Carolina Stopinski Padoan

Frequency of brain tissue donation for research after suicide

Objectives: To describe the frequency of brain tissue donation for research purposes by families of individuals that committed suicide. Methods: All requests for brain tissue donation to a brain biorepository made to the families of individuals aged 18-60 years who had committed suicide between March 2014 and February 2016 were included. Cases presenting with brain damage due to acute trauma were excluded. Results: Fifty-six cases of suicide were reported. Of these, 24 fulfilled the exclusion criteria, and 11 others were excluded because no next of kin was found to provide informed consent. Of the 21 remaining cases, brain tissue donation was authorized in nine (tissue fragments in seven and the entire organ in two). Conclusions: Donation of brain tissue from suicide cases for research purposes is feasible. The acceptance rate of 42.8% in our sample is in accordance with international data on such donations, and similar to rates reported for neurodegenerative diseases.

“Why throw away something useful?”: Attitudes and opinions of people treated for bipolar disorder and their relatives on organ and tissue donation

In regard to mental illness, brain donation is essential for the biological investigation of central pathology. Nevertheless, little is known about the thoughts of people with mental disorders on tissue donation for research. Here, our objective was to understand the attitudes and opinions of people treated for bipolar disorder and their relatives regarding donation in general, and particularly donation for research. This is a qualitative study that used in-depth interviews to determine the thoughts of participants regarding tissue donation for research. Theoretical sampling was used as a recruitment method. Grounded theory was used as a framework for content analyses of the interviews. A semi-structured interview guide was applied with the topics: donation in general; donation for research; mental health and body organs; opinion regarding donation; feelings aroused by the topic. Although all participants were aware of organ donation for transplant, they were surprised that tissue could be donated for research. Nevertheless, once they understood the concept they were usually in favor of the idea. Although participants demonstrated a general lack of knowledge on donation for research, they were willing to learn more and viewed it as a good thing, with altruistic reasons often cited as a motive for donation. We speculate that bridging this knowledge gap may be a fundamental step towards a more ethical postmortem tissue donation process.

Aderência à técnica na psicoterapia psicanalítica: estudo preliminar

Classicamente, o treinamento em psicoterapia psicanalitica esta baseado em um tripe proposto por Freud para formacao de psicanalistas: aprendizado teorico, supervisao clinica e analise/psicoterapia psicanalitica pessoal. Por ser uma atividade realizada de forma isolada, sem que o professor/supervisor esteja presente durante a sessao, nao ha garantia de que esse aprendizado esteja sendo utilizado na pratica clinica do terapeuta em formacao. Ademais, a aplicacao da tecnica psicanalitica tambem depende de caracteristicas do paciente: quando o paciente nao apresenta capacidade de insight e de abstracao ou quando necessita de contencao por parte do terapeuta, o terapeuta tende a utilizar tecnicas mais diretivas, abordagens de apoio ou tecnicas mistas em sua pratica1,2. Diante dessas constatacoes, questiona-se: os psicoterapeutas de um ambulatorio de psicoterapia psicanalitica (Contemporâneo – Instituto de Psicanalise e Transdisciplinaridade, Porto Alegre/RS) de fato atuam psicanaliticamente com seus pacientes? Os pacientes dessa instituicao propiciam o uso da tecnica psicanalitica durante seus atendimentos? O ambulatorio em questao agrega uma escola de psicanalise que forma especialistas em psicoterapia psicanalitica com base no tripe acima mencionado. Decidiu-se, entao, submeter a analise de pares de juizes 118 sessoes dialogadas de pacientes adultos atendidos no referido ambulatorio nos ultimos cinco anos, cedidas pelos terapeutas (67 sessoes, 56,8%) e seus supervisores (51 sessoes, 53,2%). Quinze terapeutas e 81 pacientes estao representados nessas sessoes. As sessoes foram avaliadas por oito juizes (psicologos especialistas em psicoterapia psicanalitica), independentemente, apos treinamento. Utilizou-se o Instrumento para Avaliacao de Sessoes Psicanaliticas (IASP), o qual apresenta boa confiabilidade e e composto pelos itens: neutralidade do terapeuta, tipo de intervencoes utilizadas, uso de interpretacoes, uso da teoria psicanalitica para compreensao do material, criacao de espacos reflexivos e relacao terapeuta-paciente3,4. A pontuacao final da sessao pode variar de 0 a 25 pontos, e sessoes com pontuacoes iguais ou superiores a 13 sao consideradas psicanaliticas. O instrumento nao mensura a qualidade da sessao e a adequacao das intervencoes do terapeuta; nao ha necessariamente correlacao entre a aderencia a tecnica e a qualidade da sessao. Das 118 sessoes analisadas, houve concordância em que 106 delas seriam psicanaliticas e que duas nao seriam; nao houve concordância quanto as demais 10 sessoes. Ajustando para