Sandra Scivoletto

Mental disorders affect approximately 10–15% of children and adolescents worldwide. In South America these numbers are probably higher due to poverty and adverse life events that frequently affect this region. The availability of qualified services and well-trained professionals to care for those children are by far insufficient. The aim of this study was to assess and describe child and adolescent psychiatry (CAP) training in Brazil, Argentina, Uruguay, and Chile, to support the development and strengthen training standards. The coordinators of CAP residency programs in Brazil, Argentina, Uruguay, and Chile were invited to answer an online questionnaire about the characteristics of their training programs. Twelve programs from Brazil, three programs from Chile, two from Argentina, and one from Uruguay completed the questionnaires. In the last three countries, CAP is recognized as an independent specialty, while in Brazil it is considered a subspecialty of psychiatry. None of the countries have a national guideline for CAP residency training. Recently, there has been an increase in the number of professionals interested in pursuing a formal CAP training. This is the first study aiming to evaluate the current scenario of CAP training in South America. The results point to a great potential in the evaluated programs, but also to the need for homogeneous criteria for CAP training and evaluation of residents. A more efficient communication among programs would be an enriching strategy for their development, which may be facilitated by the results of this study.

The experience of maltreatment can impair child development, including changes in the process of emotions recognition, which may result in impairment of social interactions and behavioral disabilities. In order to measure the association between maltreatment and changes on emotion recognition among Brazilian adolescents, the Emotional Recognition Test on Human Faces (ERTHF) was applied to a sample of 50 adolescents who had suffered different intensities and types of abuse. The social and clinical characteristics of the participants were analyzed and, from ERTHF data, the accuracy and response time for the emotion recognition. Males were 60%, with mean age of 13 years and 3 months; 60% were living in shelters. Emotion recognition changes were associated with intensity and types of maltreatment. Physical neglect (48%) was associated with changes in neutral and negative emotions recognition. Emotional neglect (48%) and emotional abuse (46%) were associated with changes in both positive and negative emotions recognition. Physical abuse (38%) was associated with changes in positive emotion recognition only. False recognition of anger was the most common outcome of maltreatment, being associated with physical neglect (p=0.015) and emotional neglect (p=0.047). Our results point out to the need to add emotional and facial recognition’s rehabilitation interventions to better attend the specific demands of maltreated children and to increase the chances of social and family reintegration.

Background: Child neglect is highly prevalent and associated with a series of biological and social consequences. Early neglect may alter the recognition of emotional faces, but its precise impact remains unclear. We aim to review and analyze data from recent literature about recognition and processing of facial expressions in individuals with history of childhood neglect. Methods: We conducted a systematic review using PubMed, PsycINFO, ScIELO and EMBASE databases in the search of studies for the past 10 years. Results: In total, 14 studies were selected and critically reviewed. A heterogeneity was detected across methods and sample frames. Results were mixed across studies. Different forms of alterations to perception of facial expressions were found across 12 studies. There was alteration to the recognition and processing of both positive and negative emotions, but for emotional face processing there was predominance in alteration toward negative emotions. Conclusions: This is the first review to examine specifically the effects of early neglect experience as a prevalent condition of child maltreatment. The results of this review are inconclusive due to methodological diversity, implement of distinct instruments and differences in the composition of the samples. Despite these limitations, some studies support our hypothesis that individuals with history of early negligence may present alteration to the ability to perceive face expressions of emotions. The article brings relevant information that can help in the development of more effective therapeutic strategies to reduce the impact of neglect on the cognitive and emotional development of the child.

Professionals who work with maltreated children and the socially vulnerable typically show high levels of stress due to the physical and mental overload caused by the excessive demands of their work, in terms of both quantity and emotional strain.2

Introduction: Non-Suicidal Self-Injury (NSSI) is considered a dysfunctional way of dealing with problem situations.Objective: This study aimed to investigate the problem solving capacity in adults with NSSI compared to controls.Methods: Thirty-three patients who sought treatment for NSSI (NSSI group) were compared with 33 individuals without psychiatric disorder (control group). We also investigated Axis I disorders, executive functions and problem solving capacity.Results: In both groups, the majority were women (77.25%) with a mean age of 30 years, and the beginning of NSSI behavior of 16 years. The most common NSSI behaviour was skin cutting, and the most common reason given for engaging in that behaviour was “to stop negative feelings”. The most common psychiatric comorbidities were major depressive disorder (60.6%). Compared to controls, the group with NSSI showed lower results in relation to problem solving capacity (P = 0.000) and mental flexibility (P = 0.007). Deficits in problem solving capacity may be a reflection of low mental flexibility of adults with NSSI. This may be a risk factor for the beginning of NSSI and the persistence of it in adulthood.Conclusion: Early identification and treatment focused on problem solving capacity during the adolescence may prevent the chronicity of NSSI.Disclosure of interest: The authors have not supplied their declaration of competing interest.

Sudden Cardiac Death After ECT, Journal of Psychiatry and Psychiatric Disorders

To study the co-occurrence of psychiatric disorders (PD) and communication disorders (CD) and their relationship with global functioning in maltreated children and adolescents. The sample comprised 143 maltreated children and adolescents (55.8% male). All underwent clinical communication and psychiatric evaluations, as well as global functioning assessment using the Children's Global Assessment Scale (C-GAS). Four groups emerged from evaluation: Group 1 (n=7, 4.9%) did not exhibit any disorders; Group 2 (n=26, 18.2%) exhibited PD; Group 3 (n=34, 23.8%) exhibited CD; and Group 4 (n=76, 53.1%) exhibited both PD and CD on evaluation. Significant differences in global functioning scores were found between G1 and G2, G1 and G4, G2 and G4, and G3 and G4, with the highest C-GAS scores found in G1 and the lowest in G4. Rates of PD and CD are high in this maltreated population. The presence of PD has a major impact on C-GAS score, and the simultaneous presence of CD increases the already impaired function of PD. Demonstration of the additive effects of PD and CD on youth functioning suggests that professionals should be alert to the presence of both disorders to better act preventively and therapeutically in a high-risk population.