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

{"title":"Emotion regulation and the COVID-19 pandemic: a practical guide to rehabilitating children and adolescents.","authors":"Tatiana Cohab Khafif, Ana Kleinman, Luisa de Siqueira Rotenberg, Beny Lafer","doi":"10.1590/1516-4446-2021-0038","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-0038","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic has resulted in a global mental health crisis, contributing to the appearance of psychiatric symptoms and the worsening of existing mental health conditions among children and adolescents. Social distancing measures, school clo-sures, elevated stress in the home environment, eco-nomic recession, and increased screen time may have impacted the development of youth and contributed to a worsening of their emotion regulation (ER) skills. 1 Thus, there is a growing need for evidence-based practices and strategies to guide clinicians in dealing with emerging demands.Although life is slowly returning to normal, it is important to carefully consider last year’s toll on mental health and its possible short- and long-term ramifications; evidence has been accumulating about long-term COVID-19 symptoms in youth, such as fatigue and brain fog. In addition, increasing social anxiety, which been fueled by the large amount of time in home schooling and away from peers, is one of the burdens that have been overwhelming families, schools, and clinicians alike. 2 ER strategies enable individuals to reason with and about emotions, regulating their intensity and frequency. These strategies affect one’s awareness of and ability to express emotions, as well as to handle interpersonal relationships wisely. Young people with higher levels of psychological distress show heightened difficulties in reading non-verbal cues, which translates into difficulties in understanding the emotions of oneself and others, leading into social, functional, and academic difficulties. Thus, appraising a patient’s ER skills is an essential part of a comprehensive mental health assessment. ER skills provide individuals with the means to better understand and communicate feelings and needs, improving their overall functioning. ER strategies can be taught by","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"235-236"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/f7/bjp-44-03-235.PMC9169484.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39814731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of brain stimulation techniques for substance use disorder treatment.","authors":"Heather E Webber, Joy M Schmitz","doi":"10.1590/1516-4446-2021-0040","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-0040","url":null,"abstract":"Adminis-tration-approved pharmacotherapies to treat stimulant and other use disorders. New approaches are urgently needed to combat the increasing prevalence of SUDs and overdose deaths. It is that is a chronic disease of the brain involving changes in neural circuitry associated with cognitive and reward functioning. Brain stimulation techniques are novel modulate these we describe","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"239-241"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/41/bjp-44-03-239.PMC9169471.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39722876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"eHealth tools for assessing psychomotor activity in schizophrenia: a systematic review.","authors":"Rosa Molina,&nbsp;Alejandro Porras-Segovia,&nbsp;Marta Ruiz,&nbsp;Enrique Baca-García","doi":"10.1590/1516-4446-2019-0867","DOIUrl":"https://doi.org/10.1590/1516-4446-2019-0867","url":null,"abstract":"<p><strong>Objective: </strong>Psychomotor abnormalities are relevant symptoms in the clinical presentation of schizophrenia, and assessing them could facilitate monitoring. New technologies can measure psychomotor activity objectively and continuously, but evidence on the topic is scarce. Our aim is to systematically review the existing evidence about eHealth tools for assessing psychomotor activity in patients diagnosed with schizophrenia.</p><p><strong>Method: </strong>We performed a systematic search of the PubMed and Embase databases and identified 15 relevant articles on eHealth tools for assessing psychomotor activity in schizophrenia.</p><p><strong>Results: </strong>eHealth devices accurately assessed psychomotor activity and were well accepted. Abnormalities in psychomotor activity helped differentiate between different subtypes of schizophrenia. Abnormal increases in psychomotor activity were correlated with acute presentations, while lower activity was associated with relapses, deterioration, and negative symptoms.</p><p><strong>Conclusion: </strong>Actigraphy is still the preferred eHealth device in research settings, but mobile applications have great potential. Further studies are needed to explore the possibilities of psychomotor monitoring and mobile health applications for preventing relapses in schizophrenia. eHealth could be useful for monitoring psychomotor activity, which might help prevent relapses.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"102-107"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/dd/bjp-43-01-102.PMC7861176.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38064068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and panic disorder: clinical considerations for the most physical of mental disorders.","authors":"Giampaolo Perna,&nbsp;Daniela Caldirola","doi":"10.1590/1516-4446-2020-1235","DOIUrl":"https://doi.org/10.1590/1516-4446-2020-1235","url":null,"abstract":"Shortness of breath, choking or smothering sensations, chest pain or discomfort, and fear of dying. Due to the coronavirus disease 2019 (COVID-19) pandemic, our minds have been conditioned to associate these symptoms with a rather severe form of the disease. Although such symptoms could indicate a case of COVID-19, they are also common in panic attacks (PAs) (i.e., the hallmark of panic disorder [PD]), in which respiratory symptoms occur along with other panic symptoms that are mainly physical in nature. Experimental evidence has supported the hypothesis, unique in the realm of mental disorders, that subclinical alterations of basic physical functioning, mainly the respiratory system, may be involved in the pathogenesis of PAs. Patients with PD were thought to have a hyperactive suffocation alarm, which results in a specific behavioral and respiratory hypersensitivity to hypercapnia. Different laboratory challenges that induce hypercapnia (e.g., the Read’s rebreathing technique, the prolonged inhalation of 5% or 7% of CO2-enriched air, and the double inhalation of a 35% CO2 and 65% O2 gas mixture) resulted in higher rates of PAs and respiratory-response abnormalities in PD patients than controls. Moreover, these patients are hypersensitive to various other laboratory respiratory challenges, such as breath-holding, hyperventilation, and a hypoxic challenge test. They suffer from irregular breathing patterns, impaired diaphragmatic breathing with reduced vital capacity, chronic hyperventilation, and a common sensation of difficulty in breathing during activities of daily living. Finally, PD has remarkable associations with asthma or chronic obstructive pulmonary disease. PD patients also have imbalanced autonomic regulation, reduced heart rate variability, poorer cardiovascular fitness, and higher variability of electrocardiographic QT interval and cardiac repolarization. Although the source of these features is still unclear, patients with PD experience, from a clinical point of view, a significant burden of respiratory and physical symptoms or discomfort during PAs, as well as in certain environmental situations. Furthermore, the fear of suffocation is one of their primary troubles. Overall, they seem to exhibit greater physical and emotional difficulties in coping with somatic sensations and internal bodily changes than individuals suffering from other anxiety disorders. Given these peculiar features, PD patients are likely to have distinct difficulty in dealing with a disease like COVID-19, since it may be severe and life-threatening and, most importantly, it may cause various respiratory symptoms, which could lead to respiratory failure. Hence, when PD patients develop COVID-19, a complex clinical picture might emerge that deserves consideration from clinicians involved in managing COVID-19 patients. First, clinicians should bear in mind that PD patients are particularly hypersensitive, from a biological and psychological point of view, to res","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"110-111"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/eb/bjp-43-01-110.PMC7861169.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38231669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The root of the problem: identifying major sources of stress in Brazilian medical students and developing the Medical Student Stress Factor Scale.","authors":"Rodolfo F Damiano,&nbsp;Isabella N de Oliveira,&nbsp;Oscarina da S Ezequiel,&nbsp;Alessandra L Lucchetti,&nbsp;Giancarlo Lucchetti","doi":"10.1590/1516-4446-2019-0824","DOIUrl":"https://doi.org/10.1590/1516-4446-2019-0824","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the most common sources of stress faced by medical students and the degree to which different stressors impact their lives. As a secondary objective, a new instrument, Medical Student Stress Factor Scale (MSSF), was developed based on these stressors.</p><p><strong>Methods: </strong>The MSSF was applied to 431 medical students. The Depression, Anxiety and Stress Scale was administered to investigate the relationship between these stressors and the students' mental health.</p><p><strong>Results: </strong>The five greatest stressors were the extensive content, lack of time to study, sleep deprivation, excessive self-pressure for good grades, and lack of leisure time. The MSSF showed good psychometric characteristics, resulting in a 28-item scale with five subscales. The Relationships and Health subscales were associated with depressive symptoms; Relationships, Health, and Learning Environment/Academic Performance were associated with anxiety symptoms, while Health, and Learning Environment/Academic Performance were associated with stress symptoms.</p><p><strong>Conclusions: </strong>Our study presents important data about the most important stressors that affect medical students' lives and cause mental health issues. The factors are generally related to academic performance and the learning environment and should be targeted in future interventions.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"35-42"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/93/bjp-43-01-35.PMC7861167.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38179306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An epidemiological study of childhood development in an urban setting in Brazil.","authors":"Sheila C Caetano,&nbsp;Marcos V V Ribeiro,&nbsp;Melanie S Askari,&nbsp;Zila M Sanchez,&nbsp;Maria C do Rosário,&nbsp;Jacy Perissinoto,&nbsp;Rosa Resegue,&nbsp;Erika Felix,&nbsp;Marília Mariano,&nbsp;Thiago M Fidalgo,&nbsp;Michelle Caetano,&nbsp;Jair J Mari,&nbsp;Pamela J Surkan,&nbsp;Silvia S Martins","doi":"10.1590/1516-4446-2020-0934","DOIUrl":"https://doi.org/10.1590/1516-4446-2020-0934","url":null,"abstract":"Objective: Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4- to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and socioemotional development delays; and 2) to identify modifiable risk factors associated with mental, behavioral, or developmental disorders (MBDD), such as microsystem (i.e., parent-child relationship), mesosystem (social support), and macrosystem contextual factors (neighborhood disadvantage). Methods: A random sample of public preschool children was recruited in the city of Embu das Artes (São Paulo metropolitan area) (n=1,292 from 30 public preschools). Six-month prevalence of MBDD was measured using the Child Behavior Checklist (CBCL) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). Results: Six-month prevalence estimates were 25.4% for internalizing disorders, 12.1% for externalizing disorders, and 30.3% for socioemotional development delays. MBDD prevalence estimates were higher in families with stressful relationships and parental depression or anxiety, and in families with lower social capital. Conclusion: At least 25% of preschool children living in an urban area in Brazil presented a mental health disorder. These mental disorder were associated with modifiable factors such as stressful family relationships and lower social capital. Prevention and intervention measures such as family therapy are needed to decrease such high prevalence.","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"43-54"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/25/bjp-43-01-43.PMC7861175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38280255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive-behavioral therapy in pregnant women with generalized anxiety disorder: a retrospective cohort study on therapeutic efficacy, gestational age and birth weight.","authors":"Faruk Uguz,&nbsp;Mehmet Ak","doi":"10.1590/1516-4446-2019-0792","DOIUrl":"https://doi.org/10.1590/1516-4446-2019-0792","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of cognitive behavioral therapy in the treatment of generalized anxiety disorder during pregnancy and its effects on gestational age and birth weight.</p><p><strong>Methods: </strong>The sample included 28 untreated patients and 23 patients treated with CBT. Psychiatric diagnoses were determined through the Structured Clinical Interview for the DSM-IV. Symptom severity was assessed with standardized rating scales.</p><p><strong>Results: </strong>Post-treatment levels of anxiety symptoms were significantly lower than baseline. There was no significant difference in gestational age or newborn birth weight between the cognitive behavioral therapy group and the untreated group.</p><p><strong>Conclusions: </strong>Cognitive behavioral therapy appears to be a safe and effective treatment for generalized anxiety disorder during pregnancy.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"61-64"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/7c/bjp-43-01-61.PMC7861166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38231667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The psychiatric impact of COVID-19 pandemic on sexual health.","authors":"Gustavo M Paul,&nbsp;Bruno C Nascimento,&nbsp;João Afif-Abdo,&nbsp;Francisco R Coutinho,&nbsp;Eduardo P Miranda,&nbsp;Carmita H N Abdo","doi":"10.1590/1516-4446-2020-1197","DOIUrl":"https://doi.org/10.1590/1516-4446-2020-1197","url":null,"abstract":"The new coronavirus pandemic has been considered the greatest challenge for the health system in the modern era. Although social distancing and quarantines have been necessary as public health strategies, they may contribute to psychological and mental problems. There is evidence that reduced interpersonal communication may increase the incidence of depression and anxiety and exacerbate pre-existing conditions. In fact, loneliness, denial, anxiety, depression, insomnia and despair have been reported among suspected cases of coronavirus disease (COVID19). In addition, some studies have shown an increased risk of aggressiveness and suicide in infected individuals. Anxiety and depression are commonly seen in men with sexual disorders such as erectile dysfunction and premature ejaculation. Anxious men are more likely to experience performance anxiety, while those with depression tend to report lack of libido. In female patients, depression is strongly linked to hypoactive sexual desire disorder and anxiety has been shown to interfere with arousal and the ability to achieve orgasm. Chronic dyspareunia is 3-10 times more common in women diagnosed with depression or anxiety. Although no published study has directly investigated changes in sexual function and behavior during COVID19, negative effects on sexual health are expected. Previous pandemics have shown that social isolation associated with fear of being infected significantly reduces sexual contact. Pornography consumption has also increased concomitantly with the pandemic. On March 13, 2020, the Pornhub website reported an 11.6% increase in accesses. Excessive masturbation can interfere in a couple’s relationship, leading to growing feelings of isolation and breakups. The spread of COVID-19 through sexual activity is also concerning. Since the virus is present in upper airway fluids, it might be transmissible during sex. The International Society for Sexual Medicine produced a set of recommendations regarding the safety of sexual activity during the pandemic, including that healthy couples in confinement may maintain normal sexual activity. Individuals with respiratory symptoms or immunocompromised partners should abstain from sexual activity. Masturbation is safe as long as hygiene standards are maintained. Alternative sexual activity, such as exchanging messages, pictures or videos by digital means are not risky, and may even be good method for exploring a couple’s sexual fantasies. Therefore, COVID-19 could directly and indirectly impact the sex lives of many couples. Increasing rates of anxiety and depression may translate into higher rates of psychogenic sexual dysfunction. Protective measures to guarantee safe sex might also lead to situational difficulties, especially for those at risk of or with preexisting sexual dysfunction. The medical community must be aware of such phenomena and provide proper counseling, especially during these times, when many traditional psychological support mod","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"109"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/4f/bjp-43-01-109.PMC7861171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38233751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hikikomori and the COVID-19 pandemic: not leaving behind the socially withdrawn.","authors":"Thiago H Roza,&nbsp;Daniel T Spritzer,&nbsp;Ary Gadelha,&nbsp;Ives C Passos","doi":"10.1590/1516-4446-2020-1145","DOIUrl":"https://doi.org/10.1590/1516-4446-2020-1145","url":null,"abstract":"dated in Portuguese for the Brazilian cultural context, as well as the impossibility of objectively identifying and measuring tokophobia, make adequate therapeutic guidance difficult. A systematic review and meta-analysis was performed of the risk factors. The perception of tokophobia was assessed among pregnant women and prenatal health care professionals to identify the peculiarities of tokophobia in the Brazilian socio-cultural and clinical-obstetric context. The conceptual and psychometric analysis process allowed the development and validation of the Tokophobia Assessment Questionnaire (Questionário de Avaliação da Partofobia) in Brazilian Portuguese, available from the authors upon request. This research project was approved by the Universidade do Sul de Santa Catarina research ethics committee (protocol 87312818.0.0000.5369). The Tokophobia Assessment Questionnaire has been validated; its reliability was measured with the Pearson correlation coefficient (0.766) and the intraclass correlation coefficient (0.856). Bland-Altman analysis showed a central tendency between the difference and mean of the two Tokophobia Assessment Questionnaire applications in almost the entire sample. The general Cronbach’s alpha was 0.935 (Table 1). The Kappa index was 0.444 and the Pearson correlation coefficient between the first application of the Tokophobia Assessment Questionnaire and the Depression, Anxiety and Stress Scale was 0.607. Exploratory factor analysis identified six factors categorized into conceptual groups: physical repercussions (factor 1); feeling of panic (factor 2); social involvement (factor 3); interference in daily habits (factor 4); pregnancy avoidance (factor 5); self-perception of tokophobia (factor 6) (Table 1). Use of the item response theory demonstrated the suitability of all items (Figure 1). Therefore, the 25-item Tokophobia Assessment Questionnaire is reliable and valid and is the first instrument for assessing the clinical, emotional and psychiatric manifestations of tokophobia. Although developed for the Brazilian population, the instrument may have worldwide applicability.","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"114-116"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/01/bjp-43-01-114.PMC7861179.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38405099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in borderline personality disorder symptomatology after repetitive transcranial magnetic stimulation of the dorsomedial prefrontal cortex: preliminary results.","authors":"Angel R Calderón-Moctezuma,&nbsp;Julian V Reyes-López,&nbsp;René Rodríguez-Valdés,&nbsp;Mario Barbosa-Luna,&nbsp;Josefina Ricardo-Garcell,&nbsp;Marbella Espino-Cortés,&nbsp;Nancy Hernández-Chan,&nbsp;Lorena García-Noguez,&nbsp;Georgina Roque-Roque,&nbsp;Gerardo Trejo-Cruz,&nbsp;Sofía Cañizares-Gómez,&nbsp;Hebert Hernández-Montiel","doi":"10.1590/1516-4446-2019-0591","DOIUrl":"https://doi.org/10.1590/1516-4446-2019-0591","url":null,"abstract":"<p><strong>Objective: </strong>Current treatment for borderline personality disorder (BPD) involves psychological and pharmacological interventions. However, neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) may positively affect BPD symptomatology. The objective of this study was to evaluate the clinical and neuropsychological effects of rTMS on the dorsomedial prefrontal cortex (DMPFC) in BPD patients.</p><p><strong>Methods: </strong>Fourteen patients with BPD were randomized into two groups (active vs. sham) for 15 sessions of rTMS on the DMPFC. Clinical effects were measured using the Borderline Symptoms List (BSL), Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity over Time (BEST), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Barratt's Impulsiveness Scale (BIS). Neuropsychological effects were determined by a Stop-Signal Task (SST), the Wisconsin Card-Sorting Test (WCST), and the Iowa Gambling Test (IGT).</p><p><strong>Results: </strong>Within-group comparison showed significant differences (p < 0.05) in CGI-BPD (total score and six of nine psychopathologic domains), BEST, HDRS, HARS, and IGT scores for active modality.</p><p><strong>Conclusion: </strong>The 5 Hz-DMPFC rTMS technique was well tolerated and lessened the severity of BPD symptomatology, especially abandonment, affective issues, interpersonal relationships, suicidal behavior, anger, and paranoid ideation. Cognitive improvement was seen in decision-making. Additional studies are needed to fully evaluate the effects of rTMS on BPD symptomatology.</p><p><strong>Clinical trial registration: </strong>NCT03832777.</p>","PeriodicalId":520767,"journal":{"name":"Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)","volume":" ","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/80/bjp-43-01-65.PMC7861182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38432638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}