Trends in Psychiatry and Psychotherapy最新文献

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties in communication, deficits in social interaction, and repetitive behavioral patterns. Global prevalence estimates range from 1% to 2%, with variations attributed to cultural, social, and methodological factors. In Africa, research remains limited and highly heterogeneous, largely due to scarce diagnostic resources, persistent stigma, and the absence of consistent public policies.

Methods: A systematic search was conducted across PubMed, Embase, Scopus, and PsycInfo for articles published up to May 2025. Cross-sectional studies conducted in school-based or community populations were included. The analysis followed PRISMA guidelines, and the protocol was registered with PROSPERO (CRD420251138668). A random-effects model using the Freeman-Tukey transformation for variance stabilization was employed for statistical synthesis.

Results: Seven studies from Egypt, Kenya, Uganda, and Nigeria, comprising 71,341 participants, were included. Across included studies, reported ASD prevalence ranged from 0.54% to 23.8%. When pooled and stratified by methodological criteria, clinically confirmed ASD prevalence was 1% (95% CI, 0.0-1.0%), whereas high-risk screening prevalence was 4% (95% CI, 0.0-16.0%), with very high between-study heterogeneity (I² = 99.8%).

Conclusion: Despite substantial methodological heterogeneity, ASD prevalence estimates in Africa appear comparable to those reported in high-income countries. The marked disparity between high-risk screening prevalence and confirmed diagnoses highlights the urgent need to expand diagnostic confirmation services and strengthen training for primary healthcare professionals to bridge the gap between risk identification and definitive diagnosis across the continent.

Introduction: Adults with Autism Spectrum Disorder (ASD) often present with core symptoms and co-occurring conditions that require multidisciplinary support. The objective of this study is to describe the sociodemographic and clinical profile of a sample of Brazilian adults with ASD, with a focus on the prevalence of co-occurring mental health disorders and the investigation of gender-related disparities.

Methods: A total of 117 adults with a previous diagnosis of ASD (60.7% female; mean age = 31.84, SD = 10.03; age range: 18-61 years) were recruited by convenience sampling. Participants completed a sociodemographic and clinical history questionnaire. We analyzed associations between co-occurring mental health disorders and biological sex.

Results: Most participants had completed at least high school (95.7%). Co-occurring neurodevelopmental disorders were present in 35.9% of the sample. ADHD was the most common (30.8%). Co-occurring mental health disorders were reported by 75.2% of participants, with anxiety disorders being the most frequent (71.8%). A statistically significant gender disparity was observed, showing that women had a significantly higher prevalence of at least one mental health disorder (85.9% vs. 58.7%), anxiety (83.1% vs. 54.3%), and depression (62% vs. 37%) compared to men.

Conclusion: While not generalizable due to the convenience sampling method, these results contribute to a growing body of evidence on the high rates of co-occurring mental health disorders in adults with ASD, especially in women. This study supports the call for an expanded research agenda in Brazil to better understand the clinical reality and guide future support strategies for this population.

Introduction: Facial emotion recognition (FER) is the ability to interpret the feelings and emotions of others. Given the decline in FER ability observed in older adults, intervention studies to assess the effects of training this skill are essential. Therefore, this study aims to evaluate the effects of FER training in cognitively unimpaired older adults.

Method: A randomized, crossover clinical trial was conducted. Twenty-two individuals aged 60 years or older, without indications of depression or cognitive decline, were selected. Participants completed one session of FER training and one control training session through a Matching-to-Sample (MTS) procedure on a portable touchscreen computer, with a seven-day interval between sessions. The primary outcomes were total accuracy and accuracy by emotion in two FER tasks, using dynamic and static stimuli.

Results: In the dynamic stimuli task, repeated-measures ANOVA revealed significant differences in overall emotion accuracy (F2,40 = 4.592; p = 0.016; η²p = 0.187). Bonferroni post hoc analysis indicated improvement following FER training compared to baseline (p = 0.004). Additionally, ANOVA showed improved recognition of happiness (F2,40 = 7.732; p = 0.001; η²p = 0.279) following FER training compared to control training. Regarding the static stimuli task, ANOVA revealed significant differences in scores only for disgust (F2,40 = 5.748; p = 0.006; η²p = 0.223), with improvement following FER training compared to baseline (p = 0.005).

Conclusion: FER training increased overall performance accuracy, particularly for happiness and disgust. Future studies involving multiple training sessions, larger sample sizes, and clinical populations are essential for the generalization of these findings.

Objective: The objective of the present study was to describe and analyze the characteristics of internet use in undergraduate students that engaged in nonsuicidal self-injury (NSSI) compared with individuals not engaging in this behavior.

Methods: An observational cross-sectional study was conducted. The questionnaire used to investigate NSSI was devised based on the DSM5 diagnostic criteria. Internet use was investigated using 2 questionnaires: a questionnaire developed by the researchers; and the Portuguese version of the Internet Addiction Test (IAT). Exploratory analysis of data was performed based on summary measures. Mann-Whitney and chi-square tests were employed, and multiple logistic regression models constructed with stepwise variable selection criteria. A 5% level of significance was adopted.

Results: Data on 6,906 university students were analyzed, 1,188 (17%) of whom reported at least one NSSI episode in their lifetime. The group engaging in self-injurious behavior showed a stronger association with more intense internet use than they would like and felt they related more with individuals online than in person. The group engaging in self-injurious behavior reported using the internet more often to meet new people for friendships and for erotic relationships and preferred the excitement of the internet to intimacy with a partner.

Conclusion: The feeling of loneliness linked to self-injurious behavior might contribute to self-injurers seeking relationships online. Also, the anonymous nature of online interactions may constitute an attractive environment for expressing psychological anguish and other emotional problems. As a study limitation, this is a cross-sectional design in which associations are identified, but risk factors cannot be established.

Introduction: Population aging in Brazil has important implications for public health, including an increased prevalence of mental disorders. Few Brazilian studies have assessed these conditions in community-dwelling older adults using DSM-5 criteria.

Objective: To determine the prevalence of mental disorders in older adults according to DSM-5 diagnostic criteria.

Methods: A cross-sectional study was conducted with 267 older adults living in the catchment area of a Primary Health Care Unit in São Paulo State. Structured clinical evaluations based on DSM-5 were conducted by trained psychiatrists. Frequencies were calculated, and logistic regression analyses examined associations with sex, age, and education.

Results: The prevalence of any current mental disorder was 74.2%, with 46.8% presenting two or more diagnoses. The most frequent disorders were generalized anxiety disorder (17.6%), depressive disorders (13.5%), and neurocognitive disorders (34.0%). Female sex was associated with greater odds of generalized anxiety disorder (OR=2.3; 95% CI: 1.12-4.74; p=0.032) and marginally with major depression (OR=2.02; 95% CI: 0.93-4.42; p=0.077). Older age was associated with both mild (OR=1.06; 95% CI: 1.02-1.11; p=0.005) and major neurocognitive disorders (OR=1.06; 95% CI: 1.00-1.12; p=0.037), whereas lower education was associated with major neurocognitive disorder (OR=0.75; 95% CI: 0.59-0.95; p=0.019).

Conclusions: The prevalence of mental disorders in community-dwelling older adults was high, particularly for anxiety, depression, and neurocognitive disorders. These findings highlight the need for screening and mental health strategies targeting this population, especially in primary care settings.

Background: With increased screen time among children and adolescents, concerns about the impact of loot boxes (LB) on gambling behaviors have grown. LBs, often included in video games as purchasable items with randomized rewards, resemble gambling mechanics, raising concerns about potential risks for youth.

Methods: This systematic review collected and analyzed all available studies on LB use and gambling in individuals under 18 years old. A literature search was conducted using Cochrane, SciELO, and PubMed databases up to March 30, 2024. The inclusion criteria focused on peer-reviewed empirical studies examining the association between LBs and gambling behaviors in minors, while studies on unrelated gambling behaviors or those involving adults were excluded.

Results: From 74 initial articles, 4 studies met the inclusion criteria. Findings consistently showed a positive association between LB engagement and gambling tendencies in adolescents. Results indicate that adolescents involved with LBs are at a higher risk of problematic gambling behaviors, with gender differences also observed, as male adolescents showed higher engagement with LBs and gambling risks.

Conclusions: The review suggests a clear association between LB use and gambling behaviors in youth, with potential for LBs to act as a "gateway" to gambling. The findings highlight the need for regulatory actions, including age restrictions and educational efforts to protect youth from these risks. Further research with representative samples is necessary to deepen understanding of the LB-gambling link in young populations.

Objective: Unipolar and bipolar depression severely impact millions of individuals worldwide, with a significant subset of cases remaining unresponsive to conventional treatments. Psilocybin-assisted psychotherapy (PAP) has demonstrated therapeutic efficacy; however, the optimal psychotherapeutic approach remains undefined, ranging from unstructured models rooted in historical practices to modern frameworks that are structurally tailored for depression. This narrative review proposes a conceptualization of psychotherapeutic models employed in existing interventional trials of PAP for depression and provides a preliminary comparison of their main characteristics and evidence for efficacy.

Methods: The online databases PubMed, PsycINFO, and Google Scholar were searched for interventional trials evaluating PAP for individuals with unipolar or bipolar depression.

Results: A total of 38 publications were reviewed, contributing to the conceptualization of two main types of psychotherapy models: 1) 'Specific' approaches (most commonly Acceptance and Commitment Therapy and Perceptual-Control Therapy) and 2) 'Non-specific' models of psychological support. Both models emphasize the critical role of the therapeutic alliance, yet differ in mechanistic focus, with specific models being developed to enhance psychological flexibility and non-specific models emphasizing the concept of the 'inner-healer.' Importantly, critical gaps in the literature were identified, including methodological limitations of current evidence and the need for standardized reporting guidelines.

Conclusion: Although each PAP model differs, both may have clinical relevance in depression treatment. Future work should explore the standardized reporting of psychological interventions in PAP and comparative study designs to better evaluate non-specific and specific models and inform treatment guidelines.

Objective: This study aimed to investigate the relationship between the frequency and duration of exercise and symptoms of depression and anxiety.

Methods: This is a household survey conducted with a sample of 2,297 adults living in the city of Rio de Janeiro. The frequency and duration of exercise were measured using two closed-ended questions. Symptoms of depression and anxiety were assessed using the PHQ-9 and the GAD-7, respectively. Additionally, sociodemographic and anthropometric information (weight and height) was obtained. Bivariate and multivariate regression models were used to estimate the odds ratios (OR) of the associations between the variables.

Results: A total of 2,201 (age= 38.3 years (SE = 0.4), 62% women) individuals were evaluated. Compared to the non-exercisers, individuals who exercised at least once a week showed significantly lower odds of presenting depressive symptoms, even after adjusting for sex and BMI (OR = 0.7 [95% CI: 0.50-0.96], p = 0.03). Similar results were observed for frequency (2-4 times per week) and duration (≥1 hour and <2 hours). However, after adjusting for sex and BMI, these associations were no longer significant. Finally, no association was found between exercise and anxiety symptoms.

Conclusion: Physical exercise was associated with a lower likelihood of presenting depressive symptoms. Additionally, a moderate frequency and duration of exercise, initially associated with reduced odds of depressive symptoms, was no longer significant after adjusting for sex and BMI. Thus, body weight and sex appear to mediate the relationship between physical exercise and depressive symptoms in our sample.

Objective: Cognitive-behavioral therapy (CBT) is a first-line treatment for anxiety and depressive disorders, but its preventive efficacy remains uncertain. This study systematically reviewed and meta-analyzed randomized controlled trials of universal CBT-based interventions across all age groups, evaluating their effects on anxiety, depression, and quality of life.

Methods: We included randomized controlled trials of universal CBT programs delivered to general populations without prior risk or symptom screening. Eligible outcomes were depressive and anxiety symptoms and quality of life. Risk of bias was assessed using the Cochrane Risk of Bias tool. Separate three-level meta-analyses were conducted for each outcome, and subgroup analyses were performed by participant age and provider profession.

Results: Seventeen RCTs (n = 10,809 participants) met inclusion criteria. Pooled effect sizes were SMD = -0.02 (95% CI: -0.12 to 0.09) for quality of life, SMD = -0.09 (95% CI: -0.20 to 0.01) for depressive symptoms, and SMD = -0.03 (95% CI: -0.18 to 0.13) for anxiety symptoms. None reached statistical significance. Subgroup analyses confirmed no significant effects in children/adolescents or adults. Interventions delivered by psychologists were more effective than those delivered by teachers (SMD = 0.18), although overall preventive effects remained negligible.

Conclusions: Universal CBT interventions did not demonstrate significant preventive benefits for anxiety, depression, or quality of life across age groups. These findings suggest that universal CBT should not be adopted as a population-wide prevention strategy, and future research should prioritize targeted, data-driven approaches.