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1.
An. Fac. Cienc. Méd. (Asunción) ; 53(3): 41-52, 20201201.
Artigo em Espanhol | LILACS | ID: biblio-1177483

RESUMO

Existen varios trastornos mentales que se relacionan con el consumo del alcohol y otras drogas, cierto número de personas desarrollan un patrón evolutivo al abuso, sea este persistente o esporádico, produce perturbaciones o limitaciones clínicamente significativas con variadas manifestaciones en el hogar, la escuela y el trabajo. Se determinó la frecuencia y asociación entre trastornos psiquiátricos, patrones de consumo de sustancias y variables sociodemográficas en estudiantes de medicina de la Universidad Nacional de Asunción. El diseño de estudio fue observacional, analítico, corte transversal, La población estuvo constituida por 626 estudiantes de la carrera de medicina del primero al quinto curso, que fueron seleccionados por un muestreo no probabilístico por conveniencia. Se aplicaron 3 cuestionarios que abarcaban tres aspectos: datos sociodemográficos, abuso de drogas y diagnóstico psiquiátrico. Los datos fueron analizados mediante GNU Perfect Statistics Professionally Presented y Epi Info. Se concluyó que el trastorno más frecuente fue el Trastorno por Abuso de drogas, seguido del Trastorno Obsesivo-Compulsivo y el Trastorno Depresivo Mayor. La sustancia más consumida fue el alcohol, seguido del tabaco y la marihuana. Esta última fue la única que se asoció con todas las sustancias. El consumo de alcohol presentó asociación con TOC, Fobia Social y Ansiedad; los consumidores de benzodiacepinas presentaron mayor riesgo de Trastorno Depresivo, Trastorno por Estrés Postraumático, Bulimia, Pánico, Agorafobia, Ansiedad y Trastorno de Somatización. Se recomienda la implementación de políticas de educación preventiva, así como estudios prospectivos para evaluar relaciones de causalidad en las asociaciones encontradas.


There are several mental disorders that are related to the consumption of alcohol and other drugs, a number of people develop an evolutionary pattern of abuse, whether it is persistent or sporadic, it produces clinically significant disturbances or limitations with various manifestations at home, school and the job. The frequency and association between psychiatric disorders, patterns of substance use and socio-demographic variables in medical students of the National University of Asunción was determined. The study design was observational, analytical, cross-sectional. The population consisted of 626 medical students from the first to the fifth year, who were selected by a non-probabilistic convenience sampling. 3 questionnaires were applied that covered three aspects: sociodemographic data, drug abuse and psychiatric diagnosis. The data was analyzed using GNU Perfect Statistics Professionally Presented and Epi Info. It was concluded that the most frequent disorder was Drug Abuse Disorder, followed by Obsessive-Compulsive Disorder and Major Depressive Disorder. The most used substance was alcohol, followed by tobacco and marijuana. The latter was the only one that was associated with all substances. Alcohol consumption was associated with OCD, Social Phobia and Anxiety; Benzodiazepine users had a higher risk of Depressive Disorder, Post-Traumatic Stress Disorder, Bulimia, Panic, Agoraphobia, Anxiety and Somatization Disorder. The implementation of preventive education policies is recommended, as well as prospective studies to evaluate causal relationships in the associations found.


Assuntos
Ansiedade , Transtornos de Estresse Pós-Traumáticos , Cannabis , Transtorno Depressivo Maior , Etanol , Transtornos Mentais , Transtorno Obsessivo-Compulsivo , Estudantes , Causalidade , Estudos Prospectivos , Inquéritos e Questionários , Amostragem
2.
Rev. chil. infectol ; 37(5): 555-562, nov. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1144250

RESUMO

Resumen Introducción: Aproximadamente 50% de las personas con infección por VIH padecen de alguna patología neuro-psiquiátrica. Características intrínsecas del virus, sus complicaciones, tratamiento y el contexto socio-cultural de los infectados facilitan el desarrollo de estas co-morbilidades, que determinan, en parte, el curso y pronóstico de las personas con infección por VIH. Objetivo: Introducir en la fisiopatología, características clínicas y manejo de la patología neuro-psiquiática en la infección por VIH, centrándose en dos de sus cuadros de mayor prevalencia: el trastorno neuro-cognitivo asociado al VIH (HAND) y el trastorno depresivo mayor (TDM). Desarrollo: En general, la detección y el tratamiento precoz de la patología neuropsiquiátrica en personas con infección por VIH mejora la calidad de vida de los pacientes, el curso clínico de la infección y mejora la adherencia al tratamiento anti-retroviral, lo que constituye una herramienta importante en el control de la propagación del VIH.


Abstract Background: The prevalence of neuropsychiatric disorders in HIV infected individuals is around 50%. Despite this, these diseases are often underdiagnosed and undertreated. Direct effects of the virus, opportunistic infections, adverse effects of antiretroviral therapy and the sociocultural context of the infected persons, contribute to the development of HIV associated neurocognitive disorder (HAND) and major depressive disorder (MDD), both of which have an impact in quality of life and disease progression. Aim: To introduce physicians in the pathophysiology, clinical features and management of psychiatric disease in seropositive patients. Content: Early detection and treatment of neuropsychiatric comorbidity in HIV infected individuals improve clinical outcomes, quality of life and is an important milestone in the control of the pandemic.


Assuntos
Humanos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Transtorno Depressivo Maior/etiologia , Transtorno Depressivo Maior/epidemiologia , Qualidade de Vida , Comorbidade , Prevalência
3.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 6-13, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1055355

RESUMO

Objective: To test the feasibility and to present preliminary results of a neuroimaging protocol to evaluate adolescent depression in a middle-income setting. Methods: We assessed psychotropic medication-free adolescents (age range 14-16 years) with a diagnosis of major depressive disorder (MDD). Participants underwent a comprehensive clinical evaluation and both structural and functional magnetic resonance imaging (fMRI). In this pilot study, a preliminary single-group analysis of resting-state fMRI (rs-fMRI) data was performed, with a focus on the default mode network (DMN), cognitive control network (CCN), and salience network (SN). Results: The sample included 29 adolescents with MDD (mean age 16.01, SD 0.78) who completed the protocol. Only two participants were excluded due to MRI quality issues (head movement), and were not included in the analyses. The scans showed significant connectivity between the medial prefrontal cortex and posterior cingulate cortex (DMN), the ACC and anterior insula (SN), and the lateral prefrontal cortex and dorsal parietal cortex (CCN). Conclusion: We demonstrated the feasibility of implementing a complex neuroimaging protocol in a middle-income country. Further, our preliminary rs-fMRI data revealed patterns of resting-state connectivity consistent with prior research performed in adolescents from high-income countries.


Assuntos
Humanos , Masculino , Adolescente , Imagem por Ressonância Magnética/métodos , Transtorno Depressivo Maior/diagnóstico por imagem , Neuroimagem/métodos , Controle de Qualidade , Fatores Socioeconômicos , Brasil , Córtex Cerebral/diagnóstico por imagem , Estudos de Viabilidade , Inquéritos e Questionários , Reprodutibilidade dos Testes , Transtorno Depressivo Maior/fisiopatologia , Vias Neurais , Testes Neuropsicológicos
5.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 14-21, Jan.-Feb. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1055366

RESUMO

Objective: This study aimed to determine if personality disorder (PD) predicted functional outcomes in patients with major depressive disorder (MDD). Methods: Data (n=71) from a double-blind, randomized, placebo-controlled 12-week trial assessing the efficacy of 200 mg/day adjunctive minocycline for MDD were examined. PD was measured using the Standardized Assessment of Personality Abbreviated Scale. Outcome measures included Clinical Global Impression - Improvement (CGI-I), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Social and Occupational Functioning Scale (SOFAS), and Range of Impaired Functioning (RIFT). Analysis of covariance was used to examine the impact of PD (dichotomized factor [≥ 3] or continuous measure) on the outcome measures-treatment group correlation. Results: PD was identified in 69% of the sample. After adjusting for age, sex, and baseline scores for each of the outcome measures, there was no significant difference between participants with and without PD on week 12 scores for any of the outcome measures (all p > 0.14). Conclusion: In this secondary analysis of a primary efficacy study, PD was a common comorbidity among those with MDD, but was not a significant predictor of functional outcomes. This study adds to the limited literature on PD in randomized controlled trials for MDD. Clinical trial registration: ACTRN12612000283875.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Transtornos da Personalidade/psicologia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/tratamento farmacológico , Minociclina/administração & dosagem , Antidepressivos/administração & dosagem , Satisfação Pessoal , Testes de Personalidade , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Comorbidade , Efeito Placebo , Método Duplo-Cego , Resultado do Tratamento , Autorrelato , Pessoa de Meia-Idade
7.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 396-402, Sept.-Oct. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1039105

RESUMO

Objective: To assess the prevalence of depression and sociodemographic, behavioral, and health-related risk factors therefor in a southern Brazilian city. Methods: Population-based, cross-sectional study of adults from Rio Grande, state of Rio Grande do Sul, Brazil. Individuals (n=1,295) were selected using a multistage sampling procedure. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for major depressive episodes (MDEs). We used a conceptual causal framework to organize and assess risk factors for MDE and calculated prevalence ratios (PR) using regression models. Results: The prevalence of MDE was 8.4% (95%CI 6.0-10.7) for men and 13.4% (95%CI 11.0-15.8) for women. For men, physical inactivity (PR 2.34, 95%CI 1.09-5.00) and perceived stress (PR 20.35, 95%CI 5.92-69.96) were associated with MDE. In women, MDE prevalence was higher among those in the first tertile of economic index (PR 2.61, 95%CI 1.53-4.45), with 0-8 years of schooling (PR 2.25, 95%CI 1.24-4.11), alcohol users (PR 1.91, 95%CI 1.21-3.02), those physically inactive (PR 2.49, 95%CI 1.22-5.09), with the highest perceived stress (PR 9.17, 95%CI 3.47-24.23), with another mental disorder (PR 1.85, 95%CI 1.32-2.59), and with more noncommunicable diseases (PR 1.85, 95%CI 1.06-3.22). Conclusion: Women had a higher prevalence of depression, and socioeconomic disadvantages were important for the occurrence of MDE; however, for men, only physical inactivity and stress were important predictors, suggesting possible different causal pathways for each sex.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Transtorno Depressivo Maior/etiologia , Transtorno Depressivo Maior/epidemiologia , Fatores Socioeconômicos , Brasil/epidemiologia , Distribuição de Poisson , Prevalência , Estudos Transversais , Inquéritos e Questionários , Fatores de Risco , Distribuição por Sexo , Distribuição por Idade , Pessoa de Meia-Idade
8.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 433-436, Sept.-Oct. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1039109

RESUMO

Objective: To evaluate the association between social and health contextual variables, and between major depressive episodes (MDE) and suicidal thoughts in Brazilian adults. Methods: This population-based cross-sectional study used data from the 2013 National Health Survey (Pesquisa Nacional de Saúde). The Patient Health Questionnaire was used to evaluate the presence of MDE and suicidal thoughts. We used number of Family Health Strategy teams (FHS) per 20,000 state population, number of Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) per 1,000 state population, gross domestic product (GDP), and Gini index for each Brazilian state as contextual variables. Multilevel logistic regression models were used to calculate OR and the intraclass correlation coefficient (ICC). Results: Prevalence of MDE and suicidal thoughts was 4.1% (95%CI 3.8-4.4) and 3.8% (95%CI 3.5-4.1), respectively. Multilevel regression models showed an ICC of 1.1% for MDE (95%CI 0.5-2.3) and 1.3% for suicidal thoughts (95%CI 0.6-2.6). Neither GDP, Gini, FHS, or CAPS showed evidence of association with the outcomes. Conclusions: In general, contextual variables, within each Brazilian state, do not seem to affect the prevalence of MDE and suicidal thoughts.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Adulto Jovem , Transtorno Depressivo Maior/etiologia , Transtorno Depressivo Maior/epidemiologia , Ideação Suicida , Fatores Socioeconômicos , Brasil/epidemiologia , Modelos Logísticos , Prevalência , Estudos Transversais , Inquéritos e Questionários , Fatores de Risco , Inquéritos Epidemiológicos , Distribuição por Sexo , Distribuição por Idade , Análise Multinível , Pessoa de Meia-Idade
9.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 441-446, Sept.-Oct. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1039113

RESUMO

We conducted a narrative literature review on studies that specifically addressed the pharmacokinetics of antidepressants in patients on hemodialysis. The search included the MEDLINE, LILACS, and Web of Knowledge databases and combined Medical Subject Headings and free-text search terms for chronic kidney disease, end-stage renal disease, renal replacement therapy, depression, and antidepressants; it was limited to studies conducted in humans, with no language or time constraints. The search yielded 212 studies. After screening titles and abstracts, 32 studies were read in full and 11 ultimately met the inclusion criteria and were included in the review. Most of the studies showed no difference in the pharmacokinetics of antidepressant drugs between patients with normal renal function and patients undergoing hemodialysis. However, studies with fluvoxamine and amitriptyline showed that variations in albumin levels might affect serum concentrations of these agents. The included studies have several limitations, and there are many obstacles to the adequate treatment of depression in patients undergoing hemodialysis. Further studies on this topic are needed to support proper treatment of these patients, improving their quality of life and reducing mortality.


Assuntos
Humanos , Diálise Renal/psicologia , Transtorno Depressivo Maior/tratamento farmacológico , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Antidepressivos/farmacocinética , Resultado do Tratamento
10.
Trends psychiatry psychother. (Impr.) ; 41(4): 369-374, Oct.-Dez. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1059183

RESUMO

Abstract Objective To explore and describe sociodemographic characteristics, crack consumption patterns, and psychiatric comorbidities of female crack users receiving treatment at therapeutic communities. Methods This was a cross-sectional, descriptive, quantitative study. Forty-six women who abstained from crack use were assessed using a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and a profile of crack use questionnaire. Descriptive statistical analyses were conducted. Results Participants had a mean age of 31.02 years (standard deviation [SD] = 7.73), most were single (76.1%), white (67.4%) and had complete or incomplete elementary education (43.5%). Before treatment, 65.2% of the women reported using crack every day; 46.3% smoked between 10 to 30 crack rocks per week. Mean treatment time was 63.56 days (SD = 75.85), with a mean of 80.41 days of abstinence (SD = 74.52) and 3.37 previous treatments (SD = 5.49). Mean age upon crack use initiation was 22.61 years (SD = 8.06), and the most frequent motivation to start using crack was curiosity (78.3%). The mean lifetime duration of crack use was 82.26 months (SD = 74.76), and the physical complications most frequently reported were weight loss (93.5%), followed by sleep problems (87%). In this study, the most prevalent psychiatric diagnoses were major depressive episode (60.87%), followed by post-traumatic stress disorder (52.17%) and generalized anxiety disorder (13.07%). Conclusions Overall, a pattern of high consumption of crack was observed. The results show a high frequency of mood and anxiety disorders, with the highest frequencies found for major depressive episode and post-traumatic stress disorder.


Resumo Objetivo Explorar e descrever características sociodemográficas, padrão de consumo e comorbidades psiquiátricas em mulheres usuárias de crack recebendo tratamento em comunidades terapêuticas. Método Estudo transversal, descritivo e quantitativo. Quarenta e seis mulheres abstinentes de crack responderam a um questionário sociodemográfico, ao Mini-Exame do Estado Mental (MEEM), à Entrevista Estruturada do DSM-IV para Transtornos do Eixo I (SCID-I) e a um questionário sobre padrão de consumo de crack. Foram realizadas análises estatísticas descritivas dos dados. Resultados As participantes tinham média de 31,02 anos [desvio padrão (DP) = 7,73], eram na maioria solteiras (76,1%), brancas (67,4%) e tinham ensino fundamental completo ou incompleto (43,5%). Antes do tratamento, 65,2% das mulheres relataram usar crack todos os dias; 46,3% fumavam entre 10 e 30 pedras de crack por semana. O tempo médio de tratamento foi de 63,56 dias (DP = 75,85), com média de 80,41 dias em abstinência (DP = 74,52) e 3,37 (DP = 5,49) tratamentos anteriores. A idade média de início do uso de crack foi de 22,61 anos (DP = 8,06), e a motivação mais frequente para iniciar o uso de crack foi a curiosidade (78,3%). A duração média de uso de crack na vida foi de 82,26 meses (DP = 74,76), e as complicações físicas mais frequentemente relatadas foram perda de peso (93,5%), seguida por problemas de sono (87%). Neste estudo, os diagnósticos mais prevalentes foram episódio depressivo maior (60,87%), seguido por transtorno de estresse pós-traumático (52,17%) e transtorno de ansiedade generalizada (13,07%). Conclusões Em geral, observamos um padrão de alto consumo de crack. Os resultados mostram alta frequência de transtornos de humor e ansiedade, com maiores frequências para episódio depressivo maior e transtorno de estresse pós-traumático.


Assuntos
Humanos , Feminino , Adulto , Adulto Jovem , Fumar Cocaína/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Brasil/epidemiologia , Perda de Peso , Comorbidade , Estudos Transversais , Inquéritos e Questionários , Cocaína Crack , Estado Civil , Transtorno Depressivo Maior/epidemiologia , Escolaridade , Fumar Cocaína/psicologia , Fumar Cocaína/terapia , Testes de Estado Mental e Demência , Entrevista Psicológica
12.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(4): 316-323, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1011503

RESUMO

Objective: To estimate the prevalence of major depressive episode (MDE) in patients with presumptive pulmonary tuberculosis (pre-PTB, defined by cough lasting ≥ 3 weeks) and compare it between patients with pulmonary tuberculosis (PTB) and without PTB. Methods: Patients with pre-PTB (n=260) were screened for depression using the Patient Health Questionnaire (PHQ-9). Those individuals with scores ≥ 10 were subsequently assessed with the depression module of the Mini International Neuropsychiatric Interview (MINI-Plus) to confirm diagnosis. Associations of categorical variables with PTB and MDE were calculated using the chi-square test and OR. Results: PTB was confirmed in 98 patients (37.7%). A high proportion of both groups (active PTB and no PTB) screened positive for depression (60.2 vs. 62.1%, respectively). Among 159 patients who screened positive for depression, a subset of 97 (61.0%) were further evaluated with the MINI-Plus; current MDE was confirmed in 54.6% (53/97). On univariate and multivariate analysis, female sex was the only factor associated with the diagnosis of current MDE (p = 0.04). Conclusion: The prevalence of MDE was high among individuals with prolonged respiratory symptoms, independent of PTB diagnosis. This is consistent with other studies of depression in primary care in Brazil.


Assuntos
Humanos , Masculino , Feminino , Adulto , Tuberculose Pulmonar/complicações , Depressão/complicações , Depressão/psicologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/psicologia , Atenção Primária à Saúde , Fatores Socioeconômicos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Brasil/epidemiologia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Depressão/diagnóstico , Depressão/epidemiologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Pessoa de Meia-Idade
13.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(4): 297-302, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1011514

RESUMO

Objective: The Montgomery-Åsberg Depression Rating Scale (MADRS) is widely used to assess depression severity. The Structured Interview Guide for the MADRS (SIGMA) was created to standardize MADRS assessment. The objective of this study was to translate and validate the original SIGMA into a Brazilian Portuguese version (SIGMA-VB). Methods: We translated and cross-culturally validated the original SIGMA into the SIGMA-VB, and assessed its psychometric properties using data from 93 adult outpatients enrolled in the Integral Assessment in Unipolar Depression (AIUNI) trial. Participants were assessed by two raters on five visits over 8 weeks. We calculated multiple interrater reliability indexes for the SIGMA-VB and used the Hamilton Depression Hating Scale (HAM-D) for validation purposes. Results: According to the SIGMA-VB, participants had moderate depression at baseline followed by mild depression at 8 weeks. We found over 90% of correlation between scores attributed by different raters using the SIGMA-VB. Correlations between the SIGMA-VB and the HAM-D were above 66%. Conclusion: Our findings confirm that the SIGMA-VB is a valid and reliable instrument to assess depression severity in clinical research and practice. Its interrater reliability was similar to that of a previously published Japanese version of the SIGMA.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Adulto Jovem , Escalas de Graduação Psiquiátrica/normas , Tradução , Inquéritos e Questionários , Depressão/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Brasil , Comparação Transcultural , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Entrevista Psicológica/métodos , Pessoa de Meia-Idade
14.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(4): 280-288, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1011515

RESUMO

Objective: The incidence rate of major depression in adolescents reaches approximately 14%. This disorder is usually recurrent, without remission of symptoms even after pharmacological treatment, and persists throughout adult life. Since the effects of antidepressants take approximately 2 weeks to begin, new pharmacological therapies are under continuous exploration. Recent evidence suggests that psychedelics could produce rapid antidepressant effects. In this study, we evaluated the potential antidepressant effects of ayahuasca in a juvenile non-human primate model of depression. Methods: While living with their families, juvenile marmosets (8 males; 7 females) were observed on alternate days for four weeks during a baseline phase. This was followed by 8 weeks of an induced depressive state protocol, the social isolated context (IC), in which the animals were monitored in the first and last weeks. Subsequently, five males and four females were randomly selected for treatment, first with a single administration of saline vehicle (1.67 mL/300 g of body weight, via gavage), followed by a single dose of ayahuasca (1.67 mL/300 g of body weight, via gavage). Both phases lasted 1 week and the animals were monitored daily. A third week of sampling was called the tardive-pharmacological effects phase. In all phases the marmosets were assessed for behavior, fecal cortisol levels, and body weight. Results: After IC, the animals presented typical hypocortisolemia, but cortisol recovered to baseline levels 24 h after an acute dose of ayahuasca; this recovery was not observed in vehicle-treated animals. Additionally, in males, ayahuasca, but not the vehicle, reduced scratching, a stereotypic behavior, and increased feeding. Ayahuasca treatment also improved body weight to baseline levels in both sexes. The ayahuasca-induced behavioral response had long-term effects (14 days). Thus, in this translational juvenile animal model of depression, ayahuasca presented beneficial effects. Conclusions: These results can contribute to the validation of ayahuasca as an antidepressant drug and encourage new studies on psychedelic drugs as a tool for treating mood disorders, including for adolescents with early-onset depression.


Assuntos
Humanos , Animais , Masculino , Feminino , Banisteriopsis , Transtorno Depressivo Maior/tratamento farmacológico , Alucinógenos/administração & dosagem , Antidepressivos/administração & dosagem , Primatas , Hidrocortisona/análise , Callitrichinae , Modelos Animais de Doenças , Fezes/química
15.
Trends psychiatry psychother. (Impr.) ; 41(2): 159-166, Apr.-June 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1014742

RESUMO

Abstract Introduction The recognition of facial expressions of emotion is essential to living in society. However, individuals with major depression tend to interpret information considered imprecise in a negative light, which can exert a direct effect on their capacity to decode social stimuli. Objective To compare basic facial expression recognition skills during tasks with static and dynamic stimuli in older adults with and without major depression. Methods Older adults were selected through a screening process for psychiatric disorders at a primary care service. Psychiatric evaluations were performed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Twenty-three adults with a diagnosis of depression and 23 older adults without a psychiatric diagnosis were asked to perform two facial emotion recognition tasks using static and dynamic stimuli. Results Individuals with major depression demonstrated greater accuracy in recognizing sadness (p=0.023) and anger (p=0.024) during the task with static stimuli and less accuracy in recognizing happiness during the task with dynamic stimuli (p=0.020). The impairment was mainly related to the recognition of emotions of lower intensity. Conclusions The performance of older adults with depression in facial expression recognition tasks with static and dynamic stimuli differs from that of older adults without depression, with greater accuracy regarding negative emotions (sadness and anger) and lower accuracy regarding the recognition of happiness.


Resumo Introdução O reconhecimento de expressões faciais das emoções é essencial para a convivência em sociedade. Entretanto, indivíduos com depressão maior apresentam uma tendência a interpretar de forma negativa informações consideradas imprecisas, o que pode afetar diretamente sua capacidade de decodificação de estímulos sociais. Objetivo Comparar a habilidade de reconhecimento de expressões faciais das emoções básicas em tarefas com estímulos estáticos e dinâmicos em idosos com e sem depressão maior. Métodos Os idosos foram selecionados a partir de um rastreamento de transtornos psiquiátricos na atenção básica, realizada por meio de avaliação psiquiátrica de acordo com os critérios da 5ª edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5). Vinte e três idosos com diagnóstico de depressão e um grupo de 23 idosos sem diagnóstico psiquiátrico atual foram convidados a realizar duas tarefas de reconhecimento de emoções faciais, utilizando estímulos estáticos e dinâmicos. Resultados Os idosos com depressão maior apresentaram maior acurácia no reconhecimento da emoção tristeza (p=0,023) e da emoção raiva (p=0,024) na tarefa com estímulos estáticos, e menor acurácia para a emoção alegria na tarefa com estímulos dinâmicos (p=0,020). O prejuízo está relacionado principalmente ao reconhecimento de emoções de menores intensidades. Conclusões O desempenho de idosos com depressão maior em tarefas com estímulos estáticos e dinâmicos é diferente quando comparados com idosos sem depressão. A acurácia de emoções negativas (tristeza e raiva) é maior, enquanto que a acurácia para alegria é menor.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Transtorno Depressivo Maior/psicologia , Expressão Facial , Reconhecimento Facial/fisiologia , Emoções/fisiologia , Pessoa de Meia-Idade , Testes Neuropsicológicos
16.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(3): 194-198, May-June 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1011493

RESUMO

Objective: Childhood trauma and telomere length (TL) are important risk factors for major depressive disorder. We examined whether there was an association between childhood trauma and TL in a sample of Colombians who were assessed for depressive symptoms. Methods: We applied the Center for Epidemiologic Studies Depression scale, the Patient Health Questionnaire-9, the Hospital Anxiety and Depression scale and the Childhood Trauma Questionnaire to 92 Colombian subjects (mean age = 21). TL was measured with quantitative PCR. Spearman's correlation coefficient (rs) was used to analyze the relationship between childhood trauma scores and TL. Results: We found a significant correlation between TL and sexual abuse scores (rs = 0.428, p = 0.002) in individuals with higher depressive symptom scores. Conclusion: This is the first report of a significant association between TL and sexual abuse in a Latin American sample and provides additional evidence about the role of childhood trauma and TL in neuropsychiatric disorders.


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto Jovem , Maus-Tratos Infantis/psicologia , Telômero , Transtorno Depressivo Maior/genética , Encurtamento do Telômero/genética , Maus-Tratos Infantis/classificação , Reação em Cadeia da Polimerase , Inquéritos e Questionários , Colômbia , Transtorno Depressivo Maior/sangue
17.
Rev. méd. Chile ; 147(2): 181-189, Feb. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1004331

RESUMO

Background: Depression is the most common psychiatric disorder in people with suicidal behavior. The knowledge of its risk factors should help to design preventive strategies. Aim: To describe suicidal behavior and risk factors for attempted suicide in people with major depressive disorders (MDD). Material and Methods: A 12-month follow-up study was conducted in 112 outpatients at three psychiatric care centers of Ñuble, Chile, with baseline and quarterly assessments. Demographic, psychosocial and clinical factors as potential risk factors of suicide attempts, were assessed. A clinical interview with DSM-IV diagnostic criteria checklist, Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results: Sixty seven percent of participants had suicidal ideation and 43.8% had attempted suicide. Suicide risk was significantly higher in participants with a single major depressive episode (odds ratio [OR] = 3.98; 95% confidence intervals [CI] = 1,29-12,32 p = 0.02) and those with previous suicide attempts (OR = 13.15; 95% CI = 3,87-44.7 p < 0.01). Young age, not having a partner, being unemployed, having a severe major depressive episode, having psychotic symptoms, having a personality disorder and being devoid of medical illness increased the risk of suicide attempts, but they did not reach statistical significance. Conclusions: Significant risk factors should be specially considered when designing suicide preventive strategies in patients with MDD.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Tentativa de Suicídio/psicologia , Atenção Secundária à Saúde/estatística & dados numéricos , Transtorno Depressivo Maior/psicologia , Determinação da Personalidade/estatística & dados numéricos , Transtornos Psicóticos/psicologia , Fatores Socioeconômicos , Tentativa de Suicídio/classificação , Chile , Fatores de Risco , Seguimentos , Estudos Longitudinais , Fatores Etários , Estado Civil/estatística & dados numéricos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtorno Depressivo Maior/terapia , Ideação Suicida
18.
Clin. biomed. res ; 39(4): 292-300, 2019.
Artigo em Português | LILACS | ID: biblio-1053537

RESUMO

Introdução: A associação entre depressão e fatores de risco cardiovascular é recorrente. O aumento de risco em deprimidos está relacionado à fatores como obesidade, sedentarismo, dislipidemia, alcoolismo e tabagismo. O objetivo deste trabalho foi identificar a presença de fatores de risco para o desenvolvimento de doenças cardiovasculares em pacientes com quadro de depressão internados em um hospital do sul do Brasil. Métodos: Estudo transversal que envolveu adultos de ambos os sexos internados por episódio depressivo. O estado nutricional foi avaliado pelas medidas antropométricas de peso, altura e circunferência da cintura. Um questionário foi aplicado englobando perfil sociodemográfico, histórico familiar de doenças, consumo de produtos de tabaco e de álcool, atividade física, além do questionário autoaplicável para medida da severidade da depressão. Para avaliação do risco cardiovascular global, foi calculado o escore de Framingham. Os testes qui-quadrado de Pearson (χ2 ) ou exato de Fisher foram utilizados para testar a associação entre as variáveis categóricas, considerando o nível de significância quando p ≤ 0,05 e IC95%. Resultados: Foram avaliados 54 indivíduos, predominantemente mulheres (n = 32), com idade média de 40,2 ± 10,8 anos. A depressão foi classificada como grave na maioria dos pacientes (n = 29). Fatores de risco relacionados ao nível de atividade física (sedentarismo), dislipidemia e estado nutricional (sobrepeso e obesidade) estiveram presentes em 81,5%, 73,1% e 66,7% da amostra, respectivamente. Percentual de risco obtido por meio do escore de Framingham foi encontrado acima do normal em 42,9% dos indivíduos. Depressão leve associou-se positivamente aos pacientes com magreza/eutrofia e, ao serem estratificados como severos e não-severos, o primeiro grupo teve associação positiva com histórico familiar de excesso de peso e hipertensão. Conclusões: Diversos fatores de risco cardiovascular foram encontrados, alertando para a importância do cuidado integral da saúde do paciente e avaliação destes indicadores. (AU)


Introduction: The association between depression and cardiovascular risk factors is recurrent. Increased risk of depression is related to factors such as obesity, sedentary lifestyle, dyslipidemia, alcoholism, and smoking. The aim of this study was to identify the presence of risk factors for the development of cardiovascular disease in patients with depression admitted to a hospital in southern Brazil. Methods: A cross-sectional study involving adults of both sexes hospitalized for a depressive episode. Nutritional status was assessed by the anthropometric measurements of weight, height and waist circumference. A questionnaire was applied covering sociodemographic data, family history of diseases, consumption of tobacco and alcohol products, and physical activity, in addition to a self-administered questionnaire to measure the severity of depression. The Framingham risk score was calculated for global cardiovascular risk evaluation. Pearson's chi-square test (χ2 ) or Fisher's exact Test were used to test the association between categorical variables, considering the level of significance at p ≤ 0.05 and 95% CI. Results: Fifty-four individuals were evaluated, most were women (n = 32), with a mean age of 40.2 ± 10.8 years were evaluated. Depression was classified as severe in most patients (n = 29). Risk factors related to the physical activity level (sedentary lifestyle), dyslipidemia and nutritional status (overweight and obesity) were present in 81.5%, 73.1% and 66.7% of the sample, respectively. Percentage of risk obtained by the Framingham risk score was found above normal in 42.9% of the individuals. Mild depression was positively associated with thin/eutrophic patients and, when stratified as severe and non-severe, the first group had a positive association with family history of overweight and hypertension. Conclusions: Several cardiovascular risk factors were found, alerting to the importance of integral health care for patients and evaluation of these indicators. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estado Nutricional , Transtorno Depressivo Maior/epidemiologia , Atividade Motora , Comorbidade , Fatores de Risco , Transtorno Depressivo Maior/diagnóstico
19.
MedicalExpress (São Paulo, Online) ; 6: mo19007, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1012664

RESUMO

ABSTRACT BACKGROUND: The daily coexistence with the technologies (computer, mobile phone, tablet, among others), begins to produce significant changes in human behavior. We have observed that there is an association between dependence on technologies and major depressive disorder, as well as with other mental disorders. OBJECTIVE: To validate a scale for assessing depression and its relation to dependence on everyday technologies. METHODS: Validation of a Technology Dependent Depression Scale (TDDS) was performed in 5 phases: (1) initial scale construction with 20 questions; (2) expert evaluation; (3) application to 100 volunteers, (4) statistical analysis and results, (5) preparation of the final version of the validated TDDS. RESULTS: We used the R statistical program, version 3.4.2 and the "dplyr" package to present descriptive statistics, hypotheses tests of mean differences and factorial analysis. The results provided a validated and approved final version for TDDS. CONCLUSIONS: We constructed the final version of the validated TDDS, which is adequate for clinical contexts and to be used in future research. All the psychometric properties were checked for accuracy, reliability, presentation, clarity, pertinence and comprehension of the instrument conferring validity to the end-product.


Assuntos
Humanos , Tecnologia , Depressão , Transtorno Depressivo Maior , Rede Social
20.
Rev. bras. psiquiatr ; 40(4): 361-366, Oct.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-959258

RESUMO

Objective: To correlate neurotrophic factors - brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and beta-nerve growth factor (beta-NGF) - and severity of depressive symptoms in patients diagnosed with major depressive disorder (MDD) undergoing cognitive-behavioral therapy (CBT). Methods: In this quasi-experimental study, participants were selected by convenience and received 16 sessions of CBT. The outcomes of interest were severity of depressive symptoms and changes in neurotrophic factor levels after CBT. The differences between variables before and after treatment (deltas) were analyzed. Results: Patients had significant changes in symptom severity after treatment. No significant associations were found between Beck Depression Inventory II (BDI-II) scores and any independent variable. No correlations were observed between BDNF or GDNF levels and BDI scores before or after treatment, although there was a trend toward significant differences in beta-NGF levels. Conclusion: BDNF, beta-NGF, and GDNF were not influenced by the effects of CBT on depressive symptoms.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Terapia Cognitivo-Comportamental/métodos , Fator Neurotrófico Derivado do Encéfalo/sangue , Fator de Crescimento Neural/sangue , Transtorno Depressivo Maior/sangue , Fator Neurotrófico Derivado de Linhagem de Célula Glial/sangue , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Índice de Gravidade de Doença , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Ensaios Clínicos Controlados não Aleatórios como Assunto , Fatores de Crescimento Neural/sangue
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