Brazilian Journal of Psychiatry最新文献

{"title":"Identifying Depression Early in Adolescence: assessing the performance of a risk score for future onset of depression in an independent Brazilian sample","authors":"G. R. Cunha, A. Caye, P. Pan, H. Fisher, Rivka B. Pereira, Carolina Ziebold, R. Bressan, B. Kohrt, V. Mondelli, C. Kieling, A. Gadelha","doi":"10.1590/1516-4446-2022-2775","DOIUrl":"https://doi.org/10.1590/1516-4446-2022-2775","url":null,"abstract":"Objective: The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) was recently developed in Brazil using data from the Pelotas 1993 Birth Cohort to estimate the individualized probability of developing depression in adolescence. This model includes 11 sociodemographic variables and has been assessed in longitudinal studies from four other countries. We aimed to test the performance of IDEA-RS in an independent, community-based, school-attending sample within the same country: the Brazilian High-Risk Cohort. Methods: Standard external validation, refitted, and case mix-corrected models were used to predict depression among 1442 youth followed from a mean age of 13.5 years at baseline to 17.7 years at follow-up, using probabilities calculated with IDEA-RS coefficients. Results: The area under the curve was 0.65 for standard external validation, 0.70 for the case mix-corrected model, and 0.69 for the refitted model, with discrimination consistently above chance for predicting depression in the new dataset. There was some degree of miscalibration, corrected by model refitting (calibration-in-the-large reduced from 0.77 to 0). Conclusion: IDEA-RS was able to parse individuals with higher or lower probability of developing depression beyond chance in an independent Brazilian sample. Further steps should include model improvements and additional studies in populations with high levels of subclinical symptoms to improve clinical decision making.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84119818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased insulin resistance due to long COVID is associated with depressive symptoms and partly predicted by the inflammatory response during acute infection","authors":"H. Al-Hakeim, Haneen Tahseen Al-Rubaye, Abdulsahib S. Jubran, A. Almulla, S. Moustafa, Michael Maes","doi":"10.1101/2022.12.01.22283011","DOIUrl":"https://doi.org/10.1101/2022.12.01.22283011","url":null,"abstract":"Background. Some months after the remission of acute COVID-19 infection, some people show depressive symptoms, which are predicted by increased peak body temperature (PBT) and lowered blood oxygen saturation (SpO2). Nevertheless, no data indicate whether Long COVID is associated with increased insulin resistance (IR) in association with depressive symptoms and immune, oxidative, and nitrosative (IO&NS) processes. Methods. We used the homeostasis Model Assessment 2 (HOMA2) calculator to compute beta-cell function, insulin sensitivity and resistance (HOMA2-IR) and measured the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HAMD) in 86 Long COVID patients and 39 controls. We examined the associations between the HOMA2 indices and PBT and SpO2 during acute infection, and depression, IO&NS biomarkers (C-reactive protein, NLRP3 activation, myeloperoxidase, and advanced oxidation protein products) 3-4 months after the acute infection. Results. Long COVID is accompanied by increased HOMA2-IR, fasting blood glucose, and insulin levels. We found that 33.7% of the patients versus 0% of the controls had HOMA2-IR values >1.8, suggesting IR. PBT, but not SpO2, during acute infection significantly predicted IR, albeit with a small effect size. Increased IR was significantly associated with depressive symptoms as assessed with the BDI and HAMD above and beyond the effects of IO&NS pathways. There were no significant associations between increased IR and the activated IO&NS pathways during Long COVID. Conclusion. Long COVID is associated with new-onset IR in a subset of patients. Increased IR may contribute to the onset of depressive symptoms due to Long COVID by enhancing overall neurotoxicity.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78637012","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":"Preventing mental disorders and promoting mental health in the workplace","authors":"Javier Camacho-Rubio, G. Salazar de Pablo, C. Arango","doi":"10.1590/1516-4446-2021-2459","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2459","url":null,"abstract":"Mental health problems, of which depression a paradigmatic example, are an increasing concern. Despite the generalization of mental health care in our environment, the incidence of depression continues to grow and it is now one of the leading causes of disability. Globally, its estimated cost is one trillion dollars per year, mainly due to decreased productivity from work absenteeism. Most mental health care is carried out in clinical settings, which limits early detection and the possibility of acting on the incidence of mental conditions. Thus, early intervention strategies are needed in the fields of prevention (primary and secondary) and mental health promotion. The work environment is considered the ideal place for these activities since the general population spends a large part of their time there. According to the World Health Organization, intensifying mental health care in the general population will result in a high economic return: for every dollar invested in depression and anxiety four dollars are saved, mainly through increased productivity at work. Intervention costs could be shared with the private sector, since companies will be interested in the economic return. Workplace interventions can impact work performance, which is a central domain of mental health promotion and is affected by workload, lack of participation and control, monotonous and unpleasant tasks, poor interpersonal relationships, precarious working conditions, and lack of leadership and communication. A number of interventions have been found to effectively reduce depressive symptoms and prevent their onset. They involve different formats (individual, group, self-administered, face-to-face, or telematic) and content (psychoeducation, exercise promotion, and psychological therapies). However, further research is needed to determine which have the best results. Professional care in the workplace also allows early detection of mental disorders and referral for treatment. In the context of the COVID-19 pandemic and due to its impact on the mental health of the working population, telehealth interventions may allow safer and more inexpensive interventions. A recent meta-analysis found that the mental health of health care workers has been especially affected, and thus this group is of particular interest. One in four health professionals have suffered significant depressive symptoms during the pandemic, and more than one in three are suffering from burnout. Other symptoms include insomnia, anxiety and post-traumatic features. They are being prioritized in public health policies. In conclusion, interventions to prevent mental disorders and promote mental health in the workplace are costeffective and could decrease the incidence of depression and reduce work absenteeism. During the COVID-19 pandemic, telehealth interventions for health professionals are highly important.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82469500","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":"Assessment of the diagnostic performance of two new tools versus routine screening instruments for bipolar disorder: a meta-analysis.","authors":"Mehdi Sayyah, Ali Delirrooyfard, Fakher Rahim","doi":"10.1590/1516-4446-2021-2334","DOIUrl":"10.1590/1516-4446-2021-2334","url":null,"abstract":"<p><strong>Objective: </strong>The present meta-analysis was conducted to determine the diagnostic accuracy of the bipolarity index (BI) and Rapid Mode Screener (RMS) as compared with the Bipolar Spectrum Diagnostic Scale (BSDS), the Hypomania Checklist (HCL-32), and the Mood Disorder Questionnaire (MDQ) in people with bipolar disorder (BD).</p><p><strong>Methods: </strong>We systematically searched five databases using standard search terms, and relevant articles published between May 1990 and November 30, 2021 were collected and reviewed.</p><p><strong>Results: </strong>Ninety-three original studies were included (n=62,291). At the recommended cutoffs for the BI, HCL-32, BSDS, MDQ, and RMS, the pooled sensitivities were 0.82, 0.75, 0.71, 0.71, and 0.78, respectively, while the corresponding pooled specificities were 0.73, 0.63, 0.73, 0.77, and 0.72, respectively. However, there was evidence that the accuracy of the BI was superior to that of the other tests, with a relative diagnostic odds ratio (RDOR) of 1.22 (0.98-1.52, p < 0.0001). The RMS was significantly more accurate than the other tests, with an RDOR (95%CI) of 0.79 (0.67-0.92, p < 0.0001) for the detection of BD type I (BD-I). However, there was evidence that the accuracy of the MDQ was superior to that of the other tests, with an RDOR of 1.93 (0.89-2.79, p = 0.0019), for the detection of BD type II (BD-II).</p><p><strong>Conclusion: </strong>The psychometric properties of two new instruments, the BI and RMS, in people with BD were consistent with considerably higher diagnostic accuracy than the HCL-32, BSDS, and MDQ. However, a positive screening should be confirmed by a clinical diagnostic evaluation for BD.</p>","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9169473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88645064","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":"On our minds: the state of child and adolescent mental health","authors":"Claudia Buchweitz, A. Caye, C. Kieling","doi":"10.1590/1516-4446-2021-2344","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2344","url":null,"abstract":"On our minds: the state of child and adolescent mental health Claudia Buchweitz,0000-0000-0000-0000 Arthur Caye,0000-0000-0000-0000 Christian Kieling0000-0000-0000-0000 Programa de Depressão na Infância e na Adolescência (ProDIA), Hospital de Clı́nicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Serviço de Psiquiatria da Infância e Adolescência, HCPA, Porto Alegre, RS, Brazil.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82181470","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":"The anxiolytic effect of cannabidiol depends on the nature of the trauma when patients with post-traumatic stress disorder recall their trigger event","authors":"L. Bolsoni, J. Crippa, J. Hallak, F. Guimarães, A. Zuardi","doi":"10.1590/1516-4446-2021-2317","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2317","url":null,"abstract":"Objectives: We assessed whether administering cannabidiol (CBD) before recalling the traumatic event that triggered their disorder attenuates anxiety in patients with post-traumatic stress disorder (PTSD). As an exploratory pilot analysis, we also investigated whether this effect depends on the nature of the event (sexual vs. nonsexual trauma). Methods: Thirty-three patients of both sexes with PTSD were recruited and randomized 1:1 into two groups. One group received oral CBD (300 mg), and the other received a placebo before listening to a digital audio playback of their previously recorded report of the trigger event. Subjective and physiological measurements were taken before and after recall. We analyzed the data in two subsamples: trigger events involving sexual and nonsexual trauma. Results: In the nonsexual trauma group, the differences between measurements before and after recall were significantly smaller with CBD than placebo; this held true for anxiety and cognitive impairment. However, in the sexual trauma group, the differences were non-significant for both measurements. Conclusion: A single dose of CBD (300mg) attenuated the increased anxiety and cognitive impairment induced by recalling a traumatic event in patients with PTSD when the event involved nonsexual trauma.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81277465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and depressive symptoms among adolescents in a school-based sample","authors":"Bruna Velazquez, S. Petresco, Rivka B. Pereira, Claudia Buchweitz, P. Manfro, A. Caye, H. Fisher, B. Kohrt, V. Mondelli, C. Kieling","doi":"10.1590/1516-4446-2021-2235","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2235","url":null,"abstract":"Objective: To explore associations between self-reported weekly physical activity and depressive symptomatology among adolescents in a school-based sample from Brazil. Methods: We surveyed 7,405 adolescents aged 14 to 16 years in 101 public schools in Porto Alegre, Brazil. We assessed physical activity using an adapted version of the Patient-Centered Assessment and Counseling for Exercise Plus Nutrition – Adolescent Physical Activity Measure (PACE+), and depressive symptoms using the Brazilian Portuguese version of the Patient Health Questionnaire – Adolescent Version. We compared the depressive symptom scores among adolescents with varying levels of physical activity. Results: Of the overall sample, 84.4% exercised less than the recommended frequency of 60 minutes/day, at least 5 days/week, of moderate to intense physical activity (PACE+ score ≥ 5). Adolescents whose physical activity levels fell below that threshold had higher median depression scores (8 [IQR = 10] vs. 7 [IQR = 9], W = 4060461, p < 0.001). A similar pattern was observed for depression scores in those with PACE+ < 1 (median of 10 [IQR = 11]) and ≥ 1 (7 [IQR = 9], W = 7457608, p < 0.001). Conclusion: In this large sample of Brazilian adolescents, those who exercised less frequently and vigorously than their peers reported more depressive symptoms.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73594693","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":"Suicide attempt, impulsivity, and exposure to trauma in college students","authors":"Sidnei B. Lira, F. Vieira, D. Cavalcanti, B. Souza-Marques, L. R. Netto, F. S. Correia-Melo, G. C. Leal, J. L. Pereira, Lene L. Santos, Gisela M. Guedes, C. Teles, T. Cardoso, Â. Miranda-Scippa, F. Kapczinski, A. Lacerda, K. Koenen, G. Turecki, L. Quarantini","doi":"10.1590/1516-4446-2021-2175","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2175","url":null,"abstract":"Objectives: Past suicide attempt (SA) is one of the most important risk factors for suicide death. An ideation-to-action framework posits that impulsivity, potentially traumatic events, and mental disorders also play a role in increasing suicide risk. This study aimed to assess the association between trait impulsivity, lifetime exposure to trauma, and post-traumatic stress disorder (PTSD) with SA in a sample of Brazilian college students. Methods: A total of 2,137 participants filled self-reported questionnaires consisting of a sociodemographic and clinical questionnaire, Trauma History Questionnaire, Post-Traumatic Stress Disorder Checklist – Civilian version, and Barratt Impulsiveness Scale. Results: Our findings suggest that trait impulsivity may be interpreted as exerting a distal effect on SA, even in the presence of other variables – such as trauma history, psychological neglect, and PTSD – which also increase the odds of SA. High and medium levels of impulsivity, history of trauma, and PTSD increased the likelihood of SA. Conclusions: Intervention strategies to prevent SA may target trait impulsivity and exposure to traumatic experiences.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77602496","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":"Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic","authors":"L. Pilz, N. S. C. Couto Pereira, A. Francisco, A. Carissimi, D. Constantino, Letícia B. Caus, A. C. Abreu, Guilherme R Amando, Fernanda S Bonatto, Paula V.V. Carvalho, J. Cipolla-Neto, Anas Harb, Gabriela Lazzarotto, J. R. Marafiga, L. Minuzzi, Francisco Montagner, Fernanda A. Nishino, Melissa A B Oliveira, Bruno G T Dos Santos, Eduardo G Steibel, P. Tavares, A. Tonon, N. Xavier, Q. K. Zanona, F. Amaral, M. Calcagnotto, B. Frey, M. Hidalgo, M. Idiart, T. Russomano","doi":"10.1590/1516-4446-2021-2109","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2109","url":null,"abstract":"Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74523351","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":"Real world evidence in involuntary psychiatric hospitalizations: 64,685 cases","authors":"Christina Fornazari, M. Canfield, R. Laranjeira","doi":"10.1590/1516-4446-2021-2267","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2267","url":null,"abstract":"Objective: We explored hospitalization patterns and the clinical and individual characteristics of a large cohort of patients who underwent involuntary psychiatric hospitalization in Brazil (n=64,685). Methods: Data were collected from the District Attorney's Office of the State of São Paulo (Ministério Público do Estado de São Paulo) on all involuntary psychiatric hospitalizations in the city of São Paulo between January 2003 and February 2020. The annual involuntary psychiatric hospitalization rate was calculated and descriptive statistics of the characteristics were produced. Results: Involuntary psychiatric hospitalizations increased from 5.8 to 25.5 per 100,000 population, with an eight-folder increase in the first 10-year period (2003-2013). The majority of admissions were to public institutions (86.6%), involved a psychotic disorder in the primary diagnosis (26.1%), involved more than one diagnosis (83.7%), and lasted less than 7 days (52.4%). The majority of the patients were aged 18 to 39 years and were single, and readmission was relatively common (13%). Although the reason for admission was missing in many reports (44%), the risk of harm to self or others was the most common (68.5%). Conclusion: This is one of the largest cohorts of involuntary psychiatric hospitalization records ever explored. These findings build upon existing international evidence about involuntary psychiatric hospitalizations and show recent trends in admission rates in the largest city in Brazil.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89905801","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}