Dieta y riesgo de enfermedades mentales en adultos peruanos, estudio transversal / Diet and risk of mental illness in Peruvian adults, cross-sectional study

Las enfermedades mentales representan uno de los mayores problemas de salud pública. El consumo de alimentos ricos en antioxidantes como, frutas y verduras puede disminuir los factores de riesgo. Objetivo. Analizar la ingesta dietética y el riesgo de enfermedades mentales en adultos peruanos. Materiales y métodos. Se realizó un estudio transversal en 393 adultos peruanos, provenientes de las tres regiones del país (costa, sierra y selva). Los datos sociodemográficos, antropométricos se obtuvieron por auto reporte mediante una ficha de registro y el riesgo de enfermedades mentales se determinó con el Cuestionario de Salud General-12 (GHQ-12). Se analizaron los datos mediante el software estadístico IBM SPSS, versión 26. Se utilizó la prueba Chi-cuadrado, considerando un nivel de significancia del 5 %. Resultados. Los participantes que informaron riesgo y presencia de enfermedades mentales reportaron un consumo inadecuado de frutas, verduras y grasas saludables. El consumo adecuado de cereales integrales, frutas y verduras fue significativamente mayor en las mujeres (p<0,05). Sin embargo, más de la mitad de las mujeres demostró estar en riesgo de enfermedades mentales respecto a los hombres (p<0,001). Conclusiones. La ingesta adecuada de alimentos saludables podría resultar beneficiosa en la reducción de los riesgos de las enfermedades mentales en este grupo de población(AU)

Mental illnesses represent one of the biggest public health problems. Consuming foods rich in antioxidants such as fruits and vegetables can lower risk factors. Objective. To analyze the dietary intake and the risk of mental illnesses in Peruvian adults. Materials and methods. A cross-sectional study was carried out in 393 Peruvian adults, who came from the three regions of the country (coast, mountains and jungle). Sociodemographic and anthropometric data were obtained through a registration form and the risk of mental illnesses was determined using the General Health Questionnaire-12 (GHQ-12). The data were analyzed using the statistical software IBM SPSS, version 26. The Chi-square test was used, considering a significance level of 5%. Results. Participants who reported risk and presence of mental illness reported inadequate consumption of fruits, vegetables, and healthy fats. Adequate consumption of whole grains, fruits and vegetables was significantly higher in women (p <0.05). However, more than half of the women proved to be at risk for mental illnesses compared to men (p <0.001). Conclusions. The adequate intake of healthy foods could be beneficial in reducing the risks of mental illness in this population group(AU)q

Exploratory analysis of polygenic risk scores for psychiatric disorders: Applied to dual diagnosis

Background Concurrence of substance use disorders (SUDs) is high in individuals with psychiatric illnesses; more importantly, individuals with both disorders (dual diagnosis) have more severe symptoms. Psychiatric disorders have been proposed to share a genetic susceptibility with SUDs. To explore this shared genetic susceptibility, we analyzed whether any of the polygenic risk scores (PRSs) for psychiatric disorders could be associated to dual diagnosis in patients with schizophrenia (SCZ) or bipolar disorder (BD). Methods We included 192 individuals of Mexican ancestry: 72 with SCZ, 53 with BD, and 67 unrelated controls without psychiatric disorders. We derived calculations of PRS for autism spectrum disorders, attention-deficit/hyperactive disorder, BD, major depression, and SCZ using summary genome-wide association statistics previously published. Results We found that dual diagnosis had a shared genetic susceptibility with major depressive disorder (MDD) and SCZ; furthermore, in individuals with BD, dual diagnosis could be predicted by PRS for MDD. Conclusions Our results reinforce the notion that individuals with dual diagnosis have a higher genetic susceptibility to develop both disorders. However, analyses of larger sample sizes are required to further clarify how to predict risks through PRS within different populations.

Alterações na epigenética do sistema ocitocinérgico em resposta ao cuidado materno negligente / Epigenetics changes into the oxytocinergic system in response to negligent maternal care

O cuidado materno negligente, a falta de afeto e a dificuldade de interagir socialmente estão relacionadas com o desequilíbrio neurofisiológico da ocitocina, neurormônio com papel importante de modulação dos comportamentos sociais. Em seres humanos existem ligações conhecidas entre o estresse pré-natal e perinatal e transtornos psiquiátricos e de desenvolvimento. O objetivo deste estudo foi revisar o conceito de epigenética com foco no efeito a longo prazo do cuidado materno negligente e sua relação com alterações do sistema ocitocinérgico baseado em estudos com animais e humanos. Uma revisão narrativa da literatura foi realizada entre junho de 2017 e janeiro de 2019 através da busca de estudos na base PUBMED, com foco nos resultados qualitativos das relações epigenéticas com a negligência infantil, doenças psiquiátricas e sistema ocitocinérgico. Os estudos referidos demonstram que o cuidado materno negligente é um fator de risco para o desenvolvimento de transtornos mentais, principalmente os que incluem sintomas de desordem social. A ocitocina, por agir como uma potente mediadora das interações sociais, confiança e controle da ansiedade, parece ter papel fundamental neste contexto. A notória transgeracionalidade dos transtornos encontrados em proles de mães negligentes parece estar envolvida com mecanismos epigenéticos que inativam genes específicos do sistema ocitocinérgico no sistema nervoso central. (AU)

Negligent maternal care, lack of affection and difficulty in social interaction are related to a neurophysiological imbalance in oxytocin levels, an important modulator of social behaviors. In humans there are known links between prenatal and perinatal stress and psychiatric and developmental disorders. This study aimed to review the concept of epigenetics with a focus on the long-term effect of negligent maternal care and its relationship to changes in the oxytocinergic system, based on animal and human studies. A narrative review of the literature was conducted using studies from June 2017 to January 2019 available in the PUBMED database, focusing on qualitative results of epigenetic relationships with child neglect, psychiatric diseases and oxytocinergic system. These studies demonstrate that negligent maternal care is a risk factor for the development of mental disorders, especially those that include symptoms of social disorder. Oxytocin, as a neurohormone that acts as a potent mediator of social interactions, confidence and anxiety control, seems to play a fundamental role in this context. The notorious transgenerationality of the disorders found in the offspring of negligent mothers seems to be due to epigenetic mechanisms that inactivate specific genes of the oxytocinergic system in the central nervous system.

Precision Medicine: Changing the way we think about healthcare

Health care has changed since the decline in mortality caused by infectious diseases as well as chronic and non-contagious diseases, with a direct impact on the cost of public health and individual health care. We must now transition from traditional reactive medicine based on symptoms, diagnosis and treatment to a system that targets the disease before it occurs and, if it cannot be avoided, treats the disease in a personalized manner. Precision Medicine is that new way of thinking about medicine. In this paper, we performed a thorough review of the literature to present an updated review on the subject, discussing the impact of the use of genetics and genomics in the care process as well as medical education, clinical research and ethical issues. The Precision Medicine model is expanded upon in this article to include its principles of prediction, prevention, personalization and participation. Finally, we discuss Precision Medicine in various specialty fields and how it has been implemented in developing countries and its effects on public health and medical education.

Association between serotonin 2C receptor gene (HTR2C) polymorphisms and psychopathological symptoms in children and adolescents

Serotonin 2C receptors (5HT2C) are involved in serotonin-driven dynamic equilibrium adjustments responsible for homeostatic stability in brain structures that modulate behavior and emotions. Single nucleotide polymorphisms (SNPs) from the serotonin 2C receptor gene (HTR2C) have been associated with several neurological and mental disorders, including abnormalities in cognitive and emotional processes. The aim of this study was to evaluate the association between the rs6318 SNP of the HTR2C gene and behavioral characteristics exhibited by children and adolescents based on the Child Behavior Checklist (CBCL/6-18) inventory. Eighty-five psychiatric outpatients between 8 and 18 years of age underwent genotyping of the rs6318 SNP. The CBCL/6-18 scale was administered to their caregivers. The chi-squared test was used to assess differences in the frequency of C and G alleles of the rs6318 SNP relative to the grouped CBCL/6-18 scores; significance level was 5%. The presence of the G allele of rs6318 was found to be associated with characteristics of aggressive behavior and social problems, and aggressive behavior was found to be associated with heterozygosis in females. These findings contribute to the identification of mental and behavioral phenotypes associated with gene expression.

Del fenotipo neuropsiquiátrico al cuidado clínico del síndrome de Angelman: descripción de siete casos / Neuropsychiatrie phenotype of Angelman syndrome and clinical care: report of seven cases

El síndrome de Angelman es un trastorno neurogenético debido a la falta o reducción en la expresión del gen UBE3A en el cromosoma 15, el cual codifica la proteína ubiquitina ligasa E3A, que tiene un papel integral en el desarrollo sinóptico y la plasticidad neuronal. Se manifiesta por retraso en el neurodesarrollo o discapacidad intelectual, comportamiento característico y epilepsia. Se describen las características clínicas de siete pacientes con deleción del cromosoma 15q11-13 y su manejo integral. Por la expectativa de vida, es importante conocer y manejar las comorbilidades de forma interdisciplinaria para lograr mejorar la calidad de vida de los afectados. Se realiza una revisión de la literatura sobre la aproximación integral al diagnóstico y cuidado clínico a largo plazo de los pacientes con síndrome de Angelman.

Angelman syndrome is a neurogenetic disorder caused by a lack or reduction of expression of UBE3A located within chromosome 15, which codes for ubiquitin protein ligase E3A, which has a key role in synaptic development and neural plasticity. Its main features are developmental delay/intellectual disability, lack of speech, a characteristic behavioural profile, and epilepsy. We describe clinical features and management of seven cases with 15q11-13 deletion. Due to their life expectancy, knowing and managing its comorbidities is crucial to improve their quality of life. We review the diagnosis and long-term clinical care of patients with Angelman syndrome.

A determinação biológica dos transtornos mentais: uma discussão a partir de teses neurocientíficas recentes / La determinación biológica de los trastornos mentales: una discusión a partir de tesis neurocientíficas recientes / Biological determination of mental disorders: a discussion based on recent hypotheses from neuroscience

Resumo: A compreensão dos processos de formação dos transtornos mentais vem se mostrando desafiadora desde a fundação do campo psiquiátrico. O desenvolvimento das neurociências proporcionou novo fôlego à expectativa de encontrar estritamente no funcionamento biológico a explicação para o surgimento dos transtornos mentais. No entanto, tal objetivo não vem sendo alcançado com a esperada facilidade, de modo que novas hipóteses começam a se destacar nas pesquisas neurocientíficas. Neste artigo, identificamos as noções de epigenética, neurodesenvolvimento e plasticidade como os principais indicativos de um novo modo de compreender a biologia dos fenômenos mentais. A complexidade genética, o papel formativo do ambiente e as variações que caracterizam a vulnerabilidade implicam importantes modificações nas principais teses sobre a determinação biológica dos transtornos mentais, sugerindo uma reconfiguração dos limites entre o "social" e o "biológico" nas pesquisas em neurociências.

Resumen: La comprensión de los procesos de formación de los trastornos mentales ha representado un desafio desde que nació el campo de la psiquiatria. El desarrollo de las neurociencias proporcionó un nuevo aliento a la expectativa de encontrar, estrictamente en el funcionamiento biológico, la explicación para el surgimiento de los trastornos mentales. No obstante, tal objetivo no se alcanza con la esperada facilidad, de modo que nuevas hipótesis comienzan a destacarse en las investigaciones neurocientíficas. En este artículo, identificamos las nociones de epigenética, neurodesarrollo y plasticidad como los principales indicativos de un nuevo modo de comprender la biología de los fenómenos mentales. La complejidad genética, el papel formativo del ambiente y las variaciones que caracterizan la vulnerabilidad implican importantes modificaciones en las principales tesis sobre la determinación biológica de los trastornos mentales, sugiriendo una reconfiguración de los límites entre lo "social" y lo "biológico" en las investigaciones en neurociencias.

Abstract: Understanding the processes involved in the development of mental disorders has proven challenging ever since psychiatry was founded as a field. Neuroscience has provided new expectations that an explanation will be found for the development of mental disorders based on biological functioning alone. However, such a goal has not been that easy to achieve, and new hypotheses have begun to appear in neuroscience research. In this article we identify epigenetics, neurodevelopment, and plasticity as the principal avenues for a new understanding of the biology of mental phenomena. Genetic complexity, the environment's formative role, and variations in vulnerability involve important changes in the principal hypotheses on biological determination of mental disorders, suggesting a reconfiguration of the limits between the "social" and the "biological" in neuroscience research.

Heranças psíquicas geracionais e a conjugalidade contemporânea: uma revisão sistemática / Generational psychic heritage and contemporary conjugal: a systematic review

Este artigo tem como objetivo apresentar uma revisão sistemática da literatura relacionada às heranças psíquicas geracionais interpostas na escolha e manutenção das relações conjugais na contemporaneidade. Foram consultadas as bases de dados Scielo, Lilacs, Pepsic, Schoolar Google e CAPES, entre o período de 2000 a 2014, utilizando-se dos seguintes descritores: vínculo conjugal, transgeracionalidade, transmissão psíquica e relação conjugal. A análise de dados foi realizada a partir da elaboração de categorias temáticas metodológicas e semânticas. Os resultados evidenciaram o predomínio de estudos qualitativos e transversais dentro da temática. No que tange aos principais achados semânticos, observou-se as distintas perspectivas de homens e mulheres no que se refere ao casamento, uma vez que as heranças psíquicas geracionais, sobretudo as transgeracionais, interferem na composição do vínculo conjugal, bem como dificultam o estabelecimento de uma identidade matrimonial e familiar própria.(AU)

This article presents analyzes the scientific production of scientific papers on the phenomenon of psychic inheritance generational filed in choosing and maintaining the marital relationship nowadays. We conducted a literature review in databases Scielo, Lilacs, Pepsic, Google Scholar and CAPES, between the period 2000 to 2015. The keywords used were "marital relationship" and "transgenerationality" and "psychic transmission" and "marital relationship ". For data analysis, drafted up methodological and semantic themes. The results showed the predominance of qualitative and cross-sectional studies in the subject. With respect to the main semantic findings, there was the distinct perspectives of men and women with regard to marriage, since the generational psychic inheritance, especially transgenerational interfere in the composition of the marital bond and hinder the establishment of his own marriage and family identity.(AU)

Cognitive and behavioral heterogeneity in genetic syndromes / Heterogeneidade cognitiva e comportamental em síndromes genéticas

OBJECTIVE: this study aimed to investigate the cognitive and behavioral profiles, as well as the psychiatric symptoms and disorders in children with three different genetic syndromes with similar sociocultural and socioeconomic backgrounds. METHODS: thirty-four children aged 6 to 16 years, with Williams-Beuren syndrome (n = 10), Prader-Willi syndrome (n = 11), and Fragile X syndrome (n = 13) from the outpatient clinics of Child Psychiatry and Medical Genetics Department were cognitively assessed through the Wechsler Intelligence Scale for Children (WISC-III). Afterwards, a full-scale intelligence quotient (IQ), verbal IQ, performance IQ, standard subtest scores, as well as frequency of psychiatric symptoms and disorders were compared among the three syndromes. RESULTS: significant differences were found among the syndromes concerning verbal IQ and verbal and performance subtests. Post-hoc analysis demonstrated that vocabulary and comprehension subtest scores were significantly higher in Williams-Beuren syndrome in comparison with Prader-Willi and Fragile X syndromes, and block design and object assembly scores were significantly higher in Prader-Willi syndrome compared with Williams-Beuren and Fragile X syndromes. Additionally, there were significant differences between the syndromes concerning behavioral features and psychiatric symptoms. The Prader-Willi syndrome group presented a higher frequency of hyperphagia and self-injurious behaviors. The Fragile X syndrome group showed a higher frequency of social interaction deficits; such difference nearly reached statistical significance. CONCLUSION: the three genetic syndromes exhibited distinctive cognitive, behavioral, and psychiatric patterns. .

OBJETIVO: investigar o perfil cognitivo e comportamental, sintomas e transtornos psiquiátricos em crianças com três diferentes síndromes genéticas, com antecedentes socioculturais e socioeconômicos semelhantes. MÉTODOS: trinta e quatro crianças, entre 6 e 16 anos, com as síndromes de Williams-Beuren (n = 10), de Prader-Willi (n = 11) e do X-Frágil (n = 13), dos ambulatórios de Psiquiatria Infantil e Genética Médica, foram avaliadas cognitivamente pela Escala Wechsler de Inteligência para Crianças (WISC-III). Posteriormente, o QI total, o QI Verbal, o QI de Execução, os escores ponderados dos subtestes e a frequência de sintomas e transtornos psiquiátricos foram comparados entre as síndromes. RESULTADOS: diferenças significativas foram encontradas entre as síndromes quanto ao QI Verbal e os subtestes verbais e de execução. A análise Post-hoc demonstrou que os escores dos subtestes vocabulário e compreensão foram significativamente superiores na síndrome de Williams-Beuren em relação às síndromes de Prader-Willi e do X-Frágil, e os escores dos subtestes cubos e armar objetos foram significativamente superiores na síndrome de Prader-Willi em relação às síndromes de Williams-Beuren e do X-Frágil. Além disso, houve diferença significativa entre as síndromes quanto às características comportamentais e os sintomas psiquiátricos. O grupo com síndrome de Prader-Willi apresentou maior frequência de hiperfagia e comportamentos autolesivos. Já o grupo com síndrome do X-Frágil apresentou maior frequência do déficit da interação social. Esta diferença quase alcançou a significância estatística. CONCLUSÃO: as três síndromes genéticas ...

Genética além dos rótulos / Genetics beyond labels

A genética, ao longo de sua história, foi frequentemente vinculada a conceitos de imutabilidade e determinismo. Entretanto, o pertinente reconhecimento das interações complexas entre genes e ambiente apresenta-se como fundamental para o desenvolvimento de uma concepção não determinista do comportamento e dos transtornos mentais. Para contextualizar a visão sobre a genética psiquiátrica na área da saúde mental, discutimos, a partir de recortes históricos, o uso dessa ciência como justificativa para ações fora dos limites éticos. Além disso, trabalhamos a concepção da genética além dos rótulos, apresentando a questão da causa em transtornos mentais com uma abordagem centrada na interação gene x ambiente. Essa concepção está ligada à ideia de complexidade e heterogeneidade em oposição ao reducionismo determinista. Por fim, propomos uma abordagem integrada, apontando a necessidade de novos modelos que levem em consideração o caráter multifatorial dos transtornos mentais. Esses modelos podem não apenas auxiliar no entendimento das doenças, mas também no desenvolvimento de estratégias de prevenção e tratamento que minimizem o sofrimento advindo desses transtornos.(AU)

Genetics has been frequently linked to concepts of immutability and determinism throughout its history. However, the necessary acknowledgement of complex interactions between genes and environment is essential for the development of a non-determinist conception of behavior and mental disorders. In order to contextualize the scope of psychiatric genetics in the field of mental health, the way genetics was used as justification to unethical attitudes was discussed through a historical perspective. Besides that, we attempted to conceptualize genetics beyond labels, presenting the issue of cause in mental disorders through an approach centered in the gene vs. environment interaction. This conception is linked to the idea of complexity and heterogeneity as opposed to determinist reductionism. As a conclusion, we suggest an integrated approach pointing to the need of new models that consider the multifactorial character of mental disorders. Furthermore, these models can not only help in the understanding of diseases, but also in the development of prevention and treatments strategies that could minimize the suffering brought by these disorders.(AU)

Genomic characterization of some Iranian children with idiopathic mental retardation using array comparative genomic hybridization.

BACKGROUND: Mental retardation (MR) has a prevalence of 1‑3% and genetic causes are present in more than 50% of patients. Chromosomal abnormalities are one of the most common genetic causes of MR and are responsible for 4‑28% of mental retardation. However, the smallest loss or gain of material visible by standard cytogenetic is about 4 Mb and for smaller abnormalities, molecular cytogenetic techniques such as array comparative genomic hybridization (array CGH) should be used. It has been shown that 15‑25% of idiopathic MR (IMR) has submicroscopic rearrangements detectable by array CGH. In this project, the genomic abnormalities were investigated in 32 MR patients using this technique. MATERIALS AND METHODS: Patients with IMR with dysmorphism were investigated in this study. Karyotype analysis, fragile X and metabolic tests were first carried out on the patients. The copy number variation was then assessed in a total of 32 patients with normal results for the mentioned tests using whole genome oligo array CGH. Multiple ligation probe amplification was carried out as a confirmation test. RESULTS: In total, 19% of the patients showed genomic abnormalities. This is reduced to 12.5% once the two patients with abnormal karyotypes (upon re‑evaluation) are removed. CONCLUSION: The array CGH technique increased the detection rate of genomic imbalances in our patients by 12.5%. It is an accurate and reliable method for the determination of genomic imbalances in patients with IMR and dysmorphism.

Epigenetics in the nervous system: An overview of its essential role.

The role that epigenetic mechanisms play in phenomena such as cellular differentiation during embryonic development, X chromosome inactivation, and cancers is well‑characterized. Epigenetic mechanisms have been implicated to be the mediators of several functions in the nervous system such as in neuronal‑glial differentiation, adult neurogenesis, the modulation of neural behavior and neural plasticity, and also in higher brain functions like cognition and memory. Its particular role in explaining the importance of early life/ social experiences on adult behavioral patterns has caught the attention of scientists and has spawned the exciting new field of behavioral epigenetics which may hold the key to explaining many complex behavioral paradigms. Epigenetic deregulation is known to be central in the etiology of several neuropsychiatric disorders which underscore the importance of understanding these mechanisms more thoroughly to elucidate novel and effective therapeutic approaches. In this review we present an overview of the findings which point to the essential role played by epigenetics in the vertebrate nervous system.

A critical overview of animal models of psychiatric disorders: challenges and perspectives

Animal models of psychiatric disorders are a challenging but highly relevant issue. Most psychiatric disorders are very heterogeneous syndromes, resulting from multiple and varied causal factors and characterized by symptoms that can only be inferred with significant limitations in non-human models. As constructing a model that reproduces a whole psychiatric syndrome seems virtually impossible, researchers have tried to focus on endophenotypes, i.e., discrete traits that are more proximal to predisposing genes than the whole syndrome. These can be explored in a wide range of approaches, such as in pharmacological, lesion, and environmental models. Another challenge is to understand how genes interact with environmental factors over time to result in the syndromic phenotype. A better understanding of the subcellular mechanisms that enhance or allow brain resistance to environmental influences is required, as is a global thesis compatible with the diversity of diseases sharing similar behavioral and biological traits. With an experimental inventory of the possible causes of minor developmental failures, we may systematically explore their consequences in the adult animal and be able to decide if this will enlighten the understanding of one or another psychiatric disease.

Molecular medicine: a path towards a personalized medicine / Medicina molecular: um passo em direção à medicina personalizada

Psychiatric disorders are among the most common human illnesses; still, the molecular and cellular mechanisms underlying their complex pathophysiology remain to be fully elucidated. Over the past 10 years, our group has been investigating the molecular abnormalities in major signaling pathways involved in psychiatric disorders. Recent evidences obtained by the Instituto Nacional de Ciência e Tecnologia de Medicina Molecular (National Institute of Science and Technology - Molecular Medicine, INCT-MM) and others using behavioral analysis of animal models provided valuable insights into the underlying molecular alterations responsible for many complex neuropsychiatric disorders, suggesting that "defects" in critical intracellular signaling pathways have an important role in regulating neurodevelopment, as well as in pathophysiology and treatment efficacy. Resources from the INCT have allowed us to start doing research in the field of molecular imaging. Molecular imaging is a research discipline that visualizes, characterizes, and quantifies the biologic processes taking place at cellular and molecular levels in humans and other living systems through the results of image within the reality of the physiological environment. In order to recognize targets, molecular imaging applies specific instruments (e.g., PET) that enable visualization and quantification in space and in real-time of signals from molecular imaging agents. The objective of molecular medicine is to individualize treatment and improve patient care. Thus, molecular imaging is an additional tool to achieve our ultimate goal.

Os transtornos psiquiátricos estão entre as doenças humanas mais comuns. Os mecanismos celulares e moleculares subjacentes à sua complexa fisiopatologia ainda não estão totalmente esclarecidos. Nosso grupo está envolvido na investigação de anormalidades moleculares nas principais vias de sinalização das doenças psiquiátricas nos últimos 10 anos. Evidências recentemente obtidas pelo Instituto Nacional de Ciência e Tecnologia de Medicina Molecular (INCT-MM), utilizando análise comportamental de modelos animais, forneceram informações valiosas sobre as alterações moleculares subjacentes responsáveis por muitos distúrbios neuropsiquiátricos complexos, sugerindo que os "defeitos" nas vias de sinalização intracelular têm um papel importante na regulação do neurodesenvolvimento, bem como na fisiopatologia e eficácia do tratamento. Recursos do INCT nos permitiram iniciar pesquisas na área de imagem molecular. A imagem molecular é uma disciplina de investigação que visualiza, caracteriza e quantifica processos biológicos que ocorrem em níveis celular e molecular em seres humanos, e em outros sistemas vivos, através dos resultados de imagem dentro da realidade do ambiente fisiológico. A fim de reconhecer alvos, a imagem molecular aplica instrumentos específicos (PET, por exemplo) que permitem a visualização e quantificação em espaço e tempo real dos sinais dos agentes de imagem molecular, fornecendo medições de processos a nível molecular e celular. O objetivo da medicina molecular é individualizar o tratamento e melhorar a assistência ao paciente. Desse modo, a imagem molecular consiste em mais uma ferramenta para atingirmos nosso objetivo final.

Instruction in developmental psychiatry: preliminary findings at the undergraduate level in Brazil / Educação em psiquiatria do desenvolvimento: resultados preliminares em estudantes de graduação no Brasil

BACKGROUND: Although knowledge on developmental psychiatry is fundamental for the early recognition, treatment, and prevention of mental disorders, this subject has not been incorporated into the medical curriculum or psychiatric practice in Brazil. OBJECTIVE: To evaluate the effect of a short course on developmental psychiatry for undergraduate students and to expand education policies concerning developmental psychiatry in Brazil. METHODS: Before and after attending an extracurricular 12-hour, 4-day course on the fundamentals of developmental psychiatry, undergraduate health sciences students were tested regarding their knowledge of the subject. The pre-test/post-test included 12 randomly selected multiple-choice questions designed to evaluate knowledge related to developmental psychiatry and was administered together with a questionnaire designed to evaluate students' attitudes. To compare performances between groups, nonparametric analyses of ordinal categorical data were employed. RESULTS: The final sample comprised 43 students. The mean post-test score was significantly higher than the mean pre-test score (65.0 percent vs 39.9 percent; p < 0.0001). We found that strongly positive attitudes correlated with better performance. The 3rd and 4th year medical students performed better than the 1st and 2nd year medical students and the non-medical students. Sex differences favoring males were also observed. CONCLUSION: Our findings encourage additional educational policies related to developmental psychiatry which may result in direct clinical implications.

CONTEXTO: Apesar de vital para o reconhecimento precoce, tratamento e prevenção de transtornos mentais, a psiquiatria do desenvolvimento ainda não foi incorporada à grade curricular ou prática psiquiátrica no Brasil. OBJETIVO: Avaliar o impacto de um curso extracurricular em psiquiatria do desenvolvimento na graduação e a viabilidade de expansão de políticas de ensino em psiquiatria do desenvolvimento no Brasil. MÉTODO: Antes e após assistirem um curso de 12 horas durante 4 dias sobre fundamentos da psiquiatria do desenvolvimento, estudantes de graduação em saúde responderam um questionário composto por 12 questões de múltipla escolha randomizadas para avaliação de retenção do conhecimento e questões destinadas à avaliação de atitudes. A análise estatística incluiu testes não-paramétricos de variáveis categóricas ordinais. RESULTADOS: Em uma amostra final composta por 43 estudantes, verificou-se um desempenho significativamente superior no pós-teste (65.0 por cento vs. 39.9 por cento; p < 0.0001). Atitudes positivas em relação ao curso relacionaram-se a um melhor desempenho. Estudantes dos 3º e 4º anos de medicina apresentaram resultados superiores quando comparados aos do 1º e 2º anos de medicina e aos estudantes de outras áreas da saúde. Constatou-se melhor desempenho no sexo masculino. CONCLUSÃO: Este estudo encoraja políticas de ensino em psiquiatria do desenvolvimento que poderão ter implicações clínicas diretas.