Anxiety and Depression as Longitudinal Predictors of Mild Cognitive Impairment in Older Adults.

INTRODUCTION: Few studies have dealt with the potential correlation between anxiety, depression, and cognitive impairment in community-dwelling older adults. METHOD: This longitudinal study was conducted in the city of Montreal, Canada, with 352 older adults aged 55 years or more. The participants were interviewed at baseline and again 2 years later. The Montreal Cognitive Assessment (MoCA) score was estimated and compared between the 2 time points, the Composite International Diagnostic Interview (CIDI) was used to assess major depression and anxiety, and the K10 measured high psychological distress. Likewise, major depression, anxiety disorders, and psychological distress were evaluated at the 2 study time points. RESULTS: In older adults with a diagnosis of depression or anxiety at baseline, no significant reduction in the MoCA score indicating deterioration in cognitive function was found 2 years later. Nevertheless, in individuals with a high level of psychological distress at baseline, there was a significant reduction in MoCA scores 2 years later, indicating deterioration in cognition. The findings of the present study suggest that a high level of psychological distress in addition to environmental factors may constitute important predictors for cognitive health.

Symptoms of anxiety and depression and quality of life in parents of children with autism during the second wave of the pandemic.

BACKGROUND: Local political discord together with isolation and fear marked the COVID-19 pandemic in Brazil. AIMS: To determine the prevalence of anxiety and depression symptoms and analyze adult quality of life (QoL) during the pandemic in four groups: "childless", "children without mental problems", "children with autism" and "children with other mental problems." METHODS AND PROCEDURES: A sample of 867 individuals recruited using social media in northeastern Brazil completed the following instruments: the Hospital Anxiety and Depression Scale (HADS, Brazilian version), the WHOQOL-Bref, and a sociodemographic form OUTCOMES AND RESULTS: The mean score for depression was significantly higher in the "children with autism" group compared to the other groups. The mean anxiety score was significantly higher in the "children with autism" and "childless" groups. Mean QoL scores were lower in the "children with autism" group compared to the other groups for all the domains, with this difference being statistically significant compared with the "children without mental problems" group for all the domains. CONCLUSIONS AND IMPLICATIONS: Anxiety and depression symptoms were greater and QoL scores were lower in parents of children with autism. All groups benefitted from logistic support during the pandemic, whereas having to care for others negatively impacted QoL.

Translation into Brazilian Portuguese and validation of the M-CHAT-R/F scale for early screening of autism spectrum disorder.

OBJECTIVE: To translate and validate the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) from English to Brazilian Portuguese, taking transcultural differences into account. METHODS: Permission for the translation was obtained from the author of the scale. Translation and back-translation were performed, and the document was then assessed for reference and general equivalence. Specialists in childhood autism evaluated the scale. A preliminary version was prepared and pre-tested in a sample population, and a final version was validated with the target population. RESULTS: Only one question had issues relating to referential equivalence. The 10 individuals questioned in the pre-test all understood most of the instrument, although some suggested substituting certain terms to improve comprehension. The final version was reached following inclusion of pertinent suggestions and was submitted to validation with the target population, indicating a sensitivity of 88.2% for a cutoff point greater than 2 points. CONCLUSIONS: A Brazilian version of the M-CHAT-R/F scale, approved by specialists and understandable by the target audience, is now available for use.

A validation study of the LABIRINTO scale for the evaluation of autism spectrum disorder in children aged 2 to 4 years.

OBJECTIVE: To find evidence of the content, construct, and criterion validity of the LABIRINTO scale for the diagnosis of autism spectrum disorder (ASD) in children aged 24-59 months. METHODS: The scale was constructed in four stages: 1) items were defined based on an extensive literature review and discussions with autism and child development specialists; 2) child development specialists evaluated each item; 3) a preliminary version of the scale was applied to children diagnosed with ASD to enable any necessary adjustments; 4) the scale was then applied to 27 children with typical development and no neurodevelopmental disorder and 48 children with ASD. According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Childhood Autism Rating Scale (CARS), clinical diagnosis constitutes the gold standard. RESULTS: The scale's psychometric indexes were appropriate for construct validity, with Kaiser-Meyer-Olkin = 0.94 and root mean square error of approximation = 0.000. Only one factor on the scale had a Cronbach alpha of 0.97. The receiver operating characteristic curve indicated a cutoff of 12, with a sensitivity of 100% and specificity of 100% for distinguishing children with ASD from those with typical development. CONCLUSION: This study confirmed the validity of the LABIRINTO scale.

Signs, meanings and practices of people living with human t-cell lymphotropic virus type 1 or tropical spastic myelopathy.

BACKGROUND: Human T-cell lymphotropic virus type 1 (HTLV-1) spreads silently in the world's population and causes several syndromes. Among these, HTLV-1 associated myelopathy, also called tropical spastic paraparesis (HAM/TSP), affects the nervous system. It causes sensorimotor losses, spasticity, muscle weakness, voiding and sexual dysfunction, pain, and balance disorders. There is limited knowledge of the feelings, experiences, and coping mechanisms associated with this neglected disease. The objective of the present qualitative study was to investigate the signs, meanings, and practices of people with HAM/TSP, through narratives obtained from focus groups and individual semi-structured face-to-face interviews. RESULTS: Thirty-eight individuals diagnosed with HAM/TSP participated in the study. The following categories and subcategories emerged from the participants: Signs-physical signs, symptoms, and discovery of the disease; Meanings-reaction to diagnosis and knowledge of disease, fears, and expectations; Practices-daily life, leisure, religious, and treatment activities. CONCLUSIONS: People with HAM/TSP suffer from symptoms that limit their social participation, and they are affected by complex and multidimensional feelings. This awareness can contribute to the implementation of public policies-focused on the real perspective of these patients-that provide more directed, empathic, and harmonious care for these individuals.

The role of leisure in the lives of psychotic patients: a qualitative study.

Quality of life is defined by indicators that measure the life patterns of a person or community in relation to an ideal model. Leisure is an important component of quality of life and a tool for rehabilitation for patients with chronic psychosis. This qualitative study evaluated the role of leisure in the life of patients living with psychosis. Interviews with patients and relatives indicate that sociability is an important value for both groups. Deeper analysis, however, indicates that sociability is a culturally learned concept for patients and does not relate to their real needs. Improvement of symptoms and respect of individuality are more central to their well-being.

Problematização sobre o Transtorno Disruptivo da Desregulação do Humor / Problematization about Disruptive Mood Dysregulation Disorder / Problématisation du Trouble Disruptif avec Dysrégulation émotionnelle / Problematización del Trastorno de Desregulación Disruptiva del Estado de Ánimo

Este artigo se propõe a delinear, historicamente, o diagnóstico clínico do Transtorno Disruptivo da Desregulação do Humor (TDDH). Com base no método genealógico, essa categoria diagnóstica é desnaturalizada e recontextualizada em sua origem. Analisa-se o conceito de desregulação do humor a partir da escala CBCL (Childhood Behaviour Checklist), sua identificação como um transtorno bipolar da infância, posterior transformação no diagnóstico de TDDH e subsequente crítica deste, com a proposta de englobar os sintomas de desregulação do humor na infância, no diagnóstico de transtorno opositor-desafiante. Como alternativa, o artigo sugere que o humor irritadiço na infância é um estado afetivo primário, constituindo-se, assim, em uma predisposição orgânica primária. Já a regulação emocional é uma construção adaptativa, que se modela ao longo da vida, gerando apresentações subjetivas diversas.

Resumos This article historically outlines the clinical diagnosis of disruptive mood dysregulation disorder (DMDD). Based on the genealogical method, this diagnostic category is denaturalized and recontextualized in its origin. The concept of mood dysregulation is analyzed from the Childhood Behavior Checklist scale (CBCL), its identification as a childhood bipolar disorder, subsequent transformation in the diagnosis of DMDD and subsequent criticism of it, with the proposal of encompassing the symptoms of mood dysregulation humor in childhood into the diagnosis of oppositional defiant disorder. As an alternative, the article suggests that irritable mood in childhood is a primary affective state, thus, constituting a primary organic predisposition. Emotional regulation, on the other hand, is an adaptive construction, which is modeled throughout life, generating diverse subjective presentations.

Cet article retrace l'historique du diagnostic clinique du trouble disruptif avec dysrégulation émotionnelle (TDDE). Basée sur la méthode généalogique, cette catégorie diagnostique est dénaturalisée et recontextualisée dans ses origines. Le concept de dysrégulation émotionnelle est analysé à partir de l'échelle CBCL (Childhood Behavior Checklist), de son identification en tant que trouble bipolaire de l'enfance, de sa transformation ultérieure en diagnostic de TDDE et de sa critique ultérieure, avec la proposition d'inclure les symptômes de dysrégulation émotionnelle dans l'enfance dans le diagnostic du trouble oppositionnel avec provocation. Comme alternative, l'article suggère que l'humeur irritable dans l'enfance est un état affectif primaire, constituant ainsi une prédisposition organique primaire. La régulation émotionnelle, quant à elle, est une construction adaptative qui est modelée tout au long de la vie, générant diverses présentations subjectives.

Este artículo describe historicamente el diagnóstico clínico del trastorno de desregulación disruptiva del estado de ánimo (TDDEA). Con base en el método genealógico, esta categoria diagnostica se desnaturaliza y recontextualiza en su origen. Se analiza el concepto de desregulación del estado de ánimo a partir de la escala CBCL (Childhood Behavior Checklist), su identificación como trastorno bipolar pediátrico, posterior transformación en el diagnóstico de TDDEA y posterior crítica al mismo, con la propuesta de englobar los síntomas de desregulación del estado de ánimo en el diagnóstico de trastorno negativista desafiante. Como alternativa, se sugiere que el estado de ánimo de irritabilidad en la infancia es un estado afectivo primario, constituyendo una predisposición orgánica primaria. La regulación emocional, por su parte, es una construcción adaptativa, que se modela a lo largo de la vida, generando diversas presentaciones subjetivas.

Enacting autism: Immigrant family negotiations with nosology in practice.

This article describes how autism spectrum disorder is experienced in the context of immigrant families and how the meaning of this condition, proposed by professionals in the host country, is negotiated between families and healthcare providers. The study sample consists of 44 parents of different nationalities and their 35 children with autism spectrum disorder (ASD) living in a socioeconomically deprived neighborhood of Montreal, Canada. Individual parent interviews were audiotaped and transcribed for subsequent analysis. Results suggest that - although they may sometimes be a source of anxiety - the uncertainties regarding the etiology of ASD, as well as the gap between the explanatory models (EMs) proposed by host country professionals and the impressions of parents, seem to increase the capacity of families to resist the imposition of what they perceive as external categories. Parents perceived the day-to-day difficulties associated with their child's condition as a form of social exclusion that compromised their child's future and independence. These day-to-day difficulties were also described as directly affecting the parents' social life, constituting an important emotional and physical burden. When talking about their children, parents described the painfulness of their experiences, but also discussed how their autistic child had transformed and shaped their lives. Overall, these results show how the disease is "enacted" in the day-to-day life of parents; and suggest that such an embodied understanding of ASD may sometimes represent a form of re-appropriation of power by families faced with adversity.

Translation into Brazilian Portuguese and validation of the M-CHAT-R/F scale for early screening of autism spectrum disorder / Tradução para o português e validação da escala Modified Checklist for Autism in Toddlers, Revised with Follow-Up para rastreamento precoce de transtorno do espectro do autismo

ABSTRACT Objective: To translate and validate the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) from English to Brazilian Portuguese, taking transcultural differences into account. Methods: Permission for the translation was obtained from the author of the scale. Translation and back-translation were performed, and the document was then assessed for reference and general equivalence. Specialists in childhood autism evaluated the scale. A preliminary version was prepared and pre-tested in a sample population, and a final version was validated with the target population. Results: Only one question had issues relating to referential equivalence. The 10 individuals questioned in the pre-test all understood most of the instrument, although some suggested substituting certain terms to improve comprehension. The final version was reached following inclusion of pertinent suggestions and was submitted to validation with the target population, indicating a sensitivity of 88.2% for a cutoff point greater than 2 points. Conclusions: A Brazilian version of the M-CHAT-R/F scale, approved by specialists and understandable by the target audience, is now available for use.

RESUMO Objetivo: Realizar a tradução e validação do inglês para o português do Brasil da escala Modified Checklist for Autism in Toddlers, Revised with Follow-Up para triagem precoce do autismo, respeitando a equivalência transcultural. Métodos: Foi obtida permissão da autora da escala e realizaram-se tradução, retrotradução, avaliação da equivalência referencial e geral, avaliação de especialistas em autismo infantil, elaboração da versão preliminar, pré-teste, elaboração da versão final e validação com população-alvo. Resultados: Apenas uma das questões não foi 100% semelhante na avaliação da equivalência referencial. Das 10 pessoas interrogadas no pré-teste, todas compreenderam a maior parte do instrumento, contudo houve algumas sugestões de substituição de termos e exemplos para facilitar a compreensão. Após a incorporação das sugestões pertinentes, foi elaborada a versão final, que, submetida à validação com a população-alvo, indicou sensibilidade de 88,2% para ponto de corte maior que 2 pontos. Conclusões: O estudo torna disponível a versão em português da escala Modified Checklist for Autism in Toddlers, Revised with Follow-Up, considerada adequada por especialistas e compreensível pela população.

Prevalence of anxiety and depression in parents of children with autism spectrum disorder during the first wave of the COVID-19 pandemic on Northeast Brazil / Prevalência de ansiedade e depressão em pais de crianças com transtorno do espectro autista durante a primeira onda da pandemia de COVID-19 no Nordeste do Brasil

ABSTRACT Objective: Estimate the prevalence of anxiety and depression symptoms in parents of children with autism spectrum disorder (ASD) during the first wave of the Coronavirus Disease (COVID-19) pandemic, comparing them with parents of neurotypical children and with other mental disorders. Methods: Responses from 211 participants were collected from an online form about familial behavior during the pandemic, and the Portuguese version of the HADS scale (Hospital Anxiety and Depression Scale). Results: Anxiety symptoms were present in 51% of the sample and depression was present in 35.1%. The prevalence of depression and anxiety symptoms was 58% and 44.4% respectively in the group of parents of children from the ASD; 50.3% e 32.2% for parents of neurotypical children; and 40% and 35% in the group of parents of children with other mental disorders. Conclusions: The prevalence of anxiety and depression in parents during the pandemic was greater than that of before the pandemic period. The prevalence of anxiety symptoms, as well as the mean scores of anxiety and depression symptoms, were significantly higher for the group of parents of children with the ASD. The results point to the need for additional care for parents and caregivers of children with ASD, since the social isolation adopted as a measure to contain the pandemic seemed to pose as a risk factor for negative psychological effects especially in this group.

RESUMO Objetivo: Estimar a prevalência de sintomas de ansiedade e depressão em pais de crianças com transtorno do espectro autista (TEA), durante a primeira onda da pandemia da doença causada pelo coronavírus SARS-CoV-2 (COVID-19), comparando com pais de crianças típicas e com outros transtornos mentais. Métodos: Foram coletadas respostas de 211 participantes a partir de um questionário on-line sobre comportamento familiar durante a pandemia e da versão em português da escala HADS (Hospital Anxiety and Depression Scale). Resultados: Sintomas de ansiedade estiveram presentes em 51% da amostra e de depressão, em 35,1%. A prevalência de sintomas de ansiedade e depressão foi de 58% e 44,4%, respectivamente, no grupo de pais de crianças com TEA, 50,3% e 32,2% no grupo de pais de crianças típicas e 40% e 35% no grupo de pais de crianças com outros transtornos mentais. Conclusões: As prevalências de ansiedade e depressão em pais durante a quarentena foram superiores àquelas fora do período pandêmico. As prevalências de sintomas de ansiedade, bem como as médias dos escores de sintomas de ansiedade e depressão, foram maiores no grupo de pais de crianças com TEA. Os resultados indicam a necessidade de atenção aos pais e cuidadores das crianças com TEA, já que o isolamento social adotado como medida de contenção da pandemia se constituiu como um fator de risco para impactos psicológicos negativos especialmente nesse grupo.

Prevalence of attention deficit hyperactivity disorder in schoolchildren in the city of Salvador, Bahia, Brazil.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder of infancy and one of the most prevalent chronic diseases found in schoolchildren. OBJECTIVE: To evaluate the prevalence of ADHD in schoolchildren through the use of a questionnaire responded by school-teachers. METHOD: A total of 774 children enrolled in the public and private school systems were evaluated. The diagnostic instrument used was a Teacher ADHD scale. RESULTS: Results showed that 6.7% of children were considered highly likely to have the disorder. Of the more severe cases of ADHD, the hyperactive-impulsive subtype was more frequently identified in girls, while the inattentive subtype was more prevalent among boys. CONCLUSION: The symptoms of attention deficit in hyperactive children may be underestimated by teachers since the symptoms of hyperactivity are more noticeable and disruptive.

Treatment of restless legs syndrome.

OBJECTIVE: Restless legs syndrome is a neurological disorder characterized by a desire to move limbs, which is usually only present or worsens during rest or at night. The objective of this article was to review the available literature about pharmacological treatment for this disorder. METHOD: A search of recent literature was undertaken on online databases (Medline, Pubmed, Scielo and Lilacs). RESULTS: 502 articles were retrieved, of which 30 were selected. Dopaminergic agents, anticonvulsants, opioids, benzodiazepines, zolpidem, entacapone and ketamine were all effective on the restless legs syndrome treatment. One study showed that iron was not effective. CONCLUSIONS: Based on few double-blind, randomized, controlled trials, it seems that the best options to treat restless legs syndrome patients are gabapentin and L-dopa associated to its sustained release formulation.

The prevalence of symptoms of attention-deficit/hyperactivity disorder in parents of children with autism spectrum disorder.

This study aims to estimate the prevalence of symptoms of attention-deficit/hyperactivity disorder (ADHD) in parents of children with autism spectrum disorder (ASD). This is a cross-sectional study conducted with the parents of 89 children previously diagnosed with ASD. The research instrument used was the 18-item Adult ADHD Self-Report Scale (ASRS). Symptoms of ADHD were present in 10.4% of the mothers of children with a diagnosis of ASD and in 11.3% of the fathers. These results suggest that the prevalence of symptoms of ADHD in the parents of children with autism is higher than that found in the general adult population.

Saúde mental e qualidade de vida de pais de pessoas com TEA durante a pandemia COVID-19: uma revisão narrativa / Mental health and quality of life of parents of people with ASD during COVID-19: literature review

INTRODUÇÃO: Em dezembro de 2019 surgiram, na China, os primeiros caso de COVID-19, uma doença infectocontagiosa que, em poucos meses, evoluiu para o estado de pandemia. Foram adotadas medidas de distanciamento social, que podem gerar impactos psicológicos negativos para a população. O impacto pode ser maior para os pais de indivíduos com TEA, já que as demandas de cuidados dos filhos passam para os genitores em tempo integral. Soma-se ainda o fato de o trabalho dos pais em home-office e as demandas de trabalho doméstico. OBJETIVO: Revisar estudos sobre a saúde mental e/ou qualidade de vida de pais durante a pandemia. METODOLOGIA: Tratase de uma revisão narrativa da literatura buscando-se artigos nas bases PubMed/Medline, Scielo (Scientific Electronic Library Online), Google Scholar, Portal BVS (Biblioteca Virtual em Saúde), Periódicos Capes (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior). Foram selecionados 12 artigos de estudos qualitativos transversais a partir das bases de dados. RESULTADOS: A avaliação dos artigos mostra que os pais de indivíduos com TEA tendem a estar mais ansiosos, estressados e depressivos nesse período devido a sobrecargas físicas e emocionais. Além disso, eles apresentaram pior qualidade de vida neste período quando comparado a pais de crianças com outros transtornos e com desenvolvimento típico. CONCLUSÃO: O desenvolvimento de mais estudos sobre o tema é necessário, pois com maior embasamento científico é possível planejar um cuidado mais direcionado. O apoio virtual de profissionais e outros pais podem minimizar o impacto da pandemia sobre essa população. Entretanto, a diversidade de fatores sociais, econômicos e culturais envolvidos nessa questão requer mobilização multisetorial.

INTRODUCTION: In December 2019, the first cases of COVID-19, an infectious-contagious disease that evolved into a pandemic state, emerged in China. Social distancing measures were adopted, which can generate negative psychological impacts for the population. The impact may be greater for the parents of individuals with ASD, as the demands of the children's care are passed on to the parents on a full-time basis. In addition, the fact that parents work from home and the demands of domestic work is added. OBJECTIVE: To review studies on the mental health and/or quality of life of parents during the pandemic. METHODOLOGY: This is a narrative review of the literature looking for articles based on PubMed/Medline, Scielo (Scientific Electronic Library Online), Google Scholar, BVS Portal (Virtual Health Library), Capes Journals (Coordination for the Improvement of Health Personnel Upper level). 12 articles from qualitative crosssectional studies were selected from the databases. RESULTS: The evaluation of the articles shows that the parents of individuals with ASD tend to be more anxious, stressed, and depressed in this period due to physical and emotional overload. In addition, they had a worse quality of life in this period when compared to parents of children with other disorders and with typical development. CONCLUSION: The development of more studies on the theme is necessary because it is possible to plan more targeted care with a greater scientific basis. The virtual support of professionals and other parents can minimize the impact of the pandemic on this population. However, the diversity of social, economic, and cultural factors involved in this issue requires multisectoral mobilization.

Correlation between symptoms of autism in children and personality traits in parents / Correlação entre sintomas de autismo em crianças e traços de personalidade em pais / Correlación entre síntomas de autismo en niños y rasgos de personalidad en padres

Parents of children with autism spectrum disorder may be more likely to have a mental disorder, both due to genetic and environmental reasons. A cross-sectional study involving 161 children, 161 mothers and 108 fathers. Diagnosis followed the criteria established in DSM-5. Symptom severity was evaluated using the Childhood Autism Rating Scale. The Factorial Personality Inventory served to evaluate parents' personality traits. Several correlations were found between mothers and fathers personality traits and children symptoms. In both parents, personality traits associated with greater intransigence/less flexibility and fewer social skills were those associated with more severe autism symptoms in the children.

Os pais de crianças com transtorno do espectro do autismo podem ter maior probabilidade de ter um transtorno mental, devido a razões genéticas e ambientais. Estudo transversal envolvendo 161 crianças, 161 mães e 108 pais. O diagnóstico seguiu os critérios estabelecidos no DSM - 5. A gravidade dos sintomas foi avaliada usando a Escala de Classificação do Autismo na Infância. O Inventário Fatorial de Personalidade foi utilizado para avaliar os traços de personalidade dos pais. Várias correlações foram encontradas entre traços de personalidade de mães e pais e sintomas de crianças. Em ambos os pais, os traços de personalidade associados a maior intransigência / menor flexibilidade e menos habilidades sociais foram os associados a sintomas mais graves de autismo nas crianças.

Los padres de niños con trastorno del espectro autista pueden ser más propensos a tener un trastorno mental, tanto por razones genéticas como ambientales. Se trata de un estudio transversal con 161 niños, 161 madres y 108 padres. El diagnóstico siguió los criterios establecidos en el DSM-5. La gravedad de los síntomas se evaluó mediante la Escala de calificación de autismo infantil. El Inventario Factorial de Personalidad sirvió para evaluar los rasgos de personalidad de los padres. Se encontraron varias correlaciones entre los rasgos de personalidad de las madres y los padres y los síntomas de los niños. En ambos padres, los rasgos de personalidad asociados con una mayor intransigencia / menor flexibilidad y menos habilidades sociales fueron los asociados con síntomas de autismo más severos en los niños.

Risk and protective factors for symptoms of anxiety and depression in parents of children with autism spectrum disorder.

OBJECTIVE: The severity of symptoms of anxiety and depression was evaluated in 102 parents of children with autism spectrum disorders (ASD) and correlated with the severity of their child's behavioral symptoms. DESIGN: An observational, cross-sectional study. METHODS: The Portuguese versions of the Hospital Anxiety and Depression Scale and the Aberrant Behavior Checklist were used to assess symptoms in the parents and in their children. MAIN OUTCOMES AND RESULTS: Depression was present in 26.7% of parents and anxiety in 33.7%. Severe behavioral symptoms in the child increased the likelihood of severe anxiety and depression symptoms in the parents by a factor of 35. If the child had severe behavioral symptoms and the father lived in the family home, the likelihood of severe symptoms of anxiety and depression in the parents was 95.2% lower. CONCLUSION: The presence of the father living in the family home acted as a buffer against parents' symptoms.

[A pilot study of prevalence of hyperactivity and attention deficit disorder in scholar children in Salvador, Bahia, Brazil]. / Estudo piloto da prevalência do transtorno de déficit de atenção e hiperatividade entre crianças escolares na cidade do Salvador, Bahia, Brasil.

This study aims to estimate the prevalence of attention deficit hyperactivity disorder (ADHD) in scholar children through a teacher's questionnaire. A pilot study was conducted based in the total number of students under high school, in public and private schools in Salvador, Bahia, Brazil. The instrument used was Teacher's version of ADHS scale. Eight kids (5.3%) were recognized as highly probability of attention deficit disorder, three (2%) with high probability of subtype hyperactive/impulsive, and one (0.6%) as combined subtype. Children with ADHD might have serious social problems, not only brought by the disorder, but also due to co morbidity with other disorders, leading to serious social withdrawn. Early diagnostic and treatment of ADHD might improve educational and psychosocial development of these kids.

Increased Anxiety, Akathisia, and Suicidal Thoughts in Patients with Mood Disorder on Aripiprazole and Lamotrigine.

Introduction. Akathisia affects around 18% of patients with bipolar disorder treated with aripiprazole and may worsen when aripiprazole is combined with lamotrigine and antidepressants. Case. This paper reports on two clinical cases involving patients with a diagnosis of mood disorder who developed severe akathisia, anxiety, and suicidal ideation while using a combination of aripiprazole, antidepressants, and lamotrigine. Discussion. We recommend that patients with a mood disorder taking multiple drugs should begin aripiprazole therapy with low doses and be monitored for the development of akathisia, increased anxiety, or suicidal thoughts. The appearance of these limiting side effects requires discontinuation of the drug.

Perfil epidemiológico de mortalidade por suicídio no Brasil entre 2006 e 2015 / Epidemiological profile of mortality by suicide in Brazil between 2006 and 2015

OBJETIVOS: Descrever o perfil sociodemográfico das vítimas de suicídio no Brasil entre 2006- 2015. MÉTODOS E MATERIAIS: Utilizaram-se dados do SIM e DATASUS. Analisaram-se incidências por raça/cor, escolaridade, faixa etária, de 2006-2015. Compararam-se variações na mortalidade por suicídio com mudanças regionais nos indicadores de características socioeconômicas e demográficas. RESULTADOS: As maiores causas de suicídio foram enforcamento, lesão por armas de fogo, autointoxicação por pesticidas. Os mais acometidos foram os menos escolarizados, adultos jovens (entre 20-39 anos) ou maiores de 60 anos. As taxas entre homens são 3,7 vezes maiores em todas as regiões. A mortalidade mais elevada se encontra na região Sudeste e o maior crescimento percentual, no Norte. CONSIDERAÇÕES FINAIS: A mortalidade por suicídio continua a crescer no país, com importantes variações regionais. O Brasil ainda carece de programas governamentais que trabalhem efetivamente na prevenção do suicídio.

OBJECTIVES: To describe the sociodemographic profile of suicide victims in Brazil between 2006-2015. METHODS AND MATERIALS: Data from SIM and DATASUS were used. Incidences by race / color, education, age range, from 2006-2015 were analyzed. Variations in suicide mortality were compared with regional changes in indicators of socioeconomic and demographic characteristics. RESULTS: The main causes of suicide were hanging, firearms injuries, self-poisoning by pesticides. The most affected were the least educated, young adults (between 20-39 years old) or over 60 years old. Rates among men are 3.7 times higher in all regions. The highest mortality is found in the Southeast and the highest percentage growth in the North. FINAL CONSIDERATIONS: Death by suicide continues to increase in the country, with important regional variations. Brazil still lacks government programs that work effectively in preventing suicide.

Autism: impact of the diagnosis in the parents / Autismo: impacto do diagnóstico nos pais

ABSTRACT Objective To understand how parents react to the diagnosis of autism in their child, and the manner in which the diagnosis was revealed, as well as the method through which the researcher perceived this communication. Methods A qualitative, narrative approach was used. Semi-structured interviews were held with 21 mothers and 9 fathers of children with autism spectrum disorder (ASD) enrolled in a special needs school in Salvador, Bahia, Brazil. In another setting, a specialist university service for the diagnosis of autism located in the same city, data were collected from 11 mothers and 5 fathers receiving diagnosis using ethnographic participant observation. Analysis categories were established, and the data interpreted. Results The categories selected were: " in search of a diagnosis ", " impact of receiving the diagnosis ", " patterns of diagnosis communication ", and " coping strategies ". Conclusion The diagnosis of autism is often delayed due to doctors' unpreparedness. Awareness of their child's diagnosis exerts a negative emotional impact on parents, which can be softened using coping strategies and diagnosis communication that offers technical information, offers emotional support and provides hope regarding the child's development. Parents need to be cared for in order to provide for the needs of their children at the moment of diagnosis and throughout the entire process of caring for individuals with ASD.

RESUMO Objetivo Conhecer como os pais reagem ao diagnóstico de autismo em seu filho e ao modo em como esse foi revelado, bem como a forma que o pesquisador percebeu essa comunicação. Métodos Qualitativo, abordagem narrativa. Foram feitas entrevistas semiestruturadas com 21 mães e 9 pais com filhos com transtorno do espectro autista (TEA) de uma escola especial em Salvador, Bahia, Brasil, e utilizada técnica etnográfica de observação participante em um serviço universitário especializado em diagnóstico de autismo, na mesma cidade, com 11 mães e 5 pais. As categorias de análise foram elaboradas e os dados, interpretados. Resultados Foram selecionadas as categorias "em busca do diagnóstico", "impacto na recepção do diagnóstico", "padrões da comunicação diagnóstica" e "estratégias de enfrentamento". Conclusão O diagnóstico de autismo é tardio devido ao pouco conhecimento e/ou habilidade dos profissionais médicos. Saber do diagnóstico dos filhos produz impacto emocional negativo nos pais, o que pode ser amenizado com estratégias de enfrentamento e comunicação diagnóstica que passe informações técnicas, ofereça suporte emocional, além de esperança quanto ao desenvolvimento do filho. Os pais precisam ser cuidados, para cuidarem dos filhos, no momento do diagnóstico e em todo o percurso de assistência às pessoas com TEA.