Binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery.

PURPOSE: The aim of the present study was to determine possible associations between binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery. METHODS: A cross-sectional study was conducted with 254 obese patients recruited from the general surgery service for bariatric procedures at the hospital affiliated with the Federal University of Pernambuco, Brazil. Evaluations were performed using the Binge Eating Scale (BES), Beck Depression Inventory, Beck Scale for Suicidal Ideation (BSSI) and a questionnaire addressing sociodemographic characteristics. RESULTS: Most patients were women (82%), 48% had a moderate binge eating disorder, 42% a severe binge eating disorder, 32% had symptoms suggestive of mild, moderate or severe depression and 6% had suicidal ideation. Severe binge eating was positively associated with depressive symptoms (p < 0.001) and suicidal ideation (p < 0.05). Cases of severe binge eating were more frequent in young adults, but not necessarily associated with symptoms of depression or suicidal ideation in this portion of the sample. CONCLUSIONS: The present findings underscore the need for psychological and psychiatric follow-up of obese candidates for bariatric surgery using appropriate assessment scales to guide therapeutic approaches. LEVEL III: Evidence obtained from cross-sectional study.

Transtornos alimentares e insatisfação corporal nas práticas relacionadas ao bullying em adolescentes / Eating disorders and body dissatisfaction in practices related to bullying in adolescents / Trastornos de la conducta alimentaria e insatisfacción corporal en prácticas relacionadas con el acoso escolar en adolescentes

Objetivos: Identificar a associação dos transtornos alimentares e insatisfação corporal na prática do bullying em adolescentes. Métodos: Estudo transversal, em uma população de 144 adolescentes, entre 14 a 19 anos de uma escola pública. Foram utilizados os instrumentos Eating Attitudes Test - EAT-26; Bulimic Investigatory Test of Edinburgh ­ BITE; Body Shape Questionay - BSQ e questionário sobre Bullying, em suas versões para adolescentes. Resultados: Foi visto que cerca de 1,4% dos adolescentes apresentaram compulsão alimentar; 23,6% sintomas sugestivos para TA; 16% insatisfação corporal; 49,3% foram classificados como vítimas e/ou vítima/agressor; 29,8% foram classificados com agressor e/ou vítima/agressor. Segundo o EAT- 26 e BSQ, não houve uma correlação positiva entre bullying (vítima e/ou agressor) os sintomas sugestivos para TA (p>0,136) e a insatisfação corporal (p>0,896), respectivamente. Os adolescentes que sofreram vitimização do bullying apresentaram uma correlação positiva com sintomas de bulimia nervosa (BN) (p<0,039) e com a gravidade de sintomas (p<0,006), de acordo com escala BITE. Conclusão: Houve correlação entre o bullying e sintomas sugestivos para TA, principalmente a BN. De modo que se faz necessário o desenvolvimento de ações para redução do bullying e prevenção dos TA nos adolescentes, os resultados obtidos servem como uma alerta para a saúde pública.

Objectives: To identify an association of eating disorders and body dissatisfaction in adolescents' bullying in adolescents. Methods: A cross-sectional study was carried out in a population of 144 adolescents aged 14 to 19 years of a public school. The Food Attitude Test - EAT-26 instruments were used; Edinburgh Bulimia Research Test - BITE; Body Shape Questionay - BSQ and Bullying Quiz, in their teenage versions. Results: It was seen that it is 1.4% of adolescents binge eating; 23.6% suggestive symptoms for BP; 16% body dissatisfaction; 49.3% were classified as victims and / or victims / aggressors; 29.8% were classified as aggressor and / or victim / aggressor. According to the EAT-26 and BSQ, there was no positive alternative between bullying (victim and / or aggressor) the suggestive symptoms for AT (p> 0.136) and body dissatisfaction (p> 0.96), respectively. Adolescents who suffered from bullying had an average of bulimia nervosa (BN) symptoms (p <0.039) and a severity of symptoms (p<0.006), according to the BITE scale. Conclusion: There was a correlation between bullying and symptoms suggestive of AT, mainly BN. Thus, it is necessary to develop actions to reduce the intimidation and avoidance of AT in adolescents, the results are considered as an alert to public health.

Objetivos: Identificar una asociación de los trastornos alimentarios y la insatisfacción corporal en el acoso escolar en adolescentes. Métodos: Se realizó un estudio transversal en una población de 144 adolescentes de 14 a 19 años de una escuela pública. Fueron utilizados los instrumentos Food Attitude Test - EAT-26; Edinburgh Bulimia Research Test - BITE; Body Shape Questionay - BSQ y Bullying Quiz, en sus versiones para adolescentes. Resultados: Se observó que es 1,4% de los adolescentes atracones; 23,6% síntomas sugestivos para BP; 16% insatisfacción corporal; 49,3% fueron clasificados como víctimas y / o víctimas / agresores; 29,8% fueron clasificados como agresor y / o víctima / agresor. De acuerdo con el EAT-26 y BSQ, no hubo alternativa positiva entre la intimidación (víctima y / o agresor) los síntomas sugestivos de TA (p> 0,136) y la insatisfacción corporal (p> 0,96), respectivamente. Los adolescentes que sufrieron bullying presentaron una media de síntomas de bulimia nerviosa (BN) (p <0,039) y una gravedad de síntomas (p <0,006), según la escala BITE. Conclusiones: Se observó una correlación entre el acoso escolar y síntomas sugestivos de TA, principalmente BN. Por lo tanto, es necesario desarrollar acciones para reducir la intimidación y la evitación de TA en adolescentes, los resultados se consideran como una alerta a la salud pública.

Risk of eating disorders, changes in salivary cortisol concentrations and nutritional status of adolescents.

PURPOSE: The imposition of the thin body as an ideal of beauty and the changes that occur in adolescence lead to a constant concern with adolescents' body weight, putting them at risk for eating disorders. Thus, the study sought to investigate associations between eating disorders and salivary cortisol concentrations, nutritional status and depressive symptoms in female adolescents with bulimia. METHODS: A cross-sectional study was carried out with 1435 adolescents aged 10-19 years. The Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ) questionnaires were used. A follow-up study was conducted from a random selection of female adolescents diagnosed with Bulimia Development and Well-Being Assessment-(DAWBA) to assess associations with salivary cortisol concentrations and nutritional status. RESULTS: The prevalence of body dissatisfaction among adolescents with symptoms of bulimia was 37%. There was a significant difference between salivary cortisol and bulimia (Risk Group = 0.33 ± 0.20 µg/100 ml, Diagnostic Group = 0.44 ± 0.21 µg/100 ml p = 0.040), and correlation positive between the risk of bulimia with symptoms of depression (0.355 p = 0.002) and with Body Mass Index (0.259 p = 0.028). High concentrations of salivary cortisol in bulimic adolescents may be associated with hyperactivity of the hypothalamic-pituitary-adrenal axis and depressive symptoms. CONCLUSIONS: Nutritional status indicators cannot be used alone for the diagnosis of bulimia, since cortisol levels seem to be a reliable parameter in the identification of bulimia, provided they are used with other diagnostic criteria. LEVEL III: Evidence obtained from cross-sectional study.

The presence of migraine symptoms was associated with a higher likelihood to present eating disorders symptoms among teenage students.

OBJECTIVE: To investigate the association between migraine and signs and symptoms of eating disorders among teenagers. And as secondary objectives: to investigate the prevalence of eating disorders signs and symptoms and to identify the prevalence of migraine among teenagers. METHODS: Cross-sectional study was carried out in public schools which included adolescents aged 11-18 years, of both sexes. For eating disorders evaluation two self-reported questionnaires were used: Eating Attitudes Test-26 (EAT-26) and The Bulimic Investigatory Test of Edinburg (BITE). The presence and characterization of headache were verified following the International Classification of Headache Disorders (ICHD-II). RESULTS: 607 adolescents (388 females) with mean age of 13.9 years (95% CI: 13.7; 14) were included. The eating disorders symptoms based on EAT-26 (p = 0.041) and the bulimia nervosa symptoms (p = 0.014) evaluation were more prevalent among teenagers with migraine compared with non-migraine. Also, in multivariate analysis, the adjusted odds ratio (OR) to present bulimia nervosa symptoms is 1.85 times higher among females than males. And, the adjusted OR to present bulimia nervosa symptoms among teenagers with migraine is 1.51 times (OR) higher than among non-migraine. CONCLUSIONS: The presence of migraine symptoms were associated with a higher likelihood to present eating disorders symptoms among teenagers, especially in females, that was associated with a 1.85-fold increase in the risk to present bulimia nervosa symptoms. LEVEL OF EVIDENCE: III, Evidence obtained from cross-sectional study.

Association between eating disorders, suicide and depressive symptoms in undergraduate students of health-related courses.

OBJECTIVE: To identify symptoms of eating disorders and potential associations with risk of suicide and depressive symptoms in undergraduate students of health-related courses. METHODS: A cross-sectional study involving 271 students. The following instruments were used to identify symptoms of eating disorders: Eating Attitudes Test-26 and Bulimic Investigatory Test of Edinburgh. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to screen for depressive symptoms and risk of suicide, respectively. Participants answered a questionnaire aimed to collect biodemographic data for economic classification of the sample. RESULTS: Symptoms of eating disorders and bulimia nervosa were detected in 7.4% and 29.1% of students, respectively. Approximately 17.3% of students had symptoms of major depression, and 13.6% were at risk of suicide to some extent; risk of suicide was thought to be low in 7.4%, moderate in 0.7% and high in 5.5% of students in this subset. The risk of eating disorder development was correlated with the risk of suicide (p<0.001). CONCLUSION: Undergraduate students at risk of developing eating disorders, or with symptoms suggestive of depression, are more prone to commit suicide.

Electromyographic Patterns and the Identification of Subtypes of Awake Bruxism.

The future of awake bruxism assessment will incorporate physiological data, possibly electromyography (EMG) of the temporal muscles. But up to now, temporal muscle contraction patterns in awake bruxism have not been characterized to demonstrate clinical utility. The present study aimed to perform surface EMG evaluations of people assessed for awake bruxism to identify possible different subtypes. A 2-year active search for people with awake bruxism in three regions of the country resulted in a total of 303 participants (223 women, 38 ± 13 years, mean and SD). Their inclusion was confirmed through non-instrumental approaches for awake bruxism: self-reported questionnaire and clinical exam, performed by three experienced and calibrated dentists (Kappa = 0.75). Also, 77 age- and sex-matched healthy controls were recruited (49 women, 36 ± 14 years). Temporalis surface EMG was performed with a portable device (Myobox; NeuroUp, Brazil). EMG signals were sent to a computer via Bluetooth 4.0 at a sampling rate of 1,000 Hz. Digital signal processing was performed using the commercial neuroUP software, transformed in RMS and then normalized for peak detection (EMG peaks/min), in a 10 min session. Cluster analysis revealed three distinct subtypes of awake bruxism: phasic, tonic, and intermediate. Individuals with a predominance of EMG peaks/min were classified as the "phasic" subtype (16.8%). Those with the highest EMG rest power were classified as the "tonic" subtype (32.3%). There was also an "intermediate" subtype (50.8%), when both variables remained low. Characterization of awake bruxism physiology is important for future establishment of instrumental assessment protocols and treatment strategies.

Association between eating disorders, suicide and depressive symptoms in undergraduate students of health-related courses / Associação entre transtornos alimentares, suicídio e sintomas depressivos em universitários de cursos de saúde

ABSTRACT Objective: To identify symptoms of eating disorders and potential associations with risk of suicide and depressive symptoms in undergraduate students of health-related courses. Methods: A cross-sectional study involving 271 students. The following instruments were used to identify symptoms of eating disorders: Eating Attitudes Test-26 and Bulimic Investigatory Test of Edinburgh. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to screen for depressive symptoms and risk of suicide, respectively. Participants answered a questionnaire aimed to collect biodemographic data for economic classification of the sample. Results: Symptoms of eating disorders and bulimia nervosa were detected in 7.4% and 29.1% of students, respectively. Approximately 17.3% of students had symptoms of major depression, and 13.6% were at risk of suicide to some extent; risk of suicide was thought to be low in 7.4%, moderate in 0.7% and high in 5.5% of students in this subset. The risk of eating disorder development was correlated with the risk of suicide (p<0.001). Conclusion: Undergraduate students at risk of developing eating disorders, or with symptoms suggestive of depression, are more prone to commit suicide.

RESUMO Objetivo: Identificar sintomas de transtornos alimentares e possíveis associações com o risco de suicídio e sintomas depressivos em universitários de cursos de saúde. Métodos: Neste estudo de corte transversal, foram avaliados 271 estudantes. Foram utilizados os instrumentos Teste de Atitudes Alimentares e Bulimic Investigatory Test of Edinburgh, para identificação de sintomas de transtornos alimentares. Para o rastreamento de sintomas depressivos, foi usado o questionário de autoavaliação da Escala de Hamilton − Depressão, e o Mini International Neuropsychiatric Interview, para identificação do risco de suicídio. Todos os participantes responderam um questionário contendo informações sociodemográficas, para classificação econômica da amostra. Resultados: A frequência para sintomas de transtornos alimentares foi de 7,4% e de 29,1% para sintomas de bulimia nervosa. Cerca de 17,3% foram sintomáticos para depressão maior, e 13,6% tinham algum grau de risco de suicídio; destes, 7,4% foram considerados com risco de suicídio leve, 0,7% com risco moderado e 5,5% com risco alto de suicídio. Houve correlação entre risco para transtornos alimentares e risco de suicídio (p<0,001). Conclusão: Universitários com risco para os transtornos alimentares, bem como os que possuem sintomatologia sugestiva para depressão têm maior probabilidade de desenvolver o risco de suicídio.

Differences in cortisol concentrations in adolescents with eating disorders: a systematic review / Diferenças nas concentrações de cortisol em adolescentes com transtornos alimentares: uma análise sistemática

Abstract Objective: To perform a systematic review of the literature for scientific evidence of possible differences in cortisol concentrations in adolescents with eating disorders. Source of data: Electronic searches were conducting in the PubMed, Scientific Electronic Library Online, Virtual Health Library, and Science Direct databases for articles published between 2007 and 2017 using the keywords, cortisol, hydrocortisone; eating disorders, bulimia, bulimia nervosa, anorexia, anorexia nervosa; adolescence, adolescent, adolescents. Synthesis of data: A total of 192 articles were found. After the analysis of the eligibility criteria using the PRISMA method, 19 articles were selected for the present review. Most studies were conducted in Europe. Adolescents diagnosed with anorexia nervosa were evaluated in all studies, except one, when other eating disorders were investigated. Blood was the means used for the determination of cortisol. In ten studies, cortisol levels were higher in the group with anorexia than the control group and a reduction in cortisol levels occurred in the adolescents after being submitted to nutritional recovery. Conclusions: Patients with eating disorders may have several clinical consequences, such as changes in body fat distribution, changes in bone mineral density, worsening of neurocognitive ability, and endocrine changes (e.g., hypercortisolemia), which in turn can lead to hyperglycemia, insulin resistance, hypertension, and increased risk of infections. The findings demonstrate that adolescents with eating disorders, especially anorexia nervosa, have increased cortisol levels, which are reduced after the treatment period. Further studies on differences in cortisol concentrations in adolescents with other eating disorders are needed, using different methods.

Resumo Objetivo: Realizar uma análise sistemática da literatura em busca de evidências científicas de possíveis diferenças nas concentrações de cortisol em adolescentes com transtornos alimentares. Fonte de dados: Pesquisas eletrônicas foram realizadas nas bases de dados do Pubmed, da Scientific Electronic Library Online, da Biblioteca Virtual da Saúde e do Science Direct em busca de artigos publicados entre 2007 e 2017 que utilizaram as palavras-chave: cortisol, hidrocortisona, transtornos alimentares, bulimia, bulimia nervosa, anorexia, anorexia nervosa, adolescência, adolescente e adolescentes. Síntese dos dados: Foram encontrados 192 artigos. Após a análise dos critérios de elegibilidade utilizando o método PRISMA, 19 artigos foram selecionados para esta análise. A maioria dos estudos foi realizada na Europa. Os adolescentes diagnosticados com anorexia nervosa foram avaliados em todos os estudos, com exceção de um, em que outros transtornos alimentares foram investigados. A coleta de sangue foi o meio utilizado para a determinação do cortisol. Em dez estudos, os níveis de cortisol estavam mais elevados no grupo com anorexia do que no grupo de controle e ocorreu uma redução nos níveis de cortisol nos adolescentes após serem submetidos a uma recuperação nutricional. Conclusões: Os pacientes com transtornos alimentares podem apresentar diversas consequências clínicas, como alterações na distribuição de gordura corporal, alterações na densidade mineral óssea, piora da capacidade neurocognitiva e alterações endócrinas, como a hipercortisolemia que, por sua vez, pode levar à hiperglicemia, resistência à insulina, hipertensão e ao aumento do risco de infecções. Os achados demonstraram que os adolescentes com transtornos alimentares, principalmente a anorexia nervosa, apresentaram níveis mais elevados de cortisol, que são reduzidos após o período de tratamento. São necessários estudos adicionais sobre as diferenças nas concentrações de cortisol em adolescentes com outros transtornos alimentares, utilizando meios diferentes.

Differences in cortisol concentrations in adolescents with eating disorders: a systematic review.

OBJECTIVE: To perform a systematic review of the literature for scientific evidence of possible differences in cortisol concentrations in adolescents with eating disorders. SOURCE OF DATA: Electronic searches were conducting in the PubMed, Scientific Electronic Library Online, Virtual Health Library, and Science Direct databases for articles published between 2007 and 2017 using the keywords, cortisol, hydrocortisone; eating disorders, bulimia, bulimia nervosa, anorexia, anorexia nervosa; adolescence, adolescent, adolescents. SYNTHESIS OF DATA: A total of 192 articles were found. After the analysis of the eligibility criteria using the PRISMA method, 19 articles were selected for the present review. Most studies were conducted in Europe. Adolescents diagnosed with anorexia nervosa were evaluated in all studies, except one, when other eating disorders were investigated. Blood was the means used for the determination of cortisol. In ten studies, cortisol levels were higher in the group with anorexia than the control group and a reduction in cortisol levels occurred in the adolescents after being submitted to nutritional recovery. CONCLUSIONS: Patients with eating disorders may have several clinical consequences, such as changes in body fat distribution, changes in bone mineral density, worsening of neurocognitive ability, and endocrine changes (e.g., hypercortisolemia), which in turn can lead to hyperglycemia, insulin resistance, hypertension, and increased risk of infections. The findings demonstrate that adolescents with eating disorders, especially anorexia nervosa, have increased cortisol levels, which are reduced after the treatment period. Further studies on differences in cortisol concentrations in adolescents with other eating disorders are needed, using different methods.

Consumo de formulações emagrecedoras e risco de transtornos alimentares em universitários de cursos de saúde / Consumption of dietary substances and their association with risk of eating disorders in college students

RESUMO Objetivo Avaliar o consumo de formulações emagrecedoras e sua possível associação com o risco de transtornos alimentares (TAs) em universitários de cursos de saúde de diversos níveis socioeconômicos. Métodos Estudo epidemiológico transversal, realizado com 276 universitários matriculados em quatro cursos da área da saúde. Para a obtenção dos dados, utilizaram-se três instrumentos autoaplicáveis: o Eating Attitudes Test (EAT-26), o Bulimic Investigatory Test of Edinburgh (BITE) e, para investigar o consumo de formulações emagrecedoras, um questionário elaborado pela própria equipe de pesquisa. Para análise dos dados, aplicou-se o teste qui-quadrado, adotando-se o nível de significância de 5%. Resultados Vinte e um universitários apresentaram risco de TA pela escala EAT-26, correspondente a 7,6% dos pesquisados. A frequência do uso de formulações emagrecedoras foi de 7,2%. Houve associação significativa (p < 0,001) entre o uso de formulações emagrecedoras e a presença de risco para TA (33,3%), com percentual muito elevado quando comparado ao percentual de entrevistados sem risco de TA que estavam em uso de medicamentos (5,1%). Conclusões O consumo de formulações emagrecedoras esteve associado tanto à presença de risco para TA, nas escalas EAT-26 e BITE, quanto aos níveis socioeconômicos, principalmente para a classe de renda C.

ABSTRACT Objective to evaluate the consumption of weight loss formulations and their possible association with risk of eating disorders (ED) in university students of health courses of different socioeconomic levels. Methods A cross-sectional epidemiological study was carried out with 276 university students enrolled in four health courses. To obtain the data, three self-applied instruments were used: the Eating Attitudes Test (EAT-26), the Bulimic Investigatory Test of Edinburgh (BITE) and to investigate the consumption of weight-loss formulations a questionnaire prepared by the research team was used. For the data analysis, the chi-square test was applied, adopting the level of significance of 5%. Results Twenty-one university students presented a risk of ED by the EAT-26 scale, corresponding to 7.6% of the respondents. The frequency of use of weight loss formulations was 7.2%. There was a significant association (p < 0.001) between the use of weight loss formulations and the presence of risk for ED (33.3%), with a very high percentage when compared to the percentage of non-ED respondents who were using medication (5.1%). Conclusions The consumption of dietary formulations was associated with both the presence of risk for ED, on the EAT-26 and BITE scales, and on socioeconomic levels, especially for income class C.

Relação entre comportamento suicida e transtornos alimentares: uma revisão sistematizada / Relación entre comportamiento suicida y trastornos alimentarios: una revisiónsistematizada / Relationship between suicidal behavior and eating disorders: a systematic review

Objective: this paper offers a systematic review of the literature on eating disorders and the relationship with suicidal behavior. Methods: Searches were performed in the Medline, Lilacs, Adolec and Pubmed databases for articles published between 2003 and 2014. Results: Anorexia nervosa was the most often cited eating disorder in the articles selected. In cases of bulimia nervosa, suicide attempts and self-aggression were more frequent among those who use multiple compensation behaviors. Behavior disorders, emotional disorders and chemical dependency were described as risk factors in all publications. Conclusion: Despite the small number of studies performing an in-depth investigation into the relationship between eating disorder and suicidal behavior, the concomitant presence of these conditions places the health of patients at greater risk.

Objetivo: realizar uma revisão sistematizada da literatura acerca dos transtornos alimentares e sua relação com o comportamento suicida, analisando o conteúdo das publicações. Métodos: Foi Realizada uma busca sistematizada em bases de dados eletrônicas (Medline, Lilacs, Adolec e Pubmed), com foco em artigos publicados entre 2003 e 2014. Resultados: Dentre os estudos selecionados, a anorexia nervosa foi o distúrbio alimentar mais referido pelas publicações. No caso da bulimia nervosa, as taxas de tentativas de suicídio e/ou comportamentos auto agressivos são maiores entre indivíduos que utilizam uma compensação múltipla de comportamentos purgativos. Sobre os fatores de risco associados, evidenciou-se que os transtornos de comportamento, os transtornos emocionais e a dependência química apresentam-se descritos em todas as publicações. Conclusão: Ainda são escassos os trabalhos que investigam profundamente a relação entre transtornos alimentares e o comportamento suicida, porém é possível verificar que a presença concomitante pode comprometer ainda mais a saúde do paciente.

Objetivo: realizar una revisión sistematizada de la literatura sobre trastornos alimentarios y su relación con comportamiento suicida mediante el análisis del contenido de las publicaciones virtuales. Método: Realizar una búsqueda en bases de datos electrónicas (Medline, Liacs, Adolec y Pubmed), de artículos publicados del año 2003 al 2014. Resultados: En todos los estudios la anorexia nerviosa fue el disturbio alimentario más presente. Respecto de la bulimia nerviosa, las tasas de tentativas de suicidio y/o comportamientos autoagresivos son más elevadas entre individuos que recurren a varias formas de compensación mediante múltiples tipos de actitudes purgativas. Acerca de factores de riesgo asociados, los trastornos comportamentales, los emocionales y la dependencia química aparecen en todas las publicaciones. Conclusión: Todavía son escasos los trabajos que investigan en profundidad la relación entretrastornos alimentarios y comportamiento suicida. Se puede detectar empero que la presencia concomitante de ambas situaciones puede comprometer aun más la salud del paciente.

Cyclodextrins improving the physicochemical and pharmacological properties of antidepressant drugs: a patent review.

INTRODUCTION: Depression is a serious mood disorder and is one of the most common mental illnesses. Despite the availability of several classes of antidepressants, a substantial percentage of patients are unresponsive to these drugs, which have a slow onset of action in addition to producing undesirable side effects. Some scientific evidence suggests that cyclodextrins (CDs) can improve the physicochemical and pharmacological profile of antidepressant drugs (ADDs). The purpose of this paper is to disclose current data technology prospects involving antidepressant drugs and cyclodextrins. AREAS COVERED: We conducted a patent review to evaluate the antidepressive activity of the compounds complexed in CDs, and we analyzed whether these complexes improved their physicochemical properties and pharmacological action. The present review used 8 specialized patent databases for patent research, using the term 'cyclodextrin' combined with 'antidepressive agents' and its related terms. We found 608 patents. In the end, considering the inclusion criteria, 27 patents reporting the benefits of complexation of ADDs with CDs were included. EXPERT OPINION: The use of CDs can be considered an important tool for the optimization of physicochemical and pharmacological properties of ADDs, such as stability, solubility and bioavailability.

Prevalence of Suicide Risk Among Adolescents With Depressive Symptoms.

OBJECTIVE: To determine the prevalence of the risk of suicide among adolescents and to investigate associations between the risk of suicide and depressive symptoms. METHODS: A population-based cross-sectional study was conducted with 1,379 students aged 10-17 years enrolled in state-run public schools in northeastern Brazil in 2014. The following instruments were used to collect data: a socio-bio-demographic questionnaire; the Children's Depression Inventory (CDI) and the International Neuropsychiatric Interview (M.I.N.I. Brazilian version 5.0.0). Unidimensional and bidimensional tables were constructed for the data analysis, with absolute and relative frequencies. Odds ratios (OR) and respective intervals (95% confidence) were calculated and associated with the descriptive levels of Pearson's chi-square independence test. RESULTS: The prevalence of the risk of suicide was 29.7% in the population studied. Females aged between 14 and 17, those with siblings and those with depressive symptoms were at the greatest risk. CONCLUSION: The present findings revealed a very high risk of suicide and confirmed the significant that depressive symptoms are significantly associated with the risk of suicide among adolescents. Thus, it is necessary to develop suicide prevention programs for schools, with interdisciplinary primary healthcare actions.

As terapias cognitivo-comportamentais no tratamento da bulimia nervosa: uma revisão / The cognitive-behavior therapies in the treatment of bulimia nervosa: a review

Objetivo Realizar uma revisão na literatura sobre a utilização da terapia cognitivo-comportamental (TCC) no tratamento da bulimia nervosa entre 2009 e 2013. Métodos Três bases de dados eletrônicas foram pesquisadas, considerando artigos em língua inglesa, espanhola e portuguesa. Resultados Após as análises e exclusão dos artigos, seguindo o método PRISMA, foram selecionados 20 artigos. Os artigos selecionados foram produzidos ou na Europa ou nos Estados Unidos, em língua inglesa. Os diagnósticos da amostra variaram de exclusivamente bulimia nervosa (60%) aos que incluíram pessoas com transtorno de compulsão alimentar (35%), além de diagnósticos mistos (5%). Os estudos foram, em sua maioria, realizados em mulheres adultas. A TCC, em sua abordagem clássica no consultório, foi utilizada em todos os artigos, ora utilizada individualmente, ora comparada com outras intervenções (internet, CD-ROM e autoajuda). Encontrou-se como resultado que a TCC diminui os sintomas de compulsão alimentar e de purgação, além de oferecer ganhos secundários aos participantes, como melhora de sintomas depressivos, de ansiedade e até mudanças na personalidade. As outras intervenções pesquisadas obtiveram bons resultados na modificação dos sintomas, demonstrando que há um novo caminho a ser galgado com essas novas formas de tratamento. Conclusão O tratamento da bulimia nervosa possui evidências suficientes para que seja realizado com a terapia cognitivo-comportamental. Além dela, intervenções psicoterápicas inovadoras baseadas na TCC clássica apresentam bons indicativos de eficácia. Futuras pesquisas sobre essas diferentes intervenções são necessárias. .

Objective To review the literature about the use of cognitive-behavior therapy in bulimia nervosa treatment, between 2009 and 2013. Methods Three electronic databases were researched, and articles in English, Portuguese and Spanish were selected. Results After the analysis and exclusion of the articles, followed the PRISMA methods, were chosen 20 articles. Selected articles were produced in Europe or in United States of America, in English. The diagnosis of the sample ranged from only bulimia nervosa (60%) that included the people with binge eating disorders (35%), and mixed eating disorders diagnoses (5%). The researches were conducted mostly with women. The cognitive-behavior therapy in your classic form in office were used all of articles, sometimes used singly, sometimes used with other intervention (internet, CD-ROM, self-help). The cognitive behavior therapy decreases binge eating and purgation symptoms. It provides secondary benefits to participants like: decreases depressive and anxiety symptoms and change the participant’s personality. The other interventions studied have been successful in modifying symptoms, demonstrating that there is a new way forward climbed with these news forms of treatment. Conclusion Treatment of bulimia nervosa have enough evidences to be performed with the cognitive-behavioral therapy. Beyond, innovative psychotherapeutic interventions based on classical CBT have good indicators of effectiveness. Future research on these different interventions are needed. .

Frequência de comportamentos alimentares inadequados e sua relação com a insatisfação corporal em adolescentes / Frequency of abnormal eating behaviors and its relationship with body dissatisfaction in adolescents

OBJETIVO: Descrever a relação entre a frequência de insatisfação com a imagem corporal e a presença de sintomas de transtornos alimentares em adolescentes. MÉTODOS: O estudo foi realizado com uma amostra de 300 adolescentes, de ambos os sexos, na faixa etária de 10 a 17 anos, estudantes de uma escola pública estadual da cidade do Recife, Brasil. Foram utilizadas as versões brasileiras para adolescentes de três escalas autoaplicativas (EAT-26, BITE e BSQ), além de um questionário contendo dados biodemográficos. RESULTADOS: A frequência de sintomas de transtornos alimentares detectada pelo EAT-26 foi de 32,3%; 2,3% para comportamentos sugestivos de bulimia nervosa, por meio da escala BITE, tendo 36,67% dos alunos apresentado padrão alimentar não usual; 5,6% apresentaram insatisfação com a imagem corporal; 8,6% demonstraram tendência à preocupação com a insatisfação com a imagem corporal e 17,6% apresentaram leve insatisfação, além de 66,3%, que mostraram normalidade em relação à sua forma corporal. CONCLUSÃO: Os adolescentes apresentaram níveis de alteração na autoimagem corporal, com alta frequência de insatisfação da imagem corporal, podendo apresentar associação com comportamentos alimentares inadequados.

OBJECTIVE: To describe the relationship between frequency of body dissatisfaction and symptoms of eating disorders in adolescents. METHODS: The study was conducted with a sample of 300 adolescents of both sexes, aged from 10 to 17 years-old, students from a state school in Recife, Brazil. Authors used the Brazilian version of three self-report questionnaires for adolescents (EAT-26, BITE and BSQ), and a questionnaire containing biodemographical data. RESULTS: The frequency of symptoms of eating disorders detected by the EAT-26 was 32.3%; 2.3% for suggestive behaviors of bulimia nervosa, through BITE, and 36.67% of the students presented an unusual eating pattern; 5.6% showed body dissatisfaction, and 66.3%, showed normality in relation to its body form. CONCLUSION: These adolescents had higher levels of change in body self-image, with high frequency of body dissatisfaction, that suggest and association with inappropriate eating behaviors.

Versão brasileira do BITE para uso em adolescentes / Brazilian version of the BITE for use in adolescents / Versión brasileña de lo BITE para su uso en adolescentes

O objetivo deste estudo foi traduzir para a língua portuguesa e adaptar o Bulimic Investigatory Test of Edinburgh - BITE em uma amostra de 109 adolescentes de 12 a 16 anos. Foram feitas tradução e retrotradução, adaptação transcultural, validação de face e aplicação da escala. Para a validação do questionário, foram obtidos os dados de coincidência observada e Kappa intra e interexaminador e o Alfa de Cronbach. A concordância observada e a análise do Kappa intra e interexaminadores variou de boa a excelente (CO - 88,9 por cento a 100 por cento e Kappa 0,60 a 1,0). A medida do alfa de Cronbach indicou um grau elevado de consistência interna (0,76), que garantiu a confiabilidade da escala. A tradução do BITE - versão para adolescentes mostrou boa equivalência linguística, conceitual e da escala, mostrando índices de precisão e validade de conteúdo.(AU)

This work aimed to translate the Bulimic Investigatory Test of Edinburgh - BITE into Portuguese and adapt it in a sample of 109 adolescents aged from 12 to 16. The methodological referential was translation and retro-translation, cross cultural adaptation, face validation and final version application. Statistical analysis methods were observed coincidence, intra and inter examiners kappa index and Cronbachïs alpha. Observed coincidence and intra and inter-examiners kappa analysis varied from good to excellent (OC - 88,9 percent to 100 percent and kappa 0,60 to 1,0). Cronbachïs alpha measure indicated a high degree of intern consistence (0,76), showing reliability of scale. Translation of BITE - Adolescent's version showed a good linguistic, conceptual and scale equivalence, with precision indexes and content validity.(AU)

El objetivo de este estudio fue traducir al portugués y adaptar el Bulimic Investigatory Test of Edimburg - BITE en una muestra de 109 adolescentes de 12 a 16 años. Se hizo la traducción y la posterior traducción, adaptación cultural, validación y aplicación de la cara escala. Para validar el cuestionario, se obtuvo una coincidencia observada, kappa intra e inter-evaluador y el Alfa de Cronbach. El acuerdo observado y el análisis de kappa de intra e inter-evaluador variaba de buena a excelente (CO - 88,9 por ciento a 100 por ciento y kappa 0,60 a 1,0). La medida de la alfa de Cronbach indica un alto grado de consistencia interna (0,76), que garantiza la fiabilidad de la escala. La traducción de la BITE - versión para adolescentes mostró una buena equivalencia lingüística, conceptual y la escala, las tasas de proyección de la fiabilidad y la validez de contenido.(AU)

Versão brasileira do BITE para uso em adolescentes / Brazilian version of the BITE for use in adolescents / Versión brasileña de lo BITE para su uso en adolescentes

O objetivo deste estudo foi traduzir para a língua portuguesa e adaptar o Bulimic Investigatory Test of Edinburgh - BITE em uma amostra de 109 adolescentes de 12 a 16 anos. Foram feitas tradução e retrotradução, adaptação transcultural, validação de face e aplicação da escala. Para a validação do questionário, foram obtidos os dados de coincidência observada e Kappa intra e interexaminador e o Alfa de Cronbach. A concordância observada e a análise do Kappa intra e interexaminadores variou de boa a excelente (CO - 88,9 por cento a 100 por cento e Kappa 0,60 a 1,0). A medida do alfa de Cronbach indicou um grau elevado de consistência interna (0,76), que garantiu a confiabilidade da escala. A tradução do BITE - versão para adolescentes mostrou boa equivalência linguística, conceitual e da escala, mostrando índices de precisão e validade de conteúdo.

This work aimed to translate the Bulimic Investigatory Test of Edinburgh - BITE into Portuguese and adapt it in a sample of 109 adolescents aged from 12 to 16. The methodological referential was translation and retro-translation, cross cultural adaptation, face validation and final version application. Statistical analysis methods were observed coincidence, intra and inter examiners kappa index and Cronbachïs alpha. Observed coincidence and intra and inter-examiners kappa analysis varied from good to excellent (OC - 88,9 percent to 100 percent and kappa 0,60 to 1,0). Cronbachïs alpha measure indicated a high degree of intern consistence (0,76), showing reliability of scale. Translation of BITE - Adolescent's version showed a good linguistic, conceptual and scale equivalence, with precision indexes and content validity.

El objetivo de este estudio fue traducir al portugués y adaptar el Bulimic Investigatory Test of Edimburg - BITE en una muestra de 109 adolescentes de 12 a 16 años. Se hizo la traducción y la posterior traducción, adaptación cultural, validación y aplicación de la cara escala. Para validar el cuestionario, se obtuvo una coincidencia observada, kappa intra e inter-evaluador y el Alfa de Cronbach. El acuerdo observado y el análisis de kappa de intra e inter-evaluador variaba de buena a excelente (CO - 88,9 por ciento a 100 por ciento y kappa 0,60 a 1,0). La medida de la alfa de Cronbach indica un alto grado de consistencia interna (0,76), que garantiza la fiabilidad de la escala. La traducción de la BITE - versión para adolescentes mostró una buena equivalencia lingüística, conceptual y la escala, las tasas de proyección de la fiabilidad y la validez de contenido.

Transtorno obsessivo compulsivo em crianças e adolescentes: revisão de literatura e abordagem odontológica / Obsessive compulsive disorder in children and adolescents: literature review and dental approach

O transtorno obsessivo compulsivo (TOC) é um transtorno psiquiátrico crônico que atinge de 1 a 2% da população de crianças e adolescentes, necessitando de uma abordagem adequada durante o atendimento odontológico devido ao aumento da ansiedade, às medicações utilizadas no tratamento do transtorno e, possivelmente, devido a comportamentos compulsivos. O objetivo deste trabalho foi fazer um levantamento bibliográfico a respeito das principais características do TOC na infância e adolescência e trazer informações importantes para o atendimento odontológico destes pacientes. Após a análise da literatura, ficou claro que o TOC é um transtorno de ansiedade, e, por esta razão, é natural que estes pacientes apresentem-se muito ansiosos durante uma consulta odontológica. Sendo assim, é de grande importância que o odontopediatra tenha conhecimento de técnicas de controle de comportamento e ansiedade adequadas a estes pacientes. Além disso, o profissional deve avaliar possíveis interações com antibióticos, anestésicos e vasoconstrictores, com o objetivo de minimizar os riscos para o paciente. O uso de antidepressivos frequentemente resulta em hipossalivação. O incentivo a uma boa higiene bucal (com vigilância do responsável à compulsão por limpeza) associado ao uso de cremes e géis fluoretados, colutórios antissépticos e visitas frequentes ao dentista podem reduzir a incidência de lesões de cárie rampantes, doença periodontal e outros distúrbios associados à deficiência na produção de saliva.

Avaliação dos cuidados com a saúde oral de crianças hospitalizadas / Evaluation of oral health care in hospitalized children

O objetivo deste estudo foi conhecer os cuidados administrados com relação à saúde bucal de crianças hospitalizadas, verificando a dieta alimentar e a utilização de medicamentos com potencial cariogênico, assim como a higienização oral ou os métodos alternativos empregados durante o tempo de hospitalização. Foi feito um estudo descritivo com a aplicação de um formulário aos acompanhantes de 100 crianças internas nas enfermarias de Pediatria de um hospital público de referência no atendimento infantil em Recife, Brasil, num período de 3 meses. Foram utilizadas técnicas de estatística descritiva através da elaboração de tabelas, incluindo distribuições absolutas e percentuais e da apresentação de medidas estatísticas para a variável numérica tempo de hospitalização. As crianças apresentaram uma dieta cariogênica, como consumo de alimentos açucarados entre as refeições; medicamentos com potencial cariogênico eram administrados em horários de risco para o desenvolvimento de lesões de cárie; a higiene bucal das crianças hospitalizadas não ocorria de forma sistemática e orientada durante a internação. Verificou-se que se faz necessária a participação efetiva de um cirurgião-dentista integrado à equipe de saúde nos hospitais infantis, visando à promoção da saúde bucal. A hospitalização deve surgir como uma possibilidade de conhecer e tratar doenças, e não de propiciá-las.

This study aimed to examine oral health care of hospitalized children, verifying presence of cariogenic potential in eating habits and medication use, as well as dental brushing or the use of alternative methods during hospitalization. This descriptive study used a form applied to companions of 100 children hospitalized in the pediatric outpatient department of a reference public hospital in Recife, Brazil, during 3 months. Techniques of descriptive statistics including tables, absolute and relative distributions were used, so as presentation of statistic measures to the numeric variable time of hospitalization. Children presented a cariogenic diet which included sugar between main meals, medication with cariogenic potential in hours of risk to develop caries; oral care of hospitalized children did not occurred in a systematic and oriented way. It was verified that it is necessary an effective participation of a dentist integrated to health team in infant hospitals, aiming to promote oral health. Hospitalization must happen as a possibility of knowing and treating diseases, not causing them.