Do the physical discomforts from breast cancer treatments affect the sexuality of women who underwent mastectomy?

The objective of this integrative review is to analyze the scientific production addressing the sexuality of women with breast cancer following mastectomy, focused on the effects that the physical discomfort due to cancer treatments have on their sex life. The search included articles published in the period between 2000 and 2009 on the MEDLINE, LILACS and PsycINFO databases, using the following descriptors: mastectomy, breast neoplasms, sexuality, sexual behavior, amputation, psychosexual development, and marital relations. Nine articles were selected, which addressed the effects of the physical discomfort from cancer treatments on the patients' sexuality. The findings revealed that, even when the patient's sex life is intense and fulfilling before the disease, factors such as stress, pain, fatigue, insult to body image, and low self-esteem due to the treatments may alter the sexual functioning of the affected woman. Healthcare professionals must be sensitized in order to welcome and include the topic in policies as well as in preventive, diagnostic, and therapeutic strategies.

Mastectomy and Sexuality: An Integrative Review

Women affected by breast cancer are faced with the removal of a body part related to sexuality. This study aimed to investigate the impact of breast cancer and mastectomy in women's sexuality through the analysis of scientific literature published from 2000 to 2009. The bibliographic survey was carried out in LILACS, MedLine and PsycINFO databases. Twenty nine articles were selected to constitute the corpus of the analysis. The findings were grouped by means of content analysis. The results showed that after the removal of the breast, sexual performance is compromised, with reduced frequency of sexual intercourse in the early stages of treatment and low sexual desire, interest and satisfaction.

Efficacy of brief alcohol screening intervention for college students (BASICS): a meta-analysis of randomized controlled trials

Background: Many studies reported that brief interventions are effective in reducing excessive drinking. This study aimed to assess the efficacy of a protocol of brief intervention for college students (BASICS), delivered face-to-face, to reduce risky alcohol consumption and negative consequences. Methods: A systematic review with meta-analysis was performed by searching for randomized controlled trials (RCTs) in Medline, PsycInfo, Web of Science and Cochrane Library databases. A quality assessment of RCTs was made by using a validated scale. Combined mean effect sizes, using meta-analysis random-effects models, were calculated. Results: 18 studies were included in the review. The sample sizes ranged from 54 to 1275 (median = 212). All studies presented a good evaluation of methodological quality and four were found to have excellent quality. After approximately 12 months of follow-up, students receiving BASICS showed a significant reduction in alcohol consumption (difference between means = -1.50 drinks per week, 95% CI: -3.24 to -0.29) and alcohol-related problems (difference between means = -0.87, 95% CI: -1.58 to -0.20) compared to controls. Conclusions: Overall, BASICS lowered both alcohol consumption and negative consequences in college students. Gender and peer factors seem to play an important role as moderators of behavior change in college drinking. Characteristics of BASICS procedure have been evaluated as more favorable and acceptable by students in comparison with others interventions or control conditions. Considerations for future researches were discussed.

Sleep disorders in climacteric women

Introduction: This paper examines the various factors that contribute to the occurrence of sleep alterations during peri and post climacteric and thus produce significant imperil to women's quality of life. Among the probable causes of insomnia or sleep disorders associated to climacteric stand out the occurrence of vasomotor symptoms, depressive state and respiratory distress during sleep, such as sleep apnea, along with chronic pain, although psychosocial factors related to the climacteric bear major influence on such clinical status. Method: The bibliographic analysis was carried out using several electronic data base namely: Cochrane, Medline, Embase, Bni Plus, Biological Abstracts, Psycinfo, Web Of Science, Sigle, Dissertation Abstracts and ZETOC published in English, Spanish and Poruguese. The key terms used were: sleep, REM sleep, slow wave sleep polysomnography; electroencephalogram; sleep disturbances; disturbances of sleep onset and maintenance; excessive somnolence disturbances; climacteric; menopause; depression; neurobiology; biologic models; circadian rhythm; mental health and epidemiology. Case studies and letters to the editor were excluded. The summaries of the identified studies found in the data base were analyzed and assessed, and the data analyzed separately according to the subjective or objective criteria for data collection. Results: The climacteric transition constitutes a period of major risk for the development of depressive, vasomotor and insomnia symptoms although not caused solely by hypoestrogenism. The diagnostic methods used in the study of sleep disorders range from subjective assessment by means of response to specific questionnaires to the objective analysis of actigraphic or polissonographic daytime and nocturnal reports. Polissonographic studies of the whole night, performed at the laboratory, are the golden method of choice for diagnostic of sleep disorders. Studies point to the high prevalence of sleep disorders in the climacteric, especially insomnia, apnea and periodic movement of legs and also to the fact that this phase of life presents decrease in the quality of sleep. Women in peri and post climacteric show higher sleep latency and difficulty in its maintenance and refer being less satisfied with its quality even when compared to those who are not climacteric. Exception made to the vasomotor symptomatology, the other climacteric complaints such as mood disturbances, libido alterations, cognitive deficit, articular pain and sleep disorders are markedly associated to psychosocial factors, lifestyle and especially to women's perception of what the climacteric means to their lives. Conclusion: The analysis of the available studies revealed a proneness to deterioration of quality of life of climacteric women markedly in the sleep disturbances, depressed mood and anxiety domains and should not to be basically attributed to the climacteric. It is necessary that the professionals consider the need of assessment of such pathologies as complex phenomena and the literature lacks studies contemplating such dimensions.

Cannabidiol, a Cannabis sativa constituent, as an anxiolytic drug

Objectives: To review and describe studies of the non-psychotomimetic constituent of Cannabis sativa, cannabidiol (CBD), as an anxiolytic drug and discuss its possible mechanisms of action. Method: The articles selected for the review were identified through searches in English,articles, and book chapters were handsearched for additional references. Experimental animal and human studies were included, with no time restraints. Results: Studies using animal models of anxiety and involving healthy volunteers clearly suggest an anxiolytic-like effect of CBD. like", and "cannabidiol and anxiety". The reference lists of the publications included, review Portuguese, and Spanish in the electronic databases ISI Web of Knowledge, SciELO, PubMed, and PsycINFO, combining the search terms "cannabidiol and anxiolytic", "cannabidiol and anxiolytic-articles, and book chapters were handsearched for additional references. Experimental animal and human studies were included, with no time restraints. Results: Studies using animal models of anxiety and involving healthy volunteers clearly suggest an anxiolytic-like effect of CBD. Moreover, CBD was shown to reduce anxiety in patients with social anxiety disorder. Conclusion: like", and "cannabidiol and anxiety". The reference lists of the publications included, review Future clinical trials involving patients with different anxiety disorders are warranted, especially of panic disorder, obsessive-compulsive disorder, social anxiety disorder, and post-traumatic stress disorders. The adequate therapeutic window of CBD and the precise mechanisms involved in its anxiolytic action remain to be determined.

Animal models of prenatal immune challenge and their contribution to the study of schizophrenia: a systematic review

Prenatal immune challenge (PIC) in pregnant rodents produces offspring with abnormalities in behavior, histology, and gene expression that are reminiscent of schizophrenia and autism. Based on this, the goal of this article was to review the main contributions of PIC models, especially the one using the viral-mimetic particle polyriboinosinic-polyribocytidylic acid (poly-I:C), to the understanding of the etiology, biological basis and treatment of schizophrenia. This systematic review consisted of a search of available web databases (PubMed, SciELO, LILACS, PsycINFO, and ISI Web of Knowledge) for original studies published in the last 10 years (May 2001 to October 2011) concerning animal models of PIC, focusing on those using poly-I:C. The results showed that the PIC model with poly-I:C is able to mimic the prodrome and both the positive and negative/cognitive dimensions of schizophrenia, depending on the specific gestation time window of the immune challenge. The model resembles the neurobiology and etiology of schizophrenia and has good predictive value. In conclusion, this model is a robust tool for the identification of novel molecular targets during prenatal life, adolescence and adulthood that might contribute to the development of preventive and/or treatment strategies (targeting specific symptoms, i.e., positive or negative/cognitive) for this devastating mental disorder, also presenting biosafety as compared to viral infection models. One limitation of this model is the incapacity to model the full spectrum of immune responses normally induced by viral exposure.

Diferenças de gênero sobre expectativas do uso de álcool

CONTEXTO: Estudos indicam que expectativas sobre o uso de álcool podem contribuir para o início e a manutenção do consumo da droga e modular de forma diferente o comportamento do beber de homens e de mulheres. OBJETIVOS: Descrever e analisar diferenças de gênero sobre expectativas relacionadas ao uso de álcool em artigos da literatura indexada. MÉTODOS: Foram pesquisados artigos empíricos originais no período de 2000 a 2011 nos indexadores PubMed, SciELO, Lilacs e PsycInfo. RESULTADOS: Foram selecionados 32 estudos, sendo apenas dois de origem latino-americana. Expectativa de facilitação social foi a mais observada para ambos os gêneros. Homens apresentaram maior diversidade de expectativas sobre os efeitos do uso de álcool. Intervenções baseadas na redução de expectativas positivas parecem mais eficazes entre os homens. CONCLUSÃO: Expectativas são um importante fator de risco para o uso de álcool, independentemente do gênero. A consideração das diferenças de gênero sobre expectativas pode beneficiar o manejo clínico de problemas associados ao consumo de álcool e direcionar ações preventivas para o risco de abuso e dependência.

Mastectomia e sexualidade: uma revisão integrativa

Mulheres acometidas pelo câncer mamário são confrontadas com a retirada de uma parte do corpo relacionada à sexualidade. Este estudo teve por objetivo investigar o impacto do câncer de mama e da mastectomia na sexualidade da mulher por meio da análise da produção científica publicada no período de 2000 a 2009. O levantamento bibliográfico foi realizado a partir das bases de dados LILACS, MedLine e PsycINFO. Foram selecionados 29 artigos, que constituíram o corpus do estudo. Os achados foram agrupados por meio de análise de conteúdo. Os resultados evidenciaram que, após a retirada da mama, o desempenho sexual é comprometido, com redução da freqüência de intercurso sexual nos primeiros estágios do tratamento e diminuição da excitação, interesse e satisfação sexual.

Imagem corporal e hábitos alimentares na anorexia nervosa: uma revisão integrativa da literatura

Revisão integrativa da literatura com objetivo de investigar os construtos da imagem corporal e hábitos alimentares na anorexia nervosa (AN). As bases consultadas foram MedLine, LILACS e PsycINFO, no período de 2005 a 2009. A maioria dos artigos encontrados é constituída de estudos não-experimentais e descritivos, provenientes de fontes internacionais. Os resultados evidenciaram que a personalidade de mulheres com AN é permeada por baixa autoestima, sentimentos de inferioridade, inadequação, insegurança, perfeccionismo e obsessividade, fatores que acarretam acentuada inibição e retraimento social, e que exercem influência na distorção da imagem corporal e na aquisição de hábitos alimentares disfuncionais. Como conclusão ressalta-se a necessidade de tratamento interdisciplinar, e de novos estudos experimentais e nacionais, que busquem compreender a relação entre os construtos.

Qualidades psicométricas do Questionário de Capacidades e Dificuldades: revisão da literatura

O Questionário de Capacidades e Dificuldades (Strengths and Difficulties Questionnaire) é um instrumento amplamente pesquisado, de uso livre, que visa avaliar a saúde mental de crianças e adolescentes. Dada a relevância do uso de instrumentos aferidos para a avaliação de indicadores de saúde mental, este trabalho objetivou analisar a produção científica relacionada às propriedades psicométricas do Questionário. Procedeu-se a um levantamento bibliográfico de estudos indexados nas bases de dados MedLine, PsycINFO e Lilacs, a partir da publicação original do instrumento, abrangendo o período de 1997 a 2010, utilizando-se as seguintes palavraschave: Strengths and Difficulties Questionnaire and psychometric properties; e Strengths and Difficulties Questionnaire and validity or reliability. Foram selecionados e analisados 51 estudos psicométricos. Os resultados indicaram índices positivos de validade e fidedignidade em 21 países, incluindo o Brasil, caracterizando seu alcance transcultural e sua aplicabilidade na área de saúde mental infanto-juvenil .

Psicoterapia como estratégia de tratamento dos transtornos alimentares: análise crítica do conhecimento produzido

O objetivo deste estudo foi empreender uma análise crítica acerca do conhecimento científico produzido sobre a utilização das psicoterapias como estratégia de tratamento dos transtornos alimentares. A partir de buscas nas bases PsycINFO, PePSIC e SciELO, no período entre 1999 e 2011, foram recuperados 35 artigos, categorizados em: psicoterapias breves, grupais, psicodinâmicas, complementares, bem como psicoterapias aliadas a outros tratamentos, como o psicofarmacológico. As abordagens mais frequentemente mencionadas foram psicodinâmicas e cognitivo-comportamentais. A modalidade de atendimento predominante foi a grupal. Ainda que preconizando o uso combinado de diversas estratégias, a literatura é unânime em destacar a importância das psicoterapias no tratamento. A análise crítica evidenciou necessidade de leituras que transcendam a mera identificação de técnicas psicoterápicas consideradas mais eficazes para o tratamento dos transtornos alimentares. Deve-se considerar o contexto mais amplo no qual os tratamentos são propostos, bem como promover um diálogo aberto entre enfoques teóricos, valorizando a pluralidade de saberes e a psicoterapia como prática em permanente transformação.

Spiritual dimension of children and adolescents with cancer: an integrative review

OBJECTIVE: To review scientific literature relating to the spiritual dimension of children and adolescents with cancer. METHODS: We conducted an integrative literature review in the LILACS, SciELO, PsycINFO and MEDLINE databases in the period between 1990 to 2011. RESULTS: Twenty-one studies were analyzed and grouped into thematic categories: quality of life and elements of spirituality; alternative and complementary therapies: spirituality as a therapeutic resource; spirituality as a coping strategy and spirituality as an attribute of existential transformations. It was found that spirituality is present at different stages of the disease experience and that its forms of expression may vary, according to age and cognitive development. CONCLUSION: There is a scarcity of specific scales for this age range and a need for scientific production relating to the spiritual dimension of children and adolescents with cancer. Descriptors: Neoplasms; Children; Adolescents; Spirituality

Grupos de apoio para homens com câncer de próstata: revisão integrativa da literatura

This article is an integrative literature review to analyze the contribution of national and international studies examining the use of psychological support groups as a care strategy for patients diagnosed with prostate cancer. The electronic databases consulted were: LILACS, MedLine and PsycINFO, over a period of 20 years (1989-2009) with pre-defined criteria for inclusion. Eleven studies were selected, and based on their contributions some considerations are presented regarding the factors that favor male participation in the support groups and the potential benefits of such participation; as well as their main concerns and the influence of gender identity in the process of coping with illness. Furthermore, studies suggest some models of group intervention, along with orientation for the coordinators which emphasize the importance of these groups as an effective strategy to aid in the process of coping of prostate cancer patients.

Pain in preterm infants: effects of sex, gestational age, and neonatal illness severity

Neonates hospitalized in a neonatal intensive care unit are exposed to many painful and stressful procedures. Biobehavioral pain reactivity in preterm infants during the neonatal period may reflect the capacity of the central nervous system to regulate arousal and neurobiological organization. We review empirical studies on the effects of sex, gestational age, and neonatal illness severity on pain reactivity in children born preterm. A literature search was conducted using PubMed, Institute of Scientific Information Web of Science, PsycINFO, Latin American and Caribbean Health Sciences Literature, and Scientific Electronic Library Online databases. Additionally, a special search was performed in online journals that publish pain studies including Pain, Early Human Development, European Journal of Pain, and Pain Management Nursing. The literature search covered the period from 2004 to 2009. Data were extracted according to predefined inclusion and exclusion criteria. Of the 18 studies reviewed, 16 analyzed gestational age, 13 examined neonatal illness severity, and eight focused on sex. Most of the studies analyzed more than one of these three variables. The majority of the studies found effects of gestational age (n = 14) and neonatal illness severity (n = 11) on pain responses. Only two studies found an influence of sex on infant pain responses. In conclusion, gestational age and neonatal illness severity influence pain responses in infants born preterm. Further studies should be conducted to examine the influence of sex on pain responses.