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ABSTRACT. Panic disorder is an anxiety condition characterized by recurrent and unexpected panic attacks. The comparison between active treatment and placebo is essential to analyze an intervention’s efficacy and safety. It is important to identify and summarize the studies with higher evidence to assist health professionals and public policy managers in clinical decision-making. Objective: The aim of this study was to identify and summarize all Cochrane systematic reviews (SRs) that compared the efficacy and safety of any drug treatment compared to placebo for panic disorder patients. Methods: SRs published in the Cochrane Library were included without date restriction. All outcomes presented were analyzed. The methodological quality of the SRs was evaluated using the AMSTAR-2 tool. Results: We included three Cochrane SRs of high methodological quality on the effects of antidepressants, benzodiazepines, and azapirones for panic disorder. All medications showed benefits in response to treatment, symptom improvement, and reduced panic attacks. Dropouts were lower with tricyclic antidepressants and benzodiazepines and higher with azapirones. The occurrence of adverse events was higher for drug groups. Conclusions: Very low to moderate certainty evidence (GRADE) showed that antidepressants and benzodiazepines seem to improve clinical symptoms in individuals with short-term panic disorder compared to placebo. In addition, the use of azapirones seems to have greater adherence by patients than placebo. However, there is insufficient evidence to support its clinical efficacy.

OBJECTIVE: Bipolar disorders are often not recognized and undertreated. The diagnosis of current or past episodes of hypomania is of importance in order to increase diagnostic certainty. The Hypomania Checklist-32 is a self-applied questionnaire aimed at recognizing these episodes. As part of the international collaborative effort to develop multi-lingual versions of the Hypomania Checklist-32, we aimed to validate the Brazilian version and to compare its psychometric properties with those of the Mood Disorder Questionnaire. METHOD: Adult outpatients with bipolar disorder I (n = 37), bipolar disorder II (n = 44) and major depressive disorder (n = 42) of a specialized mood disorder unit were diagnosed according to DSM-IV-TR using a modified version of the SCID. We analyzed the internal consistency and discriminative ability of the Hypomania Checklist-32 Brazilian version in relation to the Mood Disorder Questionnaire. RESULTS: The internal consistency of the Brazilian Hypomania Checklist-32, analyzed using Cronbach's alpha coefficient, was 0.86. A score of 18 or higher in the Hypomania Checklist-32 Brazilian version distinguished between bipolar disorder and major depressive disorder, with a sensitivity of 0.75 and a specificity of 0.58, compared to 0.70 and 0.58, respectively, for the Mood Disorder Questionnaire (score > 7). The Hypomania Checklist-32 Brazilian version showed a dual factor structure characterized by "active/elated" and "risk-taking/irritable" items. Hence, the Hypomania Checklist-32 Brazilian version was found to have a higher sensitivity but the same specificity as the Mood Disorder Questionnaire. CONCLUSION: The Brazilian version of the Hypomania Checklist-32 has adequate psychometric properties and helps discriminating bipolar disorder from major depressive disorder (but not bipolar disorder I from bipolar disorder II) with good sensitivity and specificity indices, similar to those of the Mood Disorder Questionnaire.OBJETIVO: O transtorno bipolar muitas vezes não é reconhecido e deixa de ser tratado adequadamente. O diagnóstico de episódios atuais ou passados é importante, a fim de aumentar a certeza diagnóstica. O Questionário de Autoavaliação de Hipomania-32 é um questionário autoaplicável para o rastreamento desses episódios. Como parte do desenvolvimento em vários idiomas do Questionário de Autoavaliação de Hipomania-32, nós objetivamos validar a versão brasileira e comparar suas propriedades psicométricas com o Questionário de Transtornos do Humor. MÉTODO: Em uma unidade especializada em transtornos do humor foram selecionados pacientes ambulatoriais adultos com transtorno bipolar I (n = 37), transtorno bipolar II (N = 44) e transtorno depressivo maior (N = 42) de acordo com a DSM-IV-TR, utilizando uma versão modificada do SCID. Analisou-se a consistência interna e capacidade discriminativa do Questionário de Autoavaliação de Hipomania-32 versão brasileira comparada ao Questionário de Transtornos do Humor. RESULTADOS: A consistência interna do Questionário de Autoavaliação de Hipomania-32 versão brasileira é boa, com alfa de Cronbach 0,86. Um escore de 18 ou mais no Questionário de Autoavaliação de Hipomania-32 versão brasileira distingue entre o transtorno bipolar e o transtorno depressivo maior com uma sensibilidade de 0,75 e especificidade de 0,58, e para o Questionário de Transtornos do Humor, para um escore de 7 ou mais, de 0,70 e 0,58, respectivamente. O Questionário de Autoavaliação de Hipomania-32 mostrou uma estrutura caracterizada pela predominância de dois fatores (ativação/elação e irritabilidade/correr riscos). Assim, o Questionário de Autoavaliação de Hipomania-32 versão brasileira tem maior sensibilidade, mas a mesma especificidade que o Questionário de Transtornos do Humor. CONCLUSÃO: A versão brasileira do Questionário de Autoavaliação de Hipomania-32 possui propriedades psicométricas adequadas e ajuda a discriminar o transtorno bipolar do transtorno depressivo maior (mas não transtorno bipolar I de transtorno bipolar II), com boa sensibilidade e especificidade, semelhante ao Questionário de Transtornos do Humor.