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Biomedical subjects

Marcelo T Berlim

Publications and source records attributed to Marcelo T Berlim.

13 recordsLinked to original sources
PubMed2006

Does a brief training on suicide prevention among general hospital personnel impact their baseline attitudes towards suicidal behavior?

OBJECTIVE: To evaluate a brief training program on suicide prevention for front-line general hospital personnel in terms of its impact on their attitudes and beliefs towards suicidality. METHOD: Forty non-clinical (e.g., security staff), and 102 clinical (e.g., nursing attendants) professionals employed in a university hospital in Brazil were evaluated with the Suicide Behavior Attitude Questionnaire [SBAQ] before the start and immediately after a 3-hour training on suicide prevention. RESULTS: Surprisingly, there were no significant differences for the great majority of the SBAQ items (i.e., 20 of 21) between clinical and non-clinical staff both pre- and post-training. Furthermore, their attitudes and beliefs towards suicidality were significantly improved after training in the majority of SBAQ items, with p-values ranging from 0.01 to <0.0001. LIMITATIONS: Relatively small sample size, and absence of a randomized controlled design and long-term follow-up. CONCLUSIONS: Our study suggests that attitudes and beliefs of clinical and non-clinical general hospital personnel towards suicidality were unexpectedly similar, and reinforces the need for suicide awareness training programs in the general hospital setting. Additionally, we have shown that it is feasible to provide such basic knowledge concerning suicidal behavior to this specific population. This is particularly important for the development of suicide prevention programs in under-resourced countries. However, our results are preliminary, and further studies are needed to address a number of important questions in the field.

Adult↗
PubMed2006

Double depression in adult psychiatric outpatients in Brazil: distinct from major depression?

This study examines whether distinct symptom profiles, patterns of comorbidity, and suicidal symptoms uniquely characterize individuals diagnosed with double depression (DD) by comparing Brazilians with DD to those with major depressive disorder (MDD). One hundred forty two psychiatric outpatients (ages 20-77 mean=48.8, S.D.=13.2; DD, n=23; MDD, n=119) participated in structured diagnostic interviews and completed self-report measures of depressive symptoms, suicidality, and family history of mental disorders. Patients with DD exhibited a more severe symptom profile than those with MDD, as evidenced by a higher number of depressive symptoms and more intense suicidal ideation. They also appeared to be qualitatively different from individuals with MDD, as evidenced by distinct comorbidity patterns, quality of life reports, and anhedonic features. These results may be important in understanding the phenomenology of DD in psychiatric outpatients by informing diagnostics, psychotherapy, and psychotherapeutic treatment of DD.

Adult↗
PubMed2006

Quality of life and depressive symptoms in patients with major depression and end-stage renal disease: a matched-pair study.

OBJECTIVE: To compare the quality of life (QOL) and depressive symptoms of outpatients with major depression with that of nondepressed individuals undergoing hemodialysis (matched for age, gender, and ethnicity). METHODS: We used the WHOQOL BREF and the Beck Depression Inventory (BDI). RESULTS: After univariate analyses, depressed patients' QOL scores were significantly lower (P<.0001) in all the assessed domains (i.e., physical health, psychological, social relationships, environmental, and global QOL). Additionally, there was a significant difference in the severity of depression among the study groups (P<.0001). Finally, after multiple regression analysis, the QOL profile of depressed subjects remained significantly worse even when controlling for depression scores and diagnostic status. CONCLUSION: The subjective QOL of patients with major depression is significantly lower than that of subjects undergoing hemodialysis.

Adolescent↗
PubMed2005

Reliability and validity of the WHOQOL BREF in a sample of Brazilian outpatients with major depression.

The present study assessed the psychometric properties of the Brazilian version of the World Health Organization's Quality of Life Instrument--Short Version (WHOQOL BREF) in a sample of 89 adult outpatients with major depression. After analyses, the WHOQOL BREF showed good internal consistency, and was sensitive to improvement after treatment with antidepressants. Convergent validity between the WHOQOL BREF and the Beck Depression Inventory was statistically significant, as well as WHOQOL BREF's ability to discriminate between outpatients on the basis of their level of depression. In conclusion, the WHOQOL BREF seems to be a psychometrically valid and reliable instrument that it is suitable for evaluating the quality of life of Brazilian-speaking depressed outpatients.

Adult↗
PubMed2005

Four studies on how past and current suicidality relate even when "everything but the kitchen sink" is covaried.

T. E. Joiner's (2004, in press) theory of suicidal behavior suggests that past suicidal behavior plays an important role in future suicidality. However, the mechanism by which this risk is transferred and the causal implications have not been well studied. The current study provides evaluation of the nature and limits of this relationship across 4 populations, with varying degrees of suicidal behavior. Across settings, age groups, and impairment levels, the association between past suicidal behavior and current suicidal symptoms held, even when controlling for strong covariates like hopelessness and symptoms of various Axis I and II syndromes. Results provide additional support for the importance of past suicidality as a substantive risk factor for later suicidal behavior.

Humans↗
PubMed2004

"Quality of life": a brand new concept for research and practice in psychiatry.

Since the '70s, the assessment of quality of life (QOL) has grown from a 'small cottage' industry to a formal discipline within a coherent theoretical framework, accepted methods, and manifold applications. In recent years, QOL has become increasingly popular as a useful variable tailored to assess the overall impact of diseases and medical treatments from the patient's point of view. In this updating paper, we describe the most frequently used instruments, and discuss the conceptual and practical issues concerning QOL evaluation, as applied to the study of mental disorders. In addition, we present a unifying definition of QOL that has recently been developed by the World Health Organization. Finally, we conclude that QOL measures are potentially useful methods to be applied to research and clinical practice in psychiatry -- especially when used to demonstrate the impact of mental illnesses and the possible benefits of therapeutic interventions.

Biomedical Research↗
PubMed2004

Quality of life in unipolar and bipolar depression: are there significant differences?

In the present investigation, we compared the impact of illness on quality of life (QOL) in adult outpatients with unipolar (N = 89) and bipolar (N = 25) depression. While attending a university hospital in southern Brazil, patients completed the WHO's QOL Instrument-Short Version and the Beck Depression Inventory. After analyses, patients with bipolar depression reported significantly lower scores on the psychological QOL domain (p = .013) than patients with unipolar depression. There were no significant differences between the study groups in terms of social and demographic variables, in the other QOL domains assessed (i.e., physical health, social relationships, and environmental), and in the severity of depressive symptoms. In conclusion, our findings suggest that patients with bipolar and unipolar depressions have different QOL profiles, and that this difference is probably independent of the severity of the mood disturbance and might be related to the higher rates of suicide observed in the bipolar population.

Adult↗
PubMed2003

Notes on antipsychiatry.

The present paper aims to provide a review of the history and basic principles of the antipsychiatric movement, as well as to discuss the work of its most important theorists. The authors searched recent literature, as well as drawing upon some of the basic antipsychiatric texts. Antipsychiatry emerged as an international movement during the 1960s as part of the historic tumult of the period rather than as a result of the evolution of scientific ideas. Antipsychiatrists radically opposed what they understood as a hospital-centered medical specialty legally empowered to treat and institutionalize mentally disordered individuals. Indeed, many antipsychiatrists argued against the very existence of mental disorders themselves. After the 1970s, the antipsychiatry movement became increasingly less influential, due in particular to the rejection of its politicized and reductionistic understanding of psychiatry.

History, 20th Century↗
PubMed2003

Psychache and suicidality in adult mood disordered outpatients in Brazil.

Shneidman (e.g., 1998) has theorized that psychache--general psychological and emotional pain that reaches intolerable intensity--is an important suicide-related variable, and indeed, represents a source of suicidal behavior. This conceptualization, while prominent and clinically and intuitively appealing, has received relatively little empirical scrutiny. In this study, we determined whether an index closely related to psychache, psychological quality of life, would display a special and resilient association to suicidality among 60 adult psychiatric outpatients in Brazil. All patients underwent structured clinical interviews and completed various clinical and quality-of-life measures. We found that the association between psychological quality of life and suicidality remained, even when depression, hopelessness, and other domains of quality of life were controlled. Psychache appears to deserve its place among key suicide-related variables, and deserves the attention of clinicians working with suicidal people.

Adolescent↗
PubMed2003

[Posttraumatic stress disorder and major depression].

Epidemiological studies clearly indicate that posttraumatic stress disorder (PTSD) is becoming a major health concern worldwide even if still poorly recognized and not well treated. PTSD commonly co-occurs with other psychiatric disorder, especially with major depression. However, the relationship between these disorders and the treatment of this complex clinical entity are only now being addressed in the specialized literature. Some authors argued that they are two distinct entities, whereas others defended the hypothesis that the high prevalence of this comorbidity may represent an artifact derived from the diagnostic criteria currently used. Regarding the treatment of PSTD comorbid with major depression, the available data from controlled studies are insufficient to point out for a specific approach, although some small trials reported the usefulness of combining selective serotonin reuptake inhibitors and cognitive therapy.

Depressive Disorder↗
PubMedDate not supplied

The etiology of schizophrenia and the origin of language: overview of a theory.

Schizophrenia is present in all human populations with approximately the same incidence. Why does such illness persist given that it is associated with a reproductive disadvantage? What is the balancing advantage? A possible explanation is linked to human language. According to this hypothesis schizophrenia occurs as a manifestation of genetic diversity associated with language--the function by which Homo sapiens has separated from other primate species. Language originated by a genetic mutation that allowed the cerebral hemispheres to develop with a degree of specialization (or lateralization) reflected in cerebral asymmetries. Individuals with schizophrenia show lesser structural and functional brain asymmetries than the population as a whole, and this finding can be interpreted as a delay, or failure in, establishing hemispheric dominance for language. We review recent evidence supporting this theory.

Brain↗