Presença de risco de transtorno do estresse pós-traumático em policiais militares feridos por arma de fogo / Presence of risk of posttraumatic stress disorder in military police officers wounded by firearms / Presencia de riesgo de trastorno de estrés postraumático en policías militares heridos por armamiento de fuego

Este estudo teve como objetivo identificar o risco de desenvolvimento de transtorno de estresse pós-traumático (TEPT), bem como sua associação com pensamentos ou tentativas suicidas e a saúde mental de policiais militares feridos por arma de fogo, na Região Metropolitana de Belém (RMB), nos anos de 2017 a 2019. A pesquisa contou com a participação de 30 entrevistados, que responderam o Inventário Demográfico e a Lista de verificação de TEPT para o DSM-5 (PCL-5). Para análise dos dados, utilizou-se a técnica estatística Análise Exploratória de Dados e a técnica multivariada Análise de Correspondência. Os resultados revelaram a existência de risco de desenvolvimento do transtorno de forma parcial ou total em uma expressiva parcela da população entrevistada, tendo homens como maioria dos sintomáticos, com média de 38 anos, exercendo atividades operacionais e vitimados em via pública quando estavam de folga do serviço. O ferimento deixou a maioria com sequelas, com destaque para dores crônicas, limitações de locomoção e/ou mobilidade e perda parcial de um membro. E, ainda, policiais sintomáticos apresentaram comportamentos suicidas, relatando já terem pensado ou tentado tirar a própria vida. Desta forma, conclui-se que policiais militares são expostos constantemente a traumas inerentes a sua profissão. Quando há ameaça de vida, como nos casos de ferimentos por arma de fogo, são suscetíveis a sequelas físicas decorrente do ferimento, somadas a sequelas mentais tardias, como o surgimento de sintomatologias de TEPT e ideação suicida.(AU)

This study aimed to identify the risk of developing post-traumatic stress disorder (PTSD) and its associations around suicidal thoughts or attempts and mental health in military police officers injured by firearms, in the Metropolitan Region of Belem (RMB), from 2017 to 2019. The research had the participation of 30 respondents who answered the Demographic Inventory and the PTSD checklist for DSM-5 (PCL-5). For data analysis, we used the statistical technique Exploratory Data Analysis and the multivariate technique Correspondence Analysis. The results revealed the existence of risk of developing partial or total disorder in a significant portion of the interviewed population, with men as most of the symptomatic individuals, with mean age of 38 years, developing operational activities and victimized on public roads when they were off duty. The injuries left most of them with sequelae, especially chronic pain, limited locomotion and/or mobility, and partial loss of a limb. In addition, symptomatic officers showed suicidal behavior, such as reporting they had thought about or tried to take their own lives. Thus, we conclude that military policemen are constantly exposed to traumas inherent to their profession. When their lives are threatened, as in the case of firearm wounds, they are susceptible to physical sequelae resulting from the injury, in addition to late mental sequelae, such as the appearance of PTSD symptoms and suicidal ideation.(AU)

Este estudio tuvo como objetivo identificar el riesgo de desarrollo de trastorno de estrés postraumático (TEPT) y sus asociaciones con pensamientos o tentativas suicidas y la salud mental en policías militares heridos por armamiento de fuego, en la Región Metropolitana de Belém (Brasil), en el período entre 2017 y 2019. En el estudio participaron 30 entrevistados que respondieron el Inventario Demográfico y la Lista de verificación de TEPT para el DSM-5 (PCL-5). Para el análisis de datos se utilizaron la técnica estadística Análisis Exploratoria de Datos y la técnica multivariada Análisis de Correspondencia. Los resultados revelaron que existen riesgos de desarrollo de trastorno de estrés postraumático de forma parcial o total en una expresiva parcela de la población de policías entrevistados, cuya mayoría de sintomáticos eran hombres, de 38 años en media, que ejercen actividades operacionales y fueron victimados en vía pública cuándo estaban de día libre del servicio. La lesión dejó la mayoría con secuelas, especialmente con dolores crónicos, limitaciones de locomoción y/o movilidad y la pierda parcial de un miembro. Aún los policías sintomáticos presentaran comportamiento suicida, tales como relataran qué ya pensaron o tentaron quitar la propia vida. Se concluye que los policías militaran se exponen constantemente a los traumas inherentes a su profesión. Cuando existe amenaza de vida, como en los casos de heridas por armamiento de fuego, son expuestos a secuelas físicas transcurridas de la herida, sumado a secuelas mentales tardías, como el surgimiento de sintomatologías de TEPT y la ideación suicida.(AU)

Percepções de familiares sobre uma rede de cuidados de saúde mental infantojuvenil / Family perceptions about a children's mental health network / Percepciones familiares sobre una red de atención de salud mental infantojuvenil

Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)

This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)

Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)

O florir da violeta: um estudo de caso em avaliação terapêutica / The flowering of violet: a case study in therapeutic assessment / La flor de la violeta: un estudio de caso en evaluación terapéutica

A Avaliação Terapêutica (AT) é um processo avaliativo e interventivo proposto para ser semiestruturado e colaborativo com o objetivo de promover mudanças positivas no cliente, que é convidado a ter uma participação ativa durante o processo. Na AT, os resultados dos testes psicológicos padronizados ganham destaque como facilitadores do processo de autoconhecimento do cliente. Desse modo, usualmente, integram-se os achados de testes psicológicos de autorrelato com os métodos projetivos para gerar informações que possam ampliar a visão que o cliente tem de si. Neste artigo, buscou-se compreender o potencial de uso dos testes psicológicos e da relação colaborativa a partir de um caso atendido na perspectiva da AT. A participante, Violeta (nome fictício), foi atendida em 10 sessões com duração entre 60 e 115 minutos. Foram utilizados os testes psicológicos Escala de Bem-Estar Psicológico (Ebep), Escala de Vulnerabilidade e Estresse no Trabalho (Event), Bateria Fatorial de Personalidade (BFP), Método de Rorschach e Inventários de Habilidades Sociais 2 (IHS-2). Observou-se que, durante o processo, Violeta ampliou sua autopercepção, o que possibilitou mudanças no modo de agir em seus relacionamentos amorosos e na reflexão sobre como sua postura era vista por si e por seus colegas de trabalho. Acredita-se que a AT cumpriu com o objetivo de estabelecer uma experiência terapêutica que possibilitasse mudanças positivas para a cliente. Este estudo de caso contribuiu para ampliar a compreensão sobre a importância e o uso dos testes psicológicos neste modelo de avaliação psicológica.(AU)

The Therapeutic Assessment (TA) is an evaluative and interventional process proposed to be semi-structured and collaborative with the objective of promoting positive changes in the client, who is invited to have an active participation during the process. At the TA, the results of standardized psychological tests are highlighted as facilitators of the client's self-knowledge process. In this way, the findings of psychological self-report tests are usually integrated with projective methods to generate information that can broaden the client's view of themselves. In this article, understanding the potential use of psychological tests and of the collaborative relationship from a case treated from the TA perspective was sought. The participant, Violet (fictitious name), was assisted in 10 sessions lasting between 60 and 115 minutes. The psychological tests Psychological Well-Being Scale (EBEP), Vulnerability and Stress at Work Scale (EVENT), Personality Factorial Battery (BFP), Rorschach Method and Social Skills Inventories 2 (IHS-2) were used. It was observed that, during the process, Violet increased her self-perception, which allowed changes in her way of acting in her love life and in her reflection on how her posture was seen by herself and herco-workers. It is believed that TA fulfilled the objective of establishing a therapeutic experience that would enable positive changes for the client. This case study contributed to broaden the understanding about the importance and use of psychological testing in this psychological assessment model.(AU)

La Evaluación Terapéutica (ET) es un proceso de evaluación e intervención que se propone ser semiestructurado y colaborativo, con el objetivo de lograr cambios positivos en el cliente, quien es invitado a tener participación activa durante el proceso. En la ET se destacan los resultados de las pruebas psicológicas estandarizadas como facilitadoras del proceso de autoconocimiento del cliente. Los hallazgos de las pruebas psicológicas de autoinforme suelen integrarse con métodos proyectivos para generar información que pueda ampliar la visión que el cliente tiene de sí mismo. En este artículo se buscó comprender el uso potencial de las pruebas psicológicas y de la relación colaborativa a partir de un estudio de caso tratado desde la perspectiva de la ET. Atendieron a la participante Violeta (nombre ficticio), en 10 sesiones que duraron entre 60 y 115 minutos. Se utilizaron las pruebas psicológicas Escala de Bienestar Psicológico (EBEP), Escala de Vulnerabilidad y Estrés en el Trabajo (EVENT), Batería de Factorial de la Personalidad (BFP), Método de Rorschach e Inventario de Habilidades Sociales 2 (IHS-dos). Se observó que, durante el proceso, Violeta amplió su autopercepción, lo que permitió cambios en la forma de actuar en sus relaciones amorosas y en el reflejo de como ella y sus compañeros de trabajo veían su postura. Así, se cree que ET ha cumplido el objetivo de establecer una experiencia terapéutica que permitió cambios positivos a la cliente. Este estudio contribuyó a ampliar la comprensión sobre la importancia y el uso de las pruebas psicológicas en este modelo de evaluación psicológica.(AU)

Resiliência: avaliação de pacientes queimados em um hospital de urgência e emergência / Resilience: evaluation of burned patients in an urgency and emergency hospital / Resiliencia: evaluación de pacientes quemados en un hospital de urgencias y emergencias

A recuperação de vítimas de queimaduras é longa e dolorosa e afeta diversas esferas da vida do paciente. A resiliência, que se refere à capacidade humana de enfrentar e se adaptar a eventos adversos, exerce grande importância no processo de recuperação da queimadura. Logo, este trabalho objetiva avaliar a capacidade de resiliência de pacientes queimados, no momento da admissão e da alta hospitalar, em um hospital de emergência e urgência de Goiânia. Trata-se de um estudo descritivo, quantitativo e transversal que utiliza a Escala de Resiliência de Connor-Davidson (CD-RISC) como instrumento de mensuração. Na admissão hospitalar, a média da resiliência foi de 71,35, tendo sido observada uma relação significativa entre o fator Amparo da escala CD-RISC e a presença do(a) companheiro(a). O escore de resiliência encontrado nesta pesquisa é consistente com outros achados da literatura científica internacional e nacional referente à expressão da resiliência em vítimas de queimaduras e outros adoecimentos. A relação entre o fator Amparo e a presença de um(a) companheiro(a) enfatiza a importância da rede de apoio familiar na reabilitação do paciente queimado.(AU)

The recovery of burned patients is long and painful and impacts on different areas of people's lives. Resilience, which refers to the human capacity to face and adapt to adverse events, plays a major role in the process of recovery from burns. Therefore, the present study aims to assess the resilience of burned patients, on admission and hospital discharge, in an emergency and urgency hospital in Goiânia. This is a descriptive, quantitative and cross-sectional study that uses the Connor-Davidson Resilience Scale (CD RISC) as a measuring instrument. At hospital admission, the mean resilience was 71.35, with a significant association between the Support factor on the CD RISC scale and the presence of a partner. The resilience score found in the present study is consistent with other findings in the international and national scientific literature regarding the expression of resilience in victims of burns and other illnesses. The relationship between the Support factor and the presence of a partner emphasizes the importance of the family support network in the rehabilitation of the burned patient.(AU)

La recuperación de los pacientes quemados es larga y dolorosa e impacta en diferentes esferas de la vida de las personas. La resiliencia, que se refiere a la capacidad humana para enfrentar y adaptarse a eventos adversos, juega un papel importante en el proceso de recuperación de las quemaduras. Por tanto, el presente estudio tiene como objetivo evaluar la resiliencia de los pacientes quemados, en el momento del ingreso y el alta, en un hospital de emergencia y urgencia en Goiânia. Se trata de un estudio descriptivo, cuantitativo y transversal que utiliza la Escala de Resiliencia Connor-Davidson (CD RISC) como instrumento de medida. Al ingreso hospitalario, la resiliencia media fue de 71,35, con associación significativa entre el factor Amparo de la escala CD RISC y la presencia de pareja. El puntaje de resiliencia encontrado en el presente estudio es consistente con otros hallazgos en la literatura científica nacional e internacional sobre la expresión de resiliencia en víctimas de quemaduras y otras enfermedades. La relación entre el factor Amparo y la presencia de pareja enfatiza la importancia de la red de apoyo familiar en la rehabilitación del paciente quemado.(AU)

Avaliação da incidência de uso de antidepressivos em estudantes de medicina do estado de Alagoas / Evaluation of the incidence of antidepressant use among medical students in the state of Alagoas

O presente estudo objetivou determinar a frequência do uso de antidepressivos entre os estudantes de Medicina do Estado de Alagoas, dessa forma, consiste em um estudo prospectivo e transversal, realizado nas instituições de ensino superior do Estado de Alagoas possuidoras da graduação de Medicina. Critérios de inclusão foram estar matriculado e frequentando o curso, cursando do primeiro ao quarto ano e possuir 18 anos ou mais. Já os critérios de exclusão foram ser do quinto ou sexto ano de graduação; possuir idade menor que 18 anos, mesmo que emancipado. Através de questionário autopreenchido (informações sociodemográficas, estilo de vida e inventário de Ansiedade de Beck), foram entrevistados 342 acadêmicos de forma aleatória. Os dados adquiridos foram digitados, tabulados e analisados. Este estudo teve aprovação do Comitê de Ética em Pesquisa. Todos os participantes leram e assinaram o Termo de Consentimento Livre e Esclarecido em conformidade aos critérios da resolução 466/12. Dos entrevistados, 15% recorrem a antidepressivo e 85% não fazem uso desse tipo de fármaco. Mesmo dando uma percentagem baixa, ainda é preocupante e bastante importante abordar sempre esse tema e reformular o ensino médico, de modo a diminuir os níveis de estresse e ansiedade dos estudantes (AU).

This study aimed to determine the frequency of antidepressant use among medical students in the State of Alagoas, thus consisting of a prospective and cross-sectional study carried out in higher education institutions in the State of Alagoas that offer undergraduate medical education. Inclusion criteria were being enrolled and attending the course, from the first to the fourth year, and being 18 years old or older. The exclusion criteria were being in the fifth or sixth year of medical school; being younger than 18 years old, even if emancipated. Through a self-completed questionnaire (sociodemographic information, lifestyle, and Beck's Anxiety Inventory), 342 students were randomly interviewed. The data were typed, tabulated and analyzed. This study was approved by the Research Ethics Committee. All participants who participated read and signed the Informed Consent Form according to the criteria of resolution 466/12. Fifteen percent of the respondents use antidepressants and 85% do not use this type of drug. Even giving a low percentage, it is still worrisome and quite important to always address this issue and reformulate medical education in order to decrease the levels of stress and anxiety among students (AU).

Progress on the researches of acupuncture preconditioning before surgery / 中国针灸

This paper reviews the researches on acupuncture preconditioning before surgery in recent years and explores its application value from three aspects, i.e. relieving preoperative anxiety, preventing from postoperative cognitive dysfunction, and preventing from postoperative gastrointestinal dysfunction. As a relatively safe non-drug treatment, acupuncture has the underlying advantages in participating into multidisciplinary coordination in the enhanced recovery after surgery (ERAS). By building up higher-quality medical evidences and revealing the effect mechanism of acupuncture from multi-dimenisonal aspects, it is expected that acupuncture technology can be coordinated with ERAS to optimize the clinical path in the perioperative period, and boost the development of the perioperative medicine ultimately.

The mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder / 中国当代儿科杂志

OBJECTIVES@#To study the mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder (ADHD).@*METHODS@#Convenience cluster sampling was performed to select 435 eligible children with ADHD from 10 211 students in 10 elementary schools in Kashgar of Xinjiang Uygur Autonomous Region. SNAP-IV Assessment Scale, Emotion Regulation Questionnaire for Children and Adolescents, and Conners Parent Symptoms Questionnaire were used to obtain relevant information. The Spearman correlation analysis and the moderated mediation method were used for data analysis.@*RESULTS@#For the children with ADHD, the score of cognitive reappraisal was negatively correlated with the scores of symptoms and anxiety problems (rs=-0.254 and -0.270 respectively, P<0.001), and the score of symptoms was positively correlated with the score of anxiety problems (rs=0.329, P<0.001). The analysis of mediating effect showed that cognitive reappraisal played a partial mediating role between symptoms and anxiety problems, with a 95% confidence interval of 0.008-0.027, and the mediating effect accounted for 16.10% of the total effect. In addition, sex played a regulatory role in this mediation model (P<0.001).@*CONCLUSIONS@#Cognitive reappraisal plays a mediating role between symptoms and anxiety problems in children with ADHD, while sex regulates the relationship of symptoms with cognitive reappraisal and anxiety problems in these children.

Effects of staged acupuncture on endometrial receptivity and anxiety in patients with recurrent implantation failure of thin endometrium based on "thoroughfare vessel is the sea of blood" theory / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between staged acupuncture based on "thoroughfare vessel is the sea of blood" theory combined with routine hormone replacement cycle treatment and routine hormone replacement cycle treatment for patients with recurrent implantation failure (RIF) of thin endometrium.@*METHODS@#A total of 72 RIF patients with thin endometrium were randomly divided into an observation group and a control group, 36 cases in each group. The patients in the control group were treated with routine hormone replacement cycle treatment. Based on the treatment of the control group, the patients in the observation group were treated with staged acupuncture based on "thoroughfare vessel is the sea of blood" theory. The main acupoints were Neiguan (PC 6) and Gongsun (SP 4), and the supplementary acupoints were selected according to the menstrual cycle and syndrome differentiation; the acupuncture was given once every other day, 3 times a week, for 3 consecutive menstrual cycles. The thickness and shape of endometrium, and Hamilton anxiety scale (HAMA) score were observed at implantation window before and after treatment; the clinical pregnancy rate, live birth rate and cycle cancellation rate were compared between the two groups; the correlation between endometrial thickness and HAMA score was analyzed.@*RESULTS@#Compared before treatment, the endometrial thickness in the two groups and the proportion of type A+B endometrium in the observation group were increased (P<0.05), and the HAMA scores in the two groups were decreased (P<0.05) after treatment. The above indexes in the observation group were superior to those in the control group (P<0.05). The clinical pregnancy rate and live birth rate in the observation group were higher than those in the control group (P<0.05), and the cycle cancellation rate was lower than that in the control group (P<0.05). There was a negative correlation between endometrial thickness and HAMA score (P<0.05).@*CONCLUSION@#Based on the routine hormone replacement cycle treatment, the addition use of staged acupuncture based on "thoroughfare vessel is the sea of blood" theory could improve the thickness and shape of endometrium, relieve anxiety, increase the clinical pregnancy rate and live birth rate, and reduce the cycle cancellation rate in RIF patients with thin endometrium. The curative effect is superior to the routine hormone replacement cycle treatment alone.

Research advances in the correlation between chronic subjective tinnitus and anxiety state / 临床耳鼻咽喉头颈外科杂志

Tinnitus and anxiety disorder are common clinical symptoms. Comorbidity between tinnitus and anxiety state is increasing year by year. The relationship between tinnitus and anxiety state has always been a hot topic, and this paper reviews the literature on the relationship between chronic subjective tinnitus and anxiety state in recent years.

Hippocampus: Molecular, Cellular, and Circuit Features in Anxiety / 神经科学通报·英文版

Anxiety disorders are currently a major psychiatric and social problem, the mechanisms of which have been only partially elucidated. The hippocampus serves as a major target of stress mediators and is closely related to anxiety modulation. Yet so far, its complex anatomy has been a challenge for research on the mechanisms of anxiety regulation. Recent advances in imaging, virus tracking, and optogenetics/chemogenetics have permitted elucidation of the activity, connectivity, and function of specific cell types within the hippocampus and its connected brain regions, providing mechanistic insights into the elaborate organization of the hippocampal circuitry underlying anxiety. Studies of hippocampal neurotransmitter systems, including glutamatergic, GABAergic, cholinergic, dopaminergic, and serotonergic systems, have contributed to the interpretation of the underlying neural mechanisms of anxiety. Neuropeptides and neuroinflammatory factors are also involved in anxiety modulation. This review comprehensively summarizes the hippocampal mechanisms associated with anxiety modulation, based on molecular, cellular, and circuit properties, to provide tailored targets for future anxiety treatment.

Association of smartphone addiction with pain, sleep, anxiety, and depression in university students / Análise da dependência do uso de smartphone em comparação à dor, sono, ansiedade e depressão em universitários

Abstract Introduction: Smartphone use has become a popular social communication phenomenon worldwide. Its excessive use can compromise daily routines and habits, which is associated with sleep disorders, stress, anxiety and pain. Therefore, the university student stands out, as they has a lifestyle in which it is necessary to reconcile daily activities with curriculum activities, aggravating psychosocial factors. Objective: To investigate whether smartphone addiction influences sleep quality, anxiety, depression and pain in university students. Methods: We carried out an analytical cross-sectional study. For data collection, the following self-administered questionnaires were used: Smartphone Addiction Inventory (SPAI-BR), to assess smartphone dependence; Pittsburgh Sleep Quality Index (PSQI), to evaluate sleep quality; Hospital Anxiety and Depression Scale, to assess anxiety and depression (HADS), where it was subdivided into HADS-A for anxiety and HADS-D for depression; and Numeric Rating Scale (NRS) to determine physical pain intensity. The sample consisted of 301 university students studying physiotherapy and physical education at the State University of Northern Paraná (UENP). They were divided according to the score obtained in the SPAI-BR between the "regular" group (up to 6 points) and "predisposed" to smartphone dependence (7 or more points). Results: The comparisons were statistically significant in favor of the regular group: the predisposed group obtained a higher score for the questionnaires used with an average NRS of 2.37 points, average HADS-D of 9.05 points and average HADS-A of 6.01 points. Differences between groups were statistically significant: NRS, p = 0.018; HADS-A, p = 0.001; HADS-D p = 0.001; and PSQI, p = 0.001. Conclusion: The university students analyzed in this study classified as predisposed were more prone to being addicted to their smartphone, and they were more likely to have anxiety, with a worse quality of sleep and with a greater intensity of pain.

Resumo Introdução: O uso de smartphones se tornou um fenômeno social mundialmente popular de comunicação. Seu uso excessivo pode comprometer as rotinas e hábitos diários, que estão associados aos distúrbios do sono, estresse, ansiedade, algias; logo, destaca-se o universitário, que apresenta um estilo de vida em que é preciso conciliar as atividades diárias com as curriculares, agravando fatores psicossociais. Objetivo: Investigar se a dependência do uso de smartphone influencia a qualidade de sono e os níveis de ansiedade, depressão e dor em universitários. Métodos: Trata-se de um estudo transversal analítico. Para a coleta dos dados foram utilizados os questionários autoaplicáveis Inventário de Dependências do Smartphone (SPAI-BR), Escala de Pittsburgh (PSQI), Escala Hospitalar de Ansiedade e Depressão (HADS), sendo este subdividido em HADS-A (ansiedade) e HADS-D (depressão), e Escala Numérica da Dor (END). A amostra foi composta por 301 universitários da Universidade Estadual do Norte do Paraná, dos cursos de fisioterapia e educação física. Os estudantes foram divididos de acordo com o escore obtido no SPAI-BR entre grupo regular (até 6 pontos) e pré-disposto à dependência do uso de smartphone (7 ou mais pontos). Resultados: As comparações foram estatisticamente significativas a favor do grupo regular; sendo assim, o grupo pré-disposto obteve uma pontuação pior nos questionários utilizados, sendo a média END de 2,37 pontos, a média HADS-D de 9,05 e a média HADS-A de 6,01. Os valores de intensidade de dor entre os grupos foram de p = 0,018; HADS-A: p = 0,001; HADS-D: p = 0,001; PSQI: p= 0,001. Conclusão: Os universitários classificados como pré- dispostos apresentaram uma maior propensão à dependência do smartphone, além de maior chance de terem ansiedade com uma pior qualidade de sono e maior intensidade de dor.

Saúde mental na universidade: atendimento psicológico online na pandemia da covid-19 / Mental health at the university: online psychological care during the covid-19 pandemic / Salud mental en la universidad: atención psicológica en línea en la pandemia de covid-19

Com a pandemia da covid-19, o contexto universitário, que já vinha sendo palco de discussões em relação à saúde mental, tem vivenciado crises mais severas pelos estudantes. Diante deste cenário, foi desenvolvido o projeto Escuta Solidária, voltado à saúde mental dos discentes de graduação e de pós-graduação. Neste artigo, temos como objetivo discutir o atendimento psicológico online com estudantes do curso de psicologia durante o período de isolamento social rígido (maio a junho de 2020). Fizemos, com os psicólogos voluntários, um grupo focal direcionado para a experiência de atendimento psicológico online de curta duração no contexto pandêmico. Trata-se de um estudo qualitativo, realizado com os 11 psicólogos clínicos participantes do referido projeto. A partir de uma análise fenomenológica crítica, os resultados foram divididos em cinco categorias: a) limitações e contribuições do projeto; b) a importância da capacitação e supervisão clínica para a qualidade do projeto; c) atendimento psicológico online; d) ser psicólogo clínico durante a crise da covid-19; e e) demandas emergentes nos atendimentos psicológicos na quarentena. Por fim, discutimos a importância da desmistificação do atendimento psicológico em situações de crise, especialmente na modalidade online, fomentando questionamentos à formação e atuação dos profissionais, no sentido de estarmos atentos às demandas psicológicas que o contexto de crise acarreta na sociedade.(AU)

With the COVID-19 pandemic, the university context, which had already been the stage for discussions regarding mental health, has experienced more severe crises by students. In view of this scenario, the Solidarity Listening project was developed, aimed at the mental health of undergraduate and graduate students. In this article, we aim to discuss online psychological care with psychology students during the period of strict social isolation (May to June 2020). We carried out, with volunteer psychologists, a focus group aimed at the experience of short-termonline psychological care in the pandemic context. This is a qualitative study, carried out with 11 clinical psychologists participating in the aforementioned project. From a critical phenomenological analysis, the results were divided into five categories: a) limitations and contributions of the project; b) the importance of training and clinical supervision for the quality of the project; c) online psychological care; d) being a clinical psychologist during the COVID-19 crisis; and e) emerging demands in psychological care in quarantine. Finally, we discuss the importance of demystifying psychological care in crisis situations, especially in the online modality, promoting questions regarding the training and performance of professionals, to be aware of the psychological demands that the context of crisis entails in society.(AU)

La pandemia del covid-19 provocó que las universidades, que ya habían sido escenario de discusiones sobre la salud mental, experimentaran crisis más severas entre los estudiantes. Ante este escenario, se desarrolló el proyecto Escucha Solidaria, dirigido a la salud mental de estudiantes de grado y posgrado. Este artículo pretende discutir la atención psicológica en línea con estudiantes de Psicología durante el período de aislamiento social más estricto (mayo/junio de 2020). Se conformó un grupo focal con los psicólogos voluntarios orientado a la práctica de la atención psicológica en línea, a corto plazo, en el contexto de una pandemia. Se trata de un estudio cualitativo, realizado con 11 psicólogos clínicos que participaron en el mencionado proyecto. A partir del análisis fenomenológico crítico, los resultados se dividieron en cinco categorías: a) limitaciones y aportes del proyecto; b) importancia de la capacitación y la supervisión clínica para la calidad del proyecto; c) atención psicológica en línea; d) ser psicólogo clínico durante la crisis del covid-19; y e) demandas emergentes en atención psicológica en la cuarentena. Se concluye que es importante desmitificar la atención psicológica en situaciones de crisis, especialmente en la modalidad en línea, al promover principalmente preguntas sobre la formación y el desempeño de los profesionales con el fin de ser conscientes de las demandas psicológicas que el contexto de crisis conlleva la sociedad.(AU)

The psychological impact of social distancing related to the covid-19 pandemic on undergraduate and graduate students in Brazil

Aim: To evaluate the psychological impact of COVID-19 on undergraduate and graduate students of the Dental School of Ribeirão Preto, University of São Paulo. Methods: Three questionnaires were used: sociodemographic, WHO Abbreviated Quality of Life Inventory, and General Anxiety Disorder-7. Data were analyzed using Graph Pad Prism 7a (α = 5%). Mann-Whitney or Kruskal-Wallis and Dunn post-tests were used for statistical comparisons. The Spearman test was used as the correlation test. Results: 257 students responded to the online form that assessed their quality of life and anxiety level. On a scale from 1 to 100, with 100 being the best quality of life, the average obtained was 64.71 (± 13.36). In addition, 87.6% of the students rated their quality of life as good or very good. 74.7% reported good or very good health. The anxiety analysis resulted in an average of 10.04 (± 4.5), indicating moderate anxiety levels. There was an inversely proportional correlation between age and degree of anxiety (p = 0.008, r = -0.1628) and self-perceived learning and student commitment (r = 0.69). Conclusion: Despite the good quality of life and the students' good self-perception of health, they showed a moderate degree of anxiety during the social distancing caused by COVID-19, also demonstrating a decrease in interest and commitment during distance education

Autonomia da pessoa com problema de álcool: consentimento informado / Autonomy of individuals with alcohol-related disorders: informed consent / Autonomía de la persona con problema relacionado al alcohol: consentimiento informado

Resumo O consentimento livre e esclarecido, como forma de garantir envolvimento e participação em tratamento, é parte da abordagem terapêutica à pessoa com problemas relacionados ao uso de álcool. O valor ético central da autonomia e sua imanência para o consentimento informado apresenta desafios ético-clínicos no caso de pessoa que busca tratamento em situação de coerção, ansiedade ou depressão. Entre abril de 2018 e junho de 2019, conduziu-se estudo observacional longitudinal prospetivo que incluiu 150 pessoas com problemas relacionados ao uso de álcool assistidas em unidade especializada de tratamento. O objetivo foi verificar se o consentimento com interferência de coerção, perturbação de ansiedade ou depressão determina a participação terapêutica. A ausência de coerção judicial e sintomatologia ansiosa e a maior valorização da perceção de autonomia no consentimento informado relacionaram-se com a participação. Propõem-se contributos para reforçar a prática do consentimento informado assente no reconhecimento e promoção da autonomia.

Abstract Informed consent, as a way to ensure involvement and treatment adherence, is part of the therapeutic approach to individuals with alcohol-related disorders. Autonomy, as a core ethical value, and its immanence for informed consent presents ethical-clinical challenges in the case of individuals seeking treatment due to coercion, anxiety, or depression. Between April 2018 and June 2019, a prospective longitudinal observational study was conducted with 150 people with alcohol-related disorders attending a specialized treatment facility. The goal was to verify whether consent obtained under coercion, or influenced by anxiety disorder or depression determines therapeutic participation. Absence of judicial coercion and anxious symptomatology and the greater value placed on perceived autonomy in informed consent were related to participation. The study proposes contributions to strengthen the practice of obtaining informed consent based on the recognition and promotion of autonomy.

Resumen El consentimiento informado, que garantiza comprometimiento y participación en el tratamiento, forma parte del enfoque terapéutico del manejo de la persona con problemas relacionados al consumo de alcohol. El valor ético de la autonomía y su inmanencia para el consentimiento informado tiene desafíos ético-clínicos en el caso de personas que buscan tratamiento en situación de coerción, ansiedad o depresión. Entre abril de 2018 y junio de 2019 se realizó un estudio observacional longitudinal prospectivo con 150 personas con problemas relacionados al consumo de alcohol, asistidas por un centro de tratamiento especializado. Este estudio pretendió confirmar si el consentimiento por coerción, trastorno de ansiedad o depresión influye en la participación terapéutica. La ausencia de coerción judicial y de síntomas ansiosos, así como la mayor autonomía en el consentimiento se relacionaron con la participación. Se proponen aportes para reforzar la práctica del consentimiento informado desde el reconocimiento y promoción de la autonomía.

Trastorno por Déficit de Atención e Hiperactividad (TDHA) y trastornos del estado del ánimo en estudiantes de medicina humana peruanos: una prueba piloto a nivel nacional / Attention Deficit Hyperactivity Disorder (ADHD) and mood disorders in Peruvian human medicine students: a nationwide pilot test

Introducción: el Trastorno por Déficit de Atención con Hiperactividad, también conocido por sus siglas TDAH, es considerado como un trastorno del neurodesarrollo. Diversos estudios reportan que la persistencia de los síntomas durante la adultez se da en el 50-70% de niños con TDAH. Respecto del área académica, la literatura menciona que esta patología en la población universitaria oscila entre un 10 a 25% de estudiantes, en particular los de Medicina Humana. Materiales y métodos: estudio piloto con diseño Cross-sectional, para explorar las variables mencionadas en los estudiantes de todo el territorio peruano se agruparon los departamentos en cinco macro regiones, se utilizaron los cuestionarios ASRS V1.1 y DASS-21. Resultados: se contó muestra total de 250 participantes para la prueba piloto (50 por cada macro región), respecto del TDAH, 33,6% presentó resultados sugestivos. La prevalencia de trastornos del estado anímico fue del 81,6%, dentro de ellos la ansiedad fue más prevalente (70,4%), seguido por la depresión (62,8%) y el estrés (57,6%). Se encontró asociación entre el TDAH y los siguientes: trastorno anímico (PR=1,3 IC(95%) ), depresión (PR=1,51 IC(95%) ), ansiedad (PR=1,47 IC(95%) ) y estrés (PR=1,87 IC(95%) ). Conclusiones: el presente estudio piloto nos ha permitido probar satisfactoriamente el desempeño del instrumento y la técnica propuesta por el diseño metodológico en el estudio primario, confirmado con la obtención de cifras estimadas coherentes con lo descrito por la literatura, y confirmando la asociación entre las variables de interés.

Introduction: Attention Deficit Hyperactivity Disorder, also known by its acronym ADHD, is considered a neurodevelopmental disorder. Several studies report that the persistence of symptoms during adulthood occurs in 50-70% of children with ADHD. Regarding the academic area, the literature mentions that this pathology in the university population ranges from 10 to 25% of students, in particular those of human medicine. Materials and methods: pilot study with Cross-sectional design, to explore the variables mentioned in students from all over the Peruvian territory, the departments were grouped into 5 macro regions, the ASRS V1.1 and DASS-21 questionnaires were used. Results: a total sample of 250 participants was counted for the pilot test (50 for each macro region), regarding ADHD, 33.6% presented suggestive results. The prevalence of mood disorders was 81.6%, among them, anxiety was more prevalent (70.4%), followed by depression (62.8%) and stress (57.6%). An association was found between ADHD and the following: Mood disorder (PR=1.3 CI (95%) ). Depression (PR=1.51 CI (95%) ). Anxiety (PR=1.47 CI (95%) ). and Stress (PR=1.87 CI (95%) ). Conclusions: the present pilot study has allowed us to satisfactorily test the performance of the instrument and the technique proposed by the methodological design in the primary study, confirmed by obtaining estimated figures consistent with what is described in the literature, and confirming the association between the variables of interest.

Transtornos de ansiedade: histórico, aspectos clínicos e classificações atuais / Anxiety disorders: history, clinical features, and current classifications

Objetivos: contribuir para a compreensão do desenvolvimento histórico do conceito de ansiedade, das classificações dos transtornos ansiosos e suas manifestações clínicas, bem como para a atualização sobre o processo de avaliação diagnóstica. Métodos: todas as edições das classificações da Organização Mundial de Saúde (OMS) - CID e da Associação Psiquiátrica Americana (APA) - DSM foram examinadas, além de livros-texto de referência de psiquiatria clínica, de publicações sobre a história e a evolução desses diagnósticos e de publicações produzidas pelas equipes responsáveis pela revisão das classificações atuais. Resultados: entende-se por ansiedade um estado afetivo normal, como um sintoma ou um termo para nomear um grupo de transtornos mentais. Nas primeiras e subsequentes edições das classificações da OMS e da APA, entre 1948 e 1975, os quadros ansiosos faziam parte do grupo das psiconeurose/neuroses. A partir do DSM-III (1980), o grupo das neuroses foi fragmentado em diversos outros, entre os quais os transtornos de ansiedade, o que foi seguido pela CID-10 (1992), apesar de alguma distinção na composição dos subtipos. Para as últimas versões, houve um empenho de compatibilização entre as duas, contudo restaram diferenças: o DSM-5 (2013) adota critérios diagnósticos; a CID-11 (2019) utiliza descrições clínicas e diretrizes diagnósticas, além de abordagens dimensionais para alguns transtornos. Conclusão: ocorreram modificações nas classificações psiquiátricas atuais, no grupo dos transtornos de ansiedade, que precisam ser disseminadas e agregadas a estratégias de formação e qualificação profissionais, incrementando habilidades diagnósticas e permitindo uma comunicação mais uniforme e precisa na prática clínica.

Objectives: to contribute to the understanding of the historical development of the concept of anxiety, the classifications of anxiety disorders and their clinical manifestations, as well as to update on the diagnostic evaluation process. Methods: all editions of the classifications of the World Health Organization (WHO) - ICD and the American Psychiatric Association (APA) - DSM were examined, in addition to reference textbooks on clinical psychiatry, publications on the history and evolution of these diagnoses, and scientific articles produced by the teams responsible for reviewing the current classifications. Results: anxiety is understood as a normal affective state, as a symptom, or as a term to name a group of mental disorders. In the first and subsequent editions of the WHO and APA classifications, between 1948 and 1975, anxiety disorders were part of the psychoneuroses/neuroses group. As of DSM-III (1980) onwards, the neuroses group was fragmented into several others, including anxiety disorders, which was followed by ICD-10 (1992), despite some different choices of subtypes. For the latest versions, there was a compatibility effort between them. However, differences remained: DSM-5 (2013) adopts diagnostic criteria; ICD-11 (2019) uses clinical description and diagnostic guidelines, in addition to dimensional approaches for some disorders. Conclusion: modifications have occurred in current psychiatric classifications, in the group of anxiety disorders, which need to be disseminated and added to professional training and qualification strategies, increasing diagnostic skills and providing for more uniform and accurate communication in clinical practice.

Resiliencia, estrés y ansiedad de cuidadores formales durante la pandemia por COVID-19 / Resilience, anxiety and stress among formal caregivers for institutionalized older people

BACKGROUND: Caregiver stress is a common problem observed in nursing homes. AIM: To determine the association between the level of resilience and stress, anxiety and depression in formal caregivers of older people institutionalized in long-stay establishments during the COVID-19 pandemic. MATERIAL AND METHOD: One hundred ninety eight formal caregivers working at 11 long term residences for older people in southern Chile were invited to answer the SV-RES resilience and the DASS-21 anxiety and depression scales and 102 agreed to participate. RESULTS: We observed a significant association between the resilience scale score and variables such as weekly working hours (p < 0.01), current hours of sleep (p < 0.01), self-perception of sleep (p < 0.01), anxiety level (p < 0.01) and stress level (p < 0.01). Conclusions: A higher score on the Resilience Scale was associated with the absence of anxiety and stress, working between 22 and 43 hours per week, sleeping between 7 and 8 hours of sleep and a satisfactory self-perception of sleep. Studying the factors associated with resilience in formal caregivers of the elderly allows healthcare personnel to focus preventive actions, intervening promptly in risk areas associated with the work context, and strengthening the personal resources of caregivers.

Efeitos do Trabalho de Regulação Infantil nas Competências Socioemocionais de Crianças no Ambiente Escolar / Effects of Child Regulation Work on Socioemotional Competencies of Children in the School Environment / Efectos del Trabajo de Regulación Infantil sobre las Competências Socioemocionales de los Niños en Escuela

Esse estudo objetivou avaliar os efeitos do Trabalho de Regulação Infantil nas competências socioemocionais e problemas de comportamento, assim como nos escores da sintomatologia ansiosa e depressiva em crianças com idade entre 7 e 9 anos. Trata-se de um estudo quasi-experimental, em que comparou-se o grupo experimental com o grupo do tipo lista de espera antes e após a intervenção no ambiente escolar. Os responsáveis preencheram o Social Skills Rating System e a Emotional Regulation Checklist. As crianças preencheram a Social Skills Rating System, Screen for Child Anxiety Related Emotional Disorders e Children Depression Inventory. Foram identificados resultados significativos no aumento das habilidades sociais e regulação emocional, assim como diminuição nos escores de problemas de comportamento e nos sintomas de ansiedade e depressão, no grupo experimental. A diferença entre grupos ocorreu apenas nos níveis de habilidades sociais e regulação emocional. Diante dos resultados, conclui-se que o Trabalho de Regulação Infantil pode ser uma proposta de prevenção de problemas emocionais e de comportamento na escola.

This study aimed to evaluate the effects of the Child Regulation Work on socioemotional skills, behavior problems and on scores of symptoms of anxiety and depression in children aged 7 to 9 years. This is a quasi-experimental study, in which the experimental group was compared with the waiting list group, before and after the intervention in the school environment. Those responsible answered the Social Skills Rating System and the Emotional Regulation Checklist. Children answered the Social Skills Rating System, Screen for Child Anxiety Related Emotional Disorders and Children Depression Inventory. Significant results were identified in increase of social skills and levels of emotional regulation, and a significant decrease in behavior problems and symptoms of anxiety and depression, in the experimental group. The significant difference between the groups occurred only in levels of social skills and emotional regulation scores. Given the results, it is concluded that the Child Regulation Work can be a proposal for the prevention of emotional and behavioral problems at school.

Este estudio evaluó los efectos del Trabajo de Regulación Infantil sobre las habilidades socioemocionales y los síntomas de ansiedad y depresión en niños de 7 a 9 años. Este es un estudio cuasi-experimental, en que se comparó el grupo experimental con el grupo lista de espera, antes y después de la intervención en el entorno escolar. Los responsables completaron el Social Skills Rating Systemy la Emotional Regulation Checklist. Los niños completaron el Social Skills Rating System, la Screenfor Child Anxiety Related Emotional Disorders y el Children Depression Inventory. Se identificaron resultados significativos en el aumento de las habilidades sociales, los niveles de regulación emocional y una disminución de los problemas de conducta, síntomas de ansiedad y depresión, en el grupo experimental. La diferencia entre los grupos ocurrió solamente en los niveles de habilidades sociales y regulación emocional. Dados los resultados, se concluye que el Trabajo de Regulación Infantil puede ser una propuesta para la prevención de problemas emocionales y de comportamiento en la escuela.

O choque do Covid-19: teremos um transtorno da década? / Covid-19 shock: will we have a disorder of the decade? / El choque de la Covid-19: ¿tendremos un trastorno de la década?

Um novo coronavírus se propagou rapidamente por todo o mundo e caracterizou uma epidemia de grandes proporções. Em tempos de Covid-19, associados aos problemas de saúde física, de natureza econômica e social, encontram-se o sofrimento psíquico e os transtornos psicológicos. Nesse contexto, o presente ensaio teórico objetivou apresentar reflexões sobre o isolamento social, o medo da morte iminente e o possível aumento na incidência de transtornos de ansiedade, como o transtorno do estresse pós-traumático (Tept), e de outras sequelas mentais decorrentes da Covid-19. Observou-se que o contexto pandêmico apresenta importantes aspectos preditores de sintomas de transtornos ansiosos, assim como estudos empíricos iniciais indicaram um considerável aumento no número de pessoas com transtornos mentais associados à Covid-19 e decorrentes dela. Há uma demanda por pesquisas que explorem e apresentem dados empíricos a respeito dos efeitos da Covid-19 sobre a saúde mental da população, bem como que proponham estratégias de promoção e prevenção.

Un nuevo coronavirus se extendió rápidamente por todo el mundo y caracterizó una epidemia de grandes proporciones. En tiempos de Covid-19, asociado a problemas de salud física, económicos y sociales, hay sufrimiento psicológico y trastornos psicológicos. En este contexto, este ensayo teórico tuvo como objetivo presentar reflexiones sobre el aislamiento social, el miedo a la muerte inminente y el posible aumento en la incidencia de trastornos de ansiedad, como el trastorno de estrés postraumático (Tept), y otras secuelas mentales derivadas del Covid-19. Se observó que el contexto pandémico tiene importantes predictores de síntomas de trastornos de ansiedad, así como estudios empíricos iniciales indicaron un aumento considerable en el número de personas con trastornos mentales asociados al Covid-19 y resultantes del mismo. Existe una demanda de investigación que explore y presente datos empíricos sobre los efectos del Covid-19 en la salud mental de la población, además de proponer estrategias de promoción y prevención.

A new coronavirus spread rapidly around the world characterizing a pandemic. In times of coronavirus disease 2019 (Covid-19), associated with physical health problems, economic and social problems, there are psychological suffering and psychological disorders. In this context, this theoretical essay aims to present reflections on social isolation, fear of imminent death, and the possible increase in the incidence of anxiety disorders, such as post-traumatic stress disorder (PTSD) and other mental health sequelae resulting from Covid-19. We observed that the pandemic is an important predictor of symptoms of anxiety disorders, as well as initial empirical studies indicated a considerable increase in the number of people with mental disorders resulting from Covid-19. There is a demand for research that explores and presents empirical data regarding the effects of Covid-19 on the mental health of the population, as well as proposing promotion and prevention strategies.

Mental health interventions for suicide prevention among indigenous adolescents: a systematic review

ABSTRACT BACKGROUND: The legacies of colonization and of policies of forced assimilation continue to be a cause of intergenerational trauma, manifested through feelings of marginality, depression, anxiety and confusion, which place indigenous peoples at increased risk of suicide. OBJECTIVES: To assess the quality, content, delivery and effectiveness of interventions for preventing suicides among indigenous adolescents. DESIGN AND SETTING: Systematic review conducted with Cochrane methodology, Campo Grande, Mato Grosso do Sul, Brazil. METHODS: The Cochrane library, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO databases were searched for studies published up to February 2021. The following inclusion criteria were used: published in any language; interventions that aimed to prevent suicides among indigenous adolescents; randomized or non-randomized study with a control or comparative group; and validated measurements of mental health problems. RESULTS: Two studies were identified: one on adolescents in the remote Yup'ik community in south-western Alaska, and the other on Zuni adolescents in New Mexico. Both studies showed evidence of effectiveness in interventions for reducing some of the risk factors and increasing some of the protective factors associated with suicide. High levels of community engagement and culture-centeredness were key anchors of both studies, which ensured that the intervention content, delivery and outcome measurements aligned with the beliefs and practices of the communities. Both studies were judged to have a moderate risk of bias, with biases in sample selection, attrition and inadequate reporting of results. CONCLUSIONS: The current evidence base is small but signaled the value of culturally appropriate interventions for prevention of suicide among indigenous adolescents. REGISTRATION DETAILS: The study protocol is registered in the international prospective register of systematic reviews (PROSPERO); no. CRD42019141754.