Prediction of declarative memory profile in panic disorder patients: a machine learning-based approach

Objective: To develop a classification framework based on random forest (RF) modeling to outline the declarative memory profile of patients with panic disorder (PD) compared to a healthy control sample. Methods: We developed RF models to classify the declarative memory profile of PD patients in comparison to a healthy control sample using the Rey Auditory Verbal Learning Test (RAVLT). For this study, a total of 299 patients with PD living in the city of Rio de Janeiro (70.9% females, age 39.9 ± 7.3 years old) were recruited through clinician referrals or self/family referrals. Results: Our RF models successfully predicted declarative memory profiles in patients with PD based on RAVLT scores (lowest area under the curve [AUC] of 0.979, for classification; highest root mean squared percentage [RMSPE] of 17.2%, for regression) using relatively bias-free clinical data, such as sex, age, and body mass index (BMI). Conclusions: Our findings also suggested that BMI, used as a proxy for diet and exercises habits, plays an important role in declarative memory. Our framework can be extended and used as a prospective tool to classify and examine associations between clinical features and declarative memory in PD patients.

Relationship between epileptic seizures and criminal behavior: a systematic literature review / Relação entre crises epilépticas e comportamento criminoso: uma revisão sistemática da literatura

Objective: The principal objective aims to assess a possible relationship between epilepsy and aggressive behavior. Secondarily, we intend to study how epilepsy relates to criminal liability. Methods: A systematic literature review was performed, using the Web of Science,United States National Library of Medicine (PubMed),and Scielo databases. The searches were conducted in May-June 2022 and covered the period from 2000 to 2022. Eligibility criteria consisted on original articles in English and Portuguese that were interested in the association of epilepsy, criminal behavior (with aggression directed to others), criminal liability in adults with epilepsy. Results: The search yielded 921 results, 794 of which in PubMed, 115 in Web of Science, and 12 in Scielo. Articles that failed to meet the inclusion criteria (206) and duplicates (201) were excluded. Conclusion: There were no findings to indicate a significant increase in aggressive behaviors in individuals with epilepsy. However, it was possible to identify a higher prevalence of aggressive acts in males with epilepsy, besides the presence of comorbidities with mental disorders and substance use. In addition, the results suggest that in criminal offenders with epilepsy, the seizures originated in the temporal and frontal cerebral lobes. Further researchis necessary on the relationship between epilepsy, criminality, and criminal liability in order to produce more robust data to support legal proceedings.

Objetivo: O objetivo principal visa avaliar uma possível relação entre epilepsia e comportamento agressivo. Secundariamente, pretendemos estudar a relação entre epilepsia e responsabilidade penal. Método: Foi realizada uma revisão sistematizada da literatura, utilizando as bases de dados Web of Science, United States National Libraryof Medicine (PubMed) e Scielo. As buscas ocorreram no período de maio e junho de 2022, verificando o período de 2000 à 2022. Os critérios de elegibilidade consistiram em artigos originais em inglês e português, com interesse na associação entre epilepsia, comportamento criminoso (com violência direcionada a outros) e responsabilidade penal em adultos com epilepsia. Resultados: Foram encontrados 921 resultados na busca, sendo 794 na base de dados PubMed, 115 na Web of Science, e 12 na Scielo.Aqueles que não preencheram os critérios de inclusão (206) e duplicados (201) foram excluídos. Conclusão: Não houveram achados suficientes que indicassem um aumento significativo de comportamentos agressivos na população epiléptica. Entretanto, em relação a esse aspecto, foi possível estabelecer maior prevalência no sexo masculino, presença de comorbidades com transtornos mentais, além de uso de substâncias. Além disso, os resultados sugerem que, em infratores epilépticos, as crises foram provenientes das regiões temporo-frontais do cérebro. Em suma, é importante que a relação entre comportamento criminoso, epilepsia e imputabilidade penal continue sendo estudada, de modo a trazer dados mais sólidos para embasar procedimentos judiciais.

Neurophysiology in between the interests of Dom Pedro II of Brazil, and Charles Brown-Séquard (Historical Note) / Neurofisiologia entre os interesses de Dom Pedro II do Brasil e Charles Brown-Séquard (Nota Histórica)

This article presents our historical research regarding Charles Brown-Séquard, a famous scientist with important contributions to the medical field, in particular for neurology, and endocrinology, and his relationship with Dom Pedro II, the second and last Brazilian Emperor, and an enlightened ruler. The Emperor contacted several illustrious personages in support of State policy, such as for the development of experimental physiology at the Imperial Museum of Natural History, but also for personal purposes given his health problems and those of the Empress. Charles Brown-Séquard and his pilgrimage between different worlds as a physician and physiologist are presented until his definitive establishment in Paris, where he replaces Claude Bernard in the chair of experimental medicine at the Collège de France. Jacques-Arsene d'Arsonval took over after this chair, and together with Brown-Séquard, he electrophysiologically examined the Emperor's diabetic peripheral neuropathy. In this article, the Emperor´s relationship with Brown-Séquard was studied mainly from the correspondence sent to Dom Pedro II and retrieved from the Imperial Museum in Petrópolis, Brazil, and from the accounts of his meetings that included scientific sessions and clinical consultations. This article can be used to understand the progress of knowledge in the field of neurology/clinical neurophysiology, the tracking of emerging ideas in the field of science in the past and the threat to the credibility of researchers.

Este artigo apresenta nossa pesquisa histórica a respeito de Charles Brown-Séquard, famoso cientista com importantes contribuições para a área médica, em especial para a neurologia e endocrinologia, e sua relação com Dom Pedro II, segundo e último Imperador brasileiro, e governante esclarecido. O Imperador contactou várias personalidades ilustres no apoio à política de Estado, como para o desenvolvimento da fisiologia experimental no Museu Imperial de História Natural, mas também para fins pessoais dados os seus problemas de saúde e os da Imperatriz. Charles Brown-Séquard e sua peregrinação entre diferentes mundos como médico e fisiologista são apresentados até seu estabelecimento definitivo em Paris, onde substitui Claude Bernard na cadeira de medicina experimental no Collège de France. Jacques-Arsene d'Arsonval assumiu após esta cadeira e, juntamente com Brown-Séquard, examinou eletrofisiologicamente a neuropatia periférica diabética do imperador. Neste artigo, a relação do Imperador com BrownSéquard foi estudada principalmente a partir da correspondência enviada a Dom Pedro II e recuperada no Museu Imperial de Petrópolis, Brasil, e dos relatos de seus encontros que incluíam sessões científicas e consultas clínicas . Este artigo pode ser usado para entender o progresso do conhecimento no campo da neurologia/neurofisiologia clínica, o rastreamento de ideias emergentes no campo da ciência no passado e a ameaça à credibilidade dos pesquisadores.

Home care for the elderly with dementia: a systematic review / Atenção domiciliar ao idoso com demência: uma revisão sistemática

Abstract Objetive: With the global population aging, there is a growing need for home-based care to meet the health needs of the elderly. However, the quality of care provided to the aged population is now arguably a significant challenge for most healthcare systems worldwide. Methods: The present review included 13 original studies on home care and its effects on dementia patients, describing how patient care and adequate treatment can be collaborative for their improvement, for case management, and optimizing pain control and specificities. Results: Among the findings, it was evidenced that the environment impacts the form of care, once being at home can improve communication and global monitoring of dementia patients. Conclusion: In addition to the results analyzed in this review, there is a need for future, well-designed studies on the different aspects of home care, highlighting the importance of evaluating the type of care for each patient in the quest to optimize the care.

RESUMO Objetivo: Com o envelhecimento da população mundial, há uma necessidade crescente de cuidados domiciliares para atender às necessidades de saúde dos idosos. No entanto, a qualidade dos cuidados prestados à população idosa é hoje indiscutivelmente um grande desafio para a maioria dos sistemas de saúde em todo o mundo. Métodos: A presente revisão incluiu 13 estudos originais sobre cuidados domiciliares e seus efeitos em pacientes com demência, descrevendo como o cuidado e o tratamento adequado do paciente podem ser colaborativos para sua melhora, para o gerenciamento de casos e a otimização do controle de sua dor e especificidades. Resultados: Entre os achados, evidenciou-se que o ambiente impacta a forma de atendimento, pois estar em casa pode melhorar a comunicação e o acompanhamento global dos pacientes em quadro demencial. Conclusão: Além dos resultados analisados nesta revisão, há a necessidade de futuros estudos bem elaborados sobre os diferentes aspectos da atenção domiciliar, destacando a importância de avaliar o tipo de cuidado de cada paciente na busca de otimizar o cuidado.

Carbamazepine in the treatment of bipolar disorder: a systematic review / Carbamazepina no tratamento do transtorno bipolar: uma revisão sistemática

ABSTRACT Objective: Expand knowledge on the role and efficacy of carbamazepine (CBZ) in bipolar disorder (BD), based on original studies. Methods: The authors performed a systematic review of the scientific literature on the efficacy of CBZ in BD, using the PubMed/MEDLINE, Web of Science (ISI), and SciELO databases. The search terms were: ("carbamazepine") AND ("bipolar" OR "mania" OR "manic"). There was no restriction on the year of publication. Results: A total of 27 articles were selected. Among the selected articles, 14 evaluated the use of CBZ in the manic phase of BD, two in the depressive phase of BD, and 11 in the maintenance phase of BD. In the studies on the manic phase of BD, CBZ proved superior to placebo (PLA). As for the depressive phase of BD, there were two studies, both with small samples. In the maintenance phase, CBZ was inferior to lithium, and no studies compared CBZ to PLA. Conclusion: The results of the clinical studies suggest that CBZ is effective for the treatment of the manic phase. Regarding the treatment of acute depression and maintenance of BD, the results of the studies indicate that there is not enough data demonstrating the effectiveness of CBZ.

RESUMO Objetivo: Ampliar o conhecimento sobre o papel e a eficácia da carbamazepina (CBZ) no transtorno bipolar (TB), a partir de estudos originais. Métodos: Realizou-se uma revisão sistemática de literatura científica sobre a eficácia da CBZ no TB. Foram utilizadas as bases de dados PubMed/MEDLINE, Web of Science (ISI) e SciELO. Os termos de busca empregados foram: ("carbamazepine") AND ("bipolar" OR "mania" OR "manic"). Não houve restrição quanto ao período de publicação. Resultados: Foram selecionados 27 artigos. Entre os artigos selecionados, 14 avaliavam o uso da CBZ na fase de mania do TB, 2, na fase de depressão do TB e 11, na fase de manutenção do TB. A CBZ, nos estudos na fase de mania do TB, mostrou-se superior ao placebo (PLB). Em relação à fase de depressão no TB, havia dois estudos não controlados e com amostras pequenas. Quanto à fase de manutenção do TB, a CBZ foi inferior ao lítio, e não foram realizados estudos comparando com PLB. Conclusão: Os resultados dos estudos clínicos sugerem que a CBZ é eficaz para o tratamento da fase de mania. Em relação ao tratamento de depressão aguda e manutenção do TB, os resultados dos estudos indicam que não há dados suficientes que demonstrem a eficácia da CBZ.

Use of transcranial magnetic stimulation in the treatment of nonfluent primary progressive aphasia: a case report / Uso da estimulação magnética transcraniana no tratamento da afasia progressiva primária não fluente: um relato de caso

ABSTRACT Primary progressive aphasia comprises a group of neurodegenerative diseases characterized by progressive speech and language dysfunction. Neuroimaging (structural and functional), biomarkers, and neuropsychological assessments allow for early diagnosis. However, there is no pharmacological treatment for the disease. Speech and language therapy is the main rehabilitation strategy. In this case report, we describe a female patient diagnosed with nonfluent primary progressive aphasia who underwent sessions of high-frequency transcranial magnetic stimulation in the left dorsolateral prefrontal cortex and showed improvement in depression scores, naming tasks in oral and written speech, and comprehension tasks in oral and written discourse.

RESUMO As afasias progressivas primárias (APP) representam um grupo de doenças neurodegenerativas caracterizadas por disfunção progressiva da fala e da linguagem. A neuroimagem (estrutural e funcional), os biomarcadores e as avaliações neuropsicológicas permitem o diagnóstico precoce. No entanto, não há tratamento farmacológico para a doença. A terapia fonoaudiológica é a principal estratégia de reabilitação. Neste relato de caso, descrevemos uma paciente com diagnóstico de APP não fluente que foi submetida a sessões de estimulação magnética transcraniana de alta frequência no córtex pré-frontal dorsolateral esquerdo e apresentou melhora nos escores de depressão, nas tarefas de nomeação da fala oral e escrita e nas tarefas de compreensão da fala oral e escrita.

Validation of an original Behavioral Changes Scale on the Use of Digital Technologies During Social Distancing

Abstract Introduction The social distancing (SD) adopted during the coronavirus disease 2019 (COVID-19) pandemic has transformed the internet from a convenience into a necessity. The behavioral changes caused by isolation range from adaptation of consumption, work, and teaching routines to altered leisure options to occupy idle time at home. Such transformations can be positive, expanding use of digital technologies (DT), but they can also have serious future physical and emotional consequences if there conscious use of technological devices is lacking. Objectives The study aimed to validate the Behavioral Changes Scale on the Use of Digital Technologies During Social Distancing (BCSDTSD), an instrument for assessing behavioral changes related to use of DT during SD. Method Validation of the BCSDTSD in five phases: 1. construction of an initial scale with 10 questions; 2. evaluation of the questions by a panel of experts; 3. application to 1,012 volunteers via the internet; 4. statistical analysis of the results; and 5. preparation of the validated final version of the BCSDTSD. Data were analyzed using the dplyr, psy , and paran packages and the REdaS statistical program. Three statistical criteria were used in the factor analysis (FA). Results FA confirmed that all 10 questions in the questionnaire should be maintained, confirming its robust construction, and Cronbach's alpha demonstrated its internal consistency with a value of 0.725, which is satisfactory for first-application questionnaires. Conclusion The BCSDTSD instrument was validated for assessment of behavioral changes related to the use of DT during SD.

Creativity in bipolar disorder: a systematic review

Abstract Introduction Based on studies of the biographies of artists and on research in which modern diagnostic criteria were applied, it has been suggested that there is a relationship between bipolar disorder (BD) and creativity. Objective: To investigate the relationship between BD and creativity and whether creative capacity varies depending on mood state. Method We conducted a systematic search of the scientific literature indexed on the PubMed, ISI Web of Science, PsycINFO, and SciELO databases using the terms "bipolar" OR "bipolar disorder" OR "mania" OR "manic" AND "creativ*". Original studies were selected that investigated samples of at least ten patients with BD using at least one psychometric instrument to assess creativity. Results Twelve articles met the selection criteria. The results of comparisons of BD patients with control groups without BD were heterogeneous. BD was not associated with higher levels of creativity than other mental disorders. When comparing BD phases, depression was associated with worse performance on creativity tests and patients in mania (or hypomania) were not distinguished from euthymia patients. Conclusion It was not possible to corroborate the hypothesis that individuals with BD are more creative than individuals without psychiatric diagnoses or than patients suffering from other mental disorders, which may be related to the cross-sectional rather than longitudinal designs of virtually all of the clinical studies.

Early trauma and schizophrenia onset: preliminary results of an outpatient cohort in Brazil

Abstract Objectives To assess the prevalence of early trauma in individuals with onset of schizophrenia (SZ) at early (≤ 18 years) and adult (> 18 years) ages (EOP and AOP, respectively) and explore relationships between the onset of disease and clinical variables including traumatic events and psychotic and mood symptoms. Methods Subjects with SZ (n = 71) and EOP and AOP were compared for history of psychological trauma, sexual abuse, and physical punishment using the Early Trauma Inventory Self Report - Short Form (ETISR-SF). They were also compared for history of comorbidities and affective disorders using the Diagnostic Interview for Psychosis and Affective Disorders, the Positive and Negative Syndrome Scale, the Liebowitz Social Anxiety Scale, and the Calgary Depression Scale for Schizophrenia. Coefficients were calculated for correlations between scale results and disease duration. Results Early trauma was significantly associated with an early onset psychotic episode (r = -0.315, p < 0.01). General trauma and depressive symptoms in adulthood were also associated (r = 0.442, p < 0.01), as were social anxiety symptoms and early trauma (r = 0.319, p < 0.01). Total ETISR-SF scores and the physical abuse item were significantly higher in EOP than in AOP. In the hierarchical regression, PANSS scores were best predicted by a model including the duration of disease and age of first psychotic episode (R = 0.303). Conclusions Our results support the hypothesis that early trauma, including physical abuse, may play a relevant role in schizophrenia symptoms, such as an earlier psychotic occurrence, as well as features of other psychiatric disorders, such as greater severity of social anxiety and depression.

Características sociodemográficas e transtornos mentais em usuários de crack e cocaína / Sociodemographic characteristics and mental disorders in crack and cocaine users / Características sociodemográficas y trastornos mentales en consumidores de crack y cocaína

Objetivo: Identificar as características socioeconômicas, o padrão de uso das substâncias psicoativas e os transtornos mentais associados ao uso de crack e cocaína. Métodos: Caracteriza-se como descritivo, transversal e de abordagem quantitativa, realizado com 112 participantes que apresentaram um histórico de uso de crack e/ou de cocaína, com a aplicação de questionários socioeconômico, sobre o padrão de uso das substâncias psicoativas e o Mini Internacional Neuropsychiatric Interview para rastreio de transtornos mentais. Os dados foram analisados através do software Statistical Package for the Social Sciences. Resultados: 97 (86,6%) eram do sexo masculino, 63 (56,3%) eram pardos autodeclarados, 102 (91,1%) com religião, 95 (84,8%) eram solteiros (solteiro, divorciado, viúvo), 83 (74,1%) estudaram até o ensino fundamental, 71 (63,4%) possuiam filhos. Diante da aplicação do Mini International Neuropsychiatric Interview, identificou-se uma frequência de 69 (61,6%) participantes com episódio depressivo maior atual, destes 34 (30,4%) apresentando episódio depressivo maior recorrente. Metade dos participantes, 55 (49,1%), possuia risco de suicídio. Conclusão: O rastreamento do perfil psiquiátrico de usuários de cocaína e crack embasa o desenvolvimento de protocolos de tratamento e medidas de intervenção de maneira mais individualizada, o que refletira no enfrentamento diante do tratamento. (AU)

Objective: To identify the socioeconomic characteristics, the pattern of use of psychoactive substances and the mental disorders associated with the use of crack and cocaine. Methods: Characterized as descriptive, cross-sectional and with a quantitative approach, carried out with 112 participants who had a history of crack and / or cocaine use, with the application of socioeconomic questionnaires, on the pattern of substance use psychoactive drugs and the Mini International Neuropsychiatric Interview to screen for mental disorders. The data were analyzed using the Statistical Package for the Social Sciences software. Results: 97 (86.6%) were male, 63 (56.3%) were self-declared brown, 102 (91.1%) with religion, 95 (84.8%) were single (single, divorced, widowed), 83 (74.1%) studied until elementary school, 71 (63.4%) has children. In view of the application of Mini International Neuropsychiatric Interview, a frequency of 69 (61.6%) participants with a current major depressive episode was identified, of these 34 (30.4%) presenting a recurrent major depressive episode. Half of the participants, 55 (49.1%), are at risk of suicide. Conclusion: The tracking of the psychiatric profile of cocaine and crack users supports the development of treatment protocols and intervention measures in a more individualized way, which will reflect on coping with treatment. (AU)

Objetivo: Identificar las características socioeconómicas, el patrón de uso de sustancias psicoactivas y los trastornos mentales asociados al uso de crack y cocaína. Métodos: Caracterizado como descriptivo, transversal y con enfoque cuantitativo, realizado con 112 participantes que tenían antecedentes de consumo de crack y / o cocaína, con la aplicación de cuestionarios socioeconómicos, sobre el patrón de consumo de sustancias. drogas psicoactivas y la Mini Internacional Neuropsychiatric Interview para detectar trastornos mentales. Los datos se analizaron mediante el software Statistical Package for the Social Sciences. Resultados: 97 (86,6%) eran hombres, 63 (56,3%) se auto declaraban marrones, 102 (91,1%) de religión, 95 (84,8%) eran solteros (solteros, divorciados, viudos), 83 (74,1%) estudiaron hasta la escuela primaria, 71 (63,4%) tienen hijos. En vista de la aplicación de Mini International Neuropsychiatric Interview, se identificó una frecuencia de 69 (61,6%) participantes con un episodio depresivo mayor actual, de estos 34 (30,4%) presentaban un episodio depresivo mayor recurrente. La mitad de los participantes, 55 (49,1%), tienen riesgo de suicidio. Conclusión: El seguimiento del perfil psiquiátrico de los consumidores de cocaína y crack apoya el desarrollo de protocolos de tratamiento y medidas de intervención de una manera más individualizada, que se reflejará en el afrontamiento del tratamiento. (AU)

The Weekly Study Meeting in Psychiatry of the Institute of Psychiatry - Federal University of Rio de Janeiro: 70-years of culture and scientific dissemination / O Encontro Semanal do Centro de Estudos do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro: 70 anos de divulgação cultural e científica

OBJECTIVE: To describe the history of creation, development, and topics covered by the Study Center of the Institute of Psychiatry of the Federal University of Rio de Janeiro (CE ­ IPUB/UFRJ) over its 70 years. METHODS: Research in newspapers of the Hemeroteca Brasileira Digital, internal documents of IPUB/UFRJ, and interviews with eyewitnesses of the functioning of the CE. RESULTS: The Study Center has been operating on an uninterrupted basis for 70 years, every week. 472 events have been identified since the founding of the CE, but numerous other meetings have taken place. The findings were described in three major groups: 1. Academic meetings in the first half of the 20th century and insertion of the CE in the history of IPUB; 2. Topics discussed and presentations; 3. Changes in periodicity and format. CONCLUSIONS: The CE produces cultural and scientific dissemination continuously since its foundation. The type and format of events have changed over time, adapting to the needs of their community, but always serving as an important beacon for the training of specialists in mental health, dissemination of research, and tendencies about psychiatry worldwide, Latin America, and Brazil.

OBJETIVO: Descrever a história da criação e do desenvolvimento e os temas abordados pelo Centro de Estudos do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (CE ­ IPUB/UFRJ) ao longo de seus 70 anos. MÉTODOS: Pesquisa em jornais da Hemeroteca Brasileira Digital, documentos internos do IPUB/UFRJ e entrevistas com testemunhas oculares do funcionamento do CE. RESULTADOS: O Centro de Estudos funciona de maneira ininterrupta há 70 anos, semanalmente. Desde sua fundação, 472 eventos foram identificados, mas outros inúmeros encontros ocorreram. Os achados foram divididos e descritos em três grandes grupos: 1. Encontros acadêmicos na primeira metade do século XX e inserção do CE na história do IPUB; 2. Temas debatidos e apresentações; 3. Mudanças de periodicidade e formato. CONCLUSÕES: O CE produz divulgação cultural e científica continuamente desde sua fundação. O tipo e o formato dos eventos mudaram ao longo do tempo, adaptando-se às necessidades de sua comunidade, mas sempre servindo como um importante farol para a formação de especialistas em saúde mental e divulgação de pesquisas, apresentando as tendências da psiquiatria mundial, latino-americana e brasileira.

Psychological home care for type II schizencephaly: technical and theoretical aspects / Atenção psicológica domiciliar com esquizencefalia tipo II: aspectos técnicos e teóricos

Schizencephaly is an extremely rare developmental birth defect or malformation characterized by abnormal clefts in the cerebral hemispheres of the brain, extending from the cortex to the ventricles, which may be unilateral or bilateral. This case report describes the general characteristics of a psychological home care program, reporting the main theoretical and technical elements in a 12-years-old case of type II Schizencephaly. The aims of the psychological home treatment were acceptance of the new treatment reality, a reduction in aggression and anxiety, and psychological support for the patient and family. In the psychological home care, patient's awareness of illness was developed, along with family orientation, psychoeducation, relaxation techniques, and cognitive distraction. It can be observed that a significant improvement in the affective and emotional state was achieved within the patient's clinical framework.

A esquizencefalia é um defeito ou malformação congênita do desenvolvimento extremamente raro, caracterizado por fendas anormais nos hemisférios cerebrais, estendendo-se do córtex aos ventrículos, que podem ser unilaterais ou bilaterais. Este relato de caso descreve as características gerais de um programa de atenção psicológica domiciliar, relatando os principais elementos teóricos e técnicos de um paciente de 12 anos de idade com esquizencefalia tipo II. Os objetivos do tratamento psicológico domiciliar eram a aceitação da nova realidade do tratamento, a redução da agressividade e da ansiedade e o apoio psicológico ao paciente e à família. No atendimento psicológico domiciliar, a consciência do paciente sobre a doença foi desenvolvida, juntamente com a orientação familiar, psicoeducação, técnicas de relaxamento e distração cognitiva. Pode-se observar que houve melhora significativa do estado afetivo e emocional no quadro clínico do paciente.

One hundred thirty years of Dom Pedro II's death: "the emperor of the tropics" and the beginning of Brazilian Psychiatry / Cento e trinta anos da morte de Dom Pedro II: "o imperador dos trópicos" e o começo da psiquiatria brasileira

OBJETIVO: Associar a trajetória de vida de Dom Pedro II com o começo da história da psiquiatria brasileira por meio do Hospício Pedro II. MÉTODOS: Realizamos uma revisão narrativa da literatura com a pesquisa de três bases de dados: Google Scholar, PubMed e Web of Science (SciELO). RESULTADOS: A primeira instituição psiquiátrica brasileira, o Hospício Pedro II (1841-1889), foi criado por meio do Decreto nº 82, publicado no dia 18 de julho de 1841. Essa publicação ocorreu durante a cerimônia de coroação de Dom Pedro II. O objetivo dessa cerimônia de coroação era fortalecer o poder da monarquia brasileira e legitimizar a antecipação da maioridade do imperador com 14 anos. Ao longo dos 48 anos do império de Dom Pedro II, seus interesses culturais e científicos influenciaram o surgimento de uma incipiente pesquisa científica brasileira. Nesse sentido, o Hospício Pedro II não era apenas representativo de uma instituição de saúde, mas uma resposta às mudanças sociais e culturais que ocorreram após a chegada da família real portuguesa em 1808. Também era um representativo da influência da psiquiatria francesa baseada no tratamento moral de Phillipe Pinel (1745-1826). CONCLUSÃO: De forma concisa, o Hospício Pedro II era uma representação da personalidade de Dom Pedro II como um patrono da ciência, a emergência de uma psiquiatria brasileira e da hierarquia da sociedade imperial.

OBJECTIVE: Associate Dom Pedro II's life trajectory and the beginning of Brazilian psychiatry through the Pedro II Asylum. METHODS: We conducted a narrative review of the literature on three search databases: Google Scholar, PubMed, and Web of Science (SciELO). RESULTS: The first Brazilian psychiatry institution, the Pedro II Asylum (1841-1889), was created by the number 82 decree on 18 July 1841. The launching occurred at Dom Pedro II's coronation ceremony. It was a celebration that aimed at enhancing the Brazilian monarch's power and at legitimizing the emperor's adulthood at the age of fourteen. Throughout the 48 years of the Dom Pedro II empire, his cultural and science interests influenced the emergence of incipient Brazilian scientific research. In this regard, the Pedro II Asylum was portrayed not only as a health care institution but also undertook an effort to attend the social and cultural modifications promoted at the Brazilian imperial court after the Portuguese Crown family arrived in 1808. It also represented the influence of French psychiatry based on Phillipe Pinel's (1745- 1826) principles of moral treatment. CONCLUSIONS: Concisely, the Pedro II Asylum was a representation of Dom Pedro II's personality as a patron of science, the emergence of Brazilian psychiatry, and the imperial society hierarchy.

What would be the psychiatric diagnosis of D. Maria I, the "mad queen"? / Qual seria o diagnóstico psiquiátrico de D. Maria I, a "rainha louca"?

ABSTRACT Objective D. Maria I, queen of Portugal, was the mother of João VI and grandmother of Pedro IV of Portugal and I of Brazil. She became the first monarch of Brazil, where she became known as "Maria, the madwoman". We aimed to try to identify the mental disorder she suffered from. Methods We conducted a review of biographies about D. Maria I and scientific articles that discussed her case. Results The sparse information about her mental illness strongly indicates that she had several depressive and manic episodes, which were accompanied by psychotic symptoms. Conclusion Her probable psychiatric diagnosis is that of bipolar disorder.

RESUMO Objetivo D. Maria I, rainha de Portugal, era mãe de D. João VI e avó de D. Pedro IV de Portugal e I do Brasil. Tornou-se a primeira monarca do Brasil, onde ficou conhecida como "Maria, a louca". Nosso objetivo foi tentar identificar o transtorno mental de que ela sofria. Métodos Realizamos uma revisão de biografias sobre D. Maria I e artigos científicos que discutiram seu caso. Resultados A escassa informação sobre sua doença mental indica fortemente que ela teve vários episódios depressivos e maníacos, os quais foram acompanhados por sintomas psicóticos. Conclusão Seu provável diagnóstico psiquiátrico é de transtorno bipolar.