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Background: Adjunctive antidepressant therapy is commonly used to treat acute bipolar depression but few studies have examined this strategy.Aims: To examine the efficacy of agomelatine v. placebo as adjuncts to lithium or valproate in bipolar depression.Method: Patients who were currently depressed despite taking lithium or valproate for at least 6 weeks were randomised to treatment with agomelatine (n = 172) or placebo (n = 172) for 8 weeks of acute therapy and 44 weeks of continuation therapy (trial registration: ISRCTN28588282).Results: No significant differences in improvement of depressive symptoms were observed between the two groups either at 8 weeks or 52 weeks on the primary efficacy measure of change in Montgomery-Åsberg Depression Rating Scale scores from baseline to end-point. Adverse events including switches into mania/hypomania were low and similar in both groups.Conclusions: Agomelatine adjunctive therapy was not superior to placebo adjunctive therapy for acute bipolar depression. [ABSTRACT FROM AUTHOR]

Objective: As the older population increases, it is important to identify factors that may reduce the risks of dementia in the general population. One such factor is the concept of cognitive reserve (CR). The present study analyzed the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH) in the Brazilian population. This scale was originally developed to measure CR in individuals with severe mental illness. We also investigated the relationship between the CRASH and clinical or sociodemographic variables. Methods: This study was conducted with 398 individuals. We assessed sociodemographic variables and depression, anxiety, and stress symptoms (Depression, Anxiety and Stress Scale [DASS-21]) using a web-based survey. We constructed a confirmatory factor analysis (CFA) model in order to test the goodness of fit of the factor structure proposed in the original CRASH study. Results: The McDonald's hierarchical co for CRASH using CFA parameters was 0.61, and the Cronbach's alpha coefficient indicated good internal consistency when considering all items (alpha = 0.7). Conclusions: Our results suggest that CRASH can be used to assess CR in the general population in Brazil. [ABSTRACT FROM AUTHOR]

• In the networking analysis, the most important nodes for good and intermediate functioning clusters were anxiety and uneasy symptoms. The relevant nodes for low functioning cluster were anxiety, feeling of failure, and depression. • Our machine learning-based decision tree showed the low functioning cluster split into two parts: 1) subjects with symptoms of severe mental illness plus low income; 2) individuals with symptoms of severe mental illness plus age (<46 years old) plus middle income. • The majority of good functioning cluster did not have any psychiatric symptoms. The present study aims to identify pathways between psychiatric network symptoms and psychosocial functioning and their associated variables among functioning clusters in the general population. A cross-sectional web-based survey was administered in a total of 3,023 individuals in Brazil. The functioning clusters were derived by a previous study identifying three different groups based on the online Functioning Assessment Short Test. Networking analysis was fitted with all items of the Patient-Reported Outcomes Measurement Information System for depression and for anxiety (PROMIS) using the mixed graphical model. A decision tree model was used to identify the demographic and clinical characteristics of good and low functioning. A total of 926 (30.63%) subjects showed good functioning, 1,436 (47.50%) participants intermediate functioning, and 661 (21.86%) individuals low functioning. Anxiety and uneasy symptoms were the most important nodes for good and intermediate clusters but anxiety, feeling of failure, and depression were the most relevant symptoms for low functioning. The decision tree model was applied to identify variables capable to discriminate individuals with good and low functioning. The algorithm achieved balanced accuracy 0.75, sensitivity 0.87, specificity 0.63, positive predictive value 0.63 negative predictive value 0.87 (p <0.001), and an area under the curve of 0.83 (95%CI:0.79–0.86, p <0.01). Our results show that individuals who present psychological distress are more likely to experience poor functional status, suggesting that this subgroup should receive a more comprehensive psychiatric assessment and mental health care. [ABSTRACT FROM AUTHOR]

Objective To determine the prevalence of food addiction in a large Brazilian non-clinical sample. Sociodemographic and psychopathological correlates of food addiction as well as associations with quality (QoL) domains were also investigated. Methods This cross-sectional study obtained data from a Brazilian anonymous web-based research platform (N = 7639; 71.3% females). Participants provided sociodemographic data and completed the modified Yale Food Addiction Scale 2.0, PHQ-9, hypomania checklist (HCL-32), Fagerström Test for Nicotine Dependence, AUDIT, modified Skin picking-Stanford questionnaire, Minnesota impulsive disorders interview, Symptom Checklist-90-Revised inventory (SCL-90R), early trauma inventory self report-short form, and the WHO Quality of Life instrument-Abbreviated version (WHOQOL-Bref). Associations were adjusted to potential confounders through multivariable models. Results The prevalence of food addiction was 4.32% (95%CI: 3.89–4.80%), and was more common among females. Food addiction was associated with a positive screen for a major depressive episode (OR = 4.41; 95%CI: 3.46–5.62), bipolar spectrum disorder (OR = 1.98; 95%CI: 1.43–2.75), and skin picking disorder (OR = 2.02; 95%CI: 1.31–3.09). Food addiction was also independently associated with exposure to early life psychological and sexual abuse ( P = 0.008) as well as with reduced physical, psychological, social, and environment QoL (all P < 0.001). Conclusions Food addiction may be common in low and middle-income countries, though possibly less prevalent than in the US. Food addiction was associated with co-occurring mood disorders and skin picking disorder as well as with early life psychological and sexual abuse. Finally, food addiction was independently associated with broad reductions in QoL. Public health efforts towards the early recognition and management of food addiction are warranted. [ABSTRACT FROM AUTHOR]

Background: Jealousy is a heterogenous emotion on a spectrum from normality to psychopathology. The relationship between different jealousy subtypes/dimensions and affective temperaments remain unknown. In addition, few large surveys have investigated the associations between jealousy subtypes and psychopathological dimensions.Methods: A Brazilian Portuguese version of the "Questionario della Gelosia" (QUEGE) was developed. We obtained data from an anonymous web-based research platform. Socio-demographic data was obtained and participants answered the QUEGE, the TEMPS-Rio de Janeiro, and the Symptom Checklist-90-Revised (SCL-90-R).Results: 2042 participants (29% men, 71% female, mean age+SD: 28.9±8.8 years), took part in this survey. Confirmatory factor analysis provided a five-factor model for the QUEGE with self-esteem, paranoia, interpersonal sensitivity, fear of being abandoned, and obsessive dimensions. The anxious, irritable, cyclothymic, and depressive temperaments were independently associated with jealousy dimensions, whereas the hyperthymic temperament was associated with lower scores on the self-esteem jealousy dimension (N=2042, P<0.001). Jealousy subtypes were dissimilarly associated with SCL-90R psychopathological dimensions, whereas the 'obsessive' jealousy dimension was not significantly associated with SCL-90R dimension scores. We found no independent influence of gender across any jealousy dimension.Limitations: A convenience web-based sample was employed. Cross-sectional design precludes the establishment of causal inferences.Conclusions: Our data indicate that a five-factor solution may provide the best-fit model for the QUEGE. Different jealousy subtypes were independently associated with affective temperaments and psychopathological dimensions. These associations reported herein should be confirmed in prospective studies. [ABSTRACT FROM AUTHOR]

A growing body of evidence suggests that crack cocaine misuse has widespread systemic and cognitive consequences, but little attention has been given to its systemic pathophysiology. We report here changes in inflammation markers, oxidative damage and brain derived neurotrophic factor in a sample of outpatients with crack cocaine use disorders. Fifty-three outpatients were recruited for this cross-sectional study and matched with fifty control subjects. The focus of this report is in between group differences in cytokines, oxidative damage and brain-derived neurotrophic factor (BDNF). Crack cocaine use was associated with higher BDNF levels when compared to controls, present only in those who used crack cocaine in the last month. Patients also had higher circulating levels of IL-1β, TNF-α and IL-10 when compared to controls. There were no significant differences in oxidative damage between patients and controls. These results represent a first demonstration that crack cocaine use disorders entail an activation of the reward, immune and inflammatory systems., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Objectives: As the use of functioning outcomes is increasingly being advocated in multinational clinical trials and comparative studies, making available instruments with known validity and reliability in several languages is required. Here we present data on the Portuguese validation of the Functioning Assessment Short Test (FAST), which was explicitly designed to gauge functioning dimensions empirically linked to bipolar disorder., Methods: One hundred patients with bipolar disorder and matched controls were assessed with the FAST, which was evaluated regarding discriminant, content and construct validity, concurrent validity with functioning instruments, internal consistency and test-retest reliability., Results: The FAST displayed a five-factor structure very similar to its conceptualization, successfully discriminated patient and control groups, and correlated highly with other functioning measures; it also showed excellent test-retest reliability and internal consistency., Conclusions: The FAST is a measure with sufficient validity and reliability, with potential for the use in international clinical trials and comparative studies.