A b s t r a c t Objective: Metabolic syndrome is a highly prevalent disorder among the general population. Studies show an even higher prevalence among psychiatric patients. The objective of this study is to assess the prevalence of metabolic syndrome among inpatients of a psychiatric ward of a general hospital in Brazil and correlate it with their respective psychiatric diagnoses and with the antipsychotics and mood stabilizers used. Method: 170 inpatients (mean age: 45.6 years) were evaluated according to the National Cholesterol Education Program criteria for metabolic syndrome, with a modification of the criteria for blood pressure and fasting glucose. Results: The prevalence found was 29.4%, being higher in women (43.6% versus 20.8%, p = 0.002). The prevalence stratified by psychiatric diagnostic was 48.1% for depression, 38.3% for bipolar disorder, 31.8% for schizophrenia and schizoaffective disorder, 5.1% for alcoholism, and 23.1% for "other mental disorders". The prevalence for alcoholism was significantly lower than the prevalence rates associated with other diagnostic categories (p = 0.035). After using the multivariate analysis, female gender and use of lithium remained as factors associated with a diagnosis of metabolic syndrome. Conclusions: The prevalence found was 29.4%. Gender (female) and use of lithium were factors significantly associated with the diagnosis of metabolic syndrome.Descriptors: Metabolic syndrome X; Mental disorders; Schizophrenia; Bipolar disorder; Depression Resumo Objetivo: A síndrome metabólica é um transtorno de alta prevalência na população em geral. Estudos demonstram prevalência ainda maior em pacientes psiquiátricos. O objetivo deste trabalho é avaliar a prevalência de síndrome metabólica em pacientes internados em uma enfermaria psiquiátrica de um hospital geral no Brasil e correlacioná-la com os diagnósticos psiquiátricos e com o uso de medicamentos antipsicóticos e moduladores do humor. Método: Cento e setenta pacientes (idade média: 45,6 anos) foram avaliados de acordo com os critérios do National Cholesterol Education Program para síndrome metabólica, modificados nos critérios pressão arterial e glicemia de jejum. Resultados: A prevalência encontrada foi de 29,4%, sendo mais elevada em mulheres (43,6% versus 20,8%, p = 0,002). A prevalência estratificada por diagnóstico psiquiátrico foi de 48,1% para depressão, 38,3% para transtorno bipolar, 31,8% para esquizofrenia e transtornos esquizoafetivos, 5,1% para alcoolismo e 23,1% para "outros transtornos mentais". A prevalência para alcoolismo foi significativamente menor, se comparada às prevalências associadas às demais categorias diagnósticas (p = 0,035). Após análise multivariada, o sexo feminino e o uso de lítio permaneceram como fatores associados ao diagnóstico de síndrome metabólica. Conclusão: A prevalência de síndrome metabólica encontrada foi de 29,4%. O sexo feminino e o uso de lítio foram fatores significativamente associados ao diagnóstico de síndrome metabólica.

OBJETIVO: Determinar e comparar os índices de depressão e risco de suicídio entre estudantes de medicina, fisioterapia e terapia ocupacional matriculados na Faculdade de Ciências Médicas de Minas Gerais (FCMMG) no ano de 2003. MÉTODOS: Foram selecionados 342 estudantes através de amostragem por cotas. O diagnóstico psiquiátrico foi realizado por meio do Mini International Neuropsychiatric Interview (MINI). A prevalência de transtornos depressivos foi estimada segundo curso, sexo e período letivo. Para comparação utilizou-se o teste qui-quadrado (chi2) ou o teste exato de Fisher, com um nível de significância de 5% (p < 0,05). RESULTADOS: As taxas de prevalência de depressão entre os alunos foram medicina, 8,9%; fisioterapia, 6,7%; terapia ocupacional, 28,2% (p = 0,002). As taxas de prevalência para o risco de suicídio entre os alunos foram medicina, 7,5%; fisioterapia, 7,8%; terapia ocupacional, 25,6% (p = 0,005). CONCLUSÃO: As taxas de prevalência de depressão e do risco de suicídio entre os estudantes de terapia ocupacional foram significativamente mais elevadas quando em comparação com as observadas entre os de medicina e fisioterapia.

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Depression is common in Parkinson's disease (PD) and is associated with several poor outcomes. However the literature regarding treatment with antidepressants in this population is controversial. The aim of this paper was to systematically review all randomized controlled trials that studied the efficacy of antidepressants for depression in PD (dPD). Studies were retrieved from PubMed (1966-July 2012), Cochrane Library (-July 2012, issue 7), Embase (1980-July 2012), PsycINFO (1980-July 2012), Lilacs (1982-July 2012), secondary references, clinical trials registries and a thesis database. Only double-blind, randomized controlled trials in which an antidepressant was given as the main treatment and compared with placebo and/or another antidepressant were included. Out of the 1438 studies retrieved, only six could be included. Taking into account the five placebo-controlled trials, the overall risk ratio (RR) for response was 1.36 (0.98, 1.87), indicating no statistically significant superiority of antidepressants over placebo. However, in the sensitivity analysis, the RR for response was 1.41 (1.01, 1.96) and 1.48 (1.05, 2.10) after exclusion of one study with questionable results, and when only studies with low risk of bias were considered, respectively. No specific antidepressant class was superior to placebo. In general antidepressant medications were well tolerated. The results suggest antidepressants may be efficacious in the treatment of dPD. However, the results were unstable. In fact, the small number of trials and methodological drawbacks preclude definitive conclusions about their efficacy and tolerability in dPD.

Background/Aims: To evaluate the efficacy and safety of venlafaxine in the treatment of major depression in dementia. Methods: Thirty-one outpatients who had dementia and major depression participated in this randomized, double-blind, placebo-controlled, 6-week, flexible dose clinical trial. The screening measures were Cornell Scale for depression in dementia, DSM-IV for depression and dementia and Mini-Mental State Examination. The outcome measures were response rate, Montgomery-Åsberg Depression Rating scale and Clinical Global Impressions. Results: The percentage of patients defined as Montgomery-Åsberg Depression Rating scale responders was approximately the same in the placebo and in the venlafaxine groups. Clinical Global Impressions showed no significant difference between the groups. The reasons for dropouts show borderline significance between the two groups. There was no statistically significant difference in the incidence of adverse events between the venlafaxine and placebo-treated groups. Conclusions: Our data do not support the hypothesis that venlafaxine improves mood in elderly demented patients.

Summary This study investigates the association of sleep duration with risk of all‐cause mortality among elderly Brazilians using data from a 9‐year population‐based cohort study and applying a multivariable longitudinal categorical and continuous analysis using Cox’s proportional hazards models. This analysis used data from the Bambui Health and Ageing Study (BHAS), conducted in Bambuí city (approximately 15 000 inhabitants) in southeastern Brazil. The study population comprised 1512 (86.8%) of all eligible 1742 elderly residents. In multivariable analysis, using sleep duration as categorical variable and controlling for multiple measures of sociodemographic and health status, those who slept 9 h or more per night were found to be at higher risk of mortality than those who slept 7 h [hazard ratio (HR): 1.53; 95% confidence interval (CI): 1.12–2.09]. Excluding those whose deaths occurred within 2 years after entry, this association remained significant (HR: 1.56; 95% CI: 1.12–2.18). In analyses using sleep duration as a continuous variable, a linear correlation was found between sleep duration and mortality in all adjusted models in the whole sample (HR: 1.08; 95% CI: 1.02–1.15) and following exclusion of those whose deaths occurred within 2 years after entry (HR: 1.13; 95% CI: 1.06–1.21). Both linear and quadratic terms were significant, reflecting a predicted relationship, with mortality predominantly increasing in association with long sleep duration but with the addition of a slight decrease in association with shorter sleep duration. In conclusion, long rather than short sleep duration was associated principally with all‐cause mortality in this sample. It is therefore reasonable to suggest that clinicians should be aware of the potential adverse prognosis associated with prolonged sleep.