Objective: To describe the characteristics of the service and the profile of users of the Dr. Jandira Masur psychiatric outpatient clinic, in São Paulo. Methods: A cross-sectional study was carried out with a convenience sample including all patients seen at the service from the beginning of operations, in August 2010, to December 2019. Results: This study is the largest outpatient study so far conducted in Brazil, consisting of 30,151 patients, mostly women (62%). The most prevalent diagnoses were mood and anxiety disorders (36.5%), followed by neurotic disorders, stress-related and somatoform disorders (29%). Also, we observed that the number of new patients increased over time and that the outpatient clinic enabled the opening of around 74 thousand vacancies during the study period. Conclusion: The psychiatric outpatient clinic assessed proved to be a reference as care management model in the field of mental health in the Brazilian Unified Health System in the city of São Paulo.

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The outbreak of COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. In a short time, it led the health systems of several countries to collapse. Social isolation measures were imposed to prevent the rapid spread of the virus, creating sudden challenges for the adequate continuity of the mental health care services without exposingprofessionals and patients to the risk of contamination. In this scenario, telemedicine emerges as an essential tool to ensure assistance to patients with mental disorders. The objective of this article is to report on the experience of telepsychiatry implementation at the mental health outpatient clinic of Escola Bahiana de Medicina e Saúde Pública (EBMSP), located in the city of Salvador, state of Bahia, as well as to discuss the benefits and difficulties of this strategy.

This article describes a case of posttraumatic stress disorder that underwent an administrative psychiatric evaluation. It was concluded that, due to the severity of the case, there was work disability. Administrative psychiatric evaluations are extremely important for guaranteeing the rights of individuals. Detailed study of the case, comprehensive anamnesis, and psychopathological examination are all fundamental to ensure that these evaluations are carried out correctly.

Introduction: Resilience is an interactive process in which individual characteristics and interpersonal relationships are crucial to help individuals cope with negative experiences. Resilient adolescents, in addition to being less vulnerable to risks, are more successful in adapting to stressful situations. Conversely, individuals who are not very resilient present impaired coping when facing adversity, which can generate anxiety and depressive symptoms. Objective: To investigate the relationship between resilience and the prevalence of depressive and anxiety symptoms in high school students. Methods: A cross-sectional study was carried out with a sample of 80 high school students enrolled in a public school in the city of Presidente Prudente, state of São Paulo. The following instruments were used: Child Depression Inventory; Hamilton Anxiety Scale; Wagnild and Young Resilience Scale; and a sociodemographic questionnaire prepared by the authors. Results: Low resilience was 2.02 times more prevalent in adolescents with depressive symptoms, however the prevalence of low resilience was 2.54 times higher in people with a lower family income. Dating reduced the prevalence of low resilience by 45% and proved to be a protective factor in promoting resilience. The prevalence of low resilience was 50% higher in adolescents with a high degree of anxiety, however no statistically significant difference was observed. Conclusion: Based on the findings of this study, adolescents with low resilience showed ore signs of depressive symptoms. Resilience was shown to be a protective factor for depressive symptoms. Similarly, higher family income and dating were shown to be good predictors of the development of resilient individuals.

The COVID-19 pandemic resulted in the closure of schools worldwide for up to approximately eight months in 2020. One of the longest periods of removal of children and adolescents from face-to-face learning and social coexistence has occurred and still occurs in Brazil. Although it cannot be denied that many characteristics of the virus and its consequences are still poorly known, the evidence and estimates so far support a position in favor of opening schools, following all the precautions recommended by scientific institutions and health and education authorities. This article aims to map evidence and scientific documents with interpretations, from the point of view of neuropsychology and medicine, of the individual and collective impact of school closure on the socioemotional, cognitive and academic learning arenas.Children, especially the younger ones, tend to develop a lot in a few months, considering neuroscientific evidence of optimal developmental windows. Social coexistence and the formation/consolidation of socioemotional learning habits, reading habits and study opportunities in the school environment are unique. Three key arguments are addressed and briefly analyzed in this article: 1) the evidence on transmissibility and epidemiology of COVID-19 in children and their relatives/teachers support the notion that the benefits of school opening outweigh the risks; 2) there has been strong evidence of damage to cognitive, socioemotional and school learning development for students, in addition to the estimate of long-term generational impacts to be observed for at least four decades; and 3) the mental health and cost of subsequent work for parents, teachers and school institutions seem to be another risk zone. Finally, in addition to evidence, final reflections are made taking into consideration that the core of this analysis is a matter of individual decision, considering the opposing force of the collective impact of a year or more of interrupted school experience on the development of a generation and a society, especially in the context of sociocultural, economic, emotional and cognitive vulnerability.

In this paper we discuss how the use of technologies (such as virtual reality) associated with modern treatment approaches (such as cognitive behavioral therapy [CBT] with mindfulness) can contribute to moreeffective results in the treatment of stuttering. Old treatments, which focused solely on behavioral therapy, with priority use of exposure therapy, have been replaced and/or associated with new approaches using CBT as the basis of the treatment process. Currently, protocols that aim to spread the use of virtual reality technologies, video games and transcranial stimulation with this new expanded therapeutic focus, aiming to decrease anticipatory/social anxiety together while at the same time gain full attention and perception of internal and external anxiety triggers, are consistently changing the scenario of stuttering treatment. In this article, we will consider several seminal and new works that demonstrate that simulation technologies of real life situations are the practices that have shown the best results in the treatment of stuttering.

Objective: Pseudobulbar affect is a pathological form of emotional expression in which patients with neurological disorders have outbursts of laughing or crying that are incongruent with mood. Pseudobulbar affect is related to social isolation. Multiple sclerosis, in turn, is related to increased suicidality. The aim of this paper was to investigate the existence of any relationship between pseudobulbar affect and suicidal ideation in patients with multiple sclerosis. Methods: A total of 107 eligible, clinically stable patients with multiple sclerosis from the outpatient neurology clinic of Santa Casa de Misericórdia de Belo Horizonte, Brazil, underwent a standard sequence of data collection, covering clinical and demographic information. They also completed the following instruments: Center for Neurologic Study-Lability Scale (CNS-LS), Beck Depression Inventory (BDI), and Beck Hopelessness Scale (BHS). Results: Among the patients with both multiple sclerosis and pseudobulbar affect, 41.17% showed suicidal ideation, compared to 24.65% among those with multiple sclerosis without pseudobulbar affect. When depression was isolated as a confounding factor, no patients were found with pseudobulbar affect and suicidal ideation at the same time. Conclusion: Even though pseudobulbar affect is related to social isolation and mood disorders, this study did not find a relationship between pseudobulbar affect and suicidal ideation in the sample of patients with multiple sclerosis.

This study aims to investigate the sociodemographic features, clinical correlates, criminal behavior characteristics, and the level of criminal liability of sexual offenders who were referred for forensic psychiatric assessment at a forensic unit in the city of Rio de Janeiro in 2008. All written reports made by court-appointed Crimes sexuais e imputabilidade penal Sexual offenses and criminal liability psychiatric experts involving sexual offenses were reviewed. A total of 44 expert reports were identified. All alleged offenders were male. Nineteen (43.2%) offenders did not receive any psychiatric diagnosis. Nine offenders (20.4%) were diagnosed with mental retardation. In 16 cases (36.4%), some form of mental or neurological disorder was diagnosed. Of the total sample, 31 (70.4%) offenders were considered fully liable, eight (18.2%) partially liable, and five (11.4%) not liable by reason of insanity. The sexual crimes allegedly perpetrated by the offenders were rape (n = 14; 32%), attempted rape (n = 4; 9%), indecent assault (n = 26; 59%), and indecent exposure (n = 5, 11.4%). In 10 cases (22.7%), the offender was under the influence of alcohol at the moment of the offense. The systematic psychiatric evaluation of individuals who perpetrate sexual crimes may contribute to improve strategies for intervention, prevention and risk assessment of criminal recurrence of these individuals, in the community, in prisons or in forensic services or psychiatric care communities.

Improving our knowledge of what has been referred to as smartphone addiction (SA) is extremely important for clinical practice. In the past 10 years, an increasing body of clinical and epidemiological evidence has been produced in several countries. These studies point to sociodemographic factors, life habits, psychiatric disorders, and personality traits in association with SA. However, no review studies have been conducted to synthesize the findings. The objective of this study was to review the literature currently available on factors associated with SA. A systematic literature review was carried out by searching the PubMed and SciELO databases. We focused on papers published in the last 10 years; literature reviews, pre-clinical studies and expert opinions were excluded. In the final phase, 42 articles were selected. The sociodemographic factors associated with SA were female sex, age between 18 and 25 years and high household income. The associated lifestyle habits were nocturnal chronotype, reduced physical activity and sedentary lifestyle. The contents most strongly associated with SA were social networks. The dependency syndromes most strongly associated with SA were alcohol and technological addictions. The sychiatric disorders/symptoms associated were depressive and anxiety disorders, stress and insomnia. Finally, the associated personality traits were high impulsiveness, high aggressiveness, low self-esteem, type A personality and multitasking. There is evidence pointing to similarities in the epidemiological data found for SA and for other dependencies. More studies are needed to deepen our knowledge of this topic.

The term stalking comes from the English language and should be understood as a form of aggression that causes the victim the feeling of being persecuted. The prevalence of victimization by this phenomenon in the community is approximately 11%. Its occurrence is associated with a high potential for impairment of quality of life, psychological and/or physical damage, which may even reach the risk of life and increase the chance of the victim developing mental disorders. Some aggressors meet criteria for psychiatric diagnoses such as personality disorder, bipolar disorder, depression and psychotic disorder, needing attention and adequate psychiatric treatment. Psychiatrists have been involved in this phenomenon in different ways, such as: through the assessment and treatment of patients who are victims of stalking, through the treatment of aggressors or as victims of stalking, to carry out criminal liability assessments and risk assessment of the aggressors, act in the judicial demands of victims, as well as in the assessment of the need for breach of professional secrecy. This publication aims to shed light on this phenomenon, so that it is better identified, understood and addressed, and that in the near future, we can make use of effective prevention tools.