Increased cocaine and amphetamine-regulated transcript cord blood levels in the newborns exposed to crack cocaine in utero.

BACKGROUND: Cocaine and amphetamine-regulated transcript (CART) is an endogenous antioxidant present since the embryonic period. CART is activated by high levels of dopamine and might be of interested in understanding the changes in the REDOX system associated with crack/cocaine intake. The goal of this study was to determine whether exposure to crack in utero is associated with increased CART levels. METHODS: In this cross-sectional study with consecutive sampling, we compared the umbilical cord blood (UCB) CART levels (µg/mL) of newborns exposed to crack/cocaine in utero (EN, n = 57) to levels in non-exposed newborns (NEN, n = 99). In addition, we compared serum CART levels between EN and NEN mothers, in the immediate postpartum period. Potential confounders, such as perinatal data (e.g., weight, Apgar, etc.), psychopathology (DSM-IV), and use of drugs other than crack (ASSIST) were assessed. RESULTS: According to general linear model analysis, the adjusted mean CART was significantly higher in EN (0.180, 95% CI 0.088-0.272) than in NEN (0.048, 95% CI 0.020-0.076; p < 0.002; d = 0.68). The difference in CART levels between EN and NEN mothers was not significant (p ≥ 0.05). CONCLUSION: The increase in CART levels in EN UBC suggests a response to crack/cocaine-induced oxidative stress during gestational period, as a potential attempt of neuroprotection. In adult women in puerperium, however, this endogenous antioxidant recruitment does not seem to operate.

Differences in biomarkers of crack-cocaine adolescent users before/after abstinence.

AIMS: To measure the variation in Brain-Derived Neurotrophic Factor (BDNF), Thiobarbituric Acid Reactive Substances (TBARS) and interleukin (IL) levels in crack-cocaine dependent adolescents after 21days of abstinence, comparing to levels found in a group of healthy controls. DESIGN: Cross-sectional nested on a short follow-up study. SETTING: Two inpatient treatment units for adolescents, and a low-income neighborhood. PARTICIPANTS: 90 adolescents, of both genders, with diagnosis of crack cocaine dependence, and 81 healthy adolescents. MEASUREMENTS: Serum levels of IL-6, IL-10, TBARS and BDNF were assessed on admission and discharge. Drug addiction severity was assessed by the Addiction Severity Index - Teen Version (T-ASI) and Cocaine Craving Questionnaire - Brief version (CCQ-b). Psychiatric comorbidities were assessed by the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version (K-SADS-PL). Generalized Estimating Equations (GEE) were used to estimate the IL-6, IL-10, TBARS and BDNF levels, adjusted for confounders. Hedges' g was used to estimate effect size. FINDINGS: TBARS (p=0.005, d=0.04), IL-6 (p=0.027, d=0.40) and IL-10 (p=0.025, d=0.41) were elevated and BDNF (p<0.001, d=0.62) was reduced (p<0.001), in patients, in comparison to controls, at admission time. Variation in those levels between admission and discharge were not significant. CONCLUSIONS: Crack-cocaine use seems to be associated with inflammatory and oxidative imbalances in adolescents.

Comparação dos níveis séricos da Cocaine and Amphetamine Regulated Transcript (CART) entre sangue de cordão umbilical e sangue periférico em gestantes usuárias de crack / Comparison between serum levels of Cocaine and Amphetamine Regulated Transcript (CART) between umbilical cord blood and peripheral blood of pregnant crack users

INTRODUÇÃO: No Brasil, o uso de crack permanece um desafio à saúde pública devido à facilidade de aquisição da droga e sua elevada capacidade de induzir dependência. A exposição intrauterina (EIU) à cocaína está associada a alterações neurocomportamentais durante a infância e adolescência. Em estudo prévio do nosso grupo, achou-se menor nível de estresse oxidativo (EO) em recém-nascidos (RN) com EIU. Uma possível explicação pode ser a Cocaine and Amphetamine Regulated Transcript (CART), um antioxidante endógeno presente desde o período embrionário e ativado por maiores níveis de dopamina. OBJETIVO: Verificar a correlação entre os níveis de CART no sangue de cordão umbilical (SCU) e sangue periférico de 57 gestantes com exposição ao crack. MÉTODOS: Trata-se de um estudo transversal, com amostragem consecutiva, em que o desfecho primário foi a correlação entre os níveis de CART no SCU e sangue periférico materno no pós-parto imediato. Dados gestacionais e perinatais foram sistematicamente coletados. RESULTADOS: Houve correlação significativa entre os níveis de CART no sangue de cordão umbilical e sangue periférico materno (rs= 0,350 e p<0,05). CONCLUSÕES: Estes achados demonstram que os níveis de CART no sangue materno e no SCU se correlacionam. Todavia, não se pode afirmar de quem é a produção, ou se é produzida por ambos. O presente trabalho pode ajudar a elucidar os caminhos neurobiológicos responsáveis pelas alterações de neurodesenvolvimento, contribuindo para a ampliação das possibilidades de intervenções precoces.

INTRODUCTION: The use of crack cocaine remains a public health challenge in Brazil, due to easy drug acquisition and its high ability to induce dependence. Intrauterine exposure (IUE) to crack cocaine is associated with neurobehavioral changes during childhood and adolescence. In a previous study of our group, lower levels of oxidative stress (OS) were found in newborns with IUE. One possible explanation may be the Cocaine and Amphetamine Regulator Transcript (CART), an endogenous antioxidant present since the embryonic period activated by higher levels of dopamine. OBJECTIVE: The aim of this study is to investigate the correlation of CART levels between umbilical cord blood (UCB) and peripheral blood samples of 57 pregnant women exposed to crack. METHODS: This is a cross-sectional study with a consecutive sampling, in which the primary outcome was the correlation between CART levels in UCB and peripheral blood of their mothers in immediate postpartum. Gestational and perinatal data were systematically collected. Spearman correlation test was performed after checking the pattern of distribution, being considered a 0.05 significance level. RESULTS: There was a significant correlation between CART levels in umbilical cord blood and peripheral blood (rs = 0.350 and p <0.05). CONCLUSIONS: These findings suggest a correlation between CART levels at UCB and mother's blood. However, it remains unclear whether it is produced by the mother, the fetus, or both. This study may help to elucidate the neurobiological pathways responsible for neurodevelopmental changes, providing a rationale for early interventions.

Socio-demographic and clinical characteristics of pregnant and puerperal crack-cocaine using women: preliminary data

BACKGROUND The literature provides several studies on the effects of cocaine when exposed to the fetus. However, the majority of these data comes from animal models. OBJECTIVE The objective of this study is to present socio-demographic and clinical data in crack-cocaine using pregnant women and their babies, as compared to non-users. METHODS Cross-sectional study, comprised by 56 dyads of crack-cocaine using mothers-babies and 89 control dyads. In addition to the socio-demographic data and the babies’ information, data collection was based on ABIPEMI for socioeconomic level, WAIS for IQ, MINI for psychopathology and ASSIST for drug use. RESULTS Most crack users, in comparison to non-users, did not have a partner (10.52% vs 4.4%, P = 0.001) and presented lower IQ (78.15, +/-8.07 vs 84.27 +/- 9.87; P = 0.002). The prevalence of antisocial personality disorder and suicide risk in users was higher than in non-users (24.44% vs none, P < 0.001; 28.26% vs 10.46% P = 0.01). Most of the users did not participate in prenatal care (75%). The babies that the crack-cocaine using mothers gave birth to weighed significantly less than the controls (2.858 g vs 3.240 g, P = 0.002). DISCUSSION Users had a higher degree of psychopathology and lower attendance in prenatal care. There was an overlap of adverse factors, both for exposed mothers and babies. The sum of these vulnerabilities could result in significant harm to the developing infant. .

Tratamento psicoterápico para adolescentes usuários de substâncias psicoativas / Psychotherapeutic treatment for adolescents with substance abuse

O uso de álcool e demais substâncias psicoativas é um dos problemas de maior prevalência entre adolescentes. Todo adolescente que for avaliado por profissional de saúde deve ser questionado sobre seu uso de álcool e substâncias psicoativas. Em caso positivo, esse uso deve ser investigado clinicamente e, mesmo quando minimamente problemático, o adolescente deve ser encaminhado para tratamento específico. O tratamento deve levar em conta várias particularidades da adolescência para ser efetivo. Há indicação do uso de psicoterapias no atendimento a esses adolescentes. Entre elas, estão a Terapia de Família, a Terapia Cognitivo-Comportamental e a Entrevista Motivacional. Todas essas modalidades de terapia apresentam evidências de eficácia nessa faixa etária e podem ser usadas separadamente ou em conjunto. Essas modalidades de tratamento serão revisadas, sendo explicados seu método de ação e suas principais evidências de eficácia em adolescentes.(AU)

The use of alcohol and drugs in the adolescence is a common problem. Every teenager that goes through psychological evaluation should be asked about use of alcohol and drugs of abuse. If positive, this use should be clinically investigated and, referred to treatment at the slightest signs of problems. Treatment must take account of age-specific characteristics in order to be effective. There are many kinds of psychotherapies based on evidence for this age group. Among them, are Family Therapy, Cognitive Behavioral Therapy and Motivational Interviewing. Those treatment modalities are addressed, explaining their means of action and their main proofs of efficacy in adolescents.(AU)

Abordagem terapêutica de puérpera usuária de crack / Therapeutic approach of a crack-user puerperal woman

Este é o relato do atendimento de uma das mães dependentes do crack e de seu bebê, que frequentam o Ambulatório de Psiquiatria da Infância e da Adolescência do HCPA. Esta específica abordagem terapêutica visa atender a gestante e o bebê, ainda antes do nascimento, a fim de preservar um de seus direitos básicos, que é o de não ser intoxicado tão prematuramente.(AU)

This is the report of the treatment of one of the crack-dependent mothers and her baby who attended the Childhood and Adolescence Psychiatry outpatient clinic of the HCPA. This specific approach aims at attending the mother and the baby, even before birth, in order to preserve one of his/her basic rights, which is: not be intoxicated so prematurely.(AU)

[Translation and adaptation of the Motorcycle Rider Behavior Questionnaire: a Brazilian version]. / Tradução e adaptação da escala Motorcycle Rider Behavior Questionnaire: versão brasileira.

Traffic accidents are a leading cause of death in young adults. In Brazil, traffic accidents are proportionally more prevalent among motorcyclists as compared to automobile drivers. Although numerous data indicate that individual characteristics are involved in traffic accident risk, there is no instrument in Brazil to assess motorcyclists' traffic behavior. The authors thus proposed to perform translation and cultural adaptation of the Motorcycle Rider Behavior Questionnaire (MRBQ) into Brazilian Portuguese. The translation process consisted of: two independent translations into Brazilian Portuguese; unification of the translations; back-translation into English; formal assessment of semantic equivalence; application of a summary version in a convenience sample of motorcyclists; generation of a final version; and back-translation and submission to the original author, who approved this version. The Brazilian version maintained its semantic equivalence and was accepted by the convenience sample, an important characteristic for a self-completed instrument. Further studies are necessary to evaluate the questionnaire's psychometric properties in the Brazilian cultural context.

Equivalência semântica da versão em português da Escala de Experiência de Quase-Morte / Semantic equivalence of the portuguese version of the Near-Death Experience Scale

Na literatura internacional, a experiência de quase-morte (EQM) é avaliada principalmente por meio do instrumento The Near-Death Experience Scale (NDE), elaborado por Bruce Greyson, em 1983. O objetivo do presente estudo é verificar a existência de equivalência semântica entre a versão original da escala (em inglês) e a versão traduzida ao português do Brasil, avaliando os significados geral e referencial. Após as diversas etapas de avaliação da equivalência semântica, a escala foi pré-testada em seis pacientes internados após alta de um Centro de Tratamento Intensivo (CTI) de um Hospital Universitário. Na avaliação realizada por dois psicólogos e dois psiquiatras, constatou-se existir equivalência semântica entre a versão final em português e o original. Na aplicação da escala na população-alvo, verificou-se boa compreensão dos itens. Portanto, a escala está adequada à cultura brasileira, podendo ser utilizada para pesquisas sobre Experiências de Quase-Morte neste contexto(AU)

In the international literature, near-death experiences are often measured by The Near-Death Experience Scale (NDE), developed by Bruce Greyson in 1983. The aim of this study is to verify the existence of the semantic equivalence between the original version (in English) and the translated version to Brazilian Portuguese, evaluating both the general and the referential meaning. The semantic evaluation was conducted according to the several steps. Thereafter, a pre-testing was performed in six post Intensive Care Unit patients of a University Hospital. The evaluations of two psychologists and two psychiatrists have found existence of semantic equivalence between the Brazilian and the original version of the scale. The pre-test applied on the target population proved the items were intelligible. Our findings suggest that the Brazilian version of the NDE might be used in the investigation of near-death experience in Brazilian culture(AU)

Equivalência semântica da versão em português da Escala de Experiência de Quase-Morte / Semantic equivalence of the portuguese version of the Near-Death Experience Scale

Na literatura internacional, a experiência de quase-morte (EQM) é avaliada principalmente por meio do instrumento The Near-Death Experience Scale (NDE), elaborado por Bruce Greyson, em 1983. O objetivo do presente estudo é verificar a existência de equivalência semântica entre a versão original da escala (em inglês) e a versão traduzida ao português do Brasil, avaliando os significados geral e referencial. Após as diversas etapas de avaliação da equivalência semântica, a escala foi pré-testada em seis pacientes internados após alta de um Centro de Tratamento Intensivo (CTI) de um Hospital Universitário. Na avaliação realizada por dois psicólogos e dois psiquiatras, constatou-se existir equivalência semântica entre a versão final em português e o original. Na aplicação da escala na população-alvo, verificou-se boa compreensão dos itens. Portanto, a escala está adequada à cultura brasileira, podendo ser utilizada para pesquisas sobre Experiências de Quase-Morte neste contexto.

In the international literature, near-death experiences are often measured by The Near-Death Experience Scale (NDE), developed by Bruce Greyson in 1983. The aim of this study is to verify the existence of the semantic equivalence between the original version (in English) and the translated version to Brazilian Portuguese, evaluating both the general and the referential meaning. The semantic evaluation was conducted according to the several steps. Thereafter, a pre-testing was performed in six post Intensive Care Unit patients of a University Hospital. The evaluations of two psychologists and two psychiatrists have found existence of semantic equivalence between the Brazilian and the original version of the scale. The pre-test applied on the target population proved the items were intelligible. Our findings suggest that the Brazilian version of the NDE might be used in the investigation of near-death experience in Brazilian culture.

Impulsivity, age of first alcohol use and substance use disorders among male adolescents: a population based case-control study.

AIMS: To evaluate the association between impulsivity, age of first alcohol consumption (AFD) and substance use disorders (SUD) in a non-clinical sample of adolescents. DESIGN AND SETTING: Population-based case-control study of male adolescents between 15 and 20 years of age nested in a community survey in southern Brazil. PARTICIPANTS: Cases were drug or alcohol abusers/dependents defined according to DSM-IV abuse/dependence criteria (n = 63). Individuals who had experienced alcohol use but where non-abusers served as controls (n = 355). Cases and controls completed a structured face-to-face interview. MEASUREMENTS: The Mini International Neuropsychiatric Interview (MINI) was completed during the original survey and used to identify cases and controls. Impulsivity was measured by means of the Barratt Impulsivity Scale (BIS 11). Self-reported AFD and socio-demographic data were collected and analyzed through logistic regression according to a hierarchical model. FINDINGS: Impulsivity and AFD were significantly associated with SUD. Both higher impulsivity [odds ratio (OR) 3.3, 95% confidence interval (CI) 1.4-7.8] and earlier AFD (OR 1.2, 95% CI 1.0-1.3) remained associated with SUD after model adjustments. CONCLUSIONS: The findings from this population-based case-control study suggest that impulsivity and age of first alcoholic drink are associated strongly with alcohol and drug problems. Additionally, impulsivity seems to contribute to a premature exposure to alcohol by hastening the AFD. If the temporal effect of these associations is confirmed in longitudinal designs including broader population groups, our findings may contribute to the development of clinical and policy interventions aiming at reducing the incidence and morbidity associated with substance-related problems among adolescents.

Adaptation and construct validation of the Barratt Impulsiveness Scale (BIS 11) to Brazilian Portuguese for use in adolescents.

OBJECTIVE: Impulsivity is associated with different psychiatric disorders. The Barratt Impulsiveness Scale version 11 is one of the scales mostly used to measure impulsivity and it does not have a validated version for Brazilian Portuguese. The objective of this study is to adapt and conduct the construct validation of the Barratt Impulsiveness Scale version 11 for adolescents. METHOD: The scale was translated and adapted into Portuguese and then back-translated into English. The psychometric proprieties, factor analysis and construct validity were evaluated in two samples: 18 bilingual undergraduate medical students and 464 male adolescents between 15 and 20 years old from a well-delimited geographical area in the city of Canoas, southern Brazil. RESULTS: The adolescent sample had a mean age of 17.3 +/- 1.7 years. Intra-class correlation coefficient achieved a value of 0.90, and internal consistency had a of 0.62. Factor analysis did not identify the 3 factors of the original scale. Impulsivity scores from the Barratt Impulsiveness Scale version 11 had a correlation with scores for attention deficit/hyperactive disorder and oppositional defiant disorder and with number of symptoms of conduct disorder, suggesting an appropriate construct validity of the scale. CONCLUSION: Even considering some limitations in the Portuguese version, Barratt Impulsiveness Scale version 11 can be used in male adolescents and should be tested in other populations.

Adaptation and construct validation of the Barratt Impulsiveness Scale (BIS 11) to Brazilian Portuguese for use in adolescents

OBJECTIVE: Impulsivity is associated with different psychiatric disorders. The Barratt Impulsiveness Scale version 11 is one of the scales mostly used to measure impulsivity and it does not have a validated version for Brazilian Portuguese. The objective of this study is to adapt and conduct the construct validation of the Barratt Impulsiveness Scale version 11 for adolescents. METHOD: The scale was translated and adapted into Portuguese and then back-translated into English. The psychometric proprieties, factor analysis and construct validity were evaluated in two samples: 18 bilingual undergraduate medical students and 464 male adolescents between 15 and 20 years old from a well-delimited geographical area in the city of Canoas, southern Brazil. RESULTS: The adolescent sample had a mean age of 17.3 ± 1.7 years. Intra-class correlation coefficient achieved a value of 0.90, and internal consistency had alpha of 0.62. Factor analysis did not identify the 3 factors of the original scale. Impulsivity scores from the Barratt Impulsiveness Scale version 11 had a correlation with scores for attention deficit/hyperactive disorder and oppositional defiant disorder and with number of symptoms of conduct disorder, suggesting an appropriate construct validity of the scale. CONCLUSION: Even considering some limitations in the Portuguese version, Barratt Impulsiveness Scale version 11 can be used in male adolescents and should be tested in other populations.

OBJETIVO: A impulsividade está associada a diversos transtornos psiquiátricos. A escala de impulsividade de Barratt é uma das mais utilizadas para medir impulsividade mas não há uma versão validada em português. O objetivo do estudo é adaptar para o português e realizar a validação de construto da escala de impulsividade de Barratt para adolescentes. MÉTODO: A escala foi traduzida e adaptada para o português e retro-traduzida para o inglês. Foram avaliadas propriedades psicométricas, análise fatorial e validade de constructo em duas amostras: 18 estudantes de medicina bilíngües e 464 adolescentes masculinos, entre 15 e 20 anos, de uma região geograficamente delimitada de Canoas, sul do Brasil. RESULTADOS: A média de idade dos adolescentes foi de 17,3 ± 1,7 anos. O coeficiente de correlação intraclasse foi de 0,90 e a consistência interna teve alfa de 0,62 para os 30 itens. A análise fatorial não identificou os três fatores da escala original. Os escores de impulsividade da escala de impulsividade de Barratt versão 11 foram correlacionados com os escores para os transtornos de déficit de atenção e hiperatividade, oposicional desafiante, e para o número de sintomas de transtorno de conduta, conferindo validade de constructo à escala. CONCLUSÃO: Mesmo considerando as limitações da versão brasileira, a escala de impulsividade de Barratt versão 11 pode ser utilizada em adolescentes masculinos e deve ser testada em outras populações.

Uso de álcool entre adolescentes: conceitos, características epidemiológicas e fatores etiopatogênicos / Alcohol use among adolescents: concepts, epidemiological characteristics and etiopatogenic factors

O álcool é a substância mais consumida entre os jovens, sendo que a idade de início de uso tem sido cada vez menor, aumentando o risco de dependência futura. O uso de álcool na adolescência está associado a uma série de comportamentos de risco, além de aumentar a chance de envolvimento em acidentes, violência sexual e participacão em gangues. O uso de álcool por adolescentes está fortemente associado à morte violenta, queda no desempenho escolar, dificuldades de aprendizado, prejuízo no desenvolvimento e estruturacão das habilidades cognitivo-comportamentais e emocionais do jovem. O consumo de álcool causa modificacões neuroquímicas, com prejuízos na memória, aprendizado e controle dos impulsos. Os profissionais que lidam com adolescentes devem estar preparados para uma avaliacão adequada quanto ao possível uso abusivo ou dependência de álcool nesta faixa etária. Entretanto, é importante destacar que os critérios empregados por alguns instrumentos para o diagnóstico de abuso e dependência de álcool foram desenvolvidos para adultos e devem ser aplicados com ressalvas para adolescentes. Assim, é fundamental que os profissionais conhecam as características da adolescência e as particularidades da dependência química nesta faixa etária.

[Alcohol use among adolescents: concepts, epidemiological characteristics and etiopatogenic factors]. / Uso de álcool entre adolescentes: conceitos, características epidemiológicas e fatores etiopatogênicos.

Alcohol is the most consumed substance among young people, and the onset of its use is starting at an earlier age, raising the risks of future dependence. The use of alcohol in adolescence is associated with a series of risk behaviors, besides raising the risk of involvement in accidents, sexual violence, and participating in gangs. Alcohol use by adolescents is strongly associated with violent death, poor academic performance, learning difficulties and damage in the development and structuring of cognitive-behavioral and emotional abilities. Alcohol consumption causes neurochemical modifications, with damage in memory, learning and impulse control. Professionals who deal with adolescents must be prepared for a thorough evaluation regarding the possible abusive use or dependence of alcohol in this age group. However, it is important to emphasize that the criteria utilized by some diagnostic tools for abuse and dependence were developed for adults, and must be applied with caution in adolescents. Thus, it is fundamental that these professionals be aware of the characteristics and peculiarities of adolescence and chemical dependence in this age-group.

Aspectos da prática da eletroconvulsoterapia: uma revisão sistemática / Practical aspects of electroconvulsive therapy: a systematic review

A eletroconvulsoterapia (ECT) é um tratamento eficaz para uma série de transtornos psiquiátricos. Observa-se, contudo, que a sua prática ainda conta com uma série de questões não bem compreendidas. Isso explica, em parte, as diferenças na sua aplicação em diferentes serviços e a falta de protocolos claros para a sua execução. O presente trabalho é oriundo de uma revisão sistemática da literatura sobre a ECT (MEDLINEÒ 1993-2003). Ele visa a buscar respostas para as seguintes questões: há diferença, em termos de eficácia, entre o posicionamento uni ou bilateral dos eletrodos? Com que dosagem elétrica deve-se iniciar uma série de ECT? Qual a real importância do limiar convulsivo? O que é uma crise convulsiva adequada e como proceder na ausência da mesma?

Limites e alternativas para a implementaçäo de um programa para dependentes químicos em risco para infecçäo pelo HIV utilizando o conceito de Rede Social / Limits and alternatives to the implementation of a program for intravenous drug users at risk of HIV infection using the social Network Approach

Descrevem as etapas de execuçäo de um programa de açöes preventivas para usuários de drogas sob o risco de infecçäo pelo vírus da imunodeficiência humana (HIV), utilizando como paradigma de intervençäo um modelo de abordagem de redes sociais. Säo descritos os passos de instalaçäo do projeto dentro de um grande hospital universitário do sul do Brasil, com ênfase nos métodos e técnicas originais desenvolvidos pela equipe de atendimento. As dificuldades de implementaçäo do projeto säo discutidas ao longo das seçöes, buscando identificar os motivos pelos quais o programa obteve êxito apenas parcial. Destacam-se alguns pontos críticos, tais como a utilizaçäo de uma técnica ainda näo difundida em nosso meio, a dificuldade de reter em tratamento usuários de drogas injetáveis, a falta de estrutura para atendimentos imediatos, e as dificuldades em motivar equipes e pacientes para o tratamento. Ao final do texto, säo feitas sugestöes com o objetivo de facilitar o desenvolvimento de novos projetos que busquem utilizar o mesmo modelo conceitual.

Desenvolvimento de rotinas para prática de eletroconvulsoterapia no Hospital de Clínicas de Porto Alegre / Development of guidelines for eletroconvulsive therapy practice at Hospital de Clínicas de Porto Alegre

O presente trabalho revisa alguns aspectos relacionados a prática do procedimento de eletroconvulsoterapia. Este estudo surgiu frente a necessidade de implementaçäo de critérios para uma rotina deste procedimento no Hospital de Clínicas de Porto Alegre. Säo discutidos as indicaçöes, contraindicaçöes, avaliaçäo do paciente, frequência das sessöes e ECT de manutençäo, em busca de uma otimizaçäo deste procedimento

Desenvolvimento de rotinas para pratica de eletroconvulsoterapia no hospital de clinicas de Porto Alegre

O presente trabalho revisa alguns aspectos relacionados a pratica do procedimento de eletroconvulsoterapia. Este estudo surgiu frente a necessidade de implementacao de criterios para uma rotina deste procedimento no Hospital de Clinicas de Porto Alegre. Sao discutidos as indicacoes, contra-indicacoes, avaliacao do paciente, frequencia das sessoes e ECT de manutencao, em busca de uma otimizacao deste procedimento.