Trends in Psychiatry and Psychotherapy最新文献

Objective: We aim to create a web-based calculator for assessing depressive symptoms with the Patient Health Questionnaire 9 (PHQ-9), utilizing IRT-based standardized scores, to improve measurement precision, standardization, and practical application in clinical practice.

Methods: This study developed a web-based calculator using a graded response IRT model for assessing depressive symptoms with the PHQ-9, using data from the Brazilian National Health Survey 2019 (n = 90,846, aged 15 to 107 years old, 52.8% female). The tool calculates latent depressive symptoms and converts them into T-scores, with stratification by sex and age groups. The application respects patient confidentiality by deleting sensitive information postcalculation.

Results: Estimated models resulted in a mean sample size of 3244.5 participants in each group (SD: 1066). The calculator can be accessed at https://mheg.shinyapps.io/phq9-score.

Discussion: The development of an IRT-based web calculator for the PHQ-9 represents an advancement in depressive symptoms' assessment, offering precision and potential clinical utility. By standardizing scores into a common metric, this tool facilitates the interpretation of depressive symptoms and comparison across different instruments. The study's scope is limited to the Brazilian population and external validity for other contexts is warranted. Future studies should evaluate the clinical validity and the threshold of the tool for predicting real life problems.

Background: Drug overdose deaths remain a significant and understudied public health concern in Brazil. This study aimed to examine drug overdose death records from 2000 to 2020, focusing on the relationship between mood disorders and intentionality, along overall sociodemographic characteristics.

Methods: Data from the Brazilian Mortality Information System from 2000-2020 were analyzed. Records with causes of death coded as X40-X45 (accidental poisoning), X60-X65 (intentional poisoning), or Y10-Y15 (undetermined intentionality poisoning) were included. The dataset comprised 21,410 deaths, including 933 subjects with mood disorders (ICD-10 codes F30-F39). A descriptive analysis of sociodemographic variables, stratified by mood disorders, was conducted. Logistic regression models identified independent associations with intentional overdose deaths.

Results: People who died of a drug overdose were mostly men (61.55%), non-white (52.45%), and single (59.33%). Most drug overdose deaths were intentional (44.70%). Compared to overall overdoses, the subset with mood disorders included a higher share of women (67.95%), whites (63.88%), and intentional overdoses (75.24%). Female gender (OR 1.30), mood disorder (OR 2.0), non-white race (OR 0.56), high school graduates (OR 0.93), some college education (OR 1.28), and divorced or widowed (OR 0.73) were independently associated with intentional overdose deaths.

Conclusion: The sociodemographic characteristics of people who died of overdoses must guide national public policies. Strategies might involve conducting screenings for mental health disorders and drug-related problems in primary care.

Introduction: Alzheimer's disease (AD) is the leading cause of dementia in the elderly and involves pathophysiological events which results in progressive cognitive impairment and functional disabilities. Loneliness is a unique condition in which an individual perceives themselves as socially isolated, even when they are among other people. It is also a worldwide public health challenge associated with higher mortality, and risk of cardiovascular and psychiatric diseases. The aim of this study is to investigate the impacts of loneliness on the development of AD in women.

Methods: Systematic Review registered in PROSPERO (CDCRD42024521068) and adherent to PRISMA and Cochrane guidelines. In November 2025, systematic searches conducted by independent reviewers were carried out in international databases. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale and the Downs and Black Checklist.

Results: A significant association is suggested between loneliness and the development of AD. Possible causal mechanisms were identified, namely chronic stress associated with loneliness, lack of social and emotional support, and reduced cognitive and social activity. The organization of studies allows for an analysis of the incidence of AD, the progression of cognitive decline, and the relationship with neurobiological changes associated with loneliness.

Conclusion: Despite being a complex and barely understood relationship, Loneliness may play a relevant role in the development of AD among women. Psychosocial factors must be considered in the context of aging and women's mental health, emphasizing its role in increasing the risk and progression of the disease.

Background: The offspring of parents with bipolar disorder (BD) and with attention deficit hyperactivity disorder (ADHD) have a higher risk of having the same condition. Both disorders also share psychopathological symptoms; however, little is known about their genetic overlap. To examine whether the offspring of parents with BD have a greater chance of being affected by ADHD, we conducted a systematic review.

Methods: From inception to August 12, 2024, we searched the PubMed, SciELO, PsycInfo and Cochrane databases. We included studies if they investigated the association of parental bipolar disorder with offspring outcomes and made a proper investigation of disorders using validated instruments based on the Diagnostic Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD) criteria. Studies were excluded if: parents were under 18 years old or over 70; did not report original data; systematic reviews; in vitro studies; with an animal model; offspring older than 17 years of age or with any comorbid diagnosis with ADHD. To assess risk of bias, two authors independently used the Newcastle-Ottawa Scale quality assessment tool.

Results: 23 articles met the inclusion criteria. The majority of the studies reported that the offspring of parents with BD were at higher risk for ADHD. Particularly, in all case‒control studies, the risk of ADHD was higher in the case group than the control group.

Conclusion: The current studies are yet heterogeneous and literature did not uncover the biological correlation of these disorders regarding genetic, biochemical, neuroimaging and neuropsychological aspects.

Objectives: Thus, through a narrative review, this article analyzes how the advancement of technology, the use of digital resources, and social media have impacted the doctor-patient relationship.

Methods: We conducted a scoping review on the relationship between Digital Health Equity and Telemedicine and e-health via Scopus and Pubmed electronic databases. The following inclusion criteria were established: papers on the relationship between digital health equity and telemedicine and e-health, written in English and with no time limits. All study designs were eligible, including those that have utilized qualitative and quantitative methods, methodology, or guidelines reports, except for meta-reviews.

Results: With the advancement of technology and social media, a change in behavior in the population and the doctor-patient relationship was observed. Through the help of digital devices, the increased prevalence of social networks, and asynchronous consultations new opportunities were created to bring doctors and patients closer. The relationship has shifted from face-to-face and paternalistic to virtual communication with shared decisions in recent decades. It was observed that the advancement of technology and the use of digital resources have reshaped the roles of doctors and patients and their relationships.

Conclusion: Technology is the leading cause for an informed, more involved, and responsible patient. However, physicians have conflicting opinions about the use of these technologies. While recognizing its benefits for patients, they are also concerned about digital health and its impact.

Objective: Attention-deficit/hyperactivity disorder (ADHD) affects approximately 7% of children and 5% of adolescents worldwide. ADHD is characterized by inattention, hyperactivity and impulsivity as symptoms. The exact mechanism underlying this disorder is still unclear, but genetic and environmental factors play important roles. In recent years, research and treatment options have increased, including medication and/or therapeutic interventions such as music therapy. There is evidence showing benefits of music therapy on mental health, such as autism spectrum disorder (ASD). However, results regarding ADHD are limited. The aim of this meta-analysis was to verify whether music therapy is an effective tool for improving symptoms in children and adolescents with ADHD.

Methods: In accordance with PRISMA guidelines, we systematically searched the Virtual Health Library, SciELO, PubMed and Cochrane Library databases. This article included original research that investigated the effect of music therapy on hyperactive and impulsive symptoms in children and adolescents with ADHD.

Results: Music therapy was associated with a trend of efficacy involving ADHD symptoms (effect size: 1.18; CI: -3.8 - 0.21; p = 0.08). Additionally, a significant amount of heterogeneity among trials was found (I2 = 92 %). The lack of studies involving music therapy, ADHD and brain imaging, as well as limited investigation of inattention symptoms in studied articles are limitations of this article.

Conclusion: Music therapy is an important therapeutic tool for ADHD. Therefore, future research should include more robust samples and measurement scales, follow-up after experiments and further exploration of the potential connections among ADHD, music therapy, neuroimaging and neuroscientific fields.

Objective: In recent decades, there have been considerable advances in treatment and prevention of acute ischemic stroke (IS). However, even after treatment, approximately two-thirds of patients with IS have some degree of disability that requires rehabilitation, along with an increased likelihood of developing psychiatric disorders, particularly depression. The objective of this study was to determine the predictors of post-stroke depression in a 6-month period in patients with IS.

Methods: Ninety-seven patients with IS without previous depression were included in the study. The study protocol was applied during hospitalization and at 30, 90, and 180 days after hospital discharge. A binary logistic regression was then conducted. Age, sex, marital status, occupation, educational level, thrombolysis, National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) score, Barthel Index (BI), and Mini-Mental State Examination (MMSE) score were included as independent variables.

Results: Of the 97 patients, 24% of patients developed post-stroke depression. In the longitudinal follow-up, an mRS score of > 0 was the lone significant predictor of development of depression (odds ratio [OR] = 5.38; 95% confidence interval [95%CI] 1.25-23.12; p < 0.05).

Conclusion: Our results showed that in patients without previous depression, functional impairment of any degree is associated with a 5-fold greater chance of development of depression in the first 6 months post-stroke compared to patients without functional impairment.

Lithium's well-documented efficacy in preventing suicide over the long term prompts consideration of its potential for more rapid antisuicidal effects. However, evidence supporting such acute efficacy is limited. Weighing against its possible rapid benefits are significant concerns regarding lithium's side-effect profile - particularly toxicity, renal impairment, and weight gain - and the often necessary delay in achieving therapeutic levels. Moreover, the multifaceted nature of suicidality complicates identifying short-term outcomes and disentangling lithium's effects on suicidal thoughts from broader reductions in depressive symptoms. While lithium may remain invaluable for some high-risk patients in emergency settings, its routine use as a rapid-acting agent for acute suicidality is currently not well supported.

Objective: This study aimed to examine the discriminative capacity of the Dimensional Clinical Personality Inventory 2 (IDCP-2) factors for identifying individuals with elevated borderline personality disorder (BPD) traits within a Brazilian community sample while proposing an optimal cutoff score for distinguishing high BPD trait levels.

Methods: The participant cohort consisted of 1,469 adults who completed assessments, including the Level of Personality Functioning Scale - Brief Form 2.0 (LPFS), the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) (PID-5), the IDCP-2, and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) - Personality Questionnaire (PQ-SCID-II). We categorized participants into three groups utilizing the traits outlined in the Alternative Model of Personality Disorders (AMPD) from DSM-5 Section III. Furthermore, latent profile analysis based on PID-5 facets revealed the existence of three empirically derived profiles.

Results: Our findings demonstrate that IDCP-2 factors exhibited substantial discriminative power, marked by large effect sizes across most factors. To minimize false negatives, we suggest a conservative cutoff score of 22 as the most effective threshold for identifying individuals with high levels of BPD traits.

Conclusion: The BPD score generated from IDCP-2 factors holds significant promise in clinical practice, offering valuable insights into a patient's propensity to exhibit a BPD profile and providing a comprehensive clinical profile.

Psychedelics are a group of psychoactive substances that produce complex and subjective changes to consciousness and carry unique safety considerations. There is a growing body of work investigating the use of psychedelics in mental health treatment alongside increasing socio-cultural and political acceptance. This rapid evolution has prompted corporations to fund psychedelic clinical trials, leading to a potential rise in conflicts of interest in relevant studies and publications. However, the body of evidence for the safety and efficacy of psychedelic-assisted psychotherapy is early. There is concern regarding the introduction of bias in psychedelic clinical trials and the selective reporting of results amidst and beyond corporate involvement. At a crucial time in psychedelic drug reform, this paper explores the safety concerns associated with psychedelics, the potential influences of financial stakeholders on safety outcome reporting and the importance of balanced science communication in maintaining public health and safety.