Examining differences in brain metabolism associated with childhood maltreatment and suicidal attempt in euthymic patients with bipolar disorder: A PET and Machine Learning Study.

OBJECTIVE: Childhood maltreatment (CM) is a significant risk factor for the development and severity of bipolar disorder (BD) with increased risk of suicide attempts (SA). This study evaluated whether a machine learning algorithm could be trained to predict if a patient with BD has a history of CM or previous SA based on brain metabolism measured by positron emission tomography. METHODS: Thirty-six euthymic patients diagnosed with BD type I, with and without a history of CM were assessed using the Childhood Trauma Questionnaire. Suicide attempts were assessed through the Mini International Neuropsychiatric Interview (MINI-Plus) and a semi-structured interview. Resting-state positron emission tomography with 18F-fluorodeoxyglucose was conducted, electing only grey matter voxels through the Statistical Parametric Mapping toolbox. Imaging analysis was performed using a supervised machine learning approach following Gaussian Process Classification. RESULTS: Patients were divided into 18 participants with a history of CM and 18 participants without it, along with 18 individuals with previous SA and 18 individuals without such history. The predictions for CM and SA were not significant (accuracy = 41.67%; p = 0.879). CONCLUSION: Further investigation is needed to improve the accuracy of machine learning, as its predictive qualities could potentially be highly useful in determining histories and possible outcomes of high-risk psychiatric patients.

Examining differences in brain metabolism associated with childhood maltreatment and suicidal attempts in euthymic patients with bipolar disorder: a PET and machine learning study

Objective: Childhood maltreatment (CM) is a significant risk factor for the development and severity of bipolar disorder (BD) with increased risk of suicide attempts (SA). This study evaluated whether a machine learning algorithm could be trained to predict if a patient with BD has a history of CM or previous SA based on brain metabolism measured by positron emission tomography. Methods: Thirty-six euthymic patients diagnosed with BD type I, with and without a history of CM were assessed using the Childhood Trauma Questionnaire. Suicide attempts were assessed through the Mini International Neuropsychiatric Interview (MINI-Plus) and a semi-structured interview. Resting-state positron emission tomography with 18F-fluorodeoxyglucose was conducted, electing only grey matter voxels through the Statistical Parametric Mapping toolbox. Imaging analysis was performed using a supervised machine learning approach following Gaussian Process Classification. Results: Patients were divided into 18 participants with a history of CM and 18 participants without it, along with 18 individuals with previous SA and 18 individuals without such history. The predictions for CM and SA were not significant (accuracy = 41.67%; p = 0.879). Conclusion: Further investigation is needed to improve the accuracy of machine learning, as its predictive qualities could potentially be highly useful in determining histories and possible outcomes of high-risk psychiatric patients.

Prevalence of psychiatric symptoms and associated factors in the adult population from the area affected by the tailings dam rupture - Brumadinho Health Project.

OBJECTIVE: To examine the prevalence of psychiatric symptoms and associated factors in the adult population of Brumadinho (MG), after the dam collapse. METHODS: We included 2,740 participants with information about symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, thoughts of death/self-harm, and poor sleep quality collected in 2021. Prevalence values of all conditions were estimated to compare the prevalence of psychiatric symptoms with the participants' sociodemographic characteristics and place of residence. Pearson's c2 test was used, with Rao Scott's correction. Crude and adjusted logistic regressions estimated odds ratios and 95% confidence intervals to assess the association between psychiatric symptoms and participants' characteristics. RESULTS: The most common condition was depressive symptoms (29.3%), followed by post-traumatic stress symptoms (22.9%) and anxious symptoms (18.9%). Regarding the association between participants' characteristics in the adjusted analysis, being a female and living in a mining area was positively associated with symptoms of PTSD, depression, anxiety, thoughts of death/self-harm, and poor sleep quality. A positive association was also found between high school education and post-traumatic stress symptoms. In contrast a negative association was found between being aged ≥60 years and symptoms of PTSD, depression, and anxiety. CONCLUSION: High prevalence values were found for all psychiatric symptoms after the dam failure in Brumadinho. Being a female, living in the mining area, being ≥60 years old, and having an educational level were all associated with the psychiatric symptoms investigated.

Calix[n]arene-based immunogens: A new non-proteic strategy for anti-cocaine vaccine.

Introduction: Cocaine use disorder is a significant public health issue without a current specific approved treatment. Among different approaches to this disorder, it is possible to highlight a promising immunologic strategy in which an immunogenic agent may reduce the reinforcing effects of the drug if they are able to yield sufficient specific antibodies capable to bind cocaine and/or its psychoactive metabolites before entering into the brain. Several carriers have been investigated in the anti-cocaine vaccine development; however, they generally present a very complex chemical structure, which potentially hampers the proper assessment of the coupling efficiency between the hapten units and the protein structure. Objectives: The present study reports the design, synthesis and preclinical evaluation of two novel calix[n]arene-based anti-cocaine immunogens (herein named as V4N2 and V8N2) by the tethering of the hydrolysis-tolerant hapten GNE (15) on calix[4]arene and calix[8]arene moieties. Methods: The preclinical assessment corresponded to the immunogenicity and dose-response evaluation of V4N2 and V8N2. The potential of the produced antibodies to reduce the passage of cocaine analogue through the blood-brain-barrier (BBB), modifying its biodistribution was also investigated. Results: Both calix[n]arene-based immunogens elicited high titers of cocaine antibodies that modified the biodistribution of a cocaine radiolabeled analogue (99mTc-TRODAT-1) and decreased cocaine-induced behavior, according to an animal model. Conclusion: The present results demonstrate the potential of V4N2 and V8N2 as immunogens for the treatment of cocaine use disorder.

Prevalence of psychiatric symptoms and associated factors in the adult population from the area affected by the tailings dam rupture - Brumadinho Health Project / Prevalência de sintomas psiquiátricos e seus fatores associados na população adulta da área atingida pelo rompimento da barragem de rejeitos: Projeto Saúde Brumadinho

ABSTRACT: Objective: To examine the prevalence of psychiatric symptoms and associated factors in the adult population of Brumadinho (MG), after the dam collapse. Methods: We included 2,740 participants with information about symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, thoughts of death/self-harm, and poor sleep quality collected in 2021. Prevalence values of all conditions were estimated to compare the prevalence of psychiatric symptoms with the participants' sociodemographic characteristics and place of residence. Pearson's c2 test was used, with Rao Scott's correction. Crude and adjusted logistic regressions estimated odds ratios and 95% confidence intervals to assess the association between psychiatric symptoms and participants' characteristics. Results: The most common condition was depressive symptoms (29.3%), followed by post-traumatic stress symptoms (22.9%) and anxious symptoms (18.9%). Regarding the association between participants' characteristics in the adjusted analysis, being a female and living in a mining area was positively associated with symptoms of PTSD, depression, anxiety, thoughts of death/self-harm, and poor sleep quality. A positive association was also found between high school education and post-traumatic stress symptoms. In contrast a negative association was found between being aged ≥60 years and symptoms of PTSD, depression, and anxiety. Conclusion: High prevalence values were found for all psychiatric symptoms after the dam failure in Brumadinho. Being a female, living in the mining area, being ≥60 years old, and having an educational level were all associated with the psychiatric symptoms investigated.

RESUMO: Objetivo: Examinar a prevalência dos sintomas psiquiátricos e seus fatores associados na população adulta de Brumadinho (MG), após o rompimento da barragem. Métodos: Foram incluídos 2.740 participantes com informações coletadas em 2021 sobre os sintomas de estresse pós-traumático (TEPT), depressão, ansiedade, ideias de morte/automutilação e pior qualidade do sono. Estimaram-se as prevalências de todas as condições. Para a comparação das prevalências dos sintomas psiquiátricos e as características sociodemográficas e local de moradia, empregou-se o teste χ2 de Pearson, com correção de Rao-Scott. Regressões logísticas brutas e ajustadas estimaram os odds ratios e intervalos de confiança de 95%, permitindo a avaliação da associação entre os sintomas psiquiátricos e as características dos participantes. Resultados: Os sintomas depressivos foram a condição mais prevalente (29,3%), seguidos pelos sintomas de TEPT (22,9%) e sintomas ansiosos (18,9%). Com relação à investigação da associação entre as características dos participantes na análise ajustada, observou-se que o sexo feminino e os moradores da área de mineração apresentaram relação positiva com os sintomas de TEPT, depressivos, ansiosos, ideia de morte e pior qualidade de sono. Também se encontraram associação positiva entre a escolaridade de nível médio e os sintomas de TEPT e associação negativa entre aqueles com ≥60 anos e os sintomas de TEPT, depressivos e ansiosos. Conclusão: Altas prevalências foram encontradas para todos os sintomas psiquiátricos após a ruptura da barragem em Brumadinho. Sexo feminino, local de moradia na área de mineração, ≥60 anos e escolaridade foram associados aos sintomas psiquiátricos investigados.

Smartphone and Facebook addictions share common risk and prognostic factors in a sample of undergraduate students / Dependência de smartphone e dependência de Facebook compartilham fatores de risco e prognósticos em uma amostra de estudantes universitários

Abstract Introduction To improve the comprehension of the interface between smartphone addiction (SA) and Facebook addiction (FA), we hypothesize that the occurrence of both technological addictions correlate, with higher levels of negative consequences. Moreover, we hypothesize that SA is associated with lower levels of social support satisfaction. Methods We recruited a convenience sample of undergraduate students from Universidade Federal de Minas Gerais, with age ranging between 18 and 35 years. All subjects completed a self-fulfilled questionnaire comprising sociodemographic data, the Brazilian Smartphone Addiction Inventory (SPAI-BR), the Bergen Scale for Facebook Addiction, the Barrat Impulsivity Scale 11 (BIS-11), the Social Support Satisfaction Scale (SSSS), and the Brief Sensation Seeking Scale (BSSS-8). After completing the questionnaire, the interviewer conducted a Mini-International Neuropsychiatric Interview (MINI). Results In the univariate analysis, SA associated with female gender, with ages 18 to 25 years, FA, substance abuse disorders, major depressive disorder, anxiety disorders, low scores in SSSS, high scores in BSSS-8, and high scores in BIS. The group with SA and FA presented a higher prevalence of substance abuse disorders, depression, and anxiety disorders when compared to the group with SA only. Conclusion In our sample, co-occurrence of SA and FA correlated with higher levels of negative consequences and lower levels of social support satisfaction. These results strongly suggest that SA and FA share some elements of vulnerability. Further studies are warranted to clarify the directions of these associations.

Resumo Introdução Para melhorar a compreensão da interface entre dependência de smartphone (DS) e a dependência de Facebook (DF), avaliamos a hipótese de que a ocorrência simultânea de ambas as dependências corelaciona-se com o número de consequências negativas por elas produzidas. Além disso, avaliamos se a DS está associada a níveis mais baixos de satisfação com o suporte social. Método Recrutamos uma amostra de conveniência de estudantes de graduação da Universidade Federal de Minas Gerais, na faixa de 18 e 35 anos. Todos os sujeitos preencheram o questionário avaliando dados sociodemográficos e contendo a versão brasileira do Smartphone Addiction Inventory, a Escala de Bergen para DF, a Escala de Impulsividade de Barrat 11 (BIS-11), a Escala de Satisfação com o Suporte Social (SSSS) e a Escala Breve de Busca de Sensações (BSSS-8). Após o preenchimento do questionário, os entrevistadores realizaram a Mini-International Neuropsychiatric Interview. Resultados Na análise univariada, a DS associou-se ao sexo feminino, pessoas na faixa de idade entre 18 e 25 anos, rastreio para DF, transtornos por uso de substâncias, transtorno depressivo maior, transtornos de ansiedade, baixos escores na SSSS, altos escores na BSSS-8 e altos escores na BIS. O grupo rastreado positivamente para DS e DF apresentou maior prevalência de transtornos por uso de substâncias, depressão e transtornos de ansiedade quando comparado ao grupo rastreado apenas para DS. Conclusão Na amostra avaliada, a comorbidade de DS e DF se correlacionou a níveis mais altos de consequências negativas e níveis mais baixos de satisfação com o suporte social. Esses resultados sugerem que DS e DF compartilham fatores de vulnerabilidade. Estudos adicionais são necessários para esclarecer a direção dessas associações.

Corrigendum: Bad Choices Make Good Stories: The Impaired Decision-Making Process and Skin Conductance Response in Subjects With Smartphone Addiction.

[This corrects the article DOI: 10.3389/fpsyt.2019.00073.].

Bad Choices Make Good Stories: The Impaired Decision-Making Process and Skin Conductance Response in Subjects With Smartphone Addiction.

Introduction: Smartphone Addiction (SA) has caused negative consequences and functional impairments in college students, such as reduction of academic performance and impairment in sleep quality. Studies have shown that individuals with chemical and behavioral dependencies have a bias in decision-making process, which leads to short-term advantageous choices even if they cause long-term harm. This bias in decision-making process is accompanied by a change in somatic markers and is associated with the development and maintenance of addictive behavior. The decision-making process and the measurement of physiological parameters have not yet been analyzed in SA. The neuropsychological and physiological characterization of the SA can contribute to its approach with the other dependency syndromes and to its recognition as a disease. Objective: we aimed to evaluate the decision-making process under risk and under ambiguity in individuals with SA and to measure the physiological parameters that accompany this process. Method: We compared the performance in the Iowa Gambling Task (IGT), Game of Dice Task (GDT) and skin conductance response (SCR) between 50 individuals with SA and 50 controls. Results: Smartphone dependents presented a profile of impairment in decision-making under ambiguity, without impairment in decision-making under risk. They demonstrated lower SCR before disadvantageous choices, higher SCR after rewards and lower SCR after punishments during decision-making, which suggests difficulty in recognizing disadvantageous alternatives, high sensitivity to rewards, and low sensitivity to punishments. Conclusion: The impairment in the decision-making process in smartphone dependents is similar to that found in other chemical and behavioral addictions, such as alcohol addiction, gambling disorders and pathological buy. The impairment in decision under ambiguity with preservation of decision under risk may reflect dysfunction of implicit emotional processes without dysfunction of explicit cognitive process. This profile can contribute to the recognition of SA as a behavioral dependence and to guide specific preventive and therapeutic strategies.

Is there a role for cannabidiol in psychiatry?

OBJECTIVES: Understanding whether cannabidiol (CBD) is useful and safe for the treatment of psychiatric disorders is essential to empower psychiatrists and patients to take good clinical decisions. Our aim was to conduct a systematic review regarding the benefits and adverse events (AEs) of CBD in the treatment of schizophrenia, psychotic disorders, anxiety disorders, depression, bipolar disorder and substance-use disorders. METHODS: We conducted a literature search in PubMed, Scielo, and Clinicaltrials.gov databases. Evidence was classified according to the WFSBP task forces standards. RESULTS: Bibliographic research yielded 692 records. After analysis, we included six case reports and seven trials, comprising 201 subjects. Most the studies published presented several drawbacks and did not reach statistical significance. We have not found evidence regarding major depressive and bipolar disorders. The level of evidence for cannabis withdrawal is B; cannabis addiction is C2; treatment of positive symptoms in schizophrenia and anxiety in social anxiety disorder is C1. Discrete or no AEs were reported. The most frequently reported AEs are sedation and dizziness. CONCLUSIONS: The evidence regarding efficacy and safety of CBD in psychiatry is still scarce. Further larger well-designed randomised controlled trials are required to assess the effects of CBD in psychiatric disorders.

Smartphone and Facebook addictions share common risk and prognostic factors in a sample of undergraduate students.

INTRODUCTION: To improve the comprehension of the interface between smartphone addiction (SA) and Facebook addiction (FA), we hypothesize that the occurrence of both technological addictions correlate, with higher levels of negative consequences. Moreover, we hypothesize that SA is associated with lower levels of social support satisfaction. METHODS: We recruited a convenience sample of undergraduate students from Universidade Federal de Minas Gerais, with age ranging between 18 and 35 years. All subjects completed a self-fulfilled questionnaire comprising sociodemographic data, the Brazilian Smartphone Addiction Inventory (SPAI-BR), the Bergen Scale for Facebook Addiction, the Barrat Impulsivity Scale 11 (BIS-11), the Social Support Satisfaction Scale (SSSS), and the Brief Sensation Seeking Scale (BSSS-8). After completing the questionnaire, the interviewer conducted a Mini-International Neuropsychiatric Interview (MINI). RESULTS: In the univariate analysis, SA associated with female gender, with ages 18 to 25 years, FA, substance abuse disorders, major depressive disorder, anxiety disorders, low scores in SSSS, high scores in BSSS-8, and high scores in BIS. The group with SA and FA presented a higher prevalence of substance abuse disorders, depression, and anxiety disorders when compared to the group with SA only. CONCLUSION: In our sample, co-occurrence of SA and FA correlated with higher levels of negative consequences and lower levels of social support satisfaction. These results strongly suggest that SA and FA share some elements of vulnerability. Further studies are warranted to clarify the directions of these associations.

Assessment of the accuracy of a new tool for the screening of smartphone addiction.

OBJECTIVE: To translate, adapt and validate the Smartphone Addiction Inventory (SPAI) in a Brazilian population of young adults. METHOD: We employed the translation and back-translation method for the adaptation of the Brazilian version SPAI (SPAI-BR). The sample consisted of 415 university students. Data was collected through an electronic questionnaire, which consisted of the SPAI-BR and the Goodman Criteria (gold standard). The retests were carried out 10-15 days after the initial tests with 130 individuals. RESULTS: The SPAI-BR maintained semantic, idiomatic and conceptual equivalences from the original scale. The Confirmatory Factor Analysis confirmed the One-factor model of the SPAI with good fit indexes (x2 = 767.861, CFI = 0.913, TLI = 0.905, RMSE = 0.061, WRMR = 1.465). The Kuder-Richardson Coefficient showed good internal consistency. The analysis of the ROC curve established an area under the curve of 86.38%. The Intraclass-Correlation Coefficient of 0.926 between the test and the retest demonstrated an excellent temporal stability. The high correlation between SPAI-BR and the Goodman Criteria (rs = 0.750) established the convergent validity. CONCLUSION: The SPAI-BR is a valid and reliable tool for the detection of Smartphone Addiction in Brazilian university students.

Structural brain abnormalities in patients with type I bipolar disorder and suicidal behavior.

Some studies have identified brain morphological changes in the frontolimbic network (FLN) in bipolar subjects who attempt suicide (SA). The present study investigated neuroanatomical abnormalities in the FLN to find a possible neural signature for suicidal behavior in patients with bipolar disorder type I (BD-I). We used voxel-based morphometry to compare euthymic patients with BD-I who had attempted suicide (n=20), who had not attempted suicide (n=19) and healthy controls (HCs) (n=20). We also assessed the highest medical lethality of their previous SA. Compared to the participants who had not attempted suicide, the patients with BD-I who had attempted suicide exhibited significantly increased gray matter volume (GMV) in the right rostral anterior cingulate cortex (ACC), which was more pronounced and extended further to the left ACC in the high-lethality subgroup (p<0.05, with family-wise error (FWE) correction for multiple comparisons using small-volume correction). GMV in the insula and orbitofrontal cortex was also related to suicide lethality (p<0.05, FWE-corrected). The current findings suggest that morphological changes in the FLN could be a signature of previous etiopathogenic processes affecting regions related to suicidality and its severity in BD-I patients.

Gray matter brain volumes in childhood-maltreated patients with bipolar disorder type I: A voxel-based morphometric study.

BACKGROUND: Childhood maltreatment (CM) may be related to clinical expression and outcome of bipolar disorder (BD). Several neuroimaging studies have detected brain morphological changes in specific neural networks of adults who suffered maltreatment in their childhood. We investigated alterations in gray matter volume (GMV) to determine a possible neuroanatomical basis of vulnerability in patients with CM having type I BD (BD-I). METHODS: We assessed 39 euthymic DSM-IV BD-I patients with (n=20) and without (n=19) a history of CM and 20 healthy controls without maltreatment as defined by the Childhood Trauma Questionnaire (CTQ). Voxel-based morphometry (VBM) was used to compare GMV differences between patients and controls and perform linear correlations in overall BD group between GMV and CTQ scores. RESULTS: BD-I patients had significant negative correlations between CTQ total score and GMV in the right dorsolateral prefrontal cortex (PFC) and the right thalamus; between physical abuse and GMV in the right dorsolateral PFC; between physical neglect and GMV in the thalamus bilaterally; and between emotional neglect and GMV in the right thalamus. LIMITATIONS: Pharmacological treatment could have altered GMV findings. Results emerged only when using SVC approach. CTQ, a retrospective self-report, has the risk of potential recall bias. The cross-sectional design limits longitudinal and neurodevelopmental inferences. CONCLUSIONS: The severity of self-reported CM in BD-I patients is associated with morphological changes in GMV of specific neural networks relevant to responses to stress and to modulate emotional behavior.

A voxel-based morphometry study of gray matter correlates of facial emotion recognition in bipolar disorder.

Facial emotion recognition (FER) is one of the many cognitive deficits reported in bipolar disorder (BD) patients. The aim of this study was to investigate neuroanatomical correlates of FER impairments in BD type I (BD-I). Participants comprised 21 euthymic BD-I patients without Axis I DSM IV-TR comorbidities and 21 healthy controls who were assessed using magnetic resonance imaging and the Penn Emotion Recognition Test (ER40). Preprocessing of images used DARTEL (diffeomorphic anatomical registration through exponentiated Lie algebra) for optimized voxel-based morphometry in SPM8. Compared with healthy subjects, BD-I patients performed poorly in on the ER40 and had reduced gray matter volume (GMV) in the left orbitofrontal cortex, superior portion of the temporal pole and insula. In the BD-I group, the statistical maps indicated a direct correlation between FER on the ER40 and right middle cingulate gyrus GMV. Our findings are consistent with the previous studies regarding the overlap of multiple brain networks of social cognition and BD neurobiology, particularly components of the anterior-limbic neural network.

Facial emotion recognition deficits in relatives of children with autism are not associated with 5HTTLPR.

OBJECTIVE: A large body of evidence suggests that several aspects of face processing are impaired in autism and that this impairment might be hereditary. This study was aimed at assessing facial emotion recognition in parents of children with autism and its associations with a functional polymorphism of the serotonin transporter (5HTTLPR). METHOD: We evaluated 40 parents of children with autism and 41 healthy controls. All participants were administered the Penn Emotion Recognition Test (ER40) and were genotyped for 5HTTLPR. RESULTS: Our study showed that parents of children with autism performed worse in the facial emotion recognition test than controls. Analyses of error patterns showed that parents of children with autism over-attributed neutral to emotional faces. We found evidence that 5HTTLPR polymorphism did not influence the performance in the Penn Emotion Recognition Test, but that it may determine different error patterns. CONCLUSION: Facial emotion recognition deficits are more common in first-degree relatives of autistic patients than in the general population, suggesting that facial emotion recognition is a candidate endophenotype for autism.

Facial emotion recognition deficits in relatives of children with autism are not associated with 5HTTLPR / Prejuízos no reconhecimento de emoções faciais em parentes de primeiro grau de portadores de autismo não são associados com o polimorfismo 5HTTLPR

OBJECTIVE: A large body of evidence suggests that several aspects of face processing are impaired in autism and that this impairment might be hereditary. This study was aimed at assessing facial emotion recognition in parents of children with autism and its associations with a functional polymorphism of the serotonin transporter (5HTTLPR). METHOD: We evaluated 40 parents of children with autism and 41 healthy controls. All participants were administered the Penn Emotion Recognition Test (ER40) and were genotyped for 5HTTLPR. RESULTS: Our study showed that parents of children with autism performed worse in the facial emotion recognition test than controls. Analyses of error patterns showed that parents of children with autism over-attributed neutral to emotional faces. We found evidence that 5HTTLPR polymorphism did not influence the performance in the Penn Emotion Recognition Test, but that it may determine different error patterns. CONCLUSION: Facial emotion recognition deficits are more common in first-degree relatives of autistic patients than in the general population, suggesting that facial emotion recognition is a candidate endophenotype for autism.

OBJETIVO: Diversos estudos sugerem que o processamento de emoções faciais está prejudicado em portadores de autismo e que tal prejuízo possa ser hereditário. Nós estudamos o reconhecimento de emoções faciais em parentes de primeiro grau de portadores de autismo e suas associações com o polimorfismo funcional de transportador de serotonina (5HTTLPR). MÉTODO: Foram avaliados 40 parentes de primeiro grau de portadores de autismo e 41 controles saudáveis. Todos os participantes foram submetidos ao Teste de Reconhecimento de Emoções (ER40) da Bateria Neuropsicológica Computadorizada da Universidade da Pensilvânia (PENNCNP) e genotipados para o 5HTTLPR. RESULTADOS: Os parentes de primeiro grau de portadores de autismo apresentaram pior reconhecimento de emoções faciais comparados aos controles. A análise do padrão de erros mostrou que eles tendiam a reconhecer faces demonstrando emoções como neutras. O genótipo para o 5HTTLPR não influenciou a acurácia no Teste de Reconhecimento de Emoções, mas os homozigotos para o alelo L apresentaram padrão de erros diferente. Nossos resultados sugerem que prejuízos no reconhecimento de emoções faciais possam ser encontrados em maiores taxas em parentes de primeiro grau de autistas do que na população em geral. CONCLUSÃO: Nossos resultados sugerem que o reconhecimento de emoções faciais seja um candidato a endofenótipo no estudo do autismo.

Amnésia retrógrada funcional grave: relato de caso / Severe functional retrograde amnesia: case report

CONTEXTO: Uma síndrome amnésica clássica caracteriza-se por evidente prejuízo da memória anterógrada, variável e temporária amnésia retrógrada, sendo as formas não-declarativas da memória poupadas. Entretanto, publicações recentes relataram casos de prejuízo desproporcional da memória retrógrada em relação à anterógrada. OBJETIVOS: Relatar o caso de um paciente de 26 anos de idade com um quadro grave de amnésia retrógrada, aparentemente sem fatores desencadeantes. MÉTODOS: Entrevista psiquiátrica e avaliação neuropsicológica. RESULTADOS: A perda de memória do paciente se estendia por toda sua vida, mas ele era capaz de adquirir e reter novas informações. Ele também apresentava prejuízos na produção e na compreensão de palavras, assim como no reconhecimento e no uso de objetos. CONCLUSÃO: A formulação diagnóstica final do caso é difícil, apontando possivelmente o contínuo existente entre a amnésia retrógrada psicogênica e a orgânica.

BACKGROUND: A classic amnestic syndrome is characterized by a significant impairment of the anterograde memory, a variable and transitory retrograde amnesia with preserved non-declarative memory. However, case reports of patients with disproportionate compromise of the retrograde memory have been described in the recent literature. OBJECTIVES: To report a 26-year-old patient with a severe global retrograde amnesia with no evident triggering factor. METHODS: Psychiatric interview and neuropsychological evaluation. RESULTS: His memory loss compromised all domains of his life, although he could acquire and retain new information. He also exhibited prominent deficits in production and comprehension of common words as well as in recognition and use of objects. DISCUSSION: The final diagnostic formulation of the present case is difficult possibly indicating a continuum between psychogenic and organic retrograde amnesia.

Sensitivity and applicability of the Brazilian version of the Brief Assessment of Cognition in Schizophrenia (BACS).

Cognitive assessment in schizophrenia has traditionally used batteries that are long and complex or differ widely in their content. The Brief Assessment of Cognition in Schizophrenia (BACS) has been developed to cover the main cognitive deficits of schizophrenia as well as to be easily and briefly administered, portable, sensitive and reliable. OBJECTIVES: To investigate the applicability and sensitivity of the Brazilian Version of the BACS (Brazilian-BACS). METHODS: Performance of 20 stable patients with schizophrenia on the Brazilian-BACS was compared to 20 matched healthy controls. RESULTS: Applying the Brazilian-BACS required 43.4±8.4minutes for patients and 40.5±5.7 minutes for controls (p=0.17). All tests demonstrated significant differences between controls and patients (P<0.01). Pearson's correlation analysis and Cronbach's a evidenced a high internal consistency for patient performance. The cognitive deficit in the patients was approximately 1.5 standard deviations below controls. These results were consistent with those reported in the validation of the original version and in meta-analyses of similar studies. CONCLUSIONS: The Brazilian-BACS displayed good applicability and sensitivity in assessing the major cognitive constructs that are impaired in schizophrenia. Thus, the Brazilian-BACS seems to be a promising tool for assessing cognition in patients with schizophrenia in Brazil.

A avaliação cognitiva na esquizofrenia tem utilizado tradicionalmente baterias longas e complexas ou que variam significativamente em seu conteúdo. A "Brief Assessment of Cognition in Schizophrenia" (BACS) foi desenvolvida para cobrir os principais déficits cognitivos na esquizofrenia, para ser de fácil e breve aplicação, assim como portátil, sensível e confiável. OBJETIVOS: Investigar a aplicabilidade e a sensibilidade da versão brasileira da BACS (Brazilian-BACS). MÉTODOS: O desempenho de 20 pacientes estáveis com esquizofrenia na Brazilian-BACS foi comparado ao de 20 controles saudáveis pareados. RESULTADOS: A aplicação da Brazilian-BACS exigiu 43.4±8.4minutos nos pacientes e 40.5±5.7 minutos nos controles (p=0.17). Todos os testes foram significativamente diferentes entre pacientes e controles (P<0.01). A correlação de Pearson e o alfa de Cronbach evidenciaram alto grau de consistência interna no desempenho dos pacientes. O déficit cognitivo nos pacientes foi cerca de 1,5 desvio-padrão menor do que nos controles. Esses resultados são consistentes com os relatados na validação da versão original e em meta-análises de estudos similares. CONCLUSÕES: A Brazilian-BACS mostrou boas aplicabilidade e sensibilidade na investigação dos principais domínios cognitivos comprometidos na esquizofrenia. Portanto, a Brazilian-BACS mostra-se um instrumento promissor no estudo da cognição de pacientes com esquizofrenia no Brasil.

Olanzapine for recurrent excessive irritability and psychotic symptoms after mesial temporal lobectomy in a patient with temporal lobe epilepsy.

We report the case of a patient with temporal lobe epilepsy, nonresponsive to antiepileptic drugs, who became seizure-free, but developed recurrent excessive irritability and psychotic symptoms after successful mesial temporal lobectomy. This patient was refractory to various pharmacological treatments including antipsychotics, mood stabilizers, and benzodiazepines before being successfully treated with olanzapine.

Hepatotoxicidade grave secundária a psicofármacos e indicação de eletroconvulsoterapia a paciente com esquizofrenia / Severe psychotropic-induced hepatotoxicity and indication of electroconvulsive therapy in a patient with schizophrenia

Relatamos o caso de uma paciente com diagnóstico de esquizofrenia paranóide que desenvolveu dois quadros de hepatotoxicidade atribuídos a efeitos colaterais do ácido valpróico e da clozapina. Essa relação foi estabelecida pela proximidade temporal entre o início da medicação e a instalação do quadro, pela resolução deste após a suspensão da medicação e pela exclusão de outras causas de doença hepática. No seguimento, o controle clínico da paciente foi realizado com eletroconvulsoterapia (ECT). Salientamos a importância da vigilância cuidadosa dos efeitos adversos de psicofármacos, especialmente sobre a função hepática, e da ECT como possibilidade terapêutica diante de limitações farmacológicas.

We report the case of a patient with paranoid schizophrenia who developed two episodes of severe hepatotoxicity. They were attributed to the side effects of valproic acid and clozapine. This relationship was established by the temporal proximity between the onset of medication and the development of side effects, the clinical remission after drug cessation and the exclusion of other causes of hepatic diseases. On the follow-up, the patient was treated with eletroconvulsive therapy. This case report highights the relevance of careful vigilance of adverse effects of psychotropics, especially hepatotoxicity, and the role of eletroconvulsive therapy when there are pharmacological constraints.