Evaluation and diagnosis in cognitive-behavioral therapy

One of the main characteristics of cognitive-behavior therapy is that it is based on a specific clinical formulation of the case. This means that the therapist, using interviews and inventories, in a particular way, needs to understand and integrate the history of his/her client and his/her current problems. Clinical strategies can be then tailored to deal with the clients difficulties. The establishment of adequate and warm interpersonal and therapeutical relationship depends greatly on this empathic and accurate understanding of the clients problems. The present article intends to present this approach to case formulation based on a cognitive behavior perspective. It also includes a brief review of theoretic-clinical aspects, assessment tools and suggested procedures. The conclusion is that an adequate  formulation is essential to success in psychotherapy. Keywords: cognitive-behavior therapy; case formulation; psychodiagnosis. Uma das características fundamentais da terapia cognitivo-comportamental, segundo seus idealizadores, é o fato de basear-se em uma formulação clínica dos problemas do cliente. Isto significa que, mediante entrevistas e instrumentos de avaliação e medida, o terapeuta buscará integrar a história do cliente e seus problemas atuais de uma forma diferenciada, que lhe permitirá desenvolver estratégias específicas para lidar com as dificuldades apresentadas na busca de ajuda psicológica. Além disso, o estabelecimento de uma boa relação interpessoal e terapêutica depende, em grande parte, de uma compreensão empática e acurada dos problemas do cliente. É sobre esta forma diferenciada de compreender o funcionamento do indivíduo que trata este artigo, que se inicia por uma breve revisão dos aspectos teórico-clínicos da terapia cognitivo-comportamental e segue indicando como desenvolver uma formulação adequada, que instrumentos estão disponíveis ao terapeuta e quais são utilizados mais freqüentemente. Conclui-se que uma formulação adequada é essencial para o sucesso terapêutico. Palavras-chave: terapia cognitivo-comportamental; formulação de caso; psicodiagnóstico.

Eating disorders

This article intends to contribute for a greater comprehension of eating disorders, specially anorexia and bulimia. It also discusses all major variables involved in their development, including socio-cultural aspects. An emphasis is given to the great contribution of cognitive-behavioral therapy as an option for treatment.Keywords: eating disorders, bulimia, anorexia, cognitive-behavioral therapy. Este trabalho tem como objetivo contribuir para uma maior compreensão dos transtornos alimentares, especialmente anorexia e bulimia. Pretende também esclarecer uma série de fatores, inclusive socioculturais que, em conjunto, podem levar ao desenvolvimento desses transtornos. Por fim, enfatiza a importância crescente da terapia cognitivo-comportamental como forma de tratamento.Palavras-chave: transtornos alimentares, bulimia, anorexia, terapia cognitivo-comportamental

The relationship between obesity and quality of life in Brazilian adults

The incidence of obesity has reached epidemic proportions, affecting 30% of the adult population globally. During the last decade, the rising rates of obesity in developing countries has been particularly striking. One potential consequence of obesity is a decline in quality of life. Thus, the objective of the present study was to investigate the possible relationship between obesity, defined by body mass index (BMI), and quality of life, evaluated using the short version of the World Health Organization Quality of Life (WHOQOL) scale in a Brazilian population. The sample consisted of 30 men and 30 women, divided into three groups according to BMI: normal weight, obese, and morbidly obese. All of the subjects responded to the WHOQOL inventories. The results indicated that the groups with lower BMIs had better quality of life than the groups with higher BMIs. Being overweight interfered with quality of life equally in both sexes, with no difference found between men and women. The results indicate the necessity of multidisciplinary care of obese individuals

PSICOTERAPIA FUNCIONA?

Este artigo pretende discutir a eficácia da psicoterapia. São abordados temas relativos à metodologia da pesquisa clínica, sua confiabilidade e dificuldades. Fatores que interferem com os resultados da psicoterapia também são discutidos. Ênfase é dada na conciliação dos papéis de terapeuta e de pesquisador

Transtornos alimentares

This article intends to contribute for a greater comprehension of eating disorders, specially anorexia and bulimia. It also discusses all major variables involved in their development, including socio-cultural aspects. An emphasis is given to the great contribution of cognitive-behavioral therapy as an option for treatment. Keywords: eating disorders, bulimia, anorexia, cognitive-behavioral therapy

Ubc9 Sumoylation Controls SUMO Chain Formation and Meiotic Synapsis in Saccharomyces cerevisiae

Posttranslational modification with the small ubiquitin-related modifier SUMO depends on the sequential activities of E1, E2, and E3 enzymes. While regulation by E3 ligases and SUMO proteases is well understood, current knowledge of E2 regulation is very limited. Here, we describe modification of the budding yeast E2 enzyme Ubc9 by sumoylation (Ubc9^*SUMO). Although less than 1% of Ubc9 is sumoylated at Lys153 at steady state, a sumoylation-deficient mutant showed significantly reduced meiotic SUMO conjugates and abrogates synaptonemal complex formation. Biochemical analysis revealed that Ubc9^*SUMO is severely impaired in its classical activity but promoted SUMO chain assembly in the presence of Ubc9. Ubc9^*SUMO cooperates with charged Ubc9 (Ubc9~SUMO) by noncovalent backside SUMO binding and by positioning the donor SUMO for optimal transfer. Thus, sumoylation of Ubc9 converts an active enzyme into a cofactor and reveals a mechanism for E2 regulation that orchestrates catalytic (Ubc9~SUMO) and noncatalytic (Ubc9^*SUMO) functions of Ubc9

Clinical characteristics of subependymal giant cell astrocytoma in tuberous sclerosis complex

International audienceBackground: This study evaluated the characteristics of subependymal giant cell astrocytoma (SEGA) in patients with tuberous sclerosis complex (TSC) entered into the TuberOus SClerosis registry to increase disease Awareness (TOSCA). Methods: The study was conducted at 170 sites across 31 countries. Data from patients of any age with a documented clinical visit for TSC in the 12 months preceding enrollment or those newly diagnosed with TSC were entered. Results: SEGA were reported in 554 of 2,216 patients (25%). Median age at diagnosis of SEGA was 8 years (range, 18 years. SEGA were symptomatic in 42.1% of patients. Symptoms included increased seizure frequency (15.8%), behavioural disturbance (11.9%), and regression/loss of cognitive skills (9.9%), in addition to those typically associated with increased intracranial pressure. SEGA were significantly more frequent in patients with TSC2 compared to TSC1 variants (33.7 vs. 13.2 %, p < 0.0001). Main treatment modalities included surgery (59.6%) and mammalian target of rapamycin (mTOR) inhibitors (49%). Conclusions: Although SEGA diagnosis and growth typically occurs during childhood, SEGA can occur and grow in both infants and adults

Treatment patterns and use of resources in patients with tuberous sclerosis complex : insights from the TOSCA registry

Tuberous Sclerosis Complex (TSC) is a rare autosomal-dominant disorder caused by mutations in the TSC1 or TSC2 genes. Patients with TSC may suffer from a wide range of clinical manifestations; however, the burden of TSC and its impact on healthcare resources needed for its management remain unknown. Besides, the use of resources might vary across countries depending on the country-specific clinical practice. The aim of this paper is to describe the use of TSC-related resources and treatment patterns within the TOSCA registry. A total of 2,214 patients with TSC from 31 countries were enrolled and had a follow-up of up to 5 years. A search was conducted to identify the variables containing both medical and non-medical resource use information within TOSCA. This search was performed both at the level of the core project as well as at the level of the research projects on epilepsy, subependymal giant cell astrocytoma (SEGA), lymphangioleiomyomatosis (LAM), and renal angiomyolipoma (rAML) taking into account the timepoints of the study, age groups, and countries. Data from the quality of life (QoL) research project were analyzed by type of visit and age at enrollment. Treatments varied greatly depending on the clinical manifestation, timepoint in the study, and age groups. GAB Aergics were the most prescribed drugs for epilepsy, and mTOR inhibitors are dramatically replacing surgery in patients with SEGA, despite current recommendations proposing both treatment options. mTOR inhibitors are also becoming common treatments in rAML and LAM patients. Forty-two out of the 143 patients (29.4%) who participated in the QoL research project reported inpatient stays over the last year. Data from non-medical resource use showed the critical impact of TSC on job status and capacity. Disability allowances were more common in children than adults (51.1% vs 38.2%). Psychological counseling, social services and social worker services were needed by <15% of the patients, regardless of age. The long-term nature, together with the variability in its clinical manifestations, makes TSC a complex and resource-demanding disease. The present study shows a comprehensive picture of the resource use implications of TSC

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present