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Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT) at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP) were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02). Thirtyfour percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5%) reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients. Keywords: Electroconvulsive therapy, treatment outcome, psychiatric somatic therapies, treatment, general hospital psychiatry. ResumoObjetivo: Descrever o perfil sociodemográfico e clínico de pacientes submetidos a eletroconvulsoterapia (ECT) em um hospital geral universitário. Método: Neste estudo retrospectivo, foram revisados os prontuários de todos os pacientes submetidos a ECT entre janeiro de 1988 e janeiro de 2008 na unidade psiquiátrica do hospital geral da Universidade Estadual de Campinas (UNICAMP). Os pacientes/familiares foram contatados por telefone para a coleta de dados de seguimento. Resultados: Um total de 200 prontuários foram revisados. A maioria dos pacientes era do sexo feminino, com uma idade média de 39 anos e história de hospitalização psiquiátrica prévia. As principais indicações para ECT foram depressão e catatonia. Complicações foram observadas em menos de metade dos casos, e a maioria delas teve caráter temporário e não grave. Houve resultado psiquiátrico favorável em 89,7% dos pacientes, especialmente os catatônicos (100%, p = 0,02). Trinta e nove por cento dos casos foram contatados por telefone, a uma média de 8,5 anos decorridos entre o procedimento e o contato. Entre estes, três (1,5%) relataram transtornos amnésticos persistentes e 73% consideraram a ECT um bom tratamento. Conclusão: A ECT foi realizada de acordo com diretrizes internacionais. Na grande maioria dos casos, efeitos indesejáveis foram temporários e não graves. A resposta à ECT foi positiva na maioria dos casos, especialmente em pacientes catatônicos. Descritores: Eletroconvulsoterapia, resultado de tratamento, tratamentos somáticos em psiquiatria, tratamento, unidad...

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BackgroundNegative symptoms are a core feature of schizophrenia. The Brief Negative Symptom Scale (BNSS) is a new scale developed to assess negative symptoms in schizophrenia.MethodsThe present study aimed to examine the construct validity of BNSS, by using convergent and divergent validities as well as factor analysis, in a Brazilian sample of 111 outpatients diagnosed with schizophrenia by DSM-5. Patients were evaluated by the Brazilian version of the BNSS and positive and negative subscales of the Positive and Negative Syndrome Scale (PANSS)ResultsAssessment of patients by both instruments revealed an either an excellent internal consistency (Cronbach’s alpha = 0.938) or inter-rater reliability (ICC = 0.92), as well as a strong correlation between BNSS and negative PANSS (r = 0.866) and a weak correlation of the instrument with the positive PANSS (r = 0.292) thus characterizing adequate convergent and discriminant validities, respectively. The exploratory factor analysis identified two distinct factors, namely, motivation/pleasure and emotional expressivity, accounting for 68.63% of the total variance.DiscussionThe study shows that the Brazilian version of the BNSS has adequate psychometric properties and it is a reliable instrument for the assessment of negative symptoms in schizophrenia, either for clinical practice or research.

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BackgroundTreatment Resistant Schizophrenia (TRS) and Non-Treatment Resistant Schizophrenia (NTRS) may represent different biological subtypes of schizophrenia but there are few studies which investigated the distinction between these groups in terms of psychopathology. In the present study, we used both Exploratory (EFA) and Confirmatory (CFA) Factor Analyses to investigate symptom dimensions in TRS in comparison with NTRS using the Positive and Negative Syndrome Scale (PANSS).MethodsData from 1429 patients who participated in the PATTERN study a Non- Intervention Prospective Study of Patients with Persistent Symptoms of Schizophrenia) was used. TRS was defined by proxy, based on the use of clozapine (TRS) whereas NTRS used non-clozapine antipsychotics (NTRS). EFA methods included the extraction of principal components and the Varimax rotation. The number of factors was chosen based on the Kaiser criterion. Factors items were considered valid when loadings were greater or equal to 0.5. The fit to the data was evaluated by CFA in comparison with well established PANSS models using fit indexes such as: NNFI (Non-Normed Fit Index), NFI (Normed fit Index), CFI (Comparative Fit Index), RMEA (Root-Mean-Square Error of Approximation). SPSS 23.0 and R version 3.2.2 were used for statistical analyses.ResultsDemographic data showed that, when compared with NTRS, patients with TRS showed an earlier age of onset, a longer duration of illness, higher PANSS positive scores, a higher duration of persistent positive and negative symptoms. There were no differences between groups in terms of the duration of untreated psychosis. The EFA yielded almost the same five-factor structure in both groups namely Negative, Positive, Affective, Disorganized/Cognitive and Excitation factors. CFA showed that both models do not fit completely to the data when compared with well known PANSS factor analytical models.DiscussionData from a large cross-national sample of 1429 patients of the Pattern study showed that TRS and NTRS patients have an almost identical factor structure when evaluated by the PANSS. These results are similar to a previous study with a smaller sample which has evaluated the dimensions of the PANSS in patients with refractory schizophrenia.

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