Neurocognitive impairment (NCI) is frequently observed in patients infected with
human immunodeficiency virus (HIV) and results from the compromise of subcortical
brain structures by the virus. The manifestations of NCI range from asymptomatic
impairment to dementia. In addition to cognitive impairment resulting from HIV
infection, other factors such as depression are associated with the loss of cognitive
functions. The aim of this study was to estimate the prevalence of NCI in
HIV-positive patients in a city in southern Brazil and to establish possible
associations for the prevalence of NCI with HIV-related and other risk factors. This
cross-sectional study of HIV-positive outpatients was conducted in a specialized care
service in the city of Pelotas in Southern Brazil. Sociodemographic data and
HIV-related information were collected, and all patients underwent psychiatric and
neurocognitive evaluations. The prevalence of NCI among the 392 patients was 54.1%
when tracked using the IHDS (International HIV Dementia Scale) and 36.2% when the
IHDS was associated with a battery of complementary tests. A bivariate analysis
suggested an association of NCI with gender, age, educational level, depression,
current CD4 count and lowest CD4 count. The association of NCI with depression
remained in the Poisson regression (PR=1.96, 95%CI=1.12-3.42). The prevalence of
cognitive impairment in HIV-positive patients estimated in this study is in
accordance with international and Brazilian data. Of the factors analyzed, depression
showed the greatest evidence of association with neurocognitive loss. Based on our
findings, the inclusion of instruments to evaluate depression in our services for
patients with HIV and acquired immunodeficiency syndrome (AIDS) is recommended.
The prevalence of neurocognitive impairment remained high in human immunodeficiency virus-infected patients despite antiretroviral therapy. In the present study, the prevalence of this type of impairment was significantly higher in patients aged ≥50 years, most likely due to aging, human immunodeficiency virus infection, and a possible synergistic effect between these factors. Despite this higher prevalence, older patients exhibited higher rates of adherence to antiretroviral therapy and of undetectable human immunodeficiency virus viral load.
A six-session caregiver psychoeducational intervention on bipolar disorder did not bring benefits to caregiver's health. A longer longitudinal follow-up study would be crucial to see whether there were differences in degree of burden, perceived self-esteem and quality of life over time in caregivers.
Introduction
Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based interventions for reducing suicidal thoughts and behaviors.
Methods
A systematic review was performed in December 2020 using PubMed, PsycINFO, EMBASE, SciELO, Pepsic, and LILACS databases with no year restrictions. The search strategy included the terms (‘mindfulness’ OR ‘mindfulness-based’) AND (‘suicide’ OR ‘suicidal’ OR ‘suicide risk’ OR ‘suicide attempt’ OR ‘suicide ideation’ OR ‘suicide behavior’). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42020219514.
Results
A total of 14 studies met all inclusion criteria and were included in this review. Most of the studies presented Mindfulness-Based Cognitive Therapy as the MBI assessed (n=10). An emerging and rapidly growing literature on MBI presents promising results in reduction of suicide risk, particularly in patients with MDD. Four studies assessing other MBI treatment protocols (Mindfulness-Based Stress Reduction; Daily Mindfulness Meditation Practice; Mind Body Awareness and Mindfulness-Based Cognitive Behavior Therapy) all demonstrated that MBI reduces factors associated with suicide risk.
Conclusion
MBI might target specific processes and contribute to suicide risk reduction.
Smoking accounts for 24% of deaths in the general population and is also the factor that explains the biggest amount of years of life lost. It is important to understand the expectations regarding smoking behavior. The present study aimed to validate the Short Form of the Smoking Consequences Questionnaire (S-SCQ) for a Brazilian version. The Researchers did the process of semantic adaptation to language and national context. The S-SCQ was applied in a sample of 129 people. The next step was to perform psychometric analyses for the set of 21 items. Exploratory Factor Analysis, with pairwise treatment for missing cases, was used to achieve construct validity. To carry out Factor Analysis, the method of Principal Component Analysis (PCA) was used initially. Afterwards, Principal Axis Factoring (PAF) using Varimax rotation with Kaiser normalization was applied. The reliability of the total scale (21 items) showed a Cronbach alpha index of 0.851 and a 0.870 Lambda2 of Gutmann. Quite satisfactory rates were also observed in the subscales. Similarly, the item-overall correlation values also confirmed the scale’s good reliability indices.
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