L'impact de la création littéraire, en contexte d'aide, sur la symptomatologie psychophysiologique d'adolescents atteints d'une maladie chronique : étude interdisciplinaire et exploratoire.

Thèse réalisée dans le cadre d'un Ph.D.interdisciplinaire en Psychologie, en création littéraire et en orthopédagogie. L'impact de la création littéraire a été étudié chez des adolescents atteints d'une maladie chronique au CHU Sainte-Justine de Montréal. Cette recherche est exploratoire car la création littéraire n'a jamais été étudiée dans cette perspective. Elle a été réalisée sous la direction de Catherine Mavrikakis, professeure et écrivain à la Faculté des arts et sciences au Département des littératures francophones de l'Université de Montréal et de Jean-François Saucier, psychiatre et anthropologue à la Faculté de médecine au Département de psychiatrie de l'Université de Montréal et chercheur au CHU Sainte-Justine. Interdisciplinary Study.

Adolescent depression in schools: + Contigo Project

epidemiological data. It involves a high degree of mortality, namely by suicide, which is the third leading cause of death in the 15-24 age group. Objectives: To assess the presence and severity of depressive symptoms in a non-clinical population of adolescents. Methodology: This is a quantitative, descriptive and cross-sectional study, using the Portuguese version of the Beck Depression Inventory (BDI-II). The sample was composed of 741 adolescents. Results: The results show that 31.2% of the adolescents have depression and, of these, 17.7% have moderate to severe depressive symptoms. Girls have higher levels of depression (p=.00). The total mean score in the BDI-II was 12. Conclusion: Given the adolescents' high vulnerability to depression and suicide, it is essential to implement prevention programs in schools to promote the early detection of depression and suicidal behaviors, and the referral to mental health services.

Biliary duct injuries in the laparoscopic era: our experience

Aim. The main aim of our study is to evaluate the incidence, the type, the causes and the therapy of biliary duct injuries which occurred after the video laparoscopic cholecystectomies performed in our Department during the period from 1990 to 2012. Patients and methods. A retrospective analysis of 1186 VLC has been made in our Department from March 1990 to June 2012. Before the cholecystectomy all patient were evaluated with trans abdominal echography. Beyond the incidence of BDI was evaluated damaging mechanism, etiology, therapy and time of diagnosis. Results. From 1990 to 2012 a total of 9 BDIs occurred, with an incidence of 0,75%. Out of 9 patients 4 had major lesions and 5 had minor lesions; the most common BDI was Strasberg A (45%), the most common etiology was the presence of anatomical variations. In four cases the diagnosis has been intraoperative, in five cases has been postoperative. Conclusions. Our clinical experience shows that the main cause of BDI are the surgeon experience and the bile ducts anatomical variation.

Atividade física e saúde:benefícios de um programa combinado de exercício com visualização mental em doentes com Parkinson

Projeto de Investigação apresentado para a obtenção do grau de Mestre em Psicologia do Desporto e do Exercício

Atividade física e saúde:benefícios de um programa combinado de exercício com visualização mental em doentes com Parkinson

Projeto de Investigação apresentado para a obtenção do grau de Mestre em Psicologia do Desporto e do Exercício

Memória autobiográfica em jovens adultos com comportamentos suicidários

2008 Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para a obtenção de grau de Mestre na especialidade de Psicologia Clínica

L'impact de la création littéraire, en contexte d'aide, sur la symptomatologie psychophysiologique d'adolescents atteints d'une maladie chronique : étude interdisciplinaire et exploratoire

Thèse réalisée dans le cadre d'un Ph.D.interdisciplinaire en Psychologie, en création littéraire et en orthopédagogie. L'impact de la création littéraire a été étudié chez des adolescents atteints d'une maladie chronique au CHU Sainte-Justine de Montréal. Cette recherche est exploratoire car la création littéraire n'a jamais été étudiée dans cette perspective. Elle a été réalisée sous la direction de Catherine Mavrikakis, professeure et écrivain à la Faculté des arts et sciences au Département des littératures francophones de l'Université de Montréal et de Jean-François Saucier, psychiatre et anthropologue à la Faculté de médecine au Département de psychiatrie de l'Université de Montréal et chercheur au CHU Sainte-Justine. Interdisciplinary Study.

The effect of anxiety and depression scores of couples who underwent assisted reproductive techniques on the pregnancy outcomes.

Objective: The aim of this study was to determine the effect of anxiety and depression scores of couples who underwent Assisted Reproductive Techniques (ART) on pregnancy outcomes. Method: This study was conducted as a prospective and comparative study with 217 couples. The study data was collected by using a semi-structured questionnaire and the Turkish version of the State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). The questionnaire, STAI and BDI were applied to couples who initiated ART treatment. Couples’ state anxiety scores were re-evaluated after embryo transfer (ET). Results: A significant relationship was found between the depression score of women and pregnancy outcome (p < 0.05). It was determined that anxiety scores for both men and women were higher before the ART procedure, but their anxiety scores decreased after ET (p < 0.05). Spouses of women with a negative pregnancy outcome had higher trait and state anxiety mean scores (p > 0.05) and lower depression scores (p <0.05) than spouses of women with a positive pregnancy outcome. Conclusion: Study results indicated that the anxiety and depression scores of couples who had achieved a positive pregnancy result were lower than for couples with a negative result. The results of this study will contribute to the health professionals especially to the nurses who spend the most time with couples in providing consulting services and supporting psychological status of couples during ART process in Turkey.

Lesão e a sintomatologia depressiva e a sua relação com o autoconceito físico do jogador de futebol

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

Discrimination in clinical settings and its relationship to depression and anger in women living with HIV

Objectives: To describe the frequency of feared discrimination in various social situations and of perceived discrimination in clinical settings, as well as to study the relationship between discrimination and depression and anger in women living with human immunodeiciency virus (HIV). Material and methods: The scale of Feared and Perceived Discrimination for Women with HIV (DTP-40-MV), the Beck Depression Inventory (BDI-2), and the Anger Expression scale of State-Trait-anger expression inventory (STaXi-2-aX/eX) were applied to a random sample of 200 women living with HIV. Results: These women feared being discriminated against, perceived discrimination upon the review of medical records, but perceived little discrimination in clinical care. a model with good adjustment to the data showed that the fear of being discriminated against creates a disposition toward perception of discrimination in the clinical settings (latent variable with 2 indicators: review of the medical records and clinical care) and increases cognitive/affective depressive symptoms; higher anger control decreases the anger manifestation; greater discrimination perceived in the clinical settings decreases anger control, which facilitates the expression of anger and slows cognitive/affective depressive symptoms; and these latter symptoms sensitize the perception of discrimination before the clinical records. Conclusion: Feared discrimination is a clinically relevant aspect due to its frequency and effect on depressive symptoms and perception of discrimination before the review of medical records.

Anti-inflammatory agents in the treatment of bipolar depression: a systematic review and meta-analysis

OBJECTIVE: Inflammation has been implicated in the risk, pathophysiology, and progression of mood disorders and, as such, has become a target of interest in the treatment of bipolar disorder (BD). Therefore, the objective of the current qualitative and quantitative review was to determine the overall antidepressant effect of adjunctive anti-inflammatory agents in the treatment of bipolar depression. METHODS: Completed and ongoing clinical trials of anti-inflammatory agents for BD published prior to 15 May 15 2015 were identified through searching the PubMed, Embase, PsychINFO, and Clinicaltrials.gov databases. Data from randomized controlled trials (RCTs) assessing the antidepressant effect of adjunctive mechanistically diverse anti-inflammatory agents were pooled to determine standard mean differences (SMDs) compared with standard therapy alone. RESULTS: Ten RCTs were identified for qualitative review. Eight RCTs (n = 312) assessing adjunctive nonsteroidal anti-inflammatory drugs (n = 53), omega-3 polyunsaturated fatty acids (n = 140), N-acetylcysteine (n = 76), and pioglitazone (n = 44) in the treatment of BD met the inclusion criteria for quantitative analysis. The overall effect size of adjunctive anti-inflammatory agents on depressive symptoms was -0.40 (95% confidence interval -0.14 to -0.65, p = 0.002), indicative of a moderate and statistically significant antidepressant effect. The heterogeneity of the pooled sample was low (I² = 14%, p = 0.32). No manic/hypomanic induction or significant treatment-emergent adverse events were reported. CONCLUSIONS: Overall, a moderate antidepressant effect was observed for adjunctive anti-inflammatory agents compared with conventional therapy alone in the treatment of bipolar depression. The small number of studies, diversity of agents, and small sample sizes limited interpretation of the current analysis.

Mood regulatory actions of nucleus accumbens deep brain stimulation

The mood regulatory mechanisms of deep brain stimulation (DBS)therapy are yet to be fully understood. DBS is shown to have antidepressant actions in severe, treatment-resistant depression (TRD).Interestingly, DBS of mesoaccumbens neurologic targets, includingthe nucleus accumbens (NAc), have also been shown to induce mania in vulnerable individuals. The nucleus accumbens (NAc) is a critical node in the mesocorticolimbic system and plays a major role in mediating antidepressant behavioral responses in the forced swim test (FST), a preclinical screen for antidepressant efficacy. This study investigates the antidepressant effects of NAc DBS in an established animal model of TRD. Wistar rats were divided into 4 groups: TRD-DBS (n = 9), TRD-Sham (n = 8), TRD (n = 10), and Control (n = 10). Bilateral stimulating electrodes were implanted into the NAc of TRD-Sham and TRD-DBS animals. Antidepressant-resistance and depression behaviors were induced through adrenocorticotropic-hormone (ACTH-(1–24); 100 lg/day; 2nd and 3rd weeks) administration and concurrent social isolation (all 3 weeks) respectively. DBS was administered throughout the 2nd week of ACTH treatment via a back mounted rodent DBS system. 24-hour locomotor activity counts were obtained using infrareddetectors and weekly sucrose preference tests were performedthroughout the 3 week protocol. Open field and FST were completedat the end of the 3 weeks. Brains were then removed and stored at 80°C. NAc tissue levels of brain-derived and glialderived neurotrophic factors (BDNF and GDNF, respectively) were quantified using western blot. Results demonstrate significant increases in locomotor activity for TRD-DBS animals (DBS-Vs-Sham: p = 0.0248). Lowered immobility was observed during FST for TRD-DBS animals (DBS-Vs-Sham: p = 0.0188). ACTHinduced BDNF expression increased in the outer region substructure NAc-shell (p = 0.0487) and decreased in the inner region substructure NAc-core (p = 0.0275) compared to controls. These datasupport antidepressant actions of NAc DBS in TRD. Local changes in neurotrophic factors may contribute to these mechanisms. Importantly, observed increases in locomotor activity over the 3 weeks highlight the potential for mesoaccumbens DBS to impact behaviors such as locomotor activity which may contribute to risk for induction of mania. Preliminary analysis of concurrent effects of daily dopamine reuptake inhibitor GBR12909 (16 mg/kg) administration coupled with NAc DBS demonstrates dopamine-mediated augmentation of these mania-like behaviors.

Modelled cost-effectiveness evaluation of bipolar disorder treatments to guide health policy

This analysis evaluates the cost-effectiveness of acute andmaintenance treatments for bipolar disorder (I and II) to assist inefficient allocation of resources to reduce the burden of this condition.