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OBJECTIVE: The aim of this study is to investigate the effects of pregabalin on the behavior of rats under the influence of ketamine, an NMDA receptor antagonist that mimics the symptoms of schizophrenia. METHODS: Rats were injected with saline or 25 mg/kg ketamine intraperitoneally. After that, behavior modifications were investigated by the evaluation of stereotypy and hyperlocomotion, after treating rats with pregabalin (at doses of 30 mg/kg or 100 mg/kg) or placebo (saline solution). RESULTS: The administration of pregabalin reduced ketamine-induced hyperlocomotion. However, neither doses of pregabalin had a significant effect on ketamineinduced stereotypy. CONCLUSION: This is the first study to investigate the effects of pregabalin using an animal model of psychosis. Furthermore, our results indicate that behavioral changes induced by ketamine in rats can be reversed with the use of pregabalin, suggesting its potential to treat psychotic symptoms. OBJETIVO: O presente estudo tem como objetivo investigar os efeitos da pregabalina sobre as alterações comportamentais em ratos induzidas pela cetamina, um antagonista do receptor glutamatérgico NMDA, utilizado em modelos animais de psicose. MÉTODOS:Ratos receberam injeção com solução salina ou cetamina, na dose de 25 mg/kg, com posterior avaliação das alterações comportamentais induzidas, através da avaliação da estereotipia e hiperlocomoção, depois destes ratos terem sido tratados com pregabalina (30 mg/kg ou 100 mg/kg) ou placebo. RESULTADOS:A administração de pregabalina reduziu a hiperlocomoção nos ratos sob o efeito da cetamina. No entanto, nenhuma das doses de pregabalina teve efeito significativo sobre a estereotipia induzida pela cetamina. CONCLUSÃO: Este é o primeiro estudo que investiga os efeitos da pregabalina em um modelo animal de psicose. Nossos resultados indicam que alterações comportamentais induzidas pela cetamina em ratos podem ser revertidas após uso da pregabalina, o que sugere um possível potencial desta no tratamento de sintomas psicóticos.

The objectives of the present study were to adapt the Liebowitz Social Anxiety Scale from the clinician administered to the self-report version (LSAS-SR) and to perform the initial psychometric studies concerning internal consistency and item analysis.The phase of adaptation was performed by two specialists in the Mental Health area and the face validity was tested by a group of 30 university students. As part of the psychometric study of the LSAS-SR, the internal consistency was assessed and the items were analyzed by applying the scale to 682 university students.The LSAS-SR proved to be easy to understand by the group studied, with no need to make any changes in the instructions for application. The scale showed adequate internal consistency (α = 0.96) as well as an acceptable correlation between items and total score (0.38-0.72).The initial psychometric studies of the LSAS-SR presented adequate indicators, stimulating the continuation of studies involving the validation and reliability of the scale not only when applied to a sample of the general population, but also when applied to clinical groups.

Objective: to determine the ability of the reduced form of a screening instrument, the Patient Health Questionnaire-2 (PHQ-2), to assess the presence of depressive disorders in patients admitted to a general hospital. Method: A sample of 227 patients admitted to the clinical wards of a Brazilian general university hospital were assessed with Module A of the Diagnostic Structured Interview for the DSM-IV (SCID-IV) and filled out the PHQ-9 and PHQ-2. Results: The PHQ-2 demonstrated an area under the ROC curve of 0.89 ( p < 0.0001), with a cutoff point of three or more being the one that best equilibrated the sensitivity (0.86) and specificity (0.75) values. The agreement index between the PHQ-2 and module A of SCID-IV was 78.4% and the Kappa value was 0.51. Regarding reliability, the Cronbach alpha value obtained was 0.64 and the intraclass correlation coefficient was 0.52. Conclusion: PHQ-2 proved to be an instrument with good psychometric properties comparable to those of PHQ-9, being superior to the latter regarding the rate of false-positive results. In addition, it is a brief instrument that elicits little resistance on the part of the patient, being inexpensive and requiring little time, thus being of important help to the treatment teams for the detection of depressive disorder, being suitable for incorporation into hospital admission protocols and thus possibly favoring more immediate interventions.

Objective The objective of this study was to assess the acute effect of intranasally administered oxytocin (OT) on subjective states, cardiovascular, and endocrine parameters in healthy volunteers who inhaled 7.5% CO2. Methods Forty-five subjects were allocated into three matched groups of subjects who received 24 international units (IU) of OT, 2 mg of lorazepam (LZP), or placebo (PL). The challenge consisted of medical air inhalation for 20 min, 10 min of rest, and CO2 7.5% inhalation for 20 min. Subjective effects were evaluated by self-assessment scales; heart rate, blood pressure, skin conductance, and salivary cortisol were also measured. Assessments were performed at four time points: (i) baseline (−15 min); (ii) post-air inhalation (90 min); (iii) post-CO2 inhalation (120 min), and (iv) post-test (160 min). Results CO2 inhalation significantly increased the anxiety score in the PL group compared with the post-air measurement but not in the OT or LZP groups. The LZP reduced anxiety after medical air inhalation. Other parameters evaluated were not affected by OT. Conclusion OT, as well as LZP, prevented CO2-induced anxiety, suggesting that this hormone has anxiolytic properties. Copyright © 2012 John Wiley & Sons, Ltd.

BACKGROUND: Anxiety disorders are often associated with several non-psychiatric medical conditions. Among the clinical conditions found in association with anxiety stands out the joint hypermobility (JH). OBJECTIVES: To carry out a systematic review of the clinical association between anxiety disorders and JH. METHOD: A survey was conducted in MEDLINE, PsychINFO, LILACS e SciELO databases up to December 2011. We searched for articles using the keywords 'anxiety', 'joint' and 'hypermobility' and Boolean operators. The review included articles describing empirical studies on the association between JH and anxiety. The reference lists of selected articles were systematically hand-searched for other publications relevant to the review. RESULTS: Seventeen articles were included in the analysis and classified to better extract data. We found heterogeneity between the studies relate to the methodology used. Most of the studies found an association between anxiety features and JH. Panic disorder/agoraphobia was the anxiety disorder associated with JH in several studies. Etiological explanation of the relationship between anxiety and JH is still controversial. CONCLUSION: Future research in large samples from the community and clinical setting and longitudinal studies of the association between anxiety and HA and the underlying biological mechanisms involved in this association are welcome. INTRODUÇÃO: Os transtornos de ansiedade estão frequentemente associados a vários quadros clínicos não psiquiátricos. Dentre os quadros clínicos associados à ansiedade destaca-se a hipermobilidade articular (HA). Objetivo: Realizar uma revisão sistemática da associação entre os transtornos de ansiedade e a HA. MÉTODO: Foi realizada uma pesquisa nos bancos de dados MEDLINE, PsychINFO, LILACS e SciELO em busca de artigos publicados até dezembro de 2011. Usamos as palavras-chave anxiety , joint e hypermobility e os operadores boolianos. A revisão incluiu artigos que descrevem estudos empíricos sobre a associação entre ansiedade e HA. As listas de referências dos artigos selecionados foram sistematicamente pesquisadas à mão em busca de publicações relevantes para a revisão. RESULTADOS: Dezessete artigos foram incluídos na análise e classificados para uma melhor extração dos dados. Encontramos heterogeneidade entre os estudos relacionada à metodologia utilizada. A maioria dos estudos encontrou associação entre as características de ansiedade e HA. Transtorno do pânico com agorafobia foi o transtorno de ansiedade associado à HA em vários estudos. A explicação etiológica da relação entre ansiedade e HA permanece controversa. CONCLUSÃO: Estudos futuros com amostras maiores de indivíduos da comunidade e de cenários clínicos e estudos longitudinais da associação entre ansiedade e HA e dos mecanismos biológicos subjacentes envolvidos nessa associação são bem-vindos.

Anxiety disorders are not a problem of our time: sev-eral literary reports and antiquity myths demonstrate that symptoms of what we name anxiety disorders nowadays were observed long ago. Maybe one of the oldest examples lies in Greek mythology – the god Pan. He was responsible for anxiety and was the origin of the term “panic”.

O falar em publico tem sido considerado um importante estressor psicossocial. Objetivou-se, comparar e caracterizar o repertorio de habilidades sociais apresentado por universitarios portadores de Transtorno de Ansiedade Social (TAS) e nao portadores frente a uma situacao experimental estruturada, o Teste de Simulacao de Falar em Publico (TSFP). Participaram 26 universitarios, sendo 13 com diagnostico de TAS (grupo caso de TAS) e 13 nao portadores de transtornos psiquiatricos (grupo nao-caso). Esses grupos nao apresentaram diferencas significativas para a maioria dos marcadores comportamentais de ansiedade. Um numero maior de sujeitos do grupo nao-caso foi avaliado como apresentando um nivel de habilidades sociais apropriadas para falar em publico, em comparacao ao grupo caso. Os grupos diferiram significativamente na maioria dos itens indicativos da habilidade de falar em publico do Inventario de Habilidades Sociais (IHS-Del-Prette). Considera-se que a avaliacao por meio do TSFP pode favorecer o planejamento de programas de treinamento em habilidades sociais.

PURPOSE: The study aims to conduct a psychometric study of the Fagerstrom Test for Nicotine Dependence (FTND) and to assess the prevalence, sociodemographic profile, and psychiatric comorbidities of smokers in a general hospital. DESIGN AND METHODS: Two hundred sixty-four inpatients were elegible for inclusion in the study and assessed with Structured Clinical Interview for the DSM-IV (Module E), Patient Health Questionnaire, Fast Alcohol Screening Test, and FTND. FINDINGS: The cut-off note two of the FTND is the most adequate to identify tobacco abuse/dependence (sensibility: 0.59–0.76). The reliability was estimated to be 0.68–0.96. A 44% rate of tobacco abuser/dependent patients was detected, with a 28% rate of psychiatric comorbidity. PRACTICE IMPLICATIONS: Detection of the smoking habits at the time of hospitalization can be opportune, favoring the planning and the beginning of treatment.

Objectives The aim of this pilot study was to investigate whether patients with social anxiety disorder (SAD) differ from controls in the quality of skill-related behaviors displayed during a speech and in overall behavioral adequacy as perceived by observers and by the patients themselves. Design A total of 18 SAD patients and 18 controls were screened by a diagnostic interview and took part in a 3-minute speech of their own choosing. For each videotaped speech, observers rated the adequacy of the skill-related behaviors and overall performance adequacy. After the experiment, participants were asked to rate their own overall performance adequacy. Results The results showed that SAD patients exhibited significantly worse voice intonation and fluency of the speech, however no differences were found in global self-ratings. Moreover, the performance evaluations of the SAD group were consistent with the observers, while the controls evaluated their performance lower than the observers. Conclusions The results are inconsistent with the cognitive model, because patients with SAD did not underestimate their performance. Compared with spontaneous interactions, the clear rules established for such social situations as speeches may result in less cognitive distortion for SAD patients.

Preliminary report of biological basis of sensitivity to the effects of cannabis on psychosis: AKT1 and DAT1 genotype modulates the effects of δ-9-tetrahydrocannabinol on midbrain and striatal function

Este estudo objetivou verificar as associações entre as manifestações clínicas e comportamentais do Transtorno de Ansiedade Social (TAS) e aferir a validade discriminativa do Inventário de Habilidades Sociais (IHS-Del-Prette) no diagnóstico deste transtorno. Participaram 1006 estudantes universitários, na faixa etária entre 17 e 35 anos, de ambos os gêneros. Posteriormente, 86 participantes foram randomicamente selecionados desta amostra inicial e agrupados como casos e não-casos de TAS por meio de avaliação clínica sistemática. Os resultados obtidos indicaram que quanto mais elaborado for o repertório de habilidades sociais de um indivíduo, menor será a sua probabilidade de satisfazer os critérios de rastreamento de indicadores diagnósticos para o TAS. Além disso, o IHS-Del-Prette demonstrou distinguir significativamente indivíduos com e sem TAS, evidenciando-se a sua validade discriminativa. This study aimed to assess the relationship between clinical and behavioral manifestations of the Social Anxiety Disorder (SAD) and verify the discriminative validity of the Social Skills Inventory (SSI-Del-Prette) in the diagnosis of this disorder. The participants were 1,006 undergraduates, aged between 17 and 35 years old, both genders. Subsequently, 86 participants were randomly selected from the initial sample and grouped as SAD cases and non-SAD cases through systematic clinical evaluation. The results indicated that the more elaborate the repertoire of social skills of an individual is, the lower his/her likelihood of meeting the screening criteria of diagnostic indicators for SAD. Furthermore, the SSI-Del-Prette has demonstrated to significantly distinguish individuals with and without SAD, evidencing, thus, its discriminative validity.

CONTEXTO: O falar em público é o medo mais prevalente na população geral e no Transtorno de Ansiedade Social (TAS). Assim sendo, estudos que dimensionem essa situação específica são necessários. OBJETIVOS: Validar a Self Statements during Public Speaking (SSPS) em amostra da população geral de estudantes universitários (PG - n = 2.314), casos (C - n = 88) e não casos de TAS (NC - n = 90) do Brasil. MÉTODOS: Conduziu-se o estudo em duas fases: a) preenchimento dos questionários autoaplicados em sala de aula; b) participação em entrevista telefônica e ao vivo. RESULTADOS: Evidenciaram-se correlações baixas/moderadas entre SSPS e Inventário de Fobia Social (PG = 0,22-0,65; C = 0,28-0,32; NC = 0,21-0,30), Inventário de Ansiedade de Beck (PG = 0,18-0,53; C = 0,25-0,33; NC = 0,22-0,25) e Escala Breve de Fobia Social (C = não significativa, NC = 0,23-0,31) nas diferentes amostras, especialmente para a PG. A análise fatorial apontou a presença de dois fatores, associados à autoavaliação positiva e negativa. O estudo da validade discriminativa evidenciou a capacidade da SSPS de discriminar os casos dos não casos de TAS. CONCLUSÃO: A SSPS é adequada para uso no contexto brasileiro, sendo que a subescala autoavaliação positiva parece ser mais efetiva para a avaliação de amostras identificadas ou suspeitas de TAS e a subescala autoavaliação negativa ter uma característica mais rastreadora quando aplicada em amostras da população geral. BACKGROUND: Fear of public speaking is the most prevalent fear in the general population and among persons with a social anxiety disorder (SAD). Nevertheless, studies about the assessment of this specific phenomenon are still needed. OBJECTIVES: To examine the validity of the Self Statements during Public Speaking (SSPS) scale in a general population of Brazilian university students (GP, n = 2314), in an SAD sample (n = 88), and in a non-SAD sample (n = 90). METHODS: The study was conducted in two phases: a) completing a self-administered questionnaire in the classroom, b) participating in a telephone and face-to-face interview. RESULTS: The SSPS showed low/median correlations with the Social Phobia Inventory (GP = 0.22-0.65; SAD = 0.28-0.32; non-SAD = 0.21-0.30), the Beck Anxiety Inventory (GP = 0.18-0.53; SAD = 0.25-0.33; non-SAD = 0.22-0.25), and the Brief Social Phobia Scale (SAD = not significant, non-SAD = 0.23-0.31) in all the samples, especially in the GP sample. Factorial analysis indicated the presence of two factors associated with positive and negative self-assessment. The study of discriminative validity demonstrated that the SSPS has the ability to differentiate between cases and non-cases of SAD. DISCUSSION: The SSPS is an adequate instrument to be used within the Brazilian context. The positive self-assessment subscale seems to be more effective for the evaluation of SAD samples. The negative self-assessment subscale appears to have a better screening characteristic in the general population of university students.

The objective of the present study was to evaluate the response of social anxiety disorder (SAD) patients to threat scenarios. First-choice responses to 12 scenarios describing conspecific threatening situations and mean scores of defensive direction and defensive intensity dimensions were compared between 87 SAD patients free of medication and 87 matched healthy controls (HC). A significant gender difference in the first-choice responses was identified for seven scenarios among HCs but only for two scenarios among SAD patients. A significantly higher proportion of SAD patients chose "freezing" in response to "Bush" and "Noise" scenarios, whereas the most frequent response by HCs to these scenarios was "check out". SAD males chose "run away" and "yell" more often than healthy men in response to the scenarios "Park" and "Elevator", respectively. There was a positive correlation between the severity of symptoms and both defensive direction and defensive intensity dimensions. Factorial analysis confirmed the gradient of defensive reactions derived from animal studies. SAD patients chose more urgent defensive responses to threat scenarios, seeming to perceive them as more dangerous than HCs and tending to move away from the source of threat. This is consistent with the hypothesis that the physiopathology of anxiety disorders involves brain structures responsible for defensive behaviors.

Social Anxiety Disorder (SAD) is more common among PD patients than in the general population. This association may be explained by psychosocial mechanisms but it is also possible that neurobiological mechanism underlying PD can predispose to SAD. The aim of this study was to investigate a possible dopaminergic mechanism involved in PD patients with SAD, by correlating striatal dopamine transporter binding potential (DAT-BP) with intensity of social anxiety symptoms in PD patients using SPECT with TRODAT-1 as the radiopharmaceutical. Eleven PD patients with generalized SAD and 21 PD patients without SAD were included in this study; groups were matched for age, gender, disease duration and disease severity. SAD diagnosis was determined according to DSM IV criteria assessed with SCID-I and social anxiety symptom severity with the Brief Social Phobia Scale (BSPS). Demographic and clinical data were also collected. DAT-BP was significantly correlated to scores on BSPS for right putamen (r = 0.37, p = 0.04), left putamen (r = 0.43, p = 0.02) and left caudate (r = 0.39, p = 0.03). No significant correlation was found for the right caudate (r = 0.23, p = 0.21). This finding may reinforce the hypothesis that dopaminergic dysfunction might be implicated in the pathogenesis of social anxiety in PD.

PURPOSE: To carry out a systematic review of the association between maternal and school-age children depression and covariate factors. DESIGN AND METHODS: The key words maternal depression, depressed children, and school-age key words were searched in Medline, Lilacs, Scielo, IndexPsi, and PsycInfo (2004–2010). Clinical and community cross-sectional and longitudinal studies were included. A qualitative checklist was used. FINDINGS: Thirty studies were included (21.926 dyads). The results supported the association, showing several modulators: family environment, marital adjustment, social support, depression symptoms, and children-related variables. Limitations were nonrandom samples, single informants, and nondepression diagnosis. PRACTICE IMPLICATIONS: Identifying mothers with depression may be useful for prevention and early detection of school-age children's depression.

Réus GZ, Stringari RB, Ribeiro KF, Luft T, Abelaira HM, Fries GR, Aguiar BW, Kapczinski F, Hallak JE, Zuardi AW, Crippa JA, Quevedo J. Administration of cannabidiol and imipramine induces antidepressant-like effects in the forced swimming test and increases brain-derived neurotrophic factor levels in the rat amygdala.Objective:Cannabidiol is a chemical constituent fromCannabis sativaand it has multiple mechanisms of action, including antidepressant effects. The main objective of the present study was to evaluate behavioural and molecular effects induced by administration of cannabidiol and imipramine in rats.Methods:In the present study, rats were acutely or chronically treated for 14 days once a day with saline, cannabidiol (15, 30 and 60 mg/kg) or imipramine (30 mg/kg) and the animals behaviour was assessed in forced swimming and open-field tests. Afterwards, the prefrontal cortex, hippocampus and amygdala brain-derived neurotrophic factor (BDNF) levels were assessed by enzyme-linked immunosorbent sandwich assay.Results:We observed that both acute and chronic treatments with imipramine at the dose of 30 mg/kg and cannabidiol at the dose of 30 mg/kg reduced immobility time and increased swimming time; climbing time was increased only with imipramine at the dose of 30 mg/kg, without affecting locomotor activity. In addition, chronic treatment with cannabidiol at the dose of 15 mg/kg and imipramine at the dose of 30 mg/kg increased BDNF levels in the rat amygdala.Conclusion:In conclusion, our results indicate that cannabidiol has an antidepressant-like profile and could be a new pharmacological target for the treatment of major depression.

Several pharmacological targets have been proposed as modulators of panic-like reactions. However, interest should be given to other potential therapeutic neurochemical agents. Recent attention has been given to the potential anxiolytic properties of cannabidiol, because of its complex actions on the endocannabinoid system together with its effects on other neurotransmitter systems. The aim of this study was to investigate the effects of cannabidiol on innate fear-related behaviors evoked by a prey vs predator paradigm. Male Swiss mice were submitted to habituation in an arena containing a burrow and subsequently pre-treated with intraperitoneal administrations of vehicle or cannabidiol. A constrictor snake was placed inside the arena, and defensive and non-defensive behaviors were recorded. Cannabidiol caused a clear anti-aversive effect, decreasing explosive escape and defensive immobility behaviors outside and inside the burrow. These results show that cannabidiol modulates defensive behaviors evoked by the presence of threatening stimuli, even in a potentially safe environment following a fear response, suggesting a panicolytic effect.

Depression is the most common psychiatric comorbidity in Parkinson's disease (PD), but is often under-diagnosed and under-recognized.To evaluate and compare the psychometric qualities of the Patient Health Questionnaire (PHQ-2) and the depression item of the Unified Parkinson's Disease Rating Scale (UPDRS).Cross-sectional study conducted at a movement disorders outpatient clinic. One hundred ten patients with a diagnosis of PD without dementia were evaluated. A neurologist administered the PHQ-2 and the UPDRS, and the diagnosis of major depression was performed using the structured clinical interview for DSM disorders - clinical version. Two self-rating scales (Zung Self-rating Depression Scale and 15-item Geriatric Depression Scale) were also used.The prevalence of current depression in the sample was 25.5% (n = 28). The scores of the PHQ-2 discriminated between subjects with and without depression, with an area under the receiver operating characteristic curve of 0.90. The sensitivity and specificity for a cut-off score of three were 75% and 89%, respectively. The values for the depression item of the UPDRS were slightly lower.The PHQ-2 is a valid tool for screening depression in PD.

A number of studies suggest a dysregulation of the endogenous cannabinoid system in schizophrenia (SCZ). In the present study, we examined cannabinoid CB1 receptor (CB1R) binding and mRNA expression in the dorsolateral prefrontal cortex (DLPFC) (Brodmann's area 46) of SCZ patients and controls, post-mortem. Receptor density was investigated using autoradiography with the CB1R ligand [3H] CP 55 940 and CB1R mRNA expression was measured using quantitative RT-PCR in a cohort of 16 patients with paranoid SCZ, 21 patients with non-paranoid SCZ and 37 controls matched for age, post-mortem interval and pH. All cases were obtained from the University of Sydney Tissue Resource Centre. Results were analyzed using one-way analysis of variance (ANOVA) and post hoc Bonferroni tests and with analysis of covariance (ANCOVA) to control for demographic factors that would potentially influence CB1R expression. There was a main effect of diagnosis on [3H] CP 55 940 binding quantified across all layers of the DLPFC (F(2,71)=3.740, p=0.029). Post hoc tests indicated that this main effect was due to patients with paranoid SCZ having 22% higher levels of CB1R binding compared with the control group. When ANCOVA was employed, this effect was strengthened (F(2,67)=6.048, p=0.004) with paranoid SCZ patients differing significantly from the control (p=0.004) and from the non-paranoid group (p=0.016). In contrast, no significant differences were observed in mRNA expression between the different disease subtypes and the control group. Our findings confirm the existence of a CB1R dysregulation in SCZ and underline the need for further investigation of the role of this receptor particularly in those diagnosed with paranoid SCZ.

Background Prevalence and clinical correlates of depersonalization symptoms have been associated with panic disorder. Personality traits might increase the likelihood of experiencing depersonalization symptoms or depersonalization disorder in panic patients. Aims The objectives of this study are to establish the prevalence of depersonalization symptoms during the panic attack and in depersonalization disorder and to examine the personality factors associated with the presence of depersonalization in patients with panic disorder. Methods The sample comprised 104 consecutive adult outpatients with panic disorder, diagnosed according to the Semistructured Clinical Interview for DSM-IV (Axis I/II disorders). Participants were assessed with the Cambridge Depersonalization Scales, the Temperament and Character Inventory, and the Panic and Agoraphobia Scale. Results Forty-eight percent of the sample had depersonalization symptoms during the panic attack, whereas 20% of patients had a depersonalization disorder. Women presented more depersonalization disorders than did men ( P = .036). Patients with panic disorder with depersonalization disorder had a more severe panic disorder ( P = .002). Logistic regression analysis showed that self-transcendence trait (odds ratio, 1.089; 95% confidence interval, 1.021-1.162; P = .010) and severity of panic (odds ratio, 1.056; 95% confidence interval, 1.005-1.110; P = .032) were independently associated with depersonalization disorder. Conclusions A high prevalence of depersonalization symptoms and depersonalization disorder was confirmed in patients with panic disorder, supporting a dosage effect model for understanding depersonalization pathology. Self-transcendence trait and severity of panic disorder were reported as risk factors for depersonalization disorder.

Oxytocin (OT) is known to be involved in anxiety, as well as cardiovascular and hormonal regulation. The objective of this study was to assess the acute effect of intranasally administered OT on subjective states, as well as cardiovascular and endocrine parameters, in healthy volunteers ( n = 14) performing a simulated public speaking test. OT or placebo was administered intranasally 50 min before the test. Assessments were made across time during the experimental session: (1) baseline (−30 min); (2) pre-test (−15 min); (3) anticipation of the speech (50 min); (4) during the speech (1:03 h), post-test time 1 (1:26 h), and post-test time 2 (1:46 h). Subjective states were evaluated by self-assessment scales. Cortisol serum and plasma adrenocorticotropic hormone (ACTH) were measured. Additionally, heart rate, blood pressure, skin conductance, and the number of spontaneous fluctuations in skin conductance were measured. Compared with placebo, OT reduced the Visual Analogue Mood Scale (VAMS) anxiety index during the pre-test phase only, while increasing sedation at the pre-test, anticipation, and speech phases. OT also lowered the skin conductance level at the pre-test, anticipation, speech, and post-test 2 phases. Other parameters evaluated were not significantly affected by OT. The present results show that OT reduces anticipatory anxiety, but does not affect public speaking fear, suggesting that this hormone has anxiolytic properties.

In social anxiety disorder (SAD), impairments in limbic/paralimbic structures are associated with emotional dysregulation and inhibition of the medial prefrontal cortex (MPFC). Little is known, however, about alterations in limbic and frontal regions associated with the integrated morphometric, functional, and structural architecture of SAD. Whether altered gray matter volume is associated with altered functional and structural connectivity in SAD. Three techniques were used with 18 SAD patients and 18 healthy controls: voxel-based morphometry; resting-state functional connectivity analysis; and diffusion tensor imaging tractography. SAD patients exhibited significantly decreased gray matter volumes in the right posterior inferior temporal gyrus (ITG) and right parahippocampal/hippocampal gyrus (PHG/HIP). Gray matter volumes in these two regions negatively correlated with the fear factor of the Liebowitz Social Anxiety Scale. In addition, we found increased functional connectivity in SAD patients between the right posterior ITG and the left inferior occipital gyrus, and between the right PHF/HIP and left middle temporal gyrus. SAD patients had increased right MPFC volume, along with enhanced structural connectivity in the genu of the corpus callosum. Reduced limbic/paralimbic volume, together with increased resting-state functional connectivity, suggests the existence of a compensatory mechanism in SAD. Increased MPFC volume, consonant with enhanced structural connectivity, suggests a long-time overgeneralization of structural connectivity and a role of this area in the mediation of clinical severity. Overall, our results may provide a valuable basis for future studies combining morphometric, functional and anatomical data in the search for a comprehensive understanding of the neural circuitry underlying SAD.

Although the effects of cannabis on perception are well documented, little is known about their neural basis or how these may contribute to the formation of psychotic symptoms. We used functional magnetic resonance imaging (fMRI) to assess the effects of Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) during visual and auditory processing in healthy volunteers. In total, 14 healthy volunteers were scanned on three occasions. Identical 10 mg THC, 600 mg CBD, and placebo capsules were allocated in a balanced double-blinded pseudo-randomized crossover design. Plasma levels of each substance, physiological parameters, and measures of psychopathology were taken at baseline and at regular intervals following ingestion of substances. Volunteers listened passively to words read and viewed a radial visual checkerboard in alternating blocks during fMRI scanning. Administration of THC was associated with increases in anxiety, intoxication, and positive psychotic symptoms, whereas CBD had no significant symptomatic effects. THC decreased activation relative to placebo in bilateral temporal cortices during auditory processing, and increased and decreased activation in different visual areas during visual processing. CBD was associated with activation in right temporal cortex during auditory processing, and when contrasted, THC and CBD had opposite effects in the right posterior superior temporal gyrus, the right-sided homolog to Wernicke's area. Moreover, the attenuation of activation in this area (maximum 61, -15, -2) by THC during auditory processing was correlated with its acute effect on psychotic symptoms. Single doses of THC and CBD differently modulate brain function in areas that process auditory and visual stimuli and relate to induced psychotic symptoms.

Background Interactions between glutamatergic and endocannabinoid systems may contribute to schizophrenia, dissociative states, and other psychiatric conditions. Cannabidiol (CBD), a cannabinoid-1/2 (CB1/2) receptor weak partial agonist or antagonist, may play a role in the treatment of schizophrenia. Objective This study tested the hypothesis that CBD would attenuate the behavioral effects of the NMDA receptor antagonist, ketamine, in healthy human subjects. Methods Ten male healthy volunteers were evaluated twice in a randomized order. In both sessions they received ketamine (bolus of 0.26 mg/kg/1 min followed by IV infusion of 0.25 mg/kg over 30 min) preceded by either CBD (600 mg) or placebo. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS) and the CADSS (Clinician Administered Dissociative States Scale) at regular intervals from 30 min before to 90 min after ketamine administration. Results CBD significantly augmented the activating effects of ketamine, as measured by the activation subscales of the BPRS. However, CBD also showed a non-significant trend to reduce ketamine-induced depersonalization, as measured by the CADSS. Conclusion These data describe a complex pattern of psychopharmacologic interactions between CBD and ketamine at the doses of each agent studied in this experiment.

CONTEXTO: O transtorno de ansiedade social (TAS), apesar da baixa taxa de detecção e do alto índice de comorbidades associadas, é considerado uma condição tratável. Apesar da resposta estabelecida a diversas classes de medicamentos, os algoritmos para o tratamento do TAS necessitam de atualização constante. OBJETIVO: Realizar revisão sistemática da literatura no que diz respeito à eficácia dos tratamentos farmacológicos relativos ao TAS, a partir de estudos controlados, conduzidos no período de 2005 a 2010. MÉTODO: Foram utilizados os indexadores eletrônicos PsycoInfo, Lilacs e Medline, utilizando-se as palavras-chave: "social phobia or social anxiety and treatment". RESULTADOS: De acordo com critérios de inclusão adotados, 29 artigos foram incluídos e analisados. Mostram-se eficazes para o tratamento do TAS as seguintes drogas, de acordo com a classe: a) ISRSs: escitalopram, fluvoxamina, citalopram, GR205171 e sertralina; b) ISRSN: venlafaxina; c) IMAOs: fenelzina, moclobemina; d) aminoácidos: d-cicloserina; f) anticonvulsivantes: tiagabina. CONCLUSÃO: Os ISRSs e os ISRSNs têm seu uso estabelecido e ainda continuam sendo considerados primeira opção de tratamento. Porém, destaca-se o potencial futuro da d-cicloserina e dos anticonvulsivantes, com necessidade de um número maior de estudos controlados que confirmem os achado iniciais. A ação das diferentes drogas em nível neurobiológico, bem como dos tratamentos associados, necessita ainda ser mais explorada.

Objective: To assess the discriminative capacity of the Kenny Music Performance Anxiety Inventory(K-MPAI), in its version adapted for Brazil, in a sample of 230 Brazilian adult musicians.Method: The Social Phobia Inventory (SPIN) was used to assess the presence of social anxietyindicators, adopting it as the gold standard. The Mann-Whitney U test and the receiver operatingcharacteristic (ROC) curve were used for statistical analysis, with p f 0.05 set as the significancelevel.Results: Subjects with social anxiety indicators exhibited higher mean total K-MPAI scores, as well ashigher individual scores on 62% of its items. The area under the ROC curve was 0.734 (p = 0.001),and considered appropriate. Within the possible cutoff scores presented, the score -15 had the bestbalance of sensitivity and specificity values. However, the score -7 had greater specificity andaccuracy.Conclusion: The K-MPAI showed appropriate discriminant validity, with a marked associationbetween music performance anxiety and social anxiety. The cutoff scores presented in the study haveboth clinical and research value, allowing screening for music performance anxiety and identificationof possible cases.Keywords: Anxiety; performance; music; scale; screening

What is known and objective Cannabidiol (CBD) is the main non-psychotropic component of the Cannabis sativa plant. REM sleep behaviour disorder (RBD) is a parasomnia characterized by the loss of muscle atonia during REM sleep associated with nightmares and active behaviour during dreaming. We have described the effects of CBD in RBD symptoms in patients with Parkinson's disease. Cases summary Four patients treated with CBD had prompt and substantial reduction in the frequency of RBD-related events without side effects. What is new and conclusion This case series indicates that CBD is able to control the symptoms of RBD.

OBJETIVO: Desenvolver uma nova escala voltada para a avaliação da motivação para fumar, incorporando questões do 68-item Wisconsin Inventory of Smoking Dependence Motives (WISDM-68, Inventário Wisconsin dos Motivos de Dependência ao Fumo, de 68 itens) na Modified Reasons for Smoking Scale (MRSS. Escala Razões para Fumar Modificada). MÉTODOS: Nove questões do WISDM-68 relativas à associação estreita, exposição a gatilhos/processos associativos e controle de peso foram incorporadas às 21 questões da MRSS. Um total de 311 fumantes (214 homens; idade média = 37,6 ± 10,8 anos; média de cigarros consumidos ao dia = 15,0 ± 9,2) responderam a nova escala, o Fagerström Test for Nicotine Dependence (FTND, Teste de Fagerström para Dependência de Nicotina) e outras questões. Empregamos a análise fatorial exploratória para determinar a estrutura fatorial da escala. A influência de algumas características clínicas nos escores da solução fatorial final foi também avaliada. RESULTADOS: A análise fatorial revelou uma solução com 21 questões agrupadas em nove fatores: dependência, prazer de fumar, redução da tensão, estimulação, automatismo, manuseio, tabagismo social, controle de peso e associação estreita. Para a escala como um todo, o coeficiente alfa de Cronbach foi de 0,83. As mulheres exibiram maiores escores para dependência, redução da tensão, manuseio, controle de peso e associação estreita do que os homens. Os escores do FTND correlacionaram-se positivamente com dependência, redução da tensão, estimulação, automatismo, tabagismo social e associação estreita. O número de cigarros fumados ao dia se associou com dependência, redução da tensão, estimulação, automatismo, associação estreita e manuseio. Os níveis de CO exalado mostraram associações positivas com dependência, automatismo e associação estreita. CONCLUSÕES: A nova escala fornece um quadro aceitável dos fatores motivacionais associados ao tabagismo, com confiabilidade e propriedades psicométricas satisfatórias. OBJECTIVE: To develop a new scale aimed at evaluating smoking motivation by incorporating questions and domains from the 68-item Wisconsin Inventory of Smoking Dependence Motives (WISDM-68) into the Modified Reasons for Smoking Scale (MRSS). METHODS: Nine WISDM-68 questions regarding affiliative attachment, cue exposure/associative processes, and weight control were added to the 21 questions of the MRSS. The new scale, together with the Fagerström Test for Nicotine Dependence (FTND), was administered to 311 smokers (214 males; mean age = 37.6 ± 10.8 years; mean number of cigarettes smoked per day = 15.0 ± 9.2), who also provided additional information. We used exploratory factor analysis in order to determine the factor structure of the scale. The influence that certain clinical features had on the scores of the final factor solution was also analyzed. RESULTS: The factor analysis revealed a 21-question solution grouped into nine factors: addiction, pleasure from smoking, tension reduction, stimulation, automatism, handling, social smoking, weight control, and affiliative attachment. For the overall scale, the Cronbach's alpha coefficient was 0.83. Females scored significantly higher for addiction, tension reduction, handling, weight control, and affiliative attachment than did males. The FTND score correlated positively with addiction, tension reduction, stimulation, automatism, social smoking, and affiliative attachment. The number of cigarettes smoked per day was associated with addiction, tension reduction, stimulation, automatism, affiliative attachment, and handling. The level of exhaled CO correlated positively with addiction, automatism, and affiliative attachment. CONCLUSIONS: The new scale provides an acceptable framework of motivational factors for smoking, with satisfactory psychometric properties and reliability.

Objective The aim of the study was to study the psychometric properties of the Social Phobia Inventory (SPIN) in its version for the context of Brazilian adults. Methods A sample of Brazilian university students from the general population (n = 2314) and a sample of university students identified as cases (n = 88) and noncases (n = 90) of social phobia were assessed, using as a parameter the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . The different instruments were applied individually in the presence of a rater. Results The SPIN showed adequate internal consistency (.63-.90) and concurrent validity with different instruments of auto- and hetero-evaluation of social phobia. Discriminative validity showed 0.84 to 0.86 sensitivity and 0.84 to 0.87 specificity for cutoff notes between 19 and 21. Factorial analysis showed the presence of a variable number of factors as a function of the different samples. Conclusions The version of the SPIN studied is quite adequate for use in the context of Brazilian university students, favoring the screening of social phobia. However, further studies using more diverse samples are needed.

A growing body of evidence has pointed to the β-carboline harmine as a potential therapeutic target for the treatment of major depression. The present study was aimed to evaluate behavioural and molecular effects of the chronic treatment with harmine and imipramine in rats. To this aim, rats were treated for 14 days once a day with harmine (5, 10 and 15 mg/kg) and imipramine (10, 20 and 30 mg/kg) and then subjected to the forced swimming and open-field tests. Harmine and imipramine, at all doses tested, reduced immobility time of rats compared with the saline group. Imipramine increased the swimming time at 20 and 30 mg/kg and harmine increased swimming time at all doses. The climbing time increased in rats treated with imipramine (10 and 30 mg/kg) and harmine (5 and 10 mg/kg), without affecting spontaneous locomotor activity. Brain-derived neurotrophic factor (BDNF) hippocampal levels were assessed in imipramine and harmine-treated rats by ELISA sandwich assay. Interestingly, chronic administration of harmine at the higher doses (10 and 15 mg/kg), but not imipramine, increased BDNF protein levels in rat hippocampus. Finally, these findings further support the hypothesis that harmine could bring about behavior and molecular effects, similar to antidepressants drugs.

PURPOSE. The purpose of this study was to further assess the psychometric qualities of the Mini-Social Phobia Inventory (MS) to screen for social anxiety disorder (SAD). DESIGN AND METHODS. The MS and other self- and clinician-rated scales for anxiety and social anxiety were applied in 2,314 university students and in samples of SAD patients (n = 88) and nonpatients (n = 90). FINDINGS. The MS revealed adequate discriminative validity, internal consistency (α= 0.49–0.73), convergent validity with the Social Phobia Inventory, Brief Social Phobia Scale, and Self-Statements During Public Speaking Scale and convergent and divergent validity with the Beck Anxiety Inventory. PRACTICE IMPLICATIONS. The MS has shown to be a fast and efficient screening instrument for SAD in different cultures and contexts.

O objetivo do presente estudo foi comparar pedidos de interconsulta psiquiátrica realizados para dois hospitais gerais universitários brasileiros e avaliar a aplicabilidade de um protocolo de registro de interconsulta psiquiátrica (PRISMe). Foi realizada análise dos pedidos de interconsulta, do PRISMe anexado a eles e o número total de pedidos de interconsulta incluídos na amostra foi 541 (438 pedidos de interconsulta do HCFMRP-USP e 103 pedidos de interconsulta do HU-UFSC). Observou-se maior freqüência de solicitação para pacientes do sexo feminino, caucasianos, entre 31 a 60 anos e casados. Os diagnósticos psiquiátricos mais freqüentes foram depressão, transtornos de adaptação e de personalidade. Os resultados estão de acordo com a literatura nacional e internacional e as diferenças encontradas podem ser atribuídas às diferenças na infra-estrutura das instituições e nos contextos sócio-econômicos nos quais estão inseridas. Achados do presente estudo demonstram a aplicabilidade do PRISMe e sugerem que podem facilitar a sistematização da obtenção de achados clínico-demográficos e a comparabilidade entre as diferenças. The objective of the present report was to compare consultative psychiatric services in two Brazilian university hospitals and to evaluate the applicability of a standardized protocol (PRISMe) for recording psychiatric liaison consultations. Analyses of psychiatric consultations and the attached protocol were performed. 541 consecutive liaison consultations were included in the final sample (438 consecutive consultations from the Federal university hospital in São Paulo and 103 from the Federal university hospital in Santa Catarina). In both hospitals, the majority of patients were female, married, white, and 31 to 60 years of age. Depression and adjustment and personality disorders were the most common psychiatric diagnoses, which could explain the higher referral of female patients. The results are consistent with the Brazilian and international literature, and the differences between the two hospitals could be related to both logistical differences between the consultative psychiatric services and the socioeconomic contexts. The findings confirm the applicability of the PRISMe and suggest that systematization of clinical and demographic information is important for future comparative studies.

Brain imaging techniques allow the in vivo evaluation of the human brain, leading to a better understanding of its anatomical, functional and metabolic substrate. The aim of this current report is to present a systematic and critical review of neuroimaging findings in Social Anxiety Disorder (SAD). A literature review was performed in the PubMed Medline, Scielo and Web of Science databases using the following keywords: 'MRI', 'functional', 'tomography', 'PET', 'SPECT', 'spectroscopy', 'relaxometry', 'tractography' and 'voxel' crossed one by one with the terms 'social anxiety' and 'social phobic', with no limit of time. We selected 196 articles and 48 of them were included in our review. Most of the included studies have explored the neural response to facial expressions of emotion, symptoms provocation paradigms, and disorder-related abnormalities in dopamine or serotonin neurotransmission. The most coherent finding among the brain imaging techniques reflects increased activity in limbic and paralimbic regions in SAD. The predominance of evidence implicating the amygdala strengthens the notion that it plays a crucial role in the pathophysiology of SAD. The observation of alterations in pre-frontal regions and the reduced activity observed in striatal and parietal areas show that much remains to be investigated within the complexity of SAD. Interesting, follow-up designed studies observed a decrease in perfusion in these same areas after either by pharmacological or psychological treatment. The medial prefrontal cortex provided additional support for a corticolimbic model of SAD pathophysiology, being a promising area to investigation. Furthermore, the dopaminergic and GABAergic hypotheses seem directed related to its physiopathology. The present review indicates that neuroimaging has contributed to a better understanding of the neurobiology of SAD. Although there were several methodological differences among the studies, the global results have often been consistent, reinforcing the evidence of a specific cerebral circuit involved in SAD, formed by limbic and cortical areas.

Background Laboratory rodents and human studies have demonstrated that cannabidiol (CBD) presents antipsychotic effects. Several mechanisms of action have been associated to CBD effects. Most of the studies that have investigated these mechanisms have been performed in vitro and their relevance for the in vivo effects of this drug is still uncertain. Methods In spite of its low affinity for CB1 receptor (CB1R), CBD is capable of antagonizing CB1R agonists at reasonable low concentrations. CBD can also inhibit anandamide uptake and metabolism, enhancing endocannabinoid tonus. It is also possible to attribute the antipsychotic action of CBD to an antagonism of CB1R. This suggestion was reinforced by the observation that patients in the initial prodromal states of psychosis and patients with schizophrenia had higher levels of anandamide in CSF than health controls. Moreover, there would be a decrease in glutamatergic inputs from this area to the prefrontal cortex, impairing locomotor activity and working memory and endocannabinoids could regulate this system. CBD could facilitate endocannabinoids “on demand” synthesis in post-synaptic neurons, acting pre-synaptic terminals and negatively regulating the release of neurotransmitters, particularly GABA and glutamate. Results Also, an increase in anandamide levels induced by CBD could attenuate GABA release from ventral pallidum neurons, restoring the normal function of this system in psychotic patients. CBD can also increase adult neurogenesis in mice and that this effect has been shown to be dependent on the CB1 receptors. In addition to the mechanisms discussed above, CBD can produce several other effects that could also be involved to be responsible for its antipsychotic properties, including interaction with 5HT1A and TRPV1 receptors and anti-inflammatory/neuroprotective effects. CBD can act as a serotonin 1A receptor (5HT1A) agonist, although the role of 5-HT1A-mediated neurotransmission in schizophrenia is unclear, aripiprazole, an atypical antipsychotic, acts as a partial agonist at this receptor, an effect that could, together with its actions on D2 and 5-HT2A receptors, contribute to therapeutic effects of this drug. CBD can also activate Transient Receptor Vanilloid-1 (TRPV1) receptors that are expressed in several brain areas related to psychosis such as the prefrontal cortex, amygdala and hippocampus. Since CBD is also a potent anti-inflammatory, antioxidant and neuroprotective compound, it is possible that these effects are involved in its antipsychotic action. Discussion Since CBD is also a potent anti-inflammatory, antioxidant and neuroprotective compound, it is possible that these effects are involved in its antipsychotic action.

Background Preclinical studies have suggested the involvement of the endocannabinoid system in schizophrenia pathobiology. The effects of cannabinoid drugs in several animal models for schizophrenia have been used to understand the pathobiology of the disease, and to investigate potential treatments for schizophrenia symptoms. Alterations in endocannabinoid (eCB) signaling, such as cannabinoid receptor expression and anandamide levels, have also been investigated in animal models. In addition, in vitro studies have shown the molecular pathways and biological processes associated with cannabinoids’ effects in some cell types, such as glial cell cultures. Glial cells, which express cannabinoid CB1 and CB2 receptors and synthesize eCBs, have been shown to be implicated in schizophrenia. Thus, the effects of cannabinoid drugs on these cells may contribute to our knowledge about the pathobiology of schizophrenia. Specifically, oligodendrocytes are associated with white matter deficits in schizophrenia. The modulation of their function, survival, and differentiation can result in new approaches to treat schizophrenia’s white matter-associated deficits. Here we have investigated the effects of cannabidiol (CBD) on a human oligodendrocyte culture (MO3.13) in terms of protein expression. Methods MO3.13 oligodendrocytes were treated with CBD (1µM) for 8h. Proteins were extracted from these cells, digested, and processed in a state-of-the-art LC-MS/MS system. Quantitative proteomics approaches were then employed in a label-free fashion. Differentially expressed proteins among the CBD treatment and controls were analyzed using systems biology in silico tools. Results Analyses identified that several proteins were up- or down-regulated in response to CBD treatment. These proteins were analyzed in terms of biological processes, pathways, and functions. CBD affected the expression of 136 proteins. Some proteins such as the transient receptor potential channel (TRPM7), microtubule-associated proteins (MAP2 and MAP4), Rho GTPase activating proteins (21 and 23), and calcium channel voltage-dependent T type alpha 1H (CACNA1H), among others possibly involved in schizophrenia pathobiology, were increased by CBD-treatment. Discussion Studies have shown the effects of CBD on the treatment of schizophrenia; but the mechanisms involved in its antipsychotic properties are not fully understood. Herein, we observed that CBD modulated the expression of proteins that can be implicated in schizophrenia pathobiology. For instance, MAPs functions are related to cytoskeleton organization, differentiation, and migration of oligodendrocytes. Studies have shown a decrease of MAPs in schizophrenia patients; thus, increasing MAP2 and MAP4 by CBD may be an interesting mechanism to treat and prevent cytoskeleton impairments in oligodendrocytes and neurons in schizophrenia. Moreover, CBD increased the voltage gated channel (CACNA1H) that is involved in cannabinoid retrograde signaling and glutamate and GABAergic neurotransmission. CACNA1H modulates Ca2+ levels and the synaptic vesicle cycle. To note, we also found effects of CBD on pathways and biological processes involved with schizophrenia pathobiology, such as glucose metabolism, axon guidance, and inflammation mediated by cytokine signaling. In summary, these proteomic findings may provide an integrated picture of the role of endocannabinoid signaling in oligodendrocyte cells and possible implications for schizophrenia’s pathobiology.

PurposeTo perform a psychometric analysis of the Brazilian version of the Brief Social Phobia Scale (BSPS).Materials and methodsHundred and seventy-eight university students of both genders aged on average 21.2 years and identified as Social Anxiety Disorder (SAD) cases and non-cases was studied, with the structured clinical interview for DSM-IV being used as a parameter. The different instruments were applied in an individual manner in the presence of a rater and of an observer.ResultsThe BSPS showed adequate internal consistency (0.48–0.88) and concurrent and divergent validity with the Beck Anxiety Inventory (BAI) (0.21–0.62), Social Phobia Inventory (0.24–0.82) and Self Statements During Public Speaking Scale (SSPS) (0.23–0.31). Discriminative validity revealed a sensitivity of 0.88–0.90 and a specificity of 0.81(0.83 for cut-off notes of 18/19. Factorial analysis demonstrated the presence of six factors that jointly explained 71.79% of data variance. Construct validity indicated some limits of the scale regarding the diagnosis of SAD. Inter-rater reliability was strong (0.86–1.00, p < 0.001).ConclusionsThe BSPS is adequate for use with university students, although further studies in different cultures, samples and contexts are still necessary.

Harmine is a beta-carboline alkaloid that inhibits monoamine reuptake systems. Findings point to an antidepressant effect of the compounds that increases the levels of monoamines after monoamine oxidase inhibition. The present study aims to compare the behavioral effects and the BDNF hippocampus levels of acute administration of harmine and imipramine in rats. To this aim, rats were acutely treated with harmine (5, 10 and 15 mg/kg) and imipramine (10, 20 and 30 mg/kg) and animal behavior was assessed in the forced swimming and open-field tests. Afterwards, hippocampal BDNF protein levels were assessed in imipramine- and harmine-treated rats by ELISA-sandwich assay. We observed that harmine at doses of 10 and 15 mg/kg, and imipramine at 20 and 30 mg/kg reduced immobility time, and increased both climbing and swimming time of rats compared to saline group, without affecting locomotor activity. Acute administration of harmine at the higher dose, but not imipramine, increased BDNF protein levels in the rat hippocampus. Finally, these findings further support the hypothesis that harmine could be a new pharmacological target for the treatment of mood disorders.

O Transtorno de Ansiedade Social (TAS) caracteriza-se por um medo persistente de situações sociais. Objetiva-se identificar na literatura indexada, estudos relativos à qualidade técnica de instrumentos psicométricos e experimentais sobre a avaliação dos pensamentos negativos e comportamentos de segurança associados ao TAS. Foram identificados 22 artigos, agrupados em dois conjuntos, considerando os procedimentos utilizados. No primeiro conjunto os estudos investigaram as qualidades psicométricas de instrumentos que avaliam cognições e TAS, sendo que destes, quatro abordaram versões já aferidas previamente e dois avaliaram instrumentos propostos especificamente para mensurar comportamento de segurança e pensamentos negativos. Os estudos do segundo conjunto investigaram, por meio de simulações de situações de desempenho verbal, aspectos cognitivos associados à ansiedade, destacando as variáveis auto-imagem negativa, pensamentos negativos e comportamentos de segurança associados ao aumento da ansiedade social. A análise dos estudos aponta que a identificação de comportamentos evitativos pode ser útil para a implementação de intervenções.Social anxiety disorder (SAD) is characterized by and intense and constant fear of social situations. The goal of this work is to identify, in indexed publications, psychometric and empirical studies on the evaluation of negative thoughts and safety behaviors associated with SAD. Twenty-two articles were located and grouped into two sets considering the type of procedure used. In the first set, studies investigated the psychometric properties of instruments that evaluate cognition and SAD, out of which four studies addressed instruments that had been previously evaluated, and two others evaluated instruments specifically proposed for measuring safety behavior and negative thoughts. The studies in the second set used simulations of verbal performance situations to investigate the cognitive aspects associated with anxiety. These studies confirmed the association of negative self-image, negative thoughts, and safety behaviors with social anxiety. The analysis of the studies reveals that identifying avoidance behaviors can be useful for implementing intervention procedures.

O Transtorno de Ansiedade Social (TAS) caracteriza-se por um medo persistente de situações sociais. Objetiva-se identificar na literatura indexada, estudos relativos à qualidade técnica de instrumentos psicométricos e experimentais sobre a avaliação dos pensamentos negativos e comportamentos de segurança associados ao TAS. Foram identificados 22 artigos, agrupados em dois conjuntos, considerando os procedimentos utilizados. No primeiro conjunto os estudos investigaram as qualidades psicométricas de instrumentos que avaliam cognições e TAS, sendo que destes, quatro abordaram versões já aferidas previamente e dois avaliaram instrumentos propostos especificamente para mensurar comportamento de segurança e pensamentos negativos. Os estudos do segundo conjunto investigaram, por meio de simulações de situações de desempenho verbal, aspectos cognitivos associados à ansiedade, destacando as variáveis auto-imagem negativa, pensamentos negativos e comportamentos de segurança associados ao aumento da ansiedade social. A análise dos estudos aponta que a identificação de comportamentos evitativos pode ser útil para a implementação de intervenções. Social anxiety disorder (SAD) is characterized by and intense and constant fear of social situations. The goal of this work is to identify, in indexed publications, psychometric and empirical studies on the evaluation of negative thoughts and safety behaviors associated with SAD. Twenty-two articles were located and grouped into two sets considering the type of procedure used. In the first set, studies investigated the psychometric properties of instruments that evaluate cognition and SAD, out of which four studies addressed instruments that had been previously evaluated, and two others evaluated instruments specifically proposed for measuring safety behavior and negative thoughts. The studies in the second set used simulations of verbal performance situations to investigate the cognitive aspects associated with anxiety. These studies confirmed the association of negative self-image, negative thoughts, and safety behaviors with social anxiety. The analysis of the studies reveals that identifying avoidance behaviors can be useful for implementing intervention procedures.

OBJECTIVE: Experimental evidence has suggested that drugs that enhance cannabinoid type-1 (CB1) receptor activity may induce anxiolytic and antidepressant effects, whilst the opposite has been reported with antagonists. Thus, the objective of the present review is to discuss the potential psychiatric side-effects of CB1 receptor antagonists, such as rimonabant, which has been recently marketed in several countries for the treatment of smoking cessation, obesity and associated metabolic disorders. METHOD: Literature searches were performed in PubMed and SciELO databases up to February 2009. The terms searched were "obesity", "rimonabant", "cannabinoids", "unwanted effects", "diabetes", "smoking cessation" and "side-effects". RESULTS: Clinical trials have revealed that rimonabant may promote weight loss in obese patients, although it may also induce symptoms of anxiety and depression. DISCUSSION: Patients taking CB1 receptor antagonists should be carefully investigated for psychiatric side-effects. These drugs should not be prescribed for those already suffering from mental disorders. Nevertheless, the development of new compounds targeting the endocannabinoid system for the treatment of several conditions would be necessary and opportune.

Introduction: Although anxiety is a common psychiatric complication of Parkinsons disease (PD), it has received little attention compared to depression in PD, being still an under-recognized and under-diagnosed condition in clinical practice. Objective: To review general aspects of the association between anxiety and PD concerning prevalence, etiopathogenesis, clinical characteristics, comorbidities, and treatment. Method: The basic and clinical literature on anxiety and PD was reviewed via the Pubmed, Lilacs and Scielo indexing services, using the keywords anxiety, etiology, prevalence, treatment, Parkinson, and Parkinsons disease. Moreover, complementary information was extracted from the reference lists of the articles found in the search. Results: Up to 67% of PD patients present clinically significant anxiety levels. Oscillations in anxious symptoms may be related to the use of anti-Parkinson drugs and motor fluctuations. The association between anxiety in PD and depressive disorders sleep disturbances, and cognitive impairment has also been proposed as a possible explanation for this psychiatric complication. Thus far, few data on the treatment of anxiety disorders in PD are available. Conclusions: More studies investigating aspects such as prevalence, etiopathogenesis, comorbidities, impact on life quality, and treatment are necessary and opportune in order to facilitate the recognition and diagnosis of anxiety disorders in PD.

CONTEXTO: A utilizacao dos comportamentos de seguranca acentua a falha no processamento cognitivo e tende a distorcer a avaliacao de experiencias interpessoais. OBJETIVO: Avaliar a fidedignidade e a validade da escala autoaplicavel Social Phobia Safety Behaviours Scale (ECSAS), visando a verificar a associacao do transtorno de ansiedade social (TAS) a processos cognitivos e a comportamentos de seguranca. METODO: Participou deste estudo uma amostra de 155 universitarios, de ambos os sexos, sem historia previa de tratamento psiquiatrico, distribuidos em dois grupos (80 casos de TAS e 75 nao casos), avaliados sistematicamente pelo Inventario de Fobia Social (SPIN) e pela Entrevista Clinica Estruturada para o DSM-IV (SCID-IV), como recurso de confirmacao diagnostica e exclusao de outros transtornos psiquiatricos. RESULTADOS: A ECSAS apresentou consistencia interna, medida pelo alfa de Cronbach, de 0,92, e, com base no metodo de teste e reteste, com um intervalo de duas semanas, atingiu niveis satisfatorios de estabilidade temporal, com Kappa ponderado de 0,73. Quanto a validade discriminante, apresentou valores de sensibilidade de 0,963 e de especificidade de 1. Na validade convergente apresentou correlacao (r) de 0,60. CONCLUSAO: A ECSAS apresentou boas caracteristicas psicometricas, contribuindo para a avaliacao sistematica dos padroes de comportamentos de seguranca e evitacao associados ao TAS.

This case report describes a patient with manic and psychotic symptoms who had a history of neurocysticercosis and presented with an episode of hypertensive hydrocephalus in 2003. Despite her history, she was initially treated for primary psychiatric disease.

CONTEXTO: A utilização dos comportamentos de segurança acentua a falha no processamento cognitivo e tende a distorcer a avaliação de experiências interpessoais. OBJETIVO: Avaliar a fidedignidade e a validade da escala autoaplicável Social Phobia Safety Behaviours Scale (ECSAS), visando a verificar a associação do transtorno de ansiedade social (TAS) a processos cognitivos e a comportamentos de segurança. MÉTODO: Participou deste estudo uma amostra de 155 universitários, de ambos os sexos, sem história prévia de tratamento psiquiátrico, distribuídos em dois grupos (80 casos de TAS e 75 não casos), avaliados sistematicamente pelo Inventário de Fobia Social (SPIN) e pela Entrevista Clínica Estruturada para o DSM-IV (SCID-IV), como recurso de confirmação diagnóstica e exclusão de outros transtornos psiquiátricos. RESULTADOS: A ECSAS apresentou consistência interna, medida pelo alfa de Cronbach, de 0,92, e, com base no método de teste e reteste, com um intervalo de duas semanas, atingiu níveis satisfatórios de estabilidade temporal, com Kappa ponderado de 0,73. Quanto à validade discriminante, apresentou valores de sensibilidade de 0,963 e de especificidade de 1. Na validade convergente apresentou correlação (r) de 0,60. CONCLUSÃO: A ECSAS apresentou boas características psicométricas, contribuindo para a avaliação sistemática dos padrões de comportamentos de segurança e evitação associados ao TAS.CONTEXT: The use of safety behaviours stresses the cognitive failure and tends to distort the evaluation of interpersonal experiences. OBJECTIVE: To assess the reliability of the self-administered Social Phobia Safety Behaviors Scale (ECSAS in the Portuguese acronym) in order to determine the association of social anxiety disorder (SAD) with processes related to safety behaviors. METHOD: A total of 155 university students of both genders with no previous history of psychiatric treatment, divided into two groups (80 cases and 75 non-cases of SAD), were systematically assessed using the Social Phobia Inventory (SPIN) and the Structured Clinical Interview for the DSM-IV (SCID-IV) for diagnostic confirmation and for the exclusion of other psychiatric disorders. RESULTS: The internal consistency of the ECSAS measured by the Cronbach alpha was 0.92, and, based on the test-retest method separated by a two-week interval, it reached satisfactory levels of temporal stability, with a weighted Kappa of 0.73. Regarding discriminant validity, the ECSAS had 0.963 sensitivity and 1 specificity. Regarding convergent validity, it presented a correlation (r) of 0.60. CONCLUSION: The ECSAS presented good psychometric indicators, contributing to a systematic assessment of the safety and avoidance behaviors associated with SAD.

Background This study examined the effect of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on brain activation during a motor inhibition task. Methods Functional magnetic resonance imaging and behavioural measures were recorded while 15 healthy volunteers performed a Go/No-Go task following administration of either THC or CBD or placebo in a double-blind, pseudo-randomized, placebo-controlled repeated measures within-subject design. Results Relative to placebo, THC attenuated activation in the right inferior frontal and the anterior cingulate gyrus. In contrast, CBD deactivated the left temporal cortex and insula. These effects were not related to changes in anxiety, intoxication, sedation, and psychotic symptoms. Conclusions These data suggest that THC attenuates the engagement of brain regions that mediate response inhibition. CBD modulated function in regions not usually implicated in response inhibition.

OBJECTIVE: The objective of the present study was to carry out the cross- cultural validation for Brazilian Portuguese of the Social Phobia Inventory, an instrument for the evaluation of fear, avoidance and physiological symptoms associated with social anxiety disorder. METHOD: The process of translation and adaptation involved four bilingual professionals, appreciation and approval of the back- translation by the authors of the original scale, a pilot study with 30 Brazilian university students, and appreciation by raters who confirmed the face validity of the Portuguese version, which was named " Inventário de Fobia Social" . As part of the psychometric study of the Social Phobia Inventory, analysis of the items and evaluation of the internal consistency of the instrument were performed in a study conducted on 2314 university students. RESULTS: The results demonstrated that item 11, related to the fear of public speaking, was the most frequently scored item. The correlation of the items with the total score was quite adequate, ranging from 0.44 to 0.71, as was the internal consistency, which ranged from 0.71 to 0.90. DISCUSSION/CONCLUSION: The authors conclude that the Brazilian Portuguese version of the Social Phobia Inventory proved to be adequate regarding the psychometric properties initially studied, with qualities quite close to those of the original study. Studies that will evaluate the remaining indicators of validity of the Social Phobia Inventory in clinical and non-clinical samples are considered to be opportune and necessary. OBJETIVO: O objetivo deste estudo foi realizar a validação transcultural para o português do Brasil do Social Phobia Inventory, um instrumento para avaliação e mensuração dos sintomas de medo, evitação e sintomas fisiológicos associados ao transtorno de ansiedade social. MÉTODO: O processo de tradução e adaptação envolveu quatro profissionais bilingües, apreciação e aprovação da back- translation pelos autores da escala original, estudo piloto com 30 universitários brasileiros e apreciação por juízes que atestaram a validade de face da versão para o português, a qual foi denominada de Inventário de Fobia Social. Como parte do estudo psicométrico do Social Phobia Inventory, realizou- se a análise dos itens e a avaliação da consistência interna numa amostra de 2.314 estudantes universitários. RESULTADOS: Os resultados evidenciaram que o item mais pontuado foi o 11, relativo ao medo de falar em público. A correlação dos itens com o escore total foi bastante adequada, variando entre 0,44 e 0,71, bem como a consistência interna, que variou entre 0,71 e 0,90. DISCUSSÃO/CONCLUSÕES: Concluiu- se que o Social Phobia Inventory na versão para o português do Brasil mostrou- se adequado quanto às propriedades psicométricas inicialmente estudadas, com qualidade bastante próxima à do estudo original. Considera- se oportuno e necessário estudos que avaliem os demais indicadores de validade do Social Phobia Inventory, com amostras clínicas e não-clínicas.

PURPOSE. This article evaluates the comparability of the telephone and in-person Structured Clinical Interview for DSM–IV (SCID) interviews in assessing patients with social anxiety disorder (SAD) as an independent anxiety diagnosis. DESIGN AND METHODS. One hundred subjects were randomly selected and interviewed with the SCID, once by telephone and once in person (1–3 months later). FINDINGS. The prevalence of SAD assessed with the telephone interviews was 56%, whereas the in-person prevalence was 52%, with no statistically significant difference. The test–retest kappa for the 200 interviews was .84, indication of excellent agreement. PRACTICE IMPLICATIONS. These findings, along with the existing evidence of their validity, should encourage the use of SCID by telephone for SAD diagnostic interviews.

Although abnormalities in brain structures involved in the neurobiology of fear and anxiety have been implicated in the pathophysiology of panic disorder (PD), relatively few studies have made use of voxel-based morphometry (VBM) magnetic resonance imaging (MRI) to determine structural brain abnormalities in PD. We have assessed gray matter volume in 19 PD patients and 20 healthy volunteers using VBM. Images were acquired using a 1.5 T MRI scanner, and were spatially normalized and segmented using optimized VBM. Statistical comparisons were performed using the general linear model. A relative increase in gray matter volume was found in the left insula of PD patients compared with controls. Additional structures showing differential increases were the left superior temporal gyrus, the midbrain, and the pons. A relative gray matter deficit was found in the right anterior cingulate cortex. The insula and anterior cingulate abnormalities may be relevant to the pathophysiology of PD, since these structures participate in the evaluation process that ascribes negative emotional meaning to potentially distressing cognitive and interoceptive sensory information. The abnormal brain stem structures may be involved in the generation of panic attacks.