Social support and suicidality during the COVID-19 pandemic among Brazilian healthcare workers: a longitudinal assessment of an online repeated cross-sectional survey.

INTRODUCTION: Healthcare workers (HCWs) are at an increased risk of suicide compared to non-healthcare workers. This study aims to investigate the association between social support and suicidal ideation and behavior (SIB) during the COVID-19 pandemic among Brazilian HCWs. METHODS: This study utilizes data from 10,885 participants who answered the first (time point 1 - between May and June of 2020) and second (time point 2 - between December 2020 and February 2021) assessments of an online repeated cross-sectional survey for evaluating mental health and quality of life of HCWs during the COVID-19 pandemic in Brazil. Logistic regression analysis was conducted to investigate the relationship between social support as the independent variable (time point 1) and SIB as the outcomes (time point 2). RESULTS: Higher social support was associated with a significantly lower chance of reporting SIB in the month prior to follow-up assessment (adjusted odds ratio [AOR]: 0.71, CI 95% 0.66 - 0.76 and AOR 0.61, CI 95% 0.54 - 0.68, respectively). These associations were independent of sex, age, feelings of loneliness, and self-reported psychiatric disorders. CONCLUSION: Social support is associated with a lower chance of suicidality among HCWs, a protective role that is probably more evident for suicidal behavior.

Parent training for disruptive behavior symptoms in attention deficit hyperactivity disorder: a randomized clinical trial.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) affects 5% of children and 2.5% of adults worldwide. Comorbidities are frequent, and Oppositional Defiant Disorder (ODD) reaches 50%. Family environment is crucial for the severity of behaviors and for prognosis. In middle-income countries, access to treatment is challenging, with more untreated children than those under treatment. Face-to-face behavioral parent training (PT) is a well-established intervention to improve child behavior and parenting. Method: A clinical trial was designed to compare PT-online and face-to-face effects to a waiting list group. Outcomes were the ADHD and ODD symptoms, parental stress and styles, and quality of life. Families were allocated into three groups: standard treatment (ST), ST + PT online, and ST + Face-to-Face PT. We used repeated measures ANOVA for pre × post treatment analysis corrected for multiple comparisons. Results and discussion: Parent training was effective in reducing symptoms of ADHD (p = 0.030) and ODD (p = 0.026) irrespective of modality (p = 1.000). The combination of ST and PT was also associated with better quality of life in the physical domain for patients (p = 0.009) and their parents (p = 0.050). In addition to preliminary data, online intervention seems effective for parenting and improving social acceptance of children. The potential to reach many by an online strategy with a self-directed platform may imply effectiveness with a low cost for public health to support parents' symptoms management.

Children and adolescents' quality of life in repeated cross-sectional studies during the COVID-19.

During the COVID-19 pandemic, internalizing and externalizing symptoms have impacted the quality of life of children and adolescents. This cross-sectional study evaluated children's quality of life using parental reports, observing associations with mental health problems and sociodemographic variables. Some behavioral measures were linked to lower quality of life, particularly depression symptoms, relationship problems, and inattention. Multiple regression models indicated that reduced children's quality of life (R2 = 36%) was associated with higher levels of internalizing (r = -0.46) and externalizing (r = -0.23) behavioral problems and younger parents (r = -0.08). Children with previous mental disorder diagnoses had lower quality of life than those without (p < 0.001). In summary, children's quality of life during the COVID-19 pandemic was linked to current mental health, parental age, and previous history of mental disorders.

Selective visuoconstructional impairment following mild COVID-19 with inflammatory and neuroimaging correlation findings.

People recovered from COVID-19 may still present complications including respiratory and neurological sequelae. In other viral infections, cognitive impairment occurs due to brain damage or dysfunction caused by vascular lesions and inflammatory processes. Persistent cognitive impairment compromises daily activities and psychosocial adaptation. Some level of neurological and psychiatric consequences were expected and described in severe cases of COVID-19. However, it is debatable whether neuropsychiatric complications are related to COVID-19 or to unfoldings from a severe infection. Nevertheless, the majority of cases recorded worldwide were mild to moderate self-limited illness in non-hospitalized people. Thus, it is important to understand what are the implications of mild COVID-19, which is the largest and understudied pool of COVID-19 cases. We aimed to investigate adults at least four months after recovering from mild COVID-19, which were assessed by neuropsychological, ocular and neurological tests, immune markers assay, and by structural MRI and 18FDG-PET neuroimaging to shed light on putative brain changes and clinical correlations. In approximately one-quarter of mild-COVID-19 individuals, we detected a specific visuoconstructive deficit, which was associated with changes in molecular and structural brain imaging, and correlated with upregulation of peripheral immune markers. Our findings provide evidence of neuroinflammatory burden causing cognitive deficit, in an already large and growing fraction of the world population. While living with a multitude of mild COVID-19 cases, action is required for a more comprehensive assessment and follow-up of the cognitive impairment, allowing to better understand symptom persistence and the necessity of rehabilitation of the affected individuals.

The mental health of Brazilian healthcare professionals during the COVID-19 pandemic: a longitudinal study.

OBJECTIVE: To compare the distress level among Brazilian healthcare professionals during the coronavirus disease 2019 (COVID-19) pandemic and estimate risks by sex, age, and occupation. METHODS: In a longitudinal cohort design, a nationally distributed online survey was used to collect data from 10,490 active healthcare professionals who worked during the pandemic. Participants were mostly female, aged 18 to 82 years; 13 different health professions and all states of Brazil were represented. RESULTS: The most frequent professions were psychology, dentistry, and nursing. The Brief Symptom Inventory (BSI) score suggested an increased distress perception among health professionals. Females showed poorer mental health than males, but the absolute rise in Global Severity Index (GSI) score was larger in males than in females. Younger adults reported more symptoms of psychological distress than older adults. The most impacted age group was between 30-39 years. Nurse technicians presented the highest risk of distress. CONCLUSION: Health professionals are essential to overcoming the pandemic; thus, their mental health status should be monitored, and features associated with increased distress should be identified. Our findings suggest distress risk should be stratified by occupation, age, and sex. Health professionals showed an increased distress perception. Women, individuals between the ages of 30 and 39, nursing personnel, and physicians were more likely to report distress compared with other health professionals.

The mental health of Brazilian healthcare professionals during the COVID-19 pandemic: a longitudinal study

Objective: To compare the distress level among Brazilian healthcare professionals during the coronavirus disease 2019 (COVID-19) pandemic and estimate risks by sex, age, and occupation. Methods: In a longitudinal cohort design, a nationally distributed online survey was used to collect data from 10,490 active healthcare professionals who worked during the pandemic. Participants were mostly female, aged 18 to 82 years; 13 different health professions and all states of Brazil were represented. Results: The most frequent professions were psychology, dentistry, and nursing. The Brief Symptom Inventory (BSI) score suggested an increased distress perception among health professionals. Females showed poorer mental health than males, but the absolute rise in Global Severity Index (GSI) score was larger in males than in females. Younger adults reported more symptoms of psychological distress than older adults. The most impacted age group was between 30-39 years. Nurse technicians presented the highest risk of distress. Conclusion: Health professionals are essential to overcoming the pandemic; thus, their mental health status should be monitored, and features associated with increased distress should be identified. Our findings suggest distress risk should be stratified by occupation, age, and sex. Health professionals showed an increased distress perception. Women, individuals between the ages of 30 and 39, nursing personnel, and physicians were more likely to report distress compared with other health professionals.

Social Determinants in Self-Protective Behavior Related to COVID-19: Association Rule-Mining Study.

BACKGROUND: Human behavior is crucial in health outcomes. Particularly, individual behavior is a determinant of the success of measures to overcome critical conditions, such as a pandemic. In addition to intrinsic public health challenges associated with COVID-19, in many countries, some individuals decided not to get vaccinated, streets were crowded, parties were happening, and businesses struggling to survive were partially open, despite lockdown or stay-at-home instructions. These behaviors contrast with the instructions for potential benefits associated with social distancing, use of masks, and vaccination to manage collective and individual risks. OBJECTIVE: Considering that human behavior is a result of individuals' social and economic conditions, we investigated the social and working characteristics associated with reports of appropriate protective behavior in Brazil. METHODS: We analyzed data from a large web survey of individuals reporting their behavior during the pandemic. We selected 3 common self-care measures: use of protective masks, distancing by at least 1 m when out of the house, and handwashing or use of alcohol, combined with assessment of the social context of respondents. We measured the frequency of the use of these self-protective measures. Using a frequent pattern-mining perspective, we generated association rules from a set of answers to questions that co-occur with at least a given frequency, identifying the pattern of characteristics of the groups divided according to protective behavior reports. RESULTS: The rationale was to identify a pool of working and social characteristics that might have better adhesion to behaviors and self-care measures, showing these are more socially determined than previously thought. We identified common patterns of socioeconomic and working determinants of compliance with protective self-care measures. Data mining showed that social determinants might be important to shape behavior in different stages of the pandemic. CONCLUSIONS: Identification of context determinants might be helpful to identify unexpected facilitators and constraints to fully follow public policies. The context of diseases contributes to psychological and physical health outcomes, and context understanding might change the approach to a disease. Hidden social determinants might change protective behavior, and social determinants of protective behavior related to COVID-19 are related to work and economic conditions. TRIAL REGISTRATION: Not applicable.

Common Venues in Romantic Relationships of Adults With Symptoms of Autism and Attention Deficit/Hyperactivity Disorder.

Introduction: Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) figures among the most common neurodevelopmental disorders. Despite having opposite stereotypes, both ADHD and ASD compromise, though in different ways, skills such as social interactions, communication skills, and social thinking, which may underlie difficulties in romantic relationships. Methods: We evaluated 306 adults about their romantic relationships and the intensity of their love. Participants were from one of four groups:, individuals with ASD-only traits, a group with symptoms of ADHD-only, participants with neither ADHD nor ASD symptoms (control) or from a fourth group of individuals with both ADHD and ASD traits. Results: The ASD traits group had fewer married people and more people who have never been married, while the rate of divorce was higher in the ADHD traits group. Regarding the intensity of love, the mean scores of the ADHD and the ADHD+ASD traits groups were higher in the Passionate Love Scale than the mean score of the control group. Passionate love in the ASD group was no different from the other groups. Small positive correlations were found between passionate love and ADHD and ASD behavioral problems. Conclusion: Marital status was distinct depending on symptoms of a neurodevelopmental disorder in adulthood. Also, ADHD and ASD symptoms were associated with greater passionate love. Therefore, ADHD and ASD behavioral dimensions may impact long-term and short-term experiences of a person's relationship with a significant other in distinct ways. Understanding how people with neurodevelopmental disorders experience love might help us to better clarify the mechanisms associated with their relationship patterns.

Preditores de sofrimento psicológico e prevalência de transtornos mentais autodeclarados em profissionais de saúde e na população em geral durante a pandemia de Covid-19 no Brasil / Predictors of psychological distress and prevalence of self-reported mental disorders in health care professionals and in the general population during the Covid-19 pandemic in Brazil

O fardo dos transtornos mentais pode aumentar durante a pandemia de Covid-19. Por isso, é estratégico caracterizar a saúde mental da população. Analisamos dados coletados pela Internet de 164.881 profissionais de saúde e 5.635 participantes da população geral. O Índice de Gravidade Global (GSI) do Inventário Breve de Sintomas, diagnóstico autodeclarado de transtornos mentais, características sociodemográficas, estado de saúde física, história de contato com a Covid-19, percepções e preocupações e medidas preventivas adotadas foram comparados entre as amostras. Análises de regressão múltipla foram usadas para investigação de fatores associados ao GSI. O distresse psicológico foi classificado como alto ou muito alto em 13,4% dos profissionais de saúde e em 31,4% dos participantes da população geral. A prevalência de transtornos mentais ao longo da vida foi 36% para profissionais de saúde e 44,7% para a população geral, sendo os mais frequentes transtornos depressivos e ansiedade generalizada. Entre os profissionais de saúde, ser do sexo feminino e mais jovem foi associado à maior distresse psicológico. Para a população geral foram preditores de distresse a classe econômica e um domicílio com mais pessoas. Foram significativamente associados ao GSI sintomas de Covid-19, sentir-se menos produtivo no trabalho, medo de transmitir o vírus para a família, medo de dificuldades financeiras e sentir que os relacionamentos em casa pioraram. A prevalência de transtornos mentais atinge parte relevante da população brasileira. Fatores sociodemográficos, aspectos familiares e instabilidade financeira devem ser considerados no entendimento do distresse psicológico durante a pandemia.(AU)

BACKGROUND: The burden of mental disorders is likely to increase during the Covid-19 pandemic. Knowing the rate of psychological distress and mental disorders, its severity, and factors associated with psychological distress is strategical. METHOD: We analyzed online cross-sectional data from 164,881 health professionals and from 5,635 participants from the general population in Brazil. The Global Severity Index (GSI) from the Brief Symptom Inventory, self-reported diagnosis of mental disorders, sociodemographic characteristics, and factors related to Covid-19, such as physical health status, diagnosis and contact history, perceptions and concerns, and precautionary measures were compared between samples. Multiple regression analysis was used to investigate factors related to GSI scores. RESULTS: Psychological distress was high or very high in 13.4% of health professionals and in 31.4% of the general population. Health professionals reported a lower rate of current or previous history of mental disorders (36%) than participants from the general population (44.7%). Age (younger) and gender (female) predicted higher psychological distress for health professionals and economic class (lower) and household size (more members) for the general population. People with higher GSI scores reported to have experienced more physical symptoms associated with Covid-19, feeling less productive at work, being afraid of transmitting the coronavirus to the family, fear of financial difficulties, and feeling that home relations were worse during the pandemic outbreak. CONCLUSIONS: Psychological distress at the first wave of Covid-19 was associated with sociodemographic features and an anxious perception of physical symptoms, virus transmission to loved ones, disruption of family relations, and financial situation.(AU)

INTRODUCCIÓN: Es probable que la carga de los trastornos mentales aumente durante la pandemia de Covid-19. Conocer la tasa de malestar psicológico y de los trastornos mentales, su gravedad y los factores asociados al malestar psicológico es estratégico. MÉTODO: Se analizaron datos transversales en línea de 164.881 profesionales de la salud y 5.635 participantes de la población general de Brasil. Se compararon entre las muestras el Índice de Gravedad Global (GSI) del Inventario Breve de Síntomas, el diagnóstico auto declarado de trastornos mentales, las características sociodemográficas y los factores relacionados con la Covid-19. Se utilizó un análisis de regresión múltiple para investigar los factores relacionados con las puntuaciones del GSI. RESULTADOS: El malestar psicológico era alto o muy alto en 13,4% de los profesionales de la salud y en 31,4% de la población general. Los profesionales de la salud declararon tasa de 36% de trastornos mentales y la población general de 44,7%. La edad (más joven) y el sexo (femenino) predijeron un mayor malestar psicológico para los profesionales de la salud y la clase económica (más baja) y el tamaño de la familia (más miembros) para la población general. Las personas con puntuaciones más altas en el GSI declararon haber experimentado más síntomas físicos asociados a la Covid-19, sentirse menos productivos en el trabajo, tener miedo de transmitir el coronavirus a la familia, temer dificultades económicas y sentir que las relaciones domésticas empeoraron. CONCLUSIONES: La angustia psicológica se asoció a las características sociodemográficas y a la percepción ansiosa de los síntomas físicos, la transmisión del virus a los seres queridos, la perturbación de las relaciones familiares y la situación económica.(AU)

The abbreviated version of the Barratt Impulsiveness Scale (ABIS): Psychometric analysis, reliable change indexes in clinical practice and normative data.

Impulsivity is highly associated with psychopathology and dysfunctional behavior. An abbreviated Barratt Impulsiveness Scale (ABIS) was proposed as a validated, reliable and less time-consuming scale. We tested in a sample of adults, its psychometric properties and computed a reliable change index for clinical use. Internal consistency, test-retest stability suggested high reliability, while significant correlations with measures of psychiatric symptoms, and the original scale were evidence of validity. If a patient presents a change of 4 points between two applications of ABIS this indicates a reliable change, which can be used to evaluate the effect of patients' treatment or interventions.

Investigation on the Attention Deficit Hyperactivity Disorder Effect on Infatuation and Impulsivity in Adolescents.

INTRODUCTION: In this study, we proposed to investigate the association between infatuation/passionate love and impulsivity in a context of potential high impulsivity: adolescents with attention deficit and hyperactivity/impulsivity (ADHD) diagnosis compared with typically developing adolescents. METHODS: Impulsivity was understood as an exploratory and a sensation seeking behavior, a trend to engage in novel and exciting activities, and was evaluated using the UPPS Impulsive Behavior Scale. Eighty-one adolescents from 13-to-18 years old with and without ADHD diagnosis were compared regarding infatuation intensity, behavioral impulsivity, and social and educational profiles. RESULTS: After correlation analysis, we found association between higher scores on the infatuation intensity with fewer years of formal education, heightened urgency and sensation seeking. On the other hand, using the generalized equation model, we showed that the association of passionate love with behavioral urgency and sensation seeking did not change in the presence of the ADHD diagnosis. CONCLUSION: The understanding of the relationship of impulsivity with infatuation might help to clarify why some population groups show an increased risk for many negative social outcomes.

Translation, cultural adaptation, and content validity index of the Juvenile Love Scale to the Brazilian context

Abstract Background Passionate love involves physiological, emotional, and cognitive features that greatly changes behavior. This phenomenon seems universal or near universal. Even other animal species choose partners. An intense state of passionate love is associated with activity in dopamine pathways of the brain 'reward system', and recently has been regarded as a 'natural addiction'. Instruments or tools to evaluate romantic love during childhood is still scarce. Objective To perform the translation and cultural adaptation of the Juvenile Love Scale (JLS) for use in the Brazilian context targeted for adolescents between 14 and 18 years old. Methods The translation and cultural adaptation of JLS followed international recommendations, and its content validity was analyzed by a panel of experts in different areas of knowledge. Results The final version of the JLS for use in the Brazilian context showed high content validity (> 90%). Discussion To our knowledge, this is the first scale for measuring romantic or passionate love in adolescents adapted to the Brazilian context. This instrument is a significant contribution to the study of the dimensions of love, as well as to understand the impact of love on the psychiatric phenomena that pervade life in this stage of development.

Influence of COMT Val158Met polymorphism on emotional decision-making: A sex-dependent relationship?

The biological underpinnings of sex-related differences in decision-making are still under-explored. The COMT gene is related to sexual dimorphism and with different choices made under uncertainty, albeit no study has specifically investigated a moderation effect of sex on the association between the COMT gene and the performance on decision-making paradigms. In this study, we investigated the influence of the COMT Val158Met polymorphism on Iowa Gambling Task (IGT) performance depending on sex in a healthy adult sample. Participants were 192 healthy adults (84 men and 108 women). The first 40 choices in the IGT were considered decisions under ambiguity and the last 60 choices decisions under risk. To test our moderation hypothesis we used a separate regressions approach. The results revealed a sex-dependent effect of COMT Va l158Met polymorphism on decision-making as measured by the IGT. Val/Val women showed the best performance in the last trials of the IGT. Therefore, the COMT Val158Met polymorphism may be considered a genetic marker underlying sex differences in decision-making.

COMT Val(158)Met Polymorphism Is Associated with Verbal Working Memory in Neurofibromatosis Type 1.

Neurofibromatosis type I (NF1) is a neurogenetic disease marked by multiple cognitive and learning problems. Genetic variants may account for phenotypic variance in NF1. Here, we investigated the association between the catechol-O-methyltransferase (COMT) Val(158)Met polymorphism and working memory and arithmetic performance in 50 NF1 individuals. A significant association of the COMT polymorphism was observed only with verbal working memory, as measured by the backward digit-span task with an advantageous performance for Met/Met carriers. To study how genetic modifiers influence NF1 cognitive performance might be of importance to decrease the unpredictability of the cognitive profile among NF1 patients.

Ecological validity of the five digit test and the oral trails test / Validade ecológica do teste dos cinco dígitos e do oral trails test

ABSTRACT Tests evaluating the attentional-executive system are widely used in clinical practice. However, proximity of an objective cognitive test with real-world situations (ecological validity) is not frequently investigated. The present study evaluate the association between measures of the Five Digit Test (FDT) and the Oral Trails Test (OTT) with self-reported cognitive failures in everyday life as measured by the Cognitive Failures Questionnaire (CFQ). Brazilian adults from 18-to-65 years old voluntarily performed the FDT and OTT tests and reported the frequency of cognitive failures in their everyday life through the CFQ. After controlling for the age effect, the measures of controlled attentional processes were associated with cognitive failures, yet the cognitive flexibility of both FDT and OTT accounted for by the majority of variance in most aspects of the CFQ factors. The FDT and the OTT measures were predictive of real-world problems such as cognitive failures in everyday activities/situations.

RESUMO Testes que avaliam o sistema atencional-executivo são amplamente adotados no contexto clínico. Contudo, a proximidade de uma medida cognitiva objetiva com situações reais (validade ecológica) são pouco investigadas. O presente estudo objetiva avaliar a associação entre o Teste dos Cinco Dígitos (FDT) e o Oral Trails Test (OTT) com falhas cognitivas do dia a dia relatadas no Questionário de Falhas Cognitivas (CFQ). Sessenta adultos brasileiros, de 18 a 65 e cinco anos, realizaram o FDT e o OTT e reportaram a frequência das falhas cognitivas por meio do CFQ. Controlando o efeito da idade, as medidas de processos atencionais controlados foram associadas com as falhas cognitivas, sendo que o componente de flexibilidade cognitiva do FDT e do OTT explicou a maior parte da variância das falhas. O FDT e o OTT foram preditores de problemas reais do dia a dia, como as falhas cognitivas.

Ecological validity of the five digit test and the oral trails test.

Tests evaluating the attentional-executive system are widely used in clinical practice. However, proximity of an objective cognitive test with real-world situations (ecological validity) is not frequently investigated. The present study evaluate the association between measures of the Five Digit Test (FDT) and the Oral Trails Test (OTT) with self-reported cognitive failures in everyday life as measured by the Cognitive Failures Questionnaire (CFQ). Brazilian adults from 18-to-65 years old voluntarily performed the FDT and OTT tests and reported the frequency of cognitive failures in their everyday life through the CFQ. After controlling for the age effect, the measures of controlled attentional processes were associated with cognitive failures, yet the cognitive flexibility of both FDT and OTT accounted for by the majority of variance in most aspects of the CFQ factors. The FDT and the OTT measures were predictive of real-world problems such as cognitive failures in everyday activities/situations.

Use of a modified version of the switching verbal fluency test for the assessment of cognitive flexibility / Uso de uma versão modificada da fluência verbal alternada para a avaliação da flexibilidade cognitiva

Objective:Verbal fluency tests are widely used for the assessment of executive functions. However, traditional versions of the test depend on several cognitive factors beyond these components. The aim of this study was to evaluate the associations of a modified version of the verbal fluency with specific measures of executive functions.Methods:Sixty adults were evaluated using traditional versions of verbal fluency (animals/fruits) and a modified condition where subjects must switch between animals and fruits. Processing speed, semantic abilities, psychiatric symptoms and executive functions were also assessed.Results:Partial correlations between the verbal fluency tests and measures of executive functions, controlled for demographic, cognitive and psychiatric symptoms, suggest that cognitive flexibility has 9% shared variance with the verbal fluency test - category animals, 2 % with category fruits, 8% with total words in switching condition, and 20% with total correct word-pairs produced in switching condition. The other aspects of executive functions during the task had shared variance of between 1% and 7% with the verbal fluency tasks.Conclusion:The results suggest that correct word-pairs produced in switching verbal fluency may be a more specific measure for evaluating cognitive flexibility compared to other versions of verbal fluency.

Objetivo:Os testes de fluência verbal são comumente adotados para a avaliação cognitiva de pacientes com transtornos mentais ou doenças neurológicas. Embora muitas vezes utilizado na avaliação das funções executivas, sobretudo flexibilidade cognitiva, versões tradicionais do teste dependem de diversos fatores cognitivos além desses componentes. O objetivo do presente estudo é avaliar as associações de uma versão adaptada do teste de fluência verbal com medidas específicas de funções executivas.Métodos:Avaliamos sessenta adultos com versões tradicionais da fluência verbal (animais/frutas) e uma condição modificada onde o sujeito deve alternar entre animais e frutas. Avaliamos também a velocidade de processamento, habilidades semânticas, sintomas psiquiátricos e aos três componentes centrais das funções executivas (controle inibitório, memória de trabalho e flexibilidade cognitiva).Resultados:As correlações parciais entre os testes de fluência verbal e as medidas de funções executivas, controladas por fatores demográficos, cognitivos e pelos sintomas psiquiátricos, sugere que a flexibilidade cognitiva apresenta 9% de variância compartilhada com o teste de fluência verbal categoria animais, 2% com a categoria frutas, 8% com o total de palavras na fluência verbal alternada, e 20% com total de pares corretos produzidos na fluência verbal alternada. Os demais aspectos das funções executivas durante a tarefa apresentaram variância compartilhada entre 1% e 7% com as tarefas de fluência verbal.Conclusão:Os dados sugerem que o total de pares produzidos no teste de fluência verbal alternada pode ser uma medida mais especifica para a avaliação da flexibilidade cognitiva quando comparado a outras versões da fluência verbal.

Telomere length is highly inherited and associated with hyperactivity-impulsivity in children with attention deficit/hyperactivity disorder.

Telomere length (TL) is highly heritable, and a shorter telomere at birth may increase the risk of age-related problems. Additionally, a shorter TL may represent a biomarker of chronic stress and has been associated with psychiatric disorders. However, no study has explored whether there is an association between TL and the symptoms of one of the most common neurodevelopmental disorders in childhood: Attention Deficit/Hyperactive Disorder (ADHD). We evaluated 61 (range, 6-16 years) ADHD children and their parents between 2012 and 2014. TL was measured with a quantitative polymerase chain reaction method with telomere signal normalized to the signal from a single copy gene (36B4) to generate a T/S ratio. Family data was processed through a generalized estimated equations (GEE) model to determine the effect of parental TL on children TL. Inattentive and hyperactive-impulsive symptoms were also evaluated in relation to TL. For the first time, we found general heritability to be the major mechanism explaining interindividual TL variation in ADHD (father-child: 95% CI = 0.35/0.91, p < 0.001; mother-child: 95% CI = 0.38/0.74, p < 0.001). The hyperactive-impulsive dimension of ADHD was related with children's TL (r = -339, p = 0.008) and maternal TL (r = -264, p = 0.047), but not with paternal TL (p > 0.05). The ADHD inattentive dimension was not significant associated with TL in this study (p > 0.05). TL was shown to be a potential biomarker of the ADHD symptoms burden in families affected by this neurodevelopmental disorder. However, it is crucial that future studies investigating the rate of telomere attrition in relation to psychiatric problems to consider the strong determination of TL at birth by inheritance.

Neurofibromatosis: part 2--clinical management.

Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1.

Neurofibromatosis: part 2 – clinical management / Neurofibromatoses: parte 2 – manejo clínico

Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1.

A primeira parte desta diretriz abordou o diagnóstico diferencial das neurofibromatoses (NF): neurofibromatose do tipo 1 (NF1), neurofibromatose do tipo 2 (NF2) e schwannomatose (SCH). As NF compartilham algumas características, como a origem neural dos tumores e sinais cutâneos, e afetam cerca de 80 mil brasileiros. O aumento do conhecimento científico sobre as NF tem permitido melhor manejo clínico e redução da morbidade das complicações, resultando em melhor qualidade de vida para os pacientes com NF. A maioria dos médicos é capaz de realizar o diagnóstico das NF, mas a variedade de manifestações clínicas e a dificuldade de se prever o surgimento e a gravidade de complicações, torna o manejo da NF um desafio para o clínico e envolve diferentes especialistas para o tratamento adequado e aconselhamento genético, especialmente a NF2 e a SCH. O presente texto sugere algumas orientações para o acompanhamento dos portadores de NF, com ênfase na NF1.