Background: Recent findings suggest an association between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Thus, we evaluated the clinical associated features of ADHD in a large sample of adult OCD patients. Methods:A cross-sectional study including 955 adult patients with OCD from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinical characteristics in adult OCD patients with and without comorbid ADHD were compared using Fisher's exact test, t-tests or Mann-Whitney tests.Bivariate analyses were followed by logistic regression analysis to identify clinical characteristics independently associated with ADHD comorbidity. Results:The lifetime prevalence of ADHD in adult OCD patients was 13.7%. The current results indicate that OCD + ADHD patients were more severe, had an earlier onset of the obsessive-compulsive symptoms, a higher history of rheumatic fever, with higher frequencies of sensory phenomena and comorbidity with Tourette syndrome. They also had an increased risk for academic impairment and suicide attempts.Conclusion: Adult OCD patients with ADHD present some specific clinical features and may represent a special subgroup of adult OCD. Future studies should focus on the development of interventions more tailored to the phenotype of this subgroup of patients.

There is a considerable gap between the offer and the demand for mental health treatment of children and adolescents, especially in low- and middle-income countries (LMICs). Permanent education in these countries is a promising and needed strategy to reduce this gap. This study was designed to evaluate the perceived impact of an educational intervention for child and adolescent mental health professionals in Brazil, the Child and Adolescent Mental Health Specialization Course (CESMIA). The intervention consisted of a 360-hour interprofessional postgraduation course. The CESMIA offered lectures and small-group case discussions for exchanging their experiences in dealing with the patients. The students were placed in these groups according to their professions in order to ensure a proportional distribution of healthcare professionals in each group. The evaluation employed a quasi-experimental design by the use of a knowledge, attitude, and practice (KAP) survey. The 39 participants reported significant improvement in all KAP dimensions. More specifically, the data indicated a 17% improvement for attitudes, a 9.4% increase for knowledge, and a 14% improvement for the practice dimensions. The CESMIA appeared to improve the level of knowledge of participants and their attitudes and actions towards patients, which reinforces the relevance of similar courses.

O texto apresenta o histórico de uma mãe que cometeu violência sexual contra suas duas filhas. A violência sexual cometida pela mulher ou mãe mostra-se sem conhecimento sistematizado no Brasil. Este texto pretende contribuir para iniciar o debate desta questão no país, oferecendo maior visibilidade para a compreensão deste fenômeno, e trazendo à luz a dinâmica da violência sexual. Trata-se de pesquisa qualitativa, um estudo de caso instrumental de cunho documental, realizada em uma instituição de atendimento em saúde pública. As informações foram obtidas por consulta ao prontuário da pessoa que cometeu a violência sexual: dados gerais e socioeconômicos, a família, a violência cometida, as vítimas, a história de vida. Os resultados foram agrupados em eixos, corroborando literatura: vitimização da ofensora na infância e adolescência; vitimização sexual das filhas; qualidade dos vínculos afetivos; violência interacional; uso de drogas /álcool, e violência conjugal. Estes eixos estão de acordo com estudos internacionais, identificando a vitimização e o sofrimento da mulher que comete violência sexual, e priorizando os estudos de caso. Há necessidade de que os profissionais tenham qualificação específica para a identificação da violência sexual cometida por mulheres e por mães, são muitos os mitos e preconceitos que impedem a identificação desta ocorrência. Palavras chave: mulher ofensora sexual, abuso sexual infantil, criança maltratada. This paper presents the life history of a mother sex offender who has committed sexual abuse against her two daughters. The phenomenon of sexual abuse committed by a mother is shown without systematized knowledge in Brazil. This text intends to begin the debate on this issue in the country offering greater visibility to the understanding of this phenomenon and explaining the dynamic of sexual violence. It is a qualitative research, an instrumental case study of documents, carried out in a public health care institution. The data collected are related to the information contained in the health record of the person who committed sexual violence: general and socioeconomic data, family, violence committed, victims, life history. The results were grouped into axes, corroborating literature: victimization of the offender in her childhood and adolescence; sexual victimization of her daughters; quality of affective bonds; interaction violence; drug/alcohol use, and domestic violence. These axes are in accordance to international studies, identifying the victimization and the suffering of the woman who committed sexual violence, and prioritizing case studies. It is necessary that professionals have specific qualification in order to identify the occurrence of sexual violence committed by women and by mothers, since there are many myths and prejudices that prevents the identification of the occurrence of such violence.

RESUMO Introdução Considerando a prevalência dos transtornos mentais, é essencial que qualquer médico seja capaz de prestar assistência qualificada e humanizada a pessoas em sofrimento psíquico. No entanto, o usual estigma e a falta de conhecimento no manejo das doenças mentais por parte dos médicos podem representar uma barreira de acesso e ineficiência importante enfrentada pelos pacientes no sistema de saúde. Objetivo Estimar o ganho de aprendizado percebido e a redução de estigma em relação a pessoas portadoras de esquizofrenia por estudantes de Medicina após a exposição ao estágio obrigatório no internato numa escola médica pública no Distrito Federal. Método Estudo quasi-experimental para avaliação de impacto de programa educacional durante o internato médico em saúde mental. A amostra consistiu em 35 estudantes do último ano do curso de Medicina. Foram aplicados questionários para aferição do grau e tipificação do estigma em relação à esquizofrenia e à autopercepção sobre manejo de medicamentos e sobre tratamento de doenças psiquiátricas. Os instrumentos utilizaram uma escala do tipo Likert de três pontos para aferição dos resultados. Os questionários foram aplicados imediatamente antes e após a exposição ao programa educacional, que teve duração de quatro semanas. Os valores médios de autopercepção e estigma foram comparados entre os dois momentos empregando-se o teste t de Student emparelhado. Resultados Não houve mudança significativa do grau de estigmatização nas dimensões avaliadas (estereótipo total, p = .230; preconceito percebido, p = .172; distância social, p = .209; direitos civis, p = .837). Quanto à autopercepção de conhecimento, os valores médios do número de resposta igual a 3 e a soma no momento pós- são significativamente maiores que no momento pré- (p = .007 e p < .0001, respectivamente). Os ganhos não se mostraram associados significativamente com as variáveis demográficas. Conclusão A despeito do ganho em conhecimento, a imersão em saúde mental no internato do curso de Medicina ao longo de quatro semanas não se mostrou eficaz para mudança no estigma. É possível que a curta duração da intervenção implique contato insuficiente com o portador de doença mental para redução do estigma. Sugerimos a realização de novos trabalhos com ampliação da amostra e com desenhos experimentais.

The first systematic review and meta-analysis of obsessive-compulsive disorder (OCD) genetic epidemiology was published approximately 20 years ago. Considering the relevance of all the studies published since 2001, the current study aimed to update the state-of-art knowledge on the field. All published data concerning the genetic epidemiology of OCD from the CENTRAL, MEDLINE, EMBASE, BVS, and OpenGrey databases were searched by two independent researchers until September 30, 2021. To be included, the articles had to fulfill the following criteria: OCD diagnosis provided by standardized and validated instruments; or medical records; inclusion of a control group for comparison and case-control, cohort or twin study designs. The analysis units were the first-degree relatives (FDRs) of OCD or control probands and the co-twins in twin pairs. The outcomes of interest were the familial recurrence rates of OCD and the correlations of OCS in monozygotic compared with dizygotic twins. Nineteen family, twenty-nine twin, and six population-based studies were included. The main findings were that OCD is a prevalent and highly familial disorder, especially among the relatives of children and adolescent probands, that OCD has a phenotypic heritability of around 50%; and that the higher OCS correlations between MZ twins were mainly due to additive genetic or to non-shared environmental components.

These results will be helpful for planning and improving the quality of future educational programs in mental health.

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Background: The non-clinical presentation of obsessive–compulsive symptoms (OCS) in women may impact not only their daily lives and well-being but also increase the risk for emotional and behavioral problems in their children. This study aims to investigate the OCS dimension distribution in a large sample of mothers from a cohort of school age children and the association between these OCS dimensions with their own psychopathology, and with the presence of OCS and other psychopathology in their children.Method: Our final sample consisted of 2,511 mother-children dyads recruited from the elementary schools of two large cities. Throughout multiple regression analysis, we examined the correlations between demographic and clinical variables of mothers assessed by the Mini International Psychiatric Interview (MINI) and the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version (DY-BOCS-SV) with children's psychopathology status reported by the Child Behavior Checklist (CBCL).Results: The overall prevalence of mothers who reported experiencing at least one OCS was 40% (N = 1,004). “Aggression/violence” was the most frequent symptom dimension (32.2%), followed by the “symmetry/ordering” (16.4%) and the “sexual/religious” dimensions (13.8%). There was a significant correlation between the presence of OCS and maternal psychopathology in general (p &lt; 0.001, r = 0.397). Not only the presence but also the severity of the mother's OCS were strongly correlated to the total (p &lt; 0.001), internalizing (p &lt; 0.001), externalizing (p &lt; 0.001), and OCS subscale scores (p &lt; 0.001) on the CBCL.Conclusion: OCS dimensions are highly prevalent in women. Presence and severity of maternal OCS are related to children's psychopathology and behavioral problems.