Scielo RSS <![CDATA[Archives of Clinical Psychiatry (São Paulo)]]> http://www.scielo.br/rss.php?pid=0101-608320150003&lang=en vol. 42 num. 3 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.br/img/en/fbpelogp.gif http://www.scielo.br <![CDATA[Association study in Alzheimer’s disease of single nucleotide polymorphisms implicated with coffee consumption]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832015000300069&lng=en&nrm=iso&tlng=en Background There is evidence from animal and in vitro models of the protective effects of caffeine in Alzheimer’s disease. The suggested mechanisms through which caffeine may protect neurons against Alzheimer’s disease pathology include the facilitation of beta-amyloid clearance, upregulation of cholinergic transmission, and increased neuronal plasticity and survival. Epidemiological studies support that Alzheimer’s disease patients consume smaller amounts of coffee beverages throughout their lives as compared to age-matched cognitively healthy individuals. Objective The aim of the present study was to determine whether the negative association between Alzheimer’s disease and coffee consumption may be influenced by a common genetic predisposition, given the fact that the pattern of coffee consumption is determined by both environmental and genetic factors. Method We conducted an in silico search addressing the association between genetic polymorphisms related to coffee consumption and the diagnosis of Alzheimer’s disease. We further investigated the interactions between genes located in regions bearing these polymorphisms. Results Our analysis revealed no evidence for a genetic association (nor interaction between related proteins) involving coffee consumption and Alzheimer’s disease. Discussion The negative association between Alzheimer’s disease and coffee consumption suggested by epidemiological studies is most likely due to environmental factors that are not necessarily regulated by genetic background. <![CDATA[Does the brain produce the mind? A survey of psychiatrists’ opinions]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832015000300074&lng=en&nrm=iso&tlng=en Background Psychiatrists’ views on the mind-brain relationship (MBR) have marked clinical and research implications, but there is a lack of studies on this topic. Objectives To evaluate psychiatrists’ opinions on the MBR, and whether they are amenable to change or not. Methods We conducted a survey of psychiatrists’ views on the MBR just before and after a debate on the MBR at the Brazilian Congress of Psychiatry in 2014. Results Initially, from more than 600 participants, 53% endorsed the view that “the mind (your “I”) is a product of brain activity”, while 47% disagreed. Moreover, 72% contested the view that “the universe is composed only of matter”. After the debate, 30% changed from a materialist to a non-materialist view of mind, while 17% changed in the opposite way. Discussion Psychiatrists are interested in debates on the MBR, do not hold a monolithic view on the subject and their positions are open to reflection and change, suggesting the need for more in-depth studies and rigorous but open-minded debates on the subject. <hr/> Contexto As visões dos psiquiatras sobre a relação mente-cérebro (RMC) têm marcantes implicações para a clínica e a pesquisa, mas há carência de estudos sobre esse tema. Objetivos Avaliar as opiniões dos psiquiatras sobre a RMC e se elas são suscetíveis ou não a mudanças. Métodos Realizamos um levantamento sobre as visões que os psiquiatras possuem sobre a RMC imediatamente antes e após um debate sobre a RMC no Congresso Brasileiro de Psiquiatria de 2014. Resultados Inicialmente, entre mais de 600 participantes, 53% endossaram a visão de que “a mente (o ‘Eu’) é um produto da atividade cerebral”, enquanto 47% discordaram. Além disso, 72% contestaram a visão de que “o universo é composto apenas de matéria”. Após o debate, 30% mudaram de uma visão materialista da mente para uma perspectiva não materialista, enquanto 17% mudaram na direção oposta. Conclusão Os psiquiatras se interessam por debates sobre a RMC, não possuem uma visão monolítica sobre o tema e suas opiniões estão abertas a reflexões e mudanças, sugerindo a necessidade de mais estudos em profundidade e de debates rigorosos, mas não dogmáticos sobre o tema. <![CDATA[A randomized clinical trial of home-based telepsychiatric outpatient care via videoconferencing: design, methodology, and implementation]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832015000300076&lng=en&nrm=iso&tlng=en Background Healthcare providers are continuously challenged to find innovative, cost-effective alternatives and to scale up existent services to meet the growing demand upon mental health care delivery. Due to continuous advances in technologies, telepsychiatry has become an effective tool for psychiatric care. In 2012, the Institute of Psychiatry of the University of São Paulo Medical School started a randomized clinical trial of home-based telepsychiatric outpatient care via videoconferencing. Objective The objective of this article is to describe the design, methodology and implementation of a pilot project, which aimed to verify the applicability and efficiency of psychiatric attendance via Internet-based videoconferencing in a resource-constrained environment. Methods The project consisted of a 12 months follow-up study with a randomized clinical trial, which compared various quality indicators between home-based telepsychiatric aftercare via videoconferencing and face-to-face aftercare. Results The final sample comprised 107 outpatients (53 in the telepsychiatry group and 54 in the control group). Among 1,227 realized consultations, 489 were held by videoconferencing. Satisfaction with the aftercare by videoconferencing and the medication delivery was high among patients. Attending psychiatrists were satisfied with the assistance by videoconferencing. Discussion The experiences during this pilot project have overall been very positive and psychiatric outpatient care by videoconferencing seems viable to treat patients even in a resource-constrained environment. <![CDATA[A case of cycloid psychotic disorder]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832015000300079&lng=en&nrm=iso&tlng=en Based on a case of an acute and transient psychotic disorder with full recovery between recurrences, the authors remind the concept of cycloid psychoses. This diagnosis has been neglected in modern psychiatry and in the current nosological systems. However, the cycloid psychoses concept may offer an alternative diagnosis for some psychotic disorders in spite of the need of more studies to improve the understanding of its etiology and treatment. <![CDATA[Treatment-resistant mood disorders]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832015000300081&lng=en&nrm=iso&tlng=en Based on a case of an acute and transient psychotic disorder with full recovery between recurrences, the authors remind the concept of cycloid psychoses. This diagnosis has been neglected in modern psychiatry and in the current nosological systems. However, the cycloid psychoses concept may offer an alternative diagnosis for some psychotic disorders in spite of the need of more studies to improve the understanding of its etiology and treatment.