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Associations between triarchic traits and mental health symptoms: the role of coping styles as mediators
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Carvalho, Lucas de Francisco

; de Oliveira, Cibelle

; Garcia, Maria Clara Romão Pontes Rolim

; Machado, Gisele Magarotto

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20230625

Abstract: En | Text: En | PDF: En

Abstract Objectives We investigated relationships between the triarchic model of psychopathy, coping styles, and externalizing and internalizing symptoms, and verified the mediating effect of coping styles. Methods Participants were 957 adults who answered the Triarchic Psychopathy Measure (TriPM), the Inventory of Depression and Anxiety Symptoms Expanded Version (IDAS-II), and the Crime and Analogous Behavior Scale (CAB). Results Data were analyzed using four path analyses to test our hypotheses, indicating each triarchic trait is differently associated with psychological symptoms and coping styles. We also observed preferences for some coping styles affecting the association between triarchic traits and psychological symptoms. Conclusion Our findings suggest that coping styles only affect the interaction between boldness and distress, as well as between boldness and fear, indicating that specific coping strategies can account for variations in distress and fear linked to boldness.

https://doi.org/10.47626/2237-6089-2023-0625

Concealing, tolerating, and adjusting to emotions in obsessive-compulsive and anxiety disorders: a cross-sectional study
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Loureiro, Carla P.

; Thompson, Emma M. Laurito, Luana D. Moreira-de-Oliveira, Maria E. Dias, Rafaela V. de Menezes, Gabriela B Fontenelle, Leonardo F.

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20230652

Abstract: En | Text: En | PDF: En

Abstract Objective Although research has shown that mood and anxiety disorders manifest disturbed emotion regulation, it is unclear whether anxiety disorders differ from each other in terms of their emotion regulation strategies. In the present study, we investigated whether patients with anxiety disorders present different affective styles. Methods We assessed the affective styles of 32 obsessive-compulsive disorder (OCD) patients, 29 social anxiety disorder (SAD) patients, 29 panic disorder (PD) patients, and 20 healthy controls using the Affective Style Questionnaire (ASQ). A multivariate analysis of covariance (MANCOVA) was conducted to compare affective styles across groups (OCD, SAD, PD, and control), while controlling for depression, anxiety symptoms, and age. Results The MANCOVA revealed a significant, small-medium, main effect of diagnostic group on affective styles. The planned contrasts revealed that OCD and SAD patients reported significantly lower scores for “tolerance” (ASQ-T) compared to the healthy controls. There were no differences between the PD group and healthy controls. Conclusion Our findings provide evidence that individuals with OCD and SAD have difficulty tolerating strong emotions existing in the present moment in an open and non-defensive way.

https://doi.org/10.47626/2237-6089-2023-0652

Commentary on the clinical study of CBD-rich cannabis extract in children with autism spectrum disorder
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Córdova, Claudio

; Nóbrega, Otavio

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20241010

Abstract: En | Text: En | PDF: En

https://doi.org/10.47626/2237-6089-2024-1010

Psychometric properties of the Death Anxiety Scale for adult chronic patients
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Palacios-Espinosa, Ximena

; Pedraza, Ricardo Sánchez

; Gómez-Carvajal, Ana-María

; Botero-Meneses, Juan Sebastián

; Escallón, Diana María

; Leal, Diego Armando

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20230630

Abstract: En | Text: En | PDF: En

Abstract Objectives Death anxiety (DA) is a predictor of exacerbation of both physical and psychological symptoms of chronic diseases. Therefore, having short and easy-to-apply instruments to assess the presence of DA and adopting a multidisciplinary approach to address it are important. This study analyzes the psychometric properties of the Death Anxiety Scale (DAS), originally developed by Donald Templer, in a Colombian population of adult patients diagnosed with a chronic disease. Methods The original instrument was linguistically, conceptually, and culturally adapted to Colombian Spanish to be subsequently administered to 301 adult patients with chronic diseases. Results The exploratory factor analysis revealed a three-factor structure, which explained 47% of variance. Internal consistency was demonstrated (Cronbach’s alpha: 0.71; McDonald’s omega: 0.76; Guttman’s lambda 6 [G6]: 0.74; greatest lower bound: 0.54). A correlation coefficient of 0.64 was found between the total score of the DAS and the Beck Anxiety Inventory (BAI). Conclusion When comparing the results with the versions of the DAS in Spanish from Mexico and Spain, variability in the psychometric properties was observed. Language cannot therefore be assumed to be a guarantee of the reliability and validity of the instrument.

https://doi.org/10.47626/2237-6089-2023-0630

The impact of family stress and resilience on child development: a scoping review
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Mendes-Sousa, Marília M.

; Perrone, Marina B. de Melo, Rafael B. Ribeiro, Marcos V. V. Chao, Qiong Torres, Carolina Sanchez, Zila M. Surkan, Pamela J. Martins, Silvia S. Fidalgo, Thiago M. Caetano, Sheila C.

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20220556

Abstract: En | Text: En | PDF: En

Abstract Objective: Children grow up spending most of their time within the family social environment, where they can experience stressful situations such as marital conflict, a non-cohesive environment, parental alcohol use disorder, parental depression, and other parental mental health issues. All these factors are associated with children's developmental delays. We aimed to conduct a scoping review on associations between family stress and family resilience and child development delays to examine familial conditions associated with child development. Methods: We conducted a scoping review of observational studies published from January 2000 to July 2023 and indexed in the MEDLINE and LILACS databases. We included observational studies that assessed history of exposure to violence and behavioral or emotional symptoms or mental health problems among children aged 4-12. Data were independently extracted using a structured form. Results: Database searches identified 12,990 unique records. A total of 43 articles were included in the review. Three main findings emerged: (1) parental mental health problems, especially depressive symptoms in mothers, were associated with child developmental delays and mental health problems; (2) better parenting practices and a cohesive home environment were positively associated with child development; and (3) vulnerable social environments (e.g., poverty and housing insecurity) may be linked to child mental health problems. Conclusion: The studies reviewed show that promoting better family dynamics and increasing family cohesion, as well as improving parenting abilities, are beneficial to children's socioemotional development and prevention of child mental health problems. Moreover, increasing family and children's resilience improves the quality of life within family units.

https://doi.org/10.47626/2237-6089-2022-0556

Effectiveness of acceptance and commitment therapy for distress, emotion regulation, and self-compassion in patients with cardiovascular disease: a randomized clinical trial
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Fattahi, Arash

; Mazini, Fatemeh

; Jaberghaderi, Nasrin Rajabi, Fatemeh Derakhshani, Mehdi Laki, Mohammad

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20230685

Abstract: En | Text: En | PDF: En

Abstract Objective: Cardiovascular patients experience various psychological problems due to the conditions caused by their disease, making it worse if left untreated. The purpose of the current study was to evaluate the effects of acceptance and commitment therapy (ACT) on distress, emotion regulation, and self-compassion in patients with cardiovascular disease. Methods: This study was a randomized clinical trial with pre-test, post-test, and 2-month and 4-month follow-up periods accompanying a control group and an experimental group. Patients filled out questionnaires at four stages; a Depression, Anxiety, and Stress Scale (DASS-21), an Emotion Regulation Questionnaire (ERQ), and a Self-Compassion Scale (SCS). The experimental group underwent a treatment protocol based on ACT. Data were then analyzed using SPSS-25 with repeated measures analysis of variance (ANOVA). Results: ACT significantly reduced depression, anxiety, and stress, enhanced self-compassion, and improved emotion regulation in cardiac patients. Between-subjects (group) partial Eta squared (η²) for depression, anxiety, stress, reappraisal, suppression, and self-compassion were 0.61, 0.64, 0.66, 0.62, 0.66, and 0.65, respectively. Treatment efficacy was maintained at the 2-month and 6-month follow-up visits. Conclusion: The results of this study suggest that treating cardiac patients’ psychological problems in an ACT-focused manner may have an impact on how well they respond to their treatment.

https://doi.org/10.47626/2237-6089-2023-0685

Exploring protective factors in a high-risk subsample: the pivotal role of paternal support in preventing depression in a cohort of young adults
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Tietbohl-Santos, Barbara

; Montezano, Bruno Braga

; de Azevedo Cardoso, Taiane Mondin, Thaíse Campos Moreira, Fernanda Pedrotti Souza, Luciano Dias de Mattos da Silva, Ricardo Azevedo Kapczinski, Flavio Jansen, Karen Passos, Ives Cavalcante

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20240804

Abstract: En | Text: En | PDF: En

Abstract Objective: Major depressive disorder (MDD) is a global concern due to its widespread prevalence and morbidity. It is crucial to identify protective factors in high-risk individuals, including those with a familial predisposition, maltreatment history, and socioeconomic vulnerabilities. Methods: We assessed a high-risk subsample within a young adult population cohort (n = 791; mean age = 31.94 [standard deviation {SD} = 2.18]) across three waves, using multiple regression models to analyze higher education, feeling supported, spirituality, psychotherapy access, higher socioeconomic status, involvement in activities, cohabitation, and family unity in waves 1 and 2 and their association with MDD resilience at wave 3. Results: In the high-risk group, MDD incidence was 13.7% (n = 24). Paternal support had a protective effect on MDD incidence (odds ratio [OR] = 0.366; 95% confidence interval [95%CI] 0.137 to 0.955; p = 0.040) and suicide attempt risk (OR = 0.380; 95%CI 0.150 to 0.956; p = 0.038). Higher resilience scores were also protective (OR = 0.975; 95%CI 0.953 to 0.997; p = 0.030), correlating with reduced Beck Depression Inventory (BDI) (r = 0.0484; B = −0.2202; 95%CI −0.3572 to −0.0738; p = 0.003) and Montgomery-Åsberg Depression Rating Scale (MADRS) scores (r = 0.0485; B = −0.2204; 95%CI −0.3574 to −0.0741; p = 0.003). Conclusion: Our paper emphasizes reorienting the MDD approach, focusing on positive prevention strategies. It highlights the crucial role of fathers in family-based interventions and in promoting resilience in high-risk populations.

https://doi.org/10.47626/2237-6089-2024-0804

Exploring the use of lithium for suicidality in acute settings: rationale, risks, and uncertainties
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Amaral, Rafael Ramos

; Magalhães, Pedro V. S.

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20240811

Abstract: En | Text: En | PDF: En

Abstract Lithium's well-documented efficacy in preventing suicide over the long term prompts consideration of its potential for more rapid antisuicidal effects. However, evidence supporting such acute efficacy is limited. Weighing against its possible rapid benefits are significant concerns regarding lithium's side-effect profile – particularly toxicity, renal impairment, and weight gain – and the often necessary delay in achieving therapeutic levels. Moreover, the multifaceted nature of suicidality complicates identifying short-term outcomes and disentangling lithium's effects on suicidal thoughts from broader reductions in depressive symptoms. While lithium may remain invaluable for some high-risk patients in emergency settings, its routine use as a rapid-acting agent for acute suicidality is currently not well supported.

https://doi.org/10.47626/2237-6089-2024-0811

"The impact of family stress and resilience on child development": the role of parental emotional health and parenting practices in offspring mental health
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Ribas, Larissa Hallal

; Villar, Rafaela Soares

Trends in Psychiatry and Psychotherapy

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2025, Volume 47 elocation e20240794

Abstract: En | Text: En | PDF: En

https://doi.org/10.47626/2237-6089-2024-0794

10.

Validation of the Brazilian version of the Short Inventory of Grazing (SIG)
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Moraes, Carlos Eduardo Ferreira

; Heriseanu, Andreea

; Mourilhe, Carla Faller, Ana Luisa Kremer Hay, Phillipa Appolinario, Jose Carlos

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20220492

Abstract: En | Text: En | PDF: En

Abstract Objective Grazing is a disturbed eating pattern that has been associated with eating disorders and obesity. One of the new measures to investigate this eating behavior is the Short Inventory of Grazing (SIG), a two-item questionnaire that assesses grazing in general and grazing associated with the feeling of loss of control over eating (LOC grazing). However, the psychometric properties of the SIG have not been assessed in the Brazilian population. The present study aimed to cross-culturally adapt and validate a Brazilian version of the SIG. Methods The SIG was adapted to the Brazilian context following international guidelines. Then, 90 undergraduate students completed an online survey including questions from the SIG, the Binge Eating Scale (BES), the Patient Health Questionnaire-9 (PHQ9), the Generalized Anxiety Disorder-7 (GAD7), and a question related to self-reported health status. The internal consistency, test-retest reliability, and convergent validity of the questionnaire were assessed. Results The prevalence rates of at least one weekly episode of grazing in general and LOC grazing were 71.1 and 54.5%, respectively. The internal consistence of the SIG was acceptable (0.81). In addition, SIG scores on both items were positively and significantly associated with BES, GAD7, and PHQ9 scores, and with poorer self-rated health. However, SIG test and retest scores differed significantly. Conclusion Overall, the Brazilian version of the SIG demonstrated adequate psychometric properties. The instrument had adequate internal consistency, with both items exhibiting good convergent validity with related measures.

https://doi.org/10.47626/2237-6089-2022-0492

11.

Quality of life in Brazilian medical students: a systematic review and meta-analysis
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Martins, Carolina Kakiuthi

; Cruz, Jonas Carneiro

; Dellalibera-Joviliano, Renata

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20220497

Abstract: En | Text: En | PDF: En

Abstract Objectives Medical training negatively impacts the quality of life of students. Assessing the well-being of medical students could guide academic policies and future research for improving the mental and physical health status of the population at risk. This study aimed to identify the influence of medical training on the quality of life of Brazilian medical students. Methods A systematic review and meta-analysis was conducted according to the Cochrane criteria and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA). The search was performed by two independent investigators using a predefined protocol registered on the PROSPERO database (CRD42021237926). Data were extracted from PubMed, Embase, and Biblioteca Virtual de Saúde (BVS). For quantitative synthesis, a meta-analysis was conducted to assess the mean difference in the quality of life between medical students at different stages in the academic cycle, stratified by sex. All data were analyzed using the random-effects model, with a confidence interval of 95% (95%CI). Results After evaluating the eligibility criteria, five studies were included in the meta-analysis. The data revealed that students in the pre-clinical cycle of the course exhibited higher quality of life scores in the physical (3.05 [1.48-4.62], p < 0.0001) and psychological (3.05 [0.80-5.30], p < 0.0001) domains than students in the clerkship cycle. No statistically significant differences were observed in the environmental (0.78 [-2.92-4.49], p = 0.68) or social domains (1.41 [-0.52-3.34], p = 0.15). Conclusion Our analysis revealed that the medical course is associated with decreased quality of life of medical students in the physical and psychological domains. This finding was observed in both men and women. However, these findings should be interpreted with caution given the study limitations. Registration number PROSPERO, CRD42021237926.

https://doi.org/10.47626/2237-6089-2022-0497

12.

Eco-anxiety: a new disease or a “new normal”?
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de Barros, Enrique Falceto

; Falceto, Olga Garcia Zandavalli, Rafaela Brugalli Souza, Diogo Onofre

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20220543

Abstract: En | Text: En | PDF: En

https://doi.org/10.47626/2237-6089-2022-0543

13.

Brazilian Psychiatric Association Consensus for the Management of Acute Intoxication: general management and specific interventions for drugs of abuse
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Baldaçara, Leonardo

; Pettersen, Amanda de Gouvêa

; Leite, Verônica da Silveira

; Ismael, Flávia

; Motta, Carolina Pereira

; Freitas, Railson Alves

; Fasanella, Nicoli Abrazo

; Pereira, Lucas Alves

; Barros, Maria Elisa Lima

; Barbosa, Leonardo

; Teles, Ana Luiza Silva

; Palhano, Ruy

; Guimaraes, Helio Penna

; Braga, Maria Aparecida

; Castaldelli-Maia, João Mauricio

; Bicca, Carla

; Gligliotti, Analice

; Marques, Ana Cecilia Petta Roseli

; da Silva, Antônio Geraldo

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20220571

Abstract: En | Text: En | PDF: En

Abstract Objectives To present the Brazilian Psychiatric Association’s Consensus on the Management of Acute Intoxication. Methods A group of experts selected by the Brazilian Psychiatric Association searched for articles on the MEDLINE (by PubMed) and Cochrane databases, limited to human studies and acute intoxication. Working groups reviewed these materials for appropriateness to the topic and the quality of the work. A survey was conducted using the Delphi method to produce a table of agreed recommendations presented at the end of the systematic review. Three survey rounds were held to reach consensus. Results Support for intoxication should start with Initial Management: Resuscitation/Life Support/Differential Diagnosis. For this, the group proposed the following sequence of assessments: A (airway), B (breathing), C (circulation), D.1 (disability), D.2 (differential diagnosis), D.3 (decontamination), D.4 (drug antidotes), E (enhanced elimination). The group of experts then presented specific interventions for the main drugs of abuse. Conclusions Management of intoxication with drugs of abuse is complex and requires systematic protocols. The group suggests adoption of the A-B-C-D-E technique first, with constant investigation. Then, specific conduct and support until remission of intoxication. The literature is still scarce in evidence on the subject. Therefore, this consensus was necessary. We believe that at present this document can help psychiatric, general, and emergency physicians deal with emergency psychiatric episodes due to acute intoxication. This work could stimulate future studies on the topic.

https://doi.org/10.47626/2237-6089-2022-0571

14.

Self-reported social media use by adolescents in Brazil: a school-based survey
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Pereira, Rivka B.

; Martini, Thais C.

; Buchweitz, Claudia Kieling, Renata R. Fisher, Helen L. Kohrt, Brandon A. Mondelli, Valeria Kieling, Christian

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20220545

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Abstract Objective Although there is a general perception that adolescent social media use is a global phenomenon, there is a scarcity of data on patterns and preferences of social media use among youth in low- and middle-income countries (LMICs). We here describe self-reported prevalence and perceived effects of social media use in a school-based sample of Brazilian adolescents. Methods We analyzed cross-sectional data on 7,113 adolescents aged 14 to 16 years enrolled at 101 public state schools between 2018 and 2019 in Porto Alegre, state of Rio Grande do Sul, Brazil. Results Of the 7,113 adolescents with complete data for analyses, 54.9% were female, and 60.6% reported their skin color as white. At least one social media platform was used by 97.7% of adolescents every day, and 64.7% reported being online “almost constantly.” YouTube and WhatsApp were the most popular platforms. Most participants perceived the effect on their lives of social media use as neutral. Conclusion The pattern of social media use by adolescents in Porto Alegre, Brazil, is similar to that reported for samples from high income countries. Also, we found that those who reported being constantly online were also more likely to report socializing with their friends offline.

https://doi.org/10.47626/2237-6089-2022-0545

15.

Decrease in alcohol use disorder hospitalizations in Brazil: what does it mean?
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Pessôa, Renato Luís

; da Silva, Alexandre Kieslich Lucas, Luiza Silveira

Trends in Psychiatry and Psychotherapy

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2024, Volume 46 elocation e20220588

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Abstract Objective To analyze the trend of hospitalizations for alcohol use disorder (AUD) in Brazil, by region, and establish its relationship with mental health care facilities. Methods Data were collected through the Brazilian Unified Health System’s (SIH/SUS) Hospital Information System (Sistema de Informação Hospitalar) and the National Register of Health Establishments of Brazil (Cadastro Nacional de Estabelecimentos de Saúde [CNES]). We used linear regression models to estimate the effect of SUS psychiatric beds and Center for Psychosocial Care (Centro de Atenção Psicossocial [CAPS]) numbers on AUD hospitalizations. Results From 2015 to 2020, 298,735 hospitalizations for AUD were recorded. Most of the patients admitted for AUD were male (88.8%). Individuals aged 60 years and older accounted for 11.7% of our cohort. The highest concentration of hospitalizations occurred in the South region (40.1%). The rate of hospitalizations per hospital bed remained relatively constant. The number of CAPS has a negative effect on SUS psychiatric beds in Brazil (average effect -22.31 [95% confidence interval {95%CI} -26.92, -17.70]). Psychiatric beds have a positive effect on AUD hospitalizations in the country (average effect 1.82 [95%CI 0.91, 2.74]). Conclusion Prioritization guidelines for other forms of care are associated with a decrease in hospitalizations for AUD, so we highlight the importance of adequate training of health care professionals for proper referral of these patients to hospital admission when necessary.

https://doi.org/10.47626/2237-6089-2022-0588

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