Trends in Psychiatry and Psychotherapy最新文献

Introduction: Autism Spectrum Disorder (ASD) and Bipolar Disorder (BD) present significant challenges in diagnosis due to their complex nature. This review aims to examine the interface and overlapping features of these conditions.

Methods: We conducted a narrative review to examine clinical overlap, common psychiatric comorbidities, and shared neurobiological bases between ASD and BD.

Results: There is a notable convergence of symptoms in ASD and BD, including mood instability and emotional dysregulation; irritability, impulsivity, and aggressive behavior; deficits in social skills and social cognition; impairments in executive functions; sleep disturbances; problematic sexual behaviors; and sensory sensitivities. Common psychiatric comorbidities and shared neurobiological basis further underscore this potential interplay.

Conclusion: Despite distinct clinical trajectories and diagnostic criteria, our findings indicate a significant overlap in symptoms and clinical presentations between ASD and BD. This complexity makes it challenging to identify the co-occurrence of ASD and BD, which can lead to difficulties in accurately diagnosing and managing both conditions simultaneously.

Introduction: Climate change is happening, and feeling anxiety can be seen as a natural response to it. Climate anxiety is the worry about the climate crisis and could be related to specific emotions and thoughts. The aim of this study was to assess the prevalence of worry about climate change, and to describe the emotions and thoughts associated to it in Brazilian adults.

Method: Cross-sectional study with participants aged between 18-42 years (n=323). Data were collected online using the questionnaire developed by Hickman and colleagues, which assesses the worry, thoughts and feelings about climate change.

Results: 88.5% were worried about climate change. The feelings of sadness, powerlessness, fear and anxiety were reported more often among those who were worried. The most frequent thoughts were: "People have failed to take care of the planet", "The future is frightening", "My family's security will be threatened" and "Humanity is doomed".

Discussion: In this sample, the majority of the individuals were concerned about climate change, and they showed more negative emotions and thoughts when compared to individuals that were not concerned. Future studies should take care to not understand natural worries and anxiety responses to climate change as pathological.

Background: The offspring of parents with bipolar disorder (BD) and with attention deficit hyperactivity disorder (ADHD) have a higher risk of having the same condition. Both disorders also share psychopathological symptoms; however, little is known about their genetic overlap. To examine whether the offspring of parents with BD have a greater chance of being affected by ADHD, we conducted a systematic review.

Methods: From inception to August 12, 2024, we searched the PubMed, SciELO, PsycInfo and Cochrane databases. We included studies if they investigated the association of parental bipolar disorder with offspring outcomes and made a proper investigation of disorders using validated instruments based on the Diagnostic Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD) criteria. Studies were excluded if: parents were under 18 years old or over 70; did not report original data; systematic reviews; in vitro studies; with an animal model; offspring older than 17 years of age or with any comorbid diagnosis with ADHD. To assess risk of bias, two authors independently used the Newcastle-Ottawa Scale quality assessment tool.

Results: 23 articles met the inclusion criteria. The majority of the studies reported that the offspring of parents with BD were at higher risk for ADHD. Particularly, in all case‒control studies, the risk of ADHD was higher in the case group than the control group.

Conclusion: The current studies are yet heterogeneous and literature did not uncover the biological correlation of these disorders regarding genetic, biochemical, neuroimaging and neuropsychological aspects.

Objectives: Thus, through a narrative review, this article analyzes how the advancement of technology, the use of digital resources, and social media have impacted the doctor-patient relationship.

Methods: We conducted a scoping review on the relationship between Digital Health Equity and Telemedicine and e-health via Scopus and Pubmed electronic databases. The following inclusion criteria were established: papers on the relationship between digital health equity and telemedicine and e-health, written in English and with no time limits. All study designs were eligible, including those that have utilized qualitative and quantitative methods, methodology, or guidelines reports, except for meta-reviews.

Results: With the advancement of technology and social media, a change in behavior in the population and the doctor-patient relationship was observed. Through the help of digital devices, the increased prevalence of social networks, and asynchronous consultations new opportunities were created to bring doctors and patients closer. The relationship has shifted from face-to-face and paternalistic to virtual communication with shared decisions in recent decades. It was observed that the advancement of technology and the use of digital resources have reshaped the roles of doctors and patients and their relationships.

Conclusion: Technology is the leading cause for an informed, more involved, and responsible patient. However, physicians have conflicting opinions about the use of these technologies. While recognizing its benefits for patients, they are also concerned about digital health and its impact.

Objective: This study aimed to examine the discriminative capacity of Dimensional Clinical Personality Inventory 2 (IDCP-2) factors in identifying individuals with elevated Borderline Personality Disorder (BPD) traits within a Brazilian community sample while proposing an optimal cutoff score for distinguishing high BPD trait levels.

Methods: The participant cohort consisted of 1,469 adults who completed assessments, including the Level of Personality Functioning Scale - Brief Form 2.0 (LPFS), Personality Inventory for DSM-5 (PID-5), IDCP-2, and Structured Clinical Interview for the DSM-IV - Personality Questionnaire (PQ-SCID-II). We categorized participants into three groups by utilizing the traits outlined in the Alternative Model of Personality Disorders (AMPD) from DSM-5 Section III. Furthermore, latent profile analysis based on PID-5 facets revealed the existence of three empirically derived profiles.

Results: Our findings demonstrate that IDCP-2 factors exhibited substantial discriminative power, marked by large effect sizes across most factors. To minimize false negatives, we suggest a conservative cutoff score of 22 as the most effective threshold for identifying individuals with high levels of BPD traits.

Conclusion: The BPD score generated from IDCP-2 factors holds significant promise in clinical practice, offering valuable insights into a patient's propensity to exhibit a BPD profile and provide a comprehensive clinical profile.

Introduction: Clozapine is the only antipsychotic with proven superior efficacy for treatment-resistant schizophrenia. However, global utilization rates remain suboptimal due to concerns about hematological side effects. This study aimed to investigate hematological abnormalities among clozapine users at a large community center in the Brazilian countryside.

Methods: This study adopts a real-world approach and was conducted based on a retrospectively analyzed complete blood counts from clozapine users in Goiás, Brazil. We describe the total number and percentage of participants presenting blood dyscrasias. Logistic regression models, using Stata v.18, were employed to evaluate whether sex or age were associated with the presentation of neutropenia.

Results: Data from 6,160 complete blood counts from 486 patients taken between 2011 and 2018 were analyzed. Blood dyscrasias were observed in 37.4% of patients, with anemia being the most common (23.6%), followed by thrombocytopenia (9.46%) and eosinophilia (13.7%). Neutropenia occurred in 4.52% of patients, primarily mild (3.9%) and moderate (0.62%), with no cases of agranulocytosis identified.

Discussion: Clozapine users showed a higher prevalence of blood dyscrasias compared to the overall Brazilian population. Most cases of neutropenia were mild and transient. Our results suggest a lower risk of severe neutropenia and emphasize the need to investigate other blood dyscrasias.

The current study presents the case of a young man with intellectual disability related to fetal alcohol syndrome, referred for forensic psychiatric examination of criminal liability following charges of armed robbery, and who was considered not criminally liable. In such cases, it is crucial to perform early diagnosis and rely on educational and developmental services and a supportive home environment to decrease complications such as substance use and criminal involvement.

Aim: To carry out the process of cross-cultural adaptation of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context.

Method: Statistical procedures were carried out, based on the analysis of the validity of the internal structure of the scale, as well as its relationship with external variables. 224 parents/guardians of children/adolescents aged between five and 18 years participated in the study. The data collection form included instruments for assessing (hypo)manic symptoms, irritability, inattention, hyperactivity, emotional symptoms and behavioral problems. Data were collected in person, at a public school and at a Psychosocial Care Center, and online (via Google forms). Exploratory and confirmatory factor analyses, measurement invariance analyses, reliability analyzes were performed, as well as convergent and concurrent validity analyses.

Results: The one-dimensional model was investigated, showing satisfactory results, similar to those of the original scale. A reduced version was proposed with the ten most robust items from this study. Validity analyzes based on hypotheses indicated higher scores among those subjects with more clinical problems, such as the previous existence of a psychiatric diagnosis. Statistically significant and positive correlations, of low and moderate magnitudes, were observed with the scores of the other instruments used.

Final considerations: The results indicated that the adapted versions of the CMRS-P (full scale and reduced form) are promising instruments for use in the country.