Clinical and epidemiological profile of patients with mental disorders in a specialized outpatient clinic and its role in the psychosocial care network.

Introduction: Mental health disorders (MHDs) are responsible for much impairment of quality of life in Brazil and worldwide. Early diagnosis and effective treatment strategies are required due to the heterogeneous symptoms and multifactorial etiology. Methods: A descriptive retrospective observational study was performed aiming to characterize the clinical and psychiatric profiles of patients with MHD attending a Brazilian public tertiary psychiatric outpatient clinic, which is a reference health service for more than 2 million inhabitants. Predominant clinical and sociodemographic aspects of patients were evaluated between March 2019 and March 2021. Results: A total of 8,384 appointments were analyzed. The majority of patients were female, and the mean age was 45 years old. Generalized anxiety disorder (GAD) was the most common MHD. The prevailing symptoms were sadness, anxiety, and irritability, with the most prescribed medications being selective serotonin reuptake inhibitors. Conclusion: The epidemiological characterization of mental disorders in specialized mental health outpatient clinics provides evidence for the establishment of more specific protocols and advocates a dimensional transdiagnostic approach as an aid to public mental health services.

miRNA 511_5p is a potential biomarker for ocular toxoplasmosis.

BACKGROUND: Ocular toxoplasmosis (OT) is a frequent clinical manifestation due to infection by Toxoplasma gondii. It is characterized by an inflammatory process involving macrophages activated by pro-inflammatory cytokines. The expression of microRNAs takes place during the inflammatory process and, among them, miRNA 511 regulates the activation of macrophages. This study evaluated the expression of miRNA 511_5p in patients with OT and healthy controls. METHODS: A total of 361 patients from the Hospital de Base of Fundação Faculdade de Medicina de São José do Rio Preto were enrolled and divided into four groups: G1-patients with active ocular lesions and reagent serology for T. gondii; G2-patients with scars and reagent serology for T. gondii; G3-patients without ocular lesions or scars and reagent serology for T. gondii; G4-patients without ocular lesions or scars and non-reagent serology for T. gondii. All patients underwent clinical and laboratory evaluation to confirm the diagnosis of OT. Serology tests, RNA extraction and cDNA synthesis were performed. RESULTS: The miRNA 511_5p levels were compared among the groups. The G1 group showed a high blood plasma concentration of miRNA 511_5p (mean 22.34) compared with the G2 (4.65), G3 (8.91) and G4 (3.52) groups (p<0.0001). CONCLUSION: These data suggest that miRNA 511_5p has significant potential as a biomarker for OT.

Análise de processos de formação de quadros psíquicos de surdos congênitos em psicoterapia / Analysis of processes of formation of psychic pictures of congenital deaf people in psychotherapy

A fala é um dos principais instrumentos de psicoterapia. Isso representa um obstáculo para o tratamento de pacientes surdos congênitos que não utilizam a língua oral. Aqui objetivamos analisar processos de construção psíquica em pacientes surdos usuários da língua de sinais, sua relação com a modalidade linguística e indicar possíveis considerações para a psicoterapia com essa população. Realizamos um estudo de caso múltiplo por meio de um programa de psicoterapia, planejado para atender três sujeitos surdos congênitos da comunidade surda de São José do Rio Preto-SP, selecionados por sorteio, de cadastro clínico particular. O programa foi estruturado em 26 sessões, desenvolvidas por psicanalista versado na língua brasileira de sinais. As sessões ocorreram em caráter individual e sistemático, visando observar os padrões no desenvolvimento dos processos mentais, realizadas uma vez por semana, com duração de 50 minutos. Para a análise de dados utilizamos os Mapas e as Árvores de Associação de Spink (2010). Os resultados indicam que diferenças no sistema semiótico da linguagem em surdos congênitos determinam adaptações no desenvolvimento psíquico desses pacientes em razão da natureza da língua de sinais. Conclui-se que o tratamento psicoterápico para surdos deve acontecer em seu sistema semiótico próprio, sua organização simbólica e sua cultura

Speech is one of the main tools of psychotherapy. This represent an obstacle to the treatment of congenital deaf patients who do not use the oral language. Here we aim to analyze processes of psychic construction in deaf patients who use sign language, its relationship with the linguistic modality and indicate possible considerations for psychotherapy whit this population. We carried out a mutiple case study through a psychotherapy program, planned to attend three congenital deaf subjects fron the deal community of São José do Rio Preto ­SP, selected by lot, from a private clinical record. The program was structured in 26 sessions, developed by a psychoanalyst versed in the Brazilian Sign Language. The sessions tool place an individual and systematic basis, aiming to observe the patterns in the development of mental processes, held once a week, lasting 50 minutes. For data analysis we used Spink's Association Maps and Trees (2010). The results indicate that differences in the semiotic system of language in congenital deaf people determine adaptations in the psychic development of these patients due the psychotherapeutic treatment for deaf people must take place in their own semiotic system, symbolic organization and culture