Background: Although some authors have already evaluated the predictive value of various parameters regarding the duration of chronic spontaneous urticaria (CSU), it remains uncertain which ones have importance in clinical practice as prognostic factors that indeed enable prediction. Similarly, some authors have investigated parameters that might be related to severe cases of CSU. However, the results of studies evaluating several parameters as markers of disease severity are fragmented. Thus, we performed a systematic review to summarize the findings of studies investigating the parameters associated with CSU duration and severity. Methods: Two authors independently searched PubMed until June 2012 for observational retrospective or prospective studies addressing clinical or laboratory parameters associated with disease duration or severity in CSU patients. Results: We found 1,136 potentially relevant published papers related to the subject, 34 of which were included in the systematic review. A total of 16, 6 and 12 articles evaluated CSU parameters on severity, duration or both, respectively. Conclusions: Our findings suggest that disease severity might predict CSU duration. Similarly, evidence suggests that plasma levels of prothrombin fragment 1 + 2, D-dimer and C-reactive protein may function as markers of CSU severity.

Post-traumatic stress disorder (PTSD) is associated with many psychiatric and nonpsychiatric comorbidities. Growing evidence suggests that PTSD as a comorbidity may impair drug adherence, quality of life and sleep quality, as well as increase rehospitalization rates, disease relapses, intensity of symptoms, morbidity and mortality. The aim of this article is to examine the literature regarding the effects of PTSD comorbidity on physical and mental health.

ObjectiveThe purpose of this study was to evaluate whether individuals consider their HCV infection to be a potentially traumatic experience. Additionally, we investigated its association with Post-Traumatic Stress Disorder (PTSD) and the impact of PTSD diagnosis on health-related quality of life (HRQoL) in HCV infected subjects.MethodsWe conducted a cross-sectional survey of 127 HCV-infected outpatients recruited at a University Hospital in Salvador, Brazil. All subjects answered an orally-administered questionnaire to gather clinical and socio-demographic data. We investigated traumatic experiences and the subject's perception of the disease using the Trauma History Questionnaire. PTSD and other psychiatric diagnoses were assessed through the Mini International Neuropsychiatric Interview-Brazilian Version 5.0.0 (M.I.N.I. PLUS). HRQoL was assessed using Short-Form 36 (SF-36).ResultsApproximately 38.6% of the patients considered hepatitis C to be a traumatic experience. Of these, 60.7% had a PTSD diagnosis. PTSD was associated with significant impairment in quality of life for individuals in seven SF-36 domains as shown bymultivariate analysis: Role-Physical (β: −24.85; 95% CI: −42.08; −7.61), Bodily Pain (β: −19.36; 95% CI: −31.28; −7.45), General Health (β: −20.79; 95% CI: −29.65; −11.92), Vitality (β: −11.92; 95% CI: −20.74; −3.1), Social Functioning (β: −34.73; 95% CI: −46.79; −22.68), Role-Emotional (β: −26.07; 95% CI: −44.61; −7.53), Mental Health (β: −17.46; 95% CI: −24.38; −10.54).ConclusionHCV is frequently a traumatic experience and it is strongly associated with PTSD diagnosis. PTSD significantly impaired HRQoL.

Background: Obsessive-compulsive disorder (OCD) segregates in families. It follows a complex model of genetic transmission, which involves the influence of several small effect genes interacting with the environment. Methods: A systematic review of genetic association studies in OCD was performed. Articles published until 2012 were searched in the databases PubMed, Embase and ScieLO using the terms of MeSH and its associates or synonyms for "obsessivecompulsive disorder", "gene" and "genetic association studies". Results: We selected 105 papers and described their main results grouped as genes related to: serotonin, dopamine, glutamate, GABA, white matter, immune system, hormones and other genes. Discussion: There is high variability between findings of association studies among the several candidate genes studied in OCD. Glutamate-related genes are promising candidates for OCD, but there is no conclusive association between any of the candidate genes studied and OCD. Association studies with large sample size, evaluation of more homogeneous subgroups of phenotype and meta-analyses are still needed.

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IntroductionLeprosy is an infectious disease with high physical disability and is strongly associated with chronic pain, since there may be significant impairment of the peripheral nervous system. Additionally, the stigma associated with the label of leprosy persists and imposes a high social commitment of the disease.Objective/aimsDescribe the frequency of psychiatric comorbidities in leprosy patients and check if they had been previously diagnosed and were in psychiatric care.MethodThe study was conducted with a sample of 120 leprosy patients treated at two hospitals for leprosy: Hospital Dom Rodrigo de Menezes and University Hospital of Federal University of Bahia, in Salvador, Bahia, Brazil. Survey participants were older than 18 years of age, had confirmed the diagnosis of leprosy and were in antimicrobial treatment. Patients were evaluated face to face with a socio-demographic questionnaire and the Mini-International Neuropsychiatric Interview (MINIPlus) in Portuguese. The period of data collection was limited from October 2009 to June 2012.ResultsThe assessment using the MINI-Plus showed that 34 (28.33%) patients did not have any psychiatric diagnosis and 86 (71.66%) had at least one. Of these 86 patients, 25(20.83%), met the criteria for one diagnosis, 26 (21.66%) had two diagnoses and the rest, 35 (29.16%), had three or more psychiatric diagnoses. All patients with moderate or high risk for suicide had one or more psychiatric comorbidities.ConclusionLeprosy patients have a high prevalence of psychiatric comorbidities. Beyond that, most of them had no previous psychiatric diagnosis and the absolute majority were not in treatment.

IntroductionBipolar disorder (BD) commonly co-occurs with anxiety disorders (AD) and this comorbidity has been associated to worse clinical outcomes in BD patients. However frequency and clinical outcomes data might be biased once some of them had been originated from acutely ill bipolar patients as well as those in remission.Objectives/aimsTo assess AD in bipolar sample in order to know if this frequency vary according illness phase and identify possible clinical outcomes related to this comorbidity.MethodsA population of 355 outpatients with bipolar I disorder were evaluated using structured instruments (SCID). The sample was split into four groups considering the illness phase and the presence of AD: euthymic without AD (euthymic/non- AD); euthymic with AD (euthimic/AD); non-euthymic without AD (non-euthymic/non-AD) and non-euthymic with AD (noneuthymic/ AD) groups. Clinical and socio-demographics differences between the groups were compared through bivariate analysis.ResultsThere was a progressive and significantly increasing in some worst clinical outcomes frequency, such as rapid cycling, suicide attempts, substance and alcohol use disorders, history of antidepressant use and decreased scores in all domains of QoL, from control group (euthymic /non-AD) through out intermediate group (non-euthymic/non-AD) until the group most affected (non-euthymic/AD). Both euthymic/non-AD and euthimic/AD groups did not differ.ConclusionsWe identified a group of severe bipolar patients that have worse clinical outcomes, and among them, the anxiety comorbidity. But, contrary to what has been stated, AD appears to be related with poor bipolar prognosis only when other severity clinical factors are presents.