Ricardo A. Silva

Is paternal postpartum depression associated with maternal postpartum depression? Population-based study in Brazil

Objective:u2002 To describe the prevalence of paternal postpartum depression (PPD) as well as its association with maternal PPD.

Uso de álcool por adolescentes: estudo de base populacional

OBJETIVO: Estimar la prevalencia y los factores asociados al uso de alcohol por adolescentes. METODOS: Estudio transversal de base poblacional realizado entre 2005 y 2006, en Pelotas (Sur de Brasil), con 1.056 adolescentes entre 11 y 15 anos de edad. Fue aplicado un cuestionario de auto-llenado anonimo, basado en el modelo de la Organizacion Mundial de la Salud para uso de drogas. Para analisis de los datos, fue utilizada la regresion de Poisson. RESULTADOS: La prevalencia de adolescentes que refirieron el consumo de bebidas alcoholicas en el ultimo mes fue de 23,0% (IC 95%: 20,4; 25,4), la prevalencia fue de 21,7% entre el sexo femenino y 24,2% entre el masculino. La prevalencia de consumo de alcohol a los 11 anos fue de 11,9%. En el analisis de regresion multiple, entre adolescentes del sexo masculino, el uso de bebidas alcoholicas fue mayor en aquellos que relataron el uso de tabaco en el ultimo mes, en los mas viejos y en aquellos que ya habian tenido relacion sexual. En las adolescentes del sexo femenino la edad fue la unica variable asociada al uso de bebidas alcoholicas. CONCLUSIONES: El uso de bebidas alcoholicas fue prevalerte en ambos sexos y con inicio extremadamente precoz. Tabaquismo y el haber tenido relaciones sexuales tambien estuvieron asociados al uso de bebidas alcoholicas. Hay necesidad de medidas preventivas con mayor precocidad, visando controlar el uso de alcohol en el intervalo de edad de 11 a los 15 anos.OBJECTIVEnTo estimate the prevalence and factors associated with alcohol use among adolescents.nnnMETHODSnPopulation-based, cross-sectional study performed from 2005 to 2006, in the city of Pelotas, Southern Brazil, with 1,056 adolescents aged between 11 and 15 years. An anonymous, self-applied questionnaire was used, based on the World Health Organization model for drug use. Poisson regression was employed to analyze data.nnnRESULTSnPrevalence of adolescents who reported alcoholic beverage consumption in the last month was 23.0% (95% CI: 20.4;25.4), prevalence was 21.7% among females and 24.2% among males. Prevalence of alcohol consumption at 11 years of age was 11.9%. In the multiple regression analysis, alcoholic beverage use by male adolescents was higher among those who reported tobacco use in the last month, those who were older, and those who had already had sexual intercourse. Among female adolescents, age was the only variable associated with alcoholic beverage use.nnnCONCLUSIONSnAlcoholic beverage use was prevalent in both sexes and began at a very early age. Smoking and previous sexual intercourse were also associated with this use. Preventive measures need to begin earlier, aiming to control alcohol use in the 11-to-15-year age group.

The impact of maternal post-partum depression on the language development of children at 12 months

BACKGROUNDnLanguage is one of the most important acquisitions made during childhood. Before verbal language, a child develops a range of skills and behaviours that allow the child to acquire all communication skills. Factors such as environmental factors, socio-economic status and interaction with parents can affect the acquisition of vocabulary in children. Post-partum depression can negatively affect the first interactions with the child and, consequently, the emotional, social and cognitive development of the child.nnnOBJECTIVEnTo analyse the effect of the duration of the mothers depression on the language development of children at 12 months old.nnnMETHODSnThis was a longitudinal study. The participants of this study were mothers who had received prenatal care from the Brazilian National System of Public Health in Pelotas city, State of Rio Grande do Sul, Brazil. The mothers were interviewed at two different time points: from 30 to 90 days after delivery and at 12 months after delivery; the children were also evaluated at this later time point. To diagnose maternal depression, we used the Mini International Neuropsychiatric Interview, and to assess child development, we used the language scale of the Bayley Scales of Infant Development III.nnnRESULTSnWe followed 296 dyads. Maternal depression at both time points (post partum and at 12 months) was significantly associated with the language development of infants at 12 months of age. This impact was accentuated when related to the duration of the disorder. Older women and women with more than two children were more likely to have children with poorer language development, while women who were the primary caregiver had children with higher scores on the language test.nnnCONCLUSIONnThe findings indicate that maternal age, parity, primary caregiver status and duration of post-partum depression are associated with the language development of the child.

Psychiatric and substance-use comorbidities associated with lifetime crack cocaine use in young adults in the general population

OBJECTIVEnTo assess the association between lifetime crack cocaine use and psychiatric (post-traumatic stress disorder, current depression, current dysthymia, generalized anxiety disorder, panic disorder with agoraphobia, social phobia, as well as SRQ scores and suicide risk) and substance-use disorders (tobacco, alcohol, cannabis, cocaine, amphetamine, inhalants, sedatives, hallucinogens and opioids) in youth in the general population of the city of Pelotas, RS.nnnMETHODnThis was a cross-sectional population-based study, involving 1560 participants between 18 and 24 ears old. Lifetime substance use and abuse were investigated using the ASSIST inventory. Psychiatric comorbidities were assessed using the Mini-International Neuropsychiatric Interview and symptoms of common mental disorders were evaluated with the Self-Reported Questionnaire (SRQ).nnnRESULTSnThe prevalence of lifetime crack cocaine use in the sample was 2.5%. Its use was associated with total SRW scores and the presence of post-traumatic stress disorder, antisocial personality disorder and suicide risk in the final regression model. Tobacco, alcohol, cannabis, cocaine, amphetamine and cocaine dependence were also associated with lifetime use of crack cocaine.nnnDISCUSSIONnYouth with a history of crack cocaine use had a higher prevalence of psychiatric conditions such as post-traumatic stress disorder, as well as an increased risk of tobacco, alcohol, cannabis, cocaine, amphetamine and inhalant use and dependence.

Immune dysfunction in bipolar disorder and suicide risk: is there an association between peripheral corticotropin‐releasing hormone and interleukin‐1β?

OBJECTIVEnThe aim of the present study was to investigate the relationship between peripheral levels of corticotropin-releasing hormone (CRH) and interleukin-1β (IL-1β) in individuals with bipolar disorder (BD) with and without suicide risk (SR), and controls.nnnMETHODSnA total of 120 young adults (40 controls, 40 subjects with BD without SR, and 40 subjects with BD with SR) were enrolled from a population-based study carried out in the city of Pelotas, Brazil. BD and SR were assessed through the Mini International Neuropsychiatric Interview (MINI 5.0), and peripheral markers were evaluated by enzyme-linked immunosorbent assay (ELISA).nnnRESULTSnLevels of CRH were significantly lower both in subjects with BD without SR (p = 0.04) and subjects with BD with SR (p = 0.02) when compared to controls. However, levels of IL-1β were increased in subjects with BD with SR (p = 0.05) when compared to controls. Sociodemographic and clinical variables, current mood episode, and use of psychiatric medications were not associated with changes in these markers. No correlation was found between peripheral levels of CRH and IL-1β (p = 0.60) in the population or in the BD with SR group (p = 0.88).nnnCONCLUSIONSnThese results suggest that peripheral mechanisms linking stress hormones and the immune system might be critical patterns involved in suicidal behavior associated with BD.

Violent and sexual behaviors and lifetime use of crack cocaine: a population-based study in Brazil

ObjectiveTo estimate the prevalence of lifetime use of crack cocaine and to assess associations with violent and sexual behaviors in young adults selected from the general population of Pelotas, Southern Brazil.MethodsThis cross-sectional population-based study included 1,560 participants aged 18–24xa0years. The use of alcohol and other substances, including crack cocaine, was assessed using the alcohol, smoking and substance involvement screening test. Other variables included violent behaviors, firearm possession, and sexual risk behaviors. The frequency of antisocial personality disorder was also investigated. Associations were analyzed using a crude model and models adjusted for sex, social class, and the use of snorted cocaine.ResultsLifetime prevalence of crack cocaine use was 2.51xa0%, and it was higher among males and individuals coming from more vulnerable social classes (D or E). In the final multivariate models, lifetime use of crack cocaine was associated with episodes of aggression and firearm possession, as well as with a higher chance of not having used condom in the last sexual intercourse. In less conservative models, crack cocaine use was associated with other violent and sexual risk behaviors.DiscussionThe strong association observed between lifetime use of crack cocaine and different violent and sexual risk behaviors underscores relevant characteristics of people who use crack cocaine. Improving our understanding of possible causal chains leading to such associations should be a priority in future studies.

Interleukin-1β is associated with depressive episode in major depression but not in bipolar disorder

Our work was sought to investigate possible changes in peripheral levels of interleukin-1β (IL-1β) according to the diagnosis of major depression (MD) and bipolar disorder (BD) and in different mood episodes. This is a cross-sectional nested in a population-based study comparing 240 young adults (80 controls, 80 MD and 80 BD), balanced for age and gender. Serum levels of IL-1β were significantly higher in MD when compared to control or BD subjects. In addition, when divided by current mood episode, MD subjects in current depression presented higher IL-1β levels than controls. No differences in IL-1β levels were found between different episodes of BD (euthymic, depressed, mania or mixed). Moreover, the use of psychiatric medication was very low in our sample and not associated with changes in IL-1β levels. In conclusion, increased peripheral IL-1β might be a useful marker associated with a depressive episode in the context of MD.

Alcohol use among adolescents: a population-based study

OBJETIVO: Estimar la prevalencia y los factores asociados al uso de alcohol por adolescentes. METODOS: Estudio transversal de base poblacional realizado entre 2005 y 2006, en Pelotas (Sur de Brasil), con 1.056 adolescentes entre 11 y 15 anos de edad. Fue aplicado un cuestionario de auto-llenado anonimo, basado en el modelo de la Organizacion Mundial de la Salud para uso de drogas. Para analisis de los datos, fue utilizada la regresion de Poisson. RESULTADOS: La prevalencia de adolescentes que refirieron el consumo de bebidas alcoholicas en el ultimo mes fue de 23,0% (IC 95%: 20,4; 25,4), la prevalencia fue de 21,7% entre el sexo femenino y 24,2% entre el masculino. La prevalencia de consumo de alcohol a los 11 anos fue de 11,9%. En el analisis de regresion multiple, entre adolescentes del sexo masculino, el uso de bebidas alcoholicas fue mayor en aquellos que relataron el uso de tabaco en el ultimo mes, en los mas viejos y en aquellos que ya habian tenido relacion sexual. En las adolescentes del sexo femenino la edad fue la unica variable asociada al uso de bebidas alcoholicas. CONCLUSIONES: El uso de bebidas alcoholicas fue prevalerte en ambos sexos y con inicio extremadamente precoz. Tabaquismo y el haber tenido relaciones sexuales tambien estuvieron asociados al uso de bebidas alcoholicas. Hay necesidad de medidas preventivas con mayor precocidad, visando controlar el uso de alcohol en el intervalo de edad de 11 a los 15 anos.OBJECTIVEnTo estimate the prevalence and factors associated with alcohol use among adolescents.nnnMETHODSnPopulation-based, cross-sectional study performed from 2005 to 2006, in the city of Pelotas, Southern Brazil, with 1,056 adolescents aged between 11 and 15 years. An anonymous, self-applied questionnaire was used, based on the World Health Organization model for drug use. Poisson regression was employed to analyze data.nnnRESULTSnPrevalence of adolescents who reported alcoholic beverage consumption in the last month was 23.0% (95% CI: 20.4;25.4), prevalence was 21.7% among females and 24.2% among males. Prevalence of alcohol consumption at 11 years of age was 11.9%. In the multiple regression analysis, alcoholic beverage use by male adolescents was higher among those who reported tobacco use in the last month, those who were older, and those who had already had sexual intercourse. Among female adolescents, age was the only variable associated with alcoholic beverage use.nnnCONCLUSIONSnAlcoholic beverage use was prevalent in both sexes and began at a very early age. Smoking and previous sexual intercourse were also associated with this use. Preventive measures need to begin earlier, aiming to control alcohol use in the 11-to-15-year age group.

Childhood trauma, family history, and their association with mood disorders in early adulthood

To assess the prevalence of childhood trauma and types of trauma on mood disorders among young adults in a population‐based sample. We further gathered data on family history of mood disorders to test the hypothesis that childhood trauma is a mediating factor for the association between family history of mood disorder and mood disorder in adulthood.

The impact of cognitive behavioral therapy on IL-6 levels in unmedicated women experiencing the first episode of depression: a pilot study.

A group of 11 women (18-29 years old) in the first episode of depression was evaluated before and after cognitive behavioral therapy (CBT). Depressive scores, assessed by Hamilton Rating Scale (HRSD), and serum IL-6 levels significantly decreased after the seventh session. These results suggest that CBT reduced both depressive symptoms and the inflammatory state in women.