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Background: Suicide is a global health concern whose rates are soaring in many low-and-middle-income countries. Public awareness campaigns have been implemented in Brazil; however, their impact is uncertain., Methods: This was an ecological study using population data from DATA-SUS, a Brazilian official notification system, selecting only deaths that were voluntarily self-inflicted (CID-10 × 60-X84). We analyzed all available data from 2000 to 2019 to assess trends before and after the national Yellow September (YS) campaign started in 2015. Differences in trends were assessed by Joinpoint Analysis (JA) and Regression Discontinuity Analysis (RDD), unadjusted and adjusted for economic factors., Results: Overall, there was a progressive increase in the rate of relative (per 100,000 inhabitants) number of suicides over time between 2000 and 2019 (57 % increase). The JA detected a change in the slope of the curve representing an acceleration in suicides starting in the year 2015. Adjusted RDD revealed the year that Yellow September started significantly change the slope of the association between time and rates of suicide (p interaction  < 0.01), and marginal analysis detected the coefficient increased from 0.07 (95%CI 0.04-0.10) to 0.27 (95%CI -0.07-0.60) suicides/year per 100,000 inhabitants., Limitations: The ecological nature of the manuscript compromises causational implications., Conclusions: We found an increase in suicidal trends in Brazil, against the global trend that coincides with the beginning of a large national awareness campaign. Although we cannot attribute causality, our results reinforce the need of further studies to better understand the role of awareness campaigns in suicide reduction interventions, including potential unintended effects., Competing Interests: Declaration of competing interest Rodolfo Furlan Damiano: Declares no conflict of Interest Loren Beiram: Declares no conflict of Interest Bianca Besteti Fernandes: Declares no conflict of Interest Maurício Scopel Hoffmann: Declares no conflict of Interest Alexander Moreira-Almeida: Declares no conflict of Interest Christian Rück: Declares no conflict of Interest Hermano Tavares: Declares no conflict of Interest André R. Brunoni: Declares no conflict of Interest Euripedes Constantino Miguel: Declares no conflict of Interest Paulo Rossi Menezes: Declares no conflict of Interest Giovanni Abrahão Salum: Declares no conflict of InterestAcknowledgements We acknowledge Daniela Lopes Ângelo for helping to do the first statistical analysis., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: This systematic review aimed to critically analyze the studies that explored preterm birth as risk factor for postpartum depression in the last 10 years., Methods: Two independent researchers performed a systematic review of indexed studies in PubMed/Medline, Web of Science and PsycInfo database. The PRISMA for reporting systematic review model was used to conduct data extraction. A meta-analysis was performed including a sub-group of studies., Results: The final sample consisted of 26 studies and 12 were included in the meta-analysis. Most of the studies supported the association between preterm birth (PTB) and postpartum depression (PPD). However, 8 studies did not find such association and, even among studies with positive findings, results were heterogeneous, given the methodological discrepancies among the studies. The meta-analysis provided evidence of higher risk for PPD among mothers of preterm infants in assessments performed up to 24 weeks after childbirth., Limitations: Most of the studies did not consider the role of important confounding variables, such as previous history of depression. Heterogeneity of assessment tools and cut-off scores were also considered a limitation., Conclusions: Further prospective population-based studies with an integrative approach of PPD are needed to provide consistent evidence of such association. Important confounding variables and biological measures implicated in PPD should be considered. Our findings highlight the importance of maternal mental health care in this target population, as preterm birth experience seem to affect both babies and mothers. We encourage PPD assessment for mothers of preterm infants, especially in the early postpartum period., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Burnout and mental disorders have been reported in the financial industry. This study aims to examine the structural validity of the Maslach Burnout Inventory (MBI) and to investigate the connection between the dimensions of burnout and depressive symptoms in a sample of 1046 bank employees from North Brazil who completed the MBI and the Patient Health Questionnaire-9 (PHQ-9. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to cross-check the factorial structure of the MBI. One-way analysis of variance and correlation analysis were applied to elucidate the relationship between burnout and depressive symptoms. Both 3-factor and 4-factor oblique solutions were plausible EFA models of the burnout syndrome. Results of CFA supported the 19-item 4-factor structure as the best fitting model to data, with two exhaustion factors ("exhausted" and "strained"), depersonalization, and personal accomplishment. The PHQ-9 total score and individual score of depressive items were significantly correlated with all MBI dimensions, notably with the emotional exhaustion dimension. The moderate-to-high correlation observed between burnout and depression suggest the potential utility of the MBI for evaluating burnout among bank employees as well as to point out the need to evaluate systematically the burnout and depressive symptoms given to their potential association., (Copyright © 2018. Published by Elsevier B.V.)

The occurrence of white matter (WM) abnormalities in psychotic disorders has been suggested by several studies investigating brain pathology and diffusion tensor measures, but evidence assessing regional WM morphometry is still scarce and conflicting. In the present study, 122 individuals with first-episode psychosis (FEP) (62 fulfilling criteria for schizophrenia/schizophreniform disorder, 26 psychotic bipolar I disorder, and 20 psychotic major depressive disorder) underwent magnetic resonance imaging, as well as 94 epidemiologically recruited controls. Images were processed with the Statistical Parametric Mapping (SPM2) package, and voxel-based morphometry was used to compare groups (t-test) and subgroups (ANOVA). Initially, no regional WM abnormalities were observed when both groups (overall FEP group versus controls) and subgroups (i.e., schizophrenia/schizophreniform, psychotic bipolar I disorder, psychotic depression, and controls) were compared. However, when the voxelwise analyses were repeated excluding subjects with comorbid substance abuse or dependence, the resulting statistical maps revealed a focal volumetric reduction in right frontal WM, corresponding to the right middle frontal gyral WM/third subcomponent of the superior longitudinal fasciculus, in subjects with schizophrenia/schizophreniform disorder (n=40) relative to controls (n=89). Our results suggest that schizophrenia/schizophreniform disorder is associated with right frontal WM volume decrease at an early course of the illness., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Cognitive deficits are a key feature of recent-onset psychosis, but there is no consensus on whether such deficits are generalized or confined to specific domains. Besides, it is unclear whether cognitive deficits: a) are found in psychotic patients in samples from outside high-income countries; and b) whether they progress uniformly over time in schizophrenia and affective psychoses. We applied 12 tests organized into eight cognitive domains, comparing psychosis patients (n = 56, time from initial contact = 677.95+/-183.27 days) versus healthy controls (n=70) recruited from the same area of São Paulo, Brazil. Longitudinal comparisons (digit span and verbal fluency) were conducted between a previous assessment of the subjects carried out at their psychosis onset, and the current follow-up evaluation. Psychosis patients differed significantly from controls on five domains, most prominently on verbal memory. Cognitive deficits remained detectable in separate comparisons of the schizophrenia subgroup and, to a lesser extent, the affective psychosis subjects against controls. Longitudinal comparisons indicated significant improvement in schizophrenia, affective psychoses, and control subjects, with no significant group-by-time interactions. Our results reinforce the view that there are generalized cognitive deficits in association with recent-onset psychoses, particularly of non-affective nature, which persist over time., (Copyright © 2009 Elsevier Ltd. All rights reserved.)

Background: Studies investigating the performance of instruments to detect major depressive disorder (MDD) have reported inconsistent results. Subsyndromal depression (SD) has also been associated to increased morbidity, and little is known about its detection in primary care setting. This study aimed to investigate the performance of the Primary Care Evaluation of Mental Disorders (PRIME-MD) to detect MDD and any depression (threshold at SD) in an outpatient unit of a teaching general hospital., Methods: Nineteen primary care physicians using the PRIME-MD evaluated 577 patients, 240 of them (75% female; mean age, 40.0 +/- 14.4), including all with MDD and a randomly subset of those without MDD, were evaluated by 11 psychiatrists using the Structured Clinical Interview Axis I Disorders, Patient Version (SCIDI/P) for DSM-IV as the standard instrument., Results: The kappa between the PRIME-MD and the SCID was 0.42 for the diagnosis of any depression and 0.32 for MDD. The distribution of the number of depressive symptoms per patient suggested the existence of a continuum between SD and MDD, and a high frequency of subjects with 4-6 symptoms (close to the cutoff for the diagnosis of MDD)., Limitations: The sample has a modest size and is a subset of an original one., Conclusion: A continuum between SD and MDD may in part explain the relatively low agreement for the diagnosis of MDD in our sample and possibly in other studies. Studies investigating the performance of screening instruments to detect MDD, should consider the relevance of identifying SD, and the influence of the distribution of the number of depressive symptoms in their results.