Obsessive-compulsive disorder: Prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000

Objective: There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking.Method: Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a nonneurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised.Results: the authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive-compulsive group had obsessions only. Comorbidity occurred in 62% of these individuals, which was significantly greater than the group with other neuroses (10%). Co-occurring neuroses were depressive episode (37%), generalized anxiety disorder (31%), agoraphobia or panic disorder (22%), social phobia (17%), and specific phobia (15%). Alcohol dependence was present in 20% of participants, mainly men, and drug dependence was present in 13%. Obsessive-compulsive disorder, compared with other neurotic disorders, was associated with more marked social and occupational impairment. One-quarter of obsessive-compulsive disorder participants had previously attempted suicide. Individuals with pure and comorbid obsessive-compulsive disorder did not differ according to most indices of impairment, including suicidal behavior, but pure individuals were significantly less likely to have sought help (14% versus 56%).Conclusions: A rare yet severe mental disorder, obsessive-compulsive disorder is an atypical neurosis, of which the public health significance has been underestimated. Unmet need among individuals with pure obsessive-compulsive disorder is a cause for concern, requiring further investigation of barriers to care and interventions to encourage help-seeking.

Social support and common mental disorder among medical students

INTRODUÇÃO:Diferentes formas de sofrimento psíquico têm sido identificadas em estudantes da área da saúde, em especial no curso de Medicina.OBJETIVO:Estimar a prevalência de sofrimento psíquico entre estudantes de Medicina em uma faculdade no Sudeste do Brasil e avaliar sua associação com apoio social.MÉTODO:Trata-se de um estudo transversal. Foram aplicados questionários para alunos do 1º ao 6º ano do curso de Medicina da Universidade Estadual Paulista Júlio de Mesquita Filho, investigando-se características demográficas relacionadas ao curso e à adaptação à cidade. Sofrimento psíquico foi investigado na forma de Transtorno Mental Comum (TMC), avaliado por meio do Self-Reporting Questionnaire (SRQ-20). Apoio social foi avaliado com a Escala de Apoio Social (EAS). As associações entre o desfecho e as variáveis explanatórias foram analisadas por meio do teste do χ2 e, na análise multivariada, por meio da Regressão Logística, com p < 0,05.RESULTADOS:A taxa de resposta foi de 80,7%, não havendo diferença estatística entre a mostra e a população-alvo no que diz respeito ao gênero (p = 0,78). A média de idade foi de 22 anos (desvio padrão - DP = 2,2) com predomínio de mulheres (58,2%) e estudantes que vivem com amigos (62%). A prevalência de TMC foi de 44,9% (IC95% 40,2 - 49,6). Após a análise multivariada, mantiveram-se associados a TMC: sentir-se rejeitado no último ano (p < 0,001), ter pensado ou pensar em abandonar o curso (p < 0,001) e interação, avaliada pela EAS (p = 0,002).CONCLUSÕES:A prevalência de TMC entre estudantes de Medicina mostrou-se elevada, identificando-se o apoio social insuficiente como fator de risco. Esses achados sugerem que intervenções voltadas para propiciar melhores condições de interação social entre estudantes poderiam ser benéficas, diminuindo a prevalência de TMC nesse grupo.

EMOTIONAL BURDEN IN CAREGIEVERS of PATIENTS WITH OBSESSIVE-COMPULSIEVE DISORDER

The objective of this study was to evaluate the emotional burden, psychological morbidity, and level of family accommodation in caregivers of obsessive-compulsive disorder (OCD) patients, according to sociodemographic and clinical factors. Methods: Fifty Brazilian DSM-IV OCD patients and their caregivers were evaluated using the Family Accommodation Scale, the Zarit Burden Interview (ZBI), the Self-Report Questionnaire (caregivers), the Yale-Brown Obsessive-Compulsive Scale, and the Beck Depression Inventory (patients). Most caregivers (80%) were aged between 30 and 59 years and lived with the patient (88%). Results: Forty-two percent presented a common mental disorder and their mean ZBI score was 28.9. Family accommodation was moderate in 26% and severe or very severe in 24%. Caregivers' levels of psychological morbidity, accommodation, and emotional burden were associated with each other and with the severity of patient obsessive-compulsive and depressive symptoms. Conclusions: The results suggest that caregivers of OCD patients have important levels of burden and psychological morbidity and should receive orientation and support to minimize this emotional impact. Depression and Anxiety 25:1020-1027, 2008. (C) 2008 Wiley-Liss, Inc.

Hydrocephalus and moderate mental retardation in a boy with Van der Woude phenotype and IRF6 gene mutation

In this report, we present a boy with lower lip pits, distinct craniofacial dysmorphism with cleft lip and palate, central nervous system malformation, and severe mental retardation. Similar but less pronounced facial findings were present in his mentally normal mother and maternal grandfather, both presenting with lower lip pits. Cleft lip was present in patient's father. Analysis of the VWS1 and VWS2 regions were performed to elucidate the molecular basis of the phenotype of the propositus. Screening or mutations at the IRF6 gene detected a pathogenic mutation (c.960G > C) in the propositus and in his mother; and a single nucleotide polymorphism (c.175-5C > G) in the propositus and in his father. Clinical and genetic aspects of this case are discussed.

Estratégias pedagógicas para alunos com deficiência mental severa: um estudo sobre a atuação de professores de educação especial

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tecendo sons e palavras: oficina de música dirigida a portadores de distúrbios graves

Pós-graduação em Música - IA

Sofrimento mental do estudante da Faculdade de Medicina de Botucatu-UNESP: uma análise de dois estudos transversais seriados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prevalência e fatores de risco para transtorno mental comum na população urbana da região metropolitana de Sâo Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fatores de risco para o desenvolvimento de crianças atendidas em Unidades de Saúde da Família, ao final do primeiro ano de vida: aspectos sociodemográficos e de saúde mental materna

The scope of this article is to evaluate risk and protection factors for the development of 1-year-olds assisted at family health care units. It is a cross-sectional study involving 65 children of approximately 1 year of age and their mothers attended at two family health care units. The development was assessed using a developmental screening test (Denver II). The mothers filled out the SRQ-20 questionnaire to identify common mental disorder (CMD) indicators. After data collection, descriptive and inferential statistical analysis was performed. Global development was at risk in 43.1% of the children evaluated, and the most affected areas were language and fine motor development; 44.6% of mothers had results indicative of CMD when the child was 1 year of age. In bivariate analysis, reported depression, smoking, infections in pregnancy, CMD after birth and working outside the home were significantly associated with the children's development. After full statistical analysis, CMD was revealed as being a risk factor, and working away from home as being a protection factor. In order to increase the chances of success of programs targeted for children at health care units and avoiding the risk of impaired development, it is important to focus on two aspects: children's stimulation and maternal mental health.

O transtorno mental na percepção de agentes comunitários de saúde na estratégia saúde da família

The Family Health Strategy facilitates user access to mental health actions. This study aimed to verify the community health agents’ perceptions of the Family Health Strategy about mental disorder. A qualitative study was conducted with 26 randomly selected community health agents, among the professionals of 13 units, which constitute the Family Health Strategy of Itapeva (SP). The community health agents responded to a personal information questionnaire and a semi-structured interview. Data were checked through content analysis. Stigmatizing perception of the mentally disturbed persons, lack of knowledge about the process of falling ill and the mental disorder evolution, and the unpreparedness to act in this population were observed. Capacitating agents enable them to contribute in a positive way to the effective functioning of a care net in mental health in the city.

Usuários de serviço de saúde mental: o que conhecem sobre os direitos de cidadania

This is an exploratory descriptive study with a qualitative approach. It aimed at apprehending what users undergoing treatment at a mental health service know about their rights. A semistructured interview was used as a data collection strategy. Five users were interviewed. Thematic content analysis was used for data analysis, and three categories emerged: process of falling ill, experiences of treatment and users’ rights. The users reported voluntary and involuntary hospitalization experiences and that, after treatment commencement at the psychosocial care center, they perceived significant changes in mental health care. They reported that they did not know the mental health legislation, but they knew about the rights stemming from experiencing mental disorder. For users to be able to recognize and take advantage of their citizens’ rights, awareness must be developed by health care professionals, which also includes their academic education

Transtorno mental comum nos estudantes de medicina da Faculdade de Medicina de Botucatu-UNESP: uma análise longitudinal

Pós-graduação em Saúde Coletiva - FMB

Mediação como base de estratégias pedagógicas voltadas a alunos com deficiência mental severa: indicadores para a prática docente

The paper talks about the education of persons with disabilities severe mental retardation based on the idea of Reuven Feuerstein mediation. The collected data were analysed mainly under the focus quantitative, allowing extraction of details of everyday life investigated. Aims to describe and analyze the implementation process their educational, focusing on teaching strategies used by Special Education teachers in the Araraquara’s city. In addition, seeks to address the educational process of a population slightly investigated by uniting two strands of thread in an innovative way: the Theory of Structural Cognitive Modifiability (SCM) and Reuven Feuerstein education of students with severe cognitive impairment. The methodology initiated by the establishment of the teacher’s profile, their mapping and location. Data collection was achieved through three instruments: interviews with teachers, observation protocol and field diary for registration. Our results describe the work of a teacher, showing their practice, and enlist the pedagogical strategies used, mainly those related to the criteria medication. According to the Theory of Structural Cognitive Modifiability (SCM) and the idea of Mediated Learning Experience (MLE), the teacher acts as mediator, interposing themselves between stimuli the environment and the student. The work of the teacher observed indicates that the environment and the student. The work of the teacher observed indicates that she exerts her functions in teaching using pedagogical strategies which are found in her heart, precepts essential to mediation. This shows it is possible to associate the ideas of Feuerstein practices aimed at teaching students with severe mental disabilities.

Transtorno mental comum e lazer entre estudantes da área da saúde do campus de Botucatu-UNESP: um estudo transversal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Autismo: aspectos cognitivos, educacionais e neurobiológicos com base na análise dos livros Mundo singular: entenda o autismo e o Os gatos nunca mentem sobre o amor e na literatura especializada

The autism is a severe mental illness that involves psychological, social, educational and neurobiological aspects. The Education plays an important role in recovering, preserving and increasing the cognitive task of people with autism. There are several ways to observe a person with autism. Through the studying of cases, it is also possible to address issues of everyday life of the person with the illness, its cognitive issues and its obstacles of psychosocial involvement, as well as psychological aspects such as illness acknowledgement. Through specialized literature, it is possible to identify characteristics referring to the learning process and neurobiological components involved in the condition, such as brain activity disorder and genetic factors. The objectives of this paper are: from the analysis of two books: Unique World: comprehend the Autism (SILVA, A. B. B; GAIATO, M.B; REVELES, L.T) and The cats never lie about love (DILLON, J.), it is intended to describe cognitive and psychosocial aspects of the autism. Based on the specialized literature, the goal is to identify cognitive and neurobiological components in the illness. The methods that were used: analysis of the books Unique World: comprehend the Autism and The cats never lie about love to describe psychosocial and educational aspects of the autism; analysis of the specialized literature to identify clinical and neurobiological components of the illness, such as changes in brain activity, genetic factors or clinical evolution; and also details of the Education role in preserving the person with autism and his cognitive and emotional development. The study had the documentary research as reference for the methodological design, including book analysis and research in specialized literature. It is intended to deepen discussions about the Education roles related to the cognitive and neurobiological aspects of the autism