Depression in older adults from the municipality of Mochitlan, Guerrero (Mexico) / Depresión en adultos mayores del municipio de Mochitlán, Guerrero (Mexico) / Depressão em idosos do município de Mochitlán, Guerrero (Mexico)

Introduction: Depression in older adults in an important aspect since it affects significantly their health and quality of life. As people age, they may experience physical, emotional, and social changes that make them more susceptible to depression. Based on estimations from the World Health Organization, the global population over 60 years of age with some depressive symptoms will increase from 12% to 22% between 2015 and 2050. Objective: To identify the prevalence and factors associated with depression in older adults from the municipality of Mochitlan, Guerrero. Materials and methods: Mixt quantitative research with an analytical cross-sectional design and a simple random sampling of 26 older adults. Information was collected through a multiple choice survey administered by the researchers using an instrument with four sections. The ethnographic method was used for the qualitative approach, through a semi-structured interview to a focus group of seven older adults, with 3 open questions. Results: Mild (38.46%), moderate (7.69%), and serious (3.85) was found. The associated factors were: female gender; type of work; and monthly income. The qualitative analysis showed positive and negative emotions. Conclusions: 50% of the population had some type of depression.

Introducción: La depresión en adultos mayores es un tema importante debido a que afecta de manera significativa la salud y calidad de vida. A medida que las personas envejecen, pueden experimentar cambios físicos, emocionales y sociales que los hacen más susceptibles a tener depresión. La Organización Mundial de la Salud (OMS) estima que entre 2015 y 2050 la población mundial mayor de 60 años pasará del 12% al 22% de padecer algún síntoma depresivo. Objetivo: Identificar la prevalencia y factores asociados a la depresión en adultos mayores del Municipio de Mochitlán, Guerrero. Materiales y métodos: Investigación mixta, cuantitativa con diseño transversal analítico, muestreo aleatorio simple en una población de 26 adultos mayores, se recabo información mediante una encuesta aplicada por los investigadores con opción múltiple utilizando un instrumento de cuatro apartados. Para el enfoque cualitativo se utilizó el método etnográfico, mediante una entrevista semiestructurada con 3 preguntas abiertas a un grupo focal de siete adultos mayores. Resultados: Se encontró depresión leve (38,46%), moderada (7,69%) y grave (3,85%). Los factores asociados fueron género femenino, tipo de trabajo; ingreso mensual. El análisis cualitativo mostro emociones positivas y negativas. Conclusiones: 50% de la población presento algún tipo de depresión.

Introdução: A depressão em idosos é um tema importante porque afeta significativamente a saúde e a qualidade de vida. À medida que as pessoas envelhecem, elas podem passar por mudanças físicas, emocionais e sociais que as tornam mais suscetíveis à depressão. A Organização Mundial da Saúde (OMS) estima que entre 2015 e 2050, a população mundial com mais de 60 anos passará de 12% a 22% sofrendo de alguns sintomas depressivos. Objetivo: Identificar a prevalência e os fatores associados à depressão em idosos do município de Mochitlán, Guerrero. Materiais e métodos: Pesquisa mista, quantitativa, com desenho analítico transversal, amostragem aleatória simples em população de 26 idosos, as informações foram coletadas por meio de questionário aplicado pelos pesquisadores com múltipla escolha por meio de instrumento de quatro seções. Para a abordagem qualitativa utilizou-se o método etnográfico, por meio de entrevista semiestruturada com 3 questões abertas a um grupo focal de sete idosos. Resultados: Foi encontrada depressão leve (38,46%), moderada (7,69%) e grave (3,85%). Os fatores associados foram sexo feminino, tipo de trabalho; ingresso mensal. A análise qualitativa evidenciou emoções positivas e negativas. Conclusões: 50% da população apresentou algum tipo de depressão.

Effects of repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride on executive function in depressed adolescents with non-suicidal self-injury / 中国基层医药

Objective:To investigate the effects of repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride on executive function in depressed adolescents with non-suicidal self-injury.Methods:The clinical data of 120 depressed adolescents with depressive disorders who were admitted to The Second Hospital of Jinhua from August 2021 to July 2022 were retrospectively analyzed. They were randomly assigned to undergo treatment either with paroxetine hydrochloride (control group, n = 60) or repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride (observation group, n = 60). All patients were treated for 2 months. Hamilton Depression Rating Scale-24 (HAMD-24) score, Non-suicidal Self-injury Behavior and Function Scale for Adolescents (ANSSIQ) score, executive function, brain-derived neurotrophic factor, 5-hydroxytryptamine, and clinical efficacy were determined in each group. Results:After treatment, the Hamilton Depression Rating Scale-24 score in the observation group was significantly lower than that in the control group [(15.85 ± 1.08) points) vs. (18.72±1.21) points, t = 13.71, P < 0.001). After treatment, the number of self-injury attacks, number of self-injury impulsions, and the intensity of self-injury thought within 2 weeks in the observation group were significantly lower than those in the control group ( t = 3.42, 3.03, 1.92, all P < 0.05). The scores of the Trail Making Test, Stroop Word test, Stroop Color test, and Stroop Color-Word Interference Test were significantly higher in the observation group than those in the control group ( t = 2.66, 3.33, 3.97, 4.64, all P < 0.01). Brain-derived neurotrophic factor and 5-hydroxytryptamine levels in the observation group were (11.45 ± 1.79) μg/L and (136.68 ± 11.90) μg/L, respectively, which were significantly higher than (9.06±2.21) μg/L and (124.82 ± 10.34) μg/L in the control group ( t = 6.51, 5.83, both P < 0.001). The total response rate in the observation group was significantly higher than that in the control group (91.7% vs. 78.3%, Z = 2.73, P = 0.006). Conclusion:Repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride is highly effective on depressive disorders in adolescents with non-suicidal self-injury. The combined therapy can reduce symptoms, improve executive function and cognitive function, and optimize serological indicators, and thereby deserves the clinical promotion.

A qualitative study on the influencing factors of parents′ participation in emotional management of adolescents with affective disorder / 中国实用护理杂志

Objective:To understand the barriers and facilitators to parental involvement in emotionally disturbed adolescents′ emotion management and to provide a basis for healthcare professionals to develop interventions for parental involvement in emotionally disturbed adolescents′ emotion management.Methods:Use of purposive sampling method from July to December 2021, 16 face-to-face semi-structured in-depth interviews were conducted with fathers or mothers of adolescents with affective disorders from the Third Hospital of Daqing City, and the data were analyzed using the Colaizzi 7-step analysis method.Results:Refining the theme from two aspects, one was the hindering factors: parents′ own factors including lack of knowledge about the disease, little time for companionship, poor emotional control, inappropriate communication style, and poor couple relationship; the child′s own factors including pathological factors, personality; environmental factors including academic stress, interpersonal relationships; economic factors including high cost of treatment, life stress. The other was the facilitating factors: support from others including family support, professional help; positive coping including finding coping strategies, change of mindset.Conclusions:Healthcare professionals should pay attention to these influencing factors and construct a program for parental involvement in emotionally disturbed adolescents′ emotion management from various aspects, so that parents can actively participate in their children′s emotion management and promote the rehabilitation of emotionally disturbed adolescents.

Influencias del confinamiento por COVID-19 sobre la salud mental en estudiantes de grado de terapia ocupacional / Influências do confinamento COVID-19 na saúde mental de estudantes de graduação em terapia ocupacional / Influences of COVID-19 lockdown on mental health in occupational therapy undergrad students

Resumen Introducción Los años de universidad son un periodo de desarrollo crucial para la transición de la adolescencia a la adultez, por eso existe una creciente preocupación sobre la salud mental de los estudiantes. El COVID-19 puso en situación de vulnerabilidad a esta población, con aumento del riesgo de depresión, ansiedad o estrés. Objetivo Aunque los estudios sobre los efectos de la pandemia y sus consecuencias sobre la salud mental se publican de manera exponencial, existen pocos centrados en estudiantes de ciencias de la salud. Por ello, se enfoca esta temática en estudiantes de Grado en Terapia Ocupacional para explorar los efectos sobre la salud mental en la etapa de confinamiento inicial. Método Partiendo de la hipótesis de que el confinamiento ha podido poner en situación vulnerable a los estudiantes universitarios, se realizó un estudio cuantitativo longitudinal con estudiantes del Grado de Terapia Ocupacional en base a los cuestionarios General Health Questionnaire (GHQ-28), Patient Health Questionnaire (PHQ-9), Escala de Felicidad Subjetiva (SHS) y la Escala de Desesperanza de Beck. Resultados Los resultados mostraron una mejoría en las diferentes escalas entre los años 2019 y 2020, con relaciones estadísticamente significativas entre el estado de confinamiento y una reducción del riesgo de depresión a su finalización. Conclusiones Esta relación sugiere dudas sobre la temporalidad y la medición de los resultados siendo posible queque el confinamiento tuviera aspectos positivos en algunas de las dimensiones de la salud mental, dada su relación con la falta de aislamiento social en muchos casos, el establecimiento de rutinas y la reincorporación a la docencia presencial.

Resumo Introdução Os anos universitários são um período de desenvolvimento crucial para a transição da adolescência para a idade adulta, razão pela qual é crescente a preocupação com a saúde mental dos estudantes. A COVID-19 coloca esta população numa situação vulnerável, com risco acrescido de depressão, ansiedade ou stress. Objetivo Embora estudos sobre os efeitos da pandemia e suas consequências na saúde mental sejam publicados de forma exponencial, poucos são os voltados para estudantes de ciências da saúde. Por este motivo, aborda-se esta temática em alunos de graduação em terapia ocupacional para explorar os efeitos na saúde mental em fase inicial de confinamento. Método Partindo da hipótese de que o confinamento tem sido capaz de colocar estudantes universitários em situação de vulnerabilidade, foi realizado um estudo quantitativo longitudinal com estudantes do Curso Graduação em Terapia Ocupacional com base no General Health Questionnaire (GHQ-28), Patient Health Questionnaire (PHQ-9), Escala de Felicidade Subjetiva (SHS) e Escala de Desesperança de Beck. Resultados Os resultados mostraram uma melhora nas diferentes escalas entre os anos de 2019 e 2020, com relações estatisticamente significativas entre o estado de confinamento e a redução do risco de depressão ao final. Conclusão Esta relação sugere dúvidas sobre a temporalidade e a mensuração dos resultados, sendo possível que o confinamento tenha tido aspectos positivos em algumas das dimensões da saúde mental, dada sua relação com a falta de isolamento social, em muitos casos, o estabelecimento de rotinas e o retorno ao ensino presencial.

Abstract Introduction The university years are a crucial period of development for the transition from adolescence to adulthood, which is why there is a growing concern for the mental health of students. COVID-19 places this population in a vulnerable situation, with an increased risk of depression, anxiety, or stress. Objective Although studies on the effects of the pandemic and its consequences on mental health are published exponentially, few studies focus on students in health sciences. Therefore, we aimed the approach of these issues regarding undergraduates from the Degree of Occupational Therapy to explore the effects of the national lockdown on mental health. Method Based on the hypothesis that confinement may have made university students vulnerable, a quantitative longitudinal study was conducted with students of the Occupational Therapy Degree based on the General Health Questionnaire (GHQ-28), Patient Health Questionnaire (PHQ-9), Subjective Happiness Scale (SHS) and Beck's Scale of Hopelessness (BSH). Results The results showed an improvement in the different scales between 2019 and 2020, with statistically significant relationships between the state of confinement and a reduction in the risk of depression at its end. Conclusions This relationship suggests doubts about the temporality and measurement of the results since it is possible that confinement had positive aspects in some of the dimensions of mental health, given its relationship with the lack of social isolation in many cases, the establishment of routines and the return to face-to-face teaching.

Depresión psicótica secundaria a hipertiroidismo y desenlace letal por tormenta tirotóxica: a propósito de un caso / Psychotic depression secondary to hyperthyroidism and lethal outcome by thyrotoxic storm: case report

RESUMEN El rol de exceso y déficit de hormona tiroidea en la patogenia de trastornos del ánimo se ha registrado desde hace casi dos siglos. Las patologías tiroideas, las más numerosas dentro de las enfermedades endocrinas, se asocian causalmente a patología psiquiátrica en un importante porcentaje de casos. Específicamente, el hipertiroidismo produce múltiples manifestaciones psicopatológicas de tipo ansioso y depresivo, episodios de manía e, infrecuentemente, psicosis. Aunque el influjo del eje tiroideo sobre las vías neurales de noradrenalina, dopamina, y serotonina juega un rol neurobiológico fundamental en estos fenómenos, existen todavía múltiples mecanismos subyacentes por dilucidar. Dada la necesidad de un diagnóstico diferencial amplio y abarcador entre patologías psiquiátricas primarias y secundarias, reportamos el caso de una paciente de 52 años con depresión psicótica, en la que el diagnóstico tardío de hipertiroidismo acarreó consecuencias penosas y letales. La valoración clínica y laboratorial de la función tiroidea, debe ser parte de la evaluación psiquiátrica de cualquier persona con trastornos afectivos y ansiosos.

SUMMARY The role of excess and deficit of thyroid hormone in the pathogenesis of mood disorders has been recorded for almost two centuries. Thyroid pathologies, the most numerous among endocrine diseases, are causally associated with psychiatric pathology in a significant percentage of cases. Specifically, hyperthyroidism produces multiple psychopathological manifestations of anxious and depressive type, manic episodes and, infrequently, psychosis. Although the influence of the thyroid axis on the neural pathways of norepinephrine, dopamine, and serotonin plays a fundamental neurobiological role in these phenomena, there are still multiple underlying mechanisms to be elucidated. Given the need for a broad and comprehensive differential diagnosis between primary and secondary psychiatric pathologies, we report the case of a 52-year-old patient with psychotic depression in whom the late diagnosis of hyperthyroidism had painful and lethal consequences. Clinical and laboratory-based evaluations of thyroid function should be part of the psychiatric evaluation of any person with affective and anxiety disorders.

Nosografia dos Transtornos Afetivos: um recorte histórico de Kraepelin ao DSM-5 / Nosography of Affective Disorders: A historical review from Kraepelin to DSM-5 / Nosographie des troubles affectifs: un aperçu historique de Kraepelin au DSM-5 / Nosografia de los trastornos afectivos: un corte histórico de Kraepelin al DSM-5

A nosografia dos transtornos do humor e do afeto relaciona-se diretamente com as formas de apreensão dos quadros clínicos em cada contexto histórico. É indagado se o resgate histórico contribuiria para melhor compreensão e utilização da atual nosologia dos transtornos de humor. Objetiva-se realizar uma revisão histórica e crítica acerca de suas transformações conceituais e nosológicas com enfoque ao campo médico-psiquiátrico. O recorte pretendido se inicia com a proposição da "Insanidade Maníaco-Depressiva" por Emil Kraepelin em 1899, que é confrontada com as propostas pós-kraepelianas, em especial as de Karl Leonhard. Analisa-se a influência dessas na criação dos sistemas diagnósticos operacionalizados, DSM e CID. O "Transtorno Bipolar" foi um constructo introduzido pelo DSM-III e se mantém em uso até os dias atuais. Aborda-se também propostas posteriores, como a do "Espectro Bipolar".

Nosography of mood and affective disorders is directly related to how clinical pictures are understood in each historical context. Inquiring on whether a historical recollection would contribute to a better understanding and use of the current nosology of mood disorders, the study carries out a historical and critical review of its conceptual and nosological transformations on the medical-psychiatric field. Starting from Emil Kraepelin's "Manic-Depressive Insanity," proposed in 1899, the text confronts this concept with post-Kraepelian proposals, especially those of Karl Leonhard. It then analyzes their influence in the creation of two operationalized diagnostic systems — DSM and ICD. "Bipolar Disorder," a construct introduced by the DSM-III, remains in use today. Later proposals are also addressed, such as the "Bipolar Spectrum".

La nosographie des troubles de l'humeur et des troubles affectifs est directement liée à la manière dont les tableaux cliniques sont compris dans chaque contexte historique. En se demandant si un rappel historique contribuerait à une meilleure compréhension et utilisation de la nosologie actuelle des troubles de l'humeur, l'étude procède a un examen historique et critique de ses transformations conceptuelles et nosologiques dans le domaine médico-psychiatrique. Partant de la "Folie maniaco-dépressive" d'Emil Kraepelin, proposée en 1899, l'article confronte ce concept aux propositions post-Kraepeliennes, notamment celles de Karl Leonhard. On analyse ensuite leurs influence dans la création de systèmes de diagnostic opérationnalisés — le DSM et la CIM. Le "trouble bipolaire", une construction introduite par le DSM-III, est toujours utilisé aujourd'hui. D'autres propositions sont égalemment abordées, comme le "spectre bipolaire".

La nosografía de los trastornos afectivos está directamente relacionada con las formas en que se aprehenden las condiciones clínicas en cada contexto histórico. Se pregunta si la revisión histórica contribuiría a una mejor comprensión y uso de la nosología actual de los trastornos del humor. El objetivo de este artículo es realizar una revisión histórica y crítica de sus transformaciones conceptuales y nosológicas con un enfoque en el campo médico-psiquiátrico. El recorte comienza con la propuesta en el texto "Locura maníaco-depresiva", de Emil Kraepelin, en 1899, que se enfrenta a propuestas postkraepelianas, especialmente las de Karl Leonhard. Se analiza la influencia de estas propuestas en la creación de sistemas diagnósticos operacionalizados, el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM) y la Clasificación Internacional de Enfermedades (CID). El "trastorno bipolar" es una construcción introducida por el DSM-3 y sigue en uso hoy. También se abordan propuestas posteriores, como la del "espectro bipolar".

Typological Profiles of Depression of College Students: Latent Classes and Controlling for Response Bias of the Baptista Depression Short-Scale (EBADEP-short) / Perfis Tipológicos de Depressão de Universitários: Classes Latentes e Controle de Viés de Resposta da Escala Reduzida Baptista de Depressão - (EBADEP-short) / Tipología de la Depresión de Estudiantes Universitarios: Clases Latentes y Control del Sesgo de Respuesta de la Escala Reducida Baptista de Depresión (EBADEP-short)

Abstract Response styles and non-linearity might reduce the validity of scores on depression inventories. To address both issues, we explored the latent class structure of the Baptista's Depression Scale (EBADEP), and the influence of extreme response bias. In total, 1,137 Brazilian college students (M = 26 years, SD = 7.3) participated in this study. Taxometric analysis yielded ambiguous results, without clear support for either a dimensional or a categorical representation of the data. We found three latent classes: one comprising participants with a tendency to endorse items about sadness, angst, pessimism, and low self-efficacy; another with individuals scoring low on all symptoms; and a third with intermediate scores. We found no relationship between the composition of latent classes and extreme response. Participants who reported having received a diagnostic of depression were more likely to belong to the first latent class. These findings validate the clinical usefulness of a latent class structure for the EBADEP.

Resumo Respostas extremas e ausência de linearidade podem reduzir a validade de escores de depressão. Para abordar esse problema, este estudo teve por objetivo explorar a estrutura de classes latentes da Escala Baptista de Depressão (EBADEP) e a influência do viés de respostas extremas. Participaram 1.137 estudantes universitários brasileiros (M = 26 anos, DP = 7,3). A análise taxométrica indicou resultados ambíguos, sem um ajuste explicitamente melhor para uma estrutura dimensional ou categórica. Foram identificadas três classes latentes: a primeira, composta de participantes que tenderam a endossar itens de tristeza, angústia, negativismo e baixa autoeficácia; a segunda, de indivíduos com níveis baixos de sintomas; a terceira, com escores intermediários nos itens. Não foram encontradas relação entre as classes latentes e o estilo de respostas extremas. Participantes que relataram um diagnóstico de depressão apresentaram maior probabilidade de pertencer à primeira classe latente. Os resultados evidenciam a utilidade clínica da estrutura de classes latentes para a EBADEP.

Resumen Las respuestas extremas y la falta de linealidad pueden reducir la validez de los escores de depresión. Al abordar este problema, este estudio pretende explorar la estructura de clases latentes de la Escala de Depresión Baptista (EBADEP) y la influencia del sesgo de respuesta extremo. Participaron 1.137 universitarios brasileños (M = 26 años, DE = 7,3). El análisis taxométrico indicó resultados ambiguos, sin un ajuste explícitamente mejor para una estructura dimensional o categórica. Se identificaron tres clases latentes: la primera, compuesta por participantes que tendían a obtener altas puntuaciones en los ítems tristeza, angustia, negativismo y baja autoeficacia; la segunda, de individuos con bajos niveles de síntomas; y la tercera, con puntuaciones intermedias en los ítems. No se encontró relación entre las clases latentes y el estilo de respuestas extremas. Los participantes que informaron estar con diagnóstico de depresión tenían más probabilidades de pertenecer a la primera clase latente. Los resultados muestran la utilidad clínica de la estructura de clases latente para EBADEP.

Perfil social y económico de los pacientes diagnosticados con trastornos del humor del Hospital Departamental Psiquiátrico Universitario del Valle, Cali / Social and economic profile of patients diagnosed with Mood disorders at the hospital Departamental psiquiátrico Universitario del Valle-Cali"

El objetivo de este artículo consiste en dar a conocer un perfil social, económico y demográfico de la población registrada con SISBÉN en el Hospital Departamental Psiquiátrico Universitario del Valle (HDPUV) entre el 2009 y el 2018, cuyo diagnóstico se encuentra dentro del grupo de los trastornos del humor (correspondiente al espectro de códigos del CIE-10 que va desde F30 a F39, episodio maníaco, trastorno bipolar, episodio depresivo, trastorno depresivo recurrente, trastorno del humor persistente, otros trastornos del humor, trastorno del humor sin especificación). Se optó por un trabajo en el que se complementó la información entre las bases de datos del SISBÉN de Cali y la del HDPUV para profundizar en datos sobre pobreza y vulnerabilidad de las personas que son potenciales beneficiarios de programas sociales estatales. Se identificaron 5.280 pacientes diagnosticados con trastornos del humor, en su mayoría mujeres (70,4 %) en condiciones de vulnerabilidad económicas, sociales y de acceso a servicios de salud, que representan otro factor más de riesgo para su salud mental.

The aim of this article is to provide a social, economic and demographic profile of the population registered with SISBÉN at the Hospital Departamental Psiquiátrico Universitario del Valle (HDPUV) between 2009 and 2018, whose diagnosis is within the group of mood disorders, (corresponding to the spectrum of ICD- 10 codes ranging from F30 to F39, manic episode, bipolar disorder, depressive episode, recurrent depressive disorder, persistent mood disorder, other mood disorders, mood disorder without specification). We opted for a study in which we complemented the information between the Cali SISBÉN and HDPUV databases to deepen in data on poverty and vulnerability of people who are potential beneficiaries of state social programs. We identified 5,280 patients diagnosed with mood disorders, mostly women (70.4%) in conditions of economic, social and access to health services vulnerability, which represent yet another risk factor for their mental health.

A closer look at the epidemiology of schizophrenia and common mental disorders in Brazil / Um olhar mais atento à epidemiologia da esquizofrenia e de transtornos mentais comuns no Brasil

ABSTRACT. Schizophrenia and common mental disorders are noteworthy social and economic concern worldwide. Epidemiologic studies on the impact of specific mental disorders in emerging countries are scarce. Objectives: We aimed to characterize the demographic, social, and economic burden of schizophrenia and common mental disorders patients in the health system in Brazil. Methods: Data on these conditions in Brazil between 2008 and 2019 were collected through the website of the Departamento de Informática do Sistema Único de Saúde (Information Technology Department of the Unified Health System - DATASUS) maintained by the Brazilian Ministry of Health. Mean annual hospital admissions were 154,009.67, and cumulative incidence of 77.44 admissions per 100,000 inhabitants. Results: Average annual hospital expenses were US$ 67,216,056.04, with an average admission cost of US$ 432.58. The most affected age groups were older adults albeit younger individuals showed a trend towards increase of occurrences in recent years. There were a higher number of admissions in men compared to women. Conclusions: We consider the results obtained important to assist in evaluating and guiding public policies regarding the prevention and treatment in health systems.

RESUMO. A esquizofrenia e os transtornos mentais comuns são uma preocupação social e econômica notável em todo o mundo. Estudos epidemiológicos sobre o impacto de transtornos mentais específicos em países emergentes são escassos. Objetivos: Nosso objetivo foi caracterizar a carga demográfica, social e econômica de pacientes com esquizofrenia e transtornos mentais comuns no sistema de saúde no Brasil. Métodos: Os dados sobre essas condições no Brasil entre 2008 e 2019 foram coletados por meio do site do Departamento de Informática do Sistema Único de Saúde (DATASUS), mantido pelo Ministério da Saúde do Brasil. As internações hospitalares anuais médias foram de 154.009,67, e a incidência acumulada de 77,44 internações por 100.000 habitantes. Resultados: As despesas hospitalares médias anuais foram de US$ 67.216.056,04, com um custo médio de internação de US$ 432,58. As faixas etárias mais afetadas foram os adultos mais velhos, embora os mais jovens tenham demonstrado tendência a aumento de ocorrências nos últimos anos. Houve um número maior de admissões entre os homens em comparação às mulheres. Conclusões: Consideramos importantes os resultados obtidos para auxiliar na avaliação e orientação de políticas públicas de prevenção e tratamento nos sistemas de saúde.

Caracterización clínica y terapéutica del episodio depresivo en pacientes hospitalizados / Clinical and therapeutic characterization of depressive episodes in hospitalized patients

RESUMEN Introducción: la depresión es la enfermedad psiquiátrica más frecuente y puede sufrirse a cualquier edad. Cerca del 20 % de las personas padecen durante su vida una depresión, de ellos el 70 % son mujeres. Objetivo: caracterizar los pacientes hospitalizados con diagnóstico de episodio depresivo según síntomas clínicos, terapia utilizada y presencia de complicaciones, en el Hospital Clínico Quirúrgico Docente Dr. León Cuervo Rubio de Pinar del Río durante los años 2017-2018. Métodos: se realizó un estudio observacional, descriptivo y transversal. El universo quedó constituido por 116 pacientes con el diagnóstico clínico de episodio depresivo que necesitaron tratamiento psicológico durante la hospitalización. Los datos fueron obtenidos de las historias clínicas, mediante la entrevista y la observación. Resultados: se evidenció que el sexo femenino fue el mayor afectado, en edades entre 40-59 años. Como factores de riesgo sociales se incluyeron estados familiares de salud; económicos relacionados con la personalidad del paciente, y los factores biológicos. La disminución de la atención y concentración, perdida de la confianza en sí mismo, sentimientos de inferioridad, ideas de culpa e inutilidad, fueron los principales síntomas. Conclusiones: la disminución de la atención y concentración, estuvieron presentes en todos los pacientes con predominio de ideas de culpa y de inutilidad, las complicaciones escasas fueron escasas, siendo la terapia cognitivo conductual el tratamiento de elección utilizado.

ABSTRACT Introduction: depression is the most common psychiatric illness. About 20% of people suffer from depression during their lifetime, of which 70 % are women and can be suffered at any age. Objective: to characterize hospitalized patients with diagnosis of depressive episode based on clinical symptoms, therapy applied and presence of complications at Dr. León Cuervo Rubio Teaching Clinical Surgical Hospital. Pinar del Río during the years 2017-2018. Methods: an observational, descriptive and cross-sectional study was performed. The target group included 116 patients with clinical diagnosis of depressive episode who needed psychological treatment during hospitalization. Data were obtained from clinical histories, and through interview and observation. Results: it was evidenced that female gender was mostly affected, in ages between 40-59 years. The main risk factors identified were social factors, such as health relatives, economic factors related to the patient's personality, and biological factors. The main symptoms were reduced attention and concentration, loss of self-confidence and feelings of inferiority, guilt and uselessness. Conclusions: decreased of attention and concentration were present in all patients with predominance of guiltiness and uselessness ideas, scarce complications, cognitive behavioral therapy was the treatment of choice.

Quality of Sleep in Association with Relapse in Patients with Bipolar Affective Disorder

Introduction: Bipolar Affective Disorders is an episodic mooddisorder with significant global morbidity. Sleep deprivationin addition to being a core symptom and early warning sign ofimpending mood episodes can also trigger relapse. Individualswith Bipolar Affective Disorder in specific, differ in theirtendency for sleep loss to trigger relapse depending on theirsociodemographic and clinical factors.Current study objective was to evaluate the frequency andquality of sleep as a trigger for relapse of mood episode inpatients with bipolar affective disorders and to correlate itwith socio-demographic profile and clinical variables.Material and methods: This observational cross sectionalclinical study was conducted on 62 patients with ICD10diagnosis of bipolar affective disorders presenting with relapseof mood episode. Presence of acute sleep deprivation andchronic sleep insufficiency according to American academy ofsleep medicine criteria was considered. Young Mania RatingScale (YMRS) and Hamilton Depression Rating Scale (HAMD) were administered. Pittsburgh Sleep Quality Index (PSQI)Scale was used to assess quality of sleep. Written Informedconsents were taken from all the subjects. The data wasanalyzed with appropriate statistical methods.Results: Of the 62 patients assessed with diagnosis of bipolaraffective disorders presenting with mood episode, 58.1% havepoor quality of sleep and 41.9% have good quality of sleep.No statistically significant association noted in any domains ofsocio demographic profile. Statistically significant associationis noted with triggers in the present episode of relapse with94.4% of individual were noted to have sleep deprivation(p<0.001). 52.8% individuals with current episode manic,16.7% with depression, 27.8% with hypomania and 2.8% withcurrent episode mixed is noted to have poor quality of sleepand statistically significant association is noted with polarityof current episode. No statistically significant associationnoted between quality of sleep with other clinical variables.Conclusion:Poor quality of sleep may trigger relapse ofmood episode in patients with bipolar affective disorders.Our finding substantiates the need for careful assessment andmanagement of sleep disturbances during maintenance phasefor bipolar disorders

Análise bifator da Escala Baptista de Depressão: Versão Idosos (EBADEP-ID) / Bifactor analysis of the Baptista's Depression Scale / Análisis bifactor de la Escala Baptista de Depresión

Modelos bifator têm sido relatados na literatura como explicações plausíveis para a estrutura latente da depressão. O presente estudo busca expandir essa área de investigação, tendo como objetivo principal realizar uma análise exploratória bifator da Escala Baptista de Depressão - Versão Idosos (EBADEP-ID). Os participantes foram 311 idosos com idades variando de 60 a 90 anos, provenientes de cinco grupos populacionais de tipo clínico e não clínico. Os resultados mostraram um melhor ajuste aos dados para o modelo bifator com um fator geral e dois fatores específicos, quando comparado a uma simples solução unidimensional. Entretanto, todos os itens carregaram predominantemente no fator geral, ocorrendo poucas cargas significativas nos fatores específicos, o que sustenta a unidimensionalidade do instrumento. O escore geral da EBADEP-ID apresentou elevada consistência interna (0,95 pelo coeficiente alfa, e 0,98 pelo coeficiente ômega) e capacidade informativa, além de alta sensibilidade e especificidade. Implicações teóricas e práticas dos resultados, bem como limitações do estudo, são discutidas ao final.

Bifactor models have been reported in the literature as plausible explanations of the latente structure of depression. In the present study, we offer a contribution to this area of research, by performing an exploratory bifactor analysis of the Baptista's Depression Scale-elderly version (EBADEP-ID). Participants were 311 elderlies with ages ranging from 60 to 90 years, coming from five distinct clinical and nonclinical populations. The bifactor model comprising one general factor and two specific factors yielded a better fit to the data when compared with a simple unidimensional model. However, all items loaded highly on the general factor, and few items had loadings on the specific factors in the model, then supporting the unidimensionality of the EBADEP-ID. The sum score provided by the instrument achieved high internal consistency (.95 according to alpha, and .98 according to ômega coefficient) and informative capacity, besides high sensitivity and specificity. Theoretical and practical implications of the findings, as well as limitations to the study, are discussed.

Los modelos bifator han sido reportados en la literatura como explicaciones plausibles para la estructura latente de la depresión. El presente estudio busca expandir esa área de investigación, teniendo como objetivo principal realizar un análisis exploratorio bifator de la Escala Baptista de Depressão-Versão Idosos (EBADEP-ID). Los participantes fueron 311 ancianos con edades variando de 60 a 90 años, provenientes de cinco grupos poblacionales de tipo clínico y no clínico. Los resultados mostraron un mejor ajuste a los datos para el modelo bifator con un factor general y dos factores específicos, en comparación con una simple solución unidimensional. Sin embargo, todos los elementos cargaron predominantemente en el factor general, ocurriendo pocas cargas significativas en los factores específicos, lo que sostiene la unidimensionalidad del instrumento. La puntuación general de EBADEP-ID presentó elevada consistencia interna (0,95 por el coeficiente alfa, y 0,98 por el coeficiente omega) y capacidad informativa, además de alta sensibilidad y especificidad. Las implicaciones teóricas y prácticas de los resultados, así como las limitaciones del estudio, se discuten al final.

Solidão como variável preditora na depressão em adultos / Loneliness as a predictive variable in adult depression / Soledad como variable predictora en la depressión en adultos

Depressão é um transtorno multifatorial, de alta prevalência, considerada um problema de saúde pública mundial. Diversas são as variáveis implicadas no desenvolvimento e manutenção deste transtorno, como as psicológicas, sociais e biológicas. O objetivo desta pesquisa foi avaliar a solidão como fator preditivo na depressão em adultos, após controle de outros preditores tais como ansiedade, estresse, neuroticismo e variáveis clínicas. A amostra foi composta de 297 universitários de Minas Gerais, São Paulo e Rio de Janeiro. As escalas utilizadas foram a EBADEP-A, DASS-21, UCLA, MHI-5 e IGFP-5. Após regressão múltipla hierárquica, os resultados demonstraram que a saúde mental, neuroticismo, ansiedade e solidão foram os principais preditores, sendo que a solidão, após controle de todas as variáveis, acresceu 1% de variância isolada no modelo e demonstrou ser uma das variáveis mais importantes relacionadas à depressão. A avaliação clínica e intervenções devem levar em consideração esta variável na prática clínica.

Depression is a multifactorial and high prevalence disorder considered a global public health problem. There are several variables involved in the development and maintenance of this disorder, including psychological, social and biological ones. The objective of this research was to evaluate loneliness as a predictive factor in adult depression, after controlling other predictors such as anxiety, stress, neuroticism and clinical variables. The sample consisted of 297 university students from Minas Gerais, São Paulo and Rio de Janeiro. The scales used were EBADEP-A, DASS-21, UCLA, MHI-5 and IGFP-5. After multiple hierarchical regression, the results showed that mental health, neuroticism, anxiety and loneliness were the main predictors. Loneliness, after controlling for all variables, increased 1% of exclusive variance in the model and was one of the most relevant predictors of depression. Clinical evaluation and interventions should consider loneliness in clinical practice.

La depresión es un trastorno multifactorial, de alta prevalencia, considerado un problema de salud pública mundial. Diversas son las variables implicadas en el desarrollo y mantenimiento de este trastorno, entre ellos psicológicos, sociales y biológicos. El objetivo de esta investigación fue evaluar la soledad como factor predictivo en la depresión en adultos, tras el control de otros predictores tales como ansiedad, estrés, neuroticismo y variables clínicas. La muestra fue compuesta de 297 universitarios de Minas Gerais, São Paulo y Río de Janeiro. Las escalas utilizadas fueron la EBADEP-A, DASS-21, UCLA, MHI-5 e IGFP-5. Después de la regresión múltiple jerárquica, los resultados demostraron que la salud mental, el neuroticismo, la preocupación y la soledad eran los preditores principales, y la soledad, después del control de todas las variables, aumentó un 1% de varianza aislada en el modelo y demostró ser una de las variables más importantes relacionadas con la depresión. La evaluación clínica e intervenciones deben tener en cuenta esta variable en la práctica clínica.

White matter volume is decreased in bipolar disorder at early and late stages / O volume da substância branca está reduzido tanto nos estágios iniciais quanto nos estágios avançados do transtorno bipolar

Abstract Introduction: Bipolar disorder (BD) is a debilitating mood condition that affects approximately 1.3% of people worldwide, although some studies report up to 3.9% lifetime prevalence and 4-6% in adults when broad diagnostic criteria are applied. Objective: To compare differences in total white matter (WM), corpus callosum (CC) and total gray matter (GM) volumes in patients with type I BD at early and late stages compared with controls. Methods: Fifty-five subjects were enrolled in this study protocol. The double case-control design included 14 patients with BD at early stage; 15 patients at late stage; and their respective matched controls (14 and 12 subjects). Results: CC and total WM volumes were significantly smaller in patients with BD at early and late stages vs. controls. There was no difference for total GM volume in the early stage group, but in patients at late stage total GM volume was significantly smaller than in controls. The total GM volume reduction in patients at late stage is in agreement with the neuroprogression theory of BD. The reduction of WM volumes in total WM and in the CC at early and late stages supports the possibility that an early demyelination process could occur underlying the clinical manifestation of BD. Conclusion: Our findings may direct to the investigation of WM abnormalities in populations at high risk to develop BD, perhaps as early biomarkers before the overt syndrome.

Resumo Introdução: O transtorno do humor bipolar (THB) é uma condição debilitante que afeta aproximadamente 1,3% das pessoas em todo o mundo, embora alguns estudos relatem uma prevalência acumulada de até 3,9% e de 4-6% em adultos quando os critérios diagnósticos mais abrangentes são aplicados. Objetivo: Comparar as diferenças nos volumes totais de substância branca (SB), corpo caloso (CC) e volume total de substância cinzenta (SC) em pacientes com THB tipo I em estágios iniciais e tardios em comparação com controles. Métodos: Cinquenta e cinco sujeitos foram incluídos neste protocolo de estudo. O desenho de caso com duplo controle incluiu 14 pacientes com THB em estágio inicial; 15 pacientes com THB em fase tardia; e seus respectivos controles correspondentes (14 e 12 sujeitos). Resultados: Os volumes do CC e total de SB foram significativamente menores nos pacientes com THB nos estágios iniciais e tardios vs. controles. Não houve diferença para o volume total de SC no grupo em estágio inicial, mas em pacientes em fase tardia o volume total de SC foi significativamente menor do que nos controles. A redução do volume total de SC em pacientes em fase tardia está de acordo com a teoria da neuroprogressão do THB. A redução dos volumes de SB em SB total e no CC em fases precoces e tardias suporta a possibilidade de que um processo de desmielinização precoce poderia ocorrer subjacente à manifestação clínica de THB. Conclusão: Nossos achados podem direcionar a investigação de anormalidades da SB em populações de alto risco para o desenvolvimento de THB, talvez como biomarcadores precoces antes da síndrome aberta.

Variables diferenciadoras del nivel de gravedad de la depresión mediante el Sistema Comprehensivo Rorschach / Differentiated variables of the seriousness level of the depression by means of the Rorschach Comprehensive System

RESUMEN Se desarrolló una investigación descriptiva transversal, con un enfoque cuantitativo, en la que la muestra fue seleccionada de manera intencional pura, no probabilística, según criterios establecidos por los autores del estudio. Quedó constituida por las variables del Sistema Comprehensivo Rorschach pertenecientes a 120 protocolos de sujetos con trastornos depresivos, de ellos 82 presentaron depresión moderada, y 38 depresión severa. Se aplicaron los siguientes métodos empíricos: entrevista, observación, Autoescala de Zung y Conde, y el Psicodiagnóstico de Rorschach. Los estadígrafos que se utilizaron fueron el Test de Kolmogorov- Smirnov, el Test de Comparación de Proporciones y la prueba de Mann-Whitney. Como principales resultados se obtuvo que las variables del Sistema Comprehensivo Rorschach, que establecieron diferencias estadísticas altamente significativas entre los grupos de sujetos fueron: Lambda alta, Proporción afectiva baja, total de respuestas, las respuestas globales, Suma Ponderada de respuestas con el determinante color cromático y la Experiencia accesible.

ABSTRACT A transverse descriptive investigation was developed, with a quantitative approach, in that the sample was selected in a pure intentional way, not probabilistic, according to criteria established by the authors of the study. It was constituted for the variables of the Rorschach Comprehensive System belonging to 120 protocols of individuals with depressive disorders, of them 82 presented moderate depression, and 38 severe depression. The following empirical methods were applied: interview, observation, Auto-scale of Zung and Conde, and Psycho-diagnosis of Rorschach. The statisticians used were the Test of Kolmogorov - Smirnov, the Test of Comparison of Proportions and the Mann-Whitney test. As main results, it was obtained that the variables of the Rorschach Comprehensive System, which established highly significant statistical differences between the groups of individuals were: tall Lambda, low affective proportion, whole of answers, the global answers, exaggerated sum of answers with the determinant chromatic color and the accessible experience.

Effect of sodium valproate tablets and venlafaxine hydrochloride sustained-release tablets in the treatment of female schizophrenia with affective disorder / 中国基层医药

Objective To investigate the clinical effect of sodium valproate tablets combined with venlafaxine hydrochloride sustained-release tablets in female patients with schizophrenia complicated with affective disorders and its influence on the recurrence time.Methods From January 2013 to July 2016,98 female patients with schizophrenia complicated by affective disorder in Taiyuan Mental Hospital were selected and randomly divided into single group (n =49) and combination group (n =49) according to the digital table.The single drug group was treated with sodium valproate tablets,and the combination group was treated with venlafaxine hydrochloride sustained-release tablets on the basis of a single drug group.The clinical efficacy and recurrence time of the two groups were compared.Results The scores of withdrawal symptoms [(4.39 ± 0.94) points],positive symptoms [(11.55 ± 4.30) points],negative symptoms [(11.09 ± 1.21) points] and psychiatric symptoms [(12.01 ±2.16) points] in the combination group were all significantly lower than those at 1 month after treatment[(10.98 ±1.43) points,(16.74 ± 3.89) points,(18.43 ± 2.05) points,(19.83 ± 3.44) points] (t =12.957,18.471,all P ＜0.05).The incubation period and amplitude of the P300 potentials in the combination group were (314.55 ± 9.21) s,(4.05 ± 1.76)s,respectively,which were both higher than those of the single drug group [(341.60 ± 25.87)s,(2.58 ± 2.30)s] (t =18.251,15.738,all P ＜ 0.05).The eye movements of the combination group 12 weeks after operaion were (27.30 ± 1.41) s and (6.15 ± 0.98) s,respectively,which were higher than those of the single drug group[(25.10 ± 2.93) s and (5.10 ± 1.20) s] (t =13.992,15.836,all P ＜ 0.05).The recurrence rate of the combined group was 8.16％,which was lower than 18.37％ of the single drug group(x2 =6.893,P ＜ 0.05).The hospitalization duration [(14.83 ± 4.61)d],symptom improvement time [(34.94 ± 7.85)d] of the combined group were shorter than those of the single drug group [(27.91 ± 7.49) d,(59.81 ± 10.94) d] (t =18.946,21.461,all P ＜ 0.05).The recurrence time at 12 weeks after treatment of the combination group was (148.48 ± 33.19)d,which was longer than (109.46 ±28.88)d of the single drug group(t =16.893,P ＜0.05).Conclusion The combination of sodium valproate tablets and venlafaxine hydrochloride sustained-release tablets in.patients with schizophrenia complicated with affective disorders can improve the clinical effect,shorten the recurrence time and improve the cognitive function of patients,which is worth popularizing and applying.

Avaliando "depressões": dos critérios diagnósticos às escalas psicométricas / Evaluating "depressions": from diagnostic criteria to psychometric scales / Evaluación de las "depresiones": desde los criterios diagnósticos hasta las escalas psicométricas

O termo "depressão" pode ser utilizado para se referir a uma gama bastante abrangente de diagnósticos e expressões de sintomas, de maneira que duas pessoas podem apresentar sintomas completamente diferentes uma da outra e, mesmo assim, ambas terem diagnóstico semelhante. Nesse sentido, as escalas podem ser fundamentais no processo de rastreio, auxílio no diagnóstico e intervenção de pacientes com sintomatologia clinicamente significativa de depressão. Este artigo tem como objetivo discutir duas temáticas atuais que envolvem a avaliação psicológica. A primeira se refere a diferentes apontamentos (descrição, importância, críticas) sobre os critérios dos manuais psiquiátricos referentes aos transtornos depressivos. Na segunda temática, são discutidas características das escalas que avaliam sintomatologia depressiva e suas especificidades, já que elas podem ser distintas entre si, em vários aspectos, como teorias de base, dimensionalidade, número de itens, tipo de resposta, especificidades do ciclo de vida, formas de aplicação, dentre outros. (AU)

The term "depression" can be used to refer to a fairly wide range of diagnoses and expressions of symptoms, so that two people may have completely different symptoms from each other, and yet both may have a similar diagnosis. Therefore, scales can be fundamental in the screening process, aiding in diagnosis and intervention with patients presenting clinically significant symptoms of depression. This article aims to discuss two current issues in psychological assessment. The first refers to different notes (description, importance, criticism) regarding the criteria in psychiatric manuals related to depressive disorders. The second theme discusses characteristics of the scales that evaluate depressive symptomatology and their specificities are discussed, since they may differ from each other, in several aspects such as basic theories, dimensionality, number of items, response type, life cycle specificities, application forms, among others. (AU)

El término "depresión" puede ser utilizado para referirse a una gama bastante amplia de diagnósticos y expresiones sintomáticas, de tal forma, que dos personas pueden presentar síntomas completamente diferentes una de la otra y, aun así, ambas pueden tener un diagnóstico similar. En este sentido, las escalas pueden ser fundamentales en el proceso de rastreo, ayuda en el diagnóstico e intervención en pacientes con sintomatología clínicamente significativa de depresión. Este artículo tiene como finalidad discutir dos temáticas de actualidad, que involucran a la evaluación psicológica. La primera se refiere a diferentes apuntes (descripción, importancia, críticas) sobre los criterios de los manuales psiquiátricos referentes a los trastornos depresivos. En la segunda temática, se discuten características de las escalas que evalúan la sintomatología depresiva y sus particularidades, dado que las mismas pueden ser muy diferentes entre sí en varios aspectos, tales como teorías de base, dimensionalidad, número de ítems, tipo de respuesta, particularidades del ciclo de la vida, formas de aplicación, entre otros. (AU)

Sensory Processing Disorders are Associated with Duration of Current Episode and Severity of Side Effects

OBJECTIVE: Longer duration of untreated illness, longer duration of current episode, and the severity of medication side effects may negatively impact on the perceived disability and psychosocial impairment of patients with major affective and anxiety disorders. Studies also suggested the involvement of sensory perception in emotional and psychopathological processes. The present study aimed to examine the relationship between Sensory Processing Disorders (SPD), duration of untreated illness and current illness episode, and the severity of side effects related to psychoactive medications. METHODS: The sample included 178 participants with an age ranging from 17 to 85 years (mean=53.84±15.55). Participants were diagnosed with unipolar Major Depressive Disorder (MDD) (50%), Bipolar Disorder (BD) (33.7%), and Anxiety disorders (16.3%). They completed a socio-demographic questionnaire, the Udvalg for Kliniske Undersøgelser (UKU), and Adolescent/Adult Sensory Profile (AASP) questionnaire. RESULTS: Longer duration of current episode correlated with greater registration of sensory input and lower avoidance from sensory input among unipolar patients; with lower registration of sensory input, and higher tendency for sensory sensitivity/avoidance among bipolar participants; with lower sensory sensitivity/avoidance among anxiety participants, respectively. Also, mean UKU total scores correlated with lower sensory sensitivity among bipolar individuals. CONCLUSION: SPD expressed in either hypo/hyper sensitivity may serve to clinically characterize subjects with major affective and anxiety disorders.

Sensory processing patterns, coping strategies, and quality of life among patients with unipolar and bipolar disorders

Objective: To compare sensory processing, coping strategies, and quality of life (QoL) in unipolar and bipolar patients; to examine correlations between sensory processing and QoL; and to investigate the relative contribution of sociodemographic characteristics, sensory processing, and coping strategies to the prediction of QoL. Methods: Two hundred sixty-seven participants, aged 16-85 years (53.6±15.7), of whom 157 had a diagnosis of unipolar major depressive disorder and 110 had bipolar disorder type I and type II, completed the Adolescent/Adult Sensory Profile, Coping Orientations to Problems Experienced, and 12-item Short-Form Health Survey version 2. The two groups were compared with multivariate analyses. Results: The unipolar and bipolar groups did not differ concerning sensory processing, coping strategies, or QoL. Sensory processing patterns correlated with QoL independently of mediation by coping strategies. Correlations between low registration, sensory sensitivity, sensation avoidance, and reduced QoL were found more frequently in unipolar patients than bipolar patients. Higher physical QoL was mainly predicted by lower age and lower sensory sensitivity, whereas higher mental QoL was mainly predicted by coping strategies. Conclusion: While age may predict physical QoL, coping strategies predict mental QoL. Future studies should further investigate the impact of sensory processing and coping strategies on patients’ QoL in order to enhance adaptive and functional behaviors related to affective disturbances.

Therapeutic Misconception in Psychiatry Research: A Systematic Review

Therapeutic misconception (TM) denotes the phenomenon in which research subjects conflate research purpose, protocols and procedures with clinical treatment. We examined the prevalence, contributory factors, clinical associations, impact, and collated solutions on TM within psychiatric research, and made suggestions going ahead. Literature search for relevant empirical research papers was conducted until February 2015. Eighty-eight reports were extracted, of which 31 were selected, summarised into different headings for discussion of implications and collated solutions of TM. We found variable and high rates of TM (ranging from 12.5% to 86%) in some psychiatry research populations. Contributory factors to TM included perceived medical roles of researchers, media, research setting and subject factors. Greater TM in affective, neurodevelopmental and psychotic spectrum conditions were associated with demographic variables (such as lower education, increased age), clinical factors (such as poor insight, cognitive deficits, increased symptoms, poorer self-rated quality of health), and social functioning (such as decreased independence). Inattention to TM may lead to frustration, negative impression and abandonment of participation in psychiatry research. Strategies such as the employment of a neutral educator during the informed consent process and education modules may be effective in addressing TM. Further research is warranted to examine the different TM facets, specific clinical correlates and more effective management strategies.