Showing papers in "Revista De Psiquiatria Clinica in 2017"
TL;DR: In this paper, the authors carried out a critical literature review on clinical and etiological aspects, perceived causes, coping strategies and treatment of music performance anxiety (MPA) and found that MPA is highly prevalent among musicians.
Abstract: Background Music performance anxiety (MPA) is understood as a sub-type of social anxiety and is characterised by fears of a musical presentation. Objective To carry out a critical literature review on clinical and etiological aspects, perceived causes, coping strategies and treatment of MPA. Methods Electronic databases PubMed, PsycINFO and Lilacs as well as specific periodicals were used based on the key-words symptoms, diagnosis, aetiology, perceived causes, coping strategies and treatment. Results MPA is highly prevalent among musicians (> 16%), regardless of culture and formation. Cognitive, behavioural and physiological factors are associated with the aetiology of MPA, including biological and psychological predispositions. In addition, one should highlight factors related to the individual, aspects related to tasks and musical situation as perceived causes and/or predictor variables of MPA. As for the coping strategies, one can also highlight the use of breathing/relaxing techniques, increased musical practice, use of homeopathy and substances without medical prescription. Discussion MPA is impacting in the musician’s life. Despite the increasing interest in its study, it is necessary to better understand this complex phenomenon, mainly in the therapeutic context, in addition to the publicising and offering of services for prevention and treatment of MPA.
31 citations
TL;DR: Transcultural adaptation of the PCL-5 for Brazilian Portuguese followed a rigid and standardized procedure and was well understood and linguistically and culturally accepted by the participants, which did not make significant suggestions for changes.
Abstract: Background DSM-5 introduced some modifications on Posttraumatic Stress Disorder (PTSD) criteria. The instruments developed for the assessment of aspects related to PTSD needed a reformulation, as was the case of the Posttraumatic Stress Disorder Checklist (PCL). Objectives To present the process of transcultural adaptation of the three forms of the PCL-5 to Brazilian Portuguese, as well as its face validity. Methods The procedure involved independent translations, a synthesis version, back translation by an independent translator, evaluation by the original author, analysis by an expert committee, and a pretesting study (10 subjects with/without experience of a traumatic situation). The last two steps formed the face validity procedure. Results The synthesis version was approved by the original author and the agreement percentage by the expert committee was excellent, with only two items showing < 90%. The pretesting study showed that the Brazilian version was well understood and linguistically and culturally accepted by the participants, which did not make significant suggestions for changes. Discussion Transcultural adaptation of the PCL-5 for Brazilian Portuguese followed a rigid and standardized procedure. Therefore, after having its face validity assessed by an expert committee and by the target population, it is apt to be used.
24 citations
TL;DR: A single-blinded sham-controlled trial to assess the efficacy of electroconvulsive therapy (ECT) as augmentation strategy in patients with clozapine-resistant schizophrenia found improvement on psychotic symptoms as measured by the mean reduction of the PANSS positive subscale.
Abstract: Background Thirty percent of schizophrenia patients are treatment-resistant. Objective This is a single-blinded sham-controlled trial to assess the efficacy of electroconvulsive therapy (ECT) as augmentation strategy in patients with clozapine-resistant schizophrenia. Methods Twenty three subjects were randomly assigned to 12 sessions of ECT (N = 13) or placebo (Sham ECT) (N = 10). The primary outcome was improvement on psychotic symptoms as measured by the mean reduction of the PANSS positive subscale. The assessments were performed by blind raters. Results At baseline both groups were similar, except for negative and total symptoms of the PANSS, which were higher in the Sham group. At the endpoint both groups had a significant decrease from basal score. In the ECT group the PANSS total score decreased 8.78%, from 81.23 to 74.75 (p = 0.042), while the positive subscale had a mean reduction of 19% (19.31 to 16.17, p = 0.006). In the Sham group, the mean reduction of PANSS total score was 15.27% (96.80 to 87.43; p = 0.036), and the PANSS positive subscale decreased 27.81% (22.90 to 19.14, p = 0.008). The CGI score in ECT group decreased 23.0% (5.23 to 4.17; p = 0.001) and decreased 24.31% in the Sham ECT group (5.80 to 4.86; p = 0.004). Discussion In this pilot study, we found no difference between the groups.
16 citations
TL;DR: Primary psychotic disorders and secondary psychiatric disorders were significantly more frequent among men whereas primary bipolar disorders and depressive Disorders were significantlyMore frequent among women in both inpatient and outpatient settings in Saudi Arabia.
Abstract: Objective This study aimed to explore the current patterns of psychiatric diagnoses in inpatient and outpatient psychiatric settings in Saudi Arabia. Methods Cross-sectional study was conducted on patients seeking psychiatric advice at six hospitals in the five main regions of Saudi Arabia. The data were primarily obtained by reviewing patient charts. Results Total of 1,205 patients were recruited. The majority was unemployed (71.4%), had a low level of education (85.5%), and had low income (61.9%). The most common psychiatric diagnoses among inpatients were schizophrenia (55.8%), bipolar disorder (23.3%) and major depressive disorder (7.2%). The most common psychiatric diagnoses among outpatients were major depressive disorder (29.3%), schizophrenia (28.9%), generalized anxiety disorder (15.6%) and bipolar disorder (11.5%). Primary psychotic disorders and secondary psychiatric disorders were significantly more frequent among men whereas primary bipolar disorders and depressive disorders were significantly more frequent among women in both inpatient and outpatient settings. Psychotic and bipolar disorders were significantly more frequent among younger patients whereas depressive disorders were significantly more frequent among older patients; anxiety disorders were of similar frequency in all age groups. Discussion The most common psychiatric diagnoses among inpatients were schizophrenia and bipolar disorder whereas the most common psychiatric diagnoses among outpatients were major depressive disorder and schizophrenia.
14 citations
TL;DR: The association of global (or certain) BPSD, across different stages of dementia, is a non-linear relationship and the importance of taking into account clinical dementia stage for managing B PSD is suggested.
Abstract: Background To better understand the trends of behavioral and psychological symptoms of dementia (BPSD) over the disease progression is important to provide psychoeducation for dementia caregivers. Objective This study examined the severity and occurrence of BPSD across the various degrees of the disease. Methods This study was a cross-sectional design. Patients (N = 276) who had dementia from July 2001 to October 2008 were surveyed and assessed for dementia stage, using the clinical dementia rating scale (CDR). BPSD was evaluated using the Neuropsychiatric Inventory (NPI). We examined the differences between the severities and occurrence of the individual’s BPSD among various CDR stages with the Kruskal-Wallis test and Chi-square test. Results Delusion (p = 0.01), agitation/aggression (p = 0.033), apathy/indifference (p = 0.009), aberrant motor behavior (p < 0.001), nighttime behavior disturbances (p < 0.001), and eating abnormalities (p = 0.001) were significantly different among stages of dementia. The severity of BPSD became exacerbated over the course of the disease, and was highest in moderate (CDR = 2) or severe (CDR = 3) dementia. The occurrence of BPSD was highest when the CDR equaled 2 (97.5%). Discussion The association of global (or certain) BPSD, across different stages of dementia, is a non-linear relationship. These findings suggest the importance of taking into account clinical dementia stage for managing BPSD.
13 citations
TL;DR: The results of studies that assessed post-trauma interventions in adults aimed at preventing the onset of PTSD suggest that both pharmacological and psychological interventions are effective in the prevention of PTSD.
Abstract: Background Secondary interventions are implemented within a short interval following the occurrence of traumatic events with the purpose of preventing the onset of PTSD. Objective Analyze the results of studies that assessed post-trauma interventions in adults aimed at preventing the onset of PTSD or symptoms related to PTSD. Methods We performed literature searches using the search expression [(Early intervention OR secondary prevention) AND (Post traumatic stress disorder OR PTSD)] for articles published until October 2016. Among the references found, 29 fulfilled the selection criteria established for the review. Data were divided and analyzed according to the type of intervention: pharmacological or psychological. Results Psychological measures used in the studies lack homogeneity regarding the type of intervention and the assessment of intervention outcomes. Pharmacological interventions were less frequent and findings require replication, together with an expansion in the types of substances investigated. In general, many of the studies reviewed suggest that both pharmacological and psychological interventions are effective in the prevention of PTSD. Discussion Future trials should be focused on determining the best interventions for the secondary prevention of PTSD. The combination of psychological and pharmacological interventions for post-trauma patients poses opportunities and challenges that remain unexplored.
13 citations
TL;DR: In this article, a Brazilian Portuguese version of the States of Consciousness Questionnaire (SOCQ) was translated to Brazilian Portuguese and backtranslated into English, resulting in a Brazilian translation.
Abstract: Background The States of Consciousness Questionnaire (SOCQ) was developed to assess the occurrence features of the change in consciousness induced by psilocybin, and includes the Mystical Experience Questionnaire (MEQ), developed to assess the ocurrence of mystical experiences in altered states of consciousness. Objective To translate the SOCQ to Brazilian Portuguese and validate the 30-item MEQ. Methods The SOCQ was translated to Brazilian Portuguese and backtranslated into English. The two English versions were compared and differences corrected, resulting in a Brazilian translation. Using an internet-survey, 1504 Portuguese-speaking subjects answered the translated version of the SOCQ. The 4-factor version of MEQ30 was analyzed using confirmatory factor analysis and reliability analysis. Results A Brazilian Portuguese version of the SOCQ was made available. Goodness-of-fit indexes indicated that data met the factorial structure proposed for the English MEQ30. Factors presented excellent to acceptable reliability according to Cronbach’s alpha: mystical (0.95); positive mood (0.71); transcendence of time/space (0.83); and ineffability (0.81). Discussion The Brazilian Portuguese version of the MEQ30 is validated and it fits in the factorial structure performed on the original English version. The SOCQ is also available to the Brazilian Portuguese speaking population, allowing studies in different languages to be conducted and compared systematically.
11 citations
TL;DR: The trait mindfulness level is significantly related with quitting cannabis use and may be an important determining factor of the ability to quit substance use and achieve remission.
Abstract: Background: Only 29% of cannabis dependent individuals seek treatment, yet significant decreases in cannabis use are seen in 31-36% of individuals that seek treatment. Follow-up studies have found that over 60% in substance use disorders end in relapse, leading to potentially chronic and relapsing cases. New and effective therapies should be researched in order to increase the success of relapse prevention treatments. Objective: In this study we aimed to evaluate the relationship between trait mindfulness level, substance dependence severity and quitting cannabis use. Methods: A hundred and sixty four patients, diagnosed with cannabis dependence, were involved in the study; socidemographic datas were recorded and Addiction Profile Index (API), Mindfuness Attention and Awareness Scale (MAAS) were carried out. Results: We found that the trait mindfulness level is significantly related with quitting cannabis use. Discussion: Trait mindfulness may be an important determining factor of the ability to quit substance use and achieve remission.
10 citations
TL;DR: The most recent efforts are represented by Developmental Psychopathology and the Research Domain Criteria (RDoC), which presents an operational matrix recommended to be used in clinical research instead of the DSM diagnoses.
Abstract: Background: Although widely used in clinical practice and research, Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses have low validity: patients with different mental disorders can share similar symptoms, while those with the same diagnosis might have different symptoms. In fact, the DSM diagnostic system has been considered one of the main obstacles for further development of psychiatric research. Recently, it has been proposed that psychiatry nosology should be reframed according to a biologically-based etiology. Objectives: To review present and past endeavors of establishing an etiology-based nosology. Methods: Comprehensive review of articles on the topic. Results: From Hippocrates onwards, multiple attempts have been undertaken aiming to move etiology and nosology closer. The most recent efforts are represented by Developmental Psychopathology (DP) and the Research Domain Criteria (RDoC), which presents an operational matrix recommended to be used in clinical research instead of the DSM diagnoses. Discussion: The DSM-based nosology is faulty. RDoC and DP might be interesting alternatives for an etiology-based nosology. However, while DP has already brought promising results, RDoC is a novel proposal, whose advantages and disadvantages should gradually be identified in the upcoming years.
9 citations
TL;DR: The study showed that emotional exhaustion correlated with lower levels of adaptive coping, less years of experience in Oncology, and a greater amount of hours worked per week, which supports the importance of adaptive cope strategies in order to prevent symptoms of burnout when health professionals face potentially stressful occupational factors.
Abstract: Background Burnout is a multidimensional syndrome and includes symptoms of emotional exhaustion, depersonalization, and reduced personal accomplishment at work. Oncology health care providers are at high risk to develop symptoms of burnout because of work-related stressors. Adaptive coping strategies adopted to deal with stressors may prevent the development of burnout. Objective The present study aims to assess the association between burnout, functional coping strategies, and occupational factors in a sample of oncology providers, mostly nurses. Methods Sociodemographic Questionnaire, the Maslach Burnout Inventory, and the Problem Solving Inventory “Inventario de Resolucao de Problemas” were administered. Descriptive, correlational, and linear regression analyses were performed. Results The study showed that emotional exhaustion correlated with lower levels of adaptive coping, less years of experience in Oncology, and a greater amount of hours worked per week. Personal accomplishment was associated with the adaptive coping strategies. No further statistically significant associations were identified. Discussion Our findings support the importance of adaptive coping strategies in order to prevent symptoms of burnout when health professionals face potentially stressful occupational factors. Training aimed at improving adaptive coping skills may prevent burnout syndrome for health care professionals working in Oncology.
8 citations
TL;DR: Ayahuasca is a psychoactive ethnobotanical concoction that has been used for decades by indigenous groups of the Northwestern Amazon and by syncretic religious organizations for ritual and therapeutic purposes.
Abstract: Background Ayahuasca is a psychoactive ethnobotanical concoction that has been used for decades by indigenous groups of the Northwestern Amazon and by syncretic religious organizations for ritual and therapeutic purposes. In the last two decades, it is being used worldwide in evolving practices. Ayahuasca seem to therapeutic effects, but controlled studies are lacking. Moreover, its safety and toxicity are not completely understood. Objectives To present an overview of the effects of ayahuasca based on the most recent human studies. Methods Narrative review. Results Ayahuasca administration in controlled settings appears to be safe from a subjective and physiological perspective, with few adverse reactions being reported. More frequent adverse reactions occur in non-controlled settings. Prolonged psychotic reactions are rare and seem to occur especially in susceptible individuals. Ayahuasca showed antidepressive, anxiolytic, and antiaddictive effects in animal models, observational studies, and in open-label and controlled studies. Discussion Ayahuasca administration in controlled settings appear to be safe. Moreover, ayahuasca seem to have therapeutic effects for treatment-resistant psychiatric disorders that should be further investigated in randomized controlled clinical trials. However, medical complications and cases of prolonged psychotic reactions have been reported, and people with personal or family history of psychotic disorders should avoid ayahuasca intake.
TL;DR: Worsening of tremors occurred during SPST, particularly in phases with higher anxiety scores, and there were no significant differences between the groups with regard to other factors of VAMS, physiological measurements, and bradykinesia.
Abstract: Background Among non-motor symptoms of Parkinson’s disease (PD), anxiety occurs in up to 67% of patients. Clinically, PD patients report worsening of tremors in anxiogenic situations. Objective The aim of this study was to evaluate the association between motor symptoms and anxiety in PD patients and compare their performances with those of healthy volunteers. Methods Fifteen volunteers with PD and 15 healthy volunteers without clinically significant psychiatric disorders were evaluated. Both groups were subjected to a simulated public speaking test (SPST). The following parameters were measured: visual analog mood scale (VAMS), items related to tremors of UPDRS, bradykinesia tests, blood pressure, and heart rate. Results Results of repeated measures ANOVA indicated a significant effect on group × phase interaction (F3.7,105.6 = 2.56; p = 0.046) for VAMS anxiety factor. Regarding tremors, ANOVA indicated significant differences in group × phase interaction (F4.5,121 = 2.88; p = 0.021) and between the groups (F1,27 = 45.88, p < 0.001), with differences in the anticipatory phase, performance, and post-speech, compared with those in the baseline. There were no significant differences between the groups with regard to other factors of VAMS, physiological measurements, and bradykinesia. Discussion Worsening of tremors occurred during SPST, particularly in phases with higher anxiety scores.
TL;DR: The AG showed low accuracy in recognizing emotions as a whole and especially fear and disgust and the group needed greater emotional intensity to recognize joy, fear, disgust and surprise and the response time for surprise was significantly associated with alcohol dependence.
Abstract: Background Several studies have demonstrated that chronic and excessive alcohol use causes social cognition deficits. Objectives Thus, the aim of the current study is to assess the associations between emotional facial expression recognition and current alcohol dependence. Methods The sample consisted of two groups: one was composed by current alcohol dependent individuals (AG = 110); and a control group, composed of healthy individuals (CG = 110) assessed by the Structured Clinical Interview DSM-IV. The instrument to assess the recognition of facial expressions of emotion was a dynamic task at computer. Results The AG showed low accuracy in recognizing emotions as a whole and especially fear and disgust. In addition, the group needed greater emotional intensity to recognize joy, fear, disgust and surprise. It also showed increased reaction time for all emotions (p < 0.01). The logistic regression showed the response time for surprise (ODDS = 1.01) and the ability to recognize emotions such as fear (ODDS = 0.68) and disgust (ODDS = 0.70) was significantly associated with alcohol dependence. Discussion These specific associations are of great value to a more refined understanding of alcoholism, and they concern relapse and treatment.
TL;DR: A screening test for personality disorders was recently developed in Brazil, the Dimensional Clinical Personality Inventory- screening version (IDCP-SV) as discussed by the authors, however, no relationship between this screening measure and other scales or external criteria was tested.
Abstract: Background A screening test for personality disorders was recently developed in Brazil, the Dimensional Clinical Personality Inventory – screening version (IDCP-SV). However, no relationship between this screening measure and other scales or external criteria was tested. Objective To seek for validity evidence based on related criteria (e.g., other psychological tests) and external criteria (e.g., sample demographics). Methods Sample comprised 804 participants from Sao Paulo (Brazil), most female and college students, with mean age equal to 29.65 (SD = 10.73). They answered the IDCP-SV and another screening for personality disorders (IPDS), a depression measure (EBADEP-screening), a scale assessing reasoning for living (EMVIVER), and a self-report for personality disorders categories assessment (SCID-II-PQ). Results IDCP-SV identified 46.4% of community sample as positive for personality disorders. The positive group showed the great mean for almost all comparisions, including psychological tests and the demographics characteristics, including large expressive effect sizes. Discussion Data suggest that the IDCP-SV discriminates a similar percentage of people from the community to what was reported previously using other screening measures; besides, the mean comparisons between groups showed good discriminative capacity by IDCP-SV items.
TL;DR: The availability of more sophisticated repertoires of social skills may render family caregivers more resilient to burden, preserving their quality of life while enduring this task.
Abstract: Background: Caring for a demented relative is frequently associated with burden; yet, a subset of family caregivers may experience it as rewarding. Certain characteristics, including personality factors, may render caregivers more resilient to stress and therefore attenuate the perception of burden and its impact on quality of life. Objective: To determine the association between social skills and well being among family caregivers to patients with dementia. Methods: Forty-one family caregivers to patients with dementia due to Alzheimer's disease (AD) were assessed with Social Skills Inventory (SSI-Del-Prette) and the Zarit Burden Interview; quality of life was estimated with WHO-QoL-bref questionnaire. Results: We found positive correlations between total SSI scores and the psychological (r = 0.450; p = 0.003) and environmental (r = 0.408; p = 0.008) domains of WHO-QoL-bref. The SSI factor ‘self-control of aggressiveness’ (SSI-F5) was negatively correlated with the magnitude of caregiver burden (r = -0.483; p = 0.001) and positively associated with the psychological domain of WHO-QoL-bref (r = 0.446; p = 0.003). Caregivers with better ‘self-assertion in the expression of positive affect’ (SSI-F2) also had better ‘social relationships’ according to WHO-QoL-bref (r = 0.402; p = 0.009). Discussion: The availability of more sophisticated repertoires of social skills may render family caregivers more resilient to burden, preserving their quality of life while enduring this task.
TL;DR: The findings suggest Seborrheic dermatitis to be a psychosomatic disorder that requires a multi-disciplinary approach and neurotic personality characteristics were much more frequent in patients with SD.
Abstract: Background Seborrheic dermatitis is a skin disease in which psychological factors play a central role in its onset, exacerbation and remission. Objective The aim of this study was to investigate personality traits and common psychiatric conditions in patients with SD. Methods Outpatients who were admitted to the Bozok School of Medicine Department of Dermatology complaining of SD and who volunteered for study were included. Symptom Checklist 90 – Revised (SCL-90-R) and Eysenck Personality Questionnaire – Revised Short Form (EPQ-RSF) were administered before treatment to 50 patients who fulfilled the criteria for inclusion in the study. Results compiled from the 50 subjects were compared to a control group that was comprised of 50 healthy volunteers. Results Of the 50 patients that were included in the study, 25 were female and 25 were male. The Global Symptom Index (GSI; Z = -6.96, P < 0.001), Somatization (Z = -6.59, P < 0.001), Depression (Z = -7.11, P < 0.001), and Anxiety (Z = -6.64, P < 0.001) subscales of the SCL-90-R were evaluated. Statistically significantly higher scores were obtained from patients with SD in comparison with the control group on all of these subscales. In addition, the EPQ-RSF Neuroticism subscale was statistically significantly higher (Z = -4.99, P < 0.001) in patients with SD. Discussion Our results showed that common psychiatric conditions are considerably frequent in SD patients. More importantly, neurotic personality characteristics were much more frequent in these patients. These findings suggest SD to be a psychosomatic disorder that requires a multi-disciplinary approach.
TL;DR: The findings suggest that toxoplasmosis infection is not associated with severity of symptoms, quality of life, cognitive or depressive symptoms in schizophrenia patients.
Abstract: Background: Toxoplasma gondii (T. gondii) infection has been identified as a risk factor for schizophrenia. Objectives: Herein, we sought to evaluate the association between T. gondii infection and clinical symptoms and quality of life in patients with schizophrenia. Methods: We conducted a cross-sectional study with 48 patients with chronic schizophrenia and 40 controls. Peripheral blood was drawn, and IgM and IgG anti-T. gondii antibodies were evaluated by Enzyme-Linked Immunosorbent Assay (ELISA). Depressive, positive and negative symptoms were assessed, respectively, by the Calgary Depression Scale (CDS) and the Positive and Negative Syndrome Scale (PANSS). Cognitive performance was assessed in patients by the Brazilian version of the Schizophrenia Cognition Rating Scale (SCoRS-BR). Quality of life was assessed by the Brazilian version of the Quality of Life in Schizophrenia scale (QLS-BR). Results: The prevalence and titers of T. gondii IgM and IgG antibodies did not differ between patients and controls. The positive serology for T. gondii IgG antibodies was not associated with illness symptoms, cognitive performance, depressive symptoms or quality of life. Discussion: Our findings suggest that toxoplasmosis infection is not associated with severity of symptoms, quality of life, cognitive or depressive symptoms in schizophrenia patients.
TL;DR: In this paper, the authors presented a study supported by the Gaziosmanpasa University (project no: 2015/28) and the authors would like to thank the patients and the controls for their participation.
Abstract: This study was supported by the Gaziosmanpasa University (project no: 2015/28). The authors would like to thank the patients and the controls for their participation
TL;DR: Increased risks of depression, suicidality, anxiety, and alcohol abuse were significantly associated with a low level of satisfaction with pain-related QOL.
Abstract: Background: A total of 6150 junior and senior high school students aged 11–18 years participated in this study. Their level of pain-related QOL was assessed using the pain subscale of the Taiwanese QOL Questionnaire for Adolescents. The severities of depression, suicidality, anxiety, and alcohol abuse were also examined. Objectives: This study examined the associations between pain-related quality of life (QOL) and sociodemographic characteristics and those between pain-related QOL and mental health problems such as depression, suicidality, anxiety, and alcohol abuse. Methods : The association of sociodemographic factors with pain-related QOL was examined through multiple regression analysis. The association of pain-related QOL with mental health problems was examined through logistic regression analysis. Results : The boys exhibited a higher level of satisfaction with pain-related QOL than did the girls. Older age was significantly associated with a lower level of satisfaction with pain-related QOL. Residential background, parental marital status, and parental education levels were not significantly associated with the level of satisfaction with pain-related QOL. Increased risks of depression, suicidality, anxiety, and alcohol abuse were significantly associated with a low level of satisfaction with pain-related QOL.
TL;DR: The Juvenile Love Scale (JLS) was adapted for use in the Brazilian context as mentioned in this paper for adolescents between 14 and 18 years old, and its content validity was analyzed by a panel of experts in different areas of knowledge.
Abstract: Background Passionate love involves physiological, emotional, and cognitive features that greatly changes behavior. This phenomenon seems universal or near universal. Even other animal species choose partners. An intense state of passionate love is associated with activity in dopamine pathways of the brain ‘reward system’, and recently has been regarded as a ‘natural addiction’. Instruments or tools to evaluate romantic love during childhood is still scarce. Objective To perform the translation and cultural adaptation of the Juvenile Love Scale (JLS) for use in the Brazilian context targeted for adolescents between 14 and 18 years old. Methods The translation and cultural adaptation of JLS followed international recommendations, and its content validity was analyzed by a panel of experts in different areas of knowledge. Results The final version of the JLS for use in the Brazilian context showed high content validity (> 90%). Discussion To our knowledge, this is the first scale for measuring romantic or passionate love in adolescents adapted to the Brazilian context. This instrument is a significant contribution to the study of the dimensions of love, as well as to understand the impact of love on the psychiatric phenomena that pervade life in this stage of development.
TL;DR: In this article, the role of religiosity as a possible moderator between the association of impulsivity and internalizing psychiatric symptoms was analyzed in a cross-sectional study enrolling 366 adults using the abbreviated version of the Barratt Impulsiveness Scale-11, the Self Reporting Questionnaire-20, and the Duke Religion Index.
Abstract: Background There is growing interest in the role of religion in psychiatric disorders. Impulsivity is a psychological trait associated with acting without thinking, with a decision process favoring short-term outcomes without further consideration of its consequences, and is a risk factor for the development of mental disorders. Objective In this study, the objective was to analyze the role of religiosity as a possible moderator between the association of impulsivity and internalizing psychiatric symptoms. Methods The hypothesis was assessed in a cross-sectional study enrolling 366 adults evaluated using the abbreviated version of the Barratt Impulsiveness Scale-11, the Self Reporting Questionnaire-20, and the Duke Religion Index. Results Internalizing symptoms were significantly influenced by an interaction between religiosity and impulsivity. Religiosity acted as a protective factor against internalizing symptoms only for participants with high impulsivity. Discussion The results suggest a moderation role of religiosity in the association of impulsivity with internalizing symptoms.
TL;DR: The results suggest that the concept of “benign” BCECTS should be reconsidered, as children withBCECTS showed lower performance in attention and executive functions when compared to healthy children.
Abstract: Background Cognitive alterations are associated with benign childhood focal epilepsy with centrotemporal spikes (BCECTS) including aspects of executive functions. Objectives This study presents the performance profile on attention and executive function tests of fifty-eight children (BCECTS, n = 30 and controls, n = 28) aged 8-13 years. Methods The following tools were employed: Vocabulary and Block Design subtests from the Wechsler Intelligence Scale for Children III, Stroop Test, Modified Card Sorting Test, Controlled Oral Word Association – FAS and Tower of London. Results Children with BCECTS presented average IQ measure, although their performance was statistically worse when compared to the control group. Children with BCECTS showed significantly lower performance compared to the control group in the following variables: total number of recollected words on the oral fluency test, total number of categories, categorization effect and total number of errors in MCST; and execution time for the Stroop Test Card 1. After controlling for the IQ effect, the total number of errors in the MCST did not show any significant difference between the groups. Discussion Children with BCECTS showed lower performance in attention and executive functions when compared to healthy children. The results suggest that the concept of “benign” BCECTS should be reconsidered.
TL;DR: The elimination of the special treatment of delusions is not the best way to deal with the lack of discriminability of Schneiderian symptoms, and the next version of the DSM system should offer a better and clearer view on the particular role of delusions in clinical diagnosis.
Abstract: Delusions are the hallmark of psychotic disorders1. For many years, they guided the diagnostic of schizophrenia after their inclusion into the first-rank set of symptoms of schizophrenia2. However, the special treatment given to Schneider’s symptoms in the DSM and ICD systems has been highly questioned over the last years3,4. They have been shown not to be exclusive to schizophrenia, and their reliability in distinguishing bizarre from non-bizarre delusions has been found poor5,6. Schneider’s symptoms have been identified in patients with neurotic disorders7, manic-depressive disorders8, and mood disorders. Peralta and Cuesta9 concluded that Schneider’s symptoms were highly prevalent in most forms of psychotic disorders. In light of this situation, the DSM-V10 has eliminated the special treatment of Schneiderian symptoms, and with it, the special treatment of delusions as a key diagnostic input. Apart from the elimination of the subtypes of schizophrenia, the DSM-V proposes: ‘the elimination of the special attribution of bizarre delusions and Schneiderian firstrank auditory hallucinations (e.g., two or more voices conversing)’11. This decision has two main consequences within a diagnostic context. First, it means that delusions will be treated like any other symptom in terms of diagnostic relevance4. Second, it makes really obscure the exact diagnostic role of delusions within the DSM system, as it is not clear what they would be a symptom of. There are good reasons to think that, at least, the elimination of the special treatment of delusions is not the best way to deal with the lack of discriminability of Schneiderian symptoms. Delusions involve a number of experiential12, affective13,14, and cognitive12,15 alterations that do not seem to be present in such high rates in other symptoms. In addition, the adoption of psychotic delusions occurs within a context in which the whole experience of the subject and the world is rarefied1,16,17. Although delusions are not exclusive to schizophrenia; they still are a fundamental sign of profound breakdowns within the patients’ mind, breakdowns that might distinguish them from other relevant symptoms. In consequence, I think delusions should not be treated equally to other symptoms that do not involve all the abnormalities they do. Here it is important to note that not even all delusions should be treated equally. Delusions vary considerably in content and phenomenological features. Some of them are bizarre and some of them are accidentally possible12,15. Some delusions involve the presence of weird ideas about the world (I’ve been followed; people are constantly looking at me’), while others involve the distortion of ego-boundaries (‘thoughts are inserted into my mind’ – Thought Insertion), and even the disintegration of one’s own feeling of being alive (‘I’m dead’ – Cotard Delusion). All these differences in content and phenomenological features are determined by different aetiological routes. This is not something that should be ignored when weighing the diagnostic role of delusions. Differences in the type of abnormalities and doxastic contents they involve make delusions worthy of a more specific treatment within clinical diagnosis. The open problem challenge is to define such a treatment in a conceptually clear and empirically well-informed way. It follows that the clarification and serious consideration of the aetiological, content-related, and phenomenological differences between delusions might help to clarify their diagnostic role. Let’s hope the next version of the DSM system incorporates these issues in order to offer a better and clearer view on the particular role of delusions in clinical diagnosis.
TL;DR: The findings support the view that SNP has preventative properties against psychotic manifestations, and SNP had protective effects against deterioration in facial emotion and identity recognition tasks induced by ketamine.
Abstract: Background: Recent evidence has shown improvements in schizophrenia symptoms after the infusion of sodium nitroprusside (SNP), a nitric oxide (NO) donor. In the rat model of schizophrenia using ketamine injection, pretreatment with SNP seems to prevent behavioral changes associated with positive symptoms for up to one week. Objective: We investigated whether SNP would have preventative effects on psychogenic symptoms induced by ketamine in healthy subjects. Methods: Healthy subjects (N = 38) were assigned to distinct groups that received SNP in different doses (0.15, 0.25, and 0.5 mcg/kg/min). First, participants received an infusion of SNP or placebo over 75 minutes. After 10 minutes, they were injected for 1 minute with a bolus of 0.26 mg/kg of ketamine and a maintenance dose was started 5 minutes later, with 0.25 mg/kg/h of ketamine for 50 minutes. Results: Ketamine-induced psychopathological alterations induced were reduced by SNP, as assessed with the Brief Psychological Rating Scale. Scores in the objective subscale of the Clinician-Administered Dissociative States Scale were also lower in SNP sessions compared to placebo. SNP had protective effects against deterioration in facial emotion and identity recognition tasks induced by ketamine. Discussion: Our findings support the view that SNP has preventative properties against psychotic manifestations.
TL;DR: A combined therapeutic modality, adding group therapy, was associated with positive effects, such as more levels of peer support and involvement in treatment, and increasing the individual’s probability to remain abstinent.
Abstract: Background In Portugal, as far as we know, there are no recent studies that evaluated the comparative efficacy of therapeutic modalities in addiction problems by reference to a holistic and psychosocial model of effectiveness. Objectives Using a sample of Portuguese patients in outpatient treatment for drug and alcohol abuse, this study aimed to examine if a combined treatment modality (group therapy with individual intervention) had greater overall efficacy when compared to other three types of treatment without group therapy. Methods This is a correlational and cross-sectional study using a convenience sample of patients (N = 254) from an outpatient treatment in the Intervention Service on Addictive Behaviors and Substance Dependence. At the time of data collection, the patients were attending four types of treatment, such as receiving intervention based on individual psychological counseling (n = 66); receiving individual psychiatric counseling (n = 68); receiving both individual psychological and psychiatric counseling (n = 102); and receiving not only individual counseling (i.e., psychology or psychiatry), but also attending group therapy (n = 18). Results Using MANOVA and Wilks’s multivariate test criterion, there was a significant effect of treatment modality on the global efficacy, Λ = 0.88, F(9, 603) = 3.75, p < 0.0001. Examination of mean estimates indicated that patients in a combined therapeutic modality revealed more treatment involvement compared to patients in other therapeutic modalities without group therapy. Discussion The results obtained in this study highlight the importance of integrating interventions in a collaborative way. A combined therapeutic modality, adding group therapy, was associated with positive effects, such as more levels of peer support and involvement in treatment, and increasing the individual’s probability to remain abstinent.
TL;DR: A clinical report of delirium as the first clinical manifestation of melanoma brain metastases is presented, illustrating the relevance of an adequate and early differential diagnosis.
Abstract: Background Metastatic tumours sometimes present with neuropsychiatric symptoms, however psychiatric symptoms as rarely the first clinical manifestation. Cutaneous melanoma is the third most common cause of brain metastasis, with known risk factors increasing the chance of such central nervous system metastization. Objectives We present a clinical report of delirium as the first clinical manifestation of melanoma brain metastases, illustrating the relevance of an adequate and early differential diagnosis. Methods In addition to describing the clinical case, searches were undertaken in PubMed and other databases using keywords such as “brain metastasis”, “melanoma”, “agitation”, “psychiatric” and “delirium”. Results We here report the case of a 52-year-old female patient evaluated by Liaison Psychiatry after sudden onset of delirium while admitted at the Gastroenterology Department to study a hypothesis of pancreatitis. A head CT scan identified brain metastases, and after further examination, including brain biopsy, melanoma brain metastization was confirmed. Discussion Some of the diagnostic challenges of psychiatric symptoms associated with secondary brain tumours are discussed, underlining the importance of an adequate differential diagnosis when working in Psychiatry Liaison.
TL;DR: The author’s aim is to contribute towards the humanizing of psychiatry in Taiwan by promoting awareness of its role in the development and treatment of mental illness.
Abstract: Address for correspondence: Chih-Sung Liang. Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC. No.60, Xinmin Road, Beitou District, Taipei City 112, Taiwan, ROC. Tel: +886-2-2895-9808; Fax: +886-2-2895-7633. E-mail: lcsyfw@gmail.com
TL;DR: This study compared demographic and comorbidity profiles of patients admitted in April, August and December to elucidate if patient characteristics differed by season of admission and found no significant seasonality of hospitalizations for MDD in Canada.
Abstract: Background Canada, a temperate country with four defined seasons incurs an annual productivity loss of over $30 billion on major depressive disorder (MDD); however it remains unknown whether inpatient hospitalization for MDD exhibits seasonal variations. Objective Our study objective was to determine if there are seasonal variations in hospitalization rates for MDD in Canada. Methods We used time series analysis to determine monthly rates of hospitalizations for MDD from 2006 – 2013, on data from population level health-administrative databases in Ontario, Canada. We also stratified analysis by gender and three age groups: 18 to 39, 40 to 65 and those over 65. We compared demographic and comorbidity profiles of patients admitted in April, August and December to elucidate if patient characteristics differed by season of admission. Results We identified a total of 130,336 admissions for MDD for 95,439 unique patients. Baseline characteristics of the patients were similar across seasons. We did not detect significant seasonality of hospitalizations for MDD across any of the gender or age subgroups. Discussion Our results question the popularly held belief that hospitalizations for MDD vary with seasons. These findings highlight the need for uniform hospital resource allocation for MDD throughout the year in Canada.
TL;DR: Chlorpheneramine reduced sleep latency and anxiety significantly, however it resulted in poor sleep quality, and valerian-hops group showed marked anxiolysis one hour after dosing, a sleep quality similar to placebo and better than chlorpheneramines, and better alertness compared to placebo.
Abstract: Background Many sedatives and anxiolytics are used in single dose or chronically to aid sleep. Clinically important sedatives include valerian-hops and antihistamines as they are used over the counter and are highly accessible and safe agents. Objectives To evaluate and compare a single dose of chlorpheniramine versus valerian-hops combination in modulating subjective sleep measures in insomniac war refugees. Methods Insomnia among refugees was screened using the Insomnia Severity Index (ISI). Insomniac subjects were randomized to received a single dose valerian-hops (320/80 mg) (n = 65), or chlorpheneramine (4 mg) (n = 50) or placebo (n = 76) two hours prior sleeping. Participants were instructed to complete Leeds Sleep Evaluation Questionnaire (LSEQ), visual analogue scales of anxiety and sedation. Also sleep latency, total hours slept and self-rated improvement were obtained. Results Almost 75% of screened refugees had insomnia. Chlorpheneramine reduced sleep latency and anxiety significantly, however it resulted in poor sleep quality. Valerian-hops group showed marked anxiolysis one hour after dosing, a sleep quality similar to placebo and better than chlorpheneramine, and better alertness compared to placebo. Participants satisfaction was higher with chlorpheneramine and there was no difference in the total hours slept. Discussion Valerian-hops combination may provide better sleep quality than antihistamines.
TL;DR: In this paper, the authors present a translation and transcultural adaptation to Brazilian Portuguese of the Theory of Mind Task Battery for assessment of social cognition in the elderly in the Brazilian Portuguese language.
Abstract: Address for correspondence: Marcos Hortes Nisihara Chagas. Universidade Federal de São Carlos, Centro de Ciências Biológicas e da Saúde, Departamento de Gerontologia. Rodovia Washington Luís, km 235 – 13565-905 – São Carlos, SP, Brazil. Telephone: +55 (16) 98145-2367. E-mail: setroh@hotmail.com Translation and transcultural adaptation to Brazilian Portuguese of the Theory of Mind Task Battery for assessment of social cognition in the elderly