Rev Bras Psiquiatr. 2006;28(1):80-5 83 Cartas aos editores consagram o lítio como primeira escolha terapêutica em pra-ticamente todas as fases e apresentações do TB. 5 Conclui-se que os psiquiatras (principalmente aqueles em formação) de-vem ser estimulados a conhecer de forma precisa as indica-ções do lítio e aprenderem a utilizar esta medicação, que tem auxiliado tantos pacientes. O legado do brilhante professor e pesquisador Mogens Schou, falecido recentemente, permanece mais atual do que nunca. Alegre (RS), Brasil Referências 1. Fieve RR. Lithium therapy at the millennium: a revolutionary drug used for 50 years faces competing options and possible demise. Bipolar Disord. 1999;1(2):67-70. 2. Schou M, Juel-Nielsen N, Stromgren E, Voldby H. The treatment of manic psychoses by the administration of lithium salts. J Neurol Neurosurg Psychiatry. 1954;17(4):250-60. 3. Schlagenhauf G, Tupin J, White RB. The use of lithium carbonate in the treatment of manic psychoses. Am J Psychiatry. 1966;123(2):199-207. 4. Sr. Editor, Nos últimos anos, a psiquiatria brasileira avançou muito no sentido de declarar todo e qualquer potencial conflito de interesse. No último congresso da Associação Brasileira de Psiquiatria (ABP), em Belo Horizonte (MG), todos os partici-pantes foram solicitados a declarar qualquer envolvimento comercial que pudesse, mesmo que remotamente, influen-ciar as suas apresentações. A própria Revista Brasileira de Psiquiatria (RBP) tem orientações muito claras para os auto-res quando da submissão dos artigos. Por isso, foi com grande surpresa que li, na última edição da RBP, o artigo do grupo do GREA-USP, 1 no qual não consta o reconhecimento de conflitos de interesse. É fato público que pelo menos dois dos autores desse artigo trabalham ou trabalharam na época da submissão do artigo numa ONG com financiamento da indústria do álcool (CISA). Na área da dependência química, várias das principais re-vistas internacionais têm códigos muito bem definidos sobre fontes de potencial conflitos de interesse, especialmente quan-do se trata de profissionais que aceitam financiamento da in-dústria do cigarro e do álcool. A declaração de haver, por parte dos profissionais, o envolvimento com a indústria do álcool ou do cigarro, lógico que não coloca necessariamente sob suspeita todo o eventual trabalho sério do ponto de vista científico. No entanto, acho que é um direito dos leitores da RBP saberem as eventuais fontes de conflitos de interesse para desenvolverem a sua própria opinião sobre a influência dessas indústrias na qualidade dos artigos publicados. Espero que os editores da RBP possam corrigir essa falta de informação.
Neuroimaging-based diagnostics could potentially assist clinicians to make more accurate diagnoses resulting in faster, more effective treatment. We participated in the 2011 ADHD-200 Global Competition which involved analyzing a large dataset of 973 participants including Attention deficit hyperactivity disorder (ADHD) patients and healthy controls. Each participant's data included a resting state functional magnetic resonance imaging (fMRI) scan as well as personal characteristic and diagnostic data. The goal was to learn a machine learning classifier that used a participant's resting state fMRI scan to diagnose (classify) that individual into one of three categories: healthy control, ADHD combined (ADHD-C) type, or ADHD inattentive (ADHD-I) type. We used participants' personal characteristic data (site of data collection, age, gender, handedness, performance IQ, verbal IQ, and full scale IQ), without any fMRI data, as input to a logistic classifier to generate diagnostic predictions. Surprisingly, this approach achieved the highest diagnostic accuracy (62.52%) as well as the highest score (124 of 195) of any of the 21 teams participating in the competition. These results demonstrate the importance of accounting for differences in age, gender, and other personal characteristics in imaging diagnostics research. We discuss further implications of these results for fMRI-based diagnosis as well as fMRI-based clinical research. We also document our tests with a variety of imaging-based diagnostic methods, none of which performed as well as the logistic classifier using only personal characteristic data.
The aim of the present study was to determine the prevalence of psychiatric disorders in acutely ill medical inpatients. A total of 313 consecutively admitted patients were interviewed using a semistructured psychiatric interview. Diagnoses were made according to DSM-IV diagnostic criteria during two time periods, the 7 days following admission and the month prior to admission. The results showed that 85 patients (27.2%) received a DSM-IV diagnosis, with several patients having comorbid diagnoses. Major depressive disorder was present in 16 patients (5.1%), most of whom also had major depressive disorder in the month prior to admission. This prevalence rate is above that of the general population (1.2% to 2.8%), but less than that reported in most previous studies (20% to 40%). Forty-three patients (13.7%) had an adjustment disorder, 18 patients (5.8%) had an anxiety disorder, and 17 patients (5.4%) had either alcohol dependence or abuse. Nurses were more proficient than medical staff at identifying patients who had received a DSM-IV diagnosis, recognizing 61% of cases compared with 41% for medical staff.
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