Brazilian Journal of Psychiatryhttps://www.scielo.br/feed/rbp/2005.v27n1/2024-03-08T20:29:42.256000ZUnknown authorVol. 27 No. 1 - 2005WerkzeugNOTA DOS EDITORES10.1590/S1516-444620050001000012024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZRohde, Luis AugustoBressan, RodrigoMercadante, MarcosMari, JairMiguel, Euripedes Constantino
<em>Rohde, Luis Augusto</em>;
<em>Bressan, Rodrigo</em>;
<em>Mercadante, Marcos</em>;
<em>Mari, Jair</em>;
<em>Miguel, Euripedes Constantino</em>;
<br/><br/>
Effect of cannabis use in human brain activity10.1590/S1516-444620050001000022024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZMartín-Santos, RocíoAtakan, ZerrinMcGuire, Philip
<em>Martín-Santos, Rocío</em>;
<em>Atakan, Zerrin</em>;
<em>Mcguire, Philip</em>;
<br/><br/>
Maconha: qual a amplitude de seus prejuízos?10.1590/S1516-444620050001000032024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZJungerman, Flavia SLaranjeira, RonaldoBressan, Rodrigo A
<em>Jungerman, Flavia S</em>;
<em>Laranjeira, Ronaldo</em>;
<em>Bressan, Rodrigo A</em>;
<br/><br/>
Addiction's research in developing countries: adjusting abounding questions to limited resources10.1590/S1516-444620050001000042024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000Zel-Guebaly, NadyTavares, Hermano
<em>El-Guebaly, Nady</em>;
<em>Tavares, Hermano</em>;
<br/><br/>
Residência em psiquiatria no Brasil: uma contribuição para o debate10.1590/S1516-444620050001000052024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZZanetti, Marcus ViniciusCoelho, Bruno MendonçaLotufo Neto, Francisco
<em>Zanetti, Marcus Vinicius</em>;
<em>Coelho, Bruno Mendonça</em>;
<em>Lotufo Neto, Francisco</em>;
<br/><br/>
Secondary tics and tourettism10.1590/S1516-444620050001000062024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZMejia, Nicte IJankovic, Joseph
<em>Mejia, Nicte I</em>;
<em>Jankovic, Joseph</em>;
<br/><br/>
Motor and phonic tics are most frequently due to Tourette syndrome, but there are many other causes of tics. We analyzed data on 155 patients with tics and co-existent disorders (101M/54F; mean age 40.5 ± 20.2 years). Fourteen (9.0%) patients had tics associated with an insult to the basal ganglia, such as head trauma (N = 4, 2.5%), stroke (N = 2, 1.2%), encephalitis (N = 3, 1.9%) and other causes. In addition, certain drugs, toxins, and post-infectious causes were associated with tics. Rarely, peripheral injury can cause movement disorders, including tics (N = 1, 0.6%). Pervasive developmental disorders, including Asperger's syndrome (N = 13, 8.3%), mental retardation (N = 4, 2.5%), autism (N = 3, 1.9%), and Savant's syndrome (N = 1, 0.6%), also may be associated with tics, as noted in 21 of the 155 patients (13.5%). Genetic and chromosomal disorders, such as Down's syndrome 5 (3.2%), neuroacanthocytosis (N = 2, 1.2%), and Huntington's disease (N = 1, 0.6%), were associated with tics in 16 patients (10.3%). We have also examined the co-existence of tics and other movement disorders such as dystonia (N = 31, 20.0%) and essential tremor (N = 17, 10.9%). Sixteen (10.3%) patients presented psychogenic tics, and one (0.6%) psychogenic tics and dystonia; conversely, Tourette syndrome preceded the onset of psychogenic dystonia (N = 1, 0.6%), and psychogenic tremor (N = 1, 0.6%) in two patients. Finally, 12 (7.7%) patients had tics in association with non-movement related neurological disorders, such as static encephalopathy (N = 2, 1.2%) and seizures (N = 3, 1.9%). To understand the physiopathology of tics and Tourette syndrome, it is important to recognize that these may be caused or associated with other disorders.The efficacy of antidepressants for generalized anxiety disorder: a systematic review and meta-analysis10.1590/S1516-444620050001000072024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZSchmitt, RicardoGazalle, Fernando KratzLima, Maurício Silva deCunha, ÂngeloSouza, JulianoKapczinski, Flávio
<em>Schmitt, Ricardo</em>;
<em>Gazalle, Fernando Kratz</em>;
<em>Lima, Maurício Silva De</em>;
<em>Cunha, Ângelo</em>;
<em>Souza, Juliano</em>;
<em>Kapczinski, Flávio</em>;
<br/><br/>
OBJECTIVE: To investigate the efficacy and acceptability of antidepressants in the treatment of generalized anxiety disorder. METHODS: All randomized controlled trials assessing the use of antidepressants in generalized anxiety disorder up to may 2002 were included. Non randomized trials and those that included patients with both generalized anxiety disorder and another Axis I co-morbidity were excluded. Relative risks, weighted mean difference and number needed to treat were estimated. People who died or dropped out were regarded as having had no improvement. RESULTS: Antidepressants (imipramine, venlafaxine and paroxetine) were found to be superior to placebo in treating generalized anxiety disorder. The calculated number needed to treat for antidepressants in generalized anxiety disorder was 5.15. Dropout rates did not differ between antidepressants and placebo. CONCLUSION: The available evidence suggests that antidepressants would probably be a reasonable treatment for generalized anxiety disorder patients in the clinical context.The Eating Disorders Section of the Development and Well-Being Assessment (DAWBA): development and validation10.1590/S1516-444620050001000082024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZMoya, TatianaFleitlich-Bilyk, BacyGoodman, RobertNogueira, Fabiana ChameletFocchi, Patrícia SouzaNicoletti, ManoelaPinzon, VanessaCordás, Táki AthanássiosLotufo Neto, Francisco
<em>Moya, Tatiana</em>;
<em>Fleitlich-Bilyk, Bacy</em>;
<em>Goodman, Robert</em>;
<em>Nogueira, Fabiana Chamelet</em>;
<em>Focchi, Patrícia Souza</em>;
<em>Nicoletti, Manoela</em>;
<em>Pinzon, Vanessa</em>;
<em>Cordás, Táki Athanássios</em>;
<em>Lotufo Neto, Francisco</em>;
<br/><br/>
OBJECTIVE: Development and validation of the Eating Disorders Section of the Development and Well-Being Assessment (DAWBA). It is a package of questionnaires, interviews and evaluation techniques, designed to generate DSM-IV and ICD-10 based diagnoses of anorexia, bulimia nervosa and the respective partial syndromes in epidemiological studies, in subjects who are 7 to 17 years old. The parents are interviewed in all cases, as are young people aged 11 or more. METHODS: 174 girls, divided into three groups, were assessed with the Eating Disorders Section of the Development and Well-Being Assessment: 48 with eating disorders, 55 clinical controls (with depression, obsessive-compulsive disorder or gastrointestinal disease) and 71 community controls. The sensitivity, specificity and predictive values of the assessment were investigated by comparing the Development and Well-Being Assessment diagnoses with independent psychiatric diagnoses. The test-retest reliability was investigated by reapplying the measure on 55 subjects after 2 or 3 weeks. RESULTS: For the detection of any DSM-IV and ICD-10 eating disorder, the final Development and Well-Being Assessment diagnosis had a sensitivity of 100%, specificity of 94%, positive predictive value of 88%, and a negative predictive value of 100%; there was 95% agreement between the initial and repeat diagnoses (a kappa of 0.81). CONCLUSION: The Eating Disorders Section of the Development and Well-Being Assessment has suitable psychometric properties for use in clinical and epidemiological studies.Early-onset social anxiety disorder in adults: clinical and therapeutic features10.1590/S1516-444620050001000092024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZMenezes, Gabriela Bezerra deFontenelle, Leonardo F.Versiani, Márcio
<em>Menezes, Gabriela Bezerra De</em>;
<em>Fontenelle, Leonardo F.</em>;
<em>Versiani, Márcio</em>;
<br/><br/>
OBJECTIVE: To investigate possible differences in clinical and treatment response in patients suffering from early-onset (< 18 years) and late-onset (>18 years) social anxiety disorder. METHODS: Patients diagnosed with social anxiety disorder of early-onset (n = 47; 75.8%) were compared to those diagnosed with late-onset social anxiety disorder (n = 15; 24.2%) in terms of age, mode of onset, subtype, psychiatric comorbidities (according to the Structured Clinical Interview for DSM-IV), symptom severity and response (assessed according to the Clinical Global Impression scale) after at least ten weeks of drug treatment. The statistical analyses included chi² tests with Yates correction or Fisher's exact test, as well as Student's t-test or Mann-Whitney test. The level of statistic significance adopted was 5%. RESULTS: Patients presenting early-onset phobic symptoms more frequently: were inactive (chi² = 4.28; df = 1; p = 0.04); suffered from the generalized subtype of social phobia (chi² = 6.53; df = 1; p = 0.01); and presented psychiatric comorbidity (chi² = 6.71; df = 1; p = 0.01). No differences were observed between the groups in severity of symptoms and therapeutic response. CONCLUSION: The findings suggest the existence of a possible social anxiety disorder subtype characterized by early onset of symptoms, higher rates of absenteeism, a wider range of social phobia symptoms and psychiatric complications.Habits, attitudes and beliefs of smokers in four Brazilian capitals10.1590/S1516-444620050001000102024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZGigliotti, AnaliceLaranjeira, Ronaldo
<em>Gigliotti, Analice</em>;
<em>Laranjeira, Ronaldo</em>;
<br/><br/>
Tobacco consumption is a major cause of death and disease, and quitting smoking is the most important thing smokers can do to benefit their health. As of the last census, 32.5% of the Brazilian population smoked, but little is known about how many wish to quit and which factors can influence them to make such a decision. OBJECTIVE: To analyze the habits, attitudes and believes of smokers in four major Brazilian cities and compare the results with data from 17 European countries. METHODS: A total of 800 smokers were interviewed. The interviews were conducted in person and individually, using a semi-structured questionnaire. Smokers were defined as individuals who smoke at least one cigarette per week. They were recruited by intentional sampling (confronted on the street and invited to answer the questionnaire) according to pre-established quotas based on social class, gender, occupation and age. Therefore, the number of interviews in a certain population stratum within the sample was determined according to the proportion of smokers generally represented by that stratum. RESULTS: The majority of smokers interviewed presented a low to moderate degree of dependence and wanted to stop smoking. The greater was the motivation to quit, the higher was the number of quitting attempts, as well as the probability of having received medical advice. Only 21% of the smokers had been advised to stop smoking by their doctors. The factor cited by smokers as the one that would most influence their future efforts to stop was "concern about exposing children, relatives and friends to tobacco smoke". The population of Brazil, in contrast to those of European countries, seems to have a high degree of consciousness regarding the fight against tobacco.Suicidal behavior in the community: prevalence and factors associated with suicidal ideation10.1590/S1516-444620050001000112024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZBotega, Neury JoséBarros, Marilisa Berti de AzevedoOliveira, Helenice Bosco deDalgalarrondo, PauloMarín-León, Letícia
<em>Botega, Neury José</em>;
<em>Barros, Marilisa Berti De Azevedo</em>;
<em>Oliveira, Helenice Bosco De</em>;
<em>Dalgalarrondo, Paulo</em>;
<em>Marín-León, Letícia</em>;
<br/><br/>
OBJECTIVES: To estimate the life prevalence rates of suicidal ideation, suicidal plans and suicide attempts and verify factors associated to suicidal ideation. METHODS: 515 individuals > 14 years old were selected at random (cluster and stratified sample) and assessed by means of the WHO SUPRE-MISS interview, SRQ-20 and AUDIT. Life prevalence rates were estimated. Uni and multivariate analyses were performed. Odds ratios, together with confidence intervals, were adjusted by gender and age. RESULTS: Life prevalence rates were 17.1% (95% CI: 12.9 - 21.2) for suicidal ideation, 4.8% (95% CI: 2.8 - 6.8) for plans and 2.8% (95% CI: 0.09 - 4.6) for suicide attempts. Only one-third of those who attempted suicide were later treated at a health facility. The 12-month prevalence rates were, respectively, 5.3% (95% CI: 3.5 - 7.2), 1.9% (95% CI: 1.0 - 2.8) and 0.4% (95% CI: -0.3 - 1.1). Suicidal ideation was more frequently reported by women (OR = 1.7), young adults (20-29 years old: OR = 2.9; 30-39 years old: OR = 3.6, compared to the 14-19 year old group), those living alone (OR = 4.2) and those presenting mental disorders (OR between 2.8 and 3.8). CONCLUSION: The prevalence of suicidal behavior was similar to that found in most studies carried out in other countries. Suicidal ideation was consistently associated with factors related to mental disorders or psychological distress. This should be taken into account when developing strategies to prevent suicidal behavior.Validity of the CAGE questionnaire for screening alcohol-dependent inpatients on hospital wards10.1590/S1516-444620050001000122024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZCastells, Maria AliciaFurlanetto, Letícia Maria
<em>Castells, Maria Alicia</em>;
<em>Furlanetto, Letícia Maria</em>;
<br/><br/>
OBJECTIVE: To verify the validity of the CAGE questionnaire in screening inpatients with alcohol dependence. METHODS: In a transversal study, 747 medical inpatients hospitalized on general medical wards in the Federal University of Santa Catarina University Hospital were evaluated. Sociodemographic and clinical data were collected and the following instruments were used: the CAGE questionnaire and the Mini International Neuropsychiatry Interview (MINI), the latter being a semi-structured interview used as the gold standard for diagnosing alcohol dependence (according to DSM-IV criteria). Validity indices (sensitivity and specificity) were assessed for the different possible CAGE cut-off points. The ROC curve was used to determine the best cut-off point. RESULTS: The sample was composed of 747 patients. Most were men (66%), white (85%) and married (61%). Mean age was 50 ± 17 years, and mean level of education was 6 ± 4 years. According to the MINI, 48 patients (6.6%) were diagnosed as having alcohol dependence. The CAGE questionnaire presented its highest sensitivity (93.8%) when the cut-off point of 0/1 (one or more "positive" responses indicating a positive test) was used. The specificity for this cut-off point was 85.5%. CONCLUSION: Using the 0/1 cut-off point, the CAGE questionnaire presented good sensitivity (93.8%) and specificity (85.5%) for use in general hospital ward patients. Since it is an easily applied, rapidly executed and inexpensive instrument, it could be useful in screening such patients for alcohol dependence.Accuracy of psychiatric diagnosis performed under indirect supervision10.1590/S1516-444620050001000132024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZDel-Ben, Cristina MartaHallak, Jaime Eduardo CecílioSponholz Jr, AlcionMarques, João Mazzoncini de AzevedoLabate, Cybelli MoreloContel, José Onildo BetioliZuardi, Antonio Waldo
<em>Del-Ben, Cristina Marta</em>;
<em>Hallak, Jaime Eduardo Cecílio</em>;
<em>Sponholz Jr, Alcion</em>;
<em>Marques, João Mazzoncini De Azevedo</em>;
<em>Labate, Cybelli Morelo</em>;
<em>Contel, José Onildo Betioli</em>;
<em>Zuardi, Antonio Waldo</em>;
<br/><br/>
This work aimed at comparing the accuracy of the psychiatric diagnoses made under indirect supervision to the diagnoses obtained through Structured Clinical Interview for DSM-III-R (SCID). The study was conducted in 3 university services (outpatient, inpatient and emergency). Data from the emergency service were collected 3 years later, after changes in the training process of the medical staff in psychiatric diagnosis. The sensitivity for Major Depression (outpatient 10.0%; inpatients 60.0%, emergency 90.0%) and Schizophrenia (44.4%; 55.0%; 80.0%) improved over time. The reliability was poor in the outpatient service (Kw = 0.18), and at admission to the inpatient service (Kw = 0.38). The diagnosis elaborated in the discharge of the inpatient service (Kw = 0.55) and in the emergency service (Kw = 0.63) was good. Systematic training of supervisors and residents in operational diagnostic criteria increased the accuracy of psychiatric diagnoses elaborated under indirect supervision, although excellent reliability was not achieved.The cross-cultural adaptation to Portuguese of the Trauma History Questionnaire to identify traumatic experiences10.1590/S1516-444620050001000142024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZFiszman, AdrianaCabizuca, MarianaLanfredi, ClaudiaFigueira, Ivan
<em>Fiszman, Adriana</em>;
<em>Cabizuca, Mariana</em>;
<em>Lanfredi, Claudia</em>;
<em>Figueira, Ivan</em>;
<br/><br/>
BACKGROUND: Despite the high prevalence of exposure to traumatic events in Brazil, there are few studies on trauma and post-traumatic stress disorder. This paper presents the cross-cultural adaptation to Portuguese of the Trauma History Questionnaire. METHODS: Two translations and their respective back-translations were made, as well as the evaluation of the semantic equivalence, the preparation of the synthesis version, the pre-testing in the target population and the definition of the final version. DISCUSSION: Similar levels of referential meaning between the two back-translations and the original instrument were observed. Priority was given to the first translation in the decision process for the elaboration of the synthesis version. The pre-testing of this version in the target population confirmed the goal to achieve the semantic and the operational equivalence criteria. This work offers the first adaptation of a specific instrument to detect traumatic experiences in the Brazilian context.Quality of life in siblings of autistic patients10.1590/S1516-444620050001000152024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZMarciano, Adriana Regina FerreiraScheuer, Cláudia Ines
<em>Marciano, Adriana Regina Ferreira</em>;
<em>Scheuer, Cláudia Ines</em>;
<br/><br/>
OBJECTIVE: To evaluate the Quality of Life (QoL) among siblings of autistic patients. METHODS: Casuistic: siblings of autistic patients (n = 31) and, as a control group, siblings of patients with speech disorder (n = 30). Inclusion criteria: age between 7 and 11 years old; absence of current mental disorder; regular attendance to school. Exclusion criteria: antecedents of clinical or psychiatric diseases; disabilities (visual, auditive or motor); antecedents of cognitive and/or intelligence disabilities. Instruments included a questionnaire which evaluated the quality of life in a subjective way. RESULTS: it was observed worse QoL among siblings of autistic patients (p = 0.000). CONCLUSION: The hypothesis that the quality of life was compromised in children (aged 7 to 11) by the presence of an autistic sibling was confirmed, and was worse than that of siblings of children with speech disorders.Efeitos cerebrais da maconha: resultados dos estudos de neuroimagem10.1590/S1516-444620050001000162024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZCrippa, José AlexandreLacerda, Acioly L TAmaro, EdsonBusatto Filho, GeraldoZuardi, Antonio WaldoBressan, Rodrigo A
<em>Crippa, José Alexandre</em>;
<em>Lacerda, Acioly L T</em>;
<em>Amaro, Edson</em>;
<em>Busatto Filho, Geraldo</em>;
<em>Zuardi, Antonio Waldo</em>;
<em>Bressan, Rodrigo A</em>;
<br/><br/>
A maconha é a droga ilícita mais utilizada. Apesar disto, apenas um pequeno número de estudos investigaram as conseqüências neurotóxicas de longo prazo do uso de cannabis. As técnicas de neuroimagem se constituem em poderosos instrumentos para investigar alterações neuroanatômicas e neurofuncionais e suas correlações clínicas e neuropsicológicas. Uma revisão computadorizada da literatura foi conduzida nos indexadores MEDLINE e PsycLIT entre 1966 e novembro de 2004 com os termos 'cannabis', 'marijuana', 'neuroimaging', 'magnetic resonance', 'computed tomography', 'positron emission tomography', 'single photon emission computed tomography", 'SPET', 'MRI' e 'CT'. Estudos de neuroimagem estrutural apresentam resultados conflitantes, com a maioria dos estudos não relatando atrofia cerebral ou alterações volumétricas regionais. Contudo, há uma pequena evidência de que usuários de longo prazo que iniciaram um uso regular no início da adolescência apresentam atrofia cerebral assim como redução na substância cinzenta. Estudos de neuroimagem funcional relatam aumento na atividade neural em regiões que podem estar relacionadas com intoxicação por cannabis e alteração do humor (lobos frontais mesial e orbital) e redução na atividade de regiões relacionadas com funções cognitivas prejudicadas durante a intoxicação aguda. A questão crucial se efeitos neurotóxicos residuais ocorrem após o uso prolongado e regular de maconha permanece obscura, não existindo até então estudo endereçando esta questão diretamente. Estudos de neuroimagem com melhores desenhos, combinados com avaliação cognitiva, podem ser elucidativos neste aspecto.Declínio da capacidade cognitiva durante o envelhecimento10.1590/S1516-444620050001000172024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZCharchat-Fichman, HeleniceCaramelli, PauloSameshima, KoichiNitrini, Ricardo
<em>Charchat-Fichman, Helenice</em>;
<em>Caramelli, Paulo</em>;
<em>Sameshima, Koichi</em>;
<em>Nitrini, Ricardo</em>;
<br/><br/>
O declínio da capacidade cognitiva (DCC) decorre dos processos fisiológicos do envelhecimento normal ou de um estágio de transição para as demências. Estudos epidemiológicos mostram que idosos com declínio da capacidade cognitiva apresentam maior risco de desenvolver Doença de Alzheimer (DA), em particular aqueles com déficit de memória episódica. A presente atualização mostra os principais critérios diagnósticos, achados neuropatológicos e neuropsicológicos do declínio da capacidade cognitiva durante o envelhecimento.Diagnóstico precoce do Transtorno Bipolar10.1590/S1516-444620050001000182024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZGazalle, Fernando KratzAndreazza, Ana CristinaKauer-Sant'Anna, MárciaSantin, AidaKapczinski, Flávio
<em>Gazalle, Fernando Kratz</em>;
<em>Andreazza, Ana Cristina</em>;
<em>Kauer-Sant'anna, Márcia</em>;
<em>Santin, Aida</em>;
<em>Kapczinski, Flávio</em>;
<br/><br/>
Neuropsicologia Hoje10.1590/S1516-444620050001000192024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZMiotto, Eliane Correa
<em>Miotto, Eliane Correa</em>;
<br/><br/>
Terapia cognitivo-comportamental na prática psiquiátrica10.1590/S1516-444620050001000202024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000ZShansis, Flávio
<em>Shansis, Flávio</em>;
<br/><br/>
10.1590/S1516-444620050001000212024-03-08T20:29:42.256000Z2020-08-09T06:48:20.360000Z