Whitehead, Tansley, Sen, Bobbio e a abordagem One Health / Whitehead, Tansley, Sen, Bobbio and the One Health approach / Whitehead, Tansley, Sen, Bobbio y el enfoque One Health

Objetivo: traçar parâmetros para estruturar conceitos da abordagem One Health através dos pensamentos de Alfred North Whitehead, Arthur George Tansley, Amartya Sen e Norberto Bobbio. Metodologia: tratou-se de pesquisa original, com abordagem dedutiva e viés hermenêutico, baseada nos pensamentos selecionados e na orientação de Saúde Única. Resultados: One Health estrutura-se na afirmativa holística e integrada que a saúde humana, animal e ambiental estão interligadas. Sob a perspectiva de Whitehead, a abordagem One Health pode ser considerada um processo dinâmico e relacional, onde humanos, animais e meio ambiente interagem constantemente, interconectando-se por relações e processos, formando um todo. Pela perspectiva de Tansley, a ideia de One Health pode alinhar-se ao conceito de ecossistema, não podendo a saúde ser analisada isoladamente em indivíduos, mas, necessariamente, pelas interações complexas entre seres humanos, animais e o ambiente. Sob o prisma de desenvolvimento (direitos e liberdades), proposto por Sen, a abordagem One Health pode ser considerada um meio para alcançá-lo, através da interrelação de mecanismos, sistemas e instituições focados na promoção da saúde e do bem-estar. Na visão de Bobbio, direitos fundamentais, democracia e a paz, são formas éticas e primordiais para assegurar direitos, especialmente um novo direito da natureza (humanos, animal e ambiente) na busca conjunta de garantias para a convivência pacífica. Conclusão: a abordagem One Health não é apenas uma estratégia prática, mas também uma visão renovada da antiga percepção que reconhecia a interconexão de todas as formas de vida.

Objective: draw parameters to structure concepts of the One Health approach through the thoughts of Alfred North Whitehead, Arthur George Tansley, Amartya Sen, and Norberto Bobbio. Methodology: this was original research, with a deductive approach, hermeneutic bias based on the selected thoughts and the One Health. Results: One Health is structured on the holistic and integrated assertion that human, animal, and environmental health are interconnected. From Whitehead's perspective, the One Health approach can be considered a dynamic and relational process, where humans, animals, and the environment constantly interact, interconnecting through relationships and processes, forming a whole. From Tansley's perspective, the idea of One Health can align with the ecosystem concept, where health cannot be analyzed in isolation in individuals, but necessarily through the complex interactions between humans, animals, and the environment. From Sen's development prism (rights and freedoms), the One Health approach can be seen to achieve it, through the interrelation of mechanisms, systems, and institutions focused on promoting health and well-being. In Bobbio's view, fundamental rights, democracy, and peace are ethical and primary ways to ensure rights, especially a right of nature (humans, animals, and the environment) in the joint pursuit of guarantees for peaceful coexistence. Conclusion: the One Health approach is not just a practical strategy, but also a renewed vision of the old perception that recognized the interconnection of all forms of life.

Objetivo: establecer parámetros para estructurar conceptos del enfoque One Health a través de los pensamientos de Alfred North Whitehead, Arthur George Tansley, Amartya Sen y Norberto Bobbio. Metodología: se trató de una investigación original, con un enfoque deductivo, sesgo hermenéutico basado en los pensamientos seleccionados y el Salud Única. Resultados: One Health se estructura en la afirmación holística e integrada de que la salud humana, animal y ambiental están interconectadas. Desde la perspectiva de Whitehead, el enfoque One Health puede considerarse un proceso dinámico y relacional, donde humanos, animales y el medio ambiente interactúan constantemente, interconectándose a través de relaciones y procesos, formando un todo. Desde la perspectiva de Tansley, la idea de One Health puede alinearse con el concepto de ecosistema, donde la salud no puede analizarse aisladamente en individuos, sino necesariamente a través de interacciones complejas entre seres humanos, animales y el ambiente. Desde el prisma del desarrollo (derechos y libertades) propuesto por Sen, el enfoque One Health puede considerarse un medio para alcanzarlo, a través de la interrelación de mecanismos, sistemas e instituciones enfocados en la promoción de la salud y el bienestar. Desde la visión de Bobbio, los derechos fundamentales, la democracia y la paz son formas éticas y primordiales para asegurar derechos, especialmente un derecho de la naturaleza (humanos, animales y ambiente) en la búsqueda conjunta de garantías para la convivencia pacífica. Conclusión: el enfoque One Health no es solo una estrategia práctica, sino también una visión renovada de la antigua percepción que reconocía la interconexión de todas las formas de vida.

Theoretical procedures of the cross-cultural adaptation process of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context

Abstract Objectives To describe the theoretical procedures employed in the process of cross-cultural adaptation (CCA) for Brazil of the Child Mania Rating Scale - Parent Version (CMRS-P). Methods Seven steps were carried out: (1) translations and synthesis; (2) Committee of Judges-I; (3) grammatical review; (4) Committee of Judges-II; (5) semantic analysis (pre-test); (6) back-translation; and (7) discussion with the authors of the original instrument. Participants were two professional translators, 14 experts, a grammar proofreader, and 21 parents/guardians, representatives of the target population. The results were analyzed in terms of the percentage of agreement between evaluators and the content validity coefficient (CVC) and by analysis of comments and suggestions. Results Grammatical and cultural adjustments were made, in addition to substitution and/or inclusion of words and examples. Adequacy agreement indexes exceeding 86% were achieved and the CVC result for the total scale was excellent (0.95). The pre-test indicated good acceptance and understanding by participants. Conclusion The proposed version proved to be promising for use in the Brazilian context, although further psychometric studies are still needed to prove the scale's validity and reliability.

Immature defense mechanisms predict poor response to psychotherapy in major depressive patients with comorbid cluster B personality disorder

Objective: To evaluate the impact of defense mechanisms at baseline on depressive symptoms after brief psychotherapies and after 6-months of follow-up among depressed patients with and without cluster B personality disorders (PDs). Methods: This quasi-experimental study nested within a randomized clinical trial included a clinical sample of adults (18-60 years) diagnosed with major depressive disorder using the Mini-International Neuropsychiatric Interview. The Millon Clinical Multiaxial Inventory-III was applied to assess PD, the Defense Style Questionnaire 40 was used to analyze defense mechanisms, and the Beck Depression Inventory was used to measure the severity of depressive symptoms. Adjusted analysis was performed by linear regression. Results: The final sample consisted of 177 patients diagnosed with major depressive disorder, of whom 39.5% had cluster B PDs. Immature defenses at baseline significantly predicted the persistence of depressive symptoms at post-intervention and at 6-months of follow-up only in patients with PDs. Conclusion: In depressed patients with cluster B PDs, immature defenses predicted a poor response to brief therapies. The assessment of immature defenses at baseline can help identify patients at greater risk of poor therapeutic results and enable more appropriate treatment choices.

The impact of mindfulness on suicidal behavior: a systematic review

Abstract Introduction Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based interventions for reducing suicidal thoughts and behaviors. Methods A systematic review was performed in December 2020 using PubMed, PsycINFO, EMBASE, SciELO, Pepsic, and LILACS databases with no year restrictions. The search strategy included the terms ('mindfulness' OR 'mindfulness-based') AND ('suicide' OR 'suicidal' OR 'suicide risk' OR 'suicide attempt' OR 'suicide ideation' OR 'suicide behavior'). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42020219514. Results A total of 14 studies met all inclusion criteria and were included in this review. Most of the studies presented Mindfulness-Based Cognitive Therapy as the MBI assessed (n=10). An emerging and rapidly growing literature on MBI presents promising results in reduction of suicide risk, particularly in patients with MDD. Four studies assessing other MBI treatment protocols (Mindfulness-Based Stress Reduction; Daily Mindfulness Meditation Practice; Mind Body Awareness and Mindfulness-Based Cognitive Behavior Therapy) all demonstrated that MBI reduces factors associated with suicide risk. Conclusion MBI might target specific processes and contribute to suicide risk reduction.

A vacinação contra a COVID-19 pode ser compulsória no Brasil? A questão jurídica e a disputa política / Can the vaccination against COVID-19 be compulsory in Brazil? The legal issue and political dispute

Introdução: A recente celeuma em torno da COVID-19 paira sobre os direitos e deveres da população frente à vacinação e a imunização em massa. O exercício da liberdade individual e a eventual imposição de medida que torna compulsória a vacinação podem estar no foco de uma disputa política em torno da adoção de critérios científicos para a tomada de decisões governamentais que poderão trazer sérias consequências coletivas em relação à propagação e ao descontrole da doença. Objetivo:Estudar se a vacinação compulsória contra a COVID-19, uma vez instituída por lei ou ato normativo, terá fundamentação jurídica em face dos direitos fundamentais e analisar se a disputa política em torno da vacina pode estar influenciando a sua normatização. Método: Estudo exploratório e descritivo elaborado por meio de pesquisa documental e bibliográfica, coleta de textos provenientes da Organização Mundial da Saúde, do Ministério da Saúde, do governo federal, do estado de São Paulo, da análise da legislação pátria e de decisões recentes do Supremo Tribunal Federal. Resultados: Observou-se que é possível estabelecer a vacinação compulsória no Brasil assegurando os direitos fundamentais, entretanto, questões políticas estão influenciando a tomada de decisões pautadas por critérios técnico-científicos de Vigilância Sanitária. Conclusões: A restrição da liberdade individual encontra amparo no fundamento de busca pela saúde de interesse coletivo, desde que não extrapole os limites da integridade física do cidadão e da dignidade humana, vedado o uso da coerção física. A disputa política encabeçada por alguns agentes públicos pode ter acarretado atrasos e retrocessos na imunização vacinal da população brasileira, forma eficaz de controle da pandemia.

Introduction: The recent uproar around COVID-19 hangs over the rights and duties of the population regarding vaccination and mass immunization. The exercise of individual freedom and the possible imposition of a measure that makes vaccination compulsory may be the focus of a political dispute around the adoption of scientific criteria for government decision-making, and with that, bring serious collective consequences in relation to the spread and the lack of control of the disease. Objective: To study whether compulsory vaccination against COVID-19, once instituted by law or normative act, will have a legal basis in view of fundamental rights and analyze whether the political dispute around the vaccine may be influencing its regulation. Method: Exploratory and descriptive study developed through documentary and bibliographic research, collection of texts from the World Health Organization, Ministry of Health, federal government and the state of São Paulo, analysis of national legislation and recent decisions by the Supreme Court. Results: It was observed that it is possible to establish compulsory vaccination in Brazil, ensuring fundamental rights; however, political issues are influencing decision-making based on technical-scientific criteria for health surveillance. Conclusions: The restriction of individual freedom finds support in the search for health in the collective interest, as long as it does not go beyond the limits of the physical integrity of the citizen and human dignity, the use of physical coercion being prohibited. The political dispute led by some public agents may have caused delays and setbacks in the vaccination of the Brazilian population, an effective way to control the pandemic.

El derecho de la gestante a su acompañante durante el parto: previsión legal en los paises latinoamericanos y caribenhos / The right of the parturient to a companion during childbirth: legal provision in Latin American and the Caribbean countries / O direito da parturiente ao acompanhante durante o parto: previsão legal nos países do Caribe e da América Latina

El objetivo del estudio fue verificar la presencia de legislación que garantice a las parturientes el derecho a un acompañante en el parto de acuerdo con las recomendaciones de la Organización Mundial de la Salud, en el marco de la Comunidad de Estados de América Latina y el Caribe. A través de la investigación documental y bibliográfica, se observó que al menos 51% de los países de la Comunidad de Estados de América Latina y el Caribe, que representan 93.8% de la población respectiva, tienen regulaciones vigentes o en preparación sobre el parto humanizado y la presencia del acompañante. Hay evidencias de una incorporación progresiva de este derecho en la legislación de los países de la Comunidad de Estados de América Latina y el Caribe, de conformidad con las recomendaciones de la Organización Mundial de la Salud, pero todavía faltan estudios sobre su efectividad.

The objective of this study was to verify the presence of legislation that guarantees to the parturient the right to a companion during childbirth in accordance with World Health Organization recommendations, within the framework of the Community of Latin American and the Caribbean States. Through documentary and bibliographic research, it was observed that at least 51% of the countries of the Community of Latin American and the Caribbean States, which represent 93.8% of the respective population, have included or proposed regulations about humanized childbirth and the presence of the companion. There is evidence of a progressive incorporation of this right into the legislation of the countries of the Community of Latin American and the Caribbean States, in accordance with World Health Organization recommendations, however further studies on its effectiveness are still lacking.

O objetivo do estudo foi verificar a presença de legislação que garanta a mulher no trabalho o direito a um acompanhante na entrega de acordo com as recomendações da Organização Mundial da Saúde, no âmbito da Comunidade dos Estados Latino-Americanos e da Caribe. Por meio de pesquisa documental e bibliográfica, observou-se que pelo menos 51% dos países da Comunidade de Estados Latino-Americanos e Caribenhos, que representam 93,8% da respectiva população tem regulamentos em vigor ou em preparação para o parto humanizado e a presença do acompanhante. Há evidências de uma incorporação progressiva deste direito na legislação dos países da Comunidade de Estados Americanos América Latina e Caribe, de acordo com as recomendações do Mundo Saúde, mas ainda faltam estudos sobre sua eficácia.

BDNF Val66Met polymorphism and resilience in major depressive disorder: the impact of cognitive psychotherapy

Objective: Clinical and biological correlates of resilience in major depressive disorder are scarce. We aimed to investigate the effect of the Val66Met polymorphism in the BDNF gene on resilience scores in major depressive disorder patients and evaluate the polymorphism's moderation effect on resilience scores in response to cognitive therapy. Method: A total of 106 major depressive disorder patients were enrolled in this clinical randomized study. The Resilience Scale and the Hamilton Rating Scale for Depression were applied at baseline, post-treatment, and at six months of follow-up. Blood samples were obtained at baseline for molecular analysis. Results: The baseline resilience scores were higher in patients with the Met allele (114.6±17.6) than in those with the Val/Val genotype (104.04±21.05; p = 0.037). Cognitive therapy treatment increased resilience scores (p ≤ 0.001) and decreased depressive symptoms (p ≤ 0.001). In the mixed-effect model, the Val/Val genotype represented a decrease in resilience scores (t218 = -1.98; p = 0.048), and the Val66Met polymorphism interacted with sex to predict an increase in total resilience scores during cognitive treatment (t218 = 2.69; p = 0.008). Conclusion: Our results indicate that cognitive therapy intervention could improve resilience in follow-up, considering that gender and genetic susceptibility are predicted by the Val66Met polymorphism.

Cross-cultural adaptation of the City Birth Trauma Scale for the Brazilian context

Abstract Background Posttraumatic stress disorder consists of a set of symptoms that occurs in response to one or more traumatic events and can occur in postpartum, from traumatic situations related to the birth or to the baby's health in the first days of life. It is important tracking the presence of birth trauma, but there is not available instruments in the Brazilian context for this purpose. Objectives To present the cross-cultural adaptation of City Birth Trauma Scale (BiTS) into Brazilian portuguese. Methods Cross-cultural adaptation involved independent translations, synthesis,back-translation, and submission to the original author's appreciation. After the scale was subjected to face validity, followed by a pilot study with postpartum mothers. Results All steps were performed for the cross-cultural adaptation. Regarding face validity, items evaluated concerning different types of equivalence, presented satisfactory agreement values (≥4.20). Most of the expert's suggestions were followed, being the main ones related to adjustments in prepositions, pronouns and verbal subjects. Pilot study showed that the mothers had been able to understand and respond to the instrument without adjustments. Discussion BiTS's Brazilian version proved to be cross-culturally adapted, ensuring the possibility of intercultural data comparison from the semantic, idiomatic, cultural, and conceptual perspectives. New studies are being conducted to attest its psychometric adequacy.

Childhood trauma and bipolar spectrum: a population-based sample of young adults

Abstract Introduction Childhood trauma has been suggested to be involved in susceptibility to bipolar disorder (BP). However, it remains unclear whether the occurrence of childhood trauma is differently distributed in subthreshold bipolar disorder (SBP). Objective To assess childhood trauma in young adults with SBP, as compared to young adults with BP and population controls (PC). Method This was a cross-sectional, population-based study. The Mini International Neuropsychiatric Interview (MINI) was used to define the groups with BP (subjects with a lifetime or current manic episode or lifetime or current hypomania with a history of a depressive episode), SBP (subjects with a history of hypomanic episode without lifetime or current depressive episode), and subjects without mood disorders (PC). Childhood trauma was assessed using de Childhood Trauma Questionnaire (CTQ). We investigated differences regarding childhood trauma across the three groups (BP, SBP and PC). Result Except for sexual abuse, all subtypes of childhood trauma remained associated with the BP group as compared to PC. Additionally, when we compared SBP and BP, significant differences were found only for emotional abuse. No significant differences were found in relation to childhood trauma between the SBP and PC groups after adjusting for confounding factors. Conclusion These findings suggest that investigating childhood trauma, with a particular focus on emotional abuse, could be considered a preventive measure and potentially improve the prognosis.

The latent structure and reliability of the emotional trait section of the Affective and Emotional Composite Temperament Scale (AFECTS)

Abstract Background The Emotional and Affective Composite Temperament (AFECT) model describes originally six traits of volition, anger, inhibition (fear and caution subordinate factors), control, sensitivity, and coping. However, fear and caution have shown opposite relatioships with criteria-variables, indicating factor independence. Objective The current investigation aimed to advance in the evaluation of the psychometric properties of the emotional trait section of the Emotional and Affective Composite Temperament Scale (AFECTS) by examining the suitability of a 7-factor structure and the reliability of each scale using data from a population-based sample. Methods AFECTS was administered via face-to-face assessments in a single-session, population-based cross-sectional survey. Samples was composed of teenagers and adults (14 to 35 years). The latent structure and reliability were analyzed via structural equation modeling: confirmatory factor analysis was used to test the a priori correlated 7-factor model (with fear and caution designed as single-factors) and trait-scores reliability was assessed by the estimation of information curves. Results Findings attested the suitability of the 7-factor model presumed to underline the item set of the traits section of AFECTS and information curve interpretation showed adequate levels of reliability for all trait-scores. Discussion The 7-factor model showed robust indicators of construct validity for the AFECTS.

Permanent wilt point from two methods for different combinations of citrus rootstock / Ponto de murcha permanete a partir de dois métodos para diferentes combinações copa porta-enxerto de citros

ABSTRACT: Considering that water is extremely important in agricultural production, but with restricted availability in some Brazilian regions, this research sought to identify the water limit for the rootstocks: Cleóptra tangerine (Citrus reshni hort. Ex Tan), Volkamer lime (Citrus Volkameriano Pasquale), Citrandarin 'indio' (TSK X TRENG 256), Santa Cruz Rangpur lime (Citrus × limonia) and Sunki Tropical tangerine (Citrus sunki HORT. EX TAN) grafted orange 'Pera' (Citrus sinensis), obtained by two methods: the traditional method of determining the permanent wilting point described by SHANTZ & BRIGGS (1912) recovery of plants with saturated environment and by irrigating recovery method. The experimental design used was in a completely randomized design with four replications totaling 20 experimental plots. It was verified that the rootstocks Cravo Santa Cruz lemon and Volkamerian lemon were the most resistant in initial conditions of water restriction, evaluated by the method of BRIGGS & SHANTZ (1912), with recording of humidity of 0.0488 and 0.0489 respectively. Under more severe conditions of water restriction, determined by the irrigation method, Volkamerian lemon presented the highest resistance, with a humidity of 0.0371.

RESUMO: Considerando que a água é extremamente importante na produção agrícola, mas com restrita disponibilidade em algumas regiões brasileiras, é que esse trabalho buscou identificar o limite hídrico inferior para os porta-enxertos: tangerina Cleóptra (Citrus reshni hort. Ex Tan), limão Volkameriano (Citrus Volkameriano Pasquale), citrandarin 'Indio' -TSK X TRENG 256, limão Cravo Santa Cruz (Citrus × limonia) e tangerina Sunki Tropical (Citrus sunki HORT. EX TAN) enxertadas em laranja 'Pêra' (Citrus sinensis), obtidos por dois métodos: o método tradicional de determinação do ponto de murchamento permanente descrito por BRIGGS & SHANTZ (1912) com recuperação das plantas em ambiente saturado e o método de recuperação por rega. O delineamento experimental utilizado foi o inteiramente casualizado, com quatro repetições, totalizando 20 parcelas experimentais. Verificou-se que os porta-enxertos limão Cravo Santa Cruz e o limão Volkameriano foram os mais resistentes em condições iniciais de restrição hídrica, avaliado pelo método de BRIGGS & SHANTZ (1912), com registro das umidades de 0,0488 e 0,0489, respectivamente. Em condições mais severas de restrição hídrica, determinado pelo método de rega, o limão Volkameriano foi o que apresentou maior resistência, com a umidade de 0,0371.

Effect of cognitive-behavioral therapy after treatment for adults with major depression / Efeito da terapia cognitivo-comportamental um ano após tratamento para adultos com transtorno depressivo maior / Efecto de la terapia cognitiva comportamental un año después tratamiento para transtorno depresivo mayor

In Brazil, little is known about the maintenance of results after treatment of cognitive-behavioral therapy (CBT) for major depressive disorder (MDD). The objective of this study was to verify the effectiveness of individual psychotherapeutic treatment from CBT for depressive symptoms within 6 and 12 months after the intervention. We evaluated 94 participants with MDD from the Beck Depression Inventory (BDI-II). There was significant posttreatment response (p < 0.001), with no difference between the end of the treatment and the symptom assessment at 6 (p = 0.486) and 12 months (p = 0.098). A significant positive correlation was observed between the intensity of depressive symptoms at the baseline and the reduction of initial symptoms for 12-month follow-up (r = 0.49; p < 0.001). CBT significantly reduces depressive symptoms by maintaining this condition up to 12 months post-intervention without significant influence of other characteristics beyond the intensity of depressive symptoms at the beginning of the therapeutic process.

No Brasil, pouco se sabe sobre a manutenção dos resultados pós-tratamento da terapia cognitivo-comportamental (TCC) para o transtorno depressivo maior (TDM). Objetivou-se verificar a efetividade do tratamento psicoterápico individual a partir da TCC para os sintomas depressivos em um período de 6 e 12 meses pós-intervenção. Avaliaram-se 94 participantes com TDM a partir do Inventário Beck de Depressão (BDI-II). Houve resposta significativa pós-tratamento (p < 0,001), não ocorrendo diferenças entre o final do tratamento e a avaliação dos sintomas aos 6 (p = 0,486) e 12 meses (p = 0,098). Uma correlação positiva significativa foi observada entre a intensidade dos sintomas depressivos no baseline e a redução de sintomas iniciais para o acompanhamento de 12 meses (r = 0,49; p < 0,001). A TCC reduz significativamente os sintomas depressivos mantendo essa condição até 12 meses pós-intervenção sem influência significativa de outras características além da intensidade dos sintomas depressivos no início do processo terapêutico.

Este estudio verificó la efectividad del tratamiento psicoterápico individual a partir de la terapia cognitiva conductual (TCC) para los síntomas depresivos dentro de los 6 y 12 meses post-intervención. Se evaluaron 94 participantes con TDM a partir del Inventario Beck de depresión (BDI-II). Se observó una respuesta significativa post-tratamiento (p < 0,001), no ocurrieron diferencias entre el final del tratamiento y la evaluación de los síntomas a los 6 (p = 0,486) y 12 meses (p = 0,098). Había una correlación positiva significativa entre la intensidad de los síntomas depresivos en el baseline y la reducción de los síntomas iniciales para el seguimiento de 12 meses (r = 0,49; p < 0,001). La TCC reduce significativamente los síntomas depresivos manteniendo esa condición hasta 12 meses después de la intervención sin influencia significativa de otras características además de la intensidad de los síntomas depresivos al inicio del proceso terapéutico.

Prevalência de ansiedade e fatores associados em adultos / Prevalence of anxiety and associated factors in adults

RESUMO Objetivo Identificar a prevalência de transtornos de ansiedade em uma amostra de base populacional e fatores associados. Métodos Estudo transversal de base populacional realizado com indivíduos entre 18 e 35 anos. As variáveis sociodemográficas, índice de massa corporal, presença de doença crônica, abuso de álcool e tabagismo foram analisadas. Os transtornos de ansiedade foram verificados pela Mini Internacional Neuropsychiatric Interview 5.0. Foi utilizado o teste Qui-quadrado, considerando o intervalo de confiança de 95%. Resultados A amostra foi constituída por 1.953 pessoas. A prevalência de transtornos de ansiedade foi de 27,4%. Agorafobia (17,9%) e transtorno de ansiedade generalizada (14,3%) foram os quadros mais prevalentes. Mulheres apresentaram maior prevalência de ansiedade, com 32,5%, quando comparadas aos homens (21,3%) (p < 0,001). As variáveis sexo, anos de estudo, renda, doença crônica, tabagismo e álcool foram associadas a mais de três transtornos de ansiedade investigados (p < 0,001). Conclusão Os dados demonstram que os transtornos de ansiedade são muito frequentes em adultos, sendo mais prevalentes entre as mulheres. Estão associadas aos transtornos ansiosos, principalmente, as condições socioeconômicas e substâncias licitas. Conhecer as prevalências dos transtornos de ansiedade e fatores associados pode auxiliar profissionais de saúde a elaborarem melhores diagnósticos e tratamentos.

ABSTRACT Objective Identify the prevalence of anxiety disorders in a population sample and associated factors. Methods A cross-sectional study of population base conducted with individuals between 18 and 35 years old. Sociodemographic variables, body mass index (BMI), presence of diseases, and use of alcohol and smoke were analyzed. The anxiety disorders were verified by the clinical interview Mini International Neuropsychiatric Interview 5.0. For the analysis, was used the Chi-square test, considering a confidence interval of 95%. Results The prevalence of general anxiety was 27.4%. Agoraphobia (17.9%) and generalized anxiety disorder (14.3%) were the most prevalent. Women presented a higher prevalence of general anxiety with 32.5% when compared with man (21,3%) (p < 0.001). The variables gender, years of study, income, health problems, smoking, and alcohol were associated to more than three anxiety disorders investigated (p < 0,001). Conclusions The findings demonstrate that anxiety disorders are frequent in adults, being more prevalent among women. It was associated mainly with socioeconomic conditions and legal substances. Knowing the prevalence of anxiety disorders and associated factors can help health professionals to develop better diagnoses and treatments.

Metabolic syndrome and psychiatric disorders: a population-based study

Objective: To identify the association of metabolic syndrome (MetS) and psychiatric disorders in young adults in southern Brazil. Methods: This population based cross-sectional study involved a total of 1,023 young adults between the ages of 21 and 32 years. Current episodes of psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview - Plus version. MetS was evaluated using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). Results: Of the 1,023 participants, 24.3% were identified with MetS, 13.5% were diagnosed with anxiety disorders, 7.5% with current depression, 3.9% with bipolar disorders and 10.1% were at risk of suicide. MetS was associated with ethnicity (p = 0.022), excess weight (p < 0.001), current anxiety disorders (p < 0.001), current mood disorders (bipolar disorder in mood episode and current depression) (p < 0.001), and suicide risk (p < 0.001). Conclusions: MetS was associated with psychiatric disorders. Awareness of factors associated with MetS can help identify high-risk individuals and stimulate disease prevention and control programs, as well as lifestyle changes.

Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil

Objective: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil. Methods: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher's exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis. Results: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively. Conclusion: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

Effects of cognitive-behavioral therapy on neurotrophic factors in patients with major depressive disorder

Objective: To correlate neurotrophic factors - brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and beta-nerve growth factor (beta-NGF) - and severity of depressive symptoms in patients diagnosed with major depressive disorder (MDD) undergoing cognitive-behavioral therapy (CBT). Methods: In this quasi-experimental study, participants were selected by convenience and received 16 sessions of CBT. The outcomes of interest were severity of depressive symptoms and changes in neurotrophic factor levels after CBT. The differences between variables before and after treatment (deltas) were analyzed. Results: Patients had significant changes in symptom severity after treatment. No significant associations were found between Beck Depression Inventory II (BDI-II) scores and any independent variable. No correlations were observed between BDNF or GDNF levels and BDI scores before or after treatment, although there was a trend toward significant differences in beta-NGF levels. Conclusion: BDNF, beta-NGF, and GDNF were not influenced by the effects of CBT on depressive symptoms.

Impact of resilience on the improvement of depressive symptoms after cognitive therapies for depression in a sample of young adults / Impacto da resiliência na melhora dos sintomas depressivos após terapias cognitivas para depressão em uma amostra de adultos jovens

Abstract Introduction Few studies have evaluated positive measures for therapeutic response. Thus, the objective of this study was to assess the effects of resilience on severity of depressive and anxious symptoms after brief cognitive psychotherapy for depression. Methods This was a clinical follow-up study nested in a randomized clinical trial of cognitive therapies. The Resilience Scale was applied at baseline. The Hamilton Anxiety Rating Scale (HARS) and the Hamilton Depression Rating Scale (HDRS) were used at baseline, post-intervention, and at six-month follow-up. Results Sixty-one patients were assessed at baseline, post-intervention and at six-month follow-up. Resilience scores were significantly different between baseline and post-intervention assessments (p<0.001), as well as at baseline and at six-month follow-up (p<0.001). We observed a weak negative correlation between baseline resilience scores and HDRS scores at post-intervention (r=-0.295, p=0.015) and at six-month follow-up (r=-0.354, p=0.005). Furthermore, we observed a weak negative correlation between resilience scores and HARS scores at post-intervention (r=-0.292, p=0.016). Conclusion Subjects with higher resilience scores at baseline showed a lower severity of symptoms at post-intervention and at six-month follow-up.

Resumo Introdução Poucos estudos têm avaliado medidas positivas de resposta terapêutica. Assim, o objetivo deste estudo foi verificar os efeitos da resiliência na severidade dos sintomas depressivos e ansiosos após psicoterapia cognitiva breve para depressão. Métodos Trata-se de um estudo de intervenção clínica aninhado a um ensaio clínico com dois diferentes modelos de terapia cognitiva. A Resilience Scale foi aplicada no baseline, enquanto que a Hamilton Anxiety Rating Scale e a Hamilton Depression Rating Scale foram utilizadas no baseline, após a intervenção e no acompanhamento de seis meses. Resultados Sessenta e um pacientes foram avaliados no baseline, no pós-intervenção e no acompanhamento de seis meses. Os escores de resiliência foram significativamente diferentes entre as avaliações de baseline e pós-intervenção (p<0,001), bem como no baseline vs. acompanhamento de seis meses (p<0,001). Observamos uma correlação negativa fraca entre os escores de resiliência no baseline e os escores de sintomas depressivos no pós-intervenção (r=-0,295; p=0,015) e em seis meses de acompanhamento (r=-0,354; p=0,005). Além disso, observamos uma correlação negativa fraca entre os escores de resiliência e sintomas ansiosos no pós-intervenção (r=-0,292; p=0,016). Conclusão Indivíduos com maiores escores de resiliência na avaliação pré-tratamento apresentaram uma menor severidade de sintomas no pós-intervenção e no acompanhamento de seis meses.

Suicide risk and childhood trauma in individuals diagnosed with posttraumatic stress disorder / Risco de suicídio e trauma na infância em indivíduos diagnosticados com transtorno de estresse pós-traumático

Abstract Introduction Posttraumatic stress disorder (PTSD) develops after exposure to a potentially traumatic event. Its clinical condition may lead to the development of risk behaviors, and its early detection is a relevant aspect to be considered. The aim of this study was to assess the association between childhood trauma and suicide risk in individuals with PTSD. Method This was a cross-sectional study conducted with individuals aged 18 to 60 years who were evaluated at a mental health research outpatient clinic. PTSD diagnosis and suicide risk identification were performed using specific modules of the Mini International Neuropsychiatric Interview (MINI-Plus). The Childhood Trauma Questionnaire (CTQ) was used to evaluate traumatic events in childhood. Results Of the 917 individuals evaluated, 55 were diagnosed with PTSD. The suicide risk prevalence in individuals with PTSD was 63.6%. Emotional neglect and emotional abuse scores tended to be higher in the suicide risk group (p<0.2). Conclusion Our findings showed a higher prevalence of suicide risk in individuals with PTSD and support the hypothesis that the investigation of childhood traumatic experiences, especially emotional neglect and abuse, may help in the early detection of suicide risk in individuals with PTSD.

Resumo Introdução O transtorno de estresse pós-traumático (TEPT) desenvolve-se após exposição a evento traumático grave. É uma condição clínica que pode levar ao desenvolvimento de comportamentos de risco, e sua detecção precoce é um aspecto relevante a ser considerado. O objetivo deste estudo foi verificar a associação entre trauma na infância e risco de suicídio em indivíduos com TEPT. Método Este foi um estudo transversal conduzido com indivíduos de 18 a 60 anos de idade avaliados em um ambulatório de pesquisa e extensão em saúde mental. O diagnóstico do TEPT e a identificação do risco de suicídio foram realizados através dos módulos específicos da Mini International Neuropsychiatric Interview (MINI-Plus). O Childhood Trauma Questionnaire (CTQ) foi utilizado para avaliar eventos traumáticos na infância. Resultados Dos 917 indivíduos avaliados, 55 foram diagnosticados com TEPT. A prevalência de risco de suicídio em indivíduos com TEPT foi de 63,6%. Os escores de negligência emocional e abuso emocional mostraram tendência a estarem mais elevados no grupo com risco de suicídio (p<0,2). Conclusão Nossos achados mostram a alta prevalência de risco de suicídio em indivíduos com TEPT e suportam a hipótese de que a investigação de experiências traumáticas na infância, especialmente a negligência e o abuso emocionais, poderá auxiliar na identificação precoce do risco de suicídio em indivíduos com TEPT.

Gender differences of cannabis smoking on serum leptin levels: population-based study

Objective: To evaluate the serum leptin levels in cannabis smokers. Methods: This was a cross-sectional population-based study of participants between the ages of 18 and 35 years. The data were collected through a self-administered questionnaire covering sociodemographic data and the use of psychoactive substances. Leptin levels were measured using a commercial ELISA kit. Results: Of the 911 participants, 6.7% were identified as cannabis smokers and had significantly lower leptin levels (p = 0.008). When stratified by gender, there was a significant decrease in leptin levels among male smokers (p = 0.039). Conclusion: Cannabis smoking was linked to leptin levels in men, suggesting that the response to biological signals may be different between men and women.