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1.
Depress Anxiety ; 36(6): 533-542, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30990937

RESUMO

BACKGROUND: Recent findings suggest an association between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Thus, we evaluated the clinical associated features of ADHD in a large sample of adult OCD patients. METHODS: A cross-sectional study including 955 adult patients with OCD from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinical characteristics in adult OCD patients with and without comorbid ADHD were compared using Fisher's exact test, t-tests or Mann-Whitney tests. Bivariate analyses were followed by logistic regression analysis to identify clinical characteristics independently associated with ADHD comorbidity. RESULTS: The lifetime prevalence of ADHD in adult OCD patients was 13.7%. The current results indicate that OCD + ADHD patients were more severe, had an earlier onset of the obsessive-compulsive symptoms, a higher history of rheumatic fever, with higher frequencies of sensory phenomena and comorbidity with Tourette syndrome. They also had an increased risk for academic impairment and suicide attempts. CONCLUSION: Adult OCD patients with ADHD present some specific clinical features and may represent a special subgroup of adult OCD. Future studies should focus on the development of interventions more tailored to the phenotype of this subgroup of patients.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Sucesso Acadêmico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Comorbidade , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Prevalência , Tentativa de Suicídio/estatística & dados numéricos , Síndrome de Tourette/epidemiologia , Adulto Jovem
2.
Rev. bras. educ. méd ; 43(1,supl.1): 424-430, 2019. tab
Artigo em Português | LILACS-Express | ID: biblio-1057591

RESUMO

RESUMO Introdução Considerando a prevalência dos transtornos mentais, é essencial que qualquer médico seja capaz de prestar assistência qualificada e humanizada a pessoas em sofrimento psíquico. No entanto, o usual estigma e a falta de conhecimento no manejo das doenças mentais por parte dos médicos podem representar uma barreira de acesso e ineficiência importante enfrentada pelos pacientes no sistema de saúde. Objetivo Estimar o ganho de aprendizado percebido e a redução de estigma em relação a pessoas portadoras de esquizofrenia por estudantes de Medicina após a exposição ao estágio obrigatório no internato numa escola médica pública no Distrito Federal. Método Estudo quasi-experimental para avaliação de impacto de programa educacional durante o internato médico em saúde mental. A amostra consistiu em 35 estudantes do último ano do curso de Medicina. Foram aplicados questionários para aferição do grau e tipificação do estigma em relação à esquizofrenia e à autopercepção sobre manejo de medicamentos e sobre tratamento de doenças psiquiátricas. Os instrumentos utilizaram uma escala do tipo Likert de três pontos para aferição dos resultados. Os questionários foram aplicados imediatamente antes e após a exposição ao programa educacional, que teve duração de quatro semanas. Os valores médios de autopercepção e estigma foram comparados entre os dois momentos empregando-se o teste t de Student emparelhado. Resultados Não houve mudança significativa do grau de estigmatização nas dimensões avaliadas (estereótipo total, p = .230; preconceito percebido, p = .172; distância social, p = .209; direitos civis, p = .837). Quanto à autopercepção de conhecimento, os valores médios do número de resposta igual a 3 e a soma no momento pós- são significativamente maiores que no momento pré- (p = .007 e p < .0001, respectivamente). Os ganhos não se mostraram associados significativamente com as variáveis demográficas. Conclusão A despeito do ganho em conhecimento, a imersão em saúde mental no internato do curso de Medicina ao longo de quatro semanas não se mostrou eficaz para mudança no estigma. É possível que a curta duração da intervenção implique contato insuficiente com o portador de doença mental para redução do estigma. Sugerimos a realização de novos trabalhos com ampliação da amostra e com desenhos experimentais.


ABSTRACT Introduction Considering the high prevalence of mental illnesses, it is essential for any physician to offer proper treatment and attention to people with these disorders. Nevertheless, the usual stigma and lack of knowledge regarding the management of mental disorders on the part of physicians can represent a significant barrier to treatment and inefficiency faced by patients in the health care system. Objective This study aimed to measure the gain of psychiatric knowledge and the reduction in the stigmatization of people with schizophrenia by medical students after exposure to the compulsory internship program at a public medical school in the Federal District. Methods Quasi-experimental study to evaluate the impact of the training program during medical internship in the final year of undergraduate medical training. The sample was 35 final-year medical students. Questionnaires were applied to measure the degree and type of stigma in relation to schizophrenia and self-perception regarding the drug management and treatment of psychiatric diseases. A three-point Likert scale was used to measure the results. The questionnaires were applied immediately before and after exposure to the four-week training program. The medical values of self-perception and stigma were compared between two moments using the Student's t test. Results: There was no statistically significant difference found between stigmatization before and after the intervention (total stereotype, p = 0.230; perceived prejudice, p = 0.172; social distance, p = 0.209; civil rights, p = 0.837). Regarding self-perception of knowledge, the number of items reaching total confidence and the mean values after the training were significantly improved (p = 0.007 and p < 0.0001, respectively). There was no correlation with sociodemographic characteristics. Conclusion Despite the knowledge gain, medical students failed to show any improvement in the degree of stigma held after immersion in a 4-week practical psychiatric training program. The short duration of the intervention might have meant that the students' contact with patients was insufficient to reduce stigma. More studies are needed with larger groups and experimental designs.

3.
J Contin Educ Health Prof ; 38(2): 126-136, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29851717

RESUMO

INTRODUCTION: Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. METHODS: The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. RESULTS: We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. IMPLICATIONS FOR PRACTICE: These results will be helpful for planning and improving the quality of future educational programs in mental health.


Assuntos
Saúde Mental/educação , Desenvolvimento de Programas/métodos , Currículo/tendências , Método Duplo-Cego , Humanos
4.
J Interprof Care ; 31(5): 664-666, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28686508

RESUMO

There is a considerable gap between the offer and the demand for mental health treatment of children and adolescents, especially in low- and middle-income countries (LMICs). Permanent education in these countries is a promising and needed strategy to reduce this gap. This study was designed to evaluate the perceived impact of an educational intervention for child and adolescent mental health professionals in Brazil, the Child and Adolescent Mental Health Specialization Course (CESMIA). The intervention consisted of a 360-hour interprofessional postgraduation course. The CESMIA offered lectures and small-group case discussions for exchanging their experiences in dealing with the patients. The students were placed in these groups according to their professions in order to ensure a proportional distribution of healthcare professionals in each group. The evaluation employed a quasi-experimental design by the use of a knowledge, attitude, and practice (KAP) survey. The 39 participants reported significant improvement in all KAP dimensions. More specifically, the data indicated a 17% improvement for attitudes, a 9.4% increase for knowledge, and a 14% improvement for the practice dimensions. The CESMIA appeared to improve the level of knowledge of participants and their attitudes and actions towards patients, which reinforces the relevance of similar courses.


Assuntos
Serviços de Saúde do Adolescente/organização & administração , Serviços de Saúde da Criança/organização & administração , Pessoal de Saúde/educação , Relações Interprofissionais , Serviços de Saúde Mental/organização & administração , Adolescente , Adulto , Fatores Etários , Atitude do Pessoal de Saúde , Brasil , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino
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