Trends in Psychiatry and Psychotherapy最新文献

Introduction: Clinical staging is widely applied in various fields of Medicine. Staging makes it possible to constitute early diagnoses and interventions, improving prognosis and preventing disease progression. In relation to Alcohol Use Disorder (AUD), staging is still an underdeveloped subject in the scientific literature. The treatment of AUD is effective for a minority of patients, requiring more targeted interventions individually. This study aims to propose a staging model for AUD that establishes key factors related to the progression of the disorder.

Method: Non-systematic review of the literature on Pubmed/Medline database focusing on articles about AUD and that present a stratified classification and treatment outcomes for that subpopulation through the progression of the disease.

Results: The model proposed includes stages 0 (latent), I A, I B, II A, II B, III A, III B and IV.

Discussion: This study can be used as a basis for a myriad of other reviews with the aim of validating a staging model in AUD. We recommend a systematic review study to validate the model suggested in this study and correlate clinical aspects with neurobiological aspects and the effectiveness of certain treatments.

Conclusion: This work shows that, based on the stratified classification of response to treatment, it is possible to suggest a staging model for AUD. Furthermore, the stages can be subdivided based on different clinical characteristics, risk factors, prognosis and management.

Introduction: Excessive smartphone use has been linked to mental health impairments and may potentially alter human behavior. These effects are particularly pronounced among young individuals, with university students being especially susceptible to the negative influences of smartphone use.

Methods: This observational, cross-sectional study was conducted in a sample of 781 Brazilian university students. We assessed socio-economic variables, smartphone addiction, depression, anxiety, stress outcomes, eating behavior, body image satisfaction, and self-reported physical activity. MANOVA and Chi-square tests were performed to compare continuous and categorical variables between genders. K-means clustering was used to identify participant profiles based on various self-reported variables, with differences between clusters validated using the Z-test and the silhouette coefficient.

Results: Three clusters were identified. Cluster 1 featured participants with a significant disparity between their perceived and desired body image, higher scores on eating disorders, smartphone addiction, and mental health questionnaires, and lower engagement in physical exercise. Cluster 2 consisted of older participants who scored lower on smartphone addiction and mental health with a higher body mass index. Cluster 3 included younger participants with a smaller silhouette scale disparity, lower eating disorder scores, and lower body mass index. Smartphone addiction showed significant associations with eating disorders in overall eating disorders classification (X²=13.4; p<0.001), bulimic behavior (X²=20.0; p<0.001), and social pressure to eat (X²=4.3; p<0.001). It also negatively correlated with physical exercise (X²=5.7; p=0.017), but not with dieting concerns (X²=0.23; p=0.688).

Conclusion: Smartphone addiction is associated with eating disorders, stress, depression, anxiety, and lower levels of physical activity.

Introduction: Current disease-specific models for prevention of mental disorders are challenged by the overlap of psychopathology, biological mechanisms, and risk factors. Moreover, mental disorders usually begin during childhood or adolescence, when symptoms fluctuate and are highly non-specific.

Discussion: We propose a staging model that integrates three domains - psychopathology, functional impairment and risk factors-, in which prevention is defined as actions to avoid stage progression, irrespective of diagnosis. Thus, preventive interventions should be broadened to include mental health promotion and strategies of risk reduction performed individually, at any stage, even for non-symptomatic subjects (before current at-risk definitions) currently exposed to risk factors.

Conclusions: The model features three innovations: a focus shift from disease conversion to stage progression, highlights functionality as an independent target, and acknowledgment of risk factors in the staging. The model must be validated before implementation.

Objective: Caregivers appear to experience mental health implications related to their role in supporting patients with bipolar disorder (BD). This study aimed to review literature assessing the presence of not only psychiatric symptoms but also mental disorders and personality disorders in caregivers of patients with BD.

Methodology: This is a narrative review. Articles were searched in some computerized databases, including PubMed, Embase, Web of Science, PsychINFO, Liliacs, and Scielo up to June 2024. Inclusion criteria comprised articles in any language, focusing on primary caregivers of BD patients, and quantitative studies evaluating the presence of mental disorder, personality disorder, or psychiatric symptoms in this caregiver group.

Results: The review encompassed 15 articles. Only two studies utilized appropriate diagnostic instruments for assessing mental disorder, and no article evaluated personality disorder. Prevalence of caregiver's psychiatric symptoms and mental disorder was found to be higher compared to the general population.

Conclusions: The lack of studies employing diagnostic assessment tools for mental disorder in these individuals may impede timely access to treatment, affecting both the caregiver's health and the course of patients with BD. This study provides an updated overview of research on caregivers of patients with BD, despite the limitation of not being a systematic review. Further studies employing diagnostic assessments on caregivers are essential to gain deeper insights into this critical topic.

Objective: This study aimed to evaluate mental health factors in individuals affected by the floods in Rio Grande do Sul from May 10 to June 6, 2024.

Methods: A real-time survey was conducted with 1,552 participants. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Acute Stress Disorder (ASD) symptom checklist were used to assess mental health outcomes. Sociodemographic factors, trauma exposure, rescue participation, and psychological support were evaluated. Statistical analyses included t-tests, ANOVA, linear regression, and MANCOVA.

Results: High rates of depressive and anxious symptoms were found, with over half of the individuals with moderate to severe symptoms reporting no prior history of these conditions. Participants directly affected by the floods, and those with close ones affected, had higher PHQ-9, GAD-7, and ASD scores compared to the unaffected group. Moreover, younger age, female sex, lower family income, participation in rescues, and unmet psychological support needs were correlated with worse mental health outcomes. Individuals who participated in rescues had significantly higher rates of suicide ideation. Notably, psychological support had the largest effect size in mitigating mental health symptoms, regardless of trauma exposure status, when controlled for age, sex, and income according to MANCOVA.

Conclusions: The findings highlight the critical role of psychological support in disaster response and the importance of community resilience. Real-time data collection during crises can inform targeted interventions, emphasizing the need for robust mental health services and community support networks. These efforts are essential to reduce long-term psychological morbidity and foster recovery in vulnerable populations.

Objective: Approximately 6 to 13% of women suffer from antenatal depression (AD) around the world. AD can lead to several health problems for mother-baby. Vitamin D is a molecule that appears to have great preventive/therapeutic potential against neuropsychiatric disorders. The present study aimed to analyze the association between deficiency of vitamin D and AD in pregnant women in a city in the south of Brazil (Pelotas, RS). We hypothesize that pregnant women with a positive AD diagnosis have deficient levels of 25-hydroxyvitamin D (25(OH)D).

Methods: This cross-sectional study was conducted in a cohort study (CEP/UCPEL 47807915.4.0000.5339). From this cohort, 180 pregnant women at up to 24 weeks gestation were selected (130 non-depressed and 50 depressed), and the diagnosis of depression was made using the MINI-Plus. Blood was collected and stored for the later analysis of vitamin D (25(OH)D) by chemiluminescence method. The SPSS program was used for data analysis, and p<0.05 was considered statistically significant.

Results: In our study, we showed a significant association between Major Depressive Episode current in the antenatal period and vitamin D deficiency (OR: 0.9; CI 95%: 0.9;1.0, p=0.003).

Conclusion: Our results demonstrate that vitamin D deficiency may be involved in major depressive disorder in the antenatal period, in this way it advised a follow-up of vitamin D levels in the pregnancy-puerperal cycle to minimize mental health problems in women and prevent developmental deficits in children.

The Brazilian Academy of Sciences commissioned a report on mental health to develop strategies for addressing mental health challenges in the post-pandemic world. These strategies should be evidence-based, culturally sensitive, resource-efficient, and promote equity, while being tailored to specific contexts. The report's proposals are meant for discussion among S20 participating Academies of Sciences, serving as a collection of ideas to influence global mental health policies, rather than mandatory guidelines. Key points raised by the expert task force are highlighted for consideration.

Purpose: Life experiences that could either promote or attenuate depression have primarily been studied in adults. Therefore, we investigated the association between lifestyle factors and symptoms of depression in adolescents.

Design and setting: A cross-sectional study was carried out in Brazilians.

Subjects: Data from 93 individuals were analyzed out of the 150 invited participants (age 14.2±1.8, 67.74% girls).

Measures: Lifestyle habits (SMILE-C), physical activity and sitting time (IPAQ), as well as symptoms of depression (DASS-21) were evaluated.

Analysis: A network analysis was performed using the EBIC-LASSO model, with the expected influence as a centrality parameter.

Results: The lifestyle domains with the highest expected influence were diet and nutrition (1.423), walking (1.126) and Stress Management (1.015). The variables with the highest direct partial negative correlation with depression were social support (-0.307) and moderate-vigorous physical activity (-0.244), suggesting a bidirectional relationship between these variables with lower symptoms of depression.

Conclusion: Specific lifestyle areas such as social support, physical activity and nutrition appear to impact other healthy habits while reducing teen depressive symptoms.