Gláucia R Guerra Benute | USP (original) (raw)

Papers by Gláucia R Guerra Benute

Estudos Interdisciplinares em Psicologia, 2012

Journal of palliative medicine, Jan 31, 2017

Fetal malformations occur in 2% of gestations and are the fifth most common cause of neonatal dea... more Fetal malformations occur in 2% of gestations and are the fifth most common cause of neonatal death in the world. In many cases, fetal malformations result in neonatal death or long stay in intensive care facilities. Families that continue the pregnancy in such a situation need to make choices and cope with an overwhelming number of potential issues. Palliative care starting at the prenatal period is a growing field that allows the entire family to prepare for this difficult situation. To perform a systematic review of published data on palliative care in the prenatal period. PubMed and the Cochrane Library were searched using the keywords ("perinatal" OR "prenatal" OR "fetal") AND "palliative care" and also ("perinatal" OR "prenatal" OR "fetal") AND "hospice." Studies focusing on the long-term impact of prenatal palliative care published up to December 2015 were used. Quantitative and qualitative studie...

Medical Express, 2016

OBJECTIVE: To identify the risk for suicidal behavior in women who had a fetal loss resulting fro... more OBJECTIVE: To identify the risk for suicidal behavior in women who had a fetal loss resulting from ectopic pregnancy and verify the association of suicide risk with depression and psychosocial aspects. METHODS: Thirty-one women diagnosed with an ectopic pregnancy were interviewed. Major depression was identified using the Primary Care Evaluation of Mental Disorders questionnaire. The Prenatal Psychosocial Profile questionnaire was used to measure stress, social support and self-esteem. RESULTS: We found that 16% (n = 5) reported suicide risk behavior. The correlation between suicide risk and symptoms of major depression, stress and guilt was statistically significant. CONCLUSIONS: Depression and stress have been linked to the presence of suicide risk, further increasing the vulnerability of women with ectopic prgnancy, which generates intense emotional reactions as guilt.

Dementia & Neuropsychologia, 2014

Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in cl... more Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. Methods: We recruited 1447 healthy subjects aged ≥18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. Results: Among the participants, mean intellectual efficiency was 103.20 (SD: 12.0), age 41.0 (SD: 16.4) years and education 11.9 (SD: 5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correla...

Maternal and Child Health Journal, 2015

Objective To describe and determine the association between the occurrence of pica and eating att... more Objective To describe and determine the association between the occurrence of pica and eating attitudes in women with high-risk pregnancies and to determine the prevalence of pica during pregnancy. Methods A cross-sectional and prospective 24-month study was conducted with 913 women with high-risk pregnancies. Structured interviews were carried out and the Eating Attitudes Test was applied. Results Pica was diagnosed in 5.7 % of the pregnant women, and its most commonly practiced type was geophagia (57.7 %). The association between pica and signs related to the eating attitudes: "to be considered too thin by others" (p < 0.02), and "to spend too much time thinking about food" (p = 0.05); and the association between pica and the risk of both anorexia nervosa and bulimia nervosa (p < 0.01) were statistically significant. Conclusions The absence of validated instruments in the literature for assessing pica reinforces the difficulty of investigating this practice and the need for further studies. Moreover, additional efforts need to focus in the improvement of screening for other eating disorders with obstetric consequences associated with pica and be incorporated into the routine of healthcare professionals.

Revista Brasileira de Ginecologia e Obstetrícia, 2012

ObjetivO: Identificar o conhecimento e a percepção dos profissionais da saúde em relação à legisl... more ObjetivO: Identificar o conhecimento e a percepção dos profissionais da saúde em relação à legislação brasileira sobre o aborto provocado. MétOdOs: Envelopes selados não identificados contendo os questionários foram enviados a todos os profissionais (n=149) que trabalham no Departamento de Obstetrícia de hospital universitário e de hospital público da periferia de São Paulo. Responderam ao questionário 119 profissionais. Para análise dos dados, utilizou-se intervalo de confiança de 0,05 e os testes exatos de Fischer e c 2. ResultadOs: Dos profissionais entrevistados, 48,7% eram médicos, 33,6% profissionais da área de enfermagem e 17,6% eram profissionais de outras áreas (psicólogos, nutricionistas, fisioterapeutas, administrativos e técnicos de laboratórios). Constatou-se diferença significativa (p=0,01) na proporção de profissionais que acreditam que o aborto por malformação fetal não letal e no aborto decorrente de gestações não planejadas deveriam ser incluídos na legislação brasileira. Observou-se que o conhecimento da legislação e da descrição das situações permitidas por lei acerca do aborto foi significativamente diferente na comparação entre os profissionais de saúde (p=0,01). Quando questionados sobre as situações em que a legislação brasileira permite o aborto, observou-se que 32,7% dos médicos, 97,5% profissionais da área de enfermagem e 90,5% dos demais profissionais desconhecem a legislação vigente. COnClusãO: Neste estudo, evidenciou-se o desconhecimento dos profissionais de saúde com relação à legislação brasileira, em menor proporção entre obstetras e em maior proporção entre os profissionais da área de enfermagem. Foram constatadas atitudes de discriminação, julgamento e preconceito na assistência prestada às mulheres que provocam o aborto.

Revista Latinoamericana de Psicopatologia Fundamental, 2013

Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o di... more Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o diagnóstico diferencial e o tratamento para todos aqueles que padecem dos chamados transtornos alimentares. Todavia, se a Medicina, como área do saber científico, deve generalizar, a psicanálise tem como campo de pesquisa o inconsciente, o sujeito como efeito de linguagem. Com isso, a partir de observações sobre as entrevistas preliminares de um caso, no qual se evidenciava o sintoma bulímico, o presente artigo coloca em relevo algumas questões: as especificidades do sintoma para a psicanálise, a diferença radical entre instinto e pulsão e a particularidade da produção de saber em psicanálise.

Revista da Associação Médica Brasileira, 2014

Objective: to analyze women's perception in relation to their partner's reaction and beha... more Objective: to analyze women's perception in relation to their partner's reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. Methods: semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p < 0.05. Results: in both capitals, the women who induced an abortion referred to the partner as the person who could not find out about the abortion (p<0.01 in Natal; p = 0.02 in São Paulo-SP) and, simultaneously, as the one who could have avoided it (p < 0.01 in Natal; p = 0.03 in São Paulo). In Natal-RN, induced abortion was associated with the partner's absence at the ti...

Medical Express, 2014

OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patien... more OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patients among ward and ambulatory patients. METHOD: An exploratory, descriptive, and cross-sectional study was carried out among 542 high-risk pregnant women divided into two groups: 278 were outpatients receiving ambulatory care, and 264 were ward patients. Both attended a public university hospital in the State of São Paulo, Brazil. Major depressive disorder was evaluated using the Brazilian version of the Primary Care Evaluation of Mental Disorders. The w 2 test was used in the statistical analysis with a level of significance of 5% (po0.05). RESULTS: Sixty women (11.0%) were diagnosed with major depression, twenty-five (9%) were outpatients and thirty-five (13%) were ward patients. There was no statistically significant difference between groups with respect to the major depression (p ¼ 0.11). Statistically significant differences were found between outpatients and ward patients as follows: insomnia or hypersomnia (po0.01); fatigue or loss of energy (p ¼ 0.02); diminished concentration (po0.01); and restlessness or psychomotor retardation (po0.01). CONCLUSIONS: Hospitalization may intensify some depressive symptoms. The high proportion of women with major depression demonstrates the need for access to psychosocial support during the pregnancy period, especially in pregnant women at high-risk.

Twin Research and Human Genetics, 2013

Background: Twin pregnancies are at increased physiological and psychosocial risks.Objective: To ... more Background: Twin pregnancies are at increased physiological and psychosocial risks.Objective: To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support.Method: The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support.Results: Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found whe...

Arquivos de Neuro-Psiquiatria, 2010

Traumatic brain injury (TBI) is one of the most frequent causes of brain damage. Cognitive defici... more Traumatic brain injury (TBI) is one of the most frequent causes of brain damage. Cognitive deficits reported in the literature after moderate to severe TBI include memory, language, executive functions, attention and information processing speed impairments. However, systematic studies on patients with mild TBI are scarce although neuropsychological changes are present. OBJECTIVE: To investigate the cognitive functioning of patients with mild to moderate TBI. METHOD: We evaluated 12 patients with mild to moderate TBI using a comprehensive protocol (PN01) of neuropsychological tests. RESULTS: There were significant deficits of episodic memory including immediate and delayed verbal memory recall, verbal recognition, immediate and delayed visual memory recall, naming, verbal fluency and information processing speed. CONCLUSION: These results emphasize the importance of comprehensive neuropsychological assessments even in cases of mild TBI in order to identify impaired and preserved fun...

Background: Fetal malformations occur in 2% of gestations and are the fifth most common cause of ... more Background: Fetal malformations occur in 2% of gestations and are the fifth most common cause of neonatal death in the world. In many cases, fetal malformations result in neonatal death or long stay in intensive care facilities. Families that continue the pregnancy in such a situation need to make choices and cope with an overwhelming number of potential issues. Palliative care starting at the prenatal period is a growing field that allows the entire family to prepare for this difficult situation. Objective: To perform a systematic review of published data on palliative care in the prenatal period.

Objective To describe and determine the association between the occurrence of pica and eating att... more Objective To describe and determine the association between the occurrence of pica and eating attitudes in women with high-risk pregnancies and to determine the prevalence of pica during pregnancy. Methods A cross-sectional and prospective 24-month study was conducted with 913 women with high-risk pregnancies. Structured interviews were carried out and the Eating Attitudes Test was applied. Results Pica was diagnosed in 5.7 % of the pregnant women, and its most commonly practiced type was geophagia (57.7 %). The association between pica and signs related to the eating attitudes: ''to be considered too thin by others'' (p \ 0.02), and ''to spend too much time thinking about food'' (p = 0.05); and the association between pica and the risk of both anorexia nervosa and bulimia nervosa (p \ 0.01) were statistically significant. Conclusions The absence of validated instruments in the literature for assessing pica reinforces the difficulty of investigating this practice and the need for further studies. Moreover, additional efforts need to focus in the improvement of screening for other eating disorders with obstetric consequences associated with pica and be incorporated into the routine of healthcare professionals. Significance The nutritional status of the pregnant woman represents an important factor for the development of the fetus and for a healthy pregnancy. Women who have inadequate nutrient intake are more likely to develop a risky pregnancy. This problem is particularly severe when the woman presents an eating disorder like pica. The study of pica in pregnant women and its association with anxiety and depression is very important because the consequences can be serious and even result in maternal or fetal death.

4 instructor at the Morphology Department and Postgraduate Program in Health Sciences at the Fede... more 4 instructor at the Morphology Department and Postgraduate Program in Health Sciences at the Federal University of rio grande do norte (UFrn) in natal, rn, Brazil. 5 instructor at the Psychology Department, Human Sciences, literature and arts center at the Federal University of rio grande do norte (UFrn) in natal, rn, Brazil. 6 Master of Psychology, teaching Psychologist, Human Sciences, literature and arts center at the Federal University of rio grande do norte (UFrn) in natal, rn, Brazil. Objective: to analyze women's perception in relation to their partner's reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. Methods: semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p < 0.05. Results: in both capitals, the women who induced an abortion referred to the partner as the person who could not find out about the abortion (p<0.01 in Natal; p = 0.02 in São Paulo-SP) and, simultaneously, as the one who could have avoided it (p < 0.01 in Natal; p = 0.03 in São Paulo). In Natal-RN, induced abortion was associated with the partner's absence at the time pregnancy was confirmed (p = 0.02) and, in Sao Paulo-SP, with their negative reaction to news of the pregnancy (p = 0.04) and lack of participation in the abortion process (p < 0.01). Conclusion: despite having achieved independence, women still regard male participation in the abortion process as an important factor. The specifics of each capital denote the influence of the geographic and cultural dimension, indicating the need to take into account the particulars of each region in Brazil while considering a holistic approach to women's health.

Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in cl... more Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. Methods: We recruited 1447 healthy subjects aged ≥18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. Results: Among the participants, mean intellectual efficiency was 103.20 (SD: 12.0), age 41.0 (SD: 16.4) years and education 11.9 (SD: 5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correlation. Gender was not found to be significant on the multiple linear regression model, but age and education maintained their interference. Conclusion: Gender did not have the major impact on attentional tasks observed for age and education, both of which should be considered in the stratification of normative samples. DESEMPENHO DE UMA AMOSTRA DE ADULTOS BRASILEIROS NO TRAILL MAKING TEST E STROOP TEST RESUMO. Objetivo: Os testes de atenção Trail Making Test (TMT) e Stroop Test (ST) são largamente usados na prática clínica e em pesquisas. O objetivo deste estudo foi fornecer informação normativa para a população brasileira de adultos e estudar a interferência de gênero, idade e educação no TMT parte A e B e no ST cartão A, B e C. Métodos: Recrutamos 1447 sujeitos saudáveis com idade ≥18 anos, nível educacional de 0-25 anos, falantes nativos do Português (Brasil). Os sujeitos foram avaliados pelos subtestes do Wechsler Adult Intelligence Scale-III Raciocínio Matricial e Vocabulários, além do TMTA, TMTB e ST A, B e C. Resultados: Entre os participantes a média de eficiência intelectual foi de 103,20 (SD: 12,0), de idade 41,0 (SD: 16,4) anos e de escolaridade 11,9 (SD: 5,6) anos. Houve diferenças significantes por gênero em TMTA (p=0,002), TMTB (p=0,017) e STC (p=0,024). Idade se correlacionou de modo positivo com todos os testes de atenção, enquanto a escolaridade correlacionou-se de modo negativo. Após o modelo de regressão linear múltipla o gênero não manteve correlação significativa, mas idade e escolaridade mantiveram sua interferência. Conclusão: O gênero não mostrou grande impacto nas tarefas atencionais como a idade e escolaridade que devem, portanto, ser consideradas na estratificação de amostras normativas. Palavras-chave: atenção, Trail Making Test, Stroop Test, análise demográfica.

OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patien... more OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patients among ward and ambulatory patients. METHOD: An exploratory, descriptive, and cross-sectional study was carried out among 542 high-risk pregnant women divided into two groups: 278 were outpatients receiving ambulatory care, and 264 were ward patients. Both attended a public university hospital in the State of São Paulo, Brazil. Major depressive disorder was evaluated using the Brazilian version of the Primary Care Evaluation of Mental Disorders. The w 2 test was used in the statistical analysis with a level of significance of 5% (po0.05). RESULTS: Sixty women (11.0%) were diagnosed with major depression, twenty-five (9%) were outpatients and thirty-five (13%) were ward patients. There was no statistically significant difference between groups with respect to the major depression (p ¼ 0.11). Statistically significant differences were found between outpatients and ward patients as follows: insomnia or hypersomnia (po0.01); fatigue or loss of energy (p ¼ 0.02); diminished concentration (po0.01); and restlessness or psychomotor retardation (po0.01). CONCLUSIONS: Hospitalization may intensify some depressive symptoms. The high proportion of women with major depression demonstrates the need for access to psychosocial support during the pregnancy period, especially in pregnant women at high-risk.

Background: Twin pregnancies are at increased physiological and psychosocial risks. Objective: To... more Background: Twin pregnancies are at increased physiological and psychosocial risks. Objective: To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support. Method: The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support. Results: Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found when correlating depression with perception of negative aspects of having twins and belief in significant body changes during pregnancy (p = .005 and .03, respectively). Marital status, occupation, and pregnancy planning were not significantly associated with the diagnosis of depression. Conclusion: Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support. A multidisciplinary approach in these cases is fundamental to minimize further risks and complications.

Resumo OBJETIVO: Foi descrever e comparar a preferência pela via de parto entre gestantes nulípar... more Resumo OBJETIVO: Foi descrever e comparar a preferência pela via de parto entre gestantes nulíparas e primíparas, e verificar se a vivência anterior do parto exerce influência no processo de parturição. MÉTODOS: Foi realizado um estudo transversal prospectivo. Foram realizadas 100 entrevistas com questionários previamente elaborados com 56 gestantes nulíparas e 44 primíparas. Os dados categóricos e quantitativos foram avaliados pelo qui-quadrado ou Teste Exato de Fisher. O nível de significância utilizado para os testes foi de 0,05. RESULTADOS: Das gestantes, 60,7% das nulíparas e 70,5% das primíparas relataram preferir o parto por via vaginal. Ao se analisar as respostas sobre ter recebido informações suficientes sobre o tipo de parto, a existência ou não de influências na escolha pela via de parto e a preferência da via de parto pelo parceiro, não foram evidenciadas diferenças significativas entre os dois grupos (p>0,05). CONCLUSÃO: O presente estudo permitiu concluir que a vivência anterior do parto não exerce influência na expectativa do processo de parturição nem na escolha por determinada via de parto. As mulheres, ao optarem pela via de parto, buscam garantir a saúde materna e do neonato, bem como evitar o processo de dor e sofrimento. Abstract PURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.

Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o di... more Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o diagnóstico diferencial e o tratamento para todos aqueles que padecem dos chamados transtornos alimentares. Todavia, se a Medicina, como área do saber científico, deve generalizar, a psicanálise tem como campo de pesquisa o inconsciente, o sujeito como efeito de linguagem. Com isso, a partir de observações sobre as entrevistas preliminares de um caso, no qual se evidenciava o sintoma bulímico, o presente artigo coloca em relevo algumas questões: as especificidades do sintoma para a psicanálise, a diferença radical entre instinto e pulsão e a particularidade da produção de saber em psicanálise.

Resumo OBJETIVO: Comparar e analisar aspectos socioeconômicos e emocionais na vivência do aborto ... more Resumo OBJETIVO: Comparar e analisar aspectos socioeconômicos e emocionais na vivência do aborto provocado e espontâneo em mulheres da periferia da cidade de São Paulo. MÉTODOS: Estudo prospectivo e caso-controle realizado no período de julho de 2008 a março de 2010, envolvendo a realização de entrevistas semidirigidas, previamente elaboradas com mulheres que apresentavam diagnóstico médico de aborto internadas em dois hospitais públicos da periferia da cidade de São Paulo. Foram incluídas 100 mulheres com diagnóstico de aborto que foram internadas para a realização da curetagem uterina. Foram identificadas 11 mulheres que relataram ter provocado aborto (11%) que constituíram o grupo de casos. O grupo controle (n=22) foi selecionado na proporção 2:1, seguindo-se o procedimento: para cada caso de aborto provocado, os próximos dois casos de aborto espontâneo, do mesmo hospital. Foi realizada entrevista semiestruturada com perguntas relativas aos aspectos emocionais, ao contexto familiar, social e econômico. RESULTADOS: As mulheres do grupo com aborto provocado, em relação ao grupo com aborto espontâneo, apresentaram menor escolaridade, sendo mais frequente o nível fundamental (82 versus 36%, p=0,04); menor renda familiar (mediana, R$ 1.000,00 versus R$ 1.400,00, p=0,04); menor renda pessoal (mediana, R$ 200,00 versus R$ 333,00, p=0,04), maior frequência de sentimentos negativos na suspeita (82 versus 22%, p=0,004) e na confirmação (72 versus 22%, p=0,03) da gravidez. CONCLUSÃO: O aborto provocado em mulheres que procuram atendimento em hospitais da periferia da cidade de São Paulo está relacionado a condições socioeconômicas desfavoráveis, o que prejudica a vivência na suspeita e confirmação da gravidez. Abstract PURPOSE: To compare and analyze socioeconomic aspects and the emotional experience of women with spontaneous or induced abortion and in women living in the outskirts of São Paulo. METHODS: A prospective case-control study carried out from July 2008 to March 2010, involving semi-structured interviews with women who presented a previous diagnosis of abortion and who had been admitted to two public hospitals in the outskirts of São Paulo. The study included 100 women with diagnosis of abortion and were hospitalized for curettage. Eleven women who reported induced abortion (11%) represented the case group. The control group (n=22) was selected at a 2:1 ratio according to the following procedure: for every case of induced abortion, the next two cases of spontaneous abortion at the same hospital. A semistructured interview was conducted with questions regarding emotional aspects and family, social and economic context. RESULTS: The women with induced abortion compared to the group with spontaneous abortion had lower educational level, with more frequent elementary level (82 versus 36%, p=0.04), lower income (median, R$ 1,000.00 versus R$ 1,400.00, p=0.04), lower personal income (median, R$ 200.00 versus R$ 333.00, p=0.04), higher frequency of negative feelings upon suspicion (82 versus 22%, p=0.004) and confirmation (72 versus 22%, p=0.03) of pregnancy. CONCLUSION: Among women looking for health care in hospitals in the outskirts of São Paulo, induced abortion is related to unfavorable socioeconomic conditions, which affects the emotional experiences of suspicion and confirmation of pregnancy.

Estudos Interdisciplinares em Psicologia, 2012

Journal of palliative medicine, Jan 31, 2017

Fetal malformations occur in 2% of gestations and are the fifth most common cause of neonatal dea... more Fetal malformations occur in 2% of gestations and are the fifth most common cause of neonatal death in the world. In many cases, fetal malformations result in neonatal death or long stay in intensive care facilities. Families that continue the pregnancy in such a situation need to make choices and cope with an overwhelming number of potential issues. Palliative care starting at the prenatal period is a growing field that allows the entire family to prepare for this difficult situation. To perform a systematic review of published data on palliative care in the prenatal period. PubMed and the Cochrane Library were searched using the keywords ("perinatal" OR "prenatal" OR "fetal") AND "palliative care" and also ("perinatal" OR "prenatal" OR "fetal") AND "hospice." Studies focusing on the long-term impact of prenatal palliative care published up to December 2015 were used. Quantitative and qualitative studie...

Medical Express, 2016

OBJECTIVE: To identify the risk for suicidal behavior in women who had a fetal loss resulting fro... more OBJECTIVE: To identify the risk for suicidal behavior in women who had a fetal loss resulting from ectopic pregnancy and verify the association of suicide risk with depression and psychosocial aspects. METHODS: Thirty-one women diagnosed with an ectopic pregnancy were interviewed. Major depression was identified using the Primary Care Evaluation of Mental Disorders questionnaire. The Prenatal Psychosocial Profile questionnaire was used to measure stress, social support and self-esteem. RESULTS: We found that 16% (n = 5) reported suicide risk behavior. The correlation between suicide risk and symptoms of major depression, stress and guilt was statistically significant. CONCLUSIONS: Depression and stress have been linked to the presence of suicide risk, further increasing the vulnerability of women with ectopic prgnancy, which generates intense emotional reactions as guilt.

Dementia & Neuropsychologia, 2014

Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in cl... more Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. Methods: We recruited 1447 healthy subjects aged ≥18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. Results: Among the participants, mean intellectual efficiency was 103.20 (SD: 12.0), age 41.0 (SD: 16.4) years and education 11.9 (SD: 5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correla...

Maternal and Child Health Journal, 2015

Objective To describe and determine the association between the occurrence of pica and eating att... more Objective To describe and determine the association between the occurrence of pica and eating attitudes in women with high-risk pregnancies and to determine the prevalence of pica during pregnancy. Methods A cross-sectional and prospective 24-month study was conducted with 913 women with high-risk pregnancies. Structured interviews were carried out and the Eating Attitudes Test was applied. Results Pica was diagnosed in 5.7 % of the pregnant women, and its most commonly practiced type was geophagia (57.7 %). The association between pica and signs related to the eating attitudes: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;to be considered too thin by others&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.02), and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;to spend too much time thinking about food&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (p = 0.05); and the association between pica and the risk of both anorexia nervosa and bulimia nervosa (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) were statistically significant. Conclusions The absence of validated instruments in the literature for assessing pica reinforces the difficulty of investigating this practice and the need for further studies. Moreover, additional efforts need to focus in the improvement of screening for other eating disorders with obstetric consequences associated with pica and be incorporated into the routine of healthcare professionals.

Revista Brasileira de Ginecologia e Obstetrícia, 2012

ObjetivO: Identificar o conhecimento e a percepção dos profissionais da saúde em relação à legisl... more ObjetivO: Identificar o conhecimento e a percepção dos profissionais da saúde em relação à legislação brasileira sobre o aborto provocado. MétOdOs: Envelopes selados não identificados contendo os questionários foram enviados a todos os profissionais (n=149) que trabalham no Departamento de Obstetrícia de hospital universitário e de hospital público da periferia de São Paulo. Responderam ao questionário 119 profissionais. Para análise dos dados, utilizou-se intervalo de confiança de 0,05 e os testes exatos de Fischer e c 2. ResultadOs: Dos profissionais entrevistados, 48,7% eram médicos, 33,6% profissionais da área de enfermagem e 17,6% eram profissionais de outras áreas (psicólogos, nutricionistas, fisioterapeutas, administrativos e técnicos de laboratórios). Constatou-se diferença significativa (p=0,01) na proporção de profissionais que acreditam que o aborto por malformação fetal não letal e no aborto decorrente de gestações não planejadas deveriam ser incluídos na legislação brasileira. Observou-se que o conhecimento da legislação e da descrição das situações permitidas por lei acerca do aborto foi significativamente diferente na comparação entre os profissionais de saúde (p=0,01). Quando questionados sobre as situações em que a legislação brasileira permite o aborto, observou-se que 32,7% dos médicos, 97,5% profissionais da área de enfermagem e 90,5% dos demais profissionais desconhecem a legislação vigente. COnClusãO: Neste estudo, evidenciou-se o desconhecimento dos profissionais de saúde com relação à legislação brasileira, em menor proporção entre obstetras e em maior proporção entre os profissionais da área de enfermagem. Foram constatadas atitudes de discriminação, julgamento e preconceito na assistência prestada às mulheres que provocam o aborto.

Revista Latinoamericana de Psicopatologia Fundamental, 2013

Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o di... more Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o diagnóstico diferencial e o tratamento para todos aqueles que padecem dos chamados transtornos alimentares. Todavia, se a Medicina, como área do saber científico, deve generalizar, a psicanálise tem como campo de pesquisa o inconsciente, o sujeito como efeito de linguagem. Com isso, a partir de observações sobre as entrevistas preliminares de um caso, no qual se evidenciava o sintoma bulímico, o presente artigo coloca em relevo algumas questões: as especificidades do sintoma para a psicanálise, a diferença radical entre instinto e pulsão e a particularidade da produção de saber em psicanálise.

Revista da Associação Médica Brasileira, 2014

Objective: to analyze women's perception in relation to their partner's reaction and beha... more Objective: to analyze women's perception in relation to their partner's reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. Methods: semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p < 0.05. Results: in both capitals, the women who induced an abortion referred to the partner as the person who could not find out about the abortion (p<0.01 in Natal; p = 0.02 in São Paulo-SP) and, simultaneously, as the one who could have avoided it (p < 0.01 in Natal; p = 0.03 in São Paulo). In Natal-RN, induced abortion was associated with the partner's absence at the ti...

Medical Express, 2014

OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patien... more OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patients among ward and ambulatory patients. METHOD: An exploratory, descriptive, and cross-sectional study was carried out among 542 high-risk pregnant women divided into two groups: 278 were outpatients receiving ambulatory care, and 264 were ward patients. Both attended a public university hospital in the State of São Paulo, Brazil. Major depressive disorder was evaluated using the Brazilian version of the Primary Care Evaluation of Mental Disorders. The w 2 test was used in the statistical analysis with a level of significance of 5% (po0.05). RESULTS: Sixty women (11.0%) were diagnosed with major depression, twenty-five (9%) were outpatients and thirty-five (13%) were ward patients. There was no statistically significant difference between groups with respect to the major depression (p ¼ 0.11). Statistically significant differences were found between outpatients and ward patients as follows: insomnia or hypersomnia (po0.01); fatigue or loss of energy (p ¼ 0.02); diminished concentration (po0.01); and restlessness or psychomotor retardation (po0.01). CONCLUSIONS: Hospitalization may intensify some depressive symptoms. The high proportion of women with major depression demonstrates the need for access to psychosocial support during the pregnancy period, especially in pregnant women at high-risk.

Twin Research and Human Genetics, 2013

Background: Twin pregnancies are at increased physiological and psychosocial risks.Objective: To ... more Background: Twin pregnancies are at increased physiological and psychosocial risks.Objective: To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support.Method: The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support.Results: Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found whe...

Arquivos de Neuro-Psiquiatria, 2010

Traumatic brain injury (TBI) is one of the most frequent causes of brain damage. Cognitive defici... more Traumatic brain injury (TBI) is one of the most frequent causes of brain damage. Cognitive deficits reported in the literature after moderate to severe TBI include memory, language, executive functions, attention and information processing speed impairments. However, systematic studies on patients with mild TBI are scarce although neuropsychological changes are present. OBJECTIVE: To investigate the cognitive functioning of patients with mild to moderate TBI. METHOD: We evaluated 12 patients with mild to moderate TBI using a comprehensive protocol (PN01) of neuropsychological tests. RESULTS: There were significant deficits of episodic memory including immediate and delayed verbal memory recall, verbal recognition, immediate and delayed visual memory recall, naming, verbal fluency and information processing speed. CONCLUSION: These results emphasize the importance of comprehensive neuropsychological assessments even in cases of mild TBI in order to identify impaired and preserved fun...

Background: Fetal malformations occur in 2% of gestations and are the fifth most common cause of ... more Background: Fetal malformations occur in 2% of gestations and are the fifth most common cause of neonatal death in the world. In many cases, fetal malformations result in neonatal death or long stay in intensive care facilities. Families that continue the pregnancy in such a situation need to make choices and cope with an overwhelming number of potential issues. Palliative care starting at the prenatal period is a growing field that allows the entire family to prepare for this difficult situation. Objective: To perform a systematic review of published data on palliative care in the prenatal period.

Objective To describe and determine the association between the occurrence of pica and eating att... more Objective To describe and determine the association between the occurrence of pica and eating attitudes in women with high-risk pregnancies and to determine the prevalence of pica during pregnancy. Methods A cross-sectional and prospective 24-month study was conducted with 913 women with high-risk pregnancies. Structured interviews were carried out and the Eating Attitudes Test was applied. Results Pica was diagnosed in 5.7 % of the pregnant women, and its most commonly practiced type was geophagia (57.7 %). The association between pica and signs related to the eating attitudes: ''to be considered too thin by others'' (p \ 0.02), and ''to spend too much time thinking about food'' (p = 0.05); and the association between pica and the risk of both anorexia nervosa and bulimia nervosa (p \ 0.01) were statistically significant. Conclusions The absence of validated instruments in the literature for assessing pica reinforces the difficulty of investigating this practice and the need for further studies. Moreover, additional efforts need to focus in the improvement of screening for other eating disorders with obstetric consequences associated with pica and be incorporated into the routine of healthcare professionals. Significance The nutritional status of the pregnant woman represents an important factor for the development of the fetus and for a healthy pregnancy. Women who have inadequate nutrient intake are more likely to develop a risky pregnancy. This problem is particularly severe when the woman presents an eating disorder like pica. The study of pica in pregnant women and its association with anxiety and depression is very important because the consequences can be serious and even result in maternal or fetal death.

4 instructor at the Morphology Department and Postgraduate Program in Health Sciences at the Fede... more 4 instructor at the Morphology Department and Postgraduate Program in Health Sciences at the Federal University of rio grande do norte (UFrn) in natal, rn, Brazil. 5 instructor at the Psychology Department, Human Sciences, literature and arts center at the Federal University of rio grande do norte (UFrn) in natal, rn, Brazil. 6 Master of Psychology, teaching Psychologist, Human Sciences, literature and arts center at the Federal University of rio grande do norte (UFrn) in natal, rn, Brazil. Objective: to analyze women's perception in relation to their partner's reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. Methods: semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p < 0.05. Results: in both capitals, the women who induced an abortion referred to the partner as the person who could not find out about the abortion (p<0.01 in Natal; p = 0.02 in São Paulo-SP) and, simultaneously, as the one who could have avoided it (p < 0.01 in Natal; p = 0.03 in São Paulo). In Natal-RN, induced abortion was associated with the partner's absence at the time pregnancy was confirmed (p = 0.02) and, in Sao Paulo-SP, with their negative reaction to news of the pregnancy (p = 0.04) and lack of participation in the abortion process (p < 0.01). Conclusion: despite having achieved independence, women still regard male participation in the abortion process as an important factor. The specifics of each capital denote the influence of the geographic and cultural dimension, indicating the need to take into account the particulars of each region in Brazil while considering a holistic approach to women's health.

Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in cl... more Objective: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. Methods: We recruited 1447 healthy subjects aged ≥18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. Results: Among the participants, mean intellectual efficiency was 103.20 (SD: 12.0), age 41.0 (SD: 16.4) years and education 11.9 (SD: 5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correlation. Gender was not found to be significant on the multiple linear regression model, but age and education maintained their interference. Conclusion: Gender did not have the major impact on attentional tasks observed for age and education, both of which should be considered in the stratification of normative samples. DESEMPENHO DE UMA AMOSTRA DE ADULTOS BRASILEIROS NO TRAILL MAKING TEST E STROOP TEST RESUMO. Objetivo: Os testes de atenção Trail Making Test (TMT) e Stroop Test (ST) são largamente usados na prática clínica e em pesquisas. O objetivo deste estudo foi fornecer informação normativa para a população brasileira de adultos e estudar a interferência de gênero, idade e educação no TMT parte A e B e no ST cartão A, B e C. Métodos: Recrutamos 1447 sujeitos saudáveis com idade ≥18 anos, nível educacional de 0-25 anos, falantes nativos do Português (Brasil). Os sujeitos foram avaliados pelos subtestes do Wechsler Adult Intelligence Scale-III Raciocínio Matricial e Vocabulários, além do TMTA, TMTB e ST A, B e C. Resultados: Entre os participantes a média de eficiência intelectual foi de 103,20 (SD: 12,0), de idade 41,0 (SD: 16,4) anos e de escolaridade 11,9 (SD: 5,6) anos. Houve diferenças significantes por gênero em TMTA (p=0,002), TMTB (p=0,017) e STC (p=0,024). Idade se correlacionou de modo positivo com todos os testes de atenção, enquanto a escolaridade correlacionou-se de modo negativo. Após o modelo de regressão linear múltipla o gênero não manteve correlação significativa, mas idade e escolaridade mantiveram sua interferência. Conclusão: O gênero não mostrou grande impacto nas tarefas atencionais como a idade e escolaridade que devem, portanto, ser consideradas na estratificação de amostras normativas. Palavras-chave: atenção, Trail Making Test, Stroop Test, análise demográfica.

OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patien... more OBJECTIVE: To evaluate and compare the presence of major depression in high-risk obstetric patients among ward and ambulatory patients. METHOD: An exploratory, descriptive, and cross-sectional study was carried out among 542 high-risk pregnant women divided into two groups: 278 were outpatients receiving ambulatory care, and 264 were ward patients. Both attended a public university hospital in the State of São Paulo, Brazil. Major depressive disorder was evaluated using the Brazilian version of the Primary Care Evaluation of Mental Disorders. The w 2 test was used in the statistical analysis with a level of significance of 5% (po0.05). RESULTS: Sixty women (11.0%) were diagnosed with major depression, twenty-five (9%) were outpatients and thirty-five (13%) were ward patients. There was no statistically significant difference between groups with respect to the major depression (p ¼ 0.11). Statistically significant differences were found between outpatients and ward patients as follows: insomnia or hypersomnia (po0.01); fatigue or loss of energy (p ¼ 0.02); diminished concentration (po0.01); and restlessness or psychomotor retardation (po0.01). CONCLUSIONS: Hospitalization may intensify some depressive symptoms. The high proportion of women with major depression demonstrates the need for access to psychosocial support during the pregnancy period, especially in pregnant women at high-risk.

Background: Twin pregnancies are at increased physiological and psychosocial risks. Objective: To... more Background: Twin pregnancies are at increased physiological and psychosocial risks. Objective: To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support. Method: The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support. Results: Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found when correlating depression with perception of negative aspects of having twins and belief in significant body changes during pregnancy (p = .005 and .03, respectively). Marital status, occupation, and pregnancy planning were not significantly associated with the diagnosis of depression. Conclusion: Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support. A multidisciplinary approach in these cases is fundamental to minimize further risks and complications.

Resumo OBJETIVO: Foi descrever e comparar a preferência pela via de parto entre gestantes nulípar... more Resumo OBJETIVO: Foi descrever e comparar a preferência pela via de parto entre gestantes nulíparas e primíparas, e verificar se a vivência anterior do parto exerce influência no processo de parturição. MÉTODOS: Foi realizado um estudo transversal prospectivo. Foram realizadas 100 entrevistas com questionários previamente elaborados com 56 gestantes nulíparas e 44 primíparas. Os dados categóricos e quantitativos foram avaliados pelo qui-quadrado ou Teste Exato de Fisher. O nível de significância utilizado para os testes foi de 0,05. RESULTADOS: Das gestantes, 60,7% das nulíparas e 70,5% das primíparas relataram preferir o parto por via vaginal. Ao se analisar as respostas sobre ter recebido informações suficientes sobre o tipo de parto, a existência ou não de influências na escolha pela via de parto e a preferência da via de parto pelo parceiro, não foram evidenciadas diferenças significativas entre os dois grupos (p>0,05). CONCLUSÃO: O presente estudo permitiu concluir que a vivência anterior do parto não exerce influência na expectativa do processo de parturição nem na escolha por determinada via de parto. As mulheres, ao optarem pela via de parto, buscam garantir a saúde materna e do neonato, bem como evitar o processo de dor e sofrimento. Abstract PURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.

Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o di... more Os manuais de classificação e diagnóstico são bastante objetivos ao descreverem a etiologia, o diagnóstico diferencial e o tratamento para todos aqueles que padecem dos chamados transtornos alimentares. Todavia, se a Medicina, como área do saber científico, deve generalizar, a psicanálise tem como campo de pesquisa o inconsciente, o sujeito como efeito de linguagem. Com isso, a partir de observações sobre as entrevistas preliminares de um caso, no qual se evidenciava o sintoma bulímico, o presente artigo coloca em relevo algumas questões: as especificidades do sintoma para a psicanálise, a diferença radical entre instinto e pulsão e a particularidade da produção de saber em psicanálise.

Resumo OBJETIVO: Comparar e analisar aspectos socioeconômicos e emocionais na vivência do aborto ... more Resumo OBJETIVO: Comparar e analisar aspectos socioeconômicos e emocionais na vivência do aborto provocado e espontâneo em mulheres da periferia da cidade de São Paulo. MÉTODOS: Estudo prospectivo e caso-controle realizado no período de julho de 2008 a março de 2010, envolvendo a realização de entrevistas semidirigidas, previamente elaboradas com mulheres que apresentavam diagnóstico médico de aborto internadas em dois hospitais públicos da periferia da cidade de São Paulo. Foram incluídas 100 mulheres com diagnóstico de aborto que foram internadas para a realização da curetagem uterina. Foram identificadas 11 mulheres que relataram ter provocado aborto (11%) que constituíram o grupo de casos. O grupo controle (n=22) foi selecionado na proporção 2:1, seguindo-se o procedimento: para cada caso de aborto provocado, os próximos dois casos de aborto espontâneo, do mesmo hospital. Foi realizada entrevista semiestruturada com perguntas relativas aos aspectos emocionais, ao contexto familiar, social e econômico. RESULTADOS: As mulheres do grupo com aborto provocado, em relação ao grupo com aborto espontâneo, apresentaram menor escolaridade, sendo mais frequente o nível fundamental (82 versus 36%, p=0,04); menor renda familiar (mediana, R$ 1.000,00 versus R$ 1.400,00, p=0,04); menor renda pessoal (mediana, R$ 200,00 versus R$ 333,00, p=0,04), maior frequência de sentimentos negativos na suspeita (82 versus 22%, p=0,004) e na confirmação (72 versus 22%, p=0,03) da gravidez. CONCLUSÃO: O aborto provocado em mulheres que procuram atendimento em hospitais da periferia da cidade de São Paulo está relacionado a condições socioeconômicas desfavoráveis, o que prejudica a vivência na suspeita e confirmação da gravidez. Abstract PURPOSE: To compare and analyze socioeconomic aspects and the emotional experience of women with spontaneous or induced abortion and in women living in the outskirts of São Paulo. METHODS: A prospective case-control study carried out from July 2008 to March 2010, involving semi-structured interviews with women who presented a previous diagnosis of abortion and who had been admitted to two public hospitals in the outskirts of São Paulo. The study included 100 women with diagnosis of abortion and were hospitalized for curettage. Eleven women who reported induced abortion (11%) represented the case group. The control group (n=22) was selected at a 2:1 ratio according to the following procedure: for every case of induced abortion, the next two cases of spontaneous abortion at the same hospital. A semistructured interview was conducted with questions regarding emotional aspects and family, social and economic context. RESULTS: The women with induced abortion compared to the group with spontaneous abortion had lower educational level, with more frequent elementary level (82 versus 36%, p=0.04), lower income (median, R$ 1,000.00 versus R$ 1,400.00, p=0.04), lower personal income (median, R$ 200.00 versus R$ 333.00, p=0.04), higher frequency of negative feelings upon suspicion (82 versus 22%, p=0.004) and confirmation (72 versus 22%, p=0.03) of pregnancy. CONCLUSION: Among women looking for health care in hospitals in the outskirts of São Paulo, induced abortion is related to unfavorable socioeconomic conditions, which affects the emotional experiences of suspicion and confirmation of pregnancy.