Trends Exploring the use of lithium for suicidality in acute settings: rationale, risks, and uncertainties Amaral, Rafael Ramos Magalhães, Pedro V. S. Abstract in English: Abstract Lithium's well-documented efficacy in preventing suicide over the long term prompts consideration of its potential for more rapid antisuicidal effects. However, evidence supporting such acute efficacy is limited. Weighing against its possible rapid benefits are significant concerns regarding lithium's side-effect profile – particularly toxicity, renal impairment, and weight gain – and the often necessary delay in achieving therapeutic levels. Moreover, the multifaceted nature of suicidality complicates identifying short-term outcomes and disentangling lithium's effects on suicidal thoughts from broader reductions in depressive symptoms. While lithium may remain invaluable for some high-risk patients in emergency settings, its routine use as a rapid-acting agent for acute suicidality is currently not well supported. |
Review Article Concealing, tolerating, and adjusting to emotions in obsessive-compulsive and anxiety disorders: a cross-sectional study Loureiro, Carla P. Thompson, Emma M. Laurito, Luana D. Moreira-de-Oliveira, Maria E. Dias, Rafaela V. de Menezes, Gabriela B Fontenelle, Leonardo F. Abstract in English: Abstract Objective Although research has shown that mood and anxiety disorders manifest disturbed emotion regulation, it is unclear whether anxiety disorders differ from each other in terms of their emotion regulation strategies. In the present study, we investigated whether patients with anxiety disorders present different affective styles. Methods We assessed the affective styles of 32 obsessive-compulsive disorder (OCD) patients, 29 social anxiety disorder (SAD) patients, 29 panic disorder (PD) patients, and 20 healthy controls using the Affective Style Questionnaire (ASQ). A multivariate analysis of covariance (MANCOVA) was conducted to compare affective styles across groups (OCD, SAD, PD, and control), while controlling for depression, anxiety symptoms, and age. Results The MANCOVA revealed a significant, small-medium, main effect of diagnostic group on affective styles. The planned contrasts revealed that OCD and SAD patients reported significantly lower scores for “tolerance” (ASQ-T) compared to the healthy controls. There were no differences between the PD group and healthy controls. Conclusion Our findings provide evidence that individuals with OCD and SAD have difficulty tolerating strong emotions existing in the present moment in an open and non-defensive way. |
Review Article The impact of family stress and resilience on child development: a scoping review Mendes-Sousa, Marília M. Perrone, Marina B. de Melo, Rafael B. Ribeiro, Marcos V. V. Chao, Qiong Torres, Carolina Sanchez, Zila M. Surkan, Pamela J. Martins, Silvia S. Fidalgo, Thiago M. Caetano, Sheila C. Abstract in English: Abstract Objective: Children grow up spending most of their time within the family social environment, where they can experience stressful situations such as marital conflict, a non-cohesive environment, parental alcohol use disorder, parental depression, and other parental mental health issues. All these factors are associated with children's developmental delays. We aimed to conduct a scoping review on associations between family stress and family resilience and child development delays to examine familial conditions associated with child development. Methods: We conducted a scoping review of observational studies published from January 2000 to July 2023 and indexed in the MEDLINE and LILACS databases. We included observational studies that assessed history of exposure to violence and behavioral or emotional symptoms or mental health problems among children aged 4-12. Data were independently extracted using a structured form. Results: Database searches identified 12,990 unique records. A total of 43 articles were included in the review. Three main findings emerged: (1) parental mental health problems, especially depressive symptoms in mothers, were associated with child developmental delays and mental health problems; (2) better parenting practices and a cohesive home environment were positively associated with child development; and (3) vulnerable social environments (e.g., poverty and housing insecurity) may be linked to child mental health problems. Conclusion: The studies reviewed show that promoting better family dynamics and increasing family cohesion, as well as improving parenting abilities, are beneficial to children's socioemotional development and prevention of child mental health problems. Moreover, increasing family and children's resilience improves the quality of life within family units. |
Original Article Associations between triarchic traits and mental health symptoms: the role of coping styles as mediators Carvalho, Lucas de Francisco de Oliveira, Cibelle Garcia, Maria Clara Romão Pontes Rolim Machado, Gisele Magarotto Abstract in English: Abstract Objectives We investigated relationships between the triarchic model of psychopathy, coping styles, and externalizing and internalizing symptoms, and verified the mediating effect of coping styles. Methods Participants were 957 adults who answered the Triarchic Psychopathy Measure (TriPM), the Inventory of Depression and Anxiety Symptoms Expanded Version (IDAS-II), and the Crime and Analogous Behavior Scale (CAB). Results Data were analyzed using four path analyses to test our hypotheses, indicating each triarchic trait is differently associated with psychological symptoms and coping styles. We also observed preferences for some coping styles affecting the association between triarchic traits and psychological symptoms. Conclusion Our findings suggest that coping styles only affect the interaction between boldness and distress, as well as between boldness and fear, indicating that specific coping strategies can account for variations in distress and fear linked to boldness. |
Original Article Psychometric properties of the Death Anxiety Scale for adult chronic patients Palacios-Espinosa, Ximena Pedraza, Ricardo Sánchez Gómez-Carvajal, Ana-María Botero-Meneses, Juan Sebastián Escallón, Diana María Leal, Diego Armando Abstract in English: Abstract Objectives Death anxiety (DA) is a predictor of exacerbation of both physical and psychological symptoms of chronic diseases. Therefore, having short and easy-to-apply instruments to assess the presence of DA and adopting a multidisciplinary approach to address it are important. This study analyzes the psychometric properties of the Death Anxiety Scale (DAS), originally developed by Donald Templer, in a Colombian population of adult patients diagnosed with a chronic disease. Methods The original instrument was linguistically, conceptually, and culturally adapted to Colombian Spanish to be subsequently administered to 301 adult patients with chronic diseases. Results The exploratory factor analysis revealed a three-factor structure, which explained 47% of variance. Internal consistency was demonstrated (Cronbach’s alpha: 0.71; McDonald’s omega: 0.76; Guttman’s lambda 6 [G6]: 0.74; greatest lower bound: 0.54). A correlation coefficient of 0.64 was found between the total score of the DAS and the Beck Anxiety Inventory (BAI). Conclusion When comparing the results with the versions of the DAS in Spanish from Mexico and Spain, variability in the psychometric properties was observed. Language cannot therefore be assumed to be a guarantee of the reliability and validity of the instrument. |
Original Article Effectiveness of acceptance and commitment therapy for distress, emotion regulation, and self-compassion in patients with cardiovascular disease: a randomized clinical trial Fattahi, Arash Mazini, Fatemeh Jaberghaderi, Nasrin Rajabi, Fatemeh Derakhshani, Mehdi Laki, Mohammad Abstract in English: Abstract Objective: Cardiovascular patients experience various psychological problems due to the conditions caused by their disease, making it worse if left untreated. The purpose of the current study was to evaluate the effects of acceptance and commitment therapy (ACT) on distress, emotion regulation, and self-compassion in patients with cardiovascular disease. Methods: This study was a randomized clinical trial with pre-test, post-test, and 2-month and 4-month follow-up periods accompanying a control group and an experimental group. Patients filled out questionnaires at four stages; a Depression, Anxiety, and Stress Scale (DASS-21), an Emotion Regulation Questionnaire (ERQ), and a Self-Compassion Scale (SCS). The experimental group underwent a treatment protocol based on ACT. Data were then analyzed using SPSS-25 with repeated measures analysis of variance (ANOVA). Results: ACT significantly reduced depression, anxiety, and stress, enhanced self-compassion, and improved emotion regulation in cardiac patients. Between-subjects (group) partial Eta squared (η²) for depression, anxiety, stress, reappraisal, suppression, and self-compassion were 0.61, 0.64, 0.66, 0.62, 0.66, and 0.65, respectively. Treatment efficacy was maintained at the 2-month and 6-month follow-up visits. Conclusion: The results of this study suggest that treating cardiac patients’ psychological problems in an ACT-focused manner may have an impact on how well they respond to their treatment. |
Original Article Exploring protective factors in a high-risk subsample: the pivotal role of paternal support in preventing depression in a cohort of young adults Tietbohl-Santos, Barbara Montezano, Bruno Braga de Azevedo Cardoso, Taiane Mondin, Thaíse Campos Moreira, Fernanda Pedrotti Souza, Luciano Dias de Mattos da Silva, Ricardo Azevedo Kapczinski, Flavio Jansen, Karen Passos, Ives Cavalcante Abstract in English: Abstract Objective: Major depressive disorder (MDD) is a global concern due to its widespread prevalence and morbidity. It is crucial to identify protective factors in high-risk individuals, including those with a familial predisposition, maltreatment history, and socioeconomic vulnerabilities. Methods: We assessed a high-risk subsample within a young adult population cohort (n = 791; mean age = 31.94 [standard deviation {SD} = 2.18]) across three waves, using multiple regression models to analyze higher education, feeling supported, spirituality, psychotherapy access, higher socioeconomic status, involvement in activities, cohabitation, and family unity in waves 1 and 2 and their association with MDD resilience at wave 3. Results: In the high-risk group, MDD incidence was 13.7% (n = 24). Paternal support had a protective effect on MDD incidence (odds ratio [OR] = 0.366; 95% confidence interval [95%CI] 0.137 to 0.955; p = 0.040) and suicide attempt risk (OR = 0.380; 95%CI 0.150 to 0.956; p = 0.038). Higher resilience scores were also protective (OR = 0.975; 95%CI 0.953 to 0.997; p = 0.030), correlating with reduced Beck Depression Inventory (BDI) (r = 0.0484; B = −0.2202; 95%CI −0.3572 to −0.0738; p = 0.003) and Montgomery-Åsberg Depression Rating Scale (MADRS) scores (r = 0.0485; B = −0.2204; 95%CI −0.3574 to −0.0741; p = 0.003). Conclusion: Our paper emphasizes reorienting the MDD approach, focusing on positive prevention strategies. It highlights the crucial role of fathers in family-based interventions and in promoting resilience in high-risk populations. |
Letter to the Editors Commentary on the clinical study of CBD-rich cannabis extract in children with autism spectrum disorder Córdova, Claudio Nóbrega, Otavio |
Letter to the Editors "The impact of family stress and resilience on child development": the role of parental emotional health and parenting practices in offspring mental health Ribas, Larissa Hallal Villar, Rafaela Soares |