Psychosis Associated With Methimazoleinduced Hypothyroidism: A Case Report [psicose Associada Com Hipotireoidismo Induzido Por Metimazol: Um Relato De Caso]

Introduction: Thyroid dysfunction has often been associated with several psychiatric manifestations. Previous case reports/series suggest the possible role played by acute alteration of thyroid status in the onset of psychotic symptoms. Methods: Case report and literature review. Results: A 45-year-old woman with no psychiatric antecedents was brought to the ER with a full-blown psychotic episode, marked by paranoid delusions, which developed gradually over two months. She had been treated elsewhere for hyperthyroidism for five years with methimazole 40 mg/d, with poor compliance. One month before the beginning of the psychotic symptoms, methimazole was raised to 60 mg/d and she started taking it correctly. Five months earlier she had TSH: 0.074 uUI/ml and free T4: 1.3 ng/dl. At admission we found a diffuse thyroid goiter, TSH: 70.9 uUI/ml and free T4: 0.03 ng/dl. Brain CT was normal. We hospitalized her with the diagnosis of a psychosis secondary to hypothyroidism, suspended methimazole, and gave her levothyroxine (up to 75 μg/d) and risperidone (2 mg/d). The patient had a quick remission and was discharged after 15 days. Within one month she had TSH: 0.7 uUI/ml and was completely recovered psychiatrically. She has been well since then, with risperidone in the first 8 months, and without it for 10 months now. Conclusion: This case report is a reminder of the necessity of checking thyroid status as part of clinical assessment of psychoses. It also supports the hypothesis that antithyroid drugs may have severe psychiatric consequences, especially when they lead to an acute change of thyroid status.622171173Hall, R.C.W., Psychiatric effects of thyroid hormone disturbance (1983) Psychosomatics., 24 (1), pp. 7-18Nemeroff, C., Neigh, G.N., Neuroendocrinology (2009) New Oxford Textbook of Psychiatry, pp. 160-167. , In: Gelder MG, Andreasen NC, López-Ibor Jr JJ, Geddes JR, editors. 2nd ed. Oxford: Oxford University PressRathi, M.S., Recurrent thyrotoxic psychosis associated with fluctuation in thyroid status: A case report (2009) Endocrinologist., 19 (6), pp. 258-259Brewer, C., Psychosis due to acute hypothyroidism during the administration of carbimazole (1969) Br J Psychiatry., 115, pp. 1181-1183Herridge, C.F., Abey-Wickrama, I., Acute iatrogenic hypothyroid psychosis (1969) BMJ., 3, p. 154Irwin, R., Ellis, P.M., Delahunt, J., Psychosis following acute alteration of thyroid status (1997) Aust N Z J Psychiatry., 31 (5), pp. 762-764Bewsher, P.D., Gardiner, A.Q., Hedley, A.J., McLean, H.C.S., Psychosis after acute alteration of thyroid status (1971) Psychol Med., 1 (3), pp. 260-262Benvenga, S., Lapa, D., Trimarchi, F., Don't forget the thyroid in the etiology of psychoses (2003) Am J Med., 115 (2), pp. 159-160Brownlie, B.E.W., Rae, A.M., Walshe, J.W.B., Wells, J.E., Psychoses associated with thyrotoxicosis-"thyrotoxic psychosis". A report of 18 cases, with statistical analysis of incidence (2000) Eur J Endocrinol., 142, pp. 438-44

Brazilian University Students: Predictors Of Seeking Mental Health Care For A Second Time [estudantes Universitários Brasileiros: Preditores De Uma Segunda Busca Por Atendimento Em Saúde Mental]

[No abstract available]1293181182Oliveira, M.L., Dantas, C.R., Azevedo, R.C., Banzato, C.E., Demographics and complaints of uni-versity students who sought help at a campus mental health service between 1987 and 2004 (2008) Sao Paulo Med J, 126 (1), pp. 58-6

Multiaxial Diagnosis In Psychiatry: Review Of The Literature On Dsm And Icd Multiaxial Schemas [diagnóstico Multiaxial Em Psiquiatria: Revisão Da Literatura Sobre Os Esquemas Multiaxiais Dsm E Cid]

Multiaxial diagnosis schemas in psychiatry were first devised, half a century ago, as alternatives to avoid the inconsistencies of psychiatric classification caused by the lack of discrimination between descriptive and etiological terms. Three decades after the initial proposals appeared, multiaxial diagnosis emerged as major topic in diagnostic formulation in psychiatry. The third edition of the Diagnostic and Statistical Manual of Mental Diseases (DSM-III, 1980) was the first official classification to adopt a multiaxial format and its successors, the third edition revised and the fourth edition (DSM-III-R and DSM-IV), stick to such a system. Another multiaxial schema, but this one truly international both in origin and scope, was recently developed within the framework of the International and Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10). This study aimed at identifying and discussing the conceptual and empirical issues on multiaxial diagnosis in psychiatric literature, with particular emphasis on the empirical validation of the schemas currently used (DSM-IV and ICD-10).5312737Alarcon, R.D., Culture and psychiatric diagnosis: Impact on DSM-IV and ICD-10 (1995) The Psychiatric Clinics ot North America, 18 (3), pp. 449-465Angst, J., European long-term follow-up studies of schizophrenia (1988) Schizophrenia Bulletin, 14 (8), pp. 501-513Bassett, A.S., Beiser, M., DSM-III: Use of the multiaxial diagnostic system in clinical practice (1991) Canadian Journal ot Psychiatry, 36, pp. 270-274Bech, P., Hjortso, A., Lund, K., Vimar, T., Kastrup, M., An integration of the DSM-III and ICD-8 by global severity assessments for measuring multidimensional outcomes in general hospital psychiatry (1987) Acta Psychiatrica Scandinavica, 75, pp. 297-306Berganza, C.E., Mezzich, J.E., Otero-Ojeda, A.A., Jorge, M.R., Villaseñor- Bayardo, S.J., Rosas-Malpica, C., The Latin-American guide tor psychiatric diagnosis (2001) The Psychiatric Clinics of North America, 24 (3), pp. 433-446Berner, P., Gabriel, E., Kieffer, W., Schanda, H., Paranoid psychoses: New aspects of classification and prognosis coming from the Vienna Research Group (1986) Psychopathology, 19, pp. 16-29Cleghorn, J.M., Formulation: A pedagogic antidote to DSM-III (1985) Comprehensive Psychiatry, 26 (6), pp. 504-512D'Ercole, A., Skodol, A.E., Struening, E., Curtis, J., Millman, J., Diagnosis of physical illness in psychiatric patients using axis III and a standardized medical history (1991) Hospital and Community Psychiatry, 42, pp. 395-400Essen-Möeller E, Wohlfahrt S. Suggestions for the amendment of the official Swedish classification of mental disorders. Acta Psychiatrica Scandinavica 1947Supple 47: 551 -5Essen-Möeller, E., On classification of mental disorders (1961) Acta Psychiatrica Scandinavica, 37, pp. 119-126Essen-Möeller, E., Suggestions for further improvement of the international classification of mental disorders (1971) Psychological Medicine, 1, pp. 308-311Fabrega, H., Ahn, C., Mezzich, J.E., Can multiaxial diagnosis predict future use of psychiatric hospitalization? (1991) Hospital and Community Psychiatry, 42 (9), pp. 920-924Feinstein, A.I., POR, and DRG: Unsolved scientific problems in the nosology of clinical medicine (1988) Archives of Internal Medicine, 148, pp. 2269-2274Fernando, T., Mellsop, G., Nelson, K., Peace, K., Wilson, J., The reliability of axis V of DSM-III (1986) American Journal of Psychiatry, 143 (6), pp. 752-755Goldman, H.H., Skodol, A.E., Lave, T.R., Revising axis V for DSM-IV: A review of measures of social functioning (1992) American Journal of Psychiatry, 149, pp. 1148-1156Goor-Lambo, G., The reliability of axis V of the multiaxial classification scheme (1987) Journal of Clinical Psychology and Psychiatry, 28 (4), pp. 597-612Goor-Lambo, G., Orley, J., Poustka, F., Rutter, M., Classification of abnormal psychosocial situations: Preliminary report of a revision of a WHO Scheme (1990) Journal of Child Psychology and Psychiatry, 31 (2), pp. 229-241Gordon, R.E., Eisler, R.L., Gutman, E.M., Gordon, K.K., Predicting prognosis by means of the DSM-III multiaxial diagnosis (1991) Canadian Journal of Psychiatry, 36, pp. 218-221Helmchen, H., Multiaxial systems of classification (1980) Acta Psychiatrica Scandinavica, 61, pp. 33-55Helmchen, H., Multiaxial classification in psychiatry (1983) Comprehensive Psychiatry, 24 (1), pp. 20-24Jampala, V.C., Sierles, F.S., Taylor, M.A., Consumers' views of DSM-III: Attitudes and practices of U.S. psychiatrists and 1984 graduating psychiatric residents (1986) American Journal of Psychiatry, 143 (2), pp. 148-153Janca, A., Kastrup, M., Katschnig, H., López-Ibor, J.J., Mezzich, J.E., Sartorius, N., The ICD-10 multiaxial system for use in adult psychiatry: Structure and applications (1996) The Journal of Nervous and Mental Diseases, 184 (3), pp. 191-192Janca, A., Kastrup, M., Katschnig, H., López-Ibor, J.J., Mezzich, J.E., Sartorius, N., Contextual aspects of mental disorders: A proposal for axis III of the ICD-10 multiaxial system (1996) Acta Psychiatrica Scandinavica, 94, pp. 31-36Karasu, T.B., Skodol, A.E., Vlth axis for DSM-III psychodynamic evaluation (1980) American Journal of Psychiatry, 137 (5), pp. 607-610Kastrup, M., Mezzich, J.E., Quality of life: A dimension in multiaxial classification (2001) European Archives of Psychiatry and Clinical Neuroscience, 251 (SUPPL. 2). , II-32-II/37Kastrup, M., Experience with current multiaxial diagnostic systems: A critical review (2002) Psychopathology, 35, pp. 122-126Katschnig, H., Simhandl, C., New developments in the classification and diagnosis of functional disorders (1986) Psychopathology, 19, pp. 219-235Knorring, L., Perris, C., Jacobson, L., A multi-aspect classification of mental disorders (1978) Acta Psychiatrica Scandinavica, 58, pp. 401-412Leigh, H., Price, L., Ciarcia, J., Mirassou, M.M., DSM-III and consultation-liaison psychiatry: Toward a comprehensive medical model of the patient (1982) General Hospital Psychiatry, 4, pp. 283-289Lobo, A., On multiaxial psychiatric diagnosis for general medical patients (1989) British Journal of Psychiatry, 154 (SUPPL. 4), pp. 38-41Lobo, A., Campos, R., Echevererria, M.J.P., Izuzquiza, J., Campayo, J.G., Saz, P., Marcos, G., A new interview for the multiaxial assessment of psychiatric morbidity in medical settings (1993) Psychological Medicine, 23, pp. 505-510Lolas, F., Communication of emotional meaning, alexithimia, and somatoform disorders: A proposal for a diagnostic axis (1989) Psychotherapy and Psychosomatics, 52, pp. 214-219Loranger, A.W., The impact of DSM-III on diagnostic practice in a university hospital (1990) Archives of General Psychiatry, 47, pp. 672-675Malt, U., Five years of experience with the DSM-III system in clinical work and research: Some concluding remarks (1986) Acta Psychiatrica Scandinavica, 328 (SUPPL.), pp. 76-84Maricle, R., Leung, P., Bloom, J.D., The use of DSM-III axis III in recording physical illness in psychiatric patients (1987) American Journal of Psychiatry, 144 (11), pp. 1484-1486Maser, J.D., Kaelber, C., Weise, R.E., International use and attitudes toward DSM-III and DSM-III-R: Growing consensus in psychiatric classification (1991) Journal of Abnormal Psychology, 100 (3), pp. 271-279Mazure, C.M., Kincare, P., Schaffer, C.E., DSM-III-R axis IV: Clinician reliability and comparability to patients' reports of stressor severity (1995) Psychiatry, 58, pp. 56-64McKegney, F.P., McMahon, T., King, J., The use of DSM-III in a general hospital consultation-liaison service (1983) General Hospital Psychiatry, 5, pp. 115-121Mellsop, G., Varghese, F., Joshua, S., Hicks, A., The reliability of axis II of DSM-III (1982) American Journal of Psychiatry, 139, pp. 1360-1361Mezzich, J.E., Patterns and issues in multiaxial psychiatric diagnosis (1979) Psychological Medicine, 9, pp. 125-137Mezzich, J.E., Evanczuk, K.J., Mathias, R.J., Coffman, G.A., Admission decisions and multiaxial diagnosis (1984) Archives of General Psychiatry, 41, pp. 1001-1004Mezzich, J.E., Fabrega, H., Mezzich, A.C., Coffman, G.A., International experience with DSM-III (1985) The Journal of Nervous and Mental Disease, 173 (12), pp. 738-741Mezzich, J.E., Fabrega, H., Coffman, G.A., Multiaxial characterization of depressive patients (1987) The Journal of Nervous and Mental Disease, 175 (6), pp. 339-346Mezzich, J.E., On developing a psychiatric multiaxial schema for ICD-10 (1988) British Journal of Psychiatry, 152 (SUPPL.), pp. 38-43Mezzich, J.E., Architecture of clinical information and prediction of service utilization and cost (1991) Schizophrenia Bulletin, 17 (3), pp. 469-474Mezzich, J.E., Schmolke, M.M., Multiaxial diagnosis and psychotherapy planning: On the relevance of ICD-10, DSM-IV and complementary schemas (1995) Psychotherapy and Psychosomatics, 63, pp. 71-80Mezzich, J.E., Cultural formulation and comprehensive diagnosis (1995) The Psychiatric Clinics of North America, 18 (3), pp. 649-657Mezzich, J.E., Good, B.J., On culturally enhancing the DSM-IV multiaxial formulation (1997) DSM-IV Sourcebook, 3, pp. 983-989. , Washington, DC: American Psychiatric Press;Mezzich, J.E., Janca, A., Kastrup, M.C., Multiaxial diagnosis in psychiatry (2002) Psychiatric diagnosis and classification, pp. 163-176. , Maj M, Gaebel W, López-Ibor JJ, Sartorius N, editors, West Sussex: Wiley;Mezzich, J.E., International surveys on the use of ICD-10 and related diagnostic systems (2002) Psychopathology, 35, pp. 72-75Michels, R., Siebel, U., Freyberger, H.J., Stieglitz, R.D., Schaub, R.T., Dilling, H., The multiaxial system of ICD-10: Evaluation of a preliminary draft in a multicentric field trial (1996) Psychopathology, 29, pp. 347-356Michels, R., Siebel, U., Freyberger, H.J., Schönell, H., Dilling, H., Evaluation of the multiaxial system of ICD-10 (preliminary draft): Correlations between multiaxial assessment and clinical judgements of aetiology, treatment indication and prognosis (2001) Psychopathology, 34, pp. 69-74Nakdimen KA. DSM-III's multiaxial system: political finesse. American Journal of Psychiatry 1981138: 259Oken, D., Multiaxial diagnosis and the psychosomatic model of disease (2000) Psychosomatic Medicine, 62, pp. 171-175Ottosson, J.O., Perris, C., Multidimensional classification of mental disorders (1973) Psychological Medicine, 3, pp. 238-243Paul, H.A., Diagnosis: Psychiatric and psychoanalytic perspectives (1983) The American Journal of Psychoanalysis, 43 (2), pp. 99-113Puri, B.K., Baxter, R., Cordess, C.C., Characteristics of fire-setters: A study and proposed multiaxial psychiatric classification (1995) British Journal of Psychiatry, 166, pp. 393-396Rey, J.M., Plapp, J.M., Stewart, G.W., Richards, I., Bashir, M., Reliability of the psychosocial axes of DSM-III in an adolescent population (1987) British Journal of Psychiatry, 150, pp. 228-234Rey, J.M., Plapp, J.M., Stewart, G.W., Richards, I., Bashir, M., Reliability of DSM-III axis IV (1987) Archives General Psychiatry, 44, pp. 96-97Rey, J.M., Stewart, G.W., Plapp, J.M., Bashir, M., Richards, I., Validity of axis V of DSM-III and other measures of adaptative functioning (1988) Acta Psychiatrica Scandinavica, 77, pp. 535-542Rey, J.M., Stewart, G.W., Plapp, J.M., Bashir, M., Richards, I., DSM-III axis IV revisited (1988) American Journal of Psychiatry, 145 (3), pp. 286-292Russell, A.T., Cantwell, D.P., Mattinson, R., Will, L., A comparison of DSM-II and DSM-III in the diagnosis of childhood psychiatric disorders (1979) Archives of General Psychiatry, 36, pp. 1223-1226Rutter, M., Lebovici, S., Eisenberg, L., Sneznevsky, A.V., Sadoun, R., Brooke, E., Lin, T.S., A triaxial classification of mental disorders in childhood (1969) Journal of Child Psychology and Psychiatry, 10, pp. 41-61Rutter, M., Shaffer, D., Sheperd, M., An evaluation of the proposal for a multiaxial classification of child psychiatric disorders (1973) Psychological Medicine, 3, pp. 244-250Saavedra, J.E., Mezzich, J.E., Salloun, I.M., Kirisci, L., Impact of DSM-III on the diagnosis of physical disorders in ambulatory psychiatric patients (1995) The Journal of Nervous and Mental Diseases, 183 (11), pp. 711-714Saavedra, J.E., Mezzich, J.E., Salloun, I.M., Kirisci, L., Predictive validity of the physical disorders axis of the DSM multiaxial diagnostic system (1997) The Journal of Nervous and Mental Diseases, 189 (7), pp. 435-441Salloum, I.M., Mezzich, J.E., Saavedra, J.E., Kirisci, L., Usefulness of DSM-III axis III in psychiatric inpatients: An actuarial comparison with the DSM II period (1994) American Journal of Psychiatry, 151 (5), pp. 768-769Schneider, W., Heuft, G., Freyberger, H.J., Janssen, P.L., Diagnostic concepts, multimodal and multiaxial approach in psychotherapy and psychosomatics (1995) Psychotherapy and Psychosomatics, 63, pp. 63-70Schneider, W., Freyberger, H.J., Muhs, A., Schüssler, G., Results of the ICD-10 Research Criteria Study in German-speaking countries in the field of psychosomatics and psychotherapy (1996) Psychopathology, 5, pp. 306-314Schrader, G., Gordon, M., Harcourt, R., The usefulness of axis IV and V assessments (1986) American Journal of Psychiatry, 143, pp. 904-907Shaffer, D., Gould, M.S., Rutter, M., Sturge, C., Reliability and validity of a psychosocial axis in patients with child psychiatric disorder (1991) Journal of American Academy of Child Adolescent Psychiatry, 30 (1), pp. 109-115Skodol, A.E., Spitzer, R.L., Williams, J.B.W., Teaching and learning DSM-III (1981) American Journal of Psychiatry, 138 (12), pp. 1581-1586Skodol, A.E., Spitzer, R.L., DSM-III: Rationale, basic concepts, and some differences from ICD-9 (1982) Acta Psychiatrica Scandinavica, 66, pp. 271-281Skodol, A.E., Williams, J.B.W., Spitzer, R.L., Gibbon, M., Kass, F., Identifying common errors in the use of DSM-III through diagnostic supervision (1984) Hospital and Community Psychiatry, 35 (3), pp. 251-255Skodol, A.E., Link, B.G., Shrout, P.E., Horwath, E., Toward construct validity for DSM-III axis V (1988) Psychiatry Research, 24, pp. 13-23Skodol, A.E., Link, B.G., Shrout, P.E., Horwarth, E., The revision of axis V in DSM-III-R: Should symptoms have been included? (1988) American Journal of Psychiatry, 145 (7), pp. 825-829Skodol, A.E., Shrout, P.E., Use of DSM-III axis IVm clinical practice: Rating etiologically significant stressors (1989) American Journal of Psychiatry, 146 (1), pp. 61-66Skodol, A.E., Shrout, P.E., Use of DSM-III axis IV in clinical practice: Rating the severity of psychosocial stressors (1989) Psychiatry Research, 30, pp. 201-211Skodol, A.E., Axis IV: A reliable and valid measure of psychosocial stressors? (1991) Comprehensive Psychiatry, 32 (6), pp. 503-515Skodol, A.E., Axis IV (1997) DSM-IV Sourcebook, 3, pp. 409-422. , Washington, DC: American Psychiatric Press;Spitzer, R.L., Forman, J., Nee, J., DSM-III field trials: I. Initial interrater diagnostic reliability (1979) American Journal of Psychiatry, 136 (6), pp. 815-817Spitzer, R.L., Forman, J.B.W., DSM-III field trials: II. Initial experience with the multiaxial system (1979) American Journal of Psychiatry, 136 (6), pp. 818-820Spitzer, R.L., Williams, J.B.W., Skodol, A.E., DSM-III: The major achievements and an overview (1980) American Journal of Psychiatry, 137 (2), pp. 151-164Strauss, J., A comprehensive approach to psychiatric diagnosis (1975) American Journal of Psychiatry, 132 (11), pp. 1193-1197Takada, K., Nakane, Y., Progress of ICD-10 (F) family in Japan: Research, field trials and publications (1998) Psychiatry and Clinical Neurosciences, 52 (SUPPL.), pp. S341-S343Treece, C., DSM-III as a research tool (1982) American Journal of Psychiatry, 139 (5), pp. 577-583Velamoor, V.R., Waring, E.M., Fisman, S., Cernovsky, Z., Brownstone, D., DSM-III in residency training: Results of a Canadian survey (1989) Canadian Journal of Psychiatry, 34, pp. 103-106Webb, L.J., Gold, R.S., Johnstone, E.E., Diclemente, C.C., Accuracy of DSM-III diagnoses following a training program (1981) American Journal of Psychiatry, 138 (3), pp. 376-378Williams, J.B.W., Spitzer, R.L., Focusing on DSM-III's multiaxial system (1982) Hospital and Community Psychiatry, 33 (11), pp. 891-892Williams, J.B.W., The multiaxial system of DSM-III: Where did it come from and where should it go? 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(1985) Archives of General Psychiatry, 42, pp. 181-186Williams, J.B.W., Spitzer, R.L., Skodol, A.E., DSM-III in residency training: Results of a national survey (1985) American Journal of Psychiatry, 142 (6), pp. 755-758Williams, J.B.W., Goldman, H.H., Gruenberg, A., Mezzich, J.E., Skodol, A.E., The multiaxial system (1990) Hospital and Community Psychiatry, 41 (11), pp. 1181-1182Williams, J.B.W., (1998) DSM-IV multiaxial system: Final overview, 4, pp. 939-946. , DSM-IV Sourcebook-Washington, DC: American Psychiatric Press;(1997) Multiaxial presentation of the ICD-10 for use in adult psychiatry, , World Health Organization, Cambridge: Cambridge University Press;Zimmerman, M., Pfohl, B., Stangl, D., Coryell, W., The validity of DSM-III axis IV (severity of psychosocial stressors) (1985) American Journal of Psychiatry, 142 (12), pp. 1437-1441Zimmerman, M., Pfohl, B., Coryell, W., Stangl, D., The prognostic validity of DSM-III axis IV in depressed inpatients (1987) American Journal of Psychiatry, 144 (1), pp. 102-106Zung WWK, Mahorney SL, Davidson J. Classification of depressive disorders: a multiaxial approach. Journal of Clinical Psychiatry 198445[7, Sec. 2]: 5-1

From The Stigma Of Manic Depression To The Encouraging Of Treatment Of Bipolar Disorder: The Evolution Of The Approach In Two Lay Media Publications Over The Last 40 Years [do Estigma Da Psicose Maníaco-depressiva Ao Incentivo Ao Tratamento Do Transtorno Bipolar: A Evolução Da Abordagem Em Dois Veículos Midiáticos Nos últimos 40 Anos]

Objective: To examine the evolution over the past 40 years of the midia approach to bipolar disorder. Methods: A search was performed using the terms "bipolar disorder" and "manic-depressive" in the Brazilian magazine Veja and in American newspaper The New York Times. A sample of 40 texts from each source was analyzed. The texts were divided into two groups, one dated of the years between 1970 and 1999 and the second from 2000 to 2009. Results: Between 1970 and 1999 it is most often used the term "manic-depressive", but in the decade of 2000-2009, the term "bipolar disorder" prevails widely. In addition, older articles, which predominantly use the term "manic-depressive" tend to be more stigmatizing and less informative. Recent articles, on the other hand, feature more often the term "bipolar disorder" and tend to encourage treatment seeking. Conclusion: It is suggested that the midia approach to bipolar disorder, in comparison with the one given to manicdepressive psychosis, is characterized by a closer assimilation of the biomedical model.6128488Sadock, J.S., Sadock, V.A., Transtornos do humor (2007) Compêndio de psiquiatria: Ciências do comportamento e psiquiatria clínica, pp. 572-629. , In: Sadock JS, Sadock VA, 9 a ed. Porto Alegre: Artmed(2008) The Global Burden of Disease: 2004 Update, , World Health Organization, Geneva: World Health OrganizationMayes, R., Horwitz, A.V., DSM-III and the revolution in the classification of mental illness (2007) J Hist Behav Sci, 43 (4), p. 419Angst, J., Historical aspects of the dichotomy between manic-depressive disorders and schizophrenia (2002) Schizophr Res, 57 (1), pp. 5-13Lima, R.C., (2005) Somos todos desatentos? O TDA/H e a construção de bioidentidades, p. 161. , Rio de Janeiro: Relume DumaráHealy, D., The latest mania: Selling bipolar disorder (2006) PLoS Med, 3 (4), pp. e185Silvestre, A., (2007) O sujeito e o pathos na mídia, , Uma análise do discurso sobre saúde nas matérias de capa das revistas Veja e Época [dissertação]. São Paulo (SP): Universidade de São PauloHacking, I., (2000) The social construction of what, p. 264. , Cambridge, MA: Harvard University Pres

Increased Frequency Of Schizophrenia Among Brazilian Protestant Inpatients [freqüência Aumentada De Esquizofrenia Em Pacientes Evangélicos Internados]

Background: As religion plays a key role in personal and social experience of most Brazilians, it is important to determine whether and how religious affiliation can influence psychopathology and treatment outcome. Studying a sample of 300 psychiatric inpatients ten years ago, we found that Protestant Pentecostal patients were over-represented among those diagnosed as psychotic and under-represented in regard to other diagnostic categories. In addition, they had shorter hospitalization. This study aims at reassessing such earlier findings by using a much larger sample and by analyzing, in a more comprehensive fashion, a broader range of variables. Methods: The authors reviewed 989 consecutive patients admitted in a psychiatric unit in a Brazilian university general hospital. Two main groups of patients were identified and compared to each other, Catholics and Protestants. The Protestant group was constituted mostly by Pentecostals, but historical Protestants were fairly represented as well. Statistical analyses (multivariate logistical regression - model of proportional odds - and correspondence analysis) were performed to ascertain the relation between religious affiliation and clinical and demographic data. Results: Protestant patients were younger, women predominating, had less years of formal education and a lower rate of marriage. Moreover they showed a higher rate of schizophrenic disorders and a lower rate of substance-related disorders. No difference either in length of stay or clinical status on discharge was found between the two religious groups. Conclusion: These results bring corroborative evidence of over-representation of schizophrenic disorder diagnosis among Protestants inpatients in Brazil. Several hypotheses are considered to explain such finding. The possibility of selective patterns of help-seeking pathways was emphasized. It was suggested that Protestants may retain in the Church setting subjects with minor psychiatric disorders and send to psychiatric care people with more severe disorders, such as schizophrenia. We did not confirm, however, earlier findings about shorter hospitalization among Protestants. Religious affiliation did not correlate significantly with clinical status on discharge.533143152Bock, E.W., Cocharn, J.K., Beeghley, L., Moral messages: The relative influence of denomination on the religiosity-alcohol relationship (1987) Sociol Q, 28 (1), pp. 89-103Botega NJ. Psiquiatria no Hospital Geral: histórico e tendêncies. In: Botega NJ. Prática psiquiátrica no hospital geral: interconsulta e emergência. Porto Alegre: Artmed Editora, p. 15-30, 2002Dalgalarrondo P. Religious issues in psychiatry. Am J Psychiatry, 148(10): 1.414-5, 1991Dalgalarrondo, P., Gattaz, W.F., A psychiatric unit in a general hospital in Brazil: Predictors of length of stay (1992) Soc Psychiatry Psychiatr Epidemiol, 27, pp. 147-150Dalgalarrondo, P., Lotz, M., Religious affiliation and psychiatric diagnosis: The influence of Christian sect membership on diagnosis distribution (1993) Eur Arch Psychiatry Clin Neurosci, 243, pp. 47-53Dalgalarrondo, P., Lotz, M., Schepank, H., Religious affiliation and psychosomatic disorders (1997) Curare, 20 (1), pp. 15-22Dalgalarrondo, P., Soldera, M.A., Corrêa Filho, H.R., Silva, C.A.M., Uso de drogas e saúde mental em jovens católicos, evangélicos pentecostais e espíritas. Rev Bras Psiquiatr (2003) Em preparaçãoGriffith, E.E.H., Baker, F.M., Psychiatric care of African Americans (1993) Culture, Ethnicity and Mental Illness, pp. 147-174. , Albert C. 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Weak' Causes And Complex Causal Nets In Psychiatry. Running Title: Weak Causes In Psychiatry [causes "faibles" Et Réseaux Causaux Complexes: Causas "sencillas" Y Redes Causales Complejas En Psiquiatría]

We briefly analyze the concept of causality as applied to psychiatry and put forward an approach based on the notions of weak causal influences and complex causal networks. Method: a conceptual analysis of selected articles and books. Results: We present the INUS causation model proposed by the philosopher J.L.Mackie that gets around some of the difficulties related to the presence of multiple interdependent causes, as appears to be the case in mental disorders. This model seemingly works well in PTSD, as shown. Conclusion: We suggest that the failure to find "strong" causes for mental disorders may indicate the need to revise our expectations by adopting alternative models of causality. © 2009 Associação Universitária de Pesquisa em Psicopatologia Fundamental/University Association for Research in Fundamental Psychopathology.1711528Berrios, G.E., Historical development of ideas about psychiatric aetiology (2009) New Oxford Textbook of Psychiatry, , In M. G. Gelder, J. J. L.-I. Jr., & N. C. Andreasen (Eds.), New York: Oxford University PressBradford-Hill, A., The Environment and Disease: Association or Causation (1964) Proc R Soc Med, 1 (12), pp. 295-300Canguilhem, G., (1978) O Normal E O Patológico, p. 270. , Rio de Janeiro: Editora Forense- niversitáriaCartwright, N., Causal Laws and Effective Strategies (1979) The Mortality of Doctors In Relation to Their Smoking Habits. British Medical Journal, 13, pp. 419-437. , Doll, R., & radford-Hill, A. (1954)Flory, J.D., Yehuda, R., Passarelli, V., Siever, L.J., Joint Effect of Childhood Abuse and Family History of Major Depressive Disorder on Rates of PTSD in People with Personality Disorders (2012) Depression Research and Treatment, pp. 1-7. , doi:10.1155/2012/350461Forlenza, O.V., Diniz, B.S., Gattaz, W.F., Diagnosis and biomarkers of prede-mentia in Alzheimer's disease (2010) BMC Medicine, 8 (1), p. 89. , doi:10.1186/1741-7015-8-89Fulford, K.W.M., Thornton, T., Graham, G., Causes, Laws and Reasons in Psychiatric Aetiology (2006) Oxford Textbook of Philosophy and Psychiatry, pp. 408-432. , In K. W. M. Fulford, T. Thornton, & G. Graham (Eds.), New York: Oxford University PressHume, D., (2000) Tratado Da Natureza Humana, p. 762. , (D. Danowski, Ed.) (2. ed, São Paulo: Editora UNESPKeshavan, M.S., Tandon, R., Boutros, N.N., Nasrallah, H.A., Chizophrenia, "just the facts": What we know in 2008 Part 3: Neurobiology (2008) Schizophrenia Research, 106 (2-3), pp. 89-107. , doi:10.1016/j.schres.2008.07.020Loque, F.F., Notas sobre Galeno, a noção de saúde e o debate médico-flosófco sobre a causalidade (2009) Revista Archai, pp. 59-68. , Jul(3)Mackie, J.L., The Concept of Causation - Conditional Analyses (1980) The Cement of the Universe: A Study of Causation, p. 29. , Oxford University PressMacki, J.L., (1980) The Cement of the Universe: A Study of Causation, , (L. J. Cohen, Ed.) (Paperback). New York: Oxford University PressMacki, J.L., Causes and Conditions (1999) Metaphysics: An Anthology, pp. 413-427. , n J. Kim & E. Sosa (Eds.), Oxford: BlackwellMello, M.F., Yeh, M.S.L., Barbosa Neto, J., Braga, L.L., Fiks, J.P., Mendes, D.D., Moriyama, T.S., A randomized, double-blind, placebo controlled trial to assess the efficacy of topiramate in the treatment of post-traumatic stress disorder (2009) BMC Psychiatry, 9, p. 28Phillips, C.V., Goodman, K.J., The missed lessons of Sir Austin Bradford Hill (2004) Epidemiologic Perspectives & Innovations: EP+I, 1 (1), p. 3. , doi:10.1186/1742-5573-1-3Serpa Jr., O.D., Loucura, Genes E Sinapses: A Psiquiatria Biológica (1998) Mal-estar Na Natureza, pp. 165-270. , Rio de Janeiro: Te Corá EditoraSerpa Jr., O.D., Subjetividade, valor e corporeidade: Os desafos da psicopatologia (2007) Psicopatologia Hoje, pp. 11-62. , In J. F. D. S. Filho (Ed.), Rio de Janeiro: IPUBTandon, R., Keshavan, M.S., Nasrallah, H.A., Schizophrenia, "Just the Facts": What we know in 2008, part 1: Overview (2008) Schizophrenia Research, 100 (1-3), pp. 4-19. , doi:10.1016/j.schres.2008.01.022Tandon, R., Keshavan, M.S., Nasrallah, H.A., Schizophrenia, "Just the Facts" what we know in 2008, part 2: Epidemiology and etiology (2008) Schizophrenia Research, 102 (1-3), pp. 1-18. , doi:10.1016/j.schres.2008.04.011Tandon, R., Nasrallah, H.A., Keshavan, M.S., Schizophrenia, "Just the Facts" 4. Clinical features and conceptualization (2009) Schizophrenia Research, 11 (1-3), pp. 1-23. , doi:10.1016/j.schres.2009.03.005van Voorhees, E.E., Dedert, E.A., Calhoun, P.S., Brancu, M., Runnals, J., Beckham, J.C., Childhood trauma exposure in Iraq and Afghanistan war era veterans: Implications for posttraumatic stress disorder symptoms and adult functional social support (2012) Child Abuse & Neglect, , doi:10.1016/j.chiabu.2012.03.004Vieweg, W.V.R., Julius, D.A., Fernandez, A., Beatty-Brooks, M., Hettema, J.M., Pandurangi, A.K., Posttraumatic stress disorder: Clinical features, patho-physiology, and treatment (2006) The American Journal of Medicine, 119 (5), pp. 383-390. , doi:10.1016/j.amjmed.2005.09.02

Successful Ect In A Patient With A Psychiatric Presentation Of Wilson's Disease [5]

[No abstract available]20155Negro Jr., P.J., Louza Neto, M.R., Results of ECT for a case of depression in Wilson disease (1995) J Neuropsychiatry Clin Neurosci, 7, p. 384Shah, N., Kumar, D., Wilson's disease, psychosis and ECT (1997) Convuls Ther, 13, pp. 278-27

Psychopathology: Introduction

[No abstract available]384159161Mezzich, J.E., International surveys on the use of ICD-10 and related diagnostic systems (2002) Psychopathology, 35, pp. 72-75Mezzich, J.E., Üstün, T.B., International Classification and Diagnosis: Critical Experience and Future Directions (2002) Psychopathology, 35, pp. 55-202Mezzich, J.E., Berganza, C.E., Von Cranach, M., Essentials of the World Psychiatric Association's International Guidelines for Diagnostic Assessment (IGDA) (2003) Br J Psychiatry, 182 (45 SUPPL.), pp. 37-6

Multiaxial Schemas For Psychiatric Diagnosis

[No abstract available]279288Essen-Möller, E., Wohlfahrt, S., Suggestions for the amendment of the official Swedish classification of mental disorders (1947) Acta Psychiatrica Scandinavica, 47 (SUPPL.), pp. 551-555Kretschmer, E., Über psychogenese Wahnbildung bei traumatischer Hirschwäche (1919) Z. ges. Neurol. 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Washington, D.C.: American Psychiatric Publishing IncMultiaxial Presentation of the ICD-10 for use in Adult Psychiatry (1997), World Health Organization (WHO), Cambridge: Cambridge University PressJanca, A., Kastrup, M., Katschnig, H., The World Health Organization Short Disability Assessment Schedule (WHO DAS-S): a tool for the assessment of difficulties in selected areas of functioning of patients with mental disorders (1996) Social Psychiatry and Psychiatric Epidemiology, 31, pp. 349-354Janca, A., Kastrup, M., Katschnig, H., Contextual aspects of mental disorders: a proposal for axis III of the ICD-10 multiaxial system (1996) Acta Psychiatrica Scandinavica, 94, pp. 31-36Mezzich, J.E., Berganza, C.E., von Cranach, M., Essentials of the World Psychiatric Association's International Guidelines for Diagnostic Assessment (2003) British Journal of Psychiatry, 182 (SUPPL. 45), pp. 37-66Williams, J.B.W., The multiaxial system of DSM-III: Where did it come from and where should it go? I. Its origins and critiques (1985) Archives of General Psychiatry, 42, pp. 175-180Mezzich, J.E., Architecture of clinical information and prediction of service utilization and cost (1991) Schizophrenia Bulletin, 17, pp. 469-474Ditmann, V., Modern psychiatric classification in research and clinical practice (1991) Archives Suisse de Neurologie et de Psychiatrie, 142, pp. 341-353Mezzich, J.E., Multiaxial diagnosis: Purposes and challenges (1994) Psychiatric diagnosis: A world perspective, , In: Mezzich JE, et al. (eds.), New York: SpringerJanca, A., Kastrup, M., Katschnig, H., The ICD-10 multiaxial system for use in adult psychiatry (1996) Journal of Nervous and Mental Disease, 184, pp. 191-192Kastrup, M., Mezzich, J.E., Quality of life: a dimension in multiaxial classification (2001) European Archives of Psychiatry and Clinical Neuroscience, 251 (SUPPL. 2), pp. II.32-II.37Mezzich, J.E., Janca, A., Kastrup, M., Multiaxial diagnosis in psychiatry (2002) Psychiatric Diagnosis and Classification, pp. 163-176. , In: Maj M, et al. (eds.), New York: John Wiley & Sons IncMezzich, J.E., Banzato, C.E.M., Cohen, P., Report of the American Psychiatric Association Committee to Evaluate the DSM Multiaxial System (2005), Presented to the APA Assembly, Atlanta, 21 MayVelamoor, V.R., Waring, E.M., Fisman, S., DSM-III in Residency Training: Results of a Canadian Survey (1989) Canadian Journal of Psychiatry, 34, pp. 103-106Mezzich, J.E., International Surveys on the Use of ICD-10 and Related Diagnostic Systems (2002) Psychopathology, 35, pp. 72-75Tasman, A., Lost in the DSM-IV checklist: Empathy, meaning and the doctor-patient relationship (2002) Academic Psychiatry, 26, pp. 38-44Mezzich, J.E., Sharfstein, S.S., Severity of illness and diagnostic formulation: Classifying patients for prospective payment systems (1985) Hospital & Community Psychiatry, 36, pp. 770-772Gordon, R.E., Eisler, R.L., Gutman, E.M., Gordon, K.K., Predicting Prognosis by Means of the DSM-III Multiaxial Diagnosis (1991) Canadian Journal of Psychiatry, 36, pp. 218-221Alarcón, R.D., Culture and Psychiatric Diagnosis-Impact on DSM-IV and ICD-10 (1995) The Psychiatric Clinics of North America, 18, pp. 449-465Mezzich, J.E., Good, B.J., On Culturally Enhancing the DSM-IV Multiaxial Formulation (1997), 3, pp. 983-989. , In: Widiger TA, Frances AJ, Pincus HA. (eds.), DSM-IV Sourcebook, Washington, D.C.: American Psychiatric AssociationJampala, V.C., Sierles, F.S., Taylor, M.A., Consumers' Views of DSM-III: Attitudes and Practices of U.S. Psychiatrists and 1984 Graduating Psychiatric Residents (1986) American Journal of Psychiatry, 143, pp. 148-153Bassett, A.S., Beiser, M., DSM-III: Use of the Multiaxial Diagnostic System in Clinical Practice (1991) Canadian Journal of Psychiatry, 36, pp. 270-274Williams, J.B.W., DSM-IV Multiaxial System: Final Overview (1998), 4, pp. 939-946. , In: Widiger TA, Frances AJ, Pincus HA et al. 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(1991) Comprehensive Psychiatry, 32, pp. 503-515Rey, J.M., Plapp, J.M., Stewart, G.W., Reliability of DSM-III Axis IV (1987) Archives of General Psychiatry, 44, pp. 96-97Rey, J.M., Stewart, G.W., Plapp, J.M., DSM-III Axis IV Revisited (1988) American Journal of Psychiatry, 145, pp. 286-292Hilsenroth, M.J., Ackerman, S.J., Blagys, M.D., Reliability and validity of DSM-IV Axis V (2000) American Journal of Psychiatry, 157, pp. 1858-1863Goldman, H.H., Do you walk to school, or do you carry your lunch? 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Patients Who Benefit From Psychiatric Admission In The General Hospital [pacientes Que Se Beneficiam De Interna̧tiao Psiquiátrica Em Hospital Geral]

Objectives. Psychiatric hospitalization though burdensome remains a very important therapeutic option for severely-ill psychiatric patients. Hospitalization in general hospital psychiatry units (GHPU) are often regarded as the best option. A study was carried out with the purpose of assessing socioeconomic and medical variables associated with success and failure of hospitalization. Methods. A review was performed on sociodemographics and medical data of 1,463 patients admitted to a general hospital's GHPU in the period between 1986 and 1997. Statistical analysis was conducted using univariate and multivariate polythomic logistic regression. Results. In the multivariate analysis three factors were identified as associated to poor hospitalization outcomes (poor condition at discharge and longer hospital stay): age 360 years, poor social functioning, and diagnosis of organic mental disorder. Conclusions. Although 80% of the patients experienced a considerable symptomatic improvement, a small group benefited less from hospitalization. It is suggestive that these patients would benefit more from psychosocial interventions.375629634Botega, N.J., Prática psiquiátrica no hospital geral: Interconsulta e emergência (2002), pp. 15-30. , Porto Alegre: ArtmedPsiquiatria no hospital geral: histórico e tendênciasCaton, C.L.M., Gralnick, A., A review of issues surrounding length of psychiatric hospitalization (1987) Hosp. Common Psychiatry, 38, pp. 858-863Hosmer, D.W., Lemeshow, S., Applied logistic regression (1989), New York: John Wiley and SonsLieberman, P.B., Phetres, E.B.M., Binette Elliot, M.A., Egerter, E., Wiitala, S., Dimensions and predictors of change during brief psychiatric hospitalization (1993) Gen. Hosp. Psychiatry, 15, pp. 316-324Pfeiffer, S.I., O'Malley, D.S., Shott, S., Factors associated with the outcome of adults treated in psychiatric hospitals: A synthesis of findings (1996) Psychiatr. Serv., 47, pp. 263-269Rabinowitz, J., Modai, I., Inbar-Saban, N., Understanding who improves after psychiatric hospitalization (1994) Acta Psychiatr. Scand., 89, pp. 152-158Russo, J., Roy-Birne, P., Jaffe, C., Ries, R., Dagadakis, C., Avery, D., Psychiatric status, quality of life, and level of care as predictors of outcomes of acute inpatient treatment (1997) Psychiatr. Serv., 48, pp. 1427-1434(1989), The SAS Institute. The SAS System for Windows (Statistical Analysis System). Version 6.12. Cary, NCStokes, M.E., Davis, C.S., Koch, G.G., Categorical data analysis using the SAS System (1990), Cary, NC: The SAS Institut