Cuidados em saúde mental pelo programa de saúde da família: análise qualitativa de uma terapia de grupo para mulheres

Em todo o mundo é alta a prevalência dos transtornos depressivos e ansiosos, em especial no nível primário. Uma das estratégias terapêuticas é o atendimento em grupo que propicia bons resultados e cuidado adequado, incluindo melhor aproveitamento do tempo e maior abrangência no atendimento segundo experiências relatadas em diversos países.O objeto deste estudo é o discurso de mulheres com transtornos depressivos e ansiosos atendidas em grupo na atenção primária. O objetivo é conhecer representações e questões sobre o processo de adoecimento de mulheres atendidas na Estratégia de Saúde da Família (ESF) diagnosticadas com transtornos depressivos e ansiosos. Os grupos terapêuticos ocorreram em Postos de Saúde da Família, no município de Petrópolis, Rio de Janeiro, realizados pelos profissionais da ESF (médicos e enfermeiros) e supervisionados por especialistas em saúde mental. A pesquisa se deu com base análise de material de observação de dois grupo em comunidades distintas. Foi utilizado o método qualitativo, com analise das falas que foram organizadas em categorias segundo o método análise de conteúdo. Resultados: Transtornos depressivos e ansiosos são retratados no discurso das mulheres nos grupos como um processo solitário, sem apoio, compreensão e ajuda de terceiros. São agravantes: dificuldades financeiras, falta de lazer, sobrecarga de obrigações e cobranças.O álcool é retratado como apaziguador do sofrimento e da solidão. Relatam relacionamentos insatisfatórios e ocupam posições de submissão, sentindo-se desempoderadas, sem ver saída para sua situação, perpetuando pensamentos e ações, retroalimentando o sofrimento emocional. Valorizam o grupo enquanto espaço terapeutico. A possibilidade de verem retratado nas colegas situações similares encoraja a ajuda mútua. Estes são aspectos que auxiliam na autopercepção e no empoderamento. A intervenção se mostrou aplicável na atenção primária, sendo factível a não especialistas de saúde mental.

As relações entre raiva e habilidades sociais em indivíduos com transtornos alimentares

Os Transtornos Alimentares (TA) são caracterizados por graves perturbações no comportamento alimentar, geralmente de início precoce e curso duradouro. Vários fatores estão associados a sua etiologia, como fatores familiares, socioculturais, biológicos e psicológicos. Alguns autores demonstraram existir correlação entre gravidade nos comportamentos alimentares inadequados, baixos níveis de assertividade, altos níveis de hostilidade autodirigida e dificuldade em expressar a raiva. Além disso, a raiva tem sido relacionada principalmente aos episódios de compulsão alimentar e métodos compensatórios. A literatura, já há algum tempo reconhece o papel central do afeto negativo na etiologia e manutenção da compulsão alimentar. A teoria da regulação do afeto pressupõe que os episódios de compulsão alimentar estão associados a uma dificuldade para regular as emoções de forma adaptada, configurando-os como uma estratégia inadequada para aliviar sofrimento e reduzir afetos intensos. Pesquisadores indicam que um terço das mulheres com compulsão alimentar, comem em resposta a emoções negativas, mais especificamente a raiva, depressão e ansiedade. A compulsão alimentar teria como função regular a experiência emocional, reduzindo a consciência da emoção. A raiva também tem sido associada a déficits em habilidades sociais. A literatura sugere que os indivíduos socialmente habilidosos são mais propensos a manejar com a emoção da raiva do que aqueles com déficits em habilidades sociais e resolução de problemas, e que muitos dos tratamentos efetivos para raiva e comportamento agressivo incluem o desenvolvimento dessas habilidades. Assim como elevados níveis de raiva estão associados a comportamentos alimentares disfuncionais, evidências apontam para a relação entre déficits em habilidades sociais e gravidade do comportamento alimentar. A literatura mostra que no tratamento da raiva, o treinamento de habilidades sociais tem sido bastante efetivo. Dessa forma, identificar de que forma a raiva se relaciona ao comportamento alimentar inadequado , bem como aos déficits em habilidades sociais se torna relevante para a criação de programas de intervenção que tenham como objetivo ensinar o indivíduo a manejar com a raiva e frustração, aumentando assim, a capacidade de resolução de problemas e diminuindo a ocorrência de comportamentos alimentares inadequados. Portanto, o objetivo desse estudo é avaliar as relações entre habilidades sociais e a raiva em pacientes com Bulimia Nervosa e Transtorno da Compulsão Alimentar Periódica. Em função das críticas ao uso de questionários de auto-informe em pesquisas, essa tese foi dividida em três estudos. O primeiro foi uma revisão sistemática da literatura que teve como propósito avaliar as relações entre níveis disfuncionais de raiva e compulsão alimentar em pacientes com bulimia nervosa e TCAP. O segundo estudo avaliou as relações entre níveis de habilidades sociais, raiva disfuncional e gravidade da compulsão alimentar em amostra clínica, através de questionários de autorrelato. E por fim, o terceiro estudo teve como objetivo identificar pensamentos automáticos e comportamentos associados a emoção da raiva através de entrevista estruturada, composta por cinco questões abertas. Os resultados de cada estudo serão discutidos, assim como sua implicação no tratamento dos TA

Intonation modelling and adaptation for emotional prosody generation

This paper proposes an HMM-based approach to generating emotional intonation patterns. A set of models were built to represent syllable-length intonation units. In a classification framework, the models were able to detect a sequence of intonation units from raw fundamental frequency values. Using the models in a generative framework, we were able to synthesize smooth and natural sounding pitch contours. As a case study for emotional intonation generation, Maximum Likelihood Linear Regression (MLLR) adaptation was used to transform the neutral model parameters with a small amount of happy and sad speech data. Perceptual tests showed that listeners could identify the speech with the sad intonation 80% of the time. On the other hand, listeners formed a bimodal distribution in their ability to detect the system generated happy intontation and on average listeners were able to detect happy intonation only 46% of the time. © Springer-Verlag Berlin Heidelberg 2005.

Dentin phosphoprotein frameshift mutations in hereditary dentin disorders and their variation patterns in normal human population

Background: Dentin phosphoprotein ( DPP) is the most abundant non-collagenous protein in dentin, which is highly phosphorylated and plays key roles in dentin biomineralisation. The aetiology of isolated hereditary dentin disorders in most affected familie

Chronic morphine selectively impairs cued fear extinction in rats: Implications for anxiety disorders associated with opiate use

Previous studies have shown that opioid transmission plays an important role in learning and memory. However, little is known about the course of opiate-associated learning and memory deficits after cessation of chronic opiate use in a behavioral animal m

Effects of Naotan Pill on repair of neural cells and cognitive disorders in juvenile rats following hypoxia and ischemia

BACKGROUND: Hypoxia and ischemia induce neuronal damage, decreased neuronal numbers and synaptophysin levels, and deficits in learning and memory functions. Previous studies have shown that lycium barbarum polysaccharide, the most effective component of barbary wolfberry fruit, has protective effects on neural cells in hypoxia-ischemia. OBJECTIVE: To investigate the effects of Naotan Pill on glutamate-treated neural cells and on cognitive function in juvenile rats following hypoxia-ischemia. DESIGN, TIME AND SETTING: The randomized, controlled, in vivo study was performed at the Cell Laboratory of Lanzhou University, Lanzhou Institute of Modern Physics of Chinese Academy of Sciences, and Department of Traditional Chinese Medicine of Gansu Provincial Rehabilitation Center Hospital, China from December 2005 to August 2006. The cellular neurobiology, in vitro experiment was conducted at the Institute of Human Anatomy, Histology, Embryology and Neuroscience, School of Basic Medical Sciences, Lanzhou University, and Department of Traditional Chinese Medicine of Gansu Provincial Rehabilitation Center Hospital, China from March 2007 to January 2008. MATERIALS: Naotan Pill, composed of barbary wolfberry fruit, danshen root, grassleaf sweetflag rhizome, and glossy privet fruit, was prepared by Gansu Provincial Rehabilitation Center, China. Rabbit anti-synaptophysin, choline acetyl transferase polyclonal antibody, streptavidin-biotin complex kit and diaminobenzidine kit (Boster, Wuhan, China), as well as glutamate (Hualian, Shanghai, China) were used in this study. METHODS: Cortical neural cells were isolated from neonatal Wistar rats. Neural cell damage models were induced using glutamate, and administered Naotan Pill prior to and following damage. A total of 54 juvenile Wistar rats were equally and randomly assigned into model, Naotan Pill, and sham operation groups. The left common carotid artery was ligated, and then rat models of hypoxic-ischemic injury were assigned to the model and Naotan Pill groups. At 2 days following model induction, rats in the Naotan Pill group were administered Naotan Pill suspension for 21 days. In the model and sham operation groups, rats received an equal volume of saline. MAIN OUTCOME MEASURES: Neural cell morphology was observed using an inverted phase contrast microscope. Survival rate of neural cells was measured by MTT assay. Synaptophysin and choline acetyl transferase expression was observed in the hippocampal CA1 region of juvenile rats using immunohistochemistry. Cognitive function was tested by the Morris water maze. RESULTS: Pathological changes were detected in glutamate-treated neural cells. Neural cell morphology remained normal after Naotan Pill intervention. Absorbance and survival rate of neural cells were significantly greater following Naotan Pill intervention, compared to glutamate-treated neural cells (P < 0.05). Synaptophysin and choline acetyl transferase expression was lowest in the hippocampal CA1 region in the model group and highest in the sham operation group. Significant differences among groups were observed (P < 0.05). Escape latency and swimming distance were significantly longer in the model group compared to the Naotan Pill group (P < 0.05). CONCLUSION: Naotan Pill exhibited protective and repair effects on glutamate-treated neural cells. Naotan Pill upregulated synaptophysin and choline acetyl transferase expression in the hippocampus and improved cognitive function in rats following hypoxia-ischemia.

细胞外信号调节蛋白激酶-cAMP反应元件结合蛋白信号通路在应激所致抑郁行为障碍中的作用

Stress is the most important factor in the vulnerability to depression and other behavioral disorders, but the mechanisms that stress signals are transferred into depression are far from understanding. To date, the neurotransmitters, neurotrophins and signal pathway have been concerned in the topic focusing on the pathophysiology of depression, but there are still many puzzles. Increasing evidence has indicated that the alteration in neuronal plasticity is the “trace” of stress-induced damages. The extracellular signal-regulated protein kinase(ERK)-cyclic-AMP-responsive element（CRE）-binding protein(CREB)signal pathway is a powerful intracellular signal transduction pathway participating in neuronal plasticity which is involved in higher brain cognitive functions such as learning and memory. However, so far, little is known about the role of the ERK-CREB signal pathway in response to stress and emotional modulations. Thus the aim of the study was to systematically investigate the role of the ERK-CEB signal pathway in depressive-like behaviors induced by stress. Depression animal models, antidepressant agent treatment and disruption of signal pathway in specific brain regions were applied. In the present study, three experiment sessions were designed to make sure whether the ERK-CREB signal pathway was indeed one of pathophysiological mechanisms of depressive-like behaviors induced by stress. In experiment one, two different stress animal models were applied, chronic forced swim stress and chronic empty water bottle stress. After stress, all animals were tested behaviorally using open-field, elevated-plus maze and saccharine preference test, and brain samples were processed for determination of ERK, P-ERK, CREB and P-CREB using western blot. The relationships between the proteins of ERK, P-ERK, CREB and P-CREB in the brain and the behavioral variables were also analyzed. In experiment two, rats were treated with antidepressant agent fluoxetine once a day for 21 consecutive days, then the brain levels of ERK, P-ERK, CREB and P-CREB was determined, the depressive-like behaviors were also examined. In experiment three, mitogen activated extracellular-signal-regulated kinase kinase (MEK) inhibitor U0126 was administrated to inhabit the activation of ERK in the hippocampus and prefrontal cortex respectively, then behavioral measurements and protein detection were conducted. The main results of the study were as the following: (1) Chronic forced swim stress induced animals to suffer depression and disrupted the ERK-CREB signal pathway in hippocampus and prefrontal cortex. There were significant correlations between P-ERK2, P-CREB and multiple variables of depressive-like behaviors. (2) Chronic empty water bottle stress did not induce depressive-like behaviors. Such stress decreased the brain level of P-ERK2 in hippocampus and prefrontal cortex, but the level of P-CREB in the hippocampus was increased. (3) The antidepressant agent fluoxetine relieved depressive-like behaviors and increased the activities of the ERK-CREB signal pathway in stressed animals. (4) Animals treated with U0126 injection into hippocampus showed decreased activities of the ERK-CREB signal pathway in the hippocampus, and suffered depression comorbid with anxiety. (5) Animals treated with U0126 injection into prefrontal cortex showed decreased activities of the ERK-CREB signal pathway in the prefrontal cortex, and exhibited depressive-like behaviors. In conclusion, The ERK-CREB signal pathway in the hippocampus and prefrontal cortex was involved in stress responses and significantly correlated with depressive-like behaviors; The ERK-CREB signal pathway in the hippocampus and prefrontal cortex participated in the mechanism that fluoxetine reversed stress-induced behavioral disorders, and might be the target pathway of the therapeutic action of antidepressants; The disruption of the ERK-CREB signal pathway in the hippocampus or prefrontal cortex led to depressive-like behaviors in animals, suggesting that disruption of ERK-CREB pathway in the hippocampus or prefrontal cortex was involved in the pathophysiology of depression, and might be at least one of the mechanisms of depression induced by stress.

Timidity: A useful emotional mechanism for robot control?

M J Neal and J Timmis. Timidity: A useful mechanism for robot control? Informatica - special issue on perception and emotion based control, 4(27):197-204, 2003.

Biological rationale for regular physical exercise as an effective intervention for the prevention and treatment of depressive disorders

Depression is a major medical and social problem. Here we review current body of knowledge on the benefits of exercise as an effective strategy for both the prevention and treatment of this condition. We also analyze the biological pathways involved in such potential benefits, which include changes in neurotrophic factors, oxidative stress and inflammation, telomere length, brain volume and microvessels, neurotransmitters or hormones. We also identify major caveats in this field of research: further studies are needed to identify which are the most appropriate types of exercise interventions (intensity, duration, or frequency) to treat and prevent depression.

The nature of emotional support and counselling provision for people with sight loss in the United Kingdom

People with sight loss in the United Kingdom are known to have lower levels of emotional wellbeing and to be at higher risk of depression. Consequently ‘having someone to talk to’ is an important priority for people with visual impairment. An on-line survey of the provision of emotional support and counselling for people affected by sight loss across the UK was undertaken. The survey was distributed widely and received 182 responses. There were more services offering ‘emotional support’, in the form of listening and information and advice giving, than offered ‘counselling’. Services were delivered by providers with differing qualifications in a variety of formats. Waiting times were fairly short and clients presented with a wide range of issues. Funding came from a range of sources, but many felt their funding was vulnerable. Conclusions have been drawn about the need for a national standardised framework for the provision of emotional support and counselling services for blind and partially sighted people in the UK

Jakość opieki nad dzieckiem w rodzinie a jego emocjonalno-społeczne funkcjonowanie

Wydział Studiów Edukacyjnych: Zakład Teoretycznych Podstaw Edukacji

Neural Dynamics of Autistic Behaviors: Cognitive, Emotional, and Timing Substrates

What brain mechanisms underlie autism and how do they give rise to autistic behavioral symptoms? This article describes a neural model, called the iSTART model, which proposes how cognitive, emotional, timing, and motor processes may interact together to create and perpetuate autistic symptoms. These model processes were originally developed to explain data concerning how the brain controls normal behaviors. The iSTART model shows how autistic behavioral symptoms may arise from prescribed breakdowns in these brain processes.