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In higher education, reasonable accommodations are increasingly made for students with a wide range of disabilities. However, rigorous assessment is paramount to ensure these students are supported while preventing ineligible students from gaining unfair advantages. In this context, we sought to identify under which circumstances a university student should be allowed academic accommodation for attention-deficit/hyperactivity disorder (ADHD) and to outline an evidence-based policy for use in Brazil based on the global experience. We reviewed the literature to acquire information on what documents are commonly required by disability services before accommodations for ADHD are provided (including detection of malingering) and scrutinized the eligibility criteria of leading universities worldwide. Finally, renowned experts in the field and national stakeholders were consulted. Despite an exhaustive search, we found no international standard for the assessment of students with ADHD who request academic accommodation; even renowned institutions worldwide differ in their approaches to granting accommodations on the grounds of ADHD. Therefore, we propose a unified set of nationwide criteria for Brazilian universities, which could be generalized internationally. Higher education institutions in Brazil and beyond may benefit from adoption of such criteria. disabilities However advantages context attentiondeficit/hyperactivity attentiondeficithyperactivity attention deficit/hyperactivity deficit hyperactivity (ADHD evidencebased evidence experience including malingering Finally consulted search Therefore internationally attentiondeficit deficithyperactivity

https://doi.org/10.47626/1516-4446-2022-2999

Identifying Depression Early in Adolescence: assessing the performance of a risk score for future onset of depression in an independent Brazilian sample
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Cunha, Graccielle R.

; Caye, Arthur

; Pan, Pedro

; Fisher, Helen L.

; Pereira, Rivka

; Ziebold, Carolina

; Bressan, Rodrigo

; Miguel, Eurípedes Constantino

; Salum, Giovanni A.

; Rohde, Luis Augusto

; Kohrt, Brandon A.

; Mondelli, Valeria

; Kieling, Christian

; Gadelha, Ary

Brazilian Journal of Psychiatry

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2023, Volume 45 Nº 3 Páginas 242 - 248

Resumo: En | Texto: En | PDF: En

Objective: The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) was recently developed in Brazil using data from the Pelotas 1993 Birth Cohort to estimate the individualized probability of developing depression in adolescence. This model includes 11 sociodemographic variables and has been assessed in longitudinal studies from four other countries. We aimed to test the performance of IDEA-RS in an independent, community-based, school-attending sample within the same country: the Brazilian High-Risk Cohort. Methods: Standard external validation, refitted, and case mix-corrected models were used to predict depression among 1442 youth followed from a mean age of 13.5 years at baseline to 17.7 years at follow-up, using probabilities calculated with IDEA-RS coefficients. Results: The area under the curve was 0.65 for standard external validation, 0.70 for the case mix-corrected model, and 0.69 for the refitted model, with discrimination consistently above chance for predicting depression in the new dataset. There was some degree of miscalibration, corrected by model refitting (calibration-in-the-large reduced from 0.77 to 0). Conclusion: IDEA-RS was able to parse individuals with higher or lower probability of developing depression beyond chance in an independent Brazilian sample. Further steps should include model improvements and additional studies in populations with high levels of subclinical symptoms to improve clinical decision making.

https://doi.org/10.47626/1516-4446-2022-2775

Inattention symptoms in early pregnancy predict parenting skills and infant maltreatment during the first year of life
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Oliveira, Jordana Verano de

; Fatori, Daniel

; Shephard, Elizabeth

; Xavier Neto, Mauro

; Matijasevich, Alicia

; Ferraro, Alexandre Archanjo

; Rohde, Luis Augusto

; Chiesa, Anna Maria

; Miguel, Euripedes Constantino

; Polanczyk, Guilherme V.

Brazilian Journal of Psychiatry

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Ago 2022, Volume 44 Nº 4 Páginas 388 - 400

Resumo: En | Texto: En | PDF: En

Objective: Maternal attention-deficit/hyperactivity disorder has not been investigated in relation to parenting skills in adolescent mothers. This study investigated whether maternal inattention and hyperactivity/impulsivity symptoms early in pregnancy predict poorer parenting skills and infant maltreatment during the first year of life in adolescent mothers living in adverse environmental conditions. Methods: The participants in this study were 80 adolescent mothers aged 14-19 years and their babies who were taking part in a randomized controlled trial on the effects of a home-visiting program on infant development. Symptoms of maternal attention-deficit/hyperactivity disorder were assessed in the first trimester of pregnancy. Parenting skills (maternal competence, attachment to the baby, home environment) and child maltreatment were assessed when the infants were aged 6 and 12 months. Multilevel linear regression models were constructed to test the extent to which prenatal maternal inattention and hyperactivity/impulsivity symptoms predicted these parenting variables during the first year of the infant’s life. Results: Prenatal inattention symptoms significantly predicted lower maternal competence and attachment, a poorer home environment, and greater maltreatment during the first year of life. Hyperactivity did not significantly predict parenting skills or maltreatment. Conclusions: Our findings suggest that inattention symptoms may interfere with parenting abilities in adolescent mothers and should be considered in early intervention programs.

https://doi.org/10.47626/1516-4446-2021-2045

Desempenho em Aritmética de Estudantes com e sem Sintomas de TDAH
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Sperafico, Yasmini Lais Spindler

; Pisacco, Nelba Maria Teixeira

; Rohde, Luis Augusto Paim

; Nogues, Camila Peres

; Dorneles, Beatriz Vargas

Psico-USF

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Out 2021, Volume 26 Nº 4 Páginas 645 - 657

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) é um transtorno que frequentemente acarreta prejuízos ao desempenho acadêmico. O presente estudo teve como objetivo verificar a extensão desses prejuízos no desempenho aritmético, comparando estudantes com sintomas de TDAH com o de seus pares sem TDAH. O desempenho aritmético de 93 estudantes com sintomas de TDAH e 447 estudantes sem TDAH, entre 7 e 16 anos, de escolas públicas de Porto Alegre (3º a 9º ano), foi avaliado pelo Subteste de Aritmética do TDE. Estudantes com sintomas de TDAH apresentaram escores mais baixos e uma quantidade maior de erros de procedimento do que os estudantes sem o transtorno. Os resultados sugerem que sintomas frequentes de TDAH têm relação com maior ocorrência de erros no desempenho em aritmética dos estudantes avaliados neste estudo.

Abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent disorder that often impairs academic performance. The present study aimed to verify the extent of these impairments in arithmetic performance by comparing the performance of students with and without ADHD symptoms. The arithmetic performance of 93 students with ADHD symptoms and 447 students without ADHD was evaluated by the Arithmetical Subtest of the School Performance Test. Participants were attending public elementary schools in the municipality of Porto Alegre (3rd to 9th grades) and their age range was 7 to 16 years old. Those with ADHD symptoms had lower scores and a higher number of procedural errors than those without ADHD. The results suggest that frequent symptoms of ADHD are related to a higher frequency of errors in the arithmetic performance of the students assessed in this study.

Resumen El Trastorno por Déficit de Atención/Hiperactividad (TDAH) es un trastorno que frecuentemente acarrea perjuicios al desempeño académico. El presente estudio tuvo como objetivo verificar la extensión de las deficiencias en el desempeño aritmético, comparando el rendimiento de estudiantes con y sin síntomas de TDAH. El desempeño aritmético de 93 estudiantes con síntomas de TDAH y 447 estudiantes sin TDAH provenientes de escuelas públicas de Porto Alegre (del 3º al 9º año) y con edades entre los 7 y los 16 años, fueron evaluados por el Subtest de Aritmética del Test de Rendimiento Escolar. Los estudiantes con síntomas de TDAH presentaron puntuaciones más bajas y una mayor cantidad de errores de procedimiento que los estudiantes sin el trastorno. Los resultados sugieren que, en los estudiantes evaluados en este estudio, los síntomas frecuentes del TDAH se relacionan con una mayor frecuencia de errores en el desempeño en aritmética.

https://doi.org/10.1590/1413-82712021260404

Disability in children and adolescents: the extent of the impact on psychiatric disorders and educational deficits
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Zaqueu, Livia

; Teixeira, Maria Crista Triguero Veloz

; Lowenthal, Rosane

; Mari, Jair J.

; Miguel, Eurípedes Constantino

; Rohde, Luís Augusto

; Paula, Cristiane Silvestre

Trends in Psychiatry and Psychotherapy

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Set 2021, Volume 43 Nº 3 Páginas 235 - 239

Resumo: En | Texto: En | PDF: En

Abstract Introduction Most children/adolescents with disability live in low and middle-income countries and, worldwide, they are more likely to have mental health problems and achieve worse academic performance compared to those with typical development. Objective To assess whether Brazilian children/adolescents with four types of disabilities are more likely to have psychiatric disorders and educational deficits than children/adolescents with typical development. Method A multicenter cross-sectional study involving a school-based probabilistic sample of second to sixth graders (N = 1,674) from public schools in four Brazilian regions. The four types of disabilities (intellectual, visual, hearing, and motor) were assessed using the Ten Questions Questionnaire. Psychiatric disorders were measured with the Schedule for Affective Disorders/Schizophrenia for School-Age Children (K-SADS-PL), and academic performance was evaluated using the Teste de Desempenho Acadêmico – TDE (the academic performance test). Results A logistic regression model with cluster-robust errors identified the following statistically significant associations with three of the four types of disability (the exception was hearing). Intellectual disability was associated with anxiety (p < 0.01), depression (p < 0.01), attention deficit hyperactivity disorder (ADHD) (p < 0.001), school failure (p < 0.01), and poor academic performance (p < 0.01). Visual disability was associated with depression (p < 0.01). Motor disability was marginally associated with ADHD (p = 0.08). Conclusions Presence of disabilities (intellectual, visual, and motor) in children/adolescents was associated with psychiatric disorders, school failure, and academic performance. It is therefore important to identify presence of disabilities and plan and deliver specific interventions and specialized educational care for the needs presented by these children/adolescents. This is particularly important in low and middle-income countries, where these disabilities are frequent among children/adolescents.

https://doi.org/10.47626/2237-6089-2020-0059 136 downloads

Attention-deficit/hyperactivity disorder and brain metabolites from proton magnetic resonance spectroscopy: a systematic review and meta-analysis protocol
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Vidor, Marcos Vinícius

; Panzenhagen, Alana Castro

; Martins, Alexandre Ribeiro

; Cupertino, Renata Basso

; Bandeira, Cibele Edom

; Rohde, Luis Augusto

; Rovaris, Diego Luiz

; Bau, Claiton Henrique Dotto

; Grevet, Eugênio Horácio

Trends in Psychiatry and Psychotherapy

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Mar 2021, Volume 43 Nº 1 Páginas 1 - 8

Resumo: En | Texto: En | PDF: En

Abstract Despite major advances in the study of the brain, investigations on neurochemistry in vivo still lack the solid ground of more established methods, such as structural and functional magnetic resonance imaging. Proton magnetic resonance spectroscopy (MRS) is a technique that might potentially fill in this gap. Nevertheless, studies using this approach feature great methodological heterogeneity, such as varying voxel of choice, differences on emphasized metabolites, and absence of a standardized unit. In this study, we present a methodology for creating a systematic review and meta-analysis for this kind of scientific evidence using the prototypical case of attention-deficit/hyperactivity disorder. Systematic review registration: International Prospective Register of Systematic Reviews (PROSPERO), CRD42018112418.

https://doi.org/10.47626/2237-6089-2019-0111 364 downloads

Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries
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Cirillo, Alessandra

; Diniz, Elton

; Gadelha, Ary

; Asevedo, Elson

; Axelrud, Luiza K.

; Miguel, Eurípedes C.

; Rohde, Luis Augusto

; Bressan, Rodrigo A.

; Pan, Pedro

; Mari, Jair de J.

Brazilian Journal of Psychiatry

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Ago 2020, Volume 42 Nº 4 Páginas 442 - 448

Resumo: En | Texto: En | PDF: En

Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscience to study how genes and the environment shape typical and atypical brain functioning. The objective of this study was to review key studies on population neuroscience from low- and middle-income countries (LMICs) and to identify potential gaps vis-à-vis studies conducted in high-income countries. Methods: We conducted a systematic review to search for longitudinal cohort studies investigating the development of psychiatric disorders in children and adolescents in LMICs. We performed an electronic search in the EMBASE and MEDLINE databases from inception to July 5th, 2019. Results: We found six cohorts from four countries that met our search criteria: three cohorts from Brazil, one from China, one from South Africa, and one from Mauritius. Relevant examples of findings from these studies are reported. Conclusion: Our results demonstrate the impact of the valuable science output these cohort designs promote, allowing LMICs to have a share in frontline global psychiatry research. National and international funding agencies should invest in LMIC population neuroscience in order to promote replication and generalization of research from high-income countries.

https://doi.org/10.1590/1516-4446-2019-0761 584 downloads

Mental disorders and suicide risk in emerging adulthood: the 1993 Pelotas birth cohort
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Gomes, Ana Paula

; Soares, Ana Luiza G.

; Kieling, Christian

; Rohde, Luis Augusto

; Gonçalves, Helen

Revista de Saúde Pública

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2019, Volume 53 elocation 96

Resumo: En | Texto: En | PDF: En

ABSTRACT OBJECTIVE To assess the prevalence of some mental disorders and suicide risk, and the association between them in youths. METHODS Data from the 1993 Pelotas Birth Cohort (Brazil) was used. The prevalence of mental disorders at 22 years [major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), attention-deficit/ hyperactivity disorder (ADHD), bipolar disorders type 1 and 2 (BD1; BD2), post-traumatic stress disorder (PTSD), and antisocial personality disorder (APD)] and of suicide risk were assessed using the Mini International Neuropsychiatric Interview (n = 3,781). Comorbidity between disorders was also assessed. Association of each mental disorder and the number of disorders with suicide risk was assessed using Poisson regression. RESULTS The prevalence of any mental disorder was 19.1% (95%CI 17.8–20.3), and GAD was the most prevalent (10.4%; 95%CI 9.5–11.4). The prevalence of current suicide risk was 8.8% (95%CI 5.9–9.7). All disorders (except APD) and the suicide risk were higher among women. Mental disorders were associated with a higher suicide risk, with the highest risks being observed for MDD (RR = 5.6; 95%CI 4.1–7.8) and PTSD (RR = 5.0; 95%CI 3.9–6.3). The higher the number of co-occurring mental disorders, the higher the risk of suicide. CONCLUSIONS Our findings showed that about 20% of the youths had at least one mental disorder. However, this prevalence is underestimated since other relevant mental disorders were not assessed. Mental disorders were associated with higher suicide risk, especially the comorbidity between them.

https://doi.org/10.11606/s1518-8787.20190530012356 1197 downloads

Mental disorders and suicide risk in emerging adulthood: the 1993 Pelotas birth cohort
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Gomes, Ana Paula

; Soares, Ana Luiza G.

; Kieling, Christian

; Rohde, Luis Augusto

; Gonçalves, Helen

Revista de Saúde Pública

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2019, Volume 53 elocation 96

Resumo: En | Texto: En | PDF: En

https://doi.org/10.11606/s1518-8787.20190530012356

10.

Diagnostic operationalization and phenomenological heterogeneity in psychiatry: the case of attention deficit hyperactivity disorder
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Salum, Giovanni Abrahão

; Gadelha, Ary

; Polanczyk, Guilherme Vanoni

; Miguel, Eurípedes Constantino

; Rohde, Luis Augusto

Salud mental

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Dez 2018, Volume 41 Nº 6 Páginas 249 - 260

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Introduction We assessed the impact of polythetic conceptualizations of mental disorders on the validity and reliability of psychiatric diagnosis, with a specific focus on two levels of heterogeneity: phenomenological and pathophysiological. Objective We investigated this issue using attention deficit hyperactivity disorder (ADHD) as an example. Method We examined individuals from two samples enriched for psychopathology (n = 1 255 children in Porto Alegre and 1 257 children in São Paulo, Brazil). We conducted a series of data analyses to investigate phenomenological heterogeneity, including confirmatory factor analysis. We also investigated pathophysiological heterogeneity using symptom-level regressions between ADHD symptoms and four neurocognitive processes consistently linked to ADHD (working memory, inhibitory control, intra-subject variability in reaction times, and temporal processing). Lastly, we assessed the performance of polythetic systems for reliability testing inter-rater and test-rest reliability of two well-known symptomatic scales. Results Among the 116 200 possible combinations of symptoms to achieve DSM symptomatic threshold for categorical ADHD diagnosis, we found 173 combinations in the two independent samples, and only four were replicated in both samples (2.3%). We also found that the number of ADHD symptoms is a poor indicator of variation in the general ADHD latent trait. Overall, symptoms did not have specific profiles of associations with any of the neurocognitive processes. Reliability analyses revealed that increasing the number of items augments overall reliability of measurements. Discussion and conclusion Our findings illustrate both potential benefits and problems inherent to the polythetic system for ADHD. Implications for the search of mechanisms underlying psychiatric disorders are discussed.

Resumen Antecedentes Evaluamos el impacto de las conceptualizaciones politécnicas de los trastornos mentales en la validez y la fiabilidad del diagnóstico psiquiátrico, con un enfoque específico en dos niveles de heterogeneidad: fenomenológico y fisiopatológico. Objetivos Investigamos este problema utilizando el trastorno por déficit de atención e hiperactividad (TDAH) como ejemplo. Método Examinamos individuos de dos muestras enriquecidas por psicopatología (n = 1 255 niños en Porto Alegre y 1 257 niños en São Paulo, Brasil). Llevamos a cabo una serie de análisis de datos para investigar la heterogeneidad fenomenológica, incluido el análisis factorial confirmatorio. También investigamos la heterogeneidad fisiopatológica utilizando regresiones al nivel de síntomas entre los síntomas del TDAH y cuatro procesos neurocognitivos consistentemente vinculados al TDAH (memoria de trabajo, control inhibitorio, variabilidad intrasujeto en tiempos de reacción y procesamiento temporal). Por último, evaluamos el rendimiento de los sistemas politéticos para la prueba de confiabilidad interevaluador y la confiabilidad test-rest de dos escalas sintomáticas bien conocidas. Resultados Entre las 116 200 posibles combinaciones de síntomas para alcanzar el umbral sintomático del DSM para el diagnóstico categórico de TDAH, encontramos 173 combinaciones en las dos muestras independientes y sólo cuatro se replicaron en ambas muestras (2.3%). También encontramos que la cantidad de síntomas de TDAH no es un buen indicador de la variación en el rasgo latente general del TDAH. En general, los síntomas no tenían perfiles específicos de asociaciones con ninguno de los procesos neurocognitivos. Los análisis de confiabilidad revelaron que aumentar el número de artículos aumenta la confiabilidad general de las mediciones. Discusión y conclusión Nuestros hallazgos ilustran tanto los beneficios potenciales como los problemas inherentes al sistema politécnico para el TDAH. Se discuten las implicaciones para la búsqueda de mecanismos subyacentes a los trastornos psiquiátricos.

https://doi.org/10.17711/sm.0185-3325.2018.037 867 downloads

11.

Socioeconomic diversities and infant development at 6 to 9 months in a poverty area of São Paulo, Brazil
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Tella, Patricia

; Piccolo, Luciane da Rosa

; Rangel, Mayra Lemus

; Rohde, Luis Augusto

; Polanczyk, Guilherme Vanoni

; Miguel, Euripides Constantino

; Grisi, Sandra Josefina Ferraz Ellero

; Fleitlich-Bilyk, Bacy

; Ferraro, Alexandre Archanjo

Trends in Psychiatry and Psychotherapy

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Set 2018, Volume 40 Nº 3 Páginas 232 - 240

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução Os efeitos das disparidades socioeconômicas no desenvolvimento cognitivo tendem a surgir no início da primeira infância e a se ampliar ao longo da infância, e podem perpetuar-se mais tardiamente. Embora estudos mostrando os efeitos deletérios de um menor nível socioeconômico (NSE) no desenvolvimento na primeira infância tenham aumentado nos últimos 20 anos, muitos desses efeitos ainda permanecem desconhecidos, especialmente durante o primeiro ano de vida. Objetivo Investigar a influência do NSE e da escolaridade materna no desenvolvimento linguístico, motor e cognitivo do bebê. Método Foram avaliadas as habilidades cognitivas, linguísticas e motoras de 444 lactentes com 6 a 9 meses de idade selecionados em um bairro de baixo NSE na zona oeste de São Paulo, Brasil, utilizando-se as Escalas Bayley de Desenvolvimento Infantil. Um questionário também foi administrado para coletar dados sobre o background socioeconômico das famílias das crianças participantes. Resultado Foi observada uma associação positiva entre NSE e o desempenho dos lactentes nas escalas de linguagem e desenvolvimento motor. Adicionalmente, maior educação materna esteve associada a escores mais altos nas escalas de desenvolvimento linguístico e cognitivo. Conclusão Os resultados deste estudo indicam que os efeitos do NSE são detectáveis muito cedo na primeira infância. Este resultado tem implicações para o timing de avaliações e intervenções que possam ajudar as crianças a superar as consequências de viver na pobreza.

Abstract Introduction The effects of socioeconomic disparities on cognitive development tend to emerge early in infancy and to widen throughout childhood, and may perpetuate later in life. Although the study of how poverty affects early childhood has increased in the last 20 years, many of the effects remain largely unknown, especially during the first year of life. Aim To investigate the influence of socioeconomic status (SES) and maternal education on infants’ language, motor and cognitive development. Methods The cognitive, language and motor skills of 444 infants aged 6 to 9 months selected from a poor neighborhood in São Paulo, Brazil, were evaluated using the Bayley Scales of Infant Development. A questionnaire on socioeconomic background was administered to the participants’ families. Results A positive association was found between SES and infants’ performance on language and motor scales. Additionally, higher maternal education was associated with higher language and cognitive scores. Conclusion Our findings indicate that SES effects are detectable very early in infancy. This result has implications for the timing of both screening and intervention efforts to help children overcome the consequences of living in poverty.

https://doi.org/10.1590/2237-6089-2017-0008 2361 downloads

12.

3ª Diretriz Brasileira de Transplante Cardíaco
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Bacal, Fernando

; Marcondes-Braga, Fabiana G.

; Rohde, Luis Eduardo Paim

; Xavier Júnior, José Leudo

; Brito, Flávio de Souza

; Moura, Lídia Ana Zytynski

; Colafranceschi, Alexandre Siciliano

; Lavagnoli, Carlos Fernando Ramos

; Gelape, Cláudio Leo

; Almeida, Dirceu Rodrigues

; Gaiotto, Fábio Antônio

; Atik, Fernando Antibas

; Figueira, Fernando Augusto M. S.

; Souza, Germano Emílio Conceição

; Rodrigues, Hélcio

; Campos, Iáscara Wozniak

; Souza Neto, João David de

; Rossi Neto, João Manoel

; Gasparetto, Juliano

; Goldraich, Lívia Adams

; Benvenuti, Luiz Alberto

; Seguro, Luis Fernando B. C.

; Ulhôa Júnior, Marcelo Botelho

; Moreira, Maria da Consolação V.

; Ávila, Mônica Samuel

; Carneiro, Rodrigo

; Mangini, Sandrigo

; Ferreira, Sílvia Moreira Ayub

; Strabelli, Tânia Mara

Arquivos Brasileiros de Cardiologia

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Ago 2018, Volume 111 Nº 2 Páginas 230 - 289

Resumo: Pt | Texto: Pt | PDF: Pt

https://doi.org/10.5935/abc.20180153 28659 downloads

13.

Metacognitive interventions in text production and working memory in students with ADHD
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Pisacco, Nelba Maria Teixeira

; Sperafico, Yasmini Lais Spindler

; Enricone, Jacqueline Raquel Bianchi

; Guimarães, Luciano Santos Pinto

; Rohde, Luis Augusto

; Dorneles, Beatriz Vargas

Psicologia: Reflexão e Crítica

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2018, Volume 31 elocation 5

Resumo: En | Texto: En | PDF: En

Abstract This study compared the effects of two metacognitive interventions on writing, working memory (WM), and behavioral symptoms of students with attention-deficit/hyperactivity disorder (ADHD). The disorder was clinically diagnosed by a multidisciplinary team according to DSM-IV criteria. The first approach consisted of a combined intervention in text production and WM while the second focused only on WM. Participants were 47 students from the fifth to ninth grades of two public elementary schools in Porto Alegre (Brazil), randomized to one of the two interventions groups. Writing and WM were assessed before, immediately after, and 3 months after the interventions. The results suggest that both interventions contributed to improving behavior and school performance, whereas only the combined intervention increased the overall quality of narrative text, organization of paragraphs, and denouement.

https://doi.org/10.1186/s41155-017-0081-9 1444 downloads

14.

3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology
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Gualandro, Danielle Menosi

; Yu, Pai Ching

; Caramelli, Bruno

; Marques, André Coelho

; Calderaro, Daniela

; Fornari, Luciana Savoy

; Pinho, Claudio

; Feitosa, Alina Coutinho Rodrigues

; Polanczyk, Carisi Anne

; Rochitte, Carlos Eduardo

; Jardim, Carlos

; Vieira, Carolina L. Z.

; Nakamura, Debora Y. M.

; Iezzi, Denise

; Schreen, Dirk

; Adam, Eduardo Leal

; D’Amico, Elbio Antonio

; Lima, Emerson Q. de

; Burdmann, Emmanuel de Almeida

; Mateo, Enrique Indalecio Pachón

; Marcondes-Braga, Fabiana Goulart

; Machado, Fabio S.

; Paula, Flavio J. de

; Carmo, Gabriel Assis Lopes do

; Feitosa-Filho, Gilson Soares

; Prado, Gustavo Faibischew

; Lopes, Heno Ferreira

; Fernandes, João R. C.

; Lima, José J. G. de

; Sacilotto, Luciana

; Drager, Luciano Ferreira

; Vacanti, Luciano Janussi

; Rohde, Luis Eduardo Paim

; Prada, Luis F. L.

; Gowdak, Luis Henrique Wolff

; Vieira, Marcelo Luiz Campos

; Monachini, Maristela Camargo

; Macatrão-Costa, Milena Frota

; Paixão, Milena Ribeiro

; Oliveira Junior, Mucio Tavares de

; Cury, Patricia

; Villaça, Paula R.

; Farsky, Pedro Silvio

; Siciliano, Rinaldo F.

; Heinisch, Roberto Henrique

; Souza, Rogerio

; Gualandro, Sandra F.M.

; Accorsi, Tarso Augusto Duenhas

; Mathias Júnior, Wilson

Arquivos Brasileiros de Cardiologia

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Set 2017, Volume 109 Nº 3 Páginas 1 - 104

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20170140 100302 downloads

15.

Computerized cognitive training in children and adolescents with attention deficit/hyperactivity disorder as add-on treatment to stimulants: feasibility study and protocol description
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Rosa, Virginia de Oliveira

; Schmitz, Marcelo

; Moreira-Maia, Carlos Renato

; Wagner, Flavia

; Londero, Igor

; Bassotto, Caroline de Fraga

; Moritz, Guilherme

; Souza, Caroline dos Santos de

; Rohde, Luis Augusto Paim

Trends in Psychiatry and Psychotherapy

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Jun 2017, Volume 39 Nº 2 Páginas 65 - 76

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução O treinamento cognitivo tem recebido atenção especial como abordagem não medicamentosa para o tratamento do transtorno de déficit de atenção/hiperatividade (TDAH) em crianças e adolescentes. Poucos estudos avaliaram o treinamento cognitivo como abordagem complementar à medicação em ensaios clínicos randomizados controlados por placebo. O objetivo deste estudo foi explorar a viabilidade para a implementação de um programa de treinamento cognitivo computadorizado, descrever suas características principais e potencial eficácia em um pequeno estudo piloto. Métodos Seis pacientes com TDAH entre 10-12 anos de idade, em uso de psicoestimulantes e apresentando sintomas residuais, foram recrutados e randomizados para um dos dois grupos (treinamento cognitivo ou placebo) por 12 semanas. O desfecho principal foram os sintomas nucleares do TDAH avaliados através do Questionário de Swanson, Nolan e Pelham (SNAP-IV). Resultados Encontramos maior resistência do que a esperada no recrutamento dos pacientes em função de problemas logísticos para atender às sessões presenciais no hospital assim como para preencherem os critérios de status medicamentoso e ausência de algumas comorbidades. Ambos os grupos apresentaram diminuição nos escores dos sintomas de TDAH reportados pelos pais, mas sem diferença estatística entre eles. Além disso, foi observada melhora nos testes neuropsicológicos em ambos os grupos – principalmente nas tarefas treinadas pelo programa. Conclusão Este protocolo revelou a necessidade de novas estratégias para melhor avaliar a eficácia do treinamento cognitivo tal como a necessidade de implementar a intervenção no ambiente escolar a fim de obter uma avaliação com maior validade externa. Devido ao pequeno tamanho amostral deste estudo, conclusões definitivas sobre os efeitos do treinamento cognitivo como abordagem complementar aos psicoestimulantes seriam prematuras.

Abstract Background Cognitive training has received increasing attention as a non-pharmacological approach for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents. Few studies have assessed cognitive training as add-on treatment to medication in randomized placebo controlled trials. The purpose of this preliminary study was to explore the feasibility of implementing a computerized cognitive training program for ADHD in our environment, describe its main characteristics and potential efficacy in a small pilot study. Methods Six ADHD patients aged 10-12-years old receiving stimulants and presenting residual symptoms were enrolled in a randomized clinical trial to either a standard cognitive training program or a controlled placebo condition for 12 weeks. The primary outcome was core ADHD symptoms measured using the Swanson, Nolan and Pelham Questionnaire (SNAP-IV scale). Results We faced higher resistance than expected to patient enrollment due to logistic issues to attend face-to-face sessions in the hospital and to fill the requirement of medication status and absence of some comorbidities. Both groups showed decrease in parent reported ADHD symptoms without statistical difference between them. In addition, improvements on neuropsychological tests were observed in both groups – mainly on trained tasks. Conclusions This protocol revealed the need for new strategies to better assess the effectiveness of cognitive training such as the need to implement the intervention in a school environment to have an assessment with more external validity. Given the small sample size of this pilot study, definitive conclusions on the effects of cognitive training as add-on treatment to stimulants would be premature.

https://doi.org/10.1590/2237-6089-2016-0039 4883 downloads

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