Abstract Objetive: With the global population aging, there is a growing need for home-based care to meet the health needs of the elderly. However, the quality of care provided to the aged population is now arguably a significant challenge for most healthcare systems worldwide. Methods: The present review included 13 original studies on home care and its effects on dementia patients, describing how patient care and adequate treatment can be collaborative for their improvement, for case management, and optimizing pain control and specificities. Results: Among the findings, it was evidenced that the environment impacts the form of care, once being at home can improve communication and global monitoring of dementia patients. Conclusion: In addition to the results analyzed in this review, there is a need for future, well-designed studies on the different aspects of home care, highlighting the importance of evaluating the type of care for each patient in the quest to optimize the care.

RESUMO Objetivo: Com o envelhecimento da população mundial, há uma necessidade crescente de cuidados domiciliares para atender às necessidades de saúde dos idosos. No entanto, a qualidade dos cuidados prestados à população idosa é hoje indiscutivelmente um grande desafio para a maioria dos sistemas de saúde em todo o mundo. Métodos: A presente revisão incluiu 13 estudos originais sobre cuidados domiciliares e seus efeitos em pacientes com demência, descrevendo como o cuidado e o tratamento adequado do paciente podem ser colaborativos para sua melhora, para o gerenciamento de casos e a otimização do controle de sua dor e especificidades. Resultados: Entre os achados, evidenciou-se que o ambiente impacta a forma de atendimento, pois estar em casa pode melhorar a comunicação e o acompanhamento global dos pacientes em quadro demencial. Conclusão: Além dos resultados analisados nesta revisão, há a necessidade de futuros estudos bem elaborados sobre os diferentes aspectos da atenção domiciliar, destacando a importância de avaliar o tipo de cuidado de cada paciente na busca de otimizar o cuidado.

ABSTRACT Primary progressive aphasia comprises a group of neurodegenerative diseases characterized by progressive speech and language dysfunction. Neuroimaging (structural and functional), biomarkers, and neuropsychological assessments allow for early diagnosis. However, there is no pharmacological treatment for the disease. Speech and language therapy is the main rehabilitation strategy. In this case report, we describe a female patient diagnosed with nonfluent primary progressive aphasia who underwent sessions of high-frequency transcranial magnetic stimulation in the left dorsolateral prefrontal cortex and showed improvement in depression scores, naming tasks in oral and written speech, and comprehension tasks in oral and written discourse.

RESUMO As afasias progressivas primárias (APP) representam um grupo de doenças neurodegenerativas caracterizadas por disfunção progressiva da fala e da linguagem. A neuroimagem (estrutural e funcional), os biomarcadores e as avaliações neuropsicológicas permitem o diagnóstico precoce. No entanto, não há tratamento farmacológico para a doença. A terapia fonoaudiológica é a principal estratégia de reabilitação. Neste relato de caso, descrevemos uma paciente com diagnóstico de APP não fluente que foi submetida a sessões de estimulação magnética transcraniana de alta frequência no córtex pré-frontal dorsolateral esquerdo e apresentou melhora nos escores de depressão, nas tarefas de nomeação da fala oral e escrita e nas tarefas de compreensão da fala oral e escrita.

ABSTRACT Objective: Expand knowledge on the role and efficacy of carbamazepine (CBZ) in bipolar disorder (BD), based on original studies. Methods: The authors performed a systematic review of the scientific literature on the efficacy of CBZ in BD, using the PubMed/MEDLINE, Web of Science (ISI), and SciELO databases. The search terms were: (“carbamazepine”) AND (“bipolar” OR “mania” OR “manic”). There was no restriction on the year of publication. Results: A total of 27 articles were selected. Among the selected articles, 14 evaluated the use of CBZ in the manic phase of BD, two in the depressive phase of BD, and 11 in the maintenance phase of BD. In the studies on the manic phase of BD, CBZ proved superior to placebo (PLA). As for the depressive phase of BD, there were two studies, both with small samples. In the maintenance phase, CBZ was inferior to lithium, and no studies compared CBZ to PLA. Conclusion: The results of the clinical studies suggest that CBZ is effective for the treatment of the manic phase. Regarding the treatment of acute depression and maintenance of BD, the results of the studies indicate that there is not enough data demonstrating the effectiveness of CBZ.

RESUMO Objetivo: Ampliar o conhecimento sobre o papel e a eficácia da carbamazepina (CBZ) no transtorno bipolar (TB), a partir de estudos originais. Métodos: Realizou-se uma revisão sistemática de literatura científica sobre a eficácia da CBZ no TB. Foram utilizadas as bases de dados PubMed/MEDLINE, Web of Science (ISI) e SciELO. Os termos de busca empregados foram: (“carbamazepine”) AND (“bipolar” OR “mania” OR “manic”). Não houve restrição quanto ao período de publicação. Resultados: Foram selecionados 27 artigos. Entre os artigos selecionados, 14 avaliavam o uso da CBZ na fase de mania do TB, 2, na fase de depressão do TB e 11, na fase de manutenção do TB. A CBZ, nos estudos na fase de mania do TB, mostrou-se superior ao placebo (PLB). Em relação à fase de depressão no TB, havia dois estudos não controlados e com amostras pequenas. Quanto à fase de manutenção do TB, a CBZ foi inferior ao lítio, e não foram realizados estudos comparando com PLB. Conclusão: Os resultados dos estudos clínicos sugerem que a CBZ é eficaz para o tratamento da fase de mania. Em relação ao tratamento de depressão aguda e manutenção do TB, os resultados dos estudos indicam que não há dados suficientes que demonstrem a eficácia da CBZ.

Abstract Growing number of researches has studied driving phobia of in the last decades. Excessive fear of driving can cause impacts on the individual's career, social embarrassment and significant restrictions on their autonomy. The aim of this study was to investigate whether treatment with virtual reality exposure and Cognitive Behavioral Therapy (CBT) strategies were able to 1- reduce the frequency of cognitive distortions associated with driving, 2- increase participants' sense of self-efficacy, and 3 - increase the probability of going to in vivo exposure. 18 participants were randomly allocated into three groups: 1) 3 cognitive restructuring sessions + 7 virtual reality exposure sessions; 2) 3 relaxation / diaphragmatic breathing sessions + 7 virtual reality exposure sessions; 3) 3 relaxation / diaphragmatic breathing sessions and cognitive restructuring + 7 virtual reality exposure sessions. Participants answered Driving Cognition Questionnaire (DCQ) and the Self-efficacy Driving Scale (EADir - v2) in the first and tenth session. There was a significant reduction in the frequency of distorted thoughts and a significant increase in participants' sense of self-efficacy. In addition, it can be observed that the treatment favored to go to in vivo exposures. CBT strategies and virtual reality exposure proved to be effective. Although there are statistically significant changes in the mean scores of the instruments used, we can point out as limitations of this study the sample size. We use nonparametric statistical test and there was not follow up to confirm if the gains were maintained. Therefore, we recommend new investigations, controlling these variables.

Resumo A Fobia de Dirigir tem sido alvo, nas últimas décadas, de um crescente número de estudos, uma vez que o medo excessivo e perseverante de conduzir um automóvel pode promover impactos na carreira do indivíduo, embaraço social e restrições significativas em sua autonomia. O objetivo desse estudo foi investigar se o tratamento através da exposição por realidade virtual e outras estratégias da Terapia Cognitivo-Comportamental (TCC) foram capazes de 1- reduzir a frequência de pensamentos distorcidos associados à direção, 2- aumentar o senso de autoeficácia dos participantes e 3- contribuir para que esses se engajassem em exposições ao vivo. Dezoito participantes foram alocados de forma aleatória em três grupos: 1) 3 sessões de reestruturação cognitiva + 7 sessões de exposição por realidade virtual; 2) 3 sessões de relaxamento/ respiração diafragmática + 7 sessões de exposição por realidade virtual; 3) 3 sessões de relaxamento/ respiração diafragmática e reestruturação cognitiva + 7 sessões de exposição por realidade virtual. Os participantes responderam na primeira e na décima sessão o Questionário de Cognições na Direção (DCQ) e a Escala de Autoeficácia para dirigir (EADir-v2). Houve redução significativa na frequência de pensamentos distorcidos e aumento significativo no senso de autoeficácia dos participantes. Além disso, pode-se afirmar que o tratamento favoreceu para que os sujeitos enfrentassem posteriormente as exposições ao vivo. As estratégias de TCC e a exposição por realidade virtual mostraram-se eficazes. Apesar de se apresentarem mudanças estatisticamente significativas nos escores médios dos instrumentos utilizados, podemos apontar como limitações do estudo o tamanho da amostra, a utilização de um teste estatístico não paramétrico e a ausência de uma reavaliação para se confirmar se os ganhos foram mantidos. Portanto, recomendamos que outras investigações, controlando mais e melhor estas variáveis, sejam feitas.

Abstract Introduction Based on studies of the biographies of artists and on research in which modern diagnostic criteria were applied, it has been suggested that there is a relationship between bipolar disorder (BD) and creativity. Objective: To investigate the relationship between BD and creativity and whether creative capacity varies depending on mood state. Method We conducted a systematic search of the scientific literature indexed on the PubMed, ISI Web of Science, PsycINFO, and SciELO databases using the terms “bipolar” OR “bipolar disorder” OR “mania” OR “manic” AND “creativ*”. Original studies were selected that investigated samples of at least ten patients with BD using at least one psychometric instrument to assess creativity. Results Twelve articles met the selection criteria. The results of comparisons of BD patients with control groups without BD were heterogeneous. BD was not associated with higher levels of creativity than other mental disorders. When comparing BD phases, depression was associated with worse performance on creativity tests and patients in mania (or hypomania) were not distinguished from euthymia patients. Conclusion It was not possible to corroborate the hypothesis that individuals with BD are more creative than individuals without psychiatric diagnoses or than patients suffering from other mental disorders, which may be related to the cross-sectional rather than longitudinal designs of virtually all of the clinical studies.

Abstract Objectives To assess the prevalence of early trauma in individuals with onset of schizophrenia (SZ) at early (≤ 18 years) and adult (> 18 years) ages (EOP and AOP, respectively) and explore relationships between the onset of disease and clinical variables including traumatic events and psychotic and mood symptoms. Methods Subjects with SZ (n = 71) and EOP and AOP were compared for history of psychological trauma, sexual abuse, and physical punishment using the Early Trauma Inventory Self Report - Short Form (ETISR-SF). They were also compared for history of comorbidities and affective disorders using the Diagnostic Interview for Psychosis and Affective Disorders, the Positive and Negative Syndrome Scale, the Liebowitz Social Anxiety Scale, and the Calgary Depression Scale for Schizophrenia. Coefficients were calculated for correlations between scale results and disease duration. Results Early trauma was significantly associated with an early onset psychotic episode (r = -0.315, p < 0.01). General trauma and depressive symptoms in adulthood were also associated (r = 0.442, p < 0.01), as were social anxiety symptoms and early trauma (r = 0.319, p < 0.01). Total ETISR-SF scores and the physical abuse item were significantly higher in EOP than in AOP. In the hierarchical regression, PANSS scores were best predicted by a model including the duration of disease and age of first psychotic episode (R = 0.303). Conclusions Our results support the hypothesis that early trauma, including physical abuse, may play a relevant role in schizophrenia symptoms, such as an earlier psychotic occurrence, as well as features of other psychiatric disorders, such as greater severity of social anxiety and depression.

Abstract Introduction The social distancing (SD) adopted during the coronavirus disease 2019 (COVID-19) pandemic has transformed the internet from a convenience into a necessity. The behavioral changes caused by isolation range from adaptation of consumption, work, and teaching routines to altered leisure options to occupy idle time at home. Such transformations can be positive, expanding use of digital technologies (DT), but they can also have serious future physical and emotional consequences if there conscious use of technological devices is lacking. Objectives The study aimed to validate the Behavioral Changes Scale on the Use of Digital Technologies During Social Distancing (BCSDTSD), an instrument for assessing behavioral changes related to use of DT during SD. Method Validation of the BCSDTSD in five phases: 1. construction of an initial scale with 10 questions; 2. evaluation of the questions by a panel of experts; 3. application to 1,012 volunteers via the internet; 4. statistical analysis of the results; and 5. preparation of the validated final version of the BCSDTSD. Data were analyzed using the dplyr, psy , and paran packages and the REdaS statistical program. Three statistical criteria were used in the factor analysis (FA). Results FA confirmed that all 10 questions in the questionnaire should be maintained, confirming its robust construction, and Cronbach’s alpha demonstrated its internal consistency with a value of 0.725, which is satisfactory for first-application questionnaires. Conclusion The BCSDTSD instrument was validated for assessment of behavioral changes related to the use of DT during SD.

RESUMO Objetivo D. Maria I, rainha de Portugal, era mãe de D. João VI e avó de D. Pedro IV de Portugal e I do Brasil. Tornou-se a primeira monarca do Brasil, onde ficou conhecida como “Maria, a louca”. Nosso objetivo foi tentar identificar o transtorno mental de que ela sofria. Métodos Realizamos uma revisão de biografias sobre D. Maria I e artigos científicos que discutiram seu caso. Resultados A escassa informação sobre sua doença mental indica fortemente que ela teve vários episódios depressivos e maníacos, os quais foram acompanhados por sintomas psicóticos. Conclusão Seu provável diagnóstico psiquiátrico é de transtorno bipolar.

ABSTRACT Objective D. Maria I, queen of Portugal, was the mother of João VI and grandmother of Pedro IV of Portugal and I of Brazil. She became the first monarch of Brazil, where she became known as “Maria, the madwoman”. We aimed to try to identify the mental disorder she suffered from. Methods We conducted a review of biographies about D. Maria I and scientific articles that discussed her case. Results The sparse information about her mental illness strongly indicates that she had several depressive and manic episodes, which were accompanied by psychotic symptoms. Conclusion Her probable psychiatric diagnosis is that of bipolar disorder.

RESUMO Objetivo: Descrever a história da criação e do desenvolvimento e os temas abordados pelo Centro de Estudos do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (CE – IPUB/UFRJ) ao longo de seus 70 anos. Métodos: Pesquisa em jornais da Hemeroteca Brasileira Digital, documentos internos do IPUB/UFRJ e entrevistas com testemunhas oculares do funcionamento do CE. Resultados: O Centro de Estudos funciona de maneira ininterrupta há 70 anos, semanalmente. Desde sua fundação, 472 eventos foram identificados, mas outros inúmeros encontros ocorreram. Os achados foram divididos e descritos em três grandes grupos: 1. Encontros acadêmicos na primeira metade do século XX e inserção do CE na história do IPUB; 2. Temas debatidos e apresentações; 3.Mudanças de periodicidade e formato. Conclusões: O CE produz divulgação cultural e científica continuamente desde sua fundação. O tipo e o formato dos eventos mudaram ao longo do tempo, adaptando-se às necessidades de sua comunidade, mas sempre servindo como um importante farol para a formação de especialistas em saúde mental e divulgação de pesquisas, apresentando as tendências da psiquiatria mundial, latino-americana e brasileira.

ABSTRACT Objective: To describe the history of creation, development, and topics covered by the Study Center of the Institute of Psychiatry of the Federal University of Rio de Janeiro (CE – IPUB/UFRJ) over its 70 years. Methods: Research in newspapers of the Hemeroteca Brasileira Digital, internal documents of IPUB/UFRJ, and interviews with eyewitnesses of the functioning of the CE. Results: The Study Center has been operating on an uninterrupted basis for 70 years, every week. 472 events have been identified since the founding of the CE, but numerous other meetings have taken place. The findings were described in three major groups: 1. Academic meetings in the first half of the 20th century and insertion of the CE in the history of IPUB; 2. Topics discussed and presentations; 3. Changes in periodicity and format. Conclusions: The CE produces cultural and scientific dissemination continuously since its foundation. The type and format of events have changed over time, adapting to the needs of their community, but always serving as an important beacon for the training of specialists in mental health, dissemination of research, and tendencies about psychiatry worldwide, Latin America, and Brazil.

RESUMO A esquizencefalia é um defeito ou malformação congênita do desenvolvimento extremamente raro, caracterizado por fendas anormais nos hemisférios cerebrais, estendendo-se do córtex aos ventrículos, que podem ser unilaterais ou bilaterais. Este relato de caso descreve as características gerais de um programa de atenção psicológica domiciliar, relatando os principais elementos teóricos e técnicos de um paciente de 12 anos de idade com esquizencefalia tipo II. Os objetivos do tratamento psicológico domiciliar eram a aceitação da nova realidade do tratamento, a redução da agressividade e da ansiedade e o apoio psicológico ao paciente e à família. No atendimento psicológico domiciliar, a consciência do paciente sobre a doença foi desenvolvida, juntamente com a orientação familiar, psicoeducação, técnicas de relaxamento e distração cognitiva. Pode-se observar que houve melhora significativa do estado afetivo e emocional no quadro clínico do paciente.

ABSTRACT Schizencephaly is an extremely rare developmental birth defect or malformation characterized by abnormal clefts in the cerebral hemispheres of the brain, extending from the cortex to the ventricles, which may be unilateral or bilateral. This case report describes the general characteristics of a psychological home care program, reporting the main theoretical and technical elements in a 12-years-old case of type II Schizencephaly. The aims of the psychological home treatment were acceptance of the new treatment reality, a reduction in aggression and anxiety, and psychological support for the patient and family. In the psychological home care, patient’s awareness of illness was developed, along with family orientation, psychoeducation, relaxation techniques, and cognitive distraction. It can be observed that a significant improvement in the affective and emotional state was achieved within the patient’s clinical framework.