Scielo RSS <![CDATA[Archives of Clinical Psychiatry (São Paulo)]]> vol. 42 num. 6 lang. en <![CDATA[SciELO Logo]]> <![CDATA[Brazilian Portuguese transcultural adaptation of Barkley Deficits in Executive Functioning Scale (BDEFS)]]> Abstract Background Considering the importance of Executive Functions to clinical and nonclinical situations, Barkley proposed a new theory of executive functioning based on an evolutionary neuropsychological perspective and clinical research using large samples of clinical and community identified adults and children as well as children with ADHD followed to adulthood. Objective The present study aims to adapt the Barkley Deficits in Executive Functions Scales (BDEFS) to Brazilian Portuguese and also assess its construct validity in a sample of normal Brazilian adults. Methods The original version of scale was adapted to Brazilian Portuguese according to the guideline from the ISPOR Task Force. To assess the semantic equivalence between the original and adapted version, both of them were applied into a sample of 25 Brazilian bilingual adults. Finally, 60 Brazilian adults completed the BDEFS and the Brazilian versions of Barratt Impulsiveness Scale (BIS-11) and Adult Self-Report Scale (ASRS-18) to assess convergent validity. Results The BDEFS Brazilian Portuguese version has semantic correspondence with the original version indicating that the adaptation procedure was successful. The BDEFS correlated significantly with the impulsivity and attention scores from the BIS-11 and ASRS-18 supporting its construct validity. Cronbach’s alpha (α = 0.961) indicated that the BDEFS translated version has satisfactory internal consistency. Discussion Together, these findings indicate the successful adaptation of the BDEFS to Brazilian Portuguese and support its utility in that population. <![CDATA[Multidisciplinary rehabilitation program: effects of a multimodal intervention for patients with Alzheimer’s disease and cognitive impairment without dementia]]> Abstract Background Non-pharmalogical interventions represent an important complement to standard pharmalogical treatment in dementia. Objective This study aims to evaluate the effects of a multidisciplinary rehabilitation program on cognitive ability, quality of life and depression symptoms in patients with Alzheimer’s disease (AD) and cognitive impairment without dementia (CIND). Methods Ninety-seven older adults were recruited to the present study. Of these, 70 patients had mild AD and were allocated into experimental (n = 54) or control (n = 16) groups. Two additional active comparison groups were constituted with patients with moderate AD (n = 13) or with CIND (n = 14) who also received the intervention. The multidisciplinary rehabilitation program lasted for 12 weeks and was composed by sessions of memory training, recreational activities, verbal expression and writing, physical therapy and physical training, delivered in two weekly 6-hour sessions. Results As compared to controls, mild AD patients who received the intervention had improvements in cognition (p = 0.021) and quality of life (p = 0.003), along with a reduction in depressive symptoms (p &lt; 0.001). As compared to baseline, CIND patients displayed at the end of the intervention improvements in cognition (p = 0.005) and depressive symptoms (p = 0.011). No such benefits were found among patients with moderate AD.Discussion: This multidisciplinary rehabilitation program was beneficial for patients with mild AD and CIND. However, patients with moderate dementia did not benefit from the intervention. <![CDATA[Benefits of psychodynamic group therapy on depression, burden and quality of life of family caregivers to Alzheimer’s disease patients]]> Abstract Background Family members providing continuous care to demented patients suffer from severe burden that impairs quality of life and often evolves to depression. Objective This study aims to evaluate the effect of psychodynamic group psychotherapy (PGT) compared to body awareness therapy (BAT) on caregiver burden, depressive symptoms, and quality of life among family caregivers to Alzheimer disease (AD) patients. Methods Thirty-seven healthy family caregivers were randomly allocated to receive PGT (n = 20) or BAT (n = 17). Interventions were administered in the format of 14 weekly group sessions. Outcome measures were: modification of scores on Zarit Burden Scale, Beck Depression Inventory and WHO-QoL Scale. Results Participants in the PGT group displayed significant reduction on burden (p = 0.01) and depression scores (p = 0.005), and improved quality of life (p = 0.002), whereas those in the BAT group showed improvements in burden of care (p = 0.001) and quality of life (p = 0.01), but not on depressive symptoms (p = 0.13). Discussion Psychodynamic psychotherapy was associated with amelioration of depressive symptoms, but overall benefits on burden of care and quality of life were similar irrespective of the type of intervention, i.e., psychologically-oriented or not. We hypothesize that these interventions can be complementary to improve depression and burden of care among family caregivers of AD patients. <![CDATA[Reliability and validity of the Management of Aggression and Violence Attitude Scale (MAVAS-BR) for use in Brazil]]> Abstract Background Aggression and violent behavior against health care professionals is a serious problem today and has aroused the interest of researchers and authorities. Objective: The purpose of this study was to examine the reliability and validity of the Management of Aggression and Violence Attitude Scale – Brazil (MAVAS-BR) for use with Brazilian nurses. Method The MAVAS-BR was applied in a convenience sample of 262 nurses, the data were submitted to an exploratory factor analysis, and reliability was estimated using Cronbach’s alpha. Results The MAVAS-BR is composed of 23 items distributed among four factors, and the Cronbach’s alpha was σ = 0.75. Discussion The MAVAS-BR is a reliable instrument for measuring the attitudes of Brazilian nurses facing aggression and violent behavior. The scale has shown to possess validity and the recommended reliability criteria; however, additional studies using this scale should be performed to offer further evidence of its validity in the context of Brazilian nursing. <![CDATA[Patterns of clozapine and other antipsychotics prescriptions in patients with treatment-resistant schizophrenia in community mental health centers in São Paulo, Brazil]]> Abstract Background Despite of its global underuse, clozapine is still the golden standard antipsychotic for patients with treatment-resistant schizophrenia (TRS). Objective To evaluate the patterns of clozapine and other antipsychotic drugs prescription in TRS in community mental health centers in São Paulo, Brazil. Methods A multiple-choice questionnaire was applied to fifteen psychiatrists at five centers inquiring about patients’ clinical condition, adherence to oral treatment and current antipsychotic treatment. History of previous and current antipsychotic treatment was collected through medical chart review. Results Out of 442 schizophrenia patients, 103 (23.3%) fulfilled the criteria for TRS. Fifty-eight patients (56.3%) were receiving polypharmacy; 30 (29.1%) were on atypical antipsychotic monotherapy, 14 (13.6%) were on typical antipsychotic monotherapy, 25 (24.3%) were taking depot antipsychotic medication and only 22 (21.4%) were receiving clozapine. Discussion As well as in other parts of the world, many TRS patients (78.6%) receive other drugs instead of clozapine in São Paulo, the best evidence-based medication for patients with TRS. The government should make every effort to provide medical training and the equipment and logistic support to adequately serve those who could benefit from clozapine treatment at the community health centers. <![CDATA[Culture-bound syndromes in Spanish speaking Latin America: the case of <em>Nervios</em>, <em>Susto</em> and <em>Ataques de Nervios</em>]]> Abstract Background Cultural issues are important for diagnostic validity between different countries; little has been addressed from Latin America and Caribbean countries (LAC). Objective To identify LAC studies on culture-bound syndromes (CBS) and extract potential empirical evidence about Susto,Nervios and Ataques de Nervios. Methods Search strategies were carried out in Medline, Embase, Lilacs, ISI and PsycINFO, covering 1992 to 2015. Inclusion criteria studies on CBS conducted on populations residing in LAC, LAC articles on diagnostic classification and culture, where LAC has been included. Exclusion criteria studies on Latin American migrants outside LAC. Content analysis used the system proposed by Guarnaccia and Rogler (1999): epidemiological, ethnographic and socio-demographic data and identification of comorbidities with other psychiatric disorders. Results Thirty one articles were selected out of 1.090. These CBS were selected out of 1aphic data and identification of comorbidities with other ps proposed by Guarnaccia diagnostic classification and cun panic disorders and post-traumatic stress disorder and presented more psychosocial vulnerability. Discussion Analysis showed that Nervios, Susto andAtaques de Nervios are important idioms of distress, associated with socio-economically vulnerable populations and comorbidities with other psychiatric conditions, particularly post-traumatic stress disorder. More studies are needed on their relation with stress and in more LAC countries.