Mental disorders in adults from Ribeirão Preto, Brazil: a cross-sectional analysis of two birth cohorts.

BACKGROUND: In Brazil, the prevalence of mental disorders is heterogeneous, with most studies conducted in large cities with high population density. This study aimed to assess the prevalence of mental disorders and psychiatric comorbidities among young adults (22-23 years old) and adults (37-38 years old) from Ribeirão Preto, a city located in the Northeast of the São Paulo state, with approximately 700,000 inhabitants, and to explore associations with sociodemographic variables, suicide risk, and health service usage. Second, we aimed to evaluate the performance of the Self-Report Questionnaire (SRQ-20) as a screening tool for mental disorders to be applied to the local population. METHODS: Participants from the 1978/1979 and 1994 Ribeirão Preto birth cohorts were evaluated using the Mini International Neuropsychiatric Interview (MINI) and the SRQ-20 at mean ages of 22-23, and 37-38 years, respectively. RESULTS: Our sample comprised 1,769 individuals from the 1978/1979 cohort and 1,037 from the 1994 cohort. The prevalence of mental disorders ranged from 28.6% (1978/79) to 31% (1994), with frequent comorbid diagnoses (42.7% and 43.3%, respectively). Men and women had a similar prevalence of mental disorders in the younger cohort, while women had a higher prevalence in the older cohort. Low educational attainment was associated with higher rates of diagnosis. In both cohorts, alcohol and other psychoactive substance use was higher among those with a psychiatric diagnosis. Although those with a psychiatric diagnosis were less satisfied with their own health, only one-fifth had seen a mental health professional in the previous year. A psychiatric diagnosis increased the suicide risk by 5.6 to 9.1 times. Regarding the SRQ-20, the best cutoff points were 5/6 for men and 7/8 for women, with satisfactory performance. CONCLUSIONS: The prevalence and comorbidity of mental disorders were high in both cohorts and comparable to those in larger Brazilian cities. However, few individuals with a diagnosis had sought specialized care. These data suggest that the mental health gap is still significant in Brazil.

Exploring the Significance of Pharmaceutical Care in Mental Health: A Spotlight on Cannabis.

Although preliminary evidence suggests Cannabis's efficacy in symptom control for anxiety and depression-psychiatric disorders that significantly impact mental health-much remains to be understood about its effects on the central nervous system (CNS) and how to optimize treatment for these disorders. This study aims to conduct a narrative review to evaluate pharmaceutical care in treating symptoms of anxiety and depression alongside Cannabis use, focusing on safety and therapeutic efficacy optimization. We seek to conceptualize anxiety and depression disorders, review evidence on Cannabis use, evaluate the evidence quality, and identify knowledge gaps. Twelve articles were identified, revealing a significant gap in the literature regarding the integration of pharmaceutical care with Cannabis-based therapies, specifically for anxiety and depression. Despite a growing interest in the relationship between Cannabis and mental health, current research is insufficient for a comprehensive understanding. The relationship between Cannabis use and anxiety and depression disorders requires further, more targeted investigations. This study underscores the importance of future research to fill existing gaps, providing informed insights and robust guidelines for the safe and effective use of Cannabis as part of the treatment for anxiety and depression. It is crucial that pharmaceutical care integrates these therapies responsibly to improve the overall well-being of patients.

Cannabidiol in anxiety disorders: Current and future perspectives.

Anxiety disorders are highly prevalent psychiatric disorders, characterized by a chronic course and often accompanied by comorbid symptoms that impair functionality and decrease quality of life. Despite advances in basic and clinical research in our understanding of these disorders, currently available pharmacological options are associated with limited clinical benefits and side effects that frequently lead to treatment discontinuation. Importantly, a significant number of patients do not achieve remission and live with lifelong residual symptoms that limit daily functioning. Since the 1970s, basic and clinical research on cannabidiol (CBD), a non-psychotomimetic compound found in the Cannabis sativa plant, has indicated relevant anxiolytic effects, garnering attention for its therapeutic potential as an option in anxiety disorder treatment. This chapter aims to review the history of these studies on the anxiolytic effects of CBD within the current understanding of anxiety disorders. It highlights the most compelling current evidence supporting its anxiolytic effects and explores future perspectives for its clinical use in anxiety disorders.

How to treat subsyndromal anxiety disorder - practical recommendations for implementation in primary care.

BACKGROUND: Anxiety is a common and disabling condition that significantly impacts quality of life. Subsyndromal anxiety (SSA) refers to anxiety symptoms that do not meet the full diagnostic criteria for an anxiety disorder but pose a risk for developing such disorders. We aimed to provide practical recommendations for the treatment of SSA in primary care settings. METHODS: A narrative review was conducted to identify strategies for recognizing and treating patients with SSA. RESULTS: The recommendations for treating SSA include lifestyle modifications such as exercise and stress reduction techniques, psychotherapy, and pharmacological treatments, including natural compounds like the lavender oil extract Silexan. Regular follow-up care is essential to monitor treatment response and address ongoing symptoms. Additionally, the use of the GAD-7 tool is recommended for accurately identifying patients with SSA. CONCLUSION: Implementing these recommendations in primary care can lead to effective treatment of SSA, preventing the development of more severe anxiety disorders. An integrative approach, combining lifestyle modifications, psychotherapy, and pharmacotherapy, including natural compounds, offers significant benefits for managing anxiety.

Anxiety is prevalent and disablingSubsyndromal anxiety is a risk factor for anxiety disordersSubsyndromal anxiety can be assessed with the GAD-7 (Generalised Anxiety Disorder-7 scale)Subsyndromal anxiety can be treated with life-style modification, psychotherapy and pharmacological treatment, including silexan, a natural compound.

Brazilian Psychiatric Association treatment guidelines for generalized anxiety disorder: perspectives on pharmacological and psychotherapeutic approaches

Generalized anxiety disorder is a highly prevalent mental disorder. Previous data indicate that more than 18 million Brazilians suffer from this condition. Traditionally, generalized anxiety disorder has been considered a mild mental health disorder, despite its links to lower life expectancy, cardiovascular disease, and suicide. The aim of this article is to combine elements of systematic and critical reviews to produce a synthesis of the best evidence about generalized anxiety disorder treatment. Systematic reviews, meta-analyses, and randomized controlled trials were included. The descriptor used in the search was "generalized anxiety disorder," which resulted in 4,860 articles and seven other studies, of which 59 were selected. Antidepressants and benzodiazepines were indicated, as was pregabalin, and atypical antipsychotics, such as quetiapine, have been studied. Individual cognitive behavior therapy (third wave) has proven effective. There is extensive literature on many effective treatments for generalized anxiety disorder. The present review summarizes the therapeutic possibilities, emphasizing those available in Brazil. Further studies are needed to compare other available medications, assess psychotherapies and new treatments in greater depth, as well as to assess the ideal duration of therapy. Registration number: PROSPERO CRD42021288323.

Associations of academic environment, lifestyle, sense of coherence and social support with self-reported mental health status among dental students at a university in Brazil: a cross-sectional study.

OBJECTIVES: The study evaluated the association of academic environment, lifestyle, sense of coherence (SOC) and social support with self-reported mental health status among dental students. DESIGN: Secondary analysis of data from a cross-sectional, questionnaire-based survey conducted from August to October 2018. SETTING: Dental school of a public-funded university in the south-eastern region of Brazil. PARTICIPANTS: 233 undergraduate dental students recruited across all years of the course. OUTCOME MEASURES: Socioeconomic and demographic characteristics, city of origin and student's academic semester were obtained through self-completed questionnaires. Perception of the academic environment (Dundee Ready Education Environment Measure (DREEM)), individual lifestyle (Individual Lifestyle Profile Questionnaire (ILPQ)), SOC (SOC Scale (SOC-13)), social support (Medical Outcomes Study Scale (MOS)), and depression, anxiety and stress (Depression, Anxiety and Stress Scale-21 (DASS-21)) were assessed using validated instruments. The relationships between variables were investigated through multivariable negative binomial regression to obtain the rate ratios (RRs) and 95% CIs. RESULTS: Female sex was associated with greater scores of anxiety (RR 1.74, 95% CI 1.10 to 1.97) and stress (RR 1.52, 95% CI 1.12 to 2.06). Students who perceived a better academic environment and those reporting a greater SOC had a lower probability of depression, anxiety and stress. Furthermore, a favourable lifestyle was associated with lower depression scores (RR 0.99, 95% CI 0.97 to 0.99). Social support did not remain associated with depression, anxiety and stress after adjustment. CONCLUSIONS: The present findings suggest that self-reported mental health status is associated with students' sex, academic environment, SOC and lifestyle. Enhancing the educational environment and SOC, and promoting a healthy lifestyle may improve the psychological health of dental students.

A brief parent version of the Spence Children's Anxiety Scale (SCAS-P-8): Factor structure, reliability, and invariance in Ecuadorian children / Validación de la versión para padres de la Escala de Ansiedad Infantil de SpenceBreve (SCAS-P-8) en niños ecuatorianos

Abstract Objective: The present study aimed to assess the psychometric properties and factor structure of the parent-reported brief version of the Spence Children's Anxiety Scale (SCAS-P-8) in a sample of Ecuadorian children. Method: The community sample consisted of 281 children from 8 to 12 years of age and their parents. Factor structure of the scale was assessed through confirmatory factor analysis. The psychometric properties and sex and age invariance were calculated. Results: The results showed that the one-factor structure of the SCAS-P-8 provided a good fit for the data, and that the structure was invariant across gender and age, indicating that it is suitable for assessing anxiety symptoms in both boys and girls of different ages with comparable accuracy. Psychometric analysis revealed a total ordinal alpha of .85, and corrected item-total correlations varied from .41 to .61, indicating an acceptable level of homogeneity. Conclusion: The study found that the SCAS-P-8 is a psychometrically reliable tool for measuring anxiety in Ecuadorian children from 8 to 12 years of age, as reported by their parents, and can be used in both research and clinical settings to evaluate anxiety symptoms in community populations in Ecuador. Given its brief and accurate nature, the SCAS-P-8 is considered to be a useful tool for use in both research and clinical settings for evaluating anxiety symptoms in children in this country.

Resumen Objetivo: Este artículo tiene por objetivo evaluar las propiedades psicométricas y la estructura factorial de la versión breve de la Escala de Ansiedad Infantil de Spence (SCAS-P-8) informada por los padres en una muestra de niños ecuatorianos. Método: La muestra comunitaria estuvo compuesta por 281 niños de entre 8 y 12 años y sus padres. La estructura factorial de la escala fue evaluada mediante análisis factorial confirmatorio. Se calcularon las propiedades psicométricas y la invarianza en función del género y la edad. Resultados: Los resultados mostraron que la estructura unifactorial de la escala proporcionó un buen ajuste para los datos, y que esta fue invariante en cuanto al género y la edad. Esto indica que el SCAS-P-8 es una medida adecuada para evaluar los síntomas de ansiedad tanto en niños como en niñas de diferentes edades con una precisión comparable. El análisis psicométrico reveló un alfa ordinal total de .85, y las correlaciones corregidas ítem-total variaron de .41 a .61, indicando un nivel aceptable de homogeneidad. Conclusión: La escala SCAS-P-8 es una herramienta adecuada para medir la ansiedad en niños ecuatorianos de 8 a 12 años por medio de la información reportada por sus padres. Dada su naturaleza breve y precisa, el SCAS-P-8 se considera una herramienta útil para su uso tanto en investigaciones como en entornos clínicos para evaluar los síntomas de ansiedad en niños de Ecuador.

Is the locus of control a predictor and/or mediator of emotional dysregulation and psychopathological symptoms?

Locus of control has been highlighted as a variable related to mental health and well-being, as well as being indicated as a predictor for psychopathologies such as depression and anxiety. To verify these relationships, the aim of this study was to present two path analysis models related to the associations between locus of control, depression, anxiety, and emotional dysregulation. A sample of 327 participants (M age = 38.3 years, SD = 12.8), of both genders (Fem. = 75.2%), completed a sociodemographic questionnaire, the Locus of Control Scale (ELOCUS), the Baptista Depression Scale (EBADEP-A), the Emotional Dysregulation Scale (EDEA), and the Cognitive Anxiety Scale (ECOGA). Spearman correlations and path analyses were performed for the two proposed models. In the first model, the locus of control was a predictor of emotional dysregulation, symptoms of depression and anxiety. In the second model, the locus of control mediated the relationship between factors of emotional dysregulation (seeking strategies and pessimism) in relation to depression and anxiety. It was concluded that the locus of control is an important construct in the direct or indirect prediction of psychopathological symptoms.

El locus de control se ha señalado como una variable relacionada con la salud mental y el bienestar, además de estar indicado como un predictor de psicopatologías como la depresión y la ansiedad. Para verificar estas relaciones, el objetivo de este estudio fue presentar dos modelos de path analysis relacionados con las asociaciones entre locus de control, depresión, ansiedad y desregulación emocional. Una muestra de 327 participantes (M= 38.3 años, DE= 12.8), de ambos sexos (Fem. = 75.2 %), respondió un cuestionario sociodemográfico, la Escala de Locus de Control (ELOCUS), la Escala Baptista de Depresión (EBADEP-A), la Escala de Desregulación Emocional (EDEA) y la Escala de Ansiedad Cognitiva (ECOGA). Se realizaron correlaciones de Spearman y path analyses para los modelos propuestos. En el primer modelo, el locus de control fue un predictor de desregulación emocional, síntomas de depresión y ansiedad. En el segundo modelo, el locus de control medió la relación entre factores de desregulación emocional (búsqueda de estrategias y pesimismo) en relación con la depresión y la ansiedad. Se concluye que el locus de control es un constructo importante en la predicción directa o indirecta de síntomas psicopatológicos.

O locus de controle tem sido apontado como uma variável relacionada a saúde mental e bem-estar, além de ser indicado como um preditor para psicopatologias como depressão e ansiedade. No intuito de verificar essas relações, o objetivo deste estudo foi apresentar dois modelos de path analysis relacionados às associações entre locus de controle, depressão, ansiedade e desregulação emocional. Uma amostra de 327 participantes (M = 38,3 anos, DP = 12,8), ambos os sexos (Fem. = 75,2%), responderam um questionário sociodemográfico, a Escala de Locus de Controle (ELOCUS), a Escala Baptista de Depressão (EBADEP-A), a Escala de Desregulação Emocional (EDEA) e a Escala Cognitiva de Ansiedade (ECOGA). Foram realizadas correlações de Spearman, além de path analyses dos modelos propostos. No primeiro modelo, o locus de controle foi preditor da desregulação emocional, sintomatologia de depressão e ansiedade. Já, no segundo modelo, o locus de controle mediou a relação entre fatores da desregulação emocional (busca por estratégias e pessimismo) em relação a depressão e ansiedade. Conclui-se que o locus de controle é um construto importante na predição direta ou indireta de sintomas psicopatológicos.

Brazilian Psychiatric Association guidelines for the treatment of generalized anxiety disorder (GAD). Pharmacological and Psychotherapy approach. Perspectives.

OBJECTIVE: To combine elements of a systematic review and critical review to produce best evidence synthesis for the treatament of GAD. METHOD: There was included systematic reviews, metanalysis, and randomized controlled trials. Descriptor used was "generalized anxiety disorder", resulting in 4860 articles and 7 other studies, of which 59 were selected. RESULTS: Antidepressants and benzodiazepines are indicated, as well as pregabalin. From, atypical antipsychotics quetiapine has been studied. Cognitive behavior therapy (third wave of behavioral and cognitive therapies) as well as individual CBT proven to be effective. CONCLUSION: There is extensive literature on many effective treatments for GAD. The present work summarizes the therapeutic possibilities, emphasizing those available in the Brazil. Further studies are still needed to compare other available medications, to assess psychotherapies in more depth, new treatments and specially to assess the ideal time for maintaining therapy.

[Psychopathological differences between female adolescent patients with and without suicide attempt]. / Diferencias psicopatológicas entre pacientes adolescentes del sexo femenino con y sin intento de suicidio.

Background: Traditionally, psychopathology has been related to suicide risk, furthermore if we bear in mind that the recent meta-analysis on the relationship between some mental disorders and the risk of suicide attempt are inconclusive, and have been performed with non-clinical samples. Objective: To establish the psychopathological differences between female adolescent patients with and without suicide attempt. Material and methods: Comparative, prospective, correlational and cross-sectional study. A sample of 50 female participants was used, divided into 2 groups: one of cases, (n = 25), made up of female patients between 15 and 19 years of age with suicide attempt, and a control group of pairs (n = 25) with no history of suicide attempt. The following instruments were applied: the Plutchik Impulsivity Scale, the Beck Hopelessness Scale, the K-Sads-PL, the Beck Suicidal Ideation Scale, and the Hamilton Depression Scale. Results: A greater presence of the disorders evaluated was found: major depressive disorder, dysthymic disorder, generalized anxiety disorder and panic disorder in the group with suicide attempt. Furthermore, the case group obtained higher mean scores on the Beck Hopelessness Scale, the Beck Suicidal Ideation Scale, the Hamilton Depression Scale and the Plutchik Impulsivity Scale. Conclusions: The results agree with most of previous studies. It is suggested to carry out preventive interventions in cases where a considerably increased risk is detected.

Introducción: tradicionalmente se ha relacionado la psicopatología con el riesgo suicida, más si se toma en consideración que los recientes metaanálisis sobre la relación entre algunos trastornos mentales y el riesgo de tentativa suicida no son concluyentes, y se han realizado con muestras no clínicas. Objetivo: establecer las diferencias psicopatológicas entre pacientes adolescentes del sexo femenino con y sin intento suicida. Material y métodos: estudio comparativo, prospectivo, correlacional y transversal. Se utilizó una muestra de 50 participantes de sexo femenino, distribuidas en dos grupos: el de casos, (n = 25), compuesto por pacientes entre 15 y 19 años con intento suicida y un grupo control (n = 25) de pares sin historia de tentativa. Se aplicaron los siguientes instrumentos: la Escala de Impulsividad de Plutchik, la Escala de Desesperanza de Beck, el K-Sads-PL, la Escala de Ideación Suicida de Beck y la Hamilton de Depresión. Resultados: se encontró mayor presencia de los trastornos evaluados: trastorno depresivo mayor, trastorno distímico, trastorno de ansiedad generalizada y trastorno de pánico en el grupo con intento suicida. Además, el grupo caso obtuvo mayor puntución media en las escalas de Desesperanza de Beck, de Ideación Suicida de Beck, la Hamilton de Depresión y la de Impulsividad de Plutchik. Conclusiones: los resultados coinciden con la mayoría de estudios previos. Se sugiere hacer intervenciones preventivas en casos donde se detecte un riesgo considerablemente aumentado.

Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population.

OBJECTIVES: The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity and specificity of different versions of these scales in a Peruvian hospital population. DESIGN: Our study has a cross-sectional design. SETTING: Our participants are hospitalised patients in a Peruvian hospital. The gold standard was a clinical psychiatric interview following ICD-10 criteria for depression (F32.0, F32.1, F32.2 and F32.3) and anxiety (F41.0 and F41.1). PARTICIPANTS: The sample included 1347 participants. A total of 334 participants (24.8%) were diagnosed with depression, and 28 participants (2.1%) were diagnosed with anxiety. RESULTS: The PHQ-9's≥7 cut-off point showed the highest simultaneous sensitivity and specificity when contrasted against a psychiatric diagnosis of depression. For a similar contrast against the gold standard, the other optimal cut-off points were: ≥7 for the PHQ-8 and ≥2 for the PHQ-2. In particular, the cut-off point ≥8 had good performance for GAD-7 with sensitivity and specificity, and cut-off point ≥10 had lower levels of sensitivity, but higher levels of specificity, compared with the cut-off point of ≥8. Also, we present the sensitivity and specificity values of each cut-off point in PHQ-9, PHQ-8, PHQ-2, GAD-7 and GAD-2. We confirmed the adequacy of a one-dimensional model for the PHQ-9, PHQ-8 and GAD-7, while all PHQ and GAD scales showed good reliability. CONCLUSIONS: The PHQ and GAD have adequate measurement properties in their different versions. We present specific cut-offs for each version.

Concealing, Tolerating, and Adjusting to Emotions in Obsessive-Compulsive and Anxiety Disorders: A Cross-Sectional Study.

BACKGROUND: Although research has shown that mood and anxiety disorders manifest disturbed emotion regulation, it is unclear whether anxiety disorders differ between each other in terms of their emotion regulation strategies. In the present study, we investigated whether patients with anxiety disorders present different affective styles. METHODS: We assessed affective styles of 32 obsessive-compulsive disorder (OCD) patients, 29 social anxiety disorder (SAD) patients, 29 panic disorder (PD) patients, and 20 healthy controls through the Affective Style Questionnaire (ASQ). A multivariate analysis of covariance (MANCOVA) was performed to compare the affective styles across groups (OCD, SAD, PD and control), while controlling for depression, anxiety symptoms and age. RESULTS: The MANCOVA revealed a significant, small-medium, main effect of diagnostic group on affective styles. The planned contrasts revealed that OCD and SAD patients reported significantly lower scores for "tolerance" (ASQ-T) compared to healthy controls group. There were no differences between PD group and healthy controls. CONCLUSIONS: Our findings provide evidence that OCD and SAD have difficulty tolerating strong emotions existing in the present moment in an open and non-defensive way.

Placebo response in trials with patients with anxiety, obsessive-compulsive and stress disorders across the lifespan: a three-level meta-analysis.

QUESTION: Randomised controlled trials assessing treatments for anxiety, obsessive-compulsive and stress-related disorders often present high placebo response rates in placebo groups. Understanding the placebo response is essential in accurately estimating the benefits of pharmacological agents; nevertheless, no studies have evaluated the placebo response across these disorders using a lifespan approach. STUDY SELECTION AND ANALYSIS: We searched MEDLINE, PsycINFO, Embase, Cochrane, websites of regulatory agencies and international registers from inception to 9 September 2022. The primary outcome was the aggregate measure of internalising symptoms of participants in the placebo arms of randomised controlled trials designed to assess the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) in individuals diagnosed with anxiety, obsessive-compulsive or stress-related disorders. The secondary outcomes were placebo response and remission rates. Data were analysed through a three-level meta-analysis. FINDINGS: We analysed 366 outcome measures from 135 studies (n=12 583). We found a large overall placebo response (standardised mean difference (SMD)=-1.11, 95% CI -1.22 to -1.00). The average response and remission rates in placebo groups were 37% and 24%, respectively. Larger placebo response was associated with a diagnosis of generalised anxiety disorder and post-traumatic stress disorder, when compared with panic, social anxiety and obsessive-compulsive disorder (SMD range, 0.40-0.49), and with absence of a placebo lead-in period (SMD=0.44, 95% CI 0.10 to 0.78). No significant differences were found in placebo response across age groups. We found substantial heterogeneity and moderate risk of bias. CONCLUSIONS: Placebo response is substantial in SSRI and SNRI trials for anxiety, obsessive-compulsive and stress-related disorders. Clinicians and researchers should accurately interpret the benefits of pharmacological agents in contrast to placebo response. PROSPERO REGISTRATION NUMBER: CRD42017069090.

Association of polymorphisms rs4680 of the Catechol-O-Methyltransferase gene and rs6265 of the brain derived neurotrophic factor gene with the behavioral inhibition and behavioral activation systems.

Background: The Behavioral Inhibition System (BIS) comprises limbic circuitry implicated in avoidance behaviors. Its increased activation has been identified as a risk factor for anxiety and depressive disorders. In addition, both Catechol-O-Methyltransferase (COMT) and Brain Derived Neurotrophic Factor (BDNF) have been postulated as candidate genes that constitute a vulnerability for the onset of anxiety and depressive disorders. The aim of this study was to evaluate the possible association between the rs4680 polymorphism of the COMT gene and the rs6265 polymorphism of the BDNF gene with the BIS and the Behavioral Activation System (BAS) in a population sample from Colombia. Methods: Genetic information was obtained by extracting DNA from blood samples of 80 participants and using Taqman probes designed for each polymorphism. In addition, participants completed a BIS/BAS scale in order to establish a neuropsychological classification. Results: The frequency of the Met allele of the BDNF gene was greater in the group with BIS sensitivity compared to the group with BAS sensitivity. On the contrary, the frequency of the Met allele of the COMT gen did not show a significant association with the BIS. Conclusions: The rs6265 polymorphism of BDNF gene is associated with the BIS which in turn constitutes a risk factor for anxiety and depression.

Psychometric Properties of the Kessler Psychological Distress Scale in a Sample of Adolescents from Ecuador.

The Kessler psychological distress scale is a useful tool for identifying possible psychological problems and has been widely used in research and health services. Unfortunately, its application in various populations has not always been psychometrically supported. For this reason, the present study investigated the psychometric properties of its Spanish version in adolescents, verifying its factorial structure, measurement invariance by gender, internal consistency and the discrimination and difficulty parameters of its items according to the Item Response Theory (IRT). A sample of 5132 Ecuadorian adolescents was evaluated. The sample is equally distributed between male and female participants (50%) and basic and higher education (51% the former). All participants were between 11 and 20 years old. The results show that a 9-item version with correlated intercepts presents the best fit. In addition, it is invariant by gender at a strict level and has adequate internal consistency. IRT analyses indicated that all the items, except for item eight, present adequate discrimination and difficulty. Based on these results, we conclude that the 9-item version of the Psychological Distress Scale is the most appropriate for this population.

Instrumentos para diagnóstico e rastreamento do transtorno de ansiedade social adaptados para à realidade brasileira / Instrumentos de diagnóstico y cribado del trastorno de ansiedad social adaptados a la realidad brasileña / Social anxiety disorder diagnostic and screening tools adapted for the brazilian reality

Objetivo: descrever perante a literatura os instrumentos para diagnóstico e rastreamento do Transtorno de Ansiedade Social (TAS) que sejam adaptados à realidade brasileira. Método: revisão de literatura exploratória e descritiva, realizado através das bases de dados: PubMED, BVS e Scielo. No mês de agosto de 2022 com recorte temporal de 2017 a 2022. Sendo inclusos, documentos que versavam a respeito dos instrumentos para diagnóstico e rastreamento do TAS, adaptados à realidade brasileira. Resultado: ao revisar a literatura foram encontrados 14 documentos dentre as escalas de reconhecimento e rastreamento do TAS com validação e adaptação transcultural para realidade brasileira, foram encontrados quatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida e a Escala de Ansiedade Social de Liebowitz versão auto aplicada.Conclusão:há uma minoria de estudos validados e adaptados aos brasileiros dificultando assim o diagnóstico, tratamento precoce e a avaliação multidisciplinar.(AU)

Objective: to describe in the literature the instruments for diagnosis and screening of Social Anxiety Disorder (SAD) that are adapted to the Brazilian reality. Method: exploratory and descriptive literature review, conducted through the databases: PubMED, BVS and Scielo. In August 2022, with a time frame of 2017 to 2022. Included were documents about the instruments for diagnosis and screening of SAD, adapted to the Brazilian reality. Result: After reviewing the literature, 14 documents were found among the SAD recognition and screening scales with validation and cross-cultural adaptation for the Brazilian reality, four were found: Adult Social Anxiety Questionnaire; Reduced Social Interaction Anxiety Scale; Reduced Social Anxiety Scale, and the Liebowitz Social Anxiety Scale, self-applied version. Conclusion: there is a minority of studies validated and adapted to Brazilians thus hindering diagnosis, early treatment and multidisciplinary assessment.(AU)

Objetivo:describir através de la literatura los instrumentos para el diagnóstico y rastreodelTrastorno de Ansiedad Social (TAS) que se adaptan a la realidade brasileña. Método:revisión bibliográfica exploratoria y descriptiva, realizada a través de las bases de datos: PubMED, BVS y Scielo. En agosto de 2022 conunplazo de 2017 a 2022. Se incluyeron documentos sobre los instrumentos de diagnóstico y cribadodelTAS, adaptados ala realidade brasileña. Resultados: al revisar la literatura se encontraron 14 documentos dentro de las escalas de reconocimiento y rastreo de laTASconvalidación y adaptación transcultural a la realidade brasileña, se encontraroncuatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida y la Escala de Ansiedade Social de Liebowitzversión auto aplicada. Conclusión:hay una minoría de estudios validados y adaptados a losbrasileños, lo que dificulta el diagnóstico, el tratamento precoz y laevaluación multidisciplinar.(AU)

Instrumentos para diagnóstico e rastreamento do transtorno de ansiedade social adaptados para à realidade brasileira / Social anxiety disorder diagnostic and screening tools adapted for the brazilian reality

Objetivo: descrever perante a literatura os instrumentos para diagnóstico e rastreamento do Transtorno de Ansiedade Social (TAS) que sejam adaptados à realidade brasileira. Método: revisão de literatura exploratória e descritiva, realizado através das bases de dados: PubMED, BVS e Scielo. No mês de agosto de 2022 com recorte temporal de 2017 a 2022. Sendo inclusos, documentos que versavam a respeito dos instrumentos para diagnóstico e rastreamento do TAS, adaptados à realidade brasileira. Resultado: ao revisar a literatura foram encontrados 14 documentos dentre as escalas de reconhecimento e rastreamento do TAS com validação e adaptação transcultural para realidade brasileira, foram encontrados quatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida e a Escala de Ansiedade Social de Liebowitz versão auto aplicada. Conclusão:há uma minoria de estudos validados e adaptados aos brasileiros dificultando assim o diagnóstico, tratamento precoce e a avaliação multidisciplinar.(AU)

Objective: to describe in the literature the instruments for diagnosis and screening of Social Anxiety Disorder (SAD) that are adapted to the Brazilian reality. Method: exploratory and descriptive literature review, conducted through the databases: PubMED, BVS and Scielo. In August 2022, with a time frame of 2017 to 2022. Included were documents about the instruments for diagnosis and screening of SAD, adapted to the Brazilian reality. Result: After reviewing the literature, 14 documents were found among the SAD recognition and screening scales with validation and cross-cultural adaptation for the Brazilian reality, four were found: Adult Social Anxiety Questionnaire; Reduced Social Interaction Anxiety Scale; Reduced Social Anxiety Scale, and the Liebowitz Social Anxiety Scale, self-applied version. Conclusion: there is a minority of studies validated and adapted to Brazilians thus hindering diagnosis, early treatment and multidisciplinary assessment.(AU)

Objetivo:describir através de la literatura los instrumentos para el diagnóstico y rastreodelTrastorno de Ansiedad Social (TAS) que se adaptan a la realidade brasileña. Método:revisión bibliográfica exploratoria y descriptiva, realizada a través de las bases de datos: PubMED, BVS y Scielo. En agosto de 2022 conunplazo de 2017 a 2022. Se incluyeron documentos sobre los instrumentos de diagnóstico y cribadodelTAS, adaptados ala realidade brasileña. Resultados: al revisar la literatura se encontraron 14 documentos dentro de las escalas de reconocimiento y rastreo de laTASconvalidación y adaptación transcultural a la realidade brasileña, se encontraroncuatro: Questionário de Ansiedade social para Adultos; Escala de Ansiedade em Interação Social Reduzida; Escala de Ansiedade Social Reduzida y la Escala de Ansiedade Social de Liebowitzversión auto aplicada. Conclusión:hay una minoría de estudios validados y adaptados a losbrasileños, lo que dificulta el diagnóstico, el tratamento precoz y laevaluación multidisciplinar. (AU)

Early emotional memories and bonding as predictors of short-term and long-term outcome in adults with generalized anxiety disorder.

The impact of childhood experiences on the development of psychopathology is well established in the literature. Few studies, however, have assessed parental bonding during childhood as a predictor of response to anxiety disorders treatment. The aim of the study was to examine whether emotional memories of childhood parenting could predict short-term and long-term outcome in three different interventions for patients with generalized anxiety disorder (GAD): mindfulness-based intervention (Body in Mind Training [BMT]), fluoxetine (FLX), and an active control group (quality of life [QoL]). A total of 124 participants from a randomized controlled trial for GAD treatment were evaluated pre- and post-treatment and after 18 months. Patients were assessed for the severity of GAD symptoms (GAD-7, PSWQ, and DERS), early memories of warmth and safeness (EMWSS), and recall of perceived threat and subordination/submission in childhood (ELES). Negative childhood memories predicted a greater reduction in anxiety symptoms on BMT treatment compared to FLX and QoL, whereas positive childhood memories predicted more symptomatic improvement in the QoL group. Our findings suggest that individuals with GAD who have early memories of subordination and threat appear to benefit more from interventions that focus on developing emotion-regulation strategies and enhancing self-compassion, such as mindfulness-based interventions.

Relation between anxiety disorders in adolescent mothers and dental fear in children.

BACKGROUND: Maternal anxiety disorders can cause adverse consequences in child's health, cognitive development, and behavior. AIM: To investigate the association of maternal anxiety disorders with the occurrence of dental fear in children aged 24-36 months. DESIGN: This cross-sectional study is part of a cohort of adolescent mothers and their children (n = 527) in the city of Pelotas, RS, Brazil. Anxiety disorders in mothers were assessed using Mini International Neuropsychiatric Interview (DSM-IV), whereas the Dental Anxiety Question was used to assess children's dental fear. Clinical oral examinations were performed on the cohort. Poisson regression analysis was used to determine the association of maternal anxiety disorders with maternal perception of dental fear in children (p < .05). RESULTS: The prevalence of dental fear in children was 21.7% (n = 114), and maternal age, agoraphobia, social phobia, and maternal caries experience (p < .05) were associated with the presence of dental fear. After adjusted analysis, children of mothers presenting with agoraphobia (Prevalence ratios [PR] = 1.52; 95% confidence interval [CI] = 1.00-2.32) and social phobia (PR = 1.69; 95% CI = 1.06-2.71) had higher prevalence of dental fear than children whose mothers did not have any of these conditions. CONCLUSIONS: In this population of young mothers, agoraphobia and social phobia were associated with children's dental fear. Detection of and treatment for maternal mental disorders may aid in the prevention of dental fear and its oral health-related consequences.

[What has been done at IMSS regarding the users's mental health in the COVID-19 pandemic?] / ¿Qué se ha hecho en el IMSS en cuanto a la salud mental de los derechohabientes en la pandemia por COVID-19.

Nowadays, mental health has acquired greater relevance and attention as a consequence mainly of the COVID-19 pandemic, to which is attributed a negative impact on the development of life, work and social coexistence of people, along with the magnitude derived from non-communicable diseases. This is why the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute for Social Security) developed the Mental Health Comprehensive Program 2021-2024, whose main purpose was to establish strategies and lines of action for the prevention, early detection and timely management regarding mental health and addictions. Based on this, different actions have been carried out, for example, the identification of the material and human resources available at IMSS to meet the mental health issue; the training of healthcare professionals at the three levels of care; the integration of a census that has reported a prevalence of anxiety and depressive episodes in the users of 39.9 and 3%, respectively, as well as the evaluation of instruments for screening mental disorders. Therefore, this document describes what has been done in the IMSS in relation to the user's mental health in the context of the COVID-19 pandemic.

Hoy en día la salud mental ha adquirido mayor relevancia y atención como consecuencia principalmente de la pandemia por COVID-19, a la cual se le atribuye un impacto negativo en el desarrollo de la vida, el trabajo y la convivencia social de las personas, todo esto aunado a la magnitud derivada de los padecimientos no transmisibles. Es por eso que en el Instituto Mexicano del Seguro Social (IMSS) se elaboró el Programa Integral de Salud Mental 2021-2024, cuyo principal propósito fue establecer estrategias y líneas de acción para la prevención, detección temprana y manejo oportuno respecto a la salud mental y adicciones. A partir de ello se han materializado diferentes acciones, entre las que destaca la identificación de los recursos materiales y humanos con los que cuenta el IMSS para atender esta necesidad; la capacitación del personal de salud de los tres niveles de atención; la integración de un censo que ha reportado una prevalencia de ansiedad y episodio depresivo en la población derechohabiente de 39.9 y 3%, respectivamente, y la evaluación de instrumentos para realizar tamizajes de trastornos mentales. Por lo anterior, en este documento se describe lo que se ha hecho en el IMSS en relación con la salud mental de la población derechohabiente en el contexto de la pandemia por COVID-19.