Glutamate imbalance in key structure of the default mode network in adults with attention-deficit/hyperactivity disorder.

The default mode network (DMN) is atypically active in patients with ADHD, likely contributing to the inattention patterns observed in patients with the disorder. Nonetheless, magnetic resonance spectroscopy (MRS) studies have rarely targeted the posterior cingulate cortex, a key DMN region, and little is known about the biochemical setting within this network in patients with ADHD. We aimed to assess the differences in metabolite profiles of the posterior cingulate cortex-a key region of the DMN-between patients with ADHD and controls.

The course of attention-deficit/hyperactivity disorder through midlife.

The course of ADHD from childhood up to young adulthood has been characterized in several studies. However, little is known about the course of symptoms into middle age and beyond. This study aims to evaluate predictors of ADHD trajectories in midlife based on three assessments.

Transcranial Direct Current Stimulation vs Sham for the Treatment of Inattention in Adults With Attention-Deficit/Hyperactivity Disorder: The TUNED Randomized Clinical Trial.

Importance: Transcranial direct current stimulation (tDCS) may improve symptoms of inattention in adults with attention-deficit/hyperactivity disorder (ADHD). However, previous trials are characterized by small sample sizes, heterogeneous methodologies, and short treatment periods using clinic-based tDCS.

Objective: To determine the efficacy and safety of home-based tDCS in treating inattention symptoms in adult patients with ADHD.

Dissecting the cross-trait effects of the FOXP2 GWAS hit on clinical and brain phenotypes in adults with ADHD.

The Forkhead box P2 (FOXP2) encodes for a transcription factor with a broad role in embryonic development. It is especially represented among GWAS hits for neurodevelopmental disorders and related traits, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, neuroticism, and risk-taking behaviors. While several functional studies are underway to understand the consequences of FOXP2 variation, this study aims to expand previous findings to clinically and genetically related phenotypes and neuroanatomical features among subjects with ADHD.

Identifying posttraumatic stress disorder staging from clinical and sociodemographic features: a proof-of-concept study using a machine learning approach.

This proof-of-concept study aimed to investigate the viability of a predictive model to support posttraumatic stress disorder (PTSD) staging. We performed a naturalistic, cross-sectional study at two Brazilian centers: the Psychological Trauma Research and Treatment (NET-Trauma) Program at Universidade Federal of Rio Grande do Sul, and the Program for Research and Care on Violence and PTSD (PROVE), at Universidade Federal of São Paulo. Five supervised machine-learning algorithms were tested: Elastic Net, Gradient Boosting Machine, Random Forest, Support Vector Machine, and C5.

Feasibility trial of the dialectical behavior therapy skills training group as add-on treatment for adults with attention-deficit/hyperactivity disorder.

Objective: Our aim was to explore the feasibility, and efficacy of a Dialectical Behavior Therapy Skill Training Group (DBT-ST) as an add-on treatment for adult attention-deficit/hyperactivity disorder (ADHD) in Latin America.

Method: Adults with ADHD (n = 31) with stable medication treatment for ADHD and residual symptoms (ASRS > 20) were randomly assigned to DBT-ST (n = 16) or treatment as usual (TaU; n = 15) for 12 weeks. Feasibility was accessed by attendance and completion rates at 12 weeks.

Countertransference, Defense Mechanisms, and Vicarious Trauma in Work With Sexual Offenders.

This study aimed to examine the associations between countertransference induced by sex offenders, defense mechanisms, and manifestations of vicarious trauma in forensic psychiatrists and psychologists. A cross-sectional study using a mixed-methods design was performed with 56 Brazilian forensic psychiatrists and psychologists from October 2016 to May 2017. Countertransference, defense mechanisms, and vicarious trauma were assessed with the Assessment of Countertransference Scale, the Defense Style Questionnaire-40, and the Trauma and Attachment Belief Scale (TABS), respectively.

Trauma-related disorders in a low- to middle-income country: A four-year follow-up of outpatient trauma in Brazil.

Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) are developed from exposure to traumatic events including war, interpersonal violence and natural disasters. We investigated prevalence and trauma-related information in patients from an outpatient psychiatric unit in Brazil among 2014-2017. A prevalence of ASD/PTSD of 40.

Interaction structures in the psychodynamic psychotherapy of a patient with chronic diseases and somatic symptoms.

Objective: This study aimed to identify and analyze the interaction structures (ISs) (patterns of reciprocal interaction between the patient-therapist dyad) that characterize the process of a successful long-term psychodynamic psychotherapy (28 months) of a patient with chronic diseases (lupus and fibromyalgia) and somatic symptoms.

Methods: The 113 sessions were videotaped and analyzed alternately (n = 60) by independent judges using the Psychotherapy Process Q-Set. Inter-rater reliability ranged from 0.

Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis.

Background: As more patients are surviving intensive care, mental health concerns in survivors have become a research priority. Among these, post-traumatic stress disorder (PTSD) can have an important impact on the quality of life of critical care survivors. However, data on its burden are conflicting.

What is the appropriate time to measure outcome and process factors in psychodynamic psychotherapy?

Introduction: Different instruments and methods for measuring factors related to the progress and effectiveness of psychodynamic psychotherapy (PDT) have been widely discussed in the literature. However, there are no established guidelines on the most appropriate time to perform these measurements.

Objectives: The aim of this study is to problematize what is the appropriate time to measure the initial outcomes (symptoms, interpersonal relationships, quality, and social role) and process factors (alliance) in the early stages of PDT.

Brazilian Portuguese translation, cross-cultural adaptation, and apparent validation of the Trauma and Attachment Belief Scale.

Objective: This article concerns the translation, cross-cultural adaptation, and apparent validation of the Trauma and Attachment Belief Scale (TABS), an instrument used to assess the psychological effects of traumatic life experiences and vicarious trauma.

Methods: This study involved literature review and evaluation of conceptual and item equivalences involving expert discussion groups focused on the existence and pertinence of the underlying theoretical concepts and corresponding items in a Brazilian context. Two translations and respective back-translations were performed during the evaluation of semantic equivalence, as well as an evaluation considering the referential and general equivalences between the original TABS and each version.

Evidence of sexual dimorphism of HTR1B gene on major adult ADHD comorbidities.

Attention-deficit/hyperactivity disorder (ADHD) is a very common psychiatric disorder across the life cycle and frequently presents comorbidities. Since ADHD is highly heritable, several studies have focused in the underlying genetic factors involved in its etiology. One of the major challenges in this search is the phenotypic heterogeneity, which could be partly attributable to the sexual dimorphism frequently seen in psychiatric disorders.

Association between resilience and posttraumatic stress disorder among Brazilian victims of urban violence: a cross-sectional case-control study.

Introduction: This study investigated the association between resilience and posttraumatic stress disorder (PTSD) among Brazilian victims of urban violence. It also compared defense mechanisms, parental bonding, and childhood trauma between those who developed PTSD and those who did not.

Methods: This cross-sectional case-control study included 66 adult subjects exposed to recent urban violence in southern Brazil - 33 with PTSD and 33 healthy controls matched by sex and age - who were administered the Resilience Scale, Defense Style Questionnaire, Parental Bonding Instrument, and Childhood Trauma Questionnaire.

Resilience to traumatic events related to urban violence and increased IL10 serum levels.

The exposition to traumatic events related to urban violence is epidemic in Brazil, with rate of 80% in the general population, and is becoming a major cause of post-traumatic stress disorder (PTSD). The objective of the study was to compare serum levels of pro-inflammatory interleukin-6 (IL-6) and anti-inflammatory interleukin-10 (IL-10) in PTSD and resilient individuals. We hypothesized that resilient individuals present an attenuated pro-inflammatory and enhanced anti-inflammatory state.

Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy.

Objectives: The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality.

Methodology: This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers.

Internalizing disorders and quality of life in adolescence: evidence for independent associations.

Objective: To investigate whether internalizing disorders are associated with quality of life (QoL) in adolescents, even after accounting for shared risk factors.

Methods: The sample comprised 102 adolescents from a community cross-sectional study with an oversampling of anxious subjects. Risk factors previously associated with QoL were assessed and divided into five blocks organized hierarchically from proximal to distal sets of risk factors.

Therapeutic relationship on the web: to face or not to face?

In this age of unprecedented expansion of media and information dissemination and sharing, the use of electronic means should be reconsidered. The use of new technologies should be studied to understand how it may affect the relationship between patient and therapist during psychotherapy or psychoanalytic treatments. This study offers a critical discussion of the effect of technologies on clinical practice, and vignettes are used to describe their impact on frame, anonymity, abstinence and therapeutic neutrality.

Measurement methods of BDNF levels in major depression: a qualitative systematic review of clinical trials.

There is evidence that the brain-derived neurotrophic factor (BDNF) has implications for the pathophysiology of major depressive disorders (MDD). Measures of BDNF levels are highly dependent on the methodologies used and these vary among different studies. Therefore, the aim of this study was to carry out a descriptive analysis of the methodologies used to measure BDNF in clinical trials (CT) in patients with the diagnosis of major depression.

Is it all grist to the mill? Wandering between indications for psychoanalytic treatment and the analytic field.

Determining the indications and contraindications for psychoanalytic treatment seems crucial to achieve therapeutic success and improve treatment effectiveness. In reviewing the classic literature on the topic, aspects such as age, diagnosis, motivation for treatment, present moment in life, ability to gain insight, psychic suffering when seeking treatment, defensive behaviors, and frustration tolerance are clearly analyzed by therapists/analysts when indicating psychoanalytic treatments. However, traditionally, most criteria underlying such indications date back to a time when the therapeutic relationship was viewed merely as a therapist treating a patient, with no regard to the therapeutic relationship itself.

Evidence of association between Val66Met polymorphism at BDNF gene and anxiety disorders in a community sample of children and adolescents.

Different lines of evidence support BDNF as a candidate gene in mood and anxiety modulation. More recently, the Met allele of the BDNF Val66Met polymorphism has been implicated in anxiety in animal models and anxiety-traits in humans. The aim of this study is to evaluate the a priori hypothesis that the association between anxiety disorders and Val66Met polymorphism at the BDNF gene would be replicated in a community sample of children and adolescents.

The multidimensional evaluation and treatment of anxiety in children and adolescents: rationale, design, methods and preliminary findings.

Objective: This study aims to describe the design, methods and sample characteristics of the Multidimensional Evaluation and Treatment of Anxiety in Children and Adolescents - the PROTAIA Project.

Method: Students between 10 and 17 years old from all six schools belonging to the catchment area of the Primary Care Unit of Hospital de Clínicas de Porto Alegre were included in the project. It comprises five phases: (1) a community screening phase; (2) a psychiatric diagnostic phase; (3) a multidimensional assessment phase evaluating environmental, neuropsychological, nutritional, and biological factors; (4) a treatment phase, and (5) a translational phase.

Obesity and its relationship with asthma prevalence and severity in adolescents from southern Brazil.

Obesity has been pointed out as a risk factor for higher prevalence of asthma and asthma-related symptoms in adolescents. The objective was to evaluate the relationship between the prevalence of asthma and obesity in adolescents living in Santa Maria and surroundings (state of Rio Grande do Sul, southern Brazil), applying the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. A total of 4,010 of 6,123 schoolchildren, 13 to 14 years of age, enrolled in the ISAAC phase III protocol (asthma core questionnaire) and were nutritionally evaluated: height, weight, and triceps skinfold (TSF) measurements.