Revista Brasileira de Psiquiatria最新文献

This is the second part of the Brazilian S20 mental health report. The mental health working group is dedicated to leveraging scientific insights to foster innovation and propose actionable recommendations for implementation in Brazil and participating countries. In addressing the heightened mental health challenges in a post-pandemic world, strategies should encompass several key elements. This second part of the S20 Brazilian Mental Health Report will delve into some of these elements, including: the impact of climate change on mental health, the influence of environmental factors on neurodevelopmental disorders, the intersection of serious mental illness and precision psychiatry, the co-occurrence of physical and mental disorders, advancements in biomarkers for mental disorders, the utilization of digital health in mental healthcare, the implementation of interventional psychiatry, and the design of innovative mental health systems integrating principles of innovation and human rights. Reassessing the treatment settings for psychiatric patients within general hospitals, where their mental health and physical needs are addressed should be prioritized in mental health policy. As the S20 countries prepare for the future, we need principles that stand to advance innovation, uphold human rights, and strive for the highest standards in mental health care.

This is the first part of two documents prepared by experts for the Brazilian S20 mental health report. These reports outline strategies aimed at addressing the exacerbated mental health challenges arising from a post-pandemic world. Ongoing psychiatric epidemiology research has yielded evidence linking mental health with intricate social determinants, including gender, race/ethnicity, racism, socioeconomic status, social deprivation, and employment, among others. More recently, the focus has expanded to also encompass violence and social oppression. By prioritizing prevention and early intervention, harnessing technology, and fostering community support, we can mitigate the long-term impact of mental disorders emerging in life. Utilizing evidence-based practices and forging partnerships between the health and education sectors, S20 countries can promote health and safety of their student population, thereby paving the way for a more promising future for the next generations. The first document focuses on addressing the mental health concerns of vulnerable populations, catering to the needs of children, youth, and aging populations, assessing the current state of alcohol and drug addictions, scaling up psychosocial interventions in primary care, exploring the potential integration of health and educational systems, and emphasizing the imperative adoption of human rights in mental health policies.

Background: Panic disorder (PD) is a common disabling condition characterized by recurrent panic attacks. Emotional and behavioral impairments are associated with functional connectivity (FC) and network abnormalities. We used the whole brain FC, modular networks, and graph-theory analysis to investigate extensive network profiles in PD.

Method: The functional MRI data from 82 PD and 97 controls were included. Intrinsic FC between each pair of 160 regions, 6 intra-networks, and 15 inter-networks were analyzed. The topological properties were explored.

Results: PD patients showed altered FCs within the right insula, between frontal cortex-posterior cingulate cortex (PCC), frontal cortex-cerebellum, and PCC-occipital cortex (corrected P values < 0.001). Lower connections within the Sensorimotor Network (SMN) and SMN-Occipital Network (OCN) were detected (P values < 0.05). Various decreased global and local network features were found in PD (P values < 0.05). In addition, significant correlations were found between PD symptoms and nodal efficiency (Ne) in the insula (r = -0.273, P = 0.016), and the FC of the intra-insula (r = -0.226, P = 0.041).

Conclusions: PD patients present with abnormal functional brain networks, especially the decreased FC and Ne within insula, suggesting that dysfunction of information integration plays an important role in PD.

Objective: To analyse the related influencing factors of adolescent major depressive disorder (MDD) with suicidal and self-injurious behaviour (SSIB).

Methods: A total of 299 adolescents with MDD who were admitted to the psychiatric department of the hospital between February 2022 and July 2023 were selected using the convenience sampling method. The participants were divided into the SSIB group (n = 110) and the non-SSIB group (n = 189) according to whether SSIB was present, and related indicators were collected and compared.

Results: The patients' ages at the time of their first SSIB ranged from 10 to 18 years old, with a mean age of 13.30 ± 1.74 years. The most commonly injured parts were the lower arm and wrist (42.13%), and the most common injury was cutting, accounting for 40.00% of the total patients. The most common type of self-injury differed by sex (X2 = 17.798, P = 0.006); for men, hitting was the most common, and for women, cutting was the most common. In 51.41% of the patients, the period between the initial thought and the actual committing of the SSIB was less than 5 minutes. The scores of the Eysenck Personality Questionnaire, the Barratt Impulsivity Scale, the Buss-Perry Aggression Questionnaire, the Symptom Checklist-90 (all P < 0.001), and the health-risk behaviour scale (67.47 ± 12.59 vs. 41.58 ± 11.36, t = 9.587, P < 0.001) were significantly increased in the SSIB group compared with the non-SSIB group. In addition, the total score of quality of life (QOL) (11.36 ± 4.32 vs. 16.43 ± 5.64, t = 5.496, P < 0.001) was decreased in the SSIB group compared with the non-SSIB group.

Conclusion: The SSIB of adolescent patients with MDD is related to various factors, including impulsiveness, aggressiveness, personality traits, QOL, and mental health level.

Introduction: Galectins (Gal) were linked with inflammatory responses in the central nervous system, may play an important role in the pathogenesis of BD.In this study,we aimed to investigate whether serum Gal-1 and Gal-3 levels are related to BD.

Methods: 36 patients diagnosed with BD were included.C-Reactive Protein(CRP),Gal-1,Gal-3 blood levels were evaluated on the first day of hospitalization and the third week of treatment and compared with 41 healthy controls.The severity of the illness was evaluated with the Young Mania Rating Scale (YMRS).

Results: CRP levels of BD patients at hospitalization were significantly higher than the third week of treatment and healthy controls.Gal-1 levels on the first day of hospitalization and the third week of treatment were found higher than the healthy controls.There was no significant difference in Gal-3 levels of the patients on the day of hospitalization compared to healthy controls;at the end of the 3rd week of treatment,Gal-3 was statistically significantly higher than the first day of hospitalization.

Conclusion: Our study is valuable in that it is the first study to show the change in Gal levels after treatment and to evaluate the role of Gal in BD.Gal-1 may play roles in the pathophysiology of BD.Gal-3 may be a biomarker candidate for the evaluation of the treatment response.

Few pandemic studies explored positive aspects of mental health and employed an intersectional perspective, which considers the concomitant action of different risk conditions. Our intersectional investigation aimed to identify possible mental illness and well-being differences between groups identified as psychologically vulnerable in the pandemic by the WHO (immigrants, minorities, and people with psychiatric diagnoses) and people without pre-existing risk factors while controlling for sociodemographic variables. A cross-sectional survey involved 1,134 participants (76.1% women) aged 18 to 76. We utilized the Depression, Anxiety, and Stress Scales (DASS-21) for mental disorder assessment and the Life Satisfaction and Positive and Negative Affects Scales for well-being evaluation. Since a variable-centered approach, multivariate analysis revealed significant differences between the groups in the variables of mental health, depression [F(2.1131)=72.7, p<.001], anxiety [F(2.1131)=78.0, p<.001], stress [F(2.11 1)=85.9, p<.001], and subjective well-being [F(2.1131)=53.6, p<.001]. The groups also differed when we employed a person-centered approach to analyze the variables jointly using Latent Profile Analysis. We identified six mental profiles composed of different levels of depression, anxiety, stress, and well-being. Risk and intersectional groups were more likely to be characterized by Generalized Suffering [ORrisk=0.85, ORintersec=0.93] and Profound Anguish [ORrisk&intersec=0.97] profiles. Control of demographic variables indicated that mental health disparities were partially attributed to participant risk conditions.

Background: Depression is a significant global disability, and early adverse experiences (EAE) represent consistent risk factors in children. However, protective factors play a vital role in promoting healthy development and mitigating these risks.

Methods: We conducted a thorough literature search on Pubmed, APA, Emcare, and EMBASE from 1946 to August 25, 2023. We included longitudinal studies analyzing protective factors for depressive symptoms in high-risk children or adolescents, excluding cross-sectional studies, reviews, and pre-clinical studies.

Outcomes: Our analysis comprised 29 studies with 62,405 participants, identifying 38 protective factors. Positive individual characteristics, family factors, peer relationships, school-related aspects, neighborhood characteristics and intrinsic religiosity were associated with reduced depressive outcomes.

Interpretation: These findings have important implications for developing preventive strategies in this population. Addressing protective factors can contribute to preventing depression and enhancing mental well-being across the lifespan.