Trends in Psychiatry and Psychotherapy最新文献

{"title":"Perspectives on the Ketogenic Diet as a Non-pharmacological Intervention For Major Depressive Disorder.","authors":"Jade Shelp, Cristiano Chaves, Alexander Terpstra, Elena Koning, Fabiano A Gomes, Jennifer Fabe, Vitor Breda, Nicole Laurent, Christopher Palmer, Elisa Brietzke","doi":"10.47626/2237-6089-2024-0932","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0932","url":null,"abstract":"<p><strong>Background: </strong>Major Depressive Disorder (MDD) is a prevalent mood disorder characterized by persistent low mood and anhedonia, significantly impacting cognitive function and daily living. Despite available pharmacological treatments, nearly one-third of individuals with MDD do not achieve adequate symptom relief with conventional treatments. The ketogenic diet (KD), a high-fat, low-carbohydrate diet that induces ketosis, has emerged as a potential non-pharmacological intervention for MDD.</p><p><strong>Objective: </strong>To provide a comprehensive perspective on the current knowledge and gaps regarding the potential antidepressant effect of the KD, emphasizing its safety, efficacy, and mechanistic pathways.</p><p><strong>Methods: </strong>This narrative review synthesizes data from preclinical and clinical studies on the effects of KD on mood, cognitive function, and its potential as an antidepressant. Mechanistic insights from animal and human studies are explored to elucidate possible pathways through which KD may exert its effects on MDD.</p><p><strong>Results: </strong>Evidence from animal models suggests that KD may reduce depressive-like behaviors and improve cognitive function. Preliminary human studies, including case reports and observational studies, indicate potential benefits such as mood stabilization, increased energy, and reduced depression severity. Proposed mechanisms include immune-inflammatory regulation, correction of mitochondrial dysfunction, and neurotransmitter modulation. However, key gaps remain, particularly regarding the therapeutic window, long-term efficacy, and specific mechanisms of action in MDD.</p><p><strong>Conclusion: </strong>KD represents a promising avenue for further investigation as a non-pharmacological treatment of MDD. Further research is needed to establish its clinical utility, identify predictors of response, and assess its feasibility as a treatment option for MDD.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674740","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 empathy and personality in a sample of Brazilian medical students: a cross-sectional study.","authors":"Vinicius F Freitas, Pedro G P Rosa, Yasmin N Ávila, Décio G Natrielli, Marcos S Croci, Eduardo C Humes, Marcelo J A A Brañas","doi":"10.47626/2237-6089-2024-0875","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0875","url":null,"abstract":"<p><strong>Objectives: </strong>Empathy is crucial in patient-centered care, enabling shared decision-making, better satisfaction, and clinical outcomes. We examined the association between empathy and personality in a sample of medical students from Brazil.</p><p><strong>Methods: </strong>The sample comprised medical students from the first to sixth year at a private university in Sao Paulo. Empathy was evaluated cross-sectionally using the Interpersonal Reactivity Index. The NEO Five-Factor Inventory was used to assess personality domains. A multivariate linear regression analysis modeled the association between personality and empathy.</p><p><strong>Results: </strong>The final sample consisted of 227 subjects. The mean age was 24.2 (SD 4.3) years, and the sample was predominately female (75%). Higher levels of Neuroticism (β = 2.11, 95% CI 0.84-3.38, P = 0.001) and Agreeableness (β = 2.50, 95% CI 1.46-3.53, P < 0.001) were associated with higher empathy scores. Extraversion (β = 0.00, 95% CI -1.26-1.26, P = 0.998); Openness to Experience (β = 0.85, 95% CI -0.28-1.98, P = 0.138), and Conscientiousness (β = -0.80, 95% CI -1.95-0.35, P = 0.173) did not show significant associations with empathy scores. Female gender, year in the program, and sociodemographic characteristics did not show significant associations with empathy.</p><p><strong>Conclusion: </strong>Both Neuroticism and Agreeableness were found to be associated with higher empathy. We review available interventions to enhance empathy and identified potential medical education curricular changes that could foster empathy development.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674739","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":"Bias and Balance in Psychedelic Academia- A Tricky Business.","authors":"Jordan Bawks, Fabiano Gomes","doi":"10.47626/2237-6089-2024-0990","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0990","url":null,"abstract":"","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517014","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 and risk factors of death among individuals with alcohol use disorder hospitalized with COVID-19: an observational Brazilian cohort study.","authors":"Fabrício Emanuel Soares de Oliveira, Daniella Reis Barbosa Martelli, Maria Christina L Oliveira, Enrico A Colosimo, Hercílio Martelli, Eduardo A Oliveira","doi":"10.47626/2237-6089-2024-1028","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-1028","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the clinical outcomes and mortality risk factors associated with alcohol use disorder (AUD) in hospitalized COVID-19 patients.</p><p><strong>Methods: </strong>We analyzed a national database containing information on the clinical and sociodemographic aspects of patients hospitalized with severe acute respiratory syndrome between February 2020 and February 2023 in Brazil, including those aged > 18 years with laboratory-confirmed COVID-19. The primary exposure of interest was a history of AUD before admission and the primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>Among the 2,124,285 patients, 11,433 (0.53 %) had AUD. The in-hospital mortality rate was higher in the patients with AUD (46.2%) than in those without AUD (31.9%). After adjusting for confounding covariates, individuals with AUD had twice the risk of death (Odds Ratio [OR]= 1.94, 95% confidence interval [CI] 1.85-2.03) compared with non-AUD patients. Among individuals with AUD, the covariates independently associated with the primary outcome were age > 60 years, male sex, hospitalization in the Central-West, Northeast and North regions, symptoms of dyspnea and reduced oxygen saturation at admission, presence of comorbidities, and year of admission.</p><p><strong>Conclusion: </strong>In this population-based study, we found that patients with AUD had twice the risk of fatal outcomes than those without AUD.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574334","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":"Translating measurement into practice with PHQ-9 calculator: an open tool to assess depression levels in the Brazilian population.","authors":"João Villanova do Amaral, Igor Duarte, André Rafael Simioni, Gabriele Dos Santos Jobim, Ighor Miron Porto, João Pedro Gonçalves Pacheco, Rodolfo Furlan Damiano, Maurício Scopel Hoffmann","doi":"10.47626/2237-6089-2024-0978","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0978","url":null,"abstract":"<p><strong>Objective: </strong>We aim to create a web-based calculator for assessing depressive symptoms with the Patient Health Questionnaire 9 (PHQ-9), utilizing IRT-based standardized scores, to improve measurement precision, standardization, and practical application in clinical practice.</p><p><strong>Methods: </strong>This study developed a web-based calculator using a graded response IRT model for assessing depressive symptoms with the PHQ-9, using data from the Brazilian National Health Survey 2019 (n = 90,846, aged 15 to 107 years old, 52.8% female). The tool calculates latent depressive symptoms and converts them into T-scores, with stratification by sex and age groups. The application respects patient confidentiality by deleting sensitive information postcalculation.</p><p><strong>Results: </strong>Estimated models resulted in a mean sample size of 3244.5 participants in each group (SD: 1066). The calculator can be accessed at https://mheg.shinyapps.io/phq9-score.</p><p><strong>Discussion: </strong>The development of an IRT-based web calculator for the PHQ-9 represents an advancement in depressive symptoms' assessment, offering precision and potential clinical utility. By standardizing scores into a common metric, this tool facilitates the interpretation of depressive symptoms and comparison across different instruments. The study's scope is limited to the Brazilian population and external validity for other contexts is warranted. Future studies should evaluate the clinical validity and the threshold of the tool for predicting real life problems.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075829","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":"Intentional Drug Overdose Deaths and Mood Disorders in Brazil - A 20-year overview.","authors":"Daniela Mendes Chiloff, Vitor S Tardelli, Marina Costa Moreira Bianco, Kelsy C N Areco, Adalberto O Tardelli, Silvia S Martins, Thiago M Fidalgo","doi":"10.47626/2237-6089-2024-0944","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0944","url":null,"abstract":"<p><strong>Background: </strong>Drug overdose deaths remain a significant and understudied public health concern in Brazil. This study aimed to examine drug overdose death records from 2000 to 2020, focusing on the relationship between mood disorders and intentionality, along overall sociodemographic characteristics.</p><p><strong>Methods: </strong>Data from the Brazilian Mortality Information System from 2000-2020 were analyzed. Records with causes of death coded as X40-X45 (accidental poisoning), X60-X65 (intentional poisoning), or Y10-Y15 (undetermined intentionality poisoning) were included. The dataset comprised 21,410 deaths, including 933 subjects with mood disorders (ICD-10 codes F30-F39). A descriptive analysis of sociodemographic variables, stratified by mood disorders, was conducted. Logistic regression models identified independent associations with intentional overdose deaths.</p><p><strong>Results: </strong>People who died of a drug overdose were mostly men (61.55%), non-white (52.45%), and single (59.33%). Most drug overdose deaths were intentional (44.70%). Compared to overall overdoses, the subset with mood disorders included a higher share of women (67.95%), whites (63.88%), and intentional overdoses (75.24%). Female gender (OR 1.30), mood disorder (OR 2.0), non-white race (OR 0.56), high school graduates (OR 0.93), some college education (OR 1.28), and divorced or widowed (OR 0.73) were independently associated with intentional overdose deaths.</p><p><strong>Conclusion: </strong>The sociodemographic characteristics of people who died of overdoses must guide national public policies. Strategies might involve conducting screenings for mental health disorders and drug-related problems in primary care.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075660","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":"Clinical Interplay Between Autism Spectrum Disorder and Bipolar Disorder: A Narrative Review.","authors":"Mirela Paiva Vasconcelos-Moreno, Daniel Prates-Baldez, Júlio Santos-Terra, Iohanna Deckmann, Isabella Naomi Di Gesu, Renata de Sanson Lemann, Rudimar Riesgo, Carmem Gottfried, Flávio Kapczinski","doi":"10.47626/2237-6089-2024-0939","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0939","url":null,"abstract":"<p><strong>Introduction: </strong>Autism Spectrum Disorder (ASD) and Bipolar Disorder (BD) present significant challenges in diagnosis due to their complex nature. This review aims to examine the interface and overlapping features of these conditions.</p><p><strong>Methods: </strong>We conducted a narrative review to examine clinical overlap, common psychiatric comorbidities, and shared neurobiological bases between ASD and BD.</p><p><strong>Results: </strong>There is a notable convergence of symptoms in ASD and BD, including mood instability and emotional dysregulation; irritability, impulsivity, and aggressive behavior; deficits in social skills and social cognition; impairments in executive functions; sleep disturbances; problematic sexual behaviors; and sensory sensitivities. Common psychiatric comorbidities and shared neurobiological basis further underscore this potential interplay.</p><p><strong>Conclusion: </strong>Despite distinct clinical trajectories and diagnostic criteria, our findings indicate a significant overlap in symptoms and clinical presentations between ASD and BD. This complexity makes it challenging to identify the co-occurrence of ASD and BD, which can lead to difficulties in accurately diagnosing and managing both conditions simultaneously.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013710","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":"Worry related to climate change in Brazilian adults.","authors":"Maria Nieves, Karen Jansen","doi":"10.47626/2237-6089-2024-0905","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0905","url":null,"abstract":"<p><strong>Introduction: </strong>Climate change is happening, and feeling anxiety can be seen as a natural response to it. Climate anxiety is the worry about the climate crisis and could be related to specific emotions and thoughts. The aim of this study was to assess the prevalence of worry about climate change, and to describe the emotions and thoughts associated to it in Brazilian adults.</p><p><strong>Method: </strong>Cross-sectional study with participants aged between 18-42 years (n=323). Data were collected online using the questionnaire developed by Hickman and colleagues, which assesses the worry, thoughts and feelings about climate change.</p><p><strong>Results: </strong>88.5% were worried about climate change. The feelings of sadness, powerlessness, fear and anxiety were reported more often among those who were worried. The most frequent thoughts were: \"People have failed to take care of the planet\", \"The future is frightening\", \"My family's security will be threatened\" and \"Humanity is doomed\".</p><p><strong>Discussion: </strong>In this sample, the majority of the individuals were concerned about climate change, and they showed more negative emotions and thoughts when compared to individuals that were not concerned. Future studies should take care to not understand natural worries and anxiety responses to climate change as pathological.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928309","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":"Are parents with bipolar disorder at higher risk of having offspring with ADHD? A systematic review.","authors":"Leandro L Ferreira, Antonio E Nardi, Laiana A Quagliato","doi":"10.47626/2237-6089-2024-0797","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0797","url":null,"abstract":"<p><strong>Background: </strong>The offspring of parents with bipolar disorder (BD) and with attention deficit hyperactivity disorder (ADHD) have a higher risk of having the same condition. Both disorders also share psychopathological symptoms; however, little is known about their genetic overlap. To examine whether the offspring of parents with BD have a greater chance of being affected by ADHD, we conducted a systematic review.</p><p><strong>Methods: </strong>From inception to August 12, 2024, we searched the PubMed, SciELO, PsycInfo and Cochrane databases. We included studies if they investigated the association of parental bipolar disorder with offspring outcomes and made a proper investigation of disorders using validated instruments based on the Diagnostic Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD) criteria. Studies were excluded if: parents were under 18 years old or over 70; did not report original data; systematic reviews; in vitro studies; with an animal model; offspring older than 17 years of age or with any comorbid diagnosis with ADHD. To assess risk of bias, two authors independently used the Newcastle-Ottawa Scale quality assessment tool.</p><p><strong>Results: </strong>23 articles met the inclusion criteria. The majority of the studies reported that the offspring of parents with BD were at higher risk for ADHD. Particularly, in all case‒control studies, the risk of ADHD was higher in the case group than the control group.</p><p><strong>Conclusion: </strong>The current studies are yet heterogeneous and literature did not uncover the biological correlation of these disorders regarding genetic, biochemical, neuroimaging and neuropsychological aspects.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928307","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":"From Hippocrates to the Ages of Technology: A Narrative Review of the Evolution of the doctor-patient Relationship.","authors":"Isabela Azeredo Melca, Rachel Moraes Ferreira, Antonio Egídio Nardi, Anna Lucia Spear King","doi":"10.47626/2237-6089-2024-0934","DOIUrl":"https://doi.org/10.47626/2237-6089-2024-0934","url":null,"abstract":"<p><strong>Objectives: </strong>Thus, through a narrative review, this article analyzes how the advancement of technology, the use of digital resources, and social media have impacted the doctor-patient relationship.</p><p><strong>Methods: </strong>We conducted a scoping review on the relationship between Digital Health Equity and Telemedicine and e-health via Scopus and Pubmed electronic databases. The following inclusion criteria were established: papers on the relationship between digital health equity and telemedicine and e-health, written in English and with no time limits. All study designs were eligible, including those that have utilized qualitative and quantitative methods, methodology, or guidelines reports, except for meta-reviews.</p><p><strong>Results: </strong>With the advancement of technology and social media, a change in behavior in the population and the doctor-patient relationship was observed. Through the help of digital devices, the increased prevalence of social networks, and asynchronous consultations new opportunities were created to bring doctors and patients closer. The relationship has shifted from face-to-face and paternalistic to virtual communication with shared decisions in recent decades. It was observed that the advancement of technology and the use of digital resources have reshaped the roles of doctors and patients and their relationships.</p><p><strong>Conclusion: </strong>Technology is the leading cause for an informed, more involved, and responsible patient. However, physicians have conflicting opinions about the use of these technologies. While recognizing its benefits for patients, they are also concerned about digital health and its impact.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923618","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}