Scielo RSS <![CDATA[Archives of Clinical Psychiatry (São Paulo)]]> vol. 42 num. 5 lang. en <![CDATA[SciELO Logo]]> <![CDATA[Exploratory factor analysis of Kenny Music Performance Anxiety Inventory (K-MPAI) in a Brazilian musician sample]]> Abstract Background The Kenny Music Performance Anxiety Inventory (K-MPAI) is very significant among the available instruments which measures Musical Performance Anxiety (MPA). Objective The aim of this study is to find evidence of validity of the Kenny Music Performance Anxiety Inventory (K-MPAI), in its translated and adapted Brazilian version, through the study of its factor structure. Methods A convenience sample of 230 amateur musicians completed the K-MPAI. Results The initial factor analysis yielded eight factors, explaining 62.4% of variance. However, due to the factors’ composition and internal consistency values lower than 0.50, the number of factors was later set at three, considering the internal consistency of those, the theoretical propositions and symptomatology aspects that supported the construction of scale. They were named “Worries and insecurity” (α = 0.82), “Depression and hopelessness” (α = 0.77) and “Early parental relationships” (α = 0.57). Discussion/Conclusions These results point to the scale’s construct validity, since they support the theoretical basis used for the development of the K-MPAI and the clinical manifestations of the MPA. <![CDATA[Induction and comparison of craving for tobacco, marijuana and crack]]> Abstract Background The literature findings report that use of multiple substances can produce adverse clinical and behavioral effects, which may affect craving and the results of drug treatment. Also, the understanding of craving construct and its interaction in the use of smoked substances is underexplored. Objectives To induce and compare craving for tobacco, marijuana and crack-cocaine on hospitalized dependents whose drug of choice is crack-cocaine. Methods Quasi-experimental study with a convenience sample consisting of 210 males divided into 3 equal groups (Group-1: craving induced by crack; Group-2: craving induced by tobacco; and Group-3: craving induced by marijuana). All participants met ICD-10 dependence criteria for cocaine/crack, marijuana and tobacco, were aged between 18 and 65 and had used these substances for at least one year. Photos were used to induce craving and self-report instruments to evaluate possible alterations. Results This study showed that craving for tobacco was more intense than for marijuana and crack, when the groups were compared by VAS. Using specific scales, both craving for tobacco and craving for marijuana were more intense than craving for crack. Discussion These results would imply interventions at the initial stages of abstinence with cognitive-behavioural techniques and pharmacotherapy in order to reduce craving. <![CDATA[A psychiatric perspective view of bariatric surgery patients]]> Abstract Background Bariatric surgery is the only procedure that has significant results in weight loss and improvements in medical comorbidities in morbid obese patients. Severely obese patients are also associated with a higher prevalence of psychiatric disorders and poor quality of life. Objective To evaluate specific areas of psychopathology in individuals undergoing bariatric surgery. Methods A review of the literature was conducted from January 2002 to March 2014 by researching PubMed database using the following query: “morbid AND obesity AND bariatric AND surgery AND (psychiatry OR psychology)”. Results Overall improvements in eating behaviors, mood disorders and body image are reported after bariatric surgery, and the mechanism is not enlightened. Risk of suicide and consumption of substances of abuse, especially alcohol, after gastric bypass surgery are problems that clinicians must be aware. Discussion Bariatric patients should be monitored after surgery to identify who did not show the expected benefits postoperatively and the ones who develop psychiatric symptoms after an initial positive response. <![CDATA[Mediumship: review of quantitatives studies published in the 21<sup>st</sup> century]]> Abstract Background Mediumship can be defined as the alleged ability to communicate with deceased persons. The last decade has been particularly productive for this field of research and the study of mediumship can help the understanding of the human mind-brain relationship and provide objective data to the scientific community and to the general population. Objective The aim of this review is to summarize and discuss the results found on recent studies investigating mediumship. Furthermore, we aim to discuss the psychophysiology underlying mediumship and future perspectives for this study topic. Methods A literature search for articles in English, Portuguese and Spanish published from January 2000 up to June 2015 was conducted using three electronic databases (PubMed, Lilacs and Web of Science). Review articles, qualitative studies and studies investigating altered states of consciousness caused by psychoactive substances were excluded. The original search returned 150 articles, but the application of exclusion criteria resulted in the inclusion of 19 articles for final analysis. Results The general findings were: (1) an association of mediumship with good mental health, predominantly in experienced mediums, (2) heterogeneous findings regarding the ability of mediums to provide accurate information what may be due to different study methodologies and (3) incipient studies assessing physiological correlations during mediumistic communications (i.e. hypoactivation of brain regions responsible for cognitive processing and writing planning during psychography compared to a control task; electroencephalographic (EEG) changes and a slight predominance of the sympathetic nervous system). Discussion There is a paucity of empirical data available in this controversial research field. New studies employing rigorous design (e.g.triple-blind protocols to test accuracy of mediumistic communications), and sensitive methods are required. <![CDATA[An updated review on the neuropsychological profile of subjects with bipolar disorder]]> Abstract Background In recent years, growing interest in the neuropsychology of bipolar disorder has emerged, giving rise to the accumulation of a robust body of evidence on this topic and to several related questions. Objective To provide a state-of-the-art overview of the neuropsychological profile of bipolar disorder. Method A thorough literature search was performed. Published research evidence was summarized and organized along three key pathways: findings from cross-sectional studies of cognition in bipolar patients, cognitive heterogeneity among affected subjects, and trajectory of neuropsychological deficits. Results At least two thirds of bipolar patients display neuropsychological deficits, even in euthymia. Although bipolar disorder was found to be associated with an increased risk of dementia, data from elderly subjects and longitudinal research do not support a worsening of cognitive performance over time. Discussion Cognitive dysfunctions are part of the clinical conceptualization of bipolar illness. However, they may not be present in all affected subjects and their course appears to be stable in most cases. Available evidence may be highlighting the fact that bipolar disorder is characterized by remarkable heterogeneity regarding cognitive outcomes. Different variables may be related to such heterogeneity and should be the focus of therapeutic approaches and further research.