Abstract Objective Childhood maltreatment is extremely harmful to health, especially in relation to development of the psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment in a sample of adolescent schoolchildren and to investigate associations between maltreatment types and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms. Methods We conducted a cross-sectional study with a sample of 654 school students aged 11 to 17 years. We collected sociodemographic data and administered the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms as well as the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences such as abuse and negligence during childhood and adolescence. Statistical analyses were conducted to estimate correlations between sociodemographic data, anxiety, depression, and types of maltreatment. A regression analysis was also conducted to identify maltreatment types that predict psychological symptoms. Results Emotional abuse and emotional neglect were the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment type most strongly correlated with depression and anxiety and tended to co-occur with other types of maltreatment. Additionally, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescents. Conclusion The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They identify emotional abuse as the main predictor of depressive and anxiety symptoms. health life behaviors crosssectional cross sectional 65 1 years RCADS47 RCADS 47 (RCADS-47 CTQ (CTQ adolescence Statistically cooccur co occur Additionally adolescents 6 RCADS4 4 (RCADS-4 (RCADS- (RCADS

Abstract Introduction The Cognitive Distortions Questionnaire (CD-Quest) is an instrument that identifies logical errors or cognitive distortions and is used in trial-based cognitive therapy (TBCT). However, it had previously only been available for adults. Objectives To develop and validate a version of the CD-Quest for teens (CD-Quest-T) aged 11 to 17 years and test its psychometric properties. Method A total of 299 schoolchildren participated in the investigation. After content validity was assessed, the language was adapted for the target age group, and the length of the instrument was reduced to eight items (from the initial 15). Five cognitive therapists analyzed the content and structure of the items. Finally, to investigate the construct validity of the CD-Quest-T, the instrument was divided into a full scale and two subscales, which measure the frequency of the distortions and the intensity attributed to them, respectively. Results The overall internal consistency of the scale was α = 0.77, whereas subscale indices were α = 0.75 for the frequency scale and α = 0.73 for the intensity scale. Results from exploratory factor analysis and concurrent validity analysis indicated that the CD-Quest-T items have good psychometric properties and generate scores reliably. Conclusion The psychometric properties of the CD-Quest-T demonstrate its adequacy for measurement of cognitive distortions in adolescents. CDQuest CD Quest (CD-Quest trialbased trial based TBCT. TBCT . (TBCT) However adults CDQuestT T (CD-Quest-T 1 29 investigation assessed group 15. 15 15) Finally CDQuestT, T, subscales them respectively 077 0 77 0.77 075 75 0.7 073 73 reliably adolescents (TBCT 2 07 7 0.

Abstract Introduction Obsessive-compulsive disorder (OCD) is the fourth most prevalent mental disorder and is a disabling condition. OCD is associated with anatomical and functional changes in the brain, in addition to dysfunctional cognitions. The treatments of choice are selective serotonin reuptake inhibitors, cognitive-behavioral therapy (CBT), and exposure and response prevention (ERP). Trial-based cognitive therapy (TBCT) is a recent and empirically validated psychotherapy with a focus on restructuring dysfunctional negative core beliefs (CBs). The objective of this study was to evaluate the efficacy of TBCT relative to ERP for treatment of OCD. Methods A randomized, single-blind clinical trial was conducted, randomizing 26 patients for individual treatment with TBCT (n = 12) or ERP (n = 14). The groups were evaluated at baseline, at the end of 3 months (12 sessions), and at 3, 6, and 12-month follow-ups. Results Both approaches reduced the severity of symptoms with large effect sizes. These results were maintained at the 12-month follow-up assessment. Conclusion TBCT may be a valid and promising treatment for this disorder. Obsessivecompulsive Obsessive compulsive (OCD condition brain cognitions inhibitors cognitivebehavioral behavioral CBT, CBT , (CBT) ERP. . (ERP) Trialbased Trial based (TBCT CBs. CBs (CBs) randomized singleblind single blind conducted 2 n 12 14. 14 14) baseline (1 sessions, sessions sessions) 6 12month month followups. followups follow ups. ups follow-ups sizes followup up assessment (CBT (ERP (CBs 1 (

ABSTRACT Background: Patients with Bipolar Disorder (BD) have the highest lifetime risk for suicidal behavior (SB) compared to other psychiatric disorders. Neuroimaging research provides evidence of some structural and functional abnormalities in the brain of BD suicide attempters (SA), but interpretation of these findings may represent a number of features. Objective: The purpose of this study was to evaluate the volume of the prefrontal cortex in euthymic BD type I outpatients, with and without history of SA. Methods: 36 euthymic BD I outpatients (18 with and 18 without suicide attempt history) were underwent structural MRI and total and regional gray matter volumes were assessed and compared with 22 healthy controls (HC). Results: We did not found any differences in all areas between suicidal and non-suicidal BD I patients and BD patients as a group compared to HC as well. Discussion: our findings suggest that can be a different subgroups of patients in relation to prefrontal cortex volumes according to some clinical and socio-demographic caractheristics, such as number of previous episodes and continuous use of medical psychotropic drugs that may induce neuroplasticity phenomena, which restore cerebral volume and possibly can lead to long-term euthymia state.

Objective: To evaluate the interrelationships between childhood maltreatment, life satisfaction (LS), and depressive symptoms, and to investigate LS as a mediating factor in the association between childhood maltreatment and depressive symptoms. Methods: The sample consisted of 342 adolescents, aged 11 to 17 years (mean = 13.3, SD = 1.52 years), recruited from a public school in Salvador, Brazil. Participants filled out instruments for the collection of sociodemographic data and evaluation of childhood maltreatment, LS, and depressive symptoms. Structural equation modeling (SEM) was used to evaluate the mediating effect of LS. Results: We detected significant negative correlations between childhood maltreatment and LS and between LS and depressive symptoms. We observed a significant positive correlation between childhood maltreatment and depressive symptoms. LS partially mediated the association between childhood maltreatment and depressive symptoms, mitigating the impact of maltreatment. Conclusion: LS played an important mediating role in the association between childhood maltreatment and depressive symptoms. Longitudinal studies are recommended to fully elucidate these associations, reinforcing the need for attention and care of this vulnerable population.

Resumo Mesmo diante de dados internacionais sobre prevalência de problemas de comportamento durante a infância/adolescência, ainda há necessidade de explorar problemas emocionais/comportamentais vivenciados pelos adolescentes brasileiros, especialmente em situações de altos problemas sociais ou de vulnerabilidade social (VS). Foi realizado estudo observacional, transversal, com amostra de conveniência, que teve por objetivo descrever os problemas emocionais/comportamentais apresentados por adolescentes que vivem em um contexto de alta VS na cidade de Salvador-BA, a partir do ponto de vista de seus pais ou responsáveis. Foram aplicados questionário sociodemográfico e CBCL/6-18 numa amostra de 274 pais/responsáveis pelos adolescentes. Análises dos dados obtidos indicaram que 20,4% da amostra apresentaram problemas na faixa clínica para escala total do instrumento. Variáveis sociodemográficas podem influenciar os problemas de comportamento na adolescência, necessitando ser investigadas. Este estudo colabora com novos dados sobre psicopatologias infanto-juvenis em âmbito nacional, o que possibilita criar ações preventivas e encaminhamentos voltados para esta população.

Abstract Although there are international data on the prevalence of behavioral problems through childhood/adolescence, there is still a need to explore emotional/behavioral problems experienced by Brazilian adolescents, especially in situations of extreme social problems or social vulnerability (SV). This is an observational, cross-sectional study, carried out with a convenience sample, to describe emotional/behavioral problems of adolescents living in a high SV scenario in the city of Salvador-BA, from their parents or guardians’ point of view. Sociodemographic questionnaire and CBCL/6-18 were applied to a sample of 274 adolescents’ parents/guardians. Data analysis found that 20.4% of the sample had problems in the clinical range for CBCL’s Total Problems. Sociodemographic variables can impact behavioral problems in adolescence and need to be investigated. This study adds new data on child and youth psychopathologies at the national level and can promote preventive actions and referrals aimed at this population.

Resumen Aún cuando existan datos internacionales sobre la prevalencia de problemas de conducta durante la infancia/adolescencia, aún es necesario explorar los problemas emocionales/de conducta que experimentan los adolescentes brasileños, especialmente en contextos de alta vulnerabilidad social (VS). Se realizó un estudio observacional de conveniencia transversal para describir los problemas emocionales/conductuales presentados por adolescentes, de 11 a 17 años, que viven en un contexto de alta vulnerabilidad social en la ciudad de Salvador-BA, desde el punto de vista de los padres/tutores. Se aplicó un cuestionario sociodemográfico y el CBCL/6-18 a una muestra de 274 padres/tutores de adolescentes. El análisis de los datos indicó que el 20.4% de la muestra tenía problemas en el rango clínico en la escala completa del instrumento. Las variables sociodemográficas pueden influir en los problemas de conducta en la adolescencia y deben investigarse. Este estudio colabora con nuevos datos sobre las psicopatologías infantiles y juveniles en todo el país, lo que permite crear acciones preventivas y referencias dirigidas a esa población.

Abstract Human T-cell lymphotropic virus type 1 (HTLV-1) has low prevalence rates, but is endemic in some regions of the world. It is usually a chronic asymptomatic infection, but it can be associated with serious neurologic and urinary conditions. Hepatitis C virus (HCV) is broadly spread out worldwide. The majority of these infections have a chronic course that may progress to cirrhosis and hepatocellular carcinoma. Objectives: To compare sociodemographic and mental health (risk behaviors, depression, and suicide) aspects, and quality of life among patients with HCV or HTLV-1. Methods: Observational, comparative and cross-sectional study involving outpatients with HCV or HLTV-1 infection. Sociodemographic characteristics, risk behaviors and quality of life were assessed through the questionnaires Mini International Neuropsychiatric Interview - MINI Plus (depression and suicide) and Medical Outcomes Study 36-Item Short-Form Health Survey (quality of life). Univariate and multivariate statistical analyses (hierarchical logistic regression) were conducted. Results: 143 individuals with HCV and 113 individuals with HTLV-1 infection were included. Males were predominant in the HCV group (68.8%) and females in the HTLV-1 group (71.7%). The frequency of risk behaviors (sexual and drug use) was greater in those with HCV (p < 0.05). A past depressive episode was more common in the HTLV-1 group (p = 0.037). Quality of life was significantly worse in the physical functioning, vitality, mental health, and social functioning domains in those with HTLV-1 (p < 0.05). HTLV-1 infection remained independently associated with worse quality of life in multivariate analysis. Conclusions: Risk behaviors are frequent among those infected with HCV. Additionally, despite HTLV-1 being considered an infection with low morbidity, issues related to mental health (depressive episode) and decreased quality of life are relevant.

Abstract The introduction of highly active antiretroviral therapy marked a major gain in efficacy of HIV/AIDS treatment and a reduction in morbidity and mortality of the infected patients. However, high levels of adherence are required to obtain virologic suppression. In Brazil, the policy of free and universal access to antiretroviral therapy has been in place since 1996, although there are reports of poor adherence. Objective To define the clinical, demographic and psychological characteristics, and quality of life of patients with HIV/AIDS who present poor adherence to highly active antiretroviral therapy. Methods This was a cross-sectional study. To be included in the study patients had to be 18 through 65 years old, diagnosed with HIV/AIDS, having the two previous viral loads above 500 copies, a surrogate for poor adherence to antiretrovirals. The following instruments were applied to all eligible patients: the sociodemographic questionnaire “Adherence Follow-up Questionnaire”, the Beck Depression Inventory (BDI-II), the Beck Anxiety Inventory (BAI), and the 36-Item Short Form Survey. Results 47 patients were evaluated, 70.2% were female, mean age of 41.9 years (±10.5), 46.8% were single, 51.1% self-reported adherence ≥95%, 46.8% mentioned depression as the main reason for not taking the medication, 59.5% presented symptoms of moderate to severe depression, and 44.7% presented symptoms of moderate to severe anxiety. Finally, regarding health-related quality of life these patients obtained low scores in all dimensions, physical component summary of 43.96 (±9.64) and mental component summary of 33.19 (±13.35). Conclusion The psychological component is considered to be fundamental in the management of HIV/AIDS patients. Psychoeducation should be conducted at the initial evaluation to reduce negative beliefs regarding antiretroviral therapy Assessment of anxiety and depression symptoms should be done throughout therapy as both psycological conditions are associated with patient adherence, success of treatment, and ultimately with patients’ quality of life.

Abstract Background Trial-based thought record (TBTR) is a technique used in trial-based cognitive therapy (TBCT), and simulates a court trial. It was designed to restructure unhelpful core beliefs (CBs) during psychotherapy. Objective To confirm previous findings on the efficacy of TBTR in decreasing patients’ adherence to self-critical and unhelpful CBs and corresponding emotions, as well as assessing the differential efficacy of the empty-chair approach relative to the static format of TBTR. Methods Thirty-nine outpatients were submitted to a 50-minute, one-session, application of the TBTR technique in the empty-chair (n = 18) or conventional (n = 21) formats. Patients’ adherence to unhelpful CBs and the intensity of corresponding emotions were assessed after each step of TBTR, and the results obtained in each format were compared. Results Significant reductions in percent values both in the credit given to CBs and in the intensity of corresponding emotions were observed at the end of the session (p < .001), relative to baseline values. ANCOVA also showed a significant difference in favor of the empty-chair format for both belief credit and emotion intensity (p = .04). Discussion TBTR may help patients reduce adherence to unhelpful CBs and corresponding emotions and the empty-chair format seems to be more efficacious than the conventional format.

Objective: Functional neuroimaging techniques represent fundamental tools in the context of translational research integrating neurobiology, psychopathology, neuropsychology, and therapeutics. In addition, cognitive-behavioral therapy (CBT) has proven its efficacy in the treatment of anxiety disorders and may be useful in phobias. The literature has shown that feelings and behaviors are mediated by specific brain circuits, and changes in patterns of interaction should be associated with cerebral alterations. Based on these concepts, a systematic review was conducted aiming to evaluate the impact of CBT on phobic disorders measured by functional neuroimaging techniques. Methods: A systematic review of the literature was conducted including studies published between January 1980 and April 2012. Studies written in English, Spanish or Portuguese evaluating changes in the pattern of functional neuroimaging before and after CBT in patients with phobic disorders were included. Results: The initial search strategy retrieved 45 studies. Six of these studies met all inclusion criteria. Significant deactivations in the amygdala, insula, thalamus and hippocampus, as well as activation of the medial orbitofrontal cortex, were observed after CBT in phobic patients when compared with controls. Conclusion: In spite of their technical limitations, neuroimaging techniques provide neurobiological support for the efficacy of CBT in the treatment of phobic disorders. Further studies are needed to confirm this conclusion.

Objective: To determine whether there are differences in quality of life (QoL) improvement after treatment with the trial-based thought record (TBTR) versus conventional cognitive therapy (CCT) in patients with social anxiety disorder (SAD). Method: A randomized trial comparing TBTR with a set of CCT techniques, which included the standard 7-column dysfunctional thought record (DTR) and the positive data log (PDL) in patients with SAD, generalized type. Results: Repeated measures analysis of variance (ANOVA) revealed a significant time effect in the general health, vitality, social functioning, and mental health domains of the Short Form 36. It also indicated significant treatment effects on the bodily pain, social functioning, role-emotional, and mental health domains, with higher scores in the TBTR group. One-way analysis of covariance (ANCOVA), using pretreatment values as covariates, showed that TBTR was associated with significantly better QoL post-treatment (bodily pain, social functioning and role-emotional) and at follow-up (role-emotional). A significant treatment effect on the role-emotional domain at 12-month follow-up denoted a sustained effect of TBTR relative to CCT. Conclusion: This study provided preliminary evidence that TBTR is at least as effective as CCT in improving several domains of QoL in SAD, specifically when the standard 7-column DTR and the PDL are used.

Durante os últimos 40 anos, a esquizofrenia foi considerada, principalmente, como o resultado de disfunções dopaminérgicas no cérebro. Esta revisão descreve e discute algumas descobertas sobre a neurotransmissão mediada pelo óxido nítrico na esquizofrenia. A busca foi feita nas bases PubMed, SciELO e LILACS usando-se os termos schizophrenia e nitric oxide plasma levels ou nitric oxide serum levels, sem limites de tempo. As listas de referências dos artigos selecionados foram examinadas em busca de outras publicações pertinentes. Dentre 15 artigos passíveis de serem incluídos, 10 preenchiam os critérios estabelecidos para a revisão e metanálise. Esses estudos incluíram 505 pacientes com esquizofrenia e 339 voluntários saudáveis. Não foram encontradas diferenças significativas entre pacientes e voluntários saudáveis quanto aos níveis plasmáticos de nitrito total (effect size g = 0,285, IC 95% = -0,205 a 0,774, p = 0,254). No entanto, o exame separado dos estudos envolvendo pacientes em tratamento antipsicótico apresentou diferenças significativas entre pacientes e voluntários saudáveis (effect size g = 0,663, IC 95% = 0,365 to 0,961, p < 0,001), demonstrando que pacientes em tratamento possuem níveis plasmáticos mais altos de óxido nítrico. Esses resultados sugerem que os antipsicóticos podem aumentar os níveis plasmáticos de óxido nítrico e que a via nitrérgica (e sua estimulação) constituiria um alvo propício para o desenvolvimento de novos tratamentos para pacientes com esquizofrenia.

For the last 40 years, schizophrenia has been considered to be the result primarily of a dysfunction in brain dopaminergic pathways. In this review, it is described and discussed findings concerning nitric oxide-mediated neurotransmission in schizophrenia. Studies were searched in PubMed, SciELO, and LILACS using the terms schizophrenia and nitric oxide plasma levels or nitric oxide serum levels, with no time limit. The reference lists of selected articles were also hand-searched for additional articles. From 15 potential reports, 10 were eligible to be included in the review and meta-analysis. These studies included a total of 505 patients with schizophrenia and 339 healthy volunteers. No significant difference was found between patients and healthy controls regarding total nitrite plasma/serum levels (effect size g = 0.285, 95%CI = -0.205 to 0.774, p = 0.254). However, when studies with patients under antipsychotic treatment were examined separately, there was a significant difference between patients and healthy volunteers (effect size g = 0.663, 95%CI = 0.365 to 0.961, p < 0.001), showing that patients under treatment have higher levels of plasma/serum nitric oxide than controls. These results suggest that antipsychotics increase nitric oxide plasma/serum levels and that the nitrergic pathway would be a fertile target for the development of new treatments for patients with schizophrenia.

OBJETIVO: Estudar a influência dos transtornos alimentares (TA) na gravidade do transtorno bipolar (TB). MÉTODOS: Foram utilizadas a Entrevista Clínica Estruturada para o Eixo I do DSM-IV (SCID-I), a Escala de Young para Avaliação da Mania (YMRS), a Escala de Hamilton para Avaliação da Depressão (HAM-D-17), a Escala de Hamilton para Avaliação da Ansiedade (HAM-A), a Avaliação do Funcionamento Global (GAF) e a Escala Breve de Avaliação da Qualidade de Vida da Organização Mundial da Saúde (WHOQOL-BREF). Os dados clínicos e sociodemográficos também foram coletados. RESULTADOS: Entre os 355 pacientes com TB incluídos neste estudo, 19 (5,3%) também foram diagnosticados como portadores de TA. Destes, 57,9% tinham bulimia nervosa (BN) e 42,1% anorexia nervosa (AN). Dentre os pacientes com TA, 94,7% eram do gênero feminino. Os pacientes portadores de TB e TA apresentaram escores mais baixos do domínio saúde mental da WHOQOL-BREF, escores mais elevados de sintomas depressivos e mais comorbidades psiquiátricas. CONCLUSÕES: A presença de comorbidades com TA acarreta importantes desfechos negativos em pacientes bipolares. Este achado sugere que atenção deva ser dada à presença de TA em pacientes com TB e que melhores tratamentos focados nessa população sejam desenvolvidos.

OBJECTIVES: To study the impact of eating disorders (EDs) on the severity of bipolar disorder (BD). METHODS: The Structured Clinical Interview for DSM-IV Axis I (SCID-I), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D-17), Hamilton Anxiety Rating Scale (HAM-A), Global Assessment of Functioning (GAF), Clinical Global Impression (CGI), and the World Health Organization Quality of Life Assessment (WHOQOL-BREF) were used. Clinical and sociodemographic data were also collected. RESULTS: Among the 356 bipolar patients included in this study, 19 (5.3%) were also diagnosed with ED. Of these, 57.9% had bulimia nervosa (BN) and 42.1% had anorexia nervosa (AN). Among ED patients, 94.7% were female. Bipolar patients with EDs presented with lower scores in the mental health domain of the WHOQOL-BREF, higher scores of depressive symptoms, and more psychiatric comorbidities. CONCLUSIONS: ED comorbidities imposed important negative outcomes in bipolar patients. This finding suggests that attention should be given to the presence of EDs in BD patients and that better treatments focused on this population should be developed.

OBJETIVO: Este estudo investiga o planejamento estratégico em pacientes com transtorno obsessivo-compulsivo e sua possível associação com dimensões de sintomas obsessivo-compulsivos. MÉTODO: Foram avaliados 32 pacientes com transtorno obsessivo-compulsivo. O planejamento estratégico foi avaliado pelo Teste da Figura Complexa de Rey. Presença e gravidade de sintomas obsessivo-compulsivos foram avaliadas pela Escala Dimensional para Sintomas Obsessivo-Compulsivos e a Yale-Brown Obsessive-Compulsive Scale. Análises estatísticas foram realizadas utilizando nível de significância de 5%. RESULTADOS: Escores globais da Escala Dimensional para Sintomas Obsessivo-Compulsivos na pior fase apresentaram correlação significativa com os escores de cópia do Teste da Figura Complexa de Rey-Osterrieth (r = 0,4, p = 0,04), além de manter significância na análise de regressão, incluindo idade, quociente de inteligência, número de comorbidades e escores no Yale-Brown Obsessive-Compulsive Scale e Escala Dimensional para Sintomas Obsessivo-Compulsivos (β= 0,55, t = 2,1, p = 0,04). A dimensão colecionismo teve uma correlação significativa com o escore de planejamento estratégico (r = 0,44, p = 0,03). As outras dimensões de sintomas obsessivo-compulsivos não apresentaram correlações significativas com os escores de planejamento estratégico. CONCLUSÃO: A gravidade dos sintomas obsessivo-compulsivos e a dimensão colecionismo apresentaram associações significativas com escores de planejamento estratégico na cópia do Teste da Figura Complexa de Rey. Os achados reforçam a ideia de que o transtorno obsessivo-compulsivo é um transtorno heterogêneo, e de que é importante avaliar as especificidades de cada dimensão de sintomas obsessivo-compulsivos, além de sugerir que a dimensão colecionismo apresenta características neuropsicológicas distintas.

OBJECTIVE: This study investigates obsessive-compulsive disorder patients in terms of strategic planning and its association with specific obsessive-compulsive symptom dimensions. METHOD: We evaluated 32 obsessive-compulsive disorder patients. Strategic planning was assessed by the Rey-Osterrieth Complex Figure Test, and the obsessive-compulsive dimensions were assessed by the Dimensional Yale-Brown Obsessive-Compulsive Scale. In the statistical analyses, the level of significance was set at 5%. We employed linear regression, including age, intelligence quotient, number of comorbidities, the Yale-Brown Obsessive-Compulsive Scale score, and the Dimensional Yale-Brown Obsessive-Compulsive Scale. RESULTS: The Dimensional Yale-Brown Obsessive-Compulsive Scale "worst-ever" score correlated significantly with the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test (r = 0.4, p = 0.04) and was the only variable to show a significant association after linear regression (β = 0.55, t = 2.1, p = 0.04). Compulsive hoarding correlated positively with strategic planning (r = 0.44, p = 0.03). None of the remaining symptom dimensions presented any significant correlations with strategic planning. CONCLUSION: We found the severity of obsessive-compulsive symptoms to be associated with strategic planning. In addition, there was a significant positive association between the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test copy score and the hoarding dimension score on the Dimensional Yale-Brown Obsessive-Compulsive Scale. Our results underscore the idea that obsessive-compulsive disorder is a heterogeneous disorder and suggest that the hoarding dimension has a specific neuropsychological profile. Therefore, it is important to assess the peculiarities of each obsessive-compulsive symptom dimension.

CONTEXTO: Dor é uma experiência emocional e sensorial desagradável. Tanto a dor crônica como a depressão reduzem de forma significativa a qualidade de vida, além de aumentar muito os custos dos cuidados com a saúde. OBJETIVOS: Analisar a associação entre sintomas depressivos e de ansiedade em relação à dor crônica e investigar o impacto desses sintomas na saúde e na qualidade de vida em indivíduos com dor crônica. MÉTODOS: A dor foi avaliada por meio de uma Escala Analógica Visual (VAS). Os sintomas depressivos e a ansiedade foram avaliados pela Escala Hospitalar de Ansiedade e Depressão (HAD). A qualidade de vida foi avaliada por meio do SF-36. RESULTADOS: Quatrocentos pacientes foram estudados, com idade média de 45,6 ± 11,4 anos e 82,8% são do sexo feminino. De acordo com a HAD, 70% tinham ansiedade e 60%, os sintomas de depressão. A SF-36 apresentou escores < 50% para todos os domínios. Os pacientes com dor intensa/ extrema apresentaram maior frequência (70,4%) de ansiedade do que aqueles com dor selvagem/moderada (59,5%). Essa foi uma associação estatisticamente significante (p = 0,027). No entanto, a frequência de depressão não atingiu significância estatística quando ambos os grupos foram comparados (p = 0,109). CONCLUSÃO: Os sintomas depressivos/ansiedade e dor, em conjunto, apresentaram piores desfechos clínicos de cada estado sozinho. É necessária mais investigação para determinar se o tratamento da dor ajuda os sintomas dos pacientes depressivos e se o alívio dos sintomas depressivos melhora a dor e sua morbidade.

BACKGROUND: Pain is an unpleasant sensory and emotional experience. Both chronic pain and depression result in substantial disability reduced HRQoL and increased health care costs and utilization. OBJECTIVES: To evaluate the strength of the association between depressive and anxiety symptoms and chronic pain, and to investigate the impact of these symptoms on health-related quality of life (HRQoL) in chronic pain individuals. METHODS: Pain was assessed by means of a Visual Analogue Scale (VAS). Depressive and anxiety symptoms were assessed by the Hospital Anxiety and Depression (HAD) scale. Quality of life was assessed by means of the SF-36. RESULTS: Four hundred patients were studied, mean age 45.6 ± 11.4 years and 82.8% female gender. According to HAD, 70% had anxiety and 60% depression symptoms. SF-36 showed mean scores < 50% for all the domains. Patients with severe pain/extreme (70.4%) had a higher frequency of anxiety than those with pain selvagem/moderada (59,5%). This was a statistically significant (p = 0.027). However, the frequency of depression did not reach statistical significance when both groups were compared p = 0.109). DISCUSSION: Depressive/anxiety symptoms and pain together have worse clinical outcomes than each condition alone.