Effectiveness of psychological interventions for eating disorders in adolescence: An overview of systematic reviews / Eficacia de las Intervenciones Psicológicas en el Tratamiento de los Trastornos Alimentarios en Adolescentes: Una Meta-Revisión

Eating disorders (EDs) are high prevalent among adolescents with serious consequences. Evidence of effectiveness of psychological interventionsfor eating disorders in adolescents lacks a systematic synthesis of systematic reviews. The goal of this umbrella review is to summarize evidencefrom systematic reviews examining effects of psychological interventions for eating disorders targeting adolescents. Web of Science, PsycINFO andCochrane Database of Systematic Reviews were searched for systematic reviews on effectiveness and/or efficacy of any psychological interventionaiming to treat eating disorders in terms of outcomes in adolescents (improvement of eating-disorder symptoms, weight restoration and treatmentretention). The methodological quality of each study was assessed using AMSTAR 2. The original search identified 831 reviews, 9 of which wereincluded in the overview of systematic reviews rated as having a low methodological quality. Predominant psychological interventions for EDsin adolescents are family-based interventions. The efficacy of cognitive behavioral therapy and third-wave treatments has been less researched.Anorexia nervosa and bulimia nervosa are the EDs that have been studied the most. This study provides evidence supporting the positive impactof psychological interventions on eating disorders in adolescents. Family based treatment is the most evidence-based psychological intervention.There is a need for high-quality systematic reviews as well as systematic reviews to examine if psychological interventions are effective for different eating disorders. (AU)

La prevalencia de los trastornos alimentarios es elevada entre los adolescentes con consecuencias graves. La evidencia de la eficacia de las intervencionespsicológicas para los trastornos alimentarios en adolescentes carece de una meta-revisión de revisiones sistemáticas. El objetivo de esta revisiónparaguas es resumir la evidencia de las revisiones sistemáticas que examinan los efectos de las intervenciones psicológicas para los trastornosalimentarios en adolescentes. Se realizaron búsquedas en Web of Science, PsycINFO y Cochrane Database of Systematic Reviews de revisionessistemáticas sobre la efectividad y/o eficacia de las intervenciones psicológicas para trastornos alimentarios en adolescentes (reducción de síntomas, restauración del peso y retención en el tratamiento). La calidad metodológica de cada estudio se evaluó mediante AMSTAR 2. En la búsquedainicial se identificaron 831 registros, y 9 revisiones sistemáticas se incluyeron en la meta-revisión con una valoración de calidad metodológica baja.Las intervenciones psicológicas predominantes para los trastornos alimentarios en adolescentes fueron las intervenciones basadas en la familia.La eficacia de la terapia cognitivo-conductual y los tratamientos de tercera generación está menos estudiada. La anorexia nerviosa y la bulimianerviosa son los trastornos alimentarios con mayor número de estudios. Hay evidencia del impacto positivo de las intervenciones psicológicas paralos trastornos alimentarios en adolescentes. El tratamiento basado en la familia es la intervención psicológica con mayor evidencia. Se necesitanrevisiones sistemáticas de mayor calidad, así como revisiones sistemáticas para examinar la eficacia de las intervenciones psicológicas para los distintos trastornos alimentarios. (AU)

Relato de Experiência Docente: A Primeira Disciplina no Brasil sobre a Prática da Psicologia Baseada em Evidências Ministrada no Instituto de Psicologia da Universidade de São Paulo / Teaching Experience Report:The First Discipline in Brazil on the Evidence-Based Practice in Psychology Offered by the Institute of Psychology of the University of São Paulo

RESUMO Este artigo relata a experiência de ensino da primeira disciplina no Brasil sobre a Prática da Psicologia Baseada em Evidências (PPBE), oferecida pelo Instituto de Psicologia da Universidade de São Paulo. O curso instruiu os alunos sobre os conceitos da PPBE, fontes de evidências primárias e secundárias, adequação da pergunta de pesquisa ao delineamento, delineamento experimental de caso único, estudos observacionais, ensaios clínicos randomizados e sobre a execução de revisões sistemáticas, com ou sem metanálise. É importante destacar que o desenvolvimento da disciplina oportunizou a reflexão sobre a importância da PPBE no âmbito clínico, acadêmico, institucional e na gestão de políticas públicas na saúde mental. Recomenda-se a inserção da disciplina na grade curricular dos cursos de graduação e pós-graduação na área da Psicologia.

ABSTRACT This article reports the experience of teaching the first course in Brazil on the Evidence-Based Practice in Psychology (EBPP), offered by the Institute of Psychology of the University of São Paulo. The course instructed students on the concepts of EBPP, primary and secondary sources of evidence, adequacy of the research question to the experimental design, single-subject design, observational studies, randomized controlled trials and implementation of systematic reviews with or without meta-analysis. It is noteworthy that the development of the discipline allowed reflections on the importance of EBPP in clinical, academic, institutional and public policy management on mental health. It is recommended the inclusion of EBPP course in the curriculum of undergraduate and graduate students in Psychology.

Psychological Treatments for Mental Disorders in Children and Adolescents: A Review of the Evidence of Leading International Organizations.

In recent decades, the evidence on psychological treatments for children and adolescents has increased considerably. Several organizations have proposed different criteria to evaluate the evidence of psychological treatment in this age group. The aim of this study was to analyze evidence-based treatments drawn from RCTs, reviews, meta-analyses, guides and lists provided by four leading international organizations. The institutions reviewed were the National Institute for Health and Care Excellence, the Society of Clinical Child and Adolescent Psychology (Division 53) of the American Psychological Association, Cochrane Collaboration and the Australian Psychological Society in relation to mental disorders in children and adolescents. A total of 137 treatments were analyzed for 17 mental disorders and compared to determine the level of agreement among the organizations. The results indicate that, in most cases, there is little agreement among organizations and that there are several discrepancies within certain disorders. These results require reflection on the meaning attributed to evidence-based treatments with regard to psychological treatments in children and adolescents. The possible reasons for these differences could be explained by a combination of different issues: the procedures or committees may be biased, different studies were reviewed, different criteria are used by the organizations or the reviews of existing evidence were conducted in different time periods.

El lugar de la psicología en las investigaciones empíricas del suicidio en Argentina: Un estudio bibliométrico / State of psychological empirical research on suicide in Argentine: A bibliometric study

El suicidio constituye un problema de salud pública que tiene un gran impacto económico, social y psicológico a nivel mundial. Cada año se estima que mueren cerca de un millón de pers-nas en todo el mundo debido al suicidio. De lo anterior se desprende la importancia de contar con investigaciones empíricas que sustenten todo tipo de accionar en la problemática del suicidio, desde políticas en salud pública hasta tratamientos psicológicos. Dada la relevancia del tema, el estudio bibliométrico realizado tuvo como principal objetivo verificar la producción empírica sobre el suicidio en Argentina, haciendo especial énfasis en el lugar de la Psicología en dicha producción. Sintetizando, los resultados permiten concluir que la producción empírica sobre el suicidio en los principales países de Sudamérica es muy baja; más aún si se considera solamente a Argentina. Otra conclusión importante tiene que ver con la menor implicancia de la ciencia psicológica en el abordaje empírico del suicidio, comparando los aportes desde un enfoque médico. Estas conclusiones invitan a reflexionar sobre la necesidad de un mayor abordaje empírico del suicidio en la región, y particularmente en Argentina.

Suicide is a major problem of public health leading to great economic, social, and psychological costs worldwide. Around one million people die every year on the world due to suicide. Furthermore, suicide is responsible for half of violent deaths worldwide exceeding even the combination of deaths due to war or homicide. Taking into account the above, researchers around the world recommended concerted efforts to generate actions, research, and investigation with the objective of reduce risk to suicide. Therefore, evidence from empirical research supporting public health policies and psychological treatments is needed. The present article introduces a bibliometric study aimed to examine the state of empirical research on suicide in Argentina, and specially the amount of psychological empirical research. Specifically, research methodology consists of the following aspects: As regards the criteria of inclusion / exclusion of articles, the search focused on the detection of empirical suicide articles. In this sense, the main criterion for inclusion in the analysis was based on studies that have been published or were being published in scientific journals. For the aforementioned reasons, they were excluded from this study theoretical article, books, book chapters, theses, and conference presentation. Also, those articles that used the term suicide to address problems outside the addressed (e.g., Suicide Gene Therapy) were excluded from the analysis. In relation to the search strategy, the main database used has been Scopus, which maintains a leading position among bibliographic databases. In this sense, the journals included in the database have very high quality standards. The two principal terms used in the search have been suicide and suicidal. The selection of these two words is because account for the main variables involved in suicide, as expressed in terms such Suicide attempt, Suicidal act, Suicidal behavior and Suicide ideation. The full search term applied in SCOPUS is transcribed below: TITLE (suicide) OR TITLE (suicidal) AND NOT TITLE (suicidal gene) AND NOT TITLE (gene therapy) AND NOT TITLE (suicidal dna) AND NOT TITLE (suicide dna) AND NOT TITLE (suicide drugs) AND NOT TITLE (eryptosis) AND NOT TITLE (streptococcus pneumoniae) AND NOT TITLE (assisted suicidal) AND NOT TITLE (assisted suicide) AND NOT TITLE (iron suicide) AND NOT TITLE (proton suicide method) AND LIMIT-TO (DOCTYPE, "ar") OR LIMIT-TO (DOCTYPE, "re") OR LIMIT-TO (DOCTYPE,"ip"). Other databases consulted were LILACS and PUBMED. PUBMED is open access and is the main database of health sciences in the world, produced by the National Library of Medicine in the United States. These bases were mainly used to supplement the data obtained by SCOPUS and specifically, were used to achieve a broader and more complete picture of empirical studies on suicide, carried out specifically in Argentina. LILACS search term used was suici$ (Argentina). In PUBMED search term used was suici* (Argentina). The sign * and $ were used to retrieve words of the same family, such as suicide or suicidal. Finally, for the calculation of bibliometric indicators we took into account the suggestions given in the international literature. Thus, the following descriptive data were analyzed: number of items by country, number of items by country depending on the year, international collaboration of , considering year too, language of publication of articles, and thematic areas involved. Results show that scientific literature concerning suicide in South America is limited, even more in Argentine. Moreover, most research in suicide is based on medical rather than psychological approach. Indeed, regarding the number of publications (f = 443) in South American countries, they only represent 1.49% of the articles published worldwide. The scientific research on suicide is even more critical in Argentina. Specifically, when considering publications on Scopus, LILACS and PUBMED, empirical research in this country represents only 1.41% of the extant literature on suicide. However, in recent years there have been an increasing number of publications from which may reflects a burgeoning interest in this topic. Results also indicate a greater collaboration between Argentina and other countries, particularly United States, as indicated by co-authorship studies (f = 6). Surprisingly, collaboration with (main producer of scientific articles in the South American region) is scarce (f = 2). Finally, take into account publications from in research data bases analyzed (Scopus, LILACS, and PUBMED) we note that most research on suicide has been published in medical journals (f = 30;71.42%), while a lower number of articles has been published in psychological journals (f = 5; 1.19%).Globally, these results claim for more empirical research in suicide from psychologist, particularly in Argentina.

Psychological treatments for mental disorders in adults: A review of the evidence of leading international organizations.

Most mental health services throughout the world currently regard evidence-based psychological treatments as best practice for the treatment of mental disorders. The aim of this study was to analyze evidence-based treatments drawn from RCTs, reviews, meta-analyses, guides, and lists provided by the National Institute for Health and Care Excellence (NICE), Division 12 (Clinical Psychology) of the American Psychological Association (APA), Cochrane and the Australian Psychological Society (APS) in relation to mental disorders in adults. A total of 135 treatments were analyzed for 23 mental disorders and compared to determine the level of agreement among the organizations. The results indicate that, in most cases, there is little agreement among organizations and that there are several discrepancies within certain disorders. These results require reflection on the meaning attributed to evidence-based practice with regard to psychological treatments. The possible reasons for these differences are discussed. Based on these findings, proposals to unify the criteria that reconcile the realities of clinical practice with a scientific perspective were analyzed.

Facts and values in psychotherapy-A critique of the empirical reduction of psychotherapy within evidence-based practice.

This paper addresses an implicit presupposition in research-supported psychological treatments and evidence-based practice in psychology. It argues that the notion of research-supported psychological treatments is based on a reductive conceptualisation of psychotherapy. Research-supported psychological treatments hinge upon an empirical reduction where psychotherapy schools become conceptualized as mere collections of empirical propositions. However, this paper argues that the different psychotherapy schools have distinct ethoses that are constituted by normative claims. Consequently, the evaluation of the different psychotherapy schools and the practice of psychotherapy should include the underlying normative claims of these ethoses.

La urgencia de la evidencia en psicoterapia / The urgency of evidence in psychotherapy

Actualmente, y tras una larga historia de desarrollo y evolución, la psicoterapia es un campo en el que se presentan diferentes modelos de intervención, donde cada uno busca obtener un reconocimiento propio y su respectiva promoción. Ante esto, se plantea inicialmente la cuestión acerca de la utilidad de los modelos y que estos ofrezcan realmente resultados, haciéndose urgente contar con indicadores de eficacia respecto a los tratamientos empleados. En ese sentido, un paso importante ha sido la consolidación de los Tratamientos Psicológicos Eficaces (Chambless & Hollon, 1998), y más importante aún la meta de instaurar una Psicología Clínica Basada en la Evidencia (Spring, 2007). El presente artículo hace un análisis y revisión de esta propuesta, destacando la necesidad de adoptarla a favor de la coherencia con la idea de la psicología como ciencia; por otro lado también se describen las críticas o limitaciones planteadas, así como respuestas documentadas ante las mismas, considerando los retos futuros a los que conllevan para el avance de la psicología clínica y de la psicoterapia.

Currently, and after a long history of development and evolution, psychotherapy is a field where different models of intervention meet together, and everyone wants to obtain its own recognition and promotion. Considering this, it is contemplated the problem with the usefulness of the models and if them really present results, making the urgency of have an efficacy indicator of the treatments in use. In that sense, an important advance was the consolidation of the Efficacy of Psychological Treatments (Chambless & Hollon, 1998), and even more important the target of establish an Evidence-based Clinical Psychology (Spring, 2007). In this paper, it is made an analysis and review of this proposal, emphasizing the need of adopt it supporting the coherence with the idea of psychology as a science. What is more, it is described the criticism or the limitations of this point of view and some informed responses to them, considering the future challenges in the advance of clinical psychology and psychotherapy.

Prática baseada em evidências em psicologia e a história da busca pelas provas empíricas da eficácia das psicoterapias / Evidence-based practice in psychology and the history of the search for empirical proof on the efficacy of psychotherapies / La práctica basada en la evidencia en la psicología y la historia de búsqueda de las pruebas empíricas sobre la eficacia de las psicoterapias

Tradicionalmente, a escolha pelo tipo de intervenção psicoterápica para diferentes quadros clínicos depende fundamentalmente da experiência profissional do terapeuta e de sua predileção por determinadas estratégias clínicas. Todavia, esse cenário tem se modificado no contexto da prática baseada em evidências. Apesar do extenso e acalorado debate na literatura internacional da Psicologia nos últimos anos, o tema da prática baseada em evidências tem sido pouco discutido na Psicologia brasileira. Em vista disso, este artigo tem por objetivo apresentar o paradigma de prática baseada em evidências em Psicologia sob uma perspectiva histórica, enfatizando o embate entre os diferentes posicionamentos sobre o assunto e os esforços da American Psychological Association em elaborar um modelo representativo das diversas perspectivas teóricas, metodológicas, conceituais e práticas com o intuito de preencher a lacuna entre ciência e prática ainda existente na Psicologia Clínica. Espera-se que este artigo possa contribuir para uma maior participação da Psicologia brasileira nesse movimento.

Traditionally, the choice of the type of psychotherapeutic intervention for various clinical conditions fundamentally depends on the professional experience of the therapist and his/her predilection for certain clinical strategies. However, this scenario has been changing in the context ofevidence-based practice. Despite the extensive and heated debate in international psychology literature over the past few years, evidence-based practice has been scarcely discussed in Brazilian Psychology. Hence, this article aims at introducing the paradigm of evidence-based practice in psychology from a historical perspective, with particular emphasis on the clash between the different positions on the issue. It also focuses on the efforts of the American Psychological Association to design a model that is representative of various theoretical, methodological, conceptual, and practical perspectives in order to bridge the gap between science and practice that still exists in clinical Psychology. This article seeks to contribute to a greater participation of Brazilian psychology in this movement.

Tradicionalmente, la elección del tipo de intervención psicoterapéutica para diversas condiciones clínicas depende fundamentalmente de la experiencia profesional del terapeuta y de su predilección por determinadas estrategias clínicas. Sin embargo, este escenario ha ido cambiando en el contexto de lapráctica basada en la evidencia. A pesar del debate extenso y arduo en la literatura internacional de la psicología en los últimos años, el tema de la práctica basada en la evidencia ha sido poco discutido en la Psicología brasileña. En vista de ello, este artículo tiene como objetivo presentar el paradigma de la práctica basada en la evidencia en la psicología desde una perspectiva histórica, haciendo hincapié en el choque entre las diferentes posiciones sobre el tema y los esfuerzos de laAmerican Psychological Association para desarrollar un modelo representativo de las distintas perspectivas teóricas, metodológicas, conceptuales y prácticas con el fin de rellenar la brecha entre la ciencia y la práctica aún vigente en Psicología clínica. Se espera que este artículo permita contribuir para una mayor participación de la psicología brasileña en este movimiento.

Prática baseada em evidências em psicologia e a história da busca pelas provas empíricas da eficácia das psicoterapias / Evidence-based practice in psychology and the history of the search for empirical proof on the efficacy of psychotherapies / La práctica basada en la evidencia en la psicología y la historia de búsqueda de las pruebas empíricas sobre la eficacia de las psicoterapias

Resumo Tradicionalmente, a escolha pelo tipo de intervenção psicoterápica para diferentes quadros clínicos depende fundamentalmente da experiência profissional do terapeuta e de sua predileção por determinadas estratégias clínicas. Todavia, esse cenário tem se modificado no contexto da prática baseada em evidências. Apesar do extenso e acalorado debate na literatura internacional da Psicologia nos últimos anos, o tema da prática baseada em evidências tem sido pouco discutido na Psicologia brasileira. Em vista disso, este artigo tem por objetivo apresentar o paradigma de prática baseada em evidências em Psicologia sob uma perspectiva histórica, enfatizando o embate entre os diferentes posicionamentos sobre o assunto e os esforços da American Psychological Association em elaborar um modelo representativo das diversas perspectivas teóricas, metodológicas, conceituais e práticas com o intuito de preencher a lacuna entre ciência e prática ainda existente na Psicologia Clínica. Espera-se que este artigo possa contribuir para uma maior participação da Psicologia brasileira nesse movimento.(AU)

Abstract Traditionally, the choice of the type of psychotherapeutic intervention for various clinical conditions fundamentally depends on the professional experience of the therapist and his/her predilection for certain clinical strategies. However, this scenario has been changing in the context ofevidence-based practice. Despite the extensive and heated debate in international psychology literature over the past few years, evidence-based practice has been scarcely discussed in Brazilian Psychology. Hence, this article aims at introducing the paradigm of evidence-based practice in psychology from a historical perspective, with particular emphasis on the clash between the different positions on the issue. It also focuses on the efforts of the American Psychological Association to design a model that is representative of various theoretical, methodological, conceptual, and practical perspectives in order to bridge the gap between science and practice that still exists in clinical Psychology. This article seeks to contribute to a greater participation of Brazilian psychology in this movement.(AU)

Resumen Tradicionalmente, la elección del tipo de intervención psicoterapéutica para diversas condiciones clínicas depende fundamentalmente de la experiencia profesional del terapeuta y de su predilección por determinadas estrategias clínicas. Sin embargo, este escenario ha ido cambiando en el contexto de lapráctica basada en la evidencia. A pesar del debate extenso y arduo en la literatura internacional de la psicología en los últimos años, el tema de la práctica basada en la evidencia ha sido poco discutido en la Psicología brasileña. En vista de ello, este artículo tiene como objetivo presentar el paradigma de la práctica basada en la evidencia en la psicología desde una perspectiva histórica, haciendo hincapié en el choque entre las diferentes posiciones sobre el tema y los esfuerzos de laAmerican Psychological Association para desarrollar un modelo representativo de las distintas perspectivas teóricas, metodológicas, conceptuales y prácticas con el fin de rellenar la brecha entre la ciencia y la práctica aún vigente en Psicología clínica. Se espera que este artículo permita contribuir para una mayor participación de la psicología brasileña en este movimiento.(AU)

Adaptación del cuestionario de alianza de ayuda revisado versión paciente (HAQ-II-P) para la población de cordobeses / Adaptation of the revised helping alliance questionnaire patient version (HAQ-II-P) for the population of Cordobans

La Psicología Basada en la Evidencia resultaría incompleta si no indagara el rol de la relación terapéutica. No obstante la ausencia de instrumentos adaptados obstaculiza el desarrollo de estudios empíricos en el contexto local. Este trabajo tuvo por objetivo principal adaptar la versión para pacientes del Cuestionario de Alianza de Ayuda Revisado (HAq-II). A su vez, como objetivo adicional se efectuó una comparación de tres modelos teóricos de alianza terapéutica. De esta manera, luego de traducir los ítems y evaluar la equivalencia mediante un panel de expertos se administró el HAq-II a una muestra de 119 participantes que se encontraban en tratamiento psicoterapéutico breve. Los resultados del análisis factorial confirmatorio sugieren un modelo subyacente de dos dimensiones: vinculo positivo con el terapeuta (alfa = .70) y acuerdo con los objetivos y tareas (alfa = .71). Cabe destacar que dicho modelo integra coherentemente las teorías propuestas por Luborsky y Bordin.

Evidence-based psychology would be incomplete if the role of the therapeutic relationship was not investigated. However, the absence of adapted instruments impedes the development of empirical studies in the local context. The principal objective of this work was to adapt the patient version of the revised helping alliance questionnaire (HAq-II). As an additional objective a comparison of three theoretical models of therapeutic alliance was carried out. After translating the items and evaluating their equivalency via a panel of experts, the HAq-II was administered to a sample of 119 participants undergoing brief psychotherapy. The results of the confirmatory factorial analysis suggest an underlying model of two dimensions: positive bond with the therapist (alpha = .70) and goal and task agreement (alpha = .71). It should be noted that this model fits coherently with the theories proposed by Luborsky and Bordin.

Prevalência de depressão pós-parto em países desenvolvidos e em desenvolvimento: contribuições metodológicas de uma metanálise / Prevalence of postpartum depression in developed and developing countries: methodological contributions of a meta-analysis

Introdução: A depressão pós-parto (DPP) é um transtorno de humor que pode ocorrer em mulheres no primeiro ano após o parto. Estudos epidemiológicos anteriores apresentaram variações em relação à metodologia adotada e resultados conflitantes quanto à prevalência de DPP. Não há consenso sobre a possibilidade de que a prevalência de DPP seja maior nos países em desenvolvimento do que nos desenvolvidos. Objetivos: Usando revisão sistemática da literatura seguida de metanálise, objetivou-se identificar variáveis regionais e metodológicas dos estudos primários que contribuíram para as diferenças nas prevalências de DPP; e verificar se haveria diferença entre a prevalência de DPP em países desenvolvidos e em desenvolvimento, controlando-se variáveis metodológicas. Método: Trata-se de pesquisa documental, para a qual foi realizada busca em 14 bases de dados eletrônicas, usando estratégias com os termos depressão pós-parto e prevalência, sem restrição de tempo. Critérios de inclusão foram aplicados por duas revisoras independentes aos registros obtidos, em três etapas: títulos, resumos e texto completo. Dados sobre a prevalência de DPP e a metodologia adotada foram coletados dos estudos incluídos. A Escala de Loney foi usada para avaliar a qualidade metodológica. Técnicas estatísticas foram aplicadas para analisar a heterogeneidade entre os trabalhos incluídos e sintetizar os resultados, gerando médias ponderadas das prevalências para subgrupos de análise. Um modelo de metarregressão foi construído, tendo as variáveis metodológicas dos estudos como preditores e a prevalência de DPP como variável dependente. Resultados: Foram obtidos 1.881 registros de estudos originais, publicados entre 1980 e 2012, dos quais 778 tiveram o texto completo avaliado e 337 foram incluídos. A qualidade metodológica dos trabalhos foi considerada fraca. A prevalência de DPP variou entre 0,5% em Singapura e 62,8% nos Estados Unidos da América, observando-se alta heterogeneidade.(AU)

Introduction: Postpartum depression (PPD) is a mood disorder that might occur in women in the first year after delivery. Previous epidemiological studies varied with regards to methodology and showed conflicting results regarding the prevalence of PPD. There is no consensus on whether the prevalence of PPD is greater in developing countries than in developed ones, or not. Objective: Using systematic literature review followed by meta-analysis, we aimed to identify regional and methodological variables of primary studies that contributed to the differences in the prevalence of PPD; and check if there was a difference between the prevalence of PPD in developed countries and developing ones, keeping control of methodological variables. Methods: This thesis made a documental research, which searched 14 electronic databases for specialized studies, using strategies with the terms "postpartum depression" and "prevalence", without time restrictions. Inclusion criteria were applied for two reviewers to obtained records in three stages: titles, abstracts and full text. Data on the prevalence of PPD as well as methodology from the included studies were collected. The Loney Scale was used to assess the methodological quality. Statistical techniques were applied to analyze the heterogeneity among the included studies and synthesize the results, generating weighted average prevalence subgroups for analysis. A meta-regression model was constructed, using methodological variables of the studies as predictors and the prevalence of PPD as a dependent variable. Results: Records from 1881 original studies published between 1980 and 2012 were obtained, of which 778 were evaluated for full text and 337 were included. The methodological quality of the studies was considered weak. The prevalence of PPD ranged from 0.5% in Singapore to 62.8% in United States of America, observing high heterogeneity.(AU)

Psicologia Baseada em Evidências: uma abordagem promissora a ser descoberta pelos psicólogos / Evidence-Based Psychology: a promising approach to be discovered by psychologists / Psicología Basada en la Evidencia: un enfoque prometedor para ser descubierto por psicólogos

No presente artigo, sustentamos a tese que a Psicologia Baseada em Evidênciasé uma abordagem promissora e insuficientemente aproveitada pelos psicólogos brasileiros.Procuramos mostrar que a sua integração na prática profissional pode resultar em ganhossubstanciais de qualidade do trabalho desenvolvido em várias áreas de atuação dopsicólogo e no desenvolvimento de políticas de gestão. Apresentamos um exemplo deaplicação de revisão sistemática, seguida de metanálise para elucidar questionamentosa respeito da prevalência de Depressão Pós-parto (DPP) em países desenvolvidos e emdesenvolvimento. Nessa revisão, buscamos trabalhos sobre a prevalência de DPP em 14bases de dados e usamos a metanálise para sintetizar os resultados dos estudos,comparando países desenvolvidos e em desenvolvimento. Concluímos que a DPP temmaior prevalência em países em desenvolvimento. São indicadas contribuições dosresultados para a gestão em saúde(AU)

In this article, we defend the thesis that Evidence-Based Psychology is apromising approach insufficiently utilized by Brazilian psychologists. Our intention is todemonstrate that its integration with the professional practice can result in substantialgains in the quality of work developed in various areas of the psychologist and thedevelopment of management policies. We present an example of application ofsystematic review followed by meta-analysis, to clarify questions about the prevalenceof Postpartum Depression (PPD) in developed and developing countries. In this review,we looked for works on the prevalence of PPD in 14 databases and used meta-analysisto synthesize the results of studies, comparing developed and developing countries.We conclude that the PPD is most prevalent in developing countries. Possiblecontributions of results to health management were indicated(AU)

El presente artículo sustenta la tesis que la Psicología Basada en Evidenciases un abordaje prometedor pero poco aprovechado por los psicólogos brasileros.Intentamos mostrar que su incorporación en la práctica profesional puede aportargrande ganancias en la calidad del trabajo desarrollado en diferentes áreas de actuacióndel psicólogo y en el desarrollo de políticas de gestión. Presentamos un ejemplo deaplicación de revisión sistemática, seguida por un metanálises para despejarcuestionamientos en relación a la prevalencia de la Depresión post-parto (DPP) enpaíses desarrollados y en desarrollo. En esta revisión, buscamos trabajos sobre laprevalencia de la DPP en 14 bases de datos y usamos el metanálisis para sintetizarlos resultados del estudio, comprando países desarrollados y en desarrollo. Concluimosque la DPP tiene mayor prevalencia en países en desarrollo. Se indican posiblescontribuciones de los resultados para la gestión en salud(AU)

Empirically supported treatments in psychotherapy: towards an evidence-based or evidence-biased psychology in clinical settings?

THE FIELD OF RESEARCH AND PRACTICE IN PSYCHOTHERAPY HAS BEEN DEEPLY INFLUENCED BY TWO DIFFERENT APPROACHES: the empirically supported treatments (ESTs) movement, linked with the evidence-based medicine (EBM) perspective and the "Common Factors" approach, typically connected with the "Dodo Bird Verdict". About the first perspective, since 1998 a list of ESTs has been established in mental health field. Criterions for "well-established" and "probably efficacious" treatments have arisen. The development of these kinds of paradigms was motivated by the emergence of a "managerial" approach and related systems for remuneration also for mental health providers and for insurance companies. In this article ESTs will be presented underlining also some possible criticisms. Finally complementary approaches, that could add different evidence in the psychotherapy research in comparison with traditional EBM approach, are presented.