Background: The main objective of this study was to assess the safety and efficacy of deep brain stimulation (DBS) in patients with severe anorexia nervosa (AN). Methods: Eight participants received active DBS to the subcallosal cingulate (SCC) or nucleus accumbens (NAcc) depending on comorbidities (affective or anxiety disorders, respectively) and type of AN. The primary outcome measure was body mass index (BMI). Results: Overall, we found no significant difference (p = 0.84) between mean preoperative and postoperative (month 6) BMI. A BMI reference value (BMI-RV) was calculated. In patients that received preoperative inpatient care to raise the BMI, the BMI-RV was defined as the mean BMI value in the 12 months prior to surgery. In patients that did not require inpatient care, the BMI-RV was defined as the mean BMI in the 3-month period before surgery. This value was compared to the postoperative BMI (month 6), revealing a significant increase (p = 0.02). After 6 months of DBS, five participants showed an increase of ≥10% in the BMI-RV. Quality of life was improved (p = 0.03). Three cases presented cutaneous complications. Conclusion: DBS may be effective for some patients with severe AN. Cutaneous complications were observed. Longer term data are needed.

Os objetivos deste estudo foram estimar a prevalência de inatividade física no lazer e analisar a associação entre as práticas de atividades físicas (AF) pregressas na Educação Física (EF) escolar e fora do contexto escolar, sob a inatividade física no lazer durante o período da pandemia de COVID-19. Estudo transversal em que 1.679 estudantes dos cursos de graduação e pós-graduação da Universidade Federal de Uberlândia responderam um questionário online adaptado do “Indicadores de Saúde e Qualidade de Vida em Acadêmicos (ISAQ-A)". O período de coleta teve duração de 25 dias, em maio de 2020. A análise da associação empregada foram as Razões de Prevalências (RP), complementadas pelo intervalo de confiança a 95% (IC95%), nas análises brutas e ajustadas. A variável dependente foi relatar não praticar AF no lazer durante a pandemia de COVID-19. As variáveis independentes: prática de AF no período da infância e adolescência, fora da escola e participação nas aulas de Educação Física escolar (participação regular e irregular). As variáveis de controle foram estado de saúde, meios para a prática de AF antes da pandemia e renda. O nível de significância adotado foi de 5%. O não envolvimento em atividades físicas fora do contexto escolar está associado a maiores prevalências de inatividade física no lazer (RP = 1,245; IC95%: 1,087 – 1,426). Os achados deste estudo indicam que as AFs realizadas no âmbito do lazer no período da infância e adolescência podem influenciar na manutenção da prática mesmo em situações adversas, como o distanciamento social ocasionado pela pandemia de COVID-19.

Este estudo objetivou analisar a percepção sobre os antecedentes afetivos para a atividade física (AF) relacionados às necessidades psicológicas básicas (NPB) e investigar as regulações motivacionais para prática de AF no discurso dos participantes iniciantes de um programa de exercício físico na atenção básica de saúde. Trata-se de um estudo transversal de natureza qualitativa com a utilização de Grupo Focal. Participaram da pesquisa 41 adultos. Resultados demonstram que as percepções dos participantes sugerem frustração para as NPB de autonomia e competência. O comportamento dos participantes para a iniciação ao programa é regulado por diferentes contingentes externos específicos, caracterizadas por punições e medos na adesão ao programa. Não foram observadas regulações motivacionais intrínsecas e a autodeterminação para a participação no programa é baixa. Conclui-se que essa população, não percebe sentimentos ligados ao prazer pela prática de AF per se, diminuindo as chances de manutenção do comportamento para a prática de AF.

Background Up to 20% of the cases of anorexia nervosa (AN) are chronic and treatment‐resistant. Recently, the efficacy of deep brain stimulation (DBS) for severe cases of AN has been explored, with studies showing an improvement in body mass index and other psychiatric outcomes. While the effects of DBS on cognitive domains have been studied in patients with other neurological and psychiatric conditions so far, no evidence has been gathered in AN. Methods Eight patients with severe, chronic, treatment‐resistant AN received DBS either to the nucleus accumbens (NAcc) or subcallosal cingulate (SCC; four subjects on each target). A comprehensive battery of neuropsychological and clinical outcomes was used before and 6‐month after surgery. Findings Although Body Mass Index (BMI) did not normalise, statistically significant improvements in BMI, quality of life, and performance on cognitive flexibility were observed after 6 months of DBS. Changes in BMI were related to a decrease in depressive symptoms and an improvement in memory functioning. Interpretation These findings, although preliminary, support the use of DBS in AN, pointing to its safety, even for cognitive functioning; improvements of cognitive flexibility are reported. DBS seems to exert changes on cognition and mood that accompany BMI increments. Further studies are needed better to determine the impact of DBS on cognitive functions.

Objectives Evidence suggests the efficacy of mindfulness-based cognitive therapy (MBCT) to prevent depression relapse and decrease depressive symptoms during the acute phase. However, the effectiveness of MBCT in real-world heterogeneous samples treated in clinical health settings, including primary care, has received little attention. This study had two aims: (1) to evaluate the effectiveness of MBCT delivered in primary care considering pre-treatment depression scores and (2) to explore the role of participants’ characteristics on symptom improvement. Methods Data were obtained from 433 individuals who received MBCT. Participants completed the Personality Inventory for ICD-11 (PiCD) pretreatment and the Beck Depression Inventory (BDI-II) pre- and post-treatment. Results Sixty percent presented moderate-to-severe depression according to scores on the BDI-II, 18.1% presented mild depression, and 21.7% were in the non-depressed range. The severity of pre-treatment depressive symptoms was associated with outcomes. Most individuals who lacked depressive symptoms at baseline remained in the non-clinical range after the treatment. Those in the severe group benefited the most from the intervention, since 35.6% were considered recovered. Rates of deterioration ranged from 2.1 to 2.7%, depending on the depression-baseline scores. Depression severity at the entrance, attendance, and age, but not personality traits, appear to be related to symptom improvement. Conclusions According to our results, MBCT can be effectively and safely delivered in primary care.