Navegando por Palavras-chave "Child psychiatry"
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- ItemAcesso aberto (Open Access)Crenças e atitudes educativas dos pais e problemas de saúde mental em escolares(Faculdade de Saúde Pública da Universidade de São Paulo, 2005-10-01) Vitolo, Ymara Lúcia Camargo [UNIFESP]; Fleitlich-Bilyk, Bacy [UNIFESP]; Goodman, Robert; Bordin, Isabel Altenfelder Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); King's College London Institute of Psychiatry Department of Child and Adolescent PsychiatryOBJECTIVE: To verify the prevalence and identify the risk factors related to mental health problems among schoolchildren and its possible association with the beliefs and educational attitudes of parents/caretakers. METHODS: Cross-sectional study with a stratified probabilistic sample (n=454) of first to third-graders from public and private schools in Southeastern Brazil. Standardized instruments were administered to parents/caretakers by trained interviewers, including screening questionnaires for mental health problems among children and parents/caretakers; a questionnaire on beliefs and attitudes; and a questionnaire for socio-economic status. Chi-square tests and logistic regression models were used for statistical analysis. RESULTS: We found 35.2% prevalence of clinical/borderline cases among students. Parents/caretakers that believed in corporal punishment as a child-rearing method used physical aggression towards their children more frequently (64.8%). Logistic regression models showed that the act of hitting the child with a belt was associated to conduct problems and to overall mental health problems among schoolchildren in the presence of other risk factors: child gender (male), parents/caretakers with mental health problems, and adverse socioeconomic conditions. CONCLUSIONS: The high prevalence of mental health problems among schoolchildren and its association with child-rearing methods and mental health problems among parents/caretakers indicate the need for psycho-educational interventions aimed to reduce physical abuse and mental health problems in childhood.
- ItemSomente MetadadadosEarly vulnerabilities for psychiatric disorders in elementary schoolchildren from four Brazilian regions(Springer Heidelberg, 2018) Paula, Cristiane Silvestre de [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Bordin, Isabel Altenfelder Santos [UNIFESP]; Miguel, Euripedes Constantino [UNIFESP]; Fortes, Isabela; Barroso, Natalia [UNIFESP]; Rohde, Luis Augusto; Coutinho, Evandro da Silva FreireThe purpose of the study is to identify early vulnerabilities for psychiatric disorders among Brazilian elementary school children, controlling for familial and community adversities. This is a cross-sectional study examining the association between child psychiatric disorders and potential early vulnerabilities (disability, low intellectual quotient, and negative dimensions of the temperament trait self-directedness (low resourcefulness, low purposefulness, low enlightened second nature), controlling for the potential confounders: familial and community adversities. Sample: Four probabilistic samples of second-to-sixth grade students from public schools in four towns from different Brazilian regions (N = 1620). The following instruments were applied: the K-SADS-PL (to assess child/adolescent psychiatric disorders)
- ItemSomente MetadadadosMorbidade psiquiátrica em pacientes com coréia de Sydenham: um estudo descritivo(Universidade Federal de São Paulo (UNIFESP), 2000) Zappitelli, Marcelo Cardoso [UNIFESP]; Porto, Jose Alberto Del [UNIFESP]Introdução: A literatura tem demonstrado variada morbidade psiquiátrica em crianças e adolescentes com coréia de Sydenham, apontando para uma maior freqüência tanto de transtorno obsessivo-compulsivo e tiques como de quadros de ansiedade, depressão e hiperatividade com déficit de atenção. A presente pesquisa vem contribuir para o maior conhecimento desta morbidade psiquiátrica associada à coréia reumática em jovens do nosso meio. Objetivos: Avaliar a sintomatologia psiquiátrica em um grupo de crianças e adolescentes com coréia de Sydenham, identificando os transtornos psiquiátricos e os problemas de saúde mental presentes, verificando se tal sintomatologia remitia com a melhora do quadro coreico. Verificar possíveis alterações em exames de ressonância magnética de crânio e cintilografia cerebral. Verificar a influência de fatores estressores sobre a saúde mental de crianças e adolescentes com coréia de Sydenham. Método: Desenho do estudo: série de casos. A amostra constituiu-se por todos os pacientes com coréia de Sydenham aguda atendidos no ambulatório de Reumatologia Pediátrica e Alergia do Departamento de Pediatria da Universidade Federal de São Paulo, Escola Paulista de Medicina, durante um ano (N=12). Os participantes foram submetidos a uma avaliação psiquiátrica, incluindo entrevistas com os pacientes e seus responsáveis, além da aplicação de instrumentos padronizados (Kiddie-Sads-Present Episode, Child Behavior Checklist, Leyton Obsessional Inventory Child Version). Problemas de saúde mental dos responsáveis foram identificados através do Self Reporting Questionnaire. Todos os pacientes foram acompanhados por um período aproximado de três meses. Resultados: Considerando-se os 12 pacientes da amostra estudada (11 meninas e um menino, com idades entre sete e 15 anos), observou-se a presença de transtorno de ansiedade de separação (33,3%) e episódio depressivo maior (8,3%) segundo critérios do DSM-IV. Os pacientes que não preencheram critérios diagnósticos apresentaram quadros subclínicos (ansiedade ou depressão) ou sintomas isolados variados. Quanto ao total de problemas de saúde mental detectados pelo CBCL, 41,7% dos casos apresentaram escores T total em nível clínico, 33,3% tiveram problemas de saúde mental do tipo ¿internalização¿ e 41,7% do tipo ¿externalização¿. Em relação às escalas individuais, problemas com a atenção foi a escala que se mostrou mais freqüente (25%). O seguimento dos pacientes demonstrou que a sintomatologia psiquiátrica melhorou com a remissão da coréia. Devido ao tamanho reduzido da amostra a associação entre problemas de saúde mental no responsável (41,7% da amostra) e morbidade psiquiátrica, não pode ser verificada. Conclusões: Crianças e adolescentes coreicos tendem a apresentar sintomatologia psiquiátrica concomitante à coréia de Sydenham. Transtorno de ansiedade de separação é um transtorno psiquiátrico próprio da infância que pode estar associado à coréia de Sydenham aguda. Crianças e adolescentes coreicos tendem a apresentar problemas de saúde mental dos tipos “externalização” e “internalização” concomitantes à coréia de Sydenham. Problemas com a atenção podem estar associados à coréia de Sydenham aguda. Alterações nos gânglios da base e de perfusão em lobo temporal podem estar associadas à coréia de Sydenham. A morbidade psiquiátrica que acompanha o quadro coreico, tende a desaparecer com a remissão da coréia. A possível influência de fatores estressores sobre a saúde mental de crianças e adolescentes com coréia de Sydenham aguda não parece ser independente do próprio quadro coreico, pois os problemas de saúde mental não persistem após a remissão da coréia.
- ItemAcesso aberto (Open Access)Severe physical punishment and mental health problems in an economically disadvantaged population of children and adolescents(Associação Brasileira de Psiquiatria - ABP, 2006-12-01) Bordin, Isabel Altenfelder Santos [UNIFESP]; Paula, Cristiane Silvestre de [UNIFESP]; Nascimento, Rosimeire do [UNIFESP]; Duarte, Cristiane Seixas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Presbiteriana Mackenzie, Faculty of Psychology; Columbia University New York State Psychiatric Institute Department of PsychiatryOBJECTIVE: To estimate the prevalence of severe physical punishment of children/adolescents in a low-income community, and to examine child mental health problems as a potential correlate. METHOD: This study is a Brazilian cross-sectional pilot study of the World Studies of Abuse in Family Environments. A probabilistic sample of clusters including all eligible households (women aged 15-49 years, son/daughter < 18 years) was evaluated. One mother-child pair was randomly selected per household (n = 89; attrition = 11%). Outcome (severe physical punishment of children/adolescents by mother/father) was defined as shaking (if age < 2 years), kicking, choking, smothering, burning/scalding/branding, beating, or threatening with weapon. Three groups of potential correlates were examined: child/adolescent (age, gender, physical/mental health); mother (education, unemployment, physical/mental health, harsh physical punishment in childhood, marital violence); father (unemployment, drunkenness). Severe marital violence was defined as kicking, hitting, beating or use of /threat to use a weapon. The following standardized questionnaires were applied by trained interviewers: World Studies of Abuse in Family Environments Core Questionnaire, Child Behavior Checklist, Self-Report Questionnaire. RESULTS: Outcome prevalence was 10.1%. Final logistic regression models identified two correlates: maternal harsh physical punishment in childhood (total sample, OR = 5.3, p = 0.047), and child/adolescent mental health problems (sub-sample aged 4-17 years, n = 67, OR = 9.1, p = 0.017). CONCLUSIONS: Severe physical punishment of children/adolescents is frequent in the studied community. The victims have a higher probability of becoming future perpetrators. When intrafamilial violence occurs, child/adolescent mental health may be compromised.
- ItemAcesso aberto (Open Access)Transtornos de humor na infância e adolescência: sintomas precoces em filhos de bipolares e traços de temperamento e caráter como endofenótipos na depressão maior(Universidade Federal de São Paulo (UNIFESP), 2010-09-29) Zappitelli, Marcelo Cardoso [UNIFESP]; Bordin, Isabel Altenfelder Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To conduct two studies with children and adolescents, aiming to identify psychiatric disorders in the offspring of bipolar parents type I, and to evaluate temperament and character traits in patients with major depressive disorder (MDD). Methods: Study 1: The study involved a case series comprising 35 children and adolescents (20 males/15 females) aged 6 to 17 years (mean age: 12.5±2.9 years). All participants were assessed using the diagnostic interview The Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS- PL). Psychiatric family history and demographics were also evaluated. Study 2: A case-control study comprising 41 MDD children and adolescents (8-17 years) matched by gender and age to 40 healthy controls (HC). All participants were diagnostically assessed with the K-SADS-PL. Temperament and character traits were measured by the parent and child versions of The Junior Temperament and Character Inventory (JTCI), and depression severity by The Children’s Depression Rating Scale - Revised (CDRS-R). Results: Study 1: At least one psychiatric disorder was identified in 71.4% of the sample. High rates of specific disorders were noted: mood disorders (28.6%), disruptive behaviour disorders (including attention deficit hyperactivity disorder/ADHD) (40.0%) and anxiety disorders (20.0%). The rate of mood disorders comorbid with disruptive behaviour disorders (17.2%) was higher than the rate of pure mood disorders (11.4%). Presence of psychopathology was commonly reported in second-degree relatives of the offspring (71.4%). Study 2: MDD subjects had significantly higher scores on harm avoidance and novelty seeking dimensions, and lower scores on reward dependence, persistence, self-directedness and cooperativeness compared with HC. Comorbidity with disruptive behaviour disorders exerted influence on almost all dimensions of temperament and character, in general increasing the mean score differences between MDD and HC subjects. Moreover, being currently depressed did not influence the results, except for reward dependence according to parent data. Conclusions: Bipolar offspring are at high risk for developing psychiatric disorders, especially mood and disruptive behaviour disorders. MDD children and adolescents have a different temperament and character profile compared to HC subjects, pointing towards trait-like characteristics of the dimensions harm avoidance and self-directedness.