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de Freitas MBL, Luna LP, Beatriz M, Pinto RK, Alves CHL, Bittencourt L, Nardi AE, Oertel V, Veras AB, de Lucena DF, Alves GS. Resting-state fMRI is associated with trauma experiences, mood and psychosis in Afro-descendants with bipolar disorder and schizophrenia. Psychiatry Res Neuroimaging 2024; 340:111766. [PMID: 38408419 DOI: 10.1016/j.pscychresns.2023.111766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/19/2023] [Accepted: 11/26/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Bipolar disorder (BD) and schizophrenia (SCZ) may exhibit functional abnormalities in several brain areas, including the medial temporal and prefrontal cortex and hippocampus; however, a less explored topic is how brain connectivity is linked to premorbid trauma experiences and clinical features in non-Caucasian samples of SCZ and BD. METHODS Sixty-two individuals with SCZ (n = 20), BD (n = 21), and healthy controls (HC, n = 21) from indigenous and African ethnicity were submitted to clinical screening (Di-PAD), traumata experiences (ETISR-SF), cognitive and functional MRI assessment. The item psychosis/hallucinations in SCZ patients showed a negative correlation with the global efficiency (GE) in the right dorsal attention network. The items mania, irritable mood, and racing thoughts in the Di-PAD scale had a significant negative correlation with the GE in the parietal right default mode network. CONCLUSIONS Differences in the activation of specific networks were associated with earlier disease onset, history of physical abuse, and more severe psychotic and mood symptoms in SCZ and BD subjects of indigenous and black ethnicity. Findings provide further evidence on SZ and BD's brain connectivity disturbances, and their clinical significance, in non-Caucasian samples.
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Affiliation(s)
| | - Licia P Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Márcia Beatriz
- Neuroradiology Service, São Domingos Hospital, São Luís, Brazil; Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil
| | | | - Candida H Lopes Alves
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil
| | - Lays Bittencourt
- Neuropsychiatry Service, Nina Rodrigues Hospital, São Luís, Brazil
| | - Antônio E Nardi
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Viola Oertel
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Frankfurt Goethe University, Germany
| | - André B Veras
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gilberto Sousa Alves
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil; Neuropsychiatry Service, Nina Rodrigues Hospital, São Luís, Brazil; Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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C. Jardim PT, Dias JM, Grande AJ, Veras AB, Ferri ÉK, Quadros FAA, Peixoto C, Botelho FCS, I. M. G. Oliveira M, Dias IMAV, O’Keeffe M, Elia C, Dazzan P, Wolfe I, Harding S. Co-developing a health promotion programme for indigenous youths in Brazil: A concept mapping report. PLoS One 2023; 18:e0269653. [PMID: 36791063 PMCID: PMC9931109 DOI: 10.1371/journal.pone.0269653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/25/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Latin America and the Caribbean Region are home to about 42 million Indigenous people, with about 900,000 living in Brazil. The little routinely collected population-level data from Indigenous communities in the region available shows stark inequities in health and well-being. There are 305 Indigenous ethnic groups, speaking 274 languages, spread across the remote national territory, who have endured long-lasting inequities related to poverty, poor health, and limited access to health care. Malnutrition and mental health are key concerns for young people. Building on our Indigenous communities-academic partnerships over the last two decades, we collaborated with young people from the Terena Indigenous ethnic group, village leaders, teachers, parents, and local health practitioners from the Polo Base (community health centres) to obtain their perspectives on important and feasible actions for a youth health promotion programme. METHODS The report was conducted in the Tereré Village in Mato Grosso do Sul. Concept mapping, a participatory mixed method approach, was conducted in 7 workshops, 15 adults and 40 youths aged 9-17 years. Art-based concept mapping was used with 9 to 11 years old children (N = 20). Concept systems software was used to create concept maps, which were finalised during the workshops. Focused prompts related to factors that may influence the health and happiness of youths. The participatory method gave Terena youths a significant voice in shaping an agenda that can improve their health. RESULTS Terena youths identified priority actions that clustered under 'Family', 'School', 'Education', 'Socio-economic circumstances', 'Respect' and 'Sport' in response to protecting happiness; and 'Nutrition pattern', 'Physical activity', 'Local environment', and 'Well-being' in response to having a healthy body. Through the participatory lens of concept mapping, youths articulated the interconnectedness of priority actions across these clusters such that behaviours (e.g. Nutrition pattern, drinking water, physical activity) and aspirations (being able to read, to have a good job) were recognised to be dependent on a wider ecology of factors (e.g. loss of eco-systems, parent-child relationships, student- teacher relationships, parental unemployment). In response to developing youth health, Terena adults suggested priority actions that clustered under 'Relationships', 'Health issues', 'Prevention at Polo Base', 'Access to health care', 'Communication with young people', 'Community life', 'Raising awareness' and 'School support'. Their priorities reflected the need for structural transformative actions (e.g. Polo Base and school staff working together) and for embedding actions to protect Indigenous culture (e.g. integrating their cultural knowledge into training programmes). CONCLUSIONS Concept maps of Indigenous youths emphasised the need for a health promotion programme that engages with the structural and social determinants of health to protect their happiness and health, whilst those of adults emphasised the need to address specific health issues through preventative care via a school-Polo Base collaboration. Investment in a co-developed school-Polo-Base health promotion programme, with intersectoral engagement, has potential for making Indigenous health systems responsive to the inequalities of youth health, to yield dividends for healthy ageing trajectories as well as for the health of the next generation.
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Affiliation(s)
- Paulo T. C. Jardim
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Josiliane M. Dias
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Antonio J. Grande
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - André B. Veras
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Érika K. Ferri
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Fatima A. A. Quadros
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Clayton Peixoto
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | | | | | | | - Majella O’Keeffe
- Faculty of Life Sciences & Medicine, Department of Nutritional Sciences, School of Life Course Sciences, King’s College London, London, United Kingdom
| | - Christelle Elia
- Faculty of Life Sciences & Medicine, Department of Nutritional Sciences, School of Life Course Sciences, King’s College London, London, United Kingdom
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Ingrid Wolfe
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Seeromanie Harding
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
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Araujo JAMR, Veras AB, Varella AAB. Breves Considerações Sobre a Atenção à Pessoa com Transtorno do Espectro Autista na Rede Pública de Saúde. PSSA 2019. [DOI: 10.20435/pssa.v11i1.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
O Transtorno do Espectro Autista (TEA) é uma desordem do neurodesenvolvimento, caracterizada por déficits na comunicação social e presença de padrões de comportamento repetitivos. Como uma condição usualmente crônica, o TEA normalmente requer atenção de equipes interdisciplinares por afetar o desenvolvimento de forma global. Recentemente, o Ministério da Saúde publicou dois documentos que estabelecem a linha de cuidado e as diretrizes para sua reabilitação na rede pública de saúde brasileira. O presente artigo caracteriza e analisa a linha de cuidado proposta e as abordagens terapêuticas recomendadas. A análise permitiu verificar que os documentos reafirmam que pessoas com TEA são indivíduos com os mesmos direitos de pessoas com deficiência, seu cuidado deve ocorrer de maneira multidisciplinar pela Rede de Atenção Psicossocial, mas faltou clareza quanto aos critérios de escolha das abordagens terapêuticas e o local em que estas seriam oferecidas. Algumas implicações para o tratamento do TEA são discutidas.
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Carrilho CG, Cougo SS, Bombassaro T, Varella AAB, Alves GS, Machado S, Murillo-Rodriguez E, Malaspina D, Nardi AE, Veras AB. Corrigendum: Early Trauma and Cognitive Functions of Patients With Schizophrenia. Front Psychiatry 2019; 10:377. [PMID: 31191374 PMCID: PMC6547163 DOI: 10.3389/fpsyt.2019.00377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2019.00261.].
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Affiliation(s)
- Carolina G Carrilho
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Simone S Cougo
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Tatiane Bombassaro
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - André Augusto B Varella
- Research Laboratory on Autism and Behavior (LAPAC), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Gilberto S Alves
- Department of Internal Medicine, Federal University of Maranhão (UFMA), São Luís, Brazil
| | - Sergio Machado
- Physical Activity Neuroscience Laboratory, Physical Activity Sciences Postgraduate Program-Salgado de Oliveira University (UNIVERSO), São Gonçalo, Brazil.,Intercontinental Neuroscience Research Group, Universidad Anáhuac Mayab, Mérida, Mexico.,Laboratory of Panic and Respiration (LabPR-UFRJ), Psychiatry Institute of Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
| | - Eric Murillo-Rodriguez
- Intercontinental Neuroscience Research Group, Universidad Anáhuac Mayab, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina División Ciencias de la Salud, Universidad Anáhuac Mayab, Mérida, Mexico
| | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mt. Sinai Medical Center, New York, NY, United States
| | - Antonio E Nardi
- Laboratory of Panic and Respiration (LabPR-UFRJ), Psychiatry Institute of Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
| | - André B Veras
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil.,Intercontinental Neuroscience Research Group, Universidad Anáhuac Mayab, Mérida, Mexico.,Laboratory of Panic and Respiration (LabPR-UFRJ), Psychiatry Institute of Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil.,Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mt. Sinai Medical Center, New York, NY, United States
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Veras AB, Chao MV, Getz M, Goetz R, Cheniaux E, Lopes FL, Nardi AE, Walsh-Messinger J, Malaspina D, Kranz TM. Traumatic experiences and cognitive profiles of schizophrenia cases influenced by the BDNF Val66met polymorphism. Psychiatry Res 2019; 271:111-113. [PMID: 30472504 DOI: 10.1016/j.psychres.2018.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Abstract
The association of early trauma exposure with current cognition was examined in a research series of 56 schizophrenia cases with respect to the BDNF Val66Met polymorphism (rs6265, Val66Val, Val66Met, Met66Met), as met allele carriers have reduced neurotrophic activity. The Perceptual Organization Index had a significant negative correlation with trauma exposures only in met carriers, including early physical abuse, general trauma after age 18 years, and physical abuse. Within the Val66Val subgroup, there were no significant correlations between WAIS indices and traumatic experiences.
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Affiliation(s)
- André B Veras
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil; Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Departments of Psychiatry, Neuroscience, Genetics and Genomics, Icahn School of Medicine at Mt. Sinai Medical Center, New York, NY, USA.
| | - Moses V Chao
- Skirball Institute of Biomolecular Medicine, Departments of Cell Biology, Physiology & Neuroscience and Psychiatry, New York University, New York, NY, USA; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Mara Getz
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Raymond Goetz
- Department of Psychiatry, Columbia University, New York, NY USA
| | - Elie Cheniaux
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | | | - Antonio E Nardi
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | | | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience, Genetics and Genomics, Icahn School of Medicine at Mt. Sinai Medical Center, New York, NY, USA
| | - Thorsten M Kranz
- Skirball Institute of Biomolecular Medicine, Departments of Cell Biology, Physiology & Neuroscience and Psychiatry, New York University, New York, NY, USA; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
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Carrilho CG, Cougo SS, Bombassaro T, Varella AAB, Alves GS, Machado S, Murillo-Rodriguez E, Malaspina D, Nardi AE, Veras AB. Early Trauma and Cognitive Functions of Patients With Schizophrenia. Front Psychiatry 2019; 10:261. [PMID: 31057446 PMCID: PMC6482257 DOI: 10.3389/fpsyt.2019.00261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 04/05/2019] [Indexed: 12/16/2022] Open
Abstract
Aim: The following work aims to investigate the putative correlation between early trauma and cognitive functions, as well as psychotic symptoms and cognitive functions, in individuals diagnosed with schizophrenia. Methods: A quantitative assessment was performed with 20 individuals diagnosed with schizophrenia according to the 5th edition of the Diagnostic and Statistical Manual (DSM-5) criteria and who were in ongoing outpatient treatment in Psychosocial Care Centres in Brazil. Clinical measurements comprised a semistructured clinical interview, a screening questionnaire for common mental disorders, the Positive and Negative Syndrome Scale (PANSS), and the Early Trauma Inventory Self-Report-Short Form (ETISR-SF). Cognitive assessment included Beta III test, Concentrated Attention (CA) test, Color Trails Test (CTT), and Visual Face Memory (VFM) test. Results: Age-adjusted analysis showed a negative correlation between early trauma and visual memory performance (r = -0.585, p = 0.007) and negative symptoms and attention performance (r = -0.715, p = 0.000). Conclusion: Although a cause-effect relationship cannot be firmly stated, an association between early trauma experience and cognitive impairment such as visual memory, as well as a relationship between negative symptoms and attention domains, is suggested by our preliminary findings. Future studies with larger sample sizes and prospective design will clarify the long-term effects of early exposure to trauma and its clinical meaning in terms of developing psychotic-related illness.
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Affiliation(s)
- Carolina G Carrilho
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Simone S Cougo
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Tatiane Bombassaro
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - André Augusto B Varella
- Research Laboratory on Autism and Behavior (LAPAC), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Gilberto S Alves
- Department of Internal Medicine, Federal University of Maranhão (UFMA), São Luís, Brazil
| | - Sergio Machado
- Physical Activity Neuroscience Laboratory, Physical Activity Sciences Postgraduate Program-Salgado de Oliveira University (UNIVERSO), São Gonçalo, Brazil.,Intercontinental Neuroscience Research Group, Universidad Anáhuac Mayab, Mérida, Mexico.,Laboratory of Panic and Respiration (LabPR-UFRJ), Psychiatry Institute of Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
| | - Eric Murillo-Rodriguez
- Intercontinental Neuroscience Research Group, Universidad Anáhuac Mayab, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina División Ciencias de la Salud, Universidad Anáhuac Mayab, Mérida, Mexico
| | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mt. Sinai Medical Center, New York, NY, United States
| | - Antonio E Nardi
- Laboratory of Panic and Respiration (LabPR-UFRJ), Psychiatry Institute of Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
| | - André B Veras
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil.,Intercontinental Neuroscience Research Group, Universidad Anáhuac Mayab, Mérida, Mexico.,Laboratory of Panic and Respiration (LabPR-UFRJ), Psychiatry Institute of Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil.,Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mt. Sinai Medical Center, New York, NY, United States
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7
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Gabínio T, Ricci T, Kahn JP, Malaspina D, Moreira H, Veras AB. Early trauma, attachment experiences and comorbidities in schizophrenia. Trends Psychiatry Psychother 2018; 40:179-184. [PMID: 29641648 DOI: 10.1590/2237-6089-2017-0005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/22/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate attachment patterns in subjects with schizophrenia and their relationships to early traumatic events, psychotic symptoms and comorbidities. METHODS Twenty patients diagnosed with schizophrenia according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) underwent retrospective symptom assessment and careful assessment of the number and manner of childhood caregiver changes. The Diagnostic Interview for Psychosis and Affective Disorders (DI-PAD) was used to assess symptoms related to schizophrenia (positive and negative symptoms), depression and mania. Anxiety disorder comorbidities were assessed by the Liebowitz Social Anxiety Scale (LSAS), Yale-Brown Obsessions and Compulsions Scale (Y-BOCS) and Panic and Schizophrenia Interview (PaSI). Experience in Close Relationships - Relationship Structures (ECR-RS) and Early Trauma Inventory Self Report-Short Form (ETISR-SF) were used to assess attachment patterns and traumatic history, respectively. RESULTS Moderate and significant correlations between attachment patterns and early trauma showed that greater severity of anxious attachment was predicted by a higher frequency of total early traumas (Spearman ρ = 0.446, p = 0.04), mainly general traumas (ρ = 0.526, p = 0.017; including parental illness and separation, as well as natural disaster and serious accidents). Among the correlations between early trauma and comorbid symptoms, panic attacks occurring before the onset of schizophrenia showed significant and positive correlations with ETISR-SF total scores and the sexual trauma subscale. CONCLUSION Children with an unstable early emotional life are more vulnerable to the development of psychopathology, such as panic anxiety symptoms. Traumatic events may also predict later schizophrenia.
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Affiliation(s)
- Thalita Gabínio
- Grupo de Pesquisa Translacional em Saúde Mental, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Thaysse Ricci
- Grupo de Pesquisa Translacional em Saúde Mental, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Jeffrey P Kahn
- Department of Psychiatry, Weill-Cornell Medical College, New York, NY, USA
| | - Dolores Malaspina
- Department of Psychiatry and Environmental Medicine, New York University Medical Center, New York, NY, USA
| | - Helena Moreira
- Centro de Pesquisa de Intervenção Cognitivo-Comportamental, Universidade de Coimbra, Coimbra, Portugal
| | - André B Veras
- Grupo de Pesquisa Translacional em Saúde Mental, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
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8
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Veras AB, Peixoto C, Messinger JW, Getz M, Goetz R, Buckley P, Chao MV, Nardi AE, Malaspina D, Kranz TM. Early trauma and clinical features of schizophrenia cases influenced by the BDNF Val66Met allele. Schizophr Res 2018; 193:453-455. [PMID: 28711474 DOI: 10.1016/j.schres.2017.06.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022]
Affiliation(s)
- André B Veras
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil; Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (LabPR/UFRJ), Brazil; New York University Medical Center Departments of Psychiatry and Child Psychiatry, Institute for Social and Psychiatric Initiatives, New York, NY, USA.
| | - Clayton Peixoto
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil; Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (LabPR/UFRJ), Brazil
| | - Julie Walsh Messinger
- New York University Medical Center Departments of Psychiatry and Child Psychiatry, Institute for Social and Psychiatric Initiatives, New York, NY, USA; Department of Psychology, University of Dayton, Dayton, OH, USA; Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Mara Getz
- New York University Medical Center Departments of Psychiatry and Child Psychiatry, Institute for Social and Psychiatric Initiatives, New York, NY, USA
| | - Raymond Goetz
- Department of Psychiatry, Columbia University, New York, USA
| | - Peter Buckley
- Virginia Commonwealth University, School of Medicine, USA
| | - Moses V Chao
- Skirball Institute of Biomolecular Medicine, Department of Cell Biology, New York University, NY, NY, USA
| | - Antonio E Nardi
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (LabPR/UFRJ), Brazil
| | - Dolores Malaspina
- New York University Medical Center Departments of Psychiatry and Child Psychiatry, Institute for Social and Psychiatric Initiatives, New York, NY, USA
| | - Thorsten Manfred Kranz
- Skirball Institute of Biomolecular Medicine, Department of Cell Biology, New York University, NY, NY, USA
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Veras AB, Cougo S, Meira F, Peixoto C, Barros JA, Nardi AE, Malaspina D, Poyurovsky M, Kahn JP. Schizophrenia dissection by five anxiety and depressive subtype comorbidities: Clinical implications and evolutionary perspective. Psychiatry Res 2017; 257:172-178. [PMID: 28763736 DOI: 10.1016/j.psychres.2017.07.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 06/07/2017] [Accepted: 07/25/2017] [Indexed: 10/19/2022]
Abstract
Twenty patients with DSM5 schizophrenia were comprehensively and formally assessed by an experienced psychiatrist. All subjects were assessed for: positive and negative psychotic symptoms; social anxiety; panic anxiety; obsessive compulsive disorder, atypical depression; major depression; suicide risk; and global assessment of functioning. Different profiles of clinical presentation and symptom evolution emerged for patients with schizophrenia who had co-morbid depression (15%), OCD (15%), panic or limited symptom attacks (55%) and social anxiety (5%). At least eighty percent of the sample had one or more of these co-morbidities. Summing up, the data support our previous finding that panic is highly prevalent in Schizophrenia with Auditory Hallucinations (>73% here, versus 100% before), and panic was paroxysmally concurrent with voice onset. Moreover, characteristic clinical findings may help point clinicians to five specific co-morbidity psychosis subtypes. Moreover, co-morbidity dissection of psychotic diagnoses recalls and parallels the historical psychopharmacologic dissection of non-psychotic anxiety and depressive subtypes diagnoses. Larger studies should further test and explore these preliminary findings.
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Affiliation(s)
- André B Veras
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (LabPR/UFRJ), Rio de Janeiro, Brazil; Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil; Department of Psychiatry and Environmental Medicine, New York University Medical Center, New York, NY, USA.
| | - Simone Cougo
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Fernanda Meira
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Clayton Peixoto
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (LabPR/UFRJ), Rio de Janeiro, Brazil; Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Jorge A Barros
- Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Brazil
| | - Antonio E Nardi
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (LabPR/UFRJ), Rio de Janeiro, Brazil
| | - Dolores Malaspina
- Department of Psychiatry and Environmental Medicine, New York University Medical Center, New York, NY, USA
| | - Michael Poyurovsky
- Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Jeffrey P Kahn
- Department of Psychiatry, Weill-Cornell Medical College, New York, NY, USA
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Murillo-Rodríguez E, Di Marzo V, Machado S, Rocha NB, Veras AB, Neto GAM, Budde H, Arias-Carrión O, Arankowsky-Sandoval G. Role of N-Arachidonoyl-Serotonin (AA-5-HT) in Sleep-Wake Cycle Architecture, Sleep Homeostasis, and Neurotransmitters Regulation. Front Mol Neurosci 2017; 10:152. [PMID: 28611585 PMCID: PMC5447686 DOI: 10.3389/fnmol.2017.00152] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/05/2017] [Indexed: 12/19/2022] Open
Abstract
The endocannabinoid system comprises several molecular entities such as endogenous ligands [anandamide (AEA) and 2-arachidonoylglycerol (2-AG)], receptors (CB1 and CB2), enzymes such as [fatty acid amide hydrolase (FAHH) and monoacylglycerol lipase (MAGL)], as well as the anandamide membrane transporter. Although the role of this complex neurobiological system in the sleep–wake cycle modulation has been studied, the contribution of the blocker of FAAH/transient receptor potential cation channel subfamily V member 1 (TRPV1), N-arachidonoyl-serotonin (AA-5-HT) in sleep has not been investigated. Thus, in the present study, varying doses of AA-5-HT (5, 10, or 20 mg/Kg, i.p.) injected at the beginning of the lights-on period of rats, caused no statistical changes in sleep patterns. However, similar pharmacological treatment given to animals at the beginning of the dark period decreased wakefulness (W) and increased slow wave sleep (SWS) as well as rapid eye movement sleep (REMS). Power spectra analysis of states of vigilance showed that injection of AA-5-HT during the lights-off period diminished alpha spectrum across alertness in a dose-dependent fashion. In opposition, delta power spectra was enhanced as well as theta spectrum, during SWS and REMS, respectively. Moreover, the highest dose of AA-5-HT decreased wake-related contents of neurotransmitters such as dopamine (DA), norepinephrine (NE), epinephrine (EP), serotonin (5-HT) whereas the levels of adenosine (AD) were enhanced. In addition, the sleep-inducing properties of AA-5-HT were confirmed since this compound blocked the increase in W caused by stimulants such as cannabidiol (CBD) or modafinil (MOD) during the lights-on period. Additionally, administration of AA-5-HT also prevented the enhancement in contents of DA, NE, EP, 5-HT and AD after CBD of MOD injection. Lastly, the role of AA-5-HT in sleep homeostasis was tested in animals that received either CBD or MOD after total sleep deprivation (TSD). The injection of CBD or MOD increased alertness during sleep rebound period after TSD. However, AA-5-HT blocked this effect by allowing animals to display an enhancement in sleep across sleep rebound period. Overall, our findings provide evidence that AA-5-HT is an important modulator of sleep, sleep homeostasis and neurotransmitter contents.
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Affiliation(s)
- Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac MayabMérida, Mexico.,Grupo de Investigación en Envejecimiento, División Ciencias de la Salud, Universidad Anáhuac MayabMérida, Mexico.,Grupo de Investigación Desarrollos Tecnológicos para la Salud, División de Ingeniería y Ciencias Exactas, Universidad Anáhuac MayabMérida, Mexico.,Intercontinental Neuroscience Research Group
| | - Vincenzo Di Marzo
- Intercontinental Neuroscience Research Group.,Endocannabinoid Research Group, Istituto di Chimica Biomolecolare, Consiglio Nazionale delle RicerchePozzuoli, Italy
| | - Sergio Machado
- Intercontinental Neuroscience Research Group.,Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de JaneiroRio de Janeiro, Brazil.,Postgraduate Program, Salgado de Oliveira UniversityRio de Janeiro, Brazil
| | - Nuno B Rocha
- Intercontinental Neuroscience Research Group.,Faculty of Health Sciences, Polytechnic Institute of PortoPorto, Portugal
| | - André B Veras
- Intercontinental Neuroscience Research Group.,Institute of Psychiatry, Federal University of Rio de JaneiroRio de Janeiro, Brazil.,Dom Bosco Catholic UniversityRio de Janeiro, Brazil
| | - Geraldo A M Neto
- Intercontinental Neuroscience Research Group.,Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de JaneiroRio de Janeiro, Brazil
| | - Henning Budde
- Intercontinental Neuroscience Research Group.,Faculty of Human Sciences, Medical School HamburgHamburg, Germany.,Physical Activity, Physical Education, Health and Sport Research Centre (PAPESH), Sports Science Department, School of Science and Engineering Reykjavik UniversityReykjavik, Iceland.,Department of Health, Physical and Social Education, Lithuanian Sports UniversityKaunas, Lithuania
| | - Oscar Arias-Carrión
- Intercontinental Neuroscience Research Group.,Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General "Dr. Manuel Gea González"Ciudad de México, Mexico
| | - Gloria Arankowsky-Sandoval
- Intercontinental Neuroscience Research Group.,Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de YucatánMérida, Mexico
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Gabínio T, Ricci TG, Kahn JP, Malaspina D, Veras AB. Panic psychosis: paroxysmal panic anxiety concomitant with auditory hallucinations in schizophrenia. Braz J Psychiatry 2017; 39:85-86. [PMID: 28273271 PMCID: PMC7112730 DOI: 10.1590/1516-4446-2015-1690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 07/13/2016] [Indexed: 11/23/2022]
Affiliation(s)
- Thalita Gabínio
- Grupo de Pesquisa Translacional em Saúde Mental, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil.,Programa de Residência Médica em Psiquiatria, Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | - Thaysse G Ricci
- Grupo de Pesquisa Translacional em Saúde Mental, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Jeffrey P Kahn
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Dolores Malaspina
- Department of Psychiatry and Environmental Medicine, New York University Medical Center, New York, NY, USA
| | - André B Veras
- Grupo de Pesquisa Translacional em Saúde Mental, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil.,Laboratório de Pânico e Respiração, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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12
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Peixoto C, Carrilho CG, Barros JA, Ribeiro TTSB, Silva LM, Nardi AE, Cardoso A, Veras AB. The effects of dehydroepiandrosterone on sexual function: a systematic review. Climacteric 2017; 20:129-137. [PMID: 28118059 DOI: 10.1080/13697137.2017.1279141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Faced with the growing interest about the action of dehydroepiandrosterone (DHEA) and its benefits, as well as the negative impacts that sexual dysfunctions have on people's quality of life, this systematic review was undertaken with the objective of evaluating the effect of DHEA use on aspects of sexual function. METHOD An electronic search was conducted in the databases of PubMed, ISI Web of Science and Virtual Health Library (VHL) combining the terms 'DHEA treatment' and 'DHEA use' with terms such as 'sexual dysfunction', 'sexual frequency' and 'libido'. No limits on time and language were imposed. Clinical studies were considered eligible where individuals for any reason made use of DHEA and if they had any aspect of sexual function assessed. Preclinical studies and systematic reviews were considered ineligible. RESULTS The search identified 183 references and 38 were considered eligible. DHEA improved aspects such as sexual interest, lubrication, pain, arousal, orgasm and sexual frequency. Its effect was better in populations with sexual dysfunction, especially in perimenopausal and postmenopausal women. CONCLUSION Considering the studies currently published, DHEA is effective in improving several aspects of sexual function, but this effect did not reach all the populations studied.
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Affiliation(s)
- C Peixoto
- a Federal University of Rio de Janeiro, Institute of Psychiatry, Laboratory of Panic and Respiration , Rio de Janeiro , RJ , Brazil.,b Federal University of Rio de Janeiro, Institute of Psychiatry, Laboratory of Thanatology and Psychiatry in other Medical Conditions , Rio de Janeiro , RJ , Brazil.,c Translational Research Group in Mental Health , Dom Bosco Catholic University , Campo Grande , MS , Brazil
| | - C G Carrilho
- c Translational Research Group in Mental Health , Dom Bosco Catholic University , Campo Grande , MS , Brazil
| | - J A Barros
- c Translational Research Group in Mental Health , Dom Bosco Catholic University , Campo Grande , MS , Brazil
| | - T T S B Ribeiro
- c Translational Research Group in Mental Health , Dom Bosco Catholic University , Campo Grande , MS , Brazil
| | - L M Silva
- c Translational Research Group in Mental Health , Dom Bosco Catholic University , Campo Grande , MS , Brazil
| | - A E Nardi
- a Federal University of Rio de Janeiro, Institute of Psychiatry, Laboratory of Panic and Respiration , Rio de Janeiro , RJ , Brazil
| | - A Cardoso
- a Federal University of Rio de Janeiro, Institute of Psychiatry, Laboratory of Panic and Respiration , Rio de Janeiro , RJ , Brazil.,b Federal University of Rio de Janeiro, Institute of Psychiatry, Laboratory of Thanatology and Psychiatry in other Medical Conditions , Rio de Janeiro , RJ , Brazil.,c Translational Research Group in Mental Health , Dom Bosco Catholic University , Campo Grande , MS , Brazil
| | - A B Veras
- a Federal University of Rio de Janeiro, Institute of Psychiatry, Laboratory of Panic and Respiration , Rio de Janeiro , RJ , Brazil.,b Federal University of Rio de Janeiro, Institute of Psychiatry, Laboratory of Thanatology and Psychiatry in other Medical Conditions , Rio de Janeiro , RJ , Brazil.,c Translational Research Group in Mental Health , Dom Bosco Catholic University , Campo Grande , MS , Brazil
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Veras AB, do-Nascimento JS, Rodrigues RL, Guimarães ACA, Nardi AE. Psychotic symptoms in social anxiety disorder patients: report of three cases. Int Arch Med 2011; 4:12. [PMID: 21477366 PMCID: PMC3080302 DOI: 10.1186/1755-7682-4-12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 04/10/2011] [Indexed: 11/13/2022] Open
Abstract
Background Social Anxiety Disorder (SAD) is mainly characterized by an individual's intense concern about other people's opinion of the individual. Notably, among those with severe anxious symptoms, we can often observe self-referential feelings. Objective Faced with little research directed toward the exploration of psychotic symptoms in SAD patients, we will approach the topic by describing three cases. Discussion Three explanations seem possible for the psychotic manifestations in SAD. The first one depends on the individual's ability or inability to challenge the impression of being criticized by people. A second possibility would be the stressor and perpetuating role of SAD, which would make individuals more likely to present with more severe mental disorders such as delusional disorder (DD). The third explanation would be the possibility that SA is caused by a primary thought abnormality (psychotic self-reference) in some cases, instead of an affective disturbance (anxious insecurity), which led to intense concern about others' opinions. We also observed that antipsychotics did not produce significant improvement in any of the three cases. This result may be related to dopaminergic circuits and the D2 receptor hypoactivity. Conclusion The differentiation between delusion and anxious concern may be inaccurate and may change throughout the disorder's evolution. New diagnostic subcategories or the enlargement of the social anxiety diagnostic is proposed to overcome the current diagnostic imprecision. There seems to be a symptomatic spectrum between SAD and DDs.
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Affiliation(s)
- André B Veras
- Panic & Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT Translational Medicine (CNPq), Brazil.
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Nardi AE, Valença AM, Freire RC, Mochcovitch MD, Amrein R, Sardinha A, Levitan MN, Nascimento I, de-Melo-Neto VL, King AL, de O E Silva AC, Veras AB, Dias GP, Soares-Filho GL, da Costa RT, Mezzasalma MA, de Carvalho MR, de Cerqueira AC, Hallak JE, Crippa JA, Versiani M. Psychopharmacotherapy of panic disorder: 8-week randomized trial with clonazepam and paroxetine. Braz J Med Biol Res 2011. [PMID: 21344132 DOI: 10.1590/s0100‐879x2011007500020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of the present randomized, open-label, naturalistic 8-week study was to compare the efficacy and safety of treatment with clonazepam (N = 63) and paroxetine (N = 57) in patients with panic disorder with or without agoraphobia. Efficacy assessment included number of panic attacks and clinician ratings of the global severity of panic disorders with the clinical global impression (CGI) improvement (CGI-I) and CGI severity (CGI-S) scales. Most patients were females (69.8 and 68.4% in the clonazepam and paroxetine groups, respectively) and age (mean ± SD) was 35.9 ± 9.6 years for the clonazepam group and 33.7 ± 8.8 years for the paroxetine group. Treatment with clonazepam versus paroxetine resulted in fewer weekly panic attacks at week 4 (0.1 vs 0.5, respectively; P < 0.01), and greater clinical improvements at week 8 (CGI-I: 1.6 vs 2.9; P = 0.04). Anxiety severity was significantly reduced with clonazepam versus paroxetine at weeks 1 and 2, with no difference in panic disorder severity. Patients treated with clonazepam had fewer adverse events than patients treated with paroxetine (73 vs 95%; P = 0.001). The most common adverse events were drowsiness/fatigue (57%), memory/concentration difficulties (24%), and sexual dysfunction (11%) in the clonazepam group and drowsiness/fatigue (81%), sexual dysfunction (70%), and nausea/vomiting (61%) in the paroxetine group. This naturalistic study confirms the efficacy and tolerability of clonazepam and paroxetine in the acute treatment of patients with panic disorder.
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Affiliation(s)
- A E Nardi
- Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, RJ, Brasil.
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15
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Nardi AE, Valença AM, Freire RC, Mochcovitch MD, Amrein R, Sardinha A, Levitan MN, Nascimento I, de-Melo-Neto VL, King AL, de O E Silva AC, Veras AB, Dias GP, Soares-Filho GL, da Costa RT, Mezzasalma MA, de Carvalho MR, de Cerqueira AC, Hallak JE, Crippa JA, Versiani M. Psychopharmacotherapy of panic disorder: 8-week randomized trial with clonazepam and paroxetine. Braz J Med Biol Res 2011; 44:366-73. [PMID: 21344132 DOI: 10.1590/s0100-879x2011007500020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 02/03/2011] [Indexed: 11/22/2022]
Abstract
The objective of the present randomized, open-label, naturalistic 8-week study was to compare the efficacy and safety of treatment with clonazepam (N = 63) and paroxetine (N = 57) in patients with panic disorder with or without agoraphobia. Efficacy assessment included number of panic attacks and clinician ratings of the global severity of panic disorders with the clinical global impression (CGI) improvement (CGI-I) and CGI severity (CGI-S) scales. Most patients were females (69.8 and 68.4% in the clonazepam and paroxetine groups, respectively) and age (mean ± SD) was 35.9 ± 9.6 years for the clonazepam group and 33.7 ± 8.8 years for the paroxetine group. Treatment with clonazepam versus paroxetine resulted in fewer weekly panic attacks at week 4 (0.1 vs 0.5, respectively; P < 0.01), and greater clinical improvements at week 8 (CGI-I: 1.6 vs 2.9; P = 0.04). Anxiety severity was significantly reduced with clonazepam versus paroxetine at weeks 1 and 2, with no difference in panic disorder severity. Patients treated with clonazepam had fewer adverse events than patients treated with paroxetine (73 vs 95%; P = 0.001). The most common adverse events were drowsiness/fatigue (57%), memory/concentration difficulties (24%), and sexual dysfunction (11%) in the clonazepam group and drowsiness/fatigue (81%), sexual dysfunction (70%), and nausea/vomiting (61%) in the paroxetine group. This naturalistic study confirms the efficacy and tolerability of clonazepam and paroxetine in the acute treatment of patients with panic disorder.
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Affiliation(s)
- A E Nardi
- Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, RJ, Brasil.
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Veras AB, Nardi AE. The complex relationship between hypogonadism and major depression in a young male. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:421-2. [PMID: 20006970 DOI: 10.1016/j.pnpbp.2009.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 12/09/2009] [Accepted: 12/09/2009] [Indexed: 11/26/2022]
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Nardi AE, Valença AM, Nascimento I, Freire RC, Veras AB, de-Melo-Neto VL, Lopes FL, King AL, Soares-Filho GL, Mezzasalma MA, Rassi A, Zin WA. A caffeine challenge test in panic disorder patients, their healthy first-degree relatives, and healthy controls. Depress Anxiety 2009; 25:847-53. [PMID: 17823963 DOI: 10.1002/da.20354] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Our aim was to observe the induction of anxiety symptoms and panic attacks by a caffeine challenge test in panic disorder (PD) patients (DSM-IV) and their healthy first-degree relatives. We randomly selected 25 PD patients, 27 healthy first-degree relatives of probands with PD, and 22 healthy volunteers with no family history of PD. In a randomized double-blind experiment performed over two occasions 7 days apart, 480 mg caffeine and a caffeine-free solution were administered in a coffee form. Using specific panic attack criteria, 52.0% (n=13) PD patients, 40.7% (n=11) first-degree relatives (chi2=1.81, df=1, P=0.179), and none of the control subjects had a panic attack after the test (chi2=51.7, df=2, P<0.001). In this caffeine challenge test, PD patients and their first-degree relatives were more sensitive than healthy volunteers to the panic attack symptoms but less sensitive to headache, increase in blood pressure, and insomnia. Our data suggest that there is an association between panic attacks after the intake of 480 mg of caffeine in PD patients and their first-degree relatives. There is a clear differentiation of PD patients and their first-degree relatives by a caffeine test from the healthy group.
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Affiliation(s)
- Antonio E Nardi
- Laboratory of Panic & Respiration, Institute of Psychiatry, Rio de Janeiro, Brazil.
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Nardi AE, Nascimento I, Freire RC, Veras AB, de-Melo-Neto VL, Valença AM, Lopes FL, Soares-Filho GL, Levitan MN, de Carvalho MR, da Costa RT, King AL, Mezzasalma MA, Grivet LO, Rassi A, Versiani M. Demographic and clinical features of panic disorder comorbid with bipolar I disorder: a 3-year retrospective study. J Affect Disord 2008; 106:185-9. [PMID: 17604118 DOI: 10.1016/j.jad.2007.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Revised: 05/18/2007] [Accepted: 05/29/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mood disorders are considered related to anxiety disorders and their association may determine clinical course and prognosis. We aimed to describe with retrospective methodology the demographic, clinical, and treatment features in a group of panic disorder comorbid with bipolar I disorder (PD-BI) patients who were been treated for at least 3 year-period and compare them with bipolar I (BI) patients who were treated during the same period. METHOD We compared the demographic and clinical data of 26 PD-BI, 28 BI, and 25 panic disorder (PD) outpatients without history of comorbidity with mood disorder were diagnosed and treated for at least 3 years in the Federal University of Rio de Janeiro. RESULTS PD group have a higher educational level, are more married, and are more economically active. In the PD-BI and BI patients the disorders started earlier. They also turn out to have an equivalent pattern in the presence of drug abuse episodes, moderate or severe depressive episodes, psychotic episodes, suicide attempts, maniac episodes, mixed episodes, use of fewer days of antidepressants and benzodiazepines, and use of more days of antipsychotics and mood stabilizers. The PD-BI and the BI groups had a higher frequency of depressive episodes and psychotic episodes. LIMITATIONS It is a retrospective data description based on a naturalistic treatment. The sample has a small size and the some data could be different in a large sample. CONCLUSION PD-BI patients have demographic, clinical and therapeutic features similar to BI and the data support its validation as a special severe bipolar I disorder subgroup.
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Affiliation(s)
- Antonio Egidio Nardi
- Laboratory of Panic & Respiration, Federal University of Rio de Janeiro, Brazil.
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Nardi AE, Lopes FL, Valença AM, Freire RC, Veras AB, de-Melo-Neto VL, Nascimento I, King AL, Mezzasalma MA, Soares-Filho GL, Zin WA. Caffeine challenge test in panic disorder and depression with panic attacks. Compr Psychiatry 2007; 48:257-63. [PMID: 17445520 DOI: 10.1016/j.comppsych.2006.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Our aim was to observe if patients with panic disorder (PD) and patients with major depression with panic attacks (MDP) (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) respond in a similar way to the induction of panic attacks by an oral caffeine challenge test. We randomly selected 29 patients with PD, 27 with MDP, 25 with major depression without panic attacks (MD), and 28 healthy volunteers. The patients had no psychotropic drug for at least a 4-week period. In a randomized double-blind experiment performed in 2 occasions 7 days apart, 480 mg caffeine and a caffeine-free (placebo) solution were administered in a coffee form and anxiety scales were applied before and after each test. A total of 58.6% (n = 17) of patients with PD, 44.4% (n = 12) of patients with MDP, 12.0% (n = 3) of patients with MD, and 7.1% (n= 2) of control subjects had a panic attack after the 480-mg caffeine challenge test (chi(2)(3) = 16.22, P = .001). The patients with PD and MDP were more sensitive to caffeine than were patients with MD and healthy volunteers. No panic attack was observed after the caffeine-free solution intake. The patients with MD had a lower heart rate response to the test than all the other groups (2-way analysis of variance, group by time interaction with Greenhouse-Geisser correction: F(3,762) = 2.85, P = .026). Our data suggest that there is an association between panic attacks, no matter if associated with PD or MDP, and hyperreactivity to an oral caffeine challenge test.
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Affiliation(s)
- Antonio E Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro RJ-22410-003, Brazil.
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Freire RC, Lopes FL, Veras AB, Valença AM, Mezzasalma MA, Nascimento I, Nardi AE. Personality traits spectrum in panic disorder and major depression. Rev Bras Psiquiatr 2007. [DOI: 10.1590/s1516-44462006005000009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Freire RC, Lopes FL, Veras AB, Valença AM, Mezzasalma MA, Nascimento I, Nardi AE. Personality traits spectrum in panic disorder and major depression. Rev Bras Psiquiatr 2007; 29:31-4. [PMID: 17435925 DOI: 10.1590/s1516-44462007000100010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2006] [Accepted: 09/04/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Our aim was to identify the personality traits in patients with panics disorder, major depression and with both disorders (comorbidity). METHOD Diagnoses were made with the Structured Clinical Interview for DSM-IV before the treatment, and the personality evaluation with the Maudsley Personality Inventory was made during the follow-up. Four groups were analyzed: a control group (n = 30), a major depression without panic disorder group (n = 45); a panic disorder without major depression group (n = 56) and a comorbidity group (n = 21), with major depression and panic disorder, simultaneously. RESULTS All disorder groups had significantly higher neuroticism means when compared to the control group. The highest mean was in the comorbidity group, followed by the major depression group and the panic disorder group. The difference of neuroticism means between the comorbidity group and the panic disorder group also reached statistical significance. The lowest extraversion mean was in the comorbidity group, followed by the major depression group, the panic disorder group, and the control group. Compared to normal controls, extraversion was significantly low in the comorbidity and major depression groups. CONCLUSION In our sample, there was a continuum of personality traits between panic disorder and major depression and, the co-occurrence of these disorders was associated with accentuated personality traits.
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Affiliation(s)
- Rafael C Freire
- Laboratory of Panic and Respiration,, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Veras AB, Rassi A, Valença AM, Nardi AE. Prevalência de transtornos depressivos e ansiosos em uma amostra ambulatorial brasileira de mulheres na menopausa. ACTA ACUST UNITED AC 2006. [DOI: 10.1590/s0101-81082006000200005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Determinar a prevalência dos transtornos depressivo-ansiosos entre mulheres atendidas em um ambulatório de menopausa. METODOLOGIA: Avaliamos, através da entrevista semi-estruturada Mini International Neuropsychiatric Interview, 86 mulheres que encontravam-se em tratamento no ambulatório de menopausa do Instituto de Ginecologia da Universidade Federal do Rio de Janeiro. RESULTADOS: A maioria das mulheres apresentava algum diagnóstico psiquiátrico (57%) sendo mais prevalentes o transtorno de ansiedade generalizada (34,9%) e a depressão maior (31,4%). O grupo com algum diagnóstico foi representado por mulheres mais jovens, casadas, com menor escolaridade e história familiar para transtornos psiquiátricos. CONCLUSÃO: Observamos uma grande prevalência de transtornos mentais entre mulheres em atendimento ambulatorial na menopausa em nosso estudo, em relação às mulheres em atendimento em outros ambulatórios segundo a literatura. Há também uma alta taxa de prevalência de comorbidades (55,5% dos pacientes com algum transtorno) complicadoras do transtorno primário, o que pode representar a evolução para pior prognóstico pela ausência de tratamento precoce e específico.
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Veras AB, Rozenthal M, Nardi AE. Tardive dystonia, a case report. Braz J Psychiatry 2006; 28:160-1. [PMID: 16810405 DOI: 10.1590/s1516-44462006000200019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Nardi AE, Nascimento I, Freire RC, de-Melo-Neto VL, Valença AM, Dib M, Soares-Filho GL, Veras AB, Mezzasalma MA, Lopes FL, de Menezes GB, Grivet LO, Versiani M. Demographic and clinical features of schizoaffective (schizobipolar) disorder--a 5-year retrospective study. Support for a bipolar spectrum disorder. J Affect Disord 2005; 89:201-6. [PMID: 16202454 DOI: 10.1016/j.jad.2005.08.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2005] [Accepted: 08/10/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Schizobipolar disorder is considered related to both schizophrenia and bipolar disorder. We aimed to describe with retrospective methodology the demographic, clinical, and treatment features in a group of schizobipolar disorder patients who have been treated for at least a 5-year period and compare them with bipolar I and schizophrenic patients who were treated during the same period. METHOD We compared the demographic and clinical data of 61 schizobipolar, 57 bipolar I, and 55 schizophrenic outpatients who were diagnosed and treated for at least 5 years in the outpatient clinic in the Federal University of Rio de Janeiro. RESULTS The schizobipolar disorder patients had a profile similar to the bipolar I patients but are significantly different from schizophrenic patients in educational level, marital status, occupation, drug and alcohol abuse episodes, presence of depressive, mixed and maniac episodes, family history of bipolar I and mood disorders, and use of medications. Only the age of onset, suicide attempts, and family history of suicide are not significantly different among the groups. The schizophrenic patients used antipsychotics for more days and the schizobipolar and bipolar I used more antidepressants and mood stabilizers. 37 (60.6%) schizobipolar patients had their diagnosis changed to bipolar disorder by their physician in different periods during the period studied. LIMITATIONS It is a retrospective data description based on a naturalistic treatment. The family history was collected from the patient and whenever possible from one first-degree relative. CONCLUSION Schizobipolar disorder patients have demographic, clinical and therapeutic features similar to bipolar I patients and data support its definite inclusion in the bipolar spectrum group.
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Affiliation(s)
- Antonio E Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Pirajá, 407/702, Rio de Janeiro, RJ-22410-003, Brazil.
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Nardi AE, Valença AM, Nascimento I, Lopes FL, Mezzasalma MA, Freire RC, Veras AB, Zin WA, Versiani M. A three-year follow-up study of patients with the respiratory subtype of panic disorder after treatment with clonazepam. Psychiatry Res 2005; 137:61-70. [PMID: 16226812 DOI: 10.1016/j.psychres.2005.05.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2004] [Revised: 02/09/2005] [Accepted: 05/25/2005] [Indexed: 11/23/2022]
Abstract
The demographic, clinical and therapeutic features of the respiratory subtype of panic disorder (PD) versus the non-respiratory subtype were studied in a prospective design. Sixty-seven PD outpatients (DSM-IV), who had previously been categorized into respiratory (n=35) and non-respiratory (n=32) subgroups, were openly treated with clonazepam for a 3-year period. The principal measure of efficacy was the number of panic attacks, obtained from the Sheehan Panic and Anticipatory Anxiety Scale. In the first 8 weeks of treatment (acute phase), the respiratory subtype group had a significantly faster response to clonazepam. During the follow-up (weeks 12-156), the two subgroups did not differ significantly in the number of panic attacks experienced from baseline to end point. Patients in the respiratory subtype were characterized by a later onset of disorder and a family history of PD. Patients in the non-respiratory subgroup had a significantly higher number of past depressive episodes than those in the respiratory subgroup. The respiratory subgroup had a faster response after 8 weeks of treatment and an equivalent response in the 3-year follow-up period. Clonazepam had a sustained therapeutic effect over the entire treatment period.
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Affiliation(s)
- Antonio E Nardi
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Pirajá, 407/702, Rio de Janeiro-RJ-22410-003, Brazil.
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Valença AM, Nardi AE, Nascimento I, Lopes FL, Freire RC, Mezzasalma MA, Veras AB, Versiani M. Do social anxiety disorder patients belong to a bipolar spectrum subgroup? J Affect Disord 2005; 86:11-8. [PMID: 15820266 DOI: 10.1016/j.jad.2004.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Accepted: 12/09/2004] [Indexed: 11/22/2022]
Abstract
BACKGROUND It has been proposed that all forms of bipolar disorder-perhaps all primary affective disorders-are best conceptualized as a spectrum of related illness, clinically overlapping but not necessarily genetically uniform illnesses. We aim to describe with retrospective methodology the demographic, clinical, and therapeutic response in a group of social anxiety disorder (SA) patients who improves while taking antidepressants and compare them with bipolar II (B-II) patients. METHODS 57 SA outpatients (DSM-IV) were diagnosed and naturalistic efficacious treated with selective serotonin reuptake inhibitors (SSRI). Their demographic, clinical features and therapeutic response were compared with 41 DSM-IV bipolar II patients in their starting evaluations in our outpatient clinic in the Federal University of Rio de Janeiro, Brazil. RESULTS There is a sub-group of SA patients who improves while taking antidepressants and presents a clear hypomanic phase. Their improvement is identical to a mild/moderate hypomanic state. Without the antidepressant, the symptoms of SA return. The SA and B-II patients have a similar number of previous depressive episodes, alcohol abuse, suicide attempts, and family history for mood disorder. LIMITATIONS It is a retrospective data description based on a naturalist follow-up. CONCLUSION Some SA patients have demographic, clinical and therapeutic features similar to B-II patients and they might just be a Bipolar-III sub-group with a higher level of complains to social situations and without spontaneous hypomania during lifetime.
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Affiliation(s)
- Alexandre M Valença
- Institute of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Pirajá, 407/702, Rio de Janeiro-RJ-22410-003, Brazil
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