Objective:The medial prefrontal cortex (mPFC) is a highly connected cortical region that acts as a hub in major large-scale brain networks. Its dysfunction is associated with a number of psychiatric disorders, such as schizophrenia, autism, depression, substance use disorder (SUD), obsessive-compulsive disorder (OCD), and anxiety disorders. Repetitive transcranial magnetic stimulation (rTMS) studies targeting the mPFC indicate that it may be a useful therapeutic resource in psychiatry due to its selective modulation of this area and connected regions.Methods:This review examines six mPFC rTMS trials selected from 697 initial search results. We discuss the main results, technical and methodological details, safety, tolerability, and localization strategies.Results:Six different protocols were identified, including inhibitory (1 Hz) and excitatory (5, 10, and 20 Hz) frequencies applied therapeutically to patient populations diagnosed with major depressive disorder, OCD, autistic spectrum disorder, SUD, specific phobia, and post-traumatic stress disorder (PTSD). In the OCD and acrophobia trials, rTMS significantly reduced symptoms compared to placebo.Conclusion:These protocols were considered safe and add interesting new evidence to the growing body of mPFC rTMS literature. However, the small number and low methodological quality of the studies indicate the need for further research.

OBJETIVOS: Conhecer a prevalência e as características do assédio moral nas residências médica e não médica em um hospital de ensino em Recife (PE). MÉTODOS: Um questionário foi elaborado para investigar a prevalência do assédio moral, os perfis do assediado e do assediador, e possíveis sequelas. Uma definição para assédio moral foi apresentada aos participantes. RESULTADOS: Foram entrevistados 105 residentes. A prevalência do assédio foi de 41,9%, sendo mais frequente em menores de 28 anos (46,3%), mulheres (45,8%), residentes do segundo ano (47,7%) e na área médica (46,8%). Essas diferenças não foram estatisticamente significantes (p = 0,082; 0,118; 0,349; 0,225, respectivamente). As mulheres referiram mais sequelas (p = 0,013), sendo a maior parte destas de origem psíquica (58,5%) ou profissional (39,0%). Os profissionais responsáveis pela preceptoria são os principais assediadores (40,7%), seguidos daqueles com cargos na coordenação (29,1%; p = < 0,001). CONCLUSÕES: 41,9% dos residentes já foram vítimas de assédio moral. Não houve diferença significativa de prevalência entre os grupos estudados. Os cargos próximos das atividades clínicas se mostraram mais propícios a cometê-lo (preceptoria e coordenação). O sexo feminino se mostrou tão suscetível ao assédio quanto o masculino, mas sofreu significativamente mais sequelas (p = 0,013).

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Objective: Positive psychology interventions (PPIs) incorporate principles of personal strengths with the view that mental health recovery transcends symptom relief. Severe psychiatric conditions, such as schizophrenia, may benefit from such interventions. This study aims to gather the current evidence on the impact of PPIs on increasing well-being in patients on the schizophrenia spectrum and assess reductions in negative or positive symptoms. Methods: A systematic review of PPI studies with schizophrenia-spectrum patients was carried out following PRISMA recommendations. The PubMed, PsycINFO, Web of Science, and Scopus databases were searched for relevant publications in order to understand the possible effects of these interventions on well-being measures and psychotic symptoms in this population. Results: Nine studies (four controlled) were included. Meta-analysis of the controlled studies showed a significant effect (p = 0.04) for improvement of well-being (Z = 2.01). Overall, the reviewed evidence suggests well-being improvement. The effect on reduction of negative symptoms was unclear. Conclusion: Used as an adjunctive therapy, PPIs appear to be a promising resource for patients on the schizophrenia spectrum, with possible effects on well-being and symptom reduction.

Increasing evidence indicates bidirectional communication occurs between the gut and the brain via the microbiome-gut-brain axis. Accordingly, several studies point to a positive effect of probiotics on depressive symptomatology. Our study aimed to provide an updated meta-analysis on the subject. We conducted a systematic search for randomized clinical trials in multiple databases. Data analysis was performed using the Review Manager 5.4. We reviewed 26 studies, totaling 2,170 participants. The use of probiotics had a significant effect in reducing depressive symptoms (SMD: - 0.22; 95% CI: - 0.30 to - 0.13; p < 0.0001) compared to placebo. Subgroup analyses showed that probiotics influenced outcomes in participants with depression (SMD: - 0.67; 95% CI: - 0.93 to - 0.41; p < 0.00001) and with other clinical diagnoses (SMD: - 0.23; 95% CI: - 0.36 to - 0.09; p = 0.0008) but not healthy participants (SMD: - 0.11; 95% CI: - 0.23 to 0.02; p = 0.100). The use of probiotics can be a promising approach in improving the treatment of depression. It is important to conduct further studies to better assess the efficacy of probiotic as an adjuvant treatment to antidepressant medications, as well as their most effective dosages.

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