Socio-demographic and clinical characteristics of pregnant and puerperal crack-cocaine using women: preliminary data

Background The literature provides several studies on the effects of cocaine when exposed to the fetus. However, the majority of these data comes from animal models. Objective The objective of this study is to present socio-demographic and clinical data in crack-cocaine using pregnant women and their babies, as compared to non-users. Methods Cross-sectional study, comprised by 56 dyads of crack-cocaine using mothers-babies and 89 control dyads. In addition to the socio-demographic data and the babies’ information, data collection was based on ABIPEMI for socioeconomic level, WAIS for IQ, MINI for psychopathology and ASSIST for drug use. Results Most crack users, in comparison to non-users, did not have a partner (10.52% vs 4.4%, P = 0.001) and presented lower IQ (78.15, +/-8.07 vs 84.27 +/- 9.87; P = 0.002). The prevalence of antisocial personality disorder and suicide risk in users was higher than in non-users (24.44% vs none, P < 0.001; 28.26% vs 10.46% P = 0.01). Most of the users did not participate in prenatal care (75%). The babies that the crack-cocaine using mothers gave birth to weighed significantly less than the controls (2.858 g vs 3.240 g, P = 0.002). Discussion Users had a higher degree of psychopathology and lower attendance in prenatal care. There was an overlap of adverse factors, both for exposed mothers and babies. The sum of these vulnerabilities could result in significant harm to the developing infant

Physical Functional Capacity and C-Reactive Protein in schizophrenia

Introduction: Schizophrenia is a severe, debilitating mental disorder that affects both the physical health and the functional capacity of patients, causing great impairment throughout the life course. Although physical and cognitive impairments may represent different expressions of a single systemic inflammatory process, little is known about the relationship between motor function and schizophrenia.Objective: To evaluate physical functional capacity in patients with schizophrenia and ascertain whether it correlates with markers of inflammation, disease severity, and pharmacotherapy.Methods: Cross-sectional study using a convenience sampling strategy. Forty patients with stable schizophrenia, undergoing treatment, were recruited from the Outpatient Program of Hospital de Clínicas de Porto Alegre, University Hospital linked to Public Health System. Physical functional capacity was assessed by the 6-minute walk test (6MWT), and inflammatory markers were measured by C - reactive protein (CRP) and Von Willebrand Factor (VWF). Results: Mean functional capacity and clinical variables differed among patients and Brazilian population regarding heart rate (p=0.004), diastolic (p=0.001) and systolic (p<0.001) blood pressure, respiratory rate (p<0.001), CRP (p=0.015), Borg Scale of Perceived Exertion scores (p<0.001), and 6MWT both in men (p<0.001) and women (p=0.024). Additionally, 6MWT and dyspnea in Borg Scale of Perceived Exertion scores (BSPE) were positively associated to CRP (r=-.369, p=.019) and r=-.376, p=.017) and r=0.354, p=0.025 and r=0.535, p<0.001, respectively).Conclusion: The present study detected significant association between measures of functional impairment and markers of inflammation, especially elevated CRP in a group of stable outpatients with DSM-IV and ICD10 diagnosis of schizophrenia. Possible explanations for the associations could be linked to continued use of antipsychotics, although underlying neuroinflammatory mechanisms directly related to illness (schizophrenia) could not be ruled out. The findings of this study expand evidences of neuroinflammation to systemic inflammation in schizophrenia linking it to alterations of physical functional capacity and point to the need of additional studies exploring general inflammation and novel therapeutic interventions

Instruments and Diagnostic Criteria for Binge Eating Assessment in Adults: A Systematic Review

Objective: The aim of this study was to systematically review the methodologies used for BE evaluation/identification diagnosis in clinical trials (CT) with adults. Methods: The search was performed on PUBMED until July 2018. The PRISMA statement was used to improve the reporting of results.Results: 93 CTs were included among the 225 studies retrieved. The main BE evaluation/identification methods used in studies were: Binge Eating Scale; Diagnostic and Statistical Manual of Mental Disorders; Eating Disorder Diagnostic Scale; Eating Disorder Examination; Eating Disorder Examination Questionnaire; Eating Disorder Inventory; Loss of Control Over Eating Scale and Three-Factor Eating Questionnaire. Overlaps between methods were observed in studies, 61 used both DSM and an evaluation instrument, 06 only DSM and 26 only standardized questionnaires to assess BE disorder. Conclusions: The DSM-5 diagnostic criterion for binge eating disorder is considered excellent and widely used, however, when the objective of the study is to identify emotional, nutritional and qualitative issues, a questionnaire or interview about subjective perceptions can be used in a complementary way.Objetivo: O objetivo deste estudo foi revisar sistematicamente as metodologias utilizadas para&nbsp; avaliação/identificação da compulsão alimentar em ensaios clínicos com pacientes adultos. Métodos: A busca foi realizada no PUBMED até julho de 2018. Foi utilizado o protocolo PRISMA para reportar os resultados. Resultados: Foram incluídos 93 ensaios clínicos dentre os 225 que foram encontrados na busca da literatura. Os principais métodos de avaliação / identificação da compulsão alimentar utilizados nos estudos foram: Binge Eating Scale; Manual Diagnóstico e Estatístico de Transtornos Mentais; Escala de Diagnóstico de Transtorno Alimentar; Exame de Transtorno Alimentar; Questionário de Exame de Transtorno Alimentar; Inventário de Desordens Alimentares; Escala de Perda de Controle sobre a Alimentação e Questionário de Alimentação de Três Fatores. Foram observadas sobreposições entre os métodos nos estudos, 61 utilizaram o DSM e outro instrumento de avaliação, seis estudos utilizaram apenas o DSM e 26 apenas questionários padronizados para avaliar o transtorno de compulsão alimentar. Conclusão: O critério diagnóstico do DSM-5 para o transtorno de compulsão alimentar é considerado excelente e utilizado amplamente, entretanto, quando o objetivo do estudo é identificar questões emocionais, nutricionais e qualitativas, pode ser utilizado de forma complementar um questionário ou entrevista sobre percepções subjetivas

Decreased serum neurotrophin 3 in chronically medicated schizophrenic males

There is evidence that major psychiatric disorders such as schizophrenia (SZ) are associated with deregulation of synaptic plasticity with downstream alterations of neurotrophins. NT3 is an important neurotrophin in the central nervous system, and performs key biological functions, such as promoting the survival, differentiation, and plasticity of neurons. NT3 has a central role in the early neuronal development; enhancing the survival of dopaminergic neurons, suggesting possible involvement in the physiopathology of dopamine related neuropsychiatric disorders such as SZ. Variations in the NT3 gene increase the risk of SZ. Three groups of chronically medicated DSM-IV patients with SZ, on treatment with clozapine (n=12), haloperidol (n=12), risperidone (n=12) and 10 healthy controls had 5 ml blood samples collected by venipuncture. NT3 serum levels were assessed using sandwich-ELISA and were significantly lower in SZ patients (p<0.005) when compared to either controls. These findings suggest that the NT3 signaling system may play a role in the pathophysiology of SZ and might be related to the course of illness or to treatment variables. Longitudinal studies are warranted.Clarissa Severino Gama is funded by CNPq (PDE #200310/ 2007-0), Brazil, and Endeavour Awards Programme (#539/2008), Australia