Showing papers in "Revista De Psiquiatria Do Rio Grande Do Sul in 2006"

Contribuição dos domínios físico, social, psicológico e ambiental para a qualidade de vida global de idosos

Abstract: Este estudo investigou a contribuicao de cada dominio da qualidade de vida (fisico, social, psicologico e ambiental) na qualidade de vida global e em que extensao esses dominios explicam a qualidade de vida global de idosos residentes no municipio de Teixeiras, na Regiao Sudeste do Brasil. Trata-se de um estudo observacional de corte transversal, sendo a amostragem aleatoria estratificada por sexo, uso do Programa Saude da Familia e microarea de saude (n = 211, individuos com idade igual ou superior a 60 anos), representando 14,28% do total de idosos do municipio em estudo. O instrumento utilizado foi o Word Health Organization Quality of Life Instrument Bref (WHOQOL-Bref), proposto pela Organizacao Mundial de Saude, aplicado por um unico entrevistador, devidamente treinado. As analises de regressao linear mostraram que nenhuma das variaveis sociodemograficas interferiu significativamente no dominio global da qualidade de vida, e, entre os quatro dominios, o que mais explicou a qualidade de vida global foi o fisico, seguido do ambiental e do psicologico. O dominio social nao mostrou contribuicao significativa na qualidade de vida global. As possiveis explicacoes para os resultados encontrados foram discutidas.

Apresentação de uma versão em português para uso no Brasil do instrumento MTA-SNAP-IV de avaliação de sintomas de transtorno do déficit de atenção/hiperatividade e sintomas de transtorno desafiador e de oposição

Abstract: The SNAP-IV questionnaire was developed to evaluate symptoms of attention-deficit/hyperactivity disorder in children and adolescents. It can be fulfilled by parents or teachers and consists of the symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for attention-deficit/hyperactivity disorder (criterion A) and oppositional-defiant disorder. OBJECTIVES: To develop a version of the SNAP-IV used in the Multimodal Treatment Assessment Study to be applied in Brazil. METHODS: Translation, back-translation, evaluation of semantic equivalence, debriefing and definition of a final version was the methodology used to reach an adequate version. RESULTS: After translation and back-translation, 20 items were considered similar, six items were considered approximate in meaning, and five items were considered different from the original instrument in English. The final version was chosen considering many aspects, including similarity to the original version, ease of understanding and level of equivalence of the terms in different regions of the country. CONCLUSION: The Portuguese version of the SNAP-IV will allow the screening of attention-deficit/hyperactivity disorder and oppositional-defiant disorder in a similar manner to the original version.

Adaptação transcultural para o português brasileiro do Parental Bonding Instrument (PBI)

Abstract: OBJETIVE: This article aims to present a cross-cultural adaptation of the Parental Bonding Instrument to Brazilian Portuguese. It is a self-administered questionnaire developed in 1979, which has been used since then to measure the subjective experience of being parented to the age of 16 years. METHOD: The following steps were performed: conceptual equivalence, item equivalence, semantic equivalence, operational equivalence, functional equivalence, and approval of the final version by the author of the original instrument. RESULTS: The study has reached the objectives of equivalence, and the final Brazilian Portuguese version has been approved by the original author. CONCLUSION: The study provides a Brazilian Portuguese version of an instrument that has been proven extremely useful in risk and resilience researches over the past decades, assessing the perception of parental characteristics traditionally related to personality development.

Contribution of the physical, social, psychological and environmental domains to overall quality of life of the elderly

Abstract: This study investigated the contribution of each quality of life domain (physical, social, psychological and environmental) in the overall quality of life and how these domains explain the overall quality of life of elderly people resident in the city of Teixeiras, Southeastern Brazil. It is a cross-sectional observational study, random sampling stratified by gender, Family Health Program use and health micro-region (n = 211 individuals aged 60 or over), representing 14.28% of elderly people in the total municipality in study. The World Health Organization Quality of Life Instrument (WHOQOL-Bref) was used to assess the quality of life; it was applied by only one well trained interviewer. Linear regression analyses showed that none of the sociodemographic variables interfered significantly in the overall quality of life domain and, among the four domains, physical was the one that best explained the overall quality of life, followed by the environmental and psychological domains. The social domain did not show significant contribution to the overall quality of life. The possible explanations for the results were discussed.

Prevalência de compulsão alimentar entre universitárias de diferentes áreas de estudo

Abstract: INTRODUCAO: A compulsao alimentar (CA) entre mulheres tem sido considerada fator de risco para o diagnostico de transtornos alimentares mais graves. O objetivo do presente estudo foi investigar a prevalencia de CA entre universitarias e a sua associacao com IMC (indice de massa corporea) e idade. MATERIAL E METODO: Foram avaliadas 491 estudantes universitarias, com idade entre 17 e 55 anos, de tres areas de estudo (exatas, saude e humanas) da Universidade do Vale do Rio dos Sinos (UNISINOS), situada no municipio de Sao Leopoldo (RS). Para avaliar a frequencia de CA, utilizou-se o questionario auto-aplicavel Escala de Compulsao Alimentar Periodica (ECAP). As medidas de peso e estatura foram auto-informadas. RESULTADOS: A prevalencia de CA entre as universitarias estudadas foi de 18,1%. A frequencia de IMC > 25 kg/m² foi de 11,4%, e 75,8% delas apresentavam mais de 20 anos. Observou-se uma associacao significativa entre IMC e CA no grupo geral, sendo que 54,5% das universitarias com excesso de peso ou obesidade apresentaram CA (p < 0,001), e a idade nao foi associada com a presenca de CA. Porem, na area da saude, as estudantes com idade igual ou menor a 20 anos apresentaram maior frequencia de CA (p < 0,05), e, na area de humanas, o resultado foi inverso (p < 0,05). CONCLUSAO: O questionario auto-aplicavel ECAP revelou elevada prevalencia de CA entre mulheres universitarias, mostrando associacao com excesso de peso. Investigacoes futuras sao necessarias, com o objetivo de confirmar esses resultados e avaliar a presenca de outros transtornos alimentares.

Bem-estar espiritual e transtornos psiquiátricos menores em estudantes de psicologia: estudo transversal

Abstract: INTRODUCAO: Religiosidade/espiritualidade e saude mental parecem positivamente associadas. O estudo examina associacoes entre bem-estar espiritual e disturbios psiquiatricos menores em estudantes de Psicologia. METODOS: Uma escala de bem-estar espiritual, o Self-Reporting Questionnaire (SRQ-20) e informacoes sociodemograficas foram utilizadas na totalidade (n = 351) dos alunos de Psicologia da Universidade Catolica de Pelotas (RS), no ano de 2002. Foram comparados os escores atuais com os dos alunos de Direito e Medicina da mesma universidade em 2001 (n = 464). RESULTADOS: 84,6% dos alunos de Psicologia apresentaram espiritualidade negativa, comparados a 68,8% dos academicos de Medicina e 68,5% de Direito (p DISCUSSAO: Os achados coincidem com a experiencia internacional. E preocupante que estudantes de Psicologia se mostrem mais distantes de questoes espirituais/religiosas, levando em conta a associacao espiritualidade/saude-enfermidade. CONCLUSAO: A religiosidade/espiritualidade se mostrou como fator inversamente associado a transtornos psiquiatricos menores em estudantes de Psicologia.

Adaptação transcultural para o português do Social Phobia Inventory (SPIN) para utilização entre estudantes adolescentes

Abstract: INTRODUCAO: E crescente o interesse em estudar a Fobia Social, sobretudo em faixas etarias jovens, requerendo instrumentos de autopreenchimento para identificacao do transtorno. Esse estudo consistiu na adaptacao transcultural do Social Phobia Inventory (SPIN) para sua utilizacao entre adolescentes estudantes brasileiros. METODOS: O processo de adaptacao envolveu quatro etapas: traducao; retroversao; apreciacao das versoes com elaboracao de uma versao de consenso; e pre-teste comentado. RESULTADOS: Para cada item do instrumento, sao apresentados os resultados das quatro etapas e a versao final do instrumento em portugues. DISCUSSAO: E importante a utilizacao de mais de uma traducao e retroversao para possibilitar a comparacao dos itens e a identificacao de erros e assim permitir a escolha dos termos mais adequados. A realizacao do pre-teste comentado em um grupo semelhante a populacao alvo possibilita a melhor adequacao do instrumento a populacao em que sera utilizado. CONCLUSAO: Instrumentos elaborados em lingua estrangeira necessitam de processo cuidadoso de adaptacao transcultural para sua utilizacao em uma realidade sociocultural distinta.

Bulimia e transtorno da compulsão alimentar periódica: revisão sistemática e metassíntese

Abstract: OBJECTIVE: The aim of this systematic review is to identify the scope of qualitative investigations on the life experience of patients with bulimia and binge eating disorder. METHODOLOGY: Searches were conducted using the following databases: PubMed, ISI, PsycInfo, Embase, LILACS and Scielo, for articles published between 1990 and 2005. Inclusion criteria were: 1) articles with main focus on bulimia or binge eating disorders; 2) original research reported in English, Spanish, French or Portuguese; 3) use of any qualitative method, such as interview, focal group or field observation. Exclusion criteria were exclusively theoretical articles and those assessing children or elderly subjects. A meta-ethnographic approach was used to synthesize the data. Each study was carefully read, and their thematic categories were interpreted and compared to the categories of all other studies. RESULTS: Fifteen studies were included of a total of 3,415 articles. Seven overlapping main themes were identified: illness representation; negative feelings (fear, guilt, anger, loneliness, loss of control); positive feelings (self-control, power); symptom function; interpersonal relationships; sociocultural context; recovery. CONCLUSIONS: Although many issues were negative, the overall experience was not reported as being only bad. Some aspects of eating disorders were considered beneficial by the patients.

Painel brasileiro de especialistas sobre diagnóstico do transtorno de déficit de atenção/hiperatividade (TDAH) em adultos

Abstract: Considerando-se as dificuldades atuais do diagnostico do transtorno do deficit de atencao/hiperatividade em adultos, foram reunidos especialistas brasileiros que fazem pesquisas nesta area, de modo a produzir diretrizes de consenso para uso no pais. Foi realizada uma revisao nao-sistematica preliminar e concebido um texto inicial, que foi repetidamente avaliado e editado pelos autores, com acrescimos e correcoes ao longo de 6 meses, atraves de correio eletronico e de uma reuniao posterior, patrocinada pela Associacao Brasileira do Deficit de Atencao. A versao preliminar foi apresentada publicamente durante o congresso anual da Associacao Brasileira de Psiquiatria, com comentarios e sugestoes dos participantes, para a redacao da versao final.

Burnout na clínica psiquiátrica: relato de um caso

Abstract: The burnout syndrome was first described in the 1970's and is characterized by three dimensions (emotional exhaustion, depersonalization and reduced personal accomplishment). Burnout is a work organization-related health condition. Nevertheless, it is not part of any psychiatric classification. This article presents the concept of burnout, establishes its nosological status and introduces a brief discussion on the difference between burnout and depression, based on the report of a clinical case treated at Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro.

Memoria, humor y emoción

Abstract: O numero de estudos que visam compreender as interacoes entre processos cognitivos e afetivos vem aumentando nos ultimos anos, principalmente em funcao das suas inumeras implicacoes praticas, com destaque para a psicoterapia e a area forense. O presente artigo tem por objetivo apresentar algumas das possiveis interacoes entre processos afetivos e a memoria. Inicialmente sao assumidas definicoes para os termos emocao, humor e afeto. Depois, sao abordadas as relacoes entre humor, emocao e memoria, descrevendo-se os principais fenomenos investigados nessas areas. Para cada fenomeno descrito, sao expostos fundamentos empiricos e teorias explicativas. Ao final, sao discutidas limitacoes e implicacoes dos estudos sobre as relacoes entre humor, emocao e memoria, apontando-se para a necessidade de um maior consenso entre os pesquisadores da area.

Memória, humor e emoção

Abstract: O numero de estudos que visam compreender as interacoes entre processos cognitivos e afetivos vem aumentando nos ultimos anos, principalmente em funcao das suas inumeras implicacoes praticas, com destaque para a psicoterapia e a area forense. O presente artigo tem por objetivo apresentar algumas das possiveis interacoes entre processos afetivos e a memoria. Inicialmente sao assumidas definicoes para os termos emocao, humor e afeto. Depois, sao abordadas as relacoes entre humor, emocao e memoria, descrevendo-se os principais fenomenos investigados nessas areas. Para cada fenomeno descrito, sao expostos fundamentos empiricos e teorias explicativas. Ao final, sao discutidas limitacoes e implicacoes dos estudos sobre as relacoes entre humor, emocao e memoria, apontando-se para a necessidade de um maior consenso entre os pesquisadores da area.

Prevalência de transtornos depressivos e ansiosos em uma amostra ambulatorial brasileira de mulheres na menopausa

Abstract: OBJETIVE: To determine the prevalence of depressive and anxiety disorders in women receiving care in a menopause clinic. METHODS: Eighty-six women receiving care in the menopause clinic at Instituto de Ginecologia da Universidade Federal do Rio de Janeiro were assessed using the Mini-International Neuropsychiatric Interview. RESULTS: Most women had a psychiatric diagnosis (57%); generalized anxiety disorder (34.9%) and major depression (31.4%) were the most prevalent disorders. The group composed of subjects with any disorder was represented by young and married women, with lower schooling level and family history for psychiatric disorders. CONCLUSION: In our study, there was a high prevalence of psychiatric disorders in outpatient women receiving care in a menopause clinic, in relation to women receiving care in other outpatient clinics, as described in the literature. There was also a high prevalence of comorbid diseases (55.5% of patients with any disorder) complicating the primary disorder, which may compromise the prognosis due to lack of early specific treatment.

Outcome expectancy considering the use of alcohol, cannabis and tobacco

Abstract: This article aims to perform a theoretical review about the outcome expectancy construct considering the use of alcohol, cannabis and tobacco. Outcome expectancy is determined by people's belief about the effects of a drug. It is an important variable for the treatment of chemically dependent patients. Searches in the electronic databases MEDLINE, PsycINFO, ProQuest, Ovid, LILACS and Cork were carried out, using the following descriptors: belief, expectancy, expectation, drugs, psychoactive, and effect. Results showed that outcome expectancy considering the use of those substances can be generated from: exposure to conditioning stimuli, physical dependence, personal and cultural beliefs, and situational and environmental factors. In conclusion, there is the need of new researches on expectancies related to psychoactive substances and age groups in order to have a better understanding of this construct.

Contratransferência e trauma psíquico

Abstract: This article aims at reviewing important aspects of the relationship between countertransference and care of patients who were victims of psychic trauma. The treatment of traumatized patients is a potential source of psychic suffering to their therapists as well, due to the emotional burden involved and to the chances of evoking strong countertransferential reactions. A better understanding of this process could be a valuable contribution to treatment outcome, besides promoting mental health protection and prevention for therapists. Firstly, psychic trauma will be approached from its concept and definitions, including considerations on posttraumatic stress disorder and extending to countertransference reactions and their meaning in the context of traumatic situations. The impact of treating trauma victims will also be discussed through the relevance of vicarious traumatization, a phenomenon whose comprehension has been pointed out as crucial to provide better care to psychological trauma victims.

Efeitos adversos metabólicos de antipsicóticos e estabilizadores de humor

Abstract: BACKGROUND: An increase in the incidence of obesity and diabetes mellitus in psychiatric patients using antipsychotic drugs was observed as early as the 1960's. In the 1980's and 1990's, rehabilitation of clozapine, synthesis of other atypical antipsychotics, and spread of the use of lithium and valproic acid once again directed the attention to their metabolic effects. This study aims to review the medical literature with regard to metabolic side effects associated with the use of antipsychotics and mood stabilizers. METHOD: Research was carried out at MEDLINE and LILACS through October 2005. CONCLUSION: Metabolic side effects remain a major concern for psychopharmacology. Clinically relevant weight gain occurs frequently in patients taking antipsychotics and mood stabilizers, particularly clozapine, olanzapine, lithium, and valproic acid. Clozapine and olanzapine are also associated with higher incidence of diabetes mellitus and dyslipidemias, either due to weight gain or because of a direct deleterious action on glucose metabolism. Incidence of obesity and other metabolic disorders is lower with risperidone when compared to olanzapine or clozapine. Carbamazepine is associated with lower weight gain when compared to lithium or valproic acid. Drugs such as haloperidol, ziprasidone, aripiprazole and lamotrigine are not associated with significant weight gain or with higher incidence of diabetes mellitus. They are alternatives for patients more likely to develop these adverse effects.

Sobrepeso e obesidade em pacientes esquizofrênicos em uso de clozapina comparado com o uso de outros antipsicóticos

Abstract: BACKGROUND: The use of antipsychotics has been crucial in the treatment of schizophrenic patients. However, clozapine, as well as most atypical antipsychotics, may lead to higher weight gain and metabolic changes. OBJECTIVE: To compare the frequency of overweight and obesity between schizophrenic patients exposed to clozapine to the prevalence of patients exposed to other antipsychotics. METHOD: This study assessed 121 schizophrenic outpatients aged 18 years or older, both genders, consecutively referred to an outpatient clinic for schizophrenia and dementia at Hospital de Clinicas de Porto Alegre, a public hospital in Porto Alegre, Brazil. Anthropometric measures of 53 patients taking clozapine and of 68 taking other antipsychotics were assessed. All patients met DSM-IV and ICD-10 diagnostic criteria for schizophrenia. RESULTS: There was no significant difference in body mass index between schizophrenic patients taking clozapine and patients taking other antipsychotics. Analyses showed high frequency of overweight and obesity (72.7%). DISCUSSION: Due to higher frequency of overweight in the schizophrenic population, it was possible to confirm a higher risk of vascular and metabolic disorders in the sample. Absence of a significant difference with regard to the use of clozapine, compared to other antipsychotics, provides evidence for the need of prospective studies in order to determine the magnitude of weight gain and risk increase related to specific exposure to each antipsychotic drug.

História recente e perspectivas atuais da pesquisa de resultados em psicoterapia psicanalítica de longa duração

Abstract: Artigo apresentado pela autora responsavel (Simone Isabel Jung) comorequisito parcial para a obtencao do titulo de Mestre em Psiquiatria pelaUniversidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS.Titulo da dissertacao: “Avaliacao de resultados da psicoterapia psicanaliticaem um servico de atendimento de Porto Alegre” (em andamento).Conflito de interesse: Simone Isabel Jung e bolsista da Coordenacao deAperfeicoamento de Pessoal de Nivel Superior (CAPES).* Psicologa, Especialista em Psicoterapia Psicanalitica, Estudos Integrados dePsicoterapia Psicanalitica (ESIPP), Porto Alegre, RS. Mestranda em Psiquiatria,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS.** Medica. Especialista em Psiquiatria, UFRGS, Porto Alegre, RS.Mestranda em Psiquiatria, UFRGS, Porto Alegre, RS.*** Psicologa. Professora titular, Faculdade de Psicologia, PontificiaUniversidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS.Coordenadora, Programa de Pos-Graduacao, Faculdade de Psicologia,PUCRS, Porto Alegre, RS.**** Medico psiquiatra. Professor adjunto, Departamento de Psiquiatria eMedicina Legal, UFRGS, Porto Alegres, RS. Analista didata, SociedadePsicanalitica de Porto Alegre, Porto Alegre, RS. Presidente da InternationalPsychoanalytic Association (IPA).

Doença mental, mulheres e transformação social: um perfil evolutivo institucional de 1931 a 2000

Abstract: INTRODUCTION: Along the 20th century, women underwent numerous changes and reached a more active participation in society. This study aims at describing the profile of the female patients admitted to a service of psychiatric hospitalization from May 1931 to December 2000. In addition, it relates the profile of psychiatric morbidity with the historical, social and demographic changes. It also offers a comparison between the epidemiological conditions throughout the historical series and the aspects regarding the environment and the sociocultural status of women from a Southern Brazilian state. MATERIALS AND METHODS: Descriptive, longitudinal, epidemiological study including historical data and based on data collected from the medical files and statistics of a hospital. The following variables were assessed: age, marital status, race, professional area, occupation, social class and psychiatric diagnosis, all standardized according to the International Classification of Diseases (ICD-9 and ICD-10) criteria. To identify the cases, all first hospitalizations of women were used. RESULTS: Along 70 years, a total of 9,629 individuals/cases was obtained. There was a predominance of women in the age group between 26-45 years (47.9%), white (91.3%), belonging to the subproletariat (86.8%), not belonging to the economically active part of the population (96.7%) and with diagnosis of affective disorders (28.6%) and schizophrenic psychoses (25.2%). With regard to marital status, married women were prevalent (44.9%). However, in the 1990's, single women represented 54.4%, whereas married women accounted for 39.7% of the patients. CONCLUSION: Significant changes were detected in the reasons for admitting women to psychiatric services over the past years. It is suggested that the variations might have been influenced by biological determinants of severe mental diseases, and especially by the social pressure resulting from the new role of women in society.

Versão brasileira do Defense Style Questionnaire (DSQ) de Michael Bond: problemas e soluções

Abstract: O Defense Style Questionnaire (DSQ) e um instrumento para avaliacao de derivados conscientes dos mecanismos de defesa do ego, desenvolvido e validado por Michael Bond em 1983 no Canada. O presente trabalho consistiu da traducao e adaptacao desse instrumento para o portugues, assim como do estudo de confiabilidade estatistica da traducao em relacao ao original. METODOS: A traducao foi feita por um grupo de profissionais (psiquiatras, psicologos e professores de ingles) segundo a tecnica de retrotraducao. O estudo da confiabilidade da traducao foi realizado em uma amostra de 51 bilingues (ingles/portugues), os quais responderam aos testes nas duas versoes (original e traduzida). A analise estatistica da consistencia interna e das correlacoes item por item e sujeito por sujeito, assim como entre os escores medios de cada uma das formas (original e traduzida), demonstrou que as duas versoes sao equivalentes e, portanto, a traducao para o portugues e precisa. Foram ainda avaliadas as abstencoes as respostas e a taxa de concordância entre as versoes. RESULTADOS E CONCLUSAO: Todos os resultados foram bastante satisfatorios e estatisticamente significantes, o que nos permite concluir que o instrumento traduzido e adequado para uso no Brasil.

Avaliação neuropsicológica dos circuitos pré-frontais relacionados à tomada de decisão na esquizofrenia: uma revisão sistemática da literatura

Abstract: OBJECTIVES: A critical review of the literature was undertaken with articles assessing neuropsychological deficits in decision making (DM) in schizophrenic patients. METHODS: This review included all articles that performed neuropsychological assessments with tests sensitive to cortical areas associated with DM, especially the orbitofrontal cortex dysfunction. Methodological aspects of the selected studies were compared, as well as the correlation between measures in DM tasks with clinical, cognitive and functional characteristics of the samples. RESULTS: Eight articles between 1997 and 2005 were selected. With regard to the instrument used to assess DM, six used the Iowa Gambling Task (IGT), one used the Novel Decision Making Task (NDMT) and one used the Two Choice Prediction Task (TCPT). All the studies compared schizophrenic patients to healthy controls. In four articles using the IGT and the others using either the NDMT or the TCPT, schizophrenic patients showed low performance in DM tasks. DISCUSSION AND CONCLUSION: Current studies are inconclusive in assessing DM deficits in schizophrenia. Clinical characteristics such as diagnostic subtype, predominant symptoms, type of medication and psychosocial functioning can account for the results found. Further studies are required to better investigate the nature of DM deficits in schizophrenia and their relevance to clinical presentation and illness course.

Os sonhos: integrando as visões psicanalítica e neurocientífica

Abstract: A comprehensive review was carried out about psychoanalytic studies and the most recent neuroscientific researches about dreams. According to Freud, dreams represent "a (disguised) fulfillment of a (repressed) wish." For several neuroscientists, they are formed based on random stimuli originated from the brainstem and do not have any meaning. However, several studies associate the emotions experienced during waking with the content of dreams. The hypothesis that the dopaminergic mesolimbic-mesocortical system, which is associated with instinctual appetitive craving states, is essential to the formation of dreams brings some endorsement to Freudian theory. Nevertheless, there is no empirical data to support the existence of an instance of censorship that distorts the dreams. It is possible that the dreams play a role in psychological working-through of traumatic memories. In our opinion, psychoanalytic and neuroscientific views about dreams can be complementary and mutually enriching.

Memory, mood and emotion

Abstract: The number of studies that aim to understand the interactions between the cognitive and affective processes has been increasing over the past years, mainly due to their several practical implications, particularly for psychotherapy and the forensic field. The objective of this article is to

Depressão e suicídio no filme "As Horas"

Abstract: As historias dramatizadas nas telas dos cinemas sao impactantes, uma vez que suscitam sentimentos vivenciados pelos seus apreciadores. Nessa perspectiva, o presente artigo procura identificar, demonstrar e comentar o comportamento depressivo nos personagens do filme As horas, de Stephen Daldry. Os personagens ilustram a vivencia e convivencia de pessoas com quadros depressivos em diferentes epocas e em diferentes graus de morbidade. O filme procura mostrar as diferentes manifestacoes comportamentais e sintomaticas atraves da apresentacao pessoal de cada personagem e tambem atraves do cenario das historias representadas. Observam-se tracos de depressao psicotica na personagem de Virginia Woolf e um estado depressivo que tende a distimia na personagem de Laura Brown. Clarissa sugere uma "depressao dissimulada" e fortemente relacionada a Richard, cuja depressao culmina em suicidio. A condensacao de epocas e a interligacao entre os personagens refletem a universalidade e a atemporalidade dos fenomenos psiquicos, embora vividos de forma particular por cada um dos personagens.

Desenvolvimento da versão em português do Brasil do questionário sobre padrão de relacionamentos Beziehungs-Muster Fragebogen

Abstract: INTRODUCAO: O desenvolvimento da versao em portugues do Brasil do Beziehungs-Muster Fragebogen, conhecido na literatura internacional como Relationship Patterns Questionnaire, questionario que avalia o padrao central de relacao, visa a introducao, em nosso meio, de uma medida auto-aplicavel para implementacao de projetos de pesquisa cuja questao envolva o construto transferencia. METODOLOGIA: As etapas para o desenvolvimento da versao foram: obtencao da licenca dos autores; traducao do instrumento original para o portugues do Brasil; julgamento e ajuste do material traduzido por profissionais da area da psiquiatria e psicologia; retrotraducao; julgamento da equivalencia semântica; consenso de profissionais da area da psiquiatria e psicologia sobre a adequacao do instrumento a nossa cultura; interlocucao com a populacao-alvo. CONCLUSAO: O Beziehungs-Muster Fragebogen e uma medida auto-aplicavel, para avaliacao da transferencia ou padrao central da relacao, que podera facilitar a implementacao de projetos para investigar os aspectos da relacao terapeutica adjuntos a transferencia. E um metodo de facil aplicacao e analise, baixo custo e que dispensa o uso de videos ou gravadores na sessao. Estudos investigatorios acerca do padrao de relacao poderao fornecer mais resultados sobre a adaptabilidade desse instrumento a nossa cultura.

Análise qualitativa de variáveis relevantes para a aplicação do programa de terapia psicológica integrada em pacientes com esquizofrenia de três centros do Sul do Brasil

Abstract: OBJECTIVES: This study aims at (1) presenting the main difficulties in the application of the integrated psychological therapy (IPT) program for schizophrenia developed in Germany; and (2) documenting the strategies used to adapt this technique to the Brazilian reality. METHOD: Qualitative approach with data analysis through the examination of the contents of patients' verbalizations in discussion groups carried out after IPT therapy sessions with three groups of patients with schizophrenia or schizoaffective disorder diagnosis, according to DSM-IV. These patients came from three different institutions that work with IPT: Instituto de Capacitacao e Reorientacao Ocupacional (Capacitation and Occupational Rehabilitation Institute), Centro de Atencao Psicossocial (Center for Psychosocial Care) at Hospital das Clinicas de Porto Alegre, and Centro de Atencao Psicossocial (Center for Psychosocial Care) in Tubarao (SC, Brazil), including a total of 22 outpatients. RESULTS: The following categories were determined: repetition and monotony; difficulty in doing some exercises; lack of practical usefulness in doing some exercises; and need of knowing more about the disease. Positive aspects related to the technique were also reported by the patients. DISCUSSION: The results reveal very relevant aspects for the understanding of the outpatients' compliance to a treatment developed in a European country. Our findings suggest that cultural differences may interfere with the application of IPT in terms of its structure. However, improvement in functioning, as related by the outpatients, motivates us to continue searching for the adaptation of this technique to our patients' characteristics. Nevertheless, further studies, such as controlled clinical trials, are necessary to assess the effectiveness of the IPT adaptation to Brazilian patients.