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Purpose: To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension. Methods: This is a cross‐sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability. Results: Ineffective health management is probably present in 37.5% of people with hypertension. 'Failure to include treatment regimen in daily living' was the clinical indicator with the highest sensitivity value, and 'failure to take action to reduce risk factor' had the highest specificity value. Conclusions: Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario. Implications for Nursing Practice: This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing. [ABSTRACT FROM AUTHOR]

Is important to evaluate suicidal potential and related factors during pregnancy among women who have attended public health services. To determine the suicidal potential, question 10 from Edinburgh Postnatal Depression Scale (EPDS) was used. In this sample (N = 1,334), 8.1% of pregnant women demonstrated suicidal potential. The potential risk factors for suicide in depressed pregnant women were being single, divorced or widowed, thinking about having an abortion, and having anxiety symptoms; in nondepressed pregnant women were lower age, low education level, low socioeconomic class, thoughts about having an abortion and anxiety symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Bullying among adolescents has become the subject of extensive research due to its negative effects on attitude and behavior. However, Brazilian literature on the topic is scarce. Objective: To assess bullying and associated factors among adolescents in a population-based sample in southern Brazil. Method: Population-based, cross-sectional study with adolescents aged 11 to 15 years living in the municipality of Pelotas, state of Rio Grande do Sul, Brazil. Results: A total of 1,145 adolescents were included. Bullying behaviors and attitudes were found to be associated with the following factors: intentionally skipping classes, failing at school, using alcohol, smoking cigarettes, using illegal drugs, having engaged in sexual intercourse, carrying a weapon, being involved in an accident/being run over by any vehicle, and being involved in fights with physical aggression. Conclusion: Bullying is associated with several behaviors that pose risk to the adolescents' physical and psychological health. [ABSTRACT FROM AUTHOR]

Objective. To verify the prevalence and associated factors of suicidal ideation among adolescents aged 11 to 15 years. Method: Cross-sectional population-based study. Adolescents completed a self-report that contained the Children's Depression Inventory. Suicidal ideation was measured according to item 9 of the Children's Depression Inventory. Multivariate logistic regression analysis was applied using a hierarchical model. Results: 1145 adolescents were invited to participate, and 1039 were interviewed (refusal rare: 9.26%). The prevalence of suicidal ideation was 14.1%. Factors associated to suicidal ideation: female gender, current alcohol consumption, use of illicit drugs, symptoms indicating conduct disorders and high Children's Depression Inventory scores for depressive symptoms. Conclusion: Prevention strategies should focus on female adolescents, especially those sexually active with probable mental health problems and substance use. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to assess the independent effects of depression and excess body weight (EBW) on cognition and functioning in a community sample of young adults.Methods: This was a cross-sectional of 943 young adults. The diagnosis of a current depressive episode was performed using the Mini International Neuropsychiatric Interview (MINI). Cognition and functioning were assessed using the Montreal Cognitive Assessment (MoCA) and the Functional Assessment Short Test (FAST), respectively. The EBW was defined as BMI ≥ 25.0 kg/m2. The independent main effects of depression and EBW, as well as the analysis interaction were performed using two-way analysis of covariance (ANCOVA).Results: The total sample comprised 943 adults, with 75 (8.0%) individuals diagnosed with a current depressive episode and 493 (52,6%) with EBW. Of the 75 subjects with depression, 40 were identified with EBW comorbidity. Subjects with depression and EBW comorbidity reported greater cognitive and functional impairment, as compared to individuals with depression without EBW. There was a significant interaction between depression and EBW on MoCA total (p<0.001) as well as FAST total (p=0.010), work (p=0.002), cognition (p=0.023), finances (p=0.032) and relationships domains (p=0.008).Conclusions: The adverse effects of depression and EBW are independent and cumulative with respect to cognition and functioning of individuals. The understanding of the complex interactions between cognition, functioning, EBW and depression are important for development of preventive and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the prevalence of probable sleep bruxism (SB) in children aged 7–8 years and its association with sleep pattern and the time spent using devices with a screen. Material and Methods: A cross‐sectional study was conducted with children from Pelotas, Brazil (n = 556). Parents/caregivers were interviewed and provided demographic/socioeconomic information, children's daily screen time, nighttime tooth grinding or clenching, sleep duration and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN‐K‐sleep domain). Probable SB was determined based on a positive clinical inspection with/without a positive parental/caregiver's reports of tooth clenching or grinding. Hierarchical Poisson regression was performed. Results: The prevalence of probable SB was 15.83% (n = 88). There was no difference in the probable SB prevalence according to the daily screen time (p = 0.744), and low family socioeconomic status was associated with higher SB prevalence (Prevalence Ratio [PR] = 1.95; 95% Confidence Interval [95% CI]: 1.21–3.17; p = 0.006). Higher scores in the sleep domain of the BRIAN‐K scale were associated with probable SB [PR = 1.07; 95% CI: 1.01–1.30; p = 0.013]. Conclusions: Difficulties in maintaining sleep and low family socioeconomic status were associated with probable SB in schoolchildren, while screen time spent using devices with a screen was not associated. [ABSTRACT FROM AUTHOR]

Background: Cocaine abuse is capable of activating the innate immune system in the CNS resulting in deregulation of homeostasis between pro and antiinflammatory cytokines. The aim of this study was to investigate serum levels of pro and antiinflammatory cytokines, IL-6 and IL-10 respectively, in cocaine users from a young population-based sample.Methods: This is a case-control study nested in a cross-sectional population-based survey, with individuals of 18 and 35 years old. Two groups were selected: 24 healthy controls and 12 subjects who reported cocaine use. Serum IL-6 and IL-10 were measured by ELISA using a commercial kit.Results: There was a statistically significant increase in IL-6 (p=0.037) and decrease in IL-10 (p=0.007) serum levels, between cocaine users and the control group. There was also an increase in the ratio IL-6/IL-10 (p=0.013) among cocaine users individuals, when compared to the control group.Conclusions: Our results suggest that cocaine users showed an activation of the immune system when compared a control group, demonstrating a disruption in the balance of pro and antiinflammatory cytokines. Thus, peripheral cytokines may represent a putative biomarkers for cocaine users, contributing to the development of diagnosis and effective treatments. [ABSTRACT FROM AUTHOR]

Background The diagnosis of alcohol use disorder is based on clinical signs and on the measurement of biological markers. However, these markers are neither sufficiently sensitive, nor specific enough, for determining the effects of alcohol abuse on the central nervous system. Serum neurotrophins are important regulators of neural survival, development, function, and plasticity and have been found to be reduced in alcohol use disorder. The aim of this study was to investigate the alterations in serum neurotrophin levels (brain-derived neurotrophic factor [ BDNF], glial-derived neurotrophic factor [ GDNF], and nerve growth factor [ NGF]) in alcohol use disorder in a young population, and thus possibly representing the early stages of the illness. Methods This is a cross-sectional study, nested in a population-based study of people aged 18 to 35, involving 795 participants. The participants responded to the CAGE questionnaire, and a CAGE score of ≥2 was considered to be a positive screen for the abuse/dependence or moderate to severe alcohol use disorder. Serum BDNF, GDNF, and NGF levels were measured by ELISA. Results In the CAGE ≥ 2 group, GDNF ( p ≤ 0.001) and NGF ( p ≤ 0.001) serum levels were significantly increased, and the BDNF elevation was near a statistical significance ( p = 0.068) when compared to the CAGE < 2 group. A significantly positive correlation was observed only in the CAGE ≥ 2 group for BDNF/ GDNF ( r = 0.37, p < 0.001) and GDNF/ NGF ( r = 0.84, p < 0.001) levels. The correlation between the NGF and BDNF levels was significantly positive in both groups ( r = 0.28, p < 0.001 for the CAGE < 2 group, and r = 0.30, p = 0.008 for the CAGE ≥ 2 group). Conclusions These results suggest that elevated neurotrophins are candidate markers for the early stages of alcohol misuse. [ABSTRACT FROM AUTHOR]

Purpose: To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents. Methods: A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data. Results: Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18-19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14-5.59) for the maternal 'affectionless control' and a PR of 2.91 (95 % CI 1.10-7.70) for the paternal 'neglectful parenting.' Conclusions: We found that maternal 'affectionless control' and paternal 'neglectful parenting' were independent predictors of suicidality in this sample of pregnant teenagers. [ABSTRACT FROM AUTHOR]

We investigated whether women diagnosed with comorbid bipolar disorder (BD) and premenstrual dysphoric disorder (PMDD) experience higher disruptions in biological rhythms in two independent study samples. The first study has a population-based sample of 727 women, including 104 women with PMDD only, 43 women with BD only, 24 women with comorbid PMDD and BD, and 556 women without BD or PMDD (controls). Biological rhythm disruptions were cross-sectionally evaluated using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). The second study enrolled 77 outpatient women who completed prospective assessments at two timepoints: during the mid-follicular and the late-luteal phases of their menstrual cycles, using the BRIAN, and included 19 women with PMDD, 16 with BD, 17 with comorbid PMDD and BD, and 25 controls. In the population-based sample, all the diagnostic groups (BD, PMDD, BDPMDD) presented greater biological rhythm disruption than controls. In addition, women with BD presented greater overall biological rhythms disruption, and greater disruption in sleep, activity, and eating patterns, than women with PMDD. In the outpatient sample study, women with BDPMDD showed greater disruption in the social domain than women with PMDD. In the outpatient sample, women with BDPMDD reported significantly higher disruptions in biological rhythms across both the follicular and the luteal phases of the menstrual cycle. The comorbidity between BD and PMDD may affect biological rhythms beyond the luteal phase of the menstrual cycle. These results support previous literature on the increased illness burden of women diagnosed with comorbid BD and PMDD. [ABSTRACT FROM AUTHOR]

Abstract: Background: Suicidal behavior and its correlates remain relatively understudied in pregnant teenagers. Methods: A cross-sectional study with a consecutive sample of pregnant teenagers recipient of prenatal medical assistance by the national public health system in the urban area of Pelotas, southern Brazil. Sample size was estimated in 871 participants. Suicidal behavior and psychiatric disorders were assessed with the Mini International Neuropsychiatric Interview; the Abuse Assessment Screen was used to identify physical or sexual abuse; social support was assessed with the Medical Outcomes Survey Social Support Scale; a self-report questionnaire was used to collect socio-demographic, obstetric and other psychosocial data. Results: Forty three (4.94%) teenagers refused to participate, resulting in 828 participants. Prevalence of suicidal behavior was 13.3%; lifetime suicide attempts were referred by 7.4%, with 1.3% reporting attempting suicide within the last month. After adjustment, we found significant associations of suicidal behavior with the 18–19years old subgroup, low education, prior abortion, previous major depression, and physical abuse within the last 12months. Pregnant teenagers with high social support showed prevalence ratios (PR) 67% lower (PR: 0.33; 95%CI: 0.19–0.56) than those with low social support. Furthermore, a wide range of psychiatric disorders, most notably major depressive disorder (PR: 2.75; 95%CI: 1.34–5.63) and panic disorder (PR: 6.36; 95%CI: 1.61–25.10), remained associated with suicidal behavior after adjustment. Limitations: The cross-sectional design precludes causal inferences. Conclusions: We found that suicidal behavior is a relatively common feature in pregnant teenagers, frequently associated with psychiatric disorders. [Copyright &y& Elsevier]

A number of theories associate emotional factors with the triggering of sleep bruxism (SB). Few studies have used validated instruments to assess psychological characteristics and SB in children. In this study, the authors aimed to assess the prevalence of parent-reported SB in children and its association with social, emotional, and behavioral problems. The authors conducted a cross-sectional study with a school-based sample at 20 public schools in Brazil. Parents or caregivers provided information related to tooth-grinding sounds during sleep and about children's social, emotional, and behavioral problems by using the Strength and Difficulties Questionnaire. Analyses were carried out considering each subscale of the Strength and Difficulties Questionnaire and the total score. The authors estimated prevalence ratios by using a Poisson regression model. Statistical inferences were based on 95% confidence intervals. A total of 556 children aged 8 years were included. Prevalence of SB was 30.83%. Results of an adjusted analysis showed a significant association of SB with higher scores on total difficulties (overall score) (P <.001) and emotional symptoms (P <.001) and peer relationship problems (P =.010) subscales. Parental reports of emotional and behavioral problems were associated with a higher prevalence of SB in schoolchildren. This study's results contribute to those of previous investigations about the association between psychological characteristics and SB. Interdisciplinary research involving dentistry and psychology may improve the understanding of bruxism. [ABSTRACT FROM AUTHOR]

Background: Studies on the field of mood disorders has mainly focusing on the risk factors associated to develop the illness or the clinical factors associated with the clinical progression. Less attention was given to factors such as resilience that may be associated with better outcomes in the course of mood disorders. In this study, we assessed the mediation effect of resilience on the relationship between childhood trauma and mood disorders, as well as the severity of depressive symptoms in a population-based sample.Methods: This is a cross-sectional study with a community sample of young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls without any mood disorder. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The severity of depressive symptoms was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) and to assess the resilience was used the Resilience Scale (RS-25).Results: All subtypes of trauma were associated with both MDD and BD, however, only physical and emotional abuse differentiated BD from MDD subjects. Bootstrapping-enhanced mediation analyses indicated that resilience partly mediated the association of childhood trauma to both mood disorder and severity of depression.Limitation: The employed mediation analyses are cross-sectional in nature, which limits any firm conclusions regarding causality.Conclusions: The findings support the clinical assumption that resilient subjects may be partly protected against the detrimental long-term effects of childhood trauma. This study provides important information regarding the relationships among childhood trauma, resilience, and mood disorder. [ABSTRACT FROM AUTHOR]

Background: Suicide is the second leading cause of death among young adults worldwide, and few studies have assessed the factors associated with suicidality in this specific population. Thus, the aim of this study was to assess the association between mixed episodes and suicidality in a community sample of young adults. For this aim, we compared young adults in a mixed episode with individuals in a depressive or (hypo)manic episode, and community controls.Method: This is a cross-sectional population-based study including young adults aged 18-24 years old. Information about participants' age, sex, self-reported skin color and study status were obtained using a sociodemographic questionnaire. Mixed, (hypo)manic and depressive episodes, as well as suicide risk were assessed using the Mini International Neuropsychiatric Interview.Results: The sample included 1560 individuals. Young adults in a mixed episode showed a 13.50 times higher probability to have suicide risk, as compared to community controls (p < 0.001), 5.67 higher probability to have suicide risk as compared to individuals in a (hypo)manic episode (p < 0.001), and 2.18 times higher probability to have suicide risk as compared to young adults in a depressive episode (p < 0.001).Limitation: The assessment of suicide risk includes both suicide attempts and ideation.Conclusion: Young adults in a mixed episode showed a higher rate of suicide risk than individuals with depression or mania/hypomania. Considering the already increasing prevalence of suicide among young adults, there is an urgent need for the early diagnosis and treatment of mixed episodes in this specific population. [ABSTRACT FROM AUTHOR]

Introduction: Subjects with bipolar disorder suffering of a depressive episode are frequently misdiagnosed as unipolar depression, being important studies assessing the differential diagnosis between bipolar and unipolar depression.Objective: To assess the sociodemographic and clinical features of drug-free young adults in a depressive episode of bipolar or unipolar disorder in order to identify factors that may differentiate these psychiatric conditions.Methods: This is a cross-sectional study with 241 young adults aged between 18 and 29 years who were evaluated using the Structured Clinical Interview for DSM-IV (SCID). The sample comprised patients with BD (n = 89) and major depressive disorder (n = 152), experiencing a depressive episode and not using psychoactive drugs or illicit psychoactive substances.Results: The characteristics associated with bipolar depression were being male (p < 0.001), with a family history of BD (p = 0.013), a higher frequency of childhood traumatic experiences (p = 0.001), younger age of onset of mood disorder (p = 0.004), many previous depressive episodes (p = 0.027), greater severity of depressive symptoms (p < 0.001) and day/night reversal (p = 0.013). Those with unipolar depression showed a higher frequency of biological rhythm disturbances (p < 0.001), and diurnal preference (p = 0.028).Limitations: The sample has not included subjects with severe suicide risk, a possible important marker in differentiate unipolar from bipolar depression.Conclusion: Some clinical aspects may contribute to an early differential diagnosis of both bipolar and unipolar depression even in the initial stages of the disease. [ABSTRACT FROM AUTHOR]

The present study aimed to verify the association between maternal depression and emotional and behavioral problems in school children in Pelotas, Southern Brazil, considering that maternal depression increases children’s vulnerability for developing psychiatric disorders. This is a cross-sectional study with a school-based sample conducted between August 2015 and November 2016 and it is part of a major project entitled ‘Healthy Childhood in Context: A Multidisciplinary Investigation’. Schoolchildren aged between 7 and 8 years and one of their respective parents or a primary caregiver were included in the study. Maternal depression was assessed using the Mini International Neuropsychiatric Interview (MINI). The presence of emotional and behavioral problems in children was verified by the Strengths and Difficulties Questionnaire (SDQ) - parents version. Children of depressed mothers exhibited higher mean scores in all SDQ domains and in the total score when compared to children of non-depressed mothers. Lower socio-economic status was also associated with higher SDQ scores. Our results showed the effects of both maternal depression and poverty on children emotional and behavioral problems, which evidence the need for child mental health preventive care, and free quality assistance for both mothers and their children. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the serum leptin levels in cannabis smokers. Methods: This was a cross-sectional population-based study of participants between the ages of 18 and 35 years. The data were collected through a self-administered questionnaire covering sociodemographic data and the use of psychoactive substances. Leptin levels were measured using a commercial ELISA kit. Results: Of the 911 participants, 6.7% were identified as cannabis smokers and had significantly lower leptin levels (p = 0.008). When stratified by gender, there was a significant decrease in leptin levels among male smokers (p = 0.039). Conclusion: Cannabis smoking was linked to leptin levels in men, suggesting that the response to biological signals may be different between men and women. [ABSTRACT FROM AUTHOR]

To evaluate the serum levels of IL-6 and IL-10 anti-inflammatory interleukins in individuals with post-traumatic stress disorder (PTSD) in a population-based study. This is a paired study nested in a cross-sectional population-based study. All individuals who presented PTSD and did not present major depressive disorder, diagnostic by interview--Mini International Neuropsychiatric Interview were selected. From these, 41 healthy controls were matched by sex and age. Serum levels of IL-6 and IL-10 were measured by the ELISA, using commercial kits. The group of individuals with PTSD showed a significant increase in the serum levels of IL-6 and IL-10. Our results suggest that individuals with PTSD may present an activation of the immune system, which may lead to neuroinflammation. [ABSTRACT FROM AUTHOR]

Objective To assess the association between peripheral levels of inflammatory cytokines and functional impairment in subjects with Bipolar Disorder (BD), Major Depressive Disorder (MDD) and population controls. Methods This was a cross-sectional study with a matched sample of drug-free young adults with BD ( n = 48), MDD ( n = 48) and population controls ( n = 48). Mood disorder was confirmed by a certified psychologist using the Structured Clinical Interview for DSM-IV (SCID-I). Functional impairment was assessed using the Functional Assessment Short Test (FAST). Serum levels of IL-6 and IL-10 were measured by ELISA. Results Peripheral levels of IL-6 and IL-10 were not significantly different between subjects with BD, MDD compared to controls. Higher levels of functional impairment were verified in subjects with BD and MDD compared to population controls ( p ≤ 0.001). In addition, IL-6 and IL-10 levels were positively correlated with functional impairment in subjects with BD (IL-6: r = 0.349, p = 0.016; and IL-10: r = 0.351, p = 0.016). Conclusion Inflammatory dysregulation was associated with functional impairment among drug-free subjects with BD. This finding suggests that inflammatory dysregulation may be involved in the neuroprogression of BD. [ABSTRACT FROM AUTHOR]

The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI < 30) or obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk [ABSTRACT FROM PUBLISHER]

Background It is known that sleep disturbance has been considered a trait-marker of mood disorders. However, the role of disruptions in biological rhythms, such as eating, activity, and social patterns, needs to be better understood. Aim To assess the differences in biological rhythms in subjects with bipolar disorder, major depressive disorder, and healthy controls. We also tested the association between disruptions of biological rhythms and circadian preferences. Methods A cross-sectional, population-based study with a representative sample of 1023 young adults. Bipolar disorder and depression were diagnosed using The Mini International Neuropsychiatric Interview – PLUS and DSM Structured Clinical Interview. Self-reported biological rhythms and circadian preference were assessed using the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Results Bipolar disorders and depression subjects presented higher rates of disruption in biological rhythms when compared to healthy controls even after adjusting for sex, socioeconomic status, alcohol, tobacco, illicit drug use, anxiety disorder and psychotropic medication use. Euthymic subjects showed higher biological rhythm disruption when compared to controls. Higher disruption in biological rhythms was observed in subjects with evening preferences. Conclusion Higher disruption in biological rhythms occurs in individuals with depression and bipolar disorder even on periods of euthymia. [ABSTRACT FROM AUTHOR]

Aim: To assess the functional impairment of young adults with bipolar disorder with substance abuse/dependence comorbidity.Method: Cross-sectional study within a community sample. Bipolar Disorder was assessed by qualified psychologists using The Mini International Neuropsychiatric Interview - PLUS (MINI-PLUS). Substance abuse and dependence was assessed using the "Alcohol, Smoking and Substance Involvement Screening Test" (ASSIST). Functional impairment was assessed using the Functional Assessment Short Test (FAST).Results: The sample included 1259 young adults. The prevalence of Bipolar Disorder (BD) without Substance Abuse/Dependence (SAD) comorbidity was 5.9% (n=74), and the prevalence of bipolar disorder with substance abuse/dependence comorbidity was 1.4% (n=17). Both groups showed higher impairment in overall functioning, interpersonal relationship, and leisure time as compared to controls. In addition, BD+SAD showed higher impairment in the cognitive functioning domain of FAST.Limitation: A battery of neuropsychological tests was not performed.Conclusion: Functional impairment is associated with BD, independently of substance abuse or dependence. In addition, BD+SAD present a more severe impairment in the cognitive domain of FAST as compared to controls. [ABSTRACT FROM AUTHOR]

Aim To assess biological rhythm disruptions among drug-naïve young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls. Methods This was a cross-sectional study nested in a population-based study. BD and MDD were diagnosed using the Structured Clinical Interview for DSM-IV. Biological rhythm disruptions were assessed using the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Results Two hundred seventeen subjects were assessed (49 BD, 74 MDD, and 94 community controls). Biological rhythm disruption was higher in subjects with BD (40.32±9.92; p <0.001) and MDD (36.23±8.71; p <0.001) than community controls (27.67±6.88). Subjects with BD had a higher BRIAN total score ( p =0.028) and higher disruption in sleep/social domains ( p =0.018) as compared to MDD. In addition, the BRIAN scores were higher in current MDD, euthymic BD, and BD in current episode group, as compared to community controls. Limitation Cross-sectional design. Absence of assessment of biomarkers of biological rhythms. Conclusion Bipolar disorder and major depressive disorder are associated with disruption in biological rhythm. In addition, disruption in sleep/social rhythms is higher in subjects with BD when compared to subjects with MDD. We also verified biological rhythm disruption in subjects with BD during euthymic status, but not in remitted MDD. Regulation of biological rhythm may be a means to identify patients with mood disorders and potentially differentiate MDD from BD. [ABSTRACT FROM AUTHOR]

Recent studies have evaluated the role of brain-derived neurotrophic factor (BDNF) in mood disorders; however, little is known about alterations in nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF). The aim of this study was to evaluate differences among serum neurotrophic factors (BDNF, NGF and GDNF) in depressed patients and healthy controls and to verify the association between serum neurotrophic levels and clinical characteristics in a young, depressed population stratified by gender. This is a cross-sectional study with depressed patients and population controls 18-29 years of age. The concentrations of neurotrophic factors were determined by the ELISA method. The diagnosis of depression and the duration of the disease were assessed by the Structured Clinical Interview according to the diagnostic and statistical manual of mental disorders. Depression severity was measured with the 17-item Hamilton Rating Scale for Depression, and the severity of anxiety symptoms was measured using the Hamilton Anxiety Rating Scale. Serum BDNF and GDNF were lower in major depressive disorder (MDD) patients compared to controls ( p ≤ 0.001). Serum NGF levels were higher in MDD patients versus controls ( p ≤ 0.001). BDNF was associated with the duration of disease only in women ( p = 0.005). GDNF was not associated with clinical characteristics in either gender. In women, NGF was associated with the severity of depressive symptoms ( p = 0.009), anxiety ( p = 0.011) and disease duration ( p = 0.005). NGF was associated with disease duration in men ( p = 0.026). Our results demonstrated that significant neurochemical differences in NGF and BDNF, but not in GDNF, were associated with the clinical features of MDD when patients were stratified by gender. [ABSTRACT FROM AUTHOR]

Teeth are considered the most resistant structures in the human body. In forensic odontology, teeth are useful for human identification, especially when dental age estimation is necessary. Despite numerous studies, there is no consensus regarding the best methods for dental age estimation. The analysis of aspartic acid racemization, however, has shown promising results. This scoping review aimed to present a descriptive synthesis of the current literature regarding dental age estimation through aspartic acid racemization. Four electronic databases were screened: PubMed, Scielo, Web of Science, and Scopus. Cross-sectional studies published before April 2021 were selected. From 206 articles found, 26 met the eligibility criteria. Several experimental protocols and laboratory settings were detected, but the different protocols did not seem to significantly reduce error rates in dental age estimation. The analysis of aspartic acid racemization in human dental tissues produced accurate and potentially reliable results for age estimation. Aspartic acid racemization stands out especially in the adulthood - age category in which other methods struggle to deliver proper performances. Studies with larger samples, independent testing, and standardized laboratory procedures are necessary. Equator-like reporting guidelines are encouraged to enable future systematic reviews and meta-analyses. [ABSTRACT FROM AUTHOR]

Suicide is among the main causes of death of people aged between 15 and 44 years old. Childhood trauma is an important risk factor for suicide. Hence, the objective of this study was to verify the relationship between childhood trauma and current suicide risk (suicidal behavior and ideation) in individuals aged 14-35 years, in the city of Pelotas, Brazil. This is a cross-sectional, population-based study. Sample selection was performed by clusters. Suicide risk was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Moreover, the participants responded to a questionnaire concerning socioeconomic status, work, and substance use. The sample was composed of 1,380 individuals. The prevalence of suicide risk was 11.5%. The prevalence figures of childhood trauma were 15.2% (emotional neglect), 13.5% (physical neglect), 7.6% (sexual abuse), 10.1% (physical abuse), and 13.8% (emotional abuse). Suicide risk was associated (p < .001) with gender, work, alcohol abuse, tobacco use, and all types of childhood trauma. The odds of suicide risk were higher in women (OR = 1.8), people who were not currently working (OR = 2.3), individuals who presented alcohol abuse (OR = 2.6), and among tobacco smokers (OR = 3.4). Moreover, suicide risk was increased in all types of trauma: emotional neglect (OR = 3.7), physical neglect (OR = 2.8), sexual abuse (OR = 3.4), physical abuse (OR = 3.1), and emotional abuse (OR = 6.6). Thus, preventing early trauma may reduce suicide risk in young individuals. [ABSTRACT FROM AUTHOR]

Background: Caregiver burden has been associated with caregivers' mental disorders and need for support and information. However, the lack of quantitative studies and formal interventions aiming to lower burden levels in this population reflect the current negligence regarding this important issue. Aim: To identify burden levels and associated factors in caregivers of young adults with bipolar and unipolar mood disorder. Method: This is a cross-sectional study nested within a population-based cross-sectional study with young adults. Caregiver burden was assessed through the Burden Interview. Information about caregiver mental disorders (Axis I) and alcohol abuse were obtained through the Mini International Neuropsychiatric Interview (MINI) and the Cut-Down, Annoyed, Guilty and Eye-Opener (CAGE) questionnaire, respectively. Results: Caregiver burden was associated to caregiver's mood and anxiety disorders, suicide risk and being the caregiver of young adults with depression disorder and bipolar disorder. Also, burden was higher among caregivers of bipolar individuals. When excluding the control group from the analysis, only mood and anxiety disorders remained associated to caregiver burden. Conclusions: Caregivers are affected by the young adult's disorder even before a diagnosis has been given, with serious impairments in their lives. Thus, this is a subject in need of designing relevant strategies aiming to provide them with care. [ABSTRACT FROM AUTHOR]

This research aimed to compare the prevalence rates of major depressive disorder (MDD) and to differentiate the presence and severity of depressive symptoms between women and men aged 18–24 years. In this population-based, cross-sectional study (n = 1560), young adults were screened with the Mini International Neuropsychiatric Interview for MDD (n = 137). Participants then completed a self-report questionnaire to gather sociodemographic data, and the presence of each symptom of depression was assessed with the Beck Depression Inventory. The proportion of women (12.2%) with MDD was higher than that of men (5.3%). The symptoms of depression found to be significantly more prevalent in women were sadness, crying, difficulty making decisions, and lack of energy, as well as self-criticism, irritability, changes in self-image, work difficulty, and loss of interest in sex. Sadness and self-criticism were significantly more severe in women than in men. The presentation of depressive symptoms in young adults with MDD differed between men and women. [ABSTRACT FROM AUTHOR]

Abstract: Our work was sought to investigate possible changes in peripheral levels of interleukin-1β (IL-1β) according to the diagnosis of major depression (MD) and bipolar disorder (BD) and in different mood episodes. This is a cross-sectional nested in a population-based study comparing 240 young adults (80 controls, 80 MD and 80 BD), balanced for age and gender. Serum levels of IL-1β were significantly higher in MD when compared to control or BD subjects. In addition, when divided by current mood episode, MD subjects in current depression presented higher IL-1β levels than controls. No differences in IL-1β levels were found between different episodes of BD (euthymic, depressed, mania or mixed). Moreover, the use of psychiatric medication was very low in our sample and not associated with changes in IL-1β levels. In conclusion, increased peripheral IL-1β might be a useful marker associated with a depressive episode in the context of MD. [Copyright &y& Elsevier]

Objective: The purpose of this work is to study the prevalence, intensity, and treatment of pain in Portuguese palliative care teams. Methods: Twenty-one palliative care teams were invited to participate in a cross-sectional survey. Ten of these accepted and were included in the study. Data of all patients observed on the 18th week of 2011 were collected. The data collected concerning pain were: demographic data, pain intensity, drugs prescribed, and invasive techniques. The intensity of pain was rated using a five-point verbal rating scale from none to maximum. The Pain Management Index (PMI) was used to calculate the adequacy of the analgesia. Results: A total of 164 patients were included in this study. One hundred fifty-one (92 %) had cancer. The median age was 71 years (16 to 95). Eighty-four (51 %) were females. Pain was directly assessed in 136 (83 %) of the patients, whereas 27 patients could not report pain because of cognitive failure. Of those directly assessed, 77 (57 %) had pain when they were assessed: 42 (55 %) mild, 25 (32 %) moderate, 9 (12 %) severe, and 1 (1 %) maximum. Non-opioid analgesics were used: paracetamol in 61 (37 %) and NSAID in 20 (12 %). Tramadol was the only opioid for mild to moderate pain used in 25 (15 %) patients. The opioids most used for moderate to intense pain were: morphine 74 (45 %), transdermal (TD) fentanyl 32 (20 %), and buprenorphine TD 28 (17 %). The adjuvants most used were: corticosteroids 38 (23 %), gabapentin 37 (23 %), and amitriptyline 15 (9 %). Only five (4 %) patients had a negative PMI, meaning an inadequate analgesia. Conclusion: The general prevalence of pain is similar to that reported by other. The prevalence of moderate to severe pain is also similar to that reported in other studies, although severe pain is somewhat lower than indicated in most reports. According to the PMI, pain control was acceptable to good. [ABSTRACT FROM AUTHOR]

Abstract: Background: Postpartum depression affects parents of newborns. Major depression causes cognitive prejudice. Nothing is known about memory impairment in those affected of postpartum depression. This study has a purpose to assess working and short-term memories during the postpartum period in mothers and fathers in the city of Pelotas, RS, Brazil and also to correlate the changes in memory with postpartum depression, sociodemographic factors and possible confounding factors. Methods: This cross-sectional study includes families assisted by the public health system. The sample consisted of fathers and mothers of live births, born from March to December 2008. The participants were evaluated during home visits using the Edinburg Postnatal Depression Scale (EPDS) and the word span test. The cutoff point for depression in the EPDS scores was ≥13, and the word span scores were evaluated as discrete variables. Results: The sample consisted of 395 individuals (222 women and 173 men). The prevalence of depression was 16.2% among mothers and 5.2% among fathers. Depressed individuals performed worse on the memory test. Limitations: The number of men evaluated was smaller than that of women. That''s a transversal study, so we have the prevalence bias. Conclusions: This study shows that postpartum depression affects both men and women, and the symptoms of depression affect the working and short-term memories of affected individuals. Given that this was a larger study than those in the literature, the results emphasize the importance of detecting and treating postpartum depression and helping affected families. [Copyright &y& Elsevier]

Abstract: Objective: To evaluate the prevalence of episodes of mania and hypomania, as well as associated factors and comorbidities among adults 18 to 24years old in the city of Pelotas, Brazil. Method: This is a cross-sectional population-based study. The sample was selected through conglomerates, and episodes of mania and hypomania were assessed using the Mini International Neuropsychiatric. Results: The sample consisted of 1560 subjects. The lifetime prevalence of manic and hypomanic episodes was 7.5% and 5.3%, respectively. Subjects with (hypo)manic episodes had a higher prevalence of anxiety disorders, substance abuse and suicidality. Limitation: The high rate of (hypo)mania may to some extent reflect diagnostic error. Conclusion: Such high prevalence of (hypo)mania may nonetheless be valid as it was associated with corresponding rates of comorbidity and suicidality. [Copyright &y& Elsevier]

• Individuals recently diagnosed with Bipolar Disorder (BD) demonstrate more subjective cognitive complains than individuals with major depressive disorder, both during euthymic states. • There are no differences in subjective cognitive complaints between subjects recently diagnosed with BD and subjects with MDD when both groups are in a current mood episode. • Subjective assessments with COBRA, an instrument specifically designed for cognition in BD, differ from findings with general subjective assessments from previous studies. To assess the differences in subjective cognitive dysfunction between major depressive disorder (MDD) and recently diagnosed Bipolar Disorder (BD) across euthymia and mood episodes. This is a cross-sectional study corresponding to the second wave of a longitudinal study. The first wave consisted of subjects aged between 18 and 60 diagnosed with MDD. In the follow up after three years (second wave), conversion from MDD to BD diagnosis was assessed by qualified psychologists using the Mini International Neuropsychiatric Interview (MINI-Plus). Subjects were categorized in four diagnostic groups: euthymic MDD, MDD in a current mood episode, euthymic BD, and BD in a current mood episode. All subjects completed the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), an instrument specifically designed for detecting subjective cognitive deficits in BD. The total sample (n = 468) included 410 subjects with MDD and 58 individuals recently diagnosed with BD. We subdivided the 2 groups based on their current mood state, and found a significant difference in COBRA total scores between euthymic BD individuals (median 17.00 [IQR: 8.75 - 20.75]) and euthymic MDD subjects (median 8.00 [IRQ: 5.00 - 14.00], p = 0.002), showing higher subjective cognitive dysfunction in individuals recently diagnosed with BD. The differences remained significant after adjusting for the presence of lifetime psychotic symptoms. We found no differences between MDD and BD during an acute mood episode. The small sample size of individuals with BD. The findings suggest a higher presence of subjective cognitive complaints among individuals recently diagnosed with BD in comparison to individuals with MDD during euthymia. [ABSTRACT FROM AUTHOR]