O impacto da dimensão matutinidade/vespertinidade pode interferir no comportamento social e na saúde do indivíduo. Nos últimos anos, esta dimensão tem sido amplamente estudada dentro do âmbito da cronobiologia. Este estudo transversal teve como objetivo determinar o cronotipo de estudantes universitários do 6º semestre dos cursos de turno integral da Universidade de Passo Fundo - Rio Grande do Sul e observar a associação desses cronotipos com parâmetros sociodemográficos, comportamentais e também com a qualidade do sono, a sonolência diurna e distúrbios psiquiátricos menores. Os instrumentos utilizados na pesquisa foram: Pittsburg (PSQI), para avaliar a prevalência da qualidade do sono; Horne Ostberg (MEQ), para determinar o cronotipo; o SRQ20, para os distúrbios psiquiátricos menores; o Epwort (ESS), para sonolência diurna; o AUDIT, para o uso de álcool, e um questionário para variáveis sociodemográficas e comportamentais. Participaram do estudo 372 estudantes, 66,7% do sexo feminino e 33,3% masculino, com idade média de 21,6 anos DP±3,08 (IC min18 max 50); 92,2% não faziam uso de tabaco; 58,9% praticam atividade física e 58,6 % apresentaram consumo de risco para o álcool; referiram trabalhar no terceiro turno 19,7%. Quanto à prevalência para os cronotipos, foram encontrados cronotipos indiferentes 55,9%, seguidos de 39,5% para vespertinos e 4,6% matutinos. Cronotipos vespertinos foram associados ao sexo masculino odds ratio OR=1,72; pobre qualidade do sono OR=1,89; distúrbios psiquiátricos menores OR=1,92 e uso de tabaco OR=3,65. Estes resultados apontam a necessidade de ações educativas e preventivas para esta população vulnerável, no intuito de minimizar possíveis danos à sua saúde física e mental. / The impact of morningness-eveningness dimension can affect social behavior and individual health. The aim of the present study was to determine the chronotype of full time university students in the 6th semester of the Universidade de Passo Fundo - Rio Grande do Sul, Brazil - and evaluate its influence in behavioral parameters. The instruments used in the study were: a demographic questionnaire; PSQI to evaluate sleep quality; MEQ to determine chronotypes; SRQ-20 to minor psychiatric disorders; ESS to daytime sleepiness; AUDIT to alcohol use. 372 students participated in the study: 66.7% were female and 33.3% were male; aged 21.6 years + 3.08 (mean +SD). 92,2% did not use tobacco, 58.9% practiced physical activity and 58,6 showed risks of alcohol abuse; 19.7% reported working in third shift. Regarding the prevalence of chronotypes, it was found 55,9% of indifferent chronotypes, 39,5% of evening, and 4,6% of morning type. Evening chronotypes was associated that male gender odds ratio OR =1,72; poor sleep quality OR=1,89; minor psyquiatric disorders OR= 1,92 and tobacco use OR=3,65. So this study concluded that evening chronotype was related with gender, poor sleep quality, minor psychiatric disorders and tobacco use in the studied population and points to preventive actions and education for this vulnerable population.

Introdução: Transtornos psiquiátricos são comuns em pacientes com doenças pulmonares obstrutivas. Portadores de asma de difícil controle manifestam estes transtornos com freqüência superior àqueles com asma controlada. Entre os pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) os sintomas de depressão podem estar relacionados à incapacidade progressiva e as limitações das atividades de vida diária. O objetivo do estudo foi verificar a presença de sintomas de ansiedade e depressão entre os portadores de asma e DPOC. Método: Foram avaliados os instrumentos específicos de quantificação de sintomas de ansiedade e depressão, IDATE e BDI respectivamente, respondidos por pacientes do ambulatório de asma e DPOC. A população constitui-se de 189 pacientes selecionados de três grupos de estudo com objetivos terapêuticos diferentes, sendo 140 asmáticos e 49 portadores de DPOC. Entre as variáveis destes estudos constavam sintomas de ansiedade e depressão como parte da metodologia. Os dados obtidos foram comparados levando-se em consideração aspectos demográficos, funcionais e de gravidade. Resultados: Entre os pacientes asmáticos foi significativamente maior a prevalência de ansiedade moderada e grave quando comparados com aqueles com DPOC (p<0,05). Em relação a depressão, o grupo de asma não controlada apresentou resultados significativamente maiores quando comparado ao grupo de asma controlada (p<0,05). Conclusão: Entre os pacientes asmáticos a freqüência de sintomas de ansiedade e depressão foi maior que entre aqueles com DPOC, o que pode dificultar o controle clínico / Introduction: Psychiatric disorders appear to be common in obstructive pulmonary disease patients. Difficult to control asthmatics show higher frequency of these disorders than controlled asthmatics. In Chronic Obstructive Pulmonary Disease (COPD) patients the depression symptoms may be related to progressive disability and limitations in daily living activities. Our objective was to verify the presence of anxiety and depression symptoms between asthmatic and COPD patients. Methods: Evaluation of anxiety and depression symptoms questionnaires, STAI and BDI respectively, from asthmatics and COPD outpatients clinics. It was a comparative study with 189 patients, 140 asthmatics and 49 with COPD. These patients were enrolled in three different treatment protocols: controlled asthmatics, not controlled asthmatics and stable COPD; all studies measured anxiety and depression symptoms in methodology. Data among groups were analyzed and correlated through demographic, functional and gravity aspects. Results: Moderate and severe anxiety symptoms in asthmatics were significantly higher when compared with COPD group (p<0,05). Not controlled asthmatics showed depression values significantly higher when compared with asthma controlled group (p<0,05). Conclusion: This study showed that anxiety and depression symptoms frequency is higher between asthmatics when compared to COPD patients, which may prevent a good clinical control

<div><div><div><p>Impacting individual’s social and physical well-being, psychiatric disorders have been a substantial burden on public health. As such disorders are frequently observed aggregating in families, we can expect a large involvement of heritable components underlying their etiologies. Therefore, studying the genetic architecture and basis is one of the most important aims toward developing effective treatments for psychiatric disorders. The overall objective of this dissertation is to contribute to understanding the genetics of psychiatric disorders. Analyzing summary statistics from genomewide association studies (GWAS) of psychiatric disorders, we mainly present results of two projects. In the first one, we evaluated commonalities and distinctions in genetic risk of four highly comorbid childhood onset neuropsychiatric disorders: attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD) and Tourette’s syndrome (TS). Through systematic analysis of genetic architecture and correlation, we confirmed exitance of genetic components shared across ADHD, ASD and TS, as well as OCD and TS. Subsequently, we identified those components at variant, gene, and tissue specificity levels through meta-analyses. Our results pointed toward possible involvement of hypothalamus-pituitary-adrenal (HPA) axis, a human stress response system, in the etiology of these childhood onset disorders. The second project includes the proposition of a novel framework for general GWAS summary statistics-based analyses. Instead of regular odds ratio and standard errors archived in the summary statistics, we proposed a recounstruction approach to rewrite the results in terms of single nucleotide polymorphisms (SNP) allelic and genotypic frequencies. We also put forward three applications built-upon the proposed framework, and evaluated the performance on both synthetic data and real GWAS results of psychiatric disorders for each of them. Through these three applications, we demonstrated that this framework can broaden the scope of GWAS summary statistics-based analyses and unify various of analyses pipelines. We hope our work can serve as a stepping-stone for future researchers aiming at understanding and utilizing GWAS results of complex psychiatric disorders.</p></div></div></div>

Sociala medier är en digital plattform som används för att kommunicera med varandra, sprida information eller återupprätta kontakten med gamla vänner. Enligt forskning har sociala medier både positiva och negativa effekter på människors psykiska hälsa. Syftet med studien är att undersöka om sociala medier kan bidra till psykisk ohälsa hos ungdomar och unga vuxna utifrån följande frågeställningar: Påverkas kroppsuppfattningen och självkänslan hos ungdomar och unga vuxna till följd av sociala medier? Vilken effekt har samhällskraven på ungdomar och unga vuxna till följd av sociala medier? Vilken effekt har beroendet av sociala medier på ungdomar och unga vuxna? Den metod som har används är en litteraturöversikt som grundas på 13 artiklar. Resultatet visar att sociala medier har en negativ påverkan som till exempel försämrad självkänsla och kroppsuppfattning. Överdriven användning av medierna leder till ett beroende som i sin tur kan vara en bidragande faktor till psykisk ohälsa hos ungdomar och unga vuxna. Genom att utföra fler studier på hur sociala medier påverkar ungdomars och unga vuxnas psykiska hälsa, kan hälso- och sjukvården få en ökad förståelse för hur patientgruppen påverkas. Det är även viktigt att hälso- och sjukvården får en ökad kompetens inom området för att kunna ge en god vård.

Survivors of critical illness have a high prevalence of long-term cognitive and psychiatric morbidity and poor quality of life years after hospital discharge. Data are lacking regarding whether cognitive screening tests predict which critically ill patients may be at risk to develop long-term cognitive sequelae and whether cognitive sequelae predict the patients everyday functioning. This study sought to determine whether cognitive screening tests, including the Mini-Mental State Examination (MMSE) and Mini-Cog, predict long-term cognitive sequelae and everyday functioning in survivors of critical illness 6-month post-hospital discharge. A second purpose was to investigate whether cognitive sequelae are associated with poor everyday functioning in critically ill survivors. Finally, the relationship between cognitive sequelae and quality of life was assessed. Survivors of critical illness had a high rate of cognitive impairments at hospital discharge, as well as long-term cognitive and psychiatric sequelae, deficits in everyday functioning, and reduced quality of life at 6-month follow-up. The MMSE and Mini- Cog did not predict long-term cognitive sequelae or everyday functioning at 6-months. Cognitive sequelae were not associated with poor everyday functioning; however, impaired attention, memory, and mental processing speed predicted problems with managing home/transportation, and impaired attention predicted problems in health and safety, social adjustment, and memory/orientation. Cognitive sequelae were associated with reduced quality of life in the role physical domain. Altogether, these findings lend additional knowledge to the literature regarding cognitive and psychiatric sequelae, everyday functioning, and reduced quality of life in critically ill patients, and may have clinical implications for the critical care providers, patients, and caregivers. Given the large population of survivors of critical illness each year, strategies aimed at recognizing, preventing and treating these morbidities are important research and public health concerns. Investigations into the clinical and economic burden of these morbidities and methods to mitigate them, including patient screening and referral to appropriate mental health and rehabilitation services, are warranted.

No description available.

Mental disorders pose a worldwide growing public health burden. One of the major challenges for healthcare systems remains to respond to the need of patients with mental disorders for continuous and flexible treatment. The EVA64 study evaluates novel programs of flexible and integrative treatment (FIT) in hospitals. This manuscript presents results from the evaluation of FIT hospitals in comparison to hospitals from regular routine care. In addition to data from adult patients, we also present data from affiliated child and adolescent psychiatric wards employing FIT programs. Using comprehensive claims data, primary outcomes are the utilization of inpatient care and sick leave for a priori defined clusters of mental disorders. We stratify between patients already under treatment (ongoing treatment) and patients with incident treatment cases (initial treatment) at the point of inclusion in the study. In the initial treatment group, we found a significant reduction in the length of inpatient stay of 4.1 days in FIT hospitals compared to routine care. While patients with mood affective disorders (−1.8 days) and patients with neurotic, stress-related, and somatoform disorders (−3.6 days) showed an even stronger effect of the reduction of inpatient lengths of stay, the effect was significantly weaker in patients with mental and behavioral disorders due to use of alcohol (+3.3 days). Regarding the duration of sick leave, we found no significant treatment effect of FIT programs compared to routine care. In the ongoing treatment group of adult patients, we found a significantly lower utilization of inpatient treatment by 1.3 days as well as a shorter duration of sick leave by 4.3 days in FIT hospitals compared to routine care. In the cohort of children and adolescent patients, we also did not observe a significant treatment effect in either the initial treatment group or the ongoing treatment group. Registration: this study was registered in the database “Health Services Research Germany” (trial number: VVfD_EVA64_15_003713).

<p>Complex disorders are caused by multiple genetic, environmental, and lifestyle factors, and their interactions. Most human diseases are complex, including many psychiatric, autoimmune, neurodegenerative, and cardiovascular disorders. Understanding their genetic background is an essential step toward developing effective preventive and therapeutic interventions for these disorders. In this dissertation, we present an overview of state-of-the-art methodology that is used to help elucidate the genetic basis of complex diseases and apply these methods to understand the genetic background of different complex disorders. First, we carried out a GWAS for myasthenia gravis (MG), a rare autoimmune disorder, and detected a novel risk locus, AGRN, which encodes a protein, involved in neuromuscular junction activation. Additionally, we observed significant genetic correlation between MG and ADs, and variants with pleiotropic effects. Second, we explored the genetic and phenotypic relationships among 11 different autoimmune disorders (ADs), using GWAS results o to calculate polygenic risk scores (PRS) and performing a PRS- phenome-wide association study (PheWAS) analysis with 3,281 phenotypes available in the UK Biobank. We observed associations of ADs PRS with phenotypes in multiple categories, including lifestyle, biomarkers, mental and physical health. We also explored the shared genetic components among the ADs, through genetic correlation and cross-disorder meta-analysis approaches, where we</p> <p>identified pleiotropic variants among the correlated ADs. Finally, we performed a meta-analysis GWAS of Tourette Syndrome (TS) followed by post-GWAS analyses including biological annotation of the results, and association tests of TS PRS with brain volumes. We detected a novel locus, NR2F1, associated with TS, supported by eQTL and Hi-C data. TS PRS was significantly associated with right and left thalamus volumes and right putamen volume. Overall, our work demonstrates the power of GWAS and related methods to help disentangle the genetic basis of complex disease and provides important insights into the genetic basis of the specific disorders that are the focus of our studies.</p>

Antecedentes: A obesidade e os transtornos mentais são grandes desafios da medicina. A obesidade tornou-se uma epidemia mundial e os transtornos mentais têm sido cada vez mais diagnosticados. Estudos recentes mostraram frequências elevadas de transtornos mentais em pacientes candidatos à cirurgia bariátrica. Este cenário sugeriu que os transtornos psiquiátricos podem ser persistentes, coocorrentes e que haja uma possível formação de agrupamentos de sintomas psicopatológicos entre esses pacientes. Objetivo: O objetivo deste trabalho foi: 1) investigar a persistência e a coocorrência dos transtornos psiquiátricos em pacientes com obesidade pré-cirúrgicos; 2) identificar subgrupos psicopatológicos, clinicamente distintos e diferenciados por gêneros, em uma amostra de pacientes com obesidade candidatos à cirurgia bariátrica. Método: O estudo teve como base a dissertação \"Frequência de transtornos mentais entre pacientes obesos candidatos a cirurgia bariátrica, por meio de entrevista clínica estruturada para transtornos do DSM (SCID-I/P)\", apresentada ao programa de pós-graduação da Faculdade de Medicina da Universidade de São Paulo. Estudo observacional transversal em pacientes com obesidade grau III que aguardavam a cirurgia bariátrica, no Hospital das Clínicas de São Paulo. Os sujeitos foram recrutados consecutivamente da lista de espera do Ambulatório de Cirurgia Bariátrica - HC-FMUSP e submetidos à entrevista semiestruturada para diagnóstico psiquiátrico: Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID I/P). O tamanho da amostra foi de 393 pacientes; composta por 79,1% de mulheres; média de idade 43 anos e média de IMC: 47,8 kg/m². O curso dos transtornos psiquiátricos foi analisado pela persistência, por meio de razão de prevalência (RP): transtornos atuais/transtornos ao longo da vida (1M/LT); para as comorbidades utilizou-se a análise de correlação tetracórica. Os possíveis agrupamentos psicopatológicos, foram detectados pelo método da análise de classes latentes, baseado na ocorrência de transtornos mentais ao longo da vida, diferenciados por gênero. Análise de regressão logística mostrou a influência de fatores sociodemográficos na formação das classes psicopatológicas. Resultados: A maior parte da amostra apresentou dois ou mais transtornos psiquiátricos concomitantes ao longo da vida. Os transtornos de ansiedade foram as condições mais persistentes (a maior razão de prevalência entre transtornos atuais e/ou ao longo da vida) e correlacionaram-se significativamente com transtornos bipolares, depressivos e alimentares. Os transtornos bipolares foram os mais coocorrentes, associaram-se ao uso de substâncias, transtornos alimentares e de ansiedade. Em relação à análise de classe latente, para ambos os sexos, foram detectados três agrupamentos psicopatológicos. Entre as mulheres, as classes latentes foram: (1) \"oligossintomático\": 42% das pacientes apresentaram baixa probabilidade de transtornos psiquiátricos; (2) \"bipolar com comorbidades\", em 33%; e (3) \"ansiedade/depressão\", com 25%. Entre os homens: (1) \"bipolar com comorbidades\" foi encontrado em 47% dos pacientes; (2) \"oligossintomático\", com 40%; e (3) \"ansiedade/depressão\", com 13%. Para ambos os sexos, a probabilidade de apresentar transtornos alimentares foi maior nas classes \"bipolar com comorbidades\" e \"ansiedade/depressão\". Transtornos por uso de substâncias foram proeminentes entre os homens \"bipolares\". Em comparação com a classe \"oligossintomática\", a probabilidade de maior IMC foi observada entre os homens \"bipolares\" e pior desempenho no trabalho entre os homens com \"ansiedade/depressão\". Conclusões: Transtornos psiquiátricos são condições frequentes e duradouras entre pacientes à procura de cirurgia bariátrica. Transtornos de ansiedade, humor e alimentares são características persistentes e concomitantes em pacientes em busca de tratamento para obesidade. Homens e mulheres com obesidade grave, pré-cirúrgicos foram distribuídos em três perfis de comorbidades e revelaram padrões psicopatológicos análogos. A classe \"bipolar com comorbidades\" apresentou coocorrência com transtornos alimentares e uso de substâncias. Esses agrupamentos naturais de transtornos psiquiátricos entre pacientes bariátricos sugerem abordagens terapêuticas específicas e diferenciadas por gênero durante todo o percurso do procedimento cirúrgico / Background: Obesity and mental disorders have become major challenges to medicine. Obesity gained worldwide epidemic proportions and the mental disorder has been increasingly diagnosed. Recent study indicated high frequency of mental disorders in patients candidates to bariatric surgery, this panorama suggests that psychiatric disorders can be persistent and co-occurring. These conditions indicates the possibility of subgroups psychopathological between obese patients seeking to bariatric surgery. Objective: The objective of this study is: 1) to investigate the persistence and cooccurrence of psychiatric disorders and, 2) identify clinically distinct psychopathological subgroups among a sample of obese patients candidates for bariatric surgery. Method: The study is based on a study \"Frequency of mental disorders among obese candidates for bariatric surgery, using a structured clinical interview for DSM Disorders (SCID-I/P)\" presented to the post-graduate program of the Department and Institute of Psychiatry - University of São Paulo. This is a cross-sectional observational study in patients with obesity level III, awaiting bariatric surgery at the Hospital das Clínicas de São Paulo. The subjects were submitted to semi-structured interview for psychiatric diagnosis: Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID). Were consecutively recruited from the waiting list of the Bariatric Surgery Clinic-HCFMUSP. The sample size was 393 patients 79.1% women; age mean 43 years and mean of BMI 47,8% kg/m². The persistence of group of disorders was defined by prevalence ratio (PR) to denote the one month-to-lifetime (1M/LT). The co-occurrence of psychiatric disorders was investigated by the tetracoric correlation analysis. The possible psychopathological profiles were detected by the method of latent class analysis, based on the occurrence of lifetime psychiatric disorders, differentiated by gender. Logistic regression analysis showed the influence of socio-demographic factors on the formation of psychopathological classes. Results: Most of the sample presented two or more co-occurrence lifetime psychiatric disorders. While mood and eating disorders were frequent conditions, anxiety disorders were the most persistent conditions (the highest one month-to-lifetime prevalence ratio) and were significantly correlated with bipolar, depressive and eating disorders. In relation the latent class analysis, for both genders, the 3-class psychopathological clustering was the best-fitting solution. Among women, the latent classes were: (1) \"oligosymptomatic\", where in 42% of patients showed low probability of psychiatric disorders; (2) \"bipolar with comorbidities\", in 33%; and (3) \"anxiety/depression\", in 25%. Among men, (1) \"bipolar with comorbidities\" was found in 47% of patients; (2) \"oligosymptomatic\", in 40%; and (3) \"anxiety/depression\", in 13%. For both genders, the likelihood of eating disorders was higher in both \"bipolar with comorbidities\" and anxiety/depression\" classes. Substance use disorders was prominent among \"bipolar\" men. In comparison with \"oligosymptomatic\" class, the likelihood of higher BMI was observed among \"bipolar\" men and poorer work attainment among men with \"anxiety/depression\". Conclusion: Psychiatric disorders are frequent and enduring conditions among patients looking for bariatric surgery. Comorbid anxiety, mood, and eating disorders are remarkable features in treatment-seeking patients with obesity. Three comorbidity profiles were detected in pre-surgical period, in men and women with severe obesity. The class of \"bipolar with comorbidities\" most likely presented comorbidity with eating and substance use disorder. This natural clustering of psychiatric disorders among bariatric patients suggests gender-related therapeutic approaches

Bakgrund: Psykisk ohälsa har ökat sedan 1990-talet och det finns en korrelation med behovet av psykiatrisk vård. Patienter med psykiatriska sjukdomar förekommer inom den somatiska vården samt har en ökad risk för att drabbas av somatiska sjukdomar. Det medför ett ökat krav av att kunna vårda patienter med psykiatriska sjukdomar även inom somatisk vård.    Syfte: Syftet med litteraturöversikten är att belysa sjuksköterskors erfarenhet av att vårda patienter med psykiatrisk sjukdom inom somatisk vård.    Metod: Litteraturöversikt med vetenskapliga artiklar, som har hittats med relevanta sökord på olika databaser och granskats med hjälp av granskningsmallar.    Resultat: Resultatet bygger på 14 granskade artiklar, 10 kvalitativa och 4 kvantitativa. I resultatet kunde sju övergripande kategorier identifieras, dessa var Tidsbrist, Bristande miljö, Kompetens och kunskap, Utsatthet, Kommunikation och Emotionell aspekt. Resultatet visade på kunskapsbrist hos sjuksköterskor, samt att majoriteten känner negativa känslor till att vårda patienter med psykiatrisk sjukdom. Tidsbrist var ett stort hinder för sjuksköterskors möjlighet till att vårda och vårdmiljön tillät inte god vård för patienter med psykiatrisk sjukdom.     Slutsats: Sjuksköterskor behöver mer resurser för att vårda patienter med psykiatriska sjukdomar inom den somatiska vården för att uppnå en god vård för patienter. Vidare krävs utbildning inom psykiatriska sjukdomar för sjuksköterskor och en förändring av vårdmiljön behöver initieras för att främja vården av patienter med psykiatriska sjukdomar / Background: Mental health problems have increased since the 1990s and there is a correlation to the need for psychiatric care. Patients with psychiatric disorders occur in the general healthcare and the patient group has an increased risk of somatic diseases. This puts pressure on the educational level for treating patients with psychiatric disorders in general hospitals.     Aim: The purpose of this literature review is to highlight the nurses' experience of caring for patients with psychiatric illness in general care.   Method: A literature review with scientific articles, which have been found with relevant keywords on different databases and reviewed with the help of review templates.   Results: 14 reviewed articles, 10 qualitative and 4 quantitative were used in the literature review. In the results, seven categories could be identified, these were Lack of time, Lack of environment, Competence and knowledge, Vulnerability, Communication and Emotional aspect. The results showed a lack of knowledge among nurses, also the majority have negative feelings to nursing patients with psychiatric illness. Lack of time was a major obstacle to nurses' ability to care and the care environment did not allow good care for patients with psychiatric illness.   Conclusion: Nurses need more resources to care for patients with psychiatric disorders in the somatic care to achieve good patient care. Furthermore, education in psychiatrics for nurses is required and a change in the care environment needs to be initiated to promote the care of patients with psychiatric diseases.