Scielo RSS <![CDATA[Archives of Clinical Psychiatry (São Paulo)]]> vol. 42 num. 2 lang. en <![CDATA[SciELO Logo]]> <![CDATA[Body-checking and its association with nutritional status in young adults]]> Background The body-checking is a frequent behavior observed in young adults. It is associated with body dissatisfaction and inappropriate eating attitudes. However, its association with nutritional status remains unclear. Objectives This study aimed to assess the association between body-checking behavior and nutritional status. Methods We conducted a cross-sectional study with 587 (311 men) undergraduate students from the city of Juiz de Fora – Minas Gerais. The frequency of body-checking behavior was assessed by Body Checking Questionnaire and Male Body Checking Questionnaire; and inappropriate eating attitudes by Eating Attitudes Test-26. Body weight and height were self-reported. Descriptive, Chi-square test of association and Multiple Correspondence Analysis were done, adopting a statistical significant level of 5%. Results Association was found between body-checking behavior, nutritional status and gender (c2 (64) = 3219.88; p &lt; 0.001). The Multiple Correspondence Analysis demonstrated association between the nutritional status categories low weight, eutrophia and overweight conjointly with low and moderate body-checking categories. Obesity and high body-checking, in turn, were inversely associated. Discussion There was an association between nutritional status and the frequency of body-checking behaviors in young adults of both genders. Body-checking is a behavior that deserves attention and monitoring in epidemiological and clinical practices. <![CDATA[Dissociative experiences in bipolar disorder II: Are they related to childhood trauma and obsessive-compulsive symptoms?]]> Objective The aim of this study is to investigate the presence of dissociative symptoms and whether they are related to childhood trauma and obsessive-compulsive symptoms in bipolar disorder type II (BD-II). Methods Thirty-three euthymic patients (HDRS&lt;8, YMRS&lt;5) and 50 healthy subjects were evaluated by SCID-I and SCID-NP. We excluded all first and second-axis comorbidities. All patients and healthy subjects were examined with the Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ-53), and Yale-Brown Obsessive-Compulsive Disorder scale (Y-BOCS). Results In pairwise comparisons between the BD-II and control groups, the total CTQ, emotional abuse, emotional neglect, DES, and total Y-BOCS scores in the BD-II group were significantly higher than those in the control group (p &lt; 0.05). There were five cases with DES scores over 30 (15.2%) and one case (2%) in the control group. DES was weakly correlated with total CTQ and Y-BOCS in patients diagnosed with BD-II (r = 0.278, p &lt; 0.05 and r = 0.217, p &lt; 0.05, respectively). While there was no correlation between total CTQ and Y-BOCS, the CTQ sexual abuse subscale was found to be related to Y-BOCS (r = 0.330, p &lt; 0.05). Discussion These results suggest that there is a relation between childhood traumas and obsessive-compulsive symptoms, or that dissociative symptoms are more associated with anxiety than obsessive symptoms, which prevents the increase of obsessive-compulsive symptoms in BD-II. <![CDATA[Telemental health in Brazil: past, present and integration into primary care]]> Background Telemental Health Care has reported very good results and is included within mental health priorities by the World Health Organization. Objective To provide an overview of the current situation of the integration of Brazilian telemedicine activities into primary health care. Methods Critical review based on MEDLINE database, using the keywords “telemedicine”, “primary health care” “mental health” and “telemental health”, on websites of the Brazilian Ministry of Health and Brazilian Telehealth Network Program, and on personal communication. Results The Brazilian Telehealth Network Program is well positioned and connects primary health care with academic centers. Regulations standards allow a broader scope of activities for psychologists, however, are more restrictive for physicians. In Brazil most of telemental health activities are focused on education and second opinion consulting. A huge challenge must be overcome considering the regional differences and the telehealth implementation experience. Research initiatives have been initiated both in the implementation and evaluation of the mental health assistance into primary health care. Discussion Brazilian Telemental Health initiatives into Primary Care are aligned with other examples around the world, have a great potential for improving mental health care service delivery, and access to proper mental health care, especially if articulated in a national program and coordinated research. <![CDATA[Evaluation of depressive symptoms in older caregivers]]> Background The number of older caregivers is getting bigger and it is important to know if they experience depressive symptoms because there can be consequences for both caregiver and care recipient. Objective To analyze the recent publications related to the assessment of depressive symptoms in elderly caregivers. Methods Lilacs and PubMed databases were reviewed associating the descriptors “caregivers” AND “aged” AND “depression”. Inclusion criteria were texts including primary data in Portuguese, Spanish or English, published between 2009-2013, also data which evaluated elderly caregivers (≥ 60) and depression or depressive symptoms. There were found n = 1129 texts and after applying the inclusion criteria n = 17 were selected and analyzed. Results Geriatric Depressive Scale (-30 and -15 items) and Center for Epidemiologic Studies Depression scale were the most used scales to evaluate depressive symptoms in older caregivers. Caregivers were in the most of the cases female and cared for a family member with dementia. The majority of the texts that compared older caregivers to older non-caregivers found that caregivers had more depressive symptoms. Discussion Early identification of depressive symptoms can help professionals to minimize damage in caregivers and in care recipient and to plan interventions focusing on improving quality of life of this specific caregiver group. <![CDATA[Ghrelin and eating disorders]]> Background Ghrelin is a potent hormone with central and peripheral action. This hormone plays an important role in the regulation of appetite, food intake, and energy balance. Studies have suggested that ghrelin is involved with eating disorders (ED), particularly bingeing and purging. Genetic variants have also been studied to explain changes in eating behavior. Methods We conducted a literature review; we searched PubMed, Scientific Electronic Library Online (SciELO), and LILACS databases using the keywords “eating disorder”, “ghrelin”, “polymorphism”, “anorexia nervosa”, “bulimia nervosa”, “binge eating disorder”, and their combinations. We found 319 articles. Thirty-nine articles met the inclusion criteria. Results High levels of ghrelin were found in patients with anorexia nervosa (AN), especially in the purging subtype (AN-P). There was also a positive correlation between fasting ghrelin level and frequency of episodes of bingeing/purging in bulimia nervosa (BN) and the frequency of bingeing in periodic binge eating disorder (BED). Some polymorphisms were associated with AN and BN. Conclusion Changes in ghrelin levels and its polymorphism may be involved in the pathogenesis of EDs; however, further studies should be conducted to clarify the associations. <![CDATA[Forensic neuropsychological assessment: a review of its scope]]> Background Issues related to the field of mental health and justice require a multifactorial understanding of the possible causes of such issues. Objective To conduct an integrative literature review of controlled studies describing forensic neuropsychological assessment. Methods The articles were compiled and analyzed in two phases: 1) first, we retrieved all papers in PubMed by the keywords “Forensic Neuropsychology” and generated a growth curve for the subject and a cluster-based thematic distribution of publications. 2) We then conducted a curated analysis of all relevant papers indexed in Medline, PubMed and ISI, between 2000 and 2012. Results The evolution of the field during the last 15 years reveals an unstable growth pattern and three main thematic clusters. In terms of our curated analysis, a total of 390 articles were pre-selected, resulting in the selection of 44 fully-relevant studies, which comprise four main categories: cognitive damage in forensic psychiatric patients; imitation of cognitive damage; civil capacity, penal liability and violence risk; and validation of neuropsychological assessment tools. Discussion Two aspects appeared as the most relevant in this study: growth in the use of neuropsychological assessment as a diagnostic tool in the forensic context; and the necessity to enhance conformity in assessments.