Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study.

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

Compassion Protects Mental Health and Social Safeness During the COVID-19 Pandemic Across 21 Countries.

Objectives: The COVID-19 pandemic is having an unprecedented detrimental impact on mental health in people around the world. It is important therefore to explore factors that may buffer or accentuate the risk of mental health problems in this context. Given that compassion has numerous benefits for mental health, emotion regulation, and social relationships, this study examines the buffering effects of different flows of compassion (for self, for others, from others) against the impact of perceived threat of COVID-19 on depression, anxiety, and stress, and social safeness. Methods: The study was conducted in a sample of 4057 adult participants from the general community population, collected across 21 countries from Europe, Middle East, North America, South America, Asia, and Oceania. Participants completed self-report measures of perceived threat of COVID-19, compassion (for self, for others, from others), depression, anxiety, stress, and social safeness. Results: Perceived threat of COVID-19 was associated with higher scores in depression, anxiety, and stress, and lower scores in social safeness. Self-compassion and compassion from others were associated with lower psychological distress and higher social safeness. Compassion for others was associated with lower depressive symptoms. Self-compassion moderated the relationship between perceived threat of COVID-19 on depression, anxiety, and stress, whereas compassion from others moderated the effects of fears of contracting COVID-19 on social safeness. These effects were consistent across all countries. Conclusions: Our findings highlight the universal protective role of compassion, in particular self-compassion and compassion from others, in promoting resilience by buffering against the harmful effects of the COVID-19 pandemic on mental health and social safeness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-021-01822-2.

The role of social connection on the experience of COVID-19 related post-traumatic growth and stress.

BACKGROUND: Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress. METHODS: Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress. RESULTS: Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries. CONCLUSIONS: Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.

Fears of compassion magnify the harmful effects of threat of COVID-19 on mental health and social safeness across 21 countries.

BACKGROUND: The COVID-19 pandemic is a massive global health crisis with damaging consequences to mental health and social relationships. Exploring factors that may heighten or buffer the risk of mental health problems in this context is thus critical. Whilst compassion may be a protective factor, in contrast fears of compassion increase vulnerability to psychosocial distress and may amplify the impact of the pandemic on mental health. This study explores the magnifying effects of fears of compassion on the impact of perceived threat of COVID-19 on depression, anxiety and stress, and social safeness. METHODS: Adult participants from the general population (N = 4057) were recruited across 21 countries worldwide, and completed self-report measures of perceived threat of COVID-19, fears of compassion (for self, from others, for others), depression, anxiety, stress and social safeness. RESULTS: Perceived threat of COVID-19 predicted increased depression, anxiety and stress. The three flows of fears of compassion predicted higher levels of depression, anxiety and stress and lower social safeness. All fears of compassion moderated (heightened) the impact of perceived threat of COVID-19 on psychological distress. Only fears of compassion from others moderated the effects of likelihood of contracting COVID-19 on social safeness. These effects were consistent across all countries. CONCLUSIONS: Fears of compassion have a universal magnifying effect on the damaging impact of the COVID-19 pandemic on mental health and social safeness. Compassion focused interventions and communications could be implemented to reduce resistances to compassion and promote mental wellbeing during and following the pandemic.

Effects of a mindfulness based intervention in mental health professionals: burnout and stress symptoms at work

INTRODUCTION The work of mental health care professionals involves coping with stressful situations that may lead to the development of the burnout syndrome. Studies of prevalence of burnout in this population indicate a variation between 21% and 67%. Mindfulness-based intervention programs have presented promising results in reducing stress in health care professionals. The present study aims to investigate the effects of a mindfulness course on mental health professionals from a public institution in the interior of São Paulo. METHOD A non-randomized and uncontrolled clinical trial with a sample of 20 professionals was carried out to measure the participants' level of burnout, mindfulness and self-compassion before, after and four months after the intervention, through five instruments: 1) Questionnaire of Type and Volume of mindfulness practice, 2) Maslach Burnout Inventory, 3) Burnout Clinical Subtypes Questionnaire, 4) Mindfulness Awareness and Attention Scale and 5) Self Compassion Scale. The data were tabulated and analyzed by the SPSS-19 program. RESULTS The socio-demographic profile of the participants indicates a female majority (100%), with high education (76%), in a statutory work regime (81%) with a partial working day scheme (61.9%) and acting directly in the patient care (81%). On average, professionals attended 8 out of 9 course sessions. After the intervention, there was an increase in the level of mindfulness (mean before: 58.14 and mean after: 66.80), in the level of self-compassion (mean before: 81.76 and mean after: 97.95) and the reduction of the negative factors of this last scale. Regarding burnout levels, there were no significant changes except for the reduction of a factor related to lack of development. The deepening of the analysis may show correlations between these variables and other measures related to socio demographic aspects and the type and volume of practice.(AU)

Effects of Mindfulness on Diabetes Mellitus: Rationale and Overview.

Diabetes mellitus (DM) is an emerging global healthcare problem and its prevalence is increasing at an alarming rate. Despite improvements in both medical and pharmacological therapies, a complex medical condition may demand a diversified approach, such as: drug therapy, healthy diet and exercises, diabetes education programs, adherence to medical treatment and active participation of the patients in their lifestyle changes, such as stress management. The concept of mindfulness is here defined as the awareness that unfolds from the intention to attentively observe the current experience in a non-judgmental and non-evaluative way. This state of awareness can be enhanced through the use of mindfulness-based interventions (MBIs), which have been associated to many physical and psychological health indicators. The aim of this overview is to offer the rationale and potential benefits of mindfulness in the control of DM and its complications. METHODS: a narrative review of the current and updated literature available on online database and which came up using the terms "mindfulness" and "diabetes mellitus". Mindfulness-based Interventions (MBIs) can be seen as preventive and complementary interventions in DM, particularly for the relief of symptoms related to depression and anxiety in diabetic patients and also in the management of other factors, including mindful eating, physical exercises and treatment adherence. Although many studies only present research protocols, mindfulness seems to have beneficial effects on all aspects of diabetes, including incidence, control and complications. Furthermore, longer term and more carefully controlled trials are necessary in order to draw consistent conclusions on the beneficial role of MBIs on DM.

Ambulatório de mindfulness e promoção da saúde: relato de experiência / Outpatient clinic of mindfulness and health promotion: experience report

O objetivo deste trabalho foi descrever a experiência e o perfil dos usuários do ambulatório de mindfulness e promoção da saúde de uma universidade pública. O perfil dos participantes foi obtido a partir da aplicação de diferentes escalas psicométricas (BDI, SUBI, MAAS e EUROQOL 5 D), bem como informações sociodemográficas e de saúde. A descrição da experiência do ambulatório foi realizada a partir da técnica SWOT. Nesta amostra, o perfil encontrado foi predominantemente feminino, com plano de saúde e assistência médica regular. Apesar dos problemas relatados, a percepção subjetiva de qualidade de vida ficou acima da média. Pertencer a uma universidade pública, contar com equipe multiprofissional e facilitadores de distintas formações em mindfulness, além de local de fácil acesso, são pontos fortes deste ambulatório, bem como a alta prevalência de ansiedade e depressão, que podem oportunizar a expansão desta atividade.(AU)

The aim of this study was to describe the experience and the profile of users of an outpatient clinic of Mindfulness and health promotion from a public University in Brazil. The profile of the participants was obtained from the application of different psychometric scales (BDI, SUBI, MAAS and EUROQOL 5 D), as well as socio­demographic and health information. The description of the experience of the clinic was held from the SWOT technique. In this sample, the profile found was predominantly female, with health insurance and medical care. Despite the problems reported, the subjective perception of quality of life was above average. Belong to a public University, rely on multidisciplinary team and facilitators of different configurations in mindfulness, plus easily accessible location are strengths of this clinic, as well as the high prevalence of anxiety and depression, which can enhance the expansion of this activity.(AU)

Influence of personality traits in coping skills in individuals with bipolar disorder / A influência dos traços de personalidade nas habilidades de coping de indivíduos com transtorno de humor bipolar

Background: Bipolar disorder is marked by alterations in coping skills which in turn impacts the disease course. Personality traits are associated with coping skills and for this reason it has been suggested that personality traits of patients with BD may have influence over their coping skills. Objective: To investigate possible associations between coping skills and personality in individuals with bipolar disorder (BD). Methods: Thirty-five euthymic subjects with BD were compared with 40 healthy controls. Coping skills were evaluated using Ways of Coping Checklist Revised and Brief-COPE. Personality traits were assessed by Neo Personality Inventory. MANCOVA was used for between groups comparison. Results: Regarding coping, individuals with BD reported more frequent use of emotion-focused strategies than problem-focused strategies, and high levels of neuroticism and low levels of extroversion and conscientiousness on personality measures. Neuroticism influenced negatively the use of problem-focused strategies, and positively emotion-focused coping. Conscientiousness influenced the use of problem-focused strategies in both groups. There was a significant difference between emotion focused coping and personality traits between BD and control groups. Discussion: Personality traits seem to modulate coping skills and strategies in BD which may be took into account for further interventions...

Contexto: O transtorno de humor bipolar (THB) é marcado por estratégias de enfrentamento, ou coping, que determinam comportamentos que podem influenciar negativamente o curso da doença. Traços de personalidade são altamente associados com estratégias de coping, portanto se faz a hipótese de que traços de personalidade influenciem as estratégias de coping de portadores de THB. Objetivo: Este estudo buscou investigar associações entre traços de personalidade e estratégias de coping em pacientes com THB. Métodos: Trinta e cinco participantes eutímicos diagnosticados com THB e 40 controles saudáveis participaram deste estudo. Estratégias de coping foram avaliadas com a Ways of Coping Checklist Revised and Brief – COPE – e traços de personalidade foram avaliados com o Neo Personality Inventory. Resultados: Participantes com THB possuíram padrão de estratégias de coping significativamente mais baseados na emoção. Em termos de traços de personalidade, participantes com THB tiveram significativamente mais características de neuroticismo e reduzidas características de extroversão e consciência. Foram encontradas associações positivas entre índices de neuroticismo e estratégias de coping baseadas em emoções e associações negativas com estratégias baseadas no problema. Conclusão: Traços de personalidade são fundamentais para as estratégias de coping de pacientes com THB, portanto traços de personalidade devem ser considerados alvos terapêuticos para a psicopatologia...

Terapia cognitivo-comportamental na prevenção de psicose em populações em risco / Cognitive-behavioral therapy in prevention of psychosis in at-risk populations

Indivíduos em "ultra alto risco" (UAR) para psicose são aqueles que apresentam sintomas psicóticos com intensidade, frequência ou duração insuficientes para receberem o diagnóstico de uma psicose. A terapia cognitivo-comportamental (TCC) é uma das intervenções psicossociais usadas com a finalidade de prevenir ou retardar a evolução desse estado de risco para uma psicose franca. O objetivo desse estudo foi apresentar e discutir os achados dos estudos controlados com TCC na prevenção da transição para psicose em indivíduos em UAR. Uma revisão não-sistemática da literatura foi realizada, resumindo o conceito de UAR, o risco de transição para a psicose e apresentando os resultados de oito ensaios clínicos randomizados utilizando TCC para prevenir a transição para psicose. Seus resultados mostram que a TCC é um tratamento bem aceito e capaz de reduzir a intensidade dos sintomas em indivíduos em UAR. No entanto, os resultados são heterogêneos sobre a eficácia na prevenção ou no retardo do início da psicose e ainda insuficientes para que a TCC seja recomendada rotineiramente nessa situação clínica(AU)

Individuals in Ultra High Risk (UHR) for psychosis are those presenting psychotic symptoms in insufficient severity, frequency and duration to fulfill diagnosis criteria for a psychotic disorder. Cognitive-behavioral therapy (CBT) is one of the psychosocial interventions that has been used to prevent or delay evolution from this at-risk state to a full blown psychosis. The objective of this study is to present and discuss the findings of controlled studies with CBR in prevention of transition for psychosis in UHR individuals. A non systematic review was conducted; summarizing the concept of UHR, the risk of transition for psychosis and presenting results of eight randomized controlled trials evaluating CBT for prevent transition for psychosis. Their results show that CBT is well accepted and efficient in reduce severity of symptoms in individuals in UHR. Nevertheless, the results about efficacy in prevent or delay psychosis onsets are heterogeneous and still insufficient for CBT be routinely recommended in clinical context(AU)

Remissão sintomática e qualidade de vida em pacientes com depressão maior tratados com antidepressivo: um estudo prospectivo / Symptomatic remission and quality of life in patients with major depression treated with antidepressants: a prospective study

Este estudo teve como objetivo estimar a Qualidade de Vida (QV) em pacientes com transtorno depressivo maior antes e após tratamento antidepressivo eficaz. Participaram do estudo 26 indivíduos (18 a 65 anos) com episódio agudo de Transtorno Depressivo Maior, segundo critérios do DSM-IV. A duração do estudo foi de 8 semanas. Os instrumentos utilizados foram: escala de avaliação de depressão de Montgomery-Asberg (MADRS) e de Hamilton (HAMD-17). QV foi avaliada através da escala de qualidade de vida e satisfação (Q-LES-Q). Os resultados indicaram que sintomas depressivos e QV melhoraram significantemente com o tratamento (p<0,001). Sintomas de depressão e QV são significativamente correlacionados. Antes do tratamento, QV foi positivamente relacionada com o MADRS, mas não com o HAMD-17. Em todas as outras avaliações, a QV positivamente correlacionou-se com ambas as escalas, confirmando que a melhora sintomatológica traduz-se em melhora na qualidade de vida em pacientes com depressão maior

This study aimed to estimate the QoL in individuals with severe Mood Depressive Disorder, before and after effective antidepressant treatment. The Sample consisted of 26 participants with MDD. Duration of study was 2 months. Symptoms were measured with the Montgomer-Asberg depression evaluations scale (MADRS) and the Hamilton Depression Scale (HAMD-17). QoL was measured using the Quality of Life and Satisfaction (Q-LES-Q). Treatment yielded significant improvement of depressive symptoms (HAM-D17: p<0.001 and MADRS: p< 0.001) and of quality of life (Q-LES-Q - p<0.001). As measured by the correlation coefficient, qualify of life and symptom scales were significantly correlated. At baseline, quality of life was positively correlated with MADRS (p=0.037), but not with HAMD (p=0.878). For all other time points, quality of life was positively correlated with MDRS and HAMD (p≤ 0.001); increased scores in the Q-LES-Q corresponded to decreased scores in the MADRS and HAMD scales. Symptomatic improvement is significantly correlated with improved QoL in individuals with MDD

Remissão sintomática e qualidade de vida em pacientes com depressão maior tratados com antidepressivo: um estudo prospectivo / Symptomatic remission and quality of life in patients with major depression treated with antidepressants: a prospective study

Este estudo teve como objetivo estimar a Qualidade de Vida (QV) em pacientes com transtorno depressivo maior antes e após tratamento antidepressivo eficaz. Participaram do estudo 26 indivíduos (18 a 65 anos) com episódio agudo de Transtorno Depressivo Maior, segundo critérios do DSM-IV. A duração do estudo foi de 8 semanas. Os instrumentos utilizados foram: escala de avaliação de depressão de Montgomery-Asberg (MADRS) e de Hamilton (HAMD-17). QV foi avaliada através da escala de qualidade de vida e satisfação (Q-LES-Q). Os resultados indicaram que sintomas depressivos e QV melhoraram significantemente com o tratamento (p<0,001). Sintomas de depressão e QV são significativamente correlacionados. Antes do tratamento, QV foi positivamente relacionada com o MADRS, mas não com o HAMD-17. Em todas as outras avaliações, a QV positivamente correlacionou-se com ambas as escalas, confirmando que a melhora sintomatológica traduz-se em melhora na qualidade de vida em pacientes com depressão maior.(AU)

This study aimed to estimate the QoL in individuals with severe Mood Depressive Disorder, before and after effective antidepressant treatment. The Sample consisted of 26 participants with MDD. Duration of study was 2 months. Symptoms were measured with the Montgomer-Asberg depression evaluations scale (MADRS) and the Hamilton Depression Scale (HAMD-17). QoL was measured using the Quality of Life and Satisfaction (Q-LES-Q). Treatment yielded significant improvement of depressive symptoms (HAM-D17: p<0.001 and MADRS: p< 0.001) and of quality of life (Q-LES-Q - p<0.001). As measured by the correlation coefficient, qualify of life and symptom scales were significantly correlated. At baseline, quality of life was positively correlated with MADRS (p=0.037), but not with HAMD (p=0.878). For all other time points, quality of life was positively correlated with MDRS and HAMD (p≤ 0.001); increased scores in the Q-LES-Q corresponded to decreased scores in the MADRS and HAMD scales. Symptomatic improvement is significantly correlated with improved QoL in individuals with MDD.(AU)

Avaliação do coping em adultos com transtorno bipolar e a relação com traços de personalidade / Assessment of coping and its relationship with personality traits in adults with bipolar disorder

Evidências indicam que o estresse psicológico pode desempenhar um papel importante no desencadeamento e evolução do Transtorno Bipolar. Faz-se importante estudar as maneiras como os pacientes lidam com o estresse (Coping). Os objetivos deste estudo foram investigar as relações entre coping e traços de personalidade em bipolares e controles saudáveis; comparar estratégias e estilos de coping e traços de personalidade de pacientes bipolares com controles saudáveis; comparar estratégias de Coping nos pródromos da mania de pacientes bipolares I e II. Foram realizadas entrevistas diagnósticas e confirmada a eutimia dos pacientes resultando no total de 35 bipolares (foram considerados eutímicos pacientes com escore 12 na Escala de Avaliação de Mania de Young e 7 na Escala de Avaliação para Depressão de Hamilton). O grupo de comparação foi constituído por 40 indivíduos saudáveis do ponto de vista psiquiátrico. Foram avaliadas as habilidades de coping (Coping Inventory for Prodromes of Mania, Escala de Modos de Enfrentamento de Problemas e Brief COPE) e os traços de personalidade (Inventário de Personalidade NEO PI-R). As comparações das médias dos escores da escala Coping Inventory for Prodromes of Mania foram realizadas pelo teste Mann-Whitney. As comparações das médias dos escores das estratégias e estilos de coping e dos traços de personalidade foram realizadas por análises multivariadas de covariância. As associações entre estratégias e estilos de coping e traços de personalidade foram realizados pelos modelos de regressão linear múltipla...

Evidence indicates that psychological stress may play a key role in triggering the onset and evolution of Bipolar Disorder. Investigations into the ways patients cope with stress are therefore valuable. The aims of this study were to: (i) investigate the relationship between coping and personality traits in bipolar and control subjects;(ii) compare coping strategies and style besides personality traits in bipolar patients against those of healthy controls;(iii) compare coping strategies between bipolar I and II patients in the prodromes of mania. Diagnostic interviews were conducted confirming euthymia among participants and detecting a total of 35 bipolar patients (scores 12 on the Young Mania Assessment Scale and 7 on the Hamilton Depression Rating Scale indicated euthymia). The control group for comparison comprised 40 psychiatrically-healthy individuals. Coping skills (Coping Inventory for Prodromes of Mania, Ways of Coping Checklist and Brief COPE) and personality traits (Personality Inventory NEO PI-R) were assessed. Mean scores on the Coping Inventory for Prodromes of Mania were compared using Mann-Whitneys test. Mean scores for coping strategies and styles as well as personality traits were compared by multivariate covariance analyses. Associations between coping strategies and styles and personality traits were determined by multiple linear regression models. Results showed that bipolar patients made greater use of emotion-focused strategies than problem-focused strategies, exhibited high levels of Neuroticism and low levels of Extroversion and Conscientiousness...

Os psicodinamismos na esquizofrenia: o Procedimento de Desenhos-Estórias em estudos de casos / The psychodynamisms in the schizophrenia: the procedure of drawing-stories in studies of cases

Este trabalho discute aspectos psicodinâmicos da esquizofrenia, especialmente os revelados por meio da técnica projetiva de Desenhos-Estórias (Trinca, 1987), avaliados segundo Tardivo (1997). Serão apresentados três casos clínicos diagnosticados como esquizofrenia paranóide, atendidos no Ambulatório de Clínica Psiquiátrica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP. Os sujeitos são homens, de 21, 22 e 25 anos, com grau de escolaridade superior incompleto. Os três já apresentaram sintomas clássicos, como alucinações e delírios. Atualmente estão em tratamento ambulatorial e encontram-se sem crises. Foi aplicado o Procedimento de Desenhos-Estórias numa sessão. Em relação aos aspectos de conteúdo, evidenciaram-se os sinais de cisão, projeção, defesas obsessivas, isolamento afetivo, dificuldade nos relacionamentos interpessoais, sentimentos derivados do instinto de morte. São fortes os sinais de ansiedades paranóides, com as figuras humanas vistas como destrutivas e ameaçadoras. O Procedimento de Desenhos-Estórias revelou-se uma técnica eficaz no estudo das condições mentais destes indivíduos, que apresentam uma enfermidade tão importante, a qual requer tratamento multidisciplinar(AU)

O uso do procedimento de desenhos-estórias no estudo dos psicodinamismos de pacientes esquizofrênicos: uma análise segundo a interpretação freudiana dos sonhos / The use of Drawing-and-Story Procedure (D-E) in the study of psychodynamisms in schizophrenics patients: an analysis according to the freudian interpretation of dreams

O presente estudo tem como objetivos: 1) explicitar e descrever mecanismos psíquicos de um grupo de pacientes com esquizofrenia paranóide por meio do Procedimento de Desenhos-Estórias (D-E), analisados de forma análoga à interpretação freudiana dos sonhos, 2) promover a extensão do uso do D-E e um determinado tipo de análise (análise de conteúdo segundo categorias que podem ser encontradas nos sonhos) a pacientes esquizofrênicos. Parte-se do pressuposto de que a produção projetiva pode ser analisada como um sonho, visto a importância destes como uma forma direta de expressão de mecanismos psíquicos inconscientes. Esta forma de análise do D-E em pacientes esquizofrênicos configura o aspecto inédito deste trabalho. Participam deste estudos 10 homens, com idades entre 21 e 42 anos, com diagnóstico de esquizofrenia paranóide há pelo menos seis meses, atendidos no Ambulatório de Clínica Psiquiátrica (ACPQ do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP. São utilizados os seguintes instrumentos: 1) O INV-C (teste de inteligência não verbal), com o intuito de eliminar da amostra pacientes com deterioro intelectual importante; 2) 0 D-E, aplicado conforme proposta de Trinca (1987), e analisados qualitativamente de acordo com a proposta de Migliavacca (1987), que concebe uma análise semelhante à interpretação dos sonhos sob enfoque psicanalítico, levando em conta os seguintes aspectos: 1) manifestação de conteúdos inconscientes, 2) realização de desejos; 3) angústia; 4) deslocamento; 5) dramatização; 6) elaboração secundária; 7) condensação; 8) representação pelo contrário; 9) dispersão; 10) personificação; 11) simbolismo. Essa análise qualitativa é apresentada por meio de sínteses teorizadas de cada caso. Os pacientes em sua maioria expressaram por meio do D-E suas experiências, sua dor, fatos de sua vida e seus desejos. Apenas um deles não falou diretamente de si...(AU)