الملخص
Objective: To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents. Method: The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior. Results: Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA). All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine) have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects. Conclusions: There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use.
Objetivo: Realizar uma revisão sistemática da literatura científica sobre o uso de antipsicóticos atípicos (APAs) no tratamento da agressividade patológica em crianças e adolescentes. Método: Foi realizada busca eletrônica nas bases de dados MEDLINE, SciELO e LILACS, de 1992 a agosto 2011, considerando artigos publicados em língua inglesa e portuguesa. Foram utilizadas associações das seguintes expressões: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behaviour, aggression e violent behavior. Resultados: Foram identificados 67 artigos de boa qualidade metodológica, de relevância e interesse clínico para o tema em foco. De modo geral, os estudos são relativamente limitados para esta faixa etária, resultado do fato de poucos APAs terem sido aprovados pela Food and Drug Administration (FDA). Dentre as medicações consideradas nesta revisão (risperidona, olanzapina, quetiapina, ziprazidona, aripiprazol e clozapina), todas elas podem ter alguma efetividade no tratamento da agressividade em crianças e adolescentes, ficando a escolha baseada na indicação clínica e perfil de efeitos colaterais. Conclusão: O número ainda limitado de estudos acerca da efetividade e segurança na população pediátrica demanda pesquisas futuras com grupos maiores de pacientes e com mais categorias diagnósticas (como, por exemplo, as formas graves de transtorno de conduta e transtorno desafiador de oposição), desenhadas de forma randomizada e controlada. Assim poderão ser confirmados os achados até o momento e o impacto do uso em longo prazo.
الموضوعات
Humans , Male , Female , Child , Adolescent , Antipsychotic Agents/pharmacology , Antipsychotic Agents/therapeutic use , Passive-Aggressive Personality Disorder/diagnosis , Passive-Aggressive Personality Disorder/pathology , Review Literature as Topic , Meta-Analysis as Topic , Conduct Disorder/pathology , Passive-Aggressive Personality Disorder/epidemiologyالملخص
The aim of the present study was to assess the rate of personality disorders and coping strategies in female sex-workers. In this observational cross-sectional study 30 female sex-workers who were selected using convenience sampling, completed the Structured Clinical Interview DSM-IV axis H disorders [SCID-II] and Billings Coping Style Questionnaire. Data were analyzed using descriptive statistics. The findings showed a prevalence of 90% for personality disorders, with passive-aggressive personality disorder having the highest prevalence of 53.3%. Also, schizotypal personality disorder was not present in subjects. Among coping strategies, emotion-focused coping [56.7%] and somatization-focused coping [23.3%] were the most prevalent. Considering the high prevalence of personality disorder among female sex-workers and their high use of emotion-focused coping in confronting life events, training this group with coping and problem solving skills is recommended
الموضوعات
Humans , Female , Adaptation, Psychological , Women, Working/psychology , Diagnostic and Statistical Manual of Mental Disorders , Passive-Aggressive Personality Disorder/epidemiology , Surveys and Questionnaires , Schizotypal Personality Disorder/epidemiology , Cross-Sectional Studiesالملخص
La violencia intrafamiliar es muy común, sobre todo la dirigida contra la mujer. En este trabajo se revisa la prevalencia del maltrato a la mujer en México, así como los factores socioculturales, conyugales e individuales relacionados con ese fenómeno. Se proponen algunas técnicas y recursos comunitarios que pueden ser útiles en el tratamiento de estos casos. Todo médico debe investigar el origen de las lesiones, así como la posible existencia de violencia en la familia de su paciente para lograr su mejor identificación y tratamiento