Revisiting delusion subtypes in schizophrenia based on their underlying structures.

A clear understanding of the pathophysiology of schizophrenia and related spectrum disorders has been limited by clinical heterogeneity. We investigated whether relative severity and predominance of one or more delusion subtypes might yield clinically differentiable patient profiles. Patients (N = 286) with schizophrenia spectrum disorders (SSD) completed the 21-item Peters et al. Delusions Inventory (PDI-21). We performed factor analysis followed by k-means clustering to identify delusion factors and patient subtypes. Patients were further assessed via the Brief Psychiatric Rating Scale, Brief Negative Symptom Scale, Digit Symbol and Digit Substitution tasks, use of cannabis and tobacco, and stressful life events. The overall patient sample clustered into subtypes corresponding to Low-Delusion, Grandiose-Predominant, Paranoid-Predominant, and Pan-Delusion patients. Paranoid-Predominant and Pan-Delusion patients showed significantly higher burden of positive symptoms, while Low-Delusion patients showed the highest burden of negative symptoms. The Paranoia delusion factor score showed a positive association with Digit Symbol and Digit Substitution tasks in the overall sample, and the Paranoid-Predominant subtype exhibited the best performance on both tasks. Grandiose-Predominant patients showed significantly higher tobacco smoking severity than other subtypes, while Paranoid-Predominant patients were significantly more likely to have a lifetime diagnosis of Cannabis Use Disorder. We suggest that delusion self-report inventories such as the PDI-21 may be of utility in identifying sub-syndromes in SSD. From the current study, a Paranoid-Predominant form may be most distinctive, with features including less cognitive impairment and a stronger association with cannabis use.

Extension, translation and preliminary validation of the Northoff Scale for Subjective Experience in Catatonia (NSSC).

BACKGROUND: In the last two decades, much neuroscientific research has been done on the pathomechanisms of catatonia. However, catatonic symptoms have mainly been assessed with clinical rating scales based on observer ratings. Although catatonia is often associated with strong affective reactions, the subjective domain of catatonia has simply been neglected in scientific research. METHODS: The main objective of this study was to modify, extend and translate the original German version of the Northoff Scale for Subjective Experience in Catatonia (NSSC) and to examine its preliminary validity and reliability. Data were collected from 28 patients diagnosed with catatonia associated with another mental disorder (6A40) according to ICD-11. Descriptive statistics, correlation coefficients, internal consistency and principal component analysis were employed to address preliminary validity and reliability of the NSSC. RESULTS: NSSC showed high internal consistency (Cronbach's alpha = 0.92). NSSC total scores were significantly associated with Northoff Catatonia Rating Scale (r = 0.50, p < .01) and Bush Francis Catatonia Rating Scale (r = 0.41, p < .05) thus supporting its concurrent validity. There was no significant association between NSSC total score and Positive and Negative Symptoms Scale total (r = 0.26, p = .09), Brief Psychiatric Rating Scale (r = 0.29, p = .07) and GAF (r = 0.03, p = .43) scores. CONCLUSION: The extended version of the NSSC consists of 26 items and was developed to assess the subjective experience of catatonia patients. Preliminary validation of the NSSC revealed good psychometric properties. NSSC is a useful tool for everyday clinical work to assess the subjective experience of catatonia patients.

Correlation between elevated serum interleukin-1ß, interleukin-16 levels and psychiatric symptoms in patients with schizophrenia at different stages.

BACKGROUND: There is increasing evidence that immune dysfunction plays an important role in the pathogenesis of schizophrenia. Meso Scale Discovery (MSD) is bioanalytical method, which can detect serum inflammatory factors in patients. MSD has higher sensitivities, capturing a narrower range of proteins compared to other methods typically used in similar studies. The present study was aimed to explore the correlation between the levels of serum inflammatory factors and psychiatric symptoms in patients with schizophrenia at different stages and investigate a wide panel of inflammatory factors as independent factors for the pathogenesis of schizophrenia. METHODS: We recruited 116 participants, including patients with first-episode schizophrenia (FEG, n = 40), recurrence patients (REG, n = 40) with relapse-episode schizophrenia, and a control group (healthy people, HP, n = 36). Patients are diagnosed according to the DSM -V. The plasma levels of IFN-γ, IL-10, IL-1ß, IL-2, IL-6, TNF-α, CRP, VEGF, IL-15, and IL-16 were tested by the MSD technique. Patient-related data was collected, including sociodemographic data, positive and negative symptom scale (PANSS), and brief psychiatric rating scale (BPRS) and subscale scores. The independent sample T test, χ2 test, Analysis of covariance (ANCOVA), the least significant difference method (LSD), Spearman's correlation test, binary logistic regression analysis and ROC curve analysis were used in this study. RESULTS: There were significant differences in serum IL-1ß (F = 2.37, P = 0.014) and IL-16 (F = 4.40, P < 0.001) levels among the three groups. The level of serum IL-1ß in the first-episode group was significantly higher than in the recurrence group (F = 0.87, P = 0.021) and control group (F = 2.03, P = 0.013), but there was no significant difference between the recurrence group and control group (F = 1.65, P = 0.806). The serum IL-16 levels in the first-episode group (F = 1.18, P < 0.001) and the recurrence group (F = 0.83, P < 0.001) were significantly higher than in the control group, and there was no significant difference between the first-episode group and the recurrence group (F = 1.65, P = 0.61). Serum IL-1ß was negatively correlated with the general psychopathological score (GPS) of PANSS (R=-0.353, P = 0.026). In the recurrence group, serum IL-16 was positively correlated with the negative score (NEG) of the PANSS scale (R = 0.335, P = 0.035) and negatively correlated with the composite score (COM) (R=-0.329, P = 0.038). In the study, IL-16 levels were an independent variable of the onset of schizophrenia both in the first-episode (OR = 1.034, P = 0.002) and recurrence groups (OR = 1.049, P = 0.003). ROC curve analysis showed that the areas under IL-16(FEG) and IL-16(REG) curves were 0.883 (95%CI:0.794-0.942) and 0.887 (95%CI:0.801-0.950). CONCLUSIONS: Serum IL-1ß and IL-16 levels were different between patients with schizophrenia and healthy people. Serum IL-1ß levels in first-episode schizophrenia and serum IL-16 levels in relapsing schizophrenia were correlated with the parts of psychiatric symptoms. The IL-16 level may be an independent factor associating with the onset of schizophrenia.

O inventário de envolvimento paterno revisado: inclusão de pais com filhos pré-escolares / The inventory of father involvement revised: inclusion of fathers with preschool children / El inventario de envolvimiento paterno revisado: inclusión de padres de preescolares

Apesar da importância do envolvimento paterno, sua avaliação persiste desafiadora. No Brasil, o Inventário de Envolvimento Paterno (IFI-BR) vem se mostrando adequado para uso com pais de crianças de 5 a 10 anos. Entretanto, do ponto de vista do desenvolvimento infantil e de intervenções preventivas, seria importante avaliar o envolvimento paterno quando as crianças são mais novas. Assim, este trabalho teve como objetivos: identificar limitações do IFI-BR, quando usado com pais de crianças entre 2 e 10 anos, e avaliar itens para o IFI-BR-revisado. No Estudo 1, 434 pais com filhos no Ensino Infantil ou Fundamental 1 responderam a um questionário sociodemográfico e ao IFI-BR. Com base em análises de dados omissos, estrutura interna e precisão, modificações foram sugeridas, visando à manutenção da estrutura interna original do instrumento. No Estudo 2, 572 pais com filhos na mesma faixa etária responderam a um questionário sociodemográfico e à versão modificada do IFI-BR. Foram comparadas as frequências de dados omissos e estimativas de precisão para os itens originais e modificados, selecionando aqueles que melhor representavam essa amostra de pais para compor a versão revisada do IFI-BR. Esses resultados indicaram evidências adequadas de validade, com base no conteúdo da versão revisada do IFI-BR, quando utilizada para avaliar a qualidade do envolvimento paterno de pais brasileiros com filhos do Ensino Infantil ao Fundamental 1. Após verificadas evidências de validade adicionais, essa versão revisada do IFI-BR poderá ser utilizada, por exemplo, em estudos longitudinais e na avaliação de intervenções precoces com pais.(AU)

Despite the importance assigned to father involvement, evaluating this construct remains a challenge. In Brazil, the Inventário de Envolvimento Paterno (IFI-BR) has showed satisfactory evidence of validity for fathers of children between 5 and 10 years old. From the perspective of child development and preventive interventions, however, evaluating father involvement with younger children is essential. Hence, this study sought to: identify limitations of the IFI-BR for fathers of children between 2 and 10 years old, and evaluate items for a revised IFI-BR. In Study 1, 434 fathers of children in early childhood and primary school settings answered a sociodemographic questionnaire and the IFI-BR. Based on analyses of missing data, internal structure, and reliability, modifications were suggested to maintain the original internal structure. In Study 2, 572 fathers of children in the same age range answered a sociodemographic questionnaire and the modified IFI-BR. After comparison between values for missing data and reliability of the original and modified items, the items that best represented the broader sample of fathers were selected to compose the revised IFI-BR. Results indicated adequate evidence of content validity for the revised IFI-BR when used to assess the involvement of Brazilian fathers with children in early childhood education and primary school settings. After additional evidence has been verified, this revised IFI-BR can be used, for example, in longitudinal studies and to evaluate early interventions with fathers.(AU)

La participación paterna es importante, pero su evaluación sigue siendo desafiadora. En Brasil, el Inventário de Envolvimento Paterno (IFI-BR) demuestra ser adecuado para aplicar a padres de niños de 5 a 10 años de edad. No obstante, desde la perspectiva del desarrollo infantil y de las intervenciones preventivas, sería importante evaluar la participación de los padres de niños más jóvenes. Este estudio tuvo como objetivos: identificar limitaciones del IFI-BR cuando se aplica a padres de niños entre los 2 y 10 años y evaluar ítems para el IFI-BR-revisado. En Estudio 1, 434 padres con hijos en el jardín de infantes o escuela primaria respondieron un cuestionario sociodemográfico y el IFI-BR. Con base en el análisis de datos faltantes, estructura interna y exactitud, se sugirieron modificaciones para mantener la estructura interna original del instrumento. En Estudio 2, 572 padres respondieron un cuestionario sociodemográfico y la versión modificada del IFI-BR. Se compararon las frecuencias de datos faltantes y estimaciones de exactitud para los ítems originales y modificados, seleccionando aquellos que representaban mejor a esta muestra de padres para la versión revisada del IFI-BR. Estos resultados indicaron evidencia adecuada de validez, basada en el contenido de la versión revisada del IFI-BR, cuando se utilizó para evaluar la calidad de la participación de padres brasileños con niños en el jardín de infantes y en la escuela primaria. Después de verificada la evidencia adicional de validez, la versión revisada del IFI-BR se puede utilizar, por ejemplo, en estudios longitudinales y en la evaluación de intervenciones precoz con los padres.(AU)

Sistema de avaliação de testes psicológicos: histórias contadas e não contadas / Psychological test evaluation system: stories told and untold / Sistema de evaluación de tests psicológicos: historias contadas y no contadas

O Sistema de Avaliação de Testes Psicológicos (SATEPSI) recebeu notoriedade entre brasileiros e estrangeiros por oferecer um complexo sistema de qualificação dos testes psicológicos, pouco visto em âmbito mundial. Sua elaboração dependeu de uma autarquia, que o financiou, normatizou e o mantém, mas também de pesquisadores docentes de avaliação psicológica, que trouxeram a expertise da área para que houvesse o pleno estabelecimento de seus parâmetros. Passadas duas décadas de seu lançamento, o SATEPSI foi tema de artigos, capítulos, lives e diálogos digitais, nos quais foram destaque, de modo geral, as Resoluções do Conselho Federal de Psicologia, que o normatiza, e seus impactos para a área de avaliação psicológica - como, por exemplo, o aumento do número de pesquisas e de testes brasileiros qualificados. O que se pretende neste artigo é mencionar sua construção, à luz dos autores que vivenciaram o SATEPSI em funções e tempos distintos. Atenção especial será dada aos Métodos Projetivos, cuja história ainda é pouco revelada.(AU)

The system to evaluate psychological tests (Satepsi) received notoriety among Brazilians and foreigners for offering a complex system of qualification of psychological tests, which is rarely seen worldwide. Its development depended on an autarchy (which financed, standardized, and maintains it) and on researchers teaching psychological assessment, who brought their expertise to the area so its parameters could be fully established. After two decades of its launch, Satepsi was the subject of articles, chapters, lives, and digital dialogues, which usually highlighted the Resolutions of the Federal Council of Psychology that normatize psychological evaluation and their impacts, such as the increase in the number of qualified Brazilian tests. This study aims to mention its construction in the light of the authors who experienced Satepsi in different functions and times, giving special attention to Projective Methods, whose history remains to be shown.(AU)

El Sistema de Evaluación de Tests Psicológicos (SATEPSI) ganó notoriedad entre los brasileños y los extranjeros por ofrecer un complejo sistema de calificación de los tests psicológicos, poco frecuente a nivel mundial. Su elaboración dependió de una autarquía, que lo financió, lo estandarizó y lo mantiene, pero también de investigadores docentes de evaluación psicológica, que trajeron la experiencia del área para que hubiera el pleno establecimiento de sus parámetros. Tras dos décadas de su lanzamiento, SATEPSI fue tema de artículos, capítulos, en directo y diálogos digitales, en los cuales destacaron, de modo general, las Resoluciones del Consejo Federal de Psicología que lo normatiza y sus impactos para el área de evaluación psicológica, como el aumento del número de investigaciones y de pruebas brasileñas calificadas. Lo que se pretende en este artículo es mencionar su construcción, a la luz de los autores que vivieron el SATEPSI en funciones y tiempos distintos. Se prestará especial atención a los métodos proyectivos cuya historia aún no se ha revelado.(AU)

Do teste ao processo de avaliação psicológica: memórias sobre a formação do psicólogo no Brasil / From test to process in psychological assessment: memories on psychology training in Brazil / Del test al proceso de evaluación psicológica: memorias sobre la formación del psicólogo en Brasil

A temática da formação do psicólogo no Brasil no campo da avaliação psicológica ocupa importante lugar na literatura científica da área, com enfoques e levantamentos diversos. Este trabalho procura agregar conhecimento ao campo por meio de reflexão teórica e vivencial sobre diretrizes formativas em avaliação psicológica, acompanhando a construção da própria Psicologia no país. Recorreu-se a um levantamento de informações disponíveis em periódicos, anais de eventos científicos e em sites de associações científicas de Psicologia, selecionando produções qualitativamente relevantes para retratar uma perspectiva longitudinal sobre a formação em processos de avaliação psicológica, acrescentando vivências e memórias construídas ao longo de várias décadas de atuação na área. Procurou-se caracterizar algumas ações implementadas no campo desde a regulamentação da profissão até os desafios contemporâneos, enfatizando contribuições significativas de diferentes pesquisadores e grupos de investigação científica no país. O principal destaque deste trabalho está em evidenciar que a área de avaliação psicológica se movimentou no sentido de alterar sua atenção sobre os instrumentais (testes e materiais psicológicos) para os processos psicológicos envolvidos nessa prática profissional exclusiva da Psicologia no Brasil. Finaliza-se o trabalho com novos desafios impostos para essa especialidade profissional na contemporaneidade.(AU)

Professional training occupies an important place in the field of psychological assessment, appearing in the scientific literature under various approaches and surveys. This study seeks to add knowledge to this topic by means of a theoretical and experiential reflection on education guidelines, following the constitution of Psychology itself in Brazil. A bibliographical survey was carried out on journals, annals of scientific events and websites of Psychology scientific associations, selecting relevant academic productions to portrayal longitudinal perspective on training in psychological assessment, adding experiences and memories built over several decades of work. The text characterizes some actions implemented in Psychology, from its regulation to contemporary challenges, emphasizing significant contributions from different researchers and research groups in the country. Its main highlight is in revealing that psychological assessment changed its focus from instruments (psychological tests and materials) towards psychological processes involved in this professional practice that are exclusive to Brazilian Psychology. In conclusion, the paper points to contemporary new challenges imposed to this profession.(AU)

La formación de psicólogos en Brasil en el campo de la evaluación psicológica es un tema que ocupa un lugar destacado en la literatura científica del área, con diferentes enfoques y planteamientos. Este trabajo pretende contribuir con la reflexión teórica y experiencial sobre los planteamientos de formación en evaluación psicológica, siguiendo la construcción de la propia Psicología en el país. Se recogió la información disponible en revistas, anales de eventos científicos y en las páginas web de asociaciones científicas de Psicología, seleccionando las producciones cualitativamente relevantes para caracterizar una perspectiva longitudinal sobre la formación en procesos de evaluación psicológica, sumándose a experiencias y memorias construidas a lo largo de décadas de experiencia en el campo. Se buscó caracterizar algunas acciones puestas en marcha en el campo desde la regulación de la profesión hasta los desafíos contemporáneos, destacando los aportes significativos de diferentes investigadores y grupos de investigación científica del país. El principal destaque de este trabajo es mostrar que el área de evaluación psicológica pasó a trasladar su atención de las herramientas (tests y materiales psicológicos) a los procesos psicológicos involucrados en esta práctica profesional exclusiva de la Psicología en Brasil. Se finaliza con los nuevos retos impuestos para esta especialidad profesional en la contemporaneidad.(AU)

Ensaio sobre a psicologia jurídica: uso e consequências sociais do PCL-R / Essay on legal psychology: use and social consequences of the PCL-R / Ensayo sobre psicología jurídica: uso y consecuencias sociales de la PCL-R

Este trabalho tem por objetivo problematizar o agenciamento entre a psicologia e o aparelho judiciário. Para tanto, tomamos a escala Psychopathy Checklist Revised (PCL-R) - criada por Robert Hare para avaliar e mensurar a psicopatia - como um acontecimento analisador. Realizamos uma pesquisa de natureza qualitativa que fez uso da pesquisa bibliográfica e documental como estratégias metodológicas. Os dados produzidos foram analisados à luz das obras de Foucault e de autores da criminologia crítica. Pensamos a psicologia e o aparelho judiciário como marcados por lógicas normativas que produzem práticas de controle sobre os modos de existir. Por este viés, ao se agenciar com dispositivos do sistema penal, determinadas práticas psi podem instrumentalizar os artefatos de controle e repressão. Em nosso percurso de pesquisa, realizamos uma revisão de literatura da produção acadêmica brasileira relativa à utilização da escala no país (2005-2018). Partindo da análise das publicações encontradas constatou-se que a maioria das pesquisas enfatizam as propriedades psicométricas da escala e reforçam a sua eficácia em predizer a reincidência criminal. Ademais, verificou-se que as publicações levantadas não analisam as implicações ético-políticas da aplicação da escala na execução penal, assim como não consideram a instituição prisional como produtora e mantenedora da delinquência. Por fim, questionamos se a escala PCL-R seria utilizada como mais um dispositivo de controle e gestão da vida das populações que são alvo do sistema penal brasileiro.(AU)

This essay aims to problematize the agency between Psychology and the court system. For this purpose, we take the Psychopathy Checklist Revised scale (PCL-R ) - created by Robert Hare to assess and measure psychopathy - as an analyzer event. We conducted a qualitative research that used bibliographic and documentary research as methodological strategies. The data produced were analyzed considering the works of Foucault and authors of critical criminology. We think psychology and the judiciary as marked by normative logics that produce control practices over the ways of existence. By this perspective, when used with devices of the penal system, certain psychological practices instrumentalize the artifacts of control and repression. In our research course, we conducted a literature review of the Brazilian academic production related to use of the scale in the country (2005-2018). Based on the analysis of the publications found, most studies emphasize the psychometric properties of the scale and reinforce its alleged effectiveness in predicting criminal recidivism. Moreover, we verified that the publications do not analyze the ethical-political implications that applying the scale produces in criminal execution, and disregards the prison institution as a producer of delinquency. Finally, we questioned if the PCL-R scale was used more as a device for controlling and administering the lives of populations that are targets of the prison system.(AU)

Este trabajo tiene como objetivo problematizar la agencia entre la psicología y el poder judicial. Para eso, tomamos la Escala Psychopathy Checklist Revised (PCL-R), creada por Robert Hare para evaluar y medir la psicopatía, como un "evento analítico". Realizamos una investigación cualitativa que hizo uso de la investigación bibliográfica y documental como estrategias metodológicas. Los datos producidos se analizaron a raíz de los trabajos de Foucault y autores de criminología crítica. Pensamos en la psicología y en el poder judicial como marcados por lógicas normativas que producen prácticas de control sobre las formas de existir. Debido a este sesgo, cuando se trata con dispositivos del sistema penal, ciertas prácticas "psi" instrumentalizan los artefactos de control y represión. En nuestro camino de investigación, realizamos una revisión de la literatura de la producción académica brasileña con respecto al uso de la escala en el país (2005-2018). Según el análisis de las publicaciones encontradas, se descubrió que la mayoría de los estudios enfatizan las propiedades psicométricas de la Escala y refuerzan su efectividad para predecir la recurrencia criminal. Además, se encontró que las publicaciones planteadas no analizaron las implicaciones ético-políticas que la aplicación de la Escala produce en la ejecución criminal, ni consideraron a la institución penitenciaria como productora y mantenedora de la delincuencia. Finalmente, nos preguntamos si la Escala PCL-R se usaría como otro dispositivo para controlar y administrar las vidas de las poblaciones que son objetivo del sistema penal brasileño.(AU)

Caregiving for a Spouse with Cognitive Impairment: Effects on Nutrition and Other Lifestyle Factors.

BACKGROUND: Being a spousal caregiver (SCG) for a patient with cognitive impairment is well known to be associated with increased risk for dementia and cognitive decline. OBJECTIVE: This study examined the impact of the care-recipient's cognitive status on lifestyle factors influencing cognitive decline in SCGs, focusing on nutritional status and blood biomarkers. METHODS: Fifty-one SCGs participated (mean age 73.5±7.0 years) in this study. All participants underwent clinical assessment including the Mini Nutritional Assessment (MNA), Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and International Physical Activity Questionnaire to evaluate lifestyle factors, and the Mini-Mental State Examination to assess global cognition. Also, nutritional blood biomarkers were measured. RESULTS: SCGs caring for a demented spouse showed significantly higher depression scores (t = -3.608, p = 0.001) and malnutrition risk (t = 2.894, p = 0.006) compared to those caring for a non-demented spouse. Decreased care recipients' cognition was significantly correlated with higher GDS (ß= -0.593, t = -4.471, p < 0.001) and higher MNA scores (ß= 0.315, t = 2.225, p = 0.031) and lower level of high-density lipoprotein (HDL) cholesterol (ß= 0.383, t = 2.613, p = 0.012) in their SCGs. Gender had moderating effects on association of care-recipients' cognition with sleep quality (B[SE] = 0.400[0.189], p = 0.041) and HDL cholesterol (B[SE] = -1.137[0.500], p = 0.028) among SCGs. Poorer care-recipient's cognition was associated with worse sleep quality and low HDL cholesterol among wives but not husband caregivers. CONCLUSION: This study provides substantial evidence that SCGs are at risk for depression and malnutrition, which can further affect cognitive decline. As such, these factors should be well assessed and monitored among SCGs for patient with cognitive impairment.

Pseudodelirium: Psychiatric Conditions to Consider on the Differential for Delirium.

OBJECTIVE: The phenotypes of several psychiatric conditions can very closely resemble delirium; the authors describe such presentations as pseudodelirium. However, because the clinical management of these conditions differs markedly from that of delirium, prompt differentiation is essential. The authors provide an educational review to assist clinicians in identifying and managing psychiatric conditions that may be especially challenging to differentiate from delirium. METHODS: Based on clinical experience, the authors identified four psychiatric conditions as among the most difficult to differentiate from delirium: disorganized psychosis, Ganser syndrome, delirious mania, and catatonia. An overview of each condition, description of clinical features, differentiation of specific phenotypes from delirium, and review of clinical management are also provided. RESULTS: The thought and behavioral disorganization in disorganized psychosis can be mistaken for the clouded sensorium and behavioral dysregulation encountered in delirium. The fluctuating alertness and apparent confusion in Ganser syndrome resemble delirium's altered arousal and cognitive features. As its name suggests, delirious mania presents as a mixture of hyperactive delirium and mania; additional features may include psychosis, autonomic activation, and catatonia. Both delirium and catatonia have hypokinetic and hyperkinetic variants, and the two syndromes can also co-occur. CONCLUSIONS: The clinical presentations of several psychiatric conditions can blend with the phenotype of delirium, at times even co-occurring with it. Detailed evaluation is often required to differentiate such instances of pseudodelirium from delirium proper.

Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study.

BACKGROUND: Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage. METHODS: In this longitudinal, population-based study, surveys were administered to a nationwide sample of 13-18-year-olds in Iceland in October or February in 2016 and 2018, and in October, 2020 (during the COVID-19 pandemic). The surveys assessed depressive symptoms with the Symptom Checklist-90, mental wellbeing with the Short Warwick Edinburgh Mental Wellbeing Scale, and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Demographic data were collected, which included language spoken at home although not ethnicity data. We used mixed effects models to study the effect of gender, age, and survey year on trends in mental health outcomes. FINDINGS: 59 701 survey responses were included; response rates ranged from 63% to 86%. An increase in depressive symptoms (ß 0·57, 95% CI 0·53 to 0·60) and worsened mental wellbeing (ß -0·46, 95% CI -0·49 to -0·42) were observed across all age groups during the pandemic compared with same-aged peers before COVID-19. These outcomes were significantly worse in adolescent girls compared with boys (ß 4·16, 95% CI 4·05 to 4·28, and ß -1·13, 95% CI -1·23 to -1·03, respectively). Cigarette smoking (OR 2·61, 95% CI 2·59 to 2·66), e-cigarette use (OR 2·61, 95% CI 2·59 to 2·64), and alcohol intoxication (OR 2·59, 95% CI 2·56 to 2·64) declined among 15-18-year-olds during COVID-19, with no similar gender differences. INTERPRETATION: Our results suggest that COVID-19 has significantly impaired adolescent mental health. However, the decrease observed in substance use during the pandemic might be an unintended benefit of isolation, and might serve as a protective factor against future substance use disorders and dependence. Population-level prevention efforts, especially for girls, are warranted. FUNDING: Icelandic Research Fund. TRANSLATION: For the Icelandic translation of the abstract see Supplementary Materials section.

Association of Aripiprazole With Reduced Hippocampal Atrophy During Maintenance Treatment of First-Episode Schizophrenia.

PURPOSE/BACKGROUND: Hippocampal volume loss in early schizophrenia has been linked with markers of inflammation and oxidative stress, and with less response of negative symptoms. Aripiprazole has been reported to preserve hippocampal volume and to reduce inflammation. METHODS/PROCEDURES: Study 1 was a 12-month multicenter randomized placebo-controlled trial of citalopram added to clinician-determined second-generation antipsychotic medication in 95 patients with first-episode schizophrenia (FES), 19 of whom received aripiprazole. We compared participants taking aripiprazole with those on other antipsychotics to determine whether those on aripiprazole had less hippocampal volume loss. We also examined peripheral biomarker data from medication-naive patients with schizophrenia receiving 8 weeks of antipsychotic treatment (n = 24) to see whether markers of inflammation and oxidative stress that previously predicted hippocampal volume differed between aripiprazole (n = 9) and other antipsychotics (study 2). FINDINGS/RESULTS: Aripiprazole was associated with a mean increase in hippocampal volume of 0.35% (SD, 0.80%) compared with a 0.53% decrease (SD, 1.2%) with other antipsychotics during the first year of maintenance treatment in patients with FES. This difference was significant after adjusting for age, sex, citalopram treatment, and baseline Brief Psychiatric Rating Scale score (B = 0.0079, P = 0.03). Aripiprazole was also associated with reduced concentrations of the inflammatory cytokines interleukin-8 and tumor necrosis factor (P < 0.01) during the first 8 weeks of treatment in medication-naive patients with FES. IMPLICATIONS/CONCLUSIONS: These results suggest that aripiprazole may protect against hippocampal atrophy via an anti-inflammatory mechanism, but these results require replication in larger, randomized trials, and the clinical relevance of hippocampal volume loss is not established.

Recommendations of the schizophrenia expert center network for the screening prevention and treatment of sleep disorders based on the results from the real-world schizophrenia FACE-SZ national cohort.

BACKGROUND: Sleep disorders associated factors are under explored in schizophrenia while the literature suggests high and heterogeneous frequency. AIMS: The objective of the present study was to determine the prevalence and risk factors of sleep disorders in the real-world FACE-SZ national cohort. METHOD: Stabilized schizophrenic outpatients were recruited in 10 expert centers for schizophrenia. Sleep quality was explored with the Pittsburgh Sleep Quality Index (PSQI) and sleep disorders was defined by a PSQI score > 5. Psychosis severity was measured with the Positive and Negative Syndrome Scale, current major depressive episode with the Calgary Depression Scale for Schizophrenia, verbal aggressiveness with the Buss-Perry Aggression Questionnaire, adherence to treatment with the Medication Adherence Rating Scale, akathisia with the Barnes Akathisia Scale. Current somatic comorbidities and body mass index were reported. Variables with P values <0.20 in univariate analysis were included in a multivariate regression model. RESULTS: Of the 562 included patients, 327 subjects (58.2%, IC95% [54.1% - 62.3%]) reported having sleep disorders. After adjustment, sleep disorders were significantly associated with migraine (adjusted odds ratio aOR = 2.23, p = 0.041), major depressive disorder (aOR 1.79, p = 0.030), poor adherence to treatment (aOR = 0.87, p = 0.006), akathisia (aOR = 1.29, p = 0.042) and verbal aggressiveness (aOR = 1.09, p = 0.002). CONCLUSIONS: More than one on two stabilized real-life outpatients with schizophrenia have been identified with sleep disorders. Combined with the literature data, we have yielded expert recommendations for the treatment and prevention of sleep disorders including treating undiagnosed comorbid depression and migraine and managing antipsychotic treatment to improve adherence and akathisia.

The montreal cognitive assessment and mini-mental state examination visuoexecutive subtests in acute ischemic stroke patients and their correlations with demographic and clinical factors.

Visuoexecutive impairment is common among acute ischemic stroke patients. This study aimed to examine the ability of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) visuoexecutive subtests to detect visuoexecutive abnormality in acute ischemic stroke patients and to identify the predictors for their impairments. 336 patients who completed the MMSE and MoCA were enrolled in this study. We compared the proportion of participants with incorrect MoCA visuoexecutive tasks and MMSE pentagon copying. Multivariate logistic regression analysis was used to evaluate the associations between the visuoexecutive dysfunction and demographic and clinical characteristics in the samples. Among all the participants, the MoCA detected more visuoexecutive dysfunction than the MMSE (88.69% vs. 45.83%, respectively; p < 0.001). The predictors identified by the univariate analysis included the factors of gender, age, educational level, smoking, alcohol consumption, Oxfordshire Community Stroke Project (OCSP), previous strokes, initial NIHSS score and number of old lacunar infarctions, while from the multivariate logistic regression analysis, the factors of age, educational level, NIHSS score, previous strokes and number of old lacunar infarctions served as predictive factors for the visuoexecutive impairment in acute stroke patients. In conclusion, visuoexecutive impairment is associated with the factors of the educational level, stroke severity, stroke history and number of old lacunar infarctions. Our findings may guide the clinicians to intervene the risks for the patients at an early stage after stroke and form the basis for good rehabilitation plans.

Estudos documentais sobre alienação parental: uma revisão sistemática / Documentary studies on parental alienation: a systematic review / Estudios documentales sobre alienación parental: una revisión sistemática

A Alienação Parental (AP) é uma modalidade de violência psicológica que pode ser identificada no contexto das disputas de pais pela guarda de crianças em tribunais de justiça, espaço que constitui uma rica fonte de dados para pesquisa. Com o objetivo de analisar a produção científica nacional e internacional sobre AP composta por estudos com amostras documentais judiciais, este estudo realizou uma revisão sistemática utilizando o protocolo PRISMA. A palavra-chave "parental alienation" e sua respectiva tradução para o português, "alienação parental", foram pesquisadas nas bases de dados Scopus, PsycNET, PubMed e Scielo. Foi consultado também o acervo de livros do Laboratório de Análise e Prevenção da Violência (Laprev/UFSCar). Das bases de dados pesquisadas foram selecionados cinco artigos, três brasileiros, um canadense e um italiano. Do acervo do laboratório, foi selecionado um livro brasileiro. Nos artigos selecionados, nota-se que a maioria das sentenças judiciais corroborava as conclusões dos documentos psicológicos. No entanto, as análises dos relatórios psicológicos realizadas pelos estudos brasileiros e italiano identificaram uma preocupante deficiência na avaliação psicológica de suspeitas de AP, com destaque para posturas enviesadas, inadequação das normas e da estrutura dos relatórios, avaliações psicológicas mal planejadas e fraco embasamento teórico. Essas constatações apontam urgente necessidade de desenvolvimento de estratégias de aprimoramento da avaliação psicológica, a fim de fortalecer a proteção e a garantia de direitos de crianças e adolescentes envolvidos em situações de litígio conjugal.(AU)

Parental Alienation (PA) is a modality of psychological violence identifiable in the context of child custody disputes in courts of law - institution that provides a rich source of research data. To analyze the national and international literature on PA of studies conducted with court documents, this study consists of a systematic review, performed according to the PRISMA guidelines, on the Scopus, PsycNET, PubMed, and Scielo databases, as well as in the library of the Laboratory of Analysis and Prevention of Violence (LAPREV/UFSCar), for articles including the keyword "parental alienation" and its respective Portuguese translation. The search provided six samples: five articles selected from the databases (three Brazilian, one Canadian, and one Italian) and a Brazilian book from the lab collection. Most judicial sentences analyzed in the selected studies corroborate the psychological reports conclusions. However, the psychological evaluation of alleged PA cases of Brazilian and Italian reports showed concerning deficiencies, with emphasis on biased opinions, lack of adequate standards, poorly planned assessments, and questionable theoretical background. These findings stress the urgent need to develop strategies for improving psychological assessments to strengthen the protection and guaranteeing the rights of children involved in marital litigation.(AU)

La alienación parental (AP) consiste en una violencia psicológica que ejerce uno de los progenitores por la custodia de los hijos en el contexto de disputas judiciales, donde hay una rica fuente de datos de investigación. Con el fin de analizar la producción científica nacional e internacional sobre AP a partir de estudios documentales judiciales, este estudio realizó una revisión sistemática siguiendo el protocolo PRISMA. La palabra clave "parental alienation" y su correspondiente traducción al portugués "alienação parental" norteó las búsquedas en las bases de datos Scopus, PsycNET, PubMed y SciELO. Se consultó también la colección en el Laboratório de Análise e Prevenção da Violência (LAPREV/UFSCar). Las búsquedas dieron como resultado cinco artículos: tres brasileños, uno canadiense y uno italiano. De la colección del laboratorio se seleccionó un libro brasileño. Se observó en los artículos seleccionados que la mayoría de las sentencias judiciales analizadas corroboraron las conclusiones de los informes psicológicos. Sin embargo, el análisis de los documentos psicológicos realizados por los estudios brasileños e italiano identificó una preocupante deficiencia en la evaluación psicológica de sospechosas de AP, destacándose las posturas sesgadas, la inadecuación entre las normas y la estructura de los informes psicológicos, y las evaluaciones psicológicas mal planificadas y con débil fundamentación teórica. Tales constataciones apuntan que hay una necesidad urgente de desarrollar estrategias que mejoran la evaluación psicológica a fin de fortalecer la protección y la garantía de los derechos de los niños y adolescentes involucrados en situaciones de litigio familiar.(AU)

Escalas de aculturación para minorias étnicas: una revisión de literatura / Scales of acculturation for ethnic minorities: a literature review

La aculturación proceso multidimensional que afecta a grupos étnicos que se enfrentan a una cultura distinta a la originaria, ha sido estudiada en su relación con la salud, encontrándose inconsistencia en diversos estudios, pudiendo deberse a los distintos instrumentos utilizados para medir este proceso. El objetivo de esta revisión de literatura es analizar las características y propiedades psicométricas de los instrumentos que miden la aculturaciónen minorías étnicas en ciertos procesos de salud. Revisión bibliográfica narrativa, cuyo propósito fue revisar investigaciones relacionadas a la medición de aculturación asociada a la salud en grupos étnicos, en las bases de datos de CINAHAL y PubMed, seleccionándolos de acuerdo al cumplimiento de criterios de inclusión y exclusión en los últimos 10 años. Son 13 los instrumentos de aculturación encontrados en la revisión, respecto a las características de los instrumentos de aculturación el 77% de ellos tiene un enfoque bidimensional, la medición del lenguaje y/o idioma es el dominio más utilizado,el 38% de estos instrumentospresentan un nivel de fiabilidad sobre lo aceptable (0,7). Las dimensiones consideradas en los instrumentos de aculturación son distintas entre un instrumento y otro, o no consideran todas las dimensiones involucradas en el proceso de aculturación. La fiabilidad y validez no es conocida en todos los instrumentos de aculturación utilizados pudiendo afectar la correcta comprensión e interpretación de los resultados obtenidos en estudio realizados en grupo étnicos.

The multidimensional acculturation process that affects ethnic groups that face a culture different from their original has been studied in their relationship with health, finding inconsistency in various studies. These inconsistencies may be due to the different instruments used to measure this process. The objective of this literature review is to analyze the characteristics and psychometric properties of the instruments that measure acculturation in ethnic minorities in particular health processes. Narrative bibliographic review, whose purpose was to review research related to the measurement of acculturation associated with health in ethnic groups, in the CINAHAL and PubMed databases, selecting them according to compliance with inclusion and exclusion criteria in the last 10 years. There are 13 acculturation instruments found in the review, regarding the characteristics of acculturation instruments 77% of them have a two-dimensional approach, the measurement of language or dialect is the most used domain, 38% of these instruments have a level of reliability over the acceptable (0.7). Acculturation instruments do not consider all the dimensions involved in the acculturation process, being also different between one instrument and another. Reliability and validity are not known in all acculturation instruments used and may affect the correct understanding and interpretation of the results obtained in ethnic group studies

Cognitive state, substance use patterns and outcome after discharge from Kfar Izun, a unique rehabilitation facility.

We studied cognitive performance following discharge from a novel rehabilitation facility, treating individuals with psychosis that developed during trips abroad following mandatory military service. Montreal Cognitive Assessment (MoCA), phonetic and semantic fluency, State-Trait Anxiety, and self-Efficiency were administered before discharge, and 3 and 6 months after discharge. Of the 43 participants (30.2% females), 23(54.8%) had cognitive impairment (MoCA <27), and 15(35.7%) had poor phonetic fluency. Anxiety trait and state were high and inversely correlated with self-efficacy (R=-0.48, p = 0.001) and phonetic fluency (R=-0.43, p = 0.004) and was higher among those who experienced physical exposure, females, and those who served in non-combat army units. Six months after discharge, of 32 participants, 28 were working/studying with a 58.1% reduction in smoking and alcohol consumption, and 16 participants stopped substance use. Phonetic fluency improved among the high anxiety state group with no change among the others. High anxiety levels lowered among those who were still using drugs after six months. The anxiety level lowered and 87.1% of the participants were conducting a productive lifestyle at 6 months after discharge, but half still abused cannabis. Bigger sample and longer follow up would be needed to learn more about the impact of rehabilitation.

The International Collaboration on ADHD and Substance Abuse (ICASA): Mission, Results, and Future Activities.

BACKGROUND: The International Collaboration on ADHD and Substance Abuse (ICASA) is a network of 28 centers from 16 countries initiated to investigate the link between attention deficit-hyperactivity disorder (ADHD) and substance use disorder (SUD). In this article, we present the mission, the results of finished studies, and the current and future research projects of ICASA. METHODS: During the past 10 years, 3 cross-sectional studies were conducted: two International ADHD in Substance use disorders Prevalence (IASP-1 and IASP-2) studies, directed at the screening, diagnosis, and the prevalence of adult ADHD in treatment-seeking patients with SUD, and the Continuous performance test for ADHD in SUD Patients (CASP) study, testing a novel continuous performance test in SUD patients with and without adult ADHD. Recently, the prospective International Naturalistic Cohort Study of ADHD and Substance Use Disorders (INCAS) was initiated, directed at treatment provision and treatment outcome in SUD patients with adult ADHD. RESULTS: The IASP studies have shown that approximately 1 in 6 adult treatment-seeking SUD patients also have ADHD. In addition, those SUD patients with adult ADHD compared to SUD patients without ADHD report more childhood trauma exposure, slower infant development, greater problems controlling their temperament, and lower educational attainment. Comorbid patients also reported more risk-taking behavior, and a higher rate of other psychiatric disorders compared to SUD patients without ADHD. Screening, diagnosis, and treatment of this patient group are possible even before abstinence has been achieved. The results of the CASP study are reported separately in this special issue. CONCLUSIONS: The ICASA research to date has demonstrated a high prevalence of comorbid ADHD and SUD, associated with elevated rates of additional comorbidities and risk factors for adverse outcomes. More research is needed to find the best way to treat these patients, which is the main topic of the ongoing INCAS study.

Perfil dos psicólogos brasileiros que utilizam testes psicológicos: áreas e instrumentos utilizados / Profile of brazilian psychologists using psychological tests: areas and instruments used / Perfil de los psicólogos brasileños que utilizan pruebas psicológicas: áreas e instrumentos utilizados

Resumo O artigo teve como objetivo apresentar um levantamento sobre o perfil dos psicólogos brasileiros que utilizam testes psicológicos no que tange a sua(s) área(s) de atuação, ao uso que fazem dos instrumentos psicológicos em suas práticas e aos testes que utilizam com maior frequência no exercício profissional. Participaram do estudo 668 psicólogos, que exerciam a profissão, em média, a 14,06 anos (DP = 11,34). Os dados foram coletados em plataforma on-line, por meio de questionário que está sendo utilizado em vários países da América do Sul, divulgado a todos os psicólogos brasileiros com apoio de órgãos da classe. Os resultados obtidos evidenciaram que a Psicologia Clínica e da Saúde são as áreas mais prevalentes de atuação principal dos psicólogos brasileiros. Testes psicológicos são utilizados principalmente para fins psicodiagnósticos. Os grupos etários mais frequentemente cobertos pelas avaliações realizadas são adultos. Os testes psicológicos mais utilizados são destinados a avaliação de personalidade ou inteligência. A lista inclui Teste Palográfico, HTP, Rorschach, Bateria Fatorial de Personalidade e as Escalas Wechsler de Inteligência. Os testes projetivos/expressivos ou gráficos são os mais usuais para avaliação da personalidade. A maioria das respostas obtidas na análise dos cinco testes mais utilizados refere-se a algum teste considerado favorável para uso pelo Satepsi. Destaca-se a extensão da lista dos testes citados, o que indica que os psicólogos estão atentos aos novos instrumentos e às opções de que dispõem para qualificar as avaliações realizadas. Contudo, é grande o número de instrumentos utilizados que não têm avaliação certificada de suas propriedades técnicas.

Abstract This article presents a survey on the profile of Brazilian psychologists who use psychological tests regarding their area(s) of action, their use of psychological instruments in their practices and the tests they use more frequently in their professional practice. A total of 668 psychologists who practiced the profession participated in this study, having average 14.06 years (SD = 11.34). The data were collected with use of an online platform via a questionnaire that is being used in several countries of South America divulged to all Brazilian psychologists with the support of institutions related to the field. The results obtained evidenced that Clinical and Health Psychology are the most prevalent areas of action of Brazilian psychologists. Psychological tests are mainly used for psychodiagnostic purposes. The age groups most frequently covered by the assessments are adults. The most commonly used psychological tests serve for the evaluation of personality or intelligence. The list includes Palographic Test, HTP, Rorschach, Factorial Personality Battery and the Wechsler Intelligence Scales. Projective/expressive or graphical tests are the most common for personality assessment. Most of the answers obtained in the analysis of the five most used tests refer to some test considered favorable for use by Satepsi. It is worth noting the list of cited tests, which indicates that psychologists are attentive to new instruments and the options available to qualify the evaluations performed. However, there is a large number of instruments used that have no certified evaluation of their technical properties.

Resumen El artículo tuvo como objetivo presentar una encuesta sobre el perfil de los psicólogos brasileños que utilizan pruebas psicológicas en lo que se refiere a su/s área/s de actuación, al uso de los instrumentos psicológicos en sus prácticas y a las pruebas que utilizan con mayor frecuencia en el ejercicio profesional. Participaron en el estudio 668 psicólogos, que ejercían la profesión en un promedio de 14,06 años (DE = 11,34). Los datos fueron recopilados en la plataforma online por medio de un cuestionario que está siendo utilizado en varios países de América del Sur, divulgado a todos los psicólogos brasileños con apoyo de órganos profesionales. Los resultados obtenidos evidenciaron que la Psicología Clínica y de la Salud son las áreas más prevalentes de actuación principal de los psicólogos brasileños. Las pruebas psicológicas se utilizan principalmente para fines de psicodiagnóstico. Los grupos de edad más frecuentemente cubiertos por las evaluaciones realizadas son adultos. Las pruebas psicológicas más utilizadas se destinan a evaluar la personalidad o la inteligencia. La lista incluye Prueba Palográfica, HTP, Rorschach, Batería Factorial de Personalidad y las Escalas Wechsler de Inteligencia. Las pruebas proyectivas/expresivas o gráficas son las más usuales para evaluar la personalidad. La mayoría de las respuestas obtenidas en el análisis de las cinco pruebas más utilizadas se refieren a alguna prueba considerada favorable para su uso por Satepsi. Se destaca la extensión de la lista de las pruebas citadas, lo que indica que los psicólogos están atentos a los nuevos instrumentos y a las opciones de que disponen para calificar las evaluaciones realizadas. Sin embargo, hay un gran número de instrumentos utilizados que no tienen una evaluación certificada de sus propiedades técnicas.

The Use of Communication Technology to Affect Patient Outcomes in the Intensive Care Unit.

Effective two-way patient-provider communication is challenging and is even more difficult when patients are communication vulnerable. The results of being unheard and unacknowledged can contribute to negative feelings and may manifest as symptoms of anxiety and depression. Researchers explored symptoms of anxiety and depression when using a team-developed, patient-centered, and nurse-led intervention called Speak for Myself-Voice (formerly published as Speak for Myself) in five intensive care units at a Magnet status, university-affiliated medical center in East Tennessee. This was an equivalent control group design. The data were analyzed with a mixed-effect analysis of variance (between and within groups) with repeated measures to see if the treatment group changed differently than the control group across time (48 hours). This study report adds information about anxiety and depression in patients who are communication vulnerable and using communication technology.