Revista Brasileira de Psiquiatria最新文献

Objective: There has been a call for neuroscientific studies of spiritual experiences due to their global prevalence, significant impact, and importance for understanding the mind-brain problem. Mediumship is a spiritual experience where individuals claim to communicate with or be influenced by deceased persons or non-material entities. We assessed whether mediums possess specific genetic alterations.

Methods: We selected highly gifted mediums (n = 54) with over 10 years of experience who engaged in mediumistic work without material benefits, analyzed whole exome sequencing, and compared them to non-medium first-degree relatives (n = 53).

Results: We identified 15,669 variants exclusively found in mediums, likely to impact the function of 7,269 genes. Thirty-three of these genes were altered in at least one-third of all mediums but in none of their relatives. The inflammatory pathway was the most frequently affected (43.9%) with the translocation of ZAP-70 to the immunological synapse being particularly prominent.

Conclusion: This is the first exome-wide investigation of genes possibly related to mediumistic experiences. We identified gene variants that are presented in mediums but not in their first-degree non-medium relatives. These genes emerge as possible candidates for further investigations of the biological underpinnings that allow spiritual experiences such as mediumship.

Background: The practice of using drugs to modulate experiences is a well-documented phenomenon worldwide, particularly among men who have sex with men (MSM). This study aims to describe patterns of drug combinations used by Brazilian MSM, embracing a detailed examination of the Brazilian context, which may inspire research elsewhere while enriching the global panorama on MSM drug use. By focusing on Brazilian MSM, the study sheds light on specific drug use combinations, which may help in the development of effective, culturally sensitive public health strategies.

Methods: This investigation was conducted within the Latin American MSM Internet Survey (LAMIS), a pioneer online study addressing psycho-social and sexual health of MSM in the region. Conducted from January to May 2018, the survey garnered responses from over 18,139 Brazilian MSM. Using exploratory factor analysis through maximum likelihood estimation, the study identifies distinct sub-groups of drug users among 15,499 participants after exclusion due to the presence of discrepant responses. Kaiser-Meyer-Olkin measure (KMO) = 0.94) and Bartlett's Test = < 0.01) indicating adequate sampling and suitability for factor analysis across all substances.

Findings: The factor analysis revealed four primary drug combination groups among participants: Group One (Heavy Drugs Users), Group Two (Party Drug Users), Group Three (Conservative Users), and Group Four (Classic Chemsex Users). Each group represents unique drug use patterns and preferences, from the use of potent stimulants to more socially accepted substances like tobacco and cannabis. Notably, Group One, identified as "heavy" drugs users, engaged in the use of particularly risky substances, including mephedrone, crack, crystal meth, heroin and other synthetic stimulants.

Interpretation: The findings reveal diverse and complex drug use patterns among MSM in Brazil. Understanding these patterns is essential for developing targeted interventions and support mechanisms for various sub-groups within MSM. Future research should focus on the health outcomes associated with these patterns and the social and psychological contexts of drug use.

Objective: This study aims to evaluate if attitudes toward drug use, decision-making, communication, and alcohol resistance skills act as predictors of alcohol use and binge drinking initiation among Brazilian students, considering the sex differences.

Methods: We used a longitudinal sample of 1,103 seventh-grade students from 15 Brazilian public schools. We explored if attitudes toward drug use, decision-making, communication, and alcohol resistance skills at baseline predicted alcohol outcomes nine months later.

Results: We found that lower levels of resistance skills (i.e., ORboys=0.29, 95% CI: 0.12; 0.70) and positive attitudes toward drugs (i.e., ORgirls:=1.41, 95% CI: 1.02; 1.94) are predictors of alcohol use onset and binge drinking, independently of sex. Decision-making predicts binge drinking initiation only for girls (OR=0.73, 95% CI: 0.59; 0.91). Negative attitudes toward drugs are a risk factor for alcohol use initiation only for boys (OR=0.78, 95% CI: 0.64; 0.95).

Conclusion: Our findings highlighted the importance of understanding the predictors of adolescents' alcohol outcomes to inform the key components that preventive programs should address in their activities to achieve the expected preventive outcomes.

Objective: This article aims to systematically review the studies on schizophrenia in Brazil, addressing geographical coverage as an indicator of sampling representativeness, essential to infer results' generalization. It also highlights the variation in research funding across different regions.

Methods: We searched for studies carried out until July 2023. Inclusion criteria encompassed studies of patients diagnosed with schizophrenia (or its spectrum) recruited in Brazil. Data extraction comprised geographic region of first and last authors, place recruitment, research subfield, and funding sources. The review followed PRISMA guidelines for systematic reviews and meta-analyses.

Results: Out of 296 studies reviewed, most (63.18%) took place in the Southeast, particularly São Paulo (48.98%). Clinical trials comprised the majority (41.6%), with genetic studies primarily conducted in the Southeast or South (81.5%). Funding was reported in 64% of papers. The Northeast region was less likely to receive study funding compared to the Southeast.

Conclusion: Schizophrenia research in Brazil shows a clear geographic concentration, with significant disparities in funding allocation and underrepresentation of certain regions. Broadening research coverage through equitable distribution of funding opportunities and fostering collaborations with local institutions are of utmost importance to enhance the understanding and treatment of schizophrenia within Brazil's diverse socio-economic and ethnic landscape.

Objective: Post-stroke depression (PSD) affects approximately 40% of stroke survivors, with cognitive deficits being frequently observed. Transcranial Direct Current Stimulation (tDCS) has shown promise in improving cognitive performance in stroke patients. We explored the effects of tDCS on cognitive performance in PSD.

Methods: An exploratory analysis was conducted in 48 patients from a double-blinded, sham-controlled, randomized clinical trial that investigated the effects of tDCS for treating PSD. A neuropsychological battery was applied at baseline and endpoint. We assessed three key domains: (1) Stroop effect, measured by the Stroop test components (color naming, word-reading and word-color interference); (2) processing speed, assessed using the Trail Making Test and the Digit Symbol coding test; (3) executive function, evaluated with the Digit Span test and the Frontal Assessment Battery (FAB). A Linear mixed regression models were used to evaluate changes according to groups.

Results: We found that the active tDCS group worsened slightly, while the sham group improved in Executive Function for the adjusted models. Significant interactions were also found for FAB.

Conclusions: We found no consistent evidence that tDCS significantly improved the cognitive domains. The bidirectional association with cognition analysis suggest that tDCS effects may vary based on depression severity and task complexity.

Objective: To explore the association between 75 candidate genes previously reported in subjects with anxiety symptoms (AS) and depressive symptoms (DS) in a Mexican cohort.

Methods: The sample included 2012 individuals from the Mexican Genomic Database for Addiction Research (MxGDAR/Encodat) cohort, 198 showed AS, 266 DS, 66 anxiety and depressive symptoms (ADS), and 1482 healthy controls. The DI-PAD screening questionnaire was used to evaluate lifetime AS and DS. The sample was genotyped with the commercial microarray PsychArray BeadChip. We identified 707 SNPs of 75 genes previously associated with AS and DS. PLINK's logistic regression approach was performed.

Results: The analysis showed association between the rs2437092 (p=3.89x10-5) of LAMA and rs11066591 (p=4.06x10-5) of MYO1H with anxiety and depressive symptomatology. Additionally, rs7578002 (p=7.9x10-6) and rs1234428 (p=1.94x10-5) of MBD5 found association with DS. However, after adjustment for age, sex, and the three genetic principal components, only the association of rs7578002 (p=5.85x10-5) and rs1234428 (p=8.15x10-5) of MBD5 with DS remained.

Conclusions: Our study replicated the association between MBD5 and DS. The MBD5 protein is involved in gene silencing, suggesting its potential implication in the development of DS in the Mexican population.

Objective: To investigate the association between family adversities in childhood and depression in three follow-up visits of a cohort of Brazilian adults.

Methods: A total of 12,636 participants from the Longitudinal Study of Adult Health (ELSA-Brasil), who attended three interview/examination visits (2008-2010, 2012-2014, and 2017-2019), were included. Five family dysfunctions and the childhood family dysfunction score (0, 1, and 2+ dysfunctions) were used. The Clinical Interview Schedule-Revised-CIS-R assessed depression in 3 visits (no, 1, and 2 or 3) Multinomial logistic regression models estimated crude and adjusted Odds Ratios (OR) and 95% confidence intervals (95%CI).

Results: Mean age was 59.6 years (SD=8.8), 7.4% presented depression in 1 visit and 2.2% in 2 or 3 visits. After adjustments, compared to the absence of family dysfunction the presence of mental disorder (OR: 3.91; 95%CI: 2.94-5.21), substance abuse (OR: 2.14; 95%CI: 1.65-2.77) and parental separation (OR: 1.55; 95%CI: 1.12-2.15) increased the odds of depression in 2 or 3 visits. Exposure to 2+ family dysfunctions increased the odds of depression in 1 and in 2 or 3 visits, with a dose-response gradient.

Conclusion: Exposure to family dysfunction in childhood contributes to the occurrence and recurrence of depression in adults. Interventions to prevent dysfunctional family environments and their repercussions on children can reduce the burden of depression.

Objective: Disordered Eating Behaviors (DEB) are associated with dysfunctional changes in eating behavior, not meeting diagnostic criteria for eating disorders. DEB affects a significant percentage of individuals, yet it remains under-researched. The current study investigates the developmental trajectory and psychopathological correlates of DEB in children and adolescents in Brazil.

Methods: The sample included 1,583 participants from the Brazilian High-Risk Cohort, assessed across three waves between 2010 (age 6-12 years) and 2019 (age 12-21 years). Psychopathology diagnoses were evaluated using the Development and Well-Being Assessment (DAWBA) and DEB was assessed through the DAWBA eating disorders screening. Dimensional psychopathology was measured with the Child Behavior Checklist.

Results: Participants were divided into dysfunctional and non-dysfunctional eating groups. DEB showed significant variability, with few maintaining persistent patterns. DEB was strongly linked to higher internalizing symptoms, especially in girls, but less to externalizing behaviors. DEB increased the likelihood of Eating Disorders, Major Depressive Disorder, and higher BMI.

Conclusions: This study reveals that DEB are frequent among Brazilian children and adolescents and linked to psychopathology, especially internalizing symptoms, and BMI. Future research should investigate the underlying mechanisms of DEB and develop strategies for early detection and effective interventions.