OBJECTIVE:This study aimed to cross-culturally adapt the Problem Gambling Severity Index (PGSI) into Brazilian Portuguese and to conduct a preliminary assessment of its content and face validity. METHODS:The adaptation process followed internationally recognized guidelines and included several stages: initial translation, translation synthesis, back-translation, review by a committee of experts, evaluation by an expert panel of 11 specialists, pre-test with participants from the general population, and final revision. The Content Validity Index (CVI), Clarity Index (CI), and Content Validity Ratio (CVR) were calculated based on the experts' evaluations. As a first step, establishing semantic and content validity is essential before broader psychometric testing can be meaningfully conducted in the target population. RESULTS:The adapted PGSI demonstrated strong content validity, with all items reaching a CVI of 0.90 or higher and an overall mean of 0.98. The CI ranged from 2.63 to 2.90, and the CVR indicated high agreement regarding the essentiality of the items. Face validity testing with 33 participants from the general population revealed that all items were rated as understandable or entirely understandable by most participants (84.9% to 100%). Expert feedback was also used to refine the wording of items, particularly to distinguish between "gaming" and "gambling" in the Brazilian context. CONCLUSION:The Brazilian Portuguese version of the PGSI presented robust preliminary evidence of semantic, conceptual, and cultural adequacy. This version fills a critical methodological gap and provides a culturally appropriate screening and monitoring tool for use in clinical and research settings in Brazil, supporting prevention and public health monitoring of gambling-related harms, including financial impacts. Future studies will evaluate additional psychometric properties further to consolidate its use in clinical and epidemiological contexts.

The rapid expansion of online gambling in Brazil has outpaced the consolidation of regulatory safeguards, raising concerns about gambling-related harm at the population level. The Third Brazilian National Alcohol and Drugs Survey (BNADS/LENAD III) investigated gambling participation and risk gambling, providing nationally representative estimates of the magnitude of the problem and identifying vulnerable groups to inform public policy. LENAD III is a survey conducted in Brazil in 2022-2023 with 16,608 individuals aged 14 years and older. Gambling participation and risk were assessed using the Problem Gambling Severity Index (PGSI). Weighted prevalence estimates and multivariable logistic regression models were used to examine associations between structural, sociodemographic, behavioural factors, and risk gambling. Past-year gambling was reported by 17.6% of the population. Overall, 6.6% fell within the PGSI risk spectrum, while 2.8% were classified as moderate- or high-risk. Risk gambling was substantially more frequent among online gamblers. In multivariable models, online gambling remained the strongest correlate of gambling-related harm. Risk gambling in Brazil is substantial and disproportionately concentrated in online betting. Regulatory responses should prioritize structural measures that address product design, advertising exposure, and access control. Strengthening enforcement and aligning regulation with public health principles are urgent priorities.

In an era dominated by chronic disease, Lifestyle Medicine (LM) offers a profound paradigm shift, yet its efficacy is often tethered to sustained behavioral change. This article proposes a neuropsychobiological framework for LM centered on three interconnected pillars: Presence, Agency, and Connectivity. We argue that cultivating Presence—an attuned awareness of internal bodily states (interoception) and external environments—provides the foundational data for well-being. Agency, the belief in one's capacity to act intentionally and effectively upon this data, translates insight into behavior. Finally, Connectivity, encompassing both neural integration and social belonging, fosters resilience and sustains health transformations. Drawing on interoceptive predictive coding models, active inference, and the neuroscience of social bonding, we illuminate the underlying mechanisms by which these pillars empower individuals to transcend passive health management. Through humanized clinical examples and practical strategies, we illustrate how this framework can transform LM from prescriptive advice to an empowering journey of self-discovery and sustainable health.

BACKGROUND:Brief, accurate, and context-sensitive screening tools are essential for detecting gambling-related problems, but most existing instruments are not validated for on-site gambling. OBJECTIVES:This study aimed to estimate the prevalence and patterns of Gambling Disorder (GD) and problem gambling among Brazilian lottery players and to develop and test a concise screening tool optimized for this on-site context. METHODS:A multistage, stratified sampling design recruited 5,407 adult gamblers at 494 lottery kiosks. Participants completed a version of the NODS adapted to DSM-5 criteria. Using an exhaustive combinatorial approach, all 2-4-item subsets from the NODS were tested for sensitivity and specificity. RESULTS:Three combinations emerged as optimal. A three-item version (control, coping, chasing) showed the best balance for detecting problematic gambling (sensitivity = 96.5%), while a four-item version reached high specificity for GD (96.2%). All combinations outperformed the widely used NODS-CLiP. CONCLUSIONS:The study introduces the "3-Cs screener," a novel, ultra-brief tool for on-site lottery players. Its high diagnostic accuracy makes it a promising candidate for prevention and intervention strategies, though further validation in clinical and digital settings is warranted.

Introdução: A transição do cuidado em saúde mental entre serviços especializados e a Atenção Primária à Saúde (APS) é um desafio para a continuidade assistencial, sobretudo em vínculos prolongados com serviços terciários. Objetivo: Analisar a percepção de usuários de um ambulatório terciário especializado em transtornos do impulso sobre a experiência de tratamento e a transição do cuidado para a APS. Método: Estudo exploratório qualitativo, com dados quantitativos descritivos, realizado com 14 usuários do Programa Ambulatorial Integrado dos Transtornos do Impulso. Os dados foram coletados por instrumentos baseados na Entrevista de Formulação Cultural do DSM-5 e analisados por Discurso do Sujeito Coletivo e estatística descritiva. Pesquisa aprovada pelo Comitê de Ética em Pesquisa do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), sob Parecer nº 5734353 e CAAE nº 57902022.2.0000.0068. Resultado: Os participantes relataram elevada satisfação com o tratamento, destacando acolhimento, vínculo terapêutico, melhora sintomática e apoio familiar. Entretanto, a maioria apresentou insegurança quanto à continuidade do cuidado na APS, associada a dificuldades de acesso, indisponibilidade de profissionais e obtenção de medicamentos. Conclusão: A transição do cuidado em saúde mental envolve dimensões relacionais e organizacionais além da estabilidade clínica. Estratégias de planejamento compartilhado da alta e articulação entre serviços podem favorecer a continuidade assistencial e ampliar a segurança dos usuários

Objective:To assess associations between early childhood screen time trajectories and problematic media use scores by age 5.5. Methods:The present study is based on a prospective, community-based convenience sample of 315 parents of preschoolers, from Canada studied at the ages of 3.5 (2020), 4.5 (2021), and 5.5 (2022) during the Covid-19 pandemic. Parent-reported screen use at the ages of 3.5, 4.5, and 5.5 was used to estimate preschooler screen use trajectories. Using latent growth modeling, we identified low (mean = 0.9 h/day, 23%), average (mean = 3.0 h/day, 56%), and high (mean = 6.38 h/day, 21%) screen time trajectories. Parents reported child problematic media using the Problematic Media Use Measure - Short Form (PMUM-SF). Results:A multiple regression, adjusted for child sex, effortful control and parent education and stress revealed that compared to children in the low screen time trajectory, children in the high screen time trajectory had higher problematic media use scores at age 5.5 (β = 0.378, p < 0.001). In addition, children in the average screen time trajectory scored higher than children in the low screen time trajectory (β = 0.229, p ≤ 0.001). Conclusion:Our findings suggest that higher screen use in early childhood is associated with an increased risk for the development of dysregulated media use, which can interfere with family functioning. As such, parents should be encouraged to follow screen time recommendations of ≤1 h/day for children between the ages of 2 and 5.

IntroductionExcessive and compulsive behaviors, including substance and behavioral addictions, represent a growing global concern. In Brazil, the increasing prevalence of these behaviors underscores the need for effective screening tools to identify individuals at risk. The Brief Screener for Substance and Behavioral Addiction (SSBA) has been recognized internationally for its utility in both clinical assessment and public health surveillance. This study aimed to adapt the SSBA for use in Brazil, with potential applications in other Portuguese-speaking countries.MethodsThe adaptation process followed international guidelines for cross-cultural adaptation of psychometric instruments. It included forward translation into Portuguese, back-translation into English, and expert committee review to ensure semantic and conceptual equivalence. A pilot study was conducted to assess clarity and relevance. Subsequently, the Brazilian version of the SSBA was administered to a sample of 450 individuals, comprising both clinical and non-clinical populations. Psychometric analyses evaluated the instrument’s reliability, validity, and factorial structure.ResultsThe Brazilian version of the SSBA demonstrated good internal consistency and satisfactory construct validity across subscales. Confirmatory factor analysis supported the original structure of the instrument, and no major linguistic or cultural adaptations were required. The screener showed strong discriminative power between clinical and non-clinical participants, indicating its effectiveness for identifying individuals at risk for addiction-related disorders.DiscussionThe adapted SSBA is a reliable and valid tool for the Brazilian context and may be extended to other Lusophone countries. It provides a brief yet comprehensive screening method suitable for various settings, including clinical practice, research, and community health. The instrument is particularly valuable for health professionals working in addiction prevention, diagnosis, and treatment, supporting early identification and intervention efforts.

This article introduces the Somatopsyche Psychiatric Intervention (SPI), a novel body-mind approach that integrates body awareness practices, meditation, and contemporary neuroscience theories in the treatment of psychiatric conditions. SPI is structured in seven steps across eight weekly sessions, aiming to enhance emotional regulation, decision-making, and patient resilience. While the model is still undergoing empirical validation and should be considered primarily theoretical at this stage, it has been implemented biannually in a clinical outpatient setting since 2019. Preliminary data collection using validated instruments (e.g., the MAIA scale) is ongoing and will inform future publications. The SPI represents a promising integrative framework in mental health care, although challenges remain regarding the training of professionals and adaptation by patients used to more traditional methods. Further studies, including pilot trials and comparative analyses, are planned to rigorously evaluate its effectiveness.

This study provides a comparative description of treatment-seeking adults with CSBD, Gambling Disorder (GD), and Intermittent Explosive Disorder (IED) across demographic, psychiatric, and personality correlates. Participants (N = 969; CSBD n = 233, GD n = 634, IED n = 102) were evaluated at a single specialty center. CSBD was ascertained using Goodman's criteria; GD and IED were diagnosed with DSM-IV SCID procedures. Psychiatric comorbidities were assessed with the Mini-International Neuropsychiatric Interview v5.0.0, and personality with the Temperament and Character Inventory. Group differences were tested with chi-square/Fisher's exact tests and Kruskal-Wallis with Dunn's post hoc tests using familywise Bonferroni thresholds, followed by backward stepwise binary logistic regressions contrasting CSBD vs. GD and CSBD vs. IED. Relative to GD, the CSBD group was younger, more often male, more frequently non-heterosexual, and reported higher educational attainment. CSBD also showed lower odds of hypomania and anorexia nervosa (binge/purge subtype) and lower novelty-seeking, with trait means in the normative range. Relative to IED, CSBD was more often non-heterosexual, less likely to have bulimia nervosa, and showed higher cooperativeness and self-transcendence, with trait means in the normative range. Findings delineate phenotypic patterns in a treatment-seeking cohort that can sharpen screening, triage, and case formulation. Results should be interpreted as clinical characterization rather than evidence for nosological proximity, given the cross-sectional design and historical diagnostic frameworks used.

Depression and anxiety during pregnancy are critical public health concerns, impacting both maternal and fetal well-being. The onset of these mental health conditions during pregnancy can lead to adverse outcomes, such as preterm birth and impaired infant development. Traditional diagnostic and monitoring methods, reliant on self-reporting and clinical evaluations, are often hindered by stigmatization, subjective bias, and accessibility issues, leading to underdiagnosis and inadequate management of these conditions. This study addresses the challenge by making use of free conversational speech recordings via smartphones as an approach for screening depression and anxiety in pregnantwomen. By leveraging machine learning techniques to analyze speech patterns, this research seeks to offer a non-invasive, objective, and accessible method for early detection and intervention. The research involved collecting conversational speech samples from pregnantwomen attending a high-risk pregnancy outpatient service, employing smartphones to capture naturalistic speech in everyday contexts. Machine learning algorithms were utilized combined with different audio feature sets to analyze these recordings in conjunction with PHQ-4 questionnaire scores. The combination of Mel Frequency Cepstral Coefficients and OpenSmile feature sets analyzed through LightGBM classifiers emerged as the most effective, achieving an accuracy of 75% and an Area Under the Curve of 0.71. These findings highlight the potential of smartphone-based speech analysis as a viable screening tool for mental health in pregnant women, suggesting a significant shift towards accessible, real-time monitoring. This technological intervention could enhance maternal health by enabling early detection and timely care, ultimately improving pregnancy outcomes and child development.

Excoriation disorder (ED) involves uncontrollable skin picking, not explained by a dermatologic or other psychological conditions. ED is associated with emotion regulation impairment, psychosocial distress, and psychiatric comorbidities. This study investigated the efficacy of psychodrama group therapy (PGT) in reducing ED symptoms. A randomized controlled trial compared psychodrama group therapy (PGT, n = 26) and support group therapy (SGT, n = 27) as a control. The comparison included ED severity, psychosocial impact, emotion regulation, depression, anxiety, social adjustment, and general clinical status. Bayesian ANOVA models showed improvement in skin excoriation (BFincl = 1.15e + 7), emotional regulation (BFincl = 258.12), depression (BFincl = 89.73), impact of excoriation (BFincl = 71.69) and anxiety (BFincl = 20.27) over time for both groups. PGT was not more effective than SGT, but group psychotherapy is a valuable treatment option for ED.