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Na Estratégia Saúde da Família (ESF), o trabalho do Agente Comunitário de Saúde (ACS) é ponto inicial de ancoragem das ações em saúde voltadas à comunidade. Objetivo: compreender o entendimento dos ACS em relação à abordagem da temática das drogas no território em que atuam. Métodos: Estudo qualitativo, realizado com 6 ACS de uma Equipe de Unidade de ESF. Definiu-se a amostra por exaustão. Foram realizadas entrevistas, posteriormente transcritas e organizadas conforme o Discurso do Sujeito Coletivo. Resultados: Foram evidenciados entraves e equívocos no processo de trabalho dos ACS no manejo das demandas relacionadas ao uso de álcool e drogas. Conclusão: A percepção dos ACS sobre a temática do uso de drogas no cotidiano do serviço de saúde é cautelosa e restrita. Mesmo diante da identificação disto como um problema do território, suas intervenções ocorrem mediante manifestação voluntária do usuário, quando este busca o serviço de saúde.

Objective: To determine the diagnostic accuracy of the Addenbrooke’s Cognitive Examination Revised (ACE-R) as a cognitive screening tool for older adults with low levels of schooling and healthy aging, MCI and dementia in Brazil. Methods: All participants underwent neurological and psychiatric examinations and were administered a validated version of ACE-R. Results: A total of 85 participants were evaluated; most were females (84.7%, n = 72). The post hoc analysis showed statistical differences in ACE-R total scores between older adults with mild cognitive impairment (MCI) and controls (p < 0.001) and in subitem scores including verbal fluency, language, visuospatial skills and attention (p < 0.001). The visual-spatial skills subitem was the most strongly correlated with schooling level (r = 0.509, p < 0.001), whereas late, immediate recall and recognition memory were not influenced by schooling. The ACE-R had the best diagnostic accuracy in discriminating between MCI and controls = 0.69 (

Objectives To assess the prevalence of early trauma in individuals with onset of schizophrenia (SZ) at early (≤ 18 years) and adult (> 18 years) ages (EOP and AOP, respectively) and explore relationships between the onset of disease and clinical variables including traumatic events and psychotic and mood symptoms. Methods Subjects with SZ (n = 71) and EOP and AOP were compared for history of psychological trauma, sexual abuse, and physical punishment using the Early Trauma Inventory Self Report - Short Form (ETISR-SF). They were also compared for history of comorbidities and affective disorders using the Diagnostic Interview for Psychosis and Affective Disorders, the Positive and Negative Syndrome Scale, the Liebowitz Social Anxiety Scale, and the Calgary Depression Scale for Schizophrenia. Coefficients were calculated for correlations between scale results and disease duration. Results Early trauma was significantly associated with an early onset psychotic episode (r = -0.315, p < 0.01). General trauma and depressive symptoms in adulthood were also associated (r = 0.442, p < 0.01), as were social anxiety symptoms and early trauma (r = 0.319, p < 0.01). Total ETISR-SF scores and the physical abuse item were significantly higher in EOP than in AOP. In the hierarchical regression, PANSS scores were best predicted by a model including the duration of disease and age of first psychotic episode (R = 0.303). Conclusions Our results support the hypothesis that early trauma, including physical abuse, may play a relevant role in schizophrenia symptoms, such as an earlier psychotic occurrence, as well as features of other psychiatric disorders, such as greater severity of social anxiety and depression.

Objective: Decades of research have highlighted the involvement of the prefrontal cortex, anterior cingulated cortex, and limbic areas (amygdala) in panic disorder (PD). However, little attention has been given specifically to the inferior frontal gyrus. The current study aimed to investigate the neural substrates, including the inferior frontal gyrus, of both panic-related and negative conditions among individuals with PD and healthy controls. Methods: We examined 13 medication-free PD patients and 14 healthy controls with functional magnetic resonance imaging (fMRI) during exposure to negative and neutral pictures and a set of specific panic-related pictures. Results: Subtraction between the conditions indicated activation of the left amygdala region and the right inferior frontal gyrus in PD patients during the specific panic-related condition, whereas the left amygdalar region and left inferior frontal gyrus were activated during the negative condition in controls. Conclusion: These results suggest that in patients with PD, a prominent bottom-up process is involved in specific panic-related conditions, which might be associated with weak modulation of the left frontal area. These data add to our current understanding of the neural correlates of PD and can contribute to future clinical interventions targeting the functional reestablishment of these regions.

Background According to the diathesis-stress model, some individuals may have a certain underlying vulnerability (diathesis) that can be environmental or biological, such as a childhood trauma or a genetic predisposition. Hence, it is important to understand the epigenetic factors and the presence of biomarkers related to mental illness and suicide risk. Objective The present study aimed to evaluate if the presence of rs1800871 (IL- 10), rs2020933 (5-HTT) and rs1800629 (TNF – α) polymorphisms express different outcomes in terms of physical, psychological health and quality of life, considering the relations among them and the social environment, through observation of the psychological, physical, environment domains and the quality of social relations. Method A multivariate analysis (MANOVA) of the data was conducted, in which 481 participants were assessed through the instruments Quality of Life Brief Questionnaire (QOL – brief), Beck's Scale of Suicide Ideation (BSI) and the Mini International Neuropsychiatric Interview (MINI 5.5.0). The participants´ DNA was collected through a saliva sample of the oral mucosa. From the studied sample, 306 participants had mental disorder (MD) with no history of suicide attempt (HSA), 145 showed MD with HSA and 175 participants. Results A statistically significant difference (0.001 and 0.004) was found in the interaction of two factors, namely the social relationships domain and the presence of the IL- 10 polymorphism, leading to increased suicide risk and lower levels of quality of life in the physical domain. The interaction between the rs1800871 (IL-10) polymorphism and lower levels of quality of life in the environment and social environment domains appears to be related to a worse perception of physical health and a higher risk of suicide, which highlights the epigenetic influence for both physical and mental illness.

O Transtorno do Espectro Autista (TEA) é uma desordem do neurodesenvolvimento, caracterizada por déficits na comunicação social e presença de padrões de comportamento repetitivos. Como uma condição usualmente crônica, o TEA normalmente requer atenção de equipes interdisciplinares por afetar o desenvolvimento de forma global. Recentemente, o Ministério da Saúde publicou dois documentos que estabelecem a linha de cuidado e as diretrizes para sua reabilitação na rede pública de saúde brasileira. O presente artigo caracteriza e analisa a linha de cuidado proposta e as abordagens terapêuticas recomendadas. A análise permitiu verificar que os documentos reafirmam que pessoas com TEA são indivíduos com os mesmos direitos de pessoas com deficiência, seu cuidado deve ocorrer de maneira multidisciplinar pela Rede de Atenção Psicossocial, mas faltou clareza quanto aos critérios de escolha das abordagens terapêuticas e o local em que estas seriam oferecidas. Algumas implicações para o tratamento do TEA são discutidas.

Bipolar disorder is often comorbid with anxiety, which is itself associated with poorer clinical outcomes, including suicide. A better etiologic understanding of this comorbidity could inform diagnosis and treatment. The present study aims to test whether comorbid anxiety in bipolar disorder reflects shared genetic risk factors. We also sought to assess the contribution of genetic risk for anxiety to suicide attempts in bipolar disorder. Polygenic risk scores (PRS) were calculated from published genome-wide association studies of samples of controls and cases with anxiety (n = 83,566) or bipolar disorder (n = 51,710), then scored in independent target samples (total n = 3369) of individuals with bipolar disorder who reported or denied lifetime anxiety disorders or suicidal attempts in research interviews. Participants were recruited from clinical and nonclinical settings and genotyped for common genetic variants. The results show that polygenic risk for anxiety was associated with comorbid anxiety disorders and suicide attempts in bipolar disorder, while polygenic risk for bipolar disorder was not associated with any of these variables. Our findings point out that comorbid anxiety disorders in bipolar disorder reflect a dual burden of bipolar and anxiety-related genes; the latter may also contribute to suicide attempts. Clinical care that recognizes and addresses this dual burden may help improve outcomes in people living with comorbid bipolar and anxiety disorders.

IntroductionThere are more than 370 million indigenous people from 5000 cultures living in 90 countries worldwide. Although they make up 5% of the global population, they account for 15% of the extreme poor. Youth suicide is the second leading cause of mortality among 15–29 years old and disproportionately affects indigenous youth. This research protocol pertains to a systematic review of studies that use a comparator/control group to evaluate the effectiveness of suicide interventions targeting indigenous adolescents (aged 10–19 years).Methods and analysisWe will conduct a systematic search on MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO from inception to September 2019 to identify articles that compare mental health interventions for suicide prevention among indigenous adolescents. Two reviewers will independently determine the eligibility of each study. Studies will be assessed for methodological quality using the risk of bias tool to assess non-randomised studies of interventions. We will conduct a meta-analysis if possible and use established statistical methods to identify and control for heterogeneity where appropriate.Ethics and disseminationThis systematic review will use published data and does not require ethics approval. However, this review is in preparation of a feasibility study that will examine how best to support the physical and mental health of indigenous adolescents in Brazil. Ethics approval for the feasibility study was obtained from National Research Ethics Commission. Findings will be disseminated through a peer-reviewed publication and will be made available to key decision-makers with authority for indigenous health and other relevant stakeholders.PROSPERO registration numberCRD42019141754.

Years of accumulating research show high schizophrenia comorbidity with panic anxiety. Recent research has shown that auditory hallucinations have paroxysmal onset, concurrent with abrupt onset panic anxiety in patients with schizophrenia who hear voices. Fixed-dose adjunctive alprazolam or clonazepam (antipanic benzodiazepines) can substantially relieve positive and negative symptoms and panic in some schizophrenia cases. Clinical experience and limited research suggest a more uniform and pronounces benefit in patients with schizophrenia who also have panic premorbidly, concurrently, and/or with voices. Although more research is needed, there could be a distinct panic psychosis diagnosis. This is consistent with an evolutionary theory postulating five core psychoses. With appropriate medication and skilled psychotherapy, many can improve to their premorbid baseline and remain there for extended periods. Perhaps the major impediments to clinical improvement are the difficulty of diagnosing panic in psychosis, failure to use fixed dose and sufficient clonazepam, and limited use of skilled psychotherapy. [ Psychiatr Ann . 2018;48(12):561–565.]

The abnormal or excessive fat accumulation that impairs health is one of the criteria that fulfills obesity. According to epidemiological data, obesity has become a worldwide public health problem that in turn would trigger additional pathologies such as cardiorespiratory dysfunctions, cancer, gastrointestinal disturbances, depression, sleep disorders, just to mention a few. Then, the search for a therapeutical intervention aimed to prevent and manage obesity has been the focus of study during the last years. As one can assume, the increased prevalence of obesity has translated to search of efficient pharmaceuticals designed to manage this health issue. However, to further complicate the scenario, scientific literature has described that obesity is the result of interaction between multiple events. Therefore, pharmacological approaches have faced a serious challenge for develop the adequate treatment. Here, we argue that a wide range of non-pharmacological/invasive techniques can be used to manage obesity, such as diets, cognitive behavioral interventions, exercise and transcranial direct current stimulation. Combining these techniques may allow improving quality of life of obese patients.

O objetivo deste ensaio foi de apresentar as interseções entre a teoria de Paulo Freire e a Reforma Psiquiátrica brasileira, bem como sua aplicabilidade na estruturação de um trabalho clínico, que dê sustentabilidade aos preceitos desse movimento reformista. Fazemos ao longo do texto, um questionamento a respeito da operacionalização do cuidado em saúde, pautado na produção de liberdade, contraposto ao risco da execução de uma reforma superficial que não se diferencie subjetivamente da posição opressiva de segregação manicomial. Discutimos sobre a reorientação da atenção em saúde mental ancorada nos eixos da qualidade e humanização da assistência, bem como nas relações contratuais que se dão entre os trabalhadores e os usuários, adotando como referencial teórico, alguns aspectos práticos e conceituais da teoria Freireana.

The sleep–wake cycle is a process regulated by multiple neurobiological mechanisms that in aberrant functioning provokes several sleep disturbances. Among the major categories of sleep disorders, insomnia represents one of the most reported in population. Pharmacological interventions aimed for treating this sleep disturbance include compounds such as antidepressants, antihistamines, sedative-hypnotics, among others. However, using pharmacological treatments increase undesirable side effects such as addiction to sleep-inducing drugs. Here, we review and summarize recent publications available in PubMed regarding the use of non-pharmacological/invasive means to control insomnia, including physical exercise and transcranial direct current stimulation (tDCS). Current data suggest that these two strategies efficiently manage insomnia, and in turn opens new approaches to develop therapeutical tools to diminish this pathology. Nevertheless, additional research is required to understand the neurobiological mechanism of action of physical exercise and tDCS in insomnia control.

BACKGROUND Effect of Heteropterys aphrodisiaca (dog-node) on anxiety and function of adult female wistar mice. The project is an experiment with the use of H. aphrodisiac root extract, in order to observe the frequency of sexual exposure of females exposed to the extract, quantify the effect of the extract on the concentration of total testosterone and observe the anxiety levels of the animals exposed. Results will be measured with the laboratory testosterone test and LCE and CA tests. METHODS In preparation of the extract, the root was oven dried at 40°C and diluted in alcohol extract (100g of root for 1 liter of alcohol) and lyophilized. 40 adult female mice were enrolled, separated in control group (placebo) and treatment group (50 mg/kg/day) for 15, 30, 45 and 60 days. At each period, hormonal testosterone and anxiety levels by the Elevated-Cross Labyrinth (ECL) tests and Open Camp (CA) were measured in 10 animals that were later euthanized (SBNeC). RESULTS The results showed an improvement in the decrease of anxiety, as shown in the variables of number of open arm entries, time on the same side of the field, less avoidance and leakage. However, it appears that the time of exposure to the extract does not result in increased benefit, with possible decline of effect after 45 days of use. CONCLUSION With this performed experiment with the "no-de-cachorro" extract, it was possible to understand a little more how this root can act in relation to anxiety, as predicted by the pharmacology that validates the animal models; anxiolytic components decrease anxiety-related behaviors, as shown in the variables of entry numbers in the open arm, time on the same side of the field, less avoidance and escape. However, it seems that the time of exposure to the extract does not modify the performance in the tests, observing until an apparent exhaustion of the anxiolytic action, which evidences the need for more specific studies on the possible effects of the extract.

Background Oxytocin is a peptide hormone that influences the integration of social cognition with behavior and affect regulation. Oxytocin also prominently directs the transition of neuronal GABA neurotransmission from excitatory to inhibitory after birth. The oxytocin receptor (OXTR) is linked to schizophrenia, a heterogeneous syndrome. Relationships of OXTR polymorphisms with specific clinical features could aid in evaluating any role of oxytocin in the pathogenesis of schizophrenia. Method Schizophrenia cases with rare missense coding OXTR single nucleotide variants (SNVs) were identified from a well-characterized sample of cases and controls who were assessed for symptoms, cognition and early life trauma. Results Five of 48 cases showed rare OXTR variants. Compared to the other cases they had less severe negative symptoms (deficits in emotional expression and motivation) and less severe general psychopathology scores (depression and anxiety). They demonstrated lower nonverbal (performance) than verbal intelligence due to deficient perceptual organization and slow processing speed. They also reported greater early trauma exposure (physical and sexual abuse and emotional trauma). Conclusion Cases carrying rare OXTR SNVs had less negative and affective symptoms than other cases, but similar psychotic symptoms, along with specific cognitive deficits. The clinical characterization of these cases occurred in association with environmental exposure to early trauma, especially sexual abuse, which may have influenced the expression of schizophrenia in subjects harboring specific SNVs in the OXTR.

Modafinil (MOD) is a wakefulness-inducing compound prescribed for treatment of excessive daytime sleepiness as a consequence of sleep disturbances such as shift work sleep disorder, obstructive sleep apnea, restless leg syndrome, or narcolepsy. While providing effective results in patients with sleepiness, MOD also produces positive outcomes in the management of fatigue associated with different conditions including depression, cancer, or tiredness in military personnel. Although there is clear evidence of the stimulant effects of MOD, current data also show that administration of this drug apparently induces positive neurobiological effects, such as improvement in memory. However, serious concerns have been raised since some reports have suggested MOD dependence. Taken together, these findings highlight the need to characterize the changes induced by MOD which have been observed in several neurobiological functions. Moreover, further work should follow up on the likely long-term effects of this drug if used for treatment of drowsiness and tiredness. Here, we review and summarize recent findings of the medical uses of MOD in the management of sleepiness and fatigue associated with depression or cancer as well as exhaustion in military personnel. We also discuss the available literature related with the cognitive enhancing properties of this stimulant, as well as what is known and unknown about MOD addiction.

Science selected it as the 2015 Breakthrough of the Year: Clustered Regularly Interspaced Short Palindromic Repeats, also known as CRISPR. Adaptive immunity in some bacteria and archaea allow to respond and eliminate invading genetic material; CRISPR and CRISPR-associated (Cas) genes are new molecular techniques that allow deleting, replacing or otherwise editing DNA. Using modified bacterial protein and a RNA that allows a guidance to a specific DNA sequence, CRISPR provides a striking control over several genes by not deleting the entire gene but just inactivating it by deleting few bases. CRISPR/Cas9 has been used to generate knockout cells or animals by co-expressing a gRNA specific to the gene to be targeted and the endonuclease Cas9. This novel system has been tested in diverse species, with promising potential uses in humans. Theoretically, CRISPR/Cas9 will be able to remove genetic mutations related to incurable diseases, such as HIV, and certain cancer types. This scenario draws tentative and promising conditions using CRISPR/Cas9 as preventive and therapeutic tool in medical area. As expected, several groups have begun to test the putative gene editing properties of CRISPR/Cas9 on human cells. Since sleep disorders have been linked with specific genes, in this review, we suggest areas that require further investigation and experimental and/or clinical approaches to treat sleep disturbances using CRISPR/Cas9.

Objective To describe the implications of social inability as a factor that can contribute to sexual abuse in the marriage relationship of people with high-functioning autism spectrum disorder (ASD). Case description A 30-year-old male sought medical attention complaining of being “very nervous” and have difficulties in family relationships. He was diagnosed with high-functioning ASD based on the DSM-5. Married for over 4 years with a woman diagnosed with histrionic personality disorder (HPD), he asked for her to accompany him in the sessions and help him describe difficulties they had during sexual intercourse. His wife reported feeling raped in all of her sexual relations with the patient, especially when he could not understand that she did not want sex. Comments The case study leads us to believe that the social and communicative disability is a complicating factor that can contributes to the occurrence of sexual abuse in marital relationships with individuals with ASD. Social skills training, psychotherapy, and traditional medical therapies should be considered to minimize the risk of occurrence of cases of sexual abuse by individuals with high-functioning ASD against the spouses themselves.

Depression is a mental disorder that affects millions of people around the world. However, depressive symptoms can be seen in other psychiatric and medical conditions. Here, we investigate the effect of DHEA treatment on depressive symptoms in individuals with depression and/or other clinical conditions in which depressive symptoms are present. An electronic search was performed until October 2019, with no restrictions on language or year of publication in the following databases: Medline, EMBASE, LILACS, and Cochrane Library. Randomized controlled trials comparing DHEA versus placebo were included if the depressive symptoms were assessed. Fifteen studies with 853 female and male individuals were included in this review. To conduct the meta-analysis, data were extracted from 14 studies. In comparison with placebo, DHEA improved depressive symptoms (standardized mean difference [SMD] -0.28, 95% (CI) -0.45 to -0.11, p =.001, 12 studies, 742 individuals (375 in the experimental group and 367 in the placebo group), I2 = 24%), very low quality of evidence, 2 of 14 studies reporting this outcome were removed in a sensitivity analysis as they were strongly influencing heterogeneity between studies. No hormonal changes that indicated any risk to the participants' health were seen. Side effects observed were uncommon, mild, and transient, but commonly related to androgyny. In conclusion, DHEA was associated with a beneficial effect on depressive symptoms compared to placebo. However, these results should be viewed with caution, since the quality of evidence for this outcome was considered very low according to the GRADE criteria.

Aging is an inevitable process that involves changes across life in multiple neurochemical, neuroanatomical, hormonal systems, and many others. In addition, these biological modifications lead to an increase in age-related sickness such as cardiovascular diseases, osteoporosis, neurodegenerative disorders, and sleep disturbances, among others that affect activities of daily life. Demographic projections have demonstrated that aging will increase its worldwide rate in the coming years. The research on chronic diseases of the elderly is important to gain insights into this growing global burden. Novel therapeutic approaches aimed for treatment of age-related pathologies have included the endocannabinoid system as an effective tool since this biological system shows beneficial effects in preclinical models. However, and despite these advances, little has been addressed in the arena of the endocannabinoid system as an option for treating sleep disorders in aging since experimental evidence suggests that some elements of the endocannabinoid system modulate the sleep-wake cycle. This article addresses this less-studied field, focusing on the likely perspective of the implication of the endocannabinoid system in the regulation of sleep problems reported in the aged. We conclude that beneficial effects regarding the putative efficacy of the endocannabinoid system as therapeutic tools in aging is either inconclusive or still missing.

© Springer-Verlag GmbH Germany, part of Springer Nature 2020., Rationale: The nuclear receptor retinoid X receptor (RXR) belongs to a nuclear receptor superfamily that modulates diverse functions via homodimerization with itself or several other nuclear receptors, including PPARα. While the activation of PPARα by natural or synthetic agonists regulates the sleep-wake cycle, the role of RXR in the sleep modulation is unknown. Objectives: We investigated the effects of bexarotene (Bexa, a RXR agonist) or UVI 3003 (UVI, a RXR antagonist) on sleep, sleep homeostasis, levels of neurochemical related to sleep modulation, and c-Fos and NeuN expression. Methods: The sleep-wake cycle and sleep homeostasis were analyzed after application of Bexa or UVI. Moreover, we also evaluated whether Bexa or UVI could induce effects on dopamine, serotonin, norepinephrine epinephrine, adenosine, and acetylcholine contents, collected from either the nucleus accumbens or basal forebrain. In addition, c-Fos and NeuN expression in the hypothalamus was determined after Bexa or UVI treatments. Results: Systemic application of Bexa (1 mM, i.p.) attenuated slow-wave sleep and rapid eye movement sleep. In addition, Bexa increased the levels of dopamine, serotonin, norepinephrine epinephrine, adenosine, and acetylcholine sampled from either the nucleus accumbens or basal forebrain. Moreover, Bexa blocked the sleep rebound period after total sleep deprivation, increased in the hypothalamus the expression of c-Fos, and decreased NeuN activity. Remarkably, UVI 3003 (1 mM, i.p.) induced opposite effects in sleep, sleep homeostasis, neurochemicals levels, and c-Fos and NeuN activity. Conclusions: The administration of RXR agonist or antagonist significantly impaired the sleep-wake cycle and exerted effects on the levels of neurochemicals related to sleep modulation. Moreover, Bexa or UVI administration significantly affected c-Fos and NeuN expression in the hypothalamus. Our findings highlight the neurobiological role of RXR on sleep modulation., This work was supported by the Escuela de Medicina, Universidad Anáhuac Mayab (PresInvEMR2018), given to E. MR.

Purpose Demanding lifestyle characterized by extended working hours, shift work schedules as well as excessive use of mobile gadgets leads to the disruption of the circadian and homeostatic factors affecting the sleep quality of individuals. As consequence, subjects complain of suffering several sleep disorders some of them characterized by inducing excessive daytime sleepiness (EDS). Currently, the therapeutic approaches for managing EDS include medication, promotion of sleep hygiene, cognitive and behavioral therapy or using of continuous positive airway pressure machine. In this review, we propose the posology of the personalized sleep medicine by the prescription of naps for treating EDS. Methods This review included the online search in PubMed and manual review of articles (basic and clinical trials) of a range of personalized medicine potentially associated to factors of dosage in areas such as nutrition, sports and sleep. Articles in English were identified and subsequently analyzed for consideration for this review. Results Current evidence has demonstrated that naps exert positive outcomes for individuals complaining with EDS. The dosage of naps might follow similar procedures as reported for personalized interventions in diets or exercise programs (by taking the right dose, at the proper time, with a recommended frequency) which have demonstrated successfully results. Conclusions The management of EDS may include the personalized sleep medicine considering the prescription of dosage of naps., This work was supported by the Escuela de Medicina, Universidad Anáhuac Mayab under Grant PresInvEMR2019 given to E. M‑R.

A profissionalização da Psicologia, no Brasil, ocorreu em meio a embates entre diferentes profissionais envolvidos com suas aplicações, na primeira metade do século XX. Parte desses embates estava circunscrita às aplicações clínicas dos métodos e técnicas psicológicas, elementos que circulavam entre a Psicologia, a Psiquiatria e a Psicanálise. Nessa direção, esta pesquisa lança luz historiográfica a práticas e conhecimentos psicológicos que circularam nos Arquivos de Neuro-Psiquiatria, entre 1943 e 1962. Os resultados sugerem a presença de métodos e técnicas psicológicas para lidar com quadros clínicos variados, sendo prevalente a apropriação de teorias psicodinâmicas. Nota-se, portanto, apropriações clínicas da neuropsiquiatria que auxiliam em uma compreensão ampliada de embates científico-profissionais quando da regulamentação da formação e da profissão de psicólogo, no país. In Brazil, the professionalization of Psychology is a consequence of debates among different professions involved into its applications during the first half of the 20th century. Part of this debate was limited to the clinical applications of psychological methods and techniques; elements connected to Psychology, Psychiatry, and Psychoanalysis. In this regard, this study highlights psychological practices and knowledges in circulation in the “Arquivos de Neuro-Psiquiatria”, between 1943 and 1962. The results show the use of psychological methods and techniques to address different conditions, and a strong appropriation of psychodynamic theories. Clinical appropriations of Neuropsychiatry that helps to a better comprehension of the scientific and professional debates are noteworthy, connected to the institutionalization of the training and the profession of Psychologist, in the country. Au Brésil, la professionnalisation de la Psychologie s’est produite au milieu des conflits entre différents professionnels de la santé mentale au cours de la première moitié du XXème siècle. Une partie de ces conflits était limitée aux applications cliniques des méthodes et techniques psychologiques qui circulaient entre Psychologie, Psychiatrie et Psychanalyse. Ainsi, cette recherche met en évidence les pratiques et connaissances psychologiques qui ont circulé dans les «Arquivos de Neuro-Psiquiatria» (1943-1962). Les résultats suggèrent l’utilisation de méthodes et techniques psychologiques, principalement de théories psycho-dynamiques, pour traiter différents états cliniques. On remarque donc que des appropriations cliniques de neuropsychiatrie aident à comprendre les conflits scientifiques-professionnels de la réglementation de la profession de psychologue au Brésil. La profesionalización de la Psicología en Brasil se dio en la primera mitad del siglo XX, en medio de enfrentamientos entre diferentes profesionales involucrados con su aplicación. Parte de estos enfrentamientos se limitaba a las aplicaciones clínicas de los métodos y técnicas psicológicas, elementos que circulaban entre la Psicología, la Psiquiatría y el Psicoanálisis. Teniendo esto en cuenta, esta investigación ilumina historiográficamente las prácticas y los conocimientos psicológicos que circularon en los Archivos de Neuropsiquiatría, entre 1943 y 1962. Los resultados sugieren la presencia de métodos y técnicas psicológicas para manejar cuadros clínicos variados, prevaleciendo la apropiación de teorías psicodinámicas. Se observan, por lo tanto, apropiaciones clínicas de la neuropsiquiatría que ayudan para una comprensión ampliada de los enfrentamientos científico-profesionales en el momento de la reglamentación de la formación y la profesión de psicólogo en el país. Die Professionalisierung der brasilianischen Psychologie ist das Ergebnis von Debatten zwischen Vertretern unterschiedlicher Theorien, die in der ersten Hälfte des 20. Jahrhunderts stattfanden. Ein Teil dieser Debatten betraf die klinische Anwendung psychologischer Methoden und Techniken, sowie Aspekte der Psychologie, Psychiatrie und Psychoanalyse. Die vorliegende Studie beleuchtet die psychologischen Praktiken und das psychologische Wissen, welche zwischen 1943 und 1962 ihren Niederschlag in den „Arquivos de Neuro-Psiquiatria“ fanden. Die Ergebnisse unserer Untersuchung zeigen auf, dass der Einsatz dieser psychologischen Methoden und Techniken zum Ziel hatte, unterschiedliche klinische Krankheitsbilder zu behandeln, wobei psychodynamische Theorien eine bedeutende Rolle spielten. Die Tatsache der damaligen Hinwendung zur Neuropsychiatrie führt ebenfalls zu einem besseren Verständnis des wissenschaftlichen und professionellen Diskurses zur Institutionalisierung der Ausbildung und des Berufes des Psychologen in Brasilien.

Faced with the growing interest about the action of dehydroepiandrosterone (DHEA) and its benefits, as well as the negative impacts that sexual dysfunctions have on people's quality of life, this systematic review was undertaken with the objective of evaluating the effect of DHEA use on aspects of sexual function.An electronic search was conducted in the databases of PubMed, ISI Web of Science and Virtual Health Library (VHL) combining the terms 'DHEA treatment' and 'DHEA use' with terms such as 'sexual dysfunction', 'sexual frequency' and 'libido'. No limits on time and language were imposed. Clinical studies were considered eligible where individuals for any reason made use of DHEA and if they had any aspect of sexual function assessed. Preclinical studies and systematic reviews were considered ineligible.The search identified 183 references and 38 were considered eligible. DHEA improved aspects such as sexual interest, lubrication, pain, arousal, orgasm and sexual frequency. Its effect was better in populations with sexual dysfunction, especially in perimenopausal and postmenopausal women.Considering the studies currently published, DHEA is effective in improving several aspects of sexual function, but this effect did not reach all the populations studied.

The sleep–wake cycle is a neurobiological phenomenon that shows intervals of activity alternating with restfulness that appears with a periodicity approximating the 24-hour day-night cycle. The sleep–wake cycle is under the control of diverse neuroanatomical and neurochemical systems, including monoaminergic, cholinergic, adenosinergic among many other systems. In addition, neuroanatomical centers linked to sleep promotion, such as the hypothalamus, project to the cerebral cortex, subcortical relays, and brainstem. In addition, the sleep–wake cycle has been associated to aberrant features known as sleep disorders. Here, we will discuss the role of specific gene expression on sleep disturbances. Given the expansion of the knowledge in the sleep–wake cycle area, it is indeed ambitious to describe all the genetics involved in the sleep modulation. However, in this chapter we reviewed the current understanding of the sleep disorders and gene expression.