Exploring protective factors in a high-risk subsample: the pivotal role of paternal support in preventing depression in a cohort of young adults.

BACKGROUND: Major depressive disorder (MDD) is a global concern due to its widespread prevalence and morbidity. Identifying protective factors in high-risk individuals, including those with a familial predisposition, maltreatment history, and socio-economic vulnerabilities, is crucial. METHODS: We assessed a high-risk subsample within a young adult population cohort (n = 791; mean age = 31.94 [SD = 2.18]) across three waves. Using multiple regression models to analyse higher education, feeling supported, spirituality, psychotherapy access, higher socioeconomic status, involvement in activities, cohabitation, and family unity in Waves 1 and 2, and their association with MDD resilience at Wave 3. RESULTS: In the high-risk group, MDD incidence was 13.7% (n=24). Paternal support had a protective effect on MDD incidence (OR = 0.366; 95% CI [0.137 to 0.955], p = 0.040) and suicidal attempt risk (OR = 0.380; 95% CI [0.150 to 0.956], p = 0.038). Higher resilience scores were also protective (OR = 0.975; 95% CI [0.953 to 0.997], p = 0.030), correlating with reduced BDI (r = 0.0484; B = -0.2202; 95% CI [-0.3572 to -0.0738]; p = 0.003) and MADRS scores (r = 0.0485; B = -0.2204; 95% CI [-0.3574 to -0.0741]; p = 0.003). CONCLUSIONS: Our paper emphasizes reorienting the MDD approach, focusing on positive prevention strategies. It highlights fathers' crucial role in family-based interventions and promoting resilience in high-risk populations.

Factors associated with suicide risk in young women with premenstrual dysphoric disorder: A population-based study.

PURPOSE: Women with premenstrual dysphoric disorder (PMDD) are more likely to report suicide ideation and behavior when compared to women without PMDD. However, there is a lack of studies investigating the risk factors for suicide risk in women with PMDD. Thus, the aim of this study is to assess the factors associated with suicide risk in young women with PMDD. METHODS: This is a cross-sectional study including 128 young women with PMDD who were recruited from the community. PMDD and suicide risk were assessed by trained psychologists using the Mini International Neuropsychiatric Interview (MINI-PLUS). Suicide risk evaluation includes six questions that assess suicidal intention, planning and previous attempts. Subjects who answer yes to any of the six questions are classified as having current suicide risk. RESULTS: The prevalence of current suicide risk in women with PMDD was 28.1%. The factors associated with suicide risk in this population were: presenting current panic disorder (OR: 18.71 [95% CI: 1.02 - 343.27], p=0.048), a non-white skin color (OR: 4.18 [CI 95%: 1.28 - 13.61], p=0.018), greater severity of depressive symptoms (OR: 1.22 [95% CI: 1.12 - 1.32], < 0.001), and history of childhood trauma (OR: 1.04 [95% CI: 1.01 - 1.08], 0.010). CONCLUSION: Our findings indicate that there are key sociodemographic and clinical factors associated with suicide risk in young women with PMDD, enabling clinicians to identify at-risk individuals who could benefit from further screening and interventions.

Are big five personality traits associated to suicidal behaviour in adolescents? A systematic review and meta-analysis.

BACKGROUND: Suicidal behaviour is one of the main causes of death worldwide, especially among teenagers, and its development is potentially associated with the development of personality. The aim of this systematic review and meta-analysis is to describe the association between the Big Five Personality Traits and suicidal behaviour in adolescents. METHODS: Seven databases were systematically searched between June 2022 and July 2022 with no language or year restrictions. We searched for a combination of the following search items (suicid* OR suicidal behaviour OR suicidal ideation OR suicide attempts OR self injury OR self-destructive behaviour OR self-harm OR suicidal risk) AND (personality OR personality traits OR temperament OR neuroticism OR extraversion OR agreeableness OR openness to experience OR conscientiousness) AND (adolescents OR youth OR teenagers OR young adults). Meta-analysis procedures were performed using the R software. A random-effect-model was performed for the models through the incorporation of τ2, based on the DerSimonion Lard method. RESULTS: Seven studies met all inclusion criteria and were included in this systematic review. Our meta-analysis showed that higher neuroticism are both associated and a risk factor for suicidal behaviour. Higher levels of openness to experience and agreeableness, and lower levels of extraversion and conscientiousness, were linked to suicidal behaviour, especially self-harm. LIMITATIONS: Due to the heterogeneity of the studies, we were only able to perform meta-analysis regarding neuroticism. CONCLUSION: The present study may help professionals to identify adolescents in higher risk for suicidal behaviour, enabling the development of early interventions to prevent suicidality in this population.

Biological rhythms disruption mediates the association between mother's diagnosis of bipolar disorder and offspring's emotional/behavioral problems.

OBJECTIVE: The current study assesses whether the association between diagnosis of Bipolar Disorder (BD) in mothers and emotional and behavioral problems (EBP) in their offspring is mediated by a disruption in the offspring's biological rhythms. METHODS: A probabilistic sample of 492 public school children (ages 7-8, 48 % female) were assessed for biological rhythms disruption and EBP using the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids and the Strengths and Difficulties Questionnaire, respectively. Mothers' mental health (BD = 64) was evaluated using a standardized clinical interview. A mediation analysis was conducted to assess the effect of the mother's diagnosis of BD on the EBP of their offspring in relation to the offspring's biological rhythms disruptions. RESULTS: When compared to offspring of mothers without BD, offspring of mothers with BD showed greater difficulty in maintaining biological rhythms and higher prevalence of EBP. Using the presence of EBP as the outcome, 75 % of the effect of mother's BD diagnosis was mediated by offspring's biological rhythms disruption. CONCLUSIONS: Biological rhythms disruption in children fully mediates the effect of the mother's diagnosis of BD on the child's EBP. These data encourage the development of further studies to find effective strategies to prevent and treat biological rhythms disruption in offspring of mothers with BD.

Cross-cultural adaptation and psychometric properties of the Iowa-Netherlands Comparison Orientation Measure for the Brazilian context.

INTRODUCTION: The Iowa-Netherlands Comparison Orientation Measure (INCOM) was developed to measure individual differences in social comparison orientation and has been widely used in research and different contexts. The aim of this study was to adapt the online version of the INCOM and to evaluate its psychometric parameters when applied to a Brazilian population of university students. METHODS: The procedures were divided into two steps: step 1 - cross-cultural adaptation and content validity, and step 2 - assessment of psychometric characteristics. In step 1, the processes of translation, evaluation by expert committee, evaluation by the target population, and the back-translation, were performed. In step 2, 1065 university students participated and factor analysis, analysis of reliability and validity based on external measures were performed. RESULTS: The adaptation process showed satisfactory results, such as good indicators of content validity. Exploratory factor analysis indicated a two-dimensional structure and adequate factor loadings, except for item 11, which was excluded from the final version. Also, the final version of the scale presented adequate fit indices (χ2 = 148.45, df = 26; p < 0.001; RMSEA = 0.06; CFI = 0.99; TLI = 0.98). Evidence of reliability (Cronbach's alpha = 0.83) was found, in addition to positive correlations with negative affect (r =0.36) and negative correlations with positive affect and self-esteem (r = -0.15; r = -0.41, respectively). CONCLUSION: The Brazilian version of the INCOM presents satisfactory psychometric parameters and can thus be used to measure social comparison orientation.

Childhood trauma, inflammatory biomarkers and the presence of a current depressive episode: Is there a relationship in subjects from a population study?

This study aims to compare the serum cytokine levels between controls, individuals with a current depressive episode (CDE) with childhood trauma and individuals with CDE without childhood trauma. This is a cross-sectional with paired sample nested in a population-based study. For the purposes of the current study, subjects who had psychotic symptoms, generalized anxiety disorder, and who refused to perform blood collection were excluded. Subsequently, only individuals who had a current depressive episode were selected (n = 76). Another 76 subjects were randomly paired by sex and age, constituting a population control group. The measurements of serum cytokine levels were performed using the multiplex analysis method. In the group with a CDE, when compared to the population control group, the following cytokines were high: IL-1ß, IL-2, IL-4, IL-6, IL-17A, IFN-γ and TNF-α (p < 0.05). On the other hand, there was a decrease in the levels of cytokines IL-10 (p = 0.027) and IL12p70 (p = 0.001). Bonferroni test demonstrates that there is no statistically significant difference in serum cytokine levels between subjects with a CDE, with and without trauma (p > 0.05). In a multivariable logistic regression, adjusting for socioeconomic status, tobacco, alcohol and illicit drugs abuse/dependence, and use of psychiatric medication, we found that cytokines serum levels remained associated with CDE even when adjusted for these potential confounders. Our findings demonstrate that monitoring cytokine levels and immune function may be beneficial in preventing the development of a CDE. However, future research is necessary to investigate the impact of trauma on the relationship between inflammation and CDE.

Theoretical procedures of the cross-cultural adaptation process of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context.

OBJECTIVES: To describe the theoretical procedures employed in the process of cross-cultural adaptation (CCA) for Brazil of the Child Mania Rating Scale - Parent Version (CMRS-P). METHODS: Seven steps were carried out: (1) translations and synthesis; (2) Committee of Judges-I; (3) grammatical review; (4) Committee of Judges-II; (5) semantic analysis (pre-test); (6) back-translation; and (7) discussion with the authors of the original instrument. Participants were two professional translators, 14 experts, a grammar proofreader, and 21 parents/guardians, representatives of the target population. The results were analyzed in terms of the percentage of agreement between evaluators and the content validity coefficient (CVC) and by analysis of comments and suggestions. RESULTS: Grammatical and cultural adjustments were made, in addition to substitution and/or inclusion of words and examples. Adequacy agreement indexes exceeding 86% were achieved and the CVC result for the total scale was excellent (0.95). The pre-test indicated good acceptance and understanding by participants. CONCLUSION: The proposed version proved to be promising for use in the Brazilian context, although further psychometric studies are still needed to prove the scale's validity and reliability.

Theoretical procedures of the cross-cultural adaptation process of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context

Abstract Objectives To describe the theoretical procedures employed in the process of cross-cultural adaptation (CCA) for Brazil of the Child Mania Rating Scale - Parent Version (CMRS-P). Methods Seven steps were carried out: (1) translations and synthesis; (2) Committee of Judges-I; (3) grammatical review; (4) Committee of Judges-II; (5) semantic analysis (pre-test); (6) back-translation; and (7) discussion with the authors of the original instrument. Participants were two professional translators, 14 experts, a grammar proofreader, and 21 parents/guardians, representatives of the target population. The results were analyzed in terms of the percentage of agreement between evaluators and the content validity coefficient (CVC) and by analysis of comments and suggestions. Results Grammatical and cultural adjustments were made, in addition to substitution and/or inclusion of words and examples. Adequacy agreement indexes exceeding 86% were achieved and the CVC result for the total scale was excellent (0.95). The pre-test indicated good acceptance and understanding by participants. Conclusion The proposed version proved to be promising for use in the Brazilian context, although further psychometric studies are still needed to prove the scale's validity and reliability.

Socioeconomic and substance use changes in emerging adults and their relationship with mood disorders in a population-based cohort.

In this report, we aim to assess the interaction of bipolar disorder and major depressive disorder with the evolution of social roles, economic classification, and substance misuse in emerging adults. This is a longitudinal population-based study (n = 231 at baseline), in which participants were reassessed at a mean of 5 years after baseline. A structured clinical interview was used to diagnose the participants with bipolar disorder and major depression; a control group without mood disorders was included. Men with mood disorders were less likely to be married in the beginning of the study and less likely to work in the follow-up. Women with major depression were less likely to study and more likely to be in a lower economic class at the beginning of the study. In comparison, women with bipolar disorder were less likely to live with their parents and more likely to live with their children in the first wave of the study. Substance misuse was more likely in people with mood disorders, especially in men, and women with bipolar disorder had the highest likelihood in the follow-up. Albeit longitudinal analyses were limited by a possibly insufficient sample size and mediating mechanisms for change, such as stigma, were not explored, the study suggests sex-related specificities regarding the change in social roles and substance use in people with mood disorders. Emerging adults, especially those with mood disorders, are in a period of change and instability and at a greater risk for substance use and abuse.

Antenatal depression: Efficacy of a pre-post therapy study and repercussions in motor development of children during the first 18 months postpartum. Study: "Pregnancy care, healthy baby".

AIMS: To evaluate the efficacy of brief psychotherapeutic interventions of cognitive behavioral therapy to treat antenatal depression and verify the association between interventions and motor development of infants at 3 and 18 months of age. METHODS: Pre-post-intervention study nested a randomized clinical trial, both of which are extracts from a population-based cohort study of a southern Brazilian city. The major depressive episode was measured through Mini Plus, the severity of depressive symptoms by BDI-II and motor development using Bayley-III and AIMS. The follow-ups occurred during the gestational period (T2) and at 3 (T3) and 18 months (T4) after delivery. RESULTS: Data were analyzed from 336 women in the control group (not intervened) and 108 from the group of depressed women who received intervention for antenatal depression. The effectiveness of the interventions for a major depressive episode was around 80% for both models in the two follow-up stages (3 and 18 months postpartum). In addition, the children whose mothers received intervention presented 3.7 (95% CI 0.7-6.6) points higher in Bayley-III at 3 months old when compared to the children in the control group (p = 0.01). There was no difference between the two psychotherapy models tested, both being equally effective (p > 0.05). CONCLUSIONS: We found that the brief psychotherapeutic interventions of cognitive behavioral therapy for gestational depression were effective in causing remission of the condition both in the short and long term, besides indirectly causing benefits also to the children, with regard to their motor development.

Evidence of validity of the revised Helping Alliance Questionnaire based on the internal structure in a Brazilian clinical sample.

The revised Helping Alliance Questionnaire (HAq-II) is among the most used instruments that measure therapeutic alliance. Despite its use in research, this instrument is not validated for the Brazilian population. The aim of this study was to explore the evidence of validity of the HAq-II based on the internal structure in a sample of Brazilian psychiatric patients. An ambulatory convenience sample of 204 patients with major depressive disorder (MDD) and 81 patients with obsessive-compulsive disorder (OCD) was randomized between two different types of treatment. The HAq-II was completed by patients (patient version) and by 33 therapists who performed the interventions (therapist version) between the second and third sessions. We used confirmatory factor analysis (CFA) to investigate two models: (1) a one-dimensional therapeutic alliance model and (2) a two-dimensional model considering the factors 'positive alliance' and 'negative alliance'. The internal consistency of the HAq-II was measured by Cronbach's alpha. To investigate discriminant validity, we used the t-test for independent samples, ANOVA and Pearson's correlation coefficient. The analysis showed that the best model of the instrument was one-dimensional. Cronbach's alpha for both versions displayed values above 0.89. The Brazilian version of the HAq-II presented properties similar to those found in the original version. However, studies related to the one-dimensional model with other samples are necessary.

The impact of mindfulness on suicidal behavior: a systematic review.

INTRODUCTION: Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based interventions for reducing suicidal thoughts and behaviors. METHODS: A systematic review was performed in December 2020 using PubMed, PsycINFO, EMBASE, SciELO, Pepsic, and LILACS databases with no year restrictions. The search strategy included the terms ('mindfulness' OR 'mindfulness-based') AND ('suicide' OR 'suicidal' OR 'suicide risk' OR 'suicide attempt' OR 'suicide ideation' OR 'suicide behavior'). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42020219514. RESULTS: A total of 14 studies met all inclusion criteria and were included in this review. Most of the studies presented Mindfulness-Based Cognitive Therapy as the MBI assessed (n=10). An emerging and rapidly growing literature on MBI presents promising results in reduction of suicide risk, particularly in patients with MDD. Four studies assessing other MBI treatment protocols (Mindfulness-Based Stress Reduction; Daily Mindfulness Meditation Practice; Mind Body Awareness and Mindfulness-Based Cognitive Behavior Therapy) all demonstrated that MBI reduces factors associated with suicide risk. CONCLUSION: MBI might target specific processes and contribute to suicide risk reduction.

The impact of mindfulness on suicidal behavior: a systematic review

Abstract Introduction Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based interventions for reducing suicidal thoughts and behaviors. Methods A systematic review was performed in December 2020 using PubMed, PsycINFO, EMBASE, SciELO, Pepsic, and LILACS databases with no year restrictions. The search strategy included the terms ('mindfulness' OR 'mindfulness-based') AND ('suicide' OR 'suicidal' OR 'suicide risk' OR 'suicide attempt' OR 'suicide ideation' OR 'suicide behavior'). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42020219514. Results A total of 14 studies met all inclusion criteria and were included in this review. Most of the studies presented Mindfulness-Based Cognitive Therapy as the MBI assessed (n=10). An emerging and rapidly growing literature on MBI presents promising results in reduction of suicide risk, particularly in patients with MDD. Four studies assessing other MBI treatment protocols (Mindfulness-Based Stress Reduction; Daily Mindfulness Meditation Practice; Mind Body Awareness and Mindfulness-Based Cognitive Behavior Therapy) all demonstrated that MBI reduces factors associated with suicide risk. Conclusion MBI might target specific processes and contribute to suicide risk reduction.

Risk factors for new-onset bipolar disorder in a community cohort: A five-year follow up study.

The aim of this study was to assess the risk factors for new-onset Bipolar Disorder (BD) in a community sample of young adults. This is a prospective cohort study including a population-based sample of young adults aged between 18-24 years. The baseline took place from 2007 to 2009, and 1560 subjects were included. Five years after, 1244 individuals were re-evaluated (79.7% retention). Substance abuse/dependence was assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and mental disorders were assessed using the Mini International Neuropsychiatric Interview 5.0 (MINI) at both waves. The cumulative incidence of BD in five years was 4.6%. There was no significant association between sociodemographic factors and BD incidence. Tobacco, cannabis, cocaine/crack, other substances abuse/dependence increased the relative risk for BD. Depressive, anxiety, post-traumatic stress disorders, and the suicide risk increased the relative risk to BD. Depressive episode was the strongest risk factor for BD, followed by other mental disorders and substance abuse/dependence in a probabilistic community sample of young adults. Preventive actions in mental health directed at the non-clinical population are needed for early detection and better management of BD.

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.

Cognitive complaints in individuals recently diagnosed with bipolar disorder: A cross-sectional study.

AIM: To assess the differences in subjective cognitive dysfunction between major depressive disorder (MDD) and recently diagnosed Bipolar Disorder (BD) across euthymia and mood episodes. METHODS: This is a cross-sectional study corresponding to the second wave of a longitudinal study. The first wave consisted of subjects aged between 18 and 60 diagnosed with MDD. In the follow up after three years (second wave), conversion from MDD to BD diagnosis was assessed by qualified psychologists using the Mini International Neuropsychiatric Interview (MINI-Plus). Subjects were categorized in four diagnostic groups: euthymic MDD, MDD in a current mood episode, euthymic BD, and BD in a current mood episode. All subjects completed the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), an instrument specifically designed for detecting subjective cognitive deficits in BD. RESULTS: The total sample (n = 468) included 410 subjects with MDD and 58 individuals recently diagnosed with BD. We subdivided the 2 groups based on their current mood state, and found a significant difference in COBRA total scores between euthymic BD individuals (median 17.00 [IQR: 8.75 - 20.75]) and euthymic MDD subjects (median 8.00 [IRQ: 5.00 - 14.00], p = 0.002), showing higher subjective cognitive dysfunction in individuals recently diagnosed with BD. The differences remained significant after adjusting for the presence of lifetime psychotic symptoms. We found no differences between MDD and BD during an acute mood episode. LIMITATION: The small sample size of individuals with BD. CONCLUSION: The findings suggest a higher presence of subjective cognitive complaints among individuals recently diagnosed with BD in comparison to individuals with MDD during euthymia.

Sleep alterations in individuals recently diagnosed with bipolar disorder across different mood stages.

OBJECTIVES: To assess the differences in sleep impairments in major depressive disorder (MDD) and individuals recently diagnosed with bipolar disorder (BD) across different mood stages. METHODS: This is a cross-sectional study corresponding to the second wave of a prospective clinical cohort of a sample of outpatients. The first wave included subjects diagnosed with MDD aged 18 to 60 years. Averaging 3 years after the first phase (second wave), conversion from MDD to BD diagnosis was assessed using the Mini International Neuropsychiatric Interview. The total sample was divided into four groups: euthymic MDD, MDD in a current episode, euthymic BD, and BD in a current mood episode. The sleep alterations were assessed using the Pittsburgh Sleep Quality Index. RESULTS: The sample included 468 subjects (261 euthymic MDD, 149 MDD currently depressed, 16 euthymic BD, and 42 BDs currently in a (hypo)manic or depressive episode). Euthymic BD differed from euthymic MDD only in the domains of sleep efficiency and sleep disturbances, showing lower sleep efficiency (PR 4.91 [95%CI 1.94 - 12.42]) and higher sleep disturbances (PR 3.38 [95%CI 1.32 - 8.67]) in subjects recently diagnosed with BD during euthymia. These differences remained significant after adjusting for the potential confounding factors. CONCLUSIONS: The findings point out the relevance of regular sleep assessments in individuals recently diagnosed with BD, since the differences in sleep quality observed could provide insights regarding prognosis, treatment, and the extent to which these individuals display significant subsyndromal symptomatology, even in the absence of a mood episode.

Effects of depression and excess body weight on cognition and functioning in young adults: A population-based study.

OBJECTIVES: The purpose of this study is to assess the independent effects of depression and excess body weight (EBW) on cognition and functioning in a community sample of young adults. METHODS: This was a cross-sectional of 943 young adults. The diagnosis of a current depressive episode was performed using the Mini International Neuropsychiatric Interview (MINI). Cognition and functioning were assessed using the Montreal Cognitive Assessment (MoCA) and the Functional Assessment Short Test (FAST), respectively. The EBW was defined as BMI ≥ 25.0 kg/m2. The independent main effects of depression and EBW, as well as the analysis interaction were performed using two-way analysis of covariance (ANCOVA). RESULTS: The total sample comprised 943 adults, with 75 (8.0%) individuals diagnosed with a current depressive episode and 493 (52,6%) with EBW. Of the 75 subjects with depression, 40 were identified with EBW comorbidity. Subjects with depression and EBW comorbidity reported greater cognitive and functional impairment, as compared to individuals with depression without EBW. There was a significant interaction between depression and EBW on MoCA total (p<0.001) as well as FAST total (p=0.010), work (p=0.002), cognition (p=0.023), finances (p=0.032) and relationships domains (p=0.008). CONCLUSIONS: The adverse effects of depression and EBW are independent and cumulative with respect to cognition and functioning of individuals. The understanding of the complex interactions between cognition, functioning, EBW and depression are important for development of preventive and therapeutic strategies.

Predictors of conversion from major depressive disorder to bipolar disorder.

The present study has two main aims: (1) To assess whether childhood trauma helps to differentiate Major Depressive Disorder (MDD) from Bipolar Disorder (BD) in a cross-sectional design; and (2) Describe the rate of conversion from MDD to BD, as well as the clinical and demographic predictors of conversion from MDD to BD in a prospective cohort design. We conducted a prospective cohort study in two phases, in the city of Pelotas, RS, Brazil. In the first phase, 565 subjects diagnosed with MDD, and 127 with BD according to the Mini International Neuropsychiatric Interview were included. In the second phase, only individuals with MDD were reevaluated for potential conversion to BD. The rate of conversion from MDD to BD in 3 years was 12.4%. Predictors of conversion from MDD to BD included lower educational level, use of illicit substances, younger age of the first depressive episode, and family history of BD. Childhood trauma was not a significant risk factor for conversion to BD in our prospective study. Our findings can contribute to the prevention and identification of conversion from MDD to BD, as well as to the establishment of more targeted therapeutic interventions, improving the prognosis of these individuals.

Incidence of Common Mental Disorders in Teachers: Is There a Relationship with Voice Disorders?

OBJECTIVE: This study aims to evaluate the risk factors associated with the incidence of common mental disorders (CMD) in teachers, particularly the possible relationship with voice disorders. MATERIAL AND METHODS: A longitudinal quantitative study of 469 teachers of the municipal schools of Pelotas in Brazil was conducted over three years after a baseline interview. The symptoms of CMD were assessed with the Self-Reporting Questionnaire 20 items (SRQ-20 scale) and the voice disorder was assessed with the Voice Handicap Index Protocol with cutoff of 19 points. A bivariate analysis was performed using Poisson regression to verify the difference in proportion of the incidence of CMD in the different categories of independent variables. RESULTS: The incidence of CMD was 18% (N = 265). In the bivariate analysis, the risk for CMD was 77% higher for teachers who presented with a voice disorder (RR 1.77 95% CI 1.04 to 3.03). CONCLUSIONS: Teachers who reported a voice disorder had an increased risk of developing a CMD.