RESUMEN
Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P - Patient, problem, or population; I - Intervention; C - Comparison, control, or comparator; O - Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.
RESUMEN
As estimativas de prevalência mundial em neuropsiquiatria infantil são muito heterogêneas. As razões desta discrepância permanecem malcompreendidas. Localização geográfica desempenha um papel limitado nas razões da grande variabilidade nas prevalências mundiais de transtornos em neuropsiquiatria infantil. Em vez disso, esta variabilidade parece ser explicada principalmente pelas características metodológicas dos estudos. Estimativas da prevalência do transtorno de déficit de atenção e hiperatividade (TDAH) e da taxa de persistência dos sintomas em toda a vida são heterogêneas, o que levanta dúvidas sobre a validade do diagnóstico. As melhores estimativas disponíveis sobre a prevalência de TDAH é de cerca de 5,29%, para crianças e adolescentes. As estimativas de prevalência e taxa de TDAH parecem ser muito afetados pelas características metodológicas dos estudos.
The worldwide prevalence estimates of neuropsychiatric disorders in childhood are highly heterogeneous. The reasons for this discrepancyremain poorly understood. Geographic location plays a limited role in the reasons for the large variability of neuropsychiatric disordersprevalence in childhood estimates worldwide. Instead, this variability seems to be explained primarily by the methodological characteristics ofstudies. Prevalence estimates of the attention-deficit hyperactivity disorder (ADHD) and the rate of persistence of symptoms across the lifespan are heterogeneous, raising questions about the validity of the diagnosis. The best available estimates of ADHD prevalence are around 5.29% for children and adolescents. Estimates of ADHD prevalence seem to be highly affected by methodological characteristics of the studies.