Resumen Esta revisión narrativa de la literatura pretende describir la importancia de la depresión posparto (DPP), intentando identificar la mejor manera de detectarla y los beneficios de realizar un manejo oportuno. La DPP es un trastorno del estado de ánimo que afecta a las mujeres después de dar a luz. Se caracteriza por síntomas como estado de ánimo deprimido, pérdida de interés o placer, cambios de peso, trastornos del sueño, falta de energía, dificultad para concentrarse, sentimientos de culpa o inutilidad, y pensamientos suicidas. Se estima que afecta al 6,9 a 12,9% de las mujeres en los países desarrollados y hasta el 20% en los de bajos ingresos. La etiología de la DPP involucra una interacción de factores hormonales, neuroendocrinos, genéticos, neuroinflamatorios y psicosociales; además, se han identificado diversos factores de riesgo, como antecedentes familiares de depresión, estrés, falta de apoyo social y problemas de salud del bebé. La detección se puede realizar mediante escalas rápidas, como la Escala de Depresión Posparto de Edimburgo. Su manejo se basa en diferentes tipos de psicoterapia, como la terapia cognitivo-conductual, la terapia de apoyo e interpersonal, además de medidas farmacológicas como los antidepresivos inhibidores selectivos de la recaptación de serotonina (ISRS) o los inhibidores de la recaptación de serotonina y noradrenalina (IRSN), u otras terapias como la brexanolona o los estrógenos.

Abstract This narrative review of the literature aims to describe the importance of postpartum depression (PPD), trying to identify the best way to detect it and the benefits of timely management. PPD is a mood disorder that affects women after giving birth. It is characterized by symptoms such as depressed mood, loss of interest or pleasure, weight changes, sleep disorders, lack of energy, difficulty concentrating, guilt or worthlessness, and suicidal thoughts. It is estimated that it affects between 6.9% and 12.9% of women in high-income countries and up to 20% in low-income countries. The etiology of PPD involves an interplay of hormonal, neuroendocrine, genetic, neuroinflammatory, and psychosocial factors. Furthermore, various risk factors have been identified, including a family history of depression, stress, lack of social support, and health problems in the infant. Detection can be done using rapid scales like the Edinburgh Postnatal Depression Scale. Its management is based on different types of psychotherapy, namely cognitive behavioral therapy, supportive and interpersonal therapy, as well as pharmacological measures including serotonin reuptake inhibitor or serotonin and noradrenaline reuptake inhibitor antidepressants, and other therapies like brexanolone or estrogens.

Abstract Background The treatment for atopic dermatitis (AD) has been the focus of clinical research, and behavioral intervention is considered an indispensable treatment method. To our knowledge, no relevant meta-analysis has evaluated the effects of behavioral interventions on atopic dermatitis. Objectives To evaluate the effects of behavioral interventions on atopic dermatitis. Methods The authors searched PubMed, EMBASE, and Cochrane CENTRAL to retrieve relevant RCTs (up to Feb 2022). The search strategy involved a combination of related keywords. The Cochrane Q and I2 statistics were used to assess heterogeneity. Results Six RCTs involving seven reports with 246 patients were included. The results suggested that behavioral interventions could relieve eczema severity (correlation coefficient [r = −0.39]; p < 0.001) and scratching severity significantly (r = −0.19; p = 0.017), while not affect itching intensity (r = −0.02; p = 0.840). A sensitivity analysis confirmed the robustness of the results. Study limitations An important limitation of this study was the insufficient number of RCTs and the limited sample size. In addition, the study lacked a control group receiving a type of intervention other than the experimental protocol. Another limitation was the short duration of follow-up. Conclusions This study suggests that behavioral interventions could be effective in treating atopic dermatitis by reducing eczema and scratching severity. Additionally, habit-reversal behavioral therapy may be more effective for treating atopic dermatitis. AD (AD research method knowledge metaanalysis meta PubMed EMBASE up 2022. 2022 . 2022) keywords I heterogeneity 24 included correlation r −0.39 039 0 39 −0.39] 0.001 0001 001 −0.19 019 19 0.017, 0017 0.017 , 017 0.017) −0.02 002 02 0.840. 0840 0.840 840 0.840) size addition protocol followup. followup follow up. follow-up Additionally habitreversal habit reversal 202 2 −0.3 03 3 0.00 000 00 −0.1 01 1 0.01 −0.0 084 0.84 84 20 −0. 0.0 08 0.8 8 −0 0. −

RESUMEN Introducción: En Santa Clara se recibieron los primeros casos diagnosticados en Cuba de la COVID-19. A partir de alteraciones emocionales reportadas se decidió utilizar la psicoterapia cognitivo conductual como recurso terapéutico para tratar los estados depresivos consecuentes. Objetivo: Evaluar la efectividad de la psicoterapia cognitivo conductual bajo estado hipnótico en pacientes con depresión post-COVID-19. Métodos: Se realizó un estudio explicativo con enfoque cuantitativo. La muestra se seleccionó de manera aleatoria en 30 pacientes divididos en 2 grupos, ingresados entre abril y septiembre del 2020 y diagnosticados con la COVID-19. Se empleó el inventario de depresión de Beck para evaluar el estado depresivo antes y después de la intervención con psicoterapia en estado de vigilia y en hipnosis. Resultados: En ambos grupos, los síntomas depresivos desaparecieron, en el 97 % de los pacientes el estado depresivo se eliminó. La psicoterapia de enfoque cognitivo conductual en estado de vigila e hipnótico se consideró efectiva en la depresión post-COVID-19 a partir de evaluar mejoría en más del 50 % de los casos. El grupo que recibió la psicoterapia en estado hipnótico necesitó la mitad de las sesiones que el grupo en vigilia. Conclusiones: La terapia cognitivo conductual en estado hipnótico es efectiva, reduce las distorsiones cognitivas, los niveles de depresión y la sintomatología depresiva.

ABSTRACT Introduction: The first cases diagnosed in Cuba of COVID-19 were received in Santa Clara. Based on reported emotional disturbances, it was decided to use Cognitive Behavioral psychotherapy as a therapeutic resource to treat consequent depressive states. Objective: To evaluate the effectiveness of Cognitive Behavioral psychotherapy under hypnosis in patients with post-COVID-19 depression. Methods: An explanatory study with a quantitative approach was carried out. The sample was randomly selected in 30 patients divided into 2 groups, admitted between April and September 2020 and diagnosed with COVID-19. The Beck Depression Inventory was used to assess depressive state before and after the intervention with psychotherapy in the waking state and in hypnosis. Results: In both groups, the depressive symptoms disappeared, in 97% of the patients the depressive state was eliminated. Psychotherapy with a Cognitive Behavioral approach in a vigilant and hypnotic state was considered effective in post-COVID-19 depression after evaluating improvement in more than 50% of cases. The group that received psychotherapy in a hypnotic state required half as many sessions as the waking group. Conclusions: Cognitive behavioral therapy in a hypnotic state is effective, reducing cognitive distortions, levels of depression and depressive symptoms.

ABSTRACT Postpartum depression is one of the most common medical complications associated with adverse short- and long-term perinatal outcome in the mother, infant, and family. Objective: To describe various diagnostic methods and therapies used for the management of postpartum depression and to analyze the recommendations generated by different scientific groups (maternalfetal medicine, American College of Obstetrics and Gynecology, NICE guidelines, psychiatry, pediatrics). Different search strategies were used in the databases Medline (via Pubmed), Scopus, Web of Science, Embase, Cochrane, OVID Psycho, from January 01, 2020 to February 01, 2023, using the keywords "postpartum depression", "antidepressants", "cognitive behavioral therapy", "interpersonal therapy", "mindfulness", controlled vocabulary. Two investigators independently reviewed study titles and abstracts. About 14% of pregnant women develop postpartum depression. The most relevant risk factors are a history of anxiety, depression, history of psychiatric treatment, history of physical abuse, postpartum medical complications. One in seven patients (14%) develop perinatal depression. Tools such as the Edinburgh Scale should be applied to all pregnant women at their first prenatal check-up appointment, during the third trimester and in the postpartum period. There are several safe therapies that have demonstrated symptom reduction and decreased levels of relapse, with few side effects.

RESUMEN La depresión posparto es una de las complicaciones médicas más comunes, la cual se asocia con resultado perinatal adverso a corto y largo plazo en la madre, el infante y la familia. Describir diversos métodos diagnósticos y diversas terapias utilizadas para el manejo de la depresión posparto y analizar las recomendaciones generadas por las distintas agrupaciones científicas (medicina maternofetal, Colegio Americano de Ginecología y Obstetricia, NICE guidelines, psiquiatría, Pediatría). Se crearon diversas estrategias de búsqueda para las bases de datos Medline (vía Pubmed), Scopus, Web of Science, Embase, Cochrane, OVID Psycho, desde el 01 de enero del 2020 al 01 de febrero del 2023, utilizando las palabras clave “postpartum depression”, “antidepresivos”, “terapia cognitivo conductual”, “terapia interpersonal”, “mindfulness”, vocabulario controlado. Dos investigadores examinaron de forma independiente los títulos y resúmenes de los estudios. Alrededor de 14% de las embarazadas desarrollan depresión posparto. Los factores de riesgo más relevantes son antecedente de ansiedad, depresión, antecedentes de tratamiento psiquiátrico, historia de abuso físico, complicaciones médicas posparto. Una de cada siete pacientes (14%) desarrollaron depresión perinatal. Se debe aplicar herramientas como la Escala de Edimburgo a todas las gestantes en su primera cita de control prenatal, durante el tercer trimestre y en el posparto. Existen diversas terapias seguras que han demostrado reducción de los síntomas y disminución en los niveles de recaída, con pocos efectos secundarios.

Abstract Objective: To investigate the relative effectiveness of various Non-Invasive Treatment Techniques (NITs) in chronic tinnitus management. Methods: We searched PubMed, Embase and Cochrane Library databases from the time of data construction to December 31, 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, NITs were evaluated, including Aacceptance and commitment therapy (A), Cognitive behavioral therapy (C), Sound therapy (S), Transcranial magnetic stimulation (T), Electrical stimulation therapy (E), Virtual reality therapy (V), tinnitus Retraining therapy (R), general psychotherapy (D), and Placebo (P). The outcome indicators included the Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale-anxiety-Depression (HADS-D), Insomnia Severity Index (ISI), Visual Analogue Scales-Loudness (VAS-L), and Visual Analogue Scales-Distress (VAS-D). Statistical analysis was performed using Stata 14.0 for NMA. Results: This systematic review and meta-analysis included 22 randomized controlled trials comprising 2,354 patients. The treatment effects varied on each scale. For THI, S (86.9%) was the most effective, whereas P (6.5%) was the worst. For TQ, C (89.5%) was the most effective, whereas D (25.4%) was the worst. For HADS-D, A (82.4%) was the most effective, whereas D (9.47%) was the worst. For ISI, A (83.2%) was the most effective, whereas R (20.6%) was the worst. For VAS-L, S (73.5%) was the most effective, whereas E (18.9%) was the worst. For VAS-D, C (84.7%) was the most effective, whereas P (18.1%) was the worst. Conclusions: The combination of acoustics and cognitive behavioral therapy may be an effectively treat patients with chronic tinnitus. Level of evidence: How common is the problem? Level 2. Is this diagnostic or monitoring test accurate? (Diagnosis) Level 1. What will happen if we do not add a therapy? (Prognosis) Level 1. Does this intervention help? (Treatment Benefits) Level 1. What are the COMMON harms? (Treatment Harms) Level 1. What are the RARE harms? (Treatment Harms) Level 1. Is this (early detection) test worthwhile? (Screening) Level 1I. Objective NonInvasive Non Invasive (NITs management Methods PubMed 31 2022 MetaAnalyses Meta Analyses guidelines evaluated A, , (A) C, (C) S, (S) T, T (T) E, (E) V, V (V) R, (R) D, (D) P. . (P) THI (THI) TQ (TQ) ScaleanxietyDepression Scale anxiety HADSD, HADSD HADS (HADS-D) ISI (ISI) ScalesLoudness Scales Loudness VASL, VASL VAS L (VAS-L) ScalesDistress Distress VASD. VASD (VAS-D) 140 14 0 14. NMA Results metaanalysis meta 2 2354 354 2,35 scale 86.9% 869 86 9 (86.9% effective 6.5% 65 6 5 (6.5% worst 89.5% 895 89 (89.5% 25.4% 254 25 4 (25.4% HADS-D 82.4% 824 82 (82.4% 9.47% 947 47 (9.47% 83.2% 832 83 (83.2% 20.6% 206 20 (20.6% L, VAS-L 73.5% 735 73 (73.5% 18.9% 189 18 (18.9% VASD, VAS-D 84.7% 847 84 7 (84.7% 18.1% 181 1 (18.1% Conclusions evidence problem accurate Diagnosis (Diagnosis Prognosis (Prognosis help Benefits harms Harms early detection worthwhile Screening (Screening 1I I 3 202 (A (C (S (T (E (V (R (D (P (THI (TQ (HADS-D (ISI (VAS-L (VAS-D 235 35 2,3 86.9 8 (86.9 6.5 (6.5 89.5 (89.5 25.4 (25.4 82.4 (82.4 9.47 94 (9.47 83.2 (83.2 20.6 (20.6 73.5 (73.5 18.9 (18.9 84.7 (84.7 18.1 (18.1 23 2, 86. (86. 6. (6. 89. (89. 25. (25. 82. (82. 9.4 (9.4 83. (83. 20. (20. 73. (73. 18. (18. 84. (84. (86 (6 (89 (25 (82 9. (9. (83 (20 (73 (18 (84 (8 ( (2 (9 (7 (1

SUMMARY OBJECTIVE: The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy in the treatment of vasomotor, sexual dysfunction, and recurrent depression in postmenopausal women. METHODS: This prospective, open study evaluated 112 postmenopausal women with vasomotor symptoms. Sexual dysfunction has cultural, social, biological, and emotional issues and divided into two groups: G1, without depression (n=65) and G2, with recurrent depression (n=47). The subjects underwent 12 sessions of in-person cognitive behavioral therapy and 12 sessions of home-based activity over a period of 6 months. They were evaluated at 3 months following the completion of therapy. Depression, memory, and attention-related functions, as well as climactic symptoms, were assessed using a questionnaire. RESULTS: In the depression questionnaire, the G1 group had a lower initial score than the G2 group (p<0.01). Following 6 months of therapy, both groups had similar improved scores. In the depression questionnaire, the women in group G1 had higher baseline values. In the assessment of vasomotor symptoms, the values in both groups were similar and showed an improvement in vasomotor symptoms after 24 weeks of treatment, but these effects disappeared after the follow-up of 48 weeks in the G2 group. Both groups improved the sexual dysfunction after 24 weeks. CONCLUSION: Cognitive behavioral therapy may be effective in reducing vasomotor symptoms and ameliorate the sexual dysfunction and recurrent depression in postmenopausal women after 24 weeks of treatment. OBJECTIVE METHODS prospective 11 cultural social biological G n=65 n65 n 65 (n=65 n=47. n47 n=47 . 47 (n=47) 1 inperson person homebased home based Depression memory attentionrelated attention related functions questionnaire RESULTS p<0.01. p001 p p<0.01 0 01 (p<0.01) scores 2 followup follow up 4 CONCLUSION n=6 n6 (n=6 n4 n=4 (n=47 p00 p<0.0 (p<0.01 n= (n= (n=4 p0 p<0. (p<0.0 (n p<0 (p<0. p< (p<0 (p< (p

Abstract Objective To investigate whether additional Cognitive Behavior Therapy (CBT) combined with conventional therapy improves outcomes for patients with Persistent Postural-Perceptual Dizziness (PPPD) compared with conventional therapy alone. Methods Two reviewers independently searched PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov for relevant Randomized Controlled Trials (RCTs) examining CBT for PPPD which were conducted and published in English from January 2002 to November 2022. RCTs reporting any indicators for assessing corresponding symptoms of PPPD were included, such as Dizziness Handicap Inventory (DHI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9). Two independent reviewers conducted extraction of relevant information and evaluation of risk of bias. The Cochrane Collaboration risk of bias tool version 1.0 was used to evaluate risks and assess the quality of the included studies, and Cochrane Review Manager 5.3 software (RevMan 5.3) was used to perform meta-analyses. Results The results of six RCTs indicated that combining additional CBT with conventional therapy significantly improved outcomes for PPPD patients compared with conventional therapy alone, especially in DHI-Total scores (Mean Difference [MD = −8.17], 95% Confidence Interval [95% CI: −10.26, −6.09], p< 0.00001), HAMA scores (MD = −2.76, 95% CI: [−3.57, −1.94], p< 0.00001), GAD-7 scores (MD = −2.50, 95% CI [−3.29, −1.70], p< 0.00001), and PHQ-9 scores (MD = −2.29, 95% CI [−3.04, −1.55], p< 0.00001). Subgroup analysis revealed a significant benefit of additional CBT compared with conventional therapies alone, including Vestibular Rehabilitation Therapy (VRT) (MD = −8.70, 95% CI: [−12.17, −5.22], p< 0.00001), Selective Serotonin Reuptake Inhibitor (SSRI) (with controlled SSRI: MD = −10.70, 95% CI: [−14.97, −6.43], p< 0.00001), and VRT combined with SSRI (MD = −6.08, 95% CI [−9.49, −2.67], p= 0.0005) in DHI-Total scores. Conclusion Additional CBT combined with conventional therapy may provide additional improvement for patients with PPPD compared with conventional therapy alone. However, more RCTs are needed to support and guide the application of CBT in treating PPPD. Level of evidence: I; Systematic review of RCTs. (CBT PosturalPerceptual Postural Perceptual (PPPD alone PubMed Embase Science Library ClinicalTrialsgov ClinicalTrials gov (RCTs 200 2022 DHI, DHI , (DHI) HAMA, (HAMA) HAMD, HAMD (HAMD) HADS, HADS (HADS) Questionnaire9 Questionnaire 9 Questionnaire- PHQ9. PHQ9 PHQ . (PHQ-9) 10 1 0 1. studies 53 5 3 5. RevMan metaanalyses. metaanalyses meta analyses. analyses meta-analyses DHITotal Total Mean −8.17, 817 −8.17 8 17 −8.17] 95 [95 1026 26 −10.26 −6.09, 609 −6.09 6 09 −6.09] p 0.00001, 000001 0.00001 00001 0.00001) 276 2 76 −2.76 −3.57, 357 57 [−3.57 −1.94, 194 −1.94 94 −1.94] GAD7 GAD 7 GAD- 250 50 −2.50 −3.29, 329 29 [−3.29 −1.70, 170 −1.70 70 −1.70] PHQ- 229 −2.29 −3.04, 304 04 [−3.04 −1.55, 155 −1.55 55 −1.55] 0.00001. (VRT 870 −8.70 −12.17, 1217 12 [−12.17 −5.22, 522 −5.22 22 −5.22] (SSRI 1070 −10.70 −14.97, 1497 14 97 [−14.97 −6.43, 643 −6.43 43 −6.43] 608 08 −6.08 −9.49, 949 49 [−9.49 −2.67, 267 −2.67 67 −2.67] 0.0005 00005 0005 However evidence I 20 202 (DHI (HAMA (HAMD (HADS (PHQ-9 81 −8.1 [9 102 −10.2 60 −6.0 00000 0.0000 0000 27 −2.7 −3.57 35 [−3.5 19 −1.9 25 −2.5 −3.29 32 [−3.2 −1.7 −2.2 −3.04 30 [−3.0 15 −1.5 87 −8.7 −12.17 121 [−12.1 52 −5.2 107 −10.7 −14.97 149 [−14.9 64 −6.4 4 −9.49 [−9.4 −2.6 0.000 000 (PHQ- −8. [ −10. −6. −2. −3.5 [−3. −1. −3.2 −3.0 −12.1 [−12. −5. −14.9 [−14. −9.4 [−9. 0.00 00 (PHQ −8 −10 −6 −2 −3. [−3 −1 −12. [−12 −5 −14. [−14 −9. [−9 0.0 − −3 [− −12 [−1 −14 −9 0.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor crônica tem um impacto significativo na qualidade de vida dos pacientes e o uso de terapia farmacológica muitas vezes é insuficiente. As terapias baseadas em Mindfulness (Atenção Plena) apresentam-se de diversas formas e têm sido utilizadas como estratégia no manejo dessa condição. As práticas podem conduzir a atenção ao presente, auxiliar na reinterpretação da dor e aprimorar habilidades de controle físico e emocional via córtex cingulado, somatossensorial, opérculo parietal, cúneo e ínsula anterior. O objetivo deste estudo foi avaliar a Mindfulness quanto a sua influência na qualidade de vida dos pacientes com dor crônica não oncológica e as alterações neurais que essa prática promove, como maior ou menor ativação ou variação de tamanho de áreas como a ínsula e córtex cingulado, e como estas interferem na percepção da dor, tendo como finalidade verificar a aplicabilidade da Atenção Plena como método complementar ao tratamento nesse grupo de pacientes. CONTEÚDO: Revisão Sistemática submetida no banco de dados PROSPERO sob o número 359011. Realizou-se a busca nas bases de dados Pubmed, Medline, LILACS e DIALNET entre 2019 e 2022 com os descritores e operador booleano [(MINDFULNESS) AND (CHRONIC PAIN)]. Incluiu-se na seleção de artigos ensaios clínicos randomizados, estudos de coorte e estudos de caso controle nos idiomas inglês, espanhol e português. O risco de viés foi avaliado pelo ROB2 e a qualidade de evidência por meio do GRADE. Após análise, 10 estudos foram avaliados como essenciais para esta revisão. Foram incluídos os artigos que abordavam intervenção em Mindfulness para dor crônica que responderam e agregaram informações à pergunta da pesquisa e excluídos os artigos que não possuem o foco em “Mindfulness” e “dor crônica”, estudos sem livre acesso e textos cujos resultados não foram publicados até a data da busca. Para analisar as terapias de Mindfulness, os estudos, em sua maioria, abordam mais de 50 pacientes e usam escalas como o Brief Pain Inventory (BPI-DPN Q4), Patient Global Impression of Change (PGIC), Five Facet Mindfulness Questionnaire (FFMQ), Chronic Pain Acceptance Questionnaire (CPAQ) e Pain Catastrophizing Scale (PCS). CONCLUSÃO: A prática de Mindfulness é capaz de diminuir a dor crônica e melhorar sua percepção, aceitabilidade e qualidade de vida ao possibilitar a redução do sofrimento, ansiedade e estresse associados à dor por meio de alterações neurais. Por haver limitações nos estudos com relação à população-alvo específica e à padronização de avaliação, recomenda-se que artigos futuros abordem a prática em crianças, idosos e atletas com dor crônica, além de metodologia detalhada para avaliar e promover as sessões. Ressalta-se que a Mindfulness não é uma cura para a dor crônica, no entanto apresenta segurança e eficácia em seus diferentes protocolos de aplicação, com nível de evidência similar à terapia cognitiva comportamental. OBJETIVOS insuficiente apresentamse apresentam se condição presente cingulado somatossensorial parietal anterior promove CONTEÚDO 359011 Realizouse Realizou Pubmed Medline 201 202 MINDFULNESS [(MINDFULNESS CHRONIC PAIN. PAIN . PAIN)] Incluiuse Incluiu randomizados inglês português ROB GRADE análise 1 revisão “Mindfulness , crônica” maioria 5 BPIDPN BPI DPN Q4, Q4 Q Q4) PGIC, PGIC (PGIC) FFMQ, FFMQ (FFMQ) CPAQ (CPAQ PCS. PCS (PCS) CONCLUSÃO sofrimento populaçãoalvo população alvo avaliação recomendase recomenda crianças sessões Ressaltase Ressalta aplicação comportamental 35901 20 PAIN) (PGIC (FFMQ (PCS 3590 2 359 35 3

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain has a significant impact on patients’ quality of life and the use of drug therapy is often insufficient. Therapies based on Mindfulness come in different forms and have been used as a strategy to manage this condition. Practices can guide attention to the present, help reinterpret pain and improve physical and emotional control skills via the cingulate cortex, somatosensory cortex, parietal operculum, cuneus, and anterior insula. This study seeks to evaluate the results of Mindfulness in terms of its influence on the quality of life of patients with chronic non-cancer pain and the neural changes that this practice promotes, such as greater or lesser activation or variation in size of areas as insula and cingulate cortex, and how these interfere with the perception of pain, with the aim of verifying the applicability of Mindfulness as a complementary method to treatment in this group of patients. CONTENTS: Systematic Review submitted to PROSPERO datadase under number 359011. The search was carried out in the Pubmed, Medline, LILACS and DIALNET databases between 2019 and 2022 with the descriptors and Boolean operator [(MINDFULNESS) AND (CHRONIC PAIN)]. The selection of articles includes randomized clinical trials, cohort studies and case control studies in English, Spanish and Portuguese languages. The risk of bias was assessed using ROB2 and the quality of evidence using GRADE. After analysis, ten studies were assessed as essential for this review. Articles that addressed Mindfulness intervention for chronic pain that responded and added information to the research question were included and articles that did not focus on “Mindfulness” and “chronic pain”, studies without free access and texts whose results were not published up to the date of the search were excluded. To analyze Mindfulness therapies, the majority of studies cover more than 50 patients and use scales such as the Brief Pain Inventory (BPI-DPN Q4), Patient Global Impression of Change (PGIC), Five Facet Mindfulness Questionnaire (FFMQ), Chronic Pain Acceptance Questionnaire (CPAQ) and Pain Catastrophizing Scale (PCS). CONCLUSION: The practice of Mindfulness can reduce chronic pain and improving its perception, acceptability and quality of life by enabling the reduction of suffering, anxiety and stress associated with pain through neural changes. As there are limitations in the studies regarding the specific target population and standardization of assessment, it is recommended that future articles address the practice in children, the elderly and athletes with chronic pain, in addition to a detailed methodology to evaluate and promote the sessions. It should be noted that Mindfulness is not a cure for chronic pain, however it presents safety and effectiveness in its different application protocols, with a level of evidence similar to cognitive behavioral therapy. OBJECTIVES insufficient condition present cortex operculum cuneus noncancer non cancer promotes CONTENTS 359011 Pubmed Medline 201 202 MINDFULNESS [(MINDFULNESS CHRONIC PAIN. PAIN . PAIN)] trials English languages ROB GRADE analysis review “Mindfulness , pain” excluded therapies 5 BPIDPN BPI DPN Q4, Q4 Q Q4) PGIC, PGIC (PGIC) FFMQ, FFMQ (FFMQ) CPAQ (CPAQ PCS. PCS (PCS) CONCLUSION suffering assessment children sessions protocols 35901 20 PAIN) (PGIC (FFMQ (PCS 3590 2 359 35 3

Resumo Objetivo: O objetivo deste estudo é sistematizar conhecimentos sobre o atendimento online infantil através da terapia cognitivo-comportamental e sugerir formas de intervenções psicológicas diante da pandemia de COVID-19. Método: Desde o início do surto do coronavírus (SARS-CoV-2), causador da COVID-19, houve preocupação diante de uma doença que se alastrou rapidamente em várias regiões do mundo, com diferentes impactos. Além do medo de contrair a doença, dos cuidados com os familiares e das incertezas frente ao futuro, o isolamento causou impactos psicológicos diretamente relacionados à COVID-19 tanto em adultos como em crianças. Deste modo, foi feita uma busca sistemática por artigos. Resultados: A prática clínica levou ao entendimento de que as crianças passaram por mudanças, como a interrupção das idas à escola, o afastamento dos amigos e dos avós e a presença dos pais o dia todo em casa, além de, dependendo da idade, aulas online em diversos estilos, e a percepção de que os pais também não sabiam como lidar com a situação. Conclusão: Percebe-se que através do uso da terapia cognitivo-comportamental pode-se sugerir formas de intervenções psicológicas diante da pandemia de COVID-19. Assim, nota-se que resultados efetivos são possíveis com a intervenção on-line. Objetivo cognitivocomportamental cognitivo comportamental COVID19. COVID19 COVID 19. 19 Método SARSCoV2, SARSCoV2 SARSCoV SARS CoV 2 , (SARS-CoV-2) COVID19, 19, mundo futuro COVID-1 modo artigos Resultados mudanças escola casa idade estilos situação Conclusão Percebese Percebe podese pode Assim notase nota online. on line. line on-line COVID1 1 (SARS-CoV-2 COVID- (SARS-CoV- (SARS-CoV

Abstract Objective: This study aims at shedding light on online child psychotherapy using cognitive-behavioral therapy as well as suggesting forms of psychological interventions during a pandemic. Method: Since the beginning of the recent coronavirus (SARS-CoV-2) outbreak, which causes COVID-19, there has been a great concern about a disease that has rapidly spread over the world, bringing about several different socio-economic issues. The fear of contracting the disease has led to safety measures and uncertainties with regard to the future, and it is believed that social isolation has had a direct and psychological impact on both adults and children. This way, we conducted a systematic search for literature review articles. Results: The clinical practice has led to observe that children had their routine interrupted and, consequently, prevented from basic activities such as going to school, being separated from friends, being apart from grandparents, spending the day with their parents, and not to mention, depending on their age, attending online classes in the most varied ways. Conclusion: It is clear that through the use of cognitive-behavioral therapy, forms of psychological interventions can be suggested in the face of the COVID-19 pandemic. Thus, it is clear that effective results are possible with online intervention. Objective cognitivebehavioral cognitive behavioral pandemic Method SARSCoV2 SARSCoV SARS CoV 2 (SARS-CoV-2 outbreak COVID19, COVID19 COVID 19, 19 world socioeconomic socio economic issues future way articles Results consequently school friends grandparents parents mention age ways Conclusion COVID-1 Thus intervention (SARS-CoV- COVID1 1 COVID- (SARS-CoV

Resumo Objetivo Esse estudo teve como objetivo investigar abordagens, estratégias e variáveis relevantes pesquisadas no contexto brasileiro sobre agressores conjugais, bem como práticas terapêuticas utilizadas e seus impactos. Método Um total de 31 estudos foram recuperados da base de dados Lilacs (n = 25), da base de dados SciELO (n = 5) e do PePsic (n = 1). Após a exclusão de duplicatas e de estudos não relacionados a agressores, 9 estudos atenderam aos critérios de inclusão e foram incluídos na análise. Resultados Estes artigos foram analisados e agrupados de acordo com suas temáticas, resultando em cinco categorias: grupos terapêuticos de enfoque cognitivo-comportamental; grupos reflexivos sobre estereótipos de gênero; determinantes culturais; ciúme, ansiedade e consumo de álcool; e práticas parentais. Conclusão Foram observadas divergências teóricas e dispersão do conhecimento sobre o tema em diferentes áreas, o que pode dificultar o planejamento e a padronização das intervenções para agressores de parceiros íntimos. Além disso, também observou-se escassez de pesquisas sobre o tema no contexto brasileiro, o que pode contribuir para a atual dispersão do conhecimento. abordagens conjugais impactos 3 n 25, 25 , 25) 5 1. 1 . 1) análise temáticas categorias cognitivocomportamental cognitivo comportamental cognitivo-comportamental gênero culturais ciúme álcool parentais áreas íntimos disso observouse observou se 2

Abstract Objective This study aimed to investigate approaches, strategies, and relevant variables researched in the Brazilian context regarding spousal aggressors, as well as the therapeutic practices used and their impacts. Method A total of 31 studies were retrieved from the Lilacs database (n = 25), SciELO database (n = 5), and PePsic (n = 1). After excluding duplicates and studies not related to batterers, 9 studies met the inclusion criteria and were included in the analysis. Results These articles were analyzed and grouped according to their themes, resulting in five categories: cognitive-behavioral therapy groups; reflective groups on gender stereotypes; cultural determinants; jealousy, anxiety, and alcohol consumption; and parenting practices. Conclusion The review observed theoretical divergences and a dispersion of knowledge on the topic across different areas, which can hinder the planning and standardization of interventions for intimate partner aggressors. Additionally, there is a scarcity of research on the topic within the Brazilian context, which may contribute to the current dispersion of knowledge. approaches strategies aggressors impacts 3 n 25, 25 , 25) 5, 5 5) 1. 1 . 1) batterers analysis themes categories cognitivebehavioral cognitive behavioral stereotypes determinants jealousy anxiety consumption areas Additionally 2

Abstract Background Anxiety and mood disorders are the main cause of illness in people under the age of 25, accounting for 45% of the global disease burden, whereas 4.6% of teenagers aged 15 to 19 are predicted to experience anxiety. Pakistan country, with a population of 200 million, has the worst mental health indicators and fewer than 500 psychiatrists. Despite the existence of various treatments for anxiety, this goes unrecognized and untreated. Due to a lack of awareness, evaluation, prevention, and interventional programs related to being implemented among adolescents in Pakistan, there is a rise in mental health issues in the earlier years of life. It calls for a critical need for indigenous, evidence-based interventions. The present study aimed to evaluate the feasibility of cognitive behavioral therapy (CBT)-based interventions to reduce anxiety symptoms among school children in Pakistan. Methods This study was a pre-post design, two-arm, single-blinded, feasibility, randomized controlled trial. Thirtyfour participants (experimental group, n = 17; control group, n = 17) were recruited from four semi-government schools in Rawalpindi with a mean age of 15 (M = 15, SD = 0.73). Two instruments Beck Anxiety Inventory for Youth (BAI-Y II) and BASC-3 Behavioural and Emotional Screening System Student (BESS-SF) were used to assess the severity of symptoms. Participants in the intervention arm received eight-group therapy CBT sessions. A two-way factorial analysis was used to examine the efficacy of CBT in reducing symptom severity. Results This study’s findings showed that in comparison to the wait-list control group, CBT successfully improved anxiety symptoms among school children while enhancing their social skills. Conclusion This study will help improve the treatment for anxiety in Pakistan by prioritizing school-based intervention and group-based CBT intervention. Trial registration The trial has been registered at the American Economic Association’s registry for randomized controlled trials. RCT ID: AEARCTR-00095 51. Registered 2022–07-04. 25 45 burden 46 4 6 4.6 1 country 20 million 50 psychiatrists untreated awareness evaluation prevention life indigenous evidencebased evidence based CBTbased prepost pre post design twoarm, twoarm two arm, two-arm singleblinded, singleblinded single blinded, blinded single-blinded experimental group 17 semigovernment semi government M 0.73. 073 0.73 . 0 73 0.73) BAIY BAI Y II BASC3 BASC 3 BASC- BESSSF BESS SF (BESS-SF eightgroup eight sessions twoway way studys s waitlist wait list skills schoolbased groupbased Associations Association trials ID AEARCTR00095 AEARCTR 00095 AEARCTR-0009 51 2022–0704. 20220704 2022–07 04. 2022 07 04 2022–07-04 2 4. 5 0.7 7 AEARCTR0009 0009 AEARCTR-000 0704 2022–0704 2022070 202207 2022–0 202 2022–07-0 0. AEARCTR000 000 AEARCTR-00 070 2022–070 20220 2022– 2022–07- AEARCTR00 00 AEARCTR-0 AEARCTR0 AEARCTR-

Resumo Introdução Alterações de sono na população idosa podem acarretar problemas físicos, psicológicos, cognitivos e comportamentais, com possíveis impactos no desempenho ocupacional. Objetivo Compreender a percepção de pessoas idosas residentes na comunidade acerca de alterações de sono e o seu impacto no desempenho ocupacional. Método Trata-se de uma pesquisa qualitativa de caráter exploratório e transversal, realizada com pessoas idosas residentes na Vila Residencial da Universidade Federal do Rio de Janeiro. Para a coleta de dados, foram utilizados a Montreal Cognitive Assessment e o Índice de Qualidade do Sono de Pittsburgh, além de entrevista para caracterização do perfil sociodemográfico e de saúde, hábitos de vida e compreensão do impacto do sono no cotidiano. Os dados foram analisados sob a perspectiva da análise de conteúdo. Resultados Participaram seis pessoas, com idade entre 65 e 78 anos, sobretudo solteiras, com autopercepção de boa qualidade de vida e de saúde regular, além de padrão anormal de eficiência de sono no último mês. A diurese noturna e a dor crônica afetam a ocupação de descanso e sono, bem como alguns hábitos e aspectos ambientais, como uso de telas e medicamentos. As alterações de sono interferem em funções mentais que pioram a participação em ocupações, sobretudo, de lazer, atividades básicas e instrumentais da vida diária, educação e participação social. Conclusão O sono sofre interferência de aspectos fisiológicos, psicológicos, sociais e contextuais, e influencia o desempenho em ocupações. É fundamental considerar esse tema na avaliação terapêutica ocupacional. físicos psicológicos comportamentais ocupacional Tratase Trata se transversal Janeiro Pittsburgh cotidiano conteúdo 6 7 anos solteiras regular mês ambientais medicamentos ocupações lazer diária social fisiológicos contextuais

Abstract Introduction Sleep changes in the older population can cause physical, psychological, cognitive, and behavioral problems with possible impacts on occupational performance. Objective To understand the perception of older people living in a community regarding sleep changes and their impact on occupational performance. Method This is a qualitative, exploratory, and cross-sectional study, carried out with older people living in the Residential Village of the Federal University of Rio de Janeiro. To collect data, the Montreal Cognitive Assessment and the Pittsburgh Sleep Quality Index were used, in addition to interviews to characterize the sociodemographic and health profile, lifestyle habits and understanding the impact of sleep on daily life. Data were analyzed using content analysis. Results Six people participated, aged between 65 and 78 years old, mainly single, with a self-perceived good quality of life and regular health, in addition to an abnormal pattern of sleep efficiency in the last month. Nocturnal diuresis and chronic pain were found to affect rest and sleep, along with habits and environmental factors such as screen use and medication. Sleep changes interfere with mental functions that worsen participation in occupations, especially leisure, basic and instrumental activities of daily living, education and social participation. Conclusion Sleep is influenced by physiological, psychological, social and contextual aspects and influences performance in occupations. It is essential to consider this topic in occupational therapeutic assessment. physical psychological cognitive qualitative exploratory crosssectional cross sectional study Janeiro data used profile analysis participated 6 7 old single selfperceived self perceived month medication occupations leisure physiological assessment

RESUMO Objetivo: Explorar os efeitos de um programa cognitivo-comportamental que aborda a incontinência urinária na qualidade de vida de homens submetidos à prostatectomia radical. Método: Ensaio clínico controlado randomizado com pacientes submetidos à prostatectomia radical em instituição para tratamento de câncer no Brasil. Os 34 participantes foram randomizados em dois grupos: 17 no grupo controle, que recebeu o tratamento padrão da instituição, e 17 no grupo de intervenção, que recebeu o programa cognitivo-comportamental. A qualidade de vida foi avaliada usando o King’s Health Questionnaire e o International Consultation on Incontinence Questionnaire-Short Form. Resultados: Os participantes do grupo de intervenção apresentaram melhores resultados quanto à redução do impacto da incontinência urinária na qualidade de vida (p ≤ 0,001), com destaque para limitações nas atividades diárias, percepção geral de saúde, limitações físicas e sociais, emoções, sono e humor. Conclusão: O programa cognitivo-comportamental foi eficaz na redução do impacto da incontinência urinária na qualidade de vida. Este estudo contribui para a prática clínica ao fornecer uma terapia eficaz, de baixo custo e de fácil aplicação. Registro Brasileiro de Ensaios Clínicos: RBR-3sstqg. Objetivo cognitivocomportamental cognitivo comportamental Método Brasil 3 grupos 1 controle cognitivocomportamental. comportamental. Kings King s QuestionnaireShort Short Form Resultados p 0,001, 0001 0,001 , 0 001 0,001) diárias saúde sociais emoções humor Conclusão aplicação Clínicos RBR3sstqg. RBR3sstqg RBRsstqg RBR 3sstqg. 3sstqg sstqg RBR-3sstqg 000 0,00 00 0,0 0,

ABSTRACT Objective: To explore the effects of a cognitive-behavioral program addressing urinary incontinence on the quality of life of men who have undergone radical prostatectomy. Method: Randomized controlled clinical trial with patients undergoing radical prostatectomy in an institution for cancer treatment in Brazil. The 34 participants were randomized into two groups: 17 in the control group who received the institution’s standard care and 17 in the intervention group who received the cognitive-behavioral program. Quality of life was assessed using the King’s Health Questionnaire and the International Consultation on Incontinence Questionnaire-Short Form. Results: Participants from intervention group showed better results regarding the reduction of the impact of urinary incontinence on quality of life (p ≤ 0.001), with emphasis on limitations in daily activities, general health perception, physical and social limitations, emotions, and sleep and mood. Conclusion: The cognitive-behavioral program was effective in reducing the impact of urinary incontinence on quality of life. This study contributes to clinical practice by providing an effective, low-cost, and easily applicable therapy. Brazilian Registry of Clinical Trials: RBR-3sstqg. Objective cognitivebehavioral cognitive behavioral Method Brazil 3 groups 1 institutions s Kings King QuestionnaireShort Short Form Results p 0.001, 0001 0.001 , 0 001 0.001) activities perception emotions mood Conclusion lowcost, lowcost low cost, cost low-cost therapy Trials RBR3sstqg. RBR3sstqg RBRsstqg RBR 3sstqg. 3sstqg sstqg RBR-3sstqg 000 0.00 00 0.0 0.

RESUMEN Objetivo: Explorar los efectos de un programa cognitivo-conductual que aborda la incontinencia urinaria en la calidad de vida de los hombres que se han sometido a una prostatectomía radical. Método: Ensayo clínico controlado aleatorizado con pacientes sometidos a prostatectomía radical en una institución de tratamiento del cáncer en Brasil. Los 34 participantes fueron distribuidos aleatoriamente en dos grupos: 17 en el grupo de control que recibieron la atención estándar de la institución y 17 en el grupo de intervención que recibieron el programa cognitivo-conductual. La calidad de vida se evaluó utilizando el Cuestionario de Salud del Rey y el Cuestionario de Consulta Internacional sobre Incontinencia-Formulario Abreviado. Resultados: Los participantes del grupo de intervención mostraron mejores resultados en cuanto a la reducción del impacto de la incontinencia urinaria en la calidad de vida (p ≤ 0,001), con énfasis en las limitaciones en las actividades diarias, la percepción general de salud, las limitaciones físicas y sociales, las emociones y el sueño y el estado de ánimo. Conclusión: El programa cognitivo-conductual fue eficaz para reducir el impacto de la incontinencia urinaria en la calidad de vida. Este estudio contribuye a la práctica clínica al proporcionar una terapia efectiva, de bajo costo y de fácil aplicación. Registro Brasileño de Ensayos Clínicos: RBR-3sstqg. Objetivo cognitivoconductual cognitivo conductual Método Brasil 3 grupos 1 cognitivoconductual. conductual. IncontinenciaFormulario Incontinencia Formulario Abreviado Resultados p 0,001, 0001 0,001 , 0 001 0,001) diarias salud sociales ánimo Conclusión efectiva aplicación Clínicos RBR3sstqg. RBR3sstqg RBRsstqg RBR 3sstqg. 3sstqg sstqg RBR-3sstqg 000 0,00 00 0,0 0,

Objetivo: mapear os protocolos de treinamento dos músculos do assoalho pélvico disponíveis na literatura para o tratamento da incontinência urinária pós-prostatectomia. Método: trata-se de uma revisão de escopo realizada em seis bases de dados. A recuperação de informações foi realizada por meio de um instrumento específico, incluindo: título, autoria, ano de publicação, periódico, objetivo, desenho do estudo e descrição do conteúdo dos protocolos. Resultados: um total de 24 estudos foram incluídos, o que resultou em diferentes protocolos. As recomendações mais frequentes foram as seguintes: três sessões por dia; com frequência de seis a 15 contrações por sessão; realização dos exercícios nas posições deitada, sentada e em pé. As diretrizes mais citadas nos protocolos foram as contrações do esfíncter anal e do músculo bulbocavernoso. Todos os protocolos seguiram o princípio da contração regular dos músculos do assoalho pélvico, mas não houve consenso quanto ao início do protocolo, duração do tratamento, tempo de contração/relaxamento e intensidade da força de contração. Conclusão: foram encontradas diferentes orientações nos protocolos de treinamento dos músculos do assoalho pélvico para incontinência urinária pós-prostatectomia, com ênfase no tempo de contração, tempo de relaxamento, número de contrações por sessão, posição de treinamento e tempo de duração do protocolo. Diferentes conceitos foram adotados para definir a continência urinária nos protocolos. É necessário desenvolver diretrizes de consenso que definam claramente os parâmetros dos protocolos de treinamento. Objetivo pósprostatectomia. pósprostatectomia pós prostatectomia. prostatectomia pós-prostatectomia Método tratase trata se dados específico incluindo título autoria publicação periódico objetivo Resultados 2 incluídos seguintes dia 1 sessão deitada pé bulbocavernoso protocolo contraçãorelaxamento relaxamento Conclusão pósprostatectomia, prostatectomia,

Objective: to map pelvic floor muscle training protocols available in the literature for the management of post-prostatectomy urinary incontinence. Method: this is a scoping review conducted in six databases. Information retrieval was performed using a specific instrument, including: title, authorship, year of publication, journal, objective, study design and description of the protocols’ content. Results: a total of 24 studies were included, which resulted in different protocols. The most frequent recommendations were the following: three sessions per day; with a frequency of six to 15 contractions per session; performing the exercises in the lying, sitting, and standing positions. The most cited guidelines in the protocols were anal sphincter and bulbocavernosus muscle contractions. All protocols followed the principle of regular pelvic floor muscle contraction, but there was no consensus regarding the start of the protocol, treatment duration, contraction/relaxation time, and intensity of the contraction force. Conclusion: different orientations were found in the pelvic floor muscle training protocols post-prostatectomy urinary incontinence, with emphasis on contraction time, relaxation time, number of contractions per session, training position, and protocol duration time. Different concepts were adopted to define urinary continence in the protocols. It is necessary to develop consensus guidelines that clearly define the parameters of training protocols. Objective postprostatectomy post prostatectomy incontinence Method databases instrument including title authorship publication journal objective content Results 2 included following day 1 session lying sitting positions contractionrelaxation time force Conclusion position

Objetivo: mapear los protocolos de ejercicios para los músculos pélvicos disponibles en la literatura para el tratamiento de la incontinencia urinaria post prostatectomía. Método: esta es una revisión de alcance realizada en seis bases de datos. La recuperación de información se realizó mediante un instrumento específico, que incluye: título, autoría, año de publicación, revista, objetivo, diseño del estudio y descripción del contenido de los protocolos. Resultados: se incluyeron 24 estudios en total, de los cuales se obtuvieron diferentes protocolos. Las recomendaciones más frecuentes fueron: tres sesiones por día, con una frecuencia de seis a 15 contracciones por sesión; realizar los ejercicios en posición acostada, sentada y de pie. Las orientaciones más citadas en los protocolos fueron las contracciones del esfínter anal y del músculo bulbocavernoso. Todos los protocolos siguieron el principio de contracción regular de los músculos del piso pélvico, pero no hubo consenso sobre el inicio del protocolo, la duración del tratamiento, el tiempo de contracción/relajación y la intensidad de la fuerza de contracción. Conclusión: se encontraron diferentes orientaciones en los protocolos de entrenamiento de los músculos del piso pélvico para la incontinencia urinaria post prostatectomía, fundamentalmente sobre el tiempo de contracción, tiempo de relajación, número de contracciones por sesión, posición de entrenamiento y tiempo de duración del protocolo. Se adoptaron diferentes conceptos para definir la continencia urinaria en los protocolos. Es necesario desarrollar guías consensuadas que definan claramente los parámetros de los protocolos de entrenamiento. Objetivo prostatectomía Método datos específico incluye título autoría publicación revista objetivo Resultados 2 total día 1 sesión acostada pie bulbocavernoso protocolo contracciónrelajación relajación Conclusión

RESUMO JUSTIFICATIVA E OBJETIVOS: Considerando o grande impacto sofrido pelas mulheres com câncer de mama metastático, manifestado em sintomas físicos e/ou psíquicos, o presente estudo buscou compreender o impacto da dor total nessas pacientes e ressaltar a importância da intervenção interdisciplinar nesse contexto, bem como elencar alternativas de tratamento para um melhor manejo da dor e consequente melhora na qualidade de vida. CONTEÚDO: Foi realizada uma revisão narrativa de literatura nas bases de dados Scielo, Pubmed e Google Acadêmico, com base nos descritores “Dor”, “Neoplasias da Mama”, “Cuidados Paliativos”, “Práticas Interdisciplinares”, “Sistemas de Medicação” e “Terapia Cognitivo-Comportamental”, além de seus respectivos termos em inglês, com artigos publicados entre 2012 e 2022. Foram encontradas 130 publicações, das quais, após a aplicação dos critérios, 34 foram incluídas nesta revisão. Os resultados obtidos apontaram para os impactos da dor total em pacientes oncológicos, a qual repercute em sintomas mal controlados de fadiga, dispneia, má alimentação, baixa qualidade de sono, ansiedade e possíveis episódios depressivos. Nesse contexto, a interdisciplinaridade e os cuidados paliativos emergem como centrais para o cuidado dessas pacientes, uma vez que se baseiam em comunicação, decisão conjunta e integralidade. Além disso, foram observadas técnicas, tanto farmacológicas quanto psicoterapêuticas, a exemplo da terapia cognitivo-comportamental, que podem auxiliar na promoção do alívio do quadro álgico e dos demais sintomas, melhorando a qualidade de vida das pacientes. CONCLUSÃO: Entretanto, ainda existem limitações para a inclusão de equipes interdisciplinares na prática clínica, devido a falhas de comunicação, condutas individuais e hierarquização, além de outros aspectos. OBJETIVOS metastático eou ou psíquicos contexto CONTEÚDO Scielo Acadêmico Dor, Dor , “Dor” Neoplasias Mama, Mama Mama” Cuidados Paliativos, Paliativos Paliativos” Práticas Interdisciplinares, Interdisciplinares Interdisciplinares” Sistemas Medicação Terapia CognitivoComportamental, CognitivoComportamental Cognitivo Comportamental Cognitivo-Comportamental” inglês 201 2022 13 publicações quais critérios 3 oncológicos fadiga dispneia alimentação sono depressivos comunicação integralidade disso técnicas psicoterapêuticas cognitivocomportamental, cognitivocomportamental cognitivo comportamental, comportamental cognitivo-comportamental CONCLUSÃO Entretanto clínica hierarquização aspectos “Dor Cognitivo-Comportamental 20 202 1 2

ABSTRACT BACKGROUND AND OBJECTIVES: Considering the great impact suffered by women with metastatic breast cancer, manifested in physical and/or psychological symptoms, this study seeks to understand the impact of total pain on these patients and to emphasize the importance of interdisciplinary intervention in this context, as well as to list treatment alternatives for better pain management and consequent improvement in quality of life. CONTENTS: A narrative literature review was carried out in Scielo, Pubmed and Google Scholar databases, based on the descriptors “Pain”, “Breast Neoplasms”, “Palliative Care”, “Interdisciplinary Placements”, “Medication Systems” and “Cognitive Behavioral Therapy”, as well as their respective terms in Portuguese, in articles published from 2012 to 2022. 130 publications were found, of which, after applying the criteria, 34 were included in this review. The results obtained point to the impact of total pain on cancer patients, which has repercussions in terms of poorly controlled symptoms of fatigue, dyspnea, poor diet, poor sleep quality, anxiety, and possible depressive episodes. In this context, interdisciplinary and palliative care emerge as central to the treatment of these patients, since they are based on communication, joint decision-making and comprehensiveness. In addition, different techniques were observed, both pharmacological and psychotherapeutic, such as Cognitive-Behavioral Therapy, which can help relieve pain and other symptoms, improving quality of life. CONCLUSION: However, there are still limitations to the inclusion of interdisciplinary teams in clinical practice, due to communication failures, individual conduct and hierarchization, as well as other aspects. OBJECTIVES andor or context life CONTENTS Scielo databases Pain, Pain , “Pain” Breast Neoplasms, Neoplasms Neoplasms” Palliative Care, Care Care” Interdisciplinary Placements, Placements Placements” Medication Systems Cognitive Therapy Therapy” Portuguese 201 2022 13 found criteria 3 fatigue dyspnea diet anxiety episodes decisionmaking decision making comprehensiveness addition observed psychotherapeutic CognitiveBehavioral CONCLUSION However practice failures hierarchization aspects “Pain 20 202 1 2