Ten-year evolution of suicide rates and economic indicators in large Brazilian urban centers

Purpose of reviewThis was a retrospective ecological study to examine the relationship between suicide rates and economic indicators in large Brazilian urban centers. Data on macroeconomic indicators (GDP and unemployment rates) and suicide rates of the largest Brazilian cities were collected from January 2006 to December 2015.Recent findingsSix cities were included in the study: Porto Alegre in the South, Recife and Salvador in the Northeast, and Belo Horizonte, SAo Paulo and Rio de Janeiro in the Southeast region. We observed a 4% increase in the age-adjusted suicide rate in these large Brazilian urban centers from 2006 to 2015, which is less pronounced than the 9% increase in the national rates of suicide observed in the same period.SummaryThe effect of economic indicators was heterogeneous among the centers, but, overall, the variation in suicide rates was inversely related to unemployment and did not show a significant relationship with GDP. These findings indicate a more complex link between economics and suicide whenever looking at local regional indicators. Further research should focus on possible intervening factors, what may inform better preventive interventions.Global Mental Health Program, Columbia University, New York, USABrazilian National Research Council (CNPq)Univ Fed Sao Paulo UNIFESP, Dept Psychiat, Sao Paulo, BrazilColumbia Univ, Global Mental Hlth Program, New York, NY USAUniv Fed Sao Paulo UNIFESP, Dept Psychiat, Sao Paulo, BrazilWeb of Scienc

PSYCHOTIC EXPERIENCE AND ADOLESCENT BRAIN TRAJECTORY: EVIDENCE FOR STRUCTURAL ALTERATIONS IN DOPAMINERGIC REGIONS

Univ Fed Sao Paulo, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo, BrazilWeb of Scienc

Psychosis in Machado-Joseph Disease: Clinical Correlates, Pathophysiological Discussion, and Functional Brain Imaging. Expanding the Cerebellar Cognitive Affective Syndrome

Machado-Joseph disease (MJD) is the most common spinocerebellar ataxia worldwide with a broad range of clinical manifestations, but psychotic symptoms were not previously characterized. We investigated the psychiatric manifestations of a large cohort of Brazilian patients with MJD in an attempt to characterize the presence of psychotic symptoms. We evaluated 112 patients with clinical and molecular diagnosis of MJD from February 2008 to November 2013. Patients with psychotic symptoms were referred to psychiatric evaluation and brain perfusion single-photon emission computed tomography (SPECT) analysis. A specific scale-Positive and Negative Syndrome Scale (PANSS)-was used to characterize psychotic symptoms in MJD patients. We also performed an autopsy from one of the patients with MJD and psychotic symptoms. Five patients presented psychotic symptoms. Patients with psychotic symptoms were older and had a late onset of the disease (p<0.05). SPECT results showed that MJD patients had significant regional cerebral blood flow (rCBF) decrease in the cerebellum bilaterally and vermis compared with healthy subjects. No significant rCBF differences were found in patients without psychotic symptoms compared to patients with psychotic symptoms. The pathological description of a patient with MJD and psychotic symptoms revealed severe loss of neuron bodies in the dentate nucleus and substantia nigra. MJD patients with a late onset of the disease and older ones are at risk to develop psychotic symptoms during the disease progression. These clinical findings may be markers for an underlying cortical-cerebellar disconnection or degeneration of specific cortical and subcortical regions that may characterize the cerebellar cognitive affective syndrome.Univ Fed Sao Paulo, Dept Neurol & Neurosurg, Div Gen Neurol, 650 Pedro de Toledo St, BR-04039002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Neurol & Neurosurg, Ataxia Unit, 650 Pedro de Toledo St, BR-04039002 Sao Paulo, SP, BrazilUniv Estadual Ceara, Ctr Hlth Sci, Fortaleza, Ceara, BrazilUniv Fed Sao Paulo, Dept Psychiat, Sao Paulo, BrazilUniv Western Australia, Med Res Ctr, Western Australian Ctr Hlth & Ageing, Crawley, WA, AustraliaUniv Fed Sao Paulo, Dept Neurol & Neurosurg, Div Gen Neurol, 650 Pedro de Toledo St, BR-04039002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Neurol & Neurosurg, Ataxia Unit, 650 Pedro de Toledo St, BR-04039002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Psychiat, Sao Paulo, BrazilWeb of Scienc

Brain tumor in a patient with attenuated psychosis syndrome

Universidade Federal de São Paulo, Program Intervent Risk Mental States PRISMA, Dept Psychiat, BR-04039032 São Paulo, BrazilUniversidade Federal de São Paulo, Program Intervent Risk Mental States PRISMA, Dept Psychiat, BR-04039032 São Paulo, BrazilWeb of Scienc

Evaluation of NDEL1 oligopeptidase activity in blood and brain in an animal model of schizophrenia: effects of psychostimulants and antipsychotics

Nuclear distribution element-like 1 (NDEL1) enzyme activity is important for neuritogenesis, neuronal migration, and neurodevelopment. We reported previously lower NDEL1 enzyme activity in blood of treated first episode psychosis and chronic schizophrenia (SCZ) compared to healthy control subjects, with even lower activity in treatment resistant chronic SCZ patients, implicating NDEL1 activity in SCZ. Herein, higher NDEL1 activity was observed in the blood and several brain regions of a validated animal model for SCZ at baseline. In addition, long-term treatment with typical or atypical antipsychotics, under conditions in which SCZ-like phenotypes were reported to be reversed in this animal model for SCZ, showed a significant NDEL1 activity reduction in blood and brain regions which is in line with clinical data. Importantly, these results support measuring NDEL1 enzyme activity in the peripheral blood to predict changes in NDEL1 activity in the CNS. Also, acute administration of psychostimulants, at levels reported to induce SCZ-like phenotype in normal rat strains, increased NDEL1 enzyme activity in blood. Therefore, alterations in NDEL1 activity after treatment with antipsychotics or psychostimulants may suggest a possible modulation of NDEL1 activity secondary to neurotransmission homeostasis and provide new insights into the role of NDEL1 in SCZ pathophysiology

The Brazilian standardization of the MATRICS consensus cognitive battery (MCCB): Psychometric study

Objective: Translate, adapt, and validate the MATRICS Consensus Cognitive Battery (MCCB) in Brazil. Method: The present study followed three steps: 1) translation to Portuguese, cultural adaptation, and back translation to English2) completion of a pilot study (N = 30) conducted with the purpose of assessing whether the general comprehension of the items was clear and all participants adequately responded to the battery3) completion of a Reliability and Validation Study of the Brazilian version of the MCCB with 99 individuals with schizophrenia and 99 healthy subjects. All participants were administered the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) and patients were also rated on the Global Assessment of Functioning (GAF) Scale and the Positive and Negative Symptoms Scale (PANSS). Results: The results showed adequate to high levels of baseline and 4-week retest reliability, except the MSCEIT-MEadequate internal consistency for the MSCEIT-ME for the total sample and patients group, and moderate Alpha for the health control sampleas well as evidence of convergent validity and sensitivity to differentiate performance between the groups. All the 10 MCCB measures showed the lowest learning effects. Conclusion: Overall the Brazilian version of the MCCB showed similar results to the original North American version. Our findings provides reassurance that the MCCB is a reliable and valid measure of cognition across different countries and cultures, which is especially important to the ongoing work in attempting to discover cognition enhancing drugs and the effects of cognitive interventions for the treatment of schizophrenia. (C) 2017 Elsevier B.V. All rights reserved.FAPESPUniv Fed Sao Paulo Unifesp, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, Sao Paulo, BrazilUniv Fed Sao Paulo Unifesp, Dept Psychiat, Schizophrenia Program PROESQ, Sao Paulo, BrazilCtr Univ FIEO, Strict Sensu Educ Psychol Program, 300 UCLA Med Plaza,Room 2240, Los Angeles, CA 90095 USAUniv Calif Los Angeles, Dept Psychiat & Biobehav Sci, 300 UCLA Med Plaza,Room 2240, Los Angeles, CA 90095 USAUniv Calif Los Angeles, Dept Psychol, 300 UCLA Med Plaza,Room 2240, Los Angeles, CA 90095 USAUniv Fed Sao Paulo Unifesp, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, Sao Paulo, BrazilUniv Fed Sao Paulo Unifesp, Dept Psychiat, Schizophrenia Program (PROESQ), BrazilFAPESPWeb of Scienc

A study in first-episode psychosis patients: does angiotensin I-converting enzyme (ACE) activity associated with genotype predict symptoms severity reductions after treatment with the atypical antipsychotic risperidone?

Background Our previous studies showed increased angiotensin I-converting enzyme (ACE) activity in chronic schizophrenia patients compared with healthy control (HC) volunteers, and the relevance of combining ACE genotype and activity for predicting schizophrenia was suggested. Methods ACE activity was measured in plasma of ACE insertion/deletion (I/D) genotyped HC volunteers (n = 53) and antipsychotic-naïve first-episode psychosis (FEP) patients (n = 45) assessed at baseline (FEB-B) and also after 2 months (FEP-2M) of treatment with the atypical antipsychotic risperidone. Results ACE activity measurements showed significant differences among HC, FEP-B, and FEP-2M groups (F = 5.356, df = 2, P = .005) as well as between HC and FEP-2M (post-hoc Tukey’s multiple comparisons test, P = .004). No correlation was observed for ACE activity increases and symptom severity reductions in FEP as assessed by total Positive and Negative Syndrome Scale (r = −0.131, P = .434). FEP subgrouped by ACE I/D genotype showed significant ACE activity increases, mainly in the DD genotype subgroup. No correlation between ACE activity and age was observed in FEP or HC groups separately (r = 0.210, P = .392), but ACE activity level differences observed between these groups were influenced by age. Conclusions The importance of measuring the ACE activity in blood plasma, associated with ACE I/D genotyping to support the follow-up of FEP patients, did not show correlation with general symptom amelioration in the present study. However, new insights into the influence of age and I/D genotype for ACE activity changes in FEP individuals upon treatment was demonstrated

Comparing PANSS scores and corresponding CGI scores between stable and acute schizophrenic patients

Universidade Federal de São Paulo, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, BR-05039032 São Paulo, BrazilHosp Clin Luzia de Pinho Melo SPDM, Dept Mental Hlth, BR-08773130 São Paulo, BrazilSao Jose do Rio Preto Sch Med FAMERP, Dept Psychiat & Med Psychol, BR-15090000 São Paulo, BrazilISCMSP, Dept Psychiat, BR-04017030 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, BR-05039032 São Paulo, BrazilWeb of Scienc

Hemoencephalography self-regulation training and its impact on cognition: A study with schizophrenia and healthy participants

Background: Cognitive impairments in schizophrenia are strongly correlated to functional outcome and recovery rates, with no pharmacological agent approved for its treatment. Neurofeedback has emerged as a non-pharmacological approach to enhance neuroplasticity, which consists in inducing voluntary control of brain responses through operant conditioning. Method: The effects of hemoencephalography neurofeedback (HEG-NFBK) in 4 brain sites (F7, Fp1, Fp2 and F8) was studied in 8 patients with schizophrenia (SCH, mean age 36.5 +/- 9.98) and 12 health controls (mean age 32.17 +/- 5.6). We analyzed groups' performance (10 sessions) and cognitive differences in 3 time points (baseline, after training and follow-up) with generalized estimated equations. For SCH we also evaluate the impact on psychopathology. Results: We found a group * time interaction for HEG-NFBK performance in the left hemisphere sites (F7 an Fp1) and a near-to-significant in the right frontotemporal region (F8), with no group differences and a significant time effect. Most of cognitive domains improved after intervention, including information processing speed, attention processing, working memory, executive functioning, verbal and visual learning. No group * time interaction was found. Results suggest that both groups benefit from HEG-NFBK training regardless of cognitive differences at baseline. No significant time effects were found for Calgary and PANSS total scale and subscales (positive, negative neither general). Conclusion: To our knowledge, this is the first controlled trial showing effects of NFBK on cognitive performance improvement in schizophrenia. Further research investigating the effects of HEG-NFBK training in schizophrenia should be performed. (C) 2017 Elsevier B.V. All rights reserved.Univ Fed Sao Paulo, Clin Neurosci Lab, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Psychiat, Ctr Neuromodulat Studies, Sao Paulo, BrazilItallis Consciousness Technol, Atlanta, GA USAUniv Fed Rio Grande do Sul, Clin Hosp Porto Alegre, Epidemiol & Biostat Unity, Porto Alegre, RS, BrazilSao Paulo State Secretariat Hlth, Reference Ctr Alcohol Tobacco & Other Drugs CRATOD, Sao Paulo, BrazilUniv Fed Sao Paulo, Clin Neurosci Lab, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Psychiat, Ctr Neuromodulat Studies, Sao Paulo, BrazilWeb of Scienc

A General Psychopathology Factor (P Factor) in Children: Structural Model Analysis and External Validation Through Familial Risk and Child Global Executive Function

High rates of comorbidities and poor validity of disorder diagnostic criteria for mental disorders hamper advances in mental health research. Recent work has suggested the utility of continuous cross-cutting dimensions, including general psychopathology and specific factors of externalizing and internalizing (e.g., distress and fear) syndromes. The current study evaluated the reliability of competing structural models of psychopathology and examined external validity of the best fitting model on the basis of family risk and child global executive function (EF). A community sample of 8,012 families from Brazil with children ages 6-12 years completed structured interviews about the child and parental psychiatric syndromes, and a subsample of 2,395 children completed tasks assessing EF (i.e., working memory, inhibitory control, and time processing). Confirmatory factor analyses tested a series of structural models of psychopathology in both parents and children. The model with a general psychopathology factor ("P factor") with 3 specific factors (fear, distress, and externalizing) exhibited the best fit. The general P factor accounted for most of the variance in all models, with little residual variance explained by each of the 3 specific factors. In addition, associations between child and parental factors were mainly significant for the P factors and nonsignificant for the specific factors from the respective models. Likewise, the child P factor-but not the specific factors-was significantly associated with global child EF. Overall, our results provide support for a latent overarching P factor characterizing child psychopathology, supported by familial associations and child EF. General Scientific Summary An overarching general factor appears to best describe child psychopathology. This factor seems responsible for the familial aggregation of mental disorders, and it is consistently associated with global measures of executive function.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Kentucky, Dept Psychol, Lexington, KY 40506 USAUniv Fed Sao Paulo, Dept Psychiat, Sao Paulo, BrazilUniv Fed Santa Maria, Dept Neuropsychiat, Santa Maria, RS, BrazilUniv Fed Rio Grande do Sul, Dept Psychiat, Rua Ramiro Barcelos 2350, BR-90035903 Porto Alegre, RS, BrazilUniv Sao Paulo, Dept Psychiat, Sao Paulo, BrazilUniv Toronto, Dept Psychol, Toronto, ON, CanadaUniv Toronto, Dept Psychiat, Toronto, ON, CanadaChild Mind Inst, New York, NY USADepartment of Psychiatry, Universidade Federal de São PauloCNPq: 573974/2008-0FAPESP: 2008/57896-8Web of Scienc