Preliminary data on the prevalence of psychiatric disorders in Brazilian male and female juvenile delinquents

The aim of the present investigation was to study the prevalence of psychiatric disorders in a sample of delinquent adolescents of both genders and to compare the prevalence between genders. A total of 116 adolescents (99 males and 17 females) aged 12 to 19 on parole in the State of Rio de Janeiro were interviewed using the screening interview based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime (KSADS-PL). Data were collected between May 2002 and January 2003. Of 373 male and 58 female adolescents present in May 2002 in the largest institution that gives assistance to adolescents on parole in the city of Rio de Janeiro, 119 subjects were assessed (three of them refused to participate). Their average age was 16.5 years with no difference between genders. The screening interview was positive for psychopathology for most of the sample, with the frequencies of the suggested more prevalent psychiatric disorders being 54 percent for attention-deficit/hyperactivity disorder, 77 percent for conduct disorder, 41 percent for oppositional defiant disorder, 57 percent for anxiety disorder 57, 60 percent for depressive disorder 60, 63 percent for illicit drug abuse, and 58 percent for regular alcohol use. Internalizing disorders (depressive disorders, anxiety disorders and phobias) were more prevalent in the female subsample. There was no significant difference in the prevalence of illicit drug abuse between genders. There were more male than female adolescents on parole and failure to comply with the sentence was significantly more frequent in females. The high prevalence of psychopathology suggested by this study indicates the need for psychiatric treatment as part of the prevention of juvenile delinquency or as part of the sentence. However, treatment had never been available for 93 percent of the sample in this study.

Autismo associado a Síndrome de Silver-Russell: descriçäo de caso clínico / Autism and Silver-Russell Syndrome: a case report

The Silver-Russell Syndrome is characterized by pre natal onset of growth retardation marked by short stature and weight, hemmiatrophy and triangular facies. This study describes a case report and oral findings include a double tooth, color alterations and absence of several elements

Deficiência mental em São Paulo: perfil de uma população atendida institucionalmente / Mental retardation in Säo Paulo, Brazil: profile of an attended institutionalized population

A deficiência mental, por sua prevalência e sua importância em termos de estruturaçäo e atendimento, é um tema de suma importância. No Brasil, poucos säo os estudos a ela dedicados e pouquíssimos os dados que refletem as características da populaçäo por ela afetada. Em funçäo disso, os autores analisam a populaçäo de 178 instituiçöes especializadas no atendimento à deficiência mental no Estado de Säo Paulo, a partir de sua idade, sexo, cor, nível de deficiência e hipótese etiológica. Essa análise foi realizada através de questionários enviados às instituiçöes com questöes referentes aos dados estudados. Os resultados mostram predomínio de sexo masculino, cor branca, deficiência mental moderada e causas ambientais como as mais importantes em sua etiologia, ficando a síndrome de Down como a mais importante causa genética observada. Tais dados mostram algumas distorçöes na populaçäo atendida institucionalmente, bem como a importância das causas ambientais em sua gênese. Isso nos leva a mostrar, mais uma vez, a necessidade dos cuidados básicos dirigidos à populaçäo infantil

Realidade do diagnóstico em psiquiatria infantil no Brasil / Child psychiatry in Brazil: diagnosis reality

Os autores, a partir de dados do SUS obtidos por meio da INTERNET (www.datasus.gov.br), analisam a situaçäo caótica da Psiquiatria da Infância e da Adolescência em nosso país, sugerindo que, enquanto recursos profissionais adequados näo forem criados, o atendimento à Saúde Mental da Infância e da Adolescência no Brasil consistirá numa concepçäo surrealista, sem nenhum vínculo com a realidade

Autismo Infantil: diagnostico e tratamento / Infantile autism: diagnosis and treatment

O autor estuda 82 crianças provenientes do Serviço de Psiquiatria da Infancia e da Adolescencia do Hospital das Clinicas da Faculdade de Medicina da USP, diagnosticada como portadoras de autismo infantil. Em funçäo de um estudo clínico-laboratorial e psicológico, descreve as características dessa populaçäo quanto a quadros medicos associadas e nível intelectual, acentuando que essas características associadas a alguns sinais clínicos, determinam a abordagem medicamentosa e o prognostico do quadro

[Evaluation scale of autistic behavior. Validity and reliability of a scale for autistic behavior detection]. / Escala de avaliação de traços autísticos (ATA). Validade e confiabilidade de uma escala para a detecção de condutas autísticas.

This study aimed to translate, to adapt and to validate the scale of autistic traits (ATA) developed by Ballabriga et al. in Barcelona, by the analysis of 31 patients with mental deficiency and 30 patients with autism, according to the DSM-IV criteria. The "cut off point" found was 15 (p = 0.05); the reliability coefficient was 0.27; the construct validity showed low agreement (kappa = 0.04) and the internal validity was 100%, with all evaluated patients having their clinical diagnosis confirmed through the scale application. The correlation index was 0.42, showing that it is specific for autism. The scale presents discrimination capacity and internal consistency, and the Cronbach's alpha was 0.71. We consider that achieved results show that the scale is reliable to be used in our population.

[Facial recognition and autism]. / Reconhecimento facial e autismo.

Through the presentation of four facial expressions' illustrations, we evaluate the capacity of autistic children recognition, comparing with normal intelligence children and adults. The comparison of results was accomplished through the qui-square test. The differences observed were significant, showing that a disturbance of the facial expressions' perception is present in autistic children, and that it interferes directly in the social relationships.

Brief report: a case of chromosome 22 alteration associated with autistic syndrome.

The author described a male patient, age 13 years and 5 months, with behavioral profile meeting the criteria of the autistic syndrome by the DSM-III-R (APA, 1989) and DSM-IV (APA, 1995). After clinical and laboratory examinations, it was found that he had an abnormal karyotype, 46 XY, R(22). The need for clinical and laboratory case studies of autism is of great importance to develop data for defining an etiological basis for diagnosis.

Internaçäo em um serviço de psiquiatria infantil: análise de um modelo / In-patient treatment in a child psychiatric unit: a model`s analyze

O presente trabalho se propöe a trazer a experiência do Serviço de Psiquiatria da Infância e Adolescência (SEPIA) do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo (HU-FMUSP), de fevereiro a outubro de 1996, de 21 pacientes internados em suas enfermarias, sendo: 11 meninas e 10 meninos, avaliados e discutidos pela equipe multidisciplinar composta por: psiquiatras, psicólogos, enfermeiros, terapeutas ocupacionais, assistentes sociais, psicopedagogos, médicos residentes, e colaboradores, com o objetivo precípuo de se estabelecer: diagnóstico e conduta terapêutica. Nesta amostragem foram constatados: 52 por cento do sexo feminino e 48 por cento masculino; a permanência média de internaçäo oscilou entre: 20 a 30 dias, a distribuiçäo étnica: 61,9 por cento brancos, 28,57 por cento pardos, 4,7 por cento negros e amarelos, a média de idade 13 anos e oito meses e o diagnóstico mais frequênte: Transtorno Psicótico Afetivo

Interacao em um servico de psiquiatria infantil: analise de um modelo

O presente trabalho se propoe trazer a experiencia do Servico de Psiquiatria da Infancia e Adolescencia (SEPIA) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), de fevereiro a outubro de 1996, de 21 pacientes internados em suas enfermarias, sendo: 11 meninas e 10 meninos, avaliados e discutidos pela equipe multidisciplinar composta por: psiquiatras, psicologos, enfermeiros, terapeutas ocupacionais, assistentes sociais, psicopedagogos, medicos residentes, e colaboradores, com o objetivo precipuo de se estabelecer: diagnostico e conduta terapeutica. Nesta amostragem foram constatados: 52 por cento do sexo feminino e 48 por cento masculino; a permanencia media de internacao oscilou entre: 20 a 30 dias, a distribuicao etnica: 61,9 por cento brancos, 28,57 por cento pardos, 4,7 por cento negros e amarelos, a media de idade 13 anos e 8 meses e o diagnostico mais frequente: Transtorno Psicotico Afetivo.

[Epidemiological aspects of mental retardation]. / Los aspectos epidemiológicos de la deficiencia mental.

This paper covers a population from 0 up to 50 years old, considered as 'handicapped', at the A.P.A.E. in São Paulo, Brazil. Many differences in the characteristics of both social and family environment were analyzed, as well as diagnosis and etiologies regarding associated problems. An appraisal of the different influences on both social and individual factors was outlined so that strategies of attendance could be modified accordingly.

[Tuberous sclerosis: a multidisciplinary study of 15 cases]. / Esclerose tuberosa: estudo multidisciplinar de 15 casos.

Report of a multidisciplinary study of patients affected with tuberous sclerosis, 8 of them males and 7 females, with ages ranging from 19 months to 23 years; 11 of these cases were sporadic, while the remaining 4 cases lacked information regarding family data. The following skin signs were observed: Pringle's adenoma in 9 cases; achromatic spots in 9 cases; periungueal fibroma in 3 cases. One of the patients had a heart tumor. Two patients had borderline intelligence, while the other 13 were mentally retarded of varying degrees. Epileptic seizures were present in 13 patients, atypical absence and tonus crises were frequent. Three of the patients had had infantile spasms in the first year of life as the first neurological symptom of the disease. Computer assisted axial tomography was performed in 7 cases and was positive in all of them, by revealing intracranial calcifications even in 4 cases in which the standard X-ray pictures had been silent about this eventuality.

Esclerose tuberosa: estudo multidisciplinar de 15 casos / Tuberose esclerosis: a multidisciplinary study of 15 cases

Sao apresentados os resultados de estudo multidisciplinar de 15 pacientes con esclerose tuberosa, 8 do sexo masculino e 7 do sexo feminino, com idades entre 19 meses e 23 anos; 11 foram considerados como casos esporadicos e, em 4, nao foi possivel precisar os antecedentes familiares.Foram observadas as seguintes manifestacoes cutaneas: adenoma de Pringle em 9 casos; manchas acromicas em 9 casos; fibroma periungueal em 3 casos. Dos 15 casos 13 apresentaram D.M., deficiencia mental, enquanto os outros 2 tinham inteligencia limitrofe. Com excecao de 2 pacientes, todos tinham crises epilepticas e os tipos de crises mais frequentemente observados foram as ausencias atipicas e as crises tonicas. Espasmos infantis estavam presentes em 3 casos e em apenas um caso o eletrencefalograma apresentou aspecto hipsarritmico. A tomografia axial computadorizada, realizada em 7 casos, revelou calcificacoes periventriculares em todos, mesmo naqueles que apresentaram RX simples de cranio normal (4 casos)