The influence of n-6 fatty acid supplemented diet on the effect of imipramine in an animal model of depression.

Recent data have shown an association between polyunsaturated fatty acid and depression. This study examined the effect of the supplementation with n-6 fatty acid on the behavior of rats treated with imipramine and submitted to the Forced Swimming Test (FST). Non-supplemented imipramine-treated rats presented a significant reduction of immobility time in the FST whereas n-6 fatty acid-supplemented rats showed a significantly higher immobility time. Imipramine significantly increased norepinephrine plasma concentrations in the two groups. These results show that the diet supplemented with n-6 fatty acid altered the behavior of the animals in the FST, inhibiting the imipramine effect.

A 4-Year Follow-Up Study of Attention-Deficit Hyperactivity Symptoms, Comorbidities, and Psychostimulant Use in a Brazilian Sample of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

The aim of this study was to evaluate symptom persistence in attention-deficit/hyperactivity disorder (ADHD), the development of comorbidities, and psychostimulant usage patterns. Follow-up studies were conducted in 37 patients with ADHD and 22 healthy controls, aged 10 and 18, 4 years after their first assessment. The ADHD was rated as persistent if participants met all DSM-IV criteria for syndromic or sub-threshold persistence, or had functional impairments (functional persistence). Of the 37 ADHD patients we reevaluated, 75% had persistent symptoms, and psychiatric comorbidities with additional functional impairments and academic problems were more common than in controls. These follow-up findings show a high comorbidity associated with ADHD and support the importance of evaluation and treatment for ADHD and comorbidities throughout life.

The response to stress in Brazilian children and adolescents with attention deficit hyperactivity disorder.

This study assessed the function of the hypothalamic-pituitary-adrenal (HPA) axis, during response to stress, through the measurement of salivary cortisol in 38 children with attention deficit hyperactivity disorder (ADHD) and its subtypes, who were matched to 38 healthy control subjects. These measures were made at four time intervals: 15 min before exposing the subjects to a stressor - the Continuous Performance Test (CPT) - and 20, 40, and 60 min after such exposure. The baseline cortisol levels were statistically similar in both groups. The mean values of cortisol at the four time intervals were not statistically different between the three subtypes of ADHD (inattentive, hyperactive-impulsive and combined); thus, the ADHD group was treated as a single group. Following the stressor test, the ADHD group had significantly higher levels of salivary cortisol than the control group at time intervals of 20 and 40 min, whereas in this latter group exposure to the CPT did not induce an increase of cortisol. These results suggest that the increased cortisol levels in the ADHD group could be due to the lack of comorbidities. In addition, these patients, when facing a computerized test, might have responded with a motivational pathway with an increase of cortisol.

Melancholia in Latin American studies: a distinct mood disorder for the ICD-11.

OBJECTIVE: Melancholic depression is a lifetime diagnosis, typically with recurrent episodes. Melancholia, a syndrome with a long history and distinctive psychopathological features, is differentiated from major depression by the DSM-IV specifiers and partly described in the International Classification of Diseases - 10th edition. Within the present classification, it is frequently seen in severely ill patients with major depression and bipolar disorder. Nevertheless, it has a distinctive psychopathology and biological homogeneity in clinical experience and laboratory test markers, and it is differentially responsive to specific treatment interventions according to international studies. The objective of this study is to review the literature published by Latin American authors about Melancholia. METHOD: We conducted a systematic search to identify scientific literature published by Latin American authors gathering information relevant to the revision of the classification of mental and behavioral disorders in patients with melancholic depression of the International Classification of Diseases - 10th edition. The review was specifically focused on literature from Brazil and Latin America in order to examine the specific Latin American contribution for the study of melancholia as a distinct entity. RESULTS AND CONCLUSION: Melancholia can be identified as a separate mood disorder with unique psychopathology and psychoneuroendocrinology, worthy of separate attention in the classification systems. We therefore suggest that melancholia be positioned as a distinct, identifiable mood disorder that requires specific treatment.

Inflammatory aspects of depression.

A bidirectional relation between depression and natural immunity has been identified: depressive episodes are associated to a relative immunodeficiency, conversely inflammatory activity has been implicated in the development of depressive symptoms and in the pathophysiology of depression. Depression has been associated with a decrease in the number and activity of NK lymphocytes and hence patients with depression may show immunodeficiency towards intracellular microorganisms and tumors. Paradoxically, depression is sometimes accompanied by an inflammatory state, developed from the peripheral stimuli (atopy) or central stimuli (chronic stress) and mediated by proinflammatory cytokines (IL-6, TNF and IL-1). These cytokines can play a role in the pathophysiology of depression and of various diseases, supporting the hypothesis that many chronic diseases are individual manifestations of a common proinflammatory denominator.

Estudos latino-americanos sobre melancolia: um transtorno do humor melhor definido para o CID-11 / Melancholia in Latin American studies: a distinct mood disorder for the ICD-11

OBJETIVO: A depressão melancólica é um diagnóstico psiquiátrico de história de vida, geralmente com episódios recorrentes. Melancolia é uma síndrome com longa duração e características específicas de psicopatologia, insuficientemente diferenciada de depressão maior por um especificador no DSM-IV e parcialmente descrito nos critérios da Classificação Internacional de Doenças-10ª Edição. Dentro da classificação atual, é frequentemente vista em pacientes gravemente doentes com depressão e transtorno bipolar. No entanto, a melancolia possui uma homogeneidade psicopatológica e biológica distinta na experiência clínica e nos marcadores de testes laboratoriais, e é diferencialmente sensível às intervenções terapêuticas específicas. O objetivo deste estudo é revisar a literatura de artigos publicados por autores latino-americanos sobre a melancolia. MÉTODO: Realizou-se busca de artigos latino-americanos de informações relevantes para a revisão da Classificação Internacional de Doenças-10ª Edição de transtornos mentais e comportamentais em pacientes com depressão melancólica. Foi avaliada a qualidade do design de todos os estudos e realizada uma revisão abrangente sobre o assunto, com o objetivo de considerar a contribuição latino-americana para inclusão da melancolia como uma entidade distinta na futura Classificação Internacional de Doenças-11ª Edição. RESULTADOS E CONCLUSÃO: Os estudos latino-americanos fundamentam o diagnóstico da melancolia com uma psicopatologia e psiconeuroendocrinologia própria que fundamentam ser reconhecida como um transtorno de humor identificável e merecedor de uma atenção específica nos sistemas de classificação, como um transtorno de humor distinto, identificável e especificamente tratável.

OBJECTIVE: Melancholic depression is a lifetime diagnosis, typically with recurrent episodes. Melancholia, a syndrome with a long history and distinctive psychopathological features, is differentiated from major depression by the DSM-IV specifiers and partly described in the International Classification of Diseases - 10th edition. Within the present classification, it is frequently seen in severely ill patients with major depression and bipolar disorder. Nevertheless, it has a distinctive psychopathology and biological homogeneity in clinical experience and laboratory test markers, and it is differentially responsive to specific treatment interventions according to international studies. The objective of this study is to review the literature published by Latin American authors about Melancholia. METHOD: We conducted a systematic search to identify scientific literature published by Latin American authors gathering information relevant to the revision of the classification of mental and behavioral disorders in patients with melancholic depression of the International Classification of Diseases - 10th edition. The review was specifically focused on literature from Brazil and Latin America in order to examine the specific Latin American contribution for the study of melancholia as a distinct entity. RESULTS AND CONCLUSION: Melancholia can be identified as a separate mood disorder with unique psychopathology and psychoneuroendocrinology, worthy of separate attention in the classification systems. We therefore suggest that melancholia be positioned as a distinct, identifiable mood disorder that requires specific treatment.

Psiquiatria e neurociência / Psychiatry and neuroscience

Conceitos diferentes de Neurociência säo apresentados e ligeiramente discutidos. A integraçäo entre essas áreas é sugerida, após discussäo dos objetos de estudo de cada uma delas face à dicotomia "mente-cérebro"

Transtorno disfórico da fase lútea tardia: uma nova categoria diagnóstica em psiquiatria? / Late luteal phase dysphoric disorders: a new diagnostic category in psychiatry?

A síndrome pré-menstrual (SPM) é caracterizada pela presença cíclica de uma combinaçäo de sintomas afetivos, comportamentais e somáticos. Atualmente, a SPM aparece no apêndice A do DSM-III-R como proposta de uma nova categoria diagnóstica, sob a denominaçäo de transtorno disfórico da fase lútea tardia. O tema é revisado ampla e criticamente, incluindo a evoluçäo dos critérios diagnósticos, instrumentos de avaliaçäo, dados de prevalência e co-morbidade psiquiátrica. A proposta de se considerar a SPM como uma categoria diagnóstica distinta é discutida com formulaçäo de sugestöes alternativas

Previsäo de dose terapêutica do lítio / Foresight of lithium therapeutic doses

A previsäo da dose terapêutica de lítio, isto é, da dose diária de lítio que produza concentraçöes séricas dentro da faixa terapêutica é importante na clínica, principalmente em situaçöes em que se deseja obter o efeito terapêutico no menor tempo possível. Um método de previsäo, com algumas modificaçöes, foi utilizado em 17 voluntários sadios, os quais posteriormente receberam lítio durante o período de um mês. No final desse período, todos os voluntários apresentavam concentraçöes séricas na faixa terapêutica estabelecida (0,6 a 1,0 mEq/l). Essas concentraçöes apresentaram correlaçäo (r = 0,41; p < 0,05) com as concentraçöes medidas 24 horas após a dose inicial, as quais serviram para a previsäo da dose. As modificaçöes introduzidas no método de previsäo utilizado diminuíram muito a sua precisäo, limitando a sua utilidade clínica em larga escala