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Is It Time for Psychiatry to Discuss Consensus Criteria For Brazilian Journal of Psychiatry.Brazilian Journal 2019 Mar-Apr;41(2): of Psychiatry. 201997–98 Mar-Apr;41(2):97–98 Brazilian Psychiatric AssociationBrazilian Psychiatric Association Revista Brasileira de PsiquiatriaRevista Brasileira de Psiquiatria CC-BY-NC | doi:10.1590/1516-4446-2018-0221CC-BY-NC | doi:10.1590/1516-4446-2018-0221 EDITORIALEDITORIAL Is it timeIs for it time psychiatry for psychiatry to discuss to discuss consensus consensus criteria for criteria for euthymia?euthymia? Clinical, Clinical, methodological, methodological, research, research, and ethical and ethical perspectivesperspectives Contents Paulo M. Rocha,Paulo1,2 M.Humberto Rocha,1,2 CorreaHumberto da Silva Correa Filho2,3 da Silva Filho2,3 1Programa de Po´s-Graduac1Programa¸a˜o de em Po Neurocie´s-Graduacˆncias,¸a˜o Institutoem Neurocie de Cieˆncias,ˆncias Instituto Biolo´gicas, de Cie Universidadeˆncias Biolo´gicas, Federal Universidade de Minas Gerais Federal (UFMG), de Minas Belo Gerais (UFMG), Belo 2 2 3 3 REVIEW ARTICLES Horizonte, MG, Brazil.Horizonte,Departamento MG, Brazil. de SauDepartamento´de Mental, Faculdade de Sau´de deMental, Medicina, Faculdade UFMG, de Belo Medicina, Horizonte, UFMG, MG, Belo Brazil. Horizonte,Programa MG, de Brazil. Po´s- Programa de Po´s- Graduac¸a˜o em MedicinaGraduac Molecular,¸a˜o em Medicina Faculdade Molecular, de Medicina, Faculdade UFMG, de Belo Medicina, Horizonte, UFMG, MG, Belo Brazil. Horizonte,https://orcid.org/0000-0003-2314-8588 MG, Brazil. https://orcid.org/0000-0003-2314-8588 168 Anxiolytic properties of compounds that counteract oxidative stress, neuroinflammation, and glutamatergic dysfunction: a review Patrı´cia Santos, Ana P. Herrmann, Elaine Elisabetsky, Angelo Piato Euthymia is a wordEuthymia of Greek is a origin word of(eu Greekmeaning origin good; (eu meaningeuthymia good; or remissioneuthymia as the or remission absence of as criteria the absence for major of criteria for major thymo´s meaningthymo mood)´s meaning used by mood) ancient used philosophers by ancient philosophersmood episodesmood according episodes to the according DSM or to low the scores DSM or low scores 179 Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis such as Diogenessuch and as Seneca. Diogenes Its central and Seneca. concept Its regards central concepton mood regards questionnaireson mood such questionnaires as the Hamilton such as Depres- the Hamilton Depres- Amanda P. Trindade, Jose C. Appolinario, Paulo Mattos, Janet Treasure, Bruno P. Nazar a subjective anda stoic subjective state of and tranquility stoic state that of often tranquility goes thatsion often Rating goes Scalesion (HDRS) Rating and Scale the (HDRS) Young Mania and the Rating Young Mania Rating beyond the contemporarybeyond the physicalist contemporary and medical physicalist concepts and medicalScale concepts (YMRS).3 ScaleDifficulties (YMRS). persist3 Difficulties in the field persist of clinical in the field of clinical LETTERS TO THE EDITORS of mood and patternsof mood of and human patterns behavior. of human Currently, behavior. in Currently,research. Over in theresearch. last 15 Overyears, the there last has 15 years, been increas- there has been increas- medical and researchmedical practice, and research euthymia practice, refers to euthymia a status refersing to interest a status in studyinging interest the interepisodic in studying the phases interepisodic of BD. phases of BD. 188 Suicide by hanging in Brazil: challenges to mitigating its escalation of clinical remissionof clinical for mood remission syndromes for mood such syndromes as major suchA growing as major bodyA of growing evidence body shows of evidence that BD shows patients that BD patients Danilo Borges-Santos, Yuan-Pang Wang depression and bipolardepression disorder and (BD). bipolar disorder (BD). fulfilling criteriafulfilling for euthymia criteria present for euthymia a broad present range of a broad range of 189 Treating nightmares in PTSD with doxazosin: a report of three cases The DSM, publishedThe DSM, by the published American by Psychiatric the Americanresidual Psychiatric psychopathology,residual psychopathology, including cognitive including impairment cognitive impairment 4 4 Vitor Crestani Calegaro, Pedro Canova Mosele, Isabela Duarte de Souza, Emanuelly Martins da Silva, Association (APA),Association which is the (APA), most which prominent is the compila-most prominentand compila- subsyndromaland mood subsyndromal and sleep mooddysfunction. and sleepFurther- dysfunction. Further- Julia Pinto Trindade tion of standardizedtion psychiatricof standardized diagnostic psychiatric criteria diagnostic world- criteriamore, world- compellingmore, evidence compelling shows evidencethat residual shows symptoms that residual symptoms wide, traditionallywide, did traditionallynot define any did diagnostic not define criteria any diagnosticcorrelate criteria with reducedcorrelate functionality, with reduced quality functionality, of life, and quality of life, and 190 Life-threatening hypoglycemia attributable to haloperidol in a patient with schizophrenia for euthymia. Infor its euthymia. latest (fifth) In edition, its latest published (fifth) edition, just a publishedpoor prognosis just a andpoor outcome. prognosis5,6 andOnce outcome. again, the5,6 Once criteria again, the criteria Joana Couto, Luı´s Pontes dos Santos, Tiago Mendes, Raquel Lo´pez few years ago, thefew DSM-5 years ago, Task the Force DSM-5 made Task few, Force if any, madefor few, euthymia if any, in thesefor euthymia studies in has these varied studies immensely. has varied In immensely. In significant changessignificant regarding changes the issue regarding of euthymia the issue or of euthymiashort, the absence or short, of specific the absence criteria of for specific euthymia criteria imposes for euthymia imposes 191 Institutional factors in the medical burnout epidemic remission in moodremission disorders. in mood In the disorders. last decade, In the the last decade,enormous the difficultiesenormous for both difficulties clinical and for research both clinical practice. and research practice. Simone Hauck, Glen O. Gabbard Research DomainResearch Criteria (RDoC)Domain initiativeCriteria (RDoC) has been initiative the hasIn this been sense, the effortsIn this to sense,create a efforts universal to create and widely a universal used and widely used subject of increasingsubject attention. of increasing The RDoC attention. initiative The was RDoC initiativetaxonomy was for euthymictaxonomy clinical for euthymic states in clinical BD, such states as the in BD, such as the developed by thedeveloped U.S. National by the Institute U.S. National of Mental Institute Health of MentalISBD Health Task ForceISBD for Task nomenclature, Force for are nomenclature, necessary in are necessary in (NIMH) for new(NIMH) approaches for new to investigating approaches topsychiatric investigatingorder psychiatric to achieveorder optimal to comparisons achieve optimal between comparisons the results between the results disorders. However,disorders. it did However, not assess it did extensively not assess the extensivelyof distinct the clinicalof trials. distinct Additionally, clinical trials. it would Additionally, significantly it would significantly euthymic state ofeuthymic mood disorders. state of mood In 2009, disorders. the Interna- In 2009,increase the Interna- the powerincrease of pros thepective power andof pros retrospectivepective and retrospective tional Society fortional Bipolar Society Disorders for Bipolar (ISBD) Disorders Task Force (ISBD)studies Task Force to detectstudies risk facto to detectrs, clinical risk facto predictors,rs, clinical and predictors, and published a scientificpublished report a scientific on the nomenclature report on the for nomenclatureprognosis. for prognosis. course and outcomecourse of andBD. outcomeThis report of reflects BD. This efforts report to reflectsYet, efforts the to problemsYet, regarding the problems the debate regarding about the euthy- debate about euthy- create an expertcreate consensus an expert for the consensus use of clinical for the terms use of clinicalmia continues. terms mia At least continues. two more At least aspects two must more be aspects must be such as response,such remission, as response, and remission,recovery for and mood recoverymentioned. for mood First,mentioned. there has beenFirst, athere long has methodological been a long methodological episodes.1 In fact,episodes. the DSM1 In includes fact, the the DSM terms includes partial the termsdebate, partial at leastdebate, for BD, onat least the grounds for BD, oron foundation the grounds of or foundation of and complete remissionand complete as specifiers remission of mood as specifiers episodes. of moodthe episodes. euthymic state.the In euthymic this sense, state. the In evidence this sense, accumu- the evidence accumu- Thus, there areThus, still no there clear are and still precise no clear descriptions and precise of descriptionslated over of the lastlated decades over the showing last decades prominent showing residual prominent residual euthymia, ofteneuthymia, referred to often in scientific referred publications to in scientific as publicationspsychopathology as psychopathology in euthymic bipolar in euthymic patients bipolar has led patients has led ‘‘interepisodic’’ or‘‘interepisodic’’ ‘‘remitted’’ clinical or ‘‘remitted’’ states.2 clinicalUnsurpris- states.2manyUnsurpris- researchersmany to researchers raise doubts to and raise questions doubts asand questions as ingly,
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