Anna King

BACKGROUND INFORMATION: New computer technologies, namely smart cellphones and tablets, among others, interacting along the daily life of individuals may contribute toward the rise of problems: depression, stress and physical damage (undue postures, upper and lower extremity disorders, vision problems, obesity), all of them related to excessive time spent on technological equipment; together with inadequate furniture, quality of life can be seriously affected. OBJECTIVE: To validate a scale to evaluate physical damage related to the Abusive Use of Technology (PDAUTS) in daily life. METHODS: Validation of the PDAUTS was performed through 5 phases: (1) initial scale construction with 20 questions; (2) expert evaluation of questions; (3) application to 200 volunteers; (4) statistical analysis of the results; (5) preparation of the final validated version, retaining the 20 questions. RESULTS: We used the R statistical program, version 3.4.2 and the “dplyr” package to present the descrip...

Objective: To describe with prospective methodology the therapeutic response to clonazepam or paroxetine in a 3-year treatment of panic disorder (PD). Methods: A total of 120 PD outpatients (DSM-IV) were openly treated with clonazepam or paroxetine for 8 weeks. Those who responded entered a 3-year follow-up. Demographic and clinical features were compared in the two groups. Results: Efficacy was evaluated by Intent to treat, last value carried forward. The Hamilton Scale for Anxiety (HAMA) did not differ between the groups at baseline and during the first two months. In the acute treatment phase and at the end of the long-term follow-up both groups had a significant and similar response - 86.8% of the clonazepam group and 73.0% of the paroxetine group had a complete remission of panic attacks. The mean dose for clonazepam was 1.9 ± 0.2 mg/day and for paroxetine 33.8 ± 9.8 mg/day. There was no difference in the scale scores, and the reduction in panic attacks from baseline to end-point did not differ significantly between the groups. The most common adverse events during treatment were tremor/shaking, nausea/vomiting, sexual dysfunction and appetite/weight change in the paroxetine group and drowsiness, sexual dysfunction and memory/concentration complains in the clonazepam group. Conclusion: PD patients using clonazepam or paroxetine had an equivalent response during acute and long term treatment. The patients using clonazepam had significantly less side effects than the paroxetine group. Acknowledgements: Brazilian Council for scientific and technological development (CNPq). Grant: 554411/2005-9.

Introduction: Coronavirus (COVID-19) pandemic has caused social and economic damages. People have adapted to a new reality of physical distance. Objective: The study aimed to assess the use of digital devices and social media, focusing on psychosocial and demographic factors of people´s sexual behavior during the pandemic. Methods: A total of 1,357 Brazilian adults participated in a cross-sectional online survey. They were recruited through social media to obtain information regarding sexual behavior and the use of digital devices and social media. Results: Digital devices and social media were used by 38.8% of the participants. Among the group that used technological devices, most claimed to have changed their sexual behavior, with 76.9% consuming more sexual content through movies or series. Conclusion: In a smaller group, technological resources appeared as an alternative for safer sex, reducing the risks of COVID-19 transmission.

The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient's life. This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impression...

Background: Social distancing as a preventive measure to contain the spread of the COVID-19 pandemic has resulted in many people working from home, using online digital resources. Staying at home has led to the adaptation of many work activities to allow continuity of people´s jobs. It can also affect home routines and ways of working, thereby leading to changes in behavior, as the main interest of this study. Objective: The study aimed to assess the impact on human behavior of working conditions in home office format due to social distancing. Methods: Data collection was done online, using a specific computational tool (Google Forms) for this type of research, using the Home Office Work Scale (HOWS) validated and published in Mental Health and Addiction Research in 2021, with a total sample of 1,056 valid questionnaires. After the data collection, a database was created for statistical analysis of the results. Results: More women than men volunteered to answer the questionnaire, al...

BACKGROUND INFORMATION: Daily, prolonged interactivity of individuals with technologies (computer, cell phone, tablet, among others) impacts life and significantly changes habits, behaviors, personal and social relationships. Technologies lead to a multitude of advantages, but attention is required concerning possible damages. OBJECTIVE: Validation of a scale to evaluate the abuse use of technologies (TAUS). METHOD: TAUS validation was carried out in 5 phases: (1) initial scale construction with 20 questions, (2) expert evaluation, (3) application to 200 volunteers, (4) statistical analysis and results, (5) preparation of the final version of the validated TAUS. We used the R statistical program and the “dplyr” package version 3.4.2 to present descriptive statistics, to test hypotheses of means differences and for factorial analysis. Factor analysis was used for the orthogonal model. The method used was Principal Components based on Spearman’s correlation matrix. RESULTS: The result...

BACKGROUND INFORMATION: Digital game or video game disorders have been recently (June 2018) included in ICD-11 (International Classification of Diseases) by the World Health Organization (WHO). The disorder can occur with or without an internet connection. OBJECTIVE: Validation of a scale to evaluate the dependence of pathological digital game (PDGD). METHOD: Validation of the PDGD was performed in 5 phases: (1) initial scale construction with 20 questions, (2) expert assessment, (3) application to 200 volunteers, (4) statistical analysis and production of results using statistical programs, (5) elaboration of the final validated scale. RESULTS: We used the R statistical program Version 3.4.2 and the “dplyr” package to present the descriptive statistics, the hypotheses tests of differences of means and the factorial analysis. The last step was to calculate Cronbach’s alpha, in order to measure the internal consistency of the questionnaire. The value found was 0.955, which is very go...

BACKGROUND: The evolution of technologies and mobility, new digital resources have emerged transforming human behavior. These include the abusive use of digital devices, leading to various dependences regarding the way people use technology. Collective environments also begin to exhibit symptoms of such dependences. OBJECTIVE: Validate a Digital Dependence of Employees Scale (DDES), applied to personnel not holding leadership positions in organizations. METHOD: Data were collected via Internet. The sample totaled 301 volunteers from a state-owned company, of which 294 were statistically validated. Participants were asked to answer 20 questions prepared by experts. After the collection procedure, a database was created for statistical analysis. RESULTS: Statistical analysis procedure including factorial analysis was conducted, which confirmed data adequacy. Three statistical criteria were used: Bartlett Sphericity test, Kaiser-Meyer-Olkin Criterion and Factorial analysis, including S...

BACKGROUND INFORMATION: The boundary between cellphone use and abuse is quite tenuous. Research is required to evaluate the use of this device interacting in the everyday life of users, whether to speak or to perform tasks. OBJECTIVE: To construct a novel and specific scale to evaluate cellphone dependence checking its psychometric properties for clarity, accuracy and reliability. METHODS: Validation of a Cellphone Dependence Scale (CPDS) was performed in 5 phases: 1initial scale construction with 20 questions, 2expert evaluation, 3application to 200 volunteers, 4statistical analysis and results, and 5elaboration of the final version of the CPDS. RESULTS: We used the R statistical program Version 3.4.2 and the “dplyr” package to present the descriptive statistics, the hypotheses tests of differences of means and the factorial analysis. The results provided a validated and accepted final version for CPDS. The last step of the study was to calculate Cronbach’s alpha, in order to measu...

Objective: To describe with prospective methodology the therapeutic response to clonazepam or paroxetine in a 3-year treatment of panic disorder (PD). Methods: A total of 120 PD outpatients (DSM-IV) were openly treated with clonazepam or paroxetine for 8 weeks. Those who responded entered a 3-year follow-up. Demographic and clinical features were compared in the two groups. Results: Efficacy was evaluated by Intent to treat, last value carried forward. The Hamilton Scale for Anxiety (HAMA) did not differ between the groups at baseline and during the first two months. In the acute treatment phase and at the end of the long-term follow-up both groups had a significant and similar response - 86.8% of the clonazepam group and 73.0% of the paroxetine group had a complete remission of panic attacks. The mean dose for clonazepam was 1.9 ± 0.2 mg/day and for paroxetine 33.8 ± 9.8 mg/day. There was no difference in the scale scores, and the reduction in panic attacks from baseline to end-point did not differ significantly between the groups. The most common adverse events during treatment were tremor/shaking, nausea/vomiting, sexual dysfunction and appetite/weight change in the paroxetine group and drowsiness, sexual dysfunction and memory/concentration complains in the clonazepam group. Conclusion: PD patients using clonazepam or paroxetine had an equivalent response during acute and long term treatment. The patients using clonazepam had significantly less side effects than the paroxetine group. Acknowledgements: Brazilian Council for scientific and technological development (CNPq). Grant: 554411/2005-9.

Panic disorder refers to the frequent and recurring acute attacks of anxiety. Objective: This study describes the routine use of mobiles phones (MPs) and investigates the appearance of possible emotional alterations or symptoms related to their use in patients with panic disorder (PD). Background: We compared patients with PD and agoraphobia being treated at the Panic and Respiration Laboratory of The Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil, to a control group of healthy volunteers. Methods: An MP-use questionnaire was administered to a consecutive sample of 50 patients and 70 controls. Results: People with PD showed significant increases in anxiety, tachycardia, respiratory alterations, trembling, perspiration, panic, fear and depression related to the lack of an MP compared to the control group. Conclusions: Both groups exhibited dependence on and were comforted by having an MP; however, people with PD and agoraphobia showed significantly more emotion...

CONTEXT AND OBJECTIVE: Cognitive-behavioral therapy is frequently indicated for panic disorder. The aim here was to evaluate the efficacy of a model for cognitive-behavioral therapy for treating panic disorder with agoraphobia. DESIGN AND SETTING: Randomized clinical trial at Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro. METHODS: A group of 50 patients with a diagnosis of panic disorder with agoraphobia was randomized into two groups to receive: a) cognitive-behavioral therapy with medication; or b) medication (tricyclic antidepressants or selective serotonin reuptake inhibitors). RESULTS: Although there was no difference between the groups after the treatment in relation to almost all variables with the exception of some items of the Sheehan disability scale and the psychosocial and environmental problems scale, the patients who received the specific therapy presented significant reductions in panic attacks, anticipatory anxiety, agoraphobia avoidance and fear...

Introduction On the world stage unlimited internet access by smartphones have made in social, cultural and economic relations, has transformed the world to be faster and more efficient. In this context, health care requires more attention. Health professionals must be concerned about the majority of the patient’s care on the use of smartphone’s in this process. Smartphones can be cause distractions and cause poor patient care. Behavioral and psychological changes related to abusive and uncontrolled use in this population may create severe impacts not only on the user’s life but also on the community health care. Method A careful research was performed through PubMed, Web of Science and Psycho Info databases using the terms: “Smartphone addiction”, “Smartphone dependence”, “Smartphone abuse”, “physicians”, “nurses” and ‘‘health professionals”. The search covered the past 5 years up to August 2019. Articles that examine abusive use on smartphones in health professionals were included....

Objetivo: O estudo com terapia cognitivo-comportamental (TCC) procurou demonstrar a preparaçãodo paciente com transtorno do pânico para exposições agorafóbicas. Foram usadas as técnicas dasexposições interoceptivas, às próprias sensações corporais, e in vivo, a locais ou situações temidas.Metodologia: 50 indivíduos, divididos em dois grupos de 25 participantes cada um. O grupo 1 realizou 10 sessões de TCC semanais e individuais com uma hora de duração e fez uso de medicamentos e o grupo 2, controle, usou apenas medicação sem TCC. A medicação prescrita consistiu em antidepressivos tricíclicos e inibidores seletivos de recaptação da serotonina. Foram aplicados instrumentos de avaliação no início e ao fim das intervenções médica e psicológica. Resultados: Observamos uma diferença significativa entre a avaliação inicial e final no grupo 1, como: redução nos ataques de pânico, ansiedade antecipatória, esquiva agorafobia e medo das sensações corporais. Na escala de avaliação global do fun...

Facebook is notably the most widely known and used social network worldwide. It has been described as a valuable tool for leisure and communication between people all over the world. However, healthy and conscience Facebook use is contrasted by excessive use and lack of control, creating an addiction with severely impacts the everyday life of many users, mainly youths. If Facebook use seems to be related to the need to belong, affiliate with others and for self-presentation, the beginning of excessive Facebook use and addiction could be associated to reward and gratification mechanisms as well as some personality traits. Studies from several countries indicate different Facebook addiction prevalence rates, mainly due to the use of a wide-range of evaluation instruments and to the lack of a clear and valid definition of this construct. Further investigations are needed to establish if excessive Facebook use can be considered as a specific online addiction disorder or an Internet addi...

Panic disorder (PD) is characterized by frequent and recurrent acute panic attacks. The current cognitive conception for PD enhances the fear of corporal sensations, when the individual define his physical sensations as being related to a serious disease or imminent death, not interpreting them as natural physiologic mechanisms. We reported three severe cases of PD of the respiratory subtype, with agoraphobia, whose symptoms of hyperventilation predominated on clinical picture. The treatment consisted on tricycles antidepressant and cognitive-behavior therapy (CBT) sessions. The objective of reporting the cases is to demonstrate the satisfactory evolution of the treatment with the technique of panic symptoms induction exercises (SIE) in controlled laboratory environment. On that way, reducing or extinguishing hyperventilation symptoms. This procedure was considered very important in the evolution of the treatment and allowed us to prepare the patients to face subsequent agoraphobic situations.

Dependência do álcool é o consumo excessivo com perda do controle apesar das conseqüências prejudiciais decorrentes. A depressão se caracteriza por um período longo e contínuo de humor deprimido com sintomas específicos. Procuramos ressaltar a importância do tratamento da co-morbidade da depressão em pacientes alcoolistas a fim de prevenir complicações como o risco de suicídio. O suicídio e a depressão em adolescentes e adultos representam maior risco com o uso indevido do álcool. A depressão em pacientes alcoolistas precede as tentativas de suicídio na maioria dos casos. Relatamos um caso grave de paciente dependente do álcool com depressão e risco de suicídio atendido no ambulatório do Programa de Estudos e Assistência ao Uso Indevido de Drogas do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (PROJAD/IPUB/UFRJ). O tratamento consistiu no uso de antidepressivos e psicoterapia cognitivo-comportamental. O tratamento da depressão do paciente associou-se a maior ad...

Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sen...

This long-term extension of an 8-week randomized, naturalistic study in patients with panic disorder with or without agoraphobia compared the efficacy and safety of clonazepam (n = 47) and paroxetine (n = 37) over a 3-year total treatment duration. Target doses for all patients were 2 mg/d clonazepam and 40 mg/d paroxetine (both taken at bedtime). This study reports data from the long-term period (34 months), following the initial 8-week treatment phase. Thus, total treatment duration was 36 months. Patients with a good primary outcome during acute treatment continued monotherapy with clonazepam or paroxetine, but patients with partial primary treatment success were switched to the combination therapy. At initiation of the long-term study, the mean doses of clonazepam and paroxetine were 1.9 (SD, 0.30) and 38.4 (SD, 3.74) mg/d, respectively. These doses were maintained until month 36 (clonazepam 1.9 [SD, 0.29] mg/d and paroxetine 38.2 [SD, 3.87] mg/d). Long-term treatment with clonazepam led to a small but significantly better Clinical Global Impression (CGI)-Improvement rating than treatment with paroxetine (mean difference: CGI-Severity scale -3.48 vs -3.24, respectively, P = 0.02; CGI-Improvement scale 1.06 vs 1.11, respectively, P = 0.04). Both treatments similarly reduced the number of panic attacks and severity of anxiety. Patients treated with clonazepam had significantly fewer adverse events than those treated with paroxetine (28.9% vs 70.6%, P < 0.001). The efficacy of clonazepam and paroxetine for the treatment of panic disorder was maintained over the long-term course. There was a significant advantage with clonazepam over paroxetine with respect to the frequency and nature of adverse events.

The objective of the present study was to verify the response of patients with panic disorder (agoraphobia) to existing cognitive-behavior therapy models (CBT) of two respiratory subtypes of panic disorder (PD): respiratory subtype (RS) and non respiratory subtype (NRS). We randomly selected a sample of 50 patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. The medication used was tricycle or selective serotonin reuptake inhibitor antidepressants. Seventy-seven point six percent of the patients from both groups showed RS and 22.4% the NRS. The RS patients responded satisfactorily to the treatment with techniques of CBT decreasing anxiety, breathing symptoms and panic attacks. According to the global functioning assessment scale, RS patients improved from 55.8 to 70.9 in comparison with NRS ones.