Pub Date : 2023-04-26DOI: 10.1590/1516-4446-2022-2775
G. R. Cunha, A. Caye, P. Pan, H. Fisher, Rivka B. Pereira, Carolina Ziebold, R. Bressan, B. Kohrt, V. Mondelli, C. Kieling, A. Gadelha
Objective: The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) was recently developed in Brazil using data from the Pelotas 1993 Birth Cohort to estimate the individualized probability of developing depression in adolescence. This model includes 11 sociodemographic variables and has been assessed in longitudinal studies from four other countries. We aimed to test the performance of IDEA-RS in an independent, community-based, school-attending sample within the same country: the Brazilian High-Risk Cohort. Methods: Standard external validation, refitted, and case mix-corrected models were used to predict depression among 1442 youth followed from a mean age of 13.5 years at baseline to 17.7 years at follow-up, using probabilities calculated with IDEA-RS coefficients. Results: The area under the curve was 0.65 for standard external validation, 0.70 for the case mix-corrected model, and 0.69 for the refitted model, with discrimination consistently above chance for predicting depression in the new dataset. There was some degree of miscalibration, corrected by model refitting (calibration-in-the-large reduced from 0.77 to 0). Conclusion: IDEA-RS was able to parse individuals with higher or lower probability of developing depression beyond chance in an independent Brazilian sample. Further steps should include model improvements and additional studies in populations with high levels of subclinical symptoms to improve clinical decision making.
{"title":"Identifying Depression Early in Adolescence: assessing the performance of a risk score for future onset of depression in an independent Brazilian sample","authors":"G. R. Cunha, A. Caye, P. Pan, H. Fisher, Rivka B. Pereira, Carolina Ziebold, R. Bressan, B. Kohrt, V. Mondelli, C. Kieling, A. Gadelha","doi":"10.1590/1516-4446-2022-2775","DOIUrl":"https://doi.org/10.1590/1516-4446-2022-2775","url":null,"abstract":"Objective: The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) was recently developed in Brazil using data from the Pelotas 1993 Birth Cohort to estimate the individualized probability of developing depression in adolescence. This model includes 11 sociodemographic variables and has been assessed in longitudinal studies from four other countries. We aimed to test the performance of IDEA-RS in an independent, community-based, school-attending sample within the same country: the Brazilian High-Risk Cohort. Methods: Standard external validation, refitted, and case mix-corrected models were used to predict depression among 1442 youth followed from a mean age of 13.5 years at baseline to 17.7 years at follow-up, using probabilities calculated with IDEA-RS coefficients. Results: The area under the curve was 0.65 for standard external validation, 0.70 for the case mix-corrected model, and 0.69 for the refitted model, with discrimination consistently above chance for predicting depression in the new dataset. There was some degree of miscalibration, corrected by model refitting (calibration-in-the-large reduced from 0.77 to 0). Conclusion: IDEA-RS was able to parse individuals with higher or lower probability of developing depression beyond chance in an independent Brazilian sample. Further steps should include model improvements and additional studies in populations with high levels of subclinical symptoms to improve clinical decision making.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"24 1","pages":"242 - 248"},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84119818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-04DOI: 10.1101/2022.12.01.22283011
H. Al-Hakeim, Haneen Tahseen Al-Rubaye, Abdulsahib S. Jubran, A. Almulla, S. Moustafa, Michael Maes
Background. Some months after the remission of acute COVID-19 infection, some people show depressive symptoms, which are predicted by increased peak body temperature (PBT) and lowered blood oxygen saturation (SpO2). Nevertheless, no data indicate whether Long COVID is associated with increased insulin resistance (IR) in association with depressive symptoms and immune, oxidative, and nitrosative (IO&NS) processes. Methods. We used the homeostasis Model Assessment 2 (HOMA2) calculator to compute beta-cell function, insulin sensitivity and resistance (HOMA2-IR) and measured the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HAMD) in 86 Long COVID patients and 39 controls. We examined the associations between the HOMA2 indices and PBT and SpO2 during acute infection, and depression, IO&NS biomarkers (C-reactive protein, NLRP3 activation, myeloperoxidase, and advanced oxidation protein products) 3-4 months after the acute infection. Results. Long COVID is accompanied by increased HOMA2-IR, fasting blood glucose, and insulin levels. We found that 33.7% of the patients versus 0% of the controls had HOMA2-IR values >1.8, suggesting IR. PBT, but not SpO2, during acute infection significantly predicted IR, albeit with a small effect size. Increased IR was significantly associated with depressive symptoms as assessed with the BDI and HAMD above and beyond the effects of IO&NS pathways. There were no significant associations between increased IR and the activated IO&NS pathways during Long COVID. Conclusion. Long COVID is associated with new-onset IR in a subset of patients. Increased IR may contribute to the onset of depressive symptoms due to Long COVID by enhancing overall neurotoxicity.
{"title":"Increased insulin resistance due to long COVID is associated with depressive symptoms and partly predicted by the inflammatory response during acute infection","authors":"H. Al-Hakeim, Haneen Tahseen Al-Rubaye, Abdulsahib S. Jubran, A. Almulla, S. Moustafa, Michael Maes","doi":"10.1101/2022.12.01.22283011","DOIUrl":"https://doi.org/10.1101/2022.12.01.22283011","url":null,"abstract":"Background. Some months after the remission of acute COVID-19 infection, some people show depressive symptoms, which are predicted by increased peak body temperature (PBT) and lowered blood oxygen saturation (SpO2). Nevertheless, no data indicate whether Long COVID is associated with increased insulin resistance (IR) in association with depressive symptoms and immune, oxidative, and nitrosative (IO&NS) processes. Methods. We used the homeostasis Model Assessment 2 (HOMA2) calculator to compute beta-cell function, insulin sensitivity and resistance (HOMA2-IR) and measured the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HAMD) in 86 Long COVID patients and 39 controls. We examined the associations between the HOMA2 indices and PBT and SpO2 during acute infection, and depression, IO&NS biomarkers (C-reactive protein, NLRP3 activation, myeloperoxidase, and advanced oxidation protein products) 3-4 months after the acute infection. Results. Long COVID is accompanied by increased HOMA2-IR, fasting blood glucose, and insulin levels. We found that 33.7% of the patients versus 0% of the controls had HOMA2-IR values >1.8, suggesting IR. PBT, but not SpO2, during acute infection significantly predicted IR, albeit with a small effect size. Increased IR was significantly associated with depressive symptoms as assessed with the BDI and HAMD above and beyond the effects of IO&NS pathways. There were no significant associations between increased IR and the activated IO&NS pathways during Long COVID. Conclusion. Long COVID is associated with new-onset IR in a subset of patients. Increased IR may contribute to the onset of depressive symptoms due to Long COVID by enhancing overall neurotoxicity.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"46 1","pages":"205 - 215"},"PeriodicalIF":0.0,"publicationDate":"2022-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78637012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-10DOI: 10.1590/1516-4446-2021-2459
Javier Camacho-Rubio, G. Salazar de Pablo, C. Arango
Mental health problems, of which depression a paradigmatic example, are an increasing concern. Despite the generalization of mental health care in our environment, the incidence of depression continues to grow and it is now one of the leading causes of disability. Globally, its estimated cost is one trillion dollars per year, mainly due to decreased productivity from work absenteeism. Most mental health care is carried out in clinical settings, which limits early detection and the possibility of acting on the incidence of mental conditions. Thus, early intervention strategies are needed in the fields of prevention (primary and secondary) and mental health promotion. The work environment is considered the ideal place for these activities since the general population spends a large part of their time there. According to the World Health Organization, intensifying mental health care in the general population will result in a high economic return: for every dollar invested in depression and anxiety four dollars are saved, mainly through increased productivity at work. Intervention costs could be shared with the private sector, since companies will be interested in the economic return. Workplace interventions can impact work performance, which is a central domain of mental health promotion and is affected by workload, lack of participation and control, monotonous and unpleasant tasks, poor interpersonal relationships, precarious working conditions, and lack of leadership and communication. A number of interventions have been found to effectively reduce depressive symptoms and prevent their onset. They involve different formats (individual, group, self-administered, face-to-face, or telematic) and content (psychoeducation, exercise promotion, and psychological therapies). However, further research is needed to determine which have the best results. Professional care in the workplace also allows early detection of mental disorders and referral for treatment. In the context of the COVID-19 pandemic and due to its impact on the mental health of the working population, telehealth interventions may allow safer and more inexpensive interventions. A recent meta-analysis found that the mental health of health care workers has been especially affected, and thus this group is of particular interest. One in four health professionals have suffered significant depressive symptoms during the pandemic, and more than one in three are suffering from burnout. Other symptoms include insomnia, anxiety and post-traumatic features. They are being prioritized in public health policies. In conclusion, interventions to prevent mental disorders and promote mental health in the workplace are costeffective and could decrease the incidence of depression and reduce work absenteeism. During the COVID-19 pandemic, telehealth interventions for health professionals are highly important.
{"title":"Preventing mental disorders and promoting mental health in the workplace","authors":"Javier Camacho-Rubio, G. Salazar de Pablo, C. Arango","doi":"10.1590/1516-4446-2021-2459","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2459","url":null,"abstract":"Mental health problems, of which depression a paradigmatic example, are an increasing concern. Despite the generalization of mental health care in our environment, the incidence of depression continues to grow and it is now one of the leading causes of disability. Globally, its estimated cost is one trillion dollars per year, mainly due to decreased productivity from work absenteeism. Most mental health care is carried out in clinical settings, which limits early detection and the possibility of acting on the incidence of mental conditions. Thus, early intervention strategies are needed in the fields of prevention (primary and secondary) and mental health promotion. The work environment is considered the ideal place for these activities since the general population spends a large part of their time there. According to the World Health Organization, intensifying mental health care in the general population will result in a high economic return: for every dollar invested in depression and anxiety four dollars are saved, mainly through increased productivity at work. Intervention costs could be shared with the private sector, since companies will be interested in the economic return. Workplace interventions can impact work performance, which is a central domain of mental health promotion and is affected by workload, lack of participation and control, monotonous and unpleasant tasks, poor interpersonal relationships, precarious working conditions, and lack of leadership and communication. A number of interventions have been found to effectively reduce depressive symptoms and prevent their onset. They involve different formats (individual, group, self-administered, face-to-face, or telematic) and content (psychoeducation, exercise promotion, and psychological therapies). However, further research is needed to determine which have the best results. Professional care in the workplace also allows early detection of mental disorders and referral for treatment. In the context of the COVID-19 pandemic and due to its impact on the mental health of the working population, telehealth interventions may allow safer and more inexpensive interventions. A recent meta-analysis found that the mental health of health care workers has been especially affected, and thus this group is of particular interest. One in four health professionals have suffered significant depressive symptoms during the pandemic, and more than one in three are suffering from burnout. Other symptoms include insomnia, anxiety and post-traumatic features. They are being prioritized in public health policies. In conclusion, interventions to prevent mental disorders and promote mental health in the workplace are costeffective and could decrease the incidence of depression and reduce work absenteeism. During the COVID-19 pandemic, telehealth interventions for health professionals are highly important.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"15 1","pages":"461 - 462"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82469500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-14DOI: 10.1590/1516-4446-2021-2344
Claudia Buchweitz, A. Caye, C. Kieling
On our minds: the state of child and adolescent mental health Claudia Buchweitz,0000-0000-0000-0000 Arthur Caye,0000-0000-0000-0000 Christian Kieling0000-0000-0000-0000 Programa de Depressão na Infância e na Adolescência (ProDIA), Hospital de Clı́nicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Serviço de Psiquiatria da Infância e Adolescência, HCPA, Porto Alegre, RS, Brazil.
{"title":"On our minds: the state of child and adolescent mental health","authors":"Claudia Buchweitz, A. Caye, C. Kieling","doi":"10.1590/1516-4446-2021-2344","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2344","url":null,"abstract":"On our minds: the state of child and adolescent mental health Claudia Buchweitz,0000-0000-0000-0000 Arthur Caye,0000-0000-0000-0000 Christian Kieling0000-0000-0000-0000 Programa de Depressão na Infância e na Adolescência (ProDIA), Hospital de Clı́nicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Serviço de Psiquiatria da Infância e Adolescência, HCPA, Porto Alegre, RS, Brazil.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"9 1","pages":"233 - 234"},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82181470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-14DOI: 10.1590/1516-4446-2021-2317
L. Bolsoni, J. Crippa, J. Hallak, F. Guimarães, A. Zuardi
Objectives: We assessed whether administering cannabidiol (CBD) before recalling the traumatic event that triggered their disorder attenuates anxiety in patients with post-traumatic stress disorder (PTSD). As an exploratory pilot analysis, we also investigated whether this effect depends on the nature of the event (sexual vs. nonsexual trauma). Methods: Thirty-three patients of both sexes with PTSD were recruited and randomized 1:1 into two groups. One group received oral CBD (300 mg), and the other received a placebo before listening to a digital audio playback of their previously recorded report of the trigger event. Subjective and physiological measurements were taken before and after recall. We analyzed the data in two subsamples: trigger events involving sexual and nonsexual trauma. Results: In the nonsexual trauma group, the differences between measurements before and after recall were significantly smaller with CBD than placebo; this held true for anxiety and cognitive impairment. However, in the sexual trauma group, the differences were non-significant for both measurements. Conclusion: A single dose of CBD (300mg) attenuated the increased anxiety and cognitive impairment induced by recalling a traumatic event in patients with PTSD when the event involved nonsexual trauma.
{"title":"The anxiolytic effect of cannabidiol depends on the nature of the trauma when patients with post-traumatic stress disorder recall their trigger event","authors":"L. Bolsoni, J. Crippa, J. Hallak, F. Guimarães, A. Zuardi","doi":"10.1590/1516-4446-2021-2317","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2317","url":null,"abstract":"Objectives: We assessed whether administering cannabidiol (CBD) before recalling the traumatic event that triggered their disorder attenuates anxiety in patients with post-traumatic stress disorder (PTSD). As an exploratory pilot analysis, we also investigated whether this effect depends on the nature of the event (sexual vs. nonsexual trauma). Methods: Thirty-three patients of both sexes with PTSD were recruited and randomized 1:1 into two groups. One group received oral CBD (300 mg), and the other received a placebo before listening to a digital audio playback of their previously recorded report of the trigger event. Subjective and physiological measurements were taken before and after recall. We analyzed the data in two subsamples: trigger events involving sexual and nonsexual trauma. Results: In the nonsexual trauma group, the differences between measurements before and after recall were significantly smaller with CBD than placebo; this held true for anxiety and cognitive impairment. However, in the sexual trauma group, the differences were non-significant for both measurements. Conclusion: A single dose of CBD (300mg) attenuated the increased anxiety and cognitive impairment induced by recalling a traumatic event in patients with PTSD when the event involved nonsexual trauma.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"1 1","pages":"298 - 307"},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81277465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-07DOI: 10.1590/1516-4446-2021-2235
Bruna Velazquez, S. Petresco, Rivka B. Pereira, Claudia Buchweitz, P. Manfro, A. Caye, H. Fisher, B. Kohrt, V. Mondelli, C. Kieling
Objective: To explore associations between self-reported weekly physical activity and depressive symptomatology among adolescents in a school-based sample from Brazil. Methods: We surveyed 7,405 adolescents aged 14 to 16 years in 101 public schools in Porto Alegre, Brazil. We assessed physical activity using an adapted version of the Patient-Centered Assessment and Counseling for Exercise Plus Nutrition – Adolescent Physical Activity Measure (PACE+), and depressive symptoms using the Brazilian Portuguese version of the Patient Health Questionnaire – Adolescent Version. We compared the depressive symptom scores among adolescents with varying levels of physical activity. Results: Of the overall sample, 84.4% exercised less than the recommended frequency of 60 minutes/day, at least 5 days/week, of moderate to intense physical activity (PACE+ score ≥ 5). Adolescents whose physical activity levels fell below that threshold had higher median depression scores (8 [IQR = 10] vs. 7 [IQR = 9], W = 4060461, p < 0.001). A similar pattern was observed for depression scores in those with PACE+ < 1 (median of 10 [IQR = 11]) and ≥ 1 (7 [IQR = 9], W = 7457608, p < 0.001). Conclusion: In this large sample of Brazilian adolescents, those who exercised less frequently and vigorously than their peers reported more depressive symptoms.
目的:探讨以巴西学校为基础的青少年自我报告的每周体育活动与抑郁症状之间的关系。方法:我们在巴西阿雷格里港的101所公立学校调查了7405名14至16岁的青少年。我们使用改良版的以患者为中心的运动加营养评估和咨询-青少年身体活动测量(PACE+)评估身体活动，并使用巴西葡萄牙语版的患者健康问卷-青少年版评估抑郁症状。我们比较了不同体力活动水平的青少年的抑郁症状得分。结果:在整个样本中，84.4%的青少年运动少于推荐的60分钟/天，至少5天/周的中等至高强度体力活动(PACE+评分≥5)。体力活动水平低于该阈值的青少年的中位抑郁评分较高(8 [IQR = 10] vs. 7 [IQR = 9]， W = 4060461, p < 0.001)。PACE+ < 1(中位数为10 [IQR = 11])和≥1(中位数为7 [IQR = 9]， W = 7457608, p < 0.001)患者的抑郁评分也存在类似的模式。结论:在这个巴西青少年的大样本中，那些运动频率和强度低于同龄人的人报告了更多的抑郁症状。
{"title":"Physical activity and depressive symptoms among adolescents in a school-based sample","authors":"Bruna Velazquez, S. Petresco, Rivka B. Pereira, Claudia Buchweitz, P. Manfro, A. Caye, H. Fisher, B. Kohrt, V. Mondelli, C. Kieling","doi":"10.1590/1516-4446-2021-2235","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2235","url":null,"abstract":"Objective: To explore associations between self-reported weekly physical activity and depressive symptomatology among adolescents in a school-based sample from Brazil. Methods: We surveyed 7,405 adolescents aged 14 to 16 years in 101 public schools in Porto Alegre, Brazil. We assessed physical activity using an adapted version of the Patient-Centered Assessment and Counseling for Exercise Plus Nutrition – Adolescent Physical Activity Measure (PACE+), and depressive symptoms using the Brazilian Portuguese version of the Patient Health Questionnaire – Adolescent Version. We compared the depressive symptom scores among adolescents with varying levels of physical activity. Results: Of the overall sample, 84.4% exercised less than the recommended frequency of 60 minutes/day, at least 5 days/week, of moderate to intense physical activity (PACE+ score ≥ 5). Adolescents whose physical activity levels fell below that threshold had higher median depression scores (8 [IQR = 10] vs. 7 [IQR = 9], W = 4060461, p < 0.001). A similar pattern was observed for depression scores in those with PACE+ < 1 (median of 10 [IQR = 11]) and ≥ 1 (7 [IQR = 9], W = 7457608, p < 0.001). Conclusion: In this large sample of Brazilian adolescents, those who exercised less frequently and vigorously than their peers reported more depressive symptoms.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"18 1","pages":"312 - 316"},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73594693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-07DOI: 10.1590/1516-4446-2021-2175
Sidnei B. Lira, F. Vieira, D. Cavalcanti, B. Souza-Marques, L. R. Netto, F. S. Correia-Melo, G. C. Leal, J. L. Pereira, Lene L. Santos, Gisela M. Guedes, C. Teles, T. Cardoso, Â. Miranda-Scippa, F. Kapczinski, A. Lacerda, K. Koenen, G. Turecki, L. Quarantini
Objectives: Past suicide attempt (SA) is one of the most important risk factors for suicide death. An ideation-to-action framework posits that impulsivity, potentially traumatic events, and mental disorders also play a role in increasing suicide risk. This study aimed to assess the association between trait impulsivity, lifetime exposure to trauma, and post-traumatic stress disorder (PTSD) with SA in a sample of Brazilian college students. Methods: A total of 2,137 participants filled self-reported questionnaires consisting of a sociodemographic and clinical questionnaire, Trauma History Questionnaire, Post-Traumatic Stress Disorder Checklist – Civilian version, and Barratt Impulsiveness Scale. Results: Our findings suggest that trait impulsivity may be interpreted as exerting a distal effect on SA, even in the presence of other variables – such as trauma history, psychological neglect, and PTSD – which also increase the odds of SA. High and medium levels of impulsivity, history of trauma, and PTSD increased the likelihood of SA. Conclusions: Intervention strategies to prevent SA may target trait impulsivity and exposure to traumatic experiences.
{"title":"Suicide attempt, impulsivity, and exposure to trauma in college students","authors":"Sidnei B. Lira, F. Vieira, D. Cavalcanti, B. Souza-Marques, L. R. Netto, F. S. Correia-Melo, G. C. Leal, J. L. Pereira, Lene L. Santos, Gisela M. Guedes, C. Teles, T. Cardoso, Â. Miranda-Scippa, F. Kapczinski, A. Lacerda, K. Koenen, G. Turecki, L. Quarantini","doi":"10.1590/1516-4446-2021-2175","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2175","url":null,"abstract":"Objectives: Past suicide attempt (SA) is one of the most important risk factors for suicide death. An ideation-to-action framework posits that impulsivity, potentially traumatic events, and mental disorders also play a role in increasing suicide risk. This study aimed to assess the association between trait impulsivity, lifetime exposure to trauma, and post-traumatic stress disorder (PTSD) with SA in a sample of Brazilian college students. Methods: A total of 2,137 participants filled self-reported questionnaires consisting of a sociodemographic and clinical questionnaire, Trauma History Questionnaire, Post-Traumatic Stress Disorder Checklist – Civilian version, and Barratt Impulsiveness Scale. Results: Our findings suggest that trait impulsivity may be interpreted as exerting a distal effect on SA, even in the presence of other variables – such as trauma history, psychological neglect, and PTSD – which also increase the odds of SA. High and medium levels of impulsivity, history of trauma, and PTSD increased the likelihood of SA. Conclusions: Intervention strategies to prevent SA may target trait impulsivity and exposure to traumatic experiences.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"46 1","pages":"279 - 288"},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77602496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-07DOI: 10.1590/1516-4446-2021-2109
L. Pilz, N. S. C. Couto Pereira, A. Francisco, A. Carissimi, D. Constantino, Letícia B. Caus, A. C. Abreu, Guilherme R Amando, Fernanda S Bonatto, Paula V.V. Carvalho, J. Cipolla-Neto, Anas Harb, Gabriela Lazzarotto, J. R. Marafiga, L. Minuzzi, Francisco Montagner, Fernanda A. Nishino, Melissa A B Oliveira, Bruno G T Dos Santos, Eduardo G Steibel, P. Tavares, A. Tonon, N. Xavier, Q. K. Zanona, F. Amaral, M. Calcagnotto, B. Frey, M. Hidalgo, M. Idiart, T. Russomano
Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.
{"title":"Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic","authors":"L. Pilz, N. S. C. Couto Pereira, A. Francisco, A. Carissimi, D. Constantino, Letícia B. Caus, A. C. Abreu, Guilherme R Amando, Fernanda S Bonatto, Paula V.V. Carvalho, J. Cipolla-Neto, Anas Harb, Gabriela Lazzarotto, J. R. Marafiga, L. Minuzzi, Francisco Montagner, Fernanda A. Nishino, Melissa A B Oliveira, Bruno G T Dos Santos, Eduardo G Steibel, P. Tavares, A. Tonon, N. Xavier, Q. K. Zanona, F. Amaral, M. Calcagnotto, B. Frey, M. Hidalgo, M. Idiart, T. Russomano","doi":"10.1590/1516-4446-2021-2109","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2109","url":null,"abstract":"Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"20 1","pages":"136 - 146"},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74523351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-07DOI: 10.1590/1516-4446-2021-2267
Christina Fornazari, M. Canfield, R. Laranjeira
Objective: We explored hospitalization patterns and the clinical and individual characteristics of a large cohort of patients who underwent involuntary psychiatric hospitalization in Brazil (n=64,685). Methods: Data were collected from the District Attorney's Office of the State of São Paulo (Ministério Público do Estado de São Paulo) on all involuntary psychiatric hospitalizations in the city of São Paulo between January 2003 and February 2020. The annual involuntary psychiatric hospitalization rate was calculated and descriptive statistics of the characteristics were produced. Results: Involuntary psychiatric hospitalizations increased from 5.8 to 25.5 per 100,000 population, with an eight-folder increase in the first 10-year period (2003-2013). The majority of admissions were to public institutions (86.6%), involved a psychotic disorder in the primary diagnosis (26.1%), involved more than one diagnosis (83.7%), and lasted less than 7 days (52.4%). The majority of the patients were aged 18 to 39 years and were single, and readmission was relatively common (13%). Although the reason for admission was missing in many reports (44%), the risk of harm to self or others was the most common (68.5%). Conclusion: This is one of the largest cohorts of involuntary psychiatric hospitalization records ever explored. These findings build upon existing international evidence about involuntary psychiatric hospitalizations and show recent trends in admission rates in the largest city in Brazil.
目的:我们探讨了巴西非自愿精神科住院患者的住院模式和临床及个体特征(n=64,685)。方法:收集了2003年1月至2020年2月期间圣保罗州地方检察官办公室(ministrio Público do Estado de sastado de spaulo)所有非自愿精神病住院患者的数据。计算每年非自愿精神病住院率，并对其特征进行描述性统计。结果:非自愿精神病住院人数从每10万人5.8人增加到25.5人，在第一个10年期间(2003-2013年)增加了8个百分点。大多数住院患者是公立机构(86.6%)，主要诊断为精神障碍(26.1%)，多次诊断(83.7%)，持续时间少于7天(52.4%)。大多数患者年龄在18至39岁之间，单身，再入院相对常见(13%)。尽管在许多报告中遗漏了入院原因(44%)，但伤害自己或他人的风险是最常见的(68.5%)。结论:这是有史以来最大的非自愿精神病住院记录之一。这些发现建立在国际上关于非自愿精神疾病住院的现有证据的基础上，并显示了巴西最大城市住院率的最新趋势。
{"title":"Real world evidence in involuntary psychiatric hospitalizations: 64,685 cases","authors":"Christina Fornazari, M. Canfield, R. Laranjeira","doi":"10.1590/1516-4446-2021-2267","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2267","url":null,"abstract":"Objective: We explored hospitalization patterns and the clinical and individual characteristics of a large cohort of patients who underwent involuntary psychiatric hospitalization in Brazil (n=64,685). Methods: Data were collected from the District Attorney's Office of the State of São Paulo (Ministério Público do Estado de São Paulo) on all involuntary psychiatric hospitalizations in the city of São Paulo between January 2003 and February 2020. The annual involuntary psychiatric hospitalization rate was calculated and descriptive statistics of the characteristics were produced. Results: Involuntary psychiatric hospitalizations increased from 5.8 to 25.5 per 100,000 population, with an eight-folder increase in the first 10-year period (2003-2013). The majority of admissions were to public institutions (86.6%), involved a psychotic disorder in the primary diagnosis (26.1%), involved more than one diagnosis (83.7%), and lasted less than 7 days (52.4%). The majority of the patients were aged 18 to 39 years and were single, and readmission was relatively common (13%). Although the reason for admission was missing in many reports (44%), the risk of harm to self or others was the most common (68.5%). Conclusion: This is one of the largest cohorts of involuntary psychiatric hospitalization records ever explored. These findings build upon existing international evidence about involuntary psychiatric hospitalizations and show recent trends in admission rates in the largest city in Brazil.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"46 1","pages":"308 - 311"},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89905801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-28DOI: 10.1590/1516-4446-2021-2180
R. Santos, José Pedro Simões Neto, T. Belfort, I. Lacerda, M. Dourado
Objectives: To investigate the patterns of impairment in decision-making abilities and their relationship with cognitive and clinical symptoms in people with Alzheimer’s disease. We hypothesized that decision-making abilities would not be impaired at the same level and would be related to impairment of global cognition and other clinical symptoms of the disease. Methods: Using a cross-sectional design, we included a consecutive sample of 102 people with Alzheimer’s disease and their respective caregivers. We investigated the relationship between decision-making capacity and quality of life (QoL), disease awareness, mood, functionality, neuropsychiatric symptoms, and cognition. Results: Different levels of impairment were observed in the participants’ decision-making abilities. Understanding, appreciation, and reasoning were correlated, but expressing a choice was only correlated with appreciation. Deficits in understanding were related to impaired disease awareness, lower self-reported QoL, and lower comprehension of spoken language. Better appreciation was related to better orientation and lower age. Better reasoning was related to better orientation and better self-reported QoL. Deficits in expressing a choice were related to lower self-reported QoL. Conclusion: The pattern of impairment in decision-making abilities was not linear. Each decision-making ability was related to different cognitive and clinical deficits. Therefore, cognitive functioning is an insufficient criterion for judging an individual’s decision-making ability.
{"title":"Patterns of impairment in decision-making capacity in Alzheimer’s disease and its relationship with cognitive and clinical variables","authors":"R. Santos, José Pedro Simões Neto, T. Belfort, I. Lacerda, M. Dourado","doi":"10.1590/1516-4446-2021-2180","DOIUrl":"https://doi.org/10.1590/1516-4446-2021-2180","url":null,"abstract":"Objectives: To investigate the patterns of impairment in decision-making abilities and their relationship with cognitive and clinical symptoms in people with Alzheimer’s disease. We hypothesized that decision-making abilities would not be impaired at the same level and would be related to impairment of global cognition and other clinical symptoms of the disease. Methods: Using a cross-sectional design, we included a consecutive sample of 102 people with Alzheimer’s disease and their respective caregivers. We investigated the relationship between decision-making capacity and quality of life (QoL), disease awareness, mood, functionality, neuropsychiatric symptoms, and cognition. Results: Different levels of impairment were observed in the participants’ decision-making abilities. Understanding, appreciation, and reasoning were correlated, but expressing a choice was only correlated with appreciation. Deficits in understanding were related to impaired disease awareness, lower self-reported QoL, and lower comprehension of spoken language. Better appreciation was related to better orientation and lower age. Better reasoning was related to better orientation and better self-reported QoL. Deficits in expressing a choice were related to lower self-reported QoL. Conclusion: The pattern of impairment in decision-making abilities was not linear. Each decision-making ability was related to different cognitive and clinical deficits. Therefore, cognitive functioning is an insufficient criterion for judging an individual’s decision-making ability.","PeriodicalId":9246,"journal":{"name":"Brazilian Journal of Psychiatry","volume":"204 1","pages":"271 - 278"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78997901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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