Clinico-epidemiological profile of patients at children's psychosocial care centers in São Bernardo do Campo: a cross-sectional study

ABSTRACT BACKGROUDS: Child and Adolescent Psychosocial Care Centers (Centros de Atenção Psicossocial, CAPSI) are dedicated centers for persistent psychiatric disorders, which provide an individualized therapeutic approach based on extra-hospital services. OBJECTIVES: We aimed to describe the clinico-epidemiological profiles of the patients seeking interventions at the CAPSIs. DESIGN AND SETTING: A cross-sectional study was conducted in two CAPSI in São Bernardo do Campo, SP, Brazil. One CAPSI is dedicated to the treatment of alcohol- and drug-related disorders, and the other to the treatment of other mental disorders. METHODS: In July 2017, we reviewed all active medical records of these two CAPSI, and collected the patients information including sex, race, education, type of referral, initial complaints, psychiatric diagnoses, and medication utilization. RESULTS: Of the 233 patients, 69.5% were male and 42.5% lived with their immediate family. Most of the patients were referred from other health services. Complaints on admission included agitation and aggressive behavior (30.9%). Autism spectrum disorder (ASD) was the most prevalent diagnosis (46.8%), followed by depressive disorder (13.8%). Of the patients, 81.5% were on regular medical follow-up and 70.3% were on a single medication only. CONCLUSION: Aggression complaints are the most prevalent in CAPSI, and diagnoses of ASD and psychotic disorders are more common. This situation differs from most CAPSI that present school complaints as the most prevalent, in which diagnoses of attention-deficit/hyperactivity disorder and conduct disorders are likely to be more frequent. The epidemiological profile of each CAPSI should guide the implementation of human and structural resources targeting the most prevalent complaints and diagnoses.

Association between falls and cognitive performance among community-dwelling older people: a cross-sectional study

ABSTRACT BACKGROUND: Falls among older people have a negative impact on health and therefore constitute a public health problem. Cognitive decline can also accompany the aging process, and both conditions lead to significant increases in morbidity and mortality in this population. Objective: To analyze the cognitive performance of older people, classified as non-fallers, sporadic fallers and recurrent fallers, and investigate the relationship between falls and cognition. DESIGN AND SETTING: Cross-sectional study conducted in the interior of the state of São Paulo, Brazil. METHODS: Evaluations on 230 older people were conducted. They were divided into three groups: non-fallers, sporadic fallers (one fall) and recurrent fallers (two or more falls). The Mini-Mental State Examination, Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Brief Cognitive Screening Battery (BCSB), Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) similarities subtest and digit span test were applied. RESULTS: In multinomial logistic regression, being a recurrent faller was significantly associated with lower scores in the CERAD word list (odds ratio, OR = 0.92; 95% confidence interval, CI, 0.86-0.98; P = 0.01), in CERAD constructive praxis (OR = 0.88; 95% CI, 0.79-0.98; P = 0.02), in BCSB figure list memory (OR = 0.94; 95% CI, 0.89-0.99; P = 0.02) and in verbal fluency (OR = 0.89; 95% CI, 0.81-0.97; P = 0.01). Recurrent fallers also had lower scores in these same tests, compared with sporadic fallers. CONCLUSION: Cognitive impairment, especially in the domains of memory and executive functioning, can influence occurrences of recurrent falls.

Burnout syndrome and workplace violence among nursing staff: a cross-sectional study

ABSTRACT BACKGROUND: Among healthcare professionals, nursing workers are the most prone to becoming victims of workplace violence and present the highest burnout levels. OBJECTIVES: To investigate the association between burnout syndrome and workplace violence among nursing workers. DESIGN AND SETTING: Cross-sectional study carried out at a teaching hospital in southern Brazil. METHODS: This study involved 242 nursing workers. We collected data over a six-month period using a sociodemographic and occupational survey, the Survey Questionnaire Workplace Violence in the Health Sector and the Maslach Burnout Inventory - General Survey. For occupational violence, we selected the Survey Questionnaire Workplace Violence in the Health Sector. Burnout syndrome was evaluated using the Maslach Burnout Inventory - General Survey. The data were analyzed in the Statistical Package for the Social Sciences (SPSS). Categorical variables were described as absolute and relative frequencies and numerical variables in terms of central trend and dispersion measurements. For data analysis, we applied descriptive statistics and multiple logistic regression. RESULTS: The multiple models indicated that the workers who had experienced verbal abuse, physical violence and concern about workplace violence over the past 12 months had significantly higher chances of presenting high emotional exhaustion (P < 0.05) and depersonalization (P < 0.05) and low professional accomplishment (P < 0.05). CONCLUSION: Occurrence of violence significantly increased the chances of great emotional exhaustion and depersonalization and low professional achievement, within burnout syndrome. Therefore, workplace violence prevention strategies need to be put in place to provide workers with a safe workplace in which to conduct their activities.

A criação de institutos disciplinares: uma análise histórica / Creation of juvenile detention facilities: a historical analysis / La creación de institutos disciplinares: un análisis Histórico

Neste estudo objetivamos compreender as origens do Instituto Disciplinar de São Paulo, estabelecimento criado no início do período republicano, que atendia adolescentes ditos "delinquentes". Para isso, analisamos documentos históricos e as obras Classificação dos criminosos: introdução ao estudo do direito penal (1925) e Os menores delinquentes e o seu tratamento no Estado de São Paulo (1909), ambas de autoria de Candido Naziazeno Nogueira da Motta (1870-1942), jurista que apresentou o projeto de criação do primeiro Instituto Disciplinar do estado de São Paulo. Concluímos que a Escola Positiva de Direito Penal, exerceu grande influência na criação de Institutos Disciplinares no Brasil e que a predileção histórica do Estado brasileiro, em geral, pelo isolamento social ou aprisionamento como solução para o problema da delinquência juvenil demonstra que o ideário da higiene social ainda permanece na execução das políticas públicas voltadas aos jovens que atualmente denominamos em conflito com a lei. (AU)

This study aimed to understand the origins of Juvenile Detention Center of São Paulo, establishment created at the beginning of the republican period, which served so-called "delinquent" teenagers. For this, we analyzed historical documents and the works Classificação dos criminosos: introdução ao estudo do direito penal (1925) and Os menores delinquentes e o seu tratamento no Estado de São Paulo (1909), both by Candido Naziazeno Nogueira da Motta (1870-1942), jurist who presented the project to create the first Juvenile Detention Center in the state of São Paulo. We conclude that the Positive School of Criminal Law had a great influence on the creation of Juvenile Detention Centers in Brazil and that the historical predilection of the Brazilian State, in general, for social isolation or imprisonment as a solution to juvenile delinquency demonstrates that the ideal of social hygiene still remains in the execution of public policies aimed at young people that are currently in conflict with the law. (AU)

En este estudio se tuvo por objetivo comprender los orígenes de lo Instituto Disciplinar de São Paulo, establecimiento creado en el inicio del período republicano, que atendía adolescentes dichos "delincuentes". Para eso, analizamos documentos históricos y las obras Classificação dos criminosos: introdução ao estudo do direito penal (Clasificación de los criminales: introducción al estudio del derecho penal ) y Os menores delinquentes e o seu tratamento no Estado de São Paulo (1909), (Los menores delincuentes y su tratamiento en el Estado de São Paulo) (1925) ambas de autoría de Candido Naziazeno Nogueira da Motta (1870-1942), jurista que presentó el proyecto de creación del primer Instituto Disciplinar del estado de São Paulo. Concluimos que la Escola Positiva de Derecho Penal, ejerció gran influencia en la creación de Institutos Disciplinares en Brasil y que la predilección histórica del Estado brasileño, en general, por el aislamiento social o aprisionamiento como solución para el problema de la delincuencia juvenil apunta que el ideario de la higiene social aún permanece en la ejecución de las políticas públicas volcadas a los jóvenes que actualmente se denomina en conflicto con la ley. (AU)

COVID-19 pandemic in São Paulo: a quantitative study on clinical practice and mental health among medical residency specialties

ABSTRACT BACKGROUND: 2020 was a challenging year for all healthcare professionals worldwide. In São Paulo, Brazil, the virus SARS-CoV-2 took 47,222 lives up to December 29, 2020. The front line of medical professionals in São Paulo was composed of many residents, who were transferred from their rotations to cover the needs of the pandemic. OBJECTIVE: To identify medical residents' mental health and clinical issues, regarding symptoms of burnout, depression and anxiety during the pandemic, and to compare them among specialties. DESIGN AND SETTING: Quantitative study using a convenience sample of medical resident volunteers who responded to an anonymous online survey that was available during April 2020. METHODS: This investigation collected sociodemographic information and used the Oldenburg Burnout Inventory (OLBI) to measure burnout, the Patient Health Questionnaire (PHQ-9) to measure depression and the General Anxiety Disorder (GAD-7) scale to measure anxiety symptoms. This study also developed a COVID-19 Impact Questionnaire (CIQ-19) to assess the residents' beliefs and clinical practices relating to COVID-19 patients. RESULTS: The sample comprised 1,392 medical residents in São Paulo, Brazil. Clinical specialty physicians showed the highest rates of anxiety symptoms (52.6%) and burnout (51.2%), among the specialties. CONCLUSION: Clinical specialty residents are at higher risk of anxiety, depression and burnout. The symptoms of anxiety and depression have worsened during the COVID-19 pandemic. There is a general need for mental health support interventions for medical resident physicians, which requires reinforcement during this worldwide crisis.

As Contribuições da Psicologia aos Ideais da Liga Brasileira de Higiene Mental: Algumas Reflexões / The contributions of Psychology to the ideals of the Brazilian Mental Hygiene League: some considerations / Las Contribuciones de la Psicología a los Ideales de la Liga Brasileña de Higiene Mental: Algunas Reflexiones

A psicologia científica é um produto histórico configurado por uma diversidade teórica e metodológica que, em solo brasileiro, foi fortemente constituída no final do século XIX e início do século XX. Tendo em vista esta diversidade, este estudo faz um recorte e trata da parceria entre a Psicologia e a Liga Brasileira de Higiene Mental (LBHM), no que tange às aferições das diferenças individuais. O movimento higienista, materializado pela LBHM, exerceu forte influência sobre as práticas psicológicas as quais serviram de sustentação científica para a implantação de políticas públicas visando um padrão de normalidade, via seleção dos considerados capazes e incapazes, tanto para fatores relacionados a padrões de conduta e de comportamento, quanto para fatores relacionados a aprendizagem de conteúdos acadêmicos. Atualmente, em meio a inúmeras tentativas de implantação de pautas conservadoras nas políticas públicas, grande parte dos profissionais da Psicologia busca compreender em que os saberes psicológicos podem contribuir para ampliar avanços e evitar retrocessos. Exercitar a competência para a reflexão que a ciência psicológica proporciona pode ser uma alternativa para suplantar a histórica busca de um dado padrão de normalidade. Após mais de um século, esta ainda parece ser uma tarefa urgente e necessária para a Psicologia. (AU)

Scientific psychology is a historical outcome shaped by a theoretical and methodological diversity that, nationwide, was established at the end of the XIXth century and the beginning of the XXth. Bearing said diversity in mind, this study makes a cutout and addresses the collaboration between psychology and the Brazilian Mental Hygiene League (BMHL), regarding the assessment of individual differences. The hygienist movement, materialized by the BMHL, exercised a profound influence over psychological conducts which in turn acted as scientific support for the enforcement of public policies directed towards a normality standard, by means of selecting those considered capable and incapable, either by factors concerning conduct and behavior patterns, either by factors related to learning academic contents. Nowadays, facing countless attempts to establish conservative guidelines for public policies, the majority of psychologists strive to understand in what manner their specific knowledge is able to contribute to increase progress and avoid regression. To foster the reflection provided by scientific psychology might be an alternative to the historical pursue of a normality standard. A century past, this seems to remain an urgent and necessary task for Psychology. (AU)

La psicología científica es un producto histórico configurado por una diversidad teórica y metodológica que, en tierras brasileñas, se constituyó con solidez a finales del siglo XIX y al comienzo del siglo XX. Con esta diversidad en mente, este ensayo hace un recorte y aborda la sociedad entre la Psicología y la Liga Brasileña de Higiene Mental (LBHM), con respecto a la evaluación de las diferencias individuales. El movimiento higienista, materializado por la LBHM, exerció fuerte influencia sobre las prácticas psicológicas que a su vez sirvieron de fundamento científico para la implantación de políticas públicas dirigidas a un patrón de normalidad, por la vía de la selección de los considerados capaces o incapaces, sea por razones de patrón de conducta y de comportamiento, sea por razones de aprendizaje de contenidos académicos. Actualmente, a medias de las numerosas tentativas de implantación de directrizes conservadoras en las políticas públicas, gran parte de los profesionales de la Psicología busca comprender de qué manera los saberes psicológicos pueden aportar para ampliar avances y evitar retrocesos. Ejercitar la competencia para la reflexión que la ciencia psicológica proporciona puede ser una alternativa para reemplazar la histórica búsqueda de un determinado patrón de normalidad. Tras más de un siglo, esta, todavía, parece ser una tarea urgente y necesaria para la Psicología. (AU)

A Psicanálise De Crianças No Brasil: Um Relato Histórico / The Psychoanalysis Of Children In Brazil: A Historical Account

Apresenta-se um relato histórico sobre os primórdios da Psicanálise de crianças no Brasil, com destaque para os fatores políticos, culturais e sociais que influenciaram o surgimento e desenvolvimento desse campo. Destaca-se o modo como a Psiquiatria, juntamente com a medicina social do século XIX, orientou os pioneiros da Psicanálise de crianças, a partir da concepção da higiene mental escolar e sua ideologia normativa. Conclui-se que apesar da adesão a um discurso adaptacionista em seu surgimento, a Psicanálise de crianças, na atualidade, não comunga mais com um ideal normativo, haja vista que a dimensão pulsional em cada sujeito é incontrolável e responde pela singularidade do sintoma de cada criança, o que impede uma adaptação ao social como almejavam os higienistas.

A historical account of the origins of the psychoanalysis of children in Brazil is presented, highlighting the political, cultural and social factors that influenced the emergence and development of this field. We highlight the way in which Psychiatry, along with social medicine of the nineteenth century, guided the pioneers of Psychoanalysis of children, from the conception of school mental hygiene and its normative ideology. It is concluded that despite the adherence to an adaptational discourse in its emergence, the Psychoanalysis of children, today, no longer communes with a normative ideal, given that the drive dimension in each subject is uncontrollable and responds by the singularity of the symptom of each child, which prevents an adaptation to the social as hygienists.

A gestão da menoridade sob o Serviço Social de Assistência e Proteção aos Menores de São Paulo (1930-1940): encruzilhada de saberes / The management of the minority under the Social Service of Assistance and Protection for Minors of São Paulo (1930-1940): a crossroads of knowledge

Resumo Este artigo apresenta alguns resultados de uma pesquisa realizada a partir dos prontuários dos menores inseridos no Serviço Social de Assistência e Proteção aos Menores de São Paulo entre os anos 1930 e 1940. Este serviço era o responsável pela gestão tanto de crianças e adolescentes abandonados como daqueles considerados infratores. As tarefas de tutela do abandono e da infração proporcionaram a intervenção de vários profissionais, como médicos, psiquiatras, assistentes sociais e psicólogos, que acionaram um variado repertório de saberes. O principal objetivo da pesquisa foi investigar de que forma a documentação institucional categorizava os menores a partir de uma perspectiva marcada pelo ideário jurídico, pela criminologia e pela concepção de higiene mental presentes nas primeiras décadas do século XX no Brasil. A partir da análise dessa documentação foi possível identificar os saberes (jurídicos, médicos, psiquiátricos, criminológicos) que atuavam no governo dos menores, além da fundamentação que proporcionavam para as intervenções estatais em relação aos menores e, ainda, em relação aos seus familiares ou responsáveis.

Abstract This article presents some results of a study carried out from the medical records of minors inserted in the Social Service of Assistance and Protection for Minors of São Paulo between 1930 and 1940. This Service was responsible for the management of both abandoned children and adolescents and those considered offenders. The custody tasks provided the intervention of many professionals, such as physicians, psychiatrists, social workers and psychologists, who triggered different kinds of knowledge. The main objective of the research was to investigate how the institutional documentation categorized the minors from a perspective marked by the concepts of legal ideology, criminology, and mental hygiene present in the first decades of the 20th century in Brazil. From the analysis of this documentation, it was possible to identify the knowledge (legal, medical, psychiatric, criminological), its presence and composition acting in the government of minors, besides the ground that such knowledge provided for state interventions concerning minors and also their relatives or guardians.

A Study of the Discussions on Psychiatry of Korea in the 1960s and 1970s: From Mental Hygiene to Modern Psychiatry / 의사학

This study is to review the emergence of new psychiatrists, scientific rationalization, and popular internalization to reorganize the formation process of modern psychological medicine system. Unlike eugenic psychiatry from the Japanese Colonial Era, the social conditions and contexts forming autonomous system of psychiatry of Korea in the 1960s and 1970s have been concentrated. The discussion approach has been tried to secure two perspectives-treatment and criticism-at the same time and to expand the time and scope of study through the extensive texts such as newspapers, magazines, books, advertisements, and others in the 1960s and 1970s. Through formation of subject, rationalization, and popularization, this study has surveyed the characteristics of psychiatry in the 1960s and 1970s to accentuate complicated conditions and kinetic steps to systemize psychiatry as scientific field to promote treatment of patients by deviating from mental hygiene approaching national mental health from cleanliness and removal. The characteristics are summarized as follows. First, as the ethical models of good doctors, medical paternalistic doctors, and non-authoritarian symmetric doctors have been proposed as good psychiatrists by new medical specialists with experience of globality, a new subject emerges. However, there has been illegalization process of unlicensed medical practitioner excluded by the regulatory authority called “clearness.” Second, the rationalization of psychiatry has been accelerated through the dispute of enactment of Mental Hygiene Law, segmentalization of concept of mental illness, and scientific characteristics. Especially, the disputes over enactment of Mental Hygiene Law focused on criminalization of mental patients brought a result to regulate the patients as the target of humanistic treatment and potential criminals at the same time. Third, popularization of psychiatry has embraced invisible mental illness into popular daily life through visual measure called medicine advertisement, and through the discussion about social neurosis, a new paradigm for diagnosis of Korean society has been proposed. Moreover, by focusing on autobiographical works with voices of patients, this article reveals a new doctor-patient relationship.

Os serviços abertos de Saúde Mental no Brasil: o cuidado em liberdade na perspectiva dos higienistas / The open mental health services in Brazil: The care in freedom from the perspective of hygienists / Les Services Ouverts de Santé Mentale au Brésil: les soins en liberté du point de vue des hygiénistes / Los servicios abiertos de salud mental en Brasil: el cuidado en libertad desde la perspectiva de los higienistas / Ambulante psychiatrische Pflege in Brasilien: Die ambulante Betreuung aus der Perspektive der Hygienisten

O objetivo deste estudo é apresentar considerações de alguns médicos higienistas sobre os serviços abertos de saúde mental desenvolvidos no Brasil no início do século XX. Analisamos publicações dos Archivos Brasileiros de Hygiene Mental e outros materiais (1925-1955) e verificamos que a possibilidade de cuidar em liberdade (defendida pela atual Reforma Psiquiátrica) já era vislumbrada pelos higienistas, em um período no qual a assistência era, hegemonicamente, pautada no isolamento em instituições psiquiátricas.

This study aims to present considerations from hygienists about the open services for mental health developed in Brazil at the beginning of the twentieth century. We analyze publications from the Archivos Brasileiros de Hygiene Mental and other materials (1925-1955), and find that the possibility of treating people in psychic suffering in freedom (defended by the current psychiatric reform) was already glimpsed by hygienists, however, in a period during which mental health assistance was hegemonically based on isolation within psychiatric institutions.

Le but de cette étude est de présenter les réflexions de quelques médecins hygiénistes sur les services ouverts de santé mentale développés au Brésil au début du XXème siècle. On a analysé des publications des Archives Brésiliennes d’Hygiène Mentale ainsi que d’autres documents (1925-1955) et on a vérifié que la possibilité d’un traitement en liberté (soutenu par l’actuelle réforme psychiatrique) était déjà envisagée par les hygiénistes lors d’une période pendant laquelle les soins de santé mentale était basés, de façon hégémonique, sur l’isolement des patients dans les établissements psychiatriques.

El objetivo de esta investigación es presentar las consideraciones de algunos médicos higienistas sobre los servicios abiertos de salud mental desarrollados en Brasil a comienzos del siglo XX. Analizamos publicaciones de los Archivos Brasileños de Higiene Mental y otros materiales (1925-1955), y verificamos que la posibilidad del cuidado en libertad (principio defendido por la actual Reforma Psiquiátrica( ya había sido vislumbrado por los higienistas, en un período en el que la asistencia estaba, en su gran mayoría, fundamentada en el aislamiento en instituciones psiquiátricas.

Ziel der vorliegenden Studie ist es, die Ansichten einiger „Hygienebeauftragter Ärzte“ zur ambulanten psychiatrischen Pflege zu Beginn des zwanzigsten Jahrhunderts in Brasilien zu erläutern. Wir analysierten Publikationen der 'Archivos Brasileiros de Hygiene Mental' und andere Quellen aus jener Zeit (1925-1955) und stellten fest, dass einige „Hygienebeauftragte Ärzte“ die Möglichkeit der ambulante Pflege (welche heute von der psychiatrischen Reform vertreten wird) bereits in Erwägung zogen, zu einer Zeit in der die psychiatrische Pflege ausschliesslich auf die Absonderung der Patienten in psychiatrischen Anstalten basierte.

La clínica de higiene mental infantil en Brasil. La psicología como recurso / The Child Mental Hygiene Clinic in BRAZIL. Psychology as a Resource

Este estudio tuvo el objetivo de demostrar que los integrantes de la Liga Brasileña de Higiene Mental -en su mayoría médicos, educadores y juristas- contribuyeron a la inserción de los saberes psicológicos en Brasil, a principios del siglo XX. Teniendo como perspectiva teórica el análisis histórico y como fuente primaria los Arquivos Brasileiros de Higiene Mental, en su periódico oficial, se realizó una investigación bibliográfica para demostrar que este grupo encontró en los instrumentos de la psicología, entre ellos, las pruebas psicológicas, una forma de explicar las diferencias individuales. Los presupuestos de la psicología fueron tomados como base científica para tornar la higiene mental un medio de saneamiento psíquico de la población. Al crear la Clínica de Euphrenia, destinada a realizar la psicohigiene del niño, abrieron campos para inserción de la psicología en la educación y en la salud, con la profilaxis mental de la infancia como objetivo.

The objective of this study was to demonstrate that members of the Brazilian Mental Hygiene League - most of whom were physicians, educators and jurists - contributed to introduce knowledge in psychology to Brazil during the early 20th century. A bibliographical research study was carried out using historical analysis as theoretical perspective and featuring the Brazilian Mental Hygiene Archives - official publication of the League - as primary source. The aim was to demonstrate that the group found a way to explain individual differences from the instruments of psychology, including psychological tests. The assumptions of psychology were taken as scientific support to transform mental hygiene into a vehicle for mental healing of the population. By opening the Euphrenic Clinic to conduct psycho-hygiene of children, they created openings to insert psychology into the fields of education and health, with the goal of performing mental prophylaxis the population, particularly the children.

Medicina, higiene mental y saber psi en la construcción de la maternidad y la infancia en la Argentina: un análisis a través de la revista Madre y Niño (1934-1935) / Medicine, Mental Health and Psy Knowledge in the Construction of Maternity and Childhood in Argentina: an Analisys through the Journal Madre y Niño (1934-1935)

El presente trabajo se propone analizar el modo en que los saberes psi definieron ciertas concepciones en torno a la maternidad y la infancia, difundidas a través de la revista Madre y Niño, publicada en la Argentina a mediados de la década de 1930. La utilización de la psicología contribuyó a la legitimación del saber médico sobre la infancia a partir de definir su especificidad y combatir las nociones y prácticas populares, consideradas perjudiciales y anticientíficas. En la Argentina, la articulación de tales discursos y prácticas ha configurado el proceso de disciplinarización e institucionalización de la psicología y su utilización por parte de los saberes médicos como una estrategia de intervención social.

The aim of this article is to analyze how the psychological knowledge defined conceptualizations about motherhood and childhood in several articles written by doctors for the magazine Madre y Niño, published in Argentina in the mid-thirties. The use of psychological knowledge about the bond between mothers and sons, would have provided scientific legitimation to Medicine in order to define its own field of expertise. Psychology in Argentina was able to develop a common ground with other fields of knowledge such as Medicine, taking into account its attempt to differ from other popular knowledges, considered harmful and non-scientific. This field of expertise can be framed in the process of disciplinarization of psychological knowledge and can be described as a tendency towards a social intervention.

Psicología e higiene mental en Brasil: la historia por contar / Psychology and Mental Hygiene in Brazil: The History to Be Told

El presente estudio tuvo el objetivo de investigar la influencia de la Liga Brasileña de Higiene Mental (LBHM) en la construcción de la psicología científica en Brasil, en el inicio del siglo XX. Debido a la extensión del asunto y de la lista de integrantes de esta asociación, se enfocó el campo de la educación escolar y específicamente tres miembros de la LBHM: Manoel Bomfim, Plínio Olinto y Mauricio de Medeiros. Se priorizaron las fuentes primarias producidas por estos autores, a mediados del siglo XX, las cuales se analizaron a la luz de la vertiente teórica inspirada en el materialismo histórico. Como resultado, se constató que los conocimientos psicológicos fueron considerados básicos en el proceso educativo para difusión del ideario de la LBHM y consecuente progreso de la nación. Por tanto, la historia de la psicología en Brasil y la historia de la LBHM son complementarias.

The objective of this study was to investigate the influence of the Brazilian Mental Hygiene League (LBHM) on the construction of scientific psychology in Brazil in the beginning of the 20th century. Due to the extent of the subject and sheer number of members in that organization, we focused on school education and specifically on three LBHM members: Manoel Bomfim, Plínio Olinto and Maurício de Medeiros. We gave priority to primary sources produced by those authors in the mid of 20th century, which were analyzed in the light of the theoretical perspective inspired in historical materialism. As a result, we concluded that psychological knowledge was considered basic to the educational process in order to spread the ideals of the LBHM and the resulting progress of the nation. Therefore, the histories of psychology in Brazil and of the LBHM complement each other.

Modern Approach to Treating Mental Patients in Colonial Chosun / 의사학

Literature produced by the government and the private sector in the colonial era was reviewed to determine the knowledge of the people of colonial Chosun of mental illness and mental patients and the mental patient management system that they implemented or intended to implement. The results of this study show that the people of Chosun realized the need to sterilize mental patients because they considered mental patients very violent, dangerous and eugenically inferior and they believed that mental patients would eventually impede the prosperity of Chosun. The people of colonial Chosun had learned about the lifelong mental hygiene movement, which had knowledge of mental illness prevention. However, they also recognized that people who developed mental illness despite efforts to prevent such condition needed help from the modern system, especially from modern Western psychiatry. The primary responsibility to attend to mental patients was imposed on their family. The family had to understand the symptoms of mental illness according to the modern medical classification and how to deal with them. When the family could not afford to take care of its mentally ill family member due to the increase in the member's risk behavior such as frenzied-convulsive excitement, paranoia and delusion of jealousy, the family was also responsible for isolating him and connecting him with a mental hospital. The police and social workers were also responsible for observing and monitoring mental patients in their community and for connecting them with a mental hospital. The police made a list of mental patients within their area of jurisdiction and prohibited them from wandering based on the law. It was also considered desirable for mental patients who could not identify their family members to be sent to a mental hospital. Social workers were responsible for managing mental patient sanatoriums, and district commissioners sent to the police mental patients who had no family to look after them or who posed a threat to others, or else commissioned them to the government hospital. Thus, the final responsibility for mental patients was imposed on the modern Western medical team, because the district commissioners sent them to the police and the police sent them to the government mental hospital. Most educated people and government personnel in the colonial era thought modern Western psychiatry circles were responsible for mental patient management, and the Japanese empire enacted mental-health-related laws and made efforts to secure funds for the establishment of mental hospitals. As the literature at that time also show the position of the modern Western medical circle, their ambivalent attitude to mental patients must also be clarified to interpret the modern approach to treating mental patients in colonial Chosun. In this context, a research on historical figures in Japanese psychiatry, a study on the specific treatment methods used by the modern Western psychiatric team in the colonial era and their effects, and the extension of the subject period for such researches are suggested.

A saúde da família sob as lentes da higiene mental / Family health through the lens of mental hygiene

Procura instigar o debate sobre os determinantes sócio-históricos que condicionam a construção de políticas públicas de saúde mental aplicáveis ao contexto familiar brasileiro. As atuais políticas têm privilegiado a família como lugar estratégico de ações voltadas para a transformação social, com intervenção de vários atores, entre eles, psicólogos. Ao recuperar alguns pontos do ideário de higiene mental percebeu-se que esse discurso não é novidade na história da saúde brasileira. Embora os tempos, as famílias e os profissionais sejam outros, compreendeu-se que a busca de solução para a 'crise' da sociedade continua sendo atribuída ao indivíduo particular. A família, como expressão desse indivíduo, tem sido chamada para assumir responsabilidades que levem a sociedade na direção da 'ordem' e do 'progresso' da nação.

The article is meant to stimulate debate about the social and historical determinants that shape the construction of public mental health policy within the context of the Brazilian family. Current policies have emphasized the family as a strategic target of initiatives aimed at social transformation, with the intervention of different actors, including psychologists. An examination of some ideas from the field of mental hygiene suggests that this discourse is nothing new in the history of Brazilian health. While today's times, families, and professionals are different, the search for a solution to the so-called crisis of society still focuses on the individual. The family, as the expression of this individual, has been called upon to assume responsibilities that push society towards 'order' and 'progress' for the Nation.

Eugenizar a alma: a constituição da euphrenia no projeto de higiene mental voltado à infância da Liga Brasileira de Hygiene Mental / Eugenizing the soul: the constitution of "euphrenia" in the mental health project dedicated to youth, promoted by the Brazilian Mental Health League / Eugenizer l'âme: la constitution de "l'euphrenia" dans le projet d'hygiène mentale pour l'enfance de la Ligue Brésilienne d'Hygiène Mentale / La eugenesia del alma: la constitución de la "euphrenia" en el proyecto de higiene mental direccionado a la infancia de la Liga Brasileña de Higiene Mental

O presente artigo analisa a constituição da "euphrenia" como um novo domínio para a psiquiatria brasileira na sua abordagem eugênica e higiênica da infância. A análise de saberes médicos e psicológicos acerca do psiquismo infantil no Brasil das décadas de 1920 e 1930 descortina a intensa circulação afetiva intrafamiliar como ponto de ancoragem para um projeto de normalização social, ainda centrado na eugenia, mas já atravessado por uma psicologia da adaptação.

This article analyzes the establishment of "euphrenia" as a new domain for Brazilian psychiatry in its eugenic and hygienic approach to children's health. An analysis of medical and psychological knowledge regarding children's minds in Brazil in the 1920s and 1930s reveals the intense emotional climate in families as the basis for a project in social normalization, still focused on eugenics but also influenced by a psychology of adaptation.

Cet article analyse la mise en place de "l'euphrenia" comme un nouveau domaine de la psychiatrie brésilienne dans son approche eugénique et hygiénique de l'enfance. L'analyse des connaissances médicales et psychologiques sur le psychisme de l'enfant au Brésil dans les années 1920 et 1930 révèle l'intense circulation affective intrafamiliale comme point de départ pour un projet de normalisation sociale, toujours centré sur l'eugénisme, mais maintenant imprégnée par une psychologie de l'adaptation.

En este artículo se analiza la formación de la "euphrenia" como un nuevo dominio para la psiquiatría brasileña en su enfoque eugenésico e higiénico de la infancia. El análisis de los conocimientos médicos y psicológicos acerca de la psiquis infantil en Brasil durante los años de 1920 y 1930 revela la intensa circulación emocional intrafamiliar como punto de anclaje para un proyecto de normalización social, aún centrado en la eugenesia, pero ahora atravesado por una psicología de la adaptación.

The evaluation on effectiveness of psychological health intervention in elderly urban residents living on minimum subsistence allowances / 中华老年医学杂志

Objective To evaluate the effectiveness of psychological health intervention in the elderly urban residents living on minimum subsistence allowances, and to search for a suitable psychological health intervention strategy. Methods The 112 elderly persons living on minimum subsistence allowances in Xuzhou were selected by stratified cluster sampling, and they were matched with 112 controls. The elderly persons living on minimum subsistence allowances were divided into intervention group and control group. A general intervention based on community involved psychological health and care lecture, psychodrama treatment and psychological consultancy was made on the intervention. The SCL-90 was used to evaluate the psychological health status and effectiveness of psychological health intervention. Results The elderly persons living on minimum subsistence allowances had higher SCL-90 scores compared with other residents, and their psychological health status was serious. After the psychological health intervention, the SCL-90 scores were all lower in intervention group than in control group [ interpersonal relationship sensitiveness: (1.13 ± 0. 39) vs.(1.26±0.26), t=2.12, P=0.04; gloom: (1.23±0.66) vs. (1.43±0.24), t=2.08, P=0.04;anxiety: (1. 18±0.50) vs. (1.38±0.34), t=2.17, P=0.03; hostility: (1.24±0.49) vs. (1.40±0.28), t=2.03, P=0.04; other factor: (1. 31±0.56) vs. (1.49±0.31), t=2.04, P=0.04; total score: (115.89± 17.21) vs. (122.64± 10.41), t=2.42, P=0.02]. Conclusions The psychological health parameters are improved by psychological health intervention.

A infância sob a tutela do estado: alguns apontamentos / Childhood under STATE care: a few annotations / La infancia bajo la guardia del estado: algunos apuntes

Este artigo traduz o resultado de um estudo cujo objetivo foi investigar a presença ou não de influências do ideário da eugenia e higiene mental nas políticas públicas dirigidas à infância. Para alcançar este objetivo, tomamos, como fonte principal, parte da legislação federal que institui a forma de atendimento à infância no Brasil, a saber: o Código de Menores de 1927, primeira legislação que trata exclusivamente da infância, e o Código de Menores de 1979. Consultamos também periódicos e documentos da época, reveladores das contradições do período e a forma de enfrentamento das mesmas. A leitura atenta e rigorosa do material consultado indica pontos de convergência parcial entre o caminho proposto pelas legislações em tela e o ideário supracitado, com ênfase no uso de práticas de exclusão, individualização e personalização de problemas de caráter social.

This article interprets the results of a study whose objective was to investigate the presence or absence of influences from eugenics and mental hygiene beliefs in public policies directed to childhood. To that end, we took as our main source the federal legislation that instituted the form of childhood assistance in Brazil, namely: the Minors Code of 1927, which was the first piece of legislation dealing exclusively with childhood and the Minors Code of 1979. We also checked periodicals and document from those periods, which revealed contractions and the manner in which they were confronted. A careful and rigorous reading of the consulted materials indicates a partial convergence between the path proposed by the legislation and the above-mentioned set of beliefs, with emphasis on the use of practices of exclusion, individualization and personalization of social problems.

Este artículo traduce el resultado de un estudio cuyo objetivo fue investigar la presencia, o nº, de influencias del ideario de eugenía e higiene mental en las políticas públicas dirigidas a la infancia. Para lograr este objetivo tomamos como fuente principal, la legislación federal que instituyó la forma de atendimiento a la infancia en Brasil, a saber: el Código de Menores de 1927, primera legislación que trata exclusivamente de la infancia y el Código de Menores de 1979. Consultamos también los periódicos y documentos de la época, reveladores de las contradiciones del periodo y la forma de enfrentamiento de las niñas. La lectura atenta y rigurosa del material consultado indica puntos de convergencia, parcial, entre el camino propuesto por las legislaciones en tella y el ideario supracitado, con énfasis en el uso de prácticas de exclusión, individualización y personalización de problemas de carácter social.

A deficiência mental na concepção da liga brasileira de higiene mental / Mental disability in the conception of brazilian league of mental hygiene

O objetivo deste texto é investigar a concepção e as propostas de atendimento escolar destinado aos deficientes mentais segundo o ideário higienista e eugenista difundido pela Liga Brasileira de Higiene Mental (LBHM). Para tanto, utilizamos como fonte primária de estudo os Arquivos Brasileiros de Higiene Mental (ABHM), periódico publicado entre 1925 e 1947. Verificamos que a LBHM expressa diferentes opiniões quanto à concepção e às medidas de intervenção propostas para os deficientes mentais. De um lado, propõe a higienização da população, a ser alcançada com a formação de hábitos sadios através da educação escolar e especificamente da educação higiênica, com a possível adaptação do deficiente ao meio social. De outro, defende uma posição eugênica radical, que apregoa a purificação da raça, a esterilização e exclusão dos ditos degenerados (leprosos, loucos, idiotas, epilépticos, cancerosos, nefrolíticos, tuberculosos, prostitutas, vagabundos e deficientes mentais).

The aim of this study is to investigate the conception and proposals of schooling for individuals with mental disability according to the hygienic and eugenic ideology divulged by the Brazilian League for Mental Hygiene (Liga Brasileira de Higiene Mental, LBHM). To this end, we used as a primary source the Brazilian Archives of Mental Hygiene (Arquivos Brasileiros de Higiene Mental, ABHM), a newspaper published from 1925 to 1947. We concluded that there were various opinions in the LBHM about the conception and proposed intervention methods for individuals with mental disability. On one side, there were proposals of population cleansing to be achieved through healthy habits taught in schools, mainly hygienic education, with possible adaptation of the disabled individual to society. On the other hand, there was an extreme eugenic proposal that emphasized race purification, sterilization and exclusion of so-called degenerate individuals (lepers, lunatics, idiots, epileptics, cancer patients, nephrolytics, tuberculosis patients, prostitutes, vagrants and individuals with mental retardation).

Reich e o movimento de higiene mental / Reich and the mental hygiene movement

Este estudo visa investigar se a atuação do psicanalista dissidente Wilhelm Reich no cenário científico-cultural da primeira metade do século passado permite associá-lo ao movimento de higiene mental. A fim de cumprirmos tal objetivo, duas direções de pesquisa foram assumidas. A primeira envolveu escritos sobre as origens e as orientações definidoras da moderna saúde pública, do higienismo e, em especial, do movimento de higiene mental. A segunda diz respeito a um levantamento na obra reichiana - artigos, livros, capítulos de livros, cartas e entrevistas - de forma a observar: a) referências diretas ao movimento de higiene mental; b) análises ou relatos de ações do autor vinculadas a esse movimento; c) uso de linguagem característica de tal movimento. Como conclusão, foram formuladas linhas de entendimento sobre a participação de Reich no cenário científico-cultural da primeira metade do século passado, no que tange à associação desse autor com o movimento de higiene mental.

This essay takes two different research directions in order to investigate if the actions of the dissident psychoanalyst Wilhelm Reich, in the cultural-scientific scenario of the first half of the twentieth century, allow us to associate him to the mental hygiene movement. One of the research directions is a review of some writings about the origins and the defining orientations of modern public health care, hygienism and especially the mental hygiene movement. The second one concerns a referring to Reich's work - articles, books, chapters, letters and interviews - aiming to observe: a) direct references to the mental hygiene movement; b) analyses or accounts of the author's actions linked to this movement; c) usages of its characteristic vocabulary. As a conclusion, understanding guidelines about Reich's participation in the cultural-scientific scenario of the first half of the twentieth century, regarding to the mental hygiene movement, were formulated.

Este estudio tiene como objetivo el de investigar si la actuación del psicoanalista disidente Wilhelm Reich en el escenario científico-cultural de la primera mitad del siglo pasado permite asociarle al movimiento de higiene mental. Para cumplir con ese objetivo, la investigación ha tomado dos direcciones: por la primera se ocupa de escritos sobre los orígenes y las orientaciones definidoras de la moderna salud pública, del higienismo y, en especial, del movimiento de higiene mental. Por la segunda se hace una lectura de la obra reichiana - artículos, libros, capítulos de libros, cartas y entrevistas - de manera a observar: a) referencias directas al movimiento de higiene mental; b) análisis o relatos de acciones del autor relacionadas a ese movimiento; c) uso de lenguaje característico del movimiento. Como conclusión, se formularon líneas de entendimiento sobre la participación de Reich en el escenario científico-cultural de la primera mitad del siglo pasado, en lo que respecta a la asociación de ese autor con el movimiento de higiene mental.