bluuebunny/crossref_metadata_2025 huggingface dataset:
Transtornos de ansiedade e exercício físico
Authors: Araújo Sônia Regina Cassiano de , Mello Marco Túlio de , Leite José Roberto
Published: September 2007

OBJETIVO: A maioria dos estudos sobre os efeitos ansiolíticos do exercício físico, até meados da década de 90, foram realizados avaliando-se estados de ansiedade, com indivíduos jovens, universitários ou atletas, que podem ser considerados pré-condicionados, limitando a validade das conclusões para populações com ansiedade patológica. Na atualidade, o número de estudos envolvendo pacientes com transtorno de ansiedade aumentou. O presente estudo tem por objetivo a revisão de artigos que discutem a influência do exercício físico nos transtornos de ansiedade. MÉTODO: Foi realizada uma pesquisa no Medline, no período de 1966-1995 e 1996-2006, utilizando-se os descritores: anxiety, panic, phobic disorders, exercise, physical fitness, além de referências cruzadas dos artigos selecionados e análise adicional de referências na literatura específica do tema. RESULTADOS: Os achados demonstraram desenhos heterogêneos assim como limitações metodológicas. As publicações mais recentes são promissoras e acenam para a utilização de exercícios físicos aeróbios como auxiliares das terapêuticas tradicionais no tratamento dos transtornos de ansiedade. CONCLUSÃO: Verificou-se que os exercícios aeróbios cuja intensidade não ultrapasse o limiar de lactato podem ser os mais apropriados, mas ainda não esclarecem as implicações dos exercícios anaeróbios, sugerindo cautela na prescrição de exercícios para indivíduos com ansiedade patológica, principalmente em relação aos exercícios anaeróbios.
A twelve-week randomized controlled study of the cognitive-behavioral Integrated Psychological Therapy program: positive effect on the social functioning of schizophrenic patients
Authors: Zimmer Marilene , Duncan Adriana Veríssimo , Laitano Daniela , Ferreira Eloisa Elena , Belmonte-de-Abreu Paulo
Published: September 2007

OBJECTIVES: The present study was designed to evaluate the effect of twelve weekly sessions of the cognitive-behavioral program originally known as the Integriertes Psychologisches Therapieprogramm für Schizophrene Patienten, designated the Integrated Psychological Therapy (IPT) program in English, on cognition, social adjustment and quality of life in schizophrenic outpatients, comparing it to the effect of treating such patients as usual. METHOD: Fifty-six adult outpatients (from 18 to 65 years of age) with ICD-10-based diagnoses of schizophrenia were randomly assigned to two different groups: active intervention (IPT group); and treatment as usual (control group). Outcome measures were quality of life (as determined using the WHOQOL-Bref), cognition (Mini-Mental State Examination and Word Recall Test), global functioning (DSM-IV Global Assessment of Functioning Scale), social functioning (Social and Occupational Functioning Assessment Scale) and social adjustment (Social Adjustment Scale). RESULTS: The findings suggest that, in comparison with treatment as usual (control group), the twelve-session IPT program had a positive effect on several outcome measures: cognition in the domains of spatiotemporal orientation (p = 0.051) and memory (p = 0.031); overall social adjustment (p = 0.037), leisure/social life (p = 0.051) and family relations (p = 0.008); overall functioning (p = 0.000); social-occupational functioning (p = 0.000); and quality of life in the psychological domain (p = 0.021). CONCLUSIONS: The twelve-session cognitive-behavioral IPT intervention demonstrated superiority over treatment as usual in its effects on cognition, social adjustment and quality of life. Studies involving larger samples, longer follow-up periods and additional outcome measures are needed in order to assess the specific effects on dimensions of social functioning, cognitive functioning and quality of life in patients with schizophrenia.
Alcohol and drug use among university students: gender differences
Authors: Wagner Gabriela Arantes , Stempliuk Vladimir de Andrade , Zilberman Monica L , Barroso Lúcia Pereira , Andrade Arthur Guerra de
Published: September 2007

OBJECTIVE: This study compared the pattern of alcohol, legal and illegal drugs use among students of the Universidade de São Paulo (Brazil) in 1996 and 2001. METHOD: Samples of 2.564 (1996) and 2.837 (2001) students answered a questionnaire proposed by the World Health Organization, which characterizes the consumption of alcohol, legal and illegal drugs in lifetime, in the last 12 months and in the last 30 days. RESULTS: Men showed a significant increase in lifetime use of tobacco (44.8% to 50.9%), marijuana (33.7% to 39.5%) and hallucinogens (6.6% to 14.1%) between 1996 and 2001. No significant change was observed among women between 1996 and 2001 in tranquilizer use. Concerning the consumption reported in the last 12 months, both genders displayed significant increases in the consumption of marijuana (22.3% to 27.1% for men and 12.9% to 16.9% for women), amphetamines (1.9% to 5.0% for men and 3.4% to 5.6% for women), and inhalants (9.8% to 15.7% for men and 5.4% to 10.6% for women). The greatest gender difference was observed in consumption reported in the last 30 days with significant increases in male use of tobacco (19.6% to 23.5%), marijuana (15.8% to 20.5%), amphetamines (1.1% to 3.2%), and inhalants (4.0% to 7.9%). Substance use reported in the last 30 days remained stable among women between the 2 surveys. CONCLUSION: Rates of substance use among university students increased. These gender differences in substance consumption should be taken into account in the development of preventive and treatment strategies for undergraduate university students.
Brazilian female crack users show elevated serum aluminum levels
Authors: Pechansky Flavio , Kessler Felix Henrique Paim , Diemen Lisia von , Bumaguin Daniela Benzano , Surratt Hilary L , Inciardi James A
Published: September 2007

OBJECTIVE: There is no information in the literature on the impact of crack smoking using crushed aluminum cans as makeshift pipes, a common form of crack use in Brazil. Since aluminum intake is associated with neurological damage, we measured serum aluminum levels in crack smokers. The objective of this study was to ascertain the levels of aluminum in crack users who smoke on makeshift aluminum pipes. METHOD: 71 female crack smokers, their mean age being 28.0 (± 7.7), provided information about their drug use, and had blood samples tested for serum aluminum level. RESULTS: 56 (79%) subjects smoked crack from crushed can pipes, while 15 (21%) smoked from other containers. Fifty-two (73.2%) out of the 71 subjects presented a serum aluminum level of 2 µg/l and 13 (18.3%) had a serum aluminum level of 6 µg/l cut-off point, which is above the reference value. When compared to non-drug users matched by their mean age and gender, they had similar median values and interquartile ranges for serum aluminum level [3 (2-4.6) for crack smokers; 2.9 (1.6-4.1) for controls], but with different means and standard deviations (4.7 ± 4.9 and 2.9 ± 1.7, respectively). DISCUSSION: Crack smokers have high serum aluminum level, but we are unsure of its complete association with aluminum cans. Further studies are needed. If such association is proven true in future research, further issues will be raised in dealing with this important disorder, including proper planning and evaluation of public health policies in this area.
A clinical study comparing manic and mixed episodes in patients with bipolar disorder
Authors: Schwartzmann Ângela Maria , Amaral José Antonio , Issler Cilly , Caetano Sheila C , Tamada Renata S , Almeida Karla Mathias de , Soares Marcia Brito de Macedo , Dias Rodrigo da Silva , Rocca Cristiana C , Lafer Beny
Published: September 2007

OBJECTIVE: Mixed episodes have been described as more severe than manic episodes, especially due to their longer duration and their association with higher rates of suicide attempts, hospitalization and psychotic symptoms. The purpose of this study was to compare the severity between mixed and pure manic episodes according to DSM-IV criteria, through the evaluation of sociodemographic data and clinical characteristics. METHOD: Twenty-nine bipolar I patients presenting acute mixed episodes were compared to 20 bipolar I patients with acute manic episodes according to DSM-IV criteria. We analyzed (cross-sectionally) episode length, presence of psychotic symptoms, frequency of suicide attempts and hospitalization, Young Mania Rating Scale scores, Hamilton Depression Rating Scale scores and the Clinical Global Assessment Scale scores. RESULTS: Young Mania Rating Scale scores were higher in manic episodes than in mixed episodes. There were no differences in gender frequency, CGI scores and rates of hospitalization, suicide attempts and psychotic symptoms, when mixed and manic episodes where compared. Patients with mixed episodes were younger. CONCLUSION: In our sample, mixed states occurred at an earlier age than manic episodes. Contrary to previous reports, we did not find significant differences between manic and mixed episodes regarding severity of symptomatology, except for manic symptoms ratings, which were higher in acute manic patients. In part, this may be explained by the different criteria adopted on previous studies.
The Bayer: Activities of Daily Living Scale (B-ADL) in the differentiation between mild to moderate dementia and normal aging
Authors: Folquitto Jefferson C , Bustamante Sonia E Z , Barros Sérgio B , Azevedo Dionisio , Lopes Marcos A , Hototian Sergio R , Jacob Filho Wilson , Litvoc Júlio , Bottino Cássio M C
Published: September 2007

OBJECTIVES: To investigate the applicability of the Bayer - Activities of Daily Living scale and its efficiency in differentiating individuals with mild to moderate dementia from normal elderly controls. METHOD: We selected 33 patients with diagnosis of mild to severe dementia, according to ICD-10 criteria, and 59 controls. All the subjects were evaluated with the Mini-Mental State Examination and the Clinical Dementia Rating Scale and the Bayer - Activities of Daily Living scale was applied to informants. RESULTS: The internal consistency of the Bayer - Activities of Daily Living was high (Cronbach's alpha = 0.981). Mean Mini-Mental State Examination and Bayer - Activities of Daily Living scores of demented patients and controls were significantly different (p < 0.001). Mean Mini-Mental State Examination and Bayer - Activities of Daily Living scores were significantly different between Clinical Dementia Rating Scale 0 (controls; n = 59) versus Clinical Dementia Rating Scale 1 (mild dementia; n = 15), Clinical Dementia Rating Scale 0 versus Clinical Dementia Rating Scale 2 (moderate dementia; n = 13), and for Clinical Dementia Rating Scale 1 versus Clinical Dementia Rating Scale 2 (p < 0.003). DISCUSSION: The Bayer - Activities of Daily Living scale and Mini-Mental State Examination differentiated elderly controls from patients with mild or moderate dementia, and patients with mild dementia from those with moderate dementia. CONCLUSIONS: The results suggest that the Bayer - Activities of Daily Living scale applied to an informant can help in the diagnosis and follow-up of Brazilian patients with mild to moderate dementia.
Dissociative disorders and other psychopathological groups: exploring the differences through the Somatoform Dissociation Questionnaire (SDQ-20)
Authors: Santo Helena Maria Amaral do Espirito , Pio-Abreu José Luís
Published: September 2007

OBJECTIVE: The Somatoform Dissociation Questionnaire is a self-report questionnaire that has proven to be a reliable and valid instrument. The objectives of this study were to validate the Portuguese version and to determine its capability to distinguish patients with dissociative disorders from others with psychopathological disorders. METHOD: 234 patients answered the translated version of Somatoform Dissociation Questionnaire. The Portuguese Dissociative Disorders Interview Schedule was used to validate clinical diagnosis. Patients with dissociative disorder (n = 113) were compared to a control group of 121 patients with various anxiety and depression disorders. RESULTS: Reliability measured by Cronbach's a was 0.88. The best performance of the Portuguese form was at a cut-off point of 35, which distinguishes between dissociative disorder and neurotic disorders with a good diagnostic efficacy (sensitivity = 0.73). The somatoform dissociation was significantly more frequent in dissociative disorder patients, conversion disorder patients and post-traumatic stress disorder patients. CONCLUSIONS: These findings suggest that dissociative disorders can be differentiated from other psychiatric disorders through somatoform dissociation. The Portuguese version of the Somatoform Dissociation Questionnaire has fine psychometric features that sustain its cross-cultural validity.
Common mental disorders in adolescents: a population based cross-sectional study
Authors: Pinheiro Karen Amaral Tavares , Horta Bernardo Lessa , Pinheiro Ricardo Tavares , Horta Lúcia Lessa , Terres Nicole Gomes , Silva Ricardo Azevedo da
Published: September 2007

OBJECTIVE: To assess the prevalence and the factors associated with common mental disorders among adolescents in Pelotas, a southern Brazilian city. METHOD: A population based cross-sectional study was carried out in the urban area of Pelotas. Multi-stage sampling was used to obtain a sample of adolescents aged between 15 and 18 years. Adolescents were interviewed using a self-report confidential questionnaire. The presence of common mental disorders was assessed using the Self-Reporting Questionnaire 20 (SRQ-20). Multivariate analysis was carried out using the Poisson regression with a robust adjustment of variance and control for design effect. RESULTS: Nine hundred and sixty adolescents were interviewed. The prevalence of common mental disorders was 28.8%. Adolescents aged 17 years showed prevalence of 1.37 (95% CI 1.06-1.78) times greater than the 15 year olds. Adolescents whose mothers had between 5 and 8 years of schooling had a prevalence 1.42 (95% CI 1.01-1.51) times greater than those whose mothers had more than 8 years of schooling. Smoking and sedentary behavior were also associated with an increased prevalence of common mental disorders. Those who were dissatisfied with their body image showed a prevalence of 1.47 (95% CI 1.07-2.02). CONCLUSIONS: Maternal schooling, tobacco smoking, sedentary behavior and body image dissatisfaction were factors associated with the presence of common mental disorders.
Inter-rater reliability and factor analysis of the Brazilian version of the Schedule for the Assessment of Insight: Expanded Version (SAI-E)
Authors: Dantas Clarissa de Rosalmeida , Banzato Cláudio Eduardo Muller
Published: September 2007

OBJECTIVES: The Schedule for the Assessment of Insight - Expanded Version consists of 11 items that encompass: awareness of having a mental illness, ability to rename psychotic phenomena as abnormal, and compliance with treatment. The objective of the study was to evaluate the inter-rater reliability and to study the factorial structure of the Brazilian version of the instrument. METHOD: The Brazilian version of the Schedule for the Assessment of Insight - Expanded Version was used for the assessment of insight of 109 psychotic inpatients, 60 of whom had the interview tape-recorded in order to be scored by an independent evaluator. Intraclass correlation coefficient (ICC) was adopted as the inter-rater reliability coefficient. In the factor analysis, principal components analysis and Varimax rotation were adopted. RESULTS: Inter-rater reliability coefficients from good to excellent were found for the individual items of the Schedule for the Assessment of Insight - Expanded Version with ICC values ranging from 0.54 to 0.82. Regarding the total score, inter-rater reliability was excellent, with ICC = 0.90. A factorial structure similar to the one obtained by the original version of the Schedule for the Assessment of Insight - Expanded Version was found, with 3 factors accounting for 71.72% of variance. CONCLUSION: In the Brazilian context, the Schedule for the Assessment of Insight - Expanded Version presented good inter-rater reliability and factorial structure compatible to the insight dimensions that are intended to be evaluated.
Leading countries in mental health research in Latin America and the Caribbean
Authors: Razzouk Denise , Zorzetto Ricardo , Dubugras Maria Thereza , Gerolin Jerônimo , Mari Jair de Jesus
Published: September 2007

OBJECTIVE: The prevalence and burden of mental disorders have been growing in Latin-American and the Caribbean countries and research is an important tool for changing this scenario. The objective of this paper is to describe the development of mental health research in Latin American and the Caribbean countries from 1995 to 2005. METHOD: The indicators of productivity were based on the ISI Essential Science Indicators database. We compared the number of papers and citations, as well as the number of citations per paper between 1995 and 2005 for each country ranked in the Essential Science Indicators. RESULT: Eleven Latin-American countries were ranked in the ISI database and six of them demonstrated a higher level of development in mental health research: Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela. Mexico produced the largest number of papers, while Brazil showed a larger number of citations per paper. CONCLUSION: Mental health research is still incipient in Latin American and the Caribbean countries, and many challenges remain to be overcome. Also, it is necessary to establish the research priorities, to allocate more funding, and to improve researchers training in research method and design.
Psychoactive substances and the provision of specialized care: the case of Espirito Santo
Authors: Siqueira Marluce Miguel de , Barbosa Dulce A , Laranjeira Ronaldo , Hopkins Kristine
Published: September 2007

OBJECTIVE: In this study, we conducted a survey of all the institutions that provide treatment for psychoactive substances in the state of Espirito Santo, Brazil during the period 2004-2005. METHOD: We used a snowball sampling technique to include all the treatment facilities in our State in which we employed a semi-structured interview instrument for key informants at each institution. We present descriptive results and test differences between groups using the Chi-square test. RESULTS: In Espirito Santo, 250 institutions provide treatment for psychoactive substances and are distributed as follows: governmental (17.6%), nongovernmental (22.8%), and self-help groups (59.6%). Of these 250 institutions, 85 provide direct care, with the majority found in the Central region (70.6%) and followed by the Northern (15.3%) and Southern (14.1%) regions. The majority of those that provide direct care are private nonprofit centers (16.8%) institutions with ties to religious organizations make up nearly one-third (30.6%) of direct care providers. The drugs most consumed by those seeking care are alcohol (82.4%), tobacco (81.2%) and marijuana (68.2%). The institutions generally give assistance to people in the 26-45 years age group (89.4%); with regard to gender, the institutions take care of: men (31.8%), women (5.9%), and both sexes (56.5%). The treatment models most used are psychosocial (58.8%), therapeutic community (47.1%) and biomedical (43.5%) and the work is evaluated through the team technique (72.9 %). CONCLUSIONS: In the state of Espirito Santo, indirect care services are many times greater than those that offer direct care and the majority of all services are in the Central region. The populations in the mainland have a comparative disadvantage when it comes to treatment options for psychoactive substance use. We observed that a significant number of institutions that provide drug abuse treatment have financial support from religious organizations. The Espirito Santo State survey demonstrates the necessity of a decentralized provision of specialized care for psychoactive substance users, with substantially more services directed to the Northern and Southern regions of the state. Moreover, the emphasis of these new institutions should be on outpatient care.
Current clinical research environment: focus on psychiatry
Authors: Dainesi Sonia Mansoldo , Elkis Helio
Published: September 2007

The introduction of international guidelines on Good Clinical Practices (GCP) in 1996, immediately followed by the publication of Resolution CNS 196/96 in Brazil, created a great opportunity for Brazilian research centers to participate in international trials. Such studies must be strictly monitored in order to assure compliance with the regulations, as well as with the standards of patient safety. Clear agreement among the investigator, the sponsor and the institution carrying out the study must be previously defined in order to avoid any conflicts of interest during or after the study. Operational aspects, such as the time needed to gain regulatory approval of the study design, strategies for patient recruitment/retention and appropriate logistics, are also important. In 2005, the Brazilian National Clinical Research Network was established, bringing together a number of research centers in teaching hospitals. The objective was to subsidize public clinical research with state-of-the-art practices and appropriate technical/scientific training programs. The development of research protocols that prioritize public health care needs in Brazil is other fundamental goal of this network. This article addresses general aspects of clinical research, as well as some specific issues in psychiatry. Improving the health and quality of life of the global population is certainly the major objective of all of the work done in this area.
Qualidade de vida em indivíduos com transtorno obsessivo-compulsivo: revisão da literatura
Authors: Niederauer Kátia Gomes , Braga Daniela Tusi , Souza Fernanda Pasquoto de , Meyer Elizabeth , Cordioli Aristides Volpato
Published: September 2007

OBJETIVO: O transtorno obsessivo-compulsivo acomete entre 1,6 a 3,1% da população. Em virtude de uma maior compreensão do sofrimento associado aos sintomas, aumentaram os estudos e o interesse no bem-estar geral e na qualidade de vida dos portadores. MÉTODO: Foi realizada uma revisão bibliográfica de trabalhos que investigaram a qualidade de vida em portadores de transtorno obsessivo-compulsivo. A busca foi feita nas bases de dados Medline, SciELO e PsychoInfo, utilizando como palavras-chave quality of life e obsessive-compulsive disorder. Foram selecionados 27 artigos que abordaram o tema, sendo descritas as áreas mais afetadas pelo transtorno, bem como a sua relação com a qualidade de vida foram descritas. Também foram apresentados efeitos de tratamentos na qualidade de vida dos pacientes. RESULTADOS: Os relacionamentos sociais e familiares, seguidos pelo desempenho ocupacional (capacidade para trabalhar e estudar), foram as áreas mais afetadas pelo transtorno e, apesar de melhorarem com tratamento, permanecem insatisfatórios. As obsessões foram associadas a prejuízos mais significativos na qualidade de vida do que as compulsões (rituais). CONCLUSÕES: Apesar das limitações, os estudos mostram evidências do comprometimento da qualidade de vida de indivíduos com transtorno obsessivo-compulsivo, sendo este comparável ao de pacientes com esquizofrenia. Pesquisas futuras com diferentes delineamentos são necessárias para estabelecer resultados mais consistentes.
The Rey Auditory-Verbal Learning Test: applicability for the Brazilian elderly population
Authors: Malloy-Diniz Leandro Fernandes , Lasmar Viviani Antunes Parreira , Gazinelli Lenice de Sena Rabelo , Fuentes Daniel , Salgado João Vinícius
Published: September 2007

OBJECTIVE: The Rey Auditory-Verbal Learning Test is a widely recognized test in neuropsychological literature to evaluate learning and memory. This paper presents the performance of six age groups of Brazilian elderly on the Rey Auditory-Verbal Learning Test. METHOD: A version of the test was developed with a list of high-frequency one-syllable and two-syllable concrete Portuguese substantives. Two hundred and twenty-three subjects of both genders were allocated to 6 age groups (60-64, 65-69; 70-74; 75-79; 80-84 and 85-89 years old) and tested with the Rey Auditory-Verbal Learning Test. RESULTS: Educational level and age had a positive and a negative correlation, respectively, with performance on the Rey Auditory-Verbal Learning Test. Women performed significantly better than men. Our results were similar to those found for the Rey Auditory-Verbal Learning Test English version, across similar age ranges. CONCLUSION: Our results suggest that the Brazilian Portuguese Rey Auditory-Verbal Learning Test adaptation was adequate and applicable for evaluating the memory capacity of Brazilian subjects, across similar age and educational levels.
Validity of a frustration-induction procedure
Authors: Henna Elaine , Zilberman Monica L , Gentil Valentim , Gorenstein Clarice
Published: September 2007

OBJECTIVE: To test a reliable and easily administered frustration-induction procedure for experimental research. METHOD: One hundred volunteers (81 women, mean age ± SD 34.2 ± 8 years) physically and psychiatrically healthy submitted to the frustration induction procedure were prevented from reaching reward level scores. Subjective aggressiveness feelings related to frustration were self-rated in a 13-item visual analogue scale before and after the procedure. RESULTS: Significant increases in aggressiveness-related feelings were detected in 12 of the 13 items. This was consistent with the observed overt behavior of the subjects during the task. CONCLUSIONS: The frustration-induction procedure is a simple, easy to administer frustration-induction procedure that can be used in experimental studies in normal subjects.
Transtornos de humor refratários a tratamento
Authors: Machado-Vieira Rodrigo , Soares Jair C
Published: September 2007

OBJETIVOS E MÉTODO: Os transtornos de humor estão entre os transtornos psiquiátricos mais prevalentes. Apesar de novas descobertas e avanços no estudo das bases neurobiológicas e abordagens terapêuticas no transtorno bipolar e depressão recorrente, elevadas taxas de recorrência, sintomas subsindrômicos persistentes e refratariedade terapêutica são aspectos clínicos desafiadores e precisam ser abordados. O objetivo desta revisão da literatura é o de avaliar os conceitos e critérios de resistência e refratariedade ao tratamento, e evidenciar as principais alternativas terapêuticas para transtornos do humor resistentes aos tratamentos disponíveis. RESULTADOS: Fatores genéticos, erro diagnóstico e de tratamento, não-aderência, e estressores biológicos e psicossociais podem levar à perda de mecanismos regulatórios e ao aumento na prevalência de casos de refratariedade nos transtornos de humor. Com relação aos tratamentos disponíveis, o uso de doses apropriadas, seguido por associação com um segundo ou terceiro fármaco, e após, se indicado, a troca de medicação, são etapas necessárias na busca de melhor eficácia. Entretanto, no paradigma de refratariedade terapêutica, tratamentos atuando em sistemas já conhecidos, especialmente monoaminas, freqüentemente apresentam limitada eficácia. Assim, a busca por tratamentos mais eficazes para os transtornos de humor torna-se um aspecto chave para diminuir sua morbidade. CONCLUSÃO: Estratégias focadas na regulação de vias ativadoras de neuroplasticidade, incluindo agentes antiglutamatérgicos, antagonistas de receptor glucocorticóide e neuropeptídeos, podem representar opções terapêuticas promissoras.
Social inequality and common mental disorders
Authors: Marín-León Letícia , Oliveira Helenice Bosco de , Barros Marilisa Berti de Azevedo , Dalgalarrondo Paulo , Botega Neury José
Published: September 2007

OBJECTIVE: To analyze the association between the socioeconomic characteristics of individuals and common mental disorders. METHOD: A cross-sectional survey of a representative sample of the urban population, 14 years and older, in Campinas (Brazil) (n = 515) was conducted using a multipurpose instrument that included the Self-Reporting Questionnaire (SRQ-20) to assess common mental disorders in the previous 3 months. Weighted prevalence of common mental disorders was calculated for each independent variable. Crude and adjusted prevalence ratios were estimated using Poisson regression. RESULTS: The overall prevalence was 17% (95% CI 12.8-22.3), 8.9% in males and 24.4% in females. An inverse association was found between common mental disorders and the socioeconomic characteristics (schooling and employment) even after controlling for all the other variables. Higher common mental disorders prevalence was observed in those with less than 5 years of schooling (PR = 5.5) and unemployed or underemployed (PR = 2.0). CONCLUSIONS: As in other studies, common mental disorders were unevenly distributed; it was significantly more frequent in socially disadvantaged individuals. Specific actions to reduce inequalities in the general and mental health system should be studied.
Pathological gambling and obsessive-compulsive disorder: towards a spectrum of disorders of volition
Authors: Tavares Hermano , Gentil Valentim
Published: September 2007

OBJECTIVE: Pathological gambling is proposed as a participant of an impulsive-compulsive spectrum related to obsessive-compulsive disorder. This study aims to contrast pathological gambling and obsessive-compulsive disorder regarding course, comorbidity, and personality, hence testing the validity of the impulsive-compulsive spectrum. METHOD: 40 pathological gambling and 40 obsessive-compulsive disorder subjects matched to 40 healthy volunteers according to gender, age, and education were assessed with the Temperament Personality Questionnaire and the Barratt Impulsiveness Scale. Psychiatric patients were also assessed for course and comorbidity data. RESULTS: Obsessive-compulsive disorder presented an earlier onset, but the full syndrome took longer to evolve. Pathological gambling had higher comorbidity with substance-related disorders, and obsessive-compulsive disorder higher comorbidity with somatoform disorders. Gamblers scored higher than controls on the sub-factors Impulsiveness, Extravagance, Disorderliness, and Fear of Uncertainty. Obsessive-compulsive patients scored higher than controls on Fear of Uncertai-nty. Impulsiveness, Extravagance, and Disorderliness significantly correlated with the Barratt Impulsiveness Scale total score, Fear of Uncertainty did not. DISCUSSION: The course and comorbidity profiles of pathological gambling resemble an addiction and differ from obsessive-compulsive disorder. Pathological gambling combines impulsive and compulsive traits. Impulsivity and compulsivity should be regarded as orthogonal constructs, and as drives implicated in volition aspects of behavioral syndromes.
Subclinical hypothyroidism: psychiatric disorders and symptoms
Authors: Almeida Cloyra , Brasil Marco Antônio , Costa Antônio José Leal , Reis Fabiola A A , Reuters Vaneska , Teixeira Patrícia , Ferreira Márcia , Marques Amanda M , Melo Bianca A , Teixeira Letícia B B de M , Buescu Alexandre , Vaisman Mário
Published: September 2007

OBJECTIVE: To evaluate the prevalence of psychiatric disorders and symptoms in patients with subclinical hypothyroidism. METHOD: Ninety-four outpatients with at least two elevated serum thyrotrophin levels (> 4 µU/ml) and normal FT4, and 43 euthyroid outpatients, both groups from HUCFF-UFRJ, were evaluated. Psychiatric diagnosis was based on the Structured Clinical Interview Diagnostic for the DSM-IV axis I (SCID-I/DSM-IV), the psychopathological symptoms on Hamilton anxiety and depression scales, and the Beck Inventory. RESULTS: Our data showed an increased prevalence of psychiatric disorders in the subclinical hypothyroidism patients when compared to the euthyroid group (45.7% vs 25.6%; p = 0.025), mood disorders being the most frequent. The prevalence of depressive symptoms based on Beck's Scale among subclinical hypothyroidism patients was about 2.3 times higher than among euthyroid ones (45.6% vs 20.9%, p = 0.006). Anxiety symptoms were also more frequent among subclinical hypothyroidism patients (87.0% vs 60.5%, p < 0.001), mainly clinical anxiety (44.6% vs 23.3%; p = 0.001). CONCLUSION: Our results showed a significant association of subclinical hypothyroidism with psychiatric disorders and an increased frequency of subsyndromic depression and anxiety symptoms in subclinical hypothyroidism in relation to the euthyroid group.
Rehospitalization rates of patients with schizophrenia discharged on haloperidol, risperidone or clozapine
Authors: Castro Ana Paula Werneck de , Elkis Helio
Published: September 2007

OBJECTIVE:The purpose of this study was to evaluate the rehospitalization rates of patients discharged from the Institute of Psychiatry of the Hospital das Clínicas of the Universidade de São Paulo Medical School while being treated with haloperidol, risperidone or clozapine. METHOD: This is a naturalistic study designed to monitor rehospitalization rates for patients discharged on haloperidol (n = 43), risperidone (n = 22) or clozapine (n = 31). Time to readmission over the course of three years was measured by the product-limit (Kaplan-Meier) method. Risk factors associated with rehospitalizations were examined. RESULTS: At 36 months, remained in the community 74% of the haloperidol-treated patients, 59% of the risperidone-treated patients and 84% of the clozapine-treated patients. The haloperidol group showed a higher proportion of women, a late age of onset and shorter length of illness than the other groups, whereas the opposite was observed in the clozapine group. CONCLUSIONS: This study suggests that the rehospitalization rates of patients taking clozapine are lower than the rate for patients treated with haloperidol and risperidone. However confounding variables such as gender distribution and age of onset represent limitations that should be taken into account for the interpretation of the results.
Clinical aspects of super-refractory schizophrenia: a 6-month cohort observational study
Authors: Henna Neto Jorge , Elkis Hélio
Published: September 2007

OBJECTIVE: Approximately 30% of treatment-resistant schizophrenic patients do not fully respond to Clozapine and such patients are termed Clozapine non-responders or super-refractory schizophrenics. The aim of this study was to characterize patients with super-refractory schizophrenia according to demographic and psychopathological variables, as compared with patients with refractory schizophrenia or non-refractory subjects. METHOD: One hundred two outpatients meeting DSM-IV criteria for schizophrenia were followed-up for 6 months. Subjects were classified into 3 groups: non-refractory (n = 25), refractory (n = 43) and super-refractory (n = 34). Psychopathology was assessed by the Positive and Negative Syndrome Scale, the Schedule for Deficit Syndrome, the Calgary Depression Scale and the Quality of Life Scale. Patients were rated at 2-month intervals. RESULTS: Higher levels of severity at the disease onset as well as higher severity of positive symptoms were found to be predictive of super-refractoriness. CONCLUSIONS: The super-refractory schizophrenia patients have psychopathological predictive factors that need studies comparing brain images, genetical features and other clinical comparisons.
Desmame precoce em prematuros participantes do Método Mãe Canguru
Authors: Alves Anna Maria Lages , Silva Érika Henriques de Araújo Alves da , Oliveira Aline Cabral de
Published: September 2007

OBJETIVO: Identificar a prevalência e as causas de desmame precoce nos recém-nascidos pré-termo, participantes do Método Mãe Canguru em uma maternidade-escola em Alagoas. MÉTODOS: Foi aplicado um questionário contendo questões objetivas com 33 genitoras dos recém-nascidos pré-termo/ lactentes, que estavam internos na enfermaria canguru e que compareceram aos retornos ambulatoriais, no período de fevereiro a junho de 2006. Periodicamente, foi realizada a análise dos prontuários dos bebês após a alta hospitalar, observando a manutenção do aleitamento materno, a ocorrência de desmame precoce e suas respectivas causas. Após os dados obtidos serem caracterizados com a utilização de técnicas de estatística descritiva, foram aplicados os testes de aderência de Kolmogorov-Smirnov e Shapiro-Wilk e os testes de Mann-Withney e de correlação bivariada. As diferenças foram consideradas significativas para valores de p menores que 0,05 e o erro beta admitido foi de 0,1. RESULTADOS: Todos os bebês se encontravam em aleitamento materno exclusivo na alta hospitalar. O percentual de desmame foi de 27,3%, com maior ocorrência no terceiro mês de vida, constatado no período dos retornos. A causa de desmame precoce de maior prevalência está relacionada aos fatores sócio-culturais. CONCLUSÃO: O estudo revelou baixos índices de desmame precoce quando comparados aos percentuais observados em pesquisas realizadas no âmbito nacional. A maior causa de desmame precoce na população estudada está relacionada aos fatores sócio-culturais. Desta forma, o programa de atenção humanizada Método Mãe Canguru mostrou-se eficaz no que diz respeito ao incentivo ao aleitamento materno exclusivo.
A eficácia de exercícios para disfunção da tuba auditiva
Authors: Sperancini Camila Leão , Souza Damares Plácido Moreira de , Silva Tarcimara Moreira , Di Ninno Camila Queiroz de Moraes Silveira , Amorim Márcia Nogueira
Published: September 2007

OBJETIVO: Avaliar a eficácia de exercícios de sopro, sucção e respiração nasal, associados à limpeza nasal e manobra de Valsalva, nas disfunções da tuba auditiva e na prevenção de otite média de repetição. MÉTODOS: Participaram 22 crianças, de ambos os sexos, entre três e seis anos, que apresentavam história de otite média de repetição e, no momento do exame, curvas timpanométricas dos tipos A e C. Tais crianças foram submetidas diariamente aos procedimentos citados durante três meses. RESULTADOS: Ao final do trabalho, das 22 crianças analisadas, 18 apresentaram curvas do tipo A bilateralmente, não apresentando episódios de otite neste intervalo. CONCLUSÃO: Na amostra estudada, estes procedimentos mostraram-se eficazes na prevenção da disfunção tubária e otite média de repetição e podem ser utilizados de forma preventiva em crianças de creches.
Estudo sobre os ambientes favoráveis à produção da líquida não-lateral /r/ no tratamento do desvio fonológico
Authors: Keske-Soares Márcia , Mota Helena Bolli , Pagliarin Karina Carlesso , Ceron Marizete Ilha
Published: September 2007

Os ambientes favoráveis são contextos facilitadores para a aquisição do segmento tratado. Eles podem ser analisados sob os seguintes aspectos: tonicidade, contexto antecedente e vogal seguinte. O objetivo deste relato de caso foi analisar a influência das variáveis lingüísticas (ambiente favorável) no tratamento de um sujeito com desvio fonológico evolutivo. Participou do estudo um sujeito com desvio fonológico, com idade de 6:8 no início do tratamento, do sexo masculino, tratado pelo Modelo ABAB-Retirada e Provas Múltiplas. Foram analisados os dados de fala pré e pós-tratamento e as Provas Alvo Básicas do primeiro ciclo de tratamento. Nas palavras-alvo selecionadas para terapia, foram analisadas as aquisições quanto ao alvo de tratamento, a líquida não-lateral /r/, e os ambientes favoráveis à aquisição no que se refere à tonicidade e aos contextos (antecedente e seguinte). Observou-se que o /r/, nas palavras-alvo selecionadas, não era encontrado em ambientes mais favoráveis; em geral, encontrava-se em ambiente neutro ou menos favorecedor. No entanto, verificou-se generalização no que se refere à aquisição da líquida não-lateral /r/ em Onset Medial, e a produção do fonema nas palavras-alvo selecionadas foi efetiva, destacando-se as produções das palavras [ba´rata], [ko´ruZa] e [mo´rãgu], que apresentaram maior número de ocorrências.
Intervenção fonoaudiológica em recém-nascido pré-termo com gastrosquise
Authors: Rocha Marilene de Souza , Delgado Susana Elena
Published: September 2007

O objetivo deste estudo foi descrever a intervenção fonoaudiológica para a adequação da função alimentar por meio da avaliação e tratamento do sistema estomatognático e suas funções. O estudo foi feito a partir do relato de caso de um recém-nascido pré-termo com gastrosquise que foi alimentado por sonda, atendido na Neonatologia do Hospital Luterano, no período de 29/03/2005 a 22/04/2005. A avaliação fonoaudiológica foi realizada, seguindo o protocolo padronizado do serviço de Neonatologia e apresentou os seguintes resultados: órgãos do sistema estomatognático no que se refere à postura, conformação e mobilidade dentro da normalidade; reflexos orais presentes; força e ritmo adequados na sucção não nutritiva; alteração na sensibilidade oral com reflexo nauseoso anteriorizado e exacerbado; sinal de estresse de alteração respiratória durante a sucção nutritiva na mamadeira; e dificuldade de pegar o seio materno. Foram realizadas três sessões de intervenção fonoaudiológica, uma vez por semana, com orientação para a equipe de enfermagem dar continuidade na estimulação oral nos demais dias. Em uma das sessões, a mãe recebeu orientações sobre os benefícios da amamentação e a importância do uso adequado de chupetas e bico de mamadeira do tipo ortodôntico para o desenvolvimento adequado das funções orais. O recém-nascido do relato de caso teve alta sem alterações orais, mamando no seio materno com complementação de mamadeira, sugerindo desta forma, a importância da intervenção fonoaudiológica para a adequação da função alimentar.
Exposição profissional à música: uma revisão
Authors: Mendes Maria Helena , Morata Thais Catalani
Published: September 2007

O conhecimento dos níveis de pressão sonora a que músicos são expostos é complexo e difícil de ser alcançado, devido à rotina e circunstâncias de exposição variáveis, e aos padrões metodológicos variados dos trabalhos relativos à perda auditiva induzida pela música. O objetivo deste estudo foi realizar uma revisão da literatura sobre a ocorrência de perda auditiva entre músicos, em diferentes estilos musicais e níveis de exposição sonora, assim como as iniciativas atuais de prevenção dos efeitos auditivos ocasionados pela exposição à música.
A eficiência de um programa de reabilitação audiológica em idosos com presbiacusia e seus familiares
Authors: Ruschel Christine Vieira , Carvalho Claudia Ribeiro de , Guarinello Ana Cristina
Published: September 2007

OBJETIVO: O objetivo dessa pesquisa foi desenvolver um programa de treinamento de estratégias de comunicação para indivíduos idosos, portadores de deficiência auditiva, usuários de aparelhos de amplificação sonora individual e seus familiares. Além disso, objetivamos verificar a contribuição da participação de familiares no processo de reabilitação audiológica desses sujeitos e promover melhor adaptação dos mesmos em relação ao uso do aparelho auditivo. MÉTODOS: Fizeram parte da pesquisa 30 indivíduos com presbiacusia da cidade de Cascavel (PR). A amostra foi divida em dois grupos, o grupo 1 (grupo controle) foi constituído por 15 indivíduos que receberam uma única sessão de orientação e o grupo 2 (grupo experimental) constituiu-se de 15 idosos que participaram de um programa de reabilitação fonoaudiológica fracionado em seis sessões. RESULTADOS: Foram encontradas diferenças estatisticamente significativas entre os grupos controle e experimental, quando comparadas as entrevistas dos pacientes e familiares, em aspectos como: manuseio da prótese auditiva, uso do telefone com a prótese auditiva e uso do diálogo em ambientes ruidosos. CONCLUSÕES: Neste estudo constatou-se que os idosos tiveram necessidade de acompanhamento fonoaudiológico após a adaptação do aparelho auditivo, pois sozinhos, muitas vezes, não conseguiam manusear a prótese auditiva e utilizá-la de maneira adequada.
Desempenho de escolares bons leitores, com dislexia e com transtorno do déficit de atenção e hiperatividade em nomeação automática rápida
Authors: Capellini Simone Aparecida , Ferreira Tais de Lima , Salgado Cíntia Alves , Ciasca Sylvia Maria
Published: September 2007

OBJETIVOS: Caracterizar o desempenho de escolares com transtorno do déficit de atenção e hiperatividade e com dislexia em nomeação automática rápida e comparar o desempenho destes escolares com aqueles que lêem conforme o esperado para idade e escolaridade. MÉTODOS: Participaram deste estudo 30 escolares na faixa etária de oito a 12 anos de idade de 2ª a 4ª séries do ensino público fundamental, divididos em três grupos de 10 escolares, sendo um grupo de escolares com transtorno do déficit de atenção e hiperatividade, um grupo de escolares com dislexia e um grupo de escolares com bom desempenho escolar. RESULTADOS: Os resultados revelaram diferenças estatisticamente significantes, evidenciando desempenho superior do grupo controle em relação ao grupo de escolares com transtorno do déficit de atenção e hiperatividade e ao grupo de escolares com dislexia nos subtestes de cores, dígitos, letras e objetos; e desempenho superior dos escolares do grupo com transtorno do déficit de atenção em relação ao grupo de escolares com dislexia em nomeação automática rápida. CONCLUSÃO: O presente estudo demonstrou que os escolares que lêem conforme o esperado para idade e escolaridade apresentaram melhor desempenho em relação ao grupo de escolares com transtorno do déficit de atenção e hiperatividade e o grupo com dislexia, demonstrando que tal habilidade pode ser considerada um pré-requisito para o desempenho em leitura.
Linguagem e memória autobiográfica de adolescentes usuários de drogas
Authors: Oliveira Christian César Cândido de , Scheuer Cláudia , Scivoletto Sandra
Published: September 2007

OBJETIVO: Resgatar, por meio da linguagem, a memória autobiográfica de adolescentes usuários de drogas/álcool. MÉTODOS: Participaram do estudo 25 adolescentes usuários e 25 não usuários de álcool/drogas com idades entre 13 e 17 anos, do sexo masculino. Após coleta da linguagem oral, a análise deste material foi baseada no modelo que privilegia a estrutura discursiva em cenário, complicação, resposta interna, tentativa, conseqüência e reação. RESULTADOS: O grupo de usuários produziu menos tentativa (p=0,010), conseqüência (p= 0,030) e reação (p= 0,023), indicando diferente perfil na linguagem de ambos os grupos. CONCLUSÃO: O perfil da memória autobiográfica de adolescentes usuários de drogas é diferente do de adolescentes não usuários. Este dado pode estar relacionado ao comprometimento no funcionamento cognitivo e/ou de linguagem, assim como de aspectos sociais e psíquicos, ocasionando interrupções na seqüência da lembrança.