Numa amostra de 997 óbitos de pacientes portadores de transtornos mentais procedeu-se a análise critica das estatísticas de mortalidade segundo causas básicas e associadas de morte por meio da comparação das causas mencionadas nos atestados de óbito originais com as causas de novo atestado refeito após consulta a todas informações disponíveis sobre os falecidos, informações estas existentes nos prontuários clínicos, resultados de exames de laboratório, relatórios de exames radiológicos, de biópsia, de autópsia e outros. O número médio de diagnósticos por atestado, após consulta às informações adicionais, aumentou de 2,08 para 4,11, número este que não variou sensivelmente com o sexo e a idade dos falecidos, observando-se entretanto variação da média de diagnósticos por atestado segundo a especialidade do médico atestante. As causas básicas dos atestados refeitos diferiram em 43,13 por cento dos casos das causas básicas selecionadas nos atestados originais. A tabulação de todas as causas, básicas e associadas, permitiu evidenciar a importância, no processo da morte, de muitas causas menos frequentes causa básica. como As principais causas de morte, básicas e associadas, de pacientes cujos transtornos mentais incluíram-se nos grupos Psicose, Transtornos da Personalidade e Outros Transtornos Mentais Não-Psicóticos e Deficiência Mental foram analisadas a partir dos diagnósticos do atestado refeito, comparando estas causas com aquelas dos atestados originais, constatando-se que, nestes atestados, os transtornos mentais são subestimados como causa de morte. Tal subestima se deve em parte a influência das disposições da Classificação Internacional de Doenças para a seleção da causa básica de morte. Foram também estudadas as principais associações de doenças naqueles casos em que as causas básicas pertenceram a grupos de causas relacionadas aos transtornos mentais. / In a sample of 997 deceased patients bearing mental disorders, a cri tical statistical analysis of the mortal i ty due to underlying and associated causes of death was undertaken by comparing the causes mentioned in the original death certificates and those registered in the renewed ones which were made up after full review of all available information on these patients by going through such sources as medica! and hospital records besides laboratory examinations, radiological, biopsy, autopsy and other results. The average number of diagnoees per certificate after the aditional information gained by the investigation went up from 2.08 to 4.11; the latter did not vary due do sex or age of the deceased but did according to the speciality of the certifying doctor. The underlying causes of death of the renewed death certificates differed from those of the original ones in 43.13 per cent of the patients. Crosstabulation of all causes of death, both the underlying and associated ones, uncovered the importance of many less frequent causes as underlying in the process of death. The main causes of death, both underlying and associated, of patients whose mental disorders were included in the groups i of Psychosis, Personality Disorders and Other Non-Psychotic Mental Disorders as well as Mental Deficiency were analysed through data obtanined from the renewed death certificates and later compared with those· registered in the original ones. An underestimation of mental disorders as causes of death in the latter was discovered. Such underestimation is partly due to the influence of arrangements in the Internacional Classification of Diseases for the selection of the underlying cause of death. The main associations of diseases were also studied in those cases where the underlying causes of death belonged to groups of causes related to mental disorders.

Research on art therapy and psychosis has typically focused on individuals who have experienced psychotic symptoms for many years. This study used a grounded theory methodology to explore how service users experience art therapy following their first diagnosis of a psychotic disorder, and the possible mechanisms through which art therapy might be helpful for such individuals. Eight participants were interviewed, with two participants being interviewed twice. A preliminary theory was created and seven categories were constructed from the data, namely unpressured atmosphere, pleasure and engagement in art-making, expression and communication, connecting with others, changing emotional experience and experience of self, supporting recovery and continuation of art, and barriers. Participants reported that through the atmosphere of art therapy, art-making, and communication, they were able to build relationships, connect with others, experience a sense of commonality, absorption, sense of freedom and discover alternative perspectives and different understandings. Whilst this study suffered from some limitations, the results build on the current research base by suggesting possible processes and mechanisms through which art therapy is helpful, and focusing on a previously under-represented population. The findings are considered alongside existing research and theoretical perspectives. Clinical implications and recommendations for future research are also highlighted.

A assistência à saúde mental da mulher constitui-se em uma questão de dupla intervenção, em especial para aquelas em idade reprodutiva, visto que, a própria condição de maternidade traz riscos à mulher de desenvolver patologias importantes, repercutindo no cuidado com os filhos. O escopo do adoecimento mental além dos componentes biológicos envolvem as relações entre as pessoas e entre as pessoas e seus contextos de vida e, nesse sentido os profissionais da área têm ampliado suas ações além do tratamento por meio de medicamentos. E não é sem grandes dificuldades que a proposição desses serviços tem sido colocada em prática. A legislação diz que os municípios devem apresentar projetos para os serviços que pretendem implantar e, no que dizem respeito à saúde mental, os serviços abertos têm sido incentivados, em consonância com as políticas estabelecidas a partir do movimento de reforma na assistência. No presente trabalho investigou como se deu a entrada de mulheres no serviço de uma cidade do interior do estado de MG. Foram escolhidas aleatoriamente 30 mulheres conforme critérios de inclusão e exclusão de um total de 79. Destas 30, foi possível contatar e entrevistar 21. Foi utilizado o recurso da entrevista semiestruturada com foco nos seguintes tópicos: razões para busca de assistência, situações de vida relacionadas aos sintomas, repercussões do adoecimento mental em suas vidas e percepções sobre a assistência recebida. Os resultados foram apresentados considerando-se a caracterização das participantes e em conformidade com os objetivos, foram apresentados os dados relativos aos temas abordados nas entrevistas. Quanto às características sócio demográficas verificou-se que a maior parte das participantes vive com companheiro, têm de 1 a 5 filhos com idades entre 4 meses a 20 anos de idade não trabalha fora de casa atualmente, mas já trabalhou; a faixa etária predominante foi de 30 a 34 anos; escolaridade ensino fundamental incompleto, cor da pele auto declarada branca, oriundas do próprio município onde o estudo foi realizado. Os sintomas iniciais referidos pelas participantes que as levaram a buscar pela assistência foram alterações físicas, dores de cabeça, aceleração dos batimentos cardíacos, entre outros; psicológicas, tristeza, desânimo e comportamentais, buscar isolamento, negligenciar cuidados aos filhos, dentre outros. Os diagnósticos recebidos foram predominantemente transtornos de ansiedade e de depressão. As situações da vida que, na percepção das participantes, estiveram relacionadas a seu adoecimento foram conflitos conjugais, adoecimento e uso de drogas de pessoas da família. Como este repercutiu em suas vidas esteve ligado a conflitos no trabalho e na família. A assistência recebida é vista como muito boa, mas limitada por ter apenas um profissional responsável por ela. É centrada no medicamento embora seja vista também como um espaço em que podem ser escutadas e orientadas. Ao lado do recurso médico especializado aparece também o contexto religioso como meio de apoio para o enfrentamento dos problemas. O trabalho encontrou resultados semelhantes aos de outros estudos e também pode oferecer elementos ao contexto específico em que ele foi desenvolvido para a organização de serviços de assistência / The mental health care of women is an issue in dual intervention especially for those of reproductive age as the very condition of motherhood brings risks to women of developing major diseases impacting the care of the children. The scope of mental illness in addition to biological components involve the relationships between people and between people and their life contexts and, accordingly, the practitioners have expanded their actions beyond treatment through medication. And it is not without great difficulty that the proposition of these services has been put into practice. The law says that municipalities must submit projects for the services they intend to deploy and, with regard to mental health, open services have been encouraged, in line with the policies established from the reform movement in assistance. In the present study investigated how was the entry of women in the service of a city in the state of Minas Gerais. We randomly selected 30 women as criteria for inclusion and exclusion of a total of 79. Of these 30, we were able to contact and interview 21 was used feature of semi structured interviews with focus on the following topics: reasons for seeking assistance related life situations the symptoms of mental illness impact on their lives and perceptions about the care received. The results were presented considering the characterization of participants and in accordance with the objectives; the data on the topics covered in the interviews were presented. As for socio demographic characteristics found that most participants living with partner, have 1-5 children aged 4 months to 20 years old do not work outside the home today, but has worked; the predominant age group was 30-34 years; education incomplete primary education, self-declared white skin color, derived from the same town where the study was conducted. The initial symptoms reported by participants which led them to seek the assistance were physical changes, headache, rapid heartbeat, among others; psychological, sadness, depression and behavioral seek isolation, neglect care for children, among others. The diagnoses received were predominantly anxiety disorders and depression. Life situations that, in the perception of the participants, were related to marital conflicts, illness and drug use of family members. How this impacted on their lives was linked to conflicts at work and in the family. The assistance received is seen as very good, but limited by only having one professional responsible for it. It is centered in the medicine but is also seen as a space that can be listened to and oriented. Beside the specialized medical resource also appears the religious context as a means of support for dealing with problems. The study found similar results to those of other studies and can also provide elements to the specific context in which it was developed for the organization of medical care

Objetivo: Adaptação transcultural do Nurses Work Functioning Questionnaire para a língua portuguesa no contexto brasileiro. Este questionário foi desenvolvido por Gartner et al. (2011) com a finalidade de detectar precocemente quais são os trabalhadores de enfermagem afetados no trabalho por apresentarem TMC e identificar quais os aspectos específicos do trabalho que se encontram prejudicados. Método: O processo de adaptação foi realizado de acordo com metodologias internacionalmente recomendadas, seguindo as etapas de tradução, síntese, retrotradução, revisão por um comitê de juízes e pré-teste. Resultados e Discussão: O questionário foi inicialmente traduzido para o português dando origem a duas versões que foram analisadas e resultaram na síntese das traduções. Todas as versões produzidas foram submetidas à retrotradução e posteriormente encaminhadas a um comitê de juízes. Este comitê foi composto por cinco especialistas que revisaram e compararam todas as traduções, desenvolvendo uma versão final para aplicação no pré-teste. Nesta etapa foi verificada a validade de conteúdo de todos os itens do questionário por meio da aplicação da taxa de concordância de 80% entre os participantes. O pré-teste foi realizado com 35 trabalhadores de enfermagem, entre eles técnicos e enfermeiros da unidade de Cirurgia Cardíaca do Hospital São Paulo. Para conferir a confiabilidade do instrumento foi empregado o alfa de Cronbach, que apresentou valor médio de 0,88 indicando alto índice de consistência interna. Considerações Finais: Os resultados indicaram que o processo de adaptação cultural foi realizado com sucesso e a versão adaptada do questionário demonstrou possuir propriedades psicométricas adequadas, tornando-se confiável para ser aplicado na cultura brasileira. / Objective: Cross-cultural adaptation of the questionnaire: Nurses Work Functioning Questionnaire into Portuguese in the Brazilian context. This questionnaire was developed by Gartner et al. (2011) in order to detect early what are the nursing staff affected at work because they have TMC and identify the specific aspects of work that are harmed. Method: The adaptation process was conducted in accordance with internationally recommended methodologies, following the translation stages, synthesis, back translation, review by a committee of judges and pretest. Results and Discussion: The questionnaire was initially translated into Portuguese resulting in two versions which were analyzed and resulted in the synthesis of the translations. All produced versions were submitted to back translation and then carried to judges . This committee was composed of five experts who reviewed and compared all translations, developing a final version for application in the pre-test. At this stage it verified the content validity of all the items of the questionnaire by applying the concordance rate of 80% among participants. The pre-test was conducted with 35 nursing workers, including technicians and nurses from the Cardiac Surgery Unit of Hospital São Paulo. To check the reliability of the instrument was used Cronbach\'s alpha, which averaged 0.88 indicating high internal consistency index. Conclusions: The results indicated that the adaptation process was conducted successfully and the adapted version of the questionnaire has demonstrated adequate psychometric properties, making it reliable to be used with the Brazilian culture.

O presente estudo teve por objetivo avaliar atitudes e conhecimentos de profissionais de enfermagem sobre cuidados a pacientes com transtornos mentais. Trata-se de estudo descritivo, de abordagem quantitativa, realizado em unidade de urgência e emergência psiquiátrica de um pronto-socorro municipal no interior de São Paulo. Os dados foram coletados por meio da aplicação de um questionário, com uma amostra de 69 técnicos de enfermagem, caracterizados predominantemente pelo sexo feminino, adultos, com ensino médio e nível superior, atuantes em apenas um emprego e tempo de trabalho na instituição, na mesma equipe de enfermagem, entre 2 e 5 anos. À maioria havia sido disponibilizado conteúdo teórico sobre identificação de sinais e sintomas de transtornos mentais, grande parte demonstrava interesse pelo processo de educação continuada, mas menos da metade recebeu informações sobre a sistematização da assistência de enfermagem. Os sentimentos positivos expressos em relação a pacientes com transtornos mentais foram: compaixão e aceitação, e os negativos, insegurança e tristeza. As pessoas com transtornos mentais são percebidas como normalmente imprevisíveis e que necessitam de cuidados constantemente. Os sujeitos consideraram-se confortáveis em atender pessoas com transtornos mentais e afirmaram que o local mais adequado para essas pessoas é o hospital. Temas como saúde mental, violência doméstica e doenças infectocontagiosas foram sugeridos para futura abordagem na educação continuada. Os participantes consideraram o uso de drogas psicoativas a principal causa das doenças mentais. Ressalta-se que instrumentos validados para avaliar conhecimentos, atitudes e sentimento de profissionais de enfermagem ainda são escassos. Os resultados apontam a necessidade de capacitação continuada sobre assistência de enfermagem a pessoas com transtorno mental nas unidades de urgência e emergência / This present study aimed to evaluate attitudes and knowledge of staffs of nurses on nursing care to patients with mental disorders. This is a descriptive study of a quantitative approach. The study was conducted in an urgency and emergency psychiatric unit of a emergency hospital of interior of São Paulo. The instruments used were: socio-demographic information related to professional training; attitudes and knowledge on identifying signs and symptoms; feelings and nursing assistance for individual with mental disorders. The data were collected before the first class of the course of capacitation in mental health, which was divided into six themes related to the most common mental disorders (mental signs/symptoms, nursing care with emphasis on interpersonal relationships). The sample consisted of 69 nursing professionals, characterized by being predominantly female, adults with high school and college level, with only one job, and work in the institution, on the same team and in nursing from 2 to 5 years. More than a half of the sample had received theoretical content about identifying signs and symptoms of mental disorders, but fewer than half received information about the systematization of nursing care, in addition that beneficiaries announce interest in the continuing education process. The positive feelings expressed towards to patients with mental disorders were compassion and acceptance, and the negative, insecurity and sadness. Individuals with mental disorders are perceived as usually unpredictable and constantly requiring care. Feeling comfortable in helping people with mental disorders and the most appropriate place for these people is the hospitals have been evidenced. Topics such as mental health, domestic violence and infectious diseases were suggested to be working in the future in continuing education. Psychoactive drugs were considered as the main cause of mental illness. Validated tools to assess knowledge, attitudes and feelings of nursing professionals are still scarce. The results to point to need for continued capacitation in nursing assistance for people with mental disorders in urgency and emergency units

This thesis in part addressed a call by Hodapp, Glidden & Kaiser (2005) to focus on identifying potential mediators and moderators of the relationship between growing up with a sibling with an autism spectrum condition (ASC) and adverse outcomes such as poorer sibling relationship quality (SRQ) and adjustment problems. It attempted to clarify previous inconsistent findings in the literature by considering autism as a dimensional disorder (with traits present on a continuum between the general population and those on the higher end reaching a clinical cut-off for diagnosis of ASC) and focusing on the autistic traits of (mainly) older siblings in a dyad. Specifically, these related to attention to detail, impaired mind reading ability, impaired social skills and impaired imagination. In addition, when looking at families with an ASC child, using a relatively homogenous sample group of typically developing younger siblings (YS) in middle childhood controlled for factors that potentially influenced past mixed findings. Hypotheses were extended to an analogous sample of young adults by asking dyads for both retrospective and current (adult) SRQ and self reported autistic traits. Themes emerging from the actual lived experiences of typically developing younger siblings of children with autism were also considered, and highlighted a number of difficulties faced by these siblings. The quantitative findings indicate that different elements of the social and communication domains relate to negativity compared to positivity in SRQ, and that there is a significant relationship between attention to detail (i.e. the non-social domain) and typical YS adjustment but not between YS adjustment and the social and communication domains. For young adults, reports of higher impairments in imagination were associated with retrospective reports of lower positivity in SRQ, and level of attention to detail was significantly associated with rivalry in adult SRQ. Overall these findings indicate that different autistic traits should be considered as separate influences on SRQ and adjustment.

O presente estudo teve por objetivo avaliar atitudes e conhecimentos de profissionais de enfermagem sobre cuidados a pacientes com transtornos mentais. Trata-se de estudo descritivo, de abordagem quantitativa, realizado em unidade de urgência e emergência psiquiátrica de um pronto-socorro municipal no interior de São Paulo. Os dados foram coletados por meio da aplicação de um questionário, com uma amostra de 69 técnicos de enfermagem, caracterizados predominantemente pelo sexo feminino, adultos, com ensino médio e nível superior, atuantes em apenas um emprego e tempo de trabalho na instituição, na mesma equipe de enfermagem, entre 2 e 5 anos. À maioria havia sido disponibilizado conteúdo teórico sobre identificação de sinais e sintomas de transtornos mentais, grande parte demonstrava interesse pelo processo de educação continuada, mas menos da metade recebeu informações sobre a sistematização da assistência de enfermagem. Os sentimentos positivos expressos em relação a pacientes com transtornos mentais foram: compaixão e aceitação, e os negativos, insegurança e tristeza. As pessoas com transtornos mentais são percebidas como normalmente imprevisíveis e que necessitam de cuidados constantemente. Os sujeitos consideraram-se confortáveis em atender pessoas com transtornos mentais e afirmaram que o local mais adequado para essas pessoas é o hospital. Temas como saúde mental, violência doméstica e doenças infectocontagiosas foram sugeridos para futura abordagem na educação continuada. Os participantes consideraram o uso de drogas psicoativas a principal causa das doenças mentais. Ressalta-se que instrumentos validados para avaliar conhecimentos, atitudes e sentimento de profissionais de enfermagem ainda são escassos. Os resultados apontam a necessidade de capacitação continuada sobre assistência de enfermagem a pessoas com transtorno mental nas unidades de urgência e emergência / This present study aimed to evaluate attitudes and knowledge of staffs of nurses on nursing care to patients with mental disorders. This is a descriptive study of a quantitative approach. The study was conducted in an urgency and emergency psychiatric unit of a emergency hospital of interior of São Paulo. The instruments used were: socio-demographic information related to professional training; attitudes and knowledge on identifying signs and symptoms; feelings and nursing assistance for individual with mental disorders. The data were collected before the first class of the course of capacitation in mental health, which was divided into six themes related to the most common mental disorders (mental signs/symptoms, nursing care with emphasis on interpersonal relationships). The sample consisted of 69 nursing professionals, characterized by being predominantly female, adults with high school and college level, with only one job, and work in the institution, on the same team and in nursing from 2 to 5 years. More than a half of the sample had received theoretical content about identifying signs and symptoms of mental disorders, but fewer than half received information about the systematization of nursing care, in addition that beneficiaries announce interest in the continuing education process. The positive feelings expressed towards to patients with mental disorders were compassion and acceptance, and the negative, insecurity and sadness. Individuals with mental disorders are perceived as usually unpredictable and constantly requiring care. Feeling comfortable in helping people with mental disorders and the most appropriate place for these people is the hospitals have been evidenced. Topics such as mental health, domestic violence and infectious diseases were suggested to be working in the future in continuing education. Psychoactive drugs were considered as the main cause of mental illness. Validated tools to assess knowledge, attitudes and feelings of nursing professionals are still scarce. The results to point to need for continued capacitation in nursing assistance for people with mental disorders in urgency and emergency units

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / This letter has the purpose to comment the article by Marwaha et al. regarding affective instability and mental disorders. We wish to highlight the importance to report the proper measures of association in case-control studies, and the impact of adjusting the results when finding associations with possible confounders in the bivariate analysis. / Revisión por pares / Revisión por pares

The purpose of this study is to determine if a new intervention using techniques from Acceptance and Commitment Therapy (ACT; Hayes et al., 1999) in combination with activities from The Body Project (Stice et al., 2009), will be able to reduce negative body image concerns and increase mindfulness skills in college females. Prior to receiving the intervention, participants completed a pre-test measuring their current body image concerns as well as mindfulness abilities. The intervention was administered in a large, group setting and took approximately 35 minutes to administer. After receiving the intervention, participants completed the same assessment measures as the pre-test, but in a post-test form. Results indicate that there was a significant difference in body image after participants received the intervention of ACT and The Body Project. There was not a significant difference for the mindfulness facets measured in the study. This research contributes to a growing area of eating disorder treatment using ACT, and can help provide evidence for the benefits of using specific ACT and The Body Project activities for treating and preventing negative body image.

This study examines the relationship between age of onset of drug use and later drug dependence, and that of age of onset of drug use and current offense type/severity. In addition, it investigates the relationship between mental disorders, drug dependence, and current offense type/severity. Data from years 2007 to 2010 of the Arrestee Drug Abuse Monitoring Program II (ADAM II) were used. The analyses included cross tabulation and chi square. The results indicated that early onset marijuana users (those who began using at age fourteen or younger) were more likely to develop drug dependence than late onset users of marijuana. In addition, early onset users of heroin and of methamphetamine were more likely to develop drug dependence than late onset users of those drugs. No significant relationships were found between early onset of any of the four drugs and offense type; however significant relationships were found between early onset of marijuana and of methamphetamine, and offense severity. Significant relationships were found between offense severity and mental disorders, but not between offense type and mental disorders. Significant relationships were found for both offense type and severity when cross tabulated with mental disorders and drug dependence. These results indicate that more research is needed on these topics. This is because the findings of the current study partially support what has been found in existing literature. A clearer understanding of the topics of the current study is needed in order to draw definite conclusions.