Taiane de Azevedo Cardoso

Prevalence of episodes of mania and hypomania and associated comorbidities among young adults

OBJECTIVEnTo evaluate the prevalence of episodes of mania and hypomania, as well as associated factors and comorbidities among adults 18 to 24 years old in the city of Pelotas, Brazil.nnnMETHODnThis is a cross-sectional population-based study. The sample was selected through conglomerates, and episodes of mania and hypomania were assessed using the Mini International Neuropsychiatric.nnnRESULTSnThe sample consisted of 1560 subjects. The lifetime prevalence of manic and hypomanic episodes was 7.5% and 5.3%, respectively. Subjects with (hypo)manic episodes had a higher prevalence of anxiety disorders, substance abuse and suicidality.nnnLIMITATIONnThe high rate of (hypo)mania may to some extent reflect diagnostic error.nnnCONCLUSIONnSuch high prevalence of (hypo)mania may nonetheless be valid as it was associated with corresponding rates of comorbidity and suicidality.

Neuroprogression and Cognitive Functioning in Bipolar Disorder: A Systematic Review

Bipolar disorder (BD) has been associated with impairments in a range of cognitive domains including attention, verbal learning, and mental flexibility. These deficits are increased during the acute phases of the illness and worsen over the course of BD. This review will examine the literature in relation to potential mechanisms associated with cognitive decline in BD. Scopus (all databases), Pubmed, and Ovid Medline were systematically searched with no language or year restrictions, up to January 2015, for human studies that collected cross-sectional and longitudinal cognitive data in adults with BD and matched healthy controls (HC). Selected search terms were “bipolar,” “cognitive,” “aging,” “illness duration,” “onset,” and “progression.” Thirty-nine studies satisfied the criteria for consideration. There is evidence that cognitive function in BD is negatively associated with features of illness progression such as number of mood episodes, illness duration, and hospitalizations. Aging does not appear to affect cognitive functioning to a greater extent than in HC. Furthermore, the small number of longitudinal studies in this field does not allow to reaching firm conclusion in terms of which sub-populations would be more prone to cognitive decline in BD. The decline in cognitive abilities over the course of the BD seems to be associated with the number of episodes and number of hospitalizations. No meaningful interaction of age and bipolar disorder has been found in terms of cognitive decline. Future large-scale longitudinal studies are necessary to confirm these findings and assist in the development of preventive interventions in vulnerable individuals.

Neurotrophic factors, clinical features and gender differences in depression.

AbstractnRecent studies have evaluated the role of brain-derived neurotrophic factor (BDNF) in mood disorders; however, little is known about alterations in nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF). The aim of this study was to evaluate differences among serum neurotrophic factors (BDNF, NGF and GDNF) in depressed patients and healthy controls and to verify the association between serum neurotrophic levels and clinical characteristics in a young, depressed population stratified by gender. This is a cross-sectional study with depressed patients and population controls 18–29xa0years of age. The concentrations of neurotrophic factors were determined by the ELISA method. The diagnosis of depression and the duration of the disease were assessed by the Structured Clinical Interview according to the diagnostic and statistical manual of mental disorders. Depression severity was measured with the 17-item Hamilton Rating Scale for Depression, and the severity of anxiety symptoms was measured using the Hamilton Anxiety Rating Scale. Serum BDNF and GDNF were lower in major depressive disorder (MDD) patients compared to controls (pxa0≤xa00.001). Serum NGF levels were higher in MDD patients versus controls (pxa0≤xa00.001). BDNF was associated with the duration of disease only in women (pxa0=xa00.005). GDNF was not associated with clinical characteristics in either gender. In women, NGF was associated with the severity of depressive symptoms (pxa0=xa00.009), anxiety (pxa0=xa00.011) and disease duration (pxa0=xa00.005). NGF was associated with disease duration in men (pxa0=xa00.026). Our results demonstrated that significant neurochemical differences in NGF and BDNF, but not in GDNF, were associated with the clinical features of MDD when patients were stratified by gender.n

Biological rhythms in bipolar and depressive disorders: A community study with drug-naïve young adults

AIMnTo assess biological rhythm disruptions among drug-naïve young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls.nnnMETHODSnThis was a cross-sectional study nested in a population-based study. BD and MDD were diagnosed using the Structured Clinical Interview for DSM-IV. Biological rhythm disruptions were assessed using the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN).nnnRESULTSnTwo hundred seventeen subjects were assessed (49 BD, 74 MDD, and 94 community controls). Biological rhythm disruption was higher in subjects with BD (40.32±9.92; p<0.001) and MDD (36.23±8.71; p<0.001) than community controls (27.67±6.88). Subjects with BD had a higher BRIAN total score (p=0.028) and higher disruption in sleep/social domains (p=0.018) as compared to MDD. In addition, the BRIAN scores were higher in current MDD, euthymic BD, and BD in current episode group, as compared to community controls.nnnLIMITATIONnCross-sectional design. Absence of assessment of biomarkers of biological rhythms.nnnCONCLUSIONnBipolar disorder and major depressive disorder are associated with disruption in biological rhythm. In addition, disruption in sleep/social rhythms is higher in subjects with BD when compared to subjects with MDD. We also verified biological rhythm disruption in subjects with BD during euthymic status, but not in remitted MDD. Regulation of biological rhythm may be a means to identify patients with mood disorders and potentially differentiate MDD from BD.

Quality of life and mood disorder episodes: Community sample

OBJECTIVEnTo assess quality of life among Brazilian young adults who are 18-24 years old and who experience depressive, manic/hypomanic, and mixed episodes.nnnMETHODnThis is a cross-sectional population-based study. The sample was selected in clusters. Mood disorders were assessed using a short, structured diagnostic interview-the Mini International Neuropsychiatric Interview (MINI) for DSM-IV and ICD-10 psychiatric disorders. Quality of life was assessed by the MOS 36-item Short-form General Health Survey (SF-36).nnnRESULTSnThe sample comprised 1560 young adults. The prevalence ratio of mood disorder episodes were as follows: 10.0% depressive episode, 2.3% manic/hypomanic episode, and 2.4% mixed episode. Lower scores were found in all domains of quality of life among young adults who experience mood disorder episodes when compared to the general population (p<0.001 in the eight domains of the SF-36). Moreover, the impact on quality of life was higher among young adults with mixed episodes, followed by depressive episodes.nnnCONCLUSIONnYoung adults with mood disorders, even without a previous diagnosis of bipolar disorder, have an impaired quality of life in comparison to the general population.

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 effect of proinflammatory cytokines in Cognitive Behavioral Therapy

Major depressive disorder (MDD) is a debilitating disorder and its pathophysiology is associated with deregulation of the immune system. We investigated the changes in circulating levels of proinflammatory cytokines (specifically IL-6 and TNF-α) measured by the ELISA kit in two psychotherapeutic interventions for MDD: Narrative Cognitive Therapy (NCT) and Cognitive Behavioral Therapy (CBT). This is a randomized clinical trial including 97 individuals (18 to 29years-old) with MDD. In CBT there was a significant difference in serum levels of IL-6 and TNF-α, therefore indicating that CBT was more effective than NCT on serum levels proinflammatory cytokines.

Bullying and associated factors in adolescents aged 11 to 15 years

INTRODUCAO: O bullying entre adolescentes tem sido objeto de varias pesquisas devido aos prejuizos comportamentais que acarreta. Contudo, a literatura brasileira sobre o tema e escassa. OBJETIVO: Avaliar comportamentos de bullying e fatores associados em uma amostra de base populacional de adolescentes vivendo no sul do Brasil. METODO: Estudo transversal, de base populacional, com adolescentes de 11 a 15 anos de idade residentes na cidade de Pelotas, RS, Brasil. RESULTADOS: Um total de 1.145 adolescentes foram selecionados. Os comportamentos e atitudes de bullying mostraram-se associados aos seguintes fatores: faltar aula intencionalmente, reprovar algum ano na escola, usar alcool, cigarro e/ou drogas ilicitas, ter tido relacoes sexuais, portar arma, sofrer algum acidente ou atropelamento e brigar e/ou agredir alguem. CONCLUSAO: O bullying esteve associado com varios comportamentos considerados de risco para a saude fisica e psicologica dos adolescentes.INTRODUCTIONnBullying among adolescents has become the subject of extensive research due to its negative effects on attitude and behavior. However, Brazilian literature on the topic is scarce.nnnOBJECTIVEnTo assess bullying and associated factors among adolescents in a population-based sample in southern Brazil.nnnMETHODnPopulation-based, cross-sectional study with adolescents aged 11 to 15 years living in the municipality of Pelotas, state of Rio Grande do Sul, Brazil.nnnRESULTSnA total of 1,145 adolescents were included. Bullying behaviors and attitudes were found to be associated with the following factors: intentionally skipping classes, failing at school, using alcohol, smoking cigarettes, using illegal drugs, having engaged in sexual intercourse, carrying a weapon, being involved in an accident/being run over by any vehicle, and being involved in fights with physical aggression.nnnCONCLUSIONnBullying is associated with several behaviors that pose risk to the adolescents physical and psychological health.

Risco de suicídio e comportamentos de risco à saúde em jovens de 18 a 24 anos: um estudo descritivo

O objetivo foi avaliar risco de suicidio e comportamentos de risco em jovens. Estudo transversal na zona urbana de Pelotas, Rio Grande do Sul, Brasil, realizado por amostragem sistematica. Foram incluidos jovens de 18 a 24 anos, com capacidade cognitiva e que assinaram termo de consentimento. Foram aferidos risco de suicidio (MINI); comportamentos de risco (YRBSS); abuso/dependencia de substâncias (ASSIST); e nivel socioeconomico (ABEP). Os dados foram analisados no programa SPSS. A amostra constituiu-se de 1560 jovens e a prevalencia de risco de suicidio foi de 8,6%. O risco de suicidio foi associado com: ter sofrido acidente com necessidade de ir ao pronto-socorro (p = 0,011), ter entrado em briga com agressao fisica (p = 0,016), ter carregado arma branca (p = 0,001) e arma de fogo (p < 0,001), ter abuso/dependencia de substâncias (p < 0,001), nao ter utilizado preservativo na ultima relacao sexual (p = 0,025), nao ter parceiro fixo (p < 0,001) e ter relacao sexual com cinco ou mais pessoas (p = 0,018). Jovens com comportamentos de risco tambem demonstram indicios de risco de suicidio.

Anxiety disorders in young people: a population-based study

OBJECTIVEnTo assess the prevalence of anxiety disorders and associated factors in young adults.nnnMETHODSnCross-sectional population-based study of individuals between the ages of 18 and 24 years randomly selected from 89 census-based sectors to ensure an adequate sample size. Household selection within the sectors was performed according to a systematic sampling process. Anxiety disorders were assessed using the Mini International Neuropsychiatric Interview (MINI). The final sample comprised 1,560 young adults.nnnRESULTSnOf the participants who were diagnosed with anxiety disorders, 12.3% had agoraphobia, 9.7% had generalised anxiety disorder, 4.0% had social phobia, 3.3% had obsessive-compulsive disorder, 2.5% had panic disorder, and 2.1% had post-traumatic stress disorder; only 23.8% had received any previous treatment. Anxiety disorders were associated with sex, socioeconomic status, psychiatric problems in parents, alcohol abuse, and tobacco use.nnnCONCLUSIONSnThe identification of factors associated with anxiety disorders in young people enables us to develop intervention strategies. Anxiety disorders are not only highly prevalent but are also associated with significant functional impairment, significant reductions in quality of life, lower productivity, and higher rates of comorbidities.