Revista Brasileira De Psiquiatria
CONCLUSION: The adolescents identified as victims did not generally attack other students, i.e., did not identify themselves as perpetrators. The high prevalence of maltreatment and bullying detected in this study, especially the verbal, social, and physical types, underscores the need for interventions addressing bullying in schools. PMID: 31188920 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - June 10, 2019 Category: Psychiatry Authors: Reisen A, Viana MC, Santos-Neto ETD Tags: Braz J Psychiatry Source Type: research
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Revista Brasileira de Psiquiatria's journal/conference profile on Publons, with 128 reviews by 59 reviewers - working with reviewers, publishers, institutions, and funding agencies to turn peer review into a measurable research output.
CONCLUSION: Specific FRS may predict remission after treatment in FEP patients. This finding could give new importance to Kurt Schneider's classic work by contributing to future updates of diagnostic protocols and improving estimation of prognosis. PMID: 31166544 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - May 30, 2019 Category: Psychiatry Authors: Malinowski FR, Tasso BC, Ortiz BB, Higuchi CH, Noto C, Belangero SI, Bressan RA, Gadelha A, Cordeiro Q Tags: Braz J Psychiatry Source Type: research
Abstract OBJECTIVE: Although studies have shown an association between poor sleep and chronotype with psychiatric problems in young adults, few have focused on identifying multiple concomitant risk factors. METHODS: We assessed depressive symptoms (Beck Depression Inventory [BDI]), circadian typology (Morningness-Eveningness Questionnaire [MEQ]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), perceived stress (Perceived Stress Scale [PSS]), social rhythm (Social Rhythm Metrics [SRM]), and salivary cortisol (morning, evening and night, n=37) in 236 men (all 18 years old). Separate analyses were conduct...
Source: Revista Brasileira de Psiquiatria - May 30, 2019 Category: Psychiatry Authors: Tonon AC, Carissimi A, Schimitt RL, de Lima LS, Pereira FDS, Hidalgo MP Tags: Braz J Psychiatry Source Type: research
Abstract OBJECTIVE: The relationship between biomarkers of amyloid-beta aggregation (Aβ1-42) and/or neurodegeneration (Tau protein) in cerebrospinal fluid (CSF) and cognitive decline is still unclear. We aimed to ascertain whether CSF biomarkers correlate with cognitive performance in healthy and cognitively impaired subjects, starting from clinical diagnoses. METHODS: We tested for correlation between CSF biomarkers and Mini-Mental State Examination (MMSE) scores in 208 subjects: 54 healthy controls, 82 with mild cognitive impairment (MCI), 46 with Alzheimer's disease (AD), and 26 with other dementias (...
Source: Revista Brasileira de Psiquiatria - May 30, 2019 Category: Psychiatry Authors: Radanovic M, Oshiro CA, Freitas TQ, Talib LL, Forlenza OV Tags: Braz J Psychiatry Source Type: research
CONCLUSION: These protocols were considered safe and add interesting new evidence to the growing body of mPFC rTMS literature. However, the small number and low methodological quality of the studies indicate the need for further research. PMID: 31166547 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - May 30, 2019 Category: Psychiatry Authors: Marques RC, Vieira L, Marques D, Cantilino A Tags: Braz J Psychiatry Source Type: research
ani H Abstract OBJECTIVE: Cocaine use disorders (CUDs) represent a major public health problem in many countries. To better understand the interaction between the environmental modulations and phenotype, the aim of the present study was to investigate the DNA methylation pattern of CUD patients, who had concomitant cocaine and crack dependence, and healthy controls. METHODS: We studied DNA methylation profiles in the peripheral blood of 23 CUD patients and 24 healthy control subjects using the Illumina Infinium HumanMethylation450 BeadChip arrays. RESULTS: Comparison between CUD patients and controls rev...
Source: Revista Brasileira de Psiquiatria - May 16, 2019 Category: Psychiatry Authors: Camilo C, Maschietto M, Vieira HC, Tahira AC, Gouveia GR, Feio Dos Santos AC, Negrão AB, Ribeiro M, Laranjeira R, Vallada H, Brentani H Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: Longitudinal neuroimaging studies with larger samples of both juvenile and adult GAD patients, as well as at risk individuals and unaffected relatives, should be carried out in order to shed light on the specific biological signature of GAD. PMID: 31116259 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - May 16, 2019 Category: Psychiatry Authors: Madonna D, Delvecchio G, Soares JC, Brambilla P Tags: Braz J Psychiatry Source Type: research
Abstract Cannabis is the most commonly used illegal drug, and is associated with well-documented adverse health outcomes, both acute and chronic. Cannabis use prevalence in Brazil is lower than in high-use regions in the Americas (e.g., North America), but concentrated among young people. Frameworks for cannabis control are increasingly shifting towards public health-oriented principles, with some countries undertaking respective policy reforms. These frameworks require a continuum of population-level interventions (e.g., prevention and treatment) including targeted prevention of adverse health outcomes among user...
Source: Revista Brasileira de Psiquiatria - May 16, 2019 Category: Psychiatry Authors: Fischer B, Malta M, Messas G, Ribeiro M Tags: Braz J Psychiatry Source Type: research
CONCLUSION: In this secondary analysis of a primary efficacy study, PD was a common comorbidity among those with MDD, but was not a significant predictor of functional outcomes. This study adds to the limited literature on PD in randomized controlled trials for MDD. CLINICAL TRIAL REGISTRATION: ACTRN12612000283875. PMID: 31116261 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - May 16, 2019 Category: Psychiatry Authors: Kavanagh BE, Williams LJ, Berk M, Turner A, Jackson HJ, Mohebbi M, Kanchanatawan B, Ashton MM, Ng CH, Maes M, Berk L, Malhi GS, Dowling N, Singh AB, Dean OM Tags: Braz J Psychiatry Source Type: research
CONCLUSION: MBSR combined with MT significantly alleviated clinical symptoms, and could be considered a new, effective psychotherapeutic intervention for patients with osteosarcoma. PMID: 31116262 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - May 16, 2019 Category: Psychiatry Authors: Liu H, Gao X, Hou Y Tags: Braz J Psychiatry Source Type: research
Authors: Abstract [This corrects the article doi: 10.1590/1516-4446-2018-0221]. PMID: 31116263 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - May 16, 2019 Category: Psychiatry Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: Non-authoritative parenting style and parental drunkenness seem to play an important role in adolescents' binge drinking behavior. At the population level, parenting style appears associated with a greater contribution to this behavior among adolescents. Prevention strategies targeting parental drunkenness may be bolstered if a broader approach including parenting styles is in place. PMID: 30994851 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - April 15, 2019 Category: Psychiatry Authors: Zuquetto CR, Opaleye ES, Feijó MR, Amato TC, Ferri CP, Noto AR Tags: Braz J Psychiatry Source Type: research
CONCLUSION: This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders. PMID: 30994852 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - April 15, 2019 Category: Psychiatry Authors: Işık-Ulusoy S Tags: Braz J Psychiatry Source Type: research
Abstract OBJECTIVE: To test the reliability and the discriminant and convergent validity of the abbreviated Brazilian Portuguese World Health Organization's Quality of Life Instrument - Spirituality, Religion, and Personal Beliefs module (WHOQOL-SRPB BREF). METHODS: In a sample of 404 individuals, we applied a general questionnaire, the WHOQOL-BREF, the long-form SRPB, the Brief Religious-Spiritual Coping Scale (RCOPE), and the Beck Depression Inventory (BDI). Priority was given to the 9-item SRPB assessment: its unidimensionality was tested through confirmatory factor analysis and Rasch analysis. RESULT...
Source: Revista Brasileira de Psiquiatria - April 15, 2019 Category: Psychiatry Authors: Zimpel RR, Panzini RG, Bandeira DR, Fleck MP, da Rocha NS Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: Female medical students had lower QoL scores in the physical health and psychological domains of WHOQOL-Bref compared to male students. Specific interventions should be designed for this group as appropriate. SYSTEMATIC REVIEW REGISTRY NUMBER: PROSPERO CRD-42018102259. PMID: 30994854 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - April 15, 2019 Category: Psychiatry Authors: Solis AC, Lotufo-Neto F Tags: Braz J Psychiatry Source Type: research
Abstract OBJECTIVE: To analyze the efficacy and safety of paliperidone palmitate 3-monthly (PP3M) in Latin American patients with schizophrenia vs. rest-of-world (ROW). METHODS: We analyzed data from two multinational, double-blind (DB), randomized, controlled phase 3 studies including patients with schizophrenia (DSM-IV-TR) previously stabilized on PP1M/PP3M (open-label [OL] phase). Patients were randomized to PP3M or PP1M (noninferiority study A) and PP3M or placebo (study B) in DB phase. The subgroup analysis included Latin American (Argentina, Brazil, Colombia, Mexico) patients. Primary efficacy endpoints...
Source: Revista Brasileira de Psiquiatria - April 15, 2019 Category: Psychiatry Authors: Savitz AJ, Xu H, Gopal S, Nuamah I, Mathews M, Soares B Tags: Braz J Psychiatry Source Type: research
CONCLUSION: In developing countries, the use of resilience factors based only on years of education may be misleading. Sociocultural issues influence the educational system and achievement and, consequently, affect the use of this simple measure. Resilience-factor studies should consider using crystallized abilities when studying populations with sociocultural particularities. PMID: 30994856 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - April 15, 2019 Category: Psychiatry Authors: Bertola L, Ávila RT, Bicalho MAC, Malloy-Diniz LF Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: In general, contextual variables, within each Brazilian state, do not seem to affect the prevalence of MDE and suicidal thoughts. PMID: 30994857 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - April 15, 2019 Category: Psychiatry Authors: Carpena MX, Martins-Silva T, Costa FS, Darley R, Loret de Mola C Tags: Braz J Psychiatry Source Type: research
CONCLUSION: A combination of environmental stressors (HAB and PSD) may induce endophenotypes related to bipolar disorder. PMID: 30892378 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - March 14, 2019 Category: Psychiatry Authors: Rabelo-da-Ponte FD, Pessoa Gomes JM, Torres NL, Barbosa JIC, de Andrade GM, Macedo D, Ceppi B Tags: Braz J Psychiatry Source Type: research
CONCLUSION: Although Li prevented an LPS-induced increase in serum iNOS levels, its potential anti-inflammatory effects in this animal model of mania were conflicting. PMID: 30843957 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - March 7, 2019 Category: Psychiatry Authors: Bristot G, Ascoli BM, Scotton E, Géa LP, Pfaffenseller B, Kauer-Sant'Anna M Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: Gender incongruence variables were not significant predictors of distress. This result supports the recent changes proposed by the Word Health Organization in ICD-11 to move transgender conditions from the Mental and Behavioral Disorders chapter to a new chapter on Sexual Disorders and Conditions Related to Sexual Health. PMID: 30843958 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - March 7, 2019 Category: Psychiatry Authors: Lobato MI, Soll BM, Brandelli Costa A, Saadeh A, Gagliotti DAM, Fresán A, Reed G, Robles R Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: Individuals with NSSI may benefit from better management of psychiatric comorbidities, specifically depressive symptoms and social adjustment difficulties. Conversely, the treatment of individuals with IED may be improved by targeting comorbid generalized anxiety disorder. Our results provide important insight for the development of tailored interventions for specific subtypes of aggression. PMID: 30843959 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - March 7, 2019 Category: Psychiatry Authors: Medeiros GC, Seger-Jacob L, Garreto AK, Kim HS, Coccaro EF, Tavares H Tags: Braz J Psychiatry Source Type: research
CONCLUSION: If non-pharmacological strategies fail, medications are needed to control agitation and violent behavior. Once medicated, the patient should be monitored until a tranquil state is possible without excessive sedation. SYSTEMATIC REVIEW REGISTRY NUMBER: CRD42017054440. PMID: 30843960 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - March 7, 2019 Category: Psychiatry Authors: Baldaçara L, Diaz AP, Leite V, Pereira LA, Dos Santos RM, Gomes Júnior VP, Calfat ELB, Ismael F, Périco CAM, Porto DM, Zacharias CEK, Cordeiro Q, da Silva AG, Tung TC Tags: Braz J Psychiatry Source Type: research
Abstract We conducted a narrative literature review on studies that specifically addressed the pharmacokinetics of antidepressants in patients on hemodialysis. The search included the MEDLINE, LILACS, and Web of Knowledge databases and combined Medical Subject Headings and free-text search terms for chronic kidney disease, end-stage renal disease, renal replacement therapy, depression, and antidepressants; it was limited to studies conducted in humans, with no language or time constraints. The search yielded 212 studies. After screening titles and abstracts, 32 studies were read in full and 11 ultimately met the i...
Source: Revista Brasileira de Psiquiatria - March 7, 2019 Category: Psychiatry Authors: Constantino JL, Fonseca VA Tags: Braz J Psychiatry Source Type: research
CONCLUSION: AUD, cannabis and cocaine use were significantly associated with SI and SA, even after the adjustments. Public health initiatives targeting suicide prevention should consider including assessment and management of substance misuse, and therapeutic approaches to substance misuse should include assessment of suicidality. PMID: 30785535 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 18, 2019 Category: Psychiatry Authors: Abdalla RR, Miguel AC, Brietzke E, Caetano R, Laranjeira R, Madruga CS Tags: Braz J Psychiatry Source Type: research
CONCLUSION: Our findings confirm that the SIGMA-VB is a valid and reliable instrument to assess depression severity in clinical research and practice. Its interrater reliability was similar to that of a previously published Japanese version of the SIGMA. PMID: 30785536 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 18, 2019 Category: Psychiatry Authors: Fernandes F, Carneiro A, Campos RN, Soeiro-de-Souza MG, Barros VB, Moreno RA Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: Overall, these results support the use of the Y-BOCS-II among individuals from China. Future study by an independent group is necessary to replicate these findings, as well as investigate interrater reliability and treatment sensitivity. PMID: 30785537 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 18, 2019 Category: Psychiatry Authors: Zhang CC, Gong H, Zhang Y, Jin H, Yang Y, Li B, Li Y, Luo X, Liu W, Fang F, Li B, Sun B, Fletcher T, La Buissonnière-Ariza V, Goodman WK, Storch EA Tags: Braz J Psychiatry Source Type: research
CONCLUSION: Supporting an individual in FEP can have a negative impact on QoL. Maintaining caregivers' mental health and subjective evaluation of the caregiving experience must be primary goals of FEP services. Complementary studies of FEP caregivers' QoL can support the design of personalized interventions in the near future. PMID: 30785538 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 18, 2019 Category: Psychiatry Authors: Jorge RC, Cogo-Moreira H, Araripe Neto AG, Chaves AC Tags: Braz J Psychiatry Source Type: research
CONCLUSION: Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence. PMID: 30785539 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 18, 2019 Category: Psychiatry Authors: Jaen-Varas D, Mari JJ, Asevedo E, Borschmann R, Diniz E, Ziebold C, Gadelha A Tags: Braz J Psychiatry Source Type: research
CONCLUSION: Overall, 90.6% of units of analysis had a stable or increasing trend in suicide rates from 1997 to 2015. If these trends remain, most of Brazil will fail to achieve the WHO-recommended reduction in suicide rates by 2020. PMID: 30785540 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 18, 2019 Category: Psychiatry Authors: Rodrigues CD, de Souza DS, Rodrigues HM, Konstantyner TCRO Tags: Braz J Psychiatry Source Type: research
DISCUSSION: These findings offer empirical evidence supporting YSQ-SF construct validity and, consequently, its application in adults. PMID: 30785541 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 18, 2019 Category: Psychiatry Authors: Sperb W, da Silva JA, Cogo-Moreira H, Lara DR, de Carvalho HW Tags: Braz J Psychiatry Source Type: research
CONCLUSION: The hypothesis was confirmed, as we did find the groups proposed at the spectrum level of the HiTOP. We also found a compulsivity factor, encompassing the main traits from the conscientiousness dimension of IDCP-2, which is related to obsessive-compulsive PD. Finding the six groupings of traits in the HiTOP model contributes to the validity of this model, and confirms the existence of proposed spectra. PMID: 30758432 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 7, 2019 Category: Psychiatry Authors: Pianowski G, Carvalho LF, Miguel FK Tags: Braz J Psychiatry Source Type: research
CONCLUSION: Women had a higher prevalence of depression, and socioeconomic disadvantages were important for the occurrence of MDE; however, for men, only physical inactivity and stress were important predictors, suggesting possible different causal pathways for each sex. PMID: 30758433 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 7, 2019 Category: Psychiatry Authors: Carpena MX, Dumith SC, Loret de Mola C, Neiva-Silva L Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: Youth whose mothers smoke appear to have lower SRP than those whose mothers do not smoke. Living in a poor outer-city area was associated with higher SRP. PMID: 30758434 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - February 7, 2019 Category: Psychiatry Authors: Wagner GA, Sanchez ZM, Fidalgo TM, Caetano SC, Carliner H, Martins SS Tags: Braz J Psychiatry Source Type: research
CONCLUSION: This study provides evidence of an association between cyberbullying, traditional bullying and self-perceived bullying among low-income Brazilian adolescents. PMID: 30672967 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - January 17, 2019 Category: Psychiatry Authors: Vieira MA, Rønning JA, Mari JJ, Bordin IA Tags: Braz J Psychiatry Source Type: research
PMID: 30672968 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - January 17, 2019 Category: Psychiatry Authors: Stein DJ, Reed GM Tags: Braz J Psychiatry Source Type: research
CONCLUSIONS: The findings of this study contradict the standard of care for mild and moderate AD in Brazil, which is based on rivastigmine. A pharmacological treatment option based on current Brazilian clinical practice guidelines for AD suggests that rivastigmine is less cost-effective (0.39 QALY/BRL 32,685.77) than donepezil. Probabilistic analysis indicates that donepezil is the most cost-effective treatment for mild and moderate AD. PMID: 30427385 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - November 8, 2018 Category: Psychiatry Authors: da Silva LR, Vianna CMM, Mosegui GBG, Peregrino AAF, Marinho V, Laks J Tags: Braz J Psychiatr Source Type: research
CONCLUSION: Differences in psychiatrists' religious and spiritual beliefs are associated with different attitudes concerning their approach to R/S. The results suggest that medical practice may lead to a religious conflict among devout psychiatrists, making them question their faith. Training might be of importance for handling R/S in clinical practice and for raising awareness about potential evaluative biases in the assessment of patients' religiosity. PMID: 30427386 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - November 8, 2018 Category: Psychiatry Authors: Menegatti-Chequini MC, Maraldi EO, Peres MFP, Leão FC, Vallada H Tags: Braz J Psychiatr Source Type: research
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CONCLUSIONS: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders. PMID: 30427387 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - November 8, 2018 Category: Psychiatry Authors: Cia AH, Stagnaro JC, Aguilar-Gaxiola S, Sustas S, Serfaty E, Nemirovsky M, Kessler RC, Benjet C Tags: Braz J Psychiatr Source Type: research
Revista Brasileira De Psiquiatria Impact Factor
CONCLUSIONS: These results can contribute to the validation of ayahuasca as an antidepressant drug and encourage new studies on psychedelic drugs as a tool for treating mood disorders, including for adolescents with early-onset depression. PMID: 30427388 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - November 8, 2018 Category: Psychiatry Authors: da Silva FS, Silva EAS, Sousa GM, Maia-de-Oliveira JP, Soares-Rachetti VP, de Araujo DB, Sousa MBC, Lobão-Soares B, Hallak J, Galvão-Coelho NL Tags: Braz J Psychiatr Source Type: research
CONCLUSION: Among women in Brazil, the harmful use of alcohol is increasing, which has an impact on female reproductive health and exposure to risks. There is a need for specific prevention initiatives focusing on alcohol-related behaviors in women. PMID: 30365669 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 22, 2018 Category: Psychiatry Authors: Massaro LTS, Abdalla RR, Laranjeira R, Caetano R, Pinsky I, Madruga CS Tags: Rev Bras Psiquiatr Source Type: research
This study relied on confirmatory factor analysis of schizophrenia patients (n=141) and healthy controls (n=119). The main analyses examined the degree to which three executive functions (updating, set-shifting, and inhibition) could be separated in schizophrenia and compared this model among groups. Structural equation modeling analysis was also performed to examine the extent to which executive function components contribute to functional outcome in schizophrenia. RESULTS: Multiple-group confirmatory factor analysis with unconstrained model parameters indicated that the full three-factor model may fit the data in bo...
Source: Revista Brasileira de Psiquiatria - October 22, 2018 Category: Psychiatry Authors: Berberian AA, Gadelha A, Dias NM, Mecca TP, Comfort WE, Bressan RA, Lacerda AT Tags: Rev Bras Psiquiatr Source Type: research
CONCLUSION: The CAMDEX-DS can be considered the first valid and reliable instrument for evaluating dementia in adults with DS in Brazil. Its use in such individuals could improve clinical practice and research. PMID: 30365671 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 22, 2018 Category: Psychiatry Authors: Fonseca LM, Haddad GG, Mattar GP, Oliveira MC, Simon SS, Guilhoto LM, Busatto GF, Zaman S, Holland AJ, Hoexter MQ, Bottino CM Tags: Rev Bras Psiquiatr Source Type: research
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CONCLUSION: The prevalence of MDE was high among individuals with prolonged respiratory symptoms, independent of PTB diagnosis. This is consistent with other studies of depression in primary care in Brazil. PMID: 30365672 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 22, 2018 Category: Psychiatry Authors: Castro-Silva KM, Carvalho AC, Cavalcanti MT, Martins PDS, França JR, Oquendo M, Kritski AL, Sweetland A Tags: Rev Bras Psiquiatr Source Type: research
CONCLUSION: In the included studies, PTSD symptoms were most prevalent in the CSA + adult sexual assault groups, providing further evidence for the revictimization hypothesis. PMID: 30328955 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 11, 2018 Category: Psychiatry Authors: Cividanes GC, Mello AF, Mello MF Tags: Rev Bras Psiquiatr Source Type: research
CONCLUSION: Our findings confirm the anxiolytic-like properties of CBD and are consonant with results of animal studies describing bell-shaped dose-response curves. Optimal therapeutic doses of CBD should be rigorously determined so that research findings can be adequately translated into clinical practice. PMID: 30328956 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 11, 2018 Category: Psychiatry Authors: Linares IM, Zuardi AW, Pereira LC, Queiroz RH, Mechoulam R, Guimarães FS, Crippa JA Tags: Rev Bras Psiquiatr Source Type: research
CONCLUSION: The most promising results of NIBS have been obtained for depression. These techniques excel in safety and tolerability, although their efficacy still warrants improvement. PMID: 30328957 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 11, 2018 Category: Psychiatry Authors: Brunoni AR, Sampaio-Junior B, Moffa AH, Aparício LV, Gordon P, Klein I, Rios RM, Razza LB, Loo C, Padberg F, Valiengo L Tags: Rev Bras Psiquiatr Source Type: research
CONCLUSION: Our results support the structure of the Brazilian adaptation of the FCQ-T-r, which seems to be a viable instrument to investigate food cravings, particularly in time-constrained settings. Further studies are needed to verify these findings in other age ranges and clinical samples. PMID: 30328958 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 11, 2018 Category: Psychiatry Authors: Queiroz de Medeiros AC, Pedrosa LFC, Yamamoto ME Tags: Rev Bras Psiquiatr Source Type: research
CONCLUSIONS: These findings suggest that psychiatrists in training may be failing to investigate traumatic events and their consequences and strongly indicate that trauma-related issues should be given more prominence in psychiatry curricula and psychiatrist training. PMID: 30328959 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 11, 2018 Category: Psychiatry Authors: da Silva HC, Furtado da Rosa MM, Berger W, Luz MP, Mendlowicz M, Coutinho ESF, Portella CM, Marques PIS, Mograbi DC, Figueira I, Ventura P Tags: Rev Bras Psiquiatr Source Type: research
CONCLUSIONS: Suicidal risk manifests differently throughout the life cycle, and different types of bonds may protect from or increase risk of suicide. PMID: 30328960 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Psiquiatria)
Source: Revista Brasileira de Psiquiatria - October 11, 2018 Category: Psychiatry Authors: Maino MP, Morales S, Echávarri O, Barros J, García A, Moya C, Szmulewicz T, Fischman R, Núñez C, Tomicic A Tags: Rev Bras Psiquiatr Source Type: research
Revista Brasileira de Psiquiatria Psychiatry
Official Journal of the Brazilian Psychiatric Association 7PMVNF0001001400160001t0001/VNCFS000100120001t0001'FCSVBSZ00100013001100120014
ORIGINAL ARTICLE
The panic disorder respiratory ratio: a dimensional approach to the respiratory subtype Rafael Christophe Freire,1 Isabella Nascimento,1 Alexandre Martins Valença,2 Fabiana Leão Lopes,1 Marco André Mezzasalma,1 Valfrido Leão de Melo Neto,1 Walter Araujo Zin,3 Antonio Egidio Nardi1 Laboratory of Panic and Respiration, Universidade Federal do Rio de Janeiro and National Institute for Translational Medicine, Brazil 2 Department of Psychiatry, Universidade Federal Fluminense, Brazil 3 Laboratory of Respiration Physiology, Universidade Federal do Rio de Janeiro, Brazil 1
Received on October 25, 2011; accepted on February 23, 2012
DESCRIPTORS: Anxiety Disorders; Depressive Disorder; Carbon Dioxide; Panic Attack; Respiratory System.
Abstract Objective: The respiratory ratio is a dimensional construct of the respiratory subtype of panic disorder (PD). The respiratory subtype has been correlated with an increased sensitivity to CO2 inhalation, positive family history of PD and low comorbidity with depression. The objective of our study was to determine whether the respiratory ratio is correlated with CO2-induced panic attacks and other clinical and demographic features. Methods: We examined 91 patients with PD and submitted them to a double-breath 35% CO2 challenge test. The respiratory ratio was calculated based on the Diagnostic Symptom Questionnaire (DSQ) scores recorded in a diary in the days preceding the CO2 challenge. The scores of the respiratory symptoms were summed and divided by the total DSQ score. Results: The respiratory ratio was correlated with CO2 sensitivity, DQG0003WKHUH0003ZDV0003D0003QRQ0010VWDWLVWLFDOO0003VLJQLÀFDQW0003WUHQG0003WRZDUGV0003D0003FRUUHODWLRQ0003ZLWK0003D0003IDPLO0003KLVWRU0003RI0003 PD. Conclusions: The positive correlation between the respiratory ratio and the anxiety elicited by the CO2 inhalation indicates that the intensity of respiratory symptoms may be proportional to the sensitivity to carbon dioxide. © 2013 Associação Brasileira de Psiquiatria. Published by Elsevier Editora Ltda. All rights reserved.
Corresponding author: Rafael Christophe Freire. Laboratory of Panic and Respiration, Universidade Federal do Rio de Janeiro. Address: Rua Visconde de Piraja 407/702, Rio de Janeiro, RJ, Brazil. Zip code: 22410-003. Phone/Fax: 55 21 2521 6147. E-mail: [email protected] © 2013 Associação Brasileira de Psiquiatria. PublishedPublished by Elsevier AllLtda. rights 1516-4446 - © 2013 Associação Brasileira de Psiquiatria. by Editora Elsevier Ltda. Editora Allreserved. rights reserved. doi: 10.1016/j.rbp.2012.02.008
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Introduction According to the DSM-IV,1 panic disorder (PD) is a unitary diagnostic category. Nevertheless, within this category, there are diverse clinical presentations, leading to concerns that PD is not a singular diagnosis.2 As a response to WKHVH0003 FRQFHUQV000f0003 DOWHUQDWLYH0003 FODVVLÀFDWLRQ0003 VFKHPHV0003 KDYH0003 been devised.2 Authors have proposed that the subtypes should be defined by the most prominent symptoms during a typical panic attack (PA), such as respiratory, cardiovascular, and gastrointestinal subtypes.3 Respiratory abnormalities, such as increased sensitivity to CO2, are associated with PD, and there may be a connection between the respiratory subtype of PD and these abnormalities. 4,5 Klein6 proposed that spontaneous PAs occur when the brain’s suffocation monitor erroneously signals a lack of useful air, maladaptively triggering an evolved suffocation alarm system. Such a dysfunction would make an individual vulnerable to “false suffocation alarms”, namely, PAs. Respiratory tests have been fruitful in generating hypotheses about PD,6,7 indicating that CO2 sensitivity may be part of a hypersensitive suffocation detector.6 PD patients exhibit both behaviorally and physiologically abnormal responses to respiratory challenge tests.8,9 The CO2 inhalation increases pCO2 and reduces pH in the blood, changes that are also observed in the brain.10 Some regions of the brain that are sensitive to H+/CO2 have been implicated in both ventilation control and defensive behaviors, including panic. The increase of CO2 and H+ in the brain may activate these structures, inducing PAs and increasing ventilation.10 The administration of 1 or 2 vital capacity breaths of a 35% CO2/65% O2 mixture to patients with PD is a brief but intense stimulation, accompanied by neurovegetative symptoms similar to real-life PA symptomatology.11,12 These respiratory tests induce dose-dependent anxiety and panic symptoms in many subjects with and without PD,10,13,14 but in 3'0003SDWLHQWV000f0003WKLV0003UHVSRQVH0003LV0003VLJQLÀFDQWO0003PRUH0003LQWHQVH001111,12,15 ,Q0003 DGGLWLRQ000f0003 KHDOWK0003 ÀUVW0010GHJUHH0003 UHODWLYHV0003 RI0003 3'0003 SDWLHQWV0003 UHDFW0003VLJQLÀFDQWO0003PRUH0003WR0003&22 inhalations than do healthy subjects without a family history of PD.16 The research on CO2 challenge tests strongly suggests a relationship between the pathophysiology of PD and some disturbance in breathing control.4,11 Recent studies indicate that patients with the respiratory subtype of PD are more sensitive to 35% CO2 challenge tests and hyperventilation tests than subjects without this subtype.17-19 Hypersensitivity to CO2 and prominent respiratory symptoms might be markers for genetic vulnerability to respiratory PD.5,16 Briggs et al.200003 GHÀQHG0003 WKH0003 UHVSLUDWRU0003 VXEWSH0003 RI0003 3'0003 as a distinct subgroup of PD patients with prominent respiratory symptoms. Respiratory subtype patients are more likely to have a family history of PD and exhibit low comorbidity with depression, longer illness duration and low neuroticism scores.5 These patients also exhibit higher scores on PD severity scales, and the improvement with pharmacological treatment is observed more quickly than in patients without this subtype. 20,210003&RQWURYHUVLDO0003ÀQGLQJV0003 also exist regarding the respiratory subtype, such as the correlation with the age of onset, tobacco and alcohol use.5 A principal component analysis with PD symptoms conducted by Briggs et al.20 determined that the presence of the fear of dying, chest pain/discomfort, shortness of breath,
R.C. Freire et al.
SDUHVWKHVLDV000f0003DQG0003IHHOLQJV0003RI0003FKRNLQJ0003GXULQJ0003D00033$0003GHÀQHG0003D0003 GLVWLQFW0003VXEJURXS0003RI00033'0003SDWLHQWV00110003,I0003DW0003OHDVW0003IRXU0003RI0003WKH0003ÀYH0003 respiratory symptoms were present in a given patient, he or she was considered to have the respiratory subtype.20 Throughout the years, many studies17-19,21-23 have been based RQ0003%ULJJV·V0003FODVVLÀFDWLRQ000f0003EXW0003QRQH0003RI0003WKH0003VWXGLHV0003DGGUHVVHG0003 WZR0003LPSRUWDQW0003SUREOHPV001d0003WKH0003FODVVLÀFDWLRQ0003GRHV0003QRW0003DFFRXQW0003 for the intensity of the respiratory and non-respiratory symptoms; and patients with many symptoms have an increased FKDQFH0003WR0003EH0003FODVVLÀHG0003ZLWK0003WKH0003UHVSLUDWRU0003VXEWSH00110003:LWK0003 %ULJJV·0003FODVVLÀFDWLRQ000f0003SDWLHQWV0003ZLWK0003PDUNHG0003JDVWURLQWHVWLQDO0003RU0003 neurologic symptoms may report mild respiratory symptoms DQG0003EH0003LQFRUUHFWO0003FODVVLÀHG0003LQ0003WKH0003UHVSLUDWRU0003VXEWSH001100032Q0003 the other hand, if a patient has strong feelings of choking, shortness of breath and chest discomfort but does not experience paresthesias and fear of dying, he will not be diagnosed with the respiratory subtype. A method that accounted for the intensity of symptoms would lead to a more reliable clasVLÀFDWLRQ0003RI0003SDWLHQW0003VDPSOHV00110003&RQVLVWHQW0003ÀQGLQJV0003DUH0003UHSRUWHG0003 in patients with the respiratory subtype, such as a positive family history and high sensitivity to CO2 challenge tests.18,19,23 +RZHYHU000f00033'0003VWXGLHV0003UHSRUW0003FRQÁLFWLQJ0003ÀQGLQJV0003UHJDUGLQJ0003WKH0003 age of onset and comorbidities.24 These inconsistencies may EH0003GXH0003WR0003WKH0003OLPLWDWLRQV0003RI0003WKH0003%ULJJV·0003FODVVLÀFDWLRQ00110003 7KH0003 SUHYDLOLQJ0003 VVWHPV0003 RI0003 FODVVLÀFDWLRQ0003 RI0003 SVFKLDWULF0003 disorders assume that the categorical representation is appropriate; disorders are laid out as distinct types and diagnosed as present or absent. However, some authors propose that dimensional taxonomy should be used in at least some conditions.25 Studies indicate that dimensional constructs PD0003EH0003VXSHULRU0003WR0003FDWHJRULFDO0003FODVVLÀFDWLRQV0003EHFDXVH0003LQ0003DGGLtion to capturing the core symptoms, dimensional constructs capture the subtle psychopathology of anxiety disorders.25,26 Dimensional variation exists between and within categories, DQG0003TXDQWLWDWLYH0003YDULDWLRQ0003FDQ0003EH0003VLPSOLÀHG0003LQWR0003FDWHJRULFDO0003 distinctions,25 such as the respiratory subtype. ,Q0003WKH0003FXUUHQW0003VWXG000f0003ZH0003GHÀQHG0003WKH0003UHVSLUDWRU0003UDWLR000f0003D0003 dimensional correlate of the respiratory subtype, as the ratio between the respiratory and the non-respiratory symptoms occurring during PA, accounting for the intensity of each symptom. We hypothesize that the respiratory ratio is correlated with high sensitivity to CO2 challenges, positive family history of PD and a low prevalence of major depression. The objective of this study was to ascertain whether the respiratory ratio can predict CO2-induced PAs and whether WKH0003UHVSLUDWRU0003UDWLR0003LV0003FRUUHODWHG0003ZLWK0003VSHFLÀF0003FOLQLFDO0003DQG0003 GHPRJUDSKLF0003IHDWXUHV0003LQ00033'0003SDWLHQWV001100037KLV0003VWXG0003LV0003WKH0003ÀUVW0003 attempt to build a body of evidence concerning the respiratory ratio.
Methods Subjects In the current study, a database from a previous research project27 was used. Patients with a diagnosis of PD with agoraphobia were consecutively recruited as they presented to the Laboratory of Panic and Respiration at the Institute of Psychiatry of the Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. The data collection for the original study lasted for approximately six months. After subjects
The panic disorder respiratory ratio
received a clinical diagnosis of PD, made by an expert psychiatrist, they were interviewed by a second psychiatrist with the Structured Clinical Interview Diagnostic28 for DSM-IV.1 If the two clinicians disagreed on the diagnosis, they met to confer. If a consensus on the diagnosis could not be reached, the subject was not enrolled. Patients who met the DSM-IV criteria for current major depression, bipolar disorder, obsessive-compulsive disorder, schizophrenia, delusional or psychotic disorders, organic brain syndrome, severe personality disorder, suicide risk, epilepsy, or substance abuse or dependence (during the previous year) were excluded. Patients with comorbid dysthymia, generalized anxiety disorder, or past major depression were included if PD was judged to be the principal diagnosis. The protocol was explained to the subjects, who signed a voluntary written consent form to participate in the study. The subjects were informed that the procedure was not dangerous, but that anxiety symptoms could occur during the test. Our local ethics committee approved the protocol (approval number CAAE-0008.0.249.000-05, 14/2005), which complied with the principles of the Declaration of Helsinki. The inclusion criteria selected 18 to 55 years of age; both genders; occurrence of at least three PAs in the two weeks before the challenge test day and no use of any psychotropic drugs for at least one week by any subject. Exclusion criteria included unstable medical condition; cognitive-behavior psychotherapy during the study; use of any regular antipsychotic, antidepressant, regular benzodiazepine or non-benzodiazepine anxiolytic PHGLFDWLRQ0003IRU0003IRXU0003ZHHNV0003EHIRUH0003WKH0003XVH000f0003WKH0003XVH0003RI0003ÁXR[HWLQH0003IRU0003ÀYH0003ZHHNV0003EHIRUH0003WKH0003WHVW0003RU0003D0003SRVLWLYH0003XULQH0003WHVW0003 for benzodiazepines or other drugs before the test. Subjects with a history of respiratory disease and smokers were also excluded. All subjects underwent a physical examination and laboratory examinations to ensure that they were healthy enough to participate in a CO2 challenge test. The patients had no respiratory or cardiovascular abnormalities and were IUHH0003RI0003FDIIHLQH0003LQJHVWLRQ0003IRU0003RQH0003GD00110003$OO0003VXEMHFWV0003ÀOOHG0003RXW0003 a form with sociodemographic and clinical data, including age, gender, education, occupation, marital status, family history of PD and age of onset of PD. The family members were not examined.
Measures The Subjective Units of Disturbance Scale (SUDS) is a quantitative evaluation method ranging from 0 (no anxiety) to 10 (maximum anxiety).29 The Diagnostic Symptom Questionnaire (DSQ) is a list of 13 PA symptoms adapted from DSM-IV1 in which the presence and level of discomfort of each panic symptom experienced after the inhalations is rated on a 0- (none) to 4-point (very severe) scale, and the total score ranges from 0 to 52.30 Both the SUDS and DSQ were used in the CO2 inhalation procedure. To avoid baseline interference in the quantitative assessment of the SUDS measurements, the percentage of maximum increase or decrease possible in the SUDS score (PMIDPSUDS) was calculated.31 The ¨68'60003ZDV0003FDOFXODWHG0003DV0003WKH0003GLIIHUHQFH0003EHWZHHQ0003WKH000368'60003 score after the CO2 inhalation (SUDS2) and the SUDS score EHIRUH0003WKH0003LQKDODWLRQ0003000b68'60014 00110003,I0003WKH0003¨68'60003ZDV0003QHJDWLYH000f0003 WKH000330,'368'60003ZDV0003HTXDO0003WR0003WKH0003¨68'60003GLYLGHG0003E000368'6001400110003
59
,I0003WKH0003¨68'60003ZDV0003SRVLWLYH000f0003WKH000330,'368'60003ZDV0003HTXDO0003WR0003WKH0003 ¨68'60003GLYLGHG0003E0003WKH0003GLIIHUHQFH0003EHWZHHQ0003WKH0003PD[LPXP000368'60003 score (10) and SUDS1.31 'XULQJ0003WKLV0003ÀUVW0003YLVLW0003WR0003RXU0003UHVHDUFK0003FHQWHU000f0003HDFK0003SDWLHQW0003 received a diary in which they recorded any PAs that occurred between the screen visit and the visit for the CO2 test one week after. The respiratory ratio was calculated based on the DSQ scores of non-induced PAs registered in the diary. The scores of the respiratory symptoms (fear of dying, chest pain/discomfort, shortness of breath, paresthesias, and feelings of choking) were summed and divided by the total DSQ score for each patient.
Procedure Before the inhalations, all subjects were asked to relax for 10 minutes. Respiratory frequency, pulse, and blood pressure were checked, and the measurements were repeated 1 and 5 minutes after the test. Using a double-blind (patient and medical raters) design setup, the patients inhaled the 35% CO2 mixture or atmospheric compressed air, randomly selected ZLWK0003D0003FRLQ0003ÁLS0003E0003DQ0003LQGHSHQGHQW0003VWDII0003PHPEHU001100037KH0003VDPH0003 test procedure was repeated after 20 minutes using other gas (i.e., 35% CO2 or compressed air). During the test procedure, the patients exhaled as fully as possible, placed the inhalation mask, took a fast vital capacity breath, held their breath for 8 seconds, exhaled, and repeated the fast vital capacity breath, again holding for 8 seconds. The compliance with the tests was established by the three members of our team who attended present during the tests. Both tests were attended by one medical staff member who dealt with the patient and the gases (independent staff member) and by two test-blind rater psychiatrists. To measure the anxiety level before and after the CO2 inhalation, we asked the subjects to complete the SUDS. The DSQ was also completed after the respiratory challenge. Based on the DSQ, a CO20010LQGXFHG00033$0003ZDV0003GHÀQHG0003DV0003WKH0003 following: (1) the presence of 4 or more DSM-IV PA symptoms, where either the presence or the increase in DSM-IV symptomatology was used for diagnosis; (2) at least one DSM-IV cognitive panic symptom, that is, fear of dying, losing control, or going crazy; (3) the patient’s statement that the sensation of panic or fear after the test resembled a spontaneous PA; and (4) an agreement of 2 medical doctors blind to whether the patient was receiving CO2 or compressed air that the patient had a clinical PA. The SUDS scores were not used for diagnosing a PA. All of these criteria were used in the diagnosis of a PA to increase the reliability and cliniFDO0003VLJQLÀFDQFH0011
Statistical analysis To calculate the correlations between the respiratory ratio and the other variables, the authors used the Pearson &RUUHODWLRQ0003&RHIÀFLHQW0003IRU0003FRQWLQXRXV0003YDULDEOHV0003ZLWK0003QRUPDO0003 GLVWULEXWLRQV000f0003WKH00036SHDUPDQ·V00035DQN0003&RUUHODWLRQ0003&RHIÀFLHQW0003 for ordinal variables and continuous variables without normal distributions and the Point-Biserial Correlation (PBC) to correlate continuous and dichotomous variables. The PBC is a VSHFLDO0003FDVH0003RI0003WKH00033HDUVRQ0003&RUUHODWLRQ0003&RHIÀFLHQW0003LQ0003ZKLFK0003 a continuous variable is correlated with a true dichotomy. 7KH0003 FRUUHODWLRQ0003 FRHIÀFLHQWV0003 ZHUH0003 FRQVLGHUHG0003 VPDOO0003 ZKHQ0003 approximately .10, medium when .30 and large when .50.32
60
R.C. Freire et al.
Responders and non-responders to the CO2 challenge were compared with respect to their respiratory ratio and demographic and clinical features. The Student’s t-test was used to compare the means of numeric variables between the two groups, and the chi-square test was used to compare categorical variables. To ascertain the predictive value of the respiratory ratio, the ROC curve was analyzed. A respiratory ratio cutoff was GHÀQHG0003EDVHG0003RQ0003WKH0003VPDOOHVW0003GLIIHUHQFH0003EHWZHHQ0003WKH0003VHQVLWLYLW0003DQG0003VSHFLÀFLW0003YDOXHV001100037KH0003SRVLWLYH0003SUHGLFWLYH0003YDOXH0003 and negative predictive value were calculated. All analyses were two-tailed, and the level of statistical VLJQLÀFDQFH0003ZDV0003VHW0003DW000300180011
Results A sample of 91 patients with PD was included in the trial. A total of 62 patients with PD (68.1%) suffered a PA after the CO2 test (responders), and 29 patients with PD (31.9%) did not suffer a PA after the test (non-responders). In our sample, we did not reject the normality hypothesis of the respiratory ratio (Kolmogorov Smirnov Z, p = .872), and the mean was .458 (SD = .104), indicating that the respiratory symptoms represented approximately 45.8% of the PD symptoms registered in the diary of all patients. The respiratory ratio exhibited moderate positive correlations with PMIDPSUDS and the response to CO2 inhalation. We also observed trends towards positive correlations with SUDS2 and family history and a negative correlation with education (Table 1). The hypothesis of normality was rejected for PMIDPSUDS (Kolmogorov Smirnov Z, p = .003) and SUDS2 (Kolmogorov Smirnov Z, p < .001), and linear regression based on normality was not possible using these variables. Although it would have been possible to use a nonparametric regression, it would KDYH0003EHHQ0003GLIÀFXOW0003IRU0003SVFKLDWULVWV0003WR0003UHDG00110003:H0003GHFLGHG0003QRW0003 to base our conclusions on linear regressions.
Table 1 Correlations of the respiratory ratio. Variable
Method
Correlation strength
Gender Age
PBC Pearson
.017 .169
Education
PBC
-.183 *
Occupation
PBC
.138
Marital status
PBC
.142
Family history
PBC
.189 *
Age of onset
Pearson
-.089
MDD
PBC
.086
DSQ
Pearson
.107
SUDS1
Spearman
-.095
SUDS2
Spearman
.198 *
PMIDPSUDS
Spearman
.236
CO2PA
PBC
.334 **
3%&001d00033RLQW0010ELVHULDO0003FRUUHODWLRQ001e00033HDUVRQ001d00033HDUVRQ0003FRUUHODWLRQ0003FRHIÀFLHQW001e0003 6SHDUPDQ001d00036SHDUPDQ·V0003UDQN0003FRUUHODWLRQ0003FRHIÀFLHQW001e00030'001d00033UHYLRXV0003 major depressive disorder episodes; SUDS1: SUDS score before the CO2 inhalation; SUDS2: SUDS score after the CO2 inhalation; PMIDPSUDS: Percentage of maximum increase or decrease possible in the SUDS scale; corresponds to the anxiety increase induced by the CO2 inhalation; CO2PA: CO2-induced panic attack. * p < .1; ** p