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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

OBJETIVO: Revisar a eficácia do placebo em comparação com a dos antipsicóticos atípicos e típicos no tratamento da esquizofrenia e do transtorno esquizoafetivo, bem como avaliar a pertinência do uso do placebo nos ensaios clínicos com antipsicóticos. MÉTODO: Foram incluídos estudos nos quais os antipsicóticos atípicos foram comparados com antipsicóticos típicos e placebo simultaneamente. A pesquisa bibliográfica incluiu os termos "amisulprida", "aripiprazol", "clozapina", "olanzapina", "quetiapina", "risperidona", "sertindol", "ziprasidona" e "zotepina". Os principais parâmetros de eficácia foram a proporção de "eventos" (definidos como deterioração ou falta de melhora de pelo menos 20% na Positive and Negative Syndrome Scale ou Brief Psychiatric Rating Scale) e os riscos relativos combinados (efeitos randômicos), com seus respectivos intervalos de confiança de 95%. Foram também estimados os tamanhos de amostras nos estudos em que a droga pesquisada fosse comparada com um antipsicótico típico ou com placebo. RESULTADOS: As taxas de eficácia combinada foram de 40,8%, 34,9% e 21,3%, respectivamente, para os antipsicóticos atípicos, antipsicóticos típicos e placebo. Cento e sessenta e seis pacientes teriam de ser incluídos quando a nova droga fosse comparada com placebo se os cálculos fossem baseados na diferença de 20% encontrada entre o antipsicótico atípico e placebo, ao passo que 2.054 teriam de ser incluídos se a diferença procurada fosse aquela encontrada entre o antipsicótico atípico e o antipsicótico típico, isto é, 6%. Os insucessos terapêuticos estimados seriam de 115 entre os 166 pacientes quando a droga em estudo fosse comparada com placebo, e de 1.274 entre os 2.054 pacientes quando fosse comparada com um antipsicótico típico. CONCLUSÕES: Os estudos controlados por placebo podem reduzir o número de indivíduos expostos aos efeitos prejudiciais de drogas ineficazes.

OBJECTIVE: To review the efficacy of placebo in comparison with atypical and typical antipsychotics for the treatment of schizophrenia and schizoaffective disorder and to evaluate the pertinence of using placebo in clinical trials with antipsychotics. METHOD: Trials in which the atypical antipsychotics were compared with typical antipsychotics and placebo were included. A search was conducted using the terms "amisulpride", "aripiprazole", "clozapine", "olanzapine", "quetiapine", "risperidone", "sertindole", "ziprasidone" and "zotepine". Main efficacy parameters were calculated using the proportion of "events" (defined as a deterioration or lack of improvement by at least 20% in Positive and Negative Syndrome Scale or Brief Psychiatric Rating Scale) and the pooled relative risk with random effects, with their respective 95% confidence intervals. We also calculated the necessary sample sizes in studies in which the study drug is compared to a typical antipsychotic or placebo. RESULTS: The pooled efficacy rates observed were 40.8%, 34.9% and 21.3% for the atypical antipsychotics, typical antipsychotics and placebo, respectively. One hundred and sixty six patients would have to be included when a new drug is compared with placebo if calculation is based on a difference of 20% found between the atypical antipsychotic and placebo and 2,054 if the difference sought were that found between the atypical antipsychotic and the typical antipsychotic, i.e. 6%. The estimated therapeutic failures would be 115 of the 166 patients when the study drug is compared with placebo, and 1,274 failures in the 2,054 patients when the study drug is compared to the typical antipsychotic. CONCLUSIONS: Placebo controlled studies may reduce the number of individuals exposed to the harmful effects of ineffective drugs.

The aim of our study was to determine the impact of psychiatric comorbidities on the health-related quality of life of HCV-infected patients. Assessment of clinical, socio-demographic and quality of life data of the patients followed up at a Hepatology unit was performed by using a standard questionnaire and the SF-36 instrument. Psychiatric diagnoses were confirmed by using the Mini International Neuropsychiatric Interview, Brazilian version 5.0.0 (MINI Plus). Evaluation using the MINI plus demonstrated that 46 (51%) patients did not have any psychiatric diagnosis, while 44 (49%) had at least one psychiatric diagnosis. Among patients with a psychiatric comorbidity, 26 (59.1%) had a current mental disorder, out of which 22 (84.6%) had not been previously diagnosed. Patients with psychiatric disorders had lower scores in all dimensions of the SF-36 when compared to those who had no psychiatric diagnosis. Scores of physical functioning and bodily pain domains were lower for those suffering from a current psychiatric disorder when compared to those who had had a psychiatric disorder in the past. Females had lower scores of bodily pain and mental health dimensions when compared to males. Scores for mental health dimension were also lower for patients with advanced fibrosis. The presence of a psychiatric comorbidity was the variable that was most associated with the different scores in the SF-36, compared to other variables such as age, gender, aminotransferase levels, and degree of fibrosis.

OBJETIVO: Descrever o uso de técnicas cognitivas e revisar os estudos de eficácia da terapia cognitivo-comportamental no tratamento da depressão. MÉTODO: Revisão não-sistemática proveniente dos estudos originais, complementada por informações provenientes de metanálises e livros-texto especializados. RESULTADOS: Foram descritos os fundamentos da terapia cognitivo-comportamental no tratamento da depressão e revisadas as evidências de eficácia em curto e longo prazo. Discutimos igualmente o uso de tratamento farmacológico concomitante à terapia cognitivo-comportamental. CONCLUSÕES: A terapia cognitivo-comportamental é uma das abordagens que apresentam mais evidências empíricas de eficácia no tratamento da depressão, quer oferecida de forma isolada ou em combinação com farmacoterapia.

OBJECTIVE: To describe the use of cognitive techniques and to review studies on the efficacy of CBT in the treatment of depression. METHOD: A non-systematic review of the literature of original studies complemented with data from meta-analyses and specialized textbooks. RESULTS: The fundamentals of cognitive-behavioral therapy in the treatment of depression are described and the evidence of short- and long-term efficacy is reviewed. The use of pharmacological therapy in conjunction with CBT is also discussed. CONCLUSIONS: CBT in the treatment of depression is one of the therapeutic modalities with the highest empirical evidence of efficacy, whether applied alone or in combination with pharmacotherapy.