Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.
Background and ObjectivesThe neuropsychological exam plays a central role in the assessment of elderly patients with cognitive complaints. It is particularly relevant to differentiate patients with mild dementia from those subjects with mild cognitive impairment. Formal education is a critical factor in neuropsychological performance; however, there are few studies that evaluated the psychometric properties, especially criterion related validity, neuropsychological tests for patients with low formal education. The present study aims to investigate the validity of an unstructured neuropsychological assessment protocol for this population and develop cutoff values for clinical use.Methods and ResultsA protocol composed by the Rey-Auditory Verbal Learning Test, Frontal Assessment Battery, Category and Letter Fluency, Stick Design Test, Clock Drawing Test, Digit Span, Token Test and TN-LIN was administered to 274 older adults (96 normal aging, 85 mild cognitive impairment and 93 mild Alzheimer`s disease) with predominantly low formal education. Factor analysis showed a four factor structure related to Executive Functions, Language/Semantic Memory, Episodic Memory and Visuospatial Abilities, accounting for 65% of explained variance. Most of the tests showed a good sensitivity and specificity to differentiate the diagnostic groups. The neuropsychological protocol showed a significant ecological validity as 3 of the cognitive factors explained 31% of the variance on Instrumental Activities of Daily Living.ConclusionThe study presents evidence of the construct, criteria and ecological validity for this protocol. The neuropsychological tests and the proposed cutoff values might be used for the clinical assessment of older adults with low formal education.
Objective: The Rey Auditory-Verbal Learning Test, which is used to evaluate learning and memory, is a widely recognized tool in the general literature on neuropsychology. This paper aims at presenting the performance of Brazilian adult subjects on the Rey Auditory-Verbal Learning Test, and was written after we published a previous study on the performance of Brazilian elderly subjects on this same test. Method: A version of the test, featuring a list of high-frequency one-syllable and two-syllable concrete Portuguese substantives, was developed. Two hundred and forty-three (243) subjects from both genders were allocated to 6 different age groups (20-24; 25-29; 30-34; 35-44; 45-54 and 55-60 years old). They were then tested using the Rey Auditory-Verbal Learning Test. Results: Performance on the Rey Auditory-Verbal Learning Test showed a positive correlation with educational level and a negative correlation with age. Women performed significantly better than men. When applied across similar age ranges, our results were similar to those recorded for the English version of the Rey Auditory-Verbal Learning Test. Conclusion: Our results suggest that the adaptation of the Rey Auditory-Verbal Learning Test to Brazilian Portuguese is appropriate and that it is applicable to Brazilian subjects for memory capacity evaluation purposes and across similar age groups and educational levels. (20-24, 25-29, 30-34, 35-44, 45-54 e 55-60 anos) Descriptors
The Tower of London (TOL) is used for evaluating planning skills, which is a component of the executive functions. Different versions and scoring criteria were developed for this task, and some of them present with different psychometrical properties. This study aimed to evaluate two specific scoring methods of the TOL in diagnosing Mild Cognitive Impairment and probable Alzheimer's disease. The TOL total scores from 60 patients of each diagnosis were compared with the performance of 60 healthy-aged controls using receiver operating characteristics analysis and multinomial logistic regression. Krikorian method better diagnosed Alzheimer's disease, while Portellas's was better at discriminating healthy controls from Mild Cognitive Impairment, but were not efficient at comparing this last group with Alzheimer's patients. Regression analysis indicates that in addition to screening tests, TOL improves the classification of the three groups. The results suggest the two scoring methods used for this task may be useful for different diagnostic purposes.
Resumo Nesse ensaio, objetivamos pensar a pandemia a partir da situação das mulheres. Para tanto, analisamos o modo como a crise sanitária aciona teórico-politicamente noções sobre a casa e a guerra, tomadas como dispositivos de análise. A casa tenciona fronteiras entre público e privado, principalmente ao olharmos para a violência contra mulheres e para o trabalho doméstico. A guerra, estratégia que tem sido usada para pensar o combate ao coronavírus, aciona masculinidades afastando as mulheres dos espaços de decisões políticas para enfrentamento da pandemia, apesar de estarem na linha de frente como trabalhadoras da saúde e em outros serviços essenciais. Entretanto, a gramática bélica também possibilita a denúncia de ataques às mulheres em tempos de crise. Nos usos destes dispositivos, identificamos modos de direcionar a comoção social e hierarquizar vidas. Atentamos para a importância de transversalizar a perspectiva de gênero na construção de políticas públicas durante e pós-pandemia.
O cenário da pandemia de COVID-19 representa um desafio sem precedentes para a sociedade. Em que pese a importância das medidas imediatas visando à prevenção da propagação da doença, cuidados com os indivíduos acometidos e medidas para minimizar os impactos econômicos e sociais, a abordagem de temas relacionados à saúde mental da população em geral é também crucial. As contribuições interdisciplinares relacionadas à saúde mental envolvem a compreensão dos mecanismos cognitivos e comportamentais que sustentam hábitos, atitudes e crenças. Essa compreensão é fundamental para maximizar a eficácia das estratégias que implicam em mudanças significativas na forma de comportar, conceber e planejar atividades quotidianas. O presente artigo discute abordagens da psiquiatria, psicologia e ciências relacionadas no manejo de questões relacionadas à mudança de comportamento, hábitos de nutrição e atividade física, trabalho e grupos etários vulneráveis.
Introduction: The preservation of oral comprehension in the elderly is correlated with the preservation of their cognitive functions. Oral comprehension is a key feature for communication and its evaluation allows for the identification of more specific cognitive deficits, in addition to facilitating the development of more effective, early intervention strategies. Objective: Provide contemporary standards for the use of an instrument to assess oral comprehension, the Token Test, in a sample of healthy seniors. Method: A sample of 120 patients (76 women) with mean age of 71.1 years and 6.9 years of formal education, was assessed using the Mini Mental State Examination to identify the existence of cognitive impairment, and the Token Test to assess oral comprehension. Results: There were significant correlations (p < 0.01) between the token test scores for education and age, which accounted for 5% and 21% of shared variance, respectively. These two variables were considered on the normative data tables. Discussion: The data obtained indicate that the standards provided here are sufficiently representative. This study identifies the need for future studies comparing the Token Test performance in elderly people either healthy or in the process of cognitive decline.
Este artigo analisa os enunciados relativos à maternidade que configuram o que chamamos de "norma" da maternidade. Seguimos as reflexões de Foucault, principalmente no que se refere à genealogia como forma de pensar o presente. Utilizamos o relato das trajetórias de mulheres que são mães e trabalhadoras para a produção dos materiais de análise. Os materiais possibilitaram a problematização de alguns enunciados que constituem a maternidade na contemporaneidade. Descrevemos a intensificação do investimento em um padrão de mulher mãe que tem como produto uma norma da maternidade. Essa norma da maternidade, apesar de ser produzida socialmente, passa a ser naturalizada. Ela funciona associando algumas características a um modo de ser mãe considerado mais adequado, tais como tempo e idade certos para ser mãe, número de filhos, condições financeiras. A partir dela, outros modos de ser mãe são avaliados e hierarquizados.
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