OBJECTIVES: To describe the prevalence of Major Depressive Disorder (MDD) during pregnancy in teenage mothers and to assess its association with socio-demographic characteristics, obstetric history and psychosocial variables. METHODS: A cross-sectional study was conducted with a sample of pregnant teenagers enrolled in the national public health system in the urban area of Pelotas, southern Brazil. MDD was assessed with the Mini International Neuropsychiatric Interview, the Abuse Assessment Screen was used to identify physical abuse within the last 12 months and during pregnancy, and social support was assessed with the Medical Outcomes Survey Social Support Scale. RESULTS: Forty-three (4.94%) potential subjects refused to participate, resulting in 828 total participants. The prevalence of MDD was 17.8%, 9.2% reported they had been subjected to violence within the last 12 months, while 5.8% had suffered violence during pregnancy, and the mean (SD) overall social support score was 87.40 (11.75). After adjustment, we found the highest incidence of MDD in adolescents with less than 8 years of education, followed by those with previous episodes of MDD and those with lower overall social support. CONCLUSIONS: MDD is a relatively common condition in pregnant teenagers and appears to be more prevalent in young mothers who are both socioeconomically and psychosocially underprivileged.

OBJETIVO: Verificar a prevalência dos episódios depressivos e bipolares em homens no período pré e pós-natal, assim como 12 meses após o parto. MÉTODO: Estudo longitudinal com amostra de pais cujas crianças nasceram entre abril de 2007 e maio de 2008 em maternidades da cidade de Pelotas-RS, no sul do Brasil. Episódios depressivos e maníacos/hipomaníacos foram mensurados com o Mini Neuropsychiatric Interview em três tempos diferentes: entre a 28ª e 34ª semanas de gestação (T1), 30 a 60 dias após o parto (T2) e 12 meses após o nascimento da criança. RESULTADOS: A prevalência de episódios depressivos foi 5,0% em T1, 4,5% em T2 e 4,3% em T3. Episódios mistos estiveram presentes em 3,0, 1,7 e 0,9%, respectivamente, e somaram 61,1% de casos de depressão antenatal, 37,5% pós-natal e 21,4% aos 12 meses pós-parto. Episódio depressivo e maníaco/hipomaníaco esteve significativamente associado durante a gestação e o pós-parto. CONCLUSÃO: Episódios bipolares são comuns em homens com sintomas depressivos durante a gestação de suas companheiras e no período pós-natal. Essa população deveria ser cuidadosamente investigada para sintomas maníacos e hipomaníacos, a fim de ser adequadamente tratada.

OBJECTIVE: We describe the prevalence of depressive and bipolar spectrum episodes in fathers in antenatal and postnatal periods, as well as at 12 months after childbirth. METHOD: A longitudinal follow-up study was conducted with a representative sample of 739 fathers whose children were born between April 2007 and May 2008 in maternity wards in the city of Pelotas, southern Brazil. Paternal psychopathology was measured with the Mini Neuropsychiatric Interview (MINI) across three time points: between 28 and 34 weeks of pregnancy (T1), 30 to 60 days postpartum (T2), and 12 months after childbirth (T3). RESULTS: The prevalence of depressive episodes was 5.0% at T1, 4.5% at T2, and 4.3% at T3. Mixed episodes were present in 3%, 1.7%, and 0.9% of subjects, respectively, and accounted for 61.1% of the cases of depression in the antenatal period, 37.5% in postpartum, and 21.4% at 12 months. Depressive and manic/hypomanic episodes were significantly associated during pregnancy and in postpartum, but not at 12 months after childbirth. CONCLUSION: Bipolar episodes were common in men with depressive symptoms during their partner's pregnancy in the postpartum period and, to a lesser extent, 12 months after childbirth. Therefore, this population should be carefully investigated for manic and hypomanic symptoms.

Relatamos o caso de uma paciente com diagnóstico de esquizofrenia paranóide que desenvolveu dois quadros de hepatotoxicidade atribuídos a efeitos colaterais do ácido valpróico e da clozapina. Essa relação foi estabelecida pela proximidade temporal entre o início da medicação e a instalação do quadro, pela resolução deste após a suspensão da medicação e pela exclusão de outras causas de doença hepática. No seguimento, o controle clínico da paciente foi realizado com eletroconvulsoterapia (ECT). Salientamos a importância da vigilância cuidadosa dos efeitos adversos de psicofármacos, especialmente sobre a função hepática, e da ECT como possibilidade terapêutica diante de limitações farmacológicas.

We report the case of a patient with paranoid schizophrenia who developed two episodes of severe hepatotoxicity. They were attributed to the side effects of valproic acid and clozapine. This relationship was established by the temporal proximity between the onset of medication and the development of side effects, the clinical remission after drug cessation and the exclusion of other causes of hepatic diseases. On the follow-up, the patient was treated with eletroconvulsive therapy. This case report highlights the relevance of careful vigilance of adverse effects of psychotropics, especially hepatotoxicity, and the role of eletroconvulsive therapy when there are pharmacological constraints.