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The original list of books found and selected are presented in Tables 1 , 2. Referenced articles and books citations were also checked. In older textbooks, terms and notions that are semantically related to MSE have changed over time.


Therefore, any mention of a mental examination that clearly described careful mental observation techniques or descriptions was considered as similar or equivalent to MSE. Textbook set with editions, publication years, and the 12 titles in bold chosen for investigation of MSE. MSE in the investigated textbooks, number of items, how it is named, and their items or assessed functions.

A comprehensive review was carried out on Brazilian authors, researchers and literature, focusing on different MSE traditions, describing its various approaches and MSE segmentation around psychic functions. The list of discrete elements assembled into MSE was studied in detail. The works examined spanned over the last 49 years.

The books were written mostly by psychiatrists with clinical expertise, working as University Professors or lecturers. No MSE standard was identified, even though every author confirmed its relevance and consistency. Most authors provided orientations on how to proceed with a careful patient observation during an interview, aimed at obtaining objective data. The most referred method, to organize and register MSE, consistently cited by some authors, was descriptive psychopathology with a phenomenological orientation.

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Textbooks agreed and actively encouraged a very detailed description of observed mental functions as the best way to record MSE. Additionally, there was no agreement on how to summarize its components 20 — 22 , 45 — Throughout the time span studied, MSE was not the standard term used to refer to psychic examination and was first adopted in in the Brazilian psychopathology and semiology textbook by Paulo Dalgalarrondo 46 , after which it was consistently used.

It remains unclear if the term was chosen because of evidence-based efforts on examination, or if it represents a particular tradition. All authors used subdivisions to analyze and describe MSE, but each provided a specific set. Even though there was a clear consensus that consciousness could only be artificially fragmented for didactic purposes, no agreement, convergence or discussion about the nature or number of necessary items could be identified.

The theoretical basis underlying the operating subdivisions is therefore lacking.

Cópia de Livros Digitais

It was not possible to track the origins of this notion, since the authors did not mentioned or contextualize it. Some hypothesis is developed through discussion.

It is noteworthy that among the initial textbook list, some belonged to a field aimed at researching psychotherapy and psychoanalysis—therefore promoting a broader signification of psychopathology. Although these books were not included, and considering that psychoanalytic psychopathology is different from descriptive psychopathology, it probably suggests that psychoanalysis has had some influence in Brazilian psychiatric practices, perhaps in a slightly different way than what occurred in the United States 33 , 56 , A better evaluation of such influence would be desirable, but it is out of the scope of this paper.

Discussion Mental Health as a Brazilian tradition started in the nineteenth-century, after the creation of the hospice, by a Portuguese emperor 58 — It was not before the beginning of , however, that academic psychiatry began to thrive, particularly after studies published by Juliano Moreira, Ulisses Pernambucano, followed by studies on forensic psychiatry published by Nina Rodrigues and Franco da Rocha psychiatry 62 — Influenced by German and French authors, Paim thoroughly recommended detailed observations and descriptions of subjective reports 52 and behaviors as the best way to register and carry out psychic examination This coupling of observation and description was continually reinforced by most authors analyzed 20 — 22 , 45 — 55 , The number of partitions ranged from 6 49 up to 18 items Paim did not list mental functions in his treatise but had openly used it in his psychopathology textbook.

These conceptual developments in Brazilian psychopathology call for further studies.

We considered them as hints at the importance of mental function fragmentation and structure in psychopathology. It was not possible to identify how subdivisions were adopted or created according to Brazilian textbooks.


The lack of theoretical background may be responsible for the significant variation observed. Dividing or stratifying MSE seems to be the best method to analyze and to conveniently engage in description efforts, to evaluate psychic life. A discussion concerning ways to split MSE for adequate observation and educational purposes is out of the scope of the present review, but highly desirable.

Since there are no globally standardized guidelines on psychopathology training 66 , bedside examination skills must be regarded seriously, as an asset worth further exploring. Contemporary Brazilian authors however usually mention clear descriptions of mental function subdivisions, setting standards on how to study MSE and how to describe it.

We could not identify any efforts aimed toward comparative clinical psychopathology. It may have a forensic and juridical background, as its etymology suggests. Besides lawsuit writing rights, there were many other compulsory examination practices that the Brazilian and then the eugenics Constitution recommended. Psychiatrists were accountable for defining a person's state of mental health in many common judiciary cases such as criminal subjects, couples before marriage, institutionalized children, among others.

For instance, forensic demands synthesis during a long diagnostic process and extensive judicial records. Johgo consider supporting us by disabling your ad blocker on our website. Classical and Flamenco guitar lessons via Skype worldwide — Classical and Flamenco guitars from Spain.

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Hormonal determinants of depression and cognitive function in independently-living elders. Endocrinol Nutr ; 55 9 : DHEA-S is a protective anabolic hormone with an important role in maintaining and restoring the human organism. It is known for its antioxidant activity and ability to help in neuronal preservation. The effects of dehydroepiandrosterone DHEA in the treatment of depression and depressive symptoms in other psychiatric and medical illnesses: a systematic review.

Curr Drug Targets ; 15 9 : Low levels of dehydroepiandrosterone sulfate in younger burnout patients. PLoS One ; 10 10 : e Int J Androl ; 31 1 : The relationship between longitudinal declines in dehydroepiandrosterone sulfate concentrations and cognitive performance in older men.

Arch Intern Med ; 14 : Age, hormones, and cognitive functioning among middle-aged and elderly men: cross-sectional evidence from the Massachusetts Male Aging Study. The role of sex and sex-related hormones in cognition, mood and well-being in older men and women. Biol Psychol ; However, a literature review in the period of time between and observed that despite cross-cohort studies point to evidence of relationship between DHEA-S and cognition, RCTs and longitudinal studies were not able to consistently confirm these evidences [ 14 Maggio M, De Vita F, Fisichella A, et al.Secondly, this psychic analysis of the pathological feature determined that Bleuler talked about essential symptoms clivage or Spaltung, autism, dereistic thinking, etc.

Zilboorg G, Henry GW. Curitiba: Maresfield Garde ns. The above-mentioned clinical investigations were able to specify these three features of mental illnesses. Ana Celina Garcia Albornoz. Philosophical perspectives on psychiatric diagnostic classification. Maisa S. Coordenadora de cursos no Grupo Dom. Outline of an organo-dynamic conception of the structure, nosography, and pathogenesis of mental diseases. On both moments, the study of mental illnesses Pinel,19 Esquirol,20 etc.