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VALIDITY OF THE BRAZILIAN-PORTUGUESE VERSION OF MOOREHEAD-ARDELT QUALITY OF LIFE QUESTIONNAIRE II AMONG PATIENTS WITH SEVERE OBESITY
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Cremonesi, Mariane de Carvalho

; Duarte-Guerra, Leorides

; Pajecki, Denis

; Santo, Marco Aurelio

; Lotufo Neto, Francisco

; Wang, Yuan-Pang

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2023, Volume 36 elocation e1767

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

ABSTRACT BACKGROUND: Patients with obesity present multiple comorbid psychiatric conditions and experience impairments in health-related quality of life. Reliable and valid tools that evaluate health-related quality of life are essential for clinical practice. AIMS: This study aimed to investigate the reliability and validity of the six-item Moorehead-Ardelt Quality of Life Questionnaire II among Brazilian patients with severe obesity. METHODS: We assessed 387 patients (mean age 43 years, 78.8% women, mean body mass index of 46.5 kg/m²) on the waiting list of a bariatric surgery center. Trained research assistants concurrently applied the Moorehead-Ardelt Quality of Life-II, the Montgomery-Åsberg Depression Rating Scale, and the Global Assessment of Functioning for assessing health-related quality of life, comorbid depressive symptoms, and patient functioning level, respectively. RESULTS: The internal consistency of the Moorehead-Ardelt Quality of Life-II was considered acceptable. The total score was correlated with the severity of depressive symptoms and functioning level. The more body mass index increases, the more health-related quality of life worsens. The Moorehead-Ardelt Quality of Life-II presented a unidimensional structure. CONCLUSIONS: The unidimensional Moorehead-Ardelt Quality of Life-II is a reliable and valid measure for evaluating health-related quality of life in Brazilian patients with severe obesity. The questionnaire allows to quickly assess the health-related quality of life of patients in different bariatric contexts, considering depression and functional level.

RESUMO RACIONAL: Pacientes com obesidade apresentam múltiplas condições psiquiátricas comórbidas e experienciam prejuízos na qualidade de vida relacionada à saúde. Ferramentas confiáveis e válidas que avaliam a qualidade de vida relacionada à saúde são essenciais para a prática clínica. OBJETIVOS: Este estudo teve como objetivo investigar a confiabilidade e validade do Moorehead-Ardelt Quality of Life-II de seis itens entre pacientes com obesidade grave. MÉTODOS: Foram avaliados 387 pacientes (idade média de 43 anos, 78,8% mulheres, índice de massa corporal (IMC) médio de 46,5 kg/m², na lista de espera de um centro cirurgia bariátrica. Assistentes de pesquisa treinados aplicaram simultaneamente o Moorehead-Ardelt Quality of Life-II, a Escala de Depressão de Montgomery-Åsberg e a Avaliação Global do Funcionamento para avaliar, respectivamente, a qualidade de vida relacionada à saúde, os sintomas depressivos comórbidos e o nível funcional do paciente. RESULTADOS: A consistência interna do Moorehead-Ardelt Quality of Life-II foi considerada aceitável. A pontuação total do Moorehead-Ardelt Quality of Life-II foi correlacionada com a gravidade dos sintomas depressivos e nível funcional. Quanto maior o IMC, menor a qualidade de vida relacionada à saúde. O Moorehead-Ardelt Quality of Life-II apresentou uma estrutura unidimensional. CONCLUSÕES: O questionário Moorehead-Ardelt Quality of Life-II unidimensional é confiável e válido na avaliação da qualidade de vida relacionada à saúde em pacientes brasileiros com obesidade grave. O questionário permite avaliar rapidamente a qualidade de vida relacionada à saúde dos pacientes em diferentes contextos, considerando depressão e nível funcional.

https://doi.org/10.1590/0102-672020230049e1767

Scientific diving in Brazil: history, present and perspectives
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Leite, Tatiana S.

; Pinheiro, Igor E.

; Berchez, Flávio

; Bertoncini, Áthila A.

; Cima, Oswaldo M. Del

; Demetrescu, Irene E.

; Francini-Filho, Ronaldo B.

; Kikuchi, Ruy K.P

; Machado, Arthur A.

; Maia-Nogueira, Rodrigo

; Martins, Flavio L.

; Mendes, Liana F.

; Rambelli, Gilson

; Sampaio, Claudio L.S.

; Segal, Barbara

; Aguiar, Aline A.

; Auler, Augusto S.

; Barroco-Neto, José

; Bonaldo, Roberta M.

; Buchmann, Francisco S.

; Calippo, Flavio

; Cesar, Augusto

; Gama, Matheus A.C.

; Ghilardi-Lopes, Natalia

; Leão, Zelinda M.A.N.

; Lessa, Guilherme C.

; Menegola, Carla

; Pinheiro, Hudson T.

; Rocha, Luiz A.

; Sabino, José

; Seoane, José C.S.

; Sestokas, Julia

; Tiago, Cláudio C.

; Wegner, Ewerton

; Lotufo, Tito

Ocean and Coastal Research

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2023, Volume 71 elocation e23045

Abstract: En | Text: En | PDF: En

Abstract Scientific diving (SD) is defined as any diving activity that applies scientific procedures to produce subsidies for studies and technical works in underwater environments. The first report of an underwater scientific study in Brazil dates to the 19th century, in the Abrolhos reefs. Currently, in Brazil, scientific diving has been performed in various areas, from shallow coastal regions to remote and sometimes hard-to-reach places, such as oceanic islands, flooded caves, and icy areas like Antarctica. However, the regulation of SD in Brazil still lacks more concrete actions towards an effective and efficient self-regulation that offers physical safety to practitioners and institutional safeguards for organizations that use it in their research projects. Thus, this article aims to contribute to a better understanding of this critical issue in Brazil and to serve as a reference and incentive for the training of professionals and the development of these activities in the country. It includes: 1) a historical review of SD; 2) a diagnosis of the training and application of SD in Brazil; 3) the evolution of marine sciences in Brazil from the perspective of SD; 4) a review of the use of environmental assessment and underwater conservation techniques in oceans and internal waters; 5) an analysis of the evolution of scientific diver training in Brazil, including a diagnosis on training; 6) the history and updates of the rules, regulations, and safety of SD. Given all the potential of diving combined with specific techniques for research, monitoring, and marine and limnic science in Brazil, we aim to understand the evolution of scientific diving teaching and to outline perspectives in the country, as it is crucial for the training of qualified scientists capable of performing these underwater tasks. Finally, we present future plans for the development of this activity in Brazil from the point of view of research and the labor market.

https://doi.org/10.1590/2675-2824071.23036tsl

Relationships between worry and depressive symptoms during two group therapies for generalized anxiety disorder
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Martins, Daniel Santos

; Sampaio, Thiago Pacheco de Almeida

; Lotufo Neto, Francisco

Jornal Brasileiro de Psiquiatria

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jun 2022, Volume 71 N. 2 Pages 100 - 107

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

RESUMO Objetivo: O transtorno de ansiedade generalizada (TAG) é um diagnóstico crônico e incapacitante, associado a diversos prejuízos e com relevante prevalência na população mundial e na brasileira. Este estudo tem por objetivo investigar a relação longitudinal de duas manifestações relevantes para o transtorno (preocupação e sintomas depressivos), utilizando uma análise cross-lagged panel model (CLPM) por meio de dados de um ensaio clínico randomizado (ECR). Métodos: Um total de 92 pacientes adultos com TAG foi randomizado para duas psicoterapias em grupo: terapia comportamental baseada em aceitação (TCBA) ou terapia de apoio não diretiva (TAND). Cada grupo teve duração de 10 sessões, distribuídas em 14 semanas. O tratamento teve quatro tempos de medida: linha de base, meio do tratamento, pós-tratamento e seguimento de três meses. As variáveis investigadas foram: preocupações, medidas pelo Penn State Worry Questionnaire (PSWQ), e sintomas depressivos, medidos pela Depression Anxiety Stress Scales (DASS-D). Os modelos CLMP foram gerados pelo programa Mplus. Resultados: O modelo do grupo TAND revelou duas rotas significativas: preocupação para sintomas depressivos (primeira onda) e sintomas depressivos para preocupação (segunda onda). Não houve outro efeito cross-lagged que obteve significância estatística. Esses dados mostram que houve influência alternada entre os sintomas somente durante o período de um dos dois tratamentos testados, configurando um padrão heterogêneo das rotas cross-lagged . Conclusão: A psicoterapia suportiva em grupo potencialmente interfere no padrão da relação direta entre preocupação e sintomas depressivos em adultos com TAG.

ABSTRACT Objective: Generalized anxiety disorder (GAD) is a chronic and disabling disorder associated with various impairments and shows a significant prevalence in the worldwide and Brazilian populations. This study aimed to investigate the longitudinal relationship of two symptoms relevant to the disorder (worry and depressive symptoms) in the context of a randomized clinical trial (RCT) by using a cross-lagged panel model (CLPM) analysis. Methods: A total of 92 adult patients with GAD were randomized to receive ten sessions of either acceptance‐based group behavioral therapy (ABBT) or nondirective supportive group therapy (NDST). Treatment had four time-point measures. Worries were measured using the Penn State Worry Questionnaire (PSWQ), and depression was measured using the Depression Anxiety Stress Scales (DASS-D). Results: The NDST model revealed significant paths from worry to depression (first wave) and from depression to worry (second wave). There was no other significant cross-lagged effect. These data show that there was an influence between symptoms only during one of the treatment groups, and without a homogeneous and constant pattern in any of the cross-lagged routes. Conclusion: A supportive group psychotherapy potentially interferes with the pattern of the direct relationship between worries and depressive symptoms in adults with GAD.

https://doi.org/10.1590/0047-2085000000361

Suicide among college students: much ado about nothing?
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Altavini, Camila Siebert

; Asciutti, Antonio Paulo Rinaldi

; Solis, Ana Cristina Oliveira

; Santana, Geilson Lima

; Lotufo-Neto, Francisco

; Wang, Yuan-Pang

Brazilian Journal of Psychiatry

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apr 2022, Volume 44 N. 2 Pages 217 - 217

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-4446-2021-2376

Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial
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El Rafihi-Ferreira, Renatha

; Morin, Charles M.

; Toscanini, Andrea C.

; Lotufo Neto, Francisco

; Brasil, Israel S.

; Gallinaro, João G.

; Borges, Daniel Suzuki

; Conway, Silvia G.

; Hasan, Rosa

Brazilian Journal of Psychiatry

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oct 2021, Volume 43 N. 5 Pages 504 - 509

Abstract: En | Text: En | PDF: En

Objective: To evaluate a protocol for acceptance and commitment therapy-based behavioral intervention for insomnia (ACT-BBI-I) in adults compared to cognitive behavioral therapy for insomnia (CBT-I). Methods: Forty-five adults with chronic insomnia were randomized to ACT-BBI-I or CBT-I. Both interventions were performed in six weekly group sessions. The common treatment elements in both protocols included stimulus control and sleep restriction. CBT-I is focused on the cognitive restructuring of maladaptive beliefs about sleep and the daytime effects of insomnia. ACT-BBI-I focuses on therapeutic processes of acceptance, availability, values, defusion, and commitment. The results were evaluated through the following instruments: a sleep diary, the Insomnia Severity Index, the Epworth Sleepiness Scale, the Hospital Anxiety and Depression Scale, the Acceptance and Action Questionnaire-II, and the Dysfunctional Beliefs and Attitudes about Sleep scale. Results: Both interventions had a significant positive impact on sleep patterns, insomnia, anxiety, beliefs about sleep, and psychological flexibility. All improvement was maintained at the 6-month follow-up. Conclusion: The results suggest that integrating principles of ACT with behavioral techniques may be useful for treating insomnia. Further research should identify whether the principles of ACT result in added effectiveness compared to behavioral components alone. Clinical trial registration: RBR-7nc5wq

https://doi.org/10.1590/1516-4446-2020-0947 330 downloads

Personality Impairment in Children and Adolescents with ADHD
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Haddad, Anna Helena

; Yazig, Latife

; Resende, Ana Cristina

; Areco, Kelsy Catherina Nema

; Semer, Norma Lottenberg

; Lotufo Neto, Francisco

Paidéia (Ribeirão Preto)

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2021, Volume 31 elocation e3105

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

Resumo O transtorno da falta de atenção com hiperatividade em crianças e adolescentes manifesta-se de forma heterogênea com relação aos aspectos de personalidade. O presente estudo teve por objetivo avaliar, por meio do Índice de Enfraquecimento do Ego, características do funcionamento da personalidade de crianças e adolescentes, entre 9 e 15 anos incompletos, com o diagnóstico do transtorno (grupo clínico) e compará-las com um grupo não-clínico. Os grupos contemplaram 42 participantes cada. Utilizou-se para o diagnóstico a entrevista Kiddie-Sads Referente ao Momento Presente e ao Longo da Vida, e o Sistema de Avaliação por Performance no Rorschach (R-PAS) para as características de personalidade. Os participantes do grupo clínico, quando comparados com seus pares, mostraram capacidade de discernir comportamentos adaptativos por meio de julgamento adequado, dificuldade em manter estáveis os processos de pensamento e raciocínio, visão negativa de si próprios e dos demais, dificuldade para estabelecer relacionamentos cooperativos.

Abstract Attention deficit hyperactivity disorder in children and adolescents manifests itself in a heterogeneous manner as regards personality aspects. This study aimed to evaluate, by using the Ego Impairment Index, the personality functioning characteristics of children and adolescents between 9 and 15 years old (to be completed), diagnosed with the disorder (clinical group) and compare them with a non-clinical group. The groups included 42 participants each. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version was used for diagnosis, and the Rorschach Performance Assessment System (R-PAS) was utilized for personality traits. When compared to their peers, the participants in the clinical group showed ability to discern adaptive behaviors through proper judgment, difficulty in keeping thinking and reasoning processes stable, a negative view of themselves and others, in addition to difficulty in establishing cooperative relationships.

Resumen El trastorno por déficit de atención con hiperactividad es uno de los más encontrados entre las patologías infantiles y se manifiesta de forma no homogénea con relación a los aspectos de personalidad. Este estudio comparó a través de lo Índice de Enflaquecimiento del Ego características de personalidad de niños y adolescentes entre 9 y 15 años incompletos con diagnóstico con un grupo de mismo sexo y edad sin diagnóstico. Cada grupo estaba compuesto por 42 participantes. Se utilizó la entrevista Kiddie-Sads sobre el momento presente y al largo de la vida para el diagnóstico y el Sistema de Evaluación por Performance en el Rorschach (R-PAS), para las características de personalidad. El grupo clínico mostró capacidad para discernir conductas adaptativas a través del juicio adecuado, dificultad para mantener estables los procesos de pensamiento y razonamiento, visión negativa de sí mismos y de los demás, dificultad para establecer relaciones de cooperación.

https://doi.org/10.1590/1982-4327e3105 1963 downloads

O lugar dos ensaios clínicos aleatorizados na pesquisa em psicoterapia: uma crítica epistemológica
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Sampaio, Thiago Pacheco de Almeida

; Lotufo Neto, Francisco

Psicologia USP

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2021, Volume 32 elocation e200015

Resumo O Ensaio Clínico Aleatorizado (ECA) é considerado o tipo de desenho metodológico com maior poder de verificação da eficácia das psicoterapias. Entretanto, especialmente a partir da segunda metade do século XX, muitas críticas direcionadas às concepções epistemológicas subjacentes às ditas “ciências duras” atingiram também, no âmbito das ciências da saúde, os estudos que adotavam esse desenho. Este artigo é uma reflexão crítica sobre algumas das objeções feitas aos ECAs, avaliando de que maneira e até que ponto estes poderiam se configurar como estratégia válida de investigação científica no contexto crítico apontado. Conclui-se que o ECA pode e deve ser utilizado - desde que em contexto crítico - por seu valor pragmático, enquanto produtor de predições e intervenções capazes de solucionar problemas clínicos, inevitavelmente definidos e estabelecidos a partir do ponto de vista particular de uma comunidade.

Abstract The randomized controlled clinical trial (RCT) is considered the type of methodological design with the greatest power to verify the efficacy of psychotherapies. However, especially from the second half of the twentieth century, many criticisms directed at the epistemological conceptions underlying the so-called “hard sciences” have also affected the studies that adopted this design. This article is a critical reflection on some of the objections made to randomized clinical trials, evaluating how and to what extent these trials could be configured as a valid scientific research strategy in this critical context. We concluded that the RCT should be used - as long as it is performed in a critical context - due to its pragmatic value, as a producer of predictions and interventions capable of solving clinical problems, inevitably defined and established from the particular point of view of a community.

Resumen El ensayo clínico aleatorizado (ECA) se considera el tipo de diseño metodológico con mayor poder para verificar la eficacia de las psicoterapias. Sin embargo, especialmente desde la segunda mitad del siglo XX, muchas críticas dirigidas a las concepciones epistemológicas subyacentes a las llamadas “ciencias duras” también han afectado, dentro del alcance de las ciencias de la salud, los estudios que adoptan este diseño. Este artículo es una reflexión crítica sobre algunas de las objeciones hechas a los ECA, evaluando cómo y en qué medida podrían configurarse como una estrategia de investigación científica válida en este contexto crítico. Se concluye que el ECA puede y debe usarse, siempre y cuando se encuentre en un contexto crítico, por su valor pragmático como productor de predicciones e intervenciones capaces de resolver los problemas clínicos inevitablemente definidos y establecidos desde el punto de vista particular de una comunidade.

Résumé L’essai clinique randomisé est considéré comme le type de conception méthodologique ayant le plus puissant pour vérifier l’efficacité des psychothérapies. Cependant, surtout depuis la seconde moitié du XXe siècle, de nombreuses critiques adressées aux conceptions épistémologiques qui sous-tendent les sciences dites « dures » ont également affecté, dans le cadre des sciences de la santé, les études qui ont adopté cette conception. Cet article est une réflexion critique sur certaines des objections faites aux essais cliniques randomisés, évaluant comment et dans quelle mesure ceux-ci pourraient être configurés comme une stratégie valide de recherche scientifique dans le contexte critique signalé. On en conclu que l’ECA peut et doit être utilisé - à condition que ce soit dans un contexte critique - pour sa valeur pragmatique, en tant que producteur de prédictions et d’interventions capables de résoudre des problèmes cliniques, inévitablement définies et établies du point de vue particulier d’une communauté.

https://doi.org/10.1590/0103-6564e200015 71 downloads

Cinema brasileiro e o ensino dos transtornos da personalidade
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Honorato, Tabata Galindo

; Mazzaia, Maria Cristina

; Avezani, Amanda Carolina Franciscatto

; Lotufo Neto, Francisco

Revista Brasileira de Educação Médica

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2021, Volume 45 N. 2 elocation e096

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

Resumo: Introdução: O uso de filmes comerciais em sala de aula é uma prática comum e acessível. A prática de exibição de filmes para o ensino é definida pelo termo cinemeducation. Objetivo: O presente estudo partiu da hipótese de que o cinemeducation, como metodologia ativa, poderia contribuir para o aprendizado dos transtornos da personalidade (TP) na graduação. Foram ministradas aulas presenciais para 213 estudantes de Medicina, Enfermagem, Psicologia, Fisioterapia e Fonoaudiologia, para avaliar o conhecimento desenvolvido sobre TP. Método: O estudo é transversal e quantitativo, composto por amostras pareadas e dependentes (antes e depois). As etapas foram: 1. aplicação de instrumento avaliativo em forma de questionário (antes); 2. aula composta por exibição de cenas de filmes brasileiros e reflexão e discussão sobre elas; 3. aplicação do mesmo questionário (depois); e 4. análise estatística comparativa entre os resultados. Resultados: O método se mostrou efetivo para o processo ensino-aprendizagem, havendo melhora autorreferida no conhecimento dos estudantes após a aula (questão 1) e melhora observável ao identificarem e conceituarem os TP (questão 3). Além disso, os estudantes referiram, em média, que a estratégia contribuía para a aprendizagem, antes da aula, e mantiveram em média essa opinião, depois (questão 2). Conclusões: Alcançou-se o objetivo proposto porque se utilizou amostra estatisticamente significativa de estudantes, e os resultados confirmaram que o método é efetivo para o ensino. Além disso, a discussão evidenciou que o uso dos filmes pode contribuir para o o aprendizado, condizendo com as características de estudantes da geração atual, uma vez que valoriza o uso de tecnologias em sala de aula e permite o aprendizado crítico-reflexivo e a participação ativa dos sujeitos. As limitações do estudo se referem à escassez de filmes brasileiros contemporâneos que exemplifiquem todos os TP, não havendo cenas representativas para TP esquizotípica, dependente e esquiva. Além disso, considera-se necessário estudo comparativo entre o método tradicional de ensino dos TP e o cinemeducation, de forma a investigar a eficácia deste quando comparado às aulas tradicionais.

Abstract: Introduction: The use of commercial films in the classroom is a common and accessible practice. The practice of showing films for teaching is defined by the term cinemeducation. Objective: The present study was based on the hypothesis that cinemeducation, as an active methodology, could contribute to the learning of Personality Disorders (PD) during undergraduate training. Face-to-face classes were given to 213 students of medicine, nursing, psychology, physiotherapy and speech therapy, to assess the knowledge developed about PD. Method: The study is cross-sectional and quantitative, composed of paired and dependent samples (before and after). The steps were: a) application of an assessment tool in the form of a questionnaire (before); b) class, consisting of exhibition, reflection and discussion of scenes from Brazilian films, c) application of the same questionnaire (after), and d) comparative statistical analysis between the results. Results: The results showed that the method is effective for the teaching-learning process, with self-reported improvement in students’ knowledge after class (question 1), and an observable improvement when identifying and conceptualizing PD (question 3). Furthermore, students reported, on average, that the strategy contributed to learning, before class, and they maintained that opinion, on average, afterwards (question 2). Conclusions: The proposed objective was achieved by using a statistically significant sample of students and the results confirmed that the method is effective for teaching. The discussion showed that the use of films can improve learning, and it is consistent with the characteristics of students of the actual generation, since it values the use of technologies in the classroom, allowing critical-reflective teaching and the active student participation. The limitations of the study include the scarcity of contemporary Brazilian films that exemplify all PDs, with no representative scenes for schizotypical, dependent and avoidant PD. Furthermore, a comparative study between the traditional method of teaching PD and cinemeducation is considered necessary in order to investigate its effectiveness when compared to traditional classes.

https://doi.org/10.1590/1981-5271v45.2-20200176 240 downloads

The impact of COVID-19 on Brazilian mental health through vicarious traumatization
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Serafim, Antonio de P.

; Gonçalves, Priscila D.

; Rocca, Cristiana C.

; Lotufo Neto, Francisco

Brazilian Journal of Psychiatry

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aug 2020, Volume 42 N. 4 Pages 450 - 450

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-4446-2020-0999 1355 downloads

10.

Predictors of quality of life in Brazilian medical students: a systematic review and meta-analysis
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Solis, Ana C.

; Lotufo-Neto, Francisco

Brazilian Journal of Psychiatry

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dec 2019, Volume 41 N. 6 Pages 556 - 567

Abstract: En | Text: En | PDF: En

Objective: To examine predictors associated with quality of life (QoL) in Brazilian medical students. Methods: PubMed, PsycINFO, EMBASE, LILACS, and Google Scholar were searched for research articles in English or Portuguese published through August 2018. Observational studies that measured QoL with standard instruments were selected. Three instruments were used to evaluate QoL: the World Health Organization QoL questionnaires (WHOQOL-Bref and WHOQOL-100) and 36-item Short Form Health Survey (SF-36). Hedges’ g was used to calculate effect sizes. A random-effects model was used in meta-analyses. PRISMA guidelines were followed. Results: The initial search retrieved 8,504 articles; 24 met the eligibility criteria for systematic review, and seven for meta-analyses of gender (n=3,402 students). Predictors of QoL such as gender, years of medical school(years of study), economic class, educational environment, academic efficacy, depression, burnout, resilience, empathic concern, sleep difficulties, chronic illness, body mass index, and leisure-time physical activity were identified in the systematic review. The most frequent predictors of QoL detected in Brazilian medical students were associated with gender and years of study. Conclusions: Female medical students had lower QoL scores in the physical health and psychological domains of WHOQOL-Bref compared to male students. Specific interventions should be designed for this group as appropriate. Systematic review registry number: PROSPERO CRD-42018102259.

https://doi.org/10.1590/1516-4446-2018-0116 1532 downloads

11.

Treatment of anxiety disorders in clinical practice: a critical overview of recent systematic evidence
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Mangolini, Vitor Iglesias

; Andrade, Laura Helena

; Lotufo-Neto, Francisco

; Wang, Yuan-Pang

Clinics

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2019, Volume 74 elocation e1316

Abstract: En | Text: En | PDF: En

The aim of this study was to review emerging evidence of novel treatments for anxiety disorders. We searched PubMed and EMBASE for evidence-based therapeutic alternatives for anxiety disorders in adults, covering the past five years. Eligible articles were systematic reviews (with or without meta-analysis), which evaluated treatment effectiveness of either nonbiological or biological interventions for anxiety disorders. Retrieved articles were summarized as an overview. We assessed methods, quality of evidence, and risk of bias of the articles. Nineteen systematic reviews provided information on almost 88 thousand participants, distributed across 811 clinical trials. Regarding the interventions, 11 reviews investigated psychological or nonbiological treatments; 5, pharmacological or biological; and 3, more than one type of active intervention. Computer-delivered psychological interventions were helpful for treating anxiety of low-to-moderate intensity, but the therapist-oriented approaches had greater results. Recommendations for regular exercise, mindfulness, yoga, and safety behaviors were applicable to anxiety. Transcranial magnetic stimulation, medication augmentation, and new pharmacological agents (vortioxetine) presented inconclusive benefits in patients with anxiety disorders who presented partial responses or refractoriness to standard treatment. New treatment options for anxiety disorders should only be provided to the community after a thorough examination of their efficacy.

https://doi.org/10.6061/clinics/2019/e1316 4705 downloads

12.

The antisocial personality disorder in the Brazilian movies
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Honorato, Tabata Galindo

; Oliva, Vítor Hugo Sambati

; Castaldelli-Maia, João Mauricio

; Lotufo Neto, Francisco

Jornal Brasileiro de Psiquiatria

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jul 2018, Volume 67 N. 3 Pages 143 - 150

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

RESUMO Objetivo: O transtorno de personalidade antissocial (TPA) é um tema de interesse para alunos e profissionais da psiquiatria/saúde mental. O acesso aos aspectos psicopatológicos por meio de filmes é capaz de melhorar a compreensão acerca dos transtornos. Este estudo buscou avaliar a frequência do TPA e de seus critérios diagnósticos no cinema brasileiro, para o ensino. Métodos: O método consistiu em levantamento da amostra (por conveniência, dado que o estudo é recorte de outro projeto maior); aplicação de instrumento e análise dos resultados. Resultados: Entre os personagens, 44,73% foram diagnosticados com TPA. Todos os critérios diagnósticos para TPA se fizeram presentes. O critério mais frequente foi a prática de atos ilegais. A impulsividade esteve associada à agressividade em 29,4% dos casos e ao uso de substâncias psicoativas em quase 30% dos casos. Entre os personagens, 35,3% sofreram morte prematura e violenta. Conclusão: A pesquisa possibilitou identificar as características do TPA no cinema nacional. As trajetórias dos personagens contaram com trechos de realismo variável, mas muitas cenas foram capazes de representar o diagnóstico com clareza. Os dados se mostraram suficientes para indicar a potencialidade do material como base didático-pedagógica.

ABSTRACT Objective: The antisocial personality disorder (APD) is one theme of interest for psychiatry/mental health students and professionals. The access to psychopathology aspects by means of movies is able to improve the understanding about these disorders. This study aimed at evaluates the frequency of APD and of its diagnostic criteria in the Brazilian cinema for teaching purposes. Methods: The method consisted of survey sampling (for convenience, once the study is extracted from another greater project); use of a diagnostic instrument and analysis of the results. Results: 44.73% of the personalities were diagnosed with APD. All the diagnostic criteria for APD were present. The most frequent criterion was the practice of illegal acts. Impulsivity was associated with aggressiveness in 29.4% of the cases and with the use of psychoactive substances in almost 30% of the cases. 35.3% of the characters had a premature and violent death. Conclusion: The research enabled the identification of APD diagnostic criteria in the Brazilian cinema. Many scenes were able to represent the diagnosis clearly. The data proved to be sufficient in indicate the potentiality of the material as a didactic and pedagogical foundation.

https://doi.org/10.1590/0047-2085000000201 3901 downloads

13.

Factor structure and psychometric properties of the Dispositional Resilience Scale among Brazilian adult patients
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Solano, João Paulo Consentino

; Bracher, Eduardo Sawaya Botelho

; Faisal-Cury, Alexandre

; Ashmawi, Hazem Adel

; Carmona, Maria José Carvalho

; Lotufo Neto, Francisco

; Vieira, Joaquim Edson

Arquivos de Neuro-Psiquiatria

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dec 2016, Volume 74 N. 12 Pages 1014 - 1020

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

RESUMO Objetivo Verificar as propriedades psicométricas da versão brasileira da Escala de Resiliência Disposicional (DRS-15). Métodos A adaptação transcultural foi feita com 65 pacientes. A validação foi estudada pela aplicação do Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), Self-Report Questionnaire (SRQ) e outros instrumentos a 575 participantes de ambulatórios psiquiátricos (transtorno borderline de personalidade, ansiedade ou transtorno de estresse pós-traumático) e não-psiquiátricos (dor crônica, avaliação pré-anestésica ou acompanhantes). A estabilidade foi verificada com 123 participantes. Resultados A análise exploratória revelou três fatores, com propriedades aceitáveis (alfa de 0,71; coeficiente de correlação intraclasse de 0,81). Notaram-se correlações com o ISSL, SRQ e demais instrumentos, exceto para o fator 3. Na amostra psiquiátrica, a resiliência disposicional dos pacientes borderlines foi menor que a dos pacientes com transtornos de ansiedade. Conclusão Esta versão da DRS-15 apresentou boa confiabilidade numa amostra de adultos; a validade foi confirmada para dois fatores da escala.

ABSTRACT Objective Verifying the psychometrics of a Brazilian version of the Dispositional Resilience Scale (DRS-15). Methods Cross-cultural adaptation was done interviewing 65 adult patients. Validation was evaluated by application of the Lipp Brazilian Stress Symptoms Inventory (ISSL), Self-Report Questionnaire (SRQ), and other measures to 575 participants from the psychiatric ambulatories (for borderline personality, anxiety or post-traumatic stress disorders) and non-psychiatric ambulatories (chronic pain, pre-anesthetic consultation and companions for the latter). Temporal stability was verified with 123 participants. Results Exploratory factor analysis yielded a three-factor solution. Psychometrics were acceptable (alpha coefficient, 0.71; intraclass correlation coefficient, 0.81). Correlations with the ISSL, SRQ and other measures were noted except for factor 3. In the psychiatric sample, hardiness scores of borderline patients were lower than those of patients with anxiety disorders. Conclusion This version of the DRS-15 exhibited good reliability in a sample of Brazilian patients; validity was confirmed in two of the scale factors.

https://doi.org/10.1590/0004-282x20160148 3525 downloads

14.

Factor structure and psychometric properties of the Connor-Davidson resilience scale among Brazilian adult patients
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Solano, João Paulo Consentino

; Bracher, Eduardo Sawaya Botelho

; Faisal-Cury, Alexandre

; Ashmawi, Hazem Adel

; Carmona, Maria José Carvalho

; Lotufo Neto, Francisco

; Vieira, Joaquim Edson

Sao Paulo Medical Journal

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oct 2016, Volume 134 N. 5 Pages 400 - 406

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

RESUMO: CONTEXTO E OBJETIVO: A resiliência pessoal está associada a diversos desfechos em saúde mental. A escala de resiliência de Connor-Davidson (CD-RISC) vem sendo amplamente empregada como uma medida autorrelatada de resiliência. Este estudo teve por objetivo verificar a confiabilidade e a validade de uma versão da CD-RISC para o português no contexto cultural brasileiro. DESENHO E LOCAL: Estudo transversal de validação conduzido nos ambulatórios de hospital público universitário. MÉTODOS: De acordo com diretrizes bem conhecidas, a adaptação cultural foi feita com 65 adultos entrevistados em ambulatórios psiquiátricos e não psiquiátricos de um hospital de ensino. A validação se deu pela aplicação concorrente do Inventário de Stress para Adultos de Lipp (ISSL), Questionário de Autorrelato de Sintomas (SRQ), Escalas de Incapacidade de Sheehan (SDS) e Escala Graduada de Dor Crônica (CPG) a 575 pacientes do mesmo hospital. A estabilidade temporal foi verificada numa segunda aplicação a 123 participantes. RESULTADOS: A análise fatorial identificou quatro fatores, nomeados como tenacidade, adaptabilidade-tolerância, amparo e intuição. Um coeficiente alfa de 0,93 e um coeficiente de correlação intraclasse de 0,84 indicaram adequadas consistência interna e estabilidade temporal. Correlações significativas entre esta versão da CD-RISC e o ISSL, SRQ, SDS e CPG foram identificadas. Os pacientes do ambulatório para personalidade borderline tiveram escores de resiliência significativamente mais baixos que os pacientes dos ambulatórios geral de ansiedade ou de estresse pós-traumático. CONCLUSÃO: A presente versão em português da escala de resiliência de Connor-Davidson apresentou confiabilidade e validade adequadas numa amostra de pacientes brasileiros adultos.

ABSTRACT: CONTEXT AND OBJECTIVE: Personal resilience is associated with several mental health outcomes. The Connor-Davidson resilience scale (CD-RISC) is a widely used self-report measurement of resilience. This study aimed to investigate the reliability and validity of a Brazilian Portuguese version of the CD-RISC. DESIGN AND SETTING: Cross-sectional validation study carried out in the outpatient clinics of a public university hospital. METHODS: The cross-cultural adaptation followed established guidelines and involved interviews with 65 adults in psychiatric and non-psychiatric outpatient clinics at a teaching hospital. Validation was assessed through concurrent application of the Lipp Brazilian Stress Symptom Inventory (ISSL), Self-Report Questionnaire (SRQ), Sheehan Disability Scales (SDS) and Chronic Pain Grade (CPG) to 575 patients at the same setting. Temporal stability was verified through a second application to 123 participants. RESULTS: Factor analysis identified four factors, named tenacity, adaptability-tolerance, reliance on support from outside and intuition. The alpha coefficient of 0.93 and intraclass correlation coefficient of 0.84 indicated good internal consistency and temporal stability. Significant correlations between this version of the CD-RISC and the ISSL, SRQ, SDS and CPG were noted. The patients at the outpatient clinic for borderline personality had resilience scores that were significantly lower than those of the patients at the general anxiety or post-traumatic stress outpatient clinics. CONCLUSION: This Brazilian Portuguese version of the Connor-Davidson resilience scale exhibited adequate reliability and validity among a sample of Brazilian adult patients.

https://doi.org/10.1590/1516-3180.2015.02290512 3495 downloads

15.

Virtual reality exposure using three-dimensional images for the treatment of social phobia
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Gebara, Cristiane M.

; Barros-Neto, Tito P. de

; Gertsenchtein, Leticia

; Lotufo-Neto, Francisco

Brazilian Journal of Psychiatry

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mar 2016, Volume 38 N. 1 Pages 24 - 29

Abstract: En | Text: En | PDF: En

Objective: To test a potential treatment for social phobia, which provides exposure to phobia-inducing situations via computer-generated, three-dimensional images, using an open clinical trial design. Methods: Twenty-one patients with a DSM-IV diagnosis of social phobia took part in the trial. Treatment consisted of up to 12 sessions of exposure to relevant images, each session lasting 50 minutes. Results: Improvements in social anxiety were seen in all scales and instruments used, including at follow-up 6 months after the end of treatment. The average number of sessions was seven, as the participants habituated rapidly to the process. Only one participant dropped out. Conclusion: This study provides evidence that exposure to computer-generated three-dimensional images is relatively inexpensive, leads to greater treatment adherence, and can reduce social anxiety. Further studies are needed to corroborate these findings.

https://doi.org/10.1590/1516-4446-2014-1560 8036 downloads

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