Leonardo Machado

A systematic review of the neural correlates of positive emotions.

Objective: To conduct a systematic literature review of human studies reporting neural correlates of positive emotions. Methods: The PubMed and Web of Science databases were searched in January 2016 for scientific papers written in English. No restrictions were placed on year of publication. Results: Twenty-two articles were identified and 12 met the established criteria. Five had been published during the last 4 years. Formation and regulation of positive emotions, including happiness, are associated with significant reductions in activity in the right prefrontal cortex and bilaterally in the temporoparietal cortex, as well as with increased activity in the left prefrontal regions. They are also associated with increased activity in the cingulate gyrus, inferior and middle temporal gyri, amygdalae, and ventral striatum. Conclusion: It is too early to claim that there is an established understanding of the neuroscience of positive emotions and happiness. However, despite overlap in the brain regions involved in the formation and regulation of positive and negative emotions, we can conclude that positive emotions such as happiness activate specific brain regions.

Happiness and health in psychiatry: what are their implications?

Background Happiness is a lasting state and is associated with the absence of negative emotions, the presence of positive emotions, life satisfaction, social engagement and objectives in life. Researchers have demonstrated the benefits of happiness in many aspects of life, but few studies have been conducted within psychiatry.Objectives To develop a critical literature review of studies on happiness and health in order to bring some further and useful information to psychiatry updating the article “Happiness: a review” published in 2007 in Revista de Psiquiatria Clinica.Methods Computational searching was undertaken of digital data basis (PubMed and SciELO) using the keywords “happiness” and “health”. One hundred twenty-seven papers published between 2004 and 2014 were found, but only 76 had the keywords in the title or abstract and with this were selected.Results Personality traits, such as self-direction; being married; being involved in physical and leisure activities; higher educational backgrounds and intelligence quotient; religiosity, volunteering and altruism; good physical and mental health; were positively related to happiness.Discussion Analysis of the concept of happiness and its associated emotions may be more complex than describing the symptoms of psychiatric disorders. Despite this, the study of happiness brings several positive implications for psychiatry.

Happiness and Defense Styles in Psychiatrists.

Abstract The aim of this study was to measure happiness in a sample of Brazilian psychiatrists and correlate it with the defense styles used by them and sociodemographic data. This study was observational, cross-sectional, and analytical. Data were collected through self-administered questionnaires by Brazilian psychiatrists who participated in the XXXII Brazilian Congress of Psychiatry, 2014. In this sample of psychiatrists, happiness levels were high (scoring 5.69 of a total of 7), and mature defense styles prevailed, especially humor and anticipation. In a multivariate analysis, having children, good sleep quality, increased sexual interest, and use of defense styles such as humor, anticipation, and idealization all showed a positive relationship with happiness; on the other hand, using defense style such as acting out or annulment demonstrated a negative relationship with happiness. Despite the well-known professional burden that they bear, Brazilian psychiatrists surveyed presented, in general, high levels of subjective well-being and happiness.

Neural correlates of wellbeing scales: Preliminary data

In the field of positive psychology, wellbeing is divided into eudaimonic wellbeing (EWB) and subjective wellbeing (SWB). EWB is connected to the personal fulfilment of one’s potential and consists of parameters that include positive relationships with others and self-acceptance. SWB is connected to the experience of satisfaction and has a cognitive component (satisfaction with life) and an affective component (positive emotions). There are validated scales for measuring the two types of wellbeing, and in recent years, neuroimaging studies have been used to assess their neural correlates (Lewis et al., 2014; Sato et al., 2015). EWB has shown a positive association with the grey matter volume of the right insular cortex. The study used voxel-based morphometry techniques to analyse structural magnetic resonance images from 70 young, healthy subjects who had also completed Ryff’s 42-item measure of EWB (Lewis et al., 2014). The anterior insula is important to interoceptive awareness, which consists of detecting and interpreting certain internal bodily states. In contrast, the posterior insula processes information related to somatic and auditory sensation and control of somatic musculature. Most studies have reported a negative association between the insula volume and the presence of depression (Clark et al., 2010). Taken together, previous results and those of the present study point to the possibility that the insula promotes EWB by generating a set of capacities that act jointly to integrate interoceptive states and external circumstances and successfully manage this emotional milieu (Lewis et al., 2014). SWB has been shown to be positively associated with grey-matter volume in the right precuneus in a study of 51 volunteers without psychiatric disorders that used the subjective happiness scale, the emotional intensity scale and the purpose in life test (Sato et al., 2015). The precuneus is involved in consciousness, body movements in space, self-awareness and retrieval of episodic memories and visuospatial imagery (Clark et al., 2010). The precuneus region has the highest cortical glucose metabolism in brain, which highlights its importance to subjective consciousness in humans. The precuneus may play an important role in integrating various types of information and converting them into SWB (Sato et al., 2015). These data are preliminary. However, the first conclusion we can draw is that EWB and SWB seem to be different constructs associated with specific brain regions and that the scales measuring them appear to be valid. Further studies in this field deserve encouragement and may be valuable for understanding healthy brain functioning.

Subjective well-being, religiosity and anxiety: a cross-sectional study applied to a sample of Brazilian medical students

OBJECTIVE To assess associations between subjective well-being (SWB), religiosity, anxiety and other factors in a sample of Brazilian medical students from a public university in northeastern Brazil. METHODS The present study followed a cross-sectional, observational, analytical approach. Data were collected by administering a self-applicable questionnaire composed of questions focused on sociodemographic data and based on the Satisfaction With Life Scale (SWL), Positive Affect and Negative Affect Scale (PANAS), Penn State Worry Questionnaire (PSWQ), and the Duke Religiosity Index (DUREL). RESULTS The sample comprised 417 medical school students (73.54% of all the enrolled students). The medical students assessed presented a medium level of satisfaction with life, low mean positive emotion levels and high anxiety/uneasiness levels. Surprisingly, lower anxiety and intrinsic religiosity (IR) scores were associated with higher scores in the two SWB parameters (positive emotions and satisfaction with life). Furthermore, the factors leisure activities, good sleep quality, financial support, age, and gender were associated with the highest SWB scores (with emotional and cognitive components, or with only one of these two components). CONCLUSIONS Data in the current study corroborated the negative association between SWB and anxiety; however, in opposition to the literature, they also evidenced a negative association between SWB and IR. In addition, the present research signaled the need for creating preventive intervention programs to increase SWB through positive psychological techniques and/or to decrease anxiety by applying, for instance, cognitive-behavioral therapy paradigms and/or mindfulness techniques to medical students.

Influence of Age and Education on the Performance of Elderly in the Brazilian Version of the Montreal Cognitive Assessment Battery

Aims: To provide normative data for the Brazilian version of the Montreal Cognitive Assessment (MoCA-BR) and to measure the effect of sociodemographic variables on the cognitive performance of cognitively healthy elderly people. Methods: A sample of 110 cognitively healthy individuals, aged over 65 years, with at least 4 years of schooling were recruited from 3 health care centers for the elderly in Recife, Brazil. The cognitive performance was assessed using MoCA-BR. Results: The average score of these elderly people in the MoCA-BR was 23.2 ± 2.7. Their schooling correlated positively with the cognitive performance, with a Spearman’s coefficient of 0.33 (p < 0.001). There was a statistically significant negative correlation between age and the cognitive performance (Spearman’s rho = –0.19). The multiple linear regression model with the highest adjusted coefficient of determination was the one that included schooling and age (adjusted R2 = 0.127). Conclusions: The cognitive performance of healthy elderly was evaluated and was strongly influenced by schooling and, to a lower degree, by age.

When the Patient Believes That the Organs Are Destroyed: Manifestation of Cotard's Syndrome

Cotards Syndrome (CS) is a rare clinical event described for the first time in 1880 by the neurologist and psychiatrist Jules Cotard and characterized by negation delusions (or nihilists). Immortality and hypochondriac delusions are also typical. Nowadays, it is known that CS can be associated with many neuropsychiatric conditions. In this article, we describe the case of a patient that believed not having more organs and having the body deformed and whose CS was associated with a bigger depressive disorder. Although the electroconvulsive therapy is the most described treatment modality in the literature, the reported case had therapeutic success with association of imipramine and risperidone.

Folie à deux (transtorno delirante induzido)

Folie a deux, or induced delusional disorder, is a rare syndrome characterized by transfer of delusions from a primary subject to one or more secondary subjects. Though a diagnosis considered rare and even so forgotten in current psychiatric treated our article describes a case of folie a deux between mother (primary delusional subject) and daughter (previously healthy and secondary psychotic subject) had therapeutic success and evolution very favorable. Although our case had favorable development, there are reports in the literature tragic outcomes as infanticide. In addition, our article draws attention to some important aspects. First, folie a deux frames can occur in many situations and not only in feedlots, unlike the current classification systems tend to do. Also, they are not as rare as it is supposed. Finally, clinicians should be alert to possible psychiatric problems not recognized in the individual considered secondary.