Are patients with panic disorder respiratory subtype more vulnerable to tobacco, alcohol or illicit drug use?

CONTEXTO: Estudos anteriores têm mostrado associações entre o transtorno de pânico (TP) e o uso de tabaco, álcool e substâncias ilícitas. É conhecido que transtornos de uso de substâncias interferem negativamente no prognóstico de transtornos de ansiedade e depressão. No subtipo respiratório (SR) do TP há mais história familiar de TP e maior risco de comorbidades com transtornos de ansiedade. OBJETIVOS: Descrever os padrões de uso de tabaco, álcool e outras substâncias em pacientes com TP. Além disso, analisar se pacientes do SR usam mais essas substâncias do que os pacientes do subtipo não respiratório. MÉTODOS: Esse foi um estudo transversal com 71 pacientes com TP. As escalas Alcohol Use Disorders Identification Test e Fagerstrom Tobacco Questionnaire foram aplicadas. Pacientes com quatro ou cinco sintomas respiratórios foram considerados no SR, e os demais pacientes foram considerados como do subtipo não respiratório. RESULTADOS: Na amostra estudada, 31,0% dos pacientes eram fumantes, 11,3% faziam uso perigoso de álcool e nenhum fazia uso de substâncias ilícitas. Não houve diferença entre os subtipos respiratório e não respiratório em relação a tabagismo, uso de álcool, cannabis, cocaína, estimulantes e alucinógenos. CONCLUSÃO: O SR não foi correlacionado com o uso de tabaco, álcool ou drogas ilícitas. Mais estudos clínicos e epidemiológicos focando a relação entre o TP e uso de substâncias são necessários.BACKGROUND: Studies have documented high use of tobacco, alcohol and illicit drugs in patients with panic disorder (PD). The comorbid substance use disorders worsen the prognosis of mood and anxiety disorders. The respiratory subtype (RS) of PD seems to represent a more severe and distinct form of this disorder associated with higher familial history of PD and more comorbidity with other anxiety disorders. OBJECTIVES: Describe the patterns of tobacco, alcohol or illicit drug use in PD patients, and also to ascertain if patients with the RS use these substances more than those of the non-respiratory subtype. METHODS: This is a cross-sectional study with 71 PD patients. The Alcohol Use Disorders Identification Test and Fagerstrom Tobacco Questionnaire were used in the evaluation. Patients with four or five respiratory symptoms were classified in the RS, the remaining patients were classified as non-respiratory subtype. RESULTS: In our sample 31.0% were smokers, 11.3% were hazardous alcohol users and none of them was using illicit drugs. There were no differences between the respiratory and non-respiratory subtypes regarding the use of tobacco, alcohol, cannabis, cocaine, stimulants and hallucinogens. DISCUSSION: The RS was not correlated to the use of tobacco, alcohol and illicit drugs. Additional epidemiological and clinical studies focusing the relationship between PD and substance use are warranted

Dream-Reality confusion: differential psychiatric diagnosis in narcoleptic subjects

Dream-reality confusion (DRC) is the consequence of hypnagogic content confusion with real events and memories. Narcoleptic subjects eventually have DRC and can be misdiagnosed as schizophrenic or with another disorder with delusional or hallucinatory symptoms. Although dream-related experiences and hallucinatory perception share neurophysiological pathways, they are phenomenologically distinct. The lack of phenomenological intentionality in Dreamrelated perceptions, the different cognitive pathways for delusion generation, and other differences between mental disorders psychopathology, and DRC-related phenomena are here discussed. The lived world and awake experience interpretation, and dream neurobiology in narcoleptic subjects related to DRC, might indicate some hints for the mind-brain gap issue that still exists in neurology and psychiatry

Multidisciplinary contributions towards an evolutive interpretation of bipolar disorders: Could it be the pathological drift of a potentially adaptive condition?

This paper tries to summarize the results of studies from different areas of knowledge supporting the idea that temperamental traits, such as "reckless/hyper-exploratory"attitudes, commonly believed to be associated with psychopathology, surprisingly turn out as adaptive under specific stress conditions. In particular, this paper analyzes an ethologic line of research on primates suggesting models for a sociobiological interpretation of mood disorders in humans; a study that found high frequencies of a genetic variance associated with bipolar disorder in people without bipolar disorder but with hyperactivity/novelty-seeking traits; the outcomes of socio-anthropological-historical surveys on the evolution of mood disorders in Western countries in the last centuries; surveys on changing societies in Africa and African migrants in Sardinia; and studies that found higher frequencies of mania and subthreshold mania among Sardinian immigrants in Latin American megacities. Although it is not unequivocally accepted that the prevalence of mood disorders has increased, it would be logical to suppose that a nonadaptive condition should have disappeared over time; mood disorders, on the contrary, persist and their prevalence might have even increased. This new interpretation could lead to counter discrimination and stigma towards people suffering from the disorder and would be a central point in psychosocial treatments in addition to pharmacological therapy. Our aim is to hypothesize that bipolar disorder, strongly characterized by these traits, may be the result of the interaction between genetic characteristics, not necessarily pathological, and specific environmental conditions rather than a mere product of an aberrant genetic profile. If mood disorders were mere nonadaptive conditions, they would have disappeared over time; however, their prevalence paradoxically persists if not even increases over time. The hypothesis that bipolar disorder may result from the interaction between genetic characteristics, not necessarily pathological, and specific environmental factors seems more credible than considering bipolar disorder as a mere product of an aberrant genetic profile

Tradução e adaptação transcultural da versão brasileira do Inventário de Ansiedade Geriátrica (GAI) = Translation and cross-cultural adaptation of the Brazilian version of the Geriatric Anxiety Inventory (GAI)

Introduction: There has been a growing interest in the cross-cultural adaptation of instruments for assessment of anxiety, but studies involving anxiety specifically in the geriatric population is still unusual. Thus, there is a lack of instruments designed to comply with this population. Translation and cultural adaptation is the first step to providing comparisons between different cultural contexts. Objective: Elaborate the semantic equivalence of the Geriatric Anxiety Inventory to Brazilian Portuguese. Method: The cross-cultural adaptation process consisted in four steps: two translations, two back- translations, both made by independent translators, the development of a synthetic version, and a pretest applied in a population sample. Results: For each item of the instrument, we present the results of four steps. Throughout the process, any problems found could be solved by ensuring the quality of the instrument and its appropriateness to the population to which it is intended. Discussion: The use of four-step method proved effective and safe in the process of semantic equivalence

The remarkable Juliano Moreira (1872-1933): an Afro-Brazilian psychiatrist, scientist, and humanist in an environment of slavery and racism

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Flavour Matters in Leptogenesis

We give analytic approximations to the baryon asymmetry produced by thermal leptogenesis with hierarchical right-handed neutrinos. Our calculation includes flavour-dependent washout processes and CP violation in scattering, and neglects gauge interactions and finite temperature corrections. Our approximate formulae depend upon the three CP asymmetries in the individual lepton flavours as well as on three flavour-dependent efficiency factors. We show that the commonly used expressions for the lepton asymmetry, which depend on the total CP asymmetry and one single efficiency factor, may fail to reproduce the correct lepton asymmetry in a number of cases. We illustrate the importance of using the flavour-dependent formulae in the context of a two right-handed neutrino model.Comment: Additional typos corrected (in particular, the plots and captions now agree

Terapia cognitivo-comportamental para luto pela morte súbita de cônjuge

INTRODUCTION: The mourning due to the sudden death of a spouse has special features that should be considered in therapy process of those who undergo this experience. METHODS: Case work of grief therapy using a cognitive-behavioral protocol. The progress of the patient was assessed at the beginning and end of treatment with BDI, BAI, BHS, ISSL and GHQ. RESULTS: There was reduction in depression, anxiety and hopelessness. Regarding stress, the patient, that was in the stage of exhaustion passed to resistance. Reduction of psychological stress (95% to 50%), distrust about their own performance (90% to 40%), sleep disturbances (95% to 45%), death wish (95% to 20%) and also of psychosomatic disorders (95% to 60%). DISCUSSION: The therapeutic protocol through the focus of cognitive-behavioral therapy was effective for that specific type of mourning.INTRODUÇÃO: O processo de luto devido à morte súbita de cônjuge apresenta particularidades que devem ser consideradas no atendimento clínico daqueles que passam por essa experiência. MÉTODOS: Estudo de caso de terapia para luto utilizando protocolo de atendimento cognitivista comportamental. O progresso da paciente foi avaliado no início e término do tratamento com Inventário Beck de Depressão (BDI), Inventário Beck de Ansiedade (BAI) e Escala Beck de Desesperança (BHS), Inventário de Sintomas de Stress de Lipp (ISSL) e Questionário de Saúde Geral (QSG). RESULTADOS: Houve redução da depressão, ansiedade e desesperança. Em relação ao estresse, a paciente passou da fase de exaustão para a de resistência. Houve redução do estresse psíquico (de 95% para 50%), da desconfiança em relação ao próprio desempenho (de 90% para 40%), de distúrbios do sono (de 95% para 45%), de desejo de morte (de 95% para 20%) e também de distúrbios psicossomáticos (de 95% para 60%). CONCLUSÃO: O atendimento terapêutico para esse tipo específico de luto mediante o enfoque da terapia cognitivo-comportamental se mostrou eficaz

Brazilian version of the Social Interaction Self-Statement Test (SISST): translation and cross-cultural adaptation

BACKGROUND: The Social Interaction Self-Statement Test (SISST) proposes to evaluate cognitive responses in adults who reported heterosocial difficulties. Its cross-cultural adaptation is the first stage for future comparisons on the construct measured by the instrument in different populations. OBJECTIVE: Semantic adaptation of the SISST for Brazilian Portuguese. METHODS: Process consisted of two translations and back-translations, performed by independent evaluators without any prior knowledge of the scale to be translated. Development of synthetic version was conducted jointly by two different expertises in mental health. RESULTS: The four stages of the process were presented. The use of two translations and back-translations allowed a broader discussion for synthetic version. The participation of specialists in mental health collaborated to the appropriateness of the terms used for the construct measured. The experimental application offered greater security to the process of semantic equivalence. DISCUSSION: Through the use of this methodology was possible to elaborate the version of SISST for Brazilian Portuguese.CONTEXTO: O Social Interaction Self-Statement Test (SISST) apresenta como proposta avaliar respostas cognitivas em adultos que referem dificuldades heterossociais. Sua adaptação transcultural apresenta-se como primeiro passo para futuras comparações relativas ao construto medido pelo instrumento em diferentes amostras. OBJETIVO: Adaptação semântica do SISST para o português brasileiro. MÉTODOS: Processo realizado por meio de duas traduções e retrotraduções, elaboradas por avaliadores independentes e sem conhecimentos prévios da escala a ser traduzida. Elaboração de versão sintética realizada conjuntamente por dois diferentes especialistas, bilíngues, em saúde mental. RESULTADOS: São apresentadas as quatro etapas do processo. A utilização de duas traduções e retrotraduções permitiu uma discussão mais ampla para construção da versão sintética. A participação de especialistas em saúde mental colaborou para a adequação dos termos utilizados em relação ao construto medido. A aplicação experimental ofereceu maior segurança ao processo de equivalência semântica. CONCLUSÃO: Por meio da metodologia utilizada, foi possível elaborar uma versão do SISST para o português brasileiro