Milena Pereira Pondé

Tradução para o português da escala M-CHAT para rastreamento precoce de autismo

INTRODUCTION: The Modified Checklist for Autism in Toddlers (M-CHAT) is a screening instrument for autism that can be applied to parents of children aged 18-24 months. It is self-applicable, simple, and has high sensibility and specificity. It was developed in English and it is still not available in Portuguese. In the scientific literature there is no agreement as to the translation technique, cross-cultural adaptation being one of the possibilities. The objective of the present study was to translate the M-CHAT scale from English into Brazilian Portuguese to scan early autism, preserving cross-cultural equivalence. METHOD: After obtaining permission from the author of the scale, its translation was performed, followed by its back-translation; evaluation of reference equivalence; first pretest in a sample of the target population; evaluation of general equivalence; evaluation by specialists in infantile autism; development of a preliminary version; second pretest with parents of autistic children treated in a Pediatric Ambulatory of the Brazilian Public Health System; and development of its final version. RESULTS: Evaluation of reference equivalence showed that 78% of the questions were similar, 13% approximate, and 9% different. Of the 20 people interviewed in the first pretest, nine understood 100% of the questions. The second pretest demonstrated good acceptance and understanding by the target population, with no complaints in 70% of the sample. After detailed evaluations, the final version was developed. CONCLUSION: The study makes the Portuguese version of the M-CHAT scale available, which was considered adequate by specialists and understood by the population.Introduction: The Modified Checklist for Autism in Toddlers (M-CHAT) is a screening instrument for autism that can be applied to parents of children aged 18-24 months. It is self-applicable, simple, and has high sensibility and specificity. It was developed in English and it is still not available in Portuguese. In the scientific literature there is no agreement as to the translation technique, cross-cultural adaptation being one of the possibilities. The objective of the present study was to translate the M-CHAT scale from English into Brazilian Portuguese to scan early autism, preserving cross-cultural equivalence. Method: After obtaining permission from the author of the scale, its translation was performed, followed by its back-translation; evaluation of reference equivalence; first pretest in a sample of the target population; evaluation of general equivalence; evaluation by specialists in infantile autism; development of a preliminary version; second pretest with parents of autistic children treated in a Pediatric Ambulatory of the Brazilian Public Health System; and development of its final version. Results: Evaluation of reference equivalence showed that 78% of the questions were similar, 13% approximate, and 9% different. Of the 20 people interviewed in the first pretest, nine understood 100% of the questions. The second pretest demonstrated good acceptance and understanding by the target population, with no complaints in 70% of the sample. After detailed evaluations, the final version was developed. Conclusion: The study makes the Portuguese version of the M-CHAT scale available, which was considered adequate by specialists and understood by the population.

The prevalence of mental disorders in prisoners in the city of Salvador, Bahia, Brazil.

Abstract:  The number of individuals affected by serious psychiatric disorders in Brazilian prisons is unknown. This cross‐sectional study was conducted in prison complexes within the city of Salvador, Bahia, Brazil. The sample consisted of 497 prisoners, and the outcome measure was the Brazilian Portuguese version of the Mini International Neuropsychiatric Interview. The prevalence rates found in the closed and semi‐open prison systems, respectively, were as follows: depression 17.6% and 18.8%; bipolar mood disorder 5.2% and 10.1%; anxiety disorders 6.9% and 14.4%; borderline personality disorder 19.7% and 34.8%; antisocial personality disorder 26.9% and 24.2%; alcohol addiction 26.6% and 35.3%; drug addiction 27.9% and 32.4%; psychosis 1.4% and 12.6%; attention deficit/hyperactivity disorder (ADHD) in childhood 10.3% and 22.2%; and ADHD in adulthood 4.1% and 5.3%. This study revealed higher rates of substance‐related disorders and lower rates of psychotic and mood disorders compared to other prevalence studies carried out in prison populations.

Prevalence of attention deficit hyperactivity disorder in schoolchildren in the city of Salvador, Bahia, Brazil

BACKGROUND Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder of infancy and one of the most prevalent chronic diseases found in schoolchildren. OBJECTIVE To evaluate the prevalence of ADHD in schoolchildren through the use of a questionnaire responded by school-teachers. METHOD A total of 774 children enrolled in the public and private school systems were evaluated. The diagnostic instrument used was a Teacher ADHD scale. RESULTS Results showed that 6.7% of children were considered highly likely to have the disorder. Of the more severe cases of ADHD, the hyperactive-impulsive subtype was more frequently identified in girls, while the inattentive subtype was more prevalent among boys. CONCLUSION The symptoms of attention deficit in hyperactive children may be underestimated by teachers since the symptoms of hyperactivity are more noticeable and disruptive.

Lack of effect of motivation on the adherence of HIV-positive/AIDS patients to antiretroviral treatment

UNLABELLED As a result of the potent drug combinations of reverse transcriptase inhibitors and protease inhibitors currently available, it is now possible to achieve extreme reductions in the numbers of viral particles in the peripheral blood of HIV-positive patients undergoing treatment, to the point that they are undetectable. Moreover, the immunological recovery resulting from continued and prolonged use of these drugs significantly reduces both mortality and the incidence of opportunistic infections. However, the strict therapeutic regimens required, the number of pills, adverse events and the stigma of a disease that requires the patient to introduce pill-taking into his/her lifestyle brings into question one aspect of mental health, which is motivation to do that which is being proposed. We investigated the influence of each of the components of the adherence trilogy: information, motivation and behavioral abilities, as risk factors in a population of HIV-positive/AIDS patients undergoing antiretroviral treatment in the city of Salvador, Bahia, Brazil. MATERIAL AND METHODS An intervention study was carried out by introducing motivational assistance into the routine recommendations for the treatment of patients who were initiating antiretroviral (ARV) therapy. Seventy-six treatment-naive patients, who had been selected to initiate ARV therapy, were included. These patients were divided into two groups. Group A, in which the regular routine of the institution was followed, received information on the disease and its treatment;patients in group B had the same routine, but they were also followed-up fortnightly and given motivational intervention. Evaluations of viral load and CD4 count before and following treatment were used to measure adherence. RESULTS There was no significant difference between the two groups. CONCLUSIONS As the rates of non-adhesion were at the lower limits of the ranges reported in the literature, it would appear that providing motivation and information can be of help to the patient.

Estudo piloto da prevalência do transtorno de déficit de atenção e hiperatividade entre crianças escolares na cidade do Salvador, Bahia, Brasil

This study aims to estimate the prevalence of attention deficit hyperactivity disorder (ADHD) in scholar children through a teachers questionnaire. A pilot study was conducted based in the total number of students under high school, in public and private schools in Salvador, Bahia, Brazil. The instrument used was Teachers version of ADHS scale. Eight kids (5.3%) were recognized as highly probability of attention deficit disorder, three (2%) with high probability of subtype hyperactive/impulsive, and one (0.6%) as combined subtype. Children with ADHD might have serious social problems, not only brought by the disorder, but also due to co morbidity with other disorders, leading to serious social withdrawn. Early diagnostic and treatment of ADHD might improve educational and psychosocial development of these kids.

Control of psychomotor agitation and aggressive behavior in patients with autistic disorder: a retrospective chart review

OBJECTIVE To evaluate the efficacy of pharmacotherapy on the symptoms of psychomotor agitation and aggressive behavior in a sample of patients with autistic spectrum disorder. METHOD The charts of all patients with a diagnosis of autistic spectrum disorder, receiving care for psychomotor agitation and/or aggressive behavior in two psychiatric outpatient departments between 2001 and 2006, were reviewed. The Clinical Global Impression-Severity and -Improvement scales (CGI-S and CGI-I) were applied to the data retrieved from the charts. RESULTS The majority of the 26 patients included were treated with second-generation antipsychotics. A positive, statistically significant correlation was found between the implementation of pharmacotherapy and a reduction in CGI-S scores (p<0.05). Treatment response in patients with no mental retardation was better than in those mentally retarded (p<0.05). The majority of patients in whom clinical improvement was found following implementation of treatment had participated in at least one form of intervention therapy in addition to the principal treatment (p<0.05). CONCLUSION Second-generation antipsychotics seem to reduce psychomotor agitation and aggressive behavior in patients with autistic spectrum disorder; however, further studies are required to evaluate the side effects of these drugs in relation to their beneficial effects.

The Relationship Between Mental Disorders and Types of Crime in Inmates in a Brazilian Prison

This cross‐sectional study conducted in prisons in the city of Salvador, Bahia, Brazil, investigated the association between the presence of psychiatric disorders in 462 prisoners and the types of crimes committed by them. Psychiatric diagnosis was obtained by means of the Brazilian Portuguese version of the Mini‐International Neuropsychiatric Interview. A statistically significant association was found between some psychiatric disorders and specific groups of crime: lifelong substance addiction with sex crimes and homicide; antisocial personality disorder with robbery and with kidnapping and extortion; borderline personality disorder with sex crimes; and lifelong alcohol addiction with fraud and conspiracy and with armed robbery and murder. It was concluded that the mental disorders considered more severe (psychosis and bipolar disorder) were not associated with violent crimes, suggesting that the severity of the psychotic disorder may be the factor that has caused psychosis to be associated with violent crimes in previous studies.

Risk and protective factors for symptoms of anxiety and depression in parents of children with autism spectrum disorder

Abstract Objective: The severity of symptoms of anxiety and depression was evaluated in 102 parents of children with autism spectrum disorders (ASD) and correlated with the severity of their child’s behavioral symptoms. Design: An observational, cross-sectional study. Methods: The Portuguese versions of the Hospital Anxiety and Depression Scale and the Aberrant Behavior Checklist were used to assess symptoms in the parents and in their children. Main outcomes and results: Depression was present in 26.7% of parents and anxiety in 33.7%. Severe behavioral symptoms in the child increased the likelihood of severe anxiety and depression symptoms in the parents by a factor of 35. If the child had severe behavioral symptoms and the father lived in the family home, the likelihood of severe symptoms of anxiety and depression in the parents was 95.2% lower. Conclusion: The presence of the father living in the family home acted as a buffer against parents’ symptoms.

Adaptação transcultural parcial da escala Aberrant Behavior Checklist (ABC), para avaliar eficácia de tratamento em pacientes com retardo mental

A ABC (Aberrant Behavior Checklist) visa avaliar a resposta ao tratamento de transtornos comportamentais em portadores de retardo mental. O objetivo deste estudo e descrever a adaptacao transcultural parcial da escala ABC para o portugues do Brasil. Foi realizada avaliacao da equivalencia conceitual e de itens, foram feitas duas traducoes (T1 e T2), suas respectivas retraducoes (R1 e R2), avaliacao das equivalencias referencial e geral, avaliacao de especialistas, pre-teste e elaboracao da versao final. Em relacao a equivalencia conceitual e de itens a ABC foi considerada pertinente a nossa cultura. Quanto a equivalencia semântica, houve uma boa correspondencia entre os itens de R1 e a ABC original, e razoavel entre estes e R2. Portanto optou-se por utilizar os itens de T1. Todos os professores compreenderam 94,8% da escala, enquanto todos os parentes entenderam 87,9%. Fica disponivel a versao em portugues do Brasil da escala ABC, respeitando a equivalencia conceitual e de itens e semântica.The aim of the ABC (Aberrant Behavior Checklist) is to evaluate the treatment response for aberrant behavior in patients with mental retardation. The aim of this study was to describe the partial cross-cultural adaptation of the ABC scale to Brazilian Portuguese. The process included conceptual and item equivalence, two translations (T1, T2) and their back-translations (R1, R2), evaluation of referential and general equivalence, expert evaluations, a pre-test, and elaboration of the final version. Conceptual and item equivalences of the ABC were considered pertinent to Brazilian culture. Semantic equivalence showed good correspondence between R1 items and ABC. Reasonable correspondence was obtained between ABC items and R2. All of the professors understood 94.8% of the items in the scale, while relatives understood 87.9%. The Brazilian Portuguese version of the ABC scale thus is available for use, with the appropriate conceptual, item, and semantic equivalence.

Sintomas ansiosos e depressivos e sua correlação com intensidade da dor em pacientes com neuropatia periférica

Introduction: Peripheral neuropathies include sensory-motor dysfunctions and chronic pain that may trigger psychiatric disorders such as anxiety and depression. The objective of the present study was to estimate the frequency of anxious and depressive symptoms among patients with peripheral neuropathies, correlating them with pain severity. Methods: Cross-sectional study conducted in an outpatient neurology clinic between April 2006 and March 2007. The Hospital Anxiety and Depression Scale and the Pain Visual Analogue Scale were used to evaluate pain. The sample included 54 patients. Results: We found a frequency of 68.5% (n = 37) of anxious symptoms and 51.9% (n = 28) of depressive symptoms. Severe pain was reported by 57.4% of the patients. There was a positive correlation between pain severity and anxious and depressive symptoms (p ≤ 0.05). Headache, trauma and family history of psychiatric disease were also associated with anxious and depressive symptoms. Conclusions: Our fi ndings demonstrate a high frequency of anxious and depressive symptoms in patients with peripheral neuropathies. Such symptoms are positively correlated with pain severity.