Archives of Clinical Psychiatry
https://revistas.usp.br/acp
<p>A partir de Janeiro de 2014, a Revista de Psiquiatria Clínica aceitará apenas submissões de manuscritos em INGLÊS!</p> <p><img src="/Vol39_n52.jpg" alt=""></p>Universidade de São Paulo. Faculdade de Medicina. Instituto de PsiquiatriaenArchives of Clinical Psychiatry0101-6083<p><span style="font-family: Verdana,Arial,Helvetica,sans-serif;">Once accepted for publication, the manuscript becomes permanent property of the <span style="font-family: Verdana,Arial,Helvetica,sans-serif;">Archives of Clinical Psychiatry</span>. This copyright transfer subsumes exclusive and unlimited entitlement of the <span style="font-family: Verdana,Arial,Helvetica,sans-serif;">Archives of Clinical Psychiatry</span> to publish and distribute the full contents of articles in whichever publishing medium, including press and electronic media, in Brazil and abroad.</span></p><p><span style="font-family: Verdana,Arial,Helvetica,sans-serif;">Manuscripts are accepted with the understanding that the Editor and the editorial staff have the right to make revisions aimed at greater conciseness, clarity, and conformity with Journal style, of course without changing its content.</span></p>The impact of exercise in improving executive function impairments among children and adolescents with ADHD, autism spectrum disorder, and fetal alcohol spectrum disorder: a systematic review and meta-analysis
https://revistas.usp.br/acp/article/view/185201
<p>Objective: he goal of this work was to perform a systematic review and meta-analysis evaluating and comparing exercise related improvements in various executive function (EF) domains among children and adolescents with attention-deficit hyperactivity disorder (ADHD), Autism Spectrum Disorders (ASD), and Fetal Alcohol Spectrum Disorders (FASD). Methods: A systematic literature research was conducted in PubMed, CENTRAL, and PsycInfo from October 1st, 2018 through January 30th, 2019 for original peer-reviewed articles investigating the relationship between exercise interventions and improvements in three domains of executive function (working memory, attention/set shifting, and response inhibition) among children and adolescents with ADHD, ASD, and FASD. Effect sizes (ES) were extracted and combined with random-effects meta-analytic methods. Covariates and moderators were then analyzed using meta-regression and subgroup analyses. Results: A total of 28 studies met inclusion criteria, containing information on 1,281 youth (N=1197 ADHD, N= 54 ASD, N=30 FASD). For ADHD, exercise interventions were associated with moderate improvements in attention/set-shifting (ES 0.38, 95% CI 0.01-0.75, k=14) and approached significance for working memory (ES 0.35, 95%CI -0.17-0.88, k=5) and response inhibition (ES 0.39, 95%CI -0.02-0.80, k=12). For ASD and FASD, exercise interventions were associated with large improvements in working memory (ES 1.36, 95%CI 1.08-1.64) and response inhibition (ES 0.78, 95%CI 0.21-1.35) and approached significance for attention/set-shifting (ES 0.69, 95% -0.28-1.66). There was evidence of substantial methodologic and substantive heterogeneity among studies. Sample size, mean age, study design, and the number or duration of intervention sessions did not significantly moderate the relationship between exercise and executive function. Conclusion: Exercise interventions among children and adolescents with neurodevelopmental disorders were associated with moderate improvements in executive function domains. Of note, studies of youth with ASD and FASD tended to report higher effect sizes compared to studies of youth with ADHD, albeit few existing studies. Exercise may be a potentially cost-effective and readily implementable intervention to improve executive function in these populations.</p>
Review ArticleEpidemiologydepressionanxietyprisonersMINIAnjali L. VarigondaJuliet B. EdgcombBonnie T. Zima
Copyright (c) 2020 Archives of Clinical Psychiatry
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2020-09-092020-09-0914615610.1590/0101-60830000000251Prevalence and associated factors with depression and anxiety in prisoners in South of Brazil
https://revistas.usp.br/acp/article/view/185195
<p>Background: Brazil has the third largest prison population in the world. Research in the world has confirmed a high prevalence of mental disorders in this population. Objective: To identify prevalence and associated factors with depression and anxiety in prisoners of the closed prison system. Methods: This is a cross-sectional study with 643 prisoners were interviewed in six prisons in Rio Grande do Sul, Brazil. To evaluate depression and anxiety, the Mini International Neuropsychiatric Interview 5.0 (MINI) was used and sociodemographic, inprisonment and lifestyle habits variables were also collected. Results: The prevalence of depression found in the study was 20.6% (95% CI: 17.5-23.8) and of anxiety was 19.9% (95% CI: 16.8-23.0). The following were identified as risk factors for depression: being female, having a history of mental illness, non-white skin color, having a religion, not receiving visits, smoking, using drugs and not performing physical activities. Risk factors for anxiety were: being female, having a history of mental illness, a family history of mental illness, smoking and using drugs. Discussion: The study confirmed the high rates of depression and anxiety in the population deprived of liberty. In addition, women were twice as likely to have both disorders compared to men.</p>
Original ArticlesEpidemiologydepressionanxietyprisonersMINICaroline Ribeiro CostaRaúl Andrés Mendoza SassiVinícius de Souza TímbolaTalita Rubin LazzariAna Julia ReisCarla Vitola Gonçalves
Copyright (c) 2021 Archives of Clinical Psychiatry
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2021-04-302021-04-30899410.1590/0101-60830000000239 Lithium-induced asymptomatic dose-related elevation of serum creatine kinase: a case report
https://revistas.usp.br/acp/article/view/185192
Letters to the EditorMao-Hsiu HuaShen-Chieh ChangMong-Liang Lu
Copyright (c) 2020 Archives of Clinical Psychiatry
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2021-04-302021-04-3012112210.1590/0101-60830000000245Paliperidone-induced mania: a case report
https://revistas.usp.br/acp/article/view/185184
Letters to the EditorNesÇe B. BalMeryem G. Teksin BakirAli ÇayköylüElvan ÖzalpÇagla KoçberberBahriye E. Yilmazoglu
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2020-07-092020-07-0911912010.1590/0101-60830000000244Cross-cultural adaptation of the City Birth Trauma Scale for the Brazilian context
https://revistas.usp.br/acp/article/view/185092
<p>Background: Posttraumatic stress disorder consists of a set of symptoms that occurs in response to one or more traumatic events and can occur in postpartum, from traumatic situations related to the birth or to the baby’s health in the first days of life. It is important tracking the presence of birth trauma, but there is not available instruments in the Brazilian context for this purpose. Objectives: To present the cross-cultural adaptation of City Birth Trauma Scale (BiTS) into Brazilian portuguese. Methods: Cross-cultural adaptation involved independent translations, synthesis,back-translation, and submission to the original author’s appreciation. After the scale was subjected to face validity, followed by a pilot study with postpartum mothers. Results: All steps were performed for the cross-cultural adaptation. Regarding face validity, items evaluated concerning different types of equivalence, presented satisfactory agreement values (≥4.20). Most of the expert’s suggestions were followed, being the main ones related to adjustments in prepositions, pronouns and verbal subjects. Pilot study showed that the mothers had been able to understand and respond to the instrument without adjustments. Discussion: BiTS’s Brazilian version proved to be cross-culturally adapted, ensuring the possibility of intercultural data comparison from the semantic, idiomatic, cultural, and conceptual perspectives. New studies are being conducted to attest its psychometric adequacy</p>
Brief ReportTraumabirthcross-cultural adaptationpsychometricsMariana Fortunata DonadonAna Carolina R. DarwinEduardo A. BombonattiKarina Pereira-LimaRafael Guimarães SantosJoão Paulo Machado-de-SousaThiago Dornela Apolinário da SilvaOmero B. Poli NetoClaudia Maria GaspardoAmaury CantilinoLuciano Dias de Mattos SouzaSusan AyresFlávia L. Osório
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2020-07-092020-07-0911011810.1590/0101-60830000000243Prevalence and associated risk factors of postpartum depression: a cross sectional study
https://revistas.usp.br/acp/article/view/185080
<p>Background: Postpartum mood disturbance affects up to 85% of women, with most symptoms of this disturbance being temporary and mild. However up to one in seven women experience a persistent type of depression which is associated with major maternal and neonatal morbidity if it is not managed. Objective: To estimate the prevalence of postpartum depression and to identify the associated risk factors. Methods: A cross sectional study was conducted in randomly selected 3 primary health care centers affiliated to Suez governorate, Egypt. An interviewed questionnaire was used containing potential risk factors for postpartum depression. An Arabic version of the Edinburgh postnatal depression scale (EPDS) was used to screen for postpartum depression symptoms. Results: A total of 237 postpartum mothers were included in the study. 139 (58.6%) of the mothers completed secondary level of education, 195 (82.3%) of them were housewives and 181 (76.4%) had cesarean section. The estimated postpartum depression prevalence was 26.6% and suicidal ideation accounted for 4.6%. Factors significantly associated with high EPDS scores were bad relationship with the husband, having >2 children, an unplanned pregnancy and unhealthy newborn; with P-values of 0.000, 0.004, 0.000, and 0.018, respectively. Discussion: the prevalence of postpartum depression among Egyptian women is considered slightly high with its negative and long term consequences on the mothers and their children, accordingly screening, proper management & referral to specialist care is highly recommended.</p>
Original ArticlesPostpartumdepressionrisk factorsReda GowedaTayseer Metwally
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2020-07-092020-07-0910610910.1590/0101-60830000000242Clinical characteristics of cognitive deficits in major depressive disorder: a 6-month prospective study
https://revistas.usp.br/acp/article/view/185078
<p>Background: Previous studies have shown that major depressive disorder (MDD) is associated with a variety of cognitive deficits, which can persist even in remitted states. Nevertheless, the relationship between the cognitive and affective symptoms in depression remains obscure. The aim of the present study was to explore the clinical characteristics and correlates of the cognitive deficits in patients with MDD. Methods: Clinical and neuropsychological assessments were conducted at baseline and 6-month follow-ups. The severity of the disease and the effect of treatment were assessed with the Hamilton Depression Scale-17. Neuropsychological tests, including the digital symbol substitution test and digit span test, were administered to 67 depressed patients and 56 healthy participants. Results: MDD patients showed impairments in memory, attention, and executive function at baseline. After the 6-month treatment phase, patients in remission showed significant alleviation of these cognitive deficits, although impairments in attention and executive function were still present when compared to controls. Discussion: Significant cognitive deficits are present in MDD. The speed of remission of cognitive functions seems to be slower than and inconsistent with emotional symptoms, which provides new support for the argument that cognitive deficits are independent factors from the emotional symptoms in MDD.</p>
Original ArticlesMajor depressive disordercognitive deficitsexecutive functionremissionYajuan JiWeihui LiBangshan LiuJin LiuYumeng JuMi WangYanchao ChenLingjiang Li
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2020-07-092020-07-0910110510.1590/0101-60830000000241What are the factors that contribute to aggression in patients with co-occurring antisocial personality disorder and substance abuse?
https://revistas.usp.br/acp/article/view/185004
<p>Background: A significant number of individuals with high levels of aggression have substance use disorder problems. Objective: This study aimed to evaluate the effect of substance use disorder on aggression in young men with Antisocial personality disorder (ASPD). Methods: This cross-sectional study included 328 patients and were diagnosed with ASPD with a comorbidity of substance use disorder, along with 111 healthy young male subjects. Results: The total aggression scores of the patients with a diagnosis of ASPD were significantly higher than those of the healthy group (p < 0.001). Mean scores of aggression subscale, except for indirect aggression, were higher in patients diagnosed with ASPD (p < 0.05). There was a positive correlation between aggression scores and total API scores in patients diagnosed with ASPD (p < 0.001). Aggression scores were higher when subjects were using volatile substances compared to other substances (p < 0.05). Aggression scores increased with duration of substance use disorder (p < 0.001). Discussion: Substance use disorder should be treated first to mitigate aggression in individuals with ASPD. Patients with severe addiction to volatile substances should be given treatment priority. Further studies are necessary to determine the cause of aggression in individuals who abuse substances.</p>
Original ArticlesAntisocial personality disordersubstance use disorderaggressionyoung menBülent Devrim AkçayDuygu Akçay
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2020-07-092020-07-099510010.1590/0101-60830000000240Treatment of food addiction: preliminary results
https://revistas.usp.br/acp/article/view/184998
Letter to the EditorEdgar Luis Lima de OliveiraEmilie LacroixAndrea Lorena Costa StravogiannisMaria de Fátima VasquesCristiane Ruiz DuranteÉrica Panzani DuranDaniela PereiraJanice Rico CabralHermano Tavares
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2020-09-092020-09-0916316410.1590/0101-60830000000256Huntington’s disease presenting as mixed state episode
https://revistas.usp.br/acp/article/view/184996
Letter to the EditorLaiane Tábata Souza CorgosinhoJoão Antônio Bomfim SilvaRogério Gomes BeatoVinicius Sousa Pietra Pedroso
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2020-09-092020-09-0916216210.1590/0101-60830000000255Vortioxetine-induced nausea and its treatment: a case report
https://revistas.usp.br/acp/article/view/184993
Letter to the EditorCalogero CrapanzanoAndrea PolitanoChiara AmendolaDespoina KoukounaIlaria Casolaro
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2020-09-092020-09-0916016110.1590/0101-60830000000254Excessive consumption of tianeptine by a person with former alcohol problem
https://revistas.usp.br/acp/article/view/184991
Letter to the EditorJakub GrabowskiLeszek Bidzan
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2020-09-092020-09-0915915910.1590/0101-60830000000253Treatment of insomnia with repetitive transcranial magnetic stimulation (rTMS) in a patient with posttraumatic stress disorder (PTSD)
https://revistas.usp.br/acp/article/view/184988
Letter to the EditorAbdullah BoluIbrahim GündoğmuşTaner ÖznurCemil Çelik
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2020-09-092020-09-0915715810.1590/0101-60830000000252Lesion localization and performance on Theory of Mind tests in stroke survivors: a systematic review
https://revistas.usp.br/acp/article/view/184932
<p>Background: Theory of Mind (ToM) is the ability to attribute mental states to oneself and others. Individuals with a brain lesion following a stroke exhibit a compromised ability to perform ToM tasks. Objective: To analyze studies that evaluated ToM in stroke survivors considering the lesion localization and performance on ToM tests. Methods: The searches were carried out until November 28, 2018, using the following search terms: “social cognition” or “Theory of Mind” and “stroke”. Searches were conducted in the PubMed, PsycInfo, Web of Science and Scopus data bases. The initial search led to the retrieval of 425 articles. After the exclusion of duplicates and the analysis of the titles, abstracts and full texts, 20 articles were selected for the present review. Results: The studies showed that patients with lesion in the right hemisphere present lower performance on ToM tasks compared to those with lesion in the left hemisphere. In addition, patients with lesion in the right hemisphere presented significant impairment in the performance on ToM tasks compared to healthy individuals. Furthermore, the studies that evaluated lesions in specific regions such as temporal lobe, prefrontal cortex, posterior parietal cortex, and temporo-parietal junction, indicated a significant deficit in ToM performance of these patients compared to healthy individuals. Discussion: This review showed that stroke survivors have a poor performance on ToM tasks. The right hemisphere and prefrontal cortex seem to be associated with the deficit of this ability.</p>
Review ArticleSocial cognitionTheory of MindstrokeAna Julia de Lima BomfimBianca Letícia Cavalmoretti FerreiraGuilherme Riccioppo RodriguesOctavio Marques Pontes-NetoMarcos Hortes Nisihara Chagas
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2020-09-092020-09-0914014510.1590/0101-60830000000250The effect of trauma type on the severity of Post-Traumatic Stress Disorder (PTSD) symptoms
https://revistas.usp.br/acp/article/view/184930
<p>Objective: The high prevalence of trauma exposure calls for detailed research on how trauma type affects the development of Post-Traumatic Stress Disorder (PTSD). Therefore, the aim of our study was to investigate the effects of the type of trauma on the severity of symptoms, anxiety, depression, and dissociative experiences in the PTSD patient population. Method: The sample of the study consists of 80 volunteer PTSD patients (20 sexual trauma, 20 work accidents, 20 traffic accidents and 20 combat related trauma). Once the severity of symptoms was determined in all subjects by the Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory, Beck Anxiety Inventory and Dissociative Experiences Scale (DES) were applied. Results: A statistically significant difference were found between trauma types with regard to age, time without treatment, and the total and subscale scores obtained in DES and CAPS. It was found that in the group that has PTSD diagnosis related to sexual trauma, the length of the time without treatment, DES and CAPS scores. Conclusion: The study we conducted showed that PTSD continued more severe and resistant after a sexual trauma. Moreover, specific type of trauma was significant in PTSD patients.</p>
Original ArticlesPost-Traumatic Stress Disorder (PTSD)trauma typeseveritysexual traumaAyşegül Taşdelen KulIbrahim Gündoğmuş
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2020-09-092020-09-0913513910.1590/0101-60830000000249Is there a relationship between thyroid hormone levels and suicide attempt in adolescents?
https://revistas.usp.br/acp/article/view/184926
<p>Background: Thoughts about suicide are quite common in adolescent. While such thoughts can be caused by many reasons, the most wellknown of these are mood disorders. There are studies related to coexistence of thyroid pathologies and mood disorders in adult. Objectives: In this study, we aimed to investigate the difference of thyroid hormone levels in between adolescents with suicide attempt history and normal population. Methods: The study was prospective and was designed as a case-control study. Demographic characteristics of the patients were obtained and Serum fT3, fT4 and TSH levels were examined. Results: 222 cases were included in the study, including 101 cases and 121 controls. As for TSH levels, the mean serum levels of the whole group was 1.96 ± 1.08 mU/L, while the mean serum levels of the control group was 2.33 ± 1.5 mU/L and the mean serum levels of the case group was 0.50 ± 0.3 mU/L which revealed that the mean serum levels of the case group was significantly lower (p<0.01). Conclusion: It was found that serum TSH levels were significantly lower in case group than control group and the individuals with subclinical hyperthyroidism had more suicide attempts than the ones in control group.</p>
Original ArticlesGamze GokalpEmel BerksoySefika BardakGulsah DemirSule DemirMurat Anil
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2020-09-092020-09-0913013410.1590/0101-60830000000248Prevalence and comorbidity of psychiatric symptomology in Pakistani female adolescents
https://revistas.usp.br/acp/article/view/184924
<p>Background: Previous researchers have demonstrated the co-existence of psychiatric conditions across clinical as well as non-clinical samples in diverse situations. The present study examined the prevalence and co-morbidity of various psychiatric symptoms (e.g. learning disabilities, depression and anxiety) in school-age female adolescents. Methods: In a cross-sectional random sampling method, 252 girls from two government schools in Lahore were assessed by Learning Disabilities Checklist, Children Depression Inventory and the Spence Anxiety Scale. Results: The results demonstrate significant prevalence and co-morbidity of psychiatric symptoms. Of the 252 participants, 34%, 21% and 68% had significant learning disabilities, depression and anxiety symptoms respectively. In addition, 27% of them presented symptoms of three studied psychiatric conditions. A highly significant positive correlation was found between learning disabilities, depression and anxiety symptoms. Methods: There is a dire need for preventative intervention programs to promote mental health at school level. Further, assessment plans for the screening of psychiatric symptoms in normative samples also need to be put in place.</p>
Original ArticlesLearning disabilitiesdepressionanxietyfemale adolescentsFarzana AshrafNajma NajamAasia Nusrat
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2020-09-092020-09-0912512910.1590/0101-60830000000247Lithium and Lactation
https://revistas.usp.br/acp/article/view/184922
EditorialMaria Luisa ImazRocio Martin-Santos
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2020-09-092020-09-0912312410.1590/0101-60830000000246Correlates of neuropsychiatric and motor tests with language assessment in patients with Lewy body dementia
https://revistas.usp.br/acp/article/view/180727
<p>Background: Lewy body dementia (LBD) impairs performance in daily activities and affects motor, language and visuospatial tasks. Objective: We aimed to correlate neuropsychiatric and motor assessments with language and visual organization tests in LBD. Methods: Twenty-two patients with dementia with Lewy bodies and ten patients with Parkinson’s disease dementia participated on a cross-sectional study that assessed cognition, functionality, caregiver burden, verbal fluency, the primer-level dictation section of the Boston Diagnostic Aphasia Examination (PLD-BDAE), the Hooper Visual Organization Test, the Neuropsychiatric Inventory and the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale. Results: Language and visuospatial test results followed motor impairment and general cognitive performance. Whereas visual organization did not predict performance in the PLD-BDAE, visuospatial abilities and verbal fluency were concurrently associated, suggesting that linguistic impairment in LBD may be attributed to neuropsychological components of cognition and language. Only visual organization was associated with behaviour, suggesting that neuropsychiatric symptoms associate with differential impairment of visual organization in comparison with language in LBD. Schooling did not affect visual organization or language test performance, while the length of dementia was negatively associated with visual organization and verbal fluency. Discussion: Though visual organization tests follow behaviour and motor performance in LBD, there is differential impairment regarding language skills.</p>
Original ArticlesLewy body dementialanguagespatial processingneuropsychiatryneuropsychological testsFernando Chiodini MachadoFabricio Ferreira de OliveiraSheilla de Medeiros Correia MarinGustavo SampaioPaulo Henrique Ferreira Bertolucci
Copyright (c) 2019 Archives of Clinical Psychiatry
2019-06-122019-06-12758110.1590/0101-60830000000236Social communication impairments and restricted, repetitive patterns ("Kodawari") considered from the "Comprehension" section of the WISC-IV in autism spectrum disorder
https://revistas.usp.br/acp/article/view/180726
<p>Background: Many studies have used the Wechsler Intelligence Scale (WISC) to examine the characteristics of autism spectrum disorder (ASD). However, most studies have been based on profile analysis, not on content analysis. Objective: The objective of the present study was to apply the WISC-IV to clinical assessment of ASD and clarify how the characteristics of the disorder were reflected in specific items. Methods: The study participants were 20 patients aged 5-16 years diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We recruited 20 patients with attention-deficit/hyperactivity disorder (ADHD) and 20 patients with other disorders (neurotic disorders) as controls. We then compared the scores of the ninth item of the WISC-IV ("Comprehension") among the three groups. Results: The differences observed between the ASD vs. the other disorders group were not significant by the standard scoring method. Thus, a two-level scoring method of 0 and ≥1 point was adopted. As a result, significantly more participants in the ASD group scored 0 points compared with the ADHD and other disorders group</p>
Brief ReportAutism spectrum disorderattention-deficit/hyperactivity disordercontent analysisDSM-5WISCFujio YokoyamaNobuyuki ShonoAyaka TakasugiReiko SatoEita OchiShinji OkinagaHiroshi OdaYuko HagiwaraTakahiro MatsuokaToshio OtaKoji Matsuo
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2019-06-122019-06-12828410.1590/0101-60830000000237Evidence for a distinct depression-type schizophrenia: a pilot study
https://revistas.usp.br/acp/article/view/180723
Letters to the EditorLiying LiuCe ChenGongying LiXiaodong LinDeguo JiangHongjun TianXu LangChuanjun ZhuoLixue Qiu
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2019-06-122019-06-12878810.1590/0101-60830000000239Serotonin syndrome associated with methadone and milk thistle seeds: a case report
https://revistas.usp.br/acp/article/view/180719
<p>Background: Serotonin syndrome is rarely, potentially life threatening condition, associated with use of serotonin acting medications and psychoactive drugs. In the majority of cases the symptoms occur soon after the initiation of a new drug or a change in the dose. Objective: To present a case report and to describe the possible mechanism of development of serotonin syndrome during the interactions between milk thistle seeds and methadone on hepatic cytochrome enzyme system P450. Methods: A case report of a young man on regular therapy with methadone, who develop a serotonin syndrome after ingestion a high dose of milk thistle seeds. Results: Commercial preparations of milk thistle include the extract silibinin, which exhibits no beneficial or harmful drug interactions at normal doses, but at higher concentrations it can lead to dose-dependent effects on methadone metabolism, through inhibition of CYP3A4 and P-glycoprotein. As a result, it may lead to enhanced serotonin re-uptake inhibition and increased serotonin activity. Discussion: Milk thistle is widely used and recommended for detoxification, but it may have serious and life threatening interactions with psychotropic drugs and psychoactive substances when used in high doses.</p>
Letters to the EditorSerotonin syndromemilk thistlesilymarinmethadoneinteractioncytochrome P450Andreja CelofigaTomo Brus Hladen
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2019-06-122019-06-12858610.1590/0101-60830000000238PER3 VNTR variant and susceptibility to smoking status/substance use disorder in a Turkish population
https://revistas.usp.br/acp/article/view/180714
<p>Background: Substance use and smoking exert devastating impact on sleep, especially hindering the ease of falling asleep, compromising the sleep maintenance, and distorting the sleep cycles. PERIOD genes are believed to play a role in individual differences in sleep timing by influencing circadian. Objective: The aim of this study was to ascertain whether Per3 VNTR variant affects suspectibility of individuals to substance use disorder (SUD) and smoking status in a Turkish population. Methods: A total of 549 subjects, including 212 SUD patients, 160 smoker, and 177 healthy controls, matched by ethnicity, age, and gender, were recruited in a case-control study. Genotyping of Per3 variant was performed using PCR method. Results: When the SUD, smoker groups and controls were compared in terms of 5R/5R, 5R/4R, 4R/4R genotypes, no significant difference was observed. Besides, allele frequencies of Per3 VNTR were similar among the groups. Discussion: Our data indicate that Per3 VNTR variant is not associated with the risk of SUD and smoking status in our population.</p>
Original ArticlesSubstance use disordersmoking statusPer3VNTRPCRAyse Feyda NursalPinar Cetinay AydıMehmet Atilla UysalMustafa PehlivaYasemin OyaciSacide Pehliva
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2019-06-122019-06-12717410.1590/0101-60830000000235Using data from schizophrenia outcome study to estimate the time to treatment outcome and the early-response cut-off score that predicts outcome at week 16
https://revistas.usp.br/acp/article/view/180712
<p>Background: Being able to make an estimation of the time to clinical outcome, and making predictions early during treatment about the possibility of later response/non-response to treatment, is an important asset that can help to guide treatment strategies and counsel patients and caregivers about treatment expectations. Objectives: The study aimed to determine the time course to treatment outcome and the psychopathological cut-off score at week 4 that predicts outcome at week 16. Methods: This was a naturalistic follow-up study of 160 incident cases of schizophrenia over 16 weeks. Four intervals of follow-up clinical assessments were done. Standard criteria for response and remission were applied. Results: The mean (median) times, in weeks, to response and remission using Brief Psychiatric Rating Scale (BPRS) data were 8.1(8.0); 8.4(8.0); and 10.9 (12.0), respectively. The Areas Under the Curves were high, for response (0.909; 95% C.I., 0.85-0.97) and remission (0.86; 95% C.I., 0.81 -0.94) at week 16. A cut-off score of 20.7% reduction in the total BPRS score at week 4, predicted response status (79.5% sensitivity, 84.2% specificity) and remission status (77.6% sensitivity, 73.3% specificity) at week 16. In addition, a cut-off of 10.21% reduction in the total Scale for Assessment of Negative Symptoms (SANS) score at week 4, predicted response (70.8% sensitivity, 95.5% specificity) at week 16. Discussion: The results are in line with the general clinical impression that, by 2 months, most acutely ill inpatients are fit for discharge; and introduced for further investigation 10.21% reduction in SANS Score as a marker of treatment resistance in schizophrenia.</p>
Original ArticlesTime-to-outcomeearly-responsecut-offpredictionschizophreniaJustus Uchenna OnuJude Uzoma Ohaeri
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2019-06-122019-06-12657010.1590/0101-60830000000234The role of thought suppression in conversion disorder in relation to depression, symptom interpretation and sleep hygiene: a case-control study
https://revistas.usp.br/acp/article/view/180710
<p>Background: Thought suppression has been associated with a number of psychiatric disorders. However, the association with conversion disorder (CD) has not been investigated yet. Objective: To investigate the role of thought suppression in CD. Methods: Eighty consecutive outpatients with a diagnosis of CD and sixty age, sex and neighborhood-similar controls were evaluated using Beck Depression Inventory-I (BDI-I), White Bear Suppression Inventory (WBSI), Symptom Interpretation Questionnaire (SIQ) and Sleep Hygiene Index (SHI). Cases and controls were compared in regard to thought suppression scores considering their status of high depression scores via a logistic regression model. The reciprocal associations of thought suppression with other clinical dimensions in CD were assessed. Finally, structural equation modelling was applied to untangle the possible connections. Results: CD patients had significantly higher scores of thought suppression than the control group. However, the difference was below the significance level when CD patients without comorbid high depression scores were taken into account. Thought suppression was associated with the clinical severity of CD. According to the structural equation model, older age and somatic attributions to the common bodily sensations were the significant correlates of thought suppression among CD patients. Discussion: Thought suppression may be considered as a non-specific marker of clinical severity in CD.</p>
Original ArticlesConversionthought suppressiondepressionsleep hygienesomatic attributionPınar Güzel ÖzdemirUmut KırlıMesut IsÇıkSÇüheda Tapan
Copyright (c) 2019 Archives of Clinical Psychiatry
2019-06-122019-06-12596410.1590/0101-60830000000233Neutrophil-lymphocyte ratio in catatonia
https://revistas.usp.br/acp/article/view/180674
<p>There is growing evidence of subclinical inflammation in mental disorders. Objective: The aim of this study was to investigate frequency of symptoms of catatonia and the newly diagnosed subclinical inflammatory markers which are neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), monocyte/lymphocyte (MLR) ratios in catatonia patients due to mental disorders. Methods: Patients who were admitted to psychiatry clinic with the diagnosis of catatonia according to DSM 5 in the last two years and equal number of control group were included in this retrospective study. Univariate analysis of covariance controlled for possible confounders was used to compare NLR, PLR, MLR ratios between patients and the control group. Results: A total of 34 catatonia patients and 34 healthy controls were included in the study. Patients’ mean age was 30.88 + 13.4. NLR value was significantly higher in the patient group than control group. There was no significant difference between the patients and control group according to PLR, MLR values. Discussion: The presence of subclinical inflammation in catatonic syndrome due to mental disorders should be considered. Subclinical inflammation that was observed in numerous mental disorders continues in catatonia due to mental disorders. Large-scale studies are needed to determine the role of inflammation in catatonia.</p>
Original ArticlesCatatoniainflammationneutrophil-lymphocyte ratioplatelet lymphocyte ratiomonocyte/lymphocyte ratiosymptom frequencySengul Kocamer SahinCelal YaşamaliMuhammet Berkay ÖzyürekGülçin ElboğaAbdurrahman AltindağAhmet Ziya Şahin
Copyright (c) 2020 Archives of Clinical Psychiatry
2020-04-282020-04-28555810.1590/0101-60830000000232An analytical study of iboga alkaloids contained in Tabernanthe iboga-derived products offered by ibogaine treatment providers
https://revistas.usp.br/acp/article/view/180673
<p>Therapeutic properties of ibogaine in the treatment of addiction are attracting both clinicians and patients to its use. Since ibogaine is not an authorized medicine, the quality of these products is not always known, increasing the probability of adverse reactions. Objective: This study collects different types of iboga-derived samples from treatment providers, vendors and online buyers to analyse their content. Methods: Analysis of iboga products (n = 16) was performed using gas chromatography and mass spectrometry methods (GC/MS). Products included Iboga root bark, Total Alkaloids (TA), Purified Total Alkaloids (PTA HCl), ibogaine hydrochloride (ibogaine HCl) and one Voacanga africana root bark. Results: The content of ibogaine was highly variable, ranging from 0.6% to 11.2% for products sold as iboga root bark, from 8.2% to 32.9% for products sold as TA, 73.7% for one sample sold as PTA and from 61.5% to 73.4% for products sold as ibogaine HCl. One sample did not show any iboga alkaloids. Other alkaloids and unknown substances were found in almost all samples. Discussion: The purity of iboga products is highly variable. These results should be taken into consideration by suppliers and users, especially regarding correct dosing to avoid overdose, as well as potential interactions with other substances.</p>
Original ArticlesTabernanthe ibogaibogainesample analysisaddiction treatmentharm reductionJosé Carlos BousoIvan FornísMireia Ventura VilamalaBenjamin De LoenenAlberto Sainz-CortDaniel F. Jiménez-GarridoRafael Guimarães dos SantosJaime E. C. HallakMiguel Ángel Alcázar-CórcolesChristopher W. Jenks
Copyright (c) 2020 Archives of Clinical Psychiatry
2020-04-282020-04-28515410.1590/0101-60830000000231Depression, PTSD and alexithymia in victims of intimate partner violence: a case-control study
https://revistas.usp.br/acp/article/view/180671
<p>Intimate partner violence (IPV) regards millions of women worldwide and can lead to serious psychopathological consequences. Objective: We aimed to evaluate differences between a group of abused women and controls, and potential predictors of depression and PTSD in the IPV group. Methods: We recruited 57 women who experienced IPV and 57 age-matched controls from the general population. After collecting socio-demographic characteristics, we administered the following scales: Hamilton Depression Rating Scale (HDRS), Davidson Trauma Scale (DTS), Toronto Alexithymia Scale (TAS-20) and Revised-Conflict Tactics Scale (CTS-2). Results: Our results showed differences between women who experienced IPV and controls in the socio-economic status, employment and educational levels, childhood abuse and early terminations of pregnancy. Notably, the rates of depression, PTSD, and alexithymia were significantly different between the two groups. Linear regression models revealed that sexual coercion was an independent positive predictor of depressive symptoms, while alexithymia played a role in the development of PTSD in the group of abused women. Discussion: Given the prevalence of depression and PTSD in victims of IPV, it is important to always investigate for IPV in women seeking for help in mental health services. Alexithymia in victims of IPV deserves to be further investigated by researchers.</p>
Original ArticlesIntimate partner violencePTSDdepressionalexithymiadomestic violencesexual coercionMaria Salvina SignorelliLaura Fusar-PoliEleonora ArcidiaconoPasquale CaponnettoEugenio Aguglia
Copyright (c) 2020 Archives of Clinical Psychiatry
2020-04-282020-04-28455010.1590/0101-60830000000230Mediating role of childhood abuse for the relationship between schizotypal traits and obsessive-compulsive disorder
https://revistas.usp.br/acp/article/view/180669
<p>The mediating role of childhood trauma in the relationship between schizotypal symptoms and obsessive-compulsive disorder (OCD) was not sufficiently investigated to date. Objectives: In the present study, our major goal was to analyse the mediator role of childhood abuse (emotional, physical, and sexual), and neglect (emotional and physical) on the link between schizotypal symptoms and OCD, after controlling for duration of OCD, the mean number of comorbid Axis I disorders, and current anxiety. Methods: One hundred fifteen patients (aged 18-65 years) who had primary diagnosis of OCD and YaleBrown Obsessive-Compulsive Scale score ≥16 were assessed using the short form of Childhood Trauma Questionnaire questionnaire (CTQ-SF), Schizotypal Personality Questionnaire (SPQ), and Beck Anxiety Inventory (BAI). Results: The all types of schizotypal symptoms were significantly correlated with the scores of childhood abuse and neglect, and BAI. The childhood abuse as a mediator significantly predicted the total YBOCS scores (p = 0.02) after when BAI scores were controlled. However, childhood neglect was not multivariately related to current OCD severity, and did not mediate the relationship between schizotypal traits and total YBOCS scores. Discussion: We suggested that childhood trauma mediated the schizotypal traits in relationship with current OCD severity independent from anxiety severity.</p>
Original ArticlesObsessive-compulsive disorderchildhood traumaschizotypal traitsCagdas Oyku MemisBilge DoganDoga SevincokIsmet AshikLevent Sevincok
Copyright (c) 2020 Archives of Clinical Psychiatry
2020-04-282020-04-28404410.1590/0101-60830000000229Parent-teacher report reliability on the fourth edition of the Swanson, Nolan and Pelham scale in a Brazilian clinical sample of children and adolescents with attention-deficit/hyperactivity disorder
https://revistas.usp.br/acp/article/view/2020-04-28
<p>Parents and teachers can be valuable sources of information for characterizing children’s ADHD-related impairments in different environments. However, evidence indicated that those categories of informants often provide conflicting responses in formal assessment scales, which may challenge diagnostic decisions regarding the condition. Objective: We aimed to investigate reliability rates between parents and teachers of children and adolescents with and without ADHD using SNAP IV. Methods: 199 children and adolescents aged 6 to 17 years were evaluated for ADHD symptoms using parent-rated and teacher-rated SNAP IV scales. Intraclass correlation coefficients were analyzed for ADHD domains (inattention and hyperactivity/impulsivity), as well as for defiant-oppositional behavior. Results: Reports from parents and teachers showed low reliability for all ADHD domains. Parents’ scores on the SNAP IV were higher than those of teachers. Parents and teachers provided highly discrepant responses concerning to the presence and severity of ADHD in children and adolescents, which might result from intrinsic aspects related to their daily functioning in different settings. Discussion: Clinicians should consider those trends in parental and teachers’ responses when interpreting results from informant-based instruments for detecting ADHD.</p>
Original ArticlesReproducibility of resultsattention-deficit disorder with hyperactivityPsychiatric Status Rating Scalesattention-deficit and disruptive behavior disordersPriscila Corção B. MoraesBruno Figueiredo DamásioGabriel Cardoso Medeiros de LimaFelipe Kenji SudoPaulo Eduardo Luiz de Mattos
Copyright (c) 2020 Archives of Clinical Psychiatry
2021-02-182021-02-18353910.1590/0101-60830000000228