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1.
J. Health Biol. Sci. (Online) ; 11(1): 1-9, Jan. 2023. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1524426

ABSTRACT

Objetivo: caracterizar o perfil clínico e epidemiológico dos usuários com demanda em saúde mental, assistidos em uma Unidade Saúde da Família no município de Rondonópolis, MT. Métodos: trata-se de um estudo transversal e descritivo, realizado por meio da análise documental de dados secundários presentes em um banco de dados já existente de usuários desta Unidade de Saúde da Família. Resultados: foram analisados 224 prontuários, dos quais 73% pertenciam a pacientes do sexo feminino. Em ambos os sexos, os diagnósticos mais prevalentes foram transtorno depressivo maior (40,6%), transtorno de ansiedade generalizada (38,4%) e transtorno do sono (33,5%). Conclusões: mediante a caracterização clínica e epidemiológica dos usuários com demanda em saúde mental, há a necessidade de planejar intervenções em saúde voltadas para a realidade local a fim de minimizar o sofrimento da população adscrita.


Objective: to characterize the clinical and epidemiological profile of users with mental health needs assisted in a Family Health Strategy in the city of Rondonópolis, MT. Methods: observational, descriptive, cross-sectional, and quantitative epidemiological study based on document analysis of secondary data present in an existing database of users of the Family Health Strategy. Results: 224 medical records were analyzed, of which 73% belong to female patients. In both sexes, the most prevalent diagnoses were Major Depressive Disorder (40.6%), Generalized Anxiety Disorder (38.4%), and Sleep Disorder (33.5%). Conclusions: the clinical and epidemiological characterization of users with mental health needs contributes to the planning of health interventions focused on this theme


Subject(s)
Humans , Male , Female , Primary Health Care , Psychotropic Drugs , Cross-Sectional Studies , Depressive Disorder , Mental Disorders
2.
Psicol. ciênc. prof ; 43: e262380, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1529226

ABSTRACT

Este artigo apresenta como principal objeto de estudo a falsa acusação de abuso sexual no contexto da alienação parental para, diante dela, estabelecer a seguinte problemática: será possível propor uma eventual correlação entre si e os processos psíquicos do luto e da melancolia? Neste sentido, a partir do recurso teórico ao referencial psicanalítico de Freud e de Laplanche, debate as circunstâncias que norteiam o discurso levado ao Judiciário pelo genitor alienante valorizando em tal movimento não apenas a realidade material da prova, tão importante no campo jurídico, mas também a realidade psíquica ditada pelo inconsciente, a qual se pauta em uma noção de verdade que, na sua vinculação direta com a particularidade de cada sujeito e com o dinamismo das relações específicas que ele estabelece consigo mesmo e com os outros, coloca em xeque as certezas positivistas da norma. Em termos conclusivos, destaca o quanto, a despeito da atual literatura existente sobre alienação parental no Brasil a correlacionar, em regra, a um luto mal elaborado por parte do alienante, é possível e mesmo desejável cogitar também a presença da melancolia - ou, mais especificamente, de traços melancólicos intermediários - na formação e desenvolvimento desse fenômeno.(AU)


This article presents as the main object of study the false accusation of sexual abuse in the context of parental alienation, to establish the following problem: would it be possible to propose a probable correlation between parental alienation and the psychic processes of mourning and melancholia? In this sense, based on the psychoanalytic theoretical framework of Freud and Laplanche, the article discusses the circumstances that guide the discourse taken to the judiciary branch by the alienating parent, valuing in such action not only the material reality of the evidence, which is very important in the legal field, but also the psychic reality dictated by the unconscious, which is guided by a notion of truth that, in its direct connection with the particularity of each subject and with the dynamism of the specific relations that they establish with themselves and others, threatens the positivist certainties of the norm. In conclusive terms, it highlights how, despite the current existing literature on parental alienation in Brazil generally correlates it to a poorly elaborated mourning by the alienating person, it is possible and even desirable to also consider the presence of melancholia-or, more specifically, of intermediate melancholic traits-in the formation and development of this phenomenon.(AU)


Este artículo presenta como principal objeto de estudio la falsa acusación de abuso sexual en el contexto de alienación parental, con el fin de responder al siguiente planteamiento: ¿Es posible proponer una posible correlación entre la alienación parental y los procesos psíquicos de duelo y melancolía? Para ello, desde el marco psicoanalítico de Freud y de Laplanche, se discuten las circunstancias del discurso llevado al Poder Judicial por el padre alienante, que valora en tal movimiento no solo la realidad material de la prueba, tan importante en el campo jurídico, sino también la realidad psíquica dictada por el inconsciente, el cual se guía por una noción de verdad que, en su conexión directa con la particularidad de cada sujeto y con el dinamismo de las relaciones específicas que establece consigo mismo y con otros, pone en jaque las certezas positivistas de la norma. En la conclusión, destaca cómo, a pesar de la literatura actual existente sobre la alienación parental en Brasil, en general, la correlaciona con un duelo mal diseñado por parte de la persona alienante, es posible e incluso deseable considerar la presencia de la melancolía -más específicamente, de rasgos melancólicos intermediarios- en la formación y desarrollo de este fenómeno.(AU)


Subject(s)
Humans , Male , Female , Sex Offenses , Social Alienation , Bereavement , False Representation , Depressive Disorder , Deception , Parent-Child Relations , Paternal Behavior , Paternal Deprivation , Pedophilia , Psychology , Psychology, Social , Public Policy , Rape , Rejection, Psychology , Repression, Psychology , Repression-Sensitization , Scapegoating , Self-Assessment , Self Concept , Shame , Social Justice , Social Sciences , Spouse Abuse , Suicide , Therapeutics , Unconscious, Psychology , Child Abuse, Sexual , Child Custody , Divorce , Family , Marriage , Child , Child, Abandoned , Child Advocacy , Child Care , Child Rearing , Child Welfare , Mental Health , Risk Factors , Adolescent , Parenting , Codependency, Psychological , Marital Status , Domestic Violence , Sexuality , Crime , Disasters Consequence Analysis , Surveillance in Disasters , Textbook , Defense Mechanisms , Whistleblowing , Trust , Aggression , Dependency, Psychological , Reproductive Rights , Diagnosis , Double Bind Interaction , Emotions , Ethics , Expert Testimony , Family Conflict , Family Relations , Fear , Apathy , Defamation , Physical Abuse , Fraud , Freedom , Freudian Theory , Forensic Psychology , Frustration , Disgust , Sadness , Respect , Psychological Distress , Betrayal , Emotional Abuse , Citizenship , Guilt , Hate , Hostility , Human Rights , Judgment , Jurisprudence , Love , Malpractice , Morale , Mothers , Narcissism , Object Attachment
3.
Psicol. ciênc. prof ; 43: e244244, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1448957

ABSTRACT

Com os avanços tecnológicos e o aprimoramento da prática médica via ultrassonografia, já é possível detectar possíveis problemas no feto desde a gestação. O objetivo deste estudo foi analisar a prática do psicólogo no contexto de gestações que envolvem riscos fetais. Trata-se de um estudo qualitativo sob formato de relato de experiência como psicólogo residente no Serviço de Medicina Fetal da Maternidade Escola da Universidade Federal do Rio de Janeiro (UFRJ). Os registros, feitos por observação participante e diário de campo, foram analisados em dois eixos temáticos: 1) intervenções psicológicas no trabalho em equipe em consulta de pré-natal, exame de ultrassonografia e procedimento de amniocentese; e 2) intervenções psicológicas em casos de bebês incompatíveis com a vida. Os resultados indicaram que o psicólogo nesse serviço é essencial para atuar de forma multiprofissional na assistência pré-natal para gravidezes de alto risco fetal. Ademais, a preceptoria do residente é relevante para sua formação e treinamento para atuação profissional no campo da psicologia perinatal.(AU)


Face to the technological advances and the improvement of medical practice via ultrasound, it is already possible to detect possible problems in the fetus since pregnancy. The objective of this study was to analyze the psychologist's practice in the context of pregnancies which involve fetal risks. It is a qualitative study based on an experience report as a psychologist trainee at the Fetal Medicine Service of the Maternity School of UFRJ. The records, based on the participant observation and field diary, were analyzed in two thematic axes: 1) psychological interventions in the teamwork in the prenatal attendance, ultrasound examination and amniocentesis procedure; and 2) psychological interventions in cases of babies incompatible to the life. The results indicated that the psychologist in this service is essential to work in a multidisciplinary way at the prenatal care for high fetal risk pregnancies. Furthermore, the resident's preceptorship is relevant to their education and training for professional performance in the field of Perinatal Psychology.(AU)


Con los avances tecnológicos y la mejora de la práctica médica a través de la ecografía, ya se puede detectar posibles problemas en el feto desde el embarazo. El objetivo de este estudio fue analizar la práctica del psicólogo en el contexto de embarazos de riesgos fetal. Es un estudio cualitativo basado en un relato de experiencia como residente de psicología en el Servicio de Medicina Fetal de la Escuela de Maternidad de la Universidade Federal do Rio de Janeiro (UFRJ). Los registros, realizados en la observación participante y el diario de campo, se analizaron en dos ejes temáticos: 1) intervenciones psicológicas en el trabajo en equipo, en la consulta prenatal, ecografía y los procedimientos de amniocentesis; y 2) intervenciones psicológicas en casos de bebés incompatibles con la vida. Los resultados señalaron como fundamental la presencia del psicólogo en este servicio trabajando de forma multidisciplinar en la atención prenatal en el contexto de embarazos de alto riesgo fetal. Además, la tutela del residente es relevante para su educación y formación para el desempeño profesional en el campo de la Psicología Perinatal.(AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Pregnancy, High-Risk , Psychosocial Intervention , Heart Defects, Congenital , Anxiety , Orientation , Pain , Parent-Child Relations , Parents , Paternity , Patient Care Team , Patients , Pediatrics , Placenta , Placentation , Pregnancy Complications , Pregnancy Maintenance , Prognosis , Psychoanalytic Theory , Psychology , Puerperal Disorders , Quality of Life , Radiation , Religion , Reproduction , Reproductive and Urinary Physiological Phenomena , General Surgery , Syndrome , Congenital Abnormalities , Temperance , Therapeutics , Urogenital System , Bioethics , Physicians' Offices , Infant, Premature , Labor, Obstetric , Pregnancy , Pregnancy, Animal , Pregnancy Outcome , Adaptation, Psychological , Pharmaceutical Preparations , Echocardiography , Magnetic Resonance Spectroscopy , Family , Abortion, Spontaneous , Child Rearing , Child Welfare , Mental Health , Family Health , Survival Rate , Life Expectancy , Cause of Death , Ultrasonography, Prenatal , Chromosome Mapping , Parental Leave , Mental Competency , Polycystic Kidney, Autosomal Recessive , Down Syndrome , Perinatal Care , Comprehensive Health Care , Chemical Compounds , Depression, Postpartum , Neurobehavioral Manifestations , Disabled Children , Diagnostic Techniques and Procedures , Gravidity , Crisis Intervention , Affect , Cytogenetic Analysis , Spirituality , Complicity , Value of Life , Humanizing Delivery , Death , Decision Making , Defense Mechanisms , Abortion, Threatened , Delivery of Health Care , Dementia , Uncertainty , Organogenesis , Qualitative Research , Pregnant Women , Early Diagnosis , Premature Birth , Nuchal Translucency Measurement , Child Mortality , Depression , Depressive Disorder , Postpartum Period , Diagnosis , Diagnostic Techniques, Obstetrical and Gynecological , Ethanol , Ego , Emotions , Empathy , Environment , Humanization of Assistance , User Embracement , Ethics, Professional , Cell Nucleus Shape , Prenatal Nutrition , Cervical Length Measurement , Family Conflict , Family Therapy , Resilience, Psychological , Reproductive Physiological Phenomena , Female Urogenital Diseases and Pregnancy Complications , Gestational Sac , Brief, Resolved, Unexplained Event , Fetal Death , Embryonic and Fetal Development , Multimodal Imaging , Mortality, Premature , Clinical Decision-Making , Pediatric Emergency Medicine , Child, Foster , Freedom , Burnout, Psychological , Birth Setting , Frustration , Sadness , Respect , Psychological Distress , Genetics , Psychological Well-Being , Obstetricians , Guilt , Happiness , Health Occupations , Hospitalization , Hospitals, Maternity , Hospitals, University , Human Development , Human Rights , Imagination , Infections , Infertility , Anencephaly , Jurisprudence , Obstetric Labor Complications , Licensure , Life Change Events , Life Support Care , Loneliness , Love , Medical Staff, Hospital , Intellectual Disability , Morals , Mothers , Narcissism , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Neonatology , Nervous System Malformations , Object Attachment
4.
Psicol. ciênc. prof ; 43: e247962, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1422424

ABSTRACT

Resumo Conceitos como o de alteridade, encontro de saberes, polifasia cognitiva, o princípio de familiaridade e de representações sociais operaram na complexa tarefa de compreender como os encontros entre profissionais e usuários sustentavam e/ou transformavam as práticas de acolhimento. Entretanto, a experiência da minha pesquisa de doutorado me levou a questionar os próprios conceitos utilizados da Teoria das Representações Sociais. Ao final do ensaio, após discutir aspectos teórico-metodológicos, o princípio de familiaridade e a questão da tensão e dos afetos nas representações sociais, espero evidenciar como o movimento provocado pelo encontro com usuários e profissionais de uma Rede de Atenção Psicossocial levou-me a questionar pontos essenciais da teoria: o papel domesticador das representações, a forma ainda estática de evidenciar os fenômenos, a separação entre um sujeito que representa e o objeto representado e a dificuldade em usar suas ferramentas conceituais para acompanhar processos me fazem repensar meu lugar e minha função de pesquisador.


Abstract Concepts such as alterity, encounter of knowledge, cognitive polyphasia, the principle of familiarity and the very concept of social representations operated in the complex task of understanding how the encounters between professionals and users supported and / or transformed user embracement practices. However, the experience of my doctoral research led me to question the very concepts used in the Theory of Social Representations. At the end of the essay, after discussing theoretical and methodological aspects, the principle of familiarity and the issue of tension and affects in social representations, I hope to show how the movement caused by the encounter with users and professionals of a Psychosocial Care Network, led me to question essential points of the theory: the domesticating role of representations, the still static way of showing phenomena, the separation between a subject that represents and the object represented and the difficulty in using their conceptual tools to accompany processes makes me rethink my place and role as a researcher.


Resumen Conceptos como la alteridad, el encuentro de saberes, la polifasia cognitiva, el principio de familiaridad y el concepto mismo de representaciones sociales operaron en la compleja tarea de comprender cómo los encuentros entre profesionales y usuarios apoyaron y / o transformaron las prácticas de acogimiento. Sin embargo, la experiencia de mi investigación doctoral me llevó a cuestionar los propios conceptos utilizados en la Teoría de las Representaciones Sociales. Al final del ensayo, después de discutir aspectos teóricos y metodológicos, el principio de familiaridad y el tema de tensión y afectos en las representaciones sociales, Espero mostrar cómo el movimiento provocado por el encuentro con usuarios y profesionales de una Red de Atención Psicosocial, me llevó a cuestionar puntos esenciales de la teoría: el rol domesticador de las representaciones, la forma todavía estática de mostrar los fenómenos, la separación entre un sujeto que representa y el objeto representado y la dificultad para utilizar sus herramientas conceptuales para acompañar procesos, me hace repensar mi lugar y rol como investigador.


Subject(s)
Humans , Psychology, Social , Qualitative Research , Social Representation , Pain , Politics , Prejudice , Psychiatry , Psychology , Public Policy , Rehabilitation , Sex Offenses , Social Isolation , Social Support , Socioeconomic Factors , Sociology , Stress Disorders, Post-Traumatic , Substance Withdrawal Syndrome , Pathological Conditions, Signs and Symptoms , Thinking , Unemployment , Health Surveillance , Ill-Housed Persons , Family , Illicit Drugs , Hygiene , Mental Health , Crack Cocaine , Life , Substance-Related Disorders , Affective Symptoms , State , Aggression , Depressive Disorder , Economics , Empathy , Methodology as a Subject , User Embracement , Ethics , Mental Fatigue , Drug Users , Drug Overdose , Compassion Fatigue , Emotional Adjustment , Pessimism , Psychological Trauma , Psychiatric Rehabilitation , Occupational Stress , Incivility , Survivorship , Worldview , Freedom , Self-Neglect , Solidarity , Psychological Distress , Food Insecurity , Home Environment , Social Vulnerability , Homicide , Hospitals, Psychiatric , Intelligence , Life Change Events , Loneliness , Mental Disorders
5.
Chinese Acupuncture & Moxibustion ; (12): 405-408, 2023.
Article in Chinese | WPRIM | ID: wpr-980736

ABSTRACT

Professor HAN Wei 's clinical experience of acupuncture and moxibustion with Tongyang Xingshen (promoting yang and regaining consciousness) for adolescent depressive disorder is introduced. It is believed that the internal causes of adolescent depressive disorder are mostly emotional and physical factors, while the external causes are mainly social factors, and yang-qi stagnation and emotional disorder are the key pathogenesis. The key of acupuncture and moxibustion with Tongyang Xingshen is warming and regulating the governor vessel. The governor vessel acupoints at head, neck and back are selected. At head, Baihui (GV 20) and Yintang (GV 24+) are selected; at neck, Fengfu (GV 16) and Dazhui (GV 14) are selected; at back, Taodao (GV 13), Shenzhu (GV 12), Shendao (GV 11), Zhiyang (GV 9) and Jinsuo (GV 8) are selected. The combination of disease differentiation and syndrome differentiation should be highly valued, and the moxibustion with Tongyang and acupuncture with Xingshen should be used simultaneously, and the strong stimulation is suggested.


Subject(s)
Adolescent , Humans , Moxibustion , Acupuncture Therapy , Acupuncture Points , Physical Examination , Depressive Disorder
6.
Chinese Acupuncture & Moxibustion ; (12): 374-378, 2023.
Article in Chinese | WPRIM | ID: wpr-980731

ABSTRACT

OBJECTIVE@#To observe the impacts of acupuncture on depressive mood and sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia, and explore its effect mechanism.@*METHODS@#A total of 60 patients with comorbid mild-to-moderate depressive disorder and insomnia were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, acupuncture and low frequency repeated transcranial magnetic stimulation (rTMS) were combined for the intervention. Acupuncture was applied to Baihui (GV 20), Yintang (GV 24+), Neiguan (PC 6) and Yanglingquan (GB 34), etc., the needles were retained for 30 min; and the intradermal needles were embedded at Xinshu (BL 15) and Danshu (BL 19) for 2 days. After acupuncture, the rTMS was delivered at the right dorsolateral prefrontal cortex (R-DLPFC), with 1 Hz and 80% of movement threshold, lasting 30 min in each treatment. In the control group, the sham-acupuncture was adopted, combined with low frequency rTMS. The acupoint selection and manipulation were the same as the observation group. In the two groups, acupuncture was given once every two days, 3 times weekly; while, rTMS was operated once daily, for consecutive 5 days a week. The duration of treatment consisted of 4 weeks. Hamilton depression scale-17 (HAMD-17) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment, as well as 1 month after the treatment completion (follow-up period) separately. Besides, the levels of nerve growth factor (BDNF) and γ-aminobutyric acid (GABA) in the serum were detected before and after treatment in the two groups.@*RESULTS@#After treatment and in follow-up, the HAMD-17 scores were lower than those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than the control group (P<0.05). After treatment, the total scores and the scores of each factor of PSQI were reduced in the two groups in comparison with those before treatment except for the score of sleep efficiency in the control group (P<0.05); the total PSQI score and the scores for sleep quality, sleep latency, sleep efficiency and daytime dysfunction in the observation group were all lower than those in the control group (P<0.05). In the follow-up, except for the scores of sleep duration and sleep efficiency in the control group, the total PSQI score and the scores of all the other factors were reduced compared with those before treatment in the two groups (P<0.05); the total PSQI score and the scores of sleep quality, sleep latency, sleep duration, sleep efficiency and daytime dysfunction in the observation group were lower than the control group (P<0.05). After treatment, the levels of serum BDNF and GABA were increased in comparison with those before treatment in the observation group (P<0.05), and the level of serum BDNF was higher than that in the control group (P<0.05).@*CONCLUSION@#Acupuncture relieves depressive mood and improves sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia. The effect mechanism may be related to the regulation of BDNF and GABA levels and the promotion of brain neurological function recovery.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/therapy , Transcranial Magnetic Stimulation , Brain-Derived Neurotrophic Factor , Treatment Outcome , Acupuncture Therapy , Acupuncture Points , gamma-Aminobutyric Acid , Depressive Disorder
7.
Chinese Acupuncture & Moxibustion ; (12): 1169-1172, 2023.
Article in Chinese | WPRIM | ID: wpr-1007461

ABSTRACT

Depressive disorder is manifested as emotional and physical abnormality. Theoretically, the governor vessel is distributed along the spine, related to the brain and communicated with five zang and six fu organs. It is the key meridian for understanding the various symptoms of depressive disorder. Depressive disorder is caused by dysfunction, stagnation or emptiness of the governor vessel, resulting in malnutrition of the brain. In clinical diagnosis and treatment, based on the theory of the governor vessel, the etiology and pathogenesis are analyzed in the patients with depressive disorder. In order to achieve harmonizing mutually the mental and physical conditions, acupuncture is delivered to adjust the spirit and physical state, moving cupping is to regulate the governor vessel, tuina manipulation is to promote meridians and collaterals and physical exercise is to coordinate the body and the spirit.


Subject(s)
Humans , Acupuncture Therapy/methods , Meridians , Acupuncture , Brain , Depressive Disorder , Acupuncture Points
8.
Braz. j. biol ; 83: 1-6, 2023. tab
Article in English | LILACS, VETINDEX | ID: biblio-1468878

ABSTRACT

Desvenlafaxine succinate (DVS) inhibits serotonin reuptake selectively and is approved for major depressive disorders. This research investigated influence of DVS on modulating brain monoamine and oxidative stress in mice. The antiepileptic potential of DVS (10, 20, or 30 mg/kg/i.p.) in pentylenetetrazole (PTZ; 85 mg/kg) with i.p. route of administration, strychnine (STR; 75 mg/kg) with i.p. route, pilocarpine (400 mg/kg) with s.c. route and maximal electroshock MES-induced convulsion in mouse models. The activities of oxidative stress, i.e. superoxide dismutase (SOD), glutathione (GSH) and lipid peroxidation (LPO) as well as gamma-aminobutyric acid (GABA) in the brains of PTZ-induced convulsive mice. Treatment with DVS increased the latency to develop siezures and declined mortalities in rodents against PTZ, STR and pilocarpine-induced convulsions. Results of MES-leaded siezures revealed that DVS reduced tonic hind limb extension duration and mortalities significantly. Brain, SOD, GSH and GABA level were significantly (P<0.01) increased and LPO reduced significantly (P<0.01) after DVS treatment. Furthermore, the DVS did not show any motor coordination signs in the rotarod test. We demonstrated that the role of DVS in convulsion genesis in mice under control condition and attenuate the PTZ-induced oxidative damage.


O succinato de desvenlafaxina (DVS) inibe seletivamente a recaptação da serotonina e é aprovado para transtornos depressivos maiores. Esta pesquisa investigou a influência do DVS na modulação da monoamina cerebral e do estresse oxidativo em camundongos. O potencial antiepiléptico de DVS (10, 20 ou 30 mg / kg / i.p.) Em pentilenotetrazole (PTZ; 85 mg / kg) com i.p. via de administração, estricnina (STR; 75 mg / kg) com i.p. via, pilocarpina (400 mg / kg) com s.c. rota e convulsão induzida por MES de eletrochoque máximo em modelos de camundongos. As atividades de estresse oxidativo, ou seja, superóxido dismutase (SOD), glutationa (GSH) e peroxidação lipídica (LPO), bem como ácido gama-aminobutírico (GABA) nos cérebros de camundongos convulsivos induzidos por PTZ. O tratamento com DVS aumentou a latência para desenvolver crises e diminuiu a mortalidade em roedores contra convulsões induzidas por PTZ, STR e pilocarpina. Os resultados de siezures conduzidos por MES revelaram que o DVS reduziu significativamente a duração e a mortalidade da extensão tônica dos membros posteriores. Os níveis de cérebro, SOD, GSH e GABA aumentaram significativamente (P < 0,01) e o LPO reduziu significativamente (P < 0,01) após o tratamento com DVS. Além disso, o DVS não apresentou sinais de coordenação motora no teste do rotarod. Demonstramos o papel do DVS na gênese da convulsão em camundongos sob condição de controle e atenua o dano oxidativo induzido por PTZ.


Subject(s)
Male , Animals , Mice , Anticonvulsants/administration & dosage , Seizures/drug therapy , Oxidative Stress/drug effects , Pentylenetetrazole/adverse effects , Desvenlafaxine Succinate/pharmacology , Depressive Disorder/drug therapy , Mice
9.
São Paulo; s.n; s.n; 2023. 206 p. tab.
Thesis in Portuguese | LILACS | ID: biblio-1437697

ABSTRACT

Diretrizes clínicas (DCs) de alta qualidade são importantes para a assistência efetiva de pacientes com doenças crônicas, incluindo a depressão. A depressão é um dos principais problemas de saúde mundial, sendo um dos transtornos psiquiátricos mais comumente encontrados na prática médica, afetando cerca de 300 milhões de pessoas. Além de sua natureza debilitante e onerosa, muitas vezes pode levar a desfechos graves, tal como o suicídio, principalmente em pacientes que não respondem aos tratamentos. Assim, o objetivo geral desta tese foi identificar fatores das DCs associados à qualidade metodológica desses documentos e de suas recomendações, e comparar as recomendações para duas situações de falhas da farmacoterapia: pacientes não respondedores e pacientes com depressão resistente ao tratamento (DRT). Operacionalmente, foram feitas revisões sistemáticas da literatura em bases científicas e específicas de DCs, e incluídas DCs publicadas nos últimos onze anos que contivessem recomendações para o tratamento farmacológico de adultos com depressão. Para avaliação geral das DCs, foi aplicado o instrumento AGREE II, e para avaliação específica das recomendações, o instrumento AGREE-REX. As DCs foram consideradas de alta qualidade quando pontuaram com escores maiores ou iguais a 60% (no estudo descrito no capítulo 2) e maiores ou iguais a 80% (no estudo descrito no capítulo 3) no domínio 3 (Rigor de desenvolvimento) do AGREE II. As DCs com recomendações de alta qualidade foram as que pontuaram com mais de 60% no domínio 1 (Aplicabilidade Clínica) do AGREE-REX. Das 63 DCs selecionadas, 17 (27%) apresentaram alta qualidade, e 7 (11%) apresentaram recomendações de alta qualidade. Os fatores associados à maior qualidade foram gerenciamento de conflitos de interesses, equipe multiprofissional e tipo de instituição. A inclusão de representante do paciente na equipe também foi associada a recomendações de maior qualidade. Verificou-se que a maioria das DCs concorda com a necessidade de: reavaliar o diagnóstico, a presença de comorbidades, a adesão ao tratamento, ajustar a dosagem do antidepressivo e adicionar psicoterapia como os primeiros passos para aqueles que não respondem ao tratamento antidepressivo de primeira linha. Em relação às recomendações, há falhas importantes, incluindo a não apresentação de definição padronizada de resposta adequada/inadequada/parcial, e o não estabelecimento de tempo de tratamento necessário para declarar DRT. Todas as DCs incluíram a possibilidade de substituição do antidepressivo, potencialização com outros medicamentos e combinação de antidepressivos. Todavia, três DCs não recomendaram uma sequência entre eles. Por fim, verificou-se que das 17 DCs de alta qualidade e das 7 DCs com recomendações de alta qualidade, apenas duas incluíram definição e recomendações para DRT. Não existe consenso entre as DCs de alta qualidade quanto à definição e uso do termo DRT. Não foi possível extrair uma estratégia terapêutica convergente para DRT em adultos. Os resultados obtidos reforçam a necessidade de maior foco no aprimoramento da qualidade das DCs e de suas recomendações, especialmente nos subgrupos relativos à resposta inadequada ao tratamento e a DRT, nas quais as definições não são claras


High-quality clinical practice guidelines (CPGs) are important for treating patients with chronic diseases such as depression. Depression is a major health concern worldwide, affecting approximately 300 million people. It is one of the most prevalent psychiatric disorders in medical practice. It is not only debilitating and costly but can also lead to tragic consequences such as suicide, particularly in patients who do not respond to treatment. The objective of this thesis was to identify CPGs factors associated with the methodological quality of these documents and their recommendations. Furthermore, this thesis aimed to compare the recommendations in two pharmacotherapy failure situations: inadequate response to treatment and treatment-resistant depression (TRD). Systematic literature reviews were conducted on scientific and CPG-specific databases. Reviews were also conducted on CPGs published in the last eleven years that included recommendations for pharmacological treatment of adults with depression. The AGREE II instrument was used for the CPGs general assessment, while the AGREE-REX instrument was used specifically to assess their recommendations. CPGs were considered high quality if they achieved a score of at least 60% in the study mentioned in Chapter 2 and a score of at least 80% in the study mentioned in Chapter 3 in the AGREE II, rigour of development domain. The CPGs with high-quality recommendations were those that scored greater than 60% in Domain 1 (Clinical Applicability) of the AGREE-REX. Of the 63 selected CPGs, 17 (27%) were high quality, and 7 (11.1%) had recommendations of high quality. Factors associated with higher quality were conflict of interest management, multi-professional team, and type of institution. Inclusion of a patients representative on the team was associated with higher quality recommendations. Most CPGs agreed with the need to reassess diagnoses, comorbidities, and treatment adherence. They also agreed on adjusting antidepressant dosage and providing psychotherapy as a first step for patients who do not respond to first-line antidepressant treatment. There are significant shortcomings in the recommendations. In particular, the lack of a standardized definition of adequate, inadequate, or partial response to treatment and the lack of clarity surrounding the duration of treatment required to establish TRD. All CPGs included the possibility of antidepressant substitution, potentiation with other drugs, and a combination of antidepressants. However, three CPGs did not recommend a preferred sequence for these interventions. Finally, of the 17 high-quality CPGs and the 7 CPGs with high-quality recommendations, only two included definition and recommendations for TRD. There is no consensus among the high-quality CPGs regarding the definition and use of the term TRD. Ultimately, finding a convergent therapeutic strategy for TRD in adults was not possible. These results highlighted the need to focus more on improving the quality of CPGs and their recommendations, especially in the subgroups related to inadequate response to treatment and TRD, where definitions are unclear


Subject(s)
Humans , Male , Female , Adult , Patients/classification , Practice Guideline , Depression/drug therapy , Depressive Disorder/diagnosis , Depressive Disorder, Treatment-Resistant/diagnosis , Patient Care Team/ethics , Evidence-Based Medicine/classification , Antidepressive Agents/administration & dosage
10.
Psicol. ciênc. prof ; 43: e261792, 2023. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1529200

ABSTRACT

O objetivo deste estudo foi compreender como mulheres adultas (acima de 30 anos) diagnosticadas com transtornos alimentares (TAs) vivenciam o adoecer. Trata-se de um estudo qualitativo, descritivo e exploratório, desenvolvido com base no referencial teórico-metodológico da Análise Fenomenológica Interpretativa (AFI). Participaram seis mulheres, com idades entre 34 e 65 anos, atendidas em um serviço especializado. Os dados foram coletados por meio de entrevista aberta, de inspiração fenomenológica, na modalidade remota. As entrevistas foram audiogravadas, transcritas e analisadas seguindo os passos da AFI. Duas categorias temáticas foram identificadas: "Vivendo antes do adoecer" e "Encontrando-se doente." Constatou-se que os sintomas tiveram início anteriormente à vida adulta e que houve dificuldade na confirmação do diagnóstico. Na perspectiva das participantes, conviver com a sintomatologia ficou mais complicado em função de particularidades de manejo dos sintomas na vida adulta, e a idade é percebida como um fator que impacta e dificulta ainda mais a recuperação. As participantes relataram desesperança em relação ao futuro, apesar de a maioria reconhecer melhoras no quadro clínico ao longo do tempo e de valorizar a relação de confiança estabelecida com a equipe multiprofissional.(AU)


This study aimed to understand the experience of illness of adult women (over 30 years) diagnosed with eating disorders (ED). This is a qualitative, descriptive, and exploratory study, using Interpretative Phenomenological Analysis (IPA) as theoretical and methodological framework. A sample of six women aged 34-64 years, assisted in a specialized service, were recruited to complete a phenomenological in-depth open interview. The data were remotely collected. Interviews were audio-recorded, transcribed and analyzed following the IPA. Two thematic categories were identified: "Living before the illness" and "Finding about the illness." It was found that the symptoms started before adulthood and that there was difficulty establishing the diagnosis. Living with the symptoms became more complicated due to particularities of symptom management in adulthood and age is perceived as a factor that impacts recovery and makes it even more difficult. The participants reported hopelessness about the future, although most recognized improvements in the clinical condition over time and valued the trusting relationship they established with the multiprofessional team.(AU)


El objetivo de este estudio fue comprender las experiencias de las mujeres adultas (mayores de 30 años) diagnosticadas con trastornos alimentarios (TA) respecto a la enfermedad. Se trata de un estudio cualitativo, descriptivo y exploratorio, desarrollado a partir del marco teórico y metodológico del Análisis Fenomenológico Interpretativo (AFI). Participaron seis mujeres, con edades de entre 34 y 65 años, atendidas en un servicio especializado. Los datos se recogieron mediante entrevistas abiertas, de inspiración fenomenológica, en la modalidad a distancia. Las entrevistas fueron grabadas en audio, transcritas y analizadas siguiendo los pasos del AFI. Se identificaron dos categorías temáticas: "Vivir antes de enfermar" y "Encontrarse enfermo." Se constató que los síntomas comenzaron antes de la edad adulta y que hubo dificultades de establecer el diagnóstico. La convivencia con síntomas se complicó debido a las particularidades del manejo de los síntomas en la vida adulta y la edad se percibe como un factor que influye y dificulta aún más la recuperación. Los participantes manifestaron desesperanza sobre el futuro, aunque reconocieron mejoras en el cuadro clínico con el paso del tiempo y valoraron la relación de confianza establecida con el equipo multiprofesional.(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Anorexia Nervosa , Feeding and Eating Disorders , Bulimia Nervosa , Pandemics , Anxiety , Perceptual Distortion , Appetite , Personal Satisfaction , Psychiatry , Psychology , Psychopathology , Quality of Life , Self-Assessment , Shame , Stomach Diseases , Stress, Psychological , Therapeutics , Thinness , Beauty Culture , Vomiting , Nutrition Rehabilitation , Body Weight , Aging , Menopause , Weight Loss , Family , Comorbidity , Mental Health , Mortality , Interview , Cultural Factors , Dehydration , Transcription Factors, General , Malnutrition , Depressive Disorder , Diagnosis , Diet , Diet Therapy , Emotions , Nutritional Sciences , Laxatives , Feeding Behavior , Binge-Eating Disorder , Bullying , Social Stigma , Physical Appearance, Body , Self-Control , Applied Behavior Analysis , Food Addiction , Rumination, Digestive , Mental Health Recovery , Body-Weight Trajectory , Embarrassment , Avoidant Restrictive Food Intake Disorder , Body-Shaming , Social Representation , Orthorexia Nervosa , Social Status , Guilt , Health Promotion , Mass Media , Mental Disorders , Metabolism , Obesity
11.
Psicol. ciênc. prof ; 43: e264922, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1529231

ABSTRACT

Este artigo propõe o estudo sobre o conceito de outro como semelhante e como objeto. Partindo de textos que interpelam a alteridade na psicanálise e remetendo aos temas do complexo semelhante, da satisfação, da perda, do luto, da negativa, da repetição; avalia o conceito de outro articulando textos de diversos autores. A partir da psicanálise freudiana, estuda o das Ding e a negação, discriminando com estes termos um objeto estruturante na origem do psiquismo. Aborda textos técnicos da psicanálise para delimitar o tema da repetição. Também a recordação e a repetição são vinculadas ao objeto e estudadas na perspectiva da filosofia moderna. São retomados temas do diálogo platônicos para definir o lugar do erótico e da amizade. No fim do presente artigo, propomos o termo clássico grego Oikos com valor equivalente ao da Coisa freudiana e como esta aparece em escritos psicanalíticos.(AU)


This article studies the concept of other as similar and object. It is based on texts that question the alterity in psychoanalysis and refers to the themes of otherness complex, loss, grief, negative, repetition, and evaluates the concept of other, using articles of diverse authors. Based on Freudian psychoanalysis, it studies the Thing and the denial and discriminates a structuring object in the origin of psychism. It approaches technical texts of psychoanalysis to delimitate the theme of repetition. The recordation and repetition are also linked to the object and studied from the perspective of modern philosophy. Themes of the platonic dialogues are resumed to define the place of the erotic and the friendship. In the end of the article, we propose the greek classic term Oikos, with equal value to the Freudian Thing, as this one appears in psychoanalytic writings.(AU)


Este artículo estudia el concepto Otro como semejante y como objeto. A partir de textos que interpelan la alteridad en psicoanálisis y que se refieren a temas del complejo semejante, de la satisfacción, de la pérdida, del duelo, de la negación, de la repetición, se evalúa el concepto de Otro articulando textos de diferentes autores. Basado en el psicoanálisis freudiano, se aborda Ding y la negación, discriminando con estos términos un objeto estructurante en el origen de lo psíquico. Se abordan textos técnicos del psicoanálisis para delimitar el tema de la repetición; el recuerdo y la repetición son vinculadas al objeto y estudiadas desde la perspectiva de la filosofía moderna; y se retoman temas de los diálogos platónicos para definir el lugar de lo erótico y la amistad. Al culminar este artículo se propone leer el término griego clásico Oikos con un valor equivalente al de la Cosa freudiana como aparece en los escritos psicoanalíticos.(AU)


Subject(s)
Philosophy , Psychoanalysis , Psychology , Humans , Object Attachment , Perception , Pleasure-Pain Principle , Projection , Psychopathology , Psychosexual Development , Rationalization , Rejection, Psychology , Repression, Psychology , Repression-Sensitization , Safety , Social Behavior , Social Responsibility , Sublimation, Psychological , Superego , Thinking , Truth Disclosure , Unconscious, Psychology , Beauty , Volition , Behavior and Behavior Mechanisms , Technical Cooperation , Symbolism , Attitude , Singularities , Homeopathic Cure , Mortality , Adolescent , Staff Development , Communication , Conflict, Psychological , Conscience , Consciousness , Privacy , Knowledge , Metaphor , Life , Empiricism , Address , Affect , Neurolinguistic Programming , Textbook , Virtues , Personal Autonomy , Moral Development , Research Subjects , Depressive Disorder , History, Ancient , Dreams , Drive , Education , Ego , Erotica , Academies and Institutes , Scientific Domains , User Embracement , Ethics , Extraversion, Psychological , Fantasy , Theory of Mind , Hope , Self-Control , Moral Status , Symbolic Interactionism , Freudian Theory , Psychological Distress , Food Social Space , Greece , Hate , Id , Identification, Psychological , Imagination , Individuality , Inhibition, Psychological , Interpersonal Relations , Judgment , Jungian Theory , Language , Libido , Love , Memory , Mythology
12.
Rev. ANACEM (Impresa) ; 17(1): 102-106, 2023. tab, ilus
Article in Spanish | LILACS | ID: biblio-1526312

ABSTRACT

Introducción: La depresión es un trastorno del ánimo frecuente, cuya recurrencia altera su manejo y pronóstico. El objetivo del trabajo es describir la tasa de egreso hospitalario (TEH) por episodio depresivo recurrente (EDR) entre 2018-2021 en Chile, según sexo, edad y gravedad. Materiales y métodos: Estudio observacional y transversal que considera los egresos hospitalarios por EDR en el período 2018-2021 en Chile (N=1551). Se utilizaron las bases de datos del Departamento de Estadísticas e Información de Salud y el Instituto Nacional de Estadística. Las variables estudiadas fueron sexo, grupo etario y gravedad. No requirió aprobación de comité de ética. Resultados: Se observó la menor TEH en 2020 con 1,91 egresos por cada 100.000 habitantes. Las mujeres sobresalieron durante todo el período con una TEH de 3,68 egresos por cada 100.000 habitantes. Destacó el grupo de 15 a 19 años con la mayor TEH en ambos sexos con 5,3 egresos por cada 100.000 habitantes. Respecto a gravedad, las hospitalizaciones se concentraron en pacientes de diagnóstico no especificado. Discusión: La pandemia de COVID 19 podría explicar la disminución de la TEH en 2020, al reducirse el diagnóstico y hospitalización por EDR; presumiblemente debido al fenómeno de reconversión de camas. La TEH es mayor en el sexo femenino, lo cual es concordante con la literatura. El predominio del grupo de 15 a 19 años discrepa de la evidencia, la cual indica que suele concentrarse en individuos de 25 a 64 años. Conclusión: Las TEH por EDR se concentraron en mujeres jóvenes. Es relevante conocer la epidemiología local para focalizar los recursos en la detección oportuna de factores de riesgo, para evitar episodios graves y disminuir su recurrencia.


Introduction: Depression is a common mood disorder, whose recurrence alters its management and prognosis. The aim of the paper is to describe the hospital discharge rate (HED) for recurrent depressive episode (RDE) between 2018-2021 in Chile, according to sex, age and severity. Materials and methods: Observational and cross-sectional study considering hospital discharges due to DRE in the period 2018-2021 in Chile (N=1551). The databases of the Department of Health Statistics and Information and the National Institute of Statistics were used. The variables studied were sex, age group and severity. Ethics committee approval was not required. Results: The lowest HTE was observed in 2020 with 1.91 discharges per 100,000 inhabitants. Females stood out during the entire period with an HTE of 3.68 discharges per 100,000 population. The 15-19 years age group stood out with the highest HTE in both sexes with 5.3 admissions per 100,000 inhabitants. In terms of severity, hospitalizations were concentrated in patients with unspecified diagnosis. Discussion: The COVID 19 pandemic could explain the decrease in HTE in 2020, with a reduction in diagnosis and hospitalization for RDE, presumably due to the bed conversion phenomenon. HTE is higher in the female sex, which is consistent with the literature. The predominance of the 15 to 19 years age group disagrees with the evidence, which indicates that it tends to be concentrated in individuals aged 25 to 64 years. Conclusion: HTE due to DRE was concentrated in young women. It is important to know the local epidemiology in order to focus resources on the timely detection of risk factors to avoid serious episodes and reduce their recurrence.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Depressive Disorder/epidemiology , Psychiatric Department, Hospital , Epidemiology, Descriptive , Hospitalization/statistics & numerical data , Medical Records Department, Hospital
13.
Agora (Rio J.) ; 26: e259468, 2023. graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1519976

ABSTRACT

RESUMO: Partindo do pressuposto freudiano no qual a melancolia se enquadra entre as neuroses narcísicas em oposição às neuroses de transferência, pretende-se apresentá-la no ensino de Lacan, entendendo-a como uma estrutura clínica psicótica. A melancolia é abordada como sendo um efeito de estrutura em função da não separação do objeto a, que fica (des)velado, a partir da foraclusão do Nome-do-Pai. Destaca-se o papel do supereu através do objeto voz.


ABSTRACT: Based on the Freudian assumption in which melancholy is included among the narcissistic neuroses in opposition to the transference neuroses, it is intended to present it in Lacan's teaching, understanding it as a psychotic clinical structure. Melancholy is approached as a structure effect due to the non-separation of the object a, which is (un)veiled from the foreclosure of the Name-of-the-Father. The role of the superego through the voice object is highlighted.


Subject(s)
Psychoanalysis , Psychotic Disorders , Depressive Disorder
14.
J. Health NPEPS ; 7(2): 1-14, jul - dez, 2022.
Article in Portuguese | LILACS, BDENF, ColecionaSUS | ID: biblio-1425075

ABSTRACT

Objetivo: conhecer os níveis de depressão e sintomas depressivos em angolanos com HIV. Método: estudo descritivo e misto, com estratégia exploratória sequencial, em período pré-pandêmico em um hospital público de Angola. Realizou-se entrevistas semiestruturadas, com aplicação do Inventário de Depressão de Beck. Para fins de análise, considerou o conceito de depressão a partir da classificação internacional de doenças. Resultados: prevaleceu depressão leve a moderada para ambos os sexos e estado civil. No G1, a maioria além da tristeza ou infelicidade não conseguem suportar a angústia, alguns verbalizam ter consciência de que os choros não os levará a ter vida anterior desta realidade. Agora se sentem irritados o tempo todo e não sentem mais prazer nas coisas como antes. No G2, expressaram ideias e sentimentos suicidas, estavam desanimados quanto ao futuro, percebem-se fracassados mais do que uma pessoa sem a doença, e adiam a tomada de decisão mais do que o costume. Conclusão: embora não tenha prevalecido formas severas (graves) de depressão, a ocorrência de sintomas negativos em variadas esferas da vida pode evoluir, especialmente no contexto angolano.


Objective:to know the levels of depression and depressive symptoms in Angolans with HIV. Method: descriptive and mixed study, with sequentialexploratory strategy, in the pre-pandemic period in a public hospital in Angola. Semi-structured interviews were carried out, with the application of the Beck Depression Inventory. For analysis purposes, it considered the concept of depression from the international classification of diseases. Results: mild to moderate depression prevailed for both sexes and marital status. In G1, the majority, in addition to sadness or unhappiness, cannot bear the anguish, some verbalize being aware that crying will not lead them to have a previous life in this reality. Now they feel irritable all the time and they don't enjoy things the way they used to. In G2, they expressed suicidal ideas and feelings, were discouraged about the future, perceived themselves as failures more than a person without the disease, and postponed decision-making more than usual. Conclusion: although severe forms of depression have not prevailed, the occurrence of negative symptoms in various spheres of life can evolve, especially in the angolan context.


Objetivo:conocer los niveles de depresión y síntomas depresivos en angoleños con VIH. Método:estudo descriptivo y misto, con estratégia exploratória secuencial, en el período pré-pandêmico en un hospital público de Angola. Se realizaron entrevistas semiestructuradas, con la aplicación del Inventario de Depresión de Beck. Para efectos de análisis, se consideró el concepto de depresión de la clasificación internacional de enfermedades. Resultados:predominó la depresión leve a moderada para ambos sexos y estado civil. En G1, la mayoría, además de la tristeza o la infelicidad, no pueden soportar la angustia, algunos verbalizan siendo conscientes de que el llanto no los llevará a tener una vida anterior en esta realidad. Ahora se sienten irritables todo el tiempo y no disfrutan las cosas como antes. En G2 expresaron ideas y sentimientos suicidas, estaban desanimados sobre el futuro, se percibían como fracasados más que una persona sin la enfermedad y postergaban la toma de decisiones más de lo habitual. Conclusión:aunque no han prevalecido formas severas de depresión, la aparición de síntomas negativos en diversas esferas de la vida puede evolucionar, especialmente en el contexto angoleño.


Subject(s)
Mental Health , HIV Seropositivity , Depression , Depressive Disorder , Angola
15.
Agora (Rio J.) ; 25(3): 9-16, set.-dez. 2022.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1429601

ABSTRACT

RESUMO: Propõe-se uma relação entre a reificação do corpo e o processo de imaginarização. Imaginarização é uma noção apenas aludida na obra de Lacan. Propõe-se uma leitura acerca de apresentações clínicas nas quais prevalece um estado depressivo neurótico. Hipótese: nessas situações, o sujeito parece reduzir-se ao próprio corpo, como resposta a certas exigências da cultura contemporânea. Busca-se lançar luz sobre o automatismo do gozo do corpo no circuito pulsional. Por meio da noção de imaginarização, destaca-se um enquadramento particular que o sujeito dá ao gozo, ao invés de posicionar-se como faltante na relação com o Outro.


Abstract: We propose a relationship between the reification of the body and the process of imaginarization. Imaginarization is a notion only alluded to in Lacan's work. We propose a reading about clinical presentations in which a neurotic depressive state prevails. The hypothesis: in these situations, the subject seems to be reduced to his own body, in response to certain demands of contemporary culture. Thus, we seek to shed light on the automatism of the jouissance of the body in the drive circuit. Through the notion of imaginarization, it is possible to highlight a particular framework that the subject gives to jouissance, instead of positioning themselves as lacking in the relationship with the Other.


Subject(s)
Psychoanalytic Theory , Human Body , Depressive Disorder
16.
Rev. chil. neuro-psiquiatr ; 60(4): 444-453, dic. 2022. tab, ilus, graf
Article in Spanish | LILACS | ID: biblio-1423707

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit Disorder with Hyperactivity/epidemiology , Students, Medical/psychology , Mood Disorders/epidemiology , Anxiety Disorders/epidemiology , Peru/epidemiology , Psychiatric Status Rating Scales , Stress, Psychological/epidemiology , Pilot Projects , Cross-Sectional Studies , Depressive Disorder/epidemiology
17.
Rev. cuba. inform. méd ; 14(2): e519, jul.-dic. 2022. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1408542

ABSTRACT

Este trabajo propone un sistema de diagnóstico del trastorno depresivo para el Centro de Salud Juan Pablo II. En este centro los especialistas aplican como método de evaluación el cuestionario BDI-II (Inventario de Depresión de Beck), que limita el proceso de diagnóstico porque solo contempla la sumatoria de un puntaje como resultado final. Por lo tanto, para mejorar el método de evaluación se propone la construcción de un modelo de diagnóstico basado en redes neuronales y la adaptación del cuestionario BDI-II recopilando ítems del cuestionario asociados a sus respectivos factores establecidos: emocional, cognitivo, físico y de motivación siendo las variables de entrada de la primera capa. El modelo tiene tres capas ocultas y finalmente se obtendrá una capa de salida con el diagnostico general y específico que detallará el resultado del paciente a fin de que el especialista realice un plan personalizado de tratamiento que se ajuste mejor a las necesidades del paciente(AU)


This work proposes a diagnostic system for depressive disorder for the Juan Pablo II Health Center where the specialists apply the BDI-II questionnaire (Beck's Depression Inventory) as evaluation method, which limits the diagnostic process because it only contemplates the sum of a score as a final result. Therefore, to improve the evaluation method, the construction of a diagnostic model based on neural networks and the adaptation of the BDI-II collecting questionnaire items associated with their respective established factors: emotional, cognitive, physical and motivation, being the input variables of the first layer, having three hidden layers and finally an output layer will be sought with the general and specific diagnosis that details the result of the patient so that the specialist can make a personalized treatment plan that better adjusts to the patient needs(AU)


Subject(s)
Humans , Male , Female , Medical Informatics Applications , Surveys and Questionnaires , Neural Networks, Computer , Depressive Disorder/diagnosis , Peru
18.
Rev. chil. neuro-psiquiatr ; 60(3): 337-354, sept. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1407822

ABSTRACT

RESUMEN: Introducción: Lograr la recuperación funcional lo más rápido posible en el tratamiento de la depresión unipolar es un reto que la práctica clínica debe tratar de afrontar en la actualidad, ya que cualquier retraso en lograr la remisión de los síntomas es predictivo de un mayor número de recurrencias y mayores tasas de morbimortalidad. En esta revisión comprensiva, nuestro objetivo es guiar a los clínicos en su elección de aumentar con antipsicóticos atípicos o combinar el fármaco de referencia con un segundo antidepresivo, después de que se haya optimizado la dosis del antidepresivo seleccionado inicialmente y/o se haya cambiado el antidepresivo, sin lograr remisión, o bien cuando solo han obtenido una respuesta parcial después de un tiempo suficiente a una dosis apropiada. Estas decisiones surgen con frecuencia en la práctica clínica diaria. Metodología: Se realizó una búsqueda sistemática en PubMed bajo varias combinaciones clave de palabras, resultando en 230 informes. Después de aplicar los criterios de inclusión y según el título y el resumen, el número final de informes seleccionados para la revisión completa fue de 113. Se respondieron dos preguntas principales con base en estos estudios: 1) ¿Existe evidencia para recomendar claramente la combinación de antidepresivos versus potenciación con antipsicóticos (y el momento correcto para hacerlo) en la depresión unipolar no respondedora, una vez que las estrategias de optimización o de cambio han fallado en obtener la remisión? y 2) ¿Es posible identificar algunas características clínicas para guiar la decisión de combinación de antidepresivos versus potenciación con agentes antipsicóticos? Resultados: Según nuestro análisis, no hay datos disponibles para seleccionar una estrategia de otra de manera clara. Sin embargo, sugerimos favorecer una combinación o estrategia de aumento, basada en un enfoque de "tratamiento contra objetivos dianas" para perfilar al paciente, considerando una o dos características clínicas predominantes que permanecen activas como parte de una depresión mayor con respuesta parcial. Un adecuado análisis de los dominios sintomáticos presentes, una visión crítica de las guías clínicas actuales y de las opciones preferidas, considerar la bipolaridad oculta como uno de los principales diagnósticos diferenciales y adoptar una actitud enérgica pero lúcida en esta etapa del tratamiento son, a nuestro juicio, fundamentales para lograr recuperación ad integrum del paciente.


ABSTRACT Introduction: achieving functional recovery as quickly as possible in the treatment of unipolar depression is a challenge that clinical practice must try to meet nowadays, since any delay in accomplishing remission of the symptoms is predictive of a larger number of recurrences and higher morbidity and mortality rates. In this topical review we aim to guide clinicians in their choice to augment with atypical antipsychotics or to combine the baseline drug with a second antidepressant, after the dose of the antidepressant initially selected has been optimized and/or the antidepressant has been changed, not achieving remission, or resulting only in a partial response after sufficient time at an appropriate dose. These decisions arise frequently in everyday clinical practice. Methodology: a systematic search in PubMed was performed under several key combinations of words, resulting in 230 reports. After applying inclusion criteria and based in title and abstract, the final number of reports selected for full revision were 113. Two main questions were answered based on these studies: 1) Is there evidence to clearly recommend combination of antidepressants vs. augmentation with antipsychotics (and the correct moment to do it) in non-responsive unipolar depression, once optimization or switching strategies have failed to obtain remission? and 2) Is it possible to identify some clinical features to guide the decision of combination of antidepressants vs. augmentation with antipsychotic agents? Results: According to our analysis, there is no data available to select one strategy from another in a clear-cut manner. Nevertheless, we suggest favoring a combination or augmentation strategy, based in a "treating to target" approach to profile the patient, considering one or two predominant clinical features that remain active as part of a major depression with partial response. Proper analysis of the symptomatic domains present, a critical view of current clinical guidelines and preferred options, considering hidden bipolarity as one of the main differential diagnoses and adopting an energetic but lucid attitude at this stage of treatment are, in our view, fundamental for achieving ad integrum patient recovery.


Subject(s)
Humans , Antipsychotic Agents/therapeutic use , Remission Induction/methods , Depressive Disorder/drug therapy , Antidepressive Agents/therapeutic use , Drug Synergism , Drug Therapy, Combination
19.
Junguiana ; 40(1)jan.- jun. 2022.
Article in English, Portuguese | LILACS, INDEXPSI | ID: biblio-1434719

ABSTRACT

Este ensaio visa amplificar as concepções de fantasma, seja como figuração político-narrativa, seja como dinamismo, de forma experimental e intuitiva. Para tanto, cumpre alguns itinerários: primeiramente, discorre a respeito de uma lógica fantasmal oriunda dos campos da filosofia, das ciências sociais, da literatura e da psicologia analítica; a seguir, investiga brevemente ressonâncias dessa lógica a partir de conceitos de Fisher sobre reverter a melancolia dos futuros perdidos pelo trabalho de abertura aos fantasmas; e finda com uma reflexão sobre os usos da memória enquanto resistência a partir das figuras mitológicas de Saturno, Mnemosyne e das metáforas da obra A Polícia da Memória, de Ogawa.


This essay aims to amplify the conceptions of the ghost, either as a political-narrative figuration, or as a dynamism, in an experimental and intuitive way. In order to do so, it travels through some itineraries: first, it discusses a ghostly logic originating from the fields of philosophy, social sciences, literature and analytical psychology; then, it briefly investigates resonances of this logic based on Fisher's concepts on reversing the melancholy of lost futures through the work of opening to ghosts; and ends with a reflection on the uses of memory as resistance from the mythological figures of Saturn, Mnemosyne and the metaphors of Ogawa's The Memory Police.


Este ensayo pretende ampliar las concepciones del fantasma, sea como figuración político narrativa o como dinamismo, de manera experimental e intuitiva. Para ello, cumple algunos itinerarios: en primer lugar, discute una lógica fantasmal proveniente de los campos de la filosofía, las ciencias sociales, la literatura y la psicología analítica; luego, indaga brevemente resonancias de esta lógica a partir de los conceptos de Fisher sobre revertir la melancolía de los futuros perdidos a través del trabajo de apertura a los fantasmas; y finaliza con una reflexión sobre los usos de la memoria como resistencia a partir de las figuras mitológicas de Saturno, Mnemosyne y las metáforas de La policía de la memoria de Ogawa.


Subject(s)
Depressive Disorder , Psychology , Memory , Mythology
20.
Rev. chil. neuro-psiquiatr ; 60(1): 51-61, mar. 2022. tab
Article in Spanish | LILACS | ID: biblio-1388420

ABSTRACT

Resumen Introducción: la desensibilización y reprocesamiento por movimientos oculares (EMDR) tiene abundante evidencia de eficacia en desórdenes del espectro traumático. Su eficacia en trastornos ansiosos (TA) y depresivos (TD) en niños, niñas y adolescentes ha sido escasamente estudiada. Método: se realizó una revisión narrativa para describir la evidencia disponible sobre eficacia de EMDR en TA y TD en población infantojuvenil. Se buscaron artículos disponibles en PubMed/Medline, SciELO, PsycINFO y Cochrane Library. Se incluyeron todos los artículos primarios y secundarios que evaluaron el efecto de EMDR en TA y TD en población infantojuvenil. Se revisaron sus referencias como segundo método de inclusión. Resultados: se identificaron nueve estudios (cinco en TA y cuatro en TD); tres fueron observacionales y seis experimentales. Todos tuvieron tamaños muestrales reducidos. En TA, los estudios corroboraron la eficacia de EMDR sobre el temor fóbico en fobia a las arañas, pero no sobre la conducta evitativa, donde sería superior la exposición in vivo. Dos series de casos expusieron la utilidad de EMDR en fagogobia y en TA asociados a epilepsia. En TD, EMDR fue eficaz en la reducción de sintomatología depresiva en el contexto del trastorno depresivo mayor, trastorno de estrés agudo y trastornos conductuales. EMDR fue comparable a terapia cognitivo-conductual. Conclusiones: la evidencia corrobora la eficacia de EMDR en TA y TD en niños, niñas y adolescentes. Sin embargo, es muy escasa y cuenta con limitaciones metodológicas. Es necesario realizar estudios experimentales con protocolos estandarizados y especializados de EMDR para TA y TD en población infantojuvenil.


Introduction: Eye movement desensitization and reprocessing (EMDR) has abundant evidence of efficacy in traumatic spectrum disorders. Its efficacy in anxiety disorders (AD) and depressive disorders (DD) in children and adolescents has been scarcely studied. Methods: We conducted a narrative review to describe the available evidence on the efficacy of EMDR in AD and DD in children and adolescents. We searched for articles available in PubMed/Medline, SciELO, PsycInfo and the Cochrane Library. All primary and secondary studies evaluating the effect of EMDR on AD and DD in children and adolescents were included. Their references were reviewed as a second method of inclusion. Results: nine studies were identified (five in AD and four in DD); three were observational and six experimental. All had small sample sizes. In AD, studies corroborated the efficacy of EMDR on phobic fear in spider phobia, but not on avoidance behavior, where in vivo exposure would be superior. Two case series reported the efficacy of EMDR in choking phobia and AD associated with epilepsy. In DD, EMDR was effective in reducing depressive symptomatology in the context of major depressive disorder, acute stress disorder, and conduct disorders. EMDR was comparable to cognitive behavioral therapy. Conclusions: The evidence corroborates the efficacy of EMDR in AD and DD in children and adolescents. However, it is very scarce and has methodological limitations. It is necessary to carry out experimental studies with standardized and specialized EMDR protocols for AD and DD in the child and adolescent population.


Subject(s)
Humans , Child , Adolescent , Anxiety Disorders/therapy , Depressive Disorder/therapy , Eye Movement Desensitization Reprocessing
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