Correlação entre a autopercepção de competência com o desempenho na tarefa de levantar-se do solo de sujeitos idosos saudáveis / Correlation between the self-perception of competence with performance in the task to rise from the floor of healthy elderly subjects / Correlación entre la auto percepción de competencia con rendimiento en la tarea de levantarse del suelo de los sujetos saludables a los ancianos

O objetivo deste estudo foi examinar a correlação entre a au- topercepção de competência (facilidade, dificuldade e esforço subjetivo) com o desempenho na tarefa de levantar-se do solo de idosos saudá- veis. Participaram deste estudo transversal 56 idosos voluntários sau- dáveis. A autopercepção de competência foi avaliada por meio de uma escala likert em categorias (dificuldade/facilidade) e desempenho na tarefa de levantar-se do solo foi medido por meio do número de tentativas realizadas e pelo tempo de execução da tarefa. Verificou-se correlação entre a autopercepção de competência (rho= ,807; p< 0,000) com o número de tentativas na tarefa e com o tempo (rho= -,541; p< 0,000) para levantar-se do solo. Pode-se concluir que, para esta amostra de idosos saudáveis, os aspectos da percepção de competência estão correlacionados com o desempenho para levantar-se do solo.

The objective of this study was to examine the correlation between the perception of competence with the performance on the task to get up from the soil of healthy seniors. 56 volunteers participated in this cross-sectional study. The perception of competence was assessed through a scale in seven categories and performance on the task to get up from the ground was measured through the number of retries performed and through time to run the task. It was found correlation between the perception of competence (rho =, 807; p < 0.000) with the number of attempts the task and with time (rho=-, 541; p < 0.000) to rise from the ground for this sample of healthy seniors. It can be concluded that, for this sample of healthy seniors, aspects of perception of competence are correlated with the performance to rise from the ground

El objetivo de este estudio fue examinar la correlación entre la percepción de competencia con el rendimiento en la tarea de levantarse del suelo de la tercera edad sana. 56 voluntarios participaron en este estudio transversal. La percepción de competencia se evaluó mediante una escala en siete categorías y rendimiento en la tarea de levantarse del suelo se midió a través del número de intentos realizados y a través del tiempo para ejecutar la tarea. Se encontró correlación entre la percepción de competencia (rho=, 807; p < 0.000) con el número de intentos de la tarea y con el tiempo (rho=-, 541; p < 0.000) para elevarse de la tierra para esta muestra de adultos mayores sanas. Se puede concluir que, para esta muestra de adultos mayores sanas, aspectos de la percepción de competencia están correlacionados con el rendimiento que se elevan desde el suelo.

Tradução e adaptação do examen géronto-psychomoteur para o português do Brasil / Translation and adaptation of the examen géronto-psychomoteur to brazilian portuguese

O objetivo do presente estudo foi traduzir o original francês do Examen Géronto-Psychomoteur (EGP) para o português do Brasil e adaptar para uso com idosos brasileiros. A proposta busca suprir a ausência de um instrumento multidisciplinar para avaliação funcional do idoso brasileiro. O EGP é um teste que avalia funções motoras e cognitivas, que são habilidades fundamentais para a manutenção da saúde no envelhecimento. Parâmetros internacionalmente aceitos foram adotados em três etapas: Tradução - duas traduções independentes, síntese, tradução reversa; Comitê de especialistas - cinco juízes avaliaram a equivalência conceitual, semântica e cultural, assim como a clareza da tradução; Pré-teste - foram avaliados 35 voluntários com idade média de 68,66 ± 6,22 anos. O processo de tradução apresentou um documento único na língua portuguesa utilizada no Brasil, que obteve índices de validade de conteúdo quase perfeitos para equivalência e clareza entre 0,86 e 1. Também foi calculado o coeficiente de concordância kappa de Cohen, que apontou uma forte concordância entre as avaliações dos juízes, com valores entre 0,85 e 0,96. O tempo médio de aplicação foi de 52,36 ± 7,48 minutos e a média dos escores dos participantes foi de 91,35 ± 9,85. Os parâmetros obtidos da versão brasileira do EGP mostraramse satisfatórios, indicando que o processo de adaptação do instrumento foi adequado e robusto, o que possibilita a continuidade dos estudos das propriedades psicométricas para validação do Exame Geronto Psicomotor para população idosa brasileira. (AU)

The objective of the present study was to translate the French original of the GérontoPsychomoteur Exam (EGP) into Brazilian Portuguese and adapt it for use with Brazilian elderly. It is a test that assesses motor and cognitive functions, which are fundamental skills for maintaining health in aging. International parameters were adopted in three stages, Translation: two independent translations, synthesis, reverse translation; Expert Committee: Five judges evaluated the conceptual, semantic and cultural equivalence, as well as the clarity of the translation; Pre-test: 35 volunteers with a mean age of 68.66 ± 6.22 years were evaluated. The translation process presented a unique instrument in the Portuguese language used in Brazil, which obtained almost perfect content validity indexes for equivalence and clarity between 0.86 and 1. Cohen's kappa coefficient of agreement was also calculated, which pointed to a strong agreement between the judges' evaluations, with values between 0.85 and 0.96. The mean time of application was 52.36 ± 7.48 minutes and the mean of the participants' scores was 91.35 ± 9.85. The parameters obtained from the Brazilian version of the EGP were satisfactory, indicating that the adaptation process of the instrument was adequate and robust, which allows the continuity of the psychometric properties studies to validate the Geronto Psychomotor Examination for the Brazilian elderly people. (AU)

Associação da aptidão física de idosos saudáveis com o desempenho na tarefa de levantar-se do solo / Association of physical fitness of healthy elderly with performance in the task of getting up from the floor

O objetivo deste estudo transversal foi examinar a associação da aptidão física com o desempenho na tarefa de levantar-se do solo em indivíduos idosos saudáveis. Cinquenta e seis voluntários (71,8 ± 6,96 anos; 68,8 ± 14,02 kg; 1,60 ± 0,97 cm) foram classificados de acordo com o índice de massa corporal. A avaliação da aptidão física foi feita por meio dos seguintes testes funcionais: Timed Up and Go; Teste de apoio unipodal; Teste de sentar e alcançar e o Teste de sentar e levantar. O tempo e o número de tentativas para a tarefa de levantar-se do solo foram verificados utilizando-se o Software Kinovea. Para verificar a associação entre as variáveis, foi utilizado o teste de correlação de Spearman. O nível de significância adotado foi de p < 0,05. Os resultados mostraram que houve associação entre o desempenho na tarefa de levantar-se do solo com o IMC (p < 0,009), equilíbrio dinâmico/mobilidade (p < 0,001) e força muscular de membros inferiores (p < 0,001). Dessa maneira, é plausível admitir que a tarefa de levantar-se do solo mostrou ser uma medida resumo da saúde física na amostra estudada.

The objective of this cross-sectional study was to examine the association of physical fitness with performance in the task of getting up from the floor in healthy elderly individuals. Fifty-six volunteers (71.8 ± 6.96 years, 68.8 ± 14.02 kg, 1.60 ± 0.97 cm) were classified according to the body mass index. Physical fitness assessment was performed using the following functional tests: Timed Up and Go; Unipodal support test; Sit and reach test and Sit and stand test. The time and number of attempts for the task of getting off the ground were checked using the Kinovea Software. To verify the association between the variables, the Spearman correlation test was used. The level of significance was set at p <0.05. The results showed that there was an association between the performance in the task of getting up from the ground with BMI (p <0.009), dynamic balance / mobility (p <0.001) and lower limb muscle strength (p <0.001). Thus, it is plausible to admit that the task of getting up from the floor proved to be a summary measure of physical health in the sample studied.

Efeito da equoterapia no equilíbrio de idosos: uma revisão sistemática com metanálise / Effect of hippotherapy on older balance: a systematic review with methanalysis

A prática regular de exercícios físicos de diferentes naturezas tem sido amplamente recomendada para a população idosa, em virtude dos inúmeros benefícios relacionados à capacidade funcional e cognitiva nesta etapa da vida, aumentando a longevidade com independência funcional. Os efeitos da equoterapia na melhora do equilíbrio postural estão sendo cada vez mais estudados nas diversas populações, contudo, os estudos sobre esses efeitos em idosos são recentes. Dada a importância de melhorar a prática baseada em evidências, surgiu o interesse em realizar uma síntese rigorosa de todas as consultas relacionadas com o efeito da equoterapia no equilíbrio de idosos. Esta revisão seguiu as recomendações do Preferred reporting items for Systematic Reviews and Meta-análise (PRISMA) e registrado em um banco de dados internacional de revisões sistemáticas (PROSPERO). Foram selecionados artigos de bases de dados BIREME, SCIELO, MEDLINE CINAHAL, EBSCHOST e ISI, publicados em português e inglês. As palavras-chaves utilizadas foram: "equoterapia" OR "terapia assistida por animais" AND "equilíbrio postural" AND "idoso", presentes no título ou nos resumos dos artigos. Os artigos foram avaliados com base em seu nível de evidência e conduta. Utilizou-se a escala PEDro, para avaliação metodológica dos artigos incluídos na revisão. Identificou-se 20 estudos; 4 preencheram os critérios de inclusão. Estudos sobre os efeitos de equoterapia em idosos apresentam uma homogeneidade (I2 = 0 %) e uma melhora significativa (p = 0,001) equilíbrio. Embora os estudos apontem que a equoterapia seja benéfica para a melhora do equilíbrio postural, somente 4 estudos foram analisados, havendo necessidade de mais pesquisas que relacionem essas variáveis na população idosa....(AU)

The regular practice of physical exercises of diff erent natures has been widely recommended for the elderly population, due to the innumerable benefi ts related to functional and cognitive capacity in this stage of life, increasing the longevity with functional independence.The eff ects hippotherapy on the improvement of postural balance are being increasingly studied in diff erent populations, however, studies on these eff ects in the elderly are recent. Given the importance of improving evidence-based practice, the interest in performing a rigorous synthesis of all queries related to the eff ect of hippotherapy on balance postural. This review followed the reporting items Preferred recommendations for Systematic Reviews and Meta-analysis (PRISMA) And registered in an international database of systematic reviews (PROSPERO). Were selected articles from databases BIREME, SCIELO, MEDLINE CINAHAL, EBSCHOST e ISI, published Portuguese and English. The key words used were: hippotherapy, therapeutic riding, postural balance and elderly, present in the title or summary of articles. Were used the PEDro scale for methodological evaluation of the articles included in the review. It identifi ed 20 studies; 4 met the inclusion criteria. Studies on the eff ects of hippotherapy in older adults homogeneity (I2 = 0 %) and a signifi cant improvement (p = 0.001) in the functional capacity of the elderly. Although the studies indicate that hippotherapy is benefi cial for the improvement of postural balance, only 4 studies were analyzed, and there is a need for research that relates these variables to the elderly population....(AU)

Variation of Soil Bacterial Communities in a Chronosequence of Rubber Tree (Hevea brasiliensis) Plantations.

Regarding rubber tree plantations, researchers lack a basic understanding of soil microbial communities; specifically, little is known about whether or not soil microbial variation is correlated with succession in these plantations. In this paper, we used high-throughput sequencing of the 16S rRNA gene to investigate the diversity and composition of the soil bacterial communities in a chronosequence of rubber tree plantations that were 5, 10, 13, 18, 25, and 30 years old. We determined that: (1) Soil bacterial diversity and composition show changes over the succession stages of rubber tree plantations. The diversity of soil bacteria were highest in 10, 13, and 18 year-old rubber tree plantations, followed by 30 year-old rubber tree plantations, whereas 5 and 25 year-old rubber tree plantations had the lowest values for diversity. A total of 438,870 16S rDNA sequences were detected in 18 soil samples from six rubber tree plantations, found in 28 phyla, 66 classes, 139 orders, 245 families, 355 genera, and 645 species, with 1.01% sequences from unclassified bacteria. The dominant phyla were Acidobacteria, Proteobacteria, Chloroflexi, Actinobacteria, and Verrucomicrobia (relative abundance large than 3%). There were differences in soil bacterial communities among different succession stages of rubber tree plantation. (2) Soil bacteria diversity and composition in the different stages was closely related to pH, vegetation, soil nutrient, and altitude, of which pH, and vegetation were the main drivers.

Molecular phylogeny and biogeographic diversification of linnaeoideae (caprifoliaceae s. L.) disjunctly distributed in Eurasia, North America and Mexico.

Linnaeoideae is a small subfamily of erect or creeping shrubs to small trees in Caprifoliaceae that exhibits a wide disjunct distribution in Eurasia, North America and Mexico. Most taxa of the subfamily occur in eastern Asia and Mexico but the monospecific genus Linnaea has a circumboreal to north temperate distribution. In this study, we conducted phylogenetic and biogeographic analyses for Linnaeoideae and its close relatives based on sequences of the nuclear ribosomal ITS and nine plastid (rbcL, trnS-G, matK, trnL-F, ndhA, trnD-psbM, petB-D, trnL-rpl32 and trnH-psbA) markers. Our results support that Linnaeoideae is monophyletic, consisting of four eastern Asian lineages (Abelia, Diabelia, Dipelta and Kolkwitzia), the Mexican Vesalea, and Linnaea. The Mexican Vesalea was formerly placed in Abelia, but it did not form a clade with the eastern Asian Abelia; instead Vesalea and Linnaea are sisters. The divergence time between the eastern Asian lineages and the Mexican Vesalea plus the Linnaea clade was dated to be 50.86 Ma, with a 95% highest posterior density of 42.8 Ma (middle Eocene) to 60.19 Ma (early Paleocene) using the Bayesian relaxed clock estimation. Reconstructed ancestral areas indicated that the common ancestor of Linnaea plus Vesalea may have been widespread in eastern Asia and Mexico or originated in eastern Asia during the Eocene and likely migrated across continents in the Northern Hemisphere via the North Atlantic Land Bridges or the Bering Land Bridge. The Qinling Mountains of eastern Asia are the modern-day center of diversity of Kolkwitzia-Dipelta-Diabelia clade. The Diabeliaclade became highly diversified in Japan and eastern China. Populations of Diabelia serrata in Japan and eastern China were found to be genetically identical in this study, suggesting a recent disjunction across the East China Sea, following the last glacial event.

Seasonal distribution of active systemic lupus erythematosus and its correlation with meteorological factors.

OBJECTIVE: To explore the characteristics of seasonal distribution of active systemic lupus erythematosus (SLE) and the influences of meteorological factors including temperature and humidity on active systemic lupus erythematosus. METHODS: The characteristics of seasonal distribution of active SLE and its correlation with meteorological factors were retrospectively analyzed in 640 patients living in the city of Zhanjiang, China and had active SLE between January 1997 and December 2006. RESULTS: In winter, when there are weaker ultraviolet (UV) rays, the ratio of patients with active SLE to total inpatients was 3.89 %o, which is significantly higher than in other seasons with stronger UV rays, including 2.17 %o in spring, 1.87 0 in summer and 2.12 0 in autumn. The number of patients with active SLE had significant negative correlation with mean temperature and was not significantly related to mean humidity. CONCLUSION: Active SLE has the characteristics of seasonal distribution and is associated with temperature. The mechanism remains to be further studied.

Frequency of primary glomerular disease in northeastern China

Most frequently reported Chinese renal biopsy data have originated from southeastern China. The present study analyzed the renal biopsy data from northeastern China. The records of 1550 consecutive native patients who were diagnosed with primary glomerular diseases (PGD) after renal biopsy at our hospital during 2005-2009 were used. These patients were divided into four age groups for stratified analysis: <15, 15-44, 45-59, and ≥60 years old. Among PGD, minimal change disease (MCD) was the most common histologically diagnosed disease (30.7 percent), followed by IgA nephropathy (IgAN), mesangial proliferative glomerulonephritis (MsPGN), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), focal segmental glomerulosclerosis (FSGS), and endocapillary proliferative glomerulonephritis (EnPGN). MCD was the disease most frequently observed (43.7 percent) in the <15-year-old group. MsPGN was the most common disease in the elderly group (38.1 percent). MsPGN was more prevalent in females (27.8 percent), whereas MCD was more prevalent in males (35.3 percent). Primary glomerular diseases constituted the most commonly encountered group of diseases with a high prevalence of MCD, which predominantly affected males and young adults. The prevalence of MCD was high in northeastern China. Further study is necessary to expand the epidemiologic data available for renal disease in China.

Frequency of primary glomerular disease in northeastern China.

Most frequently reported Chinese renal biopsy data have originated from southeastern China. The present study analyzed the renal biopsy data from northeastern China. The records of 1550 consecutive native patients who were diagnosed with primary glomerular diseases (PGD) after renal biopsy at our hospital during 2005-2009 were used. These patients were divided into four age groups for stratified analysis: <15, 15-44, 45-59, and ≥60 years old. Among PGD, minimal change disease (MCD) was the most common histologically diagnosed disease (30.7%), followed by IgA nephropathy (IgAN), mesangial proliferative glomerulonephritis (MsPGN), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), focal segmental glomerulosclerosis (FSGS), and endocapillary proliferative glomerulonephritis (EnPGN). MCD was the disease most frequently observed (43.7%) in the <15-year-old group. MsPGN was the most common disease in the elderly group (38.1%). MsPGN was more prevalent in females (27.8%), whereas MCD was more prevalent in males (35.3%). Primary glomerular diseases constituted the most commonly encountered group of diseases with a high prevalence of MCD, which predominantly affected males and young adults. The prevalence of MCD was high in northeastern China. Further study is necessary to expand the epidemiologic data available for renal disease in China.

Seasonal distribution of active systemic lupus erythematosus and its correlation with meteorological factors

OBJECTIVE: To explore the characteristics of seasonal distribution of active systemic lupus erythematosus (SLE) and the influences of meteorological factors including temperature and humidity on active systemic lupus erythematosus. METHODS: The characteristics of seasonal distribution of active SLE and its correlation with meteorological factors were retrospectively analyzed in 640 patients living in the city of Zhanjiang, China and had active SLE between January 1997 and December 2006. RESULTS: In winter, when there are weaker ultraviolet (UV) rays, the ratio of patients with active SLE to total inpatients was 3.89 percento, which is significantly higher than in other seasons with stronger UV rays, including 2.17 percento in spring, 1.87 0 in summer and 2.12 0 in autumn. The number of patients with active SLE had significant negative correlation with mean temperature and was not significantly related to mean humidity. CONCLUSION: Active SLE has the characteristics of seasonal distribution and is associated with temperature. The mechanism remains to be further studied.

Transtorno de déficit de atenção e hiperatividade em adultos: reconhecimento do distúrbio e proposta de intervenção com terapia cognitiva / Attention-deficit hyperactivity disorder in adults: recognizing the disturbance and a cognitive therapy intervention

O transtorno de déficit de atenção e hiperatividade é o distúrbio neurocomportamental mais comum na infância. Sabe-se, atualmente, que não ocorre remissão de sintomas nem na adolescência nem na idade adulta, mas há sua modificação em função do desenvolvimento de estratégia de enfrentamento do indivíduo, que pode ou não ser adequada.Na vida adulta, causa impacto nas áreas familiar e conjugal, ocupacional e com repercussão na financeira. O portador do transtorno apresenta disfunção executiva. As funções executivas gerenciam comportamentos, tais como produzir intenções, iniciar e terminar ações, selecionar alvos, planejar, antecipar consequências, mudar estratégias, monitorar o comportamento entre outras. Portanto, associada à farmacoterapia, a proposta de intervenção da terapia cognitiva é a construção de comportamentos saudáveis e funcionais para buscar a melhora no desempenho de funções globais, incluindo-se as acadêmicas e as laborais. A abordagem utiliza no tratamento técnicas para areestruturação cognitiva em nível de crença condicional ? cognição que corresponde a uma suposição, ou seja, um pensamento ?Se -, então?. O objetivo de corrigir as distorções cognitivas é a consolidação do novo padrão de funcionamento, facilitada pelo registro diário de comportamentos funcionais, pelo monitoramento de atividades semanaise pelos cartões de enfrentamento. Eles são utilizados nos momentos em que as dificuldades possam comprometer a motivação pela mudança. Neles são escritos os objetivos determinados na terapia, as suposições reestruturadas, as desvantagens de manter os sintomas e as vantagens em tratar a doença. A emoção negativa é identificada para que a tomada de decisão pelo tratamento seja mantida.

Attention-deficit hyperactivity disorder is the most common neurocomportamental disorder in the infancy. The symptomsdo not remit nor in adolescence or in adulthood, but individual developmental cause the modifications that are observed. In adulthood it causes a significant impact in familiar, occupational and financial areas. Executive disfunction is a characteristic of patients with the disease. Executive functions manage behaviors, such as to build intentions, beginning and finishing actions, selecting targets, planning anticipating consequences, building better strategies, monitoring behavior, and so on. For treatment, besides medication, cognitive therapy works with tecniques to underlying assumption reestructuring ? the cognition represented by ?If..., then...? statements. The goal of correcting cognitive distortions is to build up healthier and functional behaviors, for the patient to get better in global functions performance, including academic and working ones. Writing down daily functional behaviors, monitoring weekly activities and building coping cards help consolidate the new functional pattern. Coping cards are written to be used when facing difficult situations, which can disturb the motivation for changing. Therapy goals, the underlying assumption restructured, the disadvantages of keeping thesymptoms, the advantages of treating the disease are some examples of coping cards. The negative emotion is identified for the patient to keep with the decision for the adequate treatment.

Transtorno de déficit de atenção e hiperatividade: por que é preciso compreender esse diagnóstico? / Attention-deficit/hyperactivity disorder: Why is there a need to understand this diagnosis?

O déficit de atenção e hiperatividade é um transtorno psiquiátrico, mais frequentemente observado na infância, com alterações comportamentais características. Este artigo tem por objetivo chamar a atenção de profissionais da assistência básica de saúde para um quadro clínico frequente, que não sendo diagnosticado e não tratado precoce e adequadamente pode trazer consequências devastadoras à vida do indivíduo e de sua família. O adequado diagnóstico do distúrbio possibilita correta intervenção em todos os níveis de atenção à saúde da criança, permite adequado desenvolvimento e diminui os riscos a que suas manifestações podem expor esse grupo populacional.

Attention deficit/hyperactivity disorder is a psychiatric disease, most frequently observed in infancy and presents characteristic behavioral alterations. The purpose of this study is to call the attention of primary care physicians to a frequent condition that when not soon and correctly diagnosed and treated may bring devastating consequences to the patient’s individual life and also to his family. The adequate diagnosis of this disorder enables the correct intervention at all levels of attention to the child’s health, allowing adequate development and reducing the riscs that its manifestations expose to these population.

Transtorno de humor bipolar: diversas apresentações de uma mesma doença / Bipolar mood disorder: different occurrences of the same disease

O presente relato tem por objetivo acompanhar a evolução de um caso que se apresentou como mutismo seletivo e evoluiu para transtorno de humor bipolar e chamar atenção para a diversidade de sintomas possíveis no transtorno de humor. Em geral, o mutismo seletivo tem início na idade pré-escolar, porém os sintomas chamam mais atenção na idade escolar. A importância do diagnóstico e tratamento precoces reside na prevenção das complicações, tais como distúrbios no desenvolvimento social e acadêmico e na auto-estima, além da possibilidade de evolução para outros transtornos de ansiedade. O transtorno de humor bipolar é uma doença mental caracterizada por variações extremas no humor. Na criança, prejudica o crescimento emocional e seu desenvolvimento. É confundido com transtorno de déficit de atenção/hiperatividade e transtornos de comportamento, tais como transtorno de conduta e desafiador opositivo. A paciente do sexo feminino, quando avaliada, estava com 5 anos e 9 meses de idade. Concluiu-se o diagnóstico como mutismo seletivo. Foi indicada psicoterapia, com orientações aos pais e à escola, e iniciado o uso de inibidores seletivos de recaptação da serotonina, com boa resposta aos sintomas de ansiedade, mas passou a apresentar piora significativa do comportamento. Foi levantada a hipótese diagnóstica de transtorno de humor bipolar de início precoce. Medicada com estabilizador, apresentou adequação na terceira medicação e evolução satisfatória. O mutismo seletivo, considerado um transtorno de ansiedade na infância, pode ser pródromo para outros quadros psiquiátricos na infância. Há necessidade que os pediatras, médicos que primeiro acessam essas crianças, assim como os psiquiatras da infância, estejam atentos à riqueza de sintomas que pode dar seguimento ao quadro.

The purpose of the present case report is to follow the evolution of a child who presented selective mutism and evolved into bipolar mood disorder, and also to draw attention to the diversity of possible symptoms of mood disorders. In general, selective mutism starts at preschool age, although the symptoms are more evident at school age. The importance of an early diagnosis and treatment lies in the prevention of some complications, such as social and academic development and self-esteem, besides the possibility of the development of other anxiety disorders. Bipolar mood disorder is a mental disease characterized by extreme mood variations. In childhood, it hinders the child's emotional growth and development. Selective mutism is mistaken by attention deficit hyperactivity disorder, and behavioral disorders, such as conduct disorder and oppositional defiance disorder. The present case report is about a female patient evaluated at 5 years and 9 months of age. We concluded the case as being a selective mutism disorder. Not only psychotherapy, with parent and school orientation, but also medication was prescribed. The first prescribed medication was use of selective serotonin reuptake inhibitors with good results regarding anxiety symptoms, although the patient started to present significant deterioration in behavior. Because of that, the diagnostic hypothesis came to be bipolar mood disorder with an early start. The patient presented satisfactory evolution only after given a third option of mood stabilizer medication. Selective mutism, which is an anxiety disorder in childhood, can be prodromus to other psychiatric conditions at the same age. It is necessary for pediatricians, who are the doctors that first assess these children, and also child psychiatrists, to be aware of the wealth of symptoms that can give continuation to the condition.