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2.
Front Psychiatry ; 10: 73, 2019.
Article in English | MEDLINE | ID: mdl-30853918

ABSTRACT

Introduction: Smartphone Addiction (SA) has caused negative consequences and functional impairments in college students, such as reduction of academic performance and impairment in sleep quality. Studies have shown that individuals with chemical and behavioral dependencies have a bias in decision-making process, which leads to short-term advantageous choices even if they cause long-term harm. This bias in decision-making process is accompanied by a change in somatic markers and is associated with the development and maintenance of addictive behavior. The decision-making process and the measurement of physiological parameters have not yet been analyzed in SA. The neuropsychological and physiological characterization of the SA can contribute to its approach with the other dependency syndromes and to its recognition as a disease. Objective: we aimed to evaluate the decision-making process under risk and under ambiguity in individuals with SA and to measure the physiological parameters that accompany this process. Method: We compared the performance in the Iowa Gambling Task (IGT), Game of Dice Task (GDT) and skin conductance response (SCR) between 50 individuals with SA and 50 controls. Results: Smartphone dependents presented a profile of impairment in decision-making under ambiguity, without impairment in decision-making under risk. They demonstrated lower SCR before disadvantageous choices, higher SCR after rewards and lower SCR after punishments during decision-making, which suggests difficulty in recognizing disadvantageous alternatives, high sensitivity to rewards, and low sensitivity to punishments. Conclusion: The impairment in the decision-making process in smartphone dependents is similar to that found in other chemical and behavioral addictions, such as alcohol addiction, gambling disorders and pathological buy. The impairment in decision under ambiguity with preservation of decision under risk may reflect dysfunction of implicit emotional processes without dysfunction of explicit cognitive process. This profile can contribute to the recognition of SA as a behavioral dependence and to guide specific preventive and therapeutic strategies.

3.
J Affect Disord ; 178: 12-7, 2015 Jun 01.
Article in English | MEDLINE | ID: mdl-25770478

ABSTRACT

BACKGROUND: Antenatal depression (AD) can have devastating consequences. No existing scales are specifically designed to measure it. Common practice is to adapt scales originally developed for other circumstances. We designed this study to validate and determine the psychometric values for AD screening in Brazil. METHODS: We collected clinical and socio-demographic data in the second gestational trimester. The following instruments were also administered during that period: MINI-PLUS, EPDS, BDI and HAM-D. RESULTS: At the time of assessment, 17.34% of the patients were depressed, and 31.98% met the diagnostic criteria for lifetime major depression. All instruments showed an area under the curve in a receiver operating characteristic analysis greater than 0.85, with the BDI achieving a 0.90 and being the best-performing screening instrument. A score ≥11 on the EPDS (81.58% sensitivity, 73.33% specificity), ≥15 on the BDI (82.00% sensitivity, 84.26% specificity) and ≥9 on the HAM-D (87.76% sensitivity, 74.60% specificity) revealed great dichotomy between depressed and non-depressed patients. Spearman׳s rank correlation coefficients (ρ) among the scales had good values (EPDS vs. BDI 0.79; BDI vs. HAM-D 0.70, and EPDS vs. HAM-D 0.67). LIMITATIONS: This study was transversal, assessing only women in the second gestational trimester. Results may be applicable only to the Brazilian population since psychometric properties may vary with the population under study. Major depression can amplify somatic symptomatology, affecting depressive rating scale data. CONCLUSION: AD is highly prevalent in Brazil. To address the problem of under-recognition, physicians can use the EPDS, BDI and HAM-D to identify AD.


Subject(s)
Depression/diagnosis , Depressive Disorder, Major/diagnosis , Pregnancy Trimester, Second/psychology , Prenatal Diagnosis/instrumentation , Psychiatric Status Rating Scales , Adult , Brazil/epidemiology , Depression/epidemiology , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Female , Humans , Pregnancy , Prevalence , Psychiatric Status Rating Scales/standards , Psychometrics , ROC Curve , Young Adult
4.
Gen Hosp Psychiatry ; 35(4): 451.e7-9, 2013.
Article in English | MEDLINE | ID: mdl-22739113

ABSTRACT

OBJECTIVE: The objective was to report a case of experienced psychosis during the treatment with methylphenidate (MPH) in a cocaine-dependent adult treated for attention-deficit/hyperactivity disorder (ADHD) with comorbid cocaine dependence. CONCLUSION: ADHD is a frequent comorbidity in substance use disorder (SUD) patients. MPH may be effective in treating ADHD symptoms in SUD patients, thus preventing possible adverse outcomes. Cocaine-induced psychosis may be a risk factor for development of psychosis in the presence of a concurrent treatment with MPH.


Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Central Nervous System Stimulants/adverse effects , Cocaine-Related Disorders/psychology , Methylphenidate/adverse effects , Psychoses, Substance-Induced/etiology , Adult , Attention Deficit Disorder with Hyperactivity/psychology , Humans , Male
5.
Presse Med ; 41(12 Pt 1): 1209-20, 2012 Dec.
Article in French | MEDLINE | ID: mdl-23021656

ABSTRACT

Due to many available forms (powder, pasta base, freebase and crack…) and because of multiple routes of administration (intranasal, intravenous, or smoked), cocaine has become in 30 years one of the most consumed illegal drugs worldwide, after cannabis. While the frequency of consumption decreases in North America, it continues to rise in Europe, and in some countries in South America, including Brazil, despite a growing knowledge of its specific effects, physical complications and psychiatric consequences. Elsewhere (notably in Asia and Indian Ocean), amphetamine and other stimulants (including methamphetamine), whose properties and patterns of use are very similar to those of cocaine, tend to replace it. Another amphetamine derivative, MDMA or ecstasy, is also consumed by many young people of less than 25 years, in Europe and North America, in a festive setting, with specific consequences and special procedures of care. Although there is currently no consensus for a specific medication, the most appropriate therapeutic approach seems to involve a psychosocial treatment associated with an anticraving medication, which will reduce compulsive desire to consume, in order to facilitate the psychotherapeutic and social care. However, pharmacological research remains very active, and many options are explored (GABAergic or dopaminergic agonists, amphetamine derivatives with long half-life, vaccine…), whether to treat addiction to cocaine or to methamphetamine.


Subject(s)
Behavior, Addictive , Cocaine-Related Disorders/therapy , Cocaine/adverse effects , Illicit Drugs/adverse effects , Amphetamine-Related Disorders/drug therapy , Amphetamine-Related Disorders/therapy , Cocaine/administration & dosage , Cocaine-Related Disorders/drug therapy , Cocaine-Related Disorders/psychology , Humans
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