Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology

Background: Mental State Examination (MSE) is compared with physical examination as a reliable method of objective data investigation. There is a growing concern with psychiatric clinics, nosology, and the reliability of diagnostic interview methods as a source of valid diagnostic strategy. Efforts to achieve an international diagnosis protocol have been unsuccessful or polemical. This paper focuses on psychopathology, MSE, and mental function development within Brazilian psychiatry over the last few decades.Methods: Searches, interviews, and narrative reviews were done to look for systematic ways in which to conduct MSE, mental functions, symptom clusters, orientations about data observation and records. Brazilian psychopathology textbooks were examined, if they provided access to consolidated knowledge on psychopathology examination.Results: Sixteen textbooks were selected from a 49 year span. Descriptive psychopathology with phenomenological orientation was the primary trend in the MSE. Concepts derived from different traditions, most lacking common terminology, suggested some divergence among authors. Recommendations for patient observation and how to collect objective data was clear, but MSE standardization efforts were missing. A detailed description of mental function abnormalities was the main MSE record strategy, without consensus about ways to summarize and record this data. In an examination summary, mental strata was divided into “mental functions,” and MSE subsets were frequent. All authors considered the following mental functions: consciousness, perception, thought, memory, attention, orientation, and volition.Discussion: Psychiatric competence demands MSE proficiency. Official documents are not clear about performance and recording standards. MSE data was usually recorded through descriptive psychopathology. A shift from detailed descriptive findings, to an array of observed pathological elements, described through a mental function checklist was observed over time. Clinical practice and research guidelines should consider the development of reliable MSE practices; however, it has been neglected by modern psychiatry/neuroscience through the excessive emphasis on interview protocols. Better MSE practices, and the improvement of bedside skill in psychiatry are necessary and depend on the recovery of psychopathological debates and semiological reasoning, which will allow the return of phenomenology-oriented “observational” techniques

Morbidade psiquiátrica menor em trabalhadores da área de saúde

Made available in DSpace on 2018-08-06T13:15:00Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) jose_lessa_ipec_mest_2011.pdf: 1157763 bytes, checksum: 16776c8ef0e7e914763f4c7d2db98bce (MD5) Previous issue date: 2011Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Sintomas ansiosos, depressivos e somatoformes, comumente referidos como morbidade psiquiátrica menor (MPM), apresentam elevada prevalência na população geral adulta, além de serem diagnosticado s em um terço ou mais das pessoas que procuram atendimentos em serviços primários de saúde. A distribuição dessa categoria de morbidade mostra-se iníqua na população geral, pois há fatores de risco já bem estabelecidos que influenciam a sua ocorrência e persistência. O objetivo do presente estudo foi investigar a prevalência da MPM nos trabalhadores da área de saúde de uma unidade hospitalar e sua associação com características sócio-demográficas, fatores estressores de vida e acidentes de trabalho. Trata-se de um estudo seccional em 404 trabalhadores de saúde, cuja variável dependente foi o instrumento de rastreio epidemiológico General Health Questionnaire (GHQ-12). É um instrumento validado para a língua portuguesa do Brasil A coleta de dados foi realizada por meio de questionário estruturado e de autopreenchimento, aplicado com apoio de pessoal treinado. As variáveis associadas testadas foram: sócio-demográficas; Fatores Estressores de Vida listados no Manual Diagnóstico e Estatísti co dos Transtornos Mentais (DSM-IV) e a ocorrência de ac identes de trabalho. Adicionalmente, os hábitos sociais comumente associados à MPM: uso de álcool, tabagismo e trabalho em turnos de plantão. Encontrou-se associações no nível de significância 5% na amostra entre MPM e as seguintes características no modelo de regressão logística múltipla: dificuldades financeiras graves OR 2,80 (IC95% 1,37-5,69) e mudança forçada de domicílio nos últimos 12 meses OR 3,32 (IC95% 1,18-9,39); e escolaridade igual ou maior que nível superior OR 3,95 (IC95% 1,48-10,59). Conclusão: A prevalência de morbidade psiquiátrica menor detectada neste estudo foi conservadora (13%), provavelmente devido ao ponto de corte mais específico. Consistente com outros estudos nacionais e internacionais, dificuldades financeiras estiveram associadas a morbidade psiquiátrica menorAnxiety, depressive and somatoform symptoms commonly referred to as minor psychiatric disorders show high prevalence among general adult population, besides of being diagnosed in one third or more of the people seeking consultation in primary care units. The distribution of this category of morbidity in general population is skewed, once there are well established risk factors affecting their occurrence and persistence. The objective was to investigate the prevalence of minor psychiatric disorders in health workers of a hospital unit, and test its association with sociodemographic variables, as well as with stressful life events and work accidents. The design was cross-sectional. The number of participants in the study was 404 individuals. The outcome variable was the General Health Questionnaire (GHQ-12). It is a validated screening tool in Brazilian Portuguese Data were gathered by means of a multi-dimensional self-administered questionnaire, with aid of trained personnel. The associated variables tested were: socio-demographics, stressful life events as listed in the Diagnostic Statistic Manual of Mental Disorder 4th edition, and the occurrence of work accidents in the preceding year. Additionally, social habits frequently associated with minor psychiatric disorders were assessed: alcohol and tobacco use, and shift work. We found statistically significant associations (5%) in the sample between minor psychiatric disorders and the following independent variables in the final model of multiple logistic regression: financial difficulties OR 2,80 (IC95% 1,37-5,69), forced change of domicile in the preceding year OR 3,32 (IC95% 1,18-9,39), and college education or higher OR 3,95 (IC95% 1,48-10,59). Conclusion: The prevalence of minor psychiatric disorders detected in this study was conservative (13%), probably due to a more specific cutoff point. Consistent with other national and international studies, financial difficulties were associated with minor psychiatric disorder

Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease

Submitted by Rodrigo Senorans ([email protected]) on 2015-04-17T16:51:21Z No. of bitstreams: 1 Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease.pdf: 79320 bytes, checksum: 82d0d98d987d3ef323ffdae0c5e5b975 (MD5)Approved for entry into archive by Anderson Silva ([email protected]) on 2015-04-17T16:55:39Z (GMT) No. of bitstreams: 1 Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease.pdf: 79320 bytes, checksum: 82d0d98d987d3ef323ffdae0c5e5b975 (MD5)Approved for entry into archive by Anderson Silva ([email protected]) on 2015-04-17T18:37:43Z (GMT) No. of bitstreams: 1 Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease.pdf: 79320 bytes, checksum: 82d0d98d987d3ef323ffdae0c5e5b975 (MD5)Made available in DSpace on 2015-04-17T18:50:40Z (GMT). No. of bitstreams: 1 Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease.pdf: 79320 bytes, checksum: 82d0d98d987d3ef323ffdae0c5e5b975 (MD5) Previous issue date: 2014Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, BrasilUniversidade Federal do Rio de Janeiro. Instituto de Psiquiatria. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, BrasilObjective: To evaluate psychiatric comorbidities in outpatients receiving care for HIV and Chagas disease at Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. Methods: Cross-sectional study with a consecutive sample of 125 patients referred to an outpatient psychiatric clinic from February to December 2010. The Mini International Neuropsychiatric Interview (MINI) was used. Factors associated with more frequent mental disorders were estimated by odds ratios (OR) with 95% confidence intervals (95%CI) by multiple logistic regression. Results: Seventy-six (60.8%) patients with HIV, 40 (32%) patients with Chagas disease, and nine (7.2%) patients with human T-lymphotropic virus were interviewed. The majority were women (64%), with up to 8 years of formal education (56%), and unemployed (81.6%). The median age was 49 years. Suicide risk (n=71) (56%), agoraphobia (n=65) (52%), major depressive episode (n=56) (44.8%), and alcohol/drug abuse (n=43) (34.4%) predominated, the latter being directly associated with lower family income (OR = 2.64; 95%CI 1.03-6.75) and HIV infection (OR = 5.24; 95%CI 1.56-17.61). Suicide risk was associated with non-white skin color (OR = 2.21; 95%CI 1.03-4.75), unemployment (OR = 2.72; 95%CI 1.01-7.34), and diagnosis of major depression (OR = 3.34; 95%CI 1.54-7.44). Conclusion: Measures targeting adverse socioeconomic conditions and psychiatric and psychological monitoring and care should be encouraged in this population, considering the association with abuse of alcohol/other psychoactive drugs and suicide risk

Does croton argyrophyllus extract has an effect on muscle damage and lipid peroxidation in rats submitted to high intensity strength exercise?

Many species of the genus Croton have been used for anti-inflammatory, antiproliferative, antidiabetic, and antitumor purposes. The objective was to evaluate the effect of a hydroethanolic extract (HEE) from the inner bark of Croton argyrophyllus (Euphorbiaceae) on muscle damage and oxidative stress in rats after high intensity exercise. The animals were divided into four groups: (i) the sedentary group (SV; n = 7), (ii) the exercise vehicle group (EV, n = 7), (iii) the sedentary group HEE (SHG; n = 7) composed of sedentary animals and treated with the hydroethanolic extract of C. argyrophyllus (200 mg/kg, v.o.), and (iv) the HEE exercise group (HEE; n = 7) composed of animals submitted to resistance exercise (RE) and treated with the hydroethanolic extract of C. argyrophyllus (200 mg/kg, v.o.). In the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) test, the HEE showed lower values of inhibition potential (IP%) at 39.79% compared to gallic acid, 87.61%, and lipoperoxidation inhibition at 27.4% (100 µg/mL) or 28.6% (200 µg/mL) (p < 0.001). There was inhibition in free radicals in vivo. The HEE of C. argyrophyllus partially reduced the biomarkers of oxidative stress in muscle tissue and muscular damage (creatine kinase (CK) and Lactate Dehydrogenase (LDH)) (p < 0.05) in rats, and in this sense it can be an aid to the recovery process after exhaustive efforts