Brief cognitive behavioral therapy in pregnant women at risk of postpartum depression: Pre-post therapy study in a city in southern Brazil.

BACKGROUND: Postpartum depression (PPD) affects a high number of women, often the first manifestation of a mood disorder that will occur later in life, bringing serious consequences for the patient and her offspring. Depression today is the leading cause of disability worldwide. The aim of this study was to evaluate the effectiveness of a preventive cognitive behavioral therapy (CBT) for PPD. METHODS: Pre-post therapy study, as part of a population-based cohort study. Pregnant women without a diagnosis of depression participated, who were divided into two groups: risk of depression (CBT) and a control group (without therapy). The preventive therapy consisted of six sessions of CBT, administered weekly. The Outcome Questionnaire (OQ-45) was used in all sessions. The Mini International Neuropsychiatric Interview and Beck Depression Inventory-II were used on three occasions. The final statistical analyses were performed by Poisson regression. RESULTS: The prevalence of PPD in the risk group was 5.5% and in the control group 2.2%, with no difference between the groups (PR 1.66 95% CI 0.44-6.18). The OQ-45 averages gradually reduced during the therapy sessions, indicating therapeutic progress. Schooling was an associated factor, both with the manifestation of PPD and with the greater effectiveness of the therapy. LIMITATIONS: Rate of 40.5% refusal to preventive treatment and absence of a group with similar characteristics in another therapy model. CONCLUSIONS: Brief cognitive behavioral therapy applied by mental health professionals with basic training was effective in preventing the manifestation of PPD.

Suicide risk and prematurity: A study with pregnant adolescents.

OBJECTIVE: To verify the association between mood and anxiety disorders, and suicide risk during pregnancy and their relationship with premature birth in a population of pregnant adolescents attending prenatal care in the public health system of Pelotas, a southern city in Brazil. METHODS: This was a cohort study with all pregnant adolescents attending antenatal public services in the urban area of Pelotas between October 2009 and May 2011. The first assessment occurred between the 20th and 22 nd week of pregnancy and the second occurred one month after delivery. We used the Mini International Neuropsychiatric Interview (MINI) to assess mood and anxiety disorders and suicide risk. RESULTS: A total of 645 pregnant women aged between 12 and 19 years old were interviewed. An anxiety disorder was present in 9.1% of the pregnant adolescent, and 28.5% had a mood disorder. The prevalence of suicide risk was 12.6%, and 15.3% of the babies were born premature. A multivariate analysis adjusted for maternal education, number of previous pregnancies and previous preterm birth indicated that adolescents who had suicide risk during pregnancy were approximately twice as likely to give birth prematurely when compared to those who were not diagnosed with suicide risk (PR 1.79; CI 1.06-3.03). CONCLUSION: Our findings suggest that pregnant adolescents who were at risk of suicide during pregnancy were more likely to have premature babies. It is important to pay attention to the mental health of this specific population to prevent obstetric complications and consequently improve the health of the children.

Development and psychometric validation of Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) in a Brazilian sample.

OBJECTIVES: The aim of this study was to develop and examine the psychometric properties of the IGDS9-SF in a sample of Brazilian gamers and to find the best cut-off point for this instrument using a normative and clinically diagnosed sample of gamers. METHODS: A total of 610 participants were recruited to the present study. Construct validity was assessed through Exploratory and Confirmatory Factor Analysis (EFA, CFA). Criterion-related validity was established through the associations with Game Addiction Scale (GAS) and weekly gameplay. Reliability analysis was performed using the Cronbach's alpha (α) as the indicator of internal consistency. A cut-off point was estimated using the Receiver Operating Characteristics Curve (ROC curve) where the results of a clinical assessment was used as the gold standard. RESULTS: EFA and CFA findings confirmed the single-factor structure of the IGDS9-SF. Positive correlations indicated adequate criterion-related validity, and the scale was shown to be reliable (α=0.82). Finally, the optimal cut-off point for risky gaming was found to be >16 points and for diagnosis to be >21 points. CONCLUSIONS: This study provides validity and reliability evidence for the use of the Brazilian version of the IGDS9-SF in the assessment of Internet Gaming Disorder, further supporting its usefulness as a robust psychometric tool that can be employed in clinical and research settings in Brazil.

People living with HIV/AIDS: body image and its important associations with mental health and BMI.

Patients on antiretroviral therapy face new challenges, such as bodily changes. We conducted a cross-sectional study with people living with HIV/AIDS. We investigate the self-perception of body image and its associations. Most of the patients reported negative self-perception of body image (NSPBI), being mostly women, up to 40 years old and with changes in BMI. NSPBI was associated with depressive symptoms and punctual alterations in the redistribution of body fat: face, abdomen and legs, subjects still little elucidated. Assessing neglected aspects can improve the way these patients see themselves, and come to understand the disease as only a part of their lives.

Clinical features of differential diagnosis between unipolar and bipolar depression in a drug-free sample of young adults.

INTRODUCTION: Subjects with bipolar disorder suffering of a depressive episode are frequently misdiagnosed as unipolar depression, being important studies assessing the differential diagnosis between bipolar and unipolar depression. OBJECTIVE: To assess the sociodemographic and clinical features of drug-free young adults in a depressive episode of bipolar or unipolar disorder in order to identify factors that may differentiate these psychiatric conditions. METHODS: This is a cross-sectional study with 241 young adults aged between 18 and 29 years who were evaluated using the Structured Clinical Interview for DSM-IV (SCID). The sample comprised patients with BD (n = 89) and major depressive disorder (n = 152), experiencing a depressive episode and not using psychoactive drugs or illicit psychoactive substances. RESULTS: The characteristics associated with bipolar depression were being male (p < 0.001), with a family history of BD (p = 0.013), a higher frequency of childhood traumatic experiences (p = 0.001), younger age of onset of mood disorder (p = 0.004), many previous depressive episodes (p = 0.027), greater severity of depressive symptoms (p < 0.001) and day/night reversal (p = 0.013). Those with unipolar depression showed a higher frequency of biological rhythm disturbances (p < 0.001), and diurnal preference (p = 0.028). LIMITATIONS: The sample has not included subjects with severe suicide risk, a possible important marker in differentiate unipolar from bipolar depression. CONCLUSION: Some clinical aspects may contribute to an early differential diagnosis of both bipolar and unipolar depression even in the initial stages of the disease.

Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals

ABSTRACT Background/objective: There is an increasing number of older patients with human immunodeficiency virus infection due to the success of antiretroviral therapy, the improved prognosis and life expectancy of patients, and the higher number of new infections among older individuals. The main objective of the present study was to compare the characteristics of older human immunodeficiency virus patients with those of younger patients. Materials and methods: We conducted a cross-sectional study with human immunodeficiency virus-infected patients who were treated at the Specialized Care Service (Serviço de Assistência Especializada) for human immunodeficiency virus/AIDS in the city of Pelotas, South Brazil. Sociodemographic information as well as data on human immunodeficiency virus infection and treatment were collected. All participants underwent psychiatric and neurocognitive assessments, and their adherence to antiretroviral therapy was evaluated. Results: A total of 392 patients participated in the study, with 114 patients aged 50 years and older. The characteristics showing significant differences between older and younger human immunodeficiency virus-infected patients included race/ethnicity, comorbidities, duration and adherence to antiretroviral therapy, currently undetectable viral load, and cognitive impairment. Compared to younger patients, older patients were at higher risk of exhibiting cognitive impairment [OR 2.28 (95% CI: 1.35-3.82, p = 0.002)] and of having increased adherence to antiretroviral therapy [OR 3.11 (95% CI: 1.67-5.79, p < 0.001)]. Conclusions: The prevalence of neurocognitive impairment remained high in human immunodeficiency virus-infected patients despite antiretroviral therapy. In the present study, the prevalence of this type of impairment was significantly higher in patients aged ≥50 years, most likely due to aging, human immunodeficiency virus infection, and a possible synergistic effect between these factors. Despite this higher prevalence, older patients exhibited higher rates of adherence to antiretroviral therapy and of undetectable human immunodeficiency virus viral load.

Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals.

BACKGROUND/OBJECTIVE: There is an increasing number of older patients with human immunodeficiency virus infection due to the success of antiretroviral therapy, the improved prognosis and life expectancy of patients, and the higher number of new infections among older individuals. The main objective of the present study was to compare the characteristics of older human immunodeficiency virus patients with those of younger patients. MATERIALS AND METHODS: We conducted a cross-sectional study with human immunodeficiency virus-infected patients who were treated at the Specialized Care Service (Serviço de Assistência Especializada) for human immunodeficiency virus/AIDS in the city of Pelotas, South Brazil. Sociodemographic information as well as data on human immunodeficiency virus infection and treatment were collected. All participants underwent psychiatric and neurocognitive assessments, and their adherence to antiretroviral therapy was evaluated. RESULTS: A total of 392 patients participated in the study, with 114 patients aged 50 years and older. The characteristics showing significant differences between older and younger human immunodeficiency virus-infected patients included race/ethnicity, comorbidities, duration and adherence to antiretroviral therapy, currently undetectable viral load, and cognitive impairment. Compared to younger patients, older patients were at higher risk of exhibiting cognitive impairment [OR 2.28 (95% CI: 1.35-3.82, p=0.002)] and of having increased adherence to antiretroviral therapy [OR 3.11 (95% CI: 1.67-5.79, p<0.001)]. CONCLUSIONS: The prevalence of neurocognitive impairment remained high in human immunodeficiency virus-infected patients despite antiretroviral therapy. In the present study, the prevalence of this type of impairment was significantly higher in patients aged ≥50 years, most likely due to aging, human immunodeficiency virus infection, and a possible synergistic effect between these factors. Despite this higher prevalence, older patients exhibited higher rates of adherence to antiretroviral therapy and of undetectable human immunodeficiency virus viral load.

Cognitive and language performance in children is associated with maternal social anxiety disorder: A study of young mothers in southern Brazil.

BACKGROUND: It has been shown that maternal mental health is associated with poorer skills development in the offspring. However, the evidence evaluating the association between social anxiety disorder (SAD) and cognitive or language development, is scarce. AIM: To evaluate the association between maternal SAD and performance in cognitive and language tests in 30-month old children. STUDY DESIGN: This was a cohort study involving young women evaluated since pregnancy. SUBJECTS: We evaluated 520 mother-child dyads who received prenatal medical assistance through the National Public Health System in a southern Brazilian city, from October 2009 to March 2011. OUTCOME MEASURES: We used the Mini Neuropsychiatric Interview Plus (MINI Plus) to assess SAD among young mothers. Cognitive and language performance in their offspring was analyzed using the Bayley Scales of Infant and Toddler Development - 3rd Edition. RESULTS: We found an association between maternal SAD and performance in cognitive and language tests. Children of mothers with SAD had in average 4.5 less points in the Bayley scale, when compared to those with mothers without SAD: in the cognitive (ß=-4.53 [95% CI -7.8; -1.1] p=0.008) and language subscales (ß=-4.54 [95% CI -9.0; -0.5] p=0.047). CONCLUSIONS: Our findings suggest that children with mothers suffering from SAD have poorer cognitive abilities and language skills.

Comparison of two instruments to track depression symptoms during pregnancy in a sample of pregnant teenagers in Southern Brazil.

INTRODUCTION: Depression during pregnancy in adolescents is increasing significantly. However, instruments for early depression screening during prenatal care are scarce. Faced this fact, the objective of this research is to identify the best cutoff points for the Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) in a sample of pregnant adolescents. METHOD: 807 pregnant adolescents, with a mean age of 17 years, met in public antenatal services were evaluated. Two screening scales for depression were analyzed, EPDS and the BDI. These scales had their accuracy measured by AUC of their ROC curve, as well as their respective sensitivity and specificity. RESULTS: In the analysis, the best cutoff for the EPDS was≥10, in which the sensitivity was 81.1% and specificity 82.7%. For the BDI, it was with recognized the cutoff ≥11, sensitivity 86.7% and specificity 73.8%. In the analysis of the ROC AUC, values of 0.89 (CI 0.87-0.92) for the EPDS and BDI for 0.87 (CI 0.84-0.89) were identified compared to the MINI. LIMITATIONS: The sample was composed majority by middle and low income adolescent and the study was performed only with pregnant women in the second trimester. CONCLUSIONS: The results indicate that both scales have good accuracy in screening of depression in adolescent mothers. However, the EPDS scale shows higher AUC ROC and also better sensitivity and specificity values, the latter being more precise and effective for screening for depression in this population.

Systematic review of studies about countertransference in adult psychotherapy / Revisão sistemática de estudos sobre contratransferência em psicoterapia de adultos

INTRODUCTION: Countertransference, the emotional reaction of a psychotherapist toward a patient, is an important technical element of psychotherapy. The purpose of this systematic review was to identify and describe the main findings of studies that evaluated countertransference in adult psychotherapy. METHODS: A search was conducted of the databases Embase, PubMed, PsycINFO and Web of Knowledge to retrieve data published in any language at any time. RESULTS: Of the 1,081 studies found in the databases, 25 were selected. Most were about psychodynamic psychotherapy, and results indicated that positive countertransference, that is, feelings of closeness to the patient, are associated with positive outcomes, such as symptom improvement and good therapeutic alliance. CONCLUSIONS: Although few studies were found in the literature, countertransference seems to be an important source of knowledge about several aspects, such as treatment outcomes, attachment style, therapeutic alliance, patient symptoms and diagnoses (AU)

INTRODUÇÃO: Contratransferência, definida como a reação emocional do psicoterapeuta em relação ao paciente, é um elemento técnico importante da psicoterapia. Esta revisão sistemática procura identificar e descrever os principais achados de estudos que avaliaram a contratransferência na psicoterapia de adultos. MÉTODOS: Realizou-se uma busca sem restrição de língua ou data de publicação nas bases de dados Embase, PubMed, PsycINFO e Web of Knowledge. RESULTADOS: Dos 1.081 estudos encontrados nas bases de dados, 25 foram selecionados. A maioria trata de psicoterapia psicodinâmica e os resultados indicam que a contratransferência positiva, isto é, os sentimentos de proximidade com o paciente, está associada a resultados positivos, tais como a melhora dos sintomas e o desenvolvimento de uma boa aliança terapêutica. CONCLUSÕES: Apesar de poucos estudos terem sido encontrados na literatura, a contratransferência parece ser uma fonte importante para o conhecimento do resultado do tratamento, estilo de apego, aliança terapêutica, sintomas e diagnóstico, dentre outros aspectos (AU)

Serum NGF, BDNF and IL-6 levels in postpartum mothers as predictors of infant development: the influence of affective disorders.

BACKGROUND: Early adverse experiences are associated with increased risk of developing psychiatric disorders, although little is known about the neurobiological mediators involved. The mechanisms by which early environmental influences may mediate vulnerability in the development of offspring await further investigation. The present study correlated the NGF, BDNF, IL-6 and cortisol levels of mothers with postpartum affective disorders (PPAD) with infant development. METHODS: A longitudinal study was performed with 152 pregnant women and their infants. Between 60 and 120 days after delivery, women were interviewed and provided biological samples for biochemical analysis, and the infants were examined for neurobiological-motor development. RESULTS: Overall, the mothers' history of affective disorders, PPAD and anxiety disorder were associated with infant motor development. Using an adjusted linear regression analysis, PPAD (p = 0.049), maternal anxiety disorder (p = 0.043), NGF level (p = 0.034) and infant cortisol level (p = 0.013) were associated with infant motor development. Using a factorial analysis of primary components, two components were retained. The psychological factor was characterized by a positive loading of a history of affective disorder, PPAD and anxiety disorder. For the biological factor, infant cortisol adhered negatively with infant motor development, but NGF was positively associated. The psychological factor had a negative association, but the biological factor had a positive association with infant motor development. CONCLUSIONS: There are few studies that have focused on the relationship of biomarkers and infant neurodevelopment. Our study points that psychological and biological factors are associated with infant motor development, however the causal relationship between these factors is still to be defined.

Parental bonding and suicidality in pregnant teenagers: a population-based study in southern Brazil.

PURPOSE: To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents. METHODS: A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data. RESULTS: Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18-19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14-5.59) for the maternal 'affectionless control' and a PR of 2.91 (95 % CI 1.10-7.70) for the paternal 'neglectful parenting.' CONCLUSIONS: We found that maternal 'affectionless control' and paternal 'neglectful parenting' were independent predictors of suicidality in this sample of pregnant teenagers.

Systematic review of studies about countertransference in adult psychotherapy.

INTRODUCTION: Countertransference, the emotional reaction of a psychotherapist toward a patient, is an important technical element of psychotherapy. The purpose of this systematic review was to identify and describe the main findings of studies that evaluated countertransference in adult psychotherapy. METHODS: A search was conducted of the databases Embase, PubMed, PsycINFO and Web of Knowledge to retrieve data published in any language at any time. RESULTS: Of the 1,081 studies found in the databases, 25 were selected. Most were about psychodynamic psychotherapy, and results indicated that positive countertransference, that is, feelings of closeness to the patient, are associated with positive outcomes, such as symptom improvement and good therapeutic alliance. CONCLUSIONS: Although few studies were found in the literature, countertransference seems to be an important source of knowledge about several aspects, such as treatment outcomes, attachment style, therapeutic alliance, patient symptoms and diagnoses.

Major depressive disorder during teenage pregnancy: socio-demographic, obstetric and psychosocial correlates.

OBJECTIVES: To describe the prevalence of Major Depressive Disorder (MDD) during pregnancy in teenage mothers and to assess its association with socio-demographic characteristics, obstetric history and psychosocial variables. METHODS: A cross-sectional study was conducted with a sample of pregnant teenagers enrolled in the national public health system in the urban area of Pelotas, southern Brazil. MDD was assessed with the Mini International Neuropsychiatric Interview, the Abuse Assessment Screen was used to identify physical abuse within the last 12 months and during pregnancy, and social support was assessed with the Medical Outcomes Survey Social Support Scale. RESULTS: Forty-three (4.94%) potential subjects refused to participate, resulting in 828 total participants. The prevalence of MDD was 17.8%, 9.2% reported they had been subjected to violence within the last 12 months, while 5.8% had suffered violence during pregnancy, and the mean (SD) overall social support score was 87.40 (11.75). After adjustment, we found the highest incidence of MDD in adolescents with less than 8 years of education, followed by those with previous episodes of MDD and those with lower overall social support. CONCLUSIONS: MDD is a relatively common condition in pregnant teenagers and appears to be more prevalent in young mothers who are both socioeconomically and psychosocially underprivileged.

Major depressive disorder during teenage pregnancy: socio-demographic, obstetric and psychosocial correlates

OBJECTIVES: To describe the prevalence of Major Depressive Disorder (MDD) during pregnancy in teenage mothers and to assess its association with socio-demographic characteristics, obstetric history and psychosocial variables. METHODS: A cross-sectional study was conducted with a sample of pregnant teenagers enrolled in the national public health system in the urban area of Pelotas, southern Brazil. MDD was assessed with the Mini International Neuropsychiatric Interview, the Abuse Assessment Screen was used to identify physical abuse within the last 12 months and during pregnancy, and social support was assessed with the Medical Outcomes Survey Social Support Scale. RESULTS: Forty-three (4.94%) potential subjects refused to participate, resulting in 828 total participants. The prevalence of MDD was 17.8%, 9.2% reported they had been subjected to violence within the last 12 months, while 5.8% had suffered violence during pregnancy, and the mean (SD) overall social support score was 87.40 (11.75). After adjustment, we found the highest incidence of MDD in adolescents with less than 8 years of education, followed by those with previous episodes of MDD and those with lower overall social support. CONCLUSIONS: MDD is a relatively common condition in pregnant teenagers and appears to be more prevalent in young mothers who are both socioeconomically and psychosocially underprivileged.

Association of a serotonin transporter gene polymorphism (5-HTTLPR) and stressful life events with postpartum depressive symptoms: a population-based study.

We conducted a cross-sectional study nested within a cohort study with 276 postpartum women to evaluate the role of a serotonin transporter gene polymorphism (5-HTTLPR) and the stressful life events (SLE) on the risk of postpartum depression (PPD) symptoms in a community sample. Participants were assessed between 45 and 90 days after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and the Mini International Neuropsychiatric Interview (MINI). Data regarding socio-demographic variables, alcohol consumption, tobacco smoking and SLE occurring during pregnancy, were also collected. In the adjusted analysis, the women carrying the long (L) allele (LL) who experienced SLE showed higher prevalence ratios (PR) for PPD symptoms (EPDS ≥13) than those with two copies of the short (S) allele (SL) (PR = 9.91; 95% confidence interval: 1.70-57.87). In contrast, a trend of association was found between prior history of major depressive disorder (MDD) and the S allele carrier status (p = 0.07). No association was found between the formal diagnosis of current MDD and the 5-HTTLPR genotypes. In line with previous reports, we find in this sample that the L allele carrier status was associated with a heighten risk of depressive symptoms in postpartum when SLE were experienced during pregnancy.

Paternal postpartum mood: bipolar episodes?

OBJECTIVE: We describe the prevalence of depressive and bipolar spectrum episodes in fathers in antenatal and postnatal periods, as well as at 12 months after childbirth. METHOD: A longitudinal follow-up study was conducted with a representative sample of 739 fathers whose children were born between April 2007 and May 2008 in maternity wards in the city of Pelotas, southern Brazil. Paternal psychopathology was measured with the Mini Neuropsychiatric Interview (MINI) across three time points: between 28 and 34 weeks of pregnancy (T1), 30 to 60 days postpartum (T2), and 12 months after childbirth (T3). RESULTS: The prevalence of depressive episodes was 5.0% at T1, 4.5% at T2, and 4.3% at T3. Mixed episodes were present in 3%, 1.7%, and 0.9% of subjects, respectively, and accounted for 61.1% of the cases of depression in the antenatal period, 37.5% in postpartum, and 21.4% at 12 months. Depressive and manic/hypomanic episodes were significantly associated during pregnancy and in postpartum, but not at 12 months after childbirth. CONCLUSION: Bipolar episodes were common in men with depressive symptoms during their partner's pregnancy in the postpartum period and, to a lesser extent, 12 months after childbirth. Therefore, this population should be carefully investigated for manic and hypomanic symptoms.

Paternal postpartum mood: bipolar episodes? / Depressão paterna: episódio bipolar?

OBJECTIVE: We describe the prevalence of depressive and bipolar spectrum episodes in fathers in antenatal and postnatal periods, as well as at 12 months after childbirth. METHOD: A longitudinal follow-up study was conducted with a representative sample of 739 fathers whose children were born between April 2007 and May 2008 in maternity wards in the city of Pelotas, southern Brazil. Paternal psychopathology was measured with the Mini Neuropsychiatric Interview (MINI) across three time points: between 28 and 34 weeks of pregnancy (T1), 30 to 60 days postpartum (T2), and 12 months after childbirth (T3). RESULTS: The prevalence of depressive episodes was 5.0 percent at T1, 4.5 percent at T2, and 4.3 percent at T3. Mixed episodes were present in 3 percent, 1.7 percent, and 0.9 percent of subjects, respectively, and accounted for 61.1 percent of the cases of depression in the antenatal period, 37.5 percent in postpartum, and 21.4 percent at 12 months. Depressive and manic/hypomanic episodes were significantly associated during pregnancy and in postpartum, but not at 12 months after childbirth. CONCLUSION: Bipolar episodes were common in men with depressive symptoms during their partner's pregnancy in the postpartum period and, to a lesser extent, 12 months after childbirth. Therefore, this population should be carefully investigated for manic and hypomanic symptoms.

OBJETIVO: Verificar a prevalência dos episódios depressivos e bipolares em homens no período pré e pós-natal, assim como 12 meses após o parto. MÉTODO: Estudo longitudinal com amostra de pais cujas crianças nasceram entre abril de 2007 e maio de 2008 em maternidades da cidade de Pelotas-RS, no sul do Brasil. Episódios depressivos e maníacos/hipomaníacos foram mensurados com o Mini Neuropsychiatric Interview em três tempos diferentes: entre a 28ª e 34ª semanas de gestação (T1), 30 a 60 dias após o parto (T2) e 12 meses após o nascimento da criança. RESULTADOS: A prevalência de episódios depressivos foi 5,0 por cento em T1, 4,5 por cento em T2 e 4,3 por cento em T3. Episódios mistos estiveram presentes em 3,0, 1,7 e 0,9 por cento, respectivamente, e somaram 61,1 por cento de casos de depressão antenatal, 37,5 por cento pós-natal e 21,4 por cento aos 12 meses pós-parto. Episódio depressivo e maníaco/hipomaníaco esteve significativamente associado durante a gestação e o pós-parto. CONCLUSÃO: Episódios bipolares são comuns em homens com sintomas depressivos durante a gestação de suas companheiras e no período pós-natal. Essa população deveria ser cuidadosamente investigada para sintomas maníacos e hipomaníacos, a fim de ser adequadamente tratada.

Chronicity and severity of maternal postpartum depression and infant sleep disorders: a population-based cohort study in southern Brazil.

A cohort study was conducted with 397 women randomly selected from the Brazilian National System of Public Health, to describe the prevalence rates of infant sleep problems at 12-month of life, and its association with chronicity and severity of maternal depressive symptoms. Mothers were assessed, first, from the 9th to the 12th week postpartum and then at 12 months after delivery, with EPDS and a self-rating questionnaire regarding babies' sleep behavior. After controlling for possible confounders, babies whose mothers had severe chronic depressive symptoms were at higher risk for sleep disorder at 12 months of birth.

Common mental disorders and chronic non-communicable diseases in adults: a population-based study.

A cross-sectional population-based study was conducted to identify the prevalence of common mental disorders and verify the association with chronic non-communicable diseases (NCDs) and the self-reported number of chronic diseases. The Self-Reporting Questionnaire (SRQ-20) was applied in a multi-stage random sample of 1,276 adults aged 40 and older. Socio-demographic, behavioral, and health-related variables were also obtained using a structured questionnaire. Prevalence of common mental disorders was 30.2%. Lower schooling and social class and the 46-55-year age bracket were associated with psychiatric morbidity. Each chronic illness was independently associated with common mental disorders. However, a stronger association was found between common mental disorders and the total number of self-reported chronic conditions, with a prevalence ratio of 4.67 (95%CI: 3.19-6.83) for five or more self-reported NCDs. The current study emphasizes the importance of common mental disorders in chronically ill patients, particularly in those with more total chronic conditions.