Curso clínico e prognóstico do transtorno obsessivo-compulsivo

The long-term course and prognosis of obsessive-compulsive disorder (OCD) is insufficiently known. To identify predictors of OCD course, follow-up studies of patients with OCD were reviewed and their findings summarized. According to these studies, the following variables were correlated with poor outcome: early onset, severity of OCD symptoms, chronic course, poor social functioning at baseline, lifetime history of comorbid psychiatric and personality disorders, presence of parental Axis I psychiatric diagnosis, and delayed response to serotonin reuptake inhibitors in the beginning of the treatment. Due to the availability of new treatments, most patients with OCD can expect significant improvement, but not complete remission of the disorder. The reviewed follow-up studies support previous reports on the chronicity of OCD.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PsiquiatriaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Grupo Inter-Departamental de Epidemiologia ClínicaUNIFESP, EPM, Depto. de PsiquiatriaUNIFESP, EPM, Grupo Inter-Departamental de Epidemiologia ClínicaSciEL

Maternal recognition of child mental health problems in two Brazilian cities

Objective: To identify child behaviors and types of impairment that increase the likelihood of maternal recognition of emotional/behavioral problems (EBP) in children and adolescents. Methods: Maternal-reported data were obtained from two subsamples of 11-to-16-year-olds derived from cross-sectional studies conducted in two Brazilian municipalities: Itaborai, state of Rio de Janeiro (n=480), and Embu, state of Sao Paulo (n=217). The Itaborai study involved a representative sample of 6-to-16-year-olds (n=1,248response rate = 86.0%) selected from the Family Health Program registry, which covered 85.5% of the municipal population. The Embu study was based on a probabilistic sample of clusters of eligible households (women aged 15-49 years, child < 18 years), with one mother-child pair selected randomly per household (n=813response rate = 82.4%). The outcome variable was mother's opinion of whether her child had EBP. Potential correlates included types of child behaviors (hyperactivity/conduct/emotional problems as isolated or combined conditions) and impairment, assessed using the Strengths and Difficulties Questionnaire (SDQ)child's age and gendermaternal education and anxiety/depression (assessed using the Self-Reporting Questionnaire [SRQ]). Results: Multivariate regression models identified the following correlates of maternal perception of child EBP: comorbidity (co-occurring hyperactivity/conduct/emotional problems), emotional problems alone, and interference of problems with classroom learning and friendships. Conclusion: Comorbidity of different problem types, emotional problems alone, and interference with classroom learning and friendships increase the likelihood of maternal recognition of EBP in children.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPqMCT/CNPq/CT-Saude/MS/SCTIE/DECIT grant) [33/2008]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [00/14555-4]Univ Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilUniv Cambridge, Dept Psychiat, Cambridge, EnglandUniv Fed Pelotas, Programa Posgrad Epidemiol, Pelotas, RS, BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilCNPqMCT/CNPq/CT-Saude/MS/SCTIE/DECIT grant) [33/2008]FAPESP [00/14555-4]Web of Scienc

Professional and informal help-seeking among low-income adolescents exposed to violence in the community and at school

Background - Adolescents may seek help for many reasons beyond health needs, such as personal stress due to violence exposure. Objective -To investigate factors associated with receiving professional assistance and informal help due to violence exposure in the community and at school. Participants and setting - This study was conducted in Itaboraí, a low-income medium-size city in the State of Rio de Janeiro, Southeast Brazil, characterized by poverty, inequality and violence. It analyses data reported by 669 in-school adolescents (11–15-years, 51.7% girls). Methods - This is a cross-sectional study nested in a longitudinal study (Itaboraí Youth Study). The Itaboraí Youth Study involved a probabilistic community-based sample of 1409 6-to-15-year-olds based on a 3-stage probabilistic sampling plan that included a random selection of census units, eligible households and the target child. Results - Professional assistance was mainly received from psychologists (the Brazilian population has free access to health services). Family members were the main source of informal help. Correlates of professional assistance were having clinical emotional problems and not counting on an adult (if needing help) for community violence victims, and absent father for community and school violence victims. Correlates of informal help were female sex, maternal anxiety/depression and absent father for community violence victims, and younger age and higher maternal education for school violence victims. Conclusions - The mental health needs of violence victims, and maternal difficulties to deal with the adolescent distress resulting from violence exposure (maternal increased burden due to father absence and/or having anxiety/depression) are important influences on the help-seeking process

Lifetime Paid Work and Mental Health Problems among Poor Urban 9-to-13-Year-Old Children in Brazil

Objective. To verify if emotional/behavioral problems are associated with lifetime paid work in poor urban children, when taking into account other potential correlates. Methods. Cross-sectional study focused on 9-to-13-year-old children (n=212). In a probabilistic sample of clusters of eligible households (women 15–49 years and son/daughter <18 years), one mother-child pair was randomly selected per household (n=813; response rate = 82.4%). CBCL/6-18 identified child emotional/behavioral problems. Potential correlates include child gender and age, socioeconomic status/SES, maternal education, parental working status, and family social isolation, among others. Multivariate analysis examined the relationship between emotional/behavioral problems and lifetime paid work in the presence of significant correlates. Findings. All work activities were non-harmful (e.g., selling fruits, helping parents at their small business, and baby sitting). Children with lower SES and socially isolated were more involved in paid work than less disadvantaged peers. Children ever exposed to paid work were four times more likely to present anxiety/depression symptoms at a clinical level compared to non-exposed children. Multivariate modeling identified three independent correlates: child pure internalizing problems, social isolation, and low SES. Conclusion. There is an association between lifetime exposure to exclusively non-harmful paid work activities and pure internalizing problems even when considering SES variability and family social isolation

Do adolescents exposed to peer aggression at school consider themselves to be victims of bullying? The influence of sex and age

Introduction Exposure to peer aggression (PA) and bullying victimization (BV) are both expressions of peer victimization. Objectives In four age-sex groups, (1) Can exposure to PA and BV be considered distinct experiences? (2) To what extent do adolescents exposed to PA consider themselves bullying victims? and (3) What is the effect on BV of the number of PA events experienced? Methods This cross-sectional study evaluated a probabilistic community-based sample of 669 adolescents (11-15 years, 51.7% girls). A three-stage probabilistic sampling plan involved random selection of census units, eligible households, and one target child per household selected. A 15-item scale investigated exposure to PA events (physical aggression, verbal harassment, social manipulation) occurring more than once in the past six months. BV occurring more than once a week or most days in the past six months was investigated after presenting respondents with a BV definition that required them to feel harmed by their victimization experiences. Results Adolescents exposed to PA and/or BV reported PA only (76.2%), BV only (4.7%), and both (19.1%). Rates of BV among those exposed to PA were as follows: 11-to-12-year-old boys (22.7%), 13-to-15-year-old boys (9.7%), 11-to-12-year-old girls (46.5%), and 13-to-15-year-old girls (13.2%). Multiple logistic regression analysis (outcome = BV) found a significant interaction between PA, age, and sex. PA events had a significant effect on BV for all except older girls. Conclusion Exposure to PA and BV are different constructs; few older boys exposed to PA consider themselves bullying victims; and older girls are less affected by PA when it comes to BV

Maternal Awareness of Adolescent Bullying Victimization in a Low-Income Context

The published manuscript is available at EurekaSelect via https://doi.org/10.2174/2210676609666190808094820.Background: Adolescents and parents often disagree about the perception of bullying victimization since adults tend to underestimate its occurrence. Objective: This study identifies factors that can influence maternal perception of bullying victimization experienced by her son/daughter in the past 12 months. Methods: This cross-sectional study involved a representative sample of in-school adolescents (n=669, 11-15-years) living in Itaboraí city, Brazil (mean age±SE: 13.01±0.07 years; 51.7% females). A 3-stage probabilistic sampling procedure (random selection of census units, eligible households and target child) generated sampling weights. Trained lay interviewers individually applied semi-structured questionnaires to mothers and adolescents in the households. Multivariable logistic regression analysis examined factors potentially influencing maternal perception of bullying victimization experienced by her son/daughter: adolescent gender and age, adolescent self-perceived bullying victimization, exposure to severe physical punishment by parents, internalizing/externalizing behaviour problems identified by the Youth Self-Report/YSR, maternal education and maternal anxiety/depression identified by the 20-item Self-Reporting Questionnaire/SRQ-20. Results: Univariable logistic regression analysis identified a strong association between adolescent self-perceived bullying victimization and maternal perception of bullying victimization experienced by her son/daughter. Multivariable models showed that adolescent perception influenced maternal perception when adolescents had no clinical internalizing behaviour problems and when mothers had higher education. Conclusion: Anxious/depressive adolescents may hide victimization incidents, while those with no problems probably reveal these incidents to the mother. Considering that maternal low education is an indicator of low socioeconomic status, which is associated with multiple stressors, less educated mothers may be more likely to interpret these incidents as a common part of growing-up

Os limites de fronteira e a fluidez do mar

A secção UAciência é coordenada pelo Professor Universitário Armindo Rodrigues.[…]. Assim como um agente de fronteira não conhece todos os viajantes que por ele passam, também não existe conhecimento sobre todas as espécies marinhas que chegam aos Açores. Tal como nem todos os centímetros de fronteira podem ser controlados, não é possível monitorizar toda a costa açoriana. No entanto, é preciso criar meios para auxiliar os decisores públicos a detetar, controlar e erradicar os riscos a que as nossas águas podem estar sujeitas. Neste sentido, o Projeto CRYPTO - (AÇORES-01-0145-FEDER-0000091), que se iniciou a 1 de maio de 2010, é que terá a duração de 3 anos, pretende determinar a origem, distribuição e risco de algas potencialmente invasoras, com base na aplicação de técnicas avançadas como códigos de barra de ADN e modelação oceanográfica, visando a proteção do ambiente é a conservação do singular ecossistema açoriano.info:eu-repo/semantics/publishedVersio

Lifetime psychopathology among the offspring of Bipolar I parents

BACKGROUND: Recent studies have demonstrated high rates of psychopathology in the offspring of parents with bipolar disorder. The aim of this study was to identify psychiatric diagnoses in a sample of children of bipolar parents. METHOD: This case series comprised 35 children and adolescents aged 6 to 17 years, with a mean age of 12.5 + 2.9 years (20 males and 15 females), who had at least one parent with bipolar disorder type I. The subjects were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL). Family psychiatric history and demographics were also evaluated. RESULTS: Of the offspring studied, 71.4% had a lifetime diagnosis of at least one psychiatric disorder (28.6% with a mood disorder, 40% with a disruptive behavior disorder and 20% with an anxiety disorder). Pure mood disorders (11.4%) occurred less frequently than mood disorders comorbid with attention deficit hyperactivity disorder (17.1%). Psychopathology was commonly reported in second-degree relatives of the offspring of parents with bipolar disorder (71.4%). CONCLUSIONS: Our results support previous findings of an increased risk for developing psychopathology, predominantly mood and disruptive disorders, in the offspring of bipolar individuals. Prospective studies with larger samples are needed to confirm and expand these results.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)NARSADKrus Endowed Chair in Psychiatry UTHSCSAFederal University of São Paulo Department of PsychiatryThe University of Texas Health Science Center Departments of Psychiatry and OrthodonticsUniversidade de São Paulo Faculdade de Medicina Department of PsychiatryUniversity of Texas Health Science CenterThe University of Texas Health Science Center Department of PsychiatryUNIFESP, Department of PsychiatryNARSAD: MH 69774NARSAD: RR 20571NARSAD: MH068280SciEL

Lifetime psychopathology among the offspring of Bipolar I parents

BACKGROUND: Recent studies have demonstrated high rates of psychopathology in the offspring of parents with bipolar disorder. The aim of this study was to identify psychiatric diagnoses in a sample of children of bipolar parents. METHOD: This case series comprised 35 children and adolescents aged 6 to 17 years, with a mean age of 12.5 + 2.9 years (20 males and 15 females), who had at least one parent with bipolar disorder type I. The subjects were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL). Family psychiatric history and demographics were also evaluated. RESULTS: Of the offspring studied, 71.4% had a lifetime diagnosis of at least one psychiatric disorder (28.6% with a mood disorder, 40% with a disruptive behavior disorder and 20% with an anxiety disorder). Pure mood disorders (11.4%) occurred less frequently than mood disorders comorbid with attention deficit hyperactivity disorder (17.1%). Psychopathology was commonly reported in second-degree relatives of the offspring of parents with bipolar disorder (71.4%). CONCLUSIONS: Our results support previous findings of an increased risk for developing psychopathology, predominantly mood and disruptive disorders, in the offspring of bipolar individuals. Prospective studies with larger samples are needed to confirm and expand these results

Fatores de Risco para Problemas de Saúde Mental na Infância/Adolescência

A cross-sectional study was conducted in an urban low-income community in the municipality of Embu-SP with the objective of identifying factors associated with mental health problems of children and adolescents (MHPCA) in a probabilistic sample (N=67, aged 4-17 years). Standardized instruments were applied to mothers: Child Behavior Checklist; WorldSAFE Core Questionnaire (demographics, domestic violence, father/stepfather drunkenness); Self-Report Questionnaire (maternal mental health problems and suicide ideation). The results of this study identified factors statistically related to MPHCA: child/adolescent of male gender and severe physical punishment; maternal suicide ideation and severe physical marital violence; father/stepfather drunkenness. As a result, vulnerable groups with individual/family characteristics identified in this study should have priority in prevention/treatment programs. &nbsp;Estudo de corte transversal conduzido em comunidade urbana de baixa renda do município de Embu-SP com objetivo de identificar fatores associados a problemas de saúde mental em crianças/adolescentes (PSMCA) em amostra probabilística (N=67, faixa etária 4-17 anos). Foram aplicados instrumentos estruturados às mães: Child Behavior Checklist (PSMCA); WorldSAFE Core Questionnaire (dados sociodemográficos; violência doméstica; embriaguez do pai/padrasto); Self-Report Questionnaire (problemas de saúde mental maternos, ideação suicida materna). Os resultados do estudo apontaram fatores estatisticamente associados aos PSMCA: criança/adolescente ser do sexo masculino e sofrer punição física grave; ideação suicida da mãe e violência conjugal física grave contra a mãe; embriaguez do pai/padrasto. Concluindo, grupos vulneráveis com características individuais/familiares identificadas neste estudo devem ser considerados prioritários em propostas de prevenção/tratamento. &nbsp