ABSTRACT
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.
ABSTRACT
Objective: To determine whether people with a Sardinian genetic background who live in the megacities of South America have a higher frequency of hypomania than residents of Sardinia. Methods: A community survey of Sardinian immigrants was carried out in four Brazilian metropoles (n=218) and Buenos Aires (n=306). The results were compared with those of a study involving a similar methodology (Mood Disorder Questionnaire [MDQ] as a screening tool) conducted in seven Italian regions, including a sub-sample from Sardinia. Results: There was a higher prevalence of lifetime hypomania among Sardinians living in the Brazilian metropoles than among those living in Sardinia. This result was also consistent with Sardinian immigrants in Buenos Aires. After stratification by sex and age, the lifetime prevalence of MDQ scores ≥ 8 among Sardinians in South-American megacities and Sardinia was 8.6% vs. 2.9%, respectively (p < 0.0001). Conclusions: The higher frequency of hypomania in migrant populations appears to favor an evolutionary view in which mood disorders may be a maladaptive aspect of a genetic background with adaptive characteristics.
Subject(s)
Humans , Male , Female , Adult , Transients and Migrants/psychology , Bipolar Disorder/epidemiology , Argentina/epidemiology , Brazil/epidemiology , Cross-Cultural Comparison , Prevalence , Surveys and Questionnaires , Risk Factors , Cities/epidemiology , Sex Distribution , Age Distribution , Italy/ethnologyABSTRACT
Objective: To ascertain lifetime prevalence of positivity to a screening questionnaire for bipolar disorders (BD) in Sardinian immigrants to Argentina and residents of Sardinia and assess whether such positivity affects quality of life (QoL) in either group. Our hypothesis is that screen positivity for BD may be more frequent in immigrants. Methods: Observational study. Subjects were randomly selected from the membership lists of associations of Sardinian immigrants in Argentina. A study carried out in Sardinia using the same methodology was used for comparison. The Mood Disorder Questionnaire was used to screen for mania/hypomania and the Short-Form Health Survey-12 to measure QoL. Results: A higher prevalence of manic/hypomanic episodes was found in Sardinian immigrants to Argentina (p < 0.0001; odds ratio = 3.0, 95% confidence interval 1.87-4.77). Positivity at screening was associated with a lower QoL both in Sardinian immigrants to Argentina and in residents of Sardinia. Conclusions: To the best of our knowledge, this is the first study to show a higher lifetime prevalence of manic/hypomanic episodes in a general-population sample of individuals who migrated to a foreign country. Our results are in agreement with the hypothesis that hyperactive/novelty-seeking features may represent an adaptive substrate in certain conditions of social change.
Subject(s)
Humans , Male , Female , Adult , Bipolar Disorder/epidemiology , Emigrants and Immigrants/psychology , Argentina/epidemiology , Psychiatric Status Rating Scales/standards , Quality of Life/psychology , Logistic Models , Sex Factors , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires/standards , Risk Factors , Age Factors , Sex Distribution , Age Distribution , Emigrants and Immigrants/statistics & numerical data , Italy/ethnologyABSTRACT
Este artigo traz um levantamento exploratório acerca da atual produção bibliográfica brasileira concernente ao tema da saúde mental infanto-juvenil. A necessidade de sua elaboração se deve à realização da pesquisa Construção e desconstrução de demandas: uma cartografia dos dispositivos de Saúde mental Infanto-Juvenil da cidade de Belo Horizonte, em andamento desde 2009 e coordenada pelo Laboratório de Grupos, Instituições e Redes Sociais (L@gir-UFMG). Foram analisadas sistematicamente 14 publicações, escolhidas pelos pesquisadores por apresentarem contribuições pertinentes ao tema pesquisado. Por meio da análise foi possível elaborar categorias e identificar tendências quanto à forma de problematizar a saúde mental infanto-juvenil no Brasil.
This article shows an exploratory survey on the current Brazilian bibliographical production concerning the issue of child and adolescent mental health. The need for the elaboration of this study is due to the research "Construction and Deconstruction of demands: a cartography of Child and Adolescent Mental health devices in the city of Belo Horizonte", in progress since 2009 and coordinated by the Laboratory of Groups, Institutions, and Social Networks (L@gir-UFMG). Fourteen publications, selected by the researchers for presenting relevant contributions to the theme researched, were systematically analyzed. By means of the analysis it was possible to elaborate categories and to identify trends regarding the ways of structuring the problems of children and adolescents‟ mental health in Brazil.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adolescent , Child , Mental Health , Public PolicyABSTRACT
A evoluçao do tratamento cirúrgico da instabilidade anterior do joelho atualmente tem-se baseado em dois fatores já bem estabelecidos: o primeiro é a utilizaçao de enxertos biológicos com características similares às do LCA e com baixa morbidade no sítio doador; o segundo é o aprimoramento das técnicas de reconstruçao, com a finalidade de fixar o enxerto o mais próximo possível da inserçao antômica original do LCA. Neste trabalho, é descrita uma técnica que utiliza a parte central do tendao do quadríceps como enxerto na reconstruçao do LCA e que segue os princípios de fixaçao desse enxerto de forma isométrica e anatômica.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Anterior Cruciate Ligament/surgery , Orthopedic Procedures/methods , Tendon TransferABSTRACT
Os autores relatam um caso de trissomia parcial do braço curto do cromossomo 3, resultante de uma translocaçäo materna 46,XX,t(3;21) (3qter-3p25::21q22-21qter; 21qter-21q::3p25-3pter). O paciente veio a consulta genética pro apresentar malformaçäo cardíaca associada a outras alteraçöes fenotípicas. Rssalta-se a importância da avaliaçäo genética nos pacientes portadores de malformaçäo cardíaca, especialmente quando associada a outros defeitos congênitos, para a prevençäo dos casos com alto risco de recorrência familiar
Subject(s)
Child, Preschool , Humans , Male , Chromosomes, Human, Pair 3 , Trisomy , Heart Defects, Congenital/diagnosis , Genetic Counseling , Translocation, GeneticABSTRACT
Baseado na análise retrospectiva de 1.000 prontuários de pacientes internados no Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo autor discute o diagnóstico sindrômico de depressäo; encontrado em 20% dessa populaçäo. Levado em conta fatores como: sexo, idade, presença ou näo de fatores orgânicos, doença psiquiátrica e personalidade, procura classificar os vários quadros depressivos dessa populaçäo