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Objectives: We assessed whether administering cannabidiol (CBD) before recalling the traumatic event that triggered their disorder attenuates anxiety in patients with post-traumatic stress disorder (PTSD). As an exploratory pilot analysis, we also investigated whether this effect depends on the nature of the event (sexual vs. nonsexual trauma). Methods: Thirty-three patients of both sexes with PTSD were recruited and randomized 1:1 into two groups. One group received oral CBD (300 mg), and the other received a placebo before listening to a digital audio playback of their previously recorded report of the trigger event. Subjective and physiological measurements were taken before and after recall. We analyzed the data in two subsamples: trigger events involving sexual and nonsexual trauma. Results: In the nonsexual trauma group, the differences between measurements before and after recall were significantly smaller with CBD than placebo; this held true for anxiety and cognitive impairment. However, in the sexual trauma group, the differences were non-significant for both measurements. Conclusion: A single dose of CBD (300mg) attenuated the increased anxiety and cognitive impairment induced by recalling a traumatic event in patients with PTSD when the event involved nonsexual trauma.

Objective: To investigate associations between the percentage and severity of mental disorders (MD) and three different primary health care (PHC) strategies in Brazil: traditional care (TC), the Family Health Strategy (FHS), and FHS with shared mental health care (FHS+SC). Methods: Random samples were selected from three different areas of a Brazilian city. Each area was served by a different PHC strategy (TC, FHS, or FHS+SC). Five mental health professionals, blinded to the type of PHC strategy delivered in each area, conducted interviews using the Mini International Neuropsychiatric Interview (MINI) and other specific instruments to assess the prevalence and severity of MD. Results: 530 subjects were interviewed. The TC strategy was significantly associated with a higher percentage of MD when compared to FHS and FHS+SC. These results were not affected by adjustment for sociodemographic variables. The difference in prevalence of MD between the two FHS areas (with and without SC) was not statistically significant. No significant differences in MD severity were observed across the three PHC strategies. Conclusion: Areas covered by FHS showed a lower percentage of MD than those covered by TC. Presence of SC did not influence the prevalence of MD, suggesting that mental-health training of FHS teams may have minimized the influence of SC.

Studies with cannabidiol (CBD) suggest that this compound has anxiolytic properties and may mediate the reconsolidation and extinction of aversive memories. The objective of this study was to test whether the administration of CBD 300 mg before the recall of traumatic events attenuated symptoms usually induced by recall in subjects diagnosed with posttraumatic stress disorder (PTSD) and if its potential effects interfere with the reconsolidation of aversive memories. The double-blind trial included 33 participants of both sexes, aged between 18 and 60 years, diagnosed with PTSD according to the SCID-5 and randomly allocated to two groups treated with CBD (n = 17) and placebo (n = 16). In the first experimental section, participants were matched by sex, age, body mass index (BMI), and PTSD symptoms as assessed with the Posttraumatic Stress Disorder Checklist (PCL-5). On the same day, participants prepared the behavior test, recording accounts of their traumas in digital audio for a minute and a half and then imagining the trauma for 30 s. After 7 days, participants received CBD (300 mg) or placebo and performed the behavioral test, listening to the trauma account and imagining themselves in that situation. Before and after the behavioral test, subjective changes in mood and anxiety were recorded (Visual and Analogical Mood Scale - VAMS and STAI-state), along with physiological correlates of anxiety blood pressure (BP), heart rate (HR), and salivary cortisol (SC). Seven days later, participants underwent the same procedures as the previous session, but without the pharmacological intervention, to assess the effect on reconsolidation of traumatic memories. We found that CBD significantly attenuated the increase in the VAMS scale cognitive impairment factor scores, under the CBD's effect, with this effect remaining 1 week after drug administration. No significant differences between the effects of CBD and placebo on anxiety, alertness, and discomfort induced by the recall of the traumatic event during the pharmacological intervention and in the subsequent week, in the absence of it. There were no significant differences between the CBD and placebo groups regarding physiological data (BP, HR, and SC). The attenuation of cognitive impairments during trauma recall under the effect of CBD may have interfered with the reconsolidation of traumatic memories concerning its association with cognitive impairments.

O canabidiol (CBD), composto da planta Cannabis sativa, tem sido investigado em estudos com animais e humanos. Esses estudos corroboram a hipótese do efeito ansiolítico deste composto, bem como de sua interferência na reconsolidação e extinção de memórias aversivas. O objetivo desse estudo foi avaliar se a administração de 300 mg de CBD, antes da rememoração do evento traumático, atenuaria os sintomas ansiosos produzidos por essa rememoração em pessoas diagnosticadas com transtorno de estresse pós-traumático (TEPT), assim como interferiria na reconsolidação dessa memória aversiva. Foram selecionados 33 participantes, de ambos os sexos, com idades entre 18 e 60 anos, que possuem o diagnóstico de TEPT, de acordo com a Structured Clinical Interview for DSM-5 (SCID-V). Todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido (TCLE). Adotou-se um protocolo experimental administrado uma vez por semana por um período de três semanas. No dia 1, foram aplicadas as escalas Inventário de Ansiedade Traço Estado - Traço (IDATE-T), Posttraumatic Stress Disorder Checklist (PCL-5) e calculado o índice de massa corpórea (IMC). Ainda nesse dia, foi realizada a prova comportamental, a qual consistiu na gravação em áudio digital, por 90 segundos, do relato do trauma. Após a gravação, os sujeitos imaginaram o trauma por 30 segundos. Antes e após a realização da prova comportamental, foram aferidas as alterações subjetivas de humor e ansiedade (Escala Analógica e Visual do Humor-VAMS e IDATE-estado) e os correlatos fisiológicos da ansiedade: pressão arterial (PA), frequência cardíaca (FC) e cortisol salivar (CS). No dia 2, 7 dias após dia 1, os participantes foram randomizados em dois grupos, em um procedimento duplo-cego, e receberam CBD (300mg) ou Placebo. A randomização foi feita de acordo com sexo, idade, IMC e escore da PCL-5. Após 2 horas e 30 minutos da intervenção farmacológica, os participantes foram novamente submetidos à prova comportamental. Antes e após a realização da prova comportamental foram aferidas as alterações de humor, a ansiedade e seus correlatos fisiológicos. No dia 3, 7 dias após dia 2, os participantes foram submetidos ao mesmo procedimento do Dia 2 porém sem a intervenção farmacológica, para avaliar o efeito sobre a reconsolidação da memória traumática. A amostra foi predominantemente feminina, com média de idade de 32 anos, escore na PCL-5 variando entre 52 e 54 pontos. Em ambos os grupos, o trauma predominante foi o sexual, constituindo em torno da metade dos participantes. A ANOVA de medidas repetidas (ANOVAmr) não mostrou diferença significativa entre o grupo CBD e Placebo em relação ao aumento de ansiedade induzido pela rememoração do evento traumático, durante a intervenção farmacológica ou na semana posterior, na ausência da mesma. Todavia, no subgrupo de participantes, cujo trauma foi não sexual, observou-se uma atenuação significativa no aumento dos escores do fator ansiedade da escala VAMS, sob o efeito do CBD em relação ao placebo. O CBD foi capaz de atenuar os escores do fator prejuízos cognitivos da escala VAMS, sob o efeito da droga, permanecendo esse efeito uma semana após a administração da droga. Não houve diferença significativa entre os grupos CBD e Placebo com relação aos dados fisiológicos (PA, FC e CS) para os três dias de testes. O presente estudo demonstrou um papel pioneiro do CBD em atenuar os prejuízos cognitivos induzidos pela rememoração do trauma através de um possível mecanismo pelo qual o CBD mediaria a reconsolidação da memória traumática. Cannabidiol (CBD), a major component of the Cannabis sativa plant, has been investigated in animal and human studies. These studies corroborate hypotheses of the anxiolytic effect of CBD, as well as its association with the reconsolidation and extinction of aversive memories. The objective of the present study was to evaluate whether the administration of 300 mg of CBD before the recall of a traumatic event would attenuate anxiety symptoms induced by this recall, as well as associate with the reconsolidation of this aversive memory in people diagnosed with Post-Traumatic Stress Disorder (PTSD). A total of 33 participants of both sexes, aged between 18 and 60 years old, who met a PTSD diagnosis according to The Structured Clinical Interview for DSM-5 (SCID-5) were selected for the present study and signed the informed consent form. An experimental protocol administered once weekly for three weeks, was adopted. On day 1, participants completed the State-Trait Anxiety Inventory (STAI-T), Posttraumatic Stress Disorder Checklist (PCL-5), and had their body mass index (BMI) calculated. In addition, changes in subjective mood and anxiety indicators (Analog and Visual Mood Scale-VAMS and STAI-state), as well as in physiological correlates of anxiety (blood pressure [BP], heart rate [HR], and salivary cortisol [SC]) were assessed before and after the conduction of the following two-step behavioral test. First, participants\' reports of the trauma were recorded in digital audio for 90 seconds. After the audio was recorded, participants were asked to imagine the traumatic event for 30 seconds. On day 2, 7 days after day 1, participants were randomized into two groups (300 mg of CBD vs. placebo) using a double-blind procedure. Randomization was stratified by sex, age, BMI, and PCL-5 score. Two hours and 30 minutes after the pharmacological intervention, participants completed the same 2-step behavioral test that was administered on day one, and their changes in subjective mood and anxiety indicators, as well as in their physiological correlates were assessed before and after the behavioral test. On day 3, 7 days after day 2, participants underwent the same procedure as the one performed on day 2 but without pharmacological intervention in order to assess possible effects of CBD on the reconsolidation of the traumatic memory. Most participants were female, with a mean age of 32 years, and a PCL-5 score ranging from 52 to 54 points. In both groups, the predominant type of trauma was sexual, which comprised nearly half of the participants. Repeated measures ANOVA did not show significant differences between the CBD and placebo groups in relation to changes in anxiety induced by the recall of the traumatic event during the pharmacological intervention or in the subsequent week. However, in subgroup analyses for participants whose trauma was non-sexual, participants assigned to the CBD group demonstrated significant attenuation in the increase in VAMS anxiety factor scores when compared to participants assigned to placebo therapy. CBD was associated with reduced cognitive impairment (per VAMS scale) compared to placebo, with this effect remaining one week after the drug was administered. With regard to physiological measures (i.e., BP, HR, and SC), no significant differences were identified between the CBD and placebo groups on any of the three test days. Our study identifies a novel role for CBD in attenuating the cognitive impairment induced by the recall of trauma through a proposed mechanism whereby CBD mediates the traumatic memory reconsolidation.

This systematic review and meta-analysis examines whether physician depressive symptoms are associated with the risk for perceived or observed medical errors., Key Points Question What are the magnitude and direction of associations between physician depressive symptoms and medical errors? Findings In this systematic review and meta-analysis of 11 studies involving 21 517 physicians, physicians with a positive screening for depression were highly likely to report medical errors. Examination of longitudinal studies demonstrated that the association between physician depressive symptoms and medical errors is bidirectional. Meaning This study found that physician depressive symptoms were associated with medical errors, highlighting the relevance of physician well-being to health care quality and underscoring the need for systematic efforts to prevent or reduce depressive symptoms among physicians., Importance Depression is highly prevalent among physicians and has been associated with increased risk of medical errors. However, questions regarding the magnitude and temporal direction of these associations remain open in recent literature. Objective To provide summary relative risk (RR) estimates for the associations between physician depressive symptoms and medical errors. Data Sources A systematic search of Embase, ERIC, PubMed, PsycINFO, Scopus, and Web of Science was performed from database inception to December 31, 2018. Study Selection Peer-reviewed empirical studies that reported on a valid measure of physician depressive symptoms associated with perceived or observed medical errors were included. No language restrictions were applied. Data Extraction and Synthesis Study characteristics and RR estimates were extracted from each article. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using subgroup meta-analysis and metaregression. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. Main Outcomes and Measures Relative risk estimates for the associations between physician depressive symptoms and medical errors. Results In total, 11 studies involving 21 517 physicians were included. Data were extracted from 7 longitudinal studies (64%; with 5595 individuals) and 4 cross-sectional studies (36%; with 15 922 individuals). The overall RR for medical errors among physicians with a positive screening for depression was 1.95 (95% CI, 1.63-2.33), with high heterogeneity across the studies (χ2 = 49.91; P

Reconsolidation is the return of a memory to a transient state of lability, following memory consolidation, that can occur when memories are evoked. During the process of reconsolidation, memories may be modified by different means, including the administration of drugs, during a period called the ''reconsolidation window”. This process has been widely studied in animals, but human studies are limited and include several methodological pitfalls. Our objective was to conducte a systematic review of the literature that utilizes pharmacological interventions during the process of reconsolidation of aversive memories in humans, with a critical analysis of the methodologies used. Searches were made in the electronic databases PubMed, Scopus, Web of Science and SciELO using the following search terms: (memory) AND (consolidation OR reconsolidation) AND (pharmacological manipulation OR pharmacological intervention). We found 294 references and ten (3.4%) were included in the review, based on preestablished eligibility criteria. All studies were randomized, double-blind clinical trials. The most commonly studied drug was propranolol. Two studies used a protocol involving autobiographical aversive memories, while in the remaining aversive memories were produced in the laboratory. The timing of pharmacological interventions is a controversial issue in the field, as drug activity must occur within the reconsolidation window. The small number of studies and some methodological difficulties of this type of research highlights the need for studies that individually evaluate some of the issues discussed, particularly the timing of pharmacological interventions and the duration of reconsolidation windows.

AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders.BackgroundMillions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment.MethodsRandom sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model.FindingsA total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status.Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders.

Introduction Previous studies have shown attenuated cortisol awakening response in patients with posttraumatic stress disorder (PTSD). Case presentation A 15-year-old girl, a survivor of acute sexual violence, received a 7-day oral treatment with cannabidiol. She was followed-up from the first 24 hours after the event for 6 months, for assessment of the effects of this treatment on the reconsolidation of memories related to the traumatic event. Discussion Cannabidiol treatment did not prevent the onset of PTSD. Cortisol awakening responses after the onset of the disorder were attenuated compared with those observed in the same individual before the onset of PTSD, in line with previous evidence from studies comparing groups with and without PTSD.

Aim The Structured Clinical Interview for the DSM is one of the most used diagnostic instruments in clinical research worldwide. The current Clinician Version of the instrument (SCID-5-CV) has not yet been assessed in respect to its psychometric qualities. We aimed to assess the clinical validity and different reliability indicators (interrater test-retest, joint interview, face-to-face vs telephone application) of the SCID-5-CV in a large sample of 180 non-prototypical and psychiatric patients based on interviews conducted by raters with different levels of clinical experience. Methods The SCID-5-CV was administered face-to-face and by telephone by 12 psychiatrists/psychologists who took turns as raters and observers. Clinical diagnoses were established according to DSM-5 criteria and the longitudinal, expert, all data (LEAD) procedure. We calculated the percentage of agreement, diagnostic sensitivity and specificity, and the level of agreement (kappa) for diagnostic categories and specific diagnoses. Results The percentage of positive agreement between the interview and clinical diagnoses ranged between 73% and 97% and the diagnostic sensitivity/specificity were >0.70. In the joint interview, the levels of positive agreement were high (>75%) and kappa levels were >0.70 for most diagnoses. The values were less expressive, but still adequate, for interrater test-retest interviews. Conclusion The SCID-5-CV presented excellent reliability and high specificity as assessed with different methods. The clinical validity of the instrument was also confirmed, which supports its use in daily clinical practice. We highlight the adequacy of the instrument to be used via telephone and the need for careful use by professionals with little experience in psychiatric clinical practice.

Objective: To evaluate whether a short compilation of screening tools for specific disorders could identify Mental or Emotional Disorders (MEDs) in the general population. Methods: We selected validated screening tools for the most prevalent MEDs. In order to be selected, these tools should maintain the psychometric properties of the complete instrument with a reduced number of items. These instruments were: Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale-2 (GAD-2), item 3 of the Alcohol Use Disorders Identification Test (AUDIT), and three items on the Adolescent Psychotic-Like Symptom Screener (APSS-3). We called this compilation of screening tools Mini Screening for Mental Disorders (Mini-SMD). The study was divided in two phases. Firstly, 545 subjects were interviewed with the Mini-SMD and COOP/WONCA-Feelings at their residences. Subsequently, subjects who had agreed to participate (230) were reinterviewed with Mini-SMD, COOP/WONCA-Feelings and MINI interview. Test-retest reliability was calculated by Intraclass Correlation Coefficient (ICC). Receiver operating characteristic (ROC) curves were generated for the analysis of discriminative validity. Concurrent validity was calculated by analyzing the correlation between Mini-SMD and COOP/WONCA-Feelings. Results: The joint administration of screening tools for specific disorders showed sensitivities that ranged from 0.76 to 0.88 and specificities from 0.67 to 0.85. The ICC value for the total score of Mini-SMD was 0.78. The area under the curve was 0.84, with a sensitivity of 0.74 and specificity of 0.76 (for a cutoff ≥ 4). Conclusion: This study showed that a short compilation of screening tools for specific disorders can detect MEDs in general population. Objetivo: Evaluar si un breve compilado de herramientas de detección para trastornos mentales específicos puede detectar los trastornos mentales y emocionales en la población general. Método: Herramientas de detección validadas para los trastornos emocionales y mentales más frecuentes han sido seleccionadas. Como criterios de selección, estas herramientas deberían mantener las propiedades psicométricas del instrumento completo con sólo uno o pocos elementos. Las herramientas seleccionadas fueron: el Patient Health Questionnaire-2 (PHQ-2), el Generalized Anxiety Disorder Scale-2 (GAD-2), el elemento 3 del Alcohol Use Disorders Identification Test (AUDIT) y tres elementos del Adolescent Psychotic-Like Symptom Screener (APSS-3). Este compilado de herramientas de detección ha sido denominado el Mini Detección para Trastornos Mentales (Mini-DTM). El estudio se dividió en dos etapas. En la primera etapa, 545 sujetos fueron entrevistados en sus residencias con la herramienta de detección Mini-DTM y COOP/WONCA-Sentimientos. En la segunda etapa, a los sujetos que aceptaron participar (230) se entrevistaron con el Mini-DTM, COOP/WONCA-Sentimientos y la entrevista diagnóstica MINI. La fiabilidad evaluar/revaluar fue calculada mediante el Coeficiente de Correlación Intraclase (ICC). La Curva ROC (Receiver Operating Characteristic) fue generada para el análisis de la validez discriminante. La validez concurrente se calculó mediante el análisis de la correlación entre el Mini-DTM y el COOP/WONCA-Sentimientos. Resultados: La administración conjunta de las herramientas de detección para trastornos específicos mostró sensibilidades que oscilaron de 0,76 a 0,88 y especificidades que oscilaron de 0,67 a 0,85. El valor del ICC para la puntuación total del Mini-DTM fue 0,78. El área bajo la curva para la detección de trastornos mentales fue 0,84, con una sensibilidad de 0,74 y especificidad de 0,76 (punto de corte ≥ 4). Conclusión: Este estudio demostró que un breve compilado de herramientas de detección para trastornos mentales específicos (Mini-DTM) puede detectar trastornos mentales y emocionales en la población general. Objetivo: Avaliar se um compilado breve de instrumentos de triagem, para transtornos mentais específicos, pode detectar transtornos mentais e emocionais na população geral. Método: Foram selecionados instrumentos de triagem validados para os transtornos mentais e emocionais mais prevalentes. Como critério de seleção, esses instrumentos deveriam manter as propriedades psicométricas do instrumento completo com apenas um ou alguns itens. Os instrumentos selecionados foram: o Patient Health Questionnaire-2 (PHQ-2), o Generalized Anxiety Disorder Scale-2 (GAD-2), o item 3 do Alcohol Use Disorders Identification Test (AUDIT), e três itens do Adolescent Psychotic-Like Symptom Screener (APSS-3). Esse compilado de instrumentos de triagem foi chamado de Mini Rastreio para Transtornos Mentais (Mini-RTM). O estudo foi dividido em duas fases: na primeira, 545 sujeitos foram entrevistados com o instrumento de triagem Mini-RTM e COOP/WONCA-Sentimentos em suas residências; na segunda fase, os sujeitos que concordaram em participar (230) foram entrevistados com o Mini-RTM, COOP/WONCA-Sentimentos e a entrevista diagnóstica MINI. A confiabilidade teste-reteste foi calculada pelo Coeficiente de Correlação Intraclasse (ICC). A área sob a curva ROC foi gerada para a análise da validade discriminativa. A validade concorrente foi calculada pela análise da correlação entre o Mini-RTM e o COOP/WONCA-Sentimentos. Resultados: A administração conjunta dos instrumentos de triagem para transtornos específicos mostrou sensibilidades que variaram de 0,76 a 0,88 e especificidades que variaram de 0,67 a 0,85. O valor do ICC para o escore total do Mini-RTM foi de 0,78. A área sob a curva para a detecção dos transtornos mentais foi de 0,84, com sensibilidade de 0,74 e especificidade de 0,76 (ponto de corte ≥ 4). Conclusão: Esse estudo mostrou que um compilado breve de instrumentos de rastreio para transtornos mentais específicos (Mini-RTM) pode detectar transtornos mentais e emocionais na população geral.

Atualmente aumenta o reconhecimento da atenção primária em gerenciar os problemas de saúde mental e o uso de instrumentos de rastreio possibilita mensurar características psicológicas, psíquicas e comportamentais que nem sempre são consideradas. Dessa forma, o uso de instrumentos de rastreio pode auxiliar na detecção precoce de indivíduos que necessitam de tratamento, acompanhamento ou intervenção e são raros os instrumentos que englobam o rastreio de múltiplos transtornos mentais. Assim, o presente estudo teve como objetivo geral construir e validar um instrumento breve de rastreio de múltiplos transtornos mentais, o qual será chamado de Mini Rastreio para Transtornos Mentais (MINI-RTM), que reúne questões relevantes de diversos instrumentos de rastreio específicos para transtornos mentais, já existentes e validados, mas que permita a detecção dos transtornos mais comuns em atenção primária, incluindo abuso de substâncias e transtornos psicóticos. O MINI-RTM abarcou questões relativas à ansiedade, depressão, abuso e/ou dependência de álcool e substâncias e transtornos psicóticos. É um instrumento composto por nove itens com escore podendo variar de zero a 23. 545 sujeitos foram entrevistados em seus domicílios, por estudantes de medicina, treinados no MINI-RTM e item Sentimentos do COOP/WONCA. Os sujeitos que concordaram em participar da segunda fase do estudo, total de 230, receberam uma segunda visita de profissionais de saúde mental, com treinamento no MINI-RTM, no item Sentimentos do COOP/WONCA e na entrevista MINI, para possível confirmação do diagnóstico. O MINIRTM foi sujeito à análise da fidedignidade teste-reste, por meio do Coeficiente de Correlação Intraclasse (ICC), apresentando valor de 0,78, considerado satisfatório, indicando ser um instrumento bastante confiável e com índices mais expressivos que o item Sentimentos do COOP/WONCA. A análise da validade discriminativa, mostrou que o MINI-RTM apresentouse com valores de área sob a curva ROC, sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo satisfatórios. Os pontos de corte, quando comparado com a entrevista padrão-ouro MINI foram: >3 (instrumento mais sensível) e >4 (instrumento mais específico). Quando cotejado com o item Sentimentos do COOP/WONCA, para ponto de melhor acurácia, o MINI-RTM apresentou-se com menor variação entre sensibilidade e especificidade, sendo considerado mais equilibrado na detecção de casos e não casos. Quanto à análise da validade concorrente, na comparação com item Sentimentos do COOP/WONCA, o MINI-RTM apresentou valor moderado de correlação, o que era de se esperar devido ao item Sentimentos do COOP/WONCA avaliar bem estar geral e não um conjunto de transtornos. Dessa forma, o MINI-RTM apresentou-se como um instrumento de rastreio potencialmente relevante para triagem de múltiplos transtornos mentais em cuidados primários de saúde, sendo satisfatoriamente fidedigno, válido e mais abrangente que outros instrumentos de rastreio. O MINI-RTM conseguiu reunir questão importantes para um instrumento de rastreio que é a alta capacidade de discriminação entre casos e não casos e a fácil aplicabilidade. Esse instrumento está disponível para profissionais de cuidados primários de saúde, preenchendo uma importante lacuna na literatura, principalmente nacional, que é a disposição de um instrumento que rastreie múltiplos transtornos mentais, não se limitando somente a avaliação de bem estar geral ou avaliação de transtornos mentais específicos Current studies raise awareness of primary care on management of mental disorder issues and the use of screening tools allows the measurement of physical, psychological and behavioral features not always considered. Therefore, the use of screening tools may aid early detection of individuals who require treatment, assistance or intervention. In addition, screening tools that allow that allow the identification of multiple mental disorders are uncommon. Therefore, the current study aimed to build and validate a brief tool that tracks multiple mental disorders to be named Mini Screening for Mental Disorders (in Portuguese, MINI-RTM) that gathers relevant issues from various mental disorder screening tools already validated, with the addition of allowing the identification of commonplace disorders such as substance abuse and psychotic disorder. MINI-SMD comprehends questions related to anxiety, alcohol or substance abuse and/or addiction, as well as psychotic disorders. The instrument comprises nine items in which scores vary from zero to 23. 545 participants were interviewed at their homes by medicine students with training at MINI-RTM and Feelings from COOP/WONKA. The subjects who agreed to participate in the second phase of the study, total 230, received a second visit from mental health professionals with training in MINI-SMD, the item Feelings of COOP/WONCA and the MINI interview for possible confirmation of diagnosis. The MINI-SMD was subject to test-retest reliability analysis, through intraclass correlation coefficient (ICC), with value 0.78, considered satisfactory, indicating to be a very reliable instrument with more expressive indexes than Feelings from COOP / WONCA. The analysis of discriminant validity showed that MINI-RTM presented satisfactory values under the ROC curve, sensitivity, specificity, positive predictive value and negative predictive value. Cut scores when compared with the gold standard MINI interview were: > 3 (more sensitive instrument) and> 4 (more specific instrument). When collated with Feelings for better accuracy scores, MINI-RTM presented less variation between sensitivity and specificity, being considered more balanced in detecting cases and non-cases. With respect to the analysis of concurrent validity, compared to Feelings, MINI-RTM presented moderate correlation value, which has been expected since Feelings assesses well-being and not a set of disorders. Thus, MINI-RTM was presented as a potentially important screening tool for tracking multiple mental disorders in primary health care, being satisfactorily reliable, valid and more comprehensive than other screening tools. MINI-RTM managed to gather important features for a screening instrument such as high capacity of discrimination between cases and noncases and easy applicability. This tool is available for primary health care professionals, filling an important gap in the literature - mainly Brazilian - which is the provision of a tool that tracks multiple mental disorders, not only limited to the assessment of well-being or the general assessment of specific mental disorders