Anne-Marie Di Passa, Shelby Prokop-Millar, Horodjei Yaya, Emily Vandehei, Carly McIntyre-Wood, Allan Fein, Emily MacKillop, James MacKillop, Dante Duarte
{"title":"Enrollment-Cost and Recruitment Effectiveness in a dTMS Clinical Trial for Older Adults with Depression: A Mixed-Methods Analysis of Recruitment Strategies, Facilitators, and Barriers.","authors":"Anne-Marie Di Passa, Shelby Prokop-Millar, Horodjei Yaya, Emily Vandehei, Carly McIntyre-Wood, Allan Fein, Emily MacKillop, James MacKillop, Dante Duarte","doi":"10.47626/1516-4446-2025-4168","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4168","url":null,"abstract":"<p><strong>Objective: </strong>Recruitment challenges are inherent in clinical research, and are particularly pronounced in older adults with depression, who often face unique barriers such as medical comorbidities and infrequent help-seeking behaviour. Neurostimulation techniques, like deep transcranial magnetic stimulation (dTMS), are often unfamiliar to patients within the healthcare system. Existing literature offers limited insight into the costs and practical guidance associated with recruitment strategies in dTMS trials. This study aimed to address these gaps by investigating the cost-effectiveness of various recruitment strategies for dTMS trials among older adults. Furthermore, we examined potential facilitators and barriers to recruitment.</p><p><strong>Methods: </strong>This mixed-methods retrospective analysis examined recruitment data from our pilot study investigating the effects of dTMS in older adults with depression. We assessed diverse recruitment methods by analyzing enrollment rates and conducting an enrollment-cost analysis. Recruitment-related barriers and facilitators were identified using a theoretical thematic analysis.</p><p><strong>Results: </strong>Over a 14-month period, we received 185 referrals, yielding 22 enrollments. Healthcare provider outreach to affiliated mental health clinics was the most effective recruitment method, with an enrollment-cost rate (ECR) of 0.00189 ($537.63 CAD/person enrolled). The second most effective recruitment method was Facebook, producing an ECR of 0.00099 ($925.93 CAD/person enrolled). Social support from research personnel was a potential facilitator of recruitment, while time-intensiveness and accessibility challenges were noted as potential barriers.</p><p><strong>Conclusion: </strong>Our findings highlight both healthcare provider outreach within mental health clinics and Facebook advertising as effective recruitment strategies. Future research is warranted to evaluate recruitment-related facilitators and barriers to dTMS interventions for older adults with depression.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194383","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":"Bupropion plus Naltrexone for the Treatment of Binge-Eating Disorder: A Systematic Review and Meta-Analysis.","authors":"Jordana Belgamasco Cavalcanti Marçal, Milene Vitória Sampaio Sobral, Maurício Prätzel Ellwanger, Gilmara Peixoto Rister","doi":"10.47626/1516-4446-2025-4258","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4258","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aimed to evaluate the efficacy of these agents in BED patients.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and Cochrane databases up to February 2025 for randomized controlled trials (RCTs) comparing bupropion-naltrexone to placebo. The primary outcome was binge eating frequency. Secondary outcomes included body mass index (BMI), body weight, depression, lipid profile, and glycated hemoglobin (HbA1c) levels. Mean difference (MD) with 95% confidence intervals (CI) were pooled using appropriate methods.</p><p><strong>Results: </strong>Three RCTs involving 177 patients were included, with 49% receiving intervention. There was no statistically significant difference between groups in binge eating (MD -1.25; 95% CI -5.61 to 3.11; 0=0.57), BMI (MD -2.24; 95% CI -8.01 to 3.53; p=0.45), depression (MD -0.81; 95% CI -3.48 to 1.87; p=0.55), or total cholesterol (MD -9.98; 95% CI -21.31 to 3.34; p=0.15). A potential benefit was observed in HbA1c levels (MD -0.10; 95% CI -0.28 to 0.08; p=0.26).</p><p><strong>Conclusion: </strong>This meta-analysis found no significant benefit of bupropion-naltrexone over placebo in reducing binge-eating episodes or improving metabolic and psychological outcomes. A possible effect on HbA1c levels warrants further investigation.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194358","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}
Xiaotong Wang, Tao Huang, Hanzhe Lei, Qiongwen Cui, Wanjia Wei, Haixiong Lin
{"title":"Immediate and sustained effects of acupuncture on the default mode network.","authors":"Xiaotong Wang, Tao Huang, Hanzhe Lei, Qiongwen Cui, Wanjia Wei, Haixiong Lin","doi":"10.47626/1516-4446-2025-4202","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4202","url":null,"abstract":"<p><strong>Objective: </strong>Functional magnetic resonance imaging (fMRI) techniques were conducted to investigate the immediate and sustained effects of acupuncture, as well as its impact on the functional connectivity (FC) within the default mode network (DMN) and the external FC.</p><p><strong>Methods: </strong>Thirty healthy participants received acupuncture needle stimulation at Baihui (GV20) and Yintang (GV29), and underwent resting-state fMRI scans in three phases: pre-needle insertion, during needle retention, and post-needle removal. Each phase lasted for 20 minutes.</p><p><strong>Results: </strong>In terms of the within-network connectivity of the DMN, post-needle removal scans showed a decrease in FC between the medial prefrontal cortex (mPFC) and the angular gyrus (ANG) compared to pre-needle insertion scans. The FC analysis from seed points to whole-brain voxels showed the following changes: compared to pre-needle insertion scans, acupuncture needle insertion increased the FC between the posterior cingulate cortex/precuneus (PCC/PCU) and Cerebellum_8_L, acupuncture needle withdrawal increased the FC between the PCC/PCU and Cerebellum_8_L; acupuncture needle insertion decreased the FC between ANG and Frontal_Sup_Medial_L, and acupuncture needle withdrawal decreased the FC between ANG and Frontal_Sup_Medial_L.</p><p><strong>Conclusions: </strong>These results suggested that acupuncture has an impact on the DMN, and acupuncture exhibits sustained effects, not just immediate effects.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194391","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}
Juan F Cano, Sebastián Galindo-Pita, Andrés Felipe Sarmiento, Daniela Méndez, Bibiana Briceño, Germán Mejía-Salgado, Alejandra de-la-Torre
{"title":"Efficacy of Anti-Toxoplasma Medications in Symptom Severity and Cognition in Patients with Schizophrenia or Schizoaffective Disorder: Systematic Review and Meta-analysis.","authors":"Juan F Cano, Sebastián Galindo-Pita, Andrés Felipe Sarmiento, Daniela Méndez, Bibiana Briceño, Germán Mejía-Salgado, Alejandra de-la-Torre","doi":"10.47626/1516-4446-2025-4185","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4185","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis assess the efficacy of anti-Toxoplasma medications in treating schizophrenia spectrum disorders. Given the emerging evidence linking Toxoplasma gondii infection to schizophrenia, understanding these results may inform targeted treatments for patients with schizophrenia who are infected with Toxoplasma gondii.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus, and Lilacs databases following PRISMA guidelines identified studies on anti-Toxoplasma antibiotics in schizophrenia or schizoaffective disorder. Inclusion criteria focused on primary observational studies and randomized controlled trials (RCTs). The risk of bias was assessed using appropriate tools. Meta-analyses of the standardized mean differences were conducted to compare Positive and Negative Syndrome Scale (PANSS) scores from baseline to post-treatment. Statistical analyses were performed using R version 4.3.1. Funnel plots and Egger's tests were applied to assess publication bias.</p><p><strong>Results: </strong>Nineteen studies met the inclusion criteria from 5,491 screened: 13 RCTs, four secondary analyses, one cross-sectional study, and one cohort study. A meta-analysis of RCTs revealed a small effect of antibiotics on symptom improvement (-3.12, 95% CI: -5.82 to -0.41). Minocycline yielded mixed outcomes, showing improvements in negative symptoms and cognitive function in some studies but no effect in others. Other antibiotics, like azithromycin and artemisinin, showed limited benefit, except for artemether in T. gondii Immunoglobulins G positive patients. No publication bias was detected.</p><p><strong>Conclusion: </strong>Anti-Toxoplasma antibiotics may offer potential benefits as adjunctive therapy for schizophrenia. However, heterogeneity and methodological limitations complicate conclusions. Large-scale RCTs are needed further to clarify the role of anti-Toxoplasma antibiotics in schizophrenia treatment.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067482","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}
Renan M Biokino, Natalia Daher, Gabriel Feitosa, Ary Gadelha
{"title":"Nonspecific behavioral manifestations of clozapine intoxication highlight the critical role of Therapeutic Drug Monitoring in schizophrenia: Insights from a case series.","authors":"Renan M Biokino, Natalia Daher, Gabriel Feitosa, Ary Gadelha","doi":"10.47626/1516-4446-2025-4241","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4241","url":null,"abstract":"","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067564","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}
Leonardo Baldaçara, Diogo de Lacerda Veiga, Luiz Antônio Vesco Gaiotto, Ana Beatriz Paschoal, Aldo Felipe Pinto, Thales Marcon Almeida, Diogo Cesar Dos Santos, Fabiano Franca Loureiro, Leandro Fernandes Malloy-Diniz, Acioly Luiz Tavares Lacerda, Antônio E Nardi, Antônio Geraldo da Silva, Ricardo R Uchida
{"title":"Brazilian Psychiatric Association guidelines for the treatment of panic disorder. An overview of systematic reviews.","authors":"Leonardo Baldaçara, Diogo de Lacerda Veiga, Luiz Antônio Vesco Gaiotto, Ana Beatriz Paschoal, Aldo Felipe Pinto, Thales Marcon Almeida, Diogo Cesar Dos Santos, Fabiano Franca Loureiro, Leandro Fernandes Malloy-Diniz, Acioly Luiz Tavares Lacerda, Antônio E Nardi, Antônio Geraldo da Silva, Ricardo R Uchida","doi":"10.47626/1516-4446-2025-4349","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4349","url":null,"abstract":"<p><strong>Objective: </strong>To develop national evidence-based treatment guidelines for panic disorder (PD) in Brazil through an overview of systematic reviews.</p><p><strong>Methods: </strong>We searched PubMed, Scielo, and Cochrane for systematic reviews (with or without meta-analyses) of randomized controlled trials for panic disorder (with or without agoraphobia) from 2004 to 2024. Study methodology was assessed using AMSTAR 2 to assess articles and GRADE for the evidence of each outcome. The PICO framework was used to obtain response, remission, and dropout rates. PROSPERO CRD420251002430.</p><p><strong>Results: </strong>202 papers were identified, 84 were eligible, and 9 were included (AMSTAR 2 High). Response, remission, and chance of dropout were classified by GRADE. SSRIs, SNRIs, TCAs, MAIOs, CBT, and BT achieve the best response, remission, and tolerability. Combined psychotherapy and antidepressants work well together. Benzodiazepines demonstrated short-term efficacy and tolerability but are not recommended as first-line treatment due to concerns about dependency and long-term risks.</p><p><strong>Conclusion: </strong>SSRIs, SNRIs, TCAs, and CBT can be endorsed as first-line interventions for panic disorder (PD). Concomitant therapy may provide supplementary advantages. Subsequent investigations ought to concentrate on enduring results and the reduction of bias.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234875","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}
Maria Cristiane Barbosa Galvão, Daniel Ribeiro Rodrigues, Bruno Pereira da Silva, Paulo Lucas Benchimol Villasboas, Oliver John Mason, Ivan Luiz Marques Ricarte
{"title":"Technologies for the longitudinal management of bipolar disorder: advances and challenges.","authors":"Maria Cristiane Barbosa Galvão, Daniel Ribeiro Rodrigues, Bruno Pereira da Silva, Paulo Lucas Benchimol Villasboas, Oliver John Mason, Ivan Luiz Marques Ricarte","doi":"10.47626/1516-4446-2025-4253","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4253","url":null,"abstract":"<p><p>Bipolar disorder is a severe and enduring mental health disorder characterized by recurrent fluctuations in mood, energy, and behavior. The global prevalence of bipolar disorder is estimated to be between 1% and 2%, not accounting for underdiagnosis. Given the importance of this condition and its management, we aimed to review the evidence as to whether digital technologies facilitate the management of bipolar disorder. Searches conducted in PubMed, PsycINFO, Embase, Web of Science, and Scopus databases identified 33 studies, including 19 longitudinal studies, 11 cross-sectional studies, and 2 mixed-methods studies. We conclude that, for healthcare professionals, the acceptance of technologies seems to depend on their efficient integration into the workflow and the reliability of the tools. Patients, in turn, show increasing interest in using technologies to manage bipolar disorder; however, digital literacy, economic limitations, and concerns regarding security, privacy, and accessibility still limit their adoption and long-term adherence. In the scientific domain, methodological challenges, such as small sample sizes in studies and the need for more robust research, indicate that gaps remain in validating the effectiveness of these technologies. Meanwhile, technology development companies require stronger scientific foundations for development, highlighting the importance of collaboration among researchers, healthcare professionals, and industry to ensure tools that meet clinical demands.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986994","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}
Camila Siebert Altavini, Geilson Lima Santana, Laura Helena Andrade, Lúcio Garcia Oliveira, Arthur Guerra Andrade, Clarice Gorenstein, Yuan-Pang Wang
{"title":"Latent class analysis of academic adjustment and mental health among Brazilian college students: association with depression and suicide ideation.","authors":"Camila Siebert Altavini, Geilson Lima Santana, Laura Helena Andrade, Lúcio Garcia Oliveira, Arthur Guerra Andrade, Clarice Gorenstein, Yuan-Pang Wang","doi":"10.47626/1516-4446-2025-4113","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4113","url":null,"abstract":"<p><strong>Objective: </strong>Suicide is a leading cause of death among youth aged 15-29, with increasing rates of suicidal thoughts and behaviors through the years. University students facing challenges of early adulthood alongside mental health difficulties, are particularly at-risk. Effective prevention strategies are urgent, but knowledge gaps hinder intervention efforts. This study aimed to identify specific subgroups within Brazilian college students and examine their relationship with suicidal ideation (SI) and depression.</p><p><strong>Methods: </strong>Using academic and mental health indicators from a cross-sectional national survey (n = 12,245), a latent class analysis was conducted to identify subgroups based on similar characteristics. Logistic regression was conducted to identify potential associations of identified classes with SI and depressive symptoms.</p><p><strong>Results: </strong>Four distinct classes emerged: \"ordinary\", \"psychologically distressed\", \"dissatisfied\", and \"binge drinkers\". The \"psychologically distressed\" and \"dissatisfied\" subgroups were associated with a higher odds SI (OR=7.90, 95%CI=1.94-32.22; and 8.12, 95%CI=2.27-29.02) and depressive symptoms (OR=28.77, 95%CI=6.43-128.75; and 13.63, 95%CI=3.47-53.59).</p><p><strong>Conclusion: </strong>Students facing academic adjustment and mental health issues are potentially vulnerable to suicide ideation and depressive symptoms. Universities must monitor the impact of academic life on mental health and identify at-risk students for appropriate support. Further research on suicide-related vulnerabilities can guide prevention strategies in educational settings.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986978","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}
Maria A T Ribeiro, Matheus B Costanzi, Andrea F Mello, Marcelo F Mello, Vitor C Calegaro, Thiago M Fidalgo
{"title":"Binge drinking in Brazil through the Covid-19 pandemic: why gender still matters?","authors":"Maria A T Ribeiro, Matheus B Costanzi, Andrea F Mello, Marcelo F Mello, Vitor C Calegaro, Thiago M Fidalgo","doi":"10.47626/1516-4446-2025-4240","DOIUrl":"https://doi.org/10.47626/1516-4446-2025-4240","url":null,"abstract":"<p><strong>Objective: </strong>The COVID-19 pandemic impacted public health worldwide. Binge drinking is a high-risk pattern, linked to health problems and injuries. We aimed to assess the prevalence of binge drinking during four time points in the first year of the pandemic and correlate these with sociodemographic variables, providing insights into binge drinking trends.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from a national survey conducted between April 2020 and January 2021, with 11,205 adult participants. Sociodemographic variables included sex, age, sexual orientation, race/ethnicity, education level, and healthcare worker status. Regression models were used to assess associations with past-month binge drinking, which was the dependent variable.</p><p><strong>Results: </strong>Binge drinking rates were stable across the four time-points. Male sex was consistently associated with binge drinking at all time-points. Other variables such as younger age, lower educational background and non-straight sexual orientation were associated with binge drinking in specific time-points, but not in all of them.</p><p><strong>Conclusions: </strong>The persistence of gender disparities in binge drinking during a period of high unprecedented stress suggests the need for targeted interventions in future public health emergencies. Further research is required to explore the long-term impact of the pandemic on alcohol consumption behaviors and related health outcomes.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986985","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}
Andrés Felipe Avendaño-Montañez, María Del Pilar Santacruz-Ortega, Bertha Lucía Avendaño-Prieto
{"title":"Interaction between Depressive Symptoms and Activities of Daily Living with Cognitive Impairment: A Structural Equation Model with Results from the SABE Bogotá Study.","authors":"Andrés Felipe Avendaño-Montañez, María Del Pilar Santacruz-Ortega, Bertha Lucía Avendaño-Prieto","doi":"10.47626/1516-4446-2024-4037","DOIUrl":"https://doi.org/10.47626/1516-4446-2024-4037","url":null,"abstract":"<p><strong>Objective: </strong>Analyze the interaction between depressive symptomatology, instrumental and basic activities of daily living and cognitive impairment in a sample of elderly Colombians over 60 years of age by conducting a binary logistic regression and a structural equations model.</p><p><strong>Method: </strong>A secondary analysis was performed with data from the study \"SABE\" from 2012, which included 1957 people from Bogotá, Colombia. The sampling was probabilistic, clustered and stratified. The instruments used were the Mini-Mental State Assessment (MMSE), the Lawton-Brody Scale, the Barthel Index and the Geriatric Depression Scale. Bivariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Bivariate analyses revealed differences in performance between groups. The binary logistic regression model explained 42.3 % of the variance. Based on these findings, a structural equation model (SEM) was developed, which yielded the following fit indices: CMIN/gl = 4.81, GFI = .98, CFI = .97 and RMSEA = .04 [.039; .049]. The results show that IADL contribute most significantly to cognitive impairment, while depressive symptomatology and BADL contribute the least.</p><p><strong>Conclusions: </strong>Results suggest that depressive symptomatology and alterations in IADL/BADL are key factors to address in cognitive impairment, which highlights their importance in the context of mental and physical healthcare for the Colombian elderly population.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986976","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}