Scielo RSS <![CDATA[Archives of Clinical Psychiatry]]> http://www.scielo.br/rss.php?pid=0101-608320140005&lang=es vol. 41 num. 5 lang. es <![CDATA[SciELO Logo]]> http://www.scielo.br/img/en/fbpelogp.gif http://www.scielo.br <![CDATA[Eating disorder symptoms: association with perfectionism traits in male adolescents]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832014000500117&lng=es&nrm=iso&tlng=es Background Evidence indicates a relationship between perfectionism and eating disorder symptoms (EDS). However, there is no such empirical evidence in Brazilian scientific literature. Moreover, studies of EDS in the male sex are scarce. Objective To analyze a possible association between EDS and perfectionism traits in adolescent males. Methods Participants were 368 adolescents aged 12 to 15 years. We used the subscales of the Eating Attitudes Test (EAT-26) and the Multidimensional Perfectionism Scale to assess EDS and perfectionism traits, respectively. Results The results indicated a statistically significant association between the high perfectionism trait and EDS (X2 = 16.40; Wald = 15.92; p = 0.001). Moreover, the findings showed no difference in the scores of the Diet (F(1, 367) = 2.14; p = 0.23) or Concern for Food and Bulimia (F(1, 367) = 2.44; p = 0.19) subscales according to groups of perfectionism. However, we identified a higher score on the Oral Self-Control subscale of the EAT-26 in the group with high perfectionism trait than adolescents with a low perfectionism trait (F(1, 367) = 13.88; p = 0.02). Discussion: EDS were associated with perfectionism in adolescent males. <hr/> Contexto Evidências indicam relação entre o perfeccionismo e os sintomas de transtorno alimentar (STA). No entanto, nenhuma evidência empírica foi encontrada na literatura científica brasileira. Ademais, estudos com o sexo masculino são escassos. Objetivo Analisar uma possível associação entre os STA e os traços de perfeccionismo em adolescentes do sexo masculino. Métodos Participaram 368 adolescentes com idade entre 12 e 15 anos. Utilizaram-se as subescalas do Eating Attitudes Test (EAT-26) e a Multidimensional Perfectionism Scale para avaliar os STA e os traços de perfeccionismo, respectivamente. Resultados Os resultados indicaram associação estatisticamente significativa entre o alto traço de perfeccionismo e os STA (X2 = 16,40; Wald = 15,92; p = 0,001). Ademais, os achados não demonstraram diferenças nos escores das subescalas Dieta (F(1, 367) = 2,14; p = 0,23) e Bulimia e Preocupação com Alimentos (F(1, 367) = 2,44; p = 0,19) em razão dos grupos de perfeccionismo. No entanto, evidenciou-se maior escore na subescala Autocontrole Oral do EAT-26 no grupo com alto traço perfeccionista quando comparado aos adolescentes com baixo traço de perfeccionismo (F(1, 367) = 13,88; p = 0,02). Conclusão Os STA estiveram associados ao perfeccionismo em adolescentes do sexo masculino. <![CDATA[Socio-demographic and clinical characteristics of pregnant and puerperal crack-cocaine using women: preliminary data]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832014000500121&lng=es&nrm=iso&tlng=es Background The literature provides several studies on the effects of cocaine when exposed to the fetus. However, the majority of these data comes from animal models. Objective The objective of this study is to present socio-demographic and clinical data in crack-cocaine using pregnant women and their babies, as compared to non-users. Methods Cross-sectional study, comprised by 56 dyads of crack-cocaine using mothers-babies and 89 control dyads. In addition to the socio-demographic data and the babies’ information, data collection was based on ABIPEMI for socioeconomic level, WAIS for IQ, MINI for psychopathology and ASSIST for drug use. Results Most crack users, in comparison to non-users, did not have a partner (10.52% vs 4.4%, P = 0.001) and presented lower IQ (78.15, +/-8.07 vs 84.27 +/- 9.87; P = 0.002). The prevalence of antisocial personality disorder and suicide risk in users was higher than in non-users (24.44% vs none, P &lt; 0.001; 28.26% vs 10.46% P = 0.01). Most of the users did not participate in prenatal care (75%). The babies that the crack-cocaine using mothers gave birth to weighed significantly less than the controls (2.858 g vs 3.240 g, P = 0.002). Discussion Users had a higher degree of psychopathology and lower attendance in prenatal care. There was an overlap of adverse factors, both for exposed mothers and babies. The sum of these vulnerabilities could result in significant harm to the developing infant. <![CDATA[Quantitative measurement of impairment in ADHD: perspectives for research and clinical practice]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832014000500124&lng=es&nrm=iso&tlng=es Background Functional impairment is needed to make an attention deficit hyperactivity disorder (ADHD) diagnosis, but there is a paucity of instruments addressing this issue. Objective Perform psychometric analysis of a functional impairment scale (FIE). Methods A sample of 320 individuals, including ADHD probands, their siblings and parents, filled the FIE. We analyzed psychometric properties for the entire sample and age groups. Factor structure was determined by a principal component factor analysis, using oblique rotation with Kaiser normalization and Eigenvalues higher than 1. Cronbach’s alpha and Spearman-Brown were calculated. Results Family analysis revealed four components: a) “family life”, b) “self-perception”, c) “performance” and d) “social life”. Adults’ analysis revealed two components: a) “family life, social life and self-perception” and b) “performance”. Children showed the domains: a) “performance and social life”, b) “self-perception” and c) “family life” components. Cronbach’s alpha were above 0.9 in all components. Discussion Results revealed up to four domains depending on the group considered. Different life demands might explain the variability of domains on the groups. <![CDATA[Biomarkers in mood disorders research: developing new and improved therapeutics]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832014000500131&lng=es&nrm=iso&tlng=es Background Recently, surrogate neurobiological biomarkers that correlate with target engagement and therapeutic response have been developed and tested in early phase studies of mood disorders. Objective The identification of biomarkers could help develop personalized psychiatric treatments that may impact public health. Methods These biomarkers, which are associated with clinical response post-treatment, can be directly validated using multimodal approaches including genetic tools, proteomics/metabolomics, peripheral measures, neuroimaging, biostatistical predictors, and clinical predictors. Results To date, early phase biomarker studies have sought to identify measures that can serve as “biosignatures”, or biological patterns of clinical response. These studies have also sought to identify clinical predictors and surrogate outcomes associated with pathophysiological domains consistently described in the National Institute of Mental Health’s (NIMH) new Research Domain Criteria (RDoC). Using the N-methyl-D-aspartate (NMDA) antagonist ketamine as an example, we identified changes in several domains (clinical, cognitive, and neurophysiological) that predicted ketamine’s rapid and sustained antidepressant effects in individuals with treatment-resistant major depressive disorder (MDD) or bipolar depression. Discussion These approaches may ultimately provide clues into the neurobiology of psychiatric disorders and may have enormous impact Backon the development of novel therapeutics. <![CDATA[Anorexia nervosa, paternalism and clinical practice]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832014000500135&lng=es&nrm=iso&tlng=es Background Recently, surrogate neurobiological biomarkers that correlate with target engagement and therapeutic response have been developed and tested in early phase studies of mood disorders. Objective The identification of biomarkers could help develop personalized psychiatric treatments that may impact public health. Methods These biomarkers, which are associated with clinical response post-treatment, can be directly validated using multimodal approaches including genetic tools, proteomics/metabolomics, peripheral measures, neuroimaging, biostatistical predictors, and clinical predictors. Results To date, early phase biomarker studies have sought to identify measures that can serve as “biosignatures”, or biological patterns of clinical response. These studies have also sought to identify clinical predictors and surrogate outcomes associated with pathophysiological domains consistently described in the National Institute of Mental Health’s (NIMH) new Research Domain Criteria (RDoC). Using the N-methyl-D-aspartate (NMDA) antagonist ketamine as an example, we identified changes in several domains (clinical, cognitive, and neurophysiological) that predicted ketamine’s rapid and sustained antidepressant effects in individuals with treatment-resistant major depressive disorder (MDD) or bipolar depression. Discussion These approaches may ultimately provide clues into the neurobiology of psychiatric disorders and may have enormous impact Backon the development of novel therapeutics. <![CDATA[Written in stone: a clinical case of compulsive note taking]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832014000500136&lng=es&nrm=iso&tlng=es Background Recently, surrogate neurobiological biomarkers that correlate with target engagement and therapeutic response have been developed and tested in early phase studies of mood disorders. Objective The identification of biomarkers could help develop personalized psychiatric treatments that may impact public health. Methods These biomarkers, which are associated with clinical response post-treatment, can be directly validated using multimodal approaches including genetic tools, proteomics/metabolomics, peripheral measures, neuroimaging, biostatistical predictors, and clinical predictors. Results To date, early phase biomarker studies have sought to identify measures that can serve as “biosignatures”, or biological patterns of clinical response. These studies have also sought to identify clinical predictors and surrogate outcomes associated with pathophysiological domains consistently described in the National Institute of Mental Health’s (NIMH) new Research Domain Criteria (RDoC). Using the N-methyl-D-aspartate (NMDA) antagonist ketamine as an example, we identified changes in several domains (clinical, cognitive, and neurophysiological) that predicted ketamine’s rapid and sustained antidepressant effects in individuals with treatment-resistant major depressive disorder (MDD) or bipolar depression. Discussion These approaches may ultimately provide clues into the neurobiology of psychiatric disorders and may have enormous impact Backon the development of novel therapeutics.