Childhood depression: a systematic review

Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH]), “child” (MeSH), and "childhood depression" (keyword). Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs concerning childhood depression are not always taken into consideration. In this context, this review demonstrated that childhood-onset depression commonly leads to other psychiatric disorders and co-morbidities. Many of the retrieved studies also confirmed the hypothesis that human resources (eg, health care team in general) are not yet adequately trained to address childhood depression. Thus, further research on the development of programs to prepare health care professionals to deal with childhood depression is needed, as well as complementary studies, with larger and more homogeneous samples, centered on prevention and treatment of childhood depression. Keywords: child, depression, depressive disorder, mental health, mental disorder

Pinealectomy causes glucose intolerance and decreases adipose cell responsiveness to insulin in rats

Although the pineal gland influences several physiological systems, only a few studies have investigated its role in the intermediary metabolism. In the present study, male Wistar rats, pinealectomized or sham-operated 6 wk before the experiment, were submitted to both intravenous glucose tolerance tests (IVGTT) and insulin binding as well as glucose transport assays in isolated adipocytes. The insulin receptor tyrosine kinase activity was assessed in liver and muscle. The insulin secretory response during the IVGTT was impaired, particularly in the afternoon, and the glucose transport responsiveness was 33% lower in pinealectomized rats. However, no difference was observed in the insulin receptor number of adipocytes between groups as well as in insulin-stimulated tyrosine kinase activity, indicating that the initial steps in the insulin signaling were well conserved. Conversely, a 40% reduction in adipose tissue GLUT-4 content was detected. In conclusion, pinealectomy is responsible for both impaired insulin secretion and action, emphasizing the influence of the pineal gland on glucose metabolism.o TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.2756E934E94

O cotidiano do ser-adolescendo com aids: movimento ou momento existencial? El cotidiano del ser-adolecer con sida: ¿movimiento o momento existencial? The daily life of adolescents with aids: existential movement or moment?

As crianças com AIDS por transmissão vertical transitam da infância para adolescência, e pouco se sabe sobre como cuidam de si. Compreender este cotidiano do adolescer foi o objetivo desta investigação fenomenológica com análise hermenêutica heideggeriana. A entrevista com 11 meninos/meninas (12-14 anos) não institucionalizados, que conheciam seu diagnóstico, ocorreu depois da aprovação do projeto pelo Comitê de Ética de três instituições do Rio de Janeiro, cenários da pesquisa. Os resultados apontaram um cotidiano marcado pelos momentos infância e adolescência. Às vezes quer voltar a ser-criança para brincar; se re-conhece como ser-adolescente pela aparência, humor, atividades diárias, lazer e relacionamentos. Transitando entre esses momentos, re-vela-se como ser-adolescendo. Neste movimento existencial des-vela-se como ser-de-possibilidades, que não está limitado à dupla-facticidade: adolescer (segundo demarcações etárias e características predeterminadas) e AIDS (fragilidade clínica). Portanto, conjugar as dimensões biológica e existencial, no modelo assistencial-institucional, é o desafio do cuidado ao ser-adolescendo.<br>Los niños con Sida por transmisión vertical, transitan de la infancia para la adolescencia, y poco se sabe sobre cómo cuidan de si. Comprender este cotidiano del adolecer con Sida fue el objetivo de esta investigación fenomenológica bajo el analisis de la hermenéutica heideggeriana. La entrevista con 11 niños y niñas (entre 12y 14 años) , que conocían su diagnóstico y estaban no-institucionalizados, se realizó después de que el Comité de ética aprobó el proyecto de pesquisa de tres instituciones de Rio de Janeiro, escenarios de esta investigación.. Los resultados apuntaron que el cotidiano del adolecer está marcado por momentos de infancia y adolescencia. A veces quiere volver a ser-niño para jugar, y se re-conoce como ser-adolescente en la apariencia, humor, actividades diarias, ocio y relacionamientos. Transitando entre estos momentos, se re-vela como un ser-adolecer . En este movimiento existencial se re-vela como un ser-de-posibilidades, que no está limitado a este doble acontecer : adolecer (según demarcaciones de la edad y características predeterminadas) y Sida (fragilidad clínica). Ahí reside el desafío de conjugar la dimensión biológica y existencial, en un modelo asistencial-institucional de cuidado al ser-adolecer.<br>Children with vertical transmission HIV pass from childhood to adolescence and little is known about how they care for themselves. The objective was to understand the daily life of adolescents with AIDS. Heiddeger's hermeneutic analyzes was applied. The phenomenological interview of 11 non-institutionalized boys and girls (12-14 years) with a disclosed diagnosis took place in 3 reference healthcare facilities in Rio de Janeiro. The comprehensive analysis showed that adolescents' daily live is marked by childhood and adolescent moments. In childhood, there is a desire to play like other children. In adolescence, there is a desire to be like others in appearance, mood, daily activities, leisure and relationship. In passing between these two moments, a process of becoming adolescent is revealed. In this existential movement they reveal as a being-with-possibilities that are not limited in the double-facticity: adolescence (according to etaria marks and predetermined characteristics) and AIDS (clinical fragility). Therein resides the challenge of conjugating biological and existential dimensions in adolescent care