Toward Developing Clinical cut-off for the Grandiosity Scale of the Dimensional Clinical Personality Inventory 2 / Hacia el Desarrollo del Punto de Corte Clínico Para la Escala de Grandiosidad del Inventario Clínico Dimensional de Personalidad 2

ABSTRACT Objective: The present study aims to establish a clinical cut-off for the Grandiosity dimension, using item-level evaluation procedures. Methods: Participants were 5,387 adults, including outpatients diagnosed with narcissistic personality disorder (NPD), outpatients diagnosed with other personality disorders, and adults from the community. We administered the self-reported Grandiosity scale from the Dimensional Clinical Personality Inventory 2 (IDCP-2). The equating procedure was applied to generate theta scores for participants who did not answer all items. Results: The Wright map revealed that outpatients scored high on the latent continuum of the Grandiosity scale. Group comparison showed large effect sizes for the mean difference between patients and non-patients. The ROC curve supports a cut off at a -0.45 score in theta standardisation, which yields a high sensitivity (91%) and moderate specificity (58%). Moreover, the PPP (71%) and NPP (79%) values suggest that the scale is able to identify NPD patients in 71% of cases, and people without NPD in 79% of cases. Conclusions: The findings suggest the IDCP-2 Grandiosity scale is useful as an NPD screening tool. Possible clinical applications for the scale are described and the limitations of the study are discussed.

RESUMEN Objetivo: El presente estudio tiene como objetivo establecer un corte clínico para la dimensión Grandiosidad, utilizando procedimientos de evaluación a nivel de ítem. Métodos: Los participantes fueron 5.387 adultos, entre pacientes ambulatorios diagnosticados con trastorno de personalidad narcisista (NPD), pacientes ambulatorios diagnosticados con otros trastornos de la personalidad, y adultos de la comunidad. Se administró la escala de Grandiosidad autoinformada del Inventario Dimensional Clínico de Personalidad 2 (IDCP-2). El procedimiento de ecualización se aplicó para generar puntuaciones theta para los participantes que no respondieron a todos los ítems. Resultados: El mapa de Wright reveló que los pacientes ambulatorios estaban ubicados en los niveles altos en el continuo latente de la escala de Grandiosidad. La comparación grupal mostró tamaños de efecto grandes para la diferencia de medias entre pacientes y no pacientes. La curva ROC confirma un corte en -.45 puntos en la estandarización theta que produce una alta sensibilidad (91%) y una especificidad moderada (58%). Además, los valores de PPP (71%) y NPP (79%) indican que la escala puede identificar a los pacientes con NPD en el 71% de los casos y las personas sin NPD en el 79% de los casos. Conclusiones: Los resultados indican que la escala de Grandiosidad del IDCP-2 es útil como instrumento de evaluación para NPD. Se describen posibles aplicaciones clínicas para la escala y se discuten las limitaciones del estudio.

Similarities and differences in the diagnostic criteria of ICD-11 and DSM-5 for sexual dysfunction / 四川精神卫生

The purpose of this paper is to compare the similarities and differences between the diagnostic criteria of sexual dysfunction in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and the International Classification of Diseases， eleventh edition （ICD-11）. Sexual dysfunction is the inability of adults to experience various forms of satisfactory sexual performance. In this paper， the main diagnostic points of sexual dysfunction in both manuals are summarized and compared with a view to assisting psychiatric and psychological workers to acquire a better understanding of the corresponding sections.

Desafíos bioéticos del DSM-5: ¿ruptura, recalibración o más de lo mismo? / Bioethical challenges of the DSM-5: rupture, recalibration, or more of the same? / Desafios bioéticos do DSM-5: ruptura, recalibração ou mais do mesmo?

Resumen: 11. 1] El DSM-5 representa la incorporación de la psiquiatría a la medicina basada en la evidencia. 2] La psiquiatría, propia de la intención, se transformó en la fundamentada en la validación empírica. 3] El DSM-5 es expresión de la ciencia moderna que da prioridad al saber calculador, objetivador, clasificador y operacional. 4] A la ética de la beneficencia, propia de la intención, se superpuso una ética de la autonomía y de la equidad, características de la validación. 5] El DSM-5 no puede determinar si los trastornos psiquiátricos son entidades naturales, tipos prácticos hechos por los investigadores, entes construidos socialmente, rótulos que se agrupan formando un sistema.

Abstract: 15. 1] The DSM-5 represents the incorporation of psychiatry into evidence-based medicine. 2] The psychiatry proper to the intention was transformed into that based on empirical validation. 3] The DSM-5 is an expression of modern science that gives priority to calculating, objectifying, classifying, operational knowledge. 4] An ethic of autonomy and fairness characteristic of verification was superimposed on the ethics of beneficence proper to the intention. 5] DSM-5 cannot determine whether psychiatric disorders are natural entities, practical types made by researchers, socially constructed entities, labels that are grouped into a system.

Resumo: 19. 1] O DSM-5 representa a incorporação da psiquiatria à medicina baseada em evidencia. 2] A psiquiatria, própria da intenção, se transformou na fundamentada em validação empírica. 3] O DSM-5 é expressão da ciência moderna que dá prioridade ao saber calculador, objetivador, classificador e operacional. 4] À ética da beneficência, própria da intenção, se superpôs uma ética da autonomia e da equidade, características da validação. 5] O DSM-5 não pode determinar se os transtornos psiquiátricos são entidades naturais, tipos práticos criados pelos investigadores, entes construídos socialmente, rótulos que se agrupam formando um sistema.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for somatic symptoms and related disorders / 四川精神卫生

The purpose of this paper is to compare the similarities and differences between the diagnostic criteria for somatic symptoms and related disorders in the International Classification of Diseases， eleventh edition （ICD-11） and the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. The clinical features of somatic symptoms and related disorders are prominent somatic symptoms that cause significant functional impairment and suffering. This paper discusses the similarities and differences between the two diagnostic systems in order to facilitate mastery of the corresponding content.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for feeding and eating disorders / 四川精神卫生

The purpose of this paper is to discuss the similarities and differences between the diagnostic criteria of feeding and eating disorders in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and International Classification of Diseases， eleventh edition （ICD-11）. Feeding and eating disorders are clinically characterized by persistent disturbances in feeding or food-related behaviors that result in altered food consumption or absorption and significant impairment in physical health or social function. This paper discusses the similarities and differences of feeding and eating disorders in the two diagnostic manuals， in order to improve psychiatric and psychological workers’ understanding of the corresponding sections.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for elimination disorders / 四川精神卫生

The purpose of this paper is to discuss the similarities and differences between the diagnostic criteria of elimination disorders in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and International Classification of Diseases， eleventh edition （ICD-11）. Elimination disorders are clinically characterized by inappropriate urination or defecation， resulting in pain or functional impairment. This paper discussed the main points of elimination disorders in the two diagnostic manuals， in order to improve psychiatric and psychological workers’ understanding of the corresponding sections.

Mixed features in DSM-5： problems and solutions / 四川精神卫生

This study contests the mixed states in diagnostic criteria for bipolar disorder and major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， and attempts to propose possible solutions. At present， the DSM-5 defined “mixed feature specifier” in bipolar disorder faces a number of problems in clinical use， particularly with regard to the classification of incidental features， which poses some clinical difficulties. DSM-5 abandons the previous standard setting which conform to the strict diagnostic thinking that both depression and mania exist together， and primarily captures three or more non-overlapping symptoms of the opposite pole in clinical diagnosis， but the difficulty in diagnosing the states or features resulting from the coexistence of two diametrically opposed symptoms or symptom clusters has still not been effectively addressed. In practice， clinical features of depressive episodes across participants with maniac disorder and manic episodes in depressive disorder within bipolar disorder pedigrees become atypical. Therefore， this paper focuses on the psychopathological features of the mixed profile and conducts analysis in the context of clinical practice and selected research perspectives， so as to propose some potentially constructive ideas to inform the solution of the clinical problems of the mixed states.

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for sleep-wake disorders / 四川精神卫生

This paper aims to discuss the similarities and differences between the diagnostic criteria for sleep-wake disorders in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and International Classification of Diseases， eleventh edition （ICD-11）. Sleep-wake disorders are characterized by the unsatisfactory quality， quantity and circadian rhythm of sleep， leading to daytime distress and impaired social functioning. Therefore， the main diagnostic points of sleep-wake disorders in both manuals are summarized and compared in this study， in order to assist psychiatric and psychological workers to acquire a better understanding of the corresponding sections.

Factors Correlated With Internet Gaming Disorder Among Malaysian University Students

@#Introduction: Internet gaming disorder (IGD) has recently been incorporated into the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) as a disorder for future research. The primary objectives of the present study are to describe the level of IGD and to examine its correlations with sociodemographic factors and psychological comorbidities among undergraduate students in a Malaysian university. Methods: A total of 411 undergraduate students completed an online questionnaire. They were selected from a random sample of participating university faculties. The online questionnaire contained the Internet Gaming Disorder Scale-Short-Form and the Depression, Anxiety, Stress Scale. Results: The presents study reported that 52.8% of the participants had high IGH. Using hierarchical multiple regression, age (β = -0.09, p < 0.05), gender (β = -0.40, p < 0.001) and stress (β = 0.23, p < 0.05) were statistically significant predictors of IGD. Academic performance, depression and anxiety did not emerge as significant predictors. Conclusion: These findings highlight the risk factors (in particular, stress) of IGD. Further studies on interventions, particular that of preventative strategies, will be needed to combat this emerging public health problem.

Construct Validity Of Indonesian Language Version Of Childhood Autism Rating Scale™ Second Edition

@#Combination of The Childhood Autism Rating Scale™ Second Edition - Standard Clinical Tool (CARS2-ST) with criteria for autism spectrum disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) is thought to improve diagnostic process. To meet diagnostic needs, localized, Indonesian-translated version of CARS2-ST is developed. Therefore, assessment of construct validity of the Indonesian-language translated CARS2-ST must be performed. A cross-sectional study was conducted in Child Development Center in Surabaya, Indonesia from August to December 2019. Diagnosis of ASD then performed by using CARS2-ST and DSM-5 criteria. To assess construct validity, principal components analysis and Kaiser-varimax rotation was performed for CARS2-ST in order to determine factors. DSM-5 criteria for ASD was used to compare scale.There were 201 children aged 2 - 6 years old with reported speech and behavior problems. Sixty-six children were diagnosed for ASD. Factor analysis using Kaiser-varimax rotation indicates a significant two factors: social communication and interaction factor and restrictive stereotyped behaviors and sensory factor sensitivites. The factors satisfyingly reflects the criteria for ASD in DSM-5.Construct validity of Indonesian-translated version of CARS2-ST is confirmed, as shown by its correspondence with DSM-5 criteria for diagnosing . This study supports the continued relevance of the Indonesian CARS2-ST in ASD assessment.

The Patient with Depression: Assessment and Management

@#Depression in adults is a condition that is treatable by family physicians. The current Clinical Practice Guidelines from the Ministry of Health recommends a selective serotonin reuptake inhibitor (SSRI) as the first-line of pharmacotherapy. Care should be taken to assess the patient’s psychological and social factors contributing to the illness. These factors should be managed by referring the patient to an appropriate allied health professional, such as a psychologist or community based social worker. Specialist referral should be made under certain circumstances (such as treatment-resistance), or if issues pertaining to risk arise. This review aims to give an update on the recently published DSM-5 criteria for diagnosis, and the treatment of the adult patient with depression.

Mental symptoms and its influencing factors of patients with malignant tumor undergoing chemotherapy in general hospital / 中华行为医学与脑科学杂志

Objective:To estimate the mental symptoms in malignant tumor patients undergoing chemotherapy using DSM-5 cross cutting symptom measure.Methods:A total of 314 patients who undergoing chemotherapy in oncology department of Zhongshan Hospital, Fudan University who met all standards were chosen. The DSM-5 cross cutting symptom measure Level 1 Scale was used to assess the mental symptoms of the patients. SPSS 25.0 software was used for χ 2 test, Pearson correlation analysis and multiple regression analysis. Results:The most common symptoms in the patients were depressive symptoms(85/314, 27.1%), somatic symptoms (79/314, 25.2%), manic symptoms (78/314, 24.5% ) and anxiety symptoms (76/314, 24.3%). The proportion of anxiety symptoms in malignant tumor patients who were taken care of by other personnel(26/64, 40.6%) was significantly higher than that in patients who were taken care of by immediate relatives(50/250, 20.0%)(χ 2=12.23, P<0.05). Patients with unstable working conditions were more likely to have depressive symptoms (χ 2=7.64, P<0.05). There was a significant negative correlation between the patients' understanding of the disease and their scores of depressive symptoms, somatic symptoms, manic symptoms, anxiety symptoms and the total score of mental symptoms( r= -0.26, -0.15, -0.12, -0.25, -0.22, all P<0.05). In addition, the total score of mental symptoms of malignant tumor patients was significantly positively correlated with family burden and family status( r=0.11, 0.11, both P<0.05), and negatively correlated with patients' education ( r=-0.13, P<0.05). Multiple regression analysis showed that the degree of understanding of the disease( β=-0.203) and family status( β=0.197) were the influencing factors of mental symptoms of inpatients malignant tumors undergoing chemotherapy in general hospital ( F=13.653, P<0.001). Conclusion:Malignant tumor patients undergoing chemotherapy may have a variety of mental symptoms. The high incidence mainly includes depressive symptoms, somatic symptoms, manic symptoms and anxiety symptoms. The understanding of the patients to the disease and family situation are the main influencing factors.

Classificação psiquiátrica: tensionamento atual entre realismo e nominalismo / Management of diabetes by professionals and users of Primary Health Care

Resumo Apresenta-se o "nominalismo dinâmico" de Hacking, aplicado à classificação psiquiátrica, como exemplo ilustrativo de síntese entre realismo e nominalismo. Expõem-se as perspectivas realistas inscritas tanto moderadamente na proposta híbrida do Diagnostic and Statistical Manual of Mental Disorders (DSM-5), quanto fortemente na proposta naturalista de seus concorrentes: Research Domain Criteria (RDoC) e Hierarchical Taxonomy of Psychopathology (HiTOP). Aponta-se o principal efeito do naturalismo aplicado à classificação psiquiátrica, que consiste no abandono do hibridismo entre realismo e nominalismo, em prol de uma cartografia do mental que, com recurso à matemática, reivindica-se estritamente realista, respondendo a demanda por maior precisão da bipsiquiatria.

Abstract Diabetes is a disease that cannot be cured, but managed, and its management is seen as a strategy to overcome its unpleasant consequences in various life situations. This study aims to understand how the diabetes mellitus 2 management process occurs by professionals and users affected by this condition. This is a qualitative research, with observational and explanatory design, which included the participation of health professionals and users they care for, all from primary health care. Information was collected through semi-structured interviews and interpreted using Discourse Analysis. For informants, food aspects are the most difficult to deal with. The professionals' discourse points to flexible eating practices, but users understand the guidelines as prohibitions. Feeding represents a great challenge for both professionals and users, as both need to consider management practices as part of care.

Metabolic syndrome among patients taking second generation antipsychotics: does obstructive sleep apnoea and sleep quality play any role?

Background: Metabolic syndrome (MetS) is common among patients who have been exposed to second generation antipsychotics (SGA). Obstructive sleep apnoea (OSA) and sleep quality may also contribute to MetS. Aims: To study the contribution of sleep quality and OSA on the development of MetS in patients taking SGA. Methods: Total 60 patients taking SGA for more than three months were taken for the study. It was an observational, cross-sectional study. The diagnosis of OSA was done using Hindi translation of Berlin questionnaire. Hindi version of the Pittsburg Sleep Quality Index was used to assess the sleep quality. MetS was diagnosed using Adult Treatment Panel III criteria. Results: Forty two subjects did not have MetS, out of which 35 had low risk of OSA and seven had high risk of OSA, while 18 subjects had MetS of which nine each had high and low risk of OSA. The results were highly significant with a p-value of 0.007 (p?0.05). Subjects without MetS (n=42) comprised four good sleepers and 38 poor sleepers. Subjects with MetS (n=18) comprised of one good sleeper and 17 poor sleepers. The results were non-significant with a p-value of 0.525 (p?0.05). The high risk of OSA had around seven times higher likelihood of contribution to MetS. Conclusions: Sleep quality did not play a significant role in increasing the likelihood of MetS and OSA increased the likelihood of MetS in subjects exposed to SGA by seven times.

Inventario de Personalidad para el DSM-5: propiedades psicométricas en población argentina. Estudio preliminar / Personality Inventory for the DSM-5: Psychometric Properties in Argentine Population. Preliminary Study

Resumen El DSM-5 presenta un modelo dimensional alternativo para los trastornos de personalidad, que incluye rasgos patológicos organizados en cinco grandes áreas: Desapego, Afectividad Negativa, Psicoticismo, Antagonismo y Desinhibición. Para evaluar dicho modelo, se desarrolló el Personality Inventory for DSM-5. El objetivo de este trabajo fue estudiar las propiedades psicométricas de una versión adaptada del instrumento a población argentina. Se trabajó con una muestra no probabilística de 393 sujetos de población general. Se administró la versión adaptada del Personality Inventory for DSM-5 junto con el Listado de Adjetivos para Evaluar Personalidad, una medida de los cinco rasgos del modelo de los Grandes Factores de Personalidad (Amabilidad, Responsabilidad, Extraversión, Neuroticismo y Apertura a la experiencia), equivalentes normales de los rasgos patológicos del modelo alternativo. Los resultados mostraron propiedades psicométricas satisfactorias. La versión argentina del Inventario mostró una estructura de cinco factores similar a la original, con niveles adecuados de consistencia interna e ítems con buenos índices de discriminación. Se observaron diferencias por género y edad. Los hombres puntuaron más alto en Antagonismo, Psicoticismo y Desapego, y las mujeres en Afectividad Negativa. Los jóvenes puntuaron más alto en todas las escalas salvo en Desapego. Por último, se encontraron correlaciones significativas con los cinco factores correspondientes del modelo de los "cinco grandes" (ej., entre Afectividad Negativa y Neuroticismo). Los resultados brindan evidencia preliminar de validez y confiabilidad para la versión local del instrumento, y se espera que sirvan como base para su posterior perfeccionamiento, para ser implementado en tareas clínicas como de investigación.

Abstract The DSM-5 presents an alternative dimensional model for personality disorders, which includes pathological traits organized in five major areas: Detachment, Negative affectivity, Psychoticism, Antagonism and Disinhibition. To evaluate this model, the Personality Inventory for DSM-5 (PID-5) was developed. However, it is unknown how the PID-5 would work adapted to our context. On the other hand, the PID-5 suffers from various limitations (e.g., not all facets are represented in the brief version, affecting the construct validity). The objective of this paper was to study the psychometric properties of an adapted version of the PID-5 to the Argentine population. We worked with a non-probabilistic sample of 393 subjects from the general population. The adapted version of the Personality Inventory for DSM-5 was administered together with the Adjectives Checklist to Assess the Big Five Personality Factors (AEP), a measure of the five traits of Big Five Model, normal equivalents of the pathological traits of the alternative model. The following data analyzes were performed: a) Exploratory Factor Analysis to evaluate the internal structure of PID-5; b) reliability analysis to assess the internal consistency of the different scales of the PID-5; c) item analysis to assess discriminating power; d) bivariate correlation analysis to analyze the relationship between PID-5 scores and the AEP; e) multivariate analysis of covariance (MANCOVA) to analyze significant differences due to gender, age, and possible interaction effects. Results indicated satisfactory psychometric properties. The Argentinean version of the PID-5 showed a five-factor structure similar to the original, with adequate levels of internal consistency and good discrimination indices. Regarding gender, men scored higher in Antagonism, Psychoticism and Detachment, and the effect size was significant although weak. On the other hand, women scored higher in negative affectivity, but the differences were not significant. Regarding age, young people presented higher scores than adults at all scales except in Detachment, and the effect size was significant although weak. Finally, significant relationships were found with the five factors of the big five model (e.g., strong and positive correlation between Negative Affectivity and Neuroticism; moderate and negative correlations between Detachment and Extraversion, and between Disinhibition and Conscientiousness). Additionally, other high correlations were found (e.g., between Agreeableness and Detachment; Conscientiousness and Psychoticism; Neuroticism and Disinhibition). These results are in line with those found in previous studies. Finally, moderate correlations were found between PID-5 scales (e.g., Disinhibition and Antagonism; Negative Affectivity and Disinhibition; Psychoticism and Disinhibition; and Detachment and Negative Affectivity). These correlations would imply the existence of some higher order factor that would cover the dimensions of the model. Although the results found are acceptable, this study has some limitations. First, we worked with general population, and in future work it would be important to administer the instrument in clinical samples. Second, the Antagonism scale was left with only 4 items, which may affect the construct validity of the instrument. In this regard, it would be convenient to add new items, not only on this scale, to obtain a final version with an intermediate length between 25 and 220 items of the two versions of the original scale. A version of approximately 60 items may be a good solution, that includes both the different facets of the model as well as time constraints if the instrument is pretended to be used within a diagnostic battery. Beyond these limitations, the present study provides preliminary evidence of validity and reliability for the adapted version of the PID 5, and could be a start point for its deepening and improvement to be implemented in clinical and research tasks.

Social communication impairments and restricted, repetitive patterns (Kodawari) considered from the Comprehension section of the WISC-IV in autism spectrum disorder

Abstract Background Many studies have used the Wechsler Intelligence Scale (WISC) to examine the characteristics of autism spectrum disorder (ASD). However, most studies have been based on profile analysis, not on content analysis. Objective The objective of the present study was to apply the WISC-IV to clinical assessment of ASD and clarify how the characteristics of the disorder were reflected in specific items. Methods The study participants were 20 patients aged 5-16 years diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We recruited 20 patients with attention-deficit/hyperactivity disorder (ADHD) and 20 patients with other disorders (neurotic disorders) as controls. We then compared the scores of the ninth item of the WISC-IV ("Comprehension") among the three groups. Results The differences observed between the ASD vs. the other disorders group were not significant by the standard scoring method. Thus, a two-level scoring method of 0 and ≥1 point was adopted. As a result, significantly more participants in the ASD group scored 0 points compared with the ADHD and other disorders groups. Discussion The results of the present study revealed that a characteristic of ASD appeared in the ninth item of "Comprehension" on the WISC-IV.

Transtorno de compulsão alimentar: revisão sistemática da literatura / Binge eating disorder: a systematic literature review / Trastorno de compulsión alimentaria: revisión sistemática de la literatura

Através de uma Revisão Sistemática da Literatura retomamos a literatura sobre o Transtorno de Compulsão Alimentar (TCA) entre 2006 a 2016, para caracterizar e discutir as produções sobre o tema. Foi realizada uma busca nas bases de dados SciELO, Science Direct, Redalyc e Lilacs, utilizando os descritores "compulsão alimentar" e "transtorno da compulsão alimentar" e traduções para os idiomas espanhol, francês e inglês. Foram incluídos artigos disponíveis para download em periódicos com Qualis CAPES A1, A2, B1 e B2. Os achados apontam uma tendência da valorização do caráter biológico e voltado para o diagnóstico a partir do Manual Diagnóstico e Estatístico de Transtornos Mentais, com foco nos sintomas e nos tratamentos. O panorama das pesquisas demonstra a necessidade de pesquisas que se proponham a compreender o TCA de forma ampla e avaliar os possíveis impactos da efetivação como transtorno nos indivíduos envolvidos e nas práticas de saúde que os circundam.

Through a Systematic Review of Literature we return to the literature on Binge Eating Disorder (BED) between 2006 and 2016, to characterize and discuss the productions on the subject. A search was made in the databases SciELO, Science Direct, Redalyc and Lilacs, using the descriptors «compulsão alimentar¼ and «transtorno de compulsão alimentar¼ and translations into the Spanish, French and English languages. Articles available for download in journals with Qualis CAPES A1, A2, B1 and B2 were included. The findings point to a trend towards the valorization of the biological character and aimed at the diagnosis from the Diagnostic and Statistical Manual of Mental Disorders, focusing on symptoms and treatments. The research landscape demonstrates the need for research that intends to comprehend the BED in a broad way and to evaluate the possible impacts of effectiveness as a disorder in the individuals involved and in the health practices that surround them.

A través de una Revisión Sistemática de la Literatura retomamos la literatura sobre el Trastorno de Compulsión Alimentaria (TCA) entre 2006 y 2016, para caracterizar y discutir las producciones sobre el tema. Se realizó una búsqueda en las bases de datos SciELO, Science Direct, Redalyc y Lilacs, utilizando los descriptores «compulsão alimentar¼ y «transtorno da compulsão alimentar¼ y traducciones a los idiomas español, francés e inglés. Se incluyeron artículos disponibles para descargar en periódicos con Qualis CAPES A1, A2, B1 y B2. Los hallazgos apuntan una tendencia de valorización del carácter biológico y orientado hacia el diagnóstico a partir del Manual Diagnóstico y Estadístico de los Trastornos Mentales, con foco en los síntomas y en los tratamientos. El panorama de las investigaciones demuestra la necesidad de investigaciones que se propongan a comprender el TCA de forma amplia y evaluar los posibles impactos de la efectividad como trastorno en los individuos involucrados y en las prácticas de salud que los circundan

THE PATIENT WITH DEPRESSION: ASSESSMENT AND MANAGEMENT

@#Depression in adults is a condition that is treatable by family physicians. The current Clinical Practice Guidelines from the Ministry of Health recommends a selective serotonin reuptake inhibitor (SSRI) as the first-line of pharmacotherapy. Care should be taken to assess the patient’s psychological and social factors contributing to the illness. These factors should be managed by referring the patient to an appropriate allied health professional, such as a psychologist or community-based social worker. Specialist referral should be made under certain circumstances (such as treatment-resistance), or if issues pertaining to risk arise. This review aims to give an update on the recently published DSM-5 criteria for diagnosis, and the treatment of the adult patient with depression.

Anxiety Disorders - Assessment and Management in General Practice

@#The objective of this article is to provide an update on the diagnosis, assessment, and management of anxiety disorders in adults. This article covers the following disorders: panic disorder, panic attacks, specific phobia, social anxiety disorder and generalized anxiety disorder. Selective mutism and separation anxiety disorder, being childhood anxiety disorders, will not be covered. Obsessive compulsive disorder and post-traumatic stress disorder, which are not categorized as anxiety disorders in DSM-5, will not be covered. Anxiety and related disorders are common mental health disorders but are under-diagnosed and undertreated. Most cases of anxiety disorders present first to the primary care physician and can be managed in primary care.It is important to take a detailed history of the patient’s symptoms and their severity and duration, enquire about psychosocial stressors, as well as symptoms that may be suggestive of a medical condition and also to assess suicidality. A combined approach of psycho-education, relaxation training, and medications give the best results. SSRIs are first line pharmacologic treatment for most anxiety disorders. There is a need to stress that benzodiazepines have no role in the long-term treatment of anxiety disorders. They should not be given for more than 2 to 4 weeks. Treatment for generalized anxiety disorder should be for at least 32 weeks as high relapse rates are reported after discontinuing medications.

Dispositivos de segurança, psiquiatria e prevenção da criminalidade: o TOD e a noção de criança perigosa / Security devices, psychiatry and crime prevention: the TOD and the notion of a dangerous child

Resumo O artigo analisa a tendência crescente da multiplicação de diagnósticos psiquiátricos na infância, que encontra legitimidade no argumento que indica que se as patologias psiquiátricas da infância não forem devidamente tratadas, será altamente provável que, na vida adulta, surjam graves problemas psiquiátricos irreversíveis, assim como problemas associados à criminalidade e à delinquência. Analisa-se o exemplo do transtorno de oposição e desafio, conhecido como TOD, na medida em que, de acordo com o DSM-5, essa patologia supõe um alto risco para o desenvolvimento do transtorno de personalidade antissocial, patologia que apresenta conotações claramente jurídicas e criminológicas. Esses diagnósticos são analisados em perspectiva crítica a partir do conceito foucaultiano de "dispositivo de segurança".

Abstract The article analyzes the growing tendency to multiply psychiatric diagnoses in childhood, which finds legitimacy in the argument that, if childhood psychiatric disorders are not properly treated, it will be highly probable that in adult life there will be serious irreversible psychiatric problems, problems associated with crime and delinquency. The example of oppositional and defiant disorder, known as TOD, is analyzed insofar as, according to DSM-5, this pathology supposes a high risk for the development of antisocial personality disorder, a condition that presents clearly juridical connotations and criminological. These diagnoses are analyzed in a critical perspective from the Foucauldian concept of "safety device".