Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)最新文献

{"title":"Protective Effect of COVID-19 Vaccination on Post-Infection Visuospatial Deficits.","authors":"Lucas Gomes da Silva, Bruna Carmeni Di Fini, Jordano César Milagres Oliveira, Daniela Valadão Rosa, Danielle de Souza Costa, Débora Marques de Miranda, Marco Aurélio Romano-Silva, Jonas Jardim de Paula","doi":"10.47626/1516-4446-2026-4853","DOIUrl":"https://doi.org/10.47626/1516-4446-2026-4853","url":null,"abstract":"<p><strong>Objective: </strong>COVID-19 has been associated with persistent cognitive deficits months after SARS-CoV-2 infection. Vaccination reduces severe disease, but its effect on post-infection cognition remains uncertain. We evaluated whether COVID-19 vaccination attenuates cognitive deficits after SARS-CoV-2.</p><p><strong>Methods: </strong>We assessed 237 adults with COVID-19 and 105 controls. Patients were grouped by vaccination status at infection (vaccinated n=87; unvaccinated n=150). The neuropsychological assessment covered language, visuospatial ability, visual memory, verbal memory, attention, executive functions, and working memory. Group differences were tested with Aligned Rank Transform ANOVA with Holm-corrected post hoc comparisons, adjusting for education.</p><p><strong>Results: </strong>Significant group differences were observed in visuospatial ability and visual memory, assessed with the Rey-Osterrieth Complex Figure Test (Copy, Immediate and Delayed Recall) (all p < 0.001). The vaccinated group outperformed the unvaccinated group (p = 0.022) on visuospatial performance. The Rey-Osterrieth Complex Figure Test Copy did not differ significantly among participants vaccinated with CoronaVac, AstraZeneca, or Pfizer.</p><p><strong>Conclusions: </strong>The findings suggest that COVID-19 vaccination may mitigate post-infection visuospatial deficits, reinforcing the importance of immunization in preventing cognitive sequelae associated with the disease.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149241118","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":"Protective Effect of COVID-19 Vaccination on Post-Infection Visuospatial Deficits.","authors":"Lucas Gomes da Silva, Bruna Carmeni Di Fini, Jordano César Milagres Oliveira, Daniela Valadão Rosa, Danielle de Souza Costa, Débora Marques de Miranda, Marco Aurélio Romano-Silva, Jonas Jardim de Paula","doi":"0.47626/1516-4446-2026-4853","DOIUrl":"https://doi.org/0.47626/1516-4446-2026-4853","url":null,"abstract":"<p><strong>Objective: </strong>COVID-19 has been associated with persistent cognitive deficits months after SARS-CoV-2 infection. Vaccination reduces severe disease, but its effect on post-infection cognition remains uncertain. We evaluated whether COVID-19 vaccination attenuates cognitive deficits after SARS-CoV-2.</p><p><strong>Methods: </strong>We assessed 237 adults with COVID-19 and 105 controls. Patients were grouped by vaccination status at infection (vaccinated n=87; unvaccinated n=150). The neuropsychological assessment covered language, visuospatial ability, visual memory, verbal memory, attention, executive functions, and working memory. Group differences were tested with Aligned Rank Transform ANOVA with Holm-corrected post hoc comparisons, adjusting for education.</p><p><strong>Results: </strong>Significant group differences were observed in visuospatial ability and visual memory, assessed with the Rey-Osterrieth Complex Figure Test (Copy, Immediate and Delayed Recall) (all p < 0.001). The vaccinated group outperformed the unvaccinated group (p = 0.022) on visuospatial performance. The Rey-Osterrieth Complex Figure Test Copy did not differ significantly among participants vaccinated with CoronaVac, AstraZeneca, or Pfizer.</p><p><strong>Conclusions: </strong>The findings suggest that COVID-19 vaccination may mitigate post-infection visuospatial deficits, reinforcing the importance of immunization in preventing cognitive sequelae associated with the disease.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229847","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":"SoundPics: visual and auditory psychophysics reveals distinct sensory profiles that differentiate schizophrenia from bipolar disorder in early psychosis across three independent Brazilian public health clinical samples.","authors":"Maria Lucia de Bustamante Simas, Aline Mendes Lacerda, Joselma Tavares Frutuoso, Isabela de Fatima Pina de Almeida, Mateus Monteiro de Gois Barros, Katherine Karla Souza da Silva, Thays Macambira da Silva, Giuliano Baltar Melo de Souza Ramos, Tamires Lima da Silva, Naianna Mocelin Ribeiro Dos Santos, Amanda Almeida Rodrigues E Silva, Kayke Kauã de Siqueira","doi":"10.47626/1516-4446-2026-5002","DOIUrl":"https://doi.org/10.47626/1516-4446-2026-5002","url":null,"abstract":"<p><p>Psychosis assessment relies mostly on top-down cognitive and behavioral evaluations. We investigated whether low-cost visual and auditory psychophysical tests can detect early sensory alterations. Participants (schizophrenia [SCHZ] n = 45, bipolar disorder [BIP] n = 36, first-episode psychosis [FEP] n = 39) recruited from three independent Brazilian public mental health facilities (SUS) were independently compared to age-matched healthy controls (pooled N = 94). The Pictorial Size Test (PST) measured perceived image size in degrees of visual angle (dva). The Sound Appreciation Test (SAT) measured sound discomfort levels (SDL) across pure-frequency sweeps. SCHZ and FEP patients exhibited significantly larger perceived pictorial sizes relative to controls (d = 0.76, p = 0.0057; and d = 0.58, p = 0.013, respectively), whereas BIP patients did not differ from controls. Elevated hearing discomfort was present across all groups but was most pronounced in BIP (d = 1.16; p < 0.0001), followed by FEP (d = 0.70; p = 0.0057) and SCHZ (d = 0.51; p = 0.028). Empirical cutoffs derived from chronic cohorts created the hierarchical rule-based algorithm SoundPics-(V3). SoundPics differentiated schizophrenia from bipolar disorder yielding 70.8% accuracy among clinically determined cases (72 of 81) and demonstrated convergent classification in an independent FEP group. Early psychophysical screening is viable in clinical triage in public mental health settings.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229854","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":"Thirty Years of the Laboratory of Panic and Respiration: From Respiratory Panic to Translational Psychiatry.","authors":"Pablo E P Dutra, Natia Horato, Laiana Quagliato, Marleide da Mota Gomes, Antonio E Nardi","doi":"10.47626/1516-4446-2026-5265","DOIUrl":"https://doi.org/10.47626/1516-4446-2026-5265","url":null,"abstract":"","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149303621","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":"Transcranial direct current stimulation: a historical continuum from the Victorian medical battery to the contemporary do-it-yourself movement.","authors":"Sergio Machado, Alberto Souza de Sá, Thais Dominique Batista Beserra, Antonio Egidio Nardi","doi":"10.47626/1516-4446-2026-5087","DOIUrl":"https://doi.org/10.47626/1516-4446-2026-5087","url":null,"abstract":"","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009647","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":"Brazilian Psychiatric Association guidelines for the treatment of eating disorders.","authors":"Jose C Appolinario, Maria Angélica A Nunes, Carla Mourilhe, Angelica Claudino, Bacy Fleitlich-Bilyk, Marle Alvarenga, Silvia Regina Freitas, João C Hiluy, Maria Francisca F P Mauro, Maria Eliza G Cury, Pamela Gouveia, Maria Amalia Pedrosa, Adriano Segal, Taki A Cordas, Mireille Almeida, Antonio Geraldo da Silva, Leonardo Baldaçara","doi":"10.47626/1516-4446-2026-5102","DOIUrl":"10.47626/1516-4446-2026-5102","url":null,"abstract":"<p><p>Eating disorders (ED), such as anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), are serious psychiatric conditions that significantly impact psychological and medical health. This paper aims to summarize the recommendations of the Brazilian Association of Psychiatry - [Associação Brasileira de Psiquiatria (ABP)] for the treatment of EDs, based on the latest available evidence. Systematic reviews focused on the multidisciplinary treatment of ED were conducted. Findings were evaluated based on evidence strength, and recommendations using the evidence-based methodology of the Oxford Centre for Evidence-Based Medicine, finalized by an expert panel consensus. A summary of the recommendations and their corresponding levels of evidence was produced. Overall, the management of AN should use the least restrictive setting, combining monitored nutritional rehabilitation with psychotherapy. Pharmacotherapy plays a limited role in selected cases. BN is typically managed in an outpatient setting, focusing on structured nutritional care and CBT-based treatment, with pharmacotherapy adjunctive, preferably fluoxetine. BED is treated in an outpatient setting with structured care and CBT, with lisdexamfetamine as the preferred pharmacotherapy when needed. These guidelines represent a significant advancement in managing eating disorders in Brazil, providing a structured framework for clinical care while also supporting the development of future public mental health policies.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003296","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":"When 'Cannabidiol' Is Not Cannabidiol - And Why It Matters for Clinicians and Patients.","authors":"José Alexandre S Crippa","doi":"10.47626/1516-4446-2026-5187","DOIUrl":"https://doi.org/10.47626/1516-4446-2026-5187","url":null,"abstract":"","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003300","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":"Craving Reduction and Smoking Outcomes in Psilocybin-Assisted and Standard Cessation Care.","authors":"Lisbeth Strandberg, Thiago P Fernandes, Irina I Shoshina, Natanael A Santos, Nora Saether","doi":"10.47626/1516-4446-2026-5060","DOIUrl":"https://doi.org/10.47626/1516-4446-2026-5060","url":null,"abstract":"<p><strong>Objective: </strong>Smoking cessation outcomes are heterogeneous, and factors associated with these differences are not fully understood. We examined longitudinal smoking trajectories across distinct smoking profiles and evaluated whether early craving and affective symptom changes were associated with verified abstinence.</p><p><strong>Methods: </strong>Participants in this observational cohort were classified as dependence-predominant or affective-predominant using measures of smoking severity and affective symptoms. Abstinence was defined as 7-day self-reported abstinence verified by exhaled CO <8 ppm.</p><p><strong>Results: </strong>Psilocybin-assisted care was associated with greater smoking reduction at week 12 (β = 5.56, 95% CI 2.18-8.94, p = .001) and greater urge reductions at T1 (β = -3.26, 95% CI -5.31 to -1.21, p = .002) and T2 (β = -2.74, 95% CI -4.85 to -0.63, p = .011). Psilocybin-assisted care was not associated with abstinence after adjustment (OR = 1.82, 95% CI 0.68-4.86, p = .233). Early craving reduction was associated with the outcome (OR = 1.54, 95% CI 1.17-2.03, p = .002).</p><p><strong>Conclusions: </strong>Distinct patterns of change were observed across treatment pathways and smoking profiles, while early craving reduction was associated with abstinence. Future studies may clarify whether these profiles and early trajectories could help inform treatment stratification and individualized cessation strategies.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922582","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":"Burnout Syndrome: Clinical Diagnostic Challenges and Difficulties in Establishing Work-Related Causation in Forensic Practice.","authors":"Alexandre Martins Valença, Antonio Geraldo da Silva, Lisieux Elaine de Borba Telles","doi":"10.47626/1516-4446-2026-5041","DOIUrl":"10.47626/1516-4446-2026-5041","url":null,"abstract":"<p><strong>Objective: </strong>To critically examine the conceptual, diagnostic, and forensic dimensions of burnout, with emphasis on its nosological status, symptom validity, and challenges in establishing occupational causation.</p><p><strong>Methods: </strong>This study was conducted as a narrative review because the objective was to provide a conceptual and forensic synthesis rather than estimate pooled effects. The literature search was performed in PubMed/MEDLINE, Embase, PsycINFO, and Scopus. Searches included publications in English, Portuguese, and Spanish from January 1974 to March 2026 using combinations of the following keywords: burnout, occupational burnout, burnout syndrome, depression, occupational stress, forensic psychiatry, causation, occupational disease, malingering, symptom validity, work-related mental disorders, and ICD-11.</p><p><strong>Results: </strong>The literature demonstrates ongoing debate regarding the classification of burnout as a distinct nosological entity, an occupational subtype of depressive disorders, or a work-related stress syndrome. Significant overlap with depressive symptomatology has been reported, although occupational context remains a defining feature in most contemporary models. In forensic settings, the assessment of burnout-related claims is complex and requires careful consideration of symptom validity, including malingering, symptom exaggeration, secondary gain, and compensation-related phenomena. The establishment of occupational causation is further challenged by multifactorial and probabilistic models of disease, as well as by the application of epidemiological criteria such as those proposed by Bradford Hill. Psychometric instruments may support evaluation of response validity and symptom consistency, but must be interpreted within a broader clinical and contextual framework.</p><p><strong>Conclusions: </strong>Burnout remains a concept with evolving boundaries and significant diagnostic and forensic implications. A comprehensive assessment requires integration of clinical evaluation, structured psychometric tools, and contemporary models of causal inference. Greater conceptual clarity is needed to improve diagnostic consistency and enhance the reliability of forensic determinations in occupational contexts.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922561","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":"Mapping Workplace Mental Health Practices: A Scoping Review and Preliminary Conceptual Synthesis for the Brazilian Context.","authors":"José Jonas de Oliveira, Luciano de Vasconcelos, Matheus Milani Muniz de Souza, Pedro Henrique Costa Mendes, Luciano Magalhães Vitorino","doi":"10.47626/1516-4446-2026-5059","DOIUrl":"https://doi.org/10.47626/1516-4446-2026-5059","url":null,"abstract":"<p><strong>Objective: </strong>To map evidence on workplace mental health practices for promotion, prevention, screening, and management of mental health and psychosocial risks, with attention to their potential relevance to the Brazilian occupational context.</p><p><strong>Methods: </strong>A scoping review followed JBI guidance and was reported according to PRISMA-ScR. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, PsycINFO and Cochrane Library. Studies, protocols, and institutional documents published between 2020 and 2025 addressing workplace mental health practices in occupational settings were included.</p><p><strong>Results: </strong>Sixty-eight records were included. Relatively stronger evidence for short-term psychological outcomes came from moderate-robustness randomized studies of ACT and resilience training. Mindfulness was more frequently studied but showed heterogeneous and mostly short-term effects. Evidence for exercise, CBT-based self-care, coaching, and leadership interventions was preliminary or mixed. Effect sizes, sustained benefits, and organizational outcomes were inconsistently reported.</p><p><strong>Conclusion: </strong>The mapped literature was heterogeneous and concentrated on individual-level approaches, with limited assessment of organizational outcomes. Five recurring domains were organized as a hypothesis-generating conceptual synthesis to support future consensus development, contextual adaptation, feasibility assessment, and implementation research in Brazil. This synthesis is not a validated model or recommendation for routine practice.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901790","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}