RESUMEN
OBJECTIVE: This study aims to describe the design, methods and sample characteristics of the Multidimensional Evaluation and Treatment of Anxiety in Children and Adolescents - the PROTAIA Project. METHOD: Students between 10 and 17 years old from all six schools belonging to the catchment area of the Primary Care Unit of Hospital de Clínicas de Porto Alegre were included in the project. It comprises five phases: (1) a community screening phase; (2) a psychiatric diagnostic phase; (3) a multidimensional assessment phase evaluating environmental, neuropsychological, nutritional, and biological factors; (4) a treatment phase, and (5) a translational phase. RESULTS: A total of 2,457 subjects from the community were screened for anxiety disorders. From those who attended the diagnostic interview, we identified 138 individuals with at least one anxiety disorder (apart from specific phobia) and 102 individuals without any anxiety disorder. Among the anxiety cases, generalized anxiety disorder (n = 95; 68.8%), social anxiety disorder (n = 57; 41.3%) and separation anxiety disorder (n = 49; 35.5%) were the most frequent disorders. CONCLUSION: The PROTAIA Project is a promising research project that can contribute to the knowledge of the relationship between anxiety disorders and anxiety-related phenotypes with several genetic and environmental risk factors.
Asunto(s)
Trastornos de Ansiedad/terapia , Servicios de Salud Mental , Atención Primaria de Salud , Adolescente , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Brasil/epidemiología , Niño , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Evaluación de Programas y Proyectos de Salud , Escalas de Valoración PsiquiátricaRESUMEN
Different lines of evidence support BDNF as a candidate gene in mood and anxiety modulation. More recently, the Met allele of the BDNF Val66Met polymorphism has been implicated in anxiety in animal models and anxiety-traits in humans. The aim of this study is to evaluate the a priori hypothesis that the association between anxiety disorders and Val66Met polymorphism at the BDNF gene would be replicated in a community sample of children and adolescents. 240 subjects from a total sample of 2457 children and adolescents aged 10-17 years from the public schools in the catchment area of the primary care unit of a university hospital participated in this case-control study and were assessed for psychopathology using the K-SADS-PL. A sample of saliva was collected for DNA analysis of Val66Met polymorphism. BDNF was the single gene evaluated in this sample. We found a significant association between carrying one copy of the Met allele and higher chance of anxiety disorders in children and adolescents. The association remained positive even after the adjustment for potential confounders (228 subjects; OR=3.53 (CI95% 1.77-7.06; p<0.001)). Our results support the a priori hypothesis of an association between anxiety and the polymorphism Val66Met. To our knowledge, this is the first study documenting a potential role of this polymorphism in a community sample of anxious children and adolescents.
Asunto(s)
Sustitución de Aminoácidos/genética , Trastornos de Ansiedad/genética , Química Encefálica/genética , Factor Neurotrófico Derivado del Encéfalo/genética , Predisposición Genética a la Enfermedad/genética , Polimorfismo Genético/genética , Adolescente , Trastornos de Ansiedad/metabolismo , Niño , Estudios de Cohortes , Femenino , Pruebas Genéticas/métodos , Humanos , Masculino , Metionina/genética , Valina/genéticaRESUMEN
OBJECTIVE: This study aims to describe the design, methods and sample characteristics of the Multidimensional Evaluation and Treatment of Anxiety in Children and Adolescents - the PROTAIA Project. METHOD: Students between 10 and 17 years old from all six schools belonging to the catchment area of the Primary Care Unit of Hospital de Clínicas de Porto Alegre were included in the project. It comprises five phases: (1) a community screening phase; (2) a psychiatric diagnostic phase; (3) a multidimensional assessment phase evaluating environmental, neuropsychological, nutritional, and biological factors; (4) a treatment phase, and (5) a translational phase. RESULTS: A total of 2,457 subjects from the community were screened for anxiety disorders. From those who attended the diagnostic interview, we identified 138 individuals with at least one anxiety disorder (apart from specific phobia) and 102 individuals without any anxiety disorder. Among the anxiety cases, generalized anxiety disorder (n = 95; 68.8 percent), social anxiety disorder (n = 57; 41.3 percent) and separation anxiety disorder (n = 49; 35.5 percent) were the most frequent disorders. CONCLUSION: The PROTAIA Project is a promising research project that can contribute to the knowledge of the relationship between anxiety disorders and anxiety-related phenotypes with several genetic and environmental risk factors.
OBJETIVO: o objetivo deste estudo é descrever o desenho, os métodos e as características amostrais da Avaliação Multidimensional e Tratamento da Ansiedade em Crianças e Adolescentes - Projeto PROTAIA. MÉTODO: Escolares entre 10 e 17 anos de todas as escolas pertencentes à área de abrangência da unidade de atenção primária do Hospital de Clínicas de Porto Alegre foram incluídos no projeto. O projeto compreende cinco fases: 1) triagem comunitária; 2) diagnóstico psiquiátrico; 3) avaliação multidimensional, incluindo fatores ambientais, neuropsicológicos, nutricionais e marcadores biológicos; 4) tratamento; e 5) fase translacional. RESULTADOS: Um total de 2.457 sujeitos foram triados para transtornos de ansiedade na comunidade. Dos indivíduos que compareceram à avaliação diagnóstica, 138 foram detectados com ao menos um transtorno de ansiedade (excluindo fobia específica) e 102 indivíduos sem nenhum transtorno de ansiedade. Dentre os casos de ansiedade, o transtorno de ansiedade generalizada (n = 95; 68,8 por cento), transtorno de ansiedade social (n = 57; 41,3 por cento) e o transtorno de ansiedade de separação (n = 49; 35,5 por cento) foram os mais frequentes. CONCLUSÃO: O projeto PROTAIA é um projeto de pesquisa promissor que pode contribuir para o entendimento da relação entre transtornos de ansiedade e fenótipos relacionados à ansiedade com vários fatores de risco, tanto genéticos quanto ambientais.
Asunto(s)
Adolescente , Niño , Femenino , Humanos , Masculino , Trastornos de Ansiedad/terapia , Servicios de Salud Mental , Atención Primaria de Salud , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Brasil/epidemiología , Tamizaje Masivo/métodos , Evaluación de Programas y Proyectos de Salud , Escalas de Valoración PsiquiátricaRESUMEN
O presente trabalho analisa algumas características do pensamento de um paciente fóbico-obsessivo, estudando como o pensamento se estrutura dentro do psiquismo. Apresenta uma revisão de aspectos teóricos em Freud, Klein e Bion, com uma subseqüente discussão sobre um caso de psicoterapia de orientação analítica partindo desses conceitos
The present article focus on some features of a phobic-obsessive patientsthought, studying how thought can be structured inside the mind. It presents a revision of theoretical issues in Freud, Klein and Bion, with a subsequent discussion on a psychoanalytical psychotherapy case based on these concepts
Asunto(s)
Conducta Obsesiva , Trastornos Fóbicos , Psicoterapia , PensamientoRESUMEN
O presente trabalho analisa algumas características do pensamento de umpaciente fóbico-obsessivo, estudando como o pensamento se estrutura dentrodo psiquismo. Apresenta uma revisão de aspectos teóricos em Freud, Klein e Bion, com uma subseqüente discussão sobre um caso de psicoterapiade orientação analítica partindo desses conceitos
The present article focus on some features of a phobic-obsessive patientsthought, studying how thought can be structured inside the mind. It presents arevision of theoretical issues in Freud, Klein and Bion, with a subsequentdiscussion on a psychoanalytical psychotherapy case based on these concepts
Asunto(s)
Trastornos Fóbicos , Conducta Obsesiva , Pensamiento , PsicoterapiaRESUMEN
Este trabalho visa à abordagem da ansiedade sob dois diferentes pontos de vista: o da psiquiatria psicodinâmica e o da psiquiatria biológica. O trabalho enfoca o tratamento psicodinâmico e farmacológicoe propõe uma integração entre as duas correntes como um dos grandes desafios da psiquiatria atual