The implication of alexithymia in personality disorders: a systematic review.

BACKGROUND: Alexithymia, characterized by difficulty identifying and expressing emotions, is often associated with various psychiatric disorders, including personality disorders (PDs). This study aimed to explore the relationship between alexithymia and PD, focusing on their common origins and implications for treatment. METHODS: A systematic review was conducted following PRISMA guidelines using databases such as MEDLINE (PubMed), Scopus, and Web of Science. The inclusion criteria were studies assessing adults with DSM-5-diagnosed personality disorders using validated alexithymia scales. The Newcastle‒Ottawa Scale was used to assess the quality of the included studies. RESULTS: From an initial yield of 2434 citations, 20 peer-reviewed articles met the inclusion criteria. The findings indicate a significant association between alexithymia and personality disorders, particularly within Clusters B and C. Patients with these disorders exhibited higher levels of alexithymia, which correlated with increased emotional dysregulation and interpersonal difficulties. The review also highlighted the comorbidity burden of conditions such as psychosomatic disorders, eating disorders, depression, anxiety, suicidal behavior, and substance use disorders. CONCLUSIONS: These findings underscore the need for integrating alexithymia-focused assessments into clinical practice to enhance therapeutic approaches, allowing for more personalized and effective interventions. Addressing the emotional processing challenges in patients with personality disorders could significantly improve patient outcomes. Future research should prioritize establishing clinical guidelines and conducting longitudinal studies to explore the relationship between alexithymia and specific personality disorder subtypes, ensuring the practical translation of these findings into clinical practice.

Impacto psicológico de la cuarta ola pandémica en estudiantes de ciencias de la salud / Psychological impact of the fourth pandemic wave on health sciences students

Introducción: La pandemia por la COVID-19, en sucesivas olas, puede inducir a trastornos emocionales prolongados de estrés, ansiedad y depresión, con mayor impacto psicológico en estudiantes de ciencias de la salud. Objetivo: Determinar el impacto psicológico y los niveles de depresión, ansiedad y estrés en la cuarta ola pandémica en estudiantes de ciencias de la salud. Métodos: Estudio transversal, realizado en el Perú durante junio a noviembre del 2022. Se incluyeron 418 estudiantes universitarios seleccionados de manera aleatoria. Mediante una encuesta virtual se recogieron variables socioeducativas y religiosas-espirituales; se consideró impacto psicológico cuando el estudiante presentó al menos uno de los trastornos reportados en la Escala de Depresión, Ansiedad y Estrés (DASS-21). Se realizó un análisis descriptivo y se evaluaron diferencias con el ji cuadrado. Resultados:De los participantes, el 82,5 por ciento tuvo impacto psicológico; mayores proporciones fueron revelados por los estudiantes de sexo femenino (82,6 por ciento ), ≤ 20 años (86,7 por ciento), estudia y trabaja (83,7 por ciento ), estado civil conviviente (96,0 por ciento ), facultad de obstetricia (88,1por ciento ), ateo (91,7 por ciento ), no participa en actividades religiosas (85,3 por ciento ), no se considera una persona religiosa (83,5 por ciento), ni una persona espiritual (84,6 por ciento ), practica la oración semanal (87,2 por ciento ). La prevalencia de la depresión fue del 63,2 por ciento ; ansiedad 78,5 por ciento y el estrés 48,6 por ciento . Conclusiones:La pandemia, en su cuarta ola, impacta psicológicamente a 8 de cada 10 estudiantes peruanos de ciencias de la salud y los niveles de depresión, ansiedad y estrés son altos(AU)

Introduction: The COVID-19 pandemic, in successive waves, can induce prolonged emotional disorders of stress, anxiety and depression, with greater psychological impact on health science students. Objective: To determine the psychological impact and levels of depression, anxiety and stress in the fourth pandemic wave in health sciences students. Methods: Cross-sectional study, conducted in Peru, from June to November 2022. It included 418 randomly selected university students. A virtual survey was used to collect socio-educational and religious-spiritual variables; psychological impact was considered when the student presented at least one of the disorders reported in the Depression, Anxiety and Stress Scale (DASS-21). A descriptive analysis was performed and differences were evaluated with chi-square. Results: Of the participants, 82.5 percent had psychological impact; higher proportions were revealed by female students (82.6 percent ), ≤ 20 years old (86.7 percent ), studying and working (83.7percent ), cohabiting marital status (96.0 percent ), obstetrics faculty (88.1 percent ), atheist (91.7 percent ), does not participate in religious activities (85.3 percent ), does not consider herself a religious person (83.5 percent ), does not consider herself a spiritual person (84.6 percent), practices weekly prayer (87.2 percent ). The prevalence of depression was 63.2 percent ; anxiety 78.5 percent and stress 48.6 percent . Conclusions:The fourth wave of the pandemic had a psychological impact on 8 out of 10 Peruvian health science students(AU)

Determinants and impact of alexithymia on quality of life in Parkinson's disease.

INTRODUCTION: Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS: Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS: 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS: Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.

Alexithymia in systemic lupus erythematosus: A cross sectional study in a Brazilian sample.

BACKGROUND: Alexithymia is considered as a reduced capacity to be aware of, to clearly recognize, and to define one's feelings with a limited fantasy and a concrete, externally oriented cognitive style. Some studies have stated that alexithymia is more common in systemic lupus erythematosus patients (SLE) than in general population but there is a paucity of studies in such context. AIM: To study the prevalence of alexithymia in a sample of SLE patients looking for associated epidemiological and clinical findings and its relationship to quality of life. METHODS: Cross-sectional study in 93 SLE patients collecting clinical, epidemiological, and serological data, data on quality of life by 12 item short health survey (SF-12), and alexithymia by Toronto scale (TAS-26). Disease's cumulative damage was measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage index. RESULTS: In this sample (90.3% females and median age of 46 years), 55.9% had alexithymia; 22/92 (23.9%) did not and 19/93 (20.4%) had inconclusive results. Alexithymia presence had a positive association with age (p = 0.01) and a negative association with presence of glomerulonephritis (25% vs 59%; p = 0.005) and glucocorticoid use (19.2% vs 59.0%; p = 0.0007). A negative correlation of TAS-26 was observed with mental domain of (r = -0.46; p < 0.0001) and physical domain (r = -0.32; p = 0.004) of SF-12, but not with cumulative damage index. CONCLUSION: We found a high prevalence of alexithymia in this sample of SLE patients that negatively associated with quality of life, but not with cumulative damage index.

Affective response of postmenopausal women to resistance training on stable and unstable surfaces: a randomized cross-over study / Respostas afetivas de mulheres pós-menopausadas submetidas ao treinamento com pesos em superfície estável e instável: um estudo cross-over randomizado

Objective: To compare the affective response of postmenopausal women who undergo 6 weeks of resistance training on stable and unstable surfaces. Methods: This randomized counterbalanced cross-over study carried included 14 postmenopausal women (55 [SD, 3] years; height 1.55 [SD, 0.03] m; body mass 78.70 [SD, 12.00] kg; and body mass index 32.80 [SD, 4.90] kg/m²), who underwent 6 weeks of resistance training on stable and unstable surfaces. The participants were initially allocated to 1 experimental condition (stable or unstable) in a randomized counterbalanced manner. The intervention consisted of 8 exercises in 3 series of 8-10 repetitions, with intervals of 60-90 seconds, for 3 weeks. After the first 3-week protocol, they were switched to the other experimental condition for another 3 weeks. To evaluate affective response, the Hardy and Rejeski Sensation Scale was applied weekly at the end of each exercise and again at the end of the 6 weeks. Results: Affective response was similar to the general affect observed at the end of the sessions (stable surface: 5.00 [3.00]; unstable surface: 5.00 [1.00]; p = 0.114), except for the bridge exercise (stable surface: 3.00 [2.00]; unstable surface: 4.00 [2.00]; p = 0.048]). Conclusions: The affective response of these women was not affected by training on unstable surfaces, except for the bridge exercise, in which the unstable surface increased affective response

Objetivo: Comparar as respostas afetivas de mulheres pós-menopausadas submetidas a seis semanas de treinamento com pesos realizado em superfície estável e instável. Metodologia: Trata-se de um estudo cross-over, randomizado e contrabalanceado realizado com 14 mulheres pós-menopausadas (55 ± 3 anos; estatura de 1,55 ± 0,03 m; massa corporal 78,70 ± 12,00 kg; e índice de massa corporal de 32,80 ± 4,90 kg/m²) submetidas a seis semanas de treinamento com pesos em superfície estável e instável. As participantes foram alocadas, inicialmente, numa das condições experimentais de forma randomizada e contrabalanceada. A intervenção foi composta por oito exercícios em três séries de oito a dez repetições, com intervalos entre 60 e 90 segundos, durante três semanas. Para avaliação das respostas afetivas, foi aplicada a Escala de Sensação de Hardy e Rejeski ao fim da última série de cada exercício e ao final das sessões, durante as seis semanas. Resultados: As respostas afetivas foram similares para o afeto geral observado ao final das sessões [Superfície estável: 5,00 (3,00); Superfície instável: 5,00 (1,00); p = 0,114], mas não para o exercício de ponte [Superfície estável: 3,00 (2,00); Superfície instável: 4,00 (2,00); p = 0,048)]. Conclusões: Conclui-se que as respostas afetivas de mulheres pós-menopausadas, observadas ao final da sessão, não foram afetas pela instabilidade. Contudo, as sensações de prazer, no exercício de ponte, foram maiores com a inserção da instabilidade

Dental Fear/Anxiety in Children and Child Emotional and Behavioural Problems

ABSTRACT Objective: To investigate the association between emotional and behavioural problems and dental fear/anxiety (DFA) in children aged four to 12 years treated at a clinic in southern Brazil. Material and Methods: In this cross-sectional study where mother-child dyads were interviewed, emotional and behavioural problems were investigated using the Strengths and Difficulties Questionnaire (SDQ) (considering five subscales). Children's DFA was evaluated through the Venham Picture Test. For each SDQ subscale, Poisson regression model was explored. Prevalence ratios (PR) were estimated, considering a significant level of p ≤ 0.05. Results: Overall, 128 children participated in this study. Most children were female (54.7%) and aged between 7 and 9 years (39.8%). The prevalence of emotional problems was 47.7% and behavioural problems were 46.1%. The prevalence of DFA was 18.8%. Children with emotional problems had a 2.3 higher prevalence of DFA (95%CI 1.06-5.04). In general, behavioural problems were not associated with DFA (95%CI 0.84-3.34) only when conduct problems were considered (2.20; 95%CI 1.02-4.70). Conclusion: Children aged between 4 and 12 years who present emotional and conduct problems tend to show higher DFA.

Research on burnout level of juvenile trampolinists and relevant affecting factors / Pesquisa sobre o nível de burnout de trampolinistas juvenis e fatores afetivos relevantes / Investigación sobre el nivel de burnout de los trampolinistas juveniles y los factores afectivos relevantes

ABSTRACT Introduction The paper investigates burnout causes and relevant affecting factors of juvenile trampolinists. Objective With 93 participants aged U10-16 of 2019 National Juvenile Trampoline Championship as investigation objects, to improve the current situation of juvenile burnout, exploring the methodology to alleviate and eliminate it, enhancing the sense of achievement in training and competition and providing a theoretical basis for coaches to train and cultivate athletes. Methods Questionnaire survey, semi-structured interview, mathematical statistics. Results The burnout level of the trampolinists is below the moderate level, and the overall burnout level of athletes is not high; the sense of achievement decrease> negative evaluation of sports>emotional/physical exhaustion; the correlation between the overall level of burnout of athletes and different genders, training age, education stage and athlete level is not significant; in terms of burnout, there are very significant positive correlations(P<0.01) between overload factor, personal factor, and situational factor, and emotional/physical exhaustion, sense of achievement decrease and negative evaluation of sports respectively. Conclusions Strengthen the communication with trampolinists, improve their self-regulation ability in various ways, master the methods to alleviate burnout, and increase social support for them. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução O artigo investiga as causas do burnout e os fatores que afetam os jovens trampolinistas. Objetivo Ter como objeto de pesquisa 93 participantes de U10-16 do Campeonato Nacional Juvenil de Trampolim 2019, para melhorar a situação atual do burnout juvenil, explorando a metodologia para amenizá-lo e eliminá-lo, potencializando a sensação de realização em treinamentos e competições e proporcionando uma base para os treinadores trabalharem com os atletas. Métodos Questionário de levantamento, entrevista semiestruturada, estatística matemática. Resultados O nível de burnout dos trampolinistas está abaixo do nível moderado e o nível geral de burnout dos atletas não é alto; diminuição da sensação de realização> avaliação negativa de esportes> burnout emocional/físico; a correlação entre o nível geral de burnout dos atletas e os diferentes gêneros, a idade de treinamento, o estágio educacional e o nível do atleta não é significativa; Em termos de burnout, existem correlações positivas altamente significativas (P <0,01) entre o fator de sobrecarga, o fator pessoal e o fator situacional, e burnout emocional/físico, a diminuição do senso de realização e a avaliação negativa dos esportes, respectivamente. Conclusões Fortalecer a comunicação com os trampolinistas, melhorar sua capacidade de autorregulação de várias maneiras, dominar os métodos para aliviar o burnout e aumentar o apoio social para eles. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción El artículo investiga las causas del burnout y los factores que afectan a los trampolinistas juveniles. Objetivo Con 93 participantes de edades U10-16 del Campeonato Nacional Juvenil de Trampolín 2019 como objetos de investigación, mejorar la situación actual del burnout juvenil, explorando la metodología para aliviarlo y eliminarlo, potenciando el sentido de logro en entrenamientos y competencias y brindando un base para que los entrenadores trabajen con los atletas. Métodos Encuesta por cuestionario, entrevista semiestructurada, estadística matemática. Resultados El nivel de burnout de los trampolinistas está por debajo del nivel moderado y el nivel de burnout general de los atletas no es alto; disminución del sentido de logro> evaluación negativa de los deportes> burnout emocional / físico; la correlación entre el nivel general de burnout de los atletas y los diferentes géneros, la edad de entrenamiento, la etapa educativa y el nivel del atleta no es significativa; en términos de burnout, existen correlaciones positivas muy significativas (P <0,01) entre el factor de sobrecarga, el factor personal y el factor situacional, y el burnout emocional / físico, la disminución del sentido de logro y la evaluación negativa de los deportes, respectivamente. Conclusiones Fortalecer la comunicación con los trampolinistas, mejorar su capacidad de autorregulación de diversas formas, dominar los métodos para aliviar el burnout y aumentar el apoyo social a ellos. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Estrategias de afrontamiento y alteraciones emocionales en pacientes con dolor crónico de la espalda: Cienfuegos 2020 (Cuba) / Coping strategies and emotional alterations in patients with chronic back pain. Cienfuegos 2020. (Cuba)

Introducción: El dolor crónico de la espalda forma parte de los síntomas que afectan la salud musculoesquelética. Las estrategias de afrontamiento van a determinar la experiencia del dolor actuando como mediador de las emociones. Objetivo General: Caracterizar las estrategias de afrontamiento y las alteraciones emocionales en pacientes con dolor crónico de la espalda, Cienfuegos 2020. Material y Método: Se realizó un estudio descriptivo, de serie de casos, en el Hospital Provincial Dr. Gustavo Aldereguía Lima de la provincia de Cienfuegos, Cuba, en los meses de septiembre de 2019 a enero de 2020. Se realizó un muestreo no probabilístico casual o a conveniencia de participantes voluntarios, con los pacientes que fueron atendidos en consulta de Ortopedia durante el periodo de investigación declarado. El análisis estadístico de la información se realizó en el paquete estadístico SPSS. Resultados: Se obtuvo un predominio de estrategias de afrontamiento pasivas, así como alteraciones emocionales donde predomina la ansiedad y la depresión en niveles moderado-alto, mientras que en la ira se obtuvieron valores inferiores. Conclusión: Las estrategias de afrontamiento utilizadas por los pacientes de estudio se caracterizan por ir dirigidas fundamentalmente a la modificación de las reacciones emocionales que genera el dolor, pero no a lograr una adaptación a las nuevas circunstancias impuestas por la enfermedad, ni a un control instrumental del mismo.

Introduction: Chronic back pain is one of the symptoms that affect musculoskeletal health. Coping strategies will determine the experience of pain acting as a mediator of emotions. General aim: To characterize coping strategies and the emotional alterations in patients with chronic back pain, Cienfuegos 2020. Material and method: It was carried out a descriptive study, series of cases, in the University Hospital "Dr. GustavoAldereguía Lima", Cienfuegos municipality, Cuba, from September, 2019 to January, of 2020. It was done a non-probabilistic sampling to convenience. The patients who were treated at the outpatient orthopedics consulting office and voluntarily accepted to participate in the study during the declared period of investigation were chosen. The statistical analysis of the information was carried out in the statistical package SPSS. Results: A prevalence of passive coping strategies was obtained, so much in the interview semiestructurada as in the Coping Reduced Questionnaire to the pain. Regarding the negatives emotional states prevailed the anxiety and depression in moderate-high levels, while in anger lower values were obtained. Conclusions: The most frequent coping strategies in the studied patients were the passive ones, aimed to regulate emotional states, but not to control pain.

El uso excesivo de pantallas está asociado con labilidad emocional en niños preescolares / Excessive screen time is associated with emotional lability in preschool children

Introducción. En estudios anteriores, el uso excesivo o la exposición temprana a pantallas se asoció con atención deficiente, falta de control de la conducta, retraso del lenguaje y déficit en la función ejecutiva. El objetivo de este estudio fue investigar la relación entre el tiempo de uso de pantallas y la regulación emocional, que afecta las relaciones sociales de los niños de 2 a 5 años.Población y métodos. Estudio descriptivo transversal en un hospital universitario del 1.º de enero al 1.º de marzo de 2018. Se incluyó a madres de niños sanos de 2 a 5 años con un uso de pantallas inferior a 1 hora o superior a 4 horas. A quienes aceptaron participar se les administró una encuesta estructurada y la Emotion Regulation Checklist para padres.Resultados. De los 240 niños participantes, 98 (el 40,8 %) tenían un uso de pantallas ≥ 4 horas. Ser cuidado por la madre, tener 12 meses o más durante la primera exposición y no estar acompañado por los padres al usarlas se asociaron con ≥ 4 horas de uso de pantallas (p = 0,002; p = 0,002; p = 0,012, respectivamente). La proporción de participantes con una puntuación alta de labilidad/negatividad (L/N) fue significativamente mayor entre los niños con ≥ 4 horas de uso de pantallas y que no estaban acompañados por sus padres al usarlas (p = 0,004; p = 0,033, respectivamente).Conclusiones. Este estudio determinó que un uso excesivo de pantallas se asocia con labilidad emocional durante esta etapa temprana de la infancia.

Introduction. Previous studies have found that excessive screen time or early screen exposure is associated with poor attention, lack of behavioral control, delayed language and deficit in executive functions. The aim of this study was to investigate the relationship between screen time and emotion regulation skills, which is one of the important life components affecting the social relations of children aged 2 to 5 years.Population and methods.This cross-sectional descriptive study was carried out in a university hospital between January 1, 2018 and March 1, 2018. Mothers of healthy children aged 2-5 years with a daily screen time of less than 1 hour or over 4 hours were included in the study. A structured survey and the Emotion Regulation Checklist for parents were applied to the mothers who agreed to participate.Results. Of 240 children participating in the study, 98 (40.8 %) had ≥4 hours of screen time. Caring by mother, age at first screen exposure 12 months and older, not co-viewing with parents were found to be associated with ≥ 4 hours of screen time (p = 0.002, p = 0.002, p = 0.012, respectively). The ratio of participants with high-lability/negativity (L/N) score was significantly higher in children with screen time of ≥ 4 hours and not co-viewing with parents (p = 0.004, p = 0.033, respectively).Conclusions. This study investigating the relationship between the emotion regulation skill and screen time revealed that excessive screen time is associated with emotional lability in this early childhood period.

Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode

Objective: Presence of psychotic symptoms seems to be a commonplace in early-onset bipolar disorder (BD). However, few studies have examined their occurrence in adolescent-onset BD. We sought to investigate the frequency of affective and psychotic symptoms observed during the first manic episode in adolescents. Methods: Forty-nine adolescents with bipolar I disorder (DSM-IV criteria) were admitted to a psychiatric hospital during their first acute manic episode. Assessment for current psychiatric diagnosis was performed by direct clinical interview and the DSM-IV version of the Diagnostic Interview for Children and Adolescents (DICA). Results: Teenage inpatients with BD consistently exhibited typical manic features, such as euphoria, grandiosity, and psychomotor agitation. In addition, disorganization and psychotic symptoms were present in 82 and 55% of the total sample, respectively. There was no significant difference in symptoms between early- and late-adolescent subgroups. Remarkably, most patients (76%) reported previous depressive episode(s); of these, 47% had prominent psychotic features in the prior depressive period. Conclusion: These findings suggest that disorganization and psychotic symptoms during the first manic episode are salient features in adolescent-onset BD, and that psychotic depression frequently may precede psychotic mania. Nevertheless, differential diagnosis with schizophrenia should be routinely ruled out in cases of early-onset first psychotic episode.

[Affective-sexual development in people with autistic spectrum disorders]. / Desarrollo afectivo-sexual en las personas con trastornos del espectro autista.

Autistic spectrum disorders (ASD) are neurodevelopmental disorders that affect social communication and present repetitive, stereotyped and inflexible behaviour. A third of the people with a diagnosis of ASD also have intellectual disability associated and two thirds present an intellectual capacity within the average range. The nuclear autistic and others associated symptoms can affect the affective and sexual development. This article exposes which are the problems people with ASD present in the affective and sexual development, the most frequently described and brief guides for evaluation and support for an adequate affective-sexual development in people with ASD.

Los trastornos del espectro autista (TEA) son trastornos del neurodesarrollo que afectan la comunicación social y que presentan patrones de conducta repetitiva, estereotipada o/y inflexible. Un tercio de los casos diagnosticados de TEA tienen discapacidad intelectual y 2/3 una capacidad intelectual dentro de la norma. Los síntomas nucleares de autismo y otros asociados pueden afectar el desarrollo afectivo-sexual. En este artículo se expone qué dificultades en el desarrollo afectivo-sexual pueden presentar las personas con TEA y cuáles son las más frecuentemente descritas. Se propone de una manera breve, guías dirigidas a la evaluación y a la ayuda para un desarrollo afectivo-sexual satisfactorio en las personas con autismo-TEA.

Desarrollo afectivo-sexual en las personas con trastornos del espectro autista / Affective-sexual development in people with autistic spectrum disorders

Los trastornos del espectro autista (TEA) son trastornos del neurodesarrollo que afectan la comunicación social y que presentan patrones de conducta repetitiva, estereotipada o/y inflexible. Un tercio de los casos diagnosticados de TEA tienen discapacidad intelectual y 2/3 una capacidad intelectual dentro de la norma. Los síntomas nucleares de autismo y otros asociados pueden afectar el desarrollo afectivo-sexual. En este artículo se expone qué dificultades en el desarrollo afectivo-sexual pueden presentar las personas con TEA y cuáles son las más frecuentemente descritas. Se propone de una manera breve, guías dirigidas a la evaluación y a la ayuda para un desarrollo afectivo-sexual satisfactorio en las personas con autismo-TEA.

Autistic spectrum disorders (ASD) are neurodevelopmental disorders that affect social communication and present repetitive, stereotyped and inflexible behaviour. A third of the people with a diagnosis of ASD also have intellectual disability associated and two thirds present an intellectual capacity within the average range. The nuclear autistic and others associated symptoms can affect the affective and sexual development. This article exposes which are the problems people with ASD present in the affective and sexual development, the most frequently described and brief guides for evaluation and support for an adequate affective-sexual development in people with ASD.

"Something Born of the Heart": Culturally Affiliated Illnesses of Older Adults in Oaxaca.

This qualitative research identifies and analyzes emotions and interventions linked to affective experiences and cultural aspects of health/illness/care processes in 219 older adults of eight Indigenous groups in Oaxaca, Mexico. Life stories are examined from perspectives of cultural gerontology, anthropology of emotions and critical medical anthropology with a gender perspective. Significance and healing of two illnesses of cultural affiliation: tiricia (sadness of the soul) and envidia (rancor against the successful) are examined. Conditions other than diabetes and hypertension are healed by traditional remedies or spiritual cleansings. Examining tiricia and envidia permit improved knowledge and understanding of the emotional culture and the community.

EMOTIONAL REPERCUSSIONS AND QUALITY OF LIFE IN CHILDREN AND ADOLESCENTS UNDERGOING HEMODIALYSIS OR AFTER KIDNEY TRANSPLANTATION.

OBJECTIVE: To investigate the emotional repercussions and quality of life (QOL) associated with end-stage kidney disease (ESKD) in children and adolescents undergoing hemodialysis or a kidney transplant (TX). METHODS: We conducted a quantitative-qualitative study. 48 children and adolescents with ESKD were interviewed; half of them underwent hemodialysis treatment, and the other half had a kidney transplantation. Their respective 48 caregivers also participated in the study. The questionnaire involved both the Pediatric Quality of Life Inventory and a thematic story-drawing tool. An analysis of the QOL questionnaire's results was done by comparing the sum of points between groups and the theme-based story-drawing consisted of interpreting the data contained in the material using Freudian and Lacanian theories. RESULTS: In the QOL questionnaires, the total score was higher in the transplanted patients and in their caregivers, suggesting a perception of better QOL after kidney transplantation. In the specific aspects of the questionnaire, physical capacity was considered superior by children who underwent transplants and their caregivers. There were no differences between the groups in the emotional, social and school aspects. However, the caregivers of the patients who had a transplant perceived a significant difference in QOL in the school aspect. In the thematic story-drawings, emotional suffering in the two analyzed groups was evidenced regardless of the treatment. CONCLUSIONS: Despite the questionnaire results suggesting that transplantation does improve some aspects of QOL, there were no differences observed between kidney replacement therapies regarding the emotional repercussion of chronic kidney disease.

Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode.

OBJECTIVE: Presence of psychotic symptoms seems to be a commonplace in early-onset bipolar disorder (BD). However, few studies have examined their occurrence in adolescent-onset BD. We sought to investigate the frequency of affective and psychotic symptoms observed during the first manic episode in adolescents. METHODS: Forty-nine adolescents with bipolar I disorder (DSM-IV criteria) were admitted to a psychiatric hospital during their first acute manic episode. Assessment for current psychiatric diagnosis was performed by direct clinical interview and the DSM-IV version of the Diagnostic Interview for Children and Adolescents (DICA). RESULTS: Teenage inpatients with BD consistently exhibited typical manic features, such as euphoria, grandiosity, and psychomotor agitation. In addition, disorganization and psychotic symptoms were present in 82 and 55% of the total sample, respectively. There was no significant difference in symptoms between early- and late-adolescent subgroups. Remarkably, most patients (76%) reported previous depressive episode(s); of these, 47% had prominent psychotic features in the prior depressive period. CONCLUSION: These findings suggest that disorganization and psychotic symptoms during the first manic episode are salient features in adolescent-onset BD, and that psychotic depression frequently may precede psychotic mania. Nevertheless, differential diagnosis with schizophrenia should be routinely ruled out in cases of early-onset first psychotic episode.

Emotional repercussions and quality of life in children and adolescents undergoing hemodialysis or after kidney transplantation / Repercussões emocionais e qualidade de vida das crianças e adolescentes em hemodiálise ou após transplante renal

ABSTRACT Objective: To investigate the emotional repercussions and quality of life (QOL) associated with end-stage kidney disease (ESKD) in children and adolescents undergoing hemodialysis or a kidney transplant (TX). Methods: We conducted a quantitative-qualitative study. 48 children and adolescents with ESKD were interviewed; half of them underwent hemodialysis treatment, and the other half had a kidney transplantation. Their respective 48 caregivers also participated in the study. The questionnaire involved both the Pediatric Quality of Life Inventory and a thematic story-drawing tool. An analysis of the QOL questionnaire's results was done by comparing the sum of points between groups and the theme-based story-drawing consisted of interpreting the data contained in the material using Freudian and Lacanian theories. Results: In the QOL questionnaires, the total score was higher in the transplanted patients and in their caregivers, suggesting a perception of better QOL after kidney transplantation. In the specific aspects of the questionnaire, physical capacity was considered superior by children who underwent transplants and their caregivers. There were no differences between the groups in the emotional, social and school aspects. However, the caregivers of the patients who had a transplant perceived a significant difference in QOL in the school aspect. In the thematic story-drawings, emotional suffering in the two analyzed groups was evidenced regardless of the treatment. Conclusions: Despite the questionnaire results suggesting that transplantation does improve some aspects of QOL, there were no differences observed between kidney replacement therapies regarding the emotional repercussion of chronic kidney disease.

RESUMO Objetivo: Investigar as repercussões emocionais e a qualidade de vida (QV) associadas à doença renal crônica em crianças e adolescentes submetidos à hemodiálise ou ao transplante renal. Métodos: Foram entrevistadas 48 crianças e adolescentes com doença renal crônica, metade dos quais submetidos ao tratamento hemodialítico, e a outra metade, ao transplante renal. Os 48 respectivos cuidadores também participaram da pesquisa. Utilizou-se o questionário de QV Pediatric Quality of Life Inventory e o instrumento de desenho-estória com tema. A análise dos resultados do questionário de QV foi feita pela somatória dos pontos e a dos desenhos-estórias com tema consistiu na interpretação dos dados do material, utilizando as teorias freudiana e lacaniana. Resultados: Nos questionários de QV, a pontuação total foi superior na opinião dos pacientes transplantados e seus cuidadores, indicando percepção de melhor QV após o transplante renal. Nos aspectos específicos, a capacidade física também foi considerada superior por esse grupo. Não houve diferenças entre os grupos de pacientes nos aspectos emocional, social e escolar, porém os cuidadores dos pacientes transplantados notaram diferença na QV no aspecto escolar. Nos desenhos-estórias com tema, observou-se que o sofrimento emocional foi evidenciado nos dois grupos estudados. Conclusões: Não foram percebidas diferenças entre as terapêuticas renais substitutivas quanto às repercussões emocionais da doença renal crônica. Por outro lado, verificou-se que o transplante melhora a QV no aspecto geral.

Emotion regulation as the mediator of reductions in anxiety and depression in the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders: double-blind randomized clinical trial.

OBJECTIVE: An important subject in evaluation of the efficacy of treatments is to examine how the intervention is effective and to identify the consequences of that treatment. In this regard, the current study investigates the role of emotion regulation as the mediator of the treatment outcomes of therapy using the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders. METHOD: This article describes a double-blind randomized clinical trial. A sample of 26 individuals was selected based on cut-off scores for the Beck Depression Inventory and Beck Anxiety Inventory and their final diagnoses were confirmed with the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV). The sample was randomly divided into two groups: control and treatment (13 patients each). The treatment group received 20 one-hour UP sessions. The Beck Depression Inventory, the Beck Anxiety Inventory, and the Difficulties in Emotion Regulation Scale were administered at two stages, pre-treatment and post-treatment. RESULTS: The UP reduced anxiety and depression in patients through improvement in emotion regulation. Furthermore, the results showed that the difficulty engaging in goal-directed behavior and non-acceptance of emotional response subscales were capable of predicting 62% of variance in anxiety scores. In turn, two subscales, difficulty engaging in goal-directed behavior and lack of emotional clarity, predicted 72% of variance in depression scores. CONCLUSION: Emotion regulation can be considered as a potential mediating factor and as predictive of outcomes of transdiagnostic treatment based on the UP. CLINICAL TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2017072335245N1.

Evaluation of affective temperament and anxiety-depression levels in fibromyalgia patients: a pilot study

Objective: Fibromyalgia (FM) patients have higher rates of depression and anxiety disorders than healthy controls. Affective temperament features are subclinical manifestations of mood disorders. Our aim was to evaluate the affective temperaments of FM patients and investigate their association with depression and anxiety levels and clinical findings. Methods: This cross-sectional study included FM patients and healthy controls. The Hospital Anxiety and Depression Scale (HADS) was used to determine patient anxiety and depression levels, and the Temperament Scale of Memphis, Pisa and San Diego, self-administered version was applied to assess affective temperaments in all subjects. Disease severity was assessed in FM patients with the Fibromyalgia Criteria and Severity Scales and the Fibromyalgia Impact Questionnaire (FIQ). Differences between groups were evaluated using Student's t-tests. Correlations among parameters were performed. Results: This study involved 38 patients with FM (30 female) and 30 healthy controls (25 female). Depressive, anxious and cyclothymic temperaments were significantly higher in FM patients than healthy controls. Statistically significant positive correlations were found between HADS depression score and all temperaments except hyperthymic, as well as between HADS anxiety score and cyclothymic and anxious temperaments. HADS depression and anxiety scores were correlated with symptom severity. We found a higher risk of depression and anxiety among FM patients with higher FIQ scores. Conclusion: This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders.

Emotional and behavioral problems: a school-based study in southern Brazil / Problemas emocionais e comportamentais: um estudo de base escolar no sul do Brasil

Abstract Introduction Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. Objective To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. Method A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. Results A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Resumo Introdução A avaliação da saúde mental na infância necessita ser realizada dentro de um contexto amplo que considere os diferentes fatores envolvidos. Objetivo Verificar a prevalência de problemas emocionais e comportamentais em escolares, bem como fatores associados. Método Estudo transversal, com amostra de base escolar em que foram selecionadas 20 escolas por amostragem aleatória sistemática. Participaram crianças com 7-8 anos e seus pais ou principais cuidadores. A presença de problemas emocionais e comportamentais nas crianças foi rastreada pelo Strengths and Difficulties Questionnaire (SDQ). Resultados Foram avaliadas 596 díades. A prevalência de problemas emocionais e comportamentais foi de 30,0% entre os meninos e 28,2% entre as meninas. Sintomas de hiperatividade/desatenção foram mais prevalentes entre meninos (p=0,015). Pertencer a camadas menos favorecidas economicamente aumentou em 71% a probabilidade de problemas emocionais e comportamentais entre os escolares (p=0,001), enquanto ter pais ou cuidadores com transtorno mental aumentou 2,2 vezes tal probabilidade (p<0,001). Conclusões: Nossos achados demonstram a elevada prevalência de problemas emocionais e comportamentais entre escolares, bem como a influência das condições econômicas e da saúde mental de pais e cuidadores sobre a saúde mental infantil.