portuguese | english Revista Brasileira de Psiquiatria ISSN print 1516-4446
ISSN on-line 1809-452X
JCR IF 2017: 2.093
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Current issue 3, Volume 40 - Jul/Aug/Sep/2018


EDITORIAL
1 - Top Cited Session: the best of RBP
João Quevedo,; Antonio E. Nardi
Pages: 231 - 232

Descriptors:


ORIGINAL ARTICLES
2 - Changes in energy and motor activity: core symptoms of bipolar mania and depression?
Elie Cheniaux; Rafael de A. da Silva; Cristina M. Santana; Alberto Filgueiras
Pages: 233 - 237
Abstract

OBJECTIVE: To evaluate how well symptom rating scales differentiate bipolar disorder (BD) episode types.
METHODS: One hundred and six patients with BD were followed for 13 years. At each visit, the following clinical scales were administered: Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D) and Clinical Global Impressions scale for use in bipolar illness (CGI-BP). To perform a comparison between the affective states of BP, three time points in each patient's follow-up period were chosen for evaluation: the most severe manic episode, the most severe depressive episode, and the euthymic period with least symptoms. Canonical discriminant analyses (CDA) were performed to identify which symptoms best discriminated episodes.
RESULTS: CDA revealed HAM-D was worse than YMRS and CGI-BP to discriminate mood states. The items evaluating increased motor activity in YMRS (2, increased motor activity/energy) and HAM-D (9, agitation) were the best to distinguish mania, depression, and euthymia. In contrast, HAM-D item 8 (retardation) and the HAM-D and YMRS items related to mood symptoms were less important and precise.
CONCLUSION: Higher levels of energy or activity should be considered a core symptom of mania. However, our results do not confirm the association between a decrease in energy or activity and depression. HAM-D probably does not assess motor activity adequately.

Descriptors: Bipolar disorder; discriminant analysis; motor activity; energy


3 - Religiosity, depression, and quality of life in bipolar disorder: a two-year prospective study
André Stroppa; Fernando A. Colugnati; Harold G. Koenig; Alexander Moreira-Almeida
Pages: 238 - 243
Abstract

OBJECTIVE: Few quantitative studies have examined the effect of religious involvement on the course of bipolar disorder (BD). We investigated the effects of religious activity and coping behaviors on the course of depression, mania, and quality of life (QoL) in patients with BD.
METHODS: Two-year longitudinal study of 168 outpatients with BD. Linear regression was used to examine associations between religious predictors and outcome variables (manic symptoms, depression, QoL), controlling for sociodemographic variables.
RESULTS: Among the 158 patients reassessed after 2 years, positive religious coping at T1 predicted better QoL across all four domains: physical (β = 10.2, 95%CI 4.2 to 16.1), mental (β = 13.4, 95%CI 7.1 to 19.7), social (β = 10.5, 95%CI 3.6 to 17.33), and environmental (β =11.1, 95%Cl 6.2 to 16.1) at T2. Negative religious coping at T1 predicted worse mental (β = -28.1, 95%CI -52.06 to -4.2) and environmental (β = -20.4, 95%CI -39.3 to -1.6) QoL. Intrinsic religiosity at T1 predicted better environmental QoL (β = 9.56, 95%CI 2.76 to 16.36) at T2. Negative religious coping at T1 predicted manic symptoms (β = 4.1) at T2.
CONCLUSION: Religiosity/spirituality (R/S) may influence the QoL of patients with BD over time, even among euthymic patients. Targeting R/S (especially positive and negative religious coping) in psychosocial interventions may enhance the quality of recovery in patients with BD.

Descriptors: Bipolar disorder; religion; spirituality; quality of life; mania


4 - The association between social skills deficits and family history of mood disorder in bipolar I disorder
Francy B.F. Fernandes,; Cristiana C. Rocca,; Alexandre D. Gigante; Paola R. Dottori-Silva; Luciana Gerchmann; Danielle Rossini; Rodrigo Sato; Beny Lafer; Fabiano G. Nery
Pages: 244 - 248
Abstract

OBJECTIVE: To compare social skills and related executive functions among bipolar disorder (BD) patients with a family history of mood disorders (FHMD), BD patients with no FHMD and healthy control (HCs).
METHODS: We evaluated 20 euthymic patients with FHMD, 17 euthymic patients without FHMD, and 31 HCs using the Social Skills Inventory (SSI) and a neuropsychological battery evaluating executive function, inhibitory control, verbal fluency and estimated intelligence.
RESULTS: Both BD groups had lower SSI scores than controls. Scores for one subfactor of the social skills questionnaire, conversational skills and social performance, were significantly lower among patients with FHMD than among patients without FHMD (p = 0.019). Both groups of BD patients exhibited significant deficits in initiation/inhibition, but only BD patients with FHMD had deficits in verbal fluency, both compared to HC. There were no associations between social skills questionnaire scores and measures of cognitive function.
CONCLUSION: Euthymic BD patients have lower social skills and executive function performance than HC. The presence of FHMD among BD patients is specifically associated with deficits in conversational and social performance skills, in addition to deficits in verbal fluency. Both characteristics might be associated with a common genetically determined pathophysiological substrate.

Descriptors: Bipolar disorder; social skills; executive functions; family history


5 - Psychometric properties of the EUROHIS-QOL 8-item index (WHOQOL-8) in a Brazilian sample
Ana Caroline Pires; Marcelo P. Fleck Mick Power,; Neusa S. da Rocha
Pages: 249 - 255
Abstract

OBJECTIVE: To test the psychometric properties of the EUROHIS-QOL 8-item index in a Brazilian sample.
METHODS: The sample consisted of 151 patients and 174 healthy controls (n=325). Several psychometric properties were tested.
RESULTS: Reliability showed good internal consistency (Cronbach's alpha = 0.81). The measure showed good discriminant validity between patients and healthy controls (mean1 = 3.32, SD1 = 0.70; mean2 = 3.77, SD2 = 0.63, t = 6.12, p < 0.001). Convergent validity showed significant correlations (p < 0.001) between the EuRohIS-QOl 8-item index and all domains of the WHOQOL-Bref (overall r = 0.47; general health r = 0.54; physical r = 0.69; psychological r = 0.62; social relationship r = 0.55; environment r = 0.55) and between the EUROHIS-QOl 8-item index and the domains of the SF-36, except for the social domain (p = 0.38). On Rasch analysis of unidimensionality, general fit measures showed adequate performance. The EUROHIS-QOL 8-item index also showed good fit on confirmatory factor analysis (CFA) (chi-square = 18.46, degrees of freedom [df] = 15; comparative fit index [CFI] = 0.99; root mean square error of approximation [RMSEA] = 0.03; goodness of fit index [gfi] = 0.99; root mean square residual [RMR] = 0.03; p = 24).
CONCLUSION: The EUROHIS-QOL 8-item index showed good psychometric properties. It is a reliable quality of life measure that can be used in Brazilian populations.

Descriptors: Psychometric properties; quality of life; EUROHIS-QOL 8-item index; short form; WHOQOL-8


6 - Art therapy as an adjuvant treatment for depression in elderly women: a randomized controlled trial
Eliana C. Ciasca; Rita C. Ferreira; Carmen L.A. Santana; Orestes V. Forlenza; Glenda D. dos Santos; Paula S. Brum; Paula V. Nunes
Pages: 256 - 263
Abstract

OBJECTIVE: There are few quantitative studies on art therapy for the treatment of depression. The objective of this study was to evaluate if art therapy is beneficial as an adjuvant treatment for depression in the elderly.
METHODS: A randomized, controlled, single-blind study was carried out in a sample of elderly women with major depressive disorder (MDD) stable on pharmacotherapy. The experimental group (EG) was assigned to 20 weekly art therapy sessions (90 min/session). The control group (CG) was not subjected to any adjuvant intervention. Patients were evaluated at baseline and after 20 weeks, using the Geriatric Depression Scale (GDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and cognitive measures.
RESULTS: Logistic regression analysis adjusted for age revealed that women in EG (n=31) had significant improvement in GDS (p = 0.007), BDI (p = 0.025), and BAI (p = 0.032) scores as compared with controls (n=25). No difference was found in the cognitive measures.
CONCLUSION: Art therapy as an adjunctive treatment for MDD in the elderly can improve depressive and anxiety symptoms.
CLINICAL TRIAL REGISTRATION: RBR-2YXY7Z

Descriptors: Art therapy; depression; anxiety; elderly patients; clinical trial


7 - Diagnosing dementia in lower educated older persons: validation of a Brazilian Portuguese version of the Rowland Universal Dementia Assessment Scale (RUDAS)
Narahyana B. de Araujo; Thomas R. Nielsen; Knut Engedal; Maria L. Barca; Evandro S. Coutinho; Jerson Laks
Pages: 264 - 269
Abstract

OBJECTIVE: To validate the Rowland Universal Dementia Assessment Scale for use in Brazil (RUDAS-BR).
METHODS: We first completed an English-Brazilian Portuguese translation and back-translation of the RUDAS. A total of 135 subjects over 60 years of age were included: 65 cognitively healthy and 70 with Alzheimer's disease (AD) according to the DSM-IV and Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. All participants completed an interview and were screened for depression. The receiver operating characteristic curves of the RUDAS were compared with those of the Mini Mental State Examination (MMSE) regarding the sensitivity and specificity of cutoffs, taking education into consideration.
RESULTS: The areas under the curve were similar for the RUDAS-BR (0.87 [95%CI 0.82-0.93]) and the MMSE (0.84 [95%CI 0.7-0.90]). RUDAS-BR scores < 23 indicated dementia, with sensitivity of 81.5% and specificity of 76.1%. MMSe < 24 indicated dementia, with sensitivity of 72.3% and specificity of 78.9%. The cutoff score was influenced by years of education on the MMSE, but not on the RUDAS-BR.
CONCLUSIONS: The RUDAS-BR is as accurate as the MMSE in screening for dementia. RUDAS-BR scores were not influenced by education. The RUDAS-BR may improve the cognitive assessment of older persons who are illiterate or of lower educational attainment.

Descriptors: Dementia; Alzheimer's disease; education; psychiatric; tests/interviews; psychometric; cognitive neuroscience; diagnosis and classification


8 - The slant of the forehead as a craniofacial feature of impulsiveness
J. David Guerrero-Apolo; J. Blas Navarro-Pastor; Antonio Bulbena-Vilarrasa; Julián Gabarre-Mir
Pages: 270 - 276

Descriptors:


9 - Exposure to violence: associations with psychiatric disorders in Brazilian youth
Thiago M. Fidalgo; Zila M. Sanchez; Sheila C. Caetano; Solange Andreoni; Adriana Sanudo; Qixuan Chen; Sílvia S. Martins
Pages: 277 - 283
Abstract

OBJECTIVE: The effects of exposure to violent events in adolescence have not been sufficiently studied in middle-income countries such as Brazil. The aims of this study are to investigate the prevalence of psychiatric disorders among 12-year-olds in two neighborhoods with different socioeconomic status (SES) levels in São Paulo and to examine the influence of previous violent events and SES on the prevalence of psychiatric disorders.
METHODS: Students from nine public schools in two neighborhoods of São Paulo were recruited. Students and parents answered questions about demographic characteristics, SES, urbanicity and violent experiences. All participants completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to obtain DSM-IV diagnoses. The data were analyzed using weighted logistic regression with neighborhood stratification after adjusting for neighborhood characteristics, gender, SES and previous traumatic events.
RESULTS: The sample included 180 individuals, of whom 61.3% were from low SES and 39.3% had experienced a traumatic event. The weighted prevalence of psychiatric disorders was 21.7%. Having experienced a traumatic event and having low SES were associated with having an internalizing (adjusted OR = 5.46; 2.17-13.74) or externalizing disorder (adjusted OR = 4.33; 1.85-10.15).
CONCLUSIONS: Investment in reducing SES inequalities and preventing violent events during childhood may improve the mental health of youths from low SES backgrounds.

Descriptors: Adolescents; child psychiatry; epidemiology; social and political issues; violence/aggression


10 - Psychiatric disorders in adolescents with type 1 diabetes: a case-control study
Mireille C. Almeida; Denise A. Claudino; Ruth B. Grigolon; Bacy Fleitlich-Bilyk; Angélica M. Claudino
Pages: 284 - 289
Abstract

OBJECTIVES: To study the prevalence of psychiatric disorders in adolescents with and without type 1 diabetes, the factors associated with its presence, and to test the reliability of a screening tool for use in clinical settings.
METHODS: Eighty-one adolescents were enrolled in this case-control study, including 36 diabetic participants and 45 controls. Clinical and sociodemographic data were collected and psychiatric symptoms and diagnoses were obtained from adolescents and their parents using a screening tool (Strengths & Difficulties Questionnaire) and a semi-structured interview (Development and Well-Being Assessment).
RESULTS: Psychiatric disorders were identified in 22.2% of the sample (30.56% among diabetic adolescents vs. l5.56% of controls: OR = 2.39, 95%CI 0.82-6.99; p = 0.11). Overweight (body mass index percentile ≥ 85) was the only factor associated with psychiatric disorder (OR = 3.07; 95%CI 1.03-9.14; p = 0.04). Compared to the semi-structured interview, the screening instrument showed 80% sensitivity, 96% specificity, 88.9% positive predictive value and 92.3% negative predictive value for the presence of psychiatric diagnoses in adolescents.
CONCLUSION: Psychiatric morbidity was high in this sample of adolescents, especially among those with diabetes. Routine use of the Strengths and Difficulties Questionnaire can help with early detection of psychiatric disorders in this at-risk group.

Descriptors: Adolescent; epidemiology; child psychiatry; diabetes mellitus; type 1


11 - Is emotional functioning related to academic achievement among university students? Results from a cross-sectional Iranian sample
Dena Sadeghi Bahmani; Parviz Faraji; Robab Faraji; Undine E. Lang; Edith Holsboer-Trachsler; Serge Brand
Pages: 290 - 295
Abstract

OBJECTIVE: Whereas several studies have predicted academic achievement (AA) as a function of favorable cognitive factors and low negative emotional functioning (such as depression and anxiety), little is known about its associations with cognitive-emotional states of positive emotional functioning, such as social satisfaction. The present study sought to evaluate associations of AA with dimensions of negative and positive emotional functioning.
METHOD: This cross-sectional study enrolled 275 students (mean age, 21.24 years; 66.1% females), who completed questionnaires covering sociodemographic parameters and AA scores, as well as measures of loneliness and depression (representing negative emotional functioning) and social satisfaction (representing positive emotional functioning).
RESULTS: Lower scores for negative and higher scores for positive emotional functioning were associated with higher AA scores. Multiple regression analysis showed that AA was predicted independently by both low negative and high positive emotional functioning. No gender differences were observed.
CONCLUSIONS: The pattern of results observed in this study suggests that opposing dimensions of emotional functioning are independently related to AA. Students, educators, and health professionals dealing with students should focus both on increasing social satisfaction and on decreasing feelings of loneliness and depression.

Descriptors: Negative emotions; positive emotions; students; academic achievement; loneliness; depression; social satisfaction


12 - Impact of a provider training program on the treatment of children with autism spectrum disorder at psychosocial care units in Brazil
Luciana C. Silva; Maria C.T.V. Teixeira; Edith L. Ribeiro; Cristiane S. Paula
Pages: 296 - 305
Abstract

OBJECTIVE: To develop, implement, and verify the impact of a training program for health care providers working with children with autism spectrum disorder (ASD) in psychosocial care centers for children and adolescents (Centro de Atenção Psicossocial à Infância e à Adolescência - CAPSi) in São Paulo, Brazil.
METHODS: This quasi-experimental study was conducted with 14 professionals from four CAPSi units. The training program consisted of six phases: 1) pre-intervention observation; 2) meeting with staff to assess the main needs of the training program; 3) developing materials for training and evaluation; 4) meetings to discuss program implementation; 5) a final meeting for case discussion and evaluation; and 6) distance supervision. Three measures were used to evaluate the training program: i) the Knowledge, Attitudes, and Practices (KAP) questionnaire; ii) videos containing questions designed to assess program comprehension; and iii) a satisfaction survey.
RESULTS: Thirteen videos were produced to as visual aids for use during the training program, and a further 26 videos were developed to evaluate it. The program was well evaluated by the participants. The video responses and kAp questionnaire scores suggest that staff knowledge and attitudes improved after training.
CONCLUSION: The positive findings of this study suggest that the tested training program is feasible for use with multidisciplinary teams working in the CAPSi environment.

Descriptors: Child psychiatry; autism; community mental health; education, psychiatric; interdisciplinary relations


BRIEF COMMUNICATIONS
13 - Profile and costs involved in long-term compulsory hospitalization of psychiatric patients
Fernando Venturini; Eduardo C. de Moura; Paula A. Bastos; Lourdes C. Martins; Yara D. Fragoso
Pages: 306 - 308
Abstract

OBJECTIVE: Involuntary hospitalization for acute psychiatry cases can be acceptable when there is potential harm. However, there are few reasons for a patient committed on these grounds to stay in an institution for a long period. The objective of the present study was to identify the profile and costs of compulsory hospitalizations over 20 days in a public psychiatric hospital in the coastal region of the state of Sao Paulo.
METHODS: Retrospective data were collected from the medical records of 1,064 patients admitted between July 2013 and June 2016 from an intensive mental healthcare unit in Santos, state of Sao Paulo, Brazil.
RESULTS: Records were found of 527 patients who had been hospitalized for at least 21 days during the study period. Long-term hospitalization related to judicial mandates represented 5.9% of the total sample. These patients stayed in the hospital for an average period of 142 days, while patients hospitalized for any other reason stayed an average period of 35 days (p < 0.001). The cost of a longterm court-ordered hospitalization averaged US$ 21,311 per patient.
CONCLUSION: Judicial mandate has been an important reason for the long-term hospitalization of chronic psychiatric patients in Santos, Brazil.

Descriptors: Chronic psychiatric disease; hospitalization; psychiatry hospital; drug abuse; psychosis


14 - Intermittent theta-burst transcranial magnetic stimulation for autism spectrum disorder: an open-label pilot study
Caio Abujadi; Paul E. Croarkin; Bianca B. Bellini; Helena Brentani; Marco A. Marcolin
Pages: 309 - 311
Abstract

OBJECTIVE: Theta-burst stimulation (TBS) modulates synaptic plasticity more efficiently than standard repetitive transcranial magnetic stimulation delivery and may be a promising modality for neuropsychiatric disorders such as autism spectrum disorder (ASD). At present there are few effective interventions for prefrontal cortex dysfunction in ASD. We report on an open-label, pilot study of intermittent TBS (iTBS) to target executive function deficits and restricted, repetitive behaviors in male children and adolescents with ASD.
METHODS: Ten right-handed, male participants, aged 9-17 years with ASD were enrolled in an open-label trial of iTBS treatment. Fifteen sessions of neuronavigated iTBS at 100% motor threshold targeting the right dorsolateral prefrontal cortex were delivered over 3 weeks.
RESULTS: Parent report scores on the Repetitive Behavior Scale Revised and the Yale-Brown Obsessive Compulsive Scale demonstrated improvements with iTBS treatment. Participants demonstrated improvements in perseverative errors on the Wisconsin Card Sorting Test and total time for the Stroop test. The iTBS treatments were well tolerated with no serious adverse effects.
CONCLUSION: These preliminary results suggest that further controlled interventional studies of iTBS for ASD are warranted.

Descriptors: Autism spectrum disorder; intermittent theta burst stimulation; noninvasive brain stimulation; theta-burst stimulation; repetitive transcranial magnetic stimulation


15 - Brazilian version of the Cognitive Failures Questionnaire (CFQ): cross-cultural adaptation and evidence of validity and reliability
Jonas J. de Paula; Danielle S. Costa; Débora M. de Miranda; Marco A. Romano-Silva
Pages: 312 - 315
Abstract

OBJECTIVE: Cognitive failures are simple mistakes in routine activities, such as forgetting commitments and experiencing difficulty concentrating. The Cognitive Failures Questionnaire (CFQ) was designed to assess the frequency of these errors in everyday life. Although widely used in psychiatry and psychology, both in clinical and research settings, it has not been adapted for use in Brazil. Our objective was to perform cross-cultural adaptation of the CFQ for the Brazilian reality and assess its validity and reliability.
METHODS: The original version of the CFQ was translated into Brazilian Portuguese by two independent researchers, analyzed by a multidisciplinary board of experts, and back-translated into English. The final version was administered to 225 adults. Validity was assessed by correlation with the Self Reporting Questionnaire-20 (SRQ-20) and the Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale (ASRS-18). Reliability was analyzed by calculating internal consistency and test-retest stability.
RESULTS: The adapted version of the CFQ showed significant correlations with SRQ-20 (r = -0.311), ASRS-18 inattention (r = 0.696), and hyperactivity/impulsivity (r = 0.405) scores. Reliability analysis suggests high internal consistency (0.906) and temporal stability (0.813).
CONCLUSION: The Brazilian Portuguese version of the CFQ showed moderate correlations with other measures of mental health, as well as adequate reliability.

Descriptors: Cognitive neuroscience; diagnosis and classification; memory; occupational psychiatry; psychometric tests/interviews


16 - Cognitive-behavioral group therapy for intermittent explosive disorder: description and preliminary analysis
Ana M. Costa; Gustavo C. Medeiros; Sarah Redden; Jon E. Grant; Hermano Tavares; Liliana Seger
Pages: 316 - 319
Abstract

OBJECTIVES: To evaluate the efficacy of a group therapy based on cognitive-behavioral techniques customized for intermittent explosive disorder (IED). The current report presents the preliminary results of a clinical trial comparing pre- and post-intervention scores in different anger dimensions.
METHODS: The studied sample consisted of 84 treatment-seeking subjects. The mean (standard deviation) age was 43.0 (11.9) years, and 78% were male. The therapeutic group program consisted of 15 weekly sessions plus three maintenance sessions. The sessions lasted approximately 90 minutes each.
RESULTS: No differences were found in demographic profile and pre-treatment status between subjects who completed treatment (n=59) and dropouts (n=25). Comparison of State-Trait Anger Expression Scale (STAXI) scores pre- and post-treatment showed statistically significant changes in all anger scales and subscales of the questionnaire.
CONCLUSION: This preliminary report is a significant addition to currently scarce clinical data. Our findings provide further evidence that structured cognitive-behavioral group therapy, with a focus on anger management and cognitive coping, may be a promising approach to the treatment of IED.

Descriptors: Violence/aggression; psychotherapy; group therapy; cognitive therapy; impulse control disorders


SPECIAL ARTICLE
17 - Introducing care management to Brazil's alcohol and substance use disorder population
Ilana Pinsky; Camila Bernal; Lindsey Vuolo; Charles Neighbors
Pages: 320 - 324
Abstract

Brazil has a sizable alcohol and substance use disorder (ASUD) population, yet there are considerable gaps in treatment access and retention. ASUD, a chronic medical condition, is highly comorbid with medical and behavioral health disorders. This indicates a need for more targeted interventions in order to achieve health care integration (a major goal of Brazil's health care system). Care management - that is, the organization of patient care by an institution - is a viable strategy to engage individuals with ASUD who might benefit from treatment but are not aware of or do not use the available resources, as well as to help maintain patients in treatment. Care management is considered an essential supplement to the treatment of chronic disease. The objective of this article is to discuss the applicability of care management for the treatment of ASUD within the public health care system in Brazil. We describe models of care management that have been adopted internationally and identify the feasibility and advantages for its adoption in Brazil.

Descriptors: care management; substance use; Brazil; treatment integration


18 - Clinical practice guidelines for post-stroke depression in China
Fu-ying Zhao; Ying-ying Yue; Lei Li; Sen-yang Lang; Ming-wei Wang; Xiang-dong Du; Yun-long Deng; Ai-qin Wu; Yong-gui Yuan
Pages: 325 - 334
Abstract

Post-stroke depression (PSD) is a very common complication that leads to increased physical disability, poor functional outcome, and higher mortality. Therefore, early detection and treatment are very important. Since there are currently no specific guidelines for this disorder in China, the purpose of this study was to develop PSD guidelines and provide suggestions for clinicians and related workers.

Descriptors: Post-stroke depression; diagnosis; treatment


LETTERS TO THE EDITORS
19 - Transcranial magnetic stimulation in the treatment of peripartum bipolar depression: a case report
Willa Xiong; Ruthzaine Lopez; Pilar Cristancho
Pages: 344 - 345

Descriptors:


20 - Misuse of sibutramine and bulimia nervosa: a dangerous combination
Gabriela Mourão Ferreira; Bruno Palazzo Nazar; Michelle Ramos da Silva; Marcelo Alves Carriello; Silvia Freitas; José Carlos Appolinario
Pages: 343 - 343

Descriptors:


SPECIAL ARTICLE
21 - The presentation of the mind-brain problem in leading psychiatry journals
Alexander Moreira-Almeida; Saulo de F. Araujo; C. Robert Cloninger
Pages: 335 - 342
Abstract

OBJECTIVE: The mind-brain problem (MBP) has marked implications for psychiatry, but has been poorly discussed in the psychiatric literature. This paper evaluates the presentation of the MBP in the three leading general psychiatry journals during the last 20 years.
METHODS: Systematic review of articles on the MBP published in the three general psychiatry journals with the highest impact factor from 1995 to 2015. The content of these articles was analyzed and discussed in the light of contemporary debates on the MBP.
RESULTS: Twenty-three papers, usually written by prestigious authors, explicitly discussed the MBP and received many citations (mean = 130). The two main categories were critiques of dualism and defenses of physicalism (mind as a brain product). These papers revealed several misrepresentations of theoretical positions and lacked relevant contemporary literature. Without further discussion or evidence, they presented the MBP as solved, dualism as an old-fashioned or superstitious idea, and physicalism as the only rational and empirically confirmed option.
CONCLUSION: The MBP has not been properly presented and discussed in the three leading psychiatric journals in the last 20 years. The few articles on the topic have been highly cited, but reveal misrepresentations and lack of careful philosophical discussion, as well as a strong bias against dualism and toward a materialist/physicalist approach to psychiatry.

Descriptors: Body-mind relations; psychiatry; philosophy; neurosciences; neuropsychiatry