portuguese | english Revista Brasileira de Psiquiatria ISSN print 1516-4446
ISSN on-line 1809-452X
2014 JCR® Impact Factor: 1.765
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Current issue 3, Volume 37 - Jul/Aug/Set/2015


1 - Differential susceptibility of BALB/c, C57BL/6N, and CF1 mice to photoperiod changes
Luísa K. Pilz; Caroline L. Quiles; Eliane Dallegrave; Rosa Levandovski; Maria Paz L. Hidalgo; Elaine Elisabetsky
Pages: 185 - 190

OBJECTIVE: Circadian disturbances common to modern lifestyles have been associated with mood disorders. Animal models that mimic such rhythm disturbances are useful in translational research to explore factors contributing to depressive disorders. This study aimed to verify the susceptibility of BALB/c, C57BL/6N, and CF1 mice to photoperiod changes.
METHODS: Thermochron iButtons implanted in the mouse abdomen were used to characterize temperature rhythms. Mice were maintained under a 12:12 h light-dark (LD) cycle for 15 days, followed by a 10:10 h LD cycle for 10 days. Cosinor analysis, Rayleigh z test, periodograms, and Fourier analysis were used to analyze rhythm parameters. Paired Student's t test was used to compare temperature amplitude, period, and power of the first harmonic between normal and shortened cycles.
RESULTS: The shortened LD cycle significantly changed temperature acrophases and rhythm amplitude in all mouse strains, but only BALB/c showed altered period.
CONCLUSION: These findings suggest that BALB/c, the preferred strain for stress-induced models of depression, should also be favored for exploring the relationship between circadian rhythms and mood. Temperature rhythm proved to be a useful parameter for characterizing rhythm disruption in mice. Although disruption of temperature rhythm has been successfully documented in untethered mice, an evaluation of desynchronization of other rhythms is warranted.

Descriptors: Circadian dysregulation; mood disorders; core body temperature rhythms; mice

2 - The construct of psychopathy in a Chilean prison population
Elizabeth León-Mayer; Jorge O. Folino; Craig Neumann; Robert D. Hare
Pages: 191 - 196

OBJECTIVE: To test the four-factor model of the Hare Psychopathy Checklist - Revised (PCL-R) empirical construct of psychopathy in a Chilean prison population by using instruments that supply different types of data.
METHODS: Two hundred and nine male inmates of the Prison of Los Andes, Chile, were evaluated. Confirmatory factor analysis was carried out with the PCL-R and the Self-Report of Psychopathy - III - Short Form (SRP-III-SF).
RESULTS: The distributions of total PCL-R and SRP-III-SF scores were normal (Kolmorogov-Smirnov [K-S] = 1.04, p = 0.230; K-S = 0.812, p = 0.525, respectively), with means of 20.9±6.8 for the former and 61.6±15.2 for the latter. Model fit was good for the PCL-R (Tucker Lewis index [TLI] = 0.96; root mean square error of approximation [RMSEA] = 0.04) and for the SRP-SF (TLI = 0.94, RMSEA = 0.04).
CONCLUSIONS: The results obtained with the PCL-R and the SRP-SF showed adequate fit to the empirical four-factor model of psychopathy and support this model. As foreseeable, fit was better for the PCL-R, which combines several sources of information.

Descriptors: Psychopathy; assessment; self-reported tool; confirmatory factor analysis; latent variable model

3 - Association of serum brain-derived neurotrophic factor (BDNF) and tumor necrosis factor-alpha (TNF-α) with diagnosis of delirium in oncology inpatients
Cristiano Brum; Laura Stertz; Ericksen Borba; Danielle Rumi; Flávio Kapczinski; Analuiza Camozzato
Pages: 197 - 202

OBJECTIVE: To evaluate brain-derived neurotrophic factor (BDNF) and tumor necrosis factor-α (TNF-α) blood levels as disease biomarkers of delirium in oncology inpatients.
METHODS: Seventeen oncology inpatients with delirium, 28 oncology inpatients without delirium, and 25 non-oncology controls (caregivers) were consecutively recruited from a Brazilian cancer center. This sample was matched by age, sex, and education level. The Confusion Assessment Method, the Mini-Mental State Examination, and the Digit Span Test were administered to ascertain delirium diagnosis. BDNF and TNF-α levels were measured by the Sandwich-ELISA method and flow cytometry, respectively. Blood samples were collected immediately after clinical evaluation.
RESULTS: Oncology inpatients (with and without delirium) showed significantly lower BDNF levels compared with non-oncology controls (F = 13.830; p = 0.001). TNF-α levels did not differ between the three groups.
CONCLUSIOS: A cross-sectional relationship of BDNF and TNF-α blood levels with delirium in oncology inpatients was not demonstrated. The association between cancer and reduced serum BDNF levels may be mediated by confounding factors.

Descriptors: Cancer; delirium; tumor necrosis factor-α; brain-derived neurotrophic factor

4 - Childhood abuse increases the risk of depressive and anxiety symptoms and history of suicidal behavior in Mexican pregnant women
Ma. Asunción Lara; Laura Navarrete; Lourdes Nieto; Huynh-Nhu Le
Pages: 203 - 210

OBJECTIVE: To explore the relationship between individual and co-occurring childhood sexual, physical, and verbal abuse, prenatal depressive (PDS) and anxiety symptoms (PAS), and history of suicidal behavior (HSB) among Mexican pregnant women at risk of depression.
METHODS: A sample of 357 women screened for PDS was interviewed using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q), the Beck Depression Inventory (BDI-II), the anxiety subscale of the Hopkins Symptoms Checklist (SCL-90), and specific questions on verbal abuse and HSB.
RESULTS: Logistic regression analyses showed that women who had experienced childhood sexual abuse (CSA) were 2.60 times more likely to develop PDS, 2.58 times more likely to develop PAS, and 3.71 times more likely to have HSB. Childhood physical abuse (CPA) increased the risk of PAS (odds ratio [OR] = 2.51) and HSB (OR = 2.62), while childhood verbal abuse (CVA) increased PDS (OR = 1.92). Experiencing multiple abuses increased the risk of PDS (OR = 3.01), PAS (OR = 3.73), and HSB (OR = 13.73).
CONCLUSIOS: Childhood sexual, physical, and verbal abuse, especially when they co-occur, have an impact on PDS and PAS and lifetime HSB. These findings suggest that pregnant women at risk for depression should also be screened for trauma as a risk factor for perinatal psychopathology.

Descriptors: Child abuse; pregnancy; prenatal depression; prenatal anxiety; suicide

5 - Quality of life, social functioning, family structure, and treatment history associated with crack cocaine use in youth from the general population
Joana C.M. Narvaez; Flávio Pechansky; Karen Jansen; Ricardo T. Pinheiro; Ricardo A. Silva; Flávio Kapczinski; Pedro V. Magalhães
Pages: 211 - 218

OBJECTIVE: To assess the relationship between crack cocaine use and dimensions of quality of life and social functioning in young adults.
METHODS: This was a cross-sectional, population-based study involving 1,560 participants in Pelotas, Brazil. Crack cocaine use and abuse were investigated using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) inventory. Outcomes of interest were quality of life, religiosity, and social functioning in terms of education, occupational status, family structure, and medical treatment history.
RESULTS: Lifetime crack cocaine use was associated with poor quality of life, worse functioning, impaired academic performance, and lower religious involvement. A greater maternal presence and higher paternal absence were more also more pronounced in crack cocaine users, who were also more likely to seek psychological and psychiatric treatment than the general population.
CONCLUSION: Quality of life was severely impacted by crack cocaine use, especially in terms of general and physical health. Social functioning also differed between the general population and crack users, who had lower educational attainment and religious involvement. Maternal presence, paternal absence, and mental health-seeking behaviors were also more frequent among crack cocaine users, although these individuals reported lower rates of treatment satisfaction. Crack cocaine users also had significant social impairment, so that interventions involving family management and a greater focus on general health, quality of life, and functioning may make crucial contributions to the recovery of this group.

Descriptors: Crack cocaine; substance use disorders; religion; quality of life; treatment

6 - Religious coping and its influence on psychological distress, medication adherence, and quality of life in inflammatory bowel disease
Thiago H. Freitas; Thomas N. Hyphantis; Elias Andreoulakis; João Quevedo; Hesley L. Miranda; Gilberto S. Alves; Marcellus H. Souza; Lúcia L. Braga; Kenneth I. Pargament; Joanna K. Soczynska; Roger S. McIntyre; André F. Carvalho
Pages: 219 - 227

OBJECTIVE: Inflammatory bowel disease (IBD) is associated with elevated levels of anxiety and depression and a reduction in health-related quality of life (HRQoL). Nonadherence to treatment is also frequent in IBD and compromises outcomes. Religious coping plays a role in the adaptation to several chronic diseases. However, the influence of religious coping on IBD-related psychological distress, HRQoL, and treatment adherence remains unknown.
METHOD: This cross-sectional study recruited 147 consecutive patients with either Crohn's disease or ulcerative colitis. Sociodemographic data, disease-related variables, psychological distress (Hospital Anxiety and Depression Scale), religious coping (Brief RCOPE Scale), HRQoL (WHOQOL-Bref), and adherence (8-item Morisky Medication Adherence Scale) were assessed. Hierarchical multiple regression models were used to evaluate the effects of religious coping on IBD-related psychological distress, treatment adherence, and HRQoL.
RESULTS: Positive RCOPE was negatively associated with anxiety (b = -0.256; p = 0.007) as well as with overall, physical, and mental health HRQoL. Religious struggle was significantly associated with depression (b = 0.307; p < 0.001) and self-reported adherence (b = -0.258; p = 0.009). Finally, anxiety symptoms fully mediated the effect of positive religious coping on overall HRQoL.
CONCLUSION: Religious coping is significantly associated with psychological distress, HRQoL, and adherence in IBD.

Descriptors: Inflammatory bowel disease; psychological distress; adherence; religious coping; quality of life

7 - Motor development of children with attention deficit hyperactivity disorder
Francisco Rosa Neto; Juliana B. Goulardins; Daniela Rigoli; Jan P. Piek; Jorge A. de Oliveira
Pages: 228 - 234

OBJECTIVE: To compare both global and specific domains of motor development of children with attention deficit hyperactivity disorder (ADHD) with that of typically developing children.
METHODS: Two hundred children (50 children with clinical diagnoses of ADHD, according to the DSM-IV-TR and 150 typically developing controls), aged 5 to 10 years, participated in this cross-sectional study. The Motor Development Scale was used to assess fine and global motricity, balance, body schema, and spatial and temporal organization.
RESULTS: Between-group testing revealed statistically significant differences between the ADHD and control groups for all domains. The results also revealed a deficit of nearly two years in the motor development of children with ADHD compared with the normative sample.
CONCLUSION: The current study shows that ADHD is associated with a delay in motor development when compared to typically developing children. The results also suggested difficulties in certain motor areas for those with ADHD. These results may point to plausible mechanisms underlying the relationship between ADHD and motor difficulties.

Descriptors: Attention deficit hyperactivity disorder; child psychiatry; interdisciplinary relations; behavioral neurology; rehabilitation

8 - Epistasis between COMT Val158Met and DRD3 Ser9Gly polymorphisms and cognitive function in schizophrenia: genetic influence on dopamine transmission
Alexandre A. Loch; Martinus T. van de Bilt; Danielle S. Bio; Carolina M. do Prado; Rafael T. de Sousa; Leandro L. Valiengo; Ricardo A. Moreno; Marcus V. Zanetti; Wagner F. Gattaz
Pages: 235 - 241

OBJECTIVE: To assess the relationship between cognitive function, a proposed schizophrenia endophenotype, and two genetic polymorphisms related to dopamine function, catechol-O-methyl transferase (COMT) Val158Met and dopamine receptor 3 (DRD3) Ser9Gly.
METHODS: Fifty-eight outpatients with schizophrenia/schizoaffective disorder and 88 healthy controls underwent neurocognitive testing and genotyping. Analyses of covariance (ANCOVAs) using age, sex, and years of education as covariates compared cognitive performance for the proposed genotypes in patients and controls. ANCOVAs also tested for the epistatic effect of COMT and DRD3 genotype combinations on cognitive performance.
RESULTS: For executive functioning, COMT Val/Val patients performed in a similar range as controls (30.70-33.26 vs. 35.53-35.67), but as COMT Met allele frequency increased, executive functioning worsened. COMT Met/Met patients carrying the DRD3 Ser/Ser genotype performed poorest (16.184 vs. 27.388-31.824). Scores of carriers of this COMT/DRD3 combination significantly differed from all DRD3 Gly/Gly combinations (p < 0.05), from COMT Val/Met DRD3 Ser/Gly (p = 0.02), and from COMT Val/Val DRD3 Ser/Ser (p = 0.01) in patients. It also differed significantly from all control scores (p < 0.001).
CONCLUSION: Combined genetic polymorphisms related to dopamine neurotransmission might influence executive function in schizophrenia. Looking at the effects of multiple genes on a single disease trait (epistasis) provides a comprehensive and more reliable way to determine genetic effects on endophenotypes.

Descriptors: Endophenotype; psychosis; genetics; dopamine; executive function

9 - Impulsivity and compulsive buying are associated in a non-clinical sample: an evidence for the compulsivity-impulsivity continuum?
Jonas J. de Paula; Danielle de S. Costa; Flavianne Oliveira; Joana O. Alves; Lídia R. Passos; Leandro F. Malloy-Diniz
Pages: 242 - 244

OBJECTIVE: Compulsive buying is controversial in clinical psychiatry. Although it is defined as an obsessive-compulsive disorder, other personality aspects besides compulsivity are related to compulsive buying. Recent studies suggest that compulsivity and impulsivity might represent a continuum, with several psychiatric disorders lying between these two extremes. In this sense, and following the perspective of dimensional psychiatry, symptoms of impulsivity and compulsivity should correlate even in a non-clinical sample. The present study aims to investigate whether these two traits are associated in a healthy adult sample.
METHODS: We evaluated 100 adults, with no self-reported psychiatric disorders, using the Barratt Impulsiveness Scale-11 and two scales of compulsive buying.
RESULTS: Using multiple linear regressions, we found that impulsivity accounted for about 15% of variance in the compulsive-buying measure.
CONCLUSIONS: Our results suggest that an association between impulsivity and compulsive buying occurs even in non-clinical samples, evidence that compulsivity and impulsivity might form a continuum and that compulsive buying might be an intermediate condition between these two personality traits.

Descriptors: Impulsivity; compulsivity; compulsive buying; dimensional psychiatry; personality

10 - Normative data of the Barratt Impulsiveness Scale 11 (BIS-11) for Brazilian adults
Leandro F. Malloy-Diniz; Jonas J. de Paula; Alina G. Vasconcelos; Katie M. de Almondes; Rockson Pessoa; Leonardo Faria; Gabriel Coutinho; Danielle S. Costa; Victor Duran; Thales V. Coutinho; Humberto Corrêa; Daniel Fuentes; Neander Abreu; Paulo Mattos
Pages: 245 - 248

OBJECTIVE: The Barratt Impulsiveness Scale (BIS-11) is a valid and reliable instrument, and one of the most often used tools to assess impulsivity. This study assesses the performance of a large sample of adults by using a version of BIS-11 adapted to Brazilian Portuguese.
METHODS: We assessed 3,053 adults from eight Brazilian states. Internal consistencies and performance data were presented for two correction criteria of BIS-11: original and the two-factor score.
RESULTS: The associations between age, sex, region, and education and the BIS-11 scores present very small effect sizes. Therefore, we provided a percentile rank parameter for the different BIS-11 subscores considering the whole sample. Given the internal consistency of the two correction systems, we found that only the two-factor system fulfills the psychometric criteria of Cronbach's alpha (cutoff value of at least 0.6).
CONCLUSION: Our results support the use of the Brazilian adaptation of BIS-11 in different regions of the country as a measure of impulsivity. Since high impulsiveness is a characteristic of several dysfunctional behaviors, the establishment of normative parameters is of utmost relevance and should be extended to other age ranges and populations in future studies.

Descriptors: Cognitive neuroscience; diagnosis and classification; impulse control disorders not listed elsewhere; other psychological issues; tests/interviews; psychometric properties

11 - Functional capacity: a new framework for the assessment of everyday functioning in schizophrenia
Lucas M. Mantovani; Antônio L. Teixeira; JoãoV. Salgado
Pages: 249 - 255

Historically, measures of everyday functioning have focused exclusively on real-world performance. Despite the unquestionable value of "real-world functioning", it has become clear that instruments for its assessment might not be as accurate as desirable. Functional capacity is a domain of everyday functioning that can be assessed through performance-based measures. In the last decade, functional capacity has become a cornerstone for the assessment of everyday functioning, since, alongside measures of real-world functioning, it provides a much more comprehensive picture of functional outcomes than any measurement alone. Functional capacity is more stable and less vulnerable to influence from environmental factors than other domains, and its correlation with cognitive functions has encouraged the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) project to suggest that a performance-based measure of functional capacity be included as a co-primary assessment of cognition in clinical trials. Functional capacity assessment instruments may be also useful in the evaluation of remission in schizophrenia. Validation of these instruments in different countries is desirable, and should always include cross-cultural adaptation; within large countries, adjustment for regional variations should be considered.

Descriptors: Schizophrenia; disability; everyday functioning; functional capacity; real-world functioning

12 - Rumination in bipolar disorder: a systematic review
Érico de M. Silveira Jr.; Marcia Kauer-Sant'Anna
Pages: 256 - 263

OBJECTIVE: To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD).
METHODS: We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors "rumination" and "bipolar disorder" and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review.
RESULTS: Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD.
CONCLUSIONS: Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC) projects.

Descriptors: Bipolar disorder; rumination; executive function; cognitive emotion regulation; Research Domain Criteria; transdiagnostic approach

13 - Weighing the evidence for suicide prevention
Fiorela Flores-Cornejo; Mayumi Kamego-Tome; Mariana A. Zapata-Pachas; Germán F. Alvarado
Pages: 264 - 264


14 - Medical and societal aspects of alcohol consumption in Russia
Sergei V. Jargin
Pages: 264 - 265


15 - Crack-cocaine addiction in an indigenous Brazilian: a case report
Sofia Mendonça; Lígia P. Perón; Maria C. Troncarelli; Bernardo B. Rahe; Valéria Lacks; Jair J. Mari; Dartiu X. Silveira; Thiago M. Fidalgo
Pages: 265 - 266


16 - Prevalence of self-injurious behavior in people with intellectual development disorder
Humberto F. Ianni; Thiago C. Abreu; Sarah de M. Fidelis; Humberto Correa; Arthur Kummer
Pages: 266 - 267