Sydney Melancholia Prototype Index (SMPI) : translation and cross-cultural adaptation to Brazilian Portuguese

Introduction: Depression is possibly not a single syndrome but rather comprises several subtypes. DSM-5 proposes a melancholia specifier with phenotypic characteristics that could be associated with clinical progression, biological markers or therapeutic response. The Sydney Melancholia Prototype Index (SMPI) is a prototypic scale aimed to improve the diagnosis of melancholia. So far, there is only an English version of the instrument available. The aim of this study is to describe the translation and adaptation of the English version of the SMPI into Brazilian Portuguese. Methods: Translation and cross-cultural adaptation of the self-report (SMPI-SR) and clinician-rated (SMPICR) versions into Brazilian Portuguese were done following recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). This guideline includes the following steps: preparation, forward translation, reconciliation, back translation, back translation review, harmonization, cognitive debriefing, debriefing results review, proofreading and final report. Results: The Brazilian Portuguese versions of the SMPI were well-accepted by respondents. Changes in about two-thirds of the items were considered necessary to obtain the final Brazilian Portuguese version of the SMPI. Conclusions: Both versions of the SMPI are now available in Brazilian Portuguese. The instrument could become an important option to enhance studies on melancholia in Portuguese-speaking samples

First-time administration of the Sydney Melancholia Prototype Index (SMPI) to non-English-speaking patients : a study from Brazil

Objective: The Sydney Melancholia Prototype Index (SMPI) is a scale that uses a non-conventional strategy to assess melancholia status based on prototypic symptoms and illness course variables. This study aimed to evaluate the performance of the first translation of this instrument in a non-Englishspeaking population. Methods: A sample comprising 106 Brazilian outpatients with depression was evaluated simultaneously with the Brazilian version of the self-rated SMPI (SMPI-SR) and clinician-rated SMPI (SMPICR). The kappa coefficient and t test were used to evaluate concurrent validity vs. DSM-IV, CORE system, Hamilton Depression Rating Scale-6 item (HAM-D6), and HAM-D17 assignments to a melancholic or non-melancholic class. The prevalence of melancholia as well as sensitivity and specificity were calculated across instruments. Results: The prevalence of melancholia was highest using DSM-IV criteria (56.6%). The kappa agreement between SMPI-CR and DSM-IV melancholia assignment was moderate (kappa 0.44, p <= 0.001). SMPI-CR-assigned melancholic patients had significantly higher CORE, HAM-D17, and HAM-D6 scores. The test-retest consistency values for the SMPI were modest at best, and somewhat superior for the CR version. Conclusion: The Brazilian SMPI-CR presented satisfactory psychometric properties (which were superior to those of the SMPI-SR), and therefore appears to be a useful option for identifying melancholia and studying its causes and optimal treatments

Protocolos de regulação ambulatorial : condições pós-COVID-19

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Protocolos de regulação ambulatorial : psiquiatria adulto

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Telecondutas : condições pós-COVID-19

Telemedicin

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Estudo prospectivo das diferenças clínicas e funcionais entre pacientes internados por depressão psicótica e não-psicótica

Introdução: A Depressão Psicótica (DP) afeta cerca de 15-20% dos pacientes com diagnóstico de depressão. Esta condição está ligada a maior cronicidade, maior incidência de tentativas de suicídio e maior frequência de internação hospitalar em relação à Depressão Não-Psicótica. No entanto, evidências recentes sugerem que a incidência de características psicóticas pode não estar relacionada à intensidade dos sintomas depressivos. O curso distinto de doença, associado a pior resposta ao tratamento e a pior prognóstico suscitam a discussão de que a depressão psicótica pode ser uma entidade clínica distinta da depressão, representando um ponto em um continuum que tem em um de seus extremos os transtornos psicóticos e no outro, os transtornos de humor. Objetivos: Avaliar se a presença de sintomas psicóticos em pacientes internados por episódio depressivo se correlaciona com a intensidade de sintomas depressivos. Avaliar se há diferenças clínicas e funcionais que podem se relacionar com os sintomas psicóticos dos pacientes da amostra. Observar a melhora de sintomatologia psiquiátrica ao longo da internação, e se há diferença na variação de sintomas, ao longo da internação, entre os pacientes psicóticos e não-psicóticos. Métodos: 288 pacientes internados por episódio depressivo em uma unidade psiquiátrica de um hospital geral universitário foram avaliados na admissão e na alta hospitalar. Foi realizada entrevista semi-estruturada com o MINI para avaliação diagnóstica. Nos dois momentos de avaliação foram aplicadas a Escala de Hamilton para Avaliação de Depressão (HAM-D), a Escala Breve de Avaliação Psiquiátrica (BPRS), a avaliação da Impressão Clínica Global (CGI) e a Escala Global de Avaliação do Funcionamento (GAF). Outros parâmetros clínicos e epidemiológicos também foram avaliados: idade de início de sintomas, quantidade de internações prévias, tentativas de suicídio prévias, tempo de duração da internação atual e realização de Eletroconvulsoterapia (ECT) durante a internação. Resultados: 131 pacientes (45,4%) apresentaram sintomas psicóticos. Após ajuste para controle de variáveis que tinham potencial de viés de confusão – história prévia de mania ou hipomania, história prévia de uso de substâncias, sexo, idade, e anos de estudo – os dois grupos tiveram resultados similares nos resultados da HAM-D, tanto na admissão quanto na alta. Em relação às outras medidas, no entanto, os pacientes com depressão psicótica apresentaram piores níveis de funcionamento (GAF), piores resultados na avaliação clínica (CGI) e escores mais elevados na BPRS, na admissão e na alta hospitalar. Conclusão: Os pacientes com depressão psicótica apresentaram história mais grave de sintomas psiquiátricos e maior prejuízo funcional. No entanto, as diferenças entre os pacientes psicóticos e não-psicóticos não tiveram relação com os sintomas depressivos dos pacientes. Tais achados vão ao encontro de evidências recentes que sugerem que a depressão psicótica pode ser um transtorno distinto da depressão maior.Introduction: Psychotic Depression (DP) is a medical condition that affects a significant portion of depressive patients, 15-20%. This disorder is linked to greater cronicity, higher incidence of suicide attempts and a higher frequency of hospitalization, when compared to depressive episodes without psychotic features. Nevertheless, recent evidences suggest that the presence of psychotic symptoms may not correlate to depressive symptoms severity. The discrete clinical course, along with worse response to usual treatment and worse prognosis draw a hypothesis that Psychotic Depression might be a distinct disorder in relation to major depression. It reflects the intersection of psychotic and affective dimensions, and may be placed in a point of a continuum between psychotic and affective disorders. Objectives: To evaluate if the presence of psychotic symptoms in hospitalized depressive patients correlates to depressive symptoms intensity. To evaluate the existence of clinical and functioning differences among psychotic and non-psychotic depressive inpatients that could be related to the psychotic features. To estimate clinical improvement during hospitalization, and if there are dissimilarities in the variation of symptoms between psychotic and non-psychotic depressive individuals. Methods: 288 depressive inpatients of a psychiatric ward of a university tertiary hospital were assessed at admission and at discharge. We conducted MINI semi-structured interview to determine patient diagnosis. At both assessments we applied the Hamilton Depression Rating Scale (HAM-D), the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and the Global Assessment of Functioning (GAF). Other clinical and epidemiological parameters were also assessed: age at onset, number of previous hospitalizations, previous suicide attempts, length of stay and Electroconvulsive therapy (ECT) in current hospitalization. Results: 131 patients (45,4%) had psychotic features. After adjusting for potential confounding variables – previous presence of mania or hypomania, history of substance use, gender, age and years of study –, both psychotic and non-psychotic depressive patients presented similar HAM-D scores at admission and at discharge. However, psychotic depressive inpatients showed worse functioning levels (GAF), worse clinical status (CGI) and higher BPRS scores, both at admission and at discharge. Conclusion: Psychotic depressive inpatients presented more severe history of psychiatric symptoms and greater functioning disability. The differences between both groups of patients did not correlate to depressive symptoms. These findings are in conformity with recent evidences that suggest that psychotic depression might be a distinct disorder in relation to major depression