Mediating effect of eating pattern on the relationship between television exposure and caries in children.

Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

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.

Can caregivers' mental disorders be associated with childhood obesogenic eating behavior? / Os transtornos mentais dos cuidadores podem estar associados a comportamentos alimentares obesogênicos na infância?

Abstract Objective: to assess the association between caregivers' mental disorders and schoolchildren's obesogenic eating behavior. Methods: cross-sectional study used a public school-based sample of children and their primary caregivers. Caregivers had to report depressive episodes or generalized anxiety disorder (GAD) during the Mini-International Neuropsychiatric Interview (MINI). Children's obesogenic eating behavior were assessed using food responsiveness (FR) and emotional overeating (EOE) subscales of the Children's Eating Behaviour Questionnaire (CEBQ). Bivariate analysis was conducted using the t-test, ANOVA, Pearson correlation, and adjusted linear regression model was used (including variables caregivers: sex, age, economic indicator, and schooling; schoolchildren: sex and nutritional status). Results: study includes 596 children-caregiver dyads (309 boys and 287 girls). Among caregivers, 24.7% had experienced current depressive episodes, 38.7% had past depressive episodes, and 17.2% had GAD. We observed, after adjusted analysis, that having a caregiver in a current depressive episode, increases schoolchildren's obesogenic behavior of, for FR at 0.235 points (β=0.235; CI95%=0.022-0.449;) and EOE at 0.337 points (β=0.337; CI95%=0.162-0.512). Conclusion: caregivers' current depressive episodes were associated with higher averages of obesogenic eating behavior (caregiver-reported), both in consuming palatable food without feeling hungry (FR) and in increasing food intake in response to negative emotions (EOE).

Resumo Objetivos: avaliar associação entre transtornos mentais do cuidador e comportamento alimentar obesogênico de escolares. Métodos: estudo transversal com amostra de crianças da rede pública de ensino e seu cuidador principal. Episódio depressivo atual e transtorno de ansiedade generalizada (TAG) do cuidador foi avaliado pela Mini-International Neuropsychiatric Interview (MINI). Comportamentos alimentares obesogênicos das crianças foi avaliado pelas subescalas resposta à comida (FR) e sobreingestão emocional (EOE) Children's Eating Behaviour Questionnaire (CEBQ). Análise bivariada foi realizada por meio de teste-T, ANOVA e correlação de Pearson. Modelo de regressão linear ajustado (incluiu variáveis cuidadores: sexo, idade, indicador econômico e escolaridade; escolares: sexo e estado nutricional). Resultados: foram avaliadas 596 díades crianças-cuidadores (309 meninos e 287 meninas). Entre os cuidadores, 24,7% apresentaram episódio depressivo atual, 38,7% episódio depressivo passado e 17,2% TAG. Observamos, após análise ajustada, que ter um cuidador em episódio depressivo atual aumenta o comportamento obesogênico dos escolares, em 0,235 pontos para FR (β=0,235; IC95%=0,022-0,449) e em 0,337 pontos para EOE (β=0,337; IC95%=0,162-0,512). Conclusão: episódio depressivo atual do cuidador foi associado a maiores médias de comportamentos alimentares obesogênicos dos escolares, tanto no consumo de alimentos palatáveis mesmo sem fome (FR) quanto aumento da ingestão alimentar em resposta a emoções negativas (EOE).

Mediating effect of eating pattern on the relationship between television exposure and caries in children

Abstract Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

Early illness progression in mood disorders: A population-based longitudinal study.

This study is aimed at assessing changes in functioning among young people from the general population with bipolar disorder and major depressive disorder over a period of five years. Specifically, we hypothesized that significant illness progression would take place during euthymia over time in bipolar disorder. We conducted a longitudinal study with 231 people, assessed at baseline and again at a five-year follow-up. A structured clinical interview was used to diagnose participants with mood disorders. A control group without mood disorders was also included. Functioning was assessed with the Functioning Assessment Short Test, and linear mixed models were used to analyze the effect of psychopathology on change in functioning. Mood disorders were associated with significant functional impairment, but functioning significantly improved in both groups over the 5-year follow-up period. Depressive episodes, however, were associated with worse functioning at follow-up, independently of depression severity. In contrast to our initial hypothesis, we found a worsening of functioning in a five-year period associated only with depressive episodes. This suggests that interventions focused on the prevention of mood episodes early in the course of illness may be particularly promising to reduce adverse functioning outcomes.

Traumatic brain injury hospital incidence in Brazil: an analysis of the past 10 years. / Incidência hospitalar de traumatismo craniencefálico no Brasil: uma análise dos últimos 10 anos.

OBJETIVO: Caracterizar os aspectos demográficos e sociais e o ônus econômico do traumatismo craniencefálico no sistema público de saúde brasileiro na última década. MÉTODOS: Analisaram-se os dados provenientes da base de dados do Departamento de Informática do Sistema Único de Saúde referentes ao período entre janeiro de 2008 e dezembro de 2019. RESULTADOS: Entre 2008 e 2019 ocorreram, em média, no Brasil, 131.014,83 internações por traumatismo craniencefálico ao ano, com incidência de 65,54 por 100 mil habitantes. Deve-se salientar a elevada incidência de traumatismo craniencefálico em adultos idosos (acima de 70 anos), acompanhada de altas taxas de mortalidade. Além disso, há também elevada incidência de traumatismo craniencefálico em adultos jovens (20 a 29 anos e 30 a 39 anos). Os dados aqui apresentados demonstram uma proporção de traumatismos craniencefálicos de 3,6 homens/mulheres. CONCLUSÃO: Embora se acredite que os dados apresentados subestimem a incidência e mortalidade associadas com o traumatismo craniencefálico no Brasil, este estudo pode ajudar na implantação de futuras estratégias de promoção da saúde para a população brasileira e mundial, com o objetivo de diminuir a incidência, a mortalidade e os custos do traumatismo craniencefálico.

OBJECTIVE: To characterize the demographic, social, and economic burden of traumatic brain injury on the public health system in Brazil during the past decade. METHODS: Data from the database of the Information Technology Department of the Unified Health System (DATASUS) from January 2008 to December 2019 were analyzed. RESULTS: There was a mean of 131,014.83 hospital admissions per year due to traumatic brain injury in Brazil from 2008 - 2019. The incidence was 65.54 per 100.000 inhabitants during the same period. The high incidence of traumatic brain injury in older adults (>70 years old) accompanied by high mortality rates should be noted. In addition, there was a high incidence of traumatic brain injury in younger adults (20 to 29 years and 30 to 39 years). The data presented here demonstrates a 3.6 male-to-female ratio of traumatic brain injury incidence. CONCLUSION: Although we believe that the present data underestimate the incidence and mortality related to traumatic brain injury in Brazil, this study could assist in implementation of future health promotion strategies in the Brazilian population and worldwide aiming to reduce the incidence, mortality and costs of traumatic brain injury.

Incidência hospitalar de traumatismo craniencefálico no Brasil: uma análise dos últimos 10 anos / Traumatic brain injury hospital incidence in Brazil: an analysis of the past 10 years

ABSTRACT Objective: To characterize the demographic, social, and economic burden of traumatic brain injury on the public health system in Brazil during the past decade. Methods: Data from the database of the Information Technology Department of the Unified Health System (DATASUS) from January 2008 to December 2019 were analyzed. Results: There was a mean of 131,014.83 hospital admissions per year due to traumatic brain injury in Brazil from 2008 - 2019. The incidence was 65.54 per 100.000 inhabitants during the same period. The high incidence of traumatic brain injury in older adults (>70 years old) accompanied by high mortality rates should be noted. In addition, there was a high incidence of traumatic brain injury in younger adults (20 to 29 years and 30 to 39 years). The data presented here demonstrates a 3.6 male-to-female ratio of traumatic brain injury incidence. Conclusion: Although we believe that the present data underestimate the incidence and mortality related to traumatic brain injury in Brazil, this study could assist in implementation of future health promotion strategies in the Brazilian population and worldwide aiming to reduce the incidence, mortality and costs of traumatic brain injury.

Abstract Objetivo: Caracterizar os aspectos demográficos e sociais e o ônus econômico do traumatismo craniencefálico no sistema público de saúde brasileiro na última década. Métodos: Analisaram-se os dados provenientes da base de dados do Departamento de Informática do Sistema Único de Saúde referentes ao período entre janeiro de 2008 e dezembro de 2019. Resultados: Entre 2008 e 2019 ocorreram, em média, no Brasil, 131.014,83 internações por traumatismo craniencefálico ao ano, com incidência de 65,54 por 100 mil habitantes. Deve-se salientar a elevada incidência de traumatismo craniencefálico em adultos idosos (acima de 70 anos), acompanhada de altas taxas de mortalidade. Além disso, há também elevada incidência de traumatismo craniencefálico em adultos jovens (20 a 29 anos e 30 a 39 anos). Os dados aqui apresentados demonstram uma proporção de traumatismos craniencefálicos de 3,6 homens/mulheres. Conclusão: Embora se acredite que os dados apresentados subestimem a incidência e mortalidade associadas com o traumatismo craniencefálico no Brasil, este estudo pode ajudar na implantação de futuras estratégias de promoção da saúde para a população brasileira e mundial, com o objetivo de diminuir a incidência, a mortalidade e os custos do traumatismo craniencefálico.

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.

A closer look at the epidemiology of schizophrenia and common mental disorders in Brazil / Um olhar mais atento à epidemiologia da esquizofrenia e de transtornos mentais comuns no Brasil

ABSTRACT. Schizophrenia and common mental disorders are noteworthy social and economic concern worldwide. Epidemiologic studies on the impact of specific mental disorders in emerging countries are scarce. Objectives: We aimed to characterize the demographic, social, and economic burden of schizophrenia and common mental disorders patients in the health system in Brazil. Methods: Data on these conditions in Brazil between 2008 and 2019 were collected through the website of the Departamento de Informática do Sistema Único de Saúde (Information Technology Department of the Unified Health System - DATASUS) maintained by the Brazilian Ministry of Health. Mean annual hospital admissions were 154,009.67, and cumulative incidence of 77.44 admissions per 100,000 inhabitants. Results: Average annual hospital expenses were US$ 67,216,056.04, with an average admission cost of US$ 432.58. The most affected age groups were older adults albeit younger individuals showed a trend towards increase of occurrences in recent years. There were a higher number of admissions in men compared to women. Conclusions: We consider the results obtained important to assist in evaluating and guiding public policies regarding the prevention and treatment in health systems.

RESUMO. A esquizofrenia e os transtornos mentais comuns são uma preocupação social e econômica notável em todo o mundo. Estudos epidemiológicos sobre o impacto de transtornos mentais específicos em países emergentes são escassos. Objetivos: Nosso objetivo foi caracterizar a carga demográfica, social e econômica de pacientes com esquizofrenia e transtornos mentais comuns no sistema de saúde no Brasil. Métodos: Os dados sobre essas condições no Brasil entre 2008 e 2019 foram coletados por meio do site do Departamento de Informática do Sistema Único de Saúde (DATASUS), mantido pelo Ministério da Saúde do Brasil. As internações hospitalares anuais médias foram de 154.009,67, e a incidência acumulada de 77,44 internações por 100.000 habitantes. Resultados: As despesas hospitalares médias anuais foram de US$ 67.216.056,04, com um custo médio de internação de US$ 432,58. As faixas etárias mais afetadas foram os adultos mais velhos, embora os mais jovens tenham demonstrado tendência a aumento de ocorrências nos últimos anos. Houve um número maior de admissões entre os homens em comparação às mulheres. Conclusões: Consideramos importantes os resultados obtidos para auxiliar na avaliação e orientação de políticas públicas de prevenção e tratamento nos sistemas de saúde.

Emotional and behavioral problems: a school-based study in southern Brazil / Problemas emocionais e comportamentais: um estudo de base escolar no sul do Brasil

Abstract Introduction Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. Objective To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. Method A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. Results A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Resumo Introdução A avaliação da saúde mental na infância necessita ser realizada dentro de um contexto amplo que considere os diferentes fatores envolvidos. Objetivo Verificar a prevalência de problemas emocionais e comportamentais em escolares, bem como fatores associados. Método Estudo transversal, com amostra de base escolar em que foram selecionadas 20 escolas por amostragem aleatória sistemática. Participaram crianças com 7-8 anos e seus pais ou principais cuidadores. A presença de problemas emocionais e comportamentais nas crianças foi rastreada pelo Strengths and Difficulties Questionnaire (SDQ). Resultados Foram avaliadas 596 díades. A prevalência de problemas emocionais e comportamentais foi de 30,0% entre os meninos e 28,2% entre as meninas. Sintomas de hiperatividade/desatenção foram mais prevalentes entre meninos (p=0,015). Pertencer a camadas menos favorecidas economicamente aumentou em 71% a probabilidade de problemas emocionais e comportamentais entre os escolares (p=0,001), enquanto ter pais ou cuidadores com transtorno mental aumentou 2,2 vezes tal probabilidade (p<0,001). Conclusões: Nossos achados demonstram a elevada prevalência de problemas emocionais e comportamentais entre escolares, bem como a influência das condições econômicas e da saúde mental de pais e cuidadores sobre a saúde mental infantil.

Emotional and behavioral problems: a school-based study in southern Brazil.

INTRODUCTION: Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. OBJECTIVE: To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. METHOD: A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. RESULTS: A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Prevalência de ansiedade e fatores associados em adultos / Prevalence of anxiety and associated factors in adults

RESUMO Objetivo Identificar a prevalência de transtornos de ansiedade em uma amostra de base populacional e fatores associados. Métodos Estudo transversal de base populacional realizado com indivíduos entre 18 e 35 anos. As variáveis sociodemográficas, índice de massa corporal, presença de doença crônica, abuso de álcool e tabagismo foram analisadas. Os transtornos de ansiedade foram verificados pela Mini Internacional Neuropsychiatric Interview 5.0. Foi utilizado o teste Qui-quadrado, considerando o intervalo de confiança de 95%. Resultados A amostra foi constituída por 1.953 pessoas. A prevalência de transtornos de ansiedade foi de 27,4%. Agorafobia (17,9%) e transtorno de ansiedade generalizada (14,3%) foram os quadros mais prevalentes. Mulheres apresentaram maior prevalência de ansiedade, com 32,5%, quando comparadas aos homens (21,3%) (p < 0,001). As variáveis sexo, anos de estudo, renda, doença crônica, tabagismo e álcool foram associadas a mais de três transtornos de ansiedade investigados (p < 0,001). Conclusão Os dados demonstram que os transtornos de ansiedade são muito frequentes em adultos, sendo mais prevalentes entre as mulheres. Estão associadas aos transtornos ansiosos, principalmente, as condições socioeconômicas e substâncias licitas. Conhecer as prevalências dos transtornos de ansiedade e fatores associados pode auxiliar profissionais de saúde a elaborarem melhores diagnósticos e tratamentos.

ABSTRACT Objective Identify the prevalence of anxiety disorders in a population sample and associated factors. Methods A cross-sectional study of population base conducted with individuals between 18 and 35 years old. Sociodemographic variables, body mass index (BMI), presence of diseases, and use of alcohol and smoke were analyzed. The anxiety disorders were verified by the clinical interview Mini International Neuropsychiatric Interview 5.0. For the analysis, was used the Chi-square test, considering a confidence interval of 95%. Results The prevalence of general anxiety was 27.4%. Agoraphobia (17.9%) and generalized anxiety disorder (14.3%) were the most prevalent. Women presented a higher prevalence of general anxiety with 32.5% when compared with man (21,3%) (p < 0.001). The variables gender, years of study, income, health problems, smoking, and alcohol were associated to more than three anxiety disorders investigated (p < 0,001). Conclusions The findings demonstrate that anxiety disorders are frequent in adults, being more prevalent among women. It was associated mainly with socioeconomic conditions and legal substances. Knowing the prevalence of anxiety disorders and associated factors can help health professionals to develop better diagnoses and treatments.

Biological rhythm and emotional and behavioral problems among schoolchildren in Southern Brazil.

Emotional and behavioral problems have been considered an indicative of mental disorder in children. Mental health problems affect 10-20% of children and adolescents living in low-income and middle-income countries. Evidence suggests that disruptions in the biological rhythm may be a primary cause of emotional and behavioral changes, which affects several psychological functions and moods. Thus, this study aimed at verifying the association between biological rhythm and emotional and behavioral problems in schoolchildren living in Southern Brazil. This is a cross-sectional study with a school-based sample conducted between August 2015 and November 2016. The presence of emotional and behavioral problems in children was verified by the Strengths and Difficulties Questionnaire (SDQ), parents' version. This is a 25-item assessment questionnaire used to screen mental health problems in children and adolescents (from 4 to 17 years of age) in the last 6 months. The Biological Rhythm Interview of Assessment in Neuropsychiatry-Kids (BRIAN-K) was used to measure the degree of biological rhythm disruption. The BRIAN-K consists of 20 items; from among these, 17 items are added to generate a quantitative measure, with greater scores indicating more biological rhythm disruption. The final score can also be divided into four subscales: sleep, social rhythm, eating pattern and overall activities. A total of 609 children responded to the assessment instruments. With regard to parents or primary caregiver, 596 completed the assessment and 13 (2%) were not located or refused to participate in the study. Thus, 596 dyads were included in the analysis. Children with emotional and behavioral problems presented higher scores in all domains of BRIAN-K: sleep, social, activity, eating pattern and total score (p < 0.001). The following variables remained associated with emotional and behavioral problems after adjusted analysis: BRIAN-K total score (p < 0.001) and all subscales sleep (p < 0.001), social (p < 0.001), activity (p < 0.001) and eating pattern (p < 0.001). Children with emotional and behavioral problems presented higher biological rhythm disruption when compared with children without emotional and behavioral problems. Our study emphasizes the importance of biological rhythm and its influence on emotional and behavioral problems in schoolchildren. Early detection of any biological rhythm disruption may enhance further assessment of any eventual emotional and behavioral problem and even a psychopathology.

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

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

Comparison of Clinical Significance of Cognitive-Behavioral Therapy and Psychodynamic Therapy for Major Depressive Disorder: A Randomized Clinical Trial.

The aim of this study was to evaluate the effect of two brief psychotherapy models for major depressive disorder (MDD). This is a randomized clinical trial with 247 individuals diagnosed with MDD. Supportive-expressive dynamic psychotherapy (SEDP) (18 sessions) and cognitive-behavioral therapy (CBT) (16 sessions) were the two models used in this study. Participants were evaluated at baseline, during treatment, and postintervention (last session). Clinically significant changes were found in both psychotherapy models, and CBT showed higher response rates. Regarding the Beck Depression Inventory-II [F(1,120) = 4.07, p = 0.046] and Outcome Questionnaire 45.2 [F(1.114) = 7.99, p = 0.006], CBT had a better effect than SEDP. Hence, the results obtained have contributed to literature, served to corroborate the importance and effectiveness of psychodynamic psychotherapy, as well as explored the mechanisms of change, remission, and response in the treatment of MDD, which have been ignored to a large extent.

Construction of a biological rhythm assessment scale for children.

Introduction Biological rhythm is associated with the level of alertness, cognitive performance and mood of the individuals. Its regularity is essential to preserve good health and quality of life. Objective To present the steps for the construction of the scale entitled Biological Rhythm Interview of Assessment in Neuropsychiatry - Kids (BRIAN-K), designed to measure biological rhythm disruptions in Brazilian children and adolescents. Methods Items were developed following the adult version of the scale. Analysis of the psychometric characteristics of the scale was based on the responses of 373 parents/caregivers of school age children (7 and 8 years old). Results A theoretical model of 17 items with the purpose of evaluating four domains (sleep, activities, social rhythm and eating pattern) was determined using exploratory factor analysis (EFA) and via identification of a general factor. The psychometric properties of the BRIAN-K showed favorable properties. Conclusion Only two items needed to be rewritten. Further studies are needed to investigate the instrument's adequacy to different age groups and additional evidence of validity and reliability.

Construction of a biological rhythm assessment scale for children / Construção de uma escala de avaliação do ritmo biológico para crianças

Abstract Introduction Biological rhythm is associated with the level of alertness, cognitive performance and mood of the individuals. Its regularity is essential to preserve good health and quality of life. Objective To present the steps for the construction of the scale entitled Biological Rhythm Interview of Assessment in Neuropsychiatry - Kids (BRIAN-K), designed to measure biological rhythm disruptions in Brazilian children and adolescents. Methods Items were developed following the adult version of the scale. Analysis of the psychometric characteristics of the scale was based on the responses of 373 parents/caregivers of school age children (7 and 8 years old). Results A theoretical model of 17 items with the purpose of evaluating four domains (sleep, activities, social rhythm and eating pattern) was determined using exploratory factor analysis (EFA) and via identification of a general factor. The psychometric properties of the BRIAN-K showed favorable properties. Conclusion Only two items needed to be rewritten. Further studies are needed to investigate the instrument's adequacy to different age groups and additional evidence of validity and reliability.

Resumo Introdução O ritmo biológico está associado ao nível de alerta, desempenho cognitivo e humor dos indivíduos. Sua regularidade é essencial para preservar uma boa saúde e qualidade de vida. Objetivo Apresentar as etapas de construção da escala intitulada Biological Rhythm Interview of Assessment in Neuropsychiatry - Kids (BRIAN-K), criada para medir disrupturas do ritmo biológico em crianças e adolescentes brasileiros. Métodos Os itens foram desenvolvidos seguindo a versão adulta da escala. A análise das características psicométricas da escala se baseou nas respostas de 373 pais/cuidadores de crianças em idade escolar (7 e 8 anos). Resultados Um modelo teórico de 17 itens, com o objetivo de avaliar quatro domínios do ritmo biológico (sono, atividades, ritmo social e padrão alimentar) foi determinado usando análise fatorial exploratória (AFE) e pela identificação de um fator geral. As propriedades psicométricas da BRIAN-K mostraram-se satisfatórias. Conclusão Apenas dois itens precisaram ser reescritos. São necessários mais estudos para investigar a adequação do instrumento a diferentes faixas etárias e evidências adicionais de validade e confiabilidade.

Depressive Symptoms and Relationship Between Genders: Differences in Young Adults in a Randomized Clinical Trial / Sintomas Depressivos e Relação entre os Gêneros: Diferenças em Adultos Jovens de um Ensaio Clínico Randomizado / Síntomas Depresivos y la Relación entre los Géneros: Diferencias en Adultos Jóvenes de un Ensayo Clinico Randomizado

Abstract: Depression has a high prevalence in the general population, especially among women. There is no consensus in the scientific literature about differences between men and women in the manifestations of depressive symptoms, nor about psychotherapy indications according to gender. This research aimed to verify differences in depressive symptoms and symptoms improvement between young adult men and women with current Major Depressive Disorder and to identify differences between two brief Cognitive Psychotherapy models. Randomized clinical trial in which participants were randomized between: Cognitive Behavioral Therapy and Narrative Cognitive Therapy. Depressive symptoms pre and post-intervention were evaluated using the Hamilton Depression Rating Scale. The sample was composed of 25 men and 95 women. Genital symptoms and insight were significantly different between genders. Concerning improvement in symptoms according to the psychotherapy model, CBT presented a trend toward being more effective in men. Therefore, the symptoms and improvement in depressive symptoms are manifested differently between genders.

Resumo: A depressão apresenta elevada prevalência na população geral, especialmente entre as mulheres. Não existe consenso na literatura científica a respeito de diferenças das manifestações de sintomas depressivos entre homens e mulheres, bem como, quanto à indicações de psicoterapias conforme o gênero. O objetivo deste estudo foi verificar as diferenças na sintomatologia depressiva e melhora dos sintomas em homens e mulheres adultos jovens com Transtorno Depressivo Maior e identificar as diferenças entre dois modelos de Psicoterapia Cognitiva. Em ensaio clínico, os participantes foram randomizados entre: Psicoterapia Cognitivo Comportamental e Psicoterapia Cognitiva Narrativa. A sintomatologia depressiva pré e pós intervenção foi avaliada pela Hamilton Depression Scale. Participaram do estudo 25 homens e 95 mulheres. Os sintomas genitais e de consciência foram significativamente diferentes entre os gêneros. Quanto à melhora dos sintomas de acordo com o modelo psicoterapêutico, a PCC apresentou uma tendência a ser mais eficaz entre os homens. Sendo assim, é possível observar que a sintomatologia e a melhora dos sintomas depressivos manifestam-se diferentemente entre os gêneros.

Resumen: La depresión tiene una alta prevalencia en la población general, especialmente entre las mujeres. No hay consenso en la literatura científica sobre las diferencias en las manifestaciones de síntomas depresivos entre hombres y mujeres, ni sobre las indicaciones de las psicoterapias según el género. Este estudio tuvo como objetivo determinar las diferencias en los síntomas depresivos y la mejora de los síntomas en hombres y mujeres jóvenes adultos con Trastorno Depresivo Mayor actual y comprobar las diferencias entre los dos modelos de psicoterapia cognitiva. En este ensayo clínico, los participantes fueron asignados aleatoriamente entre: Psicoterapia Cognitivo Comportamental y Psicoterapia Cognitiva Narrativa. Los síntomas de depresión pre y post intervención se evaluaron mediante la Escala de Depresión de Hamilton. La muestra estuvo constituida por 25 hombres y 95 mujeres. Síntomas genitales y de conciencia fueron significativamente diferentes entre los géneros. En cuanto a la mejoría de los síntomas de acuerdo con el modelo psicoterapéutico, el PCC tuvo una tendencia a ser más eficaz entre los hombres. Es posible observar que la sintomatología y la mejora en los síntomas depresivos se manifiestan de forma diferente entre géneros.

[Quality of life with Obsessive-Compulsive Disorder: a study among Primary Care users]. / Qualidade de vida no Transtorno Obsessivo-Compulsivo: um estudo com usuários da Atenção Básica.

Quality of life (QOL) can be affected by the presence of mental disorders, like Obsessive-Compulsive Disorder (OCD). Thus, the evaluation and monitoring of QOL in patients with mental disorders enables the identification of priorities, making it possible to implement actions to improve QOL among health system users. The scope of this article is to measure QOL in OCD patients in primary health care. It involves a cross-sectional study with a convenience sample including all users of three Basic Health Units of Pelotas in the State of Rio Grande do Sul, Brazil. The quality of life was measured with the WHOQOL-Bref and the OCD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.) This study included 1081 individuals. The prevalence of OCD was 3.9%. OCD patients had a lower average in all domains of QOL when compared to individuals without OCD (p < 0.001). The findings of this study emphasize the importance of using QOL as a monitoring tool of the disorder in basic health care.

Qualidade de vida no Transtorno Obsessivo-Compulsivo: um estudo com usuários da Atenção Básica / Quality of life with Obsessive-Compulsive Disorder: a study among Primary Care users

Resumo A qualidade de vida (QV) pode ser afetada pela presença de transtornos mentais, como o Transtorno Obsessivo-Compulsivo (TOC). Assim, a avaliação e o acompanhamento dos índices de QV em pacientes com transtornos mentais permite a identificação de suas prioridades, sendo possível a implementação de ações para a melhora desses índices nos usuários do sistema de saúde. O objetivo deste artigo é avaliar a QV em portadores de TOC usuários da atenção primária à saúde. Estudo transversal com amostragem por conveniência, incluindo todos os usuários de três Unidades Básicas de Saúde de Pelotas, RS. Para avaliar a QV foi utilizada a WHOQOL-Bref, e o TOC foi avaliado através da M.I.N.I. Foram avaliados 1081 indivíduos. A prevalência de TOC foi de 3,9%. Portadores de TOC apresentaram médias inferiores em todos os domínios da QV quando comparados aos indivíduos sem TOC (p < 0,001). Os achados deste estudo enfatizam a importância de utilizar a QV como instrumento de monitoramento da melhora do transtorno no âmbito da atenção básica à saúde.

Abstract Quality of life (QOL) can be affected by the presence of mental disorders, like Obsessive-Compulsive Disorder (OCD). Thus, the evaluation and monitoring of QOL in patients with mental disorders enables the identification of priorities, making it possible to implement actions to improve QOL among health system users. The scope of this article is to measure QOL in OCD patients in primary health care. It involves a cross-sectional study with a convenience sample including all users of three Basic Health Units of Pelotas in the State of Rio Grande do Sul, Brazil. The quality of life was measured with the WHOQOL-Bref and the OCD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.) This study included 1081 individuals. The prevalence of OCD was 3.9%. OCD patients had a lower average in all domains of QOL when compared to individuals without OCD (p < 0.001). The findings of this study emphasize the importance of using QOL as a monitoring tool of the disorder in basic health care.