Mental health literacy of Latina women in the United States for their school-aged children

Despite known mental health (MH) disparities faced by Latino children relative to children from other minority groups of similar socioeconomic status (SES), little is known about how Latina mothers make MH decisions for their children. The present study examined links between Latina mothers' mental health literacy (MHL), including the recognition of and response to child psychiatric symptoms, and maternal acculturation factors as well as interpersonal violence (IPV) related symptomatology. Participants were 80 Latina mothers from Denver, Colorado and Modesto, California with at least one child between the ages of 8-12 years. Mothers were presented vignettes depicting child internalizing and externalizing disorders as well as interviewed about their help seeking behaviors. Maternal acculturation was not related to identification of disorders, but was related to more symptoms recognized for child internalizing and externalizing symptoms. Acculturation predicted use of formal source of care for child internalizing and externalizing disorder. Women demonstrated a preference for informal source of care, with the exception of IPV-related child symptoms, where women demonstrated a preference for formal source of care. IPV-related symptoms did not moderate the relationship between acculturation and MHL. The relationship between maternal acculturation, IPV related symptomatology and their combined effect on MHL for child psychiatric disorders are discussed.

Cognitive disorders and neurogenesis deficits in Huntington's disease mice are rescued by fluoxetine

Huntington's disease (HD) is a neurodegenerative disorder caused by an expanded CAG trinucleotide repeat encoding an extended polyglutamine tract in the huntingtin protein. Affected individuals display progressive motor, cognitive and psychiatric symptoms (including depression), leading to terminal decline. Given that transgenic HD mice have decreased hippocampal cell proliferation and that a deficit in neurogenesis has been postulated as an underlying cause of depression, we hypothesized that decreased hippocampal neurogenesis contributes to depressive symptoms and cognitive decline in HD. Fluoxetine, a serotonin-reuptake inhibitor commonly prescribed for the treatment of depression, is known to increase neurogenesis in the dentate gyrus of wild-type mouse hippocampus. Here we show that hippocampal-dependent cognitive and depressive-like behavioural symptoms occur in HD mice, and that the administration of fluoxetine produces a marked improvement in these deficits. Furthermore, fluoxetine was found to rescue deficits of neurogenesis and volume loss in the dentate gyrus of HD mice.

Carbamyl phosphate synthase deficiency: Diagnosed during pregnancy in a 41-year-old

Carbamyl phosphate synthase deficiency (CPS) is a rare urea cycle defect. We present a case of a 41-year-old woman diagnosed with CPS deficiency during pregnancy. She is the oldest CPS-deficient patient, at diagnosis, reported to date and the first to be diagnosed during pregnancy. This case highlights the need for consideration of inborn errors of metabolism in adults presenting with unusual neurological and psychiatric conditions. Crown Copyright (c) 2006 Published by Elsevier Ltd. All rights reserved.

Condições de Enfrentamento Psicológico de Trabalhadores Aeroportuários

Esse estudo teve por objetivos identificar sinais e sintomas de transtornos psiquiátricos e descrever tipos de enfrentamento utilizados por trabalhadores aeroportuários. Participaram desse estudo 203 trabalhadores e utilizou-se uma Escala Modo de enfrentamento problemas EMEP e uma Escala de Medida de Sinais e Sintomas psiquiátricos QMPA. Os resultados indicaram predomínio de estratégias positivas : a) focalizadas no problema (3,78) que significam que há um esforço do indivíduo no enfrentamento de situações estressantes procurando mudanças na relação entre o indivíduo e o ambiente causador de tensão; b) busca de suporte social (3,13), denotando busca de apoio instrumental, emocional ou de caráter informativo, ou seja, enquanto a maior parte da amostra apresentava estratégias mais positivas e integradoras também não apresentava sinais e sintomas psiquiátricos. Houve, portanto indicativos de que os sujeitos que compuseram essa amostra apresentaram mais respostas positivas em seus esforços cognitivos ante as situações estressantes ao mesmo tempo em que eram não suspeitos de sintomas psiquiátricos; acrescendo ao fato de que houve consonância entre os instrumentos de medida utilizados no presente estudo. Porém, uma pequena parte da amostra apresentou sinais e sintomas psiquiátricos (23,2%), bem como maior utilização de estratégias focalizadas na emoção (2,50), ou seja, estratégias de enfrentamento negativas. Embora esse fosse um número pequeno em relação à amostra total, considera-se preocupante, dado ao fato de serem trabalhadores aeroportuários e exercerem importantes funções tanto em relação ao manejo e orientação de manobras de aeronaves no solo como em relação à lida com pessoas; de modo que a associação entre sinais e sintomas com estratégias consideradas negativas implicam em transtornos que merecem acompanhamento pela equipe de saúde e de recursos humanos na empresa. É nesse sentido que aqui se sugere um trabalho de constante acompanhamento com trabalhadores em geral, a fim de verificar aqueles que necessitam de suporte psicológico e médico e aqueles que podem ser remanejados de suas funções dentro do aeroporto. O acompanhamento com instrumentais adequados, além de serem preventivos e promotores de saúde psicológica, na medida em que facilitam a detecção de sintomatologias mentais, também auxilia no planejamento de programas de saúde e, por conseguinte, como benefício no trabalho e fator preditor de saúde.(AU)

Adult cortical plasticity depends on an early postnatal critical period

Development of the cerebral cortex is influenced by sensory experience during distinct phases of postnatal development known as critical periods. Disruption of experience during a critical period produces neurons that lack specificity for particular stimulus features, such as location in the somatosensory system. Synaptic plasticity is the agent by which sensory experience affects cortical development. Here, we describe, in mice, a developmental critical period that affects plasticity itself. Transient neonatal disruption of signaling via the C-terminal domain of "disrupted in schizophrenia 1" (DISC1)-a molecule implicated in psychiatric disorders-resulted in a lack of long-term potentiation (LTP) (persistent strengthening of synapses) and experience-dependent potentiation in adulthood. Long-term depression (LTD) (selective weakening of specific sets of synapses) and reversal of LTD were present, although impaired, in adolescence and absent in adulthood. These changes may form the basis for the cognitive deficits associated with mutations in DISC1 and the delayed onset of a range of psychiatric symptoms in late adolescence.

Anti-N-methyl-D-Aspartate Receptor Encephalitis with Positive Serum Antithyroid Antibodies, IgM Antibodies Against Mycoplasma Pneumoniae and Human Herpesvirus 7 PCR in the CSF

We report the case of a boy with an encephalopathy associated with extrapyramidal and psychiatric symptoms and anti-N-methyl-D-aspartate receptor antibodies. He had positive serum antithyroid antibodies, IgM antibodies against Mycoplasma pneumoniae and human herpesvirus 7 polymerase chain reaction in the cerebrospinal fluid. He was successfully treated with rituximab, after steroids, intravenous immunoglobulin and plasma exchange. The pathophysiology of this disorder may be post-infectious and autoimmune.

Opinião dos Estudantes do Curso de Licenciatura em Enfermagem, sobre a sobrecarga do cuidador de Doentes com demência tipo de Alzheimer

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Enfermagem

Acute Psychosis as Major Clinical Presentation of Legionnaires’ Disease

We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires’ disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggested Legionella pneumophila as possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms.

Feasibility of resting-state microstates neurofeedback

Despite major progress, currently available treatment options for patients suffering from schizophrenia remain suboptimal. Antipsychotic medication is one such option, and is helpful in acute phases of the disease. However, antipsychotics cause significant side-effects that often require additional medication, and can even trigger the discontinuation of treatment. Taken together, along with the fact that 20-30% of patients are medication-resistant, it is clear that new medical care options should be developed for patients with schizophrenia. Besides medication, an emerging option to treat psychiatric symptoms is through the use of neurofeedback. This technique has proven efficacy for other disorders and, more importantly, has also proven to be feasible in patients with schizophrenia. One of the major advantages of this approach is that it allows for the influence of brain states that otherwise would be inaccessible; i.e. the physiological markers underlying psychotic symptoms. EEG resting-state microstates are a very interesting electrophysiological marker of schizophrenia symptoms. Precisely, a specific class of resting-state microstates, namely microstate class D, has consistently been found to show a temporal shortening in patients with schizophrenia compared to controls, and this shortening is correlated with the presence positive psychotic symptoms. Under the scope of biological psychiatry, appropriate treatment of psychotic symptoms can be expected to modify the underlying physiological markers accompanying behavioral manifestations of a disease. We reason that if abnormal temporal parameters of resting-state microstates seem to be related to positive symptoms in schizophrenia, regulating this EEG feature might be helpful as a treatment for patients. The goal of this thesis was to prove the feasibility of microstate class D contribution self-regulation via neurofeedback. Given that no other study has attempted to regulate microstates via neurofeedback, we first tested its feasibility in a population of healthy subjects. In the first paper we describe the methodological characteristics of the neurofeedback protocol and its implementation. Neurofeedback performance was assessed by means of linear mixed effects modeling, which provided a complete profile of the neurofeedback’s training response within and between-subjects. The protocol included 20 training sessions, and each session contained three conditions: baseline (resting-state) and two active conditions: training (auditory feedback upon self-regulation performance) and transfer (self-regulation with no feedback). With linear modeling we obtained performance indices for each of them as follows: baseline carryover (baseline increments time-dependent) and learning and aptitude for each of the active conditions. Learning refers to the increase/decrease of the microstate class D contribution, time-dependent during each active condition, and aptitude refers to the constant difference of the microstate class D contribution between each active condition and baseline independent of time. The indices provided are discussed in terms of tailoring neurofeedback treatment to individual profiles so that it can be applied in future studies or clinical practice. In our sample of participants, neurofeedback proved feasible, as all participants at least showed positive results in one of the aforementioned learning indices. Furthermore, between-subjects we observed that the contribution of microstate class D across-sessions increased by 0.42% during baseline, 1.93% during training trials, and 1.83% during transfer. This range is expected to be effective in treating psychotic symptoms in patients. In the second paper presented in this thesis, we explored the possible predictors of neurofeedback success among psychological variables measured with questionnaires. An interesting finding was the negative correlation between “motivational incongruence” and some of the neurofeedback performance indices. Even though this finding requires replication, we discuss it in terms of the interfering effects of incompatible psychological processes with neurofeedback training requirements. In the third paper, we present a meta-analysis on all available studies that have related resting-state microstate abnormalities and schizophrenia. We obtained medium effect sizes for two microstate classes, namely C and D. Combining the meta-analysis results with the fact that microstate class D abnormalities are correlated with the presence of positive symptoms in patients with schizophrenia, these results add further support for the training of this precise microstate. Overall, the results obtained in this study encourage the implementation of this protocol in a population of patients with schizophrenia. However, future studies will have to show whether patients will be able to successfully self-regulate the contribution of microstate class D and, if so, whether this regulation will have an impact on symptomatology.

Ansiedade pós acidente vascular cerebral

Se entendemos o Acidente vascular cerebral como um acontecimento incapacitante da vida dos pacientes, poderemos compreender as alterações comportamentais e emocionas que este provoca. No entanto, poucos estudos têm sido realizados acerca desta temática, tendo assim este estudo como objetivo verificar se existe uma associação clara entre a ansiedade e um determinado tipo de AVC. Aplicou-se a escala de Montereal, o State-Trait Anxiety lnventory e o Inventario Neuropsiquiátrico numa amostra constituída por pacientes que tenham sofrido AVC no período de três meses a um ano, e num grupo controlo. Os resultados mostram que não existem diferenças significativas no que respeita à ansiedade nos pacientes com AVC anterior. Conclui-se que não existe um aumento de ansiedade, mas que os défices visuo-espaciais e atencionais são mais significativos no AVC anterior. / ABSTRACT: lf we recognize Stroke as an event that can incapacitate the patients' life, we can comprehend the behaviour and emotional changes that this provokes. One of the psychiatric symptoms usually associated to Stroke is anxiety. However, few studies have been made concerning this matter, being the purpose of this study to verify if a clear association exists between anxiety and a certain type of Stroke. The Montereal Cognitiva Assessment, State-Trait Anxiety lnventory, and Neuropsychiatric lnventory were applied in a sample consisting of patients that have suffered Stroke in the period of three months to one year, and in a control group. The results show no significant differences in what regards to anxiety in patients with previous Stroke. We conclude that there is no increase in anxiety after stroke, but cognitive deficits in visual-spatial and attentional are most significant in subjects with previous stroke.

Basic symptoms in the general population and in psychotic and non-psychotic psychiatric adolescents

Cognitive-perceptive 'basic symptoms' are used complementary to ultra-high-risk criteria in order to predict onset of psychosis in the pre-psychotic phase. The aim was to investigate the prevalence of a broad selection of 'basic symptoms' in a representative general adolescent population sample (GPS; N=96) and to compare it with adolescents first admitted for early onset psychosis (EOP; N=87) or non-psychotic psychiatric disorders (NP; N=137).

Anxiety and depression symptoms in liver encephalopathy : are they psychiatric or organic?

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Shame, Dissociation, and Complex PTSD Symptoms in Traumatized Psychiatric and Control Groups: Direct and Indirect Associations With Relationship Distress

Objectives: Elevated shame and dissociation are common in dissociative identity disorder (DID) and chronic posttraumatic stress disorder (PTSD) and are part of the constellation of symptoms defined as complex PTSD. Previous work examined the relationship between shame, dissociation, and complex PTSD and whether they are associated with intimate relationship anxiety, relationship depression, and fear of relationships. This study investigated these variables in traumatized clinical samples and a nonclinical community group.

Method: Participants were drawn from the DID (n = 20), conflict-related chronic PTSD (n = 65), and nonclinical (n = 125) populations and completed questionnaires assessing the variables of interest. A model examining the direct impact of shame and dissociation on relationship functioning, and their indirect effect via complex PTSD symptoms, was tested through path analysis.

Results: The DID sample reported significantly higher dissociation, shame, complex PTSD symptom severity, relationship anxiety, relationship depression, and fear of relationships than the other two samples. Support was found for the proposed model, with shame directly affecting relationship anxiety and fear of relationships, and pathological dissociation directly affecting relationship anxiety and relationship depression. The indirect effect of shame and dissociation via complex PTSD symptom severity was evident on all relationship variables.

Conclusion: Shame and pathological dissociation are important for not only the effect they have on the development of other complex PTSD symptoms, but also their direct and indirect effects on distress associated with relationships.

Wives of pathological gamblers: personality traits, depressive symptoms and social adjustment

Objective: Wives of pathological gamblers tend to endure long marriages despite financial and emotional burden. Difficulties in social adjustment, personality psychopathology, and comorbidity with psychiatric disorders are pointed as reasons for remaining on such overwhelming relationships. The goal was to examine the social adjustment, personality and negative emotionality of wives of pathological gamblers. Method: The sample consisted of 25 wives of pathological gamblers, mean age 40.6, SD = 9.1 from a Gambling Outpatient Unit and at GAM-ANON, and 25 wives of non-gamblers, mean age 40.8, SD = 9.1, who answered advertisements placed at the Universidade de São Paulo hospital and medical school complex. They were selected in order to approximately match demographic characteristics of the wives of pathological gamblers. Subjects were assessed by the Social Adjustment Scale, Temperament and Character Inventory, Beck Depression Inventory and State-Trait Anxiety Inventory. Results: Three variables remained in the final Multiple Logistic Regression model, wives of pathological gamblers presented greater dissatisfaction with their marital bond, and higher scores on Reward Dependence and Persistence temperament factors. Both, Wives of pathological gamblers and wives of non-gamblers presented well-structured character factors excluding personality disorders. Conclusion: This personality profile may explain wives of pathological gamblers emotional resilience and their marriage longevity. Co-dependence and other labels previously used to describe them may work as a double edged sword, legitimating wives of pathological gamblers problems, while stigmatizing them as inapt and needy.