Scielo RSS <![CDATA[Archives of Clinical Psychiatry (São Paulo)]]> vol. 43 num. 3 lang. pt <![CDATA[SciELO Logo]]> <![CDATA[Confirmatory factor analysis (CFA) of the Crack Use Relapse Scale (CURS)]]> Abstract Background When it comes to crack/drug use, relapse is a relatively common event in the first weeks after the end of treatment. However little is known about what happens to patients who relapse after discharge. Objective To report the confirmatory factor analysis (CFA) of the Crack Use Relapse Scale (CURS) in an inpatient population. Methods A five-point Likert scale with 25 items and, initially, 9 theoretical factors was generated and utilized in a cross-sectional study with a sample of 333 hospitalized male crack users. Results CFA indicated a well-fitting model for the CURS. Discussion The CFA shows that the CURS model is appropriate and well-fitting for assessment of latent variables common to psychiatric and psychological constructs – in this case, relapse of crack cocaine use after inpatient treatment. <![CDATA[Early emotional trauma in alcohol-dependent men: prevalence, associations and predictive value]]> Abstract Background Several studies have indicated that early emotional traumas (EET) are highly prevalent in alcohol-dependent individuals, and that these traumas work as risk factors for the development of this disorder. Objective The aim of the current study is to evaluate the EET associations and predictive value regarding active alcohol dependence among male individuals from a developing country. Methods The sample consisted of two groups. The first was composed by adult male individuals diagnosed as alcohol dependents (AG, N = 110), and the second with no alcohol abuse and/or dependence diagnosis (CG, N = 110). Both groups were evaluated using Structured Clinical Interview based on the Diagnostic and Statistical Manual of Mental Disorders; Early Emotional Trauma Inventory; and a sociodemographic questionnaire. Results All trauma subtypes (general, physical, emotional and sexual) were more prevalent among AG than CG. However, only traumas categorized as general and emotional worked as risk factor for alcoholism development and they increased the chances to develop this disorder by 1.45 and 1.23 times, respectively. Discussion EETs are important factors that should be taken into account in interventions that aim to prevent, minimize and/or treat this clinical condition and its impact and/or severity, especially in countries such as Brazil. <![CDATA[Posttraumatic growth measures: translation and adaptation of three self-report instruments to Brazilian Portuguese]]> Abstract Background Posttraumatic growth is one of the most commonly used concepts to evaluate positive changes after trauma. The principal scales used internationally to evaluate this phenomenon have not yet a Brazilian Portuguese version. Objectives This study aimed to translate and adapt to the Brazilian context the Posttraumatic Growth Inventory (PTGI), the Core Beliefs Inventory (CBI), and the Event Related Rumination Inventory (ERRI). Methods The procedures included translation, back translation, expert committee’s evaluation, and pilot testing in the target population. Results All items of all three instruments had a good content validity index after evaluation by four experts and three reformulations. The back translation of the final version also demonstrated that all Brazilian Portuguese versions convey the same meaning as the original English version. The final version was pilot tested with 30 undergraduate students, and all the items were above the cut-off point. Discussion This study was able to produce Brazilian versions of the PTGI, CBI, and ERRI. Further studies are underway to determine the reliability, factorial validity, and convergent validity of the subscales of the instruments. <![CDATA[Level of paranormal beliefs and its relationship with explanatory models, treatment adherence and satisfaction]]> Abstract Background Paranormal beliefs are common among patients with mental illness. Such beliefs may mediate conceptualization of illness, treatment satisfaction and medication adherence. Objective To study the level of paranormal beliefs and its relationship with explanatory models, treatment adherence and satisfaction using standardized assessment tool. Methods Eighty nine patients with mental illness in remission were assessed with Sociodemographic proforma, Revised Paranormal Belief Scale (RPBS), Mental Distress Explanatory Model Questionnaire (MMAS), Morisky Medication Adherence Scale (MMAS) and Short Assessment of Patient Satisfaction (SAPS). Results Results revealed a high level of paranormal beliefs on RPBS (Mean 83.96, SD ± 23.91). Variables that had a statistically significant group difference on the score of RPBS were domicile status (p &lt; 05), diagnosis (p &lt; 001), method of treatment sought before (p &lt; 001). In a linear regression analysis four variables explained 35.4% of the variance (R2 = .38, R2Adjusted = .35, F = 13.04, p &lt; .001) in RPBS Score. These variables were total score of MDEMQ (Beta = .308, t = 3.435, p &lt; .001), total score of MMAS (beta = .357, t = 3. 716, p &lt; .001) and magico-religious treatment received earlier (beta = .306, t = 3.52, p &lt; .001) and SAPS. Discussion Based on the finding of this study, it may be concluded that the level of paranormal beliefs may vary with some demographic variables. Levels of paranormal beliefs is positively associated with explanatory models and adherence in patients with mental illness in remission. <![CDATA[Deconstructing the myth of Pasewalk: Why Adolf Hitler’s psychiatric treatment at the end of World War I bears no relevance]]> Abstract Background Even more than 70 years after the end of WW II, questions regarding the personality of dictator Adolf Hitler (1889-1945) remain unresolved. Among them, there is a focus on the problem of his state of mental health, in particular on the possible relevance of the medical treatment he received for a war injury at the military hospital of the small German town of Pasewalk in the last days of WW I. Some authors have come to postulate a profound change of his personality due either to a psychic trauma suffered or a hypnotic therapy he supposedly underwent for curing a hysterical blindness. Objectives The assumptions about Hitler’s war injury which rely on only two significant sources shall be assessed for their validity. Methods Existing historical sources and inferred hypotheses will be discussed in the light of alternative interpretations. Results The mentioned suppositions reveal their highly arbitrary character: neither a hysterical blindness of Hitler’s nor a hypnotic treatment at Pasewalk military hospital can be substantiated. Discussion Given the fact that Hitler’s medical sheet is most likely irrevocably lost, the authors plea for the acceptance of the limitations of historical research, even more so since the occurrences in Pasewalk lack any deeper importance for a historic assessment of Hitler’s personality. <![CDATA[Ten years after the FDA black box warning for antidepressant drugs: a critical narrative review]]> ABSTRACT Background The United States Food and Drug Administration (FDA) has warned about the increased suicidality risk associated with the use of selective serotonin reuptake inhibitors (SSRI) and venlafaxine in children and adolescents. Objectives To critically appraise the available evidence supporting the FDA Black box warning concerning to the use of antidepressants in child and adolescents. Methods A critical review of articles in Medline/PubMed and SciELO databases regarding the FDA Black box warning for antidepressants, and the impact of FDA warnings on antidepressant prescriptions and suicide rates. Results The warning was based on surveys that did not report either cases of suicide nor a significant difference supporting an increased suicidality rate. The concept was defined in an ambiguous way and there is currently more available evidence to support such definition. The use of SSRI and venlafaxine has been associated to lower suicidality rates, but the prescription fall due to the warning increased suicide rates. Discussion Suicidality is an inherent feature of depressive disorders so it would be desirable to consider how much of the phenomenon may be attributed to antidepressants per se. It would be appropriate to consider that suicide rates might increase also as a consequence of the warning.