strong>Several major cities face public health challenges related to Open Drug Scenes (ODS), where illicit drugs are used and sold openly in public spaces. Despite the growing public and political attention attracted by ODS, quantitative studies exploring the profile of people who use drugs (PWUD) within ODS are lacking. This study aimed to: i) examine the profile of PWUD within ODS in three metropolitan cities of Brazil, and ii) explore potential profile factors associated with willingness to change and healthcare utilisation among PWUD within ODS.</p><p><strong>Methods: </strong>Cross-sectional survey using time-location sampling method interviewed 489 PWUD at ODS across three Brazilian cities during 2021-22. Latent class analyses to identify homogeneous classes of PWUD based on ODS attendance patterns. Multinomial logistic regression models examined factors associated with willingness to change across profile classes.</p><p><strong>Results: </strong>Two PWUD profiles in ODS were identified: Chronically Excluded (61.0%) and Self Excluded (39.0%). Both showed high levels of willingness to change, and it was associated with physical health problems. Among the CE group, willingness increased with welfare benefits, emergency care for drug intoxication, and SUD treatment.</p><p><strong>Conclusion: </strong>This study offers new insights into PWUD profiles in Brazil's ODS, showing high willingness to change across both profiles despite varying levels of social exclusion. The association between willingness to change and healthcare use underscores the need for brief interventions and improved referrals to specialised treatment within primary care services. To respond to the ODS challenge public policies must integrate social and healthcare models.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Music Therapy on Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: a Systematic Review and Meta-Analysis.","authors":"Adriana de Oliveira Goes, Antonio Egidio Nardi, Laiana Azevedo Quagliato","doi":"10.47626/2237-6089-2024-1020","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-1020","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) affects approximately 7% of children and 5% of adolescents worldwide. ADHD is characterized by inattention, hyperactivity and impulsivity as symptoms. The exact mechanism underlying this disorder is still unclear, but genetic and environmental factors play important roles. In recent years, research and treatment options have increased, including medication and/or therapeutic interventions such as music therapy. There is evidence showing benefits of music therapy on mental health, such as autism spectrum disorder (ASD). However, results regarding ADHD are limited.</p><p><strong>Objective: </strong>The aim of this meta-analysis was to verify whether music therapy is an effective tool for improving symptoms in children and adolescents with ADHD.</p><p><strong>Methods: </strong>In accordance with PRISMA guidelines, we systematically searched the Virtual Health Library, SciELO, PubMed and Cochrane Library databases. This article included original research that investigated the effect of music therapy on hyperactive and impulsive symptoms in children and adolescents with ADHD.</p><p><strong>Results: </strong>Music therapy was associated with a trend of efficacy involving ADHD symptoms (effect size: 1.18; CI: -3.8 - 0.21; p = 0.08). Additionally, a significant amount of heterogeneity among trials was found (I2 = 92 %). The lack of studies involving music therapy, ADHD and brain imaging, as well as limited investigation of inattention symptoms in studied articles are limitations of this article.</p><p><strong>Conclusions: </strong>Music therapy is an important therapeutic tool for ADHD. Therefore, future research should include more robust samples and measurement scales, follow-up after experiments and further exploration of the potential connections among ADHD, music therapy, neuroimaging and neuroscientific fields.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicine, artificial intelligence and uncertainty: Why is statistical thinking fundamental?","authors":"Claudio Córdova, Otavio Nóbrega","doi":"10.47626/2237-6089-2025-1069","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1069","url":null,"abstract":"<p><p>The medical field has historically resisted uncertainty, often delaying the integration of new scientific evidence into clinical practice-sometimes by nearly two decades. This inertia reflects deep-rooted cultural and epistemological barriers that also impede the adoption of innovations such as Artificial Intelligence (AI). Yet, the call for more rigorous decision-making in medicine is not new. In the 18th century, Pierre-Simon Laplace emphasized the value of probability theory in clinical reasoning, a view later echoed by William Osler, who famously described medicine as \"the science of uncertainty and the art of probability.\" These early insights gained traction through the work of Sir Austin Bradford Hill and Archibald Cochrane, whose contributions laid the groundwork for Evidence-Based Practice (EBP). In the 1990s, Gordon Guyatt formally introduced Evidence-Based Medicine (EBM), advocating for clinical decisions grounded in empirical data, professional expertise, and patient values. In this evolving landscape, basic statistical literacy is no longer sufficient. In this context, cultivating probabilistic reasoning and statistical thinking has become essential to support ethically sound and evidence-aligned decisions to guide a meaningful transformation in both clinical training and practice.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyromania/ Firesetters and Attention Deficit Hyperactivity Disorder in children and adolescents: a systematic review.","authors":"Rodolfo Teles de Melo, Laiana Quagliato","doi":"10.47626/2237-6089-2024-0947","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0947","url":null,"abstract":"<p><strong>Background: </strong>The following article aims to explore the relationship between Pyromania/Firesetters and Attention Deficit Hyperactivity Disorder (ADHD) in childhood and adolescence.</p><p><strong>Method: </strong>A systematic literature review was carried out using search engines such as PubMed, PsycINFO, Cochrane, and Sicelo, to find relevant articles. Inclusion criteria included studies that related ADHD and Pyromania/Firesetters, while exclusion criteria included articles not related to the researched variables, articles from other systematic reviews, and articles not related to childhood and/or adolescence.</p><p><strong>Results: </strong>Of the 71 articles initially identified, five met the eligibility criteria and were included in the analysis, which demonstrated that ADHD and Pyromania/Firesetters are comorbid conditions that can be diagnosed during childhood and/or adolescence. The comorbid relationship was observed to be more prevalent in boys, with an estimated prevalence of approximately 33%. Firesetting behavior was associated with a sixfold increase in the likelihood of boys being diagnosed with ADHD. Moreover, the comorbid relationship between ADHD and Pyromania/Firesetters was linked to conduct disorders and an elevated risk of future delinquent behavior. Mental health professionals should consider investigating firesetting history during the diagnostic assessment of ADHD, as the absence of early diagnosis and treatment increases the risk of adverse social outcomes.</p><p><strong>Conclusions: </strong>The study concluded that the results demonstrated the comorbid relationship between ADHD and Pyromania/Firesetters in childhood and adolescence, but more research is needed to better understand this relationship.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity levels in Brazilian outpatients with bipolar disorder.","authors":"Fernanda Castro Monteiro, Carlos Linhares Veloso, Thaís de Almeida Britto, Clara Moreira Zettel, Laíne Keisy Siqueira da Silva, Felipe Barreto Schuch, Elie Cheniaux, Andrea Deslandes","doi":"10.47626/2237-6089-2024-1017","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-1017","url":null,"abstract":"<p><strong>Objectives: </strong>The present study aimed to evaluate physical activity (PA) levels in individuals with bipolar disorder. Specifically, it sought to compare these levels across mood states (mania, depression, euthymia).</p><p><strong>Methods: </strong>A cross-sectional study utilizing both subjective (Simple Physical Activity Questionnaire-SIMPAQ) and objective (accelerometers) measures to assess PA. Symptom severity was assessed using The Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HAM-D). Mood states were detected and assessed using the YMRS and HAM-D scales. One-way ANOVAs were used to compare differences in PA and sedentary behavior (SB) across mood states. Correlates were assessed using the Pearson correlation coefficient.</p><p><strong>Results: </strong>The sample included 43 individuals, 81.5% female, mean age of 47 years (SD=10.4). Regarding mood states, 17 patients were categorized as euthymic, 11 as manic and 15 as depression. The mania group exhibited the highest PA levels, mean = 206 minutes MVPA/week (SD=146.80), while the depression group was the most sedentary, mean = 428 (SD=224.44) minutes/day. ANOVA revealed significant differences in PA levels among the mood states (mania and depression) in accelerometry MVPA (F = 3.598; p = 0.037; η2p = 0.152) and SIMPAQ MVPA (euthymic, mania, depression) (F = 7.373; p = 0.002; η2p = 0.269).</p><p><strong>Conclusion: </strong>The mania group demonstrated higher PA levels, whereas the depression group exhibited more SB. These findings highlight distinct PA patterns that may inform clinical management and treatment of bipolar disorder.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Nucleus Accumbens Volume and Substance Use Disorder: A Narrative Review.","authors":"Érico de Carvalho Leitão Pimentel, Gabriel Moreli Ribeiro, Larissa de Goes, Elaine Minatel, Anderson Ravy Stolf, Fabiano Reis","doi":"10.47626/2237-6089-2025-1046","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1046","url":null,"abstract":"<p><strong>Introduction: </strong>The nucleus accumbens (NAc) is central to the brain's reward circuitry, mediating motivation and emotional processes. Emerging evidence suggests that structural and functional changes in the NAc, including volume alterations, may contribute to the neuropathology of substance use disorder (SUD). This review evaluates current findings on the association between NAc volumetric changes depicted by magnetic resonance imaging (MRI) and SUD.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, EMBASE, BVS, Web of Science, Scopus, Cochrane Library, and PsycINFO. Terms used in searches included Nucleus Accumbens, Mental Disorder, Substance Use Disorder, Drug Addiction, and Magnetic Resonance Imaging (MRI). The main findings from the selected studies were synthesized in a table.</p><p><strong>Results: </strong>The initial database searches yielded 3686 articles. After screening, duplicate articles, non-English/Spanish/Portuguese articles, animal studies, and studies that did not address SUD were excluded. Additional exclusion criteria included studies involving only familial risk of substance use or abstinence, as well as studies without NAc analysis or structural MRI analysis. 52 cross-sectional studies regarding associations between NAc volumes and SUDs were selected.</p><p><strong>Conclusion: </strong>The reviewed studies suggest that NAc may play a pivotal role as an associated factor in addiction, with strong associations mainly to cigarette smoking and alcohol use. Other substances show inconsistent findings. Discrepancies in results may reflect differences in study designs, type of volumetric analysis employed, and control over confounding variables. Future studies with multimodal approaches and control of confounding variables are required to strengthen these associations.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}