O infanticídio no código penal de 1940: crítica à aplicação do critério fisiopsíquico

lnfanticide is described in the Brazilian Penal Code of 1940 as follows: "The killing by the mother of her newborn child during or soon after the birth under the influence of puerperal state". "Penalty: two to six years of prison". This law grants the mother who kills her newborn child a lighter punishment than that given to homicides in general. For this to occur, however, it is necessary that the crime be committed in a special state of mind, resulting from the "influence of puerperal state". By principle, modern Psychiatry refuses a pathogenetic role to birth and puerperium wherefore we decided to study 55 cases in which a woman was prosecuted for infanticide in the city of Rio de Janeiro, between the first of January of 1900 and December 31 of 1993, in order to delineate the role that psychiatric disturbances might have played in the genesis of such cases. We found that, although 36% of the infanticide stated having committed the crime under the influence of some psychopathological disturbance, generally amnesia, the analysis of the cases revealed that in all of them this disturbance was a feigned one. On the other hand, we found that infanticides were mainly young, single, poorly educated women, generally working in non-qualified jobs, for whom an illegitimate child would represent for various reasons an additional burden. In conclusion we affirm that infanticide is a motivated act, not the consequence of any psychiatric disorder and that the privileged legal treatment enjoyed by these women is based on moral factors and not on scientific evidence.CAPESO delito do infanticídio está descrito no artigo 123 da parte especial do Código Penal de 1940: "Matar, sob a influência do estado puerperal, o próprio filho, durante o parto ou logo após". "Pena: detenção, de dois a seis anos. Este dispositivo garante à mãe que mata seu filho recém-nascido uma punição atenuada em comparação àquela reservada aos homicidas em geral. Para tanto, é necessário, contudo, que o crime tenha sido cometido num estado psíquico anômalo, resultante da "influência do estado puerperal". Partindo do princípio de que as concepções etiológicas da Psiquiatria moderna recusam um papel patogenético a fatores como o parto e o puerpério, empreendemos uma pesquisa nos autos de 55 processos referentes a casos de infanticídio ocorridos na cidade do Rio de Janeiro entre primeiro de janeiro de 1900 e 31 de dezembro de 1993, visando delimitar o papel que transtornos psiquiátricos possam ter exercido na gênese destes delitos. Constatamos que, aproximadamente 36% das acusadas aleguem ter cometido o crime na vigência de algum transtorno psicopatológico, em geral, durante um episódio de amnésia lacunar, a análise destes casos revelou que o diagnóstico mais provável era o de simulação. Em contrapartida, evidenciamos que as infanticidas são, em sua maioria, mulheres jovens, solteiras, pouco instruídas, que se ocupam de tarefas profissionais desvalorizadas, para quem o nascimento de uma criança ilegítima constituiria, por motivos variados, um ônus adicional. À guisa de conclusão, sustentamos que o infanticídio é um ato motivado e não consequência de um transtorno mental. Fica patente, portanto, que o tratamento legal privilegiado das infanticidas fundamenta-se em considerações de ordem moral e não, científica

Relationship between epileptic seizures and criminal behavior: A Systematic Literature Review

Objective: The principal objective aims to assess a possible relationship between epilepsy and aggressive behavior. Secondarily, we intend to study how epilepsy relates to criminal liability. Methods: A systematic literature review was performed, using the Web of Science,United States National Library of Medicine (PubMed),and Scielo databases. The searches were conducted in May-June 2022 and covered the period from 2000 to 2022. Eligibility criteria consisted on original articles in English and Portuguese that were interested in the association of epilepsy, criminal behavior (with aggression directed to others), criminal liability in adults with epilepsy. Results: The search yielded 921 results, 794 of which in PubMed, 115 in Web of Science, and 12 in Scielo. Articles that failed to meet the inclusion criteria (206) and duplicates (201) were excluded. Conclusion: There were no findings to indicate a significant increase in aggressive behaviors in individuals with epilepsy. However, it was possible to identify a higher prevalence of aggressive acts in males with epilepsy, besides the presence of comorbidities with mental disorders and substance use. In addition, the results suggest that in criminal offenders with epilepsy, the seizures originated in the temporal and frontal cerebral lobes. Further researchis necessary on the relationship between epilepsy, criminality, and criminal liability in order to produce more robust data to support legal proceedings

The invisible patients: posttraumatic stress disorder in parents of individuals with cystic fibrosis

BACKGROUND: Besides the growing acknowledgment of the relevance of posttraumatic stress disorder (PTSD) related to medical illness, there is no study in cystic fibrosis yet. OBJECTIVE: To assess the prevalence of PTSD and the three clusters of posttraumatic stress symptoms (PTSS) in parents of patients with cystic fibrosis. METHODS: Parents of patients with cystic fibrosis (age range: 2 to 33 years) were drawn from the Cystic Fibrosis Association of the city of Rio de Janeiro. In this cross-sectional study, parents were asked to fulfill a questionnaire for social and demographic characteristics and were interviewed by means of the PTSD module of the Structured Clinical Interview for DSM-IV. RESULTS: The sample comprised 62 subjects (46 mothers and 16 fathers). Current prevalence for full PTSD was 6.5% and that for partial PTSD was 19.4%. Parents with and without PTSS differed significantly in two psychosocial aspects: the former reported more emotional problems (p = 0.001); and acknowledged more often the need for psychological or psychiatric interventions (p = 0.002) than the latter. However, only 6.3% of the parents with PTSS were in psychological/psychiatric treatment. DISCUSSION: This preliminary study showed that the frequency of PTSD symptoms is fairly high among parents of patients with cystic fibrosis, and although these parents recognize they have emotional problems and need psychological/psychiatric treatment, their suffering remains invisible to the medical system, leading to underdiagnosis and undertreatment.CONTEXTO: Apesar do crescente reconhecimento da relevância do transtorno de estresse pós-traumático (TEPT) secundário a doenças médicas, ainda não existem estudos em fibrose cística. OBJETIVO: Verificar a prevalência de TEPT e dos três grupos de sintomas de estresse pós-traumático em pais de pacientes com fibrose cística. MÉTODOS: Pais de pacientes com fibrose cística (idade média: 2 a 33 anos) foram recrutados da Associação Carioca de Mucoviscidose. Neste estudo transversal, os pais preencheram um questionário sociodemográfico e foram entrevistados por meio do módulo de TEPT do Structured Clinical Interview for DSM-IV. RESULTADOS: A amostra era composta de 62 indivíduos (46 mães e 16 pais). A prevalência atual de TEPT foi 6,5% e de TEPT parcial, de 19,4%. Os pais com e sem sintomas de TEPT diferiram significativamente em dois aspectos psicossociais: os primeiros relataram mais problemas emocionais (p = 0,001) e reconheceram mais frequentemente a necessidade de tratamento psiquiátrico ou psicológico (p = 0,002) que os últimos. Entretanto, somente 6,3% dos pais com sintomas de TEPT estavam em tratamento psiquiátrico/psicológico. CONCLUSÕES: Este estudo preliminar demonstrou que a frequência dos sintomas de TEPT é bem elevada em pais de pacientes com fibrose cística e, apesar de esses pais reconheceram que tem problemas emocionais e precisam de tratamento psiquiátrico/psicológico, seu sofrimento permanece invisível para o sistema médico, levando ao subdiagnóstico e ao subtratamento.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Universidade Federal do Rio de Janeiro Instituto de PsiquiatriaUniversidade Federal Fluminense Departamento de Psiquiatria e Saúde MentalFundação Oswaldo Cruz Escola Nacional de Saúde PúblicaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Psiquiatria e Psicologia MédicaUNIFESP, EPM, Depto. de Psiquiatria e Psicologia MédicaSciEL

Vulnerability and Protective Factors for PTSD and Depression Symptoms Among Healthcare Workers During COVID-19: A Machine Learning Approach

Background: Healthcare workers are at high risk for developing mental health problems during the COVID-19 pandemic. There is an urgent need to identify vulnerability and protective factors related to the severity of psychiatric symptoms among healthcare workers to implement targeted prevention and intervention programs to reduce the mental health burden worldwide during COVID-19. // Objective: The present study aimed to apply a machine learning approach to predict depression and PTSD symptoms based on psychometric questions that assessed: (1) the level of stress due to being isolated from one's family; (2) professional recognition before and during the pandemic; and (3) altruistic acceptance of risk during the COVID-19 pandemic among healthcare workers. // Methods: A total of 437 healthcare workers who experienced some level of isolation at the time of the pandemic participated in the study. Data were collected using a web survey conducted between June 12, 2020, and September 19, 2020. We trained two regression models to predict PTSD and depression symptoms. Pattern regression analyses consisted of a linear epsilon-insensitive support vector machine (ε-SVM). Predicted and actual clinical scores were compared using Pearson's correlation coefficient (r), the coefficient of determination (r2), and the normalized mean squared error (NMSE) to evaluate the model performance. A permutation test was applied to estimate significance levels. // Results: Results were significant using two different cross-validation strategies to significantly decode both PTSD and depression symptoms. For all of the models, the stress due to social isolation and professional recognition were the variables with the greatest contributions to the predictive function. Interestingly, professional recognition had a negative predictive value, indicating an inverse relationship with PTSD and depression symptoms. // Conclusions: Our findings emphasize the protective role of professional recognition and the vulnerability role of the level of stress due to social isolation in the severity of posttraumatic stress and depression symptoms. The insights gleaned from the current study will advance efforts in terms of intervention programs and public health messaging

Severity of anxiety and work-related outcomes of patients with anxiety disorders

Background : This study examined associations between anxiety and work-related outcomes in an anxiety disorders clinic population, examining both pretreatment links and the impact of anxiety change over 12 weeks of treatment on work outcomes. Four validated instruments were used to also allow examination of their psychometric properties, with the goal of improving measurement of work-related quality of life in this population. Methods : Newly enrolled adult patients seeking treatment in a university-based anxiety clinic were administered four work performance measures: Work Limitations Questionnaire (WLQ), Work Productivity and Activity Impairment Questionnaire (WPAI), Endicott Work Productivity Scale (EWPS), and Functional Status Questionnaire Work Performance Scale (WPS). Anxiety severity was determined using the Beck Anxiety Inventory (BAI). The Clinical Global Impressions, Global Improvement Scale (CGI-I) was completed by patients to evaluate symptom change at a 12-week follow-up. Two severity groups (minimal/mild vs. moderate/severe, based on baseline BAI score) were compared to each other on work measures. Results : Eighty-one patients provided complete baseline data. Anxiety severity groups did not differ in job type, time on job, job satisfaction, or job choice. Patients with greater anxiety generally showed lower work performance on all instruments. Job advancement was impaired for the moderate/severe group. The multi-item performance scales demonstrated better validity and internal consistency. The WLQ and the WPAI detected change with symptom improvement. Conclusion : Level of work performance was generally associated with severity of anxiety. Of the instruments tested, the WLQ and the WPAI questionnaire demonstrated acceptable validity and internal reliability. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64535/1/20624_ftp.pd

The best of two worlds: Combining the DSM-5 and ICD-11 clusters of symptoms for posttraumatic stress disorder in a single screening scale

Objectives: The most recent DSM-5 (2013) and ICD-11 (2018) diagnostic criteria for posttraumatic stress disorder (PTSD) encompass 20 and six symptoms, respectively, organized in different structures. This study aimed to investigate the dimensions of the Posttraumatic Stress Disorder Checklist 5 (PCL-5) according to the DSM-5’s broader definition of PTSD and the ICD-11’s narrower approach, as well as to explore an alternative restricted model that retains the core symptoms explicitly related to traumatic experiences. Methods: Data were gathered from Brazilian employees (n=1,101) who had directly experienced traumatic life events or had been exposed to them because of their work activities. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to evaluate the configural and metric structures of the models. Results: We estimated seven models of the latent structure of PTSD including the four-factor DSM-5 and three-factor ICD-11 PTSD models. Given the lack of evidence of their validity, an alternative 10-symptom model was tested. The final seven-item PTSD model considerably improved estimation of the PTSD construct. This solution showed reliable items with non-redundant content, acceptable fit indices, and satisfactory configural and metric properties. Conclusion: The more parsimonious one-dimensional model comprising the core PTSD symptoms has the potential to improve assessment of PTSD

Caracterização Geoquímica e Bioestratigráfica das Superfícies de Inundação Marinha da Seção Meso-Neodevoniana, na Região de Dom Aquino (MT), Noroeste da Bacia do Paraná, Brasil

The global anoxic event in the Frasnian is well characterized in the Paraná Basin, in the upper portion of the Ponta Grossa Formation, by dark carbonaceous shales rich in organic matter. These shales are found in a section of the Ponta Grossa Formation of Meso and Neo-Devonian age, where the shales correspond to the signature of the Givetian-Frasnian transition- and, also, to the progressive drowning of the Devonian sequence in the basin. Through geochemical and biostratigraphic data obtained from the section mentioned above, it was possible to recognize flood surfaces and the maximum flooding surface in the section and, also, the progressive drowning of the Devonian sequence in the basin that reached its maximum in the Frasnian. These shales, which represent the signature of the Givetian-Frasnian transition and the maximum flooding surface, occurred in Frasnian, can be used as a chronostratigraphic marker and are also the object of interest for hydrocarbon exploration. Two miospore assemblages related to the Givetian and Frasnian and some algae of the genus Maranhites were recognized as well as acritarchs

STUCK IN A MOMENT: TONIC IMMOBILITY PREDICTS POOR QUALITY OF LIFE IN TREATED PTSD PATIENTS

Background: Posttraumatic stress disorder (PTSD) is a prevalent and disabling multisystem disorder, with significant physical and psychiatric morbidity and poor quality of life (QOL). Although peritraumatic reactions - tonic immobility and dissociation - are established predictors of PTSD severity and development, there is a dearth of investigation assessing the impact of peritraumatic reactions on QOL of PTSD patients. Quality of life has become increasingly important in health care and research as a reliable outcome measure. It comprises psychological, physical, social and environmental domains, providing important information about the impact of diseases on patient\u27s life. This study aims to investigate the impact of peritraumatic tonic immobility and peritraumatic dissociation on QOL of PTSD civilian outpatients. Subjects and methods: It is a cross-sectional study of 50 victims of urban violence with current PTSD, recruited in a specialized outpatient clinic. Instruments used were: Structured Clinical Interview IV, Peritraumatic Dissociative Experiences Questionnaire, Tonic Immobility Scale and WHOQOL-BREF (psychological, physical, social and environmental domains). Linear regression models were fitted to evaluate the impact of peritraumatic reactions - tonic immobility and dissociation - on WHOQOL-BREF scores. We controlled for sex as potential confounding. Results: The severity of peritraumatic tonic immobility negatively impacted on psychological and environment domains of quality of life. For each additional point on the Tonic Immobility Scale, there was a decreased of 0.8 points on the scores of these domains of WHOQOL-BREF. Neither the peritraumatic reactions showed effects on physical nor social domains. Possible limitations of this study include cross-sectional design, relatively small sample size of tertiary center outpatients and recall bias. Conclusions: Peritraumatic tonic immobility is related to poor quality of life, adding new insights about the relationship between this immobility reaction and PTSD