A magnetic resonance imaging-based morphometric and structural covariance network study of Brazilian adolescents stratified by depression risk

Objectives: To explore differences in regional cortical morphometric structure between adolescents at risk for depression or with current depression. Methods: We analyzed cross-sectional structural neuroimaging data from a sample of 150 Brazilian adolescents classified as low-risk (LR) (n=50) or high-risk (HR) for depression (n=50) or with current depression (n=50) through a vertex-based approach with measurements of cortical volume (CV), surface area (SA), and cortical thickness (CT). Differences between groups in subcortical volume and in the organization of networks of structural covariance were also explored. Results: No significant differences in brain structure between groups were observed in whole-brain vertex-wise CV, SA, or CT. Also, no significant differences in subcortical volume were observed between risk groups. In relation to the structural covariance network, there was an indication of an increase in the hippocampus betweenness centrality index in the HR group network compared to the LR and current depression group networks. However, this result was only statistically significant when applying false discovery rate correction for nodes within the affective network. Conclusion: In an adolescent sample recruited using an empirically based composite risk score, no major differences in brain structure were detected according to the risk and presence of depression.

Predictors of gaming disorder in children and adolescents: a school-based study

Objective: To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample. Methods: We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses. Results: Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder. Conclusion: Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.

Precisamos falar sobre tecnologia: caracterizando clinicamente os subtipos de dependência de tecnologia / We need to talk about technology: clinical characterization of the technology addiction subtypes

Os desenvolvimentos tecnológicos na área das telecomunicações e tecnologia da informação modificaram não só como as pessoas se comunicam, mas também como elas se relacionam com a própria tecnologia. A forma extrema desse comportamento, conhecida como dependência de tecnologia, é um transtorno caracterizado pela inabilidade de controlar o uso de tecnologia (internet, jogos eletrônicos, smartphones) mesmo que esse uso já esteja causando impacto negativo nas principais áreas da vida do indivíduo (relacionamentos interpessoais, saúde física, desempenho acadêmico, desempenho no trabalho). O objetivo deste artigo é revisar os subtipos de dependência de tecnologia (jogos eletrônico, redes sociais, pornografia e smartphones) que apresentam maior relevância em nossa prática clínica, apresentando suas definições e características, e ilustrando-os através de vinhetas clínicas. Além disso, discutiremos como a avaliação da relação de nossos pacientes com as tecnologias pode ser útil do ponto de vista clínico mesmo para aqueles que não apresentem um transtorno decorrente desse uso nem o tenham como motivo da busca de atendimento.(AU)

Technological developments in telecommunications and information technology have changed not only how people communicate but also how they relate to the technology itself. The extreme form of this behavior, known as technology addiction, is a disorder characterized by the inability to control the use of technology (internet, video games, smartphones) even if such use is already causing a negative impact on major areas of one's life (interpersonal relationships, physical health, academic achievement, job performance). The aim of this paper is to review the technology addiction subtypes (electronic games, social networking, pornography and smartphones) that have greater relevance in clinical practice, with its definitions and characteristics, and illustrating them through clinical vignettes. In addition, we discuss how the evaluation of the relationship of our patients with the technologies can be useful from a clinical point of view even for those who do not present a disorder resulting from this use and not seeking care due to a technology addiction.(AU)

Dependência de jogos eletrônicos em crianças e adolescentes / Video game addiction

Com o incrível avanço tecnológico das últimas décadas, os jogos eletrônicos se tornaram uma das principais atividades de lazer de crianças e adolescentes. Os problemas relacionados ao uso excessivo dos games despertam cada vez mais a atenção de profissionais da saúde, e o número de artigos sobre o tema tem aumentado progressivamente. MÉTODOS: Foi realizada uma revisão não sistemática da literatura utilizandose os bancos de dados PubMed, SciELO e LILACS. RESULTADOS: São descritas as características dos jogos e dos jogadores que parecem estar envolvidos nesse comportamento de dependência, assim como as características clínicas, as bases neurobiológicas, o perfil de comorbidades e as opções de tratamento. A inclusão da categoria Internet Gaming Disorder no DSM-5 demonstra a importância que a comunidade científica tem dado ao assunto e estimula o desenvolvimento de mais pesquisas nessa área. Estudos epidemiológicos, clínicos e de neuroimagem observam que trata-se de um transtorno prevalente principalmente entre os jovens, que acarreta prejuízo significativo na vida dos indivíduos acometidos e que apresenta grandes semelhanças com outros comportamentos de dependência. Discute-se também a influência e os potenciais mecanismos pelos quais os jogos violentos podem estimular a agressividade, principalmente entre os jogadores que já apresentam outros fatores de risco para esse comportamento. CONCLUSÃO: Apesar do crescente corpo de evidências científicas disponíveis na literatura, muitas dúvidas ainda necessitam de esclarecimento e mais pesquisas sobre o tema devem ser estimuladas para que se tenha um maior êxito no reconhecimento e tratamento desse transtorno.(AU)

Along with the amazing technological development seen in the last decades, video games have become one of the main entertainment activities of children and adolescents. The problems due to the overuse of video games have increasingly drawn more attention from health professionals, and the number of publications is growing steadily. METHODS: A non-systematic literature review using the PubMed database, SciELO and LILACS databases was performed. RESULTS: The characteristics of games and players that seem to be involved in addictive behavior, as well as clinical characteristics, neurobiology, comorbidity profile and treatment options are described. The inclusion of Internet Gaming Disorder in DSM-5 demonstrates the importance that the scientific community has given to the subject, and stimulates the development of further research. Epidemiological, clinical and neuroimaging studies show that it is a prevalent disorder particularly among youth, which causes significant impairment in the life of affected individuals, and that presents strong similarities with other addictive behaviors. The influence and potential mechanisms by which violent games can stimulate aggression, especially among players who already have other risk factors for this behavior is also discussed. CONCLUSION: Despite the growing body of scientific evidence available in the literature, many questions still need clarification, and further research on the topic should be encouraged in order to improve the recognition and treatment of this disorder.(AU)

A experiência prática do iCelg na educação continuada em psicoterapia / The Practical Experience at iCelg in Continuous Education in Psychotherapy

Autores apresentam, em carta, a importância e a experiência prática do iCelg na educação continuada em psicoterapia.

Dependência de tecnologia: o desenvolvimento de um website psicoeducativo / Technology addiction: the development of a psychoeducational website

O crescente envolvimento dos jovens com as novas tecnologias da comunicação e da informação aumenta o risco de uso problemático ou mesmo dependência de tecnologia. O Grupo de Estudos sobre Adições Tecnológicas (GEAT) estuda essa dependência comportamental desde 2006 e apresenta neste artigo o processo de criação de um website psicoeducativo sobre o assunto. O resultado desse trabalho encontra-se em www.dependenciadetecnologia.org e tem como objetivo final orientar pais, professores e outros profissionais de saúde sobre o envolvimento dos jovens com as novas tecnologias.(AU)

The increasing involvement of youth with new communication and information technologies increases the risk of problematic use or dependence on technology (technology addiction). The Study Group on Technology Addiction (GEAT) studies this behavioral addiction since 2006. This article presents the process of creating a psychoeducational website on the subject. The result of this work can be found at www.dependenciadetecnologia.org and aims to guide parents, teachers and other healthcare professionals about youth engagement with new technologies.(AU)

Matricídio: uma breve revisão / Matricide: a brief review

Matricídio, o ato de matar a mãe cometido por um(a) filho(a) é talvez o maisimpactante e destruidor de todos os crimes. Sua incidência, descrita em estudosde relato de caso e de séries de casos, fica ao redor de 1% de todos oshomicídios, contudo sua ocorrência sempre é chocante e historicamente consideradaum tabu. Os autores descrevem a epidemiologia, características euma breve revisão da literatura, contendo as três abordagens explicativasmais relatadas (cognitivo-comportamental, sistemas familiares e psicanalítica),a fim de embasar o relato de um caso de tentativa de matricídio.

Matricide, the act of killing one’s mother by her son or daughter, is perhapsthe most shocking and destructive of all crimes. Its incidence, taken from casereports and series of cases, is around 1% of all homicides – yet its occurrenceis always terrifying and historically considered a taboo. The authors describeits epidemiology and characteristics and present a brief literature reviewcomprising the three most referred theoretical approaches (cognitive-behavioral,systemic therapy and psychoanalytical) in order to set the grounds tothe report of a case of matricide attempt.