ABSTRACT Recent studies suggested that cannabis use influences on the emergence of psychosis by disrupting neurodevelopmental processes that occur during adolescence and early adulthood and which are reflected on brain anatomical changes detectable with MRI. However, no MRI studies have investigated whether intrauterine neurodevelopmental abnormalities also interact with later cannabis use to influence on psychosis risk. We investigated differences between first-episode psychosis (FEP) patients with history of cannabis use (FEPC+, n=28), FEP subjects without cannabis use (FEPC-, n=78) and healthy controls (n=80) in regard to the frequency of absent or short Adhesio Interthalamica (AI), a well-established marker of intrauterine neurodevelopment. The FEPC+ subgroup had a significantly lower prevalence of absent AI than FEPC- subjects, as well as a lack of a significantly shorter AI length compared to controls (as found in FEPC- subjects). These preliminary results show that psychosis subjects with cannabis use present a low rather than high frequency of absent AI, suggesting that fixed intrauterine neurodevelopmental abnormalities may not be associated with cannabis use later in life to influence on the emergence of psychosis. This is consistent with a view that multiple different etiological processes may lead to similar clinical presentations in patients with FEP.

Abstract Background Among non-motor symptoms of Parkinson’s disease (PD), anxiety occurs in up to 67% of patients. Clinically, PD patients report worsening of tremors in anxiogenic situations. Objective The aim of this study was to evaluate the association between motor symptoms and anxiety in PD patients and compare their performances with those of healthy volunteers. Methods Fifteen volunteers with PD and 15 healthy volunteers without clinically significant psychiatric disorders were evaluated. Both groups were subjected to a simulated public speaking test (SPST). The following parameters were measured: visual analog mood scale (VAMS), items related to tremors of UPDRS, bradykinesia tests, blood pressure, and heart rate. Results Results of repeated measures ANOVA indicated a significant effect on group × phase interaction (F3.7,105.6 = 2.56; p = 0.046) for VAMS anxiety factor. Regarding tremors, ANOVA indicated significant differences in group × phase interaction (F4.5,121 = 2.88; p = 0.021) and between the groups (F1,27 = 45.88, p < 0.001), with differences in the anticipatory phase, performance, and post-speech, compared with those in the baseline. There were no significant differences between the groups with regard to other factors of VAMS, physiological measurements, and bradykinesia. Discussion Worsening of tremors occurred during SPST, particularly in phases with higher anxiety scores.

Abstract Background Secondary interventions are implemented within a short interval following the occurrence of traumatic events with the purpose of preventing the onset of PTSD. Objective Analyze the results of studies that assessed post-trauma interventions in adults aimed at preventing the onset of PTSD or symptoms related to PTSD. Methods We performed literature searches using the search expression [(Early intervention OR secondary prevention) AND (Post traumatic stress disorder OR PTSD)] for articles published until October 2016. Among the references found, 29 fulfilled the selection criteria established for the review. Data were divided and analyzed according to the type of intervention: pharmacological or psychological. Results Psychological measures used in the studies lack homogeneity regarding the type of intervention and the assessment of intervention outcomes. Pharmacological interventions were less frequent and findings require replication, together with an expansion in the types of substances investigated. In general, many of the studies reviewed suggest that both pharmacological and psychological interventions are effective in the prevention of PTSD. Discussion Future trials should be focused on determining the best interventions for the secondary prevention of PTSD. The combination of psychological and pharmacological interventions for post-trauma patients poses opportunities and challenges that remain unexplored.

Abstract Background The investigation of heritability stands out as an important means to establish the weight of genetic and environmental factors in the development of social anxiety disorder. Objective This study aims to make a critical review of methodological designs used in the investigation of the social anxiety disorder (SAD) heritability. Methods We reviewed 31 research articles published until October 2015 and found through the electronic search bases PubMed, Web of Science, and Scopus and manual searches in the reference lists of the selected references. Most of the investigations involved adult samples and twins to assess heritability. Results There was great variability in the screening and diagnostic instruments used in the studies, leading to different outcomes. Structural equation models proved to be the most adequate to assess SAD heritability, allowing better estimates of this aspect of the disorder. SAD heritability rates varied between 13% and 76% in the articles reviewed. Discussion We discuss methodological aspects that may affect the quality and the development of improved studies to investigate SAD heritability such as sample size, quality of screening instruments, and use of diagnostic interviews. More homogeneous investigations involving larger samples and standardized instruments and methods are desirable and opportune.

Objective: To conduct a systematic literature review of animal and human studies reporting anxiolytic or antidepressive effects of ayahuasca or some of its isolated alkaloids (dimethyltryptamine, harmine, tetrahydroharmine, and harmaline). Methods: Papers published until 3 April 2015 were retrieved from the PubMed, LILACS and SciELO databases following a comprehensive search strategy and using a predetermined set of criteria for article selection. Results: Five hundred and fourteen studies were identified, of which 21 met the established criteria. Studies in animals have shown anxiolytic and antidepressive effects of ayahuasca, harmine, and harmaline, and experimental studies in humans and mental health assessments of experienced ayahuasca consumers also suggest that ayahuasca is associated with reductions in anxiety and depressive symptoms. A pilot study reported rapid antidepressive effects of a single ayahuasca dose in six patients with recurrent depression. Conclusion: Considering the need for new drugs that produce fewer adverse effects and are more effective in reducing anxiety and depression symptomatology, the described effects of ayahuasca and its alkaloids should be further investigated.

Objective: Depression is a highly prevalent condition and is considered a major public health issue. The aim of the present study was to estimate the prevalence of depressive symptoms in the Brazilian population and establish their sociodemographic correlates. Method: A cross-sectional study was conducted between November 2005 and April 2006. Data were collected in face-to-face interviews using a standardized questionnaire. The sample consisted of 3,007 interviews with individuals aged 14 years and older and followed a probabilistic design covering the Brazilian national territory. Depressive symptoms were assessed according to the Center for Epidemiologic Studies Depression Scale. Results: The observed prevalence of depressive symptoms was 28.3% (13% mild/moderate; 15.3% major/severe; p < 0.01). Increased depressive symptom rates were associated with being a female, being 45 years of age and older, having lower educational attainment, being single, having family income of up to 2.5 times minimum wage, and living in the northern region of Brazil (p < 0.05). Conclusions: The prevalence of depressive symptoms in Brazil is high, with major depressive symptoms being the most frequent form of this symptomatology. Considering the biopsychosocial model of mental disorders, this survey points to the involvement of psychosocial factors in the prevalence of depressive symptoms in Brazil.

OBJECTIVE: To adapt the trait version of the Self Statements during Public Speaking (SSPS) scale to a state version (SSPS-S) and to assess its discriminative validity for use in the Simulated Public Speaking Test (SPST). METHOD: Subjects with and without social anxiety disorder (n = 45) were assessed while performing the SPST, a clinical-experimental model of anxiety with seven different phases. RESULTS: Alterations in negative self-assessment occurred with significant changes throughout the different phases of the procedure (p = .05). Non-cases presented significantly higher mean values of the SSPS-S in all phases of the procedure than cases (p < .01). CONCLUSION: Cases assessed themselves in a less positive and more negative manner during the SPST than did non-cases. SSPS-S is adequate for this assessment, especially its negative subscale, and shows good psychometric qualities.

OBJETIVO: O presente estudo tem como objetivo investigar os efeitos da pregabalina sobre as alterações comportamentais em ratos induzidas pela cetamina, um antagonista do receptor glutamatérgico NMDA, utilizado em modelos animais de psicose. MÉTODOS:Ratos receberam injeção com solução salina ou cetamina, na dose de 25 mg/kg, com posterior avaliação das alterações comportamentais induzidas, através da avaliação da estereotipia e hiperlocomoção, depois destes ratos terem sido tratados com pregabalina (30 mg/kg ou 100 mg/kg) ou placebo. RESULTADOS:A administração de pregabalina reduziu a hiperlocomoção nos ratos sob o efeito da cetamina. No entanto, nenhuma das doses de pregabalina teve efeito significativo sobre a estereotipia induzida pela cetamina. CONCLUSÃO: Este é o primeiro estudo que investiga os efeitos da pregabalina em um modelo animal de psicose. Nossos resultados indicam que alterações comportamentais induzidas pela cetamina em ratos podem ser revertidas após uso da pregabalina, o que sugere um possível potencial desta no tratamento de sintomas psicóticos.

OBJECTIVE: The aim of this study is to investigate the effects of pregabalin on the behavior of rats under the influence of ketamine, an NMDA receptor antagonist that mimics the symptoms of schizophrenia. METHODS: Rats were injected with saline or 25 mg/kg ketamine intraperitoneally. After that, behavior modifications were investigated by the evaluation of stereotypy and hyperlocomotion, after treating rats with pregabalin (at doses of 30 mg/kg or 100 mg/kg) or placebo (saline solution). RESULTS: The administration of pregabalin reduced ketamine-induced hyperlocomotion. However, neither doses of pregabalin had a significant effect on ketamineinduced stereotypy. CONCLUSION: This is the first study to investigate the effects of pregabalin using an animal model of psychosis. Furthermore, our results indicate that behavioral changes induced by ketamine in rats can be reversed with the use of pregabalin, suggesting its potential to treat psychotic symptoms.

OBJETIVOS: Revisar e descrever os estudos do constituinte não psicotomimético da Cannabis sativa, o canabidiol (CBD), como ansiolítico e discutir seus possíveis mecanismos de ação. MÉTODO: Os artigos selecionados para a presente revisão foram identificados por meio de busca eletrônica em inglês, português e espanhol nos bancos de dados ISI Web of Knowledge, SciELO, PubMed e PsycINFO e combinando os termos "canabidiol e ansiolíticos", "canabidiol e semelhante ao ansiolítico" e "canabidiol e ansiedade". Foram também revisadas as listas de referências dos artigos incluídos, de revisões da literatura e de capítulos de livro. Incluímos trabalhos experimentais em humanos e em animais, sem limite de tempo. RESULTADOS: Estudos com modelos animais de ansiedade e envolvendo voluntários saudáveis sugerem claramente que o CBD possui efeitos ansiolíticos. Além disso, o CBD mostrou-se capaz de reduzir a ansiedade em pacientes com transtorno de ansiedade social. CONCLUSÃO: Futuros ensaios clínicos com pacientes portadores de diferentes transtornos de ansiedade, em especial pacientes com transtorno do pânico, obsessivo-compulsivo, ansiedade social e estresse pós-traumático, são oportunos. Além disso, ainda é necessário determinar a adequada faixa terapêutica do CBD e os exatos mecanismos envolvidos nessa ação ansiolítica.

OBJECTIVES: To review and describe studies of the non-psychotomimetic constituent of Cannabis sativa, cannabidiol (CBD), as an anxiolytic drug and discuss its possible mechanisms of action. METHOD: The articles selected for the review were identified through searches in English, Portuguese, and Spanish in the electronic databases ISI Web of Knowledge, SciELO, PubMed, and PsycINFO, combining the search terms "cannabidiol and anxiolytic", "cannabidiol and anxiolytic-like", and "cannabidiol and anxiety". The reference lists of the publications included, review articles, and book chapters were handsearched for additional references. Experimental animal and human studies were included, with no time restraints. RESULTS: Studies using animal models of anxiety and involving healthy volunteers clearly suggest an anxiolytic-like effect of CBD. Moreover, CBD was shown to reduce anxiety in patients with social anxiety disorder. CONCLUSION: Future clinical trials involving patients with different anxiety disorders are warranted, especially of panic disorder, obsessive-compulsive disorder, social anxiety disorder, and post-traumatic stress disorders. The adequate therapeutic window of CBD and the precise mechanisms involved in its anxiolytic action remain to be determined.

INTRODUÇÃO: Existem evidências substanciais sobre o impacto de eventos negativos da vida durante a infância na etiologia dos transtornos psiquiátricos. Examinamos a associação entre os eventos negativos ocorridos na infância e a ansiedade social em uma amostra de 571 estudantes universitários espanhóis. MÉTODOS: Em um estudo transversal realizado em 2007, foram coletados os dados de variáveis sociodemográficas, história psiquiátrica pessoal e familiar e abuso de substâncias por meio de um questionário semiestruturado e avaliamos cinco eventos negativos ocorridos na infância: (i) a perda de alguém próximo, (ii) abuso emocional, (iii) abuso físico, (iv) violência familiar e (v) abuso sexual. Todos os participantes preencheram a escala de Liebowitz para ansiedade social. RESULTADOS: A média (DP) de idade foi de 21 anos (4,5); 75% eram do sexo feminino; o escore na LSAS foi 40 (DP = 22); 14,2% tinham história psiquiátrica familiar e 50,6% tiveram eventos negativos durante a infância. A análise de regressão linear, após o controle para idade, sexo e história psiquiátrica familiar, mostraram associação positiva entre violência familiar e escore de ansiedade social (p = 0,03). Nenhum dos fatores estressores restantes produziu aumento significativo no escore da LSAS (p > 0,05). CONCLUSÃO: Os estudantes universitários com altos níveis de ansiedade social apresentaram prevalência maior de eventos negativos precoces. Portanto, a violência familiar na infância pode ser um fator de risco para ansiedade social em tal população.

INTRODUCTION: There is substantial evidence regarding the impact of negative life events during childhood on the aetiology of psychiatric disorders. We examined the association between negative early life events and social anxiety in a sample of 571 Spanish University students. METHODS: In a cross-sectional survey conducted in 2007, we collected data through a semistructured questionnaire of sociodemographic variables, personal and family psychiatric history, and substance abuse. We assessed the five early negative life events: (i) the loss of someone close, (ii) emotional abuse, (iii) physical abuse, (iv) family violence, and (v) sexual abuse. All participants completed the Liebowitz Social Anxiety Scale. RESULTS: Mean (SD) age was 21 (4.5), 75% female, LSAS score was 40 (DP = 22), 14.2% had a psychiatric family history and 50.6% had negative life events during childhood. Linear regression analyses, after controlling for age, gender, and family psychiatric history, showed a positive association between family violence and social score (p = 0.03). None of the remaining stressors produced a significant increase in LSAS score (p > 0.05). CONCLUSION: University students with high levels of social anxiety presented higher prevalence of negative early life events. Thus, childhood family violence could be a risk factor for social anxiety in such a population.

INTRODUÇÃO: Os transtornos de ansiedade estão frequentemente associados a vários quadros clínicos não psiquiátricos. Dentre os quadros clínicos associados à ansiedade destaca-se a hipermobilidade articular (HA). Objetivo: Realizar uma revisão sistemática da associação entre os transtornos de ansiedade e a HA. MÉTODO: Foi realizada uma pesquisa nos bancos de dados MEDLINE, PsychINFO, LILACS e SciELO em busca de artigos publicados até dezembro de 2011. Usamos as palavras-chave anxiety , joint e hypermobility e os operadores boolianos. A revisão incluiu artigos que descrevem estudos empíricos sobre a associação entre ansiedade e HA. As listas de referências dos artigos selecionados foram sistematicamente pesquisadas à mão em busca de publicações relevantes para a revisão. RESULTADOS: Dezessete artigos foram incluídos na análise e classificados para uma melhor extração dos dados. Encontramos heterogeneidade entre os estudos relacionada à metodologia utilizada. A maioria dos estudos encontrou associação entre as características de ansiedade e HA. Transtorno do pânico com agorafobia foi o transtorno de ansiedade associado à HA em vários estudos. A explicação etiológica da relação entre ansiedade e HA permanece controversa. CONCLUSÃO: Estudos futuros com amostras maiores de indivíduos da comunidade e de cenários clínicos e estudos longitudinais da associação entre ansiedade e HA e dos mecanismos biológicos subjacentes envolvidos nessa associação são bem-vindos.

BACKGROUND: Anxiety disorders are often associated with several non-psychiatric medical conditions. Among the clinical conditions found in association with anxiety stands out the joint hypermobility (JH). OBJECTIVES: To carry out a systematic review of the clinical association between anxiety disorders and JH. METHOD: A survey was conducted in MEDLINE, PsychINFO, LILACS e SciELO databases up to December 2011. We searched for articles using the keywords 'anxiety', 'joint' and 'hypermobility' and Boolean operators. The review included articles describing empirical studies on the association between JH and anxiety. The reference lists of selected articles were systematically hand-searched for other publications relevant to the review. RESULTS: Seventeen articles were included in the analysis and classified to better extract data. We found heterogeneity between the studies relate to the methodology used. Most of the studies found an association between anxiety features and JH. Panic disorder/agoraphobia was the anxiety disorder associated with JH in several studies. Etiological explanation of the relationship between anxiety and JH is still controversial. CONCLUSION: Future research in large samples from the community and clinical setting and longitudinal studies of the association between anxiety and HA and the underlying biological mechanisms involved in this association are welcome.