Although this study does not reflect reality, it can be used as a warning to pediatricians.

Objectives: To describe the experience of group therapy with offender adolescents in an Institution for minor violators ("Fundação CASA") and who have suffered from mental disorders related to psychoactive substance use. Methods: "Fundação CASA" is an institution created to shelter minor offenders. In 2008 some were judicially referred for treatment to a University Hospital Psychoactive Substance Outpatients Service. An operative and informative group was formed, since they have not adapted to the already existing adult group. This group met weekly, aimed to prevent relapse and initially planned to last 6 meetings. Results: Soon there were 4 adolescents who had engaged with the group and requested to increase the number of sessions. Psychodynamic issues emerged during the sessions, which were well evaluated by all participants after 10 weeks, when the group had to be ended due to the completion of sentences of 3 participants. In 2009 only 3 of them were found. The first reported a relapse, but remains abstinent. The second started working as general assistant and remained abstinent. The third continued to consume crack and was arrested by the time he was 18. Conclusions: This study showed the need for specific treatment for the group of juvenile offenders. Operative and informative groups create a communication space for drug users and other psychotic subjects. It permits group identification and allows the expression of mental suffering. Therefore this practice consists of a low complexity approach in an extremely vulnerable population, which is so prevalent in developing countries such as Brazil.

Objective: To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents. Method: The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior. Results: Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA). All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine) have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects. Conclusions: There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use. Keywords: Aggression, violence, atypical antipsychotics, behavioral disorders, children, adolescents. ResumoObjetivo: Realizar uma revisão sistemática da literatura científica sobre o uso de antipsicóticos atípicos (APAs) no tratamento da agressividade patológica em crianças e adolescentes. Método: Foi realizada busca eletrônica nas bases de dados MEDLINE, SciELO e LILACS, de 1992 a agosto 2011, considerando artigos publicados em língua inglesa e portuguesa. Foram utilizadas associações das seguintes expressões: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behaviour, aggression e violent behavior. Resultados: Foram identificados 67 artigos de boa qualidade metodológica, de relevância e interesse clínico para o tema em foco. De modo geral, os estudos são relativamente limitados para esta faixa etária, resultado do fato de poucos APAs terem sido aprovados pela Food and Drug Administration (FDA). Dentre as medicações consideradas nesta revisão (risperidona, olanzapina, quetiapina, ziprazidona, aripiprazol e clozapina), todas elas podem ter alguma efetividade no tratamento da agressividade em crianças e adolescentes, ficando a escolha baseada na indicação clínica e perfil de efeitos colaterais. Conclusão: O número ainda limitado de estudos acerca da efetividade e segurança na população pediátrica demanda pesquisas futuras com grupos maiores de pacientes e com mais categorias diagnósticas (como, por exemplo, as formas graves de transtorno de conduta e transtorno desafiador de oposição), desenhadas de forma randomizada e controlada. Assim poderão ser confirmados os achados até o momento e o impacto do uso em lo...

Os autores traduzem, pela primeira vez para o português, o artigo de Charles

No abstract

Objectives: To discuss the paradigm of melancholy in hysteria. Methods: case report of M., a 45 year-old woman, who is under psychotherapy and psychiatric treatment at the General Hospital of the University of Campinas (HC Unicamp). Results: K. is a 45 year-old divorced mother and former teacher, who started psychotherapy and psychiatric treatment at HC Unicamp in 2007, two years after the death of her father.Since such loss,K. made several violent suicide attempts: she jumped from the balcony of her apartment, took an overdose of medications, and set fire to her body in front of the mirror, which caused permanent scars. During both the psychotherapy sessions and the psychiatric consultations, K. frequently expressed how her life had lost its meaning after the death of her father. She mentioned she was no longer able to love and had no reason to continue living. She also complained about her ex-husband, from whom she was divorced after being betrayed, and about her children, who did not give her, according to her point of view, enough attention and care. Conclusions: The patient is inside a typical hysterical scene, a "spectacle" composed by dramatic acts against her life. However, it is undeniable her identification with the lost object, her father. By setting fire to her own body in front of the mirror, she shows a melancholic kind of satisfaction with the pain, caused by a massive and destructive narcissism turned against herself.

Objectives: To investigate socio-demographic and clinical trials of 19 sexually abused children. Methods: Statistical analysis with SPSS of data on psychiatric and pediatric care of sexually abused children, aged 2-12 years old, treated at the Pediatric Service of University of Campinas-Brazil Clinical Hospital in 2007.

Objectives: To review the literature on child sexual abuse with emphasis on psychosocial/psychodynamic aspects. Methods: Systematic literature review from the articles indexed in Medline, PSYinfo, Pepsic, Lilacs and Scielo in the last ten years. Terms researched were: child sexual abuse, psychosocial, psychodynamic and psychoanalysis. Results: Child sexual abuse can have devastating consequences for the psychological functioning of children, possibly interfering with their proper process of development. It can contribute to violent behavior, acts of delinquency and mental disorders in adolescence and adulthood, as well as the development of comorbid post-traumatic stress and self-aggressive behaviors, risk behaviors and teenage pregnancy. Gravity of psychic consequences increase in relation to the frequency of abuse. Aspects of power, seduction and coercion are involved. Inequalities of age and gender are highlighted. Often practiced without the use of physical force, it may be difficult to be proven. A frequent abuser of familiarity with the child creates conditions that foster abuse. The revelation of the abuse may not occur, perpetuating the suffering and helplessness of the child. Sexually abused children may develop identification with the abuser and even become sexual offenders in adulthood. There are difficulties in the conceptual definition of abuse, the establishment of protocols for investigative and therapeutic management of cases and in predicting the immediate consequences along with the medium and longterm consequences. Conclusions: Studies on the therapeutic practices used for the treatment of abused children and their families can help to construct therapeutic models, minimizing suffering in this terrible situation of violence.