Objectives: Pediatric preoperative anxiety (PPOA) has been a concerning matter for the past decades with a high prevalence and several adverse outcomes branching into social, developmental, behavioral and perioperative fields. The management of anxious children is a priority for minimizing PPOA of the upmost importance. The aim of the study was to assess the levels of preoperative anxiety and their relation to a group of selected variables in a pediatric population being submitted to ambulatory surgery under general anesthesia.Methods: Children's anxiety was assessed using the modified Yale Preoperative Anxiety Scale-Short Version at the preoperative holding area (Time 1) and at the operation room during induction of anesthesia (Time 2). A cutoff value of 30 was used to differentiate anxious children from non-anxious children (scores ≤ 30).Results: 67 children were included in the study. 9 (13.4%) were anxious children at T1 and 24 (35.8%) at T2. A gender difference was not present (p=0.634 for T1, p=0.303 for T2), but the boys presented higher scores at both times and tend to have a significant increase from T1 to T2 (p=0.049). An overall change in the anxiety status from T1 to T2 does not tend to occur (p=0.01). Younger children tend to have higher scores although not statistically significant. No statistical significant difference was found between the remaining variables. Conclusions:The prevalence of anxious children presented is lower than the estimated worldwide and reveals both the result of correct practices and best use of resources. However, the scarcity of national studies exploring this topic renders an indication to implement similar future studies, with larger samples and further studying of the potential predisposing and contributing variables. The never-ending purpose should be to institute more customized programs for minimizing PPOA by means of multimodal combinations of anxiolytic practices.
Background: The therapeutic options for neurobehavioral disorders are still limited, and in many cases, they lack a satisfactory balance between efficacy and side effects. Objective: This work aims to review current evidence regarding the potential contribution of psychedelics and hallucinogens to the discovery of new drugs for treating different psychiatric disorders. Discussion: Ayahuasca/N,N-dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), and psilocybin have evidence supporting their use in depression, and psilocybin and ayahuasca have also shown good results in treatment-resistant depression. In randomized controlled trials (RCTs) conducted with anxious patients, there were symptomatic improvements with psilocybin and LSD. Psilocybin diminished Yale–Brown Obsessive Compulsive Scale (Y-BOCS) scores in a small obsessive–compulsive disorder (OCD) sample. The evidence is less robust regarding substance use disorders, but it suggests a possible role for LSD and psilocybin in alcohol use disorders and for psilocybin in tobacco addiction. In a clinical setting, these substances seem to be safe and well-tolerated. Their mechanisms of action are not fully elucidated, but there seems to be a preponderant role of 5-hydroxytryptamine (5HT) 2A agonism, as well as connectivity changes within the default mode network (DMN) and amygdala and some other molecular modifications. Conclusion: The studies underlying the conclusions have small samples and are heterogeneous in their methods. However, the results suggest that the use of psychedelics and hallucinogens could be considered in some disorders. More studies are needed to reinforce their evidence as potential new drugs.
Translational psychiatry has been a hot topic in Neurosciences research. The authors present a commentary on the relevant findings from a transdiagnostic study applicable to clinic practice. Additional discussion on conceptual and clinical insight into this current broad line of research is explored in the integration of multi-level paradigm in Psychiatry research.
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