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Love, compassion, and attachment in psychiatric care: perspectives for research and clinical practice Love compassion care
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Damiano, Rodolfo Furlan

; Fricchione, Gregory

; Miguel, Euripedes Constantino

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20220557

Abstract: En | Text: En | PDF: En

https://doi.org/10.47626/2237-6089-2022-0557

The S20 Brazilian Mental Health Report for building a just world and a sustainable planet: Part II S S2 planet
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Mari, Jair de Jesus

; Kapczinski, Flávio

; Brunoni, André Russowsky

; Gadelha, Ary

; Prates-Baldez, Daniel

; Miguel, Eurípedes Constantino

; Scorza, Fulvio A.

; Caye, Arthur

; Quagliato, Laiana A.

; De Boni, Raquel B.

; Salum, Giovanni

; Nardi, Antonio E.

Brazilian Journal of Psychiatry

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2024, Volume 46 elocation e20243707

Abstract: En | Text: En | PDF: En

This is the second part of the Brazilian S20 mental health report. The mental health working group is dedicated to leveraging scientific insights to foster innovation and propose actionable recommendations for implementation in Brazil and participating countries. In addressing the heightened mental health challenges in a post-pandemic world, strategies should encompass several key elements. This second part of the S20 Brazilian Mental Health Report will delve into some of these elements, including: the impact of climate change on mental health, the influence of environmental factors on neurodevelopmental disorders, the intersection of serious mental illness and precision psychiatry, the co-occurrence of physical and mental disorders, advancements in biomarkers for mental disorders, the use of digital health in mental health care, the implementation of interventional psychiatry, and the design of innovative mental health systems that integrate principles of innovation and human rights. Reassessing the treatment settings for psychiatric patients in general hospitals, where their mental health and physical needs are addressed, should be prioritized in mental health policy. As the S20 countries prepare for the future, we need principles that can advance innovation, uphold human rights, and strive for the highest standards in mental health care. S S2 report postpandemic post pandemic world elements including disorders psychiatry cooccurrence co occurrence care rights hospitals addressed policy future

https://doi.org/10.47626/1516-4446-2024-3707

Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part II: cognitive-behavioral therapy ObsessiveCompulsive Obsessive Compulsive obsessivecompulsive obsessive compulsive disorder II cognitivebehavioral cognitive behavioral
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Mathis, Maria Alice de

; Chacon, Priscila

; Boavista, Rodrigo

; de Oliveira, Marcos Vinícius Sousa

; de Barros, Pedro Macul Ferreira

; Echevarria, Marco Antonio Nocito

; Ferrão, Ygor Arzeno

; Vattimo, Edoardo Filippo de Queiroz

; Lopes, Antônio Carlos

; Torres, Albina Rodrigues

; Diniz, Juliana Belo

; Fontenelle, Leonardo

; do Rosário, Maria Conceição

; Shavitt, Roseli Gedanke

; da Silva, Renata de Melo Felipe

; Miguel, Eurípedes Constantino

; Costa, Daniel Lucas da Conceição

Brazilian Journal of Psychiatry

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oct 2023, Volume 45 N. 5 Pages 431 - 447

Abstract: En | Text: En | PDF: En

Objectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association. Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD. Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD. Objectives evidencebased based cognitivebehavioral cognitive behavioral (CBT obsessivecompulsive obsessive compulsive OCD . (OCD) Methods clinicians protocol 20132020 2020 2013-202 PubMed, PubMed (PubMed Cochrane Embase PsycINFO Lilacs design measures type language tools Results 4 201 Highquality High firstline first line Internetdelivered Internet delivered Conclusion (OCD 2013202 202 2013-20 20 201320 2013-2 2 20132 2013-

https://doi.org/10.47626/1516-4446-2023-3081

Translating measurement into practice: Brazilian norms for depressive symptom assessment with the Patient Health Questionnaire (PHQ-9) practice PHQ9 PHQ 9 (PHQ-9 (PHQ- (PHQ
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Damiano, Rodolfo Furlan

; Hoffmann, Maurício Scopel

; Gosmann, Natan Pereira

; Pan, Pedro Mario

; Miguel, Eurípedes Constantino

; Salum, Giovanni Abrahão

Brazilian Journal of Psychiatry

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aug 2023, Volume 45 N. 4 Pages 310 - 317

Abstract: En | Text: En | PDF: En

Objectives: To provide practical norms for measuring depressive symptoms with the Patient Health Questionnaire 9 (PHQ-9) in Brazil through a state-of-the-art psychometrics analysis. Methods: We used a large representative dataset from the 2019 Brazilian National Health Survey (Pesquisa Nacional de Saúde – 2019), which included 90,846 Brazilian citizens. To assess scale structure, we assessed a unidimensional model using confirmatory factor analysis. Item response theory was used to characterize the distribution of depressive symptoms. Summed- and mean-based PHQ-9 scores were then linked using item response theory-based scores in generalized additive models. Finally, percentiles, T scores, and a newly developed score, called the decimal score (D score), were generated to describe PHQ-9 norms for the Brazilian population. Results: Confirmatory factor analysis revealed a good fit to the unidimensional model, being invariant to age and sex. Item response theory captured item-level information about the latent trait (reliable from 1 to 3 SDs above the mean). Brazilian norms were presented using summed scores, T scores, and D scores. Conclusion: This is the first study to determine Brazilian norms for the PHQ-9 among a large representative sample using robust psychometric tools. More precise PHQ-9 scores are now available and may be widely used in primary and specialized clinical care settings. Objectives PHQ9 PHQ (PHQ-9 stateoftheart state art Methods 201 Pesquisa 2019, , 2019) 90846 90 846 90,84 citizens structure Summed meanbased mean based PHQ- theorybased models Finally percentiles score) population Results sex itemlevel level reliable mean. . mean) Conclusion tools settings (PHQ- 20 9084 84 90,8 (PHQ 2 908 8 90,

https://doi.org/10.47626/1516-4446-2022-2945

Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment ObsessiveCompulsive Obsessive Compulsive obsessivecompulsive obsessive compulsive disorder I
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de Oliveira, Marcos Vinícius Sousa

; de Barros, Pedro Macul Ferreira

; de Mathis, Maria Alice

; Boavista, Rodrigo

; Chacon, Priscila

; Echevarria, Marco Antonio Nocito

; Ferrão, Ygor Arzeno

; Vattimo, Edoardo Felippo de Queiroz

; Lopes, Antônio Carlos

; Torres, Albina Rodrigues

; Diniz, Juliana Belo

; Fontenelle, Leonardo F.

; Rosário, Maria Conceição do

; Shavitt, Roseli Gedanke

; Miguel, Eurípedes Constantino

; da Silva, Renata de Melo Felipe

; Costa, Daniel Lucas da Conceição

Brazilian Journal of Psychiatry

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apr 2023, Volume 45 N. 2 Pages 146 - 161

Abstract: En | Text: En | PDF: En

Objectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological intervention for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first-line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed. Objectives evidencebased based obsessivecompulsive obsessive compulsive . (OCD) Methods (APA (2013 , (SSRIs) clomipramine SNRIs, SNRIs (SNRIs) glutamatemodulating glutamate modulating agents 20132020 2020 2013-202 databases study measures publication language tools ACC/AHA. ACCAHA ACC/AHA ACC AHA (ACC/AHA) Results 5 201 Highquality High firstline first line Moreover risperidone, (risperidone aripiprazole SSRIresistant SSRI resistant Conclusion 812 8 12 8-1 weeks harmful ketamine lamotrigine Nacetylcysteine, Nacetylcysteine N acetylcysteine, acetylcysteine N-acetylcysteine detailed (OCD (201 (SSRIs (SNRIs 2013202 202 2013-20 (ACC/AHA 20 81 1 8- (20 201320 2013-2 2 (2 20132 2013- (

https://doi.org/10.47626/1516-4446-2022-2891

Identifying Depression Early in Adolescence: assessing the performance of a risk score for future onset of depression in an independent Brazilian sample Adolescence
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Cunha, Graccielle R.

; Caye, Arthur

; Pan, Pedro

; Fisher, Helen L.

; Pereira, Rivka

; Ziebold, Carolina

; Bressan, Rodrigo

; Miguel, Eurípedes Constantino

; Salum, Giovanni A.

; Rohde, Luis Augusto

; Kohrt, Brandon A.

; Mondelli, Valeria

; Kieling, Christian

; Gadelha, Ary

Brazilian Journal of Psychiatry

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2023, Volume 45 N. 3 Pages 242 - 248

Abstract: En | Text: En | PDF: En

Objective: The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) was recently developed in Brazil using data from the Pelotas 1993 Birth Cohort to estimate the individualized probability of developing depression in adolescence. This model includes 11 sociodemographic variables and has been assessed in longitudinal studies from four other countries. We aimed to test the performance of IDEA-RS in an independent, community-based, school-attending sample within the same country: the Brazilian High-Risk Cohort. Methods: Standard external validation, refitted, and case mix-corrected models were used to predict depression among 1442 youth followed from a mean age of 13.5 years at baseline to 17.7 years at follow-up, using probabilities calculated with IDEA-RS coefficients. Results: The area under the curve was 0.65 for standard external validation, 0.70 for the case mix-corrected model, and 0.69 for the refitted model, with discrimination consistently above chance for predicting depression in the new dataset. There was some degree of miscalibration, corrected by model refitting (calibration-in-the-large reduced from 0.77 to 0). Conclusion: IDEA-RS was able to parse individuals with higher or lower probability of developing depression beyond chance in an independent Brazilian sample. Further steps should include model improvements and additional studies in populations with high levels of subclinical symptoms to improve clinical decision making. Objective IDEARS IDEA RS (IDEA-RS 199 adolescence 1 countries communitybased, communitybased community based, based community-based schoolattending school attending country HighRisk High Methods validation mixcorrected mix 144 135 13 5 13. 177 17 7 17. followup, followup follow up, up follow-up coefficients Results 065 0 65 0.6 070 70 0.7 069 69 dataset miscalibration calibrationinthelarge calibration large 077 77 0. . 0) Conclusion making 19 14 06 6 07

https://doi.org/10.47626/1516-4446-2022-2775

Double cone coil repetitive transcranial magnetic stimulation for severe obsessive-compulsive disorder after reversible cerebral vasoconstriction syndrome with intracerebral hemorrhage: a case report
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Silveira, Julia Belizário

; Damiano, Rodolfo Furlan

; Abelama Neto, Emilio

; Gomes, Raphael Neves dos Santos Mosqueira

; Klein, Izio

; Borrione, Lucas

; Sudbrack, Pedro

; Gentil, André Felix

; Shephard, Elizabeth

; Brunoni, André Russowski

; Miguel, Eurípedes Constantino

; Echevarria, Marco Antonio Nocito

Brazilian Journal of Psychiatry

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oct 2022, Volume 44 N. 5 Pages 562 - 564

Abstract: En | Text: En | PDF: En

https://doi.org/10.47626/1516-4446-2022-2556

Inattention symptoms in early pregnancy predict parenting skills and infant maltreatment during the first year of life
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Oliveira, Jordana Verano de

; Fatori, Daniel

; Shephard, Elizabeth

; Xavier Neto, Mauro

; Matijasevich, Alicia

; Ferraro, Alexandre Archanjo

; Rohde, Luis Augusto

; Chiesa, Anna Maria

; Miguel, Euripedes Constantino

; Polanczyk, Guilherme V.

Brazilian Journal of Psychiatry

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aug 2022, Volume 44 N. 4 Pages 388 - 400

Abstract: En | Text: En | PDF: En

Objective: Maternal attention-deficit/hyperactivity disorder has not been investigated in relation to parenting skills in adolescent mothers. This study investigated whether maternal inattention and hyperactivity/impulsivity symptoms early in pregnancy predict poorer parenting skills and infant maltreatment during the first year of life in adolescent mothers living in adverse environmental conditions. Methods: The participants in this study were 80 adolescent mothers aged 14-19 years and their babies who were taking part in a randomized controlled trial on the effects of a home-visiting program on infant development. Symptoms of maternal attention-deficit/hyperactivity disorder were assessed in the first trimester of pregnancy. Parenting skills (maternal competence, attachment to the baby, home environment) and child maltreatment were assessed when the infants were aged 6 and 12 months. Multilevel linear regression models were constructed to test the extent to which prenatal maternal inattention and hyperactivity/impulsivity symptoms predicted these parenting variables during the first year of the infant’s life. Results: Prenatal inattention symptoms significantly predicted lower maternal competence and attachment, a poorer home environment, and greater maltreatment during the first year of life. Hyperactivity did not significantly predict parenting skills or maltreatment. Conclusions: Our findings suggest that inattention symptoms may interfere with parenting abilities in adolescent mothers and should be considered in early intervention programs.

https://doi.org/10.47626/1516-4446-2021-2045

Not only pharmacodynamic: the role of brain circuits in improving the treatment of suicidal thoughts and behaviors
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Damiano, Rodolfo Furlan

; Miguel, Euripedes Constantino

; Shephard, Elizabeth

Brazilian Journal of Psychiatry

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feb 2022, Volume 44 N. 1 Pages 113 - 113

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-4446-2021-2257

10.

Disability in children and adolescents: the extent of the impact on psychiatric disorders and educational deficits
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Zaqueu, Livia

; Teixeira, Maria Crista Triguero Veloz

; Lowenthal, Rosane

; Mari, Jair J.

; Miguel, Eurípedes Constantino

; Rohde, Luís Augusto

; Paula, Cristiane Silvestre

Trends in Psychiatry and Psychotherapy

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sep 2021, Volume 43 N. 3 Pages 235 - 239

Abstract: En | Text: En | PDF: En

Abstract Introduction Most children/adolescents with disability live in low and middle-income countries and, worldwide, they are more likely to have mental health problems and achieve worse academic performance compared to those with typical development. Objective To assess whether Brazilian children/adolescents with four types of disabilities are more likely to have psychiatric disorders and educational deficits than children/adolescents with typical development. Method A multicenter cross-sectional study involving a school-based probabilistic sample of second to sixth graders (N = 1,674) from public schools in four Brazilian regions. The four types of disabilities (intellectual, visual, hearing, and motor) were assessed using the Ten Questions Questionnaire. Psychiatric disorders were measured with the Schedule for Affective Disorders/Schizophrenia for School-Age Children (K-SADS-PL), and academic performance was evaluated using the Teste de Desempenho Acadêmico – TDE (the academic performance test). Results A logistic regression model with cluster-robust errors identified the following statistically significant associations with three of the four types of disability (the exception was hearing). Intellectual disability was associated with anxiety (p < 0.01), depression (p < 0.01), attention deficit hyperactivity disorder (ADHD) (p < 0.001), school failure (p < 0.01), and poor academic performance (p < 0.01). Visual disability was associated with depression (p < 0.01). Motor disability was marginally associated with ADHD (p = 0.08). Conclusions Presence of disabilities (intellectual, visual, and motor) in children/adolescents was associated with psychiatric disorders, school failure, and academic performance. It is therefore important to identify presence of disabilities and plan and deliver specific interventions and specialized educational care for the needs presented by these children/adolescents. This is particularly important in low and middle-income countries, where these disabilities are frequent among children/adolescents.

https://doi.org/10.47626/2237-6089-2020-0059 136 downloads

11.

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Abstract: En | Text: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

12.

COMVC-19, a Program to Protect Healthcare Workers’ Mental Health During the COVID-19 Pandemic, and the Second Wave of the Pandemic: A New Moment and the Impact of Previous Experiences
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Scarduelli, Fabio Cassiodoro Veiga

; Fukuti, Pedro

; Corchs, Felipe

; Miguel, Euripedes Constantino

; Humes, Eduardo de Castro

Clinics

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2021, Volume 76 elocation e3574

Abstract: En | Text: En | PDF: En

https://doi.org/10.6061/clinics/2021/e3574

13.

How Institutions Can Protect the Mental Health and Psychosocial Well-Being of Their Healthcare Workers in the Current COVID-19 Pandemic
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Corchs, Felipe

; Kamitsuji, Carla Satie

; Rossi, Luciane De

; Rios, Izabel Cristina

; Lancman, Selma

; Bonfa, Eloisa

; Barros-Filho, Tarcisio Eloy Pessoa de

; Miguel, Eurípedes Constantino

Clinics

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2020, Volume 75 elocation e1963

Abstract: En | Text: En | PDF: En

https://doi.org/10.6061/clinics/2020/e1963 2745 downloads

14.

Diagnostic operationalization and phenomenological heterogeneity in psychiatry: the case of attention deficit hyperactivity disorder
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Salum, Giovanni Abrahão

; Gadelha, Ary

; Polanczyk, Guilherme Vanoni

; Miguel, Eurípedes Constantino

; Rohde, Luis Augusto

Salud mental

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dec 2018, Volume 41 N. 6 Pages 249 - 260

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Introduction We assessed the impact of polythetic conceptualizations of mental disorders on the validity and reliability of psychiatric diagnosis, with a specific focus on two levels of heterogeneity: phenomenological and pathophysiological. Objective We investigated this issue using attention deficit hyperactivity disorder (ADHD) as an example. Method We examined individuals from two samples enriched for psychopathology (n = 1 255 children in Porto Alegre and 1 257 children in São Paulo, Brazil). We conducted a series of data analyses to investigate phenomenological heterogeneity, including confirmatory factor analysis. We also investigated pathophysiological heterogeneity using symptom-level regressions between ADHD symptoms and four neurocognitive processes consistently linked to ADHD (working memory, inhibitory control, intra-subject variability in reaction times, and temporal processing). Lastly, we assessed the performance of polythetic systems for reliability testing inter-rater and test-rest reliability of two well-known symptomatic scales. Results Among the 116 200 possible combinations of symptoms to achieve DSM symptomatic threshold for categorical ADHD diagnosis, we found 173 combinations in the two independent samples, and only four were replicated in both samples (2.3%). We also found that the number of ADHD symptoms is a poor indicator of variation in the general ADHD latent trait. Overall, symptoms did not have specific profiles of associations with any of the neurocognitive processes. Reliability analyses revealed that increasing the number of items augments overall reliability of measurements. Discussion and conclusion Our findings illustrate both potential benefits and problems inherent to the polythetic system for ADHD. Implications for the search of mechanisms underlying psychiatric disorders are discussed.

Resumen Antecedentes Evaluamos el impacto de las conceptualizaciones politécnicas de los trastornos mentales en la validez y la fiabilidad del diagnóstico psiquiátrico, con un enfoque específico en dos niveles de heterogeneidad: fenomenológico y fisiopatológico. Objetivos Investigamos este problema utilizando el trastorno por déficit de atención e hiperactividad (TDAH) como ejemplo. Método Examinamos individuos de dos muestras enriquecidas por psicopatología (n = 1 255 niños en Porto Alegre y 1 257 niños en São Paulo, Brasil). Llevamos a cabo una serie de análisis de datos para investigar la heterogeneidad fenomenológica, incluido el análisis factorial confirmatorio. También investigamos la heterogeneidad fisiopatológica utilizando regresiones al nivel de síntomas entre los síntomas del TDAH y cuatro procesos neurocognitivos consistentemente vinculados al TDAH (memoria de trabajo, control inhibitorio, variabilidad intrasujeto en tiempos de reacción y procesamiento temporal). Por último, evaluamos el rendimiento de los sistemas politéticos para la prueba de confiabilidad interevaluador y la confiabilidad test-rest de dos escalas sintomáticas bien conocidas. Resultados Entre las 116 200 posibles combinaciones de síntomas para alcanzar el umbral sintomático del DSM para el diagnóstico categórico de TDAH, encontramos 173 combinaciones en las dos muestras independientes y sólo cuatro se replicaron en ambas muestras (2.3%). También encontramos que la cantidad de síntomas de TDAH no es un buen indicador de la variación en el rasgo latente general del TDAH. En general, los síntomas no tenían perfiles específicos de asociaciones con ninguno de los procesos neurocognitivos. Los análisis de confiabilidad revelaron que aumentar el número de artículos aumenta la confiabilidad general de las mediciones. Discusión y conclusión Nuestros hallazgos ilustran tanto los beneficios potenciales como los problemas inherentes al sistema politécnico para el TDAH. Se discuten las implicaciones para la búsqueda de mecanismos subyacentes a los trastornos psiquiátricos.

https://doi.org/10.17711/sm.0185-3325.2018.037 867 downloads

15.

Prevalência de problemas de saúde mental na infância na atenção primária
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Fatori, Daniel

; Brentani, Alexandra

; Grisi, Sandra Josefina Ferraz Ellero

; Miguel, Euripedes Constantino

; Graeff-Martins, Ana Soledade

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

sep 2018, Volume 23 N. 9 Pages 3013 - 3020

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O presente estudo populacional de corte transversal teve como objetivo verificar a prevalência de problemas de saúde mental (PSM) e descrever o uso de serviços de saúde numa amostra de crianças atendidas em unidades de saúde (UBS) do município de São Paulo. Responsáveis de 825 crianças de 6-11 anos de idade foram entrevistados. PSM das crianças foram avaliados pelo “Strength and Difficulties Questionnaire” e uso de serviços por uma versão adaptada do “Client Service Receipt Inventory Children’s version”. A prevalência de PSM internalizantes e externalizantes foi de 30,7% e 18,3%, respectivamente. O pediatra foi o profissional de saúde mais consultado (56,7%), o psicólogo foi o profissional da saúde mental mais consultado (7,9%). Apenas 3 crianças estavam em tratamento medicamentoso para PSM. A alta prevalência de PSM em crianças atendidas na AP e o baixo número de atendimentos em serviços configuram um importante problema de saúde pública. Programas de capacitação para profissionais são importantes para aprimorar a identificação e o encaminhamento de casos de PSM.

Abstract The present population study aimed at identifying the prevalence of mental health problems (MHP) and describing health services use in a sample of children attending Primary Healthcare Units (PHU) in the city of Sao Paulo. Caregivers of 825 6-11 years old children were assessed. MHP were assessed with the Strength and Difficulties Questionnaire and health services use with an adapted version of the Client Receipt Inventory Children`s version. Prevalence of internalizing and externalizing MHP was 30.7% and 18.3%, respectively. Pediatricians were the most consulted health professional (56.7%) and psychologists the most consulted mental health professional (7.9%). Only 3 children were under medication treatment for MHP. The high prevalence of MHP among children in the primary care setting and the low rate of treatment constitute a public health problem. Training programs for health professionals are relevant to help identify and refer MHP cases.

https://doi.org/10.1590/1413-81232018239.25332016 3751 downloads

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