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Background: New‐onset chronic pain has been acknowledged as part of the post‐COVID‐19 condition. However, available fine‐grained data about its clinical phenotype, trajectories and main associated characteristics remain scarce. We described the distinct temporal evolutions of post‐COVID‐19 pain and their epidemiological and phenotypical features. Methods: A prospective cross‐sectional study enrolled post‐COVID‐19 condition patients (i.e. who had persisting COVID‐19‐related symptoms over 30 days since their first positive laboratory test), whose COVID‐19 diagnosis had been supported by RT‐PCR of oral/nasopharyngeal swab or serology. They underwent in‐person evaluations with a structured interview, pain and quality‐of‐life‐related questionnaires and thorough physical examination. Chronic pain (CP) and probable neuropathic pain (NP) were defined according to IASP criteria. Results: The present study included 226 individuals, 177 (78.3%) of whom presented over 3 months since their first COVID‐19 symptom. New‐onset pain occurred in 170 (75.2%) participants and was chronic in 116 (68.2%). A chronic course was associated with COVID‐19‐related hospitalization, new‐onset fatigue, lower cognitive performance, motor and thermal sensory deficits, mood and sleep impairments and overall lower quality‐of‐life levels. Probable NP occurred in only 7.6% new‐onset pain patients, and was associated with pain chronification, new‐onset fatigue, motor and thermal sensory deficits, mechanical allodynia and lower rates of SARS‐CoV‐2 vaccination. Previous CP was reported by 86 (38.1%) individuals and had aggravated after the infection in 66 (76.7%) of them, which was associated with orthostatic hypotension. Conclusions: Post‐COVID pain phenomena follow different paths, which are associated with specific clinical and epidemiological features, and possibly distinct underlying mechanisms, prognostic and therapeutic implications. Significance: COVID‐19‐related pain usually follows a chronic course and is non‐neuropathic. Its possible courses and phenotypes are associated with distinct clinical and epidemiological features. This suggests differing underlying mechanisms, which may have significant prognostic and therapeutic implications. [ABSTRACT FROM AUTHOR]

Background and purpose: The association between alcohol intake and cognitive decline has been widely studied. Sex differences and cognitive domains affected by alcohol intake patterns make this topic complex. The objective of this study was to investigate the effect of alcohol intake on cognition in middle‐aged participants in the Brazilian Longitudinal Study of Adult Health by sex during 4 years of follow‐up. Methods: A total of 7595 participants (55% women) aged between 50 and 75 years at baseline were assessed. Semantic and phonemic fluency, memory, and executive functions were assessed at baseline (2008–2010) and repeated during Visit 2. Linear mixed models were used to investigate the association between cognition and current abstainers, never drinkers, light drinkers, moderate drinkers, and heavy drinkers. Results: Heavy alcohol intake accentuated the decline in executive functions for men (β = −0.01, p < 0.05), and in semantic fluency (β = −0.02, p < 0.05) and memory (β = −0.02, p < 0.05) for women. Never drinker men also showed an accentuated decline in semantic fluency (β = −0.02, p < 0.01). Moderate alcohol intake slowed cognitive decline in phonemic fluency for men (β = 0.02, p < 0.01) and women (β = 0.01, p < 0.01), and in executive functions (β = 0.01, p < 0.05) for women. Conclusions: Having more than 14 drinks per week can impact executive functions in men and memory in women. In addition, alcohol consumption of seven to 14 drinks per week may have a protective effect on gender‐specific cognitive functions. These findings should be considered in public health policies and guidelines on alcohol and cognitive aging. [ABSTRACT FROM AUTHOR]

Objective To evaluate the association between subclinical thyroid dysfunction and psychiatric disorders using baseline data from the Brazilian Longitudinal Study of Adult Health ( ELSA-Brasil). Design Cross-sectional study. Patients The study included 12 437 participants from the ELSA-Brasil with normal thyroid function (92·8%), 193 (1·4%) with subclinical hyperthyroidism and 784 (5·8%) with subclinical hypothyroidism, totalling 13 414 participants (50·6% of women). Measurements The mental health diagnoses of participants were assessed by trained raters using the Clinical Interview Schedule - Revised ( CIS-R) and grouped according to the International Classification of Diseases 10 ( ICD-10). Thyroid dysfunction was assessed using TSH and FT4 as well as routine use of thyroid hormones or antithyroid medications. Logistic models were presented using psychiatric disorders as the dependent variable and subclinical thyroid disorders as the independent variable. All logistic models were corrected for multiple comparisons using Bonferroni correction. Results After multivariate adjustment for possible confounders, we found a direct association between subclinical hyperthyroidism and panic disorder odds ratio [ OR], 2·55; 95% confidence Interval (95% CI), 1·09-5·94; and an inverse association between subclinical hypothyroidism and generalized anxiety disorder ( OR, 0·75; 95% CI, 0·59-0·96). However, both lost significance after correction for multiple comparisons. Conclusion Subclinical hyperthyroidism was positively associated with panic disorder and negatively associated with anxiety disorder, although not significant after adjustment for multiple comparisons. [ABSTRACT FROM AUTHOR]

Aims To examine the psychometric properties of the Brazilian version of the Modified Telephone Interview for Cognitive Status ( TICS-M) for cognitive impairment in post-stroke patients from the Stroke Mortality and Morbidity Study. Methods The original version of the TICS-M was translated and adapted into Brazilian- Portuguese language in 30 non-clinical subjects. After that, two trained researchers applied the TICS-M in 73 stroke participants from the Stroke Mortality and Morbidity Study; however, 12 carried out only the first evaluation and 61 participants completed the follow up: (i) personal interview 6 months after stroke; (ii) telephone interview 1 week after the first evaluation; and (iii) telephone interview 2 weeks after the first evaluation. The reliability of the TICS-M was calculated by test-retest Pearson's correlation, intraclass correlation and Cronbach's alpha coefficient in 61 participants. Also, using data from the same participants, we carried out the analysis of the receiver operating characteristics curve using the Mini- Mental State Examination as a comparison. The structural validity of the TICS-M was assessed through principal components analysis in 103 individuals (30 non-clinical and 73 stroke patients). Results Test-retest reliability and intraclass correlation ranged from 0.87 to 0.97 across the evaluations. The Cronbach's alpha was 0.96. Principal components analysis extracted three meaningful domains: working memory, recall memory and orientation. The best cut-off point to screen cognitive impairment was 14 out of 15 (91.5% sensitivity, 71.4% specificity). The area under the curve was 0.89. Conclusions The Brazilian version of the TICS-M has been found to be a reliable, stable and homogeneous instrument to screen cognitive impairment in stroke patients. Geriatr Gerontol Int 2015; 15: 1118-1126. [ABSTRACT FROM AUTHOR]

Objective To describe the relationship between mood/anxiety disorders and migraine headaches emphasizing the frequency of episodes based in a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health. Background It has been suggested that frequency of migraine headaches can be directly associated with the presence of psychiatric disorders. Methods Migraine headaches ( International Headache Society criteria) was classified as <1×/month, 1×/month-1×/week, 2-6×/week, and daily. Psychiatric disorders using the Clinical Interview Schedule - Revised were classified in 6 categories: common mental ( CMD), major depressive ( MDD), generalized anxiety ( GAD), panic, obsessive-compulsive ( OCD), and mixed anxiety and depressive ( MADD) disorders. We performed multivariate logistic models adjusted for age, race, education, marital status, income, and use of selective serotonin reuptake inhibitors. Results In our sample, 1261 presented definite migraine and 10,531 without migraine headaches (reference). Our main result was an increase in the strength of association between migraine and MDD as frequency of migraine increased for all sample: odds ratio of 2.14 (95% confidence interval [ CI] 1.33-3.43) for <1 episode of migraine/month to 6.94 (95% CI 4.20-11.49) for daily headaches for all sample. Significant associations with migraine were also found for GAD, OCD, MADD, and CMD for total sample: MDD, GAD, OCD, MADD, and CMD for women, and MADD and CMD for men. Among men with daily migraine complaint, we found a significant association between migraine and OCD after correction for multiple comparisons (odds ratio 29.86 [95% CI 4.66-191.43]). Analyzing probable and definite migraine cases together, we replicated the findings in a lower magnitude. Conclusions The increase in migraine frequency was associated with progressively higher frequencies of having mood/anxiety disorders in all samples suggesting for some psychiatric disorders a likely dose-response effect especially for women. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine whether the self-reported version of the Inventory of Depressive Symptomatology (IDS-SR), which is used for major depression, is a reliable tool for screening and assessment of prenatal depression. Methods: Between June 2006 and July 2008, pregnant women attending a teaching hospital in São Paulo, Brazil, completed the Portuguese version of the IDS-SR. Trained psychologists diagnosed depression via the Primary Care Evaluation of Mental Disorders questionnaire, which is based on the Diagnostic and Statistical Manual of Mental Disorders IV. Results: Of 543 participants, 60 (11%) were diagnosed with depression. The Cronbach α of the IDS-SR was 0.89, and the area under the ROC curve was 0.8. The IDS-SR cutoff score at 30 gave a sensitivity and specificity of 78% and 76%, respectively, for diagnosis of prenatal depression. Exploratory and confirmatory analyses revealed a 2-factor structure for the IDS-SR, characterized by symptoms of “mood/cognition” and “irritability/anxiety/pain”. Conclusion: The IDS-SR gave satisfactory internal consistency and accuracy for diagnosing prenatal depression, showing that it can improve early diagnosis and treatment of this condition, thereby minimizing the burden. In addition, a 2-factor model was found to account for depressive symptomatology during pregnancy, which will be useful for developing further depression subscales specific to prenatal depression. [Copyright &y& Elsevier]

Background Objective Methods Results Conclusions While headache disorders are linked to low physical activity levels, the impact of depression on this relationship is unclear.To assess how single and comorbid diagnoses of migraine and tension‐type headache (TTH) interact with depression and leisure‐time physical activity (LTPA) levels in The Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil).In this cross‐sectional analysis based on the ELSA‐Brasil baseline data, the relationship of migraine, TTH (both assessed with the International Classification of Headache Disorders, Second Edition), and depression (assessed with the Clinical Interview Schedule–Revised) with LTPA levels (International Physical Activity Questionnaire) was investigated by employing linear regression models. Models were adjusted for sociodemographic, lifestyle, and clinical covariates, and interaction terms were created to examine additive effects of comorbid conditions.Among 14,088 participants, 54.4% (7668/14,088) were female, prevalence rates were: TTH = 39.6% (5573/14,088), migraine = 27.0% (3806/14,088), depression = 0.7% (94/14,088), depression + TTH = 1.1% (148/14,088), and depression + migraine = 2.5% (356/14,088). The mean (standard deviation) LTPA levels across the groups were: no headache + no depression = 148.7 (183.0) min/week, TTH = 133.5 (170.1) min/week, migraine = 110.3 (154.8) min/week, depression = 76.5 (146.3) min/week, depression + TTH = 84.5 (127.7) min/week, and depression + migraine = 64.3 (123.2) min/week. Negative associations were found for depression (β = −55.1, 95% confidence interval [CI] −93.6 to −17.0; p = 0.005), migraine (β = −24.7, 95% CI −33.2 to −15.4; p < 0.001), and TTH (β = −15.5, 95% CI −23.1 to −7.6; p < 0.001) with LTPA. No interaction effect was observed for depression + TTH (β = 36.0, 95% CI −12.6 to 84.6; p = 0.147) and depression + migraine (β = 31.7, 95% CI −11.3 to 74.7; p = 0.149), indicating no additive effect of comorbid conditions on LTPA levels. After adjusting for headache attack frequency, only depression + migraine remained negatively associated with LTPA (β = −38.7, 95% CI −71.6 to −5.8; p = 0.021).Headache disorders and depression were independently and inversely associated with LTPA, with the strongest effects seen in depression alone or comorbid with migraine. [ABSTRACT FROM AUTHOR]