Marco Antonio Caldieraro

BACKGROUND Single session intervention (SSI) have been shown to be an effective strategy for reducing emotional distress. Enhanced psychoeducation (EP), which includes empathic listening, risk stratification, symptom monitoring, and habit modification, is particularly suitable for SSIs. OBJECTIVE This study aimed to investigate the predictors of responses to an online EP intervention among professionals from essential services during the COVID19 in Brazil with the aim of reducing emotional distress. METHODS This study analyzed data from the TELEPSI Project from April 2020 to December 2021. We included all participants who received SSIs with high levels of emotional distress (T-scores above 70 on the PROMIS for anxiety, depression, or irritability). RESULTS The final sample consisted of 460 subjects, 89.1% female and 81.1% health professionals, of which 300 subjects underwent reassessment in one month (65% retention). Participants with harmful use of social networks, spending time on social media, playing video games, smoking, drinking alcohol, using drugs, and spending time with pets showed a less pronounced decrease in symptoms. In contrast, participants who played instruments or had already received psychological treatment showed a greater magnitude of decrease in symptoms. CONCLUSIONS This study highlights the impact of lifestyle factors on SSI efficacy. These results underscore the importance of considering individual lifestyle factors when implementing SSIs, and contribute to a growing body of evidence supporting the tailored application of psychoeducational strategies in mental health interventions, particularly in high-stress environments.

Trends Psychiatry Psychother, vol.0, nAheadOfPrint, p.0-0, 2024

Trends Psychiatry Psychother, vol.0, nAheadOfPrint, p.0-0, 2022

Introduction: Mood and anxiety disorders are a prevalent and significant leading cause of years lived with a disability worldwide. Existing antidepressants drugs are only partially effective, having burdensome side effects. One-third of patients do not achieve remission after several adequate antidepressant trials, and relapses of depression are frequent. Psychotherapies for depression are limited by the lack of trained professionals, and further by out-of-pocket prohibitive costs. Existing FDA-approved, device-based interventions are either invasive or only administered in the office. Transcranial photobiomodulation (t-PBM) with near-infrared (NIR) light may be a promising treatment option for mood and anxiety disorders. Due to its low cost, and ease of self-administration, t-PBM has the potential to become widely accessible. The safety profile of t-PBM is a relevant factor for widespread use and administration. Aim: To further investigate the t-PBM safety profile, this study aims to evaluate the tolerability and safety of t-PBM for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD). Method: We completed a systematic analysis of the side effects from repeated sessions of t-PBM in three studies: an open-label study for GAD (LIGHTEN GAD) and two randomized control studies for MDD (ELATED-2; ELATED-3). Overall, 80 subjects were studied. Result: Our results show that a low dose of NIR per t-PBM session can be administered with increasing frequency (up to daily sessions) and for several weeks (up to 12 weeks) without a corresponding increase in the occurrence or severity of adverse events. Additionally, there were no significant predictors for the variance in the number of reported adverse events (such as age, sex or diagnosis). Conclusion: The literature indicates that higher dosages of transcranial NIR could lead to greater antidepressant and anxiolytic effects; this study did not find any correlation between the increasing number of t-PBM sessions and the occurrence of adverse events.

Objective: The Sydney Melancholia Prototype Index (SMPI) is a scale that uses a non-conventional strategy to assess melancholia status based on prototypic symptoms and illness course variables. This study aimed to evaluate the performance of the first translation of this instrument in a non-English-speaking population. Methods: A sample comprising 106 Brazilian outpatients with depression was evaluated simultaneously with the Brazilian version of the self-rated SMPI (SMPI-SR) and clinician-rated SMPI (SMPI-CR). The kappa coefficient and t test were used to evaluate concurrent validity vs. DSM-IV, CORE system, Hamilton Depression Rating Scale-6 item (HAM-D6), and HAM-D17 assignments to a melancholic or non-melancholic class. The prevalence of melancholia as well as sensitivity and specificity were calculated across instruments. Results: The prevalence of melancholia was highest using DSM-IV criteria (56.6%). The kappa agreement between SMPI-CR and DSM-IV melancholia assignment was moderate (kappa 0.44, p <= 0.001). SMPI-CR-assigned melancholic patients had significantly higher CORE, HAM-D17, and HAM-D6 scores. The test-retest consistency values for the SMPI were modest at best, and somewhat superior for the CR version. Conclusion: The Brazilian SMPI-CR presented satisfactory psychometric properties (which were superior to those of the SMPI-SR), and therefore appears to be a useful option for identifying melancholia and studying its causes and optimal treatments.