Trends in Psychiatry and Psychotherapy最新文献

Objective: Yellow September (YS) (Setembro Amarelo) is a Brazilian suicide prevention campaign launched in 2015, however, its effectiveness at reducing mortality is still unknown. This is an ecologically interrupted time series study that analyzed the trend in suicide rates in Brazil between 2011 and 2019 and its association with the implementation of YS at a national level.

Methods: A segmented interrupted series regression analysis was performed, using a generalized linear Poisson model, with correction for seasonal trends. Data were provided by the Mortality Information System (Sistema de Informações Sobre Mortalidade [SIM]).

Results: There was an increase in the annual rates of suicide deaths between 2011 and 2019, with 4.99 and 6.41 suicides per 100,000 inhabitants, respectively. The null hypothesis, that the YS did not change the historical trend of growth in suicides in Brazil after its implementation, was confirmed. However, there was a significant increase of 6.2% in the risk of mortality in 2017 and a significant increase of 8.6% in 2019.

Conclusion: The results are consistent with the literature, which proposes that campaigns focused solely on publicity in the media generate unsound findings regarding the effective reduction in the number of deaths by suicide. The lack of initiatives involving multisectoral actions may explain the failure of YS to change rates of death by suicide. Therefore, implementation of new lines of action focused on training professionals and expanding the care network could make it an effective instrument for reducing mortality from suicide.

Introduction: The Posttraumatic Cognitions Inventory (PTCI) is a widely used measure for assessing negative posttraumatic cognitions that are common among individuals with trauma-related disorders. There was a need for a valid and reliable short form of the PTCI in Persian.

Objectives: This study aimed to translate the 9-item version of the PTCI (PTCI-9) into Persian and evaluate its characteristics and psychometric properties.

Methods: This was a cross-sectional psychometric study using the translation and back-translation technique. Experts assessed the scale's content validity. Participants were 207 Iranian individuals recruited from the general population, 151 of whom were trauma-exposed. Participants completed the Persian version of the PTCI-9, the Beck Depression Inventory (BDI-II), and the World Health Organization Quality of Life (WHO-QOL) scale. The psychometric properties of the Persian version of PTCI-9 were assessed using exploratory and confirmatory factor analysis (CFA) methods. Cronbach's α coefficient and Pearson's correlation coefficients were also calculated.

Results: Factor analyses supported a three-factor model including the Self, World, and Self-Blame subscales. The Cronbach's alpha of the Persian version of PTCI-9 (α = 0.74) and its subscales (0.76, 0.82, 0.78) demonstrated acceptable reliability. The Persian PTCI-9 also had strong test-retest reliability (r = 0.79). The correlations between the Persian version of the PTCI-9 and the BDI-II (r = 0.60) and the WHO-QOL (r = -0.54) indicated that the scale also has convergent validity.

Conclusion: The Persian version of the PTCI-9 showed acceptable psychometric properties. It is a brief and pragmatic measure that can be used in Iranian trauma-exposed patients for research and clinical purposes.

Eating disorders (ED) are a group of potentially severe mental disorders characterized by abnormal energy balance, cognitive dysfunction, and emotional distress. Cognitive inflexibility is a major challenge to successful ED treatment and dysregulated serotonergic function has been implicated in this symptomatic dimension. Moreover, there are few effective treatment options and long-term remission of ED symptoms is difficult to achieve. There is emerging evidence for the use of psychedelic-assisted psychotherapy (PAP) for a range of mental disorders. Psilocybin is a serotonergic psychedelic that has demonstrated therapeutic benefit in a variety of psychiatric illnesses characterized by rigid thought patterns and treatment resistance. The current paper presents a narrative review of the hypothesis that psilocybin may be an effective adjunctive treatment for individuals with EDs, based on biological plausibility, transdiagnostic evidence, and preliminary results. Limitations of the PAP model and proposed future directions for its application to eating behavior are also discussed. Although the literature to date is not sufficient to propose the incorporation of psilocybin in the treatment of disordered eating behaviors, preliminary evidence supports the need for more rigorous clinical trials as an important avenue for future investigation.

Objectives: Intimate partner violence (IPV) increased extensively around the world during the pandemic, causing severe harm to women's mental health. However, there are no studies showing these effects in Brazil. The objectives of this study were to assess perpetration of IPV and presence of depression and suicidal ideation in women living in Brazil during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Cross-sectional online survey including women living in Brazil from July 2020 to June 2021. Participants answered a 43-item self-administered questionnaire exploring their characteristics and life changes due to the pandemic (CoRonavIruS Health Impact Survey [CRISIS]), IPV (World Health Organization Violence Against Women [WHO-VAW]), and depressive symptoms or suicidal ideation (Patient Health Questionnaire-9 [PHQ-9]). We used Poisson multiple regression analyses with robust variance to model associations between IPV and mental health outcomes, considering aspects of social vulnerability as covariates.

Results: We found high frequencies of IPV (33.3%), depression (36.1%), and suicidal ideation (19.8%) among the participants. IPV was significantly associated with depression (prevalence ratio [PR] = 1.502, p = 0.001 for one type of IPV; PR = 2.702, p < 0.001 for two or three types of IPV) and with suicidal ideation (PR = 2.264, p < 0.001 for one type of VPI; PR = 3.272, p < 0.001 for two or three types of IPV). Food insecurity, being black, lower educational levels, and being in a relationship with a person of the same gender were associated with one or both mental health outcomes.

Conclusions: We demonstrated associations between IPV and higher frequencies of depression and suicidal ideation in women living in Brazil during the COVID-19 pandemic, highlighting the urgency of strengthening strategies to protect women during adversity.

Introduction: Medical students are a population at increased risk for anxiety due to their demanding schedule and concerns about potential stigmatization, which often leads to discouragement when seeking help. COVID-19 pandemic has been reported to worsen this issue by restricting social interaction and mobility. To address this problem, an innovative method known as Asynchronous Digital Cognitive Education GAMA-AIMS (DCE GAMA-AIMS) has been introduced. Compared to traditional therapy, this modality can be accessed independently without the guidance of a therapist.

Objectives: To compare the effectiveness of DCE GAMA-AIMS in reducing anxiety scores compared to guided brief Cognitive Behavioral Therapy (guided bCBT).

Methods: A non-blinding RCT was conducted on 66 medical students. The participants were equally divided into two groups, namely intervention and control. The intervention group was given DCE GAMA-AIMS, while the control was administered with guided bCBT. The data obtained were analyzed using independent t-test and ANOVAs.

Results: The application had a significant effect on reducing anxiety scores from the 2nd week (M TMAS = 18) to the 8th week (M TMAS = 13). A faster and more significant improvement was observed in the intervention group from the 1st to the 2nd week compared to the control, which began to improve in the 4th week. Furthermore, the intervention group had larger effect sizes (1.32) compared to the control (0.79) from the 1st to 8th week.

Conclusion: Asynchronous DCE GAMA-AIMS and guided bCBT could reduce TMAS scores in medical students with anxiety, but DCE GAMA-AIMS yielded a greater effect size.

Introduction: Children grow up spending most of their time within the family social environment, where they can experience stressful situations such as marital conflict, a non-cohesive environment, parental alcohol use disorder, parental depression, and other parental mental health issues. All these factors are associated with children's developmental delays.

Objective: We aimed to conduct a scoping review on family stress and family resilience associated with child development delays to examine familial conditions associated with child development.

Methods: We conducted a scoping review of observational studies published between January 2000 to July 2023, indexed in MEDLINE and LILACS databases. We included observational studies that evaluated the history of exposure to violence, and behavioral or emotional symptoms, or mental health problems among children aged 4-12. Data were independently extracted using a structured form.

Results: Database searches identified 12,990 different records. A total of 43 articles were included in the review. Three main findings emerged: (1) parental mental health problems, especially depressive symptoms in mothers, were associated with child developmental delays and mental health problems; (2) better parenting practices and cohesive home environment were positively associated with child development, and (3) Vulnerable social environments (e.g., poverty and housing insecurity) may be linked to child mental health problems.

Conclusions: Studies reviewed show that promoting better family dynamics and increasing family cohesion, as well as parenting abilities, are beneficial to a child's socio-emotional development and prevention of child mental health problems. Moreover, increasing family and children's resilience improves the quality of life within family units.

Introduction: Lifestyle Medicine comprises six domains: diet, substance use, physical activity, stress management, social connection, and sleep. The comprehensive assessment of lifestyle is challenging, but the "Short Multidimensional Inventory on Lifestyle Evaluation" (SMILE) was developed to fill out this gap. In this paper, we describe the development and the psychometric properties (internal consistency, concurrent and convergent validity) of a shorter version of the SMILE among university students.

Methods: Data from a cross-sectional study including 369 students from 10 Brazilian universities were used. Considering a theoretical nomological net, we performed exploratory factor analysis to obtain the most parsimonious, interpretable and good-fitting model.

Results: The final model was called U-SMILE, comprised 24 items, and presented acceptable internal consistency (Cronbach's α = 0.73, McDonald's ω = 0.79). To evaluate the concurrent validity of the U-SMILE, we compared it to the original SMILE and found a high correlation between the instruments (Spearman's r= 0.94). Furthermore, we evaluated convergent validity by examining the U-SMILE correlation with the PHQ-9 (Spearman's r= -0.517), and GAD-7 (Spearman's r= -0.356), two validated instruments to screen for depression and anxiety, respectively.

Discussion: Our findings suggest that the U-SMILE is a valid instrument for assessing lifestyle among university students. We recommend that the use of U-SMILE to evaluate overall lifestyle scores rather than individual domain scores. Finally, we discuss the importance of clarifying the definitions of lifestyle and related constructs in future research.

Background: Ketamine and esketamine have both shown significant antidepressant effects in treatment-resistant depression (TRD), and conflicting evidence suggests that induced dissociation by these drugs can be a clinical predictor of esketamine/ketamine's efficacy.

Methods: This study is a secondary analysis from a bi-center, randomized, controlled trial. Participants were randomly assigned 1:1 to receive an IV infusion of esketamine (.25 mg/kg) or racemic ketamine (.50 mg/kg) over 40 minutes. Dissociative symptoms were assessed using the Clinician-Administered Dissociative State Scale (CADSS) 40 minutes following the beginning of the infusion. The variation in depression scores was measured with the Montgomery-Asberg Depression Rating Scale (MADRS), which was administered before the intervention as a baseline measure and 24 hrs, 72 hrs, and 7 days following infusion.

Results: Sixty-one patients were included in the analysis. Examining CADSS scores of 15 or below, for every 1-point increment in the CADSS score, there was a mean change of -0.5 (SD = 0.25; p-value 0.04) of predicted MADRS score from baseline to 24 hrs. The results for 72 hrs and 7 days following infusion were not significant. Limitations: This study was not designed to assess the relationship between ketamine or esketamine-induced dissociation and antidepressant effects as the main outcome, therefore confounding variables for this relationship were not controlled.

Conclusion: We suggest a positive relationship between dissociation intensity, measured by CADSS, and antidepressant effect 24 hours after ketamine and esketamine infusion for a CADSS score of up to 15 points.