Trends in Psychiatry and Psychotherapyhttps://www.scielo.br/feed/trends/2014.v36n3/2024-02-20T19:57:41.118000ZVol. 36 No. 3 - 2014WerkzeugTourette's syndrome and associated disorders: a systematic review10.1590/2237-6089-2014-10032024-02-20T19:57:41.118000Z2020-08-09T06:49:27.126000ZFerreira, Bárbara R.Pio-Abreu, J. L.Januário, Cristina
<em>Ferreira, Bárbara R.</em>;
<em>Pio-Abreu, J. L.</em>;
<em>Januário, Cristina</em>;
<br/><br/>
Objective: To compile data on Tourette's syndrome (TS), tics and associated disorders. Methods: A systematic review of the literature was conducted using the 5S levels of organization of healthcare research evidence (systems, summaries, synopses, syntheses, studies), based on the model described by Haynes. The search keywords were Tourette, tics and comorbidity, which were cross-referenced. Studies provided by publishers and articles being processed on July 31, 2013, were also included. Results: Of all studies retrieved during the search, 64 were selected because they analyzed the epidemiology, clinical features and etiopathogenesis of TS and its comorbidities. TS is classified as a hyperkinetic movement disorder, and at least 90% of the patients have neuropsychiatric comorbidities, of which attention deficit hyperactivity and obsessive-compulsive disorders are the most common. The syndrome is clinically heterogeneous and has been associated with a dysfunction of cortico-striatal-thalamic-cortical circuits involving various neurotransmitters. Although its genetic etiology has been widely studied, other factors may be important to understand this syndrome and its associated disorders. Conclusions: TS is a neurodevelopmental disorder that results from the impact of stress factors on a vulnerable biological substrate during the critical periods of neurodevelopment. The study of TS and its comorbidities may contribute, at different levels, to the understanding of several neuropsychiatric disorders of clinical and therapeutic relevance.Impact of physical exercise on quality of life of older adults with depression or Alzheimer's disease: a systematic review10.1590/2237-6089-2013-00642024-02-20T19:57:41.118000Z2020-08-09T06:49:27.126000ZTavares, Bianca BoscarinoMoraes, HelenaDeslandes, Andrea CamazLaks, Jerson
<em>Tavares, Bianca Boscarino</em>;
<em>Moraes, Helena</em>;
<em>Deslandes, Andrea Camaz</em>;
<em>Laks, Jerson</em>;
<br/><br/>
INTRODUCTION: Physical exercise has been associated with improvement of quality of live (QoL), but its effect among the elderly with depression and Alzheimer's disease (AD) is still unclear. This systematic review evaluated randomized and controlled studies about the effect of physical exercise on QoL of older individuals with a clinical diagnosis of depression and AD. METHODS: We searched PubMed, ISI, SciELO and Scopus from December 2011 to June 2013 using the following keywords: physical exercise, quality of life, elderly, depression, Alzheimer's disease. Only six studies met inclusion criteria: two examined patients with AD and four, patients with depression. RESULTS: The studies used different methods to prescribe exercise and evaluate QoL, but all had high quality methods. Findings of most studies with individuals with depression suggested that exercise training improved QoL, but studies with patients with AD had divergent results. CONCLUSIONS: Although different methods were used, results suggested that physical exercise is an effective non-pharmacological intervention to improve the QoL of elderly individuals with depression and AD. Future studies should investigate the effect of other factors, such as the use of specific scales for the elderly, controlled exercise prescriptions and type of control groups.Weight regain among women after metabolic and bariatric surgery: a qualitative study in Brazil10.1590/2237-6089-2013-00412024-02-20T19:57:41.118000Z2020-08-09T06:49:27.126000ZCarvalho Jr., Ataliba deTurato, Egberto RibeiroChaim, Elinton AdamiMagdaleno Jr., Ronis
<em>Carvalho Jr., Ataliba De</em>;
<em>Turato, Egberto Ribeiro</em>;
<em>Chaim, Elinton Adami</em>;
<em>Magdaleno Jr., Ronis</em>;
<br/><br/>
INTRODUCTION: Due to the increased number of bariatric surgeries over the years, aspects contributing or hindering the achievement of outcomes, among them weight regain, have acquired increased significance. Psychological factors directly influence on this unwanted situation, but there are few studies and controversies about the degree of participation of these factors. We propose a qualitative investigation to analyze the meanings of weight regain after surgery among women and how these factors influence this outcome. METHOD: This study uses the clinical-qualitative method, by means of a semi-structured interview with open questions in an intentional sample, closed by saturation, with eight women who underwent surgery at the Bariatric Surgery Outpatient Clinic of Hospital das Clínicas, Universidade Estadual de Campinas (UNICAMP), in the state of São Paulo, Brazil. RESULTS: A feeling of defeat and failure emerges with weight regain, which contributes to social isolation; there is no regret, but gratitude for the surgery; among patients, there is a sense of feeling rejected greater than a rejection that actually exists. CONCLUSION: We found out the need for further qualitative studies that help the health team to better understand the dynamic psychological factors involved in the meaning of weight regain after bariatric surgery among women, in order to adopt appropriate conducts to deal with this problem.Dysfunctional family environments and childhood psychopathology: the role of psychiatric comorbidity10.1590/2237-6089-2014-00032024-02-20T19:57:41.118000Z2020-08-09T06:49:27.126000ZFlores, Suzielle M.Salum, Giovanni A.Manfro, Gisele G.
<em>Flores, Suzielle M.</em>;
<em>Salum, Giovanni A.</em>;
<em>Manfro, Gisele G.</em>;
<br/><br/>
Introduction: The study of the association between specific characteristics of family environments and different types of psychopathology may contribute to our understanding of these complex disorders and ultimately inform therapeutics. Objective: To compare the family characteristics of four groups: typically developing children; children with anxiety disorders only; children with externalizing disorders only; and children with both anxiety and externalizing disorders. Methods: This study enrolled 115 individuals from the community. Child psychiatrists made psychiatric diagnoses using a structured clinical interview. The Family Environment scale was used to evaluate six domains of family function. Results: The group with both anxiety and externalizing disorders had higher levels of conflict in family environment and lower levels of organization when compared with typically developing children. In addition, internalizing and externalizing symptoms were positively associated with conflict and negatively with organization. Maternal depressive and anxious symptoms were also associated with higher conflict and lower organization scores. Conclusion: An important between-group difference in comorbid cases of anxiety and behavioral disorders suggests that children with this comorbidity are potential candidates for family interventions to address family conflicts and organizational aspects.Aggressive behavior during the first 24 hours of psychiatric admission10.1590/2237-6089-2014-00162024-02-20T19:57:41.118000Z2020-08-09T06:49:27.126000ZCalegaro, Vitor CrestaniDotto, Amanda BolsonFreitas, DeniseBrum, Anderson BarcellosValerio, Andrei GarzieraSchetinger, Christina ChitolinaCunha, Angelo B. M.
<em>Calegaro, Vitor Crestani</em>;
<em>Dotto, Amanda Bolson</em>;
<em>Freitas, Denise</em>;
<em>Brum, Anderson Barcellos</em>;
<em>Valerio, Andrei Garziera</em>;
<em>Schetinger, Christina Chitolina</em>;
<em>Cunha, Angelo B. M.</em>;
<br/><br/>
OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients. METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS) form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS). The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive. RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002) and individual component scores, and their results showed more activation (p < 0.001) and thinking disorders (p = 0.009), but less anxious-depression (p = 0.008). Violent patients had more severe psychomotor agitation (p = 0.027), hallucinations (p = 0.017) and unusual thought content (p = 0.020). Additionally, self-aggressive patients had more disorientation (p = 0.011) and conceptual disorganization (p = 0.007). CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation.Measures of cognitive reserve in Alzheimer's disease10.1590/2237-6089-2014-00122024-02-20T19:57:41.118000Z2020-08-09T06:49:27.126000ZSobral, MargaridaPestana, Maria HelenaPaúl, Constança
<em>Sobral, Margarida</em>;
<em>Pestana, Maria Helena</em>;
<em>Paúl, Constança</em>;
<br/><br/>
INTRODUCTION: Cognitive reserve (CR), a hypothetical construct used to obtain information about cognitive aging, describes the capacity of the adult brain to cope with the effects of neurodegenerative processes. This study evaluated CR using a CR questionnaire (CRQ) and a set of variables (education, leisure activities, lifelong occupation) that inform CR. It also developed a CR index, validated the CRQ, and examined the correlation between the different CR measures. METHODS: Functional and neuropsychological capacities of 75 outpatients (mean age: 80.2 years) with a probable AD diagnosis were evaluated. Socio-demographic data and clinical variables were collected. Patients completed two questionnaires: the Participation in Leisure Activities throughout Life questionnaire, and the CRQ. RESULTS: Participants with a greater CR had higher scores in cognitive tests than the elderly with a lower CR. A CR index was developed. CRQ reliability was 0.795 (Cronbach's alpha). There was a close association between the CR Index and the CRQ. CONCLUSIONS: This study found an association between CR measures and education, occupation and participation in leisure activities. The CRQ seems to be a suitable instrument to measure CR in Portuguese populations.Profile of patients treated with malariotherapy in a psychiatric hospital in Porto Alegre, Brazil: a historical note10.1590/2237-6089-2013-00632024-02-20T19:57:41.118000Z2020-08-09T06:49:27.126000ZTorres, Guilherme AstorLopes, Maria Helena ItaquiCheuiche, Edson MedeirosGuilhermano, Luiz Gustavo
<em>Torres, Guilherme Astor</em>;
<em>Lopes, Maria Helena Itaqui</em>;
<em>Cheuiche, Edson Medeiros</em>;
<em>Guilhermano, Luiz Gustavo</em>;
<br/><br/>
Introduction: Malariotherapy was a treatment to cure neurosyphilis developed in 1917 by Wagner-Jauregg, by inoculating blood infected with malaria in patients with neurosyphilis. The patient had febrile episodes that often cured him of the syphilitic infection. This treatment won the Nobel Prize in Medicine in 1927 and it was introduced in Hospital Psiquiátrico São Pedro (HPSP) in 1929. Methods: This is a descriptive retrospective cross-sectional study with collection of historical secondary data. Data were collected from a sample of 19 medical records of patients treated with malariotherapy in HPSP, in 1929 and 1930. Results: Most patients were white men aged from 25 to 40 years. The mean length of hospital stay was 1.4 year and the outcomes at this early application of malariotherapy were mostly negative (63.2% died). Discussion: The 19 cases evaluated in this study refer to the first year of application of malariotherapy in HPSP. The statistics available on the total number of dead and cured people over the 10 years this therapy was deployed suggest that the outcomes were better in the subsequent years, possibly due to improvement of technique. As a consequence of this innovative research, which had as its principle reorganizing the central nervous system by using the seizure triggered by malaria fever, other forms of shock therapies were developed, such as insulin therapy, cardiazol shock therapy, and electroconvulsive therapy.