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OBJECTIVES: To assess the prevalence and pattern of behavioral problems in children and adolescents with atopic dermatitis (AD) and to study their associations with clinical data and severity. METHODS: This was a single-center, cross-sectional study of patients (6-17 years) with AD. Assessment of competencies and syndrome scale scores of behavioral problems was performed by applying the Child Behavior Checklist 6-18 (CBCL 6-18) and AD severity using the Eczema Area Severity Index (EASI) score. RESULTS: Of the 100 patients with AD, 56% were male, with a mean age of 11±3 years, and 43% had moderate/severe AD. Borderline or abnormal values were found in 75% of the patients for total social competence, 57% for internalization, 27% for externalization, and 18% for aggressive behavior. A higher prevalence of aggressive behavior (27.9% vs. 10.5%; p = 0.02) and sleep disorders (32.6% vs. 15.8%; p = 0.04) was observed in patients with moderate/severe AD than in those with mild AD. Children with current or previous use of immunosuppressants/immunobiological tests had a lower frequency of normal social competence (53% vs. 83%, p = 0.012). Regarding the critical questions, 8% responded affirmatively to suicidal ideation. CONCLUSION: A high prevalence of behavioral problems was observed among children and adolescents with AD, with a predominance of internalizing profiles, mainly anxiety and depression. Children with moderate/severe AD have a higher prevalence of aggressive behaviors and sleep disorders. These findings highlight the importance of multidisciplinary teams, including mental health professionals, in caring for patients with AD.

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Abstract Objectives To assess the prevalence and pattern of behavioral problems in children and adolescents with atopic dermatitis (AD) and to study their associations with clinical data and severity. Methods This was a single-center, cross-sectional study of patients (6-17 years) with AD. Assessment of competencies and syndrome scale scores of behavioral problems was performed by applying the Child Behavior Checklist 6-18 (CBCL 6-18) and AD severity using the Eczema Area Severity Index (EASI) score. Results Of the 100 patients with AD, 56% were male, with a mean age of 11±3 years, and 43% had moderate/severe AD. Borderline or abnormal values were found in 75% of the patients for total social competence, 57% for internalization, 27% for externalization, and 18% for aggressive behavior. A higher prevalence of aggressive behavior (27.9% vs. 10.5%; p= 0.02) and sleep disorders (32.6% vs. 15.8%; p= 0.04) was observed in patients with moderate/severe AD than in those with mild AD. Children with current or previous use of immunosuppressants/immunobiological tests had a lower frequency of normal social competence (53% vs. 83%, p= 0.012). Regarding the critical questions, 8% responded affirmatively to suicidal ideation. Conclusion A high prevalence of behavioral problems was observed among children and adolescents with AD, with a predominance of internalizing profiles, mainly anxiety and depression. Children with moderate/severe AD have a higher prevalence of aggressive behaviors and sleep disorders. These findings highlight the importance of multidisciplinary teams, including mental health professionals, in caring for patients with AD.

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Abstract REM sleep behavior disorder (RBD) is characterized by a loss of atonia of skeletal muscles during REM sleep, associated with acting out behaviors during dreams. Knowledge of this pathology is important to predict neurodegenerative diseases since there is a strong association of RBD with diseases caused by the deposition of alpha-synuclein in neurons (synucleinopathies), such as Parkinson's disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB). Proper diagnosis of this condition will enable the use of future neuroprotective strategies before motor and cognitive symptoms. Diagnostic assessment should begin with a detailed clinical history with the patient and bed partner or roommate and the examination of any recorded home videos. Polysomnography (PSG) is necessary to verify the loss of sleep atonia and, when documented, the behaviors during sleep. Technical recommendations for PSG acquisition and analysis are defined in the AASM Manual for the scoring of sleep and associated events, and the PSG report should describe the percentage of REM sleep epochs that meet the criteria for RWA (REM without atonia) to better distinguish patients with and without RBD. Additionally, PSG helps rule out conditions that may mimic RBD, such as obstructive sleep apnea, non-REM sleep parasomnias, nocturnal epileptic seizures, periodic limb movements, and psychiatric disorders. Treatment of RBD involves guidance on protecting the environment and avoiding injuries to the patient and bed partner/roommate. Use of medications are also reviewed in the article. The development of neuroprotective medications will be crucial for future RBD therapy.

Resumo O transtorno comportamental do sono REM (TCSREM) é caracterizado por uma perda de atonia dos músculos esqueléticos durante o sono REM, associada a comportamentos de atuação durante os sonhos. O conhecimento desse transtorno é importante como preditor de doenças neurodegenerativas, uma vez que existe uma forte associação de TCSREM com doenças causadas pela deposição de alfa-sinucleína nos neurônios, como a doença de Parkinson (DP), atrofia de múltiplos sistemas (MSA) e demência com corpos de Lewy (DLB). O diagnóstico adequado dessa condição permitirá o uso de futuras estratégias neuroprotetoras antes do aparecimento dos sintomas motores e cognitivos. A avaliação diagnóstica deve começar com uma história clínica detalhada com o paciente e acompanhante, além de exame de vídeos. A polissonografia (PSG) é necessária para verificar a perda da atonia do sono e, quando documentados, os comportamentos durante o sono. As recomendações técnicas para aquisição e análise de PSG são definidas no Manual da AASM (Scoring of sleep and associated events) e o relatório de PSG deve descrever a porcentagem de períodos de sono REM que atendem aos critérios para REM sem atonia. Além disso, a PSG ajuda a descartar condições que podem mimetizar o TCSREM, como apneia obstrutiva do sono, parassonias do sono não REM, crises epilépticas noturnas, movimentos periódicos dos membros e transtornos psiquiátricos. O tratamento do TCSREM envolve orientações sobre adaptações do ambiente para evitar lesões ao paciente e ao colega de quarto. Medicamentos utilizados são revistos no artigo, assim como o crucial desenvolvimento de medicamentos neuroprotetores.

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Recent studies have begun to understand sleep not only as a whole-brain process but also as a complex local phenomenon controlled by specific neurotransmitters that act in different neural networks, which is called "local sleep". Moreover, the basic states of human consciousness-wakefulness, sleep onset (N1), light sleep (N2), deep sleep (N3), and rapid eye movement (REM) sleep-can concurrently appear, which may result in different sleep-related dissociative states. In this article, we classify these sleep-related dissociative states into physiological, pathological, and altered states of consciousness. Physiological states are daydreaming, lucid dreaming, and false awakenings. Pathological states include sleep paralysis, sleepwalking, and REM sleep behavior disorder. Altered states are hypnosis, anesthesia, and psychedelics. We review the neurophysiology and phenomenology of these sleep-related dissociative states of consciousness and update them with recent studies. We conclude that these sleep-related dissociative states have a significant basic and clinical impact since their study contributes to the understanding of consciousness and the proper treatment of neuropsychiatric diseases.

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Introducción: El trastorno hipersexual fue propuesto y desestimado como diagnóstico, con el argumento de escasa evidencia científica y uso indebido en asuntos legales, pero fue reconocido en 2018 como desorden del comportamiento sexual compulsivo. Es una entidad clínica que aún carece de reconocimiento diagnóstico, pero constituye un importante problema de salud mental, sexual y general. Objetivo: Presentar una paciente con un desorden del comportamiento sexual compulsivo y el procedimiento terapéutico empleado. Caso clínico: Paciente femenina de 21 años de edad, con antecedentes de abuso sexual en la infancia. Es traída por la madre porque no lograba controlar sus impulsos sexuales con repetidas búsquedas compulsivas de encuentros sexuales, uso frecuente de pornografía, con malestar clínico significativo y problemas en el área social, estudiantil y otras. Conclusiones: Al diagnosticar el desorden del comportamiento sexual compulsivo, es esencial la entrevista clínica, confeccionar la historia psiquiátrica completa, alcanzar el control de la conducta sexual, las comorbilidades y obtener una mejor calidad de vida del paciente.

Introduction: The hypersexual disorder was proposed and underrated as diagnostic with the argument of scarce scientific evidence and undue use in legal matters, but recognized in 2018 as disorder of compulsive sexual behavior. It is a clinical entity, that still lacks diagnostic recognition, but it constitutes an important problem of mental, sexual and general health. Objective: To present a patient with a disorder of the compulsive sexual behavior and the procedure therapeutic used. Clinical case: 21-year-old female patient, with antecedents of sexual abuse in the childhood. The mother brings her because was not able to control their sexual impulses with repeated compulsive searches of sexual encounters, frequent use of pornography with significant clinical malfunction, and problems in social, student and other important areas. Conclusions: When diagnosing compulsive sexual behavior disorder the essential is the clinical interview, to perform a complete psychiatric history, later to reach the control of the sexual behavior, comorbidity, and to obtain a better quality of the patients' life.

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STUDY OBJECTIVES: Our aim is to evaluate the presence of REM sleep without atonia (RWA), the objective hallmark of REM sleep Behaviour Disorder (RBD), as prodromal marker of Parkinson's disease (PD), in an adult cohort of 22q11.2 deletion syndrome (22qDS). METHODS: Sleep quality was assessed by means of Pittsburgh quality scale index (PSQI), and RBD symptoms by means of RBD questionnaire-Hong-Kong (RBDQ-HK). Attended domiciliary video-Polysomnography (v-PSG) were performed in 26 adults (18-51 years, 14 females) 22qDS patients. Electromyogram during REM sleep was analyzed by means of SINBAR procedure at 3-second time resolution (miniepochs). RESULTS: An overall poor sleep quality was observed in the cohort and high RBDQ-HK score in 7 of the 26 patients, two additional patients with positive dream enactment reported by close relatives had low score of RBDQ-HK. Nevertheless, SINBAR RWA scores were lower than cut-off threshold for RWA (mean 5.5%, range 0-12.2%). TST and the percentage of light sleep (N1) were increased, with preserved proportions of N2 and N3. Participants reported poor quality of sleep (mean PSQI > 5), with prolonged sleep latency in the v-PSG. No subjects exhibit evident dream enactment episodes during recording sessions. CONCLUSIONS: RWA was absent in the studied cohort of 22qDS adult volunteers according to validated polysomnographic criteria. High RBDQ-HK scores do not correlate with v-PSG results among 22qDS individuals.

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No Brasil, as condições psicopatológicas no ambiente laboral têm merecido uma alta atenção, pois o afastamento por tal motivo tem aumentado significativamente e impactando o setor empregatício e financeiro. Para avaliar essa questão, o presente estudo objetivou investigar o perfil do adoecimento por transtornos mentais na região Sul do Brasil. Trata-se de um estudo ecológico, com dados do Anuário Estatístico de Acidentes do Trabalho (AEAT). A comparação entre anos e estados foi realizada pelo teste de ANOVA de uma via para amostras pareadas. Verificou-se que, em Santa Catarina, os acidentes de trabalho relacionados aos transtornos mentais e comportamentais estão majoritariamente atrelados aos "Transtornos neuróticos, transtornos relacionados com o stress e transtornos somatoformes", mais especificamente, às "Reações ao stress grave e transtornos de adaptação" (74,06%). Enquanto que no Paraná e Rio Grande do Sul se relacionam com "Transtornos de humor [afetivos]", sendo que, desses os "Episódios depressivos" são a maioria (66,49%). (AU)

In Brazil, the psychopathological conditions in the work environment have deserved a high level of attention, as the absence for this reason has increased significantly and impacting the employment and financial sector. To assess this issue, this study aimed to investigate the profile of illness due to mental disorders in southern Brazil. This is an ecological study, with data from the Anuário Estatístico de Acidentes do Trabalho (AEAT). Comparison between years and states was performedusing the one-way ANOVA test for paired samples. It was found that, in Santa Catarina, work accidents related to mental and behavioral disorders are mostly linked to "Neurotic disorders, disorders related to stress and somatoform disorders", more specifically, to "Reactions to severe stress and adaptation disorders" (74.06%). While in Paraná and Rio Grande do Sul they are related to "Mood [affective] disorders", and of these "Depressive episodes" are the majority (66.49%). (AU)

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Quadruple aberrant hyperphosphorylated tau (p-τ), amyloid-ß peptide, alpha-synuclein and TDP-43 brainstem and supratentorial pathology are documented in forensic ≤40y autopsies in Metropolitan Mexico City (MMC), and p-τ is the major aberrant protein. Post-traumatic stress disorder (PTSD) is associated with an elevated risk of subsequent dementia, and rapid eye movement sleep behavior disorder (RBD) is documented in PD, AD, Lewy body dementia and ALS. This study aimed to identify an association between PTSD and potential pRBD in Mexico. An anonymous online survey of 4502 urban college-educated adults, 29.3 ± 10.3 years; MMC, n = 1865; non-MMC, n = 2637, measured PTSD symptoms using the Impact of Event Scale-Revised (IES-R) and pRBD symptoms using the RBD Single-Question. Over 50% of the participants had IES-R scores ≥33 indicating probable PTSD. pRBD was identified in 22.6% of the participants across Mexico and 32.7% in MMC residents with PTSD. MMC subjects with PTSD had an OR 2.6218 [2.5348, 2.7117] of answering yes to the pRBD. PTSD and pRBD were more common in women. This study showed an association between PTSD and pRBD, strengthening the possibility of a connection with misfolded proteinopathies in young urbanites. We need to confirm the RBD diagnosis using an overnight polysomnogram. Mexican women are at high risk for stress and sleep disorders.

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This article is a comprehensive review of the clinical evaluation of sleep-related movement disorders. In this review, the authors present a practical approach to help clinicians identify the "pattern recognition" of movement and behavior disorders during sleep, with the process of translating a particular movement that occurs when asleep, with clinically classifying disorders, and with obtaining an etiologic diagnosis. The aim is not to provide an exhaustive review of the literature, but to concentrate on the most important symptoms, so the clinical approach can be improved and the best choices can be made during the diagnostic process.

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AIM AND METHODS: Cross-sectional data from 118 Chilean children with ASD collected during the pandemic outbreak of COVID-19 in 2020 were evaluated to analyze predictors of behavioral problem impairment. RESULTS: Forty-five percent of parents stated that their children's behavioral difficulties increased in intensity or frequency. The adjusted predictors were having a family member hospitalized with COVID-19 (OR = 4.11; 95% CI = 1.53-11.1) and parents' mental health disorders during the pandemic (OR = 2.43; 95% CI = 1.01-5.83). CONCLUSION: Potentially modifiable psychosocial factors affecting children's behavior should be considered in a possible second outbreak.

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ABSTRACT Parkinson's disease (PD) has heterogeneous clinical manifestations and prognoses. It is accompanied by a group of motor and non-motor symptoms ranging from independence to total disability, limiting work and personal care activities. Currently, disease subtype markers for informing prognosis remain elusive. However, some studies have reported an association between rapid eye movement (REM) sleep behavior disorder (RBD) and faster motor and non-motor symptom progression, including autonomic dysfunction and cognitive decline. Moreover, since autonomic dysfunction has been described in idiopathic forms of RBD, and they share some central regulatory pathways, it remains unclear whether they have a primary association or if they are more severe in patients with PD and RBD, and thus are a disease subtype marker. This article aimed at critically reviewing the literature on the controversies about the prevalence of RBD in PD, the higher incidence of PD non-motor symptoms associated with RBD, the evidence of faster motor worsening in parkinsonian patients with this parasomnia, and the main pathophysiological hypotheses that support these findings.

RESUMO A doença de Parkinson (DP) apresenta variadas manifestações clínicas e distintos prognósticos. É caracterizada por um conjunto de sintomas motores e não motores que podem variar desde um quadro de independência até a completa incapacidade laborativa e de cuidados pessoais. Até o momento, não está claro quais seriam os marcadores de subtipos da doença que poderiam alertar para formas de prognóstico. Porém existem alguns estudos que mostram que a presença do transtorno comportamental do sono REM pode estar associada à progressão mais rápida dos sintomas motores e não motores, como disfunção autonômica e declínio cognitivo. Questiona-se ainda se a disautonomia está primariamente associada ao transtorno do sono REM, já que são relatadas nas formas idiopáticas deste transtorno de sono e compartilham alguns núcleos reguladores centrais. Ou se são mais graves nos pacientes com diagnóstico de DP e transtorno comportamental do sono REM, marcando assim um subtipo da doença. Esta revisão teve como objetivo revisar criticamente os principais estudos publicados envolvendo as controvérsias sobre a prevalência do transtorno comportamental do sono REM na DP, a maior incidência de sintomas não motores da DP associados ao transtorno do sono REM, as evidências de piora motora mais rápida nos pacientes parkinsonianos que apresentam este transtorno do sono e as principais hipóteses fisiopatológicas que justificam esses achados.

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This study aims to investigate the effect of Sandplay Therapy on the treatment of children who are victims of mistreatment with internalizing and/or externalizing behavioral problems. Method: The Child Behavior Check List instrument was applied to all children between 6 years 6 months and 10 years 11 months from 24 institutions. All of them presented clinical and/or borderline levels of behavior concern. The institutions where the children would compose a control group, those where they would receive Sandplay Therapy treatment (experimental group), and those where they would receive Placebo treatment were determined by drawing lot. The same instrument was applied after the treatments, or 20 weeks; in the experimental group, a test was applied after six months. The results show that the children in the experimental group showed significant improvements. These changes remained six months after the end of therapy and were verified by analyzing Sandplay scenarios.

O presente estudo tem como objetivo investigar o efeito da Terapia do Sandplay no tratamento de crianças vítimas de maus tratos e com problemas de comportamento internalizantes e/ou externalizantes. Participantes: 60 crianças vítimas de maus tratos e institucionalizadas. O instrumento Child Behavior Checklist foi aplicado nas crianças avaliadas, todas com idades entre 6 anos e 6 meses e 10 anos e 11 meses, de 24 instituições. Todas apresentaram níveis clínicos e/ou limítrofes. Por sorteio, foi determinado em qual instituição as crianças seriam grupo controle e em quais receberiam tratamento com terapia de Sandplay (grupo experimental) ou tratamento placebo. O mesmo instrumento foi aplicado após tratamentos ou 20 semanas; no grupo experimental houve testagem após seis meses. Os resultados demonstram que as crianças do grupo experimental apresentaram melhoras significativas. Essas mudanças ainda eram perceptíveis seis meses após o término da terapia e foram verificadas pela análise dos cenários de Sandplay

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ABSTRACT Introduction: A diagnosis of rapid eye movement sleep behavior disorder (RBD) currently requires confirmation with polysomnography (PSG). However, PSG may not be sufficiently available. In these situations, a clinical diagnostic measure might be useful. Objective: To validate the Brazilian Portuguese version of RBD screening questionnaire (RBDSQ) for patients with Parkinson's disease (PD). Methods: Using detailed clinical interviews and PSG analysis (diagnostic gold standard), a convenience sample of 69 subjects was divided into the following subgroups: patients with PD and RBD (PD+RBD; n=50) and patients with PD alone (PD-RBD; n=19). Results: RBDSQ-BR showed adequate internal consistency (Cronbach's α=0.809) and, except for item 8, adequate item-test correlation. The retest performed in a second sample (n=13, consecutive) showed high agreement for total score (intraclass correlation coefficient, ICC=0.863) and acceptable agreement for items 2, 3, 6.2, 6.3, 7, and 8 (K>0.60). The receiver operating characteristic (ROC) curve analysis had an area under the curve (AUC) of 0.728. A cut-off score of 4 enabled the correct diagnosis of 76.8% subjects and provided the best balance between sensitivity (84%) and specificity (57.9%), with a 2.0 likelihood ratio of a positive result (LR+) and a 0.3 likelihood ratio of a negative result (LR-). Items 2 and 6.2 had 84.2% specificity and 3.2 LR+. Combined items 1+2+6.2, 2+6.1, and 6.1+6.2 increased the specificity to 94.7%, with LR+ ranging from 6.1 to 7.6. Conclusions: RBDSQ-BR is a reliable instrument, which may be useful for RBD diagnosis of Brazilian patients with PD. The instrument is also valid and may help in a better selection of cases for a more detailed clinical evaluation or even PSG analysis.

RESUMO Introdução: O diagnóstico do transtorno comportamental do sono REM (TCSREM) implica na realização da polissonografia (PSG), mas sua disponibilidade pode não ser suficiente. Portanto, meios clínicos para o diagnóstico podem ser úteis. Objetivo: Validar para a língua portuguesa falada no Brasil o questionário de triagem do TCSREM (QT-TCSREM) em pacientes portadores de doença de Parkinson (DP). Métodos: Uma amostra por conveniência composta de 69 indivíduos foi dividida em portadores de DP com TCSREM (n=50) e DP sem TCSREM (n=19) através de entrevista clínica detalhada e análise da PSG. Resultados: QT-TCSREM-BR apresentou consistência interna adequada (α de Cronbach=0,809) e, exceto pelo item 8, correlação item-total adequada. Reteste feito em uma segunda amostra (n=13, consecutivos) evidenciou concordância elevada para o escore total (coeficiente de correlação intraclasse, CCI=0,863) e aceitável para os itens 2, 3, 6.2, 6.3, 7 e 8 (K>0,60). Análise da curva característica de operação do receptor (COR) obteve uma área sob a curva de 0,728. O corte 4 permitiu o diagnóstico correto de 76,8% dos indivíduos e apresentou o melhor equilíbrio entre sensibilidade (84%) e especificidade (57,9%), com uma razão de verossimilhança de um resultado positivo (RV+) 2,0 e de um resultado negativo (RV-) 0,3. Os itens 2 e 6.2 obtiveram especificidade 84,2% e RV+ 3,2. Itens combinados 1+2+6,2, 2+6,1 e 6,1+6,2 aumentaram a especificidade para 94,7%, com RV+ variando de 6,1 até 7,6. Conclusões: O QT-TCSREM-BR é um instrumento confiável que pode ser útil para o diagnóstico do TCSREM em pacientes com DP no Brasil. O instrumento também é válido e pode auxiliar numa melhor seleção de casos a serem submetidos a uma avaliação mais detalhada ou até mesmo a uma análise de PSG.

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Dreaming is the result of the mental activity of rapid eye movement (REM) sleep stage, and less commonly of non-REM sleep. Dreams offer unique insights into the patients' brains, minds, and emotions. Based on neurophysiological and neuroimaging studies, the biological core of dreaming stands on some brain areas activated or inactivated. Dream abnormalities in neurological disorders include a reduction / cessation of dreaming, an increase in dream frequency, changes in dream contents and accompaniments, and the occurrence of dreamlike experiences (hallucinations) mainly during the wake-sleep/sleep-wake transitions. Dream changes can be associated with several neurological conditions, and the unfolding of biological knowledge about dream experiences can also have significance in clinical practice. Regarding the dream importance in clinical neurological management, the aim of this paper encompasses a summary of sleep stages, dreams neurobiology including brain areas involved in the dreams, memory, and dreams, besides Dreams in the aging people and neurodegenerative disorders.

Sonhar é o resultado da atividade mental do estágio do sono de movimento rápido dos olhos (REM) e, menos comumente, do sono não-REM. Os sonhos oferecem informações únicas sobre o cérebro, a mente e as emoções dos pacientes. Com base em estudos neurofisiológicos e de neuroimagem, o núcleo biológico do sonho está em algumas áreas do cérebro ativadas ou inativadas. As anormalidades do sonho nos distúrbios neurológicos incluem uma redução / cessação do sonho, um aumento na frequência do sonho, alterações nos conteúdos e acompanhamentos do sonho e a ocorrência de experiências semelhantes ao sonho (alucinações), principalmente durante as transições de vigília-sono / sono-vigília. As mudanças do sonho podem estar associadas a várias condições neurológicas, e o desenvolvimento do conhecimento biológico sobre as experiências do sonho também pode ter significado na prática clínica. Com relação à importância do sonho no manejo neurológico clínico, o objetivo deste artigo é resumir os estágios do sono, a neurobiologia dos sonhos, incluindo as áreas do cérebro envolvidas nos sonhos, a memória e os sonhos, além dos sonhos nos idosos e nos distúrbios neurodegenerativos.

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Evidence points to an independent relationship among childhood maltreatment, impairments in executive functions (EF) and disruptive behavior disorders (DBD). However, it is still not fully understood how these three factors are interrelated. This study evaluated the association between childhood maltreatment and DBD testing the role of EF performance as a mediator or moderator. We studied a probabilistic school-based sample of 2016 children from 6 to 12 years. Mental disorders were assessed using the Development and Well-Being Assessment with parents and children. Children answered questions about exposure to child maltreatment and were evaluated with a set of cognitive tasks addressing inhibitory control, working memory, cognitive flexibility and planning. Childhood maltreatment was strongly associated with DBD (OR = 7.7, CI 95% 4.5-12.9). No association was found between childhood maltreatment and EF performance. Children with DBD showed worse performance in cognitive flexibility, which was not identified as a mediator or moderator of the association between childhood maltreatment and DBD. Results indicate that the association between maltreatment and disruptive behavior occurs regardless of performance in executive function in a community sample. Future studies are essential to confirm these findings and elucidate the cognitive mechanisms involved in this association.

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ABSTRACT Objective: to identify the knowledge of professionals of mental health services and social work on Behavior Disorders (BD) in childhood and adolescence, and to analyze their actions in care for children and adolescents with such disorders. Method: a qualitative, descriptive-exploratory study with 13 professionals from two mental health services and two tutorial councils. The data were collected in interviews and submitted to thematic content analysis. Results: three categories emerged from the interviews: "Knowledge about behavior disorders", which defines BD as deviations from normality and lack of limits. "Integrated and group care", which explains the integrated, multidisciplinary and group actions. "Specialized and legal care", which explains the actions through specialized, medical and judicial care. Final considerations: the results point out weaknesses and knowledge gaps of professionals, causing potential harm in the programming of effective actions, such as identification, referral and therapeutic planning.

RESUMEN Objetivo: identificar los conocimientos de los profesionales de los servicios de salud mental y asistencia social en Trastornos de la Conducta (TC) en la infancia y la adolescencia, y analizar sus acciones en la atención a niños y adolescentes con tales trastornos. Método: estudio cualitativo, descriptivo-exploratorio con 13 profesionales de dos servicios de salud mental y dos consejos de tutoría. Los datos fueron recolectados en entrevistas y sometidos a análisis de contenido temático. Resultados: de las entrevistas surgieron tres categorías: "Conocimiento sobre trastornos de conducta", que define la TC como desviaciones de la normalidad y la falta de límites. "Atención integrada y grupal", que explica las acciones integradas, multidisciplinares y grupales. "Atención especializada y jurídica", que explica las acciones a través de la atención especializada, médica y judicial. Consideraciones finales: los resultados señalan las debilidades y las brechas de conocimiento de los profesionales, causando un daño potencial en la programación de acciones efectivas, como la identificación, la referencia y la planificación terapéutica.

RESUMO Objetivo: identificar o conhecimento dos profissionais de serviços de saúde mental e assistência social sobre os Transtornos de Comportamento (TC) na infância e adolescência, e analisar suas ações na atenção a crianças e adolescentes com tais transtornos. Método: estudo qualitativo, descritivo-exploratório com 13 profissionais de dois serviços de saúde mental e dois conselhos tutelares. Os dados foram coletados em entrevistas e submetidos à análise de conteúdo temático. Resultados: três categorias emergiram das entrevistas: "Conhecimentos acerca dos transtornos de comportamento", que define os TC como desvios da normalidade e falta de limites. "O cuidado integrado e em grupo", que explica as ações integradas, multidisciplinares e através de grupos. "O cuidado especializado e jurídico", que explica as ações através do cuidado especializado, medicamentoso e judicial. Considerações finais: os resultados apontam fragilidades e lacunas de conhecimento dos profissionais acarretando potenciais prejuízos na programação de ações eficazes, como identificação, encaminhamento e planejamento terapêutico.

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Antecedentes: el trastorno por atracón frecuentemente se asocia con enfermedades psiquiátricas asociadas, dentro de las cuales se encuentra la obesidad y sus consecuencias. Objetivo: describir aspectos clínicos y epidemiológicos del trastorno por atracón, en particular, su prevalencia, sus factores de riesgo, etiología, elementos desencadenantes, diagnóstico y sus consecuencias. Método: se utilizó como buscador de información científica a Google Académico. Se utilizaron como palabras clave: trastorno por atracón, trastornos de la conducta alimentaria y obesidad. Fueron evaluados artículos de revisión, de investigación, y distintas páginas web, que en general, tenían menos de 10 años de publicados, en idioma español, portugués o inglés. Esto permitió el estudio de 70 artículos, de los cuales 45 fueron referenciados. Conclusión: la prevalencia del trastorno por atracón es variable y en relación con la muestra estudiada. Los factores de riesgo causales son multifactoriales, y resultan de la compleja interacción de factores psicológicos, físicos y socioculturales que interfieren en el comportamiento del individuo, que dificultan la comprensión de su etiología, en la que intervienen varios elementos, y puede ser desencadenado por diferentes situaciones de la vida cotidiana. Su diagnóstico se realiza aplicando los criterios del Manual Diagnóstico y Estadístico de Enfermedades Mentales, Edición 5. Como consecuencia pueden aparecer obesidad, estados de culpa, tristeza, auto-rechazo, problemas al relacionarse con el entorno, dificultades laborales, e incluso, autolesiones e ideación suicida(AU)

Background: binge eating disorder is frequently related with associated psychiatric illnesses, among which obesity and its consequences are. Objective: to describe clinical and epidemiological aspects of binge eating disorder, in particular its prevalence, risk factors, etiology, triggers, diagnosis and its consequences. Method: Google Scholar was used as a scientific information search engine. The following were used as key words: binge eating disorder, eating disorders and obesity. Review articles, research articles and different web pages were evaluated, which in general were less than 10 years old and in Spanish, Portuguese or English languages. This allowed the study of 70 articles, of which 45 were referenced. Conclusions: the prevalence of binge eating disorder is variable and in relation to the sample studied. The causal risk factors are multifactorial, and result from the complex interaction of psychological, physical and sociocultural factors that interfere in the behavior of the individual, which hinder the understanding of their etiology, in which several elements intervene, and can be triggered by different situations of daily life. Its diagnosis is made applying the criteria of the Diagnostic and Statistical Manual of Mental Illnesses, Edition 5. As a consequence, obesity, guilt, sadness, self-rejection, problems relating to the environment, labor difficulties, and even self-injury and suicidal ideation may appear(AU)

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OBJECTIVES: To determine the frequency of major sleep disorders in patients with Parkinson's disease (PD), diagnosed according to the third international classification of sleep disorders, and assess the relationship of those disorders with the quality of life. METHODS: A cross-sectional study was performed involving 88 consecutive patients with PD from outpatient clinic. Participants were subjected to clinical interviews, assessment using standardized scales (Epworth Sleepiness Scale, PD Questionnaire, Pittsburgh sleep quality index (PSQI) and, for individuals with a diagnosis of RLS/WED, International RLS/WED grading scale), and video-polysomnography. RESULTS: We observed sleep disorders in 96.5% of the participants, with REM-sleep behavior disorder found in 62.5%, obstructive sleep apnea in 62.5%, insomnia in 55.7%, and restless legs syndrome in 28.4%. We observed a correlation between health-related quality of life with the PSQI and the Epworth sleepiness scale. CONCLUSION: Patients with PD have a high prevalence of sleep disorders. The quality of sleep and excessive daytime sleepiness significantly affect the quality of life in these individuals.

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BACKGROUND: Parental warmth (PW) has a strong influence on child development and may precede the onset of psychiatric disorders in children. PW is interconnected with other family processes (e.g., coercive discipline) that may also influence the development of psychiatric disorders in children. We prospectively examined the association between PW and child psychiatric disorders (anxiety, major depression disorder, ADHD, disruptive behavior disorders) over the course of three years among Puerto Rican youth, above and beyond the influence of other family factors. METHODS: Boricua Youth Study participants, Puerto Rican children 5 to 13 years of age at Wave 1 living in the South Bronx (New York) (SB) and San Juan and Canguas (PR) (n = 2,491), were followed for three consecutive years. Youth psychiatric disorders were measured by the Diagnostic Interview Schedule for Children-IV (DISC-IV). Generalized Linear Mixed models tested the association between PW (Wave 1) and psychiatric disorders in the next two years adjusting for demographic characteristics and family processes. RESULTS: Higher levels of PW were related to lower odds of child anxiety and major depressive disorder over time (OR = 0.69[0.60; 0.79]; 0.49[0.41; 0.58], respectively). The strength of the association between PW and ADHD and disruptive behavior disorder declined over time, although it was still significant in the last assessment (OR = 0.44[0.37; 0.52]; 0.46[0.39; 0.54], respectively). PW had a unique influence on psychiatric disorders beyond the influence of other parenting and family processes. Stronger associations were observed among girls for depression and ADHD. CONCLUSIONS: Incorporating PW behaviors such as acceptance, support, and comforting into interventions focused on parenting skills may help prevent child psychiatric disorders.

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Se realizó un estudio analítico observacional de tipo casocontrol, no pareado, de los 50 niños y adolescentes epilépticos con trastornos conductuales (casos) y de otro grupo integrado por 100 pacientes con características biológicas similares, no epilépticos y sin estos trastornos, pero con el mismo grado de exposición de riesgo (controles), atendidos en 3 áreas de salud de Santiago de Cuba, desde noviembre de 2011 hasta igual mes de 2013, con vistas a determinar el grado de asociación causal de algunos factores de riesgo y la aparición de dichos trastornos. Se utilizó la razón de productos cruzados, con 95 % de confiabilidad y se calculó el riesgo atribuible. El funcionamiento familiar disfuncional resultó ser el factor de riesgo modificable de mayor impacto asociado a la alteración de la conducta.

An observational analytic non-paired, case-control study, was carried out of the 50 epileptic adolescents and children with behavioral disorders (cases) and of another group formed by 100 patients with similar biological characteristics, non epileptic and without these disorders, but with the same degree of risk exposure (controls), assisted at 3 health areas in Santiago de Cuba, from November, 2011 to the same month in 2013, aimed at determining the degree of causative association of some risk factors and the emergence of these disorders. The ratio of crossed products was used, with 95% of confidence and the attributable risk was calculated. The dysfunctional family performance was the modifiable risk factor of more impact associated to the behavior disorder.

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