RESUMO
PURPOSE: To estimate the prevalence of intermittent explosive disorder (IED) in comorbidity with other psychiatric disorders and to describe the temporal sequencing of disorders in the São Paulo Metropolitan Area, Brazil. METHODS: Data from the São Paulo Megacity Mental Health Survey, a population-based study of 5037 adult individuals, were analyzed. The World Health Organization Composite International Diagnostic Interview (CID 3.0) was used to assess lifetime DSM-IV disorders, including IED, with a response rate of 81.3%. RESULTS: The majority (76.8%) of respondents with IED meet the criteria for at least one other psychiatric disorder, with a prevalence almost twice as high as that observed in individuals without IED. The prevalence of any anxiety, mood, impulse control or substance use disorders in respondents with IED was more than two times higher compared to those without IED, with prevalence ratios ranging from 2.1 (95% CI 1.74-2.48) to 2.9 (95% CI 2.12-4.06). The diagnosis of IED occurred earlier than most of the other mental disorders, except for those with usual onset in early childhood, as Specific and Social Phobias and Attention Deficit Disorder. CONCLUSION: Considering that IED is a highly comorbid disorder and has an earlier onset than most other mental comorbidities in the Brazilian general population, these results may be useful in guiding governmental mental health actions.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Humanos , PrevalênciaRESUMO
AIMS: To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors associated with mental health treatment and adequacy of treatment. METHODS: Data come from data collected from 6710 adults with 12 month mental disorder surveys across seven surveys in six countries in North (USA), Central (Mexico) and South (Argentina, Brazil, Colombia, Peru) America who were interviewed 2001-2015 as part of the World Health Organization (WHO) World Mental Health (WMH) Surveys. DSM-IV diagnoses were made with the WHO Composite International Diagnostic Interview (CIDI). Interviews also assessed service utilization by the treatment sector, adequacy of treatment received and socio-demographic correlates of treatment. RESULTS: Little over one in four of respondents with any 12 month DSM-IV/CIDI disorder received any treatment. Although the vast majority (87.1%) of this treatment was minimally adequate, only 35.3% of cases received treatment that met acceptable quality guidelines. Indicators of social-advantage (high education and income) were associated with higher rates of service use and adequacy, but a number of other correlates varied across survey sites. CONCLUSIONS: These results shed light on an enormous public health problem involving under-treatment of common mental disorders, although the problem is most extreme among people with social disadvantage. Promoting services that are more accessible, especially for those with few resources, is urgently needed.
Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Argentina/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/terapia , Brasil/epidemiologia , Colômbia/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/terapia , Escolaridade , Utilização de Instalações e Serviços , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Renda , Masculino , Transtornos Mentais/epidemiologia , México/epidemiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/terapia , Peru/epidemiologia , Guias de Prática Clínica como Assunto , Qualidade da Assistência à Saúde , Índice de Gravidade de Doença , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Longitudinal studies of children with disruptive disorders (DDs) have shown high rates of antisocial personality disorder (ASPD) and substance use in adulthood, but few have examined the contribution of parental disorders. We examine child-/adulthood outcomes of DDs in offspring, whose biological parents did not have a history of ASPD, bipolar disorder, or substance use disorders. METHOD: Offspring (Nâ¯=â¯267) of parents with or without major depression (MDD), but no ASPD or bipolar disorders were followed longitudinally over 33 years, and associations between DDs and psychiatric and functional outcomes were tested. RESULTS: Eighty-nine (33%) offspring had a DD. Those with, compared to without DDs, had higher rates of MDD (adjusted odds ratio, AORâ¯=â¯3.42, pâ¯<â¯0.0001), bipolar disorder (AORâ¯=â¯3.10, pâ¯=â¯0.03), and substance use disorders (AORâ¯=â¯5.69, pâ¯<â¯0.0001) by age 18, as well as poorer school performance and global functioning. DDs continued to predict MDD and substance use outcomes in adulthood, even after accounting for presence of the corresponding disorder in childhood (MDD: hazards ratio, HRâ¯=â¯3.25, pâ¯<â¯0.0001; SUD, HRâ¯=â¯2.52, pâ¯<â¯0.0001). Associations were similar among the offspring of parents with and without major depression. DDs did not predict adulthood ASPD in either group. LIMITATIONS: Associations are largely accounted for by conduct disorder (CD), as there were few offspring with ADHD, and oppositional defiant disorder (ODD) was not diagnosed at the time this study began. CONCLUSION: If there is no familial risk for ASPD, bipolar disorder or substance use, childhood DDs do not lead to ASPD in adulthood; however, the children still have poorer prognosis into midlife. Early treatment of children with DD, particularly CD, while carefully considering familial risk for these disorders, may help mitigate later adversity.
Assuntos
Filho de Pais com Deficiência/psicologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Adolescente , Adulto , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno Bipolar/epidemiologia , Estudos de Casos e Controles , Criança , Transtorno da Conduta/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Razão de Chances , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Evidence suggests that skin picking disorder (SPD) could be a prevalent condition associated with comorbidity and psychosocial dysfunction. However, just a few studies have assessed the prevalence and correlates of SPD in samples from low- and middle-income countries. In addition, the impact of SPD on quality of life (QoL) dimension after multivariable adjustment to potential confounders remains unclear. METHODS: Data were obtained from a Brazilian anonymous Web-based research platform. Participants provided sociodemographic data and completed the modified Skin Picking-Stanford questionnaire, the Hypomania Checklist (HCL-32), the Patient Health Questionnaire-9 (PHQ-9), the Fagerström Test for Nicotine Dependence, Alcohol Use Disorder Identification Test (AUDIT), Symptom Checklist-90-Revised inventory (SCL-90R), early trauma inventory self report-short form, and the World Health Organization quality of life abbreviated scale (WHOQOL-Bref). Associations were adjusted to potential confounders through multivariable models. RESULTS: For our survey, 7639 participants took part (71.3% females; age: 27.2±7.9 years). The prevalence of SPD was 3.4% (95% CI: 3.0-3.8%), with a female preponderance (P<0.001). In addition, SPD was associated with a positive screen for a major depressive episode, nicotine dependence, and alcohol dependence, as well as suicidal ideation. Physical and psychological QoL was significantly more impaired in participants with SPD compared to those without SPD, even after adjustment for comorbidity. CONCLUSIONS: In this large sample, SPD was a prevalent condition associated with co-occurring depression, nicotine, and alcohol dependence. In addition, SPD was independently associated with impaired physical and psychological QoL. Public health efforts toward the early recognition and treatment of SPD are warranted.
Assuntos
Depressão/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Qualidade de Vida , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Feminino , Humanos , Masculino , PrevalênciaRESUMO
It is estimated that between 1.7 and 2.6 million people have had intermittent explosive disorder (IED) during their life in the United States alone. Co-occurring psychiatric disorders are very common in IED, being major depressive disorder arguably the most common. The objective of this study was to examine the clinical correlates of IED and depressive manifestations in 74 treatment-seeking subjects. After controlling for confounders, there were associations between major depressive disorder and severity of depressive symptoms, and (a) higher assault scores, (b) more severe hostile behavior and (c) worse social adjustment. Management of depressive symptoms may be an important for IED treatment.
Assuntos
Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Comorbidade , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estados Unidos , Adulto JovemRESUMO
OBJECTIVES: Impulse control disorder (ICD) is a common adverse effect in patients with Parkinson disease who receive dopamine agonists; however, other factors are involved in its manifestations. To study the frequency and factors involved in the development of this adverse effect in a Latin American population, we conducted a cross-sectional multicenter study. METHODS: Two hundred fifty-five patients in 3 Latin American centers were evaluated by examination and application of scales (Unified Parkinson's Disease Rating Scale, Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale, Hoehn and Yahr, Clinical Impression of Severity Index for Parkinson's Disease). RESULTS: Of the patients, 27.4% had ICD, most of whom were on dopamine agonists. Other associated risk factors included a younger age at onset of Parkinson disease, moderate symptoms, a shorter evolution of the clinical manifestations, rapid eye movement (REM) sleep disorder behavior, and the consumption of tea, mate, and alcohol. CONCLUSIONS: The frequency of ICD is higher in Latin America than in Anglo-Saxon populations. Consuming tea and mate, in addition to the use of dopamine agonists, is a factor that may demonstrate a genetic link that predisposes patients to the establishment of an ICD.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/induzido quimicamente , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Agonistas de Dopamina/efeitos adversos , Doença de Parkinson/epidemiologia , Idoso , Estudos Transversais , Transtornos Disruptivos, de Controle do Impulso e da Conduta/complicações , Feminino , Humanos , América Latina/epidemiologia , Masculino , Doença de Parkinson/tratamento farmacológico , Fatores de RiscoRESUMO
INTRODUCTION: Intermittent explosive disorder (IED) is aan externalizing externalising disorder characterized characterised by recurrent aggression episodes. Even though this disorder was described several decades ago, and it carries personal and social consequences, there is little in the medical scientific literature on this. bibliographic production about it is scanty. OBJECTIVE: To perform a conceptualization conceptualisation of this disorder, through the review and bibliometric analysis of the available scientific articles. MATERIAL AND METHODS: A search was performed in databases with the english English terms intermittent explosive disorder, impulse disorders control [MeSH], in combination with other terms. A bibliometric analysis in the GoPubMed® search engineer was also performed using all data obtained in the search. was also perfomed. DISCUSSION: IED prevalence ranges from 1.4% to 7%, it presents more frequently during middle adolescence, and with more noticeable repercussions in men males than in womenfemales. The psychopathological core of IED is the impulsive aggressive behaviour that presents in the form of «attacks¼ that occurs in response to a lower precipitating stimulus. Scientific publications about IED are few and relatively recent, and the vast majority is provided bycomes from the United States (56.56%), and headed by a single author. This fact highlights the need to replicate the findings described about the IED in order to demonstrate the validity and reliability of its diagnostic criteria. It is possible that doubts about the existence of a diagnosis lead have led to such a scant literature about the IED. CONCLUSIONS: Available studies about IED allow have allowed characterizing a group of subjects with episodes of impulsive aggression to be characterised, but this description requires replication in different latitudesneeds to be repeated in different areas.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Bibliometria , Terapia Combinada , Diagnóstico Diferencial , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/fisiopatologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/terapia , Saúde Global , Humanos , Psicoterapia , Psicotrópicos/uso terapêuticoRESUMO
INTRODUCTION: Parkinson's disease is characterized by a broad spectrum of neuropsychiatric manifestations. Its pathophysiology has been associated with the disease itself as well as with the dopaminergic treatment. MATERIAL AND METHODS: A cross-sectional study was conducted in drug-naive patients with early Parkinson's disease. All participants were evaluated through a set of scales for specific neuropsychiatric symptoms including: cognition, depression, anxiety, apathy, psychosis, and impulse control disorder. RESULTS: A total of 63 patients with Parkinson were included, of whom 26 (41.3%) subjects had some degree of cognitive impairment; seven (11.1%) had depression and 11 (15.8%) subjects had anxiety. Regarding the other symptoms, a total of 12 (19%) patients showed apathy, seven (11.1%) had psychosis, and eight (12.6%) patients had symptoms related to impulse control disorders. CONCLUSION: Neuropsychiatric disorders are common in drug-naive patients with early Parkinson's disease. Given the impact of these symptoms on quality of life, identification and proper treatment is essential.
Assuntos
Transtornos Cognitivos/epidemiologia , Transtornos Mentais/epidemiologia , Doença de Parkinson/complicações , Qualidade de Vida , Idoso , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos Cognitivos/etiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/etiologia , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Transtornos Mentais/fisiopatologia , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Doença de Parkinson/psicologia , Prevalência , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/etiologiaRESUMO
BACKGROUND: Impulse control disorders (ICDs) are a relatively recent addition to the behavioral spectrum of PD-related non-motor symptoms. Social and economic factors may play a role on the ICD phenotype of PD patients. OBJECTIVE: The aim of this study is to determine the prevalence and characterize the clinical profile of ICDs in a sample of low-income, low-education PD patients with no social security benefits from a Latin American country. METHODS: We included 300 consecutive PD patients and 150 control subjects. The presence of ICD and related disorders was assessed using a structured interview. After the interview and neurological evaluation were concluded, all subjects completed the Questionnaire for Impulsive-compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). RESULTS: Regarding ICDs and related disorders (hobbyism-punding), 25.6% (n = 77) of patients in the PD group and 16.6% (n = 25) in the control group fulfilled criteria for at least one ICD or related disorder (p = 0.032). There was a statistically significant difference in the QUIP-RS mean score between PD and control subjects (5.6 ± 9.7 and 2.7 ± 4.21, p = 0.001). The most common ICD was compulsive eating for both PD (8.6%) and control (2.6%) groups. CONCLUSIONS: The results of this study confirm that for this population, symptoms of an ICD are significantly more frequent in PD subjects than in control subjects. Nevertheless, socioeconomic differences may contribute to a lower overall frequency and distinct pattern of ICDs in PD patients compared with what has been reported in other countries.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/etiologia , Doença de Parkinson/psicologia , Idoso , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Fatores SocioeconômicosRESUMO
BACKGROUND: Previous studies have described the association between dopamine replacement therapy in Parkinson's disease and impulse control disorders. METHODS: A case-control study was performed to establish the prevalence of four of these behaviors in Brazilian patients with Parkinson's disease on stable dopamine replacement therapy and the possible associated risk factors. We investigated 152 patients and 212 healthy controls for pathological gambling, compulsive sexual behavior and compulsive buying and eating. RESULTS: Overall, patients had more impulsive control disorders than controls (18.4% vs. 4.2%, P < 0.001). Impulse control disorders were more common in younger patients (P = 0.008) and in those taking dopamine agonist (P < 0.001) and levodopa (P = 0.02). Higher Unified Parkinson's Disease Rating Scale motor score (P = 0.03) and past smoking (P = 0.02) were also associated in the univariate analysis. Variables independently associated with impulse control disorders were history of smoking (odds ratio = 1.059 for each year of smoking, P = 0.010) and current use of pramipexole (odds ratio = 2.551 for each increase in 1 mg, P < 0.001). CONCLUSIONS: Dopaminergic stimulation and previous exposure to smoking are independently associated with impulse control disorders in a dose-dependent manner.
Assuntos
Agonistas de Dopamina/uso terapêutico , Comportamento Impulsivo/tratamento farmacológico , Comportamento Impulsivo/etiologia , Doença de Parkinson/complicações , Fumar/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antiparkinsonianos/uso terapêutico , Estudos de Casos e Controles , Transtornos Disruptivos, de Controle do Impulso e da Conduta/complicações , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Relação Dose-Resposta a Droga , Feminino , Humanos , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/epidemiologia , Índice de Gravidade de Doença , Fumar/epidemiologiaRESUMO
OBJECTIVE: The object of this study is to establish the correlates of the phenomenology of conflict and power management in the Jamaican population. METHODS: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed using the 12 questions of the Jamaica Personality Disorder Inventory (JPDI) on the phenomenology of conflict and power management that are grouped into the psychological features of aggressive social behaviour, unlawful behaviour, socially unacceptable behaviour and financial transgressive behaviour. The database of responses to the demographic and JPDI questionnaires was created and analysed using the Statistical Package for the Social Sciences (SPSS) version 17. RESULTS: Of the national population sampled, 69.1% denied having any phenomenological symptoms of abnormal power management relations while 30.9% of the population admitted to having some degree of conflict and power management, ranging from mild (10.3%), to moderate (17.1), or severe (3.5%). There were 46.55% of the population which had problems with aggressive social behaviour, 9.33% had problems with unlawful behaviour, 9.58% had problems with unacceptable social behaviour and 37.74% had problems with financial transgressive behaviour. Significant gender and socio-economic class patterns for conflict and power management were revealed. This pattern of conflict and power management behaviour is critical in understanding the distinction between normal and abnormal expression of these emotions and actions. CONCLUSION: Nearly one-third of the sample population ` studied reported problems with conflict, abnormal power and authority management, impulse control and serious aggressive and transgressive behaviour.
Assuntos
Agressão/psicologia , Conflito Psicológico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Poder Psicológico , Adolescente , Adulto , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: The object of this study is to establish the correlates of the phenomenology of conflict and power management in the Jamaican population. METHODS: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed using the 12 questions of the Jamaica Personality Disorder Inventory (JPDI) on the phenomenology of conflict and power management that are grouped into the psychological features of aggressive social behaviour, unlawful behaviour, socially unacceptable behaviour and financial transgressive behaviour. The database of responses to the demographic and JPDI questionnaires was created and analysed using the Statistical Package for the Social Sciences (SPSS) version 17. RESULTS: Of the national population sampled, 69.1% denied having any phenomenological symptoms of abnormal power management relations while 30.9% of the population admitted to having some degree of conflict and power management, ranging from mild (10.3%), to moderate (17.1), or severe (3.5%). There were 46.55% of the population which had problems with aggressive social behaviour, 9.33% had problems with unlawful behaviour, 9.58% had problems with unacceptable social behaviour and 37.74% had problems with financial transgressive behaviour. Significant gender and socio-economic class patterns for conflict and power management were revealed. This pattern of conflict and power management behaviour is critical in understanding the distinction between normal and abnormal expression of these emotions and actions. CONCLUSION: Nearly one-third of the sample population studied reported problems with conflict, abnormal power and authority management, impulse control and serious aggressive and transgressive behaviour.
OBJETIVO: El objeto de este estudio es establecer los correlatos de la fenomenología del manejo de conflicto y poder en la población jamaicana. MÉTODOS: Se tomaron muestras de un total de 1506 individuos adultos de 2150 hogares, usando un método de muestreo estratificado, y se evaluaron usando las 12 preguntas del Inventario de Trastornos de la Personalidad en Jamaica (JPDI) sobre la fenomenología del manejo del conflicto y el poder, clasificadas como características psicológicas del comportamiento social agresivo, comportamiento ilícito, comportamiento socialmente inaceptable, y conducta financiera transgresora. La base de datos de respuestas a los cuestionarios de demografía y JPDI, fue creada y analizada utilizando el Paquete Estadístico para Ciencias Sociales (SPSS) versión 17. RESULTADOS: El 69.1% de la población nacional muestreada negó tener síntoma fenomenológico alguno de relaciones de poder anormal, mientras que el 30.9% de la población admitía haber tenido algún grado de manejo de conflicto y poder, fluctuando de leve (10.3%) a moderado (17.1), o severo (3.5%). Hubo 46.55% de la población con problemas de comportamiento social agresivo, 9.33% tuvo problemas de comportamiento ilegal, 9.58% tenían problemas de comportamiento social inaceptable, y 37.74% tuvo problemas de comportamiento financiero transgresor. Se pusieron de manifiesto de forma significativa patrones de género y clase socioeconómica con respecto al manejo de conflicto y poder. Este patrón de comportamiento de manejo de conflicto y poder es un factor crítico para entender la distinción entre la expresión normal y anormal de estas emociones y acciones. CONCLUSIÓN: Casi un tercio de la población de la muestra estudiada reportó problemas con el manejo de conflicto, poder anormal y autoridad, control de impulsos, y serio comportamiento agresivo y transgresor.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Transtornos da Personalidade/psicologia , Poder Psicológico , Conflito Psicológico , Agressão/psicologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade , Inquéritos e Questionários , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Jamaica/epidemiologiaRESUMO
Background: Since Internet made its first appearance for the general public, and its thereafter growth, different emerging health issues have been described. The discussion has taken place not only in the mass media, but also in the academy, initially with case reports of abuse and dependence, and now that it has been considered as a new diagnosis in the not yet finished DSM-V, either as another category within the substance abuse, or another one more related to the impulse control disorders. Methods: A systematic review of the published literature about the subject was done using related MESH terms: "Internet", "Behavior, Addictive", "Impulse Control Disorders" e "Impulsive Behavior" between 2006 and march 2012. Results: The prevalence of Internet abuse and dependence has been difficult to determine because of the lack of consensus in the diagnostic criteria. As other psychiatric entities, genetic and psychological risk factors could be involved, as well as it could be associated with other comorbidities such as mood disorders, anxiety disorders, ADHD, alcohol abuse and eating disorders. Neuroimaging studies have shown evidence of neurobiological similarities with the structures involved in substance dependence. Conclusion: For answering many of these queries specific terminology is required, in order to validate new instruments for diagnosis and follow up as well, in order to in the future describe the risk factors, natural history and treatment alternatives for this emerging disease.
Introducción: Junto con la aparición de internet, ha ido cobrando interés problemas de salud emergentes asociados al uso de las nuevas tecnologías. La discusión no sólo se ha dado en los medios de comunicación, sino también a nivel académico. Inicialmente asociado al reporte de casos de "adicción a internet", para luego llegar al punto de incluso considerar su incorporación al futuro DSM-V, ya sea homologando el fenómeno a la adicción a substancias, o como un fenómeno emparentado con los trastornos por control de impulsos. Método: Se realizó una revisión sistemática de la literatura publicada sobre el tema utilizando los términos MESH afines: "Internet", "Behavior, Addictive", "Impulse Control Disorders" e "Impulsive Behavior" que se hubieran indexado desde el 2006 a marzo de 2012. Resultados: La prevalencia del abuso y dependencia a internet ha sido difícil de esclarecer por falta de consenso en los criterios diagnósticos. Tal como en otras entidades psiquiátricas podrían existir predisponentes genéticos y psicológicos así como asociación con comorbilidades tales como trastornos del ánimo, trastornos ansiosos, síndrome de déficit atencional e hiperactividad, abuso de alcohol y trastornos alimentarios. Pareciera haber correlato neurobiológico, demostrado en neuroimágenes, con las conocidas adicciones químicas. En cuanto al tratamiento, al no haber instrumentos para medir la respuesta, aún no existe evidencia de eficacia terapéutica. Conclusión: Para esclarecer muchas de estas dudas aún no resueltas hace falta terminología específica e instrumentos validados para diagnosticar y seguir a estos pacientes, para de esta manera describir sus factores de riesgo, curso natural y alternativas de tratamiento.
Assuntos
Humanos , Comportamento Impulsivo/epidemiologia , Internet , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Comportamento Aditivo , Comorbidade , Comportamento Impulsivo/terapia , Dependência Psicológica , Prevalência , Transtornos Disruptivos, de Controle do Impulso e da Conduta/terapiaRESUMO
The objective of this study was to compare patients with obsessive-compulsive disorder (OCD) associated with pathologic skin picking (PSP) and/or trichotillomania, and patients with OCD without such comorbidities, for demographic and clinical characteristics. We assessed 901 individuals with a primary diagnosis of OCD, using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I disorders. Diagnoses of PSP and trichotillomania were made in 16.3% and 4.9% of the sample, respectively. After the logistic regression analysis, the following factors retained an association with OCD-PSP/trichotillomania: younger (odds ratio [OR] = 0.979; P = .047), younger at the onset of compulsive symptoms (OR = 0.941; P = .007), woman (OR = 2.538; P < .001), with a higher level of education (OR = 1.055; P = .025), and with comorbid body dysmorphic disorder (OR = 2.363; P = .004). These findings support the idea that OCD accompanied by PSP/trichotillomania characterizes a specific subgroup.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Tricotilomania/epidemiologia , Adulto , Distribuição por Idade , Transtornos Dismórficos Corporais/epidemiologia , Brasil/epidemiologia , Estudos de Casos e Controles , Comorbidade , Estudos Transversais , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Educação , Feminino , Humanos , Modelos Logísticos , Masculino , Transtorno Obsessivo-Compulsivo/psicologia , Prevalência , Distribuição por Sexo , Tricotilomania/psicologiaRESUMO
OBJECTIVE: To study the impact of mental disorders on failure in educational attainment in Mexico. METHODS: Diagnoses and age of onset for each of 16 DSM-IV disorders were assessed through retrospective self-reports with the Composite International Diagnostic Instrument (CIDI) during fieldwork in 2001-2002. Survival analysis was used to examine associations between early onset DSM-IV/CIDI disorders and subsequent school dropout or failure to reach educational milestones. RESULTS: More than one of two Mexicans did not complete secondary education. More than one-third of those who finished secondary education did not enter college, and one of four students who entered college did not graduate. Impulse control disorders and substance use disorders were associated with higher risk for school dropout, secondary school dropout and to a lesser degree failure to enter college. Anxiety disorders were associated with lower risk for school dropout, especially secondary school dropout and, to a lesser degree, primary school dropout. CONCLUSIONS: The heterogeneity of results found in Mexico may be due to the effect of mental disorders being diminished or masked by the much greater effect of economic hardship and low cultural expectations for educational achievement. Future research should inquire deeper into possible reasons for the better performance of students with anxiety disorders in developing countries.
OBJETIVO: Estudiar la repercusión de los trastornos mentales en el fracaso escolar en México. MÉTODOS: De septiembre del 2001 a mayo del 2002, se evaluaron los diagnósticos y la edad de aparición para cada uno de los 16 trastornos del DSM-IV mediante autoinformes retrospectivos recogidos por medio de la Entrevista Diagnóstica Internacional Compuesta (CIDI). Se empleó el anßlisis de supervivencia para analizar las asociaciones entre los trastornos del DSM-IV/CIDI de aparición temprana y el subsiguiente abandono escolar o fracaso en el logro de los hitos educativos. RESULTADOS: Mßs de uno de cada dos mexicanos no completó la educación secundaria. Mßs de una tercera parte de los que terminaron la educación secundaria no entraron en la universidad y uno de cada cuatro estudiantes que entraron el la universidad no llegó a graduarse. Los trastornos de control de los impulsos y los trastornos relacionados con el consumo de sustancias se asociaron con un mayor riesgo de abandono escolar, principalmente de abandono de la escuela secundaria y, en menor grado, de fracaso en entrar en la universidad. Los trastornos de ansiedad se asociaron con un menor riesgo de abandono escolar, especialmente de abandono de la escuela secundaria y, en menor grado, de la escuela primaria. CONCLUSIONES: La heterogeneidad de los resultados observados en México puede deberse a que el efecto de los trastornos mentales queda disminuido u oculto ante el efecto mucho mayor de las dificultades económicas y las reducidas expectativas culturales en cuanto al rendimiento escolar. En el futuro, la investigación debe inquirir mßs a fondo las posibles razones con objeto de mejorar el desempe±o de los estudiantes aquejados de trastornos de ansiedad en los países en desarrollo.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transtornos Mentais/epidemiologia , Evasão Escolar/psicologia , Idade de Início , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Maus-Tratos Infantis , Estudos Transversais , Países em Desenvolvimento , Violência Doméstica , Escolaridade , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Transtornos Mentais/psicologia , México/epidemiologia , Motivação , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Pobreza , Fatores Socioeconômicos , Evasão Escolar/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
BACKGROUND: Suicidal thoughts and behaviors, also known as suicidality, are a fairly neglected area of study in patients with obsessive-compulsive disorder (OCD). OBJECTIVE: To evaluate several aspects of suicidality in a large multicenter sample of OCD patients and to compare those with and without suicidal ideation, plans, and attempts according to demographic and clinical variables, including symptom dimensions and comorbid disorders. METHOD: This cross-sectional study included 582 outpatients with primary OCD (DSM-IV) recruited between August 2003 and March 2008 from 7 centers of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. The following assessment instruments were used: the Yale-Brown Obsessive Compulsive Scale, the Dimensional Yale-Brown Obsessive Compulsive Scale, the Beck Depression and Anxiety Inventories, the Structured Clinical Interview for DSM-IV Axis I Disorders, and 6 specific questions to investigate suicidality. After univariate analyses, logistic regression analyses were performed to adjust the associations between the dependent and explanatory variables for possible confounders. RESULTS: Thirty-six percent of the patients reported lifetime suicidal thoughts, 20% had made suicidal plans, 11% had already attempted suicide, and 10% presented current suicidal thoughts. In the logistic regression, only lifetime major depressive disorder and posttraumatic stress disorder (PTSD) remained independently associated with all aspects of suicidal behaviors. The sexual/religious dimension and comorbid substance use disorders remained associated with suicidal thoughts and plans, while impulse-control disorders were associated with current suicidal thoughts and with suicide plans and attempts. CONCLUSIONS: The risk of suicidal behaviors must be carefully investigated in OCD patients, particularly those with symptoms of the sexual/religious dimension and comorbid major depressive disorder, PTSD, substance use disorders, and impulse-control disorders.
Assuntos
Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Adulto , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtorno Obsessivo-Compulsivo/psicologia , Inventário de Personalidade , Prevalência , Religião e Psicologia , Fatores de Risco , Comportamento Sexual/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To study the impact of mental disorders on failure in educational attainment in Mexico. METHODS: Diagnoses and age of onset for each of 16 DSM-IV disorders were assessed through retrospective self-reports with the Composite International Diagnostic Instrument (CIDI) during fieldwork in 2001-2002. Survival analysis was used to examine associations between early onset DSM-IV/CIDI disorders and subsequent school dropout or failure to reach educational milestones. RESULTS: More than one of two Mexicans did not complete secondary education. More than one-third of those who finished secondary education did not enter college, and one of four students who entered college did not graduate. Impulse control disorders and substance use disorders were associated with higher risk for school dropout, secondary school dropout and to a lesser degree failure to enter college. Anxiety disorders were associated with lower risk for school dropout, especially secondary school dropout and, to a lesser degree, primary school dropout. CONCLUSIONS: The heterogeneity of results found in Mexico may be due to the effect of mental disorders being diminished or masked by the much greater effect of economic hardship and low cultural expectations for educational achievement. Future research should inquire deeper into possible reasons for the better performance of students with anxiety disorders in developing countries.
Assuntos
Transtornos Mentais/epidemiologia , Evasão Escolar/psicologia , Adolescente , Idade de Início , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Criança , Maus-Tratos Infantis , Fatores de Confusão Epidemiológicos , Estudos Transversais , Países em Desenvolvimento , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Violência Doméstica , Escolaridade , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , México/epidemiologia , Motivação , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Pobreza , Fatores Socioeconômicos , Evasão Escolar/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
BACKGROUND: Prior studies have reported that psychiatric disorders are among the strongest predictors of suicidal behavior (i.e., suicide ideation, plans, and attempts). However, surprisingly little is known about the independent associations between each disorder and each suicidal behavior due to a failure to account for comorbidity. METHODS: This study used data from a representative sample of 5782 respondents participating in the Mexican National Comorbidity Survey (2001-2002) to examine the unique associations between psychiatric disorders and suicidality. RESULTS: A prior psychiatric disorder was present in 48.8% of those with a suicide ideation and in 65.2% of those with an attempt. Discrete-time survival models adjusting for comorbidity revealed that conduct disorder and alcohol abuse/dependence were the strongest predictors of a subsequent suicide attempt. Most disorders predicted suicidal ideation but few predicted the transition from ideation to a suicide plan or attempt. LIMITATIONS: M-NCS is a household survey that excluded homeless and institutionalized people, and the diagnostic instrument used did not include an assessment of all DSM-IV disorders which would increase the comorbidity discussed here. CONCLUSIONS: These results reveal a complex pattern of associations in which diverse psychiatric disorders impact different parts of the pathway to suicide attempts. These findings will help inform clinical and public health efforts aimed at suicide prevention in Mexico and other developing countries.
Assuntos
Comparação Transcultural , Transtornos Mentais/etnologia , Transtornos Mentais/epidemiologia , Tentativa de Suicídio/etnologia , Adolescente , Adulto , Idoso , Alcoolismo/epidemiologia , Alcoolismo/etnologia , Alcoolismo/psicologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etnologia , Transtornos de Ansiedade/psicologia , Comorbidade , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/etnologia , Transtorno da Conduta/psicologia , Estudos Transversais , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/etnologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos Mentais/psicologia , México , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/etnologia , Transtornos do Humor/psicologia , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Adulto JovemRESUMO
A community survey in 4,426 adults was undertaken as part of the World Mental Health Survey Initiative reporting the prevalence and risk factors for suicide-related outcomes in Colombia. Lifetime prevalence estimates of suicide ideation, plans, attempts, and risk factors for suicide-related outcomes were assessed. Retrospective reports of disorders age-of-onset were used to study associations between primary mental disorders and first onset of suicide-related outcomes. Risks of plans and attempts were highest with ideation early age-of-onset and within the first year. The highest risk for ideation and attempt among ideators occurred in the 18-29 age group. After first employment (defined as the first paid job accepted by the respondent) and presence of mental disorders constituted risk factors. Impulse-control disorders were strongest diagnostic predictors.
Assuntos
Transtornos Mentais/epidemiologia , Prevenção do Suicídio , Adolescente , Adulto , Idade de Início , Idoso , Colômbia/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/estatística & dados numéricosRESUMO
PURPOSE OF REVIEW: To review research results on the relationship between pathological gambling and criminality, published in 2007 and 2008, in English and in Spanish. RECENT FINDINGS: An important association between pathological gambling and criminality was confirmed in populations of anonymous gamblers, helpline callers and substance abusers. Helplines provide a timely service to gamblers who have not reached the maximum stages in the development of a pathological gambling pattern. Pathological gambling is associated with violence in couples and dysfunctional families. Inversely, violence is also an antecedent promoting vulnerability toward pathological gambling. Impulsiveness shows diverse relationships with pathological gambling and violence as well. A pathological gambler's involvement in crime is exceptionally considered without responsibility by justice, but it may be an indicator of the disorder severity and the need for special therapeutic tactics. SUMMARY: While reviewing the present study, research work was published that contributed to a better understanding of the association between pathological gambling and criminality and went further into their complex relationship and the formulation of explanatory models related to impulsiveness.