Brain changes in neuroimaging of adult patients with vitamin D deficiency: systematic review protocol.

INTRODUCTION: Brain abnormalities detected through neuroimaging are described in patients with vitamin D deficiency, however, it is still not clear which cerebral alterations are more frequent and characteristic in this population. Thus, this review aims to identify and classify which are the main and most frequent brain changes found by neuroimaging in patients with vitamin D deficiency. METHODS AND ANALYSIS: The study protocol was constructed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the leading research question was formulated through Population, Intervention, Comparator, Outcome, Setting. The evidence will be researched at the following electronic databases: PubMed, PsycINFO, Scopus, Web of Science and EMBASE. Two researchers will work in the selection, analysis and inclusion phases of the articles. In the case of divergence, a third-party reviewer will be contacted. The following studies will be included: (1) cohort studies, case-control studies and cross-sectional studies; (2) studies carried out on patients with serum 25-hydroxyvitamin D levels below 30 ng/mL; (3) studies conducted with an adult population; (4) studies using neuroimaging methods. Articles considered eligible will be analysed by the Newcastle-Ottawa Quality Assessment Scale/cross-section studies to evaluate study quality. The survey will be conducted from June to December 2022. ETHICS AND DISSEMINATION: The identification of the main and most frequent brain alterations found through neuroimaging in patients with vitamin D deficiency can guide professionals as to the identification which of the main cerebral pathologies detected through neuroimaging are related to vitamin D deficiency, in choosing more sensitive and specific neuroimaging tests to detect these brain changes, in addition to emphasising the importance of monitoring and maintaining adequate serum levels of vitamin D, in order to reduce possible cognitive sequelae. Results will be announced at national and international conferences. PROSPERO REGISTRATION NUMBER: CRD42018100074.

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Perceptions of Dating Infidelity Scale in Brazilian Portuguese.

The Perceptions of Dating Infidelity Scale (PDIS) assesses how people perceive infidelity through specific behaviors. Originally developed by Wilson et al. (2011), it contains 12 items distributed into three factors: (1) ambiguous, (2) deceptive, and (3) explicit behaviors. In the present research, translation, cross-cultural adaptation, and validation of the PDIS in Brazilian Portuguese were performed. First, qualitative analyses took place: translation, translation synthesis, content validation, pre-test, and reverse translation. Then, quantitative analyses were conducted: psychometric parameter tests with confirmatory factor analysis and reliability. A total of 252 participants were recruited, 160 of whom were female (63.5%). The results indicated consistent PDIS adequacy (conceptual and idiomatic equivalences); satisfactory content validity coefficients regarding language clarity, practical pertinence, and theoretical relevance; and an almost perfect level of consensus regarding the theoretical dimension. The application of the pre-test was proven to be a good parameter for estimating the comprehension of the instrument in the culture for which it was intended. Confirmatory factor analysis showed good indices of adjustment quality of the tested trifactorial model (three factors being identified with ambiguous, deceptive, and explicit behaviors). Therefore, the structure indicated in the original version was corroborated and the instrument's reliability confirmed. The Brazilian Portuguese PDIS is a useful tool for evaluating infidelity perceptions in the Brazilian culture.

Risk of eating disorders, changes in salivary cortisol concentrations and nutritional status of adolescents.

PURPOSE: The imposition of the thin body as an ideal of beauty and the changes that occur in adolescence lead to a constant concern with adolescents' body weight, putting them at risk for eating disorders. Thus, the study sought to investigate associations between eating disorders and salivary cortisol concentrations, nutritional status and depressive symptoms in female adolescents with bulimia. METHODS: A cross-sectional study was carried out with 1435 adolescents aged 10-19 years. The Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ) questionnaires were used. A follow-up study was conducted from a random selection of female adolescents diagnosed with Bulimia Development and Well-Being Assessment-(DAWBA) to assess associations with salivary cortisol concentrations and nutritional status. RESULTS: The prevalence of body dissatisfaction among adolescents with symptoms of bulimia was 37%. There was a significant difference between salivary cortisol and bulimia (Risk Group = 0.33 ± 0.20 µg/100 ml, Diagnostic Group = 0.44 ± 0.21 µg/100 ml p = 0.040), and correlation positive between the risk of bulimia with symptoms of depression (0.355 p = 0.002) and with Body Mass Index (0.259 p = 0.028). High concentrations of salivary cortisol in bulimic adolescents may be associated with hyperactivity of the hypothalamic-pituitary-adrenal axis and depressive symptoms. CONCLUSIONS: Nutritional status indicators cannot be used alone for the diagnosis of bulimia, since cortisol levels seem to be a reliable parameter in the identification of bulimia, provided they are used with other diagnostic criteria. LEVEL III: Evidence obtained from cross-sectional study.

Clinical validation of the nursing diagnosis risk for suicide in the older adults.

OBJECTIVE: To clinically validate risk factors for the nursing diagnosis risk for suicide in older adults. METHODS: Case-control study (105 older adults). The strength of the association between variables was assessed using odds ratio (OR). Risk factors were grouped into hierarchical blocks according to the Integrated Motivational-Volitional Model of Suicidal Behaviour. RESULTS: Anxiety; guilt; divorce; hostility; inability to express feelings; loss of important relationship; financial problems; apathy; low self-esteem; hopelessness; dependence and functional incapacity; unhappiness; failure; frustration; marked change in attitude and behavior; sadness; self-neglect; stockpiling medication; depression; ideation and suicidal plans; and mental disorders were associated with risk for suicide. CONCLUSIONS: It is expected that this study will contribute to clinical nursing practice by the identification of this diagnosis in a safer and more precise manner. Descriptors: clinical judgment, nursing diagnosis, psychiatric nursing, suicide, older adult.

Validation by experts of Risk of suicide Nursing Diagnosis in the elderly.

OBJECTIVE: to validate the conceptual and operational definitions content of factors for Risk of suicide Nursing Diagnosis in the elderly. METHOD: this is validation of the conceptual and operational definitions content of factors for Risk of suicide in the elderly, performed by 15 experts, from November 2015 to March 2016. Risk factors were classified into three hierarchical chuncks. The data were analyzed by descriptive statistics and binomial test. RESULTS: of the 54 validated risk factors, only eight presented problems regarding clarity, simplicity and accuracy: chronic pain, vision problems, retirement, frustration, medication neglect and depression. Only rigidity was not validated as relevant for the study diagnosis. CONCLUSION: content validation of the risk factors for Nursing Diagnosis can guide the clinical practice of the nurse in the early detection of risk of suicide in the elderly.

Correction to: Contributions of Vitamin D in the management of depressive symptoms and cardiovascular risk factors: study protocol for a randomized, double-blind, placebo-controlled clinical trial.

An error occurred during the publication of the original article [1] which led to the text being incorrectly converted into Portuguese.

Contribuições da vitamina D no tratamento de sintomas depressivos e fatores de risco cardiovascular: protocolo de estudo para um ensaio clínico randomizado, duplo-cego e controlado por placebo.

ABSTRATO: FUNDO: A depressão é uma das principais causas de incapacidade crônica em todo o mundo e um importante fator de risco cardiovascular, aumentando o risco relativo de doença arterial coronariana, bem como as taxas de morbimortalidade cardiovascular. Concomitantemente à alta prevalência de depressão, houve uma redução na exposição à luz solar com o aumento da urbanização e do uso de protetores solares, o que levou a uma redução nos níveis séricos de 25-hidroxivitamina D. Portanto, este artigo descreve uma protocolo para um ensaio clínico com o objetivo de avaliar os efeitos da suplementação de vitamina D na depressão e fatores de risco cardiovascular para contribuir com evidências sobre a influência potencial da suplementação na regulação do humor. MéTODOS: Este estudo de protocolo foi orientado pelos itens de protocolo padrão: recomendações para ensaios intervencionistas. Um ensaio clínico randomizado, controlado por placebo, duplo-cego será realizado envolvendo 224 adultos (faixa etária de 18 a 60 anos) com depressão que estão tomando antidepressivos e não têm histórico de suplementação de vitamina D, comorbidades psiquiátricas, doença renal crônica, hipercalcemia, ou neoplasia. Os participantes serão recrutados nos ambulatórios psiquiátricos de duas universidades do nordeste do Brasil. Os participantes elegíveis que fornecerem consentimento por escrito serão designados aleatoriamente para o grupo de intervenção (n = 112; suplementação de vitamina D 50.000 UI por semana durante 6 meses) ou para o grupo controle (n = 112; placebo tomado semanalmente por 6 meses). Medidas para monitorar sintomas depressivos, exames clínicos e exames laboratoriais para avaliar fatores de risco cardiovascular e níveis séricos de vitamina D serão realizadas antes e após o período de intervenção. DISCUSSãO: Até onde sabemos, este será o primeiro ensaio clínico com o objetivo de testar a eficácia da suplementação de vitamina D na redução do risco cardiovascular e como um adjuvante à terapia da depressão por um período prolongado (6 meses). Os resultados contribuirão para a compreensão dos efeitos terapêuticos da suplementação de vitamina D no tratamento da depressão e podem ajudar a orientar políticas públicas direcionadas à suplementação de vitamina para a redução do risco cardiovascular. REGISTRO DE TESTE: Registro Brasileiro de Ensaios Clínicos, RBR-6yj8sj/ Número Universal de Ensaios (UTN) U1111-1217-9237 . Registrado em 23 de julho de 2018.

Cross-cultural adaptation, reliability, and content validity of the Brief Negative Symptom Scale (BNSS) for use in Brazil

Abstract Background The Brief Negative Symptom Scale (BNSS) assesses the presence and intensity of negative symptoms in schizophrenia. Objectives This study aimed to carry out the BNSS cross-cultural adaptation to the Brazilian Portuguese language and verify its content validity and reliability. Methods This is a methodological study that followed these steps: (1) implementation of the cross-cultural adaptation and translation protocol, (2) BNSS adapted content validation, and (3) reliability assessment. Six experts participated in the adaptation process. The sample consisted of 30 individuals diagnosed with schizophrenia and assisted at the Brazilian Psychosocial Care Center (CAPS), in João Pessoa, Paraíba, Brazil, which was the research setting. Results The cross-cultural adaptation was successful due to the values obtained for each aspect evaluated, such as semantic (0.922), idiomatic (0.910), experiential (0.961), and conceptual equivalence (0.974). The same happened with content validity regarding clarity of language (0.935), practical relevance (0.974), and theoretical relevance (0.948). Cronbach's alpha coefficient was 0.884 for the entire instrument, and the items ranged from 0.865 to 0.882. Discussion The BNSS adaptation process has shown to be satisfactory for use in the Brazilian context, constituting a useful clinical tool for teaching and research.

Behavior of self-inflicted violence in patients with bipolar disorder: A systematic review protocol.

BACKGROUND: Studies aimed at understanding the higher risk profiles for self-inflicted violence in individuals with BD become essential as a possible predictive risk measure for the presence of suicidal behavior, corroborating the expressive reduction of suicide deaths in young people who are in psychic suffering. METHODS: The protocol was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA-P) and the research question was constructed using guidelines from the Population Intervention Comparator Outcome Setting (PICOS) strategy. A third reviewer will be contacted, and two studies will be included in the selection, analysis and inclusion phases of the articles, in case of divergence, a third reviewer will be contacted. (1) methodological design studies of cohorts, case-control and cross-sectional; (2) Diagnosis of Bipolar disorder according to Diagnostic and statistical Manual of mental disorders V; (3) Studies with adult population and (4) Studies that consider at least one type of self-inflicted violence as a variable. The articles considered eligible will be analyzed by New Castle - Ottawa quality assessment scale/cross section studies (NOS) to evaluate the quality of the studies. RESULTS: The identification of the characteristics of self-harm may subsidize professionals who work in the treatment of bipolar disorder with greater attention to these practices and monitoring of possible suicidal behaviors. CONCLUSION: This study may represent one of the initial measures of evaluation on these correlations, which will allow to protocol the guidelines in the field of practice and contribute to improvements in public health indexes.

Differences in cortisol concentrations in adolescents with eating disorders: a systematic review / Diferenças nas concentrações de cortisol em adolescentes com transtornos alimentares: uma análise sistemática

Abstract Objective: To perform a systematic review of the literature for scientific evidence of possible differences in cortisol concentrations in adolescents with eating disorders. Source of data: Electronic searches were conducting in the PubMed, Scientific Electronic Library Online, Virtual Health Library, and Science Direct databases for articles published between 2007 and 2017 using the keywords, cortisol, hydrocortisone; eating disorders, bulimia, bulimia nervosa, anorexia, anorexia nervosa; adolescence, adolescent, adolescents. Synthesis of data: A total of 192 articles were found. After the analysis of the eligibility criteria using the PRISMA method, 19 articles were selected for the present review. Most studies were conducted in Europe. Adolescents diagnosed with anorexia nervosa were evaluated in all studies, except one, when other eating disorders were investigated. Blood was the means used for the determination of cortisol. In ten studies, cortisol levels were higher in the group with anorexia than the control group and a reduction in cortisol levels occurred in the adolescents after being submitted to nutritional recovery. Conclusions: Patients with eating disorders may have several clinical consequences, such as changes in body fat distribution, changes in bone mineral density, worsening of neurocognitive ability, and endocrine changes (e.g., hypercortisolemia), which in turn can lead to hyperglycemia, insulin resistance, hypertension, and increased risk of infections. The findings demonstrate that adolescents with eating disorders, especially anorexia nervosa, have increased cortisol levels, which are reduced after the treatment period. Further studies on differences in cortisol concentrations in adolescents with other eating disorders are needed, using different methods.

Resumo Objetivo: Realizar uma análise sistemática da literatura em busca de evidências científicas de possíveis diferenças nas concentrações de cortisol em adolescentes com transtornos alimentares. Fonte de dados: Pesquisas eletrônicas foram realizadas nas bases de dados do Pubmed, da Scientific Electronic Library Online, da Biblioteca Virtual da Saúde e do Science Direct em busca de artigos publicados entre 2007 e 2017 que utilizaram as palavras-chave: cortisol, hidrocortisona, transtornos alimentares, bulimia, bulimia nervosa, anorexia, anorexia nervosa, adolescência, adolescente e adolescentes. Síntese dos dados: Foram encontrados 192 artigos. Após a análise dos critérios de elegibilidade utilizando o método PRISMA, 19 artigos foram selecionados para esta análise. A maioria dos estudos foi realizada na Europa. Os adolescentes diagnosticados com anorexia nervosa foram avaliados em todos os estudos, com exceção de um, em que outros transtornos alimentares foram investigados. A coleta de sangue foi o meio utilizado para a determinação do cortisol. Em dez estudos, os níveis de cortisol estavam mais elevados no grupo com anorexia do que no grupo de controle e ocorreu uma redução nos níveis de cortisol nos adolescentes após serem submetidos a uma recuperação nutricional. Conclusões: Os pacientes com transtornos alimentares podem apresentar diversas consequências clínicas, como alterações na distribuição de gordura corporal, alterações na densidade mineral óssea, piora da capacidade neurocognitiva e alterações endócrinas, como a hipercortisolemia que, por sua vez, pode levar à hiperglicemia, resistência à insulina, hipertensão e ao aumento do risco de infecções. Os achados demonstraram que os adolescentes com transtornos alimentares, principalmente a anorexia nervosa, apresentaram níveis mais elevados de cortisol, que são reduzidos após o período de tratamento. São necessários estudos adicionais sobre as diferenças nas concentrações de cortisol em adolescentes com outros transtornos alimentares, utilizando meios diferentes.

Differences in cortisol concentrations in adolescents with eating disorders: a systematic review.

OBJECTIVE: To perform a systematic review of the literature for scientific evidence of possible differences in cortisol concentrations in adolescents with eating disorders. SOURCE OF DATA: Electronic searches were conducting in the PubMed, Scientific Electronic Library Online, Virtual Health Library, and Science Direct databases for articles published between 2007 and 2017 using the keywords, cortisol, hydrocortisone; eating disorders, bulimia, bulimia nervosa, anorexia, anorexia nervosa; adolescence, adolescent, adolescents. SYNTHESIS OF DATA: A total of 192 articles were found. After the analysis of the eligibility criteria using the PRISMA method, 19 articles were selected for the present review. Most studies were conducted in Europe. Adolescents diagnosed with anorexia nervosa were evaluated in all studies, except one, when other eating disorders were investigated. Blood was the means used for the determination of cortisol. In ten studies, cortisol levels were higher in the group with anorexia than the control group and a reduction in cortisol levels occurred in the adolescents after being submitted to nutritional recovery. CONCLUSIONS: Patients with eating disorders may have several clinical consequences, such as changes in body fat distribution, changes in bone mineral density, worsening of neurocognitive ability, and endocrine changes (e.g., hypercortisolemia), which in turn can lead to hyperglycemia, insulin resistance, hypertension, and increased risk of infections. The findings demonstrate that adolescents with eating disorders, especially anorexia nervosa, have increased cortisol levels, which are reduced after the treatment period. Further studies on differences in cortisol concentrations in adolescents with other eating disorders are needed, using different methods.

Validation by experts of Risk of suicide Nursing Diagnosis in the elderly / Validación por especialistas del Diagnóstico de Enfermería Riesgo de suicidio en ancianos / Validação por especialistas do Diagnóstico de Enfermagem Risco de suicídio em idosos

ABSTRACT Objective: to validate the conceptual and operational definitions content of factors for Risk of suicide Nursing Diagnosis in the elderly. Method: this is validation of the conceptual and operational definitions content of factors for Risk of suicide in the elderly, performed by 15 experts, from November 2015 to March 2016. Risk factors were classified into three hierarchical chuncks. The data were analyzed by descriptive statistics and binomial test. Results: of the 54 validated risk factors, only eight presented problems regarding clarity, simplicity and accuracy: chronic pain, vision problems, retirement, frustration, medication neglect and depression. Only rigidity was not validated as relevant for the study diagnosis. Conclusion: content validation of the risk factors for Nursing Diagnosis can guide the clinical practice of the nurse in the early detection of risk of suicide in the elderly.

RESUMEN Objetivo: validar el contenido de las definiciones conceptuales y operacionales de los factores del Diagnóstico de Enfermería Riesgo de suicidio en ancianos. Método: estudio de validación de contenido de las definiciones conceptuales y operativas de los factores del diagnóstico de enfermería Riesgo de suicidio en ancianos, por 15 especialistas, en noviembre de 2015 a marzo de 2016. Los factores de riesgo se clasificaron en tres bloques jerárquicos. Los datos fueron analizados por medio de estadística descriptiva y prueba binomial. Resultados: de los 54 factores de riesgo validados, ocho presentaron problemas en la claridad, simplicidad y precisión: dolor crónico, problemas visuales, jubilación, frustración, descuido con la medicación y depresión. Sólo la rigidez no fue validada como relevante para el diagnóstico. Conclusión: la validación de contenido de los factores de riesgo del diagnóstico de enfermería puede orientar la práctica clínica del enfermero en la detección precoz del riesgo de suicidio en ancianos.

RESUMO Objetivo: validar o conteúdo das definições conceituais e operacionais dos fatores do Diagnóstico de Enfermagem Risco de suicídio em idosos. Método: trata-se de validação de conteúdo das definições conceituais e operacionais dos fatores do Diagnóstico de Enfermagem Risco de suicídio em idosos, realizada por 15 especialistas, no período de novembro de 2015 a março de 2016. Os fatores de risco foram classificados em três blocos hierarquizados. Os dados foram analisados por meio de estatística descritiva e teste binomial. Resultados: dos 54 fatores de risco validados, apenas oito apresentaram problemas quanto à clareza, simplicidade e precisão: dor crônica, problemas visuais, aposentadoria, frustração, descuido com a medicação e depressão. Apenas rigidez não foi validada como relevante para o diagnóstico em estudo. Conclusão: a validação de conteúdo dos fatores de risco do Diagnóstico de Enfermagem pode nortear a prática clínica do enfermeiro na detecção precoce do risco de suicídio em idosos.

Assessment tools for the measurement of the self-efficacy of drug users: protocol for a systematic review.

INTRODUCTION: The abuse of alcohol and other drugs is a worldwide problem, the treatment of which poses a challenge to healthcare workers. OBJECTIVE: This study presents a proposal for a systematic review to analyse the psychometric properties of assessment tools developed to measure the self-efficacy of drug users with regard to resisting the urge to take drugs in high-risk situations. METHODS AND ANALYSIS: The guiding question was based on PICOS (Population Intervention Comparator Outcome Setting), and the report of the methods of review protocol was written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Searches will be performed in the PsycINFO, Cochrane, Pubmed, Web of Science, SCOPUS and CINAHL databases, followed by the use of the 'snowball' strategy. The inclusion criteria for the articles will be (1) assessment tool validation studies; (2) assessment tools developed to measure self-efficacy; (3) quantitative measures; (4) measures designed for use on adults; (5) data from self-reports of the participants; (6) studies involving a description of psychometric properties of the measures; and (7) studies that explain how the level of self-efficacy is scored. The search, selection and analysis will be performed by two independent reviewers. In cases of a divergence of opinion, a third reviewer will be consulted. The COSMIN checklist will be used for the appraisal of the methodological quality of the assessment tools and the certainty of the evidence in the articles (risk of bias) will be analysed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. ETHICS AND DISSEMINATION: This protocol does not require ethical approval. However, this protocol is part of the thesis entitled Drug-Taking Confidence Questionnaire for use in Brazil, presented for obtaining a doctorate in neuropsychiatry and behavioural sciences from the Federal University of Pernambuco, and has received approval from the human research ethics committee of the Federal University of Pernambuco (reference number: 1.179.162).The results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences. PROSPERO REGISTRATION NUMBER: CRD42017068555.

Depressive symptoms in postpartum women at Family Health Units / Sintomas depressivos em puérperas atendidas em Unidades de Saúde da Família

Abstract Objectives: to identify postpartum depression among women assisted by Family Health Units (FHU). Methods: this is a cross-sectional study with a quantitative approach carried out in FHUs at the city of Vitoria de Santo Antão - PE. Fifty eight mothers constituted the sample. We used the Portuguese version of the Postpartum Depression Screening Scale - PDSS for screening. We collected data from February to April 2011. Results: we were able to demonstrate that 8.6% of participants had scores above the PDSS cut-off point. We also found an association between postpartum depression and incomplete primary education. Conclusions: although the percentage of women with postpartum depression scores is lower than values found in other national studies, the early identification of these mothers in FHU is imperative, given the harmful repercussions that depression can cause in women, as well as in physical and psychic development of the baby.

Resumo Objetivos: identificar a depressão pós-parto (DPP) entre mulheres atendidas em Unidades de Saúde da Família (USF). Métodos: trata-se de um estudo transversal, com abordagem quantitativa realizado em USF do município da Vitória de Santo Antão - PE. A amostra foi composta por 58 puérperas. O instrumento utilizado para rastreamento foi a versão em português da Postpartum Depression Screening Scale - PDSS. Os dados foram coletados no período de fevereiro a abril de 2011. Resultados: evidenciou-se que 8,6% das participantes apresentaram pontuação acima do ponto de corte da PDSS. Os quadros sugestivos de DPP apresentaram associação estatística com o ensino fundamental incompleto. Conclusões: embora o percentual de mulheres com escores sugestivos de DPP esteja abaixo do quantitativo encontrado em outros estudos nacionais, é premente que essas mães sejam identificadas precocemente nas USFs, tendo em vista as repercussões que a depressão pode acarretar para a mulher e para o desenvolvimento físico e psíquico do bebê.

Relação entre comportamento suicida e transtornos alimentares: uma revisão sistematizada / Relación entre comportamiento suicida y trastornos alimentarios: una revisiónsistematizada / Relationship between suicidal behavior and eating disorders: a systematic review

Objective: this paper offers a systematic review of the literature on eating disorders and the relationship with suicidal behavior. Methods: Searches were performed in the Medline, Lilacs, Adolec and Pubmed databases for articles published between 2003 and 2014. Results: Anorexia nervosa was the most often cited eating disorder in the articles selected. In cases of bulimia nervosa, suicide attempts and self-aggression were more frequent among those who use multiple compensation behaviors. Behavior disorders, emotional disorders and chemical dependency were described as risk factors in all publications. Conclusion: Despite the small number of studies performing an in-depth investigation into the relationship between eating disorder and suicidal behavior, the concomitant presence of these conditions places the health of patients at greater risk.

Objetivo: realizar uma revisão sistematizada da literatura acerca dos transtornos alimentares e sua relação com o comportamento suicida, analisando o conteúdo das publicações. Métodos: Foi Realizada uma busca sistematizada em bases de dados eletrônicas (Medline, Lilacs, Adolec e Pubmed), com foco em artigos publicados entre 2003 e 2014. Resultados: Dentre os estudos selecionados, a anorexia nervosa foi o distúrbio alimentar mais referido pelas publicações. No caso da bulimia nervosa, as taxas de tentativas de suicídio e/ou comportamentos auto agressivos são maiores entre indivíduos que utilizam uma compensação múltipla de comportamentos purgativos. Sobre os fatores de risco associados, evidenciou-se que os transtornos de comportamento, os transtornos emocionais e a dependência química apresentam-se descritos em todas as publicações. Conclusão: Ainda são escassos os trabalhos que investigam profundamente a relação entre transtornos alimentares e o comportamento suicida, porém é possível verificar que a presença concomitante pode comprometer ainda mais a saúde do paciente.

Objetivo: realizar una revisión sistematizada de la literatura sobre trastornos alimentarios y su relación con comportamiento suicida mediante el análisis del contenido de las publicaciones virtuales. Método: Realizar una búsqueda en bases de datos electrónicas (Medline, Liacs, Adolec y Pubmed), de artículos publicados del año 2003 al 2014. Resultados: En todos los estudios la anorexia nerviosa fue el disturbio alimentario más presente. Respecto de la bulimia nerviosa, las tasas de tentativas de suicidio y/o comportamientos autoagresivos son más elevadas entre individuos que recurren a varias formas de compensación mediante múltiples tipos de actitudes purgativas. Acerca de factores de riesgo asociados, los trastornos comportamentales, los emocionales y la dependencia química aparecen en todas las publicaciones. Conclusión: Todavía son escasos los trabajos que investigan en profundidad la relación entretrastornos alimentarios y comportamiento suicida. Se puede detectar empero que la presencia concomitante de ambas situaciones puede comprometer aun más la salud del paciente.

Identificação de aspectos associados à tentativa de suicídio por envenenamento / Identification ofaspects associated with attempted suicide by poisoning

RESUMO Objetivo Identificar as condições psiquiátricas e aspectos sociobiodemográficos associados à tentativa de suicídio. Métodos A amostra foi constituída por 240 pacientes de ambos os sexos, com idade entre 18 a 68 anos, dos quais 120 pacientes compuseram o grupo controle e 120 o grupo experimental. Os instrumentos utilizados foram um questionário sociobiodemográfico e o Mini International Neuropsychiatric Interview (MINI). Resultados Observou-se maior presença de estressores no grupo experimental, sendo os principais a vivência de uma separação afetiva e a existência de conflitos familiares, e a condição psiquiátrica mais frequente na população estudada foi o transtorno de ansiedade generalizada e a mais associada ao comportamento suicida foi a depressão maior. Conclusões Os resultados acrescentam a importância de investigar a presença do transtorno de ansiedade generalizada como mais um fator de vulnerabilidade ao suicídio.

ABSTRACT Objective To identify psychiatric conditions and socio-bio-demographic aspects associated with attempted suicide. Methods The sample consisted of 240 patients of both sexes, aged 18 to 68 years, 120 patients comprised the control group and the experimental group 120. The instruments used were a socio-bio-demographic questionnaire and the Mini International Neuropsychiatric Interview (MINI). Results A higher presence of stressors in the experimental group, the main ones being the experience of an emotional separation and the existence of family conflicts, the most common psychiatric condition in the population studied was generalized anxiety disorder and more associated with suicidal behavior it was major depression. Conclusions These results add the importance of investigating the presence of generalized anxiety disorder as another suicide vulnerability factor.

Suicide in childhood: a literatura review. / Revisão de literatura sobre suicídio na infância.

This is an integrated review of specific literature on the main factors associated to suicidal behavior in children under 14 years. Data were retrieved from PubMed and PsycInfo databases for the 1980-2016 period, with the following descriptors: "risk of suicide"; "children"; "suicide"; "childhood". Twenty-nine papers complied with the eligibility criteria of the review and were thus selected and analyzed. Results pointed to an association of suicide with neurobiological, school-related, social and mental factors, among which the role of impulsivity stands out. In addition, results found show that most of suicidal behavior-vulnerable factors are preventable insofar as they are identified and the child receives psychological and medical treatment. We conclude that family conflicts, school-related problems, bullying, impulsivity and depression are associated with childhood suicide. In addition, the scarce national research on suicide can contribute to the invisibility of this theme when establishing health promotion and treatment programs.

Revisão de literatura sobre suicídio na infância / Suicide in childhood: a literatura review

Resumo Objetivou-se analisar a literatura específica sobre os fatores associados ao comportamento suicida em crianças com até 14 anos. Trata-se, portanto, de uma revisão integrativa sobre este tema. Os dados foram coletados nas bases de dados PubMed e Psycinfo, a partir dos seguintes descritores: "risk of suicide"; "children"; "suicide"; "childhood". O tempo de publicação foi limitado ao período de 1980 a 2016. Um total de 29 artigos preencheu os critérios de elegibilidade e, portanto, foram selecionados e analisados. Os resultados indicaram haver associação do suicídio com fatores neurobiológicos, escolares, sociais e mentais, dentre eles destaca-se o papel da impulsividade. Além disso, evidenciou-se que a maioria dos fatores de vulnerabilidade ao comportamento suicida podem ser prevenidos desde que sejam identificados e a criança receba tratamento psicológico e médico. Conclui-se que conflitos familiares, problemas na escola, bullying, impulsividade e depressão estão associados ao suicídio na infância. Adicionalmente, a escassez de pesquisas no âmbito nacional acerca da temática do suicídio pode contribuir para a invisibilidade desse tema na instauração de programas de promoção e tratamento de saúde.

Abstract This is an integrated review of specific literature on the main factors associated to suicidal behavior in children under 14 years. Data were retrieved from PubMed and PsycInfo databases for the 1980-2016 period, with the following descriptors: "risk of suicide"; "children"; "suicide"; "childhood". Twenty-nine papers complied with the eligibility criteria of the review and were thus selected and analyzed. Results pointed to an association of suicide with neurobiological, school-related, social and mental factors, among which the role of impulsivity stands out. In addition, results found show that most of suicidal behavior-vulnerable factors are preventable insofar as they are identified and the child receives psychological and medical treatment. We conclude that family conflicts, school-related problems, bullying, impulsivity and depression are associated with childhood suicide. In addition, the scarce national research on suicide can contribute to the invisibility of this theme when establishing health promotion and treatment programs.

Special features of high-risk pregnancies as factors in development of mental distress: a review.

INTRODUCTION:: Approximately 22% of all pregnant women are classified as having high-risk pregnancies, which may involve feelings of vulnerability because of having a high-risk pregnancy, resulting in greater exposure to stressful feelings. OBJECTIVE:: To review aspects of high-risk pregnancy that can have a negative impact on the these women's mental health status. METHOD:: Original articles were identified by conducting searches of the PubMed/MEDLINE, LILACS and SciELO databases, followed by a manual search of references to select articles and additional bibliographic material. Articles from the last 22 years were included in the review (1992-2014). RESULTS:: Fifteen articles were found that specifically studied high-risk pregnancies and mental health outcomes. Women with high-risk pregnancies exhibited a significantly higher level of stress and reported negative emotions as they dealt with stress and had worse emotional status than women with normal pregnancies. Researchers found that hospitalized pregnant women had higher levels of anxiety than non-hospitalized women. Studies of women going through normal and high-risk pregnancies show that women with normal pregnancies had good self-perceived quality of life. CONCLUSION:: Special features of high-risk pregnancies could be factors in development of mental distress, in addition to psychological and social factors. Therefore, only a biopsychosocial research study would be able to identify the factors that can affect the quality of mental health during high-risk pregnancy.

Special features of high-risk pregnancies as factors in development of mental distress: a review / Particularidades da gravidez de alto risco como fatores para o desenvolvimento de sofrimento mental

Abstract Introduction: Approximately 22% of all pregnant women are classified as having high-risk pregnancies, which may involve feelings of vulnerability because of having a high-risk pregnancy, resulting in greater exposure to stressful feelings. Objective: To review aspects of high-risk pregnancy that can have a negative impact on the these women's mental health status. Method: Original articles were identified by conducting searches of the PubMed/MEDLINE, LILACS and SciELO databases, followed by a manual search of references to select articles and additional bibliographic material. Articles from the last 22 years were included in the review (1992-2014). Results: Fifteen articles were found that specifically studied high-risk pregnancies and mental health outcomes. Women with high-risk pregnancies exhibited a significantly higher level of stress and reported negative emotions as they dealt with stress and had worse emotional status than women with normal pregnancies. Researchers found that hospitalized pregnant women had higher levels of anxiety than non-hospitalized women. Studies of women going through normal and high-risk pregnancies show that women with normal pregnancies had good self-perceived quality of life. Conclusion: Special features of high-risk pregnancies could be factors in development of mental distress, in addition to psychological and social factors. Therefore, only a biopsychosocial research study would be able to identify the factors that can affect the quality of mental health during high-risk pregnancy.

Resumo Introdução: Aproximadamente 22% de todas as mulheres grávidas são classificadas como tendo gravidezes de alto risco, podendo experimentar vulnerabilidade por esta situação. Desta forma, estão mais expostas a sentimentos de estresse. Objetivo: Revisar aspectos da gravidez de alto risco que podem ter um impacto negativo sobre o estado de saúde mental dessas mulheres. Métodos: Artigos originais foram localizados por meio de uma busca eletrônica nas bases de dados PubMed/MEDLINE, LILACS e SciELO, bem como uma busca manual de referências para selecionar artigos e material bibliográfico adicional. Foram selecionados artigos publicados nos últimos 22 anos (1992-2014). Resultados: Foram encontrados 15 artigos que estudavam especificamente gravidez de alto risco e o desfecho saúde mental. Mulheres grávidas de alto risco demonstraram um nível significativamente mais elevado de estresse e relataram emoções negativas ao lidar com o estresse; elas também apresentavam pior estado emocional quando comparadas a mulheres com gravidez normal. Os pesquisadores observaram que as mulheres grávidas internadas tinham níveis mais elevados de ansiedade do que mulheres não hospitalizadas. Outros estudos envolvendo mulheres com gestações normais e de alto risco mostram que as mulheres com uma gravidez normal têm uma boa percepção de sua qualidade de vida. Conclusões: As particularidades das gestações de alto risco, além de fatores psicológicos e sociais, podem ser fatores no desenvolvimento de transtornos mentais. Portanto, somente um estudo biopsicossocial seria capaz de identificar os fatores que podem afetar a qualidade da saúde mental durante a gravidez de alto risco.