Efeitos do exercício físico no transtorno do humor bipolar: uma revisão sistemática

O Transtorno de Humor Bipolar é uma condição crônica e complexa que caracteriza-se por alternância de episódios maníacos, depressivos, mistos e eutímicos; e essa condição leva a uma variação no funcionamento psicossocial ao longo do tempo. Está associado a um aumento do risco de problemas de saúde como: obesidade, câncer e diabetes mellitus. O exercício físico vem sendo estudado como uma possiblidade de intervenção não só no transtorno Bipolar como nas comorbidades. Objetivo: analisar os efeitos do exercício físico para pessoas portadoras de Transtorno de Humor Bipolar. Método: realizou-se uma busca nas bases de dados eletrônicas Pubmed, Psycinfo e Scielo. Foram selecionados os artigos que seguissem os critérios de inclusão: (1) sujeitos fossem portadores de transtorno do humor bipolar (2) estudos que avaliaram os efeitos do exercício físico para portadores de transtorno de humor bipolar; (3) estudos publicados em língua portuguesa, inglesa ou espanhola. Resultados: 13 estudos se adequaram aos critérios de inclusão e foram incluídos na pesquisa. Dentre esses três estudos encontrados abordaram aspectos neurobiológicos, dois estudos correlacionaram exercício físico com variáveis sócio-demográficas, cinco estudos apresentaram intervenções de exercício físico, dois estudos relacionados com aspectos psicossociais e um estudo sobre a percepção dos sujeitos sobre a prática de exercício físico. Considerações finais: estudos indicam benefícios da prática de exercício físico para pessoas portadoras de TB. Novos estudos são necessários a fim de especificar métodos de treinamento e particularidades do exercício para as diferentes fases do transtorno

Web-Based Emotion Regulation Training for Sexual Health: Randomized Controlled Trial

Effective emotional regulation (ER) skills are important for sexual function, as they impact emotional awareness and expression during sexual activity, and therefore, satisfaction and distress. Emotion regulation interventions may offer a promising approach to improve sexual health. Web-based emotion regulation may be a therapeutic strategy for men and women with sexual health concerns. Nevertheless, there is a scarcity of intervention trials investigating its effects in this context, much less using the internet. This study aims to investigate the effects of a web-based emotion regulation training program for sexual function in both men and women. The participants were recruited based on their self-reported sexual problems, which for men was defined by a score of <25 on the International Index Erectile Function (IIEF) and for women by a score of <26.55 on the Female Sexual Function Index (FSFI). The final sample included 60 participants who were randomized to either a web-based emotion regulation training for sexual function or to a waitlist control group. The treatment consisted of an 8-week web-based emotion regulation training for sexual function. The participants were assessed at baseline, post intervention, and the 3-month follow-up. Of the 60 participants included, only 6 completed all 3 assessment points (n=5, 20% in the treatment group and n=1, 5% in the waitlist control group) after receiving the intervention. At follow-up, there were no significant differences between groups in any measure. Among the intervention completers, large-to-moderate within-group effect sizes were observed between the assessment points on measures of emotion regulation, depression, lubrication, orgasm, thoughts of sexual failure, and abuse during sexual activity. The adherence rate was very low, limiting the generalizability of the findings. Participants who completed the intervention showed improvements in both sexual function domains and emotion regulation. Nonetheless, due to a high dropout rate, this trial failed to collect sufficient data to allow for any conclusions to be drawn on treatment effects. ClinicalTrials.gov NCT04792177; https://clinicaltrials.gov/study/NCT04792177

Developmental Screening Tools: Feasibility of Use at Primary Healthcare Level in Low- and Middle-income Settings

An estimated 150 million children have a disability. Early identification of developmental disabilities is a high priority for the World Health Organization to allow action to reduce impairments through Gap Action Program on mental health. The study identified the feasibility of using the developmental screening and monitoring tools for children aged 0-3 year(s) by non-specialist primary healthcare providers in low-resource settings. A systematic review of the literature was conducted to identify the tools, assess their psychometric properties, and feasibility of use in low- and middle-income countries (LMICs). Key indicators to examine feasibility in LMICs were derived from a consultation with 23 international experts. We identified 426 studies from which 14 tools used in LMICs were extracted for further examination. Three tools reported adequate psychometric properties and met most of the feasibility criteria. Three tools appear promising for use in identifying and monitoring young children with disabilities at primary healthcare level in LMICs. Further research and development are needed to optimize these tools

The Role of Emotion Regulation Strategies for Sexual Function and Mental Health: A Cluster Analytical Approach

We investigated distinct profiles in emotion regulation strategies (reappraisal and suppression) and their associations with sexual function and mental health. The online survey sample consisted of 5436 adult participants. The gender stratified cluster analysis resulted in a four-cluster solution for both men and women. Better sexual function and mental health scores were found for participants with high cognitive reappraisal and low expressive suppression. High expressive suppression was associated with higher anxiety and depression and worse sexual function. Sexological care should take into account the assessment of emotion regulation abilities and emotion regulation training interventions to support reappraisal strategies

The Role of Emotion Regulation Strategies for Sexual Function and Mental Health: A Cluster Analytical Approach.

peer reviewedWe investigated distinct profiles in emotion regulation strategies (reappraisal and suppression) and their associations with sexual function and mental health. The online survey sample consisted of 5436 adult participants. The gender stratified cluster analysis resulted in a four-cluster solution for both men and women. Better sexual function and mental health scores were found for participants with high cognitive reappraisal and low expressive suppression. High expressive suppression was associated with higher anxiety and depression and worse sexual function. Sexological care should take into account the assessment of emotion regulation abilities and emotion regulation training interventions to support reappraisal strategies

Sexual Satisfaction and Sexual Behaviors During the Covid-19 Pandemic: Results From the International Sexual Health and Reproductive (I-SHARE) Health Survey in Luxembourg

Aim: To identify the impact of COVID-19 measures on sexual behaviors and sexual satisfaction in Luxembourg residents. Methods: We conducted a cross-sectional online survey of adults (> 18 years of age) residing in Luxembourg, while COVID-19 restrictions were in place. The survey was available in four languages (French, German, English and Portuguese). Survey questions focused on masturbation, cuddling, condom use, sex frequency, sexting, cybersex, watching porn, and sexual satisfaction. Results: 557 volunteers completed the survey (35.5% men, 64.3% women). Sexual problems increased during the COVID-19 measures while sexual satisfaction decreased compared to prior the COVID-19 measures (assessed retrospectively). Factors associated with increased odds of sexual satisfaction were: having a steady relationship before COVID-19 restrictions, engaging in sexting, reporting good mental health and not altering alcohol intake. Conclusions: The context of the COVID-19 pandemic and the measures implemented in Luxembourg affected sexual behaviors and sexual satisfaction. Sexual and reproductive health care centers and health professionals in general should take these results into consideration when providing care. Recommendations on the importance of sexual health for general wellbeing and behaviors associated with sexual satisfaction should be offered and possibilities to experience sexuality while reducing contamination risks be discussed

Validação brasileira do alcohol craving questionnaire – Short form revised (ACQ-SFR)

Introdução: A avaliação do craving é importante para o tratamento de pacientes com Transtornos por uso de substâncias psicoativas. O objetivo deste estudo foi realizar a validação do Alcohol Craving Questionnaire-Short Form Revised- Versão Brasileira (ACQ-SFR – Versão Brasileira).Métodos: Foi um estudo observacional transversal, com uma amostra não aleatória de 121 participantes alcoolistas, do sexo masculino, internados para desintoxicação em unidade especializada. Os instrumentos utilizados foram: entrevista clínica com dados sociodemográficos e de padrão de uso de substâncias, MMSE, ACQ-SFR – Versão Brasileira, EAV do craving, BDI, BAI, estímulo visual indutor de craving. Resultados: Na análise fatorial, foram encontrados dois fatores: o fator 1 representa o craving pelo reforço positivo e negativo do álcool, e o fator 2, o propósito de consumir o álcool associado ao prazer. O alfa de Cronbach total foi de 0,91 (12 itens), o do Fator 1 foi 0,92 (8 itens) e o do Fator 2 foi 0,70 (3 itens). O total de pontos da escala foi correlacionado com a Escala Analógico-Visual (r=0,658; p<0,01). Conclusão: Conclui-se que o ACQ-SFR – Versão Brasileira demonstrou ter propriedadespsicométricas satisfatórias.Palavras-chave: Craving; validação; álcoo

Validação psicométrica do marijuana craving questionnaire -short form – versão Brasil

Introdução: O objetivo deste estudo foi realizar a validação psicométrica do Marijuana Craving Questionnaire-Short Form - Versão Brasil (MCQ-SF – Versão Brasil). Métodos: Neste estudo transversal, uma amostra não aleatória de 120 participantes do sexo masculino foi dividida em dois grupos: Grupo 1, incluindo usuários de cannabis da população geral (n=34) e Grupo 2, incluindo pacientes internados em unidade de dependência química e que preenchiam critérios diagnósticos para dependência de cannabis pela CID-10 (n=86). Os indivíduos do Grupo 1, que foram recrutados pelo método snow-ball, deviam estar utilizando a cannabis há pelo menos um ano, tê-la utilizado pela última vez há no mínimo 24 e no máximo 48 horas, e não ser dependentes de outras substâncias psicoativas salvo a nicotina. Os indivíduos do Grupo 2 deviam apenas preencher critérios diagnósticos para dependência de cannabis, não sendo necessário que não fossem dependentes de outras substâncias psicoativas. Além disso, deviam estar utilizando a cannabis há pelo menos um ano e tê-la utilizado pela última vez há no mínimo 24 horas. Os instrumentos utilizados foram: entrevista clínica com dados sociodemográficos, SRQ20, MMSE, MCQ-SF – Versão Brasil, EAV do craving, BDI, BAI, estímulo visual indutor de craving. Resultados: Na análise fatorial, foram encontrados três fatores: Emocionalidade, Intencionalidade e Compulsividade. Os três fatores apresentaram variância total de 66,74 %. O alfa de Cronbach do seu total de pontos foi 0,89. O instrumento no total de pontos foi correlacionado com a Escala Analógico-Visual (r=0,644; p<0,01). Conclusões: Conclui-se que o MCQ-SF – Versão Brasil demonstrou ter propriedades psicométricas satisfatórias

Sexual health and emotion regulation: investigating a reciprocal relationship

Sexual disorders are characterized by difficulties in the ability to respond sexually or to obtain sexual pleasure. Epidemiological data indicate that about 40-45% of adult women and 20-30% of adult men have at least one manifest sexual disorder during their lifetime. The etiology of sexual disorders is multifactorial, encompassing physiological, affective, interpersonal, and psychological, context-dependent-factors, which may predispose, precipitate, or maintain the sexual dysfunction. Psychological and emotional factors may either contribute to the development of sexual problems or be a consequence thereof. Emotional reactions and thoughts during sexual activity can also affect sexual functionality. With respect to emotions, different patterns for individuals with and without sexual dysfunction have been reported. Similarly, the difficulty or inability to face experiences or process emotions adequately, also termed emotion dysregulation, has been associated with coping strategies detrimental to health and with a variety of mental disorders. Such context suggest that emotion regulation may be important for sexual health and most likely also in the treatment of sexual problems. By deepen our knowledge of the role of emotion regulation for sexual health it would be possible to have an impact in both sexuality research and in a clinical level by providing evidence to base future of therapy programmes for people with sexual concerns. The overall objectives of the SHER project are: a) to determine the associations between emotion regulation and sexual health and; b) to develop and evaluate an internet-based intervention protocol designed to improve emotion regulation skills for people with sexual disorders. The project employed different methods, namely a literature scoping review, a cross-sectional online survey and a randomized controlled trial intervention with a three months follow-up. The dissertation presents three studies (four manuscripts) from the SHER project. The first study aimed at reviewing the existing literature on the effects of emotion regulation on sexual function and satisfaction. After searching in different databases and applying the inclusion and exclusion criteria, twenty-seven articles were analyzed. As a conclusion, was identified that emotion regulation was associated with poorer sexual health outcomes, difficulties in the sexual response cycle and overall lower sexual satisfaction. In addition, the few experimental studies (either in laboratory settings or in intervention trials) found positive effects of promoting emotion regulation change on sexual function and satisfaction. The aim of the second study was to determine whether distinct profiles in terms of preferred emotion regulation strategies are differentially associated with sexual and mental health. The sample consisted of 5436 participants aged between 18 and 77 years (M= 25.80, SD= 6.96). A gender stratified cluster analysis was performed to classify individuals according to their scores on scales measuring emotion regulation strategies (cognitive reappraisal and emotional suppression), sexual health (assessed using gender-specific self-report questionnaires), anxiety and depression symptoms. For both men and women, the results showed a four-cluster solution: low reappraisal and high suppression, n=1243; high reappraisal and low suppression, n=1695; high reappraisal and high suppression, n=1425; low reappraisal and low suppression, n=1073. Better sexual and mental health scores were found for participants with high cognitive reappraisal and low expressive suppression scores. High expressive suppression was associated with higher anxiety and depression scores and worse sexual health. We concluded by suggesting that provision of care for sexological patients should include an assessment of their emotion regulation abilities and emotion regulation training interventions fostering reappraisal should be offered when appropriate. The third study, aimed at developing and testing an internet-based emotion regulation training for sexual health (TREpS). First, an intervention protocol was established and published indicating the objectives, procedures and expected outcomes of the intervention. Later, a second manuscript reported the findings of the intervention. The intervention was composed of eight modules, delivered weekly. The module contents encompassed psychoeducation on sexual health and emotion regulation, a set of different strategies to deal with emotions (relaxation techniques, cognitive flexibility, non-judgmental awareness, self-acceptance and compassion, emotion analysis) and sexual emotional exposures. Participants were assessed in three different time points: baseline, end of the intervention and at three months after the intervention ending. Initially 60 participants met the inclusion criteria and were allocated in two groups. Nonetheless, differently than what was expected, the intervention yielded a very large dropout rate (83.4 %). In this circumstance, some changes to the study protocol have been performed, e.g., the reduction of the follow-up interval period and the complete assessment of the initially waitlist-control group in the three different time points. Since the adherence rate was very low the gathered data was insufficient to investigate treatment effects. Among the participants who completed the intervention larger and moderate effect sizes were observed between assessments for emotion regulation, depression, lubrication, orgasm and thoughts of sexual failure and abuse during sexual activity

Efeitos do exercício físico no transtorno de humor bipolar : uma revisão sistemática

Introdução: Transtorno de Humor Bipolar é uma condição crônica e complexa que caracteriza-se por alternância de episódios maníacos, depressivos, mistos e eutímicos. Essa condição leva a uma variação no funcionamento psicossocial ao longo do tempo. Está associado a um aumento do risco de problemas de saúde como: obesidade, câncer e diabetes mellitus. Estudos para avaliar o papel do exercício físico no processo terapêutico estão sendo desenvolvidos. Objetivo: Analisar os efeitos do exercício físico para pessoas portadoras de Transtorno de Humor Bipolar. Métodos: Foi realizada uma busca nas bases de dados eletrônicas Pubmed, Psycinfo e Scielo. Foram selecionados os artigos que seguissem os critérios de inclusão: (1) sujeitos fossem portadores de transtorno do humor bipolar (2) estudos especificando efeitos do exercício físico para portadores de transtorno de humor bipolar; (3) estudos publicados em língua portuguesa, inglesa ou espanhola. Resultados: 13 estudos se adequavam aos critérios de inclusão e foram incluídos na pesquisa. Três estudos encontrados abordaram aspectos neurobiológicos, 2 estudos correlacionaram exercício físico com variáveis sócio-demográficas, 7 estudos apresentaram intervenções de exercício físico e 1 estudo abordou a percepção de portadores de TB sobre os efeitos do exercício físico. Conclusões: Estudos indicam benefícios da prática de exercício físico para pessoas portadoras de TB. Novos estudos são necessários a fim de especificar métodos de treinamento e particularidades do exercício para as diferentes fases do transtorno.Introduction: Bipolar disorder is a chronic and complex condition that is characterized by alternating manic, depressive, mixed and euthymic phases. This condition leads to a variation in the psychosocial functioning over time. It is associated with an increased risk of health problems such as obesity, cancer and diabetes mellitus. Studies to assess the role of physical exercise in the therapeutic process are being developed. Objectives: To analyze the effects of physical exercise for people with Bipolar disorder Methods: A search was conducted in the electronic databases PubMed, SciELO and Psycinfo. Articles were included if they follow the inclusion criteria: (1) subjects were diagnosed with bipolar disorder (2) studies specifying effects of physical exercise for people with bipolar disorder, (3) studies published in Portuguese, English or Spanish. Results: 13 studies met the inclusion criteria and were included. 3 studies addressed neurobiological aspects of physical exercise, 2 studies correlated exercise with socio-demographic variables, 7 studies presented physical exercise interventions and 1 study addressed the perception of TB patients about the effects of physical exercise. Conclusions: Studies indicate benefits of physical activity for people with BD. Further studies are needed in order to specify training methods and particularities of the year for the different stages of the disorder