Alteraciones cognitivas y comportamentales en niños y adolescentes con trastornos psiquiátricos en ambulatorio de Río de Janeiro
DOI:
https://doi.org/10.25118/2763-9037.2025.v15.1449Palabras clave:
desempeño intelectual, trastornos del comportamiento, trastornos mentales, trastornos psiquiátricos, factores transdiagnósticosResumen
Introducción: Los cambios en el funcionamiento cognitivo y los problemas de comportamiento son más comunes en personas con trastornos psiquiátricos. Así, el agrupamiento clínico por trastornos emocionales sin tener en cuenta problemas cognitivos o conductuales puede confundir a los pacientes y ocasionar dificultades para la efectividad del tratamiento. Objetivos: Este estudio buscó investigar la presencia de quejas comportamentales y disfunciones cognitivas experimentadas por niños y adolescentes con trastornos psiquiátricos. Métodos: Un total de 97 participantes (63 del sexo masculino y 34 del sexo femenino) con edades entre 6 y 15 años y diagnosticados con trastornos psiquiátricos fueron sometidos a la Escala Wechsler Abreviada de Inteligencia (WASI) y a un cuestionario sociodemográfico y clínico. Resultados: Se verificaron factores compartidos por diferentes trastornos psiquiátricos, como el desempeño intelectual por debajo de lo esperado para el grupo etario (CI < 90), con diferencias entre los grupos diagnósticos en cuanto al CI global [X² (4) = 14.613; P < 0.05] y trastornos del comportamiento (alrededor del 46,4% de los casos), en particular en lo que se refiere a la agresividad (N = 32). Discusión/Conclusión: Además de los diagnósticos en salud mental, los factores cognitivos y comportamentales deben ser observados con atención en las clínicas médicas y psicológicas con el fin de realizar intervenciones terapéuticas más eficaces y determinar la progresión del tratamiento.
Descargas
Métricas
Citas
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 Rodrigo Gonzalez Ribeiro, Helenice Charchat Fichman, Conceição Santos Fernandes, Fábio Mello Barbirato Nascimento Sil
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Debates em Psiquiatria permite que el (los) autor (es) mantenga(n) sus derechos de autor sin restricciones. Permite al (los) autor (es) conservar sus derechos de publicación sin restricciones. Los autores deben garantizar que el artículo es un trabajo original sin fabricación, fraude o plagio; no infringe ningún derecho de autor o derecho de propiedad de terceros. Los autores también deben garantizar que cada uno atendió a los requisitos de autoría conforme a la recomendación del ICMJE y entienden que, si el artículo o parte de él es fallido o fraudulento, cada autor comparte la responsabilidad.
Reconocimiento-NoComercial 4.0 internacional (CC BY-NC 4.0) - Debates em Psiquiatria es regida por la licencia CC-BY-NC
Usted es libre de:
- Compartir — copiar y redistribuir el material en cualquier medio o formato
- Adaptar — remezclar, transformar y crear a partir del material
El licenciador no puede revocar estas libertades mientras cumpla con los términos de la licencia. Bajo las condiciones siguientes:
- Reconocimiento — Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios<. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace.
- NoComercial — No puede utilizar el material para una finalidad comercial.
No hay restricciones adicionales — No puede aplicar términos legales o medidas tecnológicas que legalmente restrinjan realizar aquello que la licencia permite.
