Bipolarity and suicidal ideation in children and adolescents: a systematic review with meta-analysis.

BACKGROUND: Affective disorders in children and adolescents have received growing attention in the world scenario of mental health. Additionally, there has been an increasing prevalence of suicidal ideation in this population. OBJECTIVE: A systematic review with meta-analysis was conducted to demonstrate the main risk factors regarding the development of suicidal ideation in the bipolar disorder. METHODS: This is a systematic review with meta-analysis using the PRISMA protocol (http://www.prisma-statement.org/). This study included secondary data. Original data in mental health were collected by mapping the evidence found in the following electronic databases: MEDLINE/PubMed, LILACS, SciELO, and ScienceDirect in the period from 2005 to 2015. RESULTS: We found 1418 registrations in such databases, and 46 of them were selected to comprise this review. The result introduces a joint risk between the studies of 2.94 CI [2.29-3.78]. A significant correlation was verified between the risk factors and the suicidal ideation. The result was r (Pearson) = 0.7103 and p value <0.001. CONCLUSION: Children and adolescents living with bipolar disorder are more vulnerable to suicidal ideation. These results reinforce the need of a more effective public policy directed toward this population.

Meta-analysis of studies on chemical, physical and biological agents in the control of Aedes aegypti.

BACKGROUND: Aedes aegypti is a vector of international concern because it can transmit to humans three important arboviral diseases: yellow fever, dengue and chikungunya. Epidemics that are repeated year after year in a variety of urban centers indicate that there are control failures, allowing the vector to continue expanding. METHODS: To identify the most effective vector control strategies and the factors that contributed to the success or failure of each strategy, we carried out a systematic review with meta-analysis of articles published in 12 databases, from 1974 to the month of December 2013. We evaluated the association between the use of whatever chemical substance, mechanical agent, biological or integrated actions against A. aegypti and the control of the vector, as measured by 10 indicators. RESULTS: We found 2,791 articles, but after careful selection, only 26 studies remained for analysis related to control interventions implemented in 15 countries, with 5 biological, 5 chemical, 3 mechanical and 13 integrated strategies. The comparison among all of them, indicated that the control of A. aegypti is significantly associated with the type of strategy used, and that integrated interventions consist of the most effective method for controlling A. aegypti. CONCLUSIONS: The most effective control method was the integrated approach, considering the influence of eco-bio-social determinants in the virus-vector-man epidemiological chain, and community involvement, starting with community empowerment as active agents of vector control.

Evaluation of the role of ATP-binding cassette transporters as a defence mechanism against temephos in populations of Aedes aegypti.

The role of ATP-binding cassette (ABC) transporters in the efflux of the insecticide, temephos, was assessed in the larvae of Aedes aegypti. Bioassays were conducted using mosquito populations that were either susceptible or resistant to temephos by exposure to insecticide alone or in combination with sublethal doses of the ABC transporter inhibitor, verapamil (30, 35 and 40 µM). The best result in the series was obtained with the addition of verapamil (40 µM), which led to a 2x increase in the toxicity of temephos, suggesting that ABC transporters may be partially involved in conferring resistance to the populations evaluated.

Impacts of COVID-19 on children and adolescents: A systematic review analyzing its psychiatric effects.

OBJECTIVE: To summarize the most relevant data from a systematic review on the impact of COVID-19 on children and adolescents, particularly analyzing its psychiatric effects. METHODS: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and included experimental studies (randomized-individually or pooled-and non-randomized controlled trials), observational studies with a group for internal comparison (cohort studies-prospective and retrospective-and case-control) and qualitative studies in the period from 2021 to 2022. RESULTS: The search identified 325 articles; we removed 125 duplicates. We selected 200 manuscripts, chosen by title and selected abstracts. We excluded 50 records after screening titles and abstracts, as they did not meet the inclusion criteria. We retrieved 150 records selected for a full reading. We excluded 90 text articles and we selected 25 records for the (n) final. Limitations: Due to the short period of data collection, from 2021 to 2022, there is a possibility of lack of relevant studies related to the mental health care of children and adolescents. In addition, there is the possibility of publication bias, such as only significant findings being published. CONCLUSION: The impact of COVID-19 on the mental health of children and adolescents is of great concern to child and youth psychiatry. Situations such as fear, anxiety, panic, depression, sleep and appetite disorders, as well as impairment in social interactions caused by psychic stress, are punctual markers of pain and psychic suffering, which have increasing impacts on the mental health panorama of children and adolescents globally, particularly in vulnerable and socially at-risk populations.

Evidence for the beneficial effect of ketamine in the treatment of patients with post-traumatic stress disorder: A systematic review and meta-analysis.

Post-traumatic stress disorder (PTSD) is an anxiety disorder with manifestations somatic resulting from reliving the trauma. The therapy for the treatment of PTSD has limitations, between reduced efficacy and "PTSD pharmacotherapeutic crisis". Scientific evidence has shown that the use of ketamine has benefits for the treatment of depressive disorders and other symptoms present in PTSD compared to other conventional therapies. Therefore, this study aims to analyze the available evidence on the effect of ketamine in the treatment of post-traumatic stress. The systematic review and the meta-analysis were conducted following PRISMA guidelines and RevManager software, using randomized controlled trials and eligible studies of quality criteria for data extraction and analysis. The sample design evaluated included the last ten years, whose search resulted in 594 articles. After applying the exclusion criteria, 35 articles were selected, of which 14 articles were part of the sample, however, only six articles were selected the meta-analysis. The results showed that the ketamine is a promising drug in the management of PTSD with effect more evident performed after 24 h evaluated by MADRS scale. However, the main limitations of the present review demonstrate that more high-quality studies are needed to investigate the influence of therapy, safety, and efficacy.

Molecular basis and clinical perspectives of deep brain stimulation for major depressive disorder.

It is possible to consider the stimulation of the cingulate gyrus in its portion below the corpus callosum (SCC, or subcallosal cingulate cortex) as an effective, promising, and safe alternative intervention for treatment-resistant depression. In studies with deep brain stimulation - DBS, when follow-on with functional magnetic resonance imaging and/or PET-CT (Positron emission tomography-computed tomography) is performed, it is observed an increase in the blood supply and glucose metabolism in this region, which is the anterior part of the limbic system. This same location has good experimental results also for the treatment of anorexia nervosa. The hypotheses suggest a greater activation of the reward system, a greater sense of well-being, and a consequent reduction in depressive symptoms, the objective of the treatment. Over the last 20 years, multicenter studies have shown symptomatic improvement in 50-60% of patients, and about a third even reach criteria for remission of the depressive disorder.

The Impacts of SARS-CoV-2 Pandemic on Suicide: A Lexical Analysis.

Background: Although COVID-19 is a public health emergency, its consequences for the mental health of the population are still scarce. Likewise, its impact on critical situations such as suicide is still poorly explored in the literature. Therefore, this study aimed to analyze in a pioneering way, through lexical and content analysis techniques, the possible impacts of the new COVID-19 pandemic on suicide behavior. Methods: A lexical analysis, whose sample (not probabilistic, i.e., for convenience) was made up of full-length papers (abstracts) and short communications, about suicide behavior in COVID-19 pandemic, in PubMed and Virtual Health Library (VHL) was carried out following a lexical and content analysis using the software IRaMuTeQ, version 0.7 alpha 2. Results: The most frequent active words were suicide behavior (n = 649), covid (n = 439), health (n = 358), mental (n = 268), and social (n = 220). Four lexical classes were found and organized into two large groups: the first group, formed by the classes 2 ("methods for psychological treatment") and 3 ("strategies to minimize the COVID-19 impacts"), was the most representative, totaling 50.6% of the text segments and second group formed by classes 1 ("signs of clinical depression") and 4 ("COVID-19 pandemic as a public health problem") with 49.4% of the text segments. Conclusion: Facing suicide behavior, the direct effects of the COVID-19 pandemic, and the negative feelings and trigger of previous psychiatric illnesses; the measures to deal with the pandemic such as social isolation, decrease in the number of professionals, the opening hours of health establishments, and decrease in the demand for medications; and competing phenomena such as the spread of fake news and lack of empathy are aggressive and potentiating factors of suicidal ideation.

The lesbian, gay, bisexual and transgender movement: A systematic review with meta-analysis.

BACKGROUND: To identify, through the conscientious, explicit and judicious use, the evidence about health behaviors and situations included in the decision making on individuals belonging to the lesbian, gay, bisexual and transgender (LGBT) group in the context of ethnic disparities and sexual minorities. METHODS: A systematic review with meta-analysis meta-synthesis from searches in electronic databases SCOPUS and Virtual Health Library (VHL), portal that hosts databases such as MEDLINE, using the following descriptors MeSH (Medical Subject Headings): 'Sexual Minorities', 'Health', 'African Continental Ancestry Group' and 'Brazil'. To achieve safe and reproducible research, the authors decided to gather the descriptors using Boolean operators AND and OR, in the following manner: in the VHL, Sexual Minorities AND Health AND African Continental Ancestry Group OR Brazil; in SCOPUS, Sexual Minorities AND Health AND African Continental Ancestry Group. The selection of articles occurred in two stages. RESULTS: Of the 52 results found, this study included 14 articles, according to the stages of screening and eligibility criteria. The research carried out proved to be scarce when related to Brazil, so that the review was constructed from studies carried out in international environment. CONCLUSION: The scarcity of studies in this area suggested lack of knowledge on the health profiles of the LGBT Afro Population. The individualized attention proved to be insufficient and reveals the need for training health professionals aware of the aspects and health care for this population, with a view to implementing integral health policies that already exist.

American cutaneous leishmaniasis in a northeast Brazilian city: clinical and epidemiological features.

INTRODUCTION: This study characterized the clinico-epidemiological profile of American cutaneous leishmaniasis (ACL) cases in Barbalha, Ceará State, Brazil. METHODS: Medical records of 363 patients visiting Federal University of Cariri between 2009 and 2014 were analyzed. RESULTS: ACL was more prevalent in men with low education level from rural zones. The main presentation was a single ulcer, mainly in the lower limbs, and 49.8% also presented lymphadenomegaly. The annual incidence ranged from 2.83 to 22.60 per 10,000 inhabitants. CONCLUSIONS: The rates observed in this study indicate the importance of additional research to contribute to the control of this endemic disease.

Mental health and public policies implemented in the Northeast of Brazil: A systematic review with meta-analysis.

INTRODUCTION: Studies about mental disorders are very rare in the Northeast of Brazil, especially when psychopathologies in children and adolescents are considered. The consequence is a small availability of data and an absence of a real epidemiological profile. METHODS: This is a systematic review with meta-analysis, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol, in the period from 2003 to 2015, using the databases LILACS, SciELO and BVS. The analysis comprised the keywords 'models of primary and secondary healthcare in mental health', 'psychiatric reform' and 'policies and services in mental health', using the Boolean operator '# AND'. Original texts based on secondary data from the Hospital Information System of the Brazilian Unified Health System were also included via the Citizen Electronic Record System, Instituto Brasileiro de Geografia e Estatística, and Ministry of Health. Grey literature was used by means of hand searching. RESULTS: A combined analysis of the strategies mentioned in the analyzed articles shows a combined odds ratio of 1.291 (confidence interval (CI) = 1.054-1.582), thus it demonstrates the efficacy of using such strategies in the elaboration of institutional apparatus in mental health. The p-value of the chi-square distribution resulted in .9753, which does not reject the hypothesis of association between strategies in mental health and possible development of institutional apparatus in mental health. CONCLUSIONS: A combined analysis of all strategies mentioned in the analyzed studies shows efficacy of using strategies to elaborate institutional apparatus in mental health.

Bipolar disorder incidence between children and adolescents: A brief communication.

BACKGROUND: Bipolar affective disorder is one of most injurious psychiatric diseases, not, rarely leading patient for suicide, and its prevalence keeps increasing worldwide, notably on low and, middle-income countries. For children living in northeast Brazil, extreme social conditions constitute, an environment of special vulnerability. OBJECTIVE: Here we show that bipolar disorder incidence, between children and adolescents in this Brazilian region increased 34.2% from 2005 to 2014 and, in, the same area and age group, deaths provoked by self-caused injuries also became progressively, greater. RESULTS: According to DATASUS, the Brazilian national databank for public health, information, in the last five years, we observed an increase of Bipolar Disorder incidence rates under, 19 year-old of about 34.2% in the northeast region of Brazil, while the increase for Brazilian general, population was 12.4%. If considered only patients under 10, this number is even greater, of 47.2%. Content of Table 2 shows this disproportion, while comparing the advance of bipolar disorder, morbidity indices nationwide and worldwide. CONCLUSION: Children living in Brazil's northeast, region are in a condition of extreme social disadvantage, what can be determinant for the recent and, sequential increase of bipolar disorder prevalence and the mortality in this age-group due to suicide, one of possible reflections of untreated mood disorders. For protecting these children is important to, identify the factors which prevent these illnesses and promote resilience for these young people.

Experiences reported by the workers of Psychosocial Care Center for Children and Adolescents in Sao Paulo City - Brazil.

The objective of this paper was to describe and analyze the context of trajectories of workers of Psychosocial Care Centers for Children and Adolescents (CAPSis) with the insertion, practice and motivation of workers in this fieldwork. Comparing the context of trajectories of employees according to the managerial nature: Social Health Organization (OSS) and city hall. Narratives-interviews were conducted with 8 workers from 2 Psychosocial Care Centers for Children and Adolescents (one managed by the City and other by Social Health Organizations), São Paulo City, Brazil. The narratives interviews were transcribed and analyzed from Shutze method. The Theoretical Framework was built from different authors and Psychiatric Reform principles. There are important differences between workers of 2 Psychosocial Care Centers for Children and Adolescents regarding professional profile, motivations, type of training and meanings attributed to work. The current trend in the field goes in opposite direction to the proposals of the Psychiatric Reform, lack of opportunities for discussion and empowerment work team of labor, which should be offered by institutions, makes both groups of professionals feel lost and alone.

Risk factors for suicide in bipolar disorder: a systematic review.

BACKGROUND: Bipolar disorder confers the highest risk of suicide among major psychological disorders. The risk factors associated with bipolar disorder and suicide exist and are relevant to clinicians and researchers. OBJECTIVE: The aim of the present study was to conduct a systematic review of articles regarding the suicide risk factors in bipolar disorder. METHODS: A systematic review of articles on suicide risk factors in bipolar disorder, published from January 1, 2010 to April 05, 2014, on SCOPUS and PUBMED databases was carried out. Search terms were "Suicide" (medical subject headings [MeSH]), "Risk factors" (MeSH), and "Bipolar" (keyword). Of the 220 retrieved studies, 42 met the eligibility criteria. RESULTS: Bipolar disorder is associated with an increased rate death by suicide which contributes to overall mortality rates. Studies covered a wide range of aspects regarding suicide risk factors in bipolar disorder, such as risk factors associated to Sociodemographic conditions, Biological characteristics, Drugs Relationships, Psychological Factors, Genetic Compound, Religious and Spirituals conditions. Recent scientific literature regarding the suicide risk factors in bipolar disorder converge to, directly or indirectly, highlight the negative impacts of risk factors to the affected population quality of life. CONCLUSION: This review demonstrated that Bipolar disorders commonly leads to other psychiatric disorders and co-morbidities involving risk of suicide. Thus the risk factors are relevant to have a better diagnosis and prognosis of BD cases involving risk of suicide.

Are there depression and anxiety genetic markers and mutations? A systematic review.

BACKGROUND: Genetic factors may encourage or even cause the occurrence of mood disorders such as anxiety and/or depression. However, despite the significant amount of work and sophisticated technology is not fully elucidated which genes or regions of nuclear or mitochondrial DNA, or which types of genetic changes, alone or in combination, can represent reliable genetic markers of anxiety and/or depression. OBJECTIVE: To identify whether there are genetic changes that can cause depression or anxiety and if there are genetic markers that can be used to detect these changes. METHODS: A systematic review of 01.01.2004 to 03.28.2014 was held by VHL (Virtual Health Library). The search was performed with the descriptors ׳׳anxiety׳׳, ׳׳depression׳׳, "mutation" and "genetic markers׳׳. The selected articles were indexed in MEDLINE. The information pertinent to the study was selected, categorized and analyzed. Of the 374 articles found, 29 met the eligibility criteria. RESULTS: FMR1 gene polymorphisms, dopaminergic (DAT, DRD, COMT), serotonin (5-HTTLPR, HTR1A, HTR2A), interleukins, MCR1, HCN (potassium channel), neurorregulinas, GABAergic (GABA, GAD, DBI) DBI, GABA (Gabra) receptors and GAD genes (GAD1, GAD2) appear to contribute to generate condition of depression or anxiety like. Mutations in mitochondrial DNA in 124pb allele of D2S2944 in ofil 1 and 2 loci of chromosomes 4 and 7, respectively, and the chromosomes 8p, 17p and 15q appear to be associated with the origin of depression or anxiety. CONCLUSION: Some studies show only associations with one of the disorders, mainly anxiety. Few have shown association with both simultaneously. Other studies showed specific association of gender, or even specific ethnic groups. It was noticed, controversies over certain markers. Interesting results were observed in combination of changes, especially in cases of SNPs, indicating that perhaps this is the most appropriate way to find reliable markers.