Background: Most of the clinical trials involving cognitive-behavioral therapy (CBT) for the treatment of anorexia nervosa (AN) used the individual therapy format, and few have been dedicated to adapting and assessing the effects of the group format. Objectives: To assess the applicability and effects of a group CBT program for Brazilian adolescents with AN. Methods: Open clinical trial with 22 patients with AN divided into an intervention group -IG (n = 11; CBT, psychiatry, nutrition and family psychoeducation-6 months) and a control group -CG (n = 11; psychiatry, nutrition and family psychoeducation-6 months). Data collected at baseline, at the end of groups and six months after the completion were: weight, height, body mass index and Eating Disorder Examination Questionnaire (EDE-Q) used to assess the severity of AN symptoms. Results: Baseline homogeneous groups, with 91% adherence in the IG vs. 54% in the CG (p = 0.05). Participants in both groups regained weight and decreased symptoms of eating disorders at the end of groups. Comparing the EDE-Q scores IG presented a statistically significant difference in the restraint subscale of the EDE-Q between the end-of-group and the follow-up (p = 0.01). Discussion: Group CBT program produced positive effects and was applicable in Brazilian adolescents with AN as an adjuvant to multidisciplinary treatment.Pegado P et al. / Arch Clin Psychiatry. 2018;45(3):57-60

Background: Efficacy studies on the treatment of anorexia nervosa (AN) in childhood and adolescence are scarce and systematic reviews are almost non-existent. Objective: Systematic review of the literature regarding the modalities of psychological intervention based on evidence used in the treatment of AN in childhood and adolescence. Methods: The research was carried out in the databases: PubMed, PsycINFO and Cochrane, using the combined keywords: anorexia nervosa and evidence-based therapy. Articles published between 1990 and 2015 were assessed. Results: Of the 139 eligible articles, 14 were selected, of which 10 (71.4%) were conducted in the United States and England. The sample ranged from 9 to 167 participants. Randomized Clinical Trial represented the most frequent design (n = 9; 63.4%), with more than half of the interventions structured in 20 or more sessions (n = 9, 64.3%). Nine types of treatments were tested, with the most tested being Family-Based Treatment (FBT) (n = 7; 50%). Interventions involving the family seem to be more effective, however, the rates for complete remission are modest. Discussion: Although evidence of efficacy was verified in the treatments analyzed, the limited number of studies, the various methodological limitations and the methodological heterogeneity between studies make the findings inconclusive.

psicologia.v16n3p83-99. Sistema de avaliação: às cegas por pares (double blind review).

RESUMOO estudo teve como objetivo comparar os escores de problemas de comportamento relatados por adolescentes, vítimas de bullying, aos escores reportados por seus professores, e discutir acerca das convergências e divergências, e de suas implicações. Para identificar alvos de bullying se utilizou a Escala de Violência Escolar e a versão traduzida do Peer Assessment. Na avaliação de problemas de comportamento foram utilizados o Youth Self Report e o Teacher Report Form. Participaram 50 adolescentes com média de 11,3 anos (DP=0,7), matriculados em duas turmas de Ensino Fundamental II (6º e 7º anos) de uma escola pública paulista. Destes, sete (14%) foram identificados como alvos de bullying, sendo quatro do gênero masculino. Problemas de comportamento internalizantes, externalizantes e totais estiveram em nível clínico na maioria das vítimas, segundo o relato dos próprios alunos e de seus professores, que relataram menos problemas de comportamento internalizantes e mais problemas de comportamento externalizantes em comparação ao referido pelos alunos alvos de bullying. Houve diferenças estatisticamente significativas em externalizantes (Z=-2,31; p=0,01). Os resultados encontrados fornecem informações sobre os padrões de interação presentes no grupo avaliado, ratificando a importância de estudos voltados ao tema e de intervenções que visem reduzir e prevenir a ocorrência de bullying. Palavras-Chave: bullying, violência escolar, problemas de comportamento, múltiplos informantes. ABSTRACTThe goal of this study was to compare the scores of behavior problems reported by bullied teenagers and their teachers, and to discuss similarities

Este estudo teve como objetivo avaliar a ocorrência de bullying em uma escola pública brasileira e comparar os problemas de comportamento relatados por vítimas ao informado por seus professores. A Escala de Violência Escolar foi utilizada para identificar os alunos vitimas de bullying. Para avaliar problemas comportamentais foram utilizados o Youth Self Report e o Teacher Report Form. Dos 154 adolescentes avaliados, 30 (19,4%) foram identificadas como alvos de bullying, (M idade=12,4 anos, DP=0,7), sendo 24 meninos (80%). Desses, 16 (53,3%) atingiram níveis clínicos de problemas internalizantes, 11(36,6%) de externalizantes e 13 (43,3%) de problemas totais. Esta sub-amostra relatou mais problemas de internalização (F=13,40,  p<0,001) e menos problemas de externalização (F=6,63, p<0,01) em comparação ao reportado pelos professores. A alta frequência de vítimas de bullying e os elevados escores de problemas internalizantes e externalizantes nessa sub-amostra apontam para a urgência de prevenir o bullying e tratar as vítimas.

Background: International studies have demonstrated an increase in the prevalence of boys and a decrease of patients' age at the beginning of outpatient treatment for eating disorders (ED). Objective: To evaluate if these changes are also present in the Brazilian population participating in the PROTAD, a Brazilian ED program, and to discuss its clinical implication for treatment. Methods: Cross-sectional study. We evaluated 150 medical records of patients under 18 years diagnosed with ED (DSM IV-TR). Patients were divided into two groups: G1 (2001-2007) (n = 77) and G2 (2008-2014) (n = 73). The girl/boy proportion and the mean age of patients were compared. Results: In G1, six boys (7.8%) were admitted (girl/boy proportion: 11.8:1), while in G2, 16 (22%) boys were admitted (girl/boy proportion: 3.5:1) (p < 0.05). The mean age in G1 was 15.6 years (SD = 1.7; 95%CI: 15.2-15.9), whereas the mean age in G2 was 14.9 years (SD = 1.9; 95%CI: 14.4-15.3) (p > 0.05). Discussion: The increase in the number of boys treated for EDs reported in international studies was also found at the PROTAD. Contrary to what has been reported in international studies, the mean age of patients at the PROTAD did not decrease significantly. Gender and sexual orientation issues, clinical presentation, prior overweight history and culture/media impact on boys should be addressed by the healthcare team to increase the therapeutic efficacy.

Objective To translate the Fear Survey Schedule for Infants-Preschoolers (FSSIP) into Brazilian Portuguese and to examine its reliability and validity for assessing fears among Brazilian preschoolers. Methods Two independent bilingual professionals conducted translation and back-translation of the original survey. The translated version was used to assess 152 preschool children divided in two groups: Clinical - 71 children referred for treatment for nighttime fear, and Control - 81 children enrolled at kindergarten who had not been referred for any mental health service in the previous 6 months. All parents filled out the FSSIP, the Child Behavior Checklist (CBCL/1.5-5), and a sociodemographic questionnaire. Results Cronbach’s alpha coefficients were 0.949 (95% CI: 0.94-0.96) for the entire sample; 0.948 (95% CI: 0.93-0.96) for the Clinical Group, and 0.95 (95% CI: 0.93-0.96) for the Control Group. The mean score for fears was higher in the clinical group (60.19 vs. 51.53, t = -2.056; p = 0.042), indicating acceptable discriminate validity. We also found positive, moderate, and statistically significant correlations between FSSIP and most CBCL scores, indicating good convergent validity. Conclusion The Brazilian Portuguese version of the FSSIP showed good psychometric properties, and hence may be used in research and clinical settings to evaluate fears in preschoolers.

Avaliações periódicas precoces de indicadores de desenvolvimento são importantes para a elaboração de programas preventivos. O objetivo deste estudo foi identificar atrasos em indicadores globais de desenvolvimento em 100 crianças (idades entre 16-24 meses, média de 21,84 meses, DP+1,94), matriculadas em creches de um município do Estado de São Paulo. O instrumento de coleta de dados foi o Teste de Triagem de Desenvolvimento de Denver II (Denver II). Na amostra estudada, o domínio de maior prejuízo foi o da linguagem, seguido pelo domínio de cuidado pessoal-social. Os resultados do estudo apontam para a necessidade de incluir na avaliação do desenvolvimento infantil fatores familiares e educacionais comumente associados a atrasos de desenvolvimento.