Alterações cognitivas e comportamentais em crianças e adolescentes com transtornos psiquiátricos em ambulatório do Rio de Janeiro
DOI:
https://doi.org/10.25118/2763-9037.2025.v15.1449Palavras-chave:
desempenho intelectual, distúrbios do comportamento, transtornos mentais e do comportamento, transtornos psiquiátricos, fatores transdiagnósticosResumo
Introdução: Alterações no funcionamento cognitivo e problemas de comportamento são mais comuns em pessoas com transtornos psiquiátricos. Assim, o agrupamento clínico por distúrbios emocionais sem levar em consideração problemas cognitivos ou comportamentais pode confundir pacientes e ocasionar dificuldades para a efetividade do tratamento. Objetivos: Este estudo buscou investigar a presença de queixas comportamentais e disfunções cognitivas vivenciadas por crianças e adolescentes com transtornos psiquiátricos. Métodos: Um total de 97 participantes (63 do sexo masculino e 34 do sexo feminino) com idades entre 6 e 15 anos e diagnosticados com transtornos psiquiátricos foram submetidos à Escala Wechsler Abreviada de Inteligência (WASI) e a um questionário sociodemográfico e clínico. Resultados: Foram verificados fatores partilhados por diferentes transtornos psiquiátricos, como desempenho intelectual abaixo do esperado para a faixa etária (QI < 90) com diferenças entre os grupos diagnósticos no que se refere ao QI global [X² (3) = 13.715; P < 0.05] e distúrbios comportamentais (cerca de 46,4% dos casos), em particular no que se refere à agressividade (N = 32). Discussão/Conclusão: Para além dos diagnósticos em saúde mental, fatores cognitivos e comportamentais devem ser observados com atenção na clínica médica e psicológica com o intuito de intervenções terapêuticas mais eficazes, além de se determinar a progressão em relação ao tratamento.
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1 Thiengo DL, Cavalcante MT, Lovisi GM. Prevalência de transtornos mentais entre crianças e adolescentes e fatores associados: uma revisão sistemática. J. bras. psiquiatr. 2014;63(4):360-72 https://doi.org/10.1590/0047-2085000000046 DOI: https://doi.org/10.1590/0047-2085000000046
2 Ahmed SP, Bittencourt-Hewitt A, Sebastian CL. Neurocognitive bases of emotion regulation development in adolescence. Dev Cogn Neurosci. 2015;15:11-25. https://doi.org/10.1016/j.dcn.2015.07.006 PMid:26340451 PMCid:PMC6989808 DOI: https://doi.org/10.1016/j.dcn.2015.07.006
3 Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry.2021;12:628252. https://doi.org/10.3389/fpsyt.2021.628252 PMid:34759846 PMCid:PMC8573252 DOI: https://doi.org/10.3389/fpsyt.2021.628252
4 Snyder HR, Miyake A, Hankin BL. Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches. Front Psychol. 2015;6:328. https://doi.org/10.3389/fpsyg.2015.00328 PMid:25859234 PMCid:PMC4374537 DOI: https://doi.org/10.3389/fpsyg.2015.00328
5 Keyes KM, Platt J, Kaufman AS, McLaughlin KA. Association of Fluid Intelligence and Psychiatric Disorders in a Population-Representative Sample of US Adolescents. JAMA Psychiatry. 2017; 74(2):179-88. https://doi.org/10.1001/jamapsychiatry.2016.3723 PMid:28030746 PMCid:PMC5288266 DOI: https://doi.org/10.1001/jamapsychiatry.2016.3723
6 Melby L, Indredavik MS, Løhaugen GC, Brubakk AM, Skranes J, Vik T. Is there an association between full IQ score and mental health problems in young adults? A study with a convenience sample. BMC Psychol. 2020;8(1):1-9. https://doi.org/10.1186/s40359-020-0372-2 PMid:32000845 PMCid:PMC6993501 DOI: https://doi.org/10.1186/s40359-020-0372-2
7 Malloy-Diniz LF, Miranda DM, Grassi-Oliveira R. Editorial: Executive Functions in Psychiatric Disorders. Front Psychol. 2017;8:1461. https://doi.org/10.3389/fpsyg.2017.01461 PMid:28928684 PMCid:PMC5591960 DOI: https://doi.org/10.3389/fpsyg.2017.01461
8 Ferreira AA, Oliveira WG, de Paula JJ. Relações entre saúde mental e falhas cognitivas no dia a dia: Papel dos sintomas internalizantes e externalizantes. J Bras Psiquiatr. 2018;67(2):74-9. https://doi.org/10.1590/0047-2085000000188 DOI: https://doi.org/10.1590/0047-2085000000188
9 Harvey PD. Domains of cognition and their assessment. Dialogues Clin Neurosci. 2019;21(3):227-37. https://doi.org/10.31887/DCNS.2019.21.3/pharvey PMid:31749647 PMCid:PMC6829170 DOI: https://doi.org/10.31887/DCNS.2019.21.3/pharvey
10 Akubuilo UC, Iloh KK, Onu JU, Ayuk AC, Ubesie AC, Ikefuna AN. Academic performance and intelligence quotient of primary school children in Enugu. Pan Afr Med J. 2020;36:129. https://doi.org/10.11604/pamj.2020.36.129.22901 PMid:32849984 PMCid:PMC7422740 DOI: https://doi.org/10.11604/pamj.2020.36.129.22901
11 Edirisooriya M, Dykiert D, Auyeung B. IQ and Internalising Symptoms in Adolescents with ASD. J Autism Dev Disord. 2021;51(11):3887-907. https://doi.org/10.1007/s10803-020-04810-y PMid:33381856 PMCid:PMC8510967 DOI: https://doi.org/10.1007/s10803-020-04810-y
12 Ngo H, VanderLaan DP, Aitken M. Self-esteem symptom severity and treatment response in adolescents with internalizing problems. J Affect Disord. 2020;273:183-91. https://doi.org/10.1016/j.jad.2020.04.045 PMid:32421601 DOI: https://doi.org/10.1016/j.jad.2020.04.045
13 Tooley UA, Bassett DS, Mackey AP. Environmental influences on the pace of brain development. Nat Rev Neurosci. 2021;22(6):372-84. https://doi.org/10.1038/s41583-021-00457-5 PMid:33911229 PMCid:PMC8081006 DOI: https://doi.org/10.1038/s41583-021-00457-5
14 Wechsler D. Escala Wechsler abreviada de Inteligência (WASI). São Paulo: Casa do Psicólogo; 2014.
15 Ball G, Kelly CE, Beare R, Seal ML. Individual variation underlying brain age estimates in typical development. Neuroimage. 2021;235:118036. https://doi.org/10.1016/j.neuroimage.2021.118036 PMid:33838267 DOI: https://doi.org/10.1016/j.neuroimage.2021.118036
16 Wechsler SM, Machado WL, Ribeiro RKSM, Souza AF, Schneider P, Goetz E, Costa W, Costa CIG. Análise da Estrutura Interna da Bateria de Avaliação Intelectual de Jovens e Adultos. Psico-USF. 2019;24(4):779-90. https://doi.org/10.1590/1413-82712019240414 DOI: https://doi.org/10.1590/1413-82712019240414
17 Schneider WJ, McGrew K. The Cattell-Horn-Carroll model of intelligence. In: Flanagan D, Harrison P, editors. Contemporary Intellectual Assessment: Theories, Tests, and Issues. 3rd ed. New York: Guilford; 2012. p. 99-144.
18 Yates DB, Trentini CM, Tosi SD, Corrêa SK, Poggere LC, Valli F. Apresentação da Escala de Inteligência Wechsler abreviada: (WASI). Aval. Psicol. 2006;5(2):227-33. http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1677-04712006000200012&lng=pt&tlng=pt
19 Razani J, Murcia G, Tabares J, Wong J. The effects of culture on WASI test performance in ethnically diverse individuals. Clin Neuropsychol. 2007;21(5):776-88. https://doi.org/10.1080/13854040701437481 PMid:17676543 DOI: https://doi.org/10.1080/13854040701437481
20 Hasson R, Wu I, Fine J. Clinical utility of the WASI-II and its association with acculturation levels among Arab American adolescent males. Appl Neuropsychol Child. 2019;8(4):295-306. https://doi.org/10.1080/21622965.2018.1442219 PMid:30773053 DOI: https://doi.org/10.1080/21622965.2018.1442219
21 Sartori RF, Valentini NC, Fonseca RP. Executive function in children with and without developmental coordination disorder: A comparative study. Child Care Health Dev. 2020;46(3):294-302. https://doi.org/10.1111/cch.12734 PMid:31845379 DOI: https://doi.org/10.1111/cch.12734
22 Vergunst F, Commisso M, Geoffroy MC, Temcheff C, Poirier M, Park J, Vitaro F, Tremblay R, Côté S, Orri M. Association of Childhood Externalizing, Internalizing, and Comorbid Symptoms With Long-term Economic and Social Outcomes. JAMA Netw Open. 2023;6(1):1-14. https://doi.org/10.1001/jamanetworkopen.2022.49568 PMid:36622675 PMCid:PMC9856729 DOI: https://doi.org/10.1001/jamanetworkopen.2022.49568
23 de Wit MM, Polderman TJ. The heritability and molecular genetics of mental disorders. In: Friedman HS, Markey CH, editors. Encyclopedia of Mental Health. 3rd ed. Cambridge: Academic Press; 2023. p. 125-39. https://doi.org/10.1016/B978-0-323-91497-0.00160-0 DOI: https://doi.org/10.1016/B978-0-323-91497-0.00160-0
24 Mayes SD, Castagna PJ, Waschbusch DA. Sex Differences in Externalizing and Internalizing Symptoms in ADHD, Autism, and General Population Samples. J Psychopathol Behav Assess. 2020;42:519-26. https://doi.org/10.1007/s10862-020-09798-4 DOI: https://doi.org/10.1007/s10862-020-09798-4
25 Ogundele MO. Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World J Clin Pediatr. 2018;7(1):9-26. https://doi.org/10.5409/wjcp.v7.i1.9 PMid:29456928 PMCid:PMC5803568 DOI: https://doi.org/10.5409/wjcp.v7.i1.9
26 Caqueo-Urízar A, Flores J, Escobar C, Urzúa A, Irarrázaval M. Psychiatric disorders in children and adolescents in a middle-income Latin American country. BMC Psychiatry. 2020;20(1):104. https://doi.org/10.1186/s12888-020-02512-4 PMid:32138703 PMCid:PMC7059272 DOI: https://doi.org/10.1186/s12888-020-02512-4
27 Piao J, Huang Y, Han C, Li Y, Xu Y, Liu Y, He X. Alarming changes in the global burden of mental disorders in children and adolescents from 1990 to 2019: a systematic analysis for the Global Burden of Disease study. Eur Child Adolesc Psychiatry. 2022;31(11):1827-45. https://doi.org/10.1007/s00787-022-02040-4 PMid:35831670 DOI: https://doi.org/10.1007/s00787-022-02040-4
28 Zijlmans JL, Lamballais S, Vernooij MW, Ikram MA, Luik AI. Sociodemographic, Lifestyle, Physical, and Psychosocial Determinants of Cognitive Reserve. J Alzheimers Dis. 2022;85(2):701-13. https://doi.org/10.3233/JAD-215122 PMid:34864674 PMCid:PMC8842775 DOI: https://doi.org/10.3233/JAD-215122
29 Voldsbekk I, Kjelkenes R, Wolfers T, Dahl A, Lund MJ, Kaufmann T, Fernandez-Cabello S, de Lange A-NG, Tammes CK, Andreassen AO, Westlye LT, Alnaes D. Shared pattern of impaired social communication and cognitive ability in the youth brain across diagnostic boundaries. Dev Cogn Neurosci. 2023;60:101219. https://doi.org/10.1016/j.dcn.2023.101219 PMid:36812678 PMCid:PMC9975702 DOI: https://doi.org/10.1016/j.dcn.2023.101219
30 Chavez-Baldini U, Nieman DH, Keestra A, Lok A, Mocking RJT, de Koning P, Krzhizhanovskaya. VV, Bockting CLH, Rooijen GV, Smit DJA, Sutterland AL, Verweij KJH, Wingen GV, Wigman JTW, Vulink NC, Denys D. The relationship between cognitive functioning and psychopathology in patients with psychiatric disorders: a transdiagnostic network analysis. Psychol Med. 2023;53(2):476-85. https://doi.org/10.1017/S0033291721001781 PMid:34165065 PMCid:PMC9899564 DOI: https://doi.org/10.1017/S0033291721001781
31 Frazier TW, Demaree HA, Youngstrom EA. Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology. 2004;18(3):543-555. https://doi.org/10.1037/0894-4105.18.3.543 PMid:15291732 DOI: https://doi.org/10.1037/0894-4105.18.3.543
32 Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, Durkin MS, Fitzgerald RT, Furnier SM, Hughes MM, Ladd-Acosta CM, McArthur D, Pas ET, Salinas A, Vehorn A, Williams S, Esler A, Grzybowski A, Hall-Lande J, Nguyen RHN, Pierce K, Zahorodny W, Hudson A, Hallas L, Mancilla KC, Patrick M, Shenouda J, Sidwell K, DiRienzo M, Gutierrez J, Spivey MH, Lopez M, Pettygrove S, Schwenk YD, Washington A, Shaw KA. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ. 2023;72(2): 1-14. https://doi.org/10.15585/mmwr.ss7202a1 PMid:36952288 PMCid: PMC10042614 DOI: https://doi.org/10.15585/mmwr.ss7202a1
33 American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Association; 2013. https://doi.org/10.1176/appi.books.9780890425596 DOI: https://doi.org/10.1176/appi.books.9780890425596
34 Lord C, Brugha TS, Charman T, Cusack J, Dumas G, Frazier T, Jones EJH, Jones RM, Pickles A, State MW, Taylor JL, Veenstra-VanderWeele J. Autism spectrum disorder. Nat Rev Dis Primers. 2020;6(1):1-23. https://doi.org/10.1038/s41572-019-0138-4 PMid:31949163 PMCid:PMC8900942 DOI: https://doi.org/10.1038/s41572-019-0138-4
35 Little L, Anwyll M, Norsworthy L, Corbett L, Schultz-Froggatt M, Gallagher P. Processing speed and sustained attention in bipolar disorder and major depressive disorder: A systematic review and meta-analysis. Bipolar Disord. 2024;26(2), 109-28. https://doi.org/10.1111/bdi.13396 PMid:37973384 DOI: https://doi.org/10.1111/bdi.13396
36 Schalock RL, Borthwick-Duffy SA, Bradley VJ, Buntinx WH, Coulter DL. Intellectual disability: definition, classification, and systems of supports 11th ed. Silver Spring: American Association on Intellectual and Developmental Disabilities; 2009.
37 Springer KS, Levy HC, Tolin DF. Remission in CBT for adult anxiety disorders: A meta-analysis. Clin Psychol Rev. 2018;61:1-8. https://doi.org/10.1016/j.cpr.2018.03.002 PMid:29576326 DOI: https://doi.org/10.1016/j.cpr.2018.03.002
38 Henderson C, Farrelly S, Flach C, Borschmann R, Birchwood M, Thornicroft G, Waheed W, Szmukler G. Informed advance refusals of treatment by people with severe mental illness in a randomised controlled trial of joint crisis plans: demand, content, and correlates. BMC Psychiatry. 2017;17(1):376. https://doi.org/10.1186/s12888-017-1542-5 PMid:29178895 PMCid:PMC5702102 DOI: https://doi.org/10.1186/s12888-017-1542-5
39 Hett D, Morales-Muñoz I, Durdurak BB, Carlish M, Marwaha S. Rates and associations of relapse over 5 years of 2649 people with bipolar disorder: a retrospective UK cohort study. Int J Bipolar Disord. 2023;11(1):23. https://doi.org/10.1186/s40345-023-00302-x PMid:37391627 PMCid:PMC10313572 DOI: https://doi.org/10.1186/s40345-023-00302-x
40 Westwood SJ, Parlatini V, Rubia K, Cortese S, Sonuga-Barke EJS. European ADHD Guidelines Group (EAGG). Computerized cognitive training in attention-deficit/hyperactivity disorder (ADHD): a meta-analysis of randomized controlled trials with blinded and objective outcomes. Mol Psychiatry. 2023;28(4):1402-14. https://doi.org/10.1038/s41380-023-02000-7 PMid:36977764 PMCid:PMC10208955 DOI: https://doi.org/10.1038/s41380-023-02000-7
41 Ormel J, Hollon SD, Kessler RC, Cuijpers P, Monroe SM. More treatment but no less depression: The treatment-prevalence paradox. Clin Psychol Rev. 2022;91:102111. https://doi.org/10.1016/j.cpr.2021.102111 PMid:34959153 DOI: https://doi.org/10.1016/j.cpr.2021.102111
42 Charchat-Fichman H. Neuropsicologia Clínica. São Paulo: Manole; 2021.
43 Langer AI, Schmidt C, Mayol R, Díaz M, Lecaros J, Krogh E, Pardow A, Vergara C, Vergara G, Pérez-Herrera, Villar MJ, Maturana A, Gaspar PA. The effect of a mindfulness-based intervention in cognitive functions and psychological well-being applied as an early intervention in schizophrenia and high-risk mental state in a Chilean sample: study protocol for a randomized controlled trial. Trials. 2017;18(1):233. https://doi.org/10.1186/s13063-017-1967-7 PMid:28545578 PMCid:PMC5445512 DOI: https://doi.org/10.1186/s13063-017-1967-7
44 Kosheleff AR, Mason O, Jain R, Koch J, Rubin J. Functional Impairments Associated With ADHD in Adulthood and the Impact of Pharmacological Treatment. J Atten Disord. 2023;27(7):669-97. https://doi.org/10.1177/10870547231158572 PMid:36876491 PMCid:PMC10173356 DOI: https://doi.org/10.1177/10870547231158572
45 McCutcheon RA, Keefe RS, McGuire PK. Cognitive impairment in schizophrenia: etiology, pathophysiology, and treatment. Mol Psychiatry. 2023;28:1902-18. https://doi.org/10.1038/s41380-023-01949-9 PMid:36690793 PMCid:PMC10575791 DOI: https://doi.org/10.1038/s41380-023-01949-9
46 Naamanka E, Salakka I, Parkkila M, Hotti J, Poutiainen E. Effectiveness of teleneuropsychological rehabilitation: Systematic review of randomized controlled trials. J Int Neuropsychol Soc. 2024;30(3):295-312. https://doi.org/10.1017/S1355617723000565 PMid:37746802 DOI: https://doi.org/10.1017/S1355617723000565
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