Abstract Objectives To describe the theoretical procedures employed in the process of cross-cultural adaptation (CCA) for Brazil of the Child Mania Rating Scale - Parent Version (CMRS-P). Methods Seven steps were carried out: (1) translations and synthesis; (2) Committee of Judges-I; (3) grammatical review; (4) Committee of Judges-II; (5) semantic analysis (pre-test); (6) back-translation; and (7) discussion with the authors of the original instrument. Participants were two professional translators, 14 experts, a grammar proofreader, and 21 parents/guardians, representatives of the target population. The results were analyzed in terms of the percentage of agreement between evaluators and the content validity coefficient (CVC) and by analysis of comments and suggestions. Results Grammatical and cultural adjustments were made, in addition to substitution and/or inclusion of words and examples. Adequacy agreement indexes exceeding 86% were achieved and the CVC result for the total scale was excellent (0.95). The pre-test indicated good acceptance and understanding by participants. Conclusion The proposed version proved to be promising for use in the Brazilian context, although further psychometric studies are still needed to prove the scale’s validity and reliability.

Objective: To evaluate the impact of defense mechanisms at baseline on depressive symptoms after brief psychotherapies and after 6-months of follow-up among depressed patients with and without cluster B personality disorders (PDs). Methods: This quasi-experimental study nested within a randomized clinical trial included a clinical sample of adults (18-60 years) diagnosed with major depressive disorder using the Mini-International Neuropsychiatric Interview. The Millon Clinical Multiaxial Inventory-III was applied to assess PD, the Defense Style Questionnaire 40 was used to analyze defense mechanisms, and the Beck Depression Inventory was used to measure the severity of depressive symptoms. Adjusted analysis was performed by linear regression. Results: The final sample consisted of 177 patients diagnosed with major depressive disorder, of whom 39.5% had cluster B PDs. Immature defenses at baseline significantly predicted the persistence of depressive symptoms at post-intervention and at 6-months of follow-up only in patients with PDs. Conclusion: In depressed patients with cluster B PDs, immature defenses predicted a poor response to brief therapies. The assessment of immature defenses at baseline can help identify patients at greater risk of poor therapeutic results and enable more appropriate treatment choices.

Abstract Objective To conduct a systematic review to describe cognitive abilities in bipolar disorder (BD) in comparison to cognitive abilities in mild cognitive impairment (MCI) and dementia. Methods A literature search was performed with no year or language restrictions. The search yielded 1,461 articles, with 1,261 remaining after removal of duplicates, five of which were suitable for the systematic review: two for the comparison between BD and MCI and three comparing BD and dementia. Results Analyses from our systematic review showed that euthymic individuals with BD present impairments in cognitive domains such as attention and executive functioning, motor skills, conceptual thinking, and visuo-spatial abilities that are equally severe as or more severe than the impairments observed in individuals with MCI. In contrast, studies comparing BD and dementia indicated that Alzheimer’s disease (AD) dementia and behavioral variant frontotemporal dementia (bvFTD) both showed greater cognitive deficits than BD during euthymia, whereas BD during a mood episode demonstrated higher cognitive impairments than bvFTD. Conclusion Findings from our systematic review suggest that cognitive impairments in euthymic BD fall into a range between the impairments seen in MCI and those seen in dementia. More studies are needed to analyze these comparisons, while also focusing on comparing different clinical stages of BD with MCI and dementia to analyze the progression of the clinical course and cognitive dysfunction in BD.PROSPERO registration ID: CRD42020150412

Abstract Introduction Bipolar disorder (BD) has a high heritability rate. Current studies have been dedicated to identifying prodromes of BD in the offspring of parents with BD (BO) and the sleep patterns of these individuals have been considered important factors. Objective To describe changes in sleep parameters among offspring of parents with BD when compared to offspring of controls and to identify if changes in parameters and quality of sleep predict the onset of BD among these individuals. Methods PubMed, PsycINFO, and Embase were systematically searched with no year or language restrictions, up to August 18, 2020. We searched for a combination of the following search items (“sleep*”) AND (“bipolar disorder*” OR “mania” OR “hypomania” OR “bipolar depression”) AND (“ultra-high risk” OR “high risk” OR “offspring” OR “first degree relatives”). Results A total of 10 studies were included in the systematic review and 4 studies were included in the meta-analysis. Our meta-analysis showed that the BO had greater daytime sleepiness as compared to the offspring of control parents. The systematic review indicated that shorter sleep duration, sleep disorders, and other related features can differentiate the two groups. Finally, some sleep patterns such as decreased sleep, difficulty falling asleep, and overall sleep problems might be predictors for the development of BD. Conclusion Results from the meta-analysis indicated that BO had greater daytime sleepiness. Qualitative results showed that the offspring of parents with BD have an increased likelihood of experiencing an adverse sleep pattern.