The objective of this study is to present the rationale, methods, design and preliminary results from the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders. We describe the sample selection and the components of each phases of the study, its instruments, tasks and procedures. Preliminary results are limited to the baseline phase and encompass: (i) the efficacy of the oversampling procedure used to increase the frequency of both child and family psychopathology; (ii) interrater reliability and (iii) the role of differential participation rate. A total of 9937 children from 57 schools participated in the screening procedures. From those 2512 (random = 958; high risk = 1554) were further evaluated with diagnostic instruments. The prevalence of any child mental disorder in the random strata and high-risk strata was 19.9% and 29.7%. The oversampling procedure was successful in selecting a sample with higher family rates of any mental disorders according to diagnostic instruments. Interrater reliability (kappa) for the main diagnostic instrument range from 0.72 (hyperkinetic disorders) to 0.84 (emotional disorders). The screening instrument was successful in selecting a sub-sample with "high risk" for developing mental disorders. This study may help advance the field of child psychiatry and ultimately provide useful clinical information.

Future longitudinal studies should investigate dimensional correlations between OCD and ED.

Our findings challenge the IB-EF hypothesis for ADHD and underscore the importance of processing efficiency as the key specific mechanism for ADHD pathophysiology.

(2012). Clinical features of ticrelated obsessive-compulsive disorder: results from a large multicenter study. CNS Spectrums, 17, pp 87-93 doi:10.1017/ S1092852912000491 Objective. To evaluate the clinical features of obsessive-compulsive disorder (OCD) patients with comorbid tic disorders (TD) in a large, multicenter, clinical sample.Method. A cross-sectional study was conducted that included 813 consecutive OCD outpatients from the Brazilian OCD Research Consortium and used several instruments of assessment, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Yale Global Tic Severity Scale (YGTSS), the USP Sensory Phenomena Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders.Results. The sample mean current age was 34.9 years old (SE 0.54), and the mean age at obsessivecompulsive symptoms (OCS) onset was 12.8 years old (SE 0.27). Sensory phenomena were reported by 585 individuals (72% of the sample). The general lifetime prevalence of TD was 29.0% (n 5 236), with 8.9% (n 5 72) presenting Tourette syndrome, 17.3% (n 5 141) chronic motor tic disorder, and 2.8% (n 5 23) chronic vocal tic disorder. The mean tic severity score, according to the YGTSS, was 27.2 (SE 1.4) in the OCD 1 TD group. Compared to OCD patients without comorbid TD, those with TD (OCD 1 TD group, n 5 236) were more likely to be males (49.2% vs. 38.5%, p , .005) and to present sensory phenomena and comorbidity with anxiety disorders in general: separation anxiety disorder, social phobia, specific phobia, generalized anxiety disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder, impulse control disorders in general, and skin picking. Also, the ''aggressive,'' ''sexual/religious,'' and ''hoarding'' symptom dimensions were more severe in the OCD 1 TD group.Conclusion. Tic-related OCD may constitute a particular subgroup of the disorder with specific phenotypical characteristics, but its neurobiological underpinnings remain to be fully disentangled.

Background A small proportion of individuals with Tourette syndrome (TS) have a lifelong course of illness that fails to respond to conventional treatments. Open label studies have suggested that low frequency (1-Hz) repetitive transcranial magnetic stimulation (rTMS) targeting the supplementary motor area (SMA) may be effective in reducing tic severity. Objective/Hypothesis To examine the efficacy of rTMS over the SMA for TS in a randomized double-blind sham-controlled trial (RCT). Methods We conducted a two-site RCT-rTMS with 20 adults with severe TS for 3 weeks. Treatment consisted of 15 sessions (1-Hz; 30 min; 1,800 pulses per day) of active or sham rTMS at 110% of the motor threshold over the SMA. A subsequent 3 week course of active rTMS treatment was offered. Results Of the 20 patients (16 males; mean age of 33.7 ± 12.2 years), 9 received active and 11 received sham rTMS. After 3 weeks, patients receiving active rTMS showed on average a 17.3% reduction in the YGTSS total tic score compared to a 13.2% reduction in those receiving sham rTMS, resulting in no statistically significant reduction in tic severity (p=0.27). An additional 3 week open label active treatment for those patients (n = 7) initially randomized to active rTMS resulted in a significant overall 29.7% reduction in tic severity compared to baseline (p=0.04). Conclusion This RCT did not demonstrate efficacy of 3-week SMA-targeted low frequency rTMS in the treatment of severe adult TS. Further studies using longer or alternative stimulation protocols are warranted.

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ResumoContexto: O abuso de álcool é considerado atualmente um dos maiores problemas de saúde devido ao impacto mundial que esta problemática gera em termos sociais e financeiros. Objetivos: Discutir, a partir do referencial econômico, as conseqüências sociais do abuso do álcool e introduzir os conceitos relacionados à economia da saúde. Métodos: Revisão da literatura com base nos sistemas MEDLINE, LILACS e SciELO de artigos publicados nas línguas, portuguesa e inglesa no período de 1987 a 2007, e posterior busca manual com base na bibliografia de interesse dos artigos selecionados. Resultados: Foram encontrados 50 artigos sobre estudos econômicos e conceitos econômicos em diversas áreas; desses, 15 diretamente relacionados ao custo social do abuso do álcool. O método de apuração dos custos e a composição dos itens de custos foram semelhantes em todos os estudos. Conclusões: Os estudos econômicos se apresentam incipientes no Brasil e avançados nos países desenvolvidos. A necessidade de pesquisas nacionais que abordem o custo social do abuso do álcool tem como uma das finalidades promover subsídios para se pensar e efetivar a construção de políticas públicas mais consistentes e que estejam em consonância com o perfil epidemiológico e socioeconômico do país.Gallassi, A.D. et al. / Rev. Psiq. Clín 35, supl 1; 25-30, 2008 Palavras-chave: Impacto econômico, custos sociais, abuso do álcool, conceitos econômicos, políticas públicas. AbstractBackground: Alcohol abuse is currently considered one of the largest worldwide health problems due to its social and financial impact. Objectives: To discuss the economic and social impact of alcohol abuse and to introduce concepts related to health economics. Methods: Literature review of articles written in Portuguese and in English (published between 1987 and 2007) stored in the MEDLINE, LILACS and SciELO databases was carried out. Results: Fifty articles on economic studies and economic concepts in various areas were found, among which 15 were directly related to the social costs of alcohol abuse. The costs assessment methods and the composition of cost items were similar in all studies. Conclusions: Economic studies are new in Brazil, but are advanced in developed countries. National research on the social costs of alcohol abuse is necessary in order to promote knowledge as a means of creating and implementing public policies that are more consistent with and in alignment with the epidemiological and socioeconomic profile of the country.