RESUMO
BACKGROUND: After >2 years of the Coronavirus Disease-19 (COVID-19) pandemic, it is well established how sleep symptoms are rising, especially among healthcare workers (HCW). The aim of this study is to evaluate what features are associated with sleep disturbances in the HCW population. METHODS: Cross-sectional and longitudinal analysis of social and clinical variables associated with sleep problems and insomnia incidence in HCW in a large, national-level cohort. The measurement of sleep problems was assessed by self-report using Jenkins Sleep Scale (JSS). A multivariate analysis was used in the cross-sectional design and generalized linear models were used in the longitudinal design. RESULTS: 10,467 HCW were analyzed in the cross-sectional analysis, 3313 participants were analyzed in the three timepoints of the study. Sex, previously diagnosed mental illness and frontline work with COVID-19 were associated with higher scores in JSS in the univariate analysis. In the multivariate analysis, only previous diagnosis of mental illness was related with sleep difficulties, especially previously diagnosed insomnia. The longitudinal analysis concluded that previous diagnosis of mental illnesses was associated with higher levels of insomnia development (OR = 11.62). The self-reported disorders found to be major risk factors were addiction (OR = 7.69), generalized anxiety disorder (OR = 3.67), social anxiety (OR = 2.21) and bipolar disorder (OR = 2.21). LIMITATIONS: Attrition bias. CONCLUSIONS: Previous diagnosis of mental illness was strongly related to insomnia development in HCW during the COVID-19 pandemic. Strategies that focus on this population are advised.
Assuntos
COVID-19 , Distúrbios do Início e da Manutenção do Sono , Humanos , COVID-19/epidemiologia , Pandemias , Saúde Mental , SARS-CoV-2 , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Estudos Transversais , Brasil/epidemiologia , Ansiedade/psicologia , Depressão/psicologia , Pessoal de Saúde/psicologia , Sono , Atenção à SaúdeRESUMO
Children with ADHD and ASD may present differences in the affective-motivational processes. We systematically review the literature regarding temporal discounting in children up to 12 years with ADHD and ASD. Six articles were included, five studies with ADHD children (n = 231), one with ASD children (n = 21), all including typically developing children as controls (n = 210). Five studies (four with ADHD and one with ASD) found greater temporal reward discounting for clinical groups. Occurrence of ADHD appears to rush even more the decision-making process at this stage of development, but there is still a lack in the literature, especially evaluating individuals with ASD.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Espectro Autista/psicologia , Comportamento de Escolha/fisiologia , Desvalorização pelo Atraso , Recompensa , Criança , Feminino , Humanos , MasculinoRESUMO
Neurofibromatosis Type 1 (NF1) can cause a wide range of cognitive deficits, but its underlying nature is still unknown. We investigated the correlation between cognitive performance and specific patterns of resting-state brain metabolism in a NF1 sample. Sixteen individuals diagnosed with NF1 underwent 18F-FDG PET/CT brain imaging followed by a neuropsychological assessment. Principal component analysis was performed on 17 measures of cognitive function and a machine learning approach based on Gaussian Process Regression was used to individually predict the components that represented most of the variance in the neuropsychological data. The accuracy of the method was estimated using leave-one-out cross-validation and its significance through permutation testing. We found that only the first component could be accurately predicted from resting state metabolism (r = 0.926, p<0.001). Multiple and heterogeneous measures contribute to the first component, mainly WISC/WAIS Procedure and Verbal IQ, verbal memory and fluency. Considering the accurate prediction of measures of neuropsychological performance based on brain metabolism in NF1 patients, this suggests an underlying metabolic pattern that relates to cognitive performance in this group.
Assuntos
Encéfalo/metabolismo , Transtornos Cognitivos/diagnóstico , Neurofibromatose 1/psicologia , Adolescente , Adulto , Encéfalo/diagnóstico por imagem , Criança , Transtornos Cognitivos/metabolismo , Feminino , Fluordesoxiglucose F18/metabolismo , Humanos , Aprendizado de Máquina , Masculino , Neurofibromatose 1/diagnóstico por imagem , Neurofibromatose 1/metabolismo , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Análise de Componente Principal , Adulto JovemRESUMO
Neurofibromatoses (NF) are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH), which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management.
Assuntos
Neurilemoma/patologia , Neurofibromatoses/patologia , Neurofibromatose 1/patologia , Neurofibromatose 2/patologia , Neoplasias Cutâneas/patologia , Diagnóstico Diferencial , Testes Genéticos , Humanos , Gradação de Tumores , Fatores de RiscoRESUMO
BACKGROUND: Impulsivity is a multidimensional construct which has been associated with dopaminergic neurotransmission. Nonetheless, until this moment, few studies addressed the relationship between different types of impulsivity and the single nucleotide polymorphism caused by a substitution of valine (val) with methionine (met) in the 158 codon of the Catechol-o-Methyltransferase gene (COMT-val158met). The present study aimed to investigate the association between val158met COMT polymorphism and impulsive behavior measured by two neuropsychological tests. METHODOLOGY/PRINCIPAL FINDINGS: We administered two neuropsychological tests, a Continuous Performance Task and the Iowa Gambling Task were applied to 195 healthy participants to characterize their levels of motor, attentional and non-planning impulsivity. Then, subjects were grouped by genotype, and their scores on impulsivity measures were compared. There were no significant differences between group scores on attentional and motor impulsivity. Those participants who were homozygous for the met allele performed worse in the Iowa Gambling Task than val/val and val/met subjects. CONCLUSIONS/SIGNIFICANCE: Our results suggest that met allele of val158met COMT polymorphism is associated with poor performance in decision-making/cognitive impulsivity task. The results reinforce the hypothesis that val and met alleles of the val158met polymorphism show functional dissociation and are related to different prefrontal processes.