Othon Bastos

Depressão e ansiedade em adolescentes de escolas públicas e privadas

OBJETIVE: To identify depression and anxiety prevalences within adolescents registered and frequenting public and private schools in the city of Recife - Pernambuco. METHODS: According to a population based, prevalence study, admitting a population of 10.414 pupils of public and private schools, depression and depressive upheavals prevalence of 20,3%, precision of 5% and significance level of 0,05, the random and stratified sampling included 243 pupils, of basic and mean levels of 11 schools, aging from 14 to 16 years old. The variables were: age, religion, school type, adscription and size, scholarship, study duration, scholar and labor condition, characteristic of familiar nucleus, sex, marriage status, skin type according to Fitzpatrick scale (investigated by a demographic questionnaire) and depression and anxiety degrees by Hamilton scales. Statistical analysis was performed with Statistical Package for Social Sciences. RESULTS: The prevalences of expressive depressive symptoms and anxiety were equal to 59.9% and 19.9%, respectively. The associations of serious intensity depressive symptoms with female sex and religious belief different from Christianity chain were significant. The suicidal ideation/suicide attempt was related by 34.3% of students. There was significant association of suicidal ideation with light or moderate depressive symptoms and moderate degree of anxiety, as well as of suicide attempt with: serious depressive symptoms, study in private school and severe anxiety. CONCLUSIONS: The gravity of psychopathologic characteristics in a so young age is to deserve a psychosocial intervention to reduce its repercussions for the future.

AD8-Brazil: Cross-Cultural Validation of the Ascertaining Dementia Interview in Portuguese

Dementia is a global public health problem and detection in the primary care setting, particularly in developing countries, is challenging. The aim of this research was to produce the cross-cultural validation of the AD8 interview to the Brazilian Portuguese Language. The original version of the AD8 was submitted to translation, back-translation, and application of the questionnaire to 20 elderly informants for face validation. The AD8-Brazil was then evaluated in 109 community-dwelling elderly with a sociodemographic questionnaire, clinical examination, Mini Mental State Examination (MMSE), Katz Inventory of Activities of Daily Living (ADL), and Clinical Dementia Rating scale (CDR). The AD8-Brazil was compared with the other instruments and with the clinical diagnosis (DSM-IV) for criterion validation. There was significant agreement of AD8-Brazil with diagnosis of dementia (p < 0.001), MMSE (p = 0.047), and ADL (PFisher = 0.004). Also, the AD8-Brazil was able to differentiate the stages of dementia by CDR scale. The reliability was high (alpha = 0.818) and reproducibility analysis showed excellent inter-rater (kappa = 0.889) and test-retest consistency (kappa = 0.814). The AD8-Brazil showed excellent discrimination between CDR 0 and CDR > 0 (area under the curve 86.1%) and between CDR 0 and CDR 0.5 (area under the curve 76.9%). The administration of the questionnaire took 2.3 ± 0.1 minutes. The Brazilian version of the AD8 is a valid, reliable, quick, and easy screening instrument for dementia.

Characterization of depressive syndrome in schizophrenic outpatients

OBJECTIVE: The authors carried out a cross-sectional study with the aim of characterizing and describing depressive pictures in schizophrenic patients seen at the Psychiatry Outpatient Clinic of the Federal University of Pernambuco (HC-UFPE). The patients had the diagnosis of schizophrenia confirmed on the basis of the operating criteria of the DSM-IV. METHODS: Those who where in the period of stabilization of the clinical picture were selected for the study defined according the following criteria:the last psychotic episode must be happened two months before at least, and during this period the alterations of the antipsychotics doses had been lower than 5 mg of haloperidol or equivalent doses of others neuroleptics. A total of one hundred and four patients took part. Following the identification of the depressive symptoms using the Calgary Depression Scale for Schizophrenia (CDSS), thirty-one patients (29.8%) fulfilled the diagnostic criteria described in the DSM-IV. Of these, 22.1% had the diagnosis of major depression and 7.7% of minor depression according the DSM-IV. Two groups were constituted: Group A, schizophrenics with a depressive syndrome, and Group B, schizophrenics without such a syndrome. An assessment was made of the distribution of the symptoms of the CDSS scores in both groups, the sociodemographic, clinical and therapeutic variables in relation to the frequency of the depressive syndrome, and the patients clinical course. For the investigation of certain clinical features, the following tools were used: problem list (psychosocial stressors) contained in axis IV of the DSM-IV intended to detect the presence of factors triggering the initial episode of schizophrenia and the Global Assessment of Functioning (GAF ¾ Axis V ¾ DSM-IV) to characterize the current functioning of the patients. CONCLUSIONS: The results obtained allowed the authors to draw the following conclusions: all the items that comprise the Brazilian version of the CDSS were statistically significant in characterizing the depressive syndrome; a comparison of the sociodemographic and therapeutic variables revealed no statistically significant differences between the two groups, and this was also the case with the majority of the clinical features. Statistically significant differences, however, were found in relation to the greater frequency of life events (psychosocial stressors) in triggering the first episode of schizophrenia and the higher incidence of affective disorders antecedents in family members (first and second degree) among the depressed patients. The mean duration of the depressive syndrome during follow-up of the patients was 5.30 months. The patients in whom there was a recurrence of the psychotic episode presented a delusional-hallucinatory clinical picture. This study seeks to contribute to the inclusion of the Postpsychotic Depressive Disorder (PSD) of Schizophrenia (DSM-IV), in the group of Schizophrenic Disorders.

Depressão em esquizofrenia

A literature review on the presence of depressive symptoms in schizophrenic patients, especially post-schizophrenic depression, was carried out. It was conducted a Medline search through the years 1966-2000 to identify original papers and review articles on the following: historical data, main studies, clinical features and progression, diagnosis and differential diagnosis, etiopathogenesis, and prognosis. Post- schizophrenic depression is an independent syndromic entity and should be considered as a clinical variety of delusional schizophrenic forms, and part of the natural disease progression.

Camille Claudel: a revulsion of nature The art of madness or the madness of art?

(Suassuna, 1996). However, art produced by mental patients has also been termed psychopathological art, an expression which greatly displeases me for there is no such thing as sick, psychotic or mad art and neither can a work of art be said to be mentally ill. For this reason, I would rather refer to it by the scholarly term previously referred.In the context of art produced by the mentally ill, it is extremely important to tell the artist – amateur or professional – who has exercised his technical skills from the insane that eventually became an artist, i.e., a psychiatric patient who either spontaneously or through occupational therapy started producing plastic arts or literary works. It is evident that both the works produced before the presentation of any pathological symptoms and the ones produced after them provide clear clues as to the morbid processes which have been developing in the patient’s mind (conscious and unconscious psychic life).