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Diaz AP, Pinto AB, Araújo MIC, Joaquim RM, Costa DDS, Serpa ALDO, Pisani AR, Conwell Y, Miranda DM, Malloy-Diniz LF, da Silva AG. Social support and suicidality during the COVID-19 pandemic among Brazilian healthcare workers: a longitudinal assessment of an online repeated cross-sectional survey. Braz J Psychiatry 2024. [PMID: 38598451 DOI: 10.47626/1516-4446-2023-3466] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/28/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Healthcare workers (HCWs) are at an increased risk of suicide compared to non-healthcare workers. This study aims to investigate the association between social support and suicidal ideation and behavior (SIB) during the COVID-19 pandemic among Brazilian HCWs. METHODS This study utilizes data from 10,885 participants who answered the first (time point 1 - between May and June of 2020) and second (time point 2 - between December 2020 and February 2021) assessments of an online repeated cross-sectional survey for evaluating mental health and quality of life of HCWs during the COVID-19 pandemic in Brazil. Logistic regression analysis was conducted to investigate the relationship between social support as the independent variable (time point 1) and SIB as the outcomes (time point 2). RESULTS Higher social support was associated with a significantly lower chance of reporting SIB in the month prior to follow-up assessment (adjusted odds ratio [AOR]: 0.71, CI 95% 0.66 - 0.76 and AOR 0.61, CI 95% 0.54 - 0.68, respectively). These associations were independent of sex, age, feelings of loneliness, and self-reported psychiatric disorders. CONCLUSION Social support is associated with a lower chance of suicidality among HCWs, a protective role that is probably more evident for suicidal behavior.
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Affiliation(s)
- Alexandre Paim Diaz
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Andre Braule Pinto
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Universidade Federal do Amazonas (UFAM), Faculdade de Psicologia (FAPSI), Programa de Pós-Graduação em Psicologia (PPGPSI), AM, Brazil
| | | | - Rui Mateus Joaquim
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Danielle de Souza Costa
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Luiz de Oliveira Serpa
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Human Developmental Sciences Graduate Program, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Anthony R Pisani
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Yeates Conwell
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Debora M Miranda
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro F Malloy-Diniz
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Department of Psychiatry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antonio G da Silva
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Associação Brasileira de Psiquiatria, São Paulo, Brazil. Faculdade de Medicina da Universidade do Porto, Portugal
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Peper-Nascimento J, Rogers ML, Diaz AP, Keller GS, Richards JA, Ceretta LB, Cohen LJ, Quevedo J, Galynker I, Valvassori SS. Abbreviated Suicidal Narrative Inventory: Factor Structure, Internal Consistency, and Validity in a Brazilian Sample. Braz J Psychiatry 2024. [PMID: 38467495 DOI: 10.47626/1516-4446-2023-3270] [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] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/11/2024] [Indexed: 03/13/2024]
Abstract
AIM To investigate the factor structure, reliability, and validity of the Brazilian version of the Abbreviated Suicidal Narrative Inventory (SNI-38). METHODS We used an anonymous online questionnaire of the SNI-38 and self-report measures administered between November 2020 and October 2021 in the Brazilian community. Participants were recruited through social media advertisements. Confirmatory factor analysis was carried out to test the factor structure of the SNI-38. In addition, we examined internal consistency, and convergent validity against stressful life events, the suicide crisis syndrome, suicidal ideation, and suicide attempts. RESULTS 2660 participants were included. The eight-factor model SNI-38 had a good model fit (χ2[637] = 7,473.98, p < .001, CFI = .99, TLI = .99, RMSEA = .07, SRMR = .06); all items were significantly and positively loaded onto their respective factors (factor loadings ≥ .45). Reliability was good to high in all subscales except goal disengagement. Additionally, all subscales - except goal disengagement - were correlated positively which the suicide crisis syndrome, stressful life events, lifetime/past-month suicidal ideation, and lifetime suicide attempts. CONCLUSIONS These findings provide preliminary support for the validity of the Brazilian version of the SNI-38, being an appropriate and valid tool for measuring suicidal narrative among Brazilian samples.
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Affiliation(s)
- Jefté Peper-Nascimento
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Alexandre Paim Diaz
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY. USA
| | - Gabriela Serafim Keller
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Jenelle A Richards
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Luciane B Ceretta
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Lisa J Cohen
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA. Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - João Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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Peper-Nascimento J, Rogers ML, Richards JA, Diaz AP, Ceretta LB, Keller GS, Quevedo J, Galynker I, Valvassori SS. The Revised Suicide Crisis Inventory (SCI-2): Factor Structure, Internal Consistency, and Validity in a Brazilian Sample. Braz J Psychiatry 2024. [PMID: 38377007 DOI: 10.47626/1516-4446-2023-3366] [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] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/27/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To examine the factor structure, reliability, and validity of the Brazilian version of the Suicide Crisis Inventory (SCI-2) among Brazilian adults. METHODS The SCI-2 was cross-culturally adapted into Portuguese and administered to 2,265 individuals in the Brazilian community. Confirmatory factor analyses, internal consistency, and convergent and criterion validity against the suicidal narrative, stressful life events, suicidal ideation, and suicide attempts were examined. RESULTS The revised one-factor model of the SCI-2 resulted in adequate, but not optimal, model fit (χ2[1539] = 31,442.79, p < .001, CFI = .99, TLI = .99, RMSEA = .09, SRMR = .05). The revised five-factor model, on the other hand, demonstrated good fit (χ2[1529] = 14,174.86, p < .001, CFI = 1.00, TLI = 1.00, RMSEA = .06, SRMR = .04). Comparison of these two models indicated that the five-factor exhibited a superior model fit to the one-factor model. The SCI-2 total and subscales showed strong internal consistency, good convergent, and criterion validity in relation to stressful life events, suicidal narrative (except goal disengagement subscale), suicidal ideation, and suicide attempts. CONCLUSIONS These findings indicate that the Brazilian version of the SCI-2 is a valid tool for measuring symptoms of the Suicide Crisis Syndrome.
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Affiliation(s)
- Jefté Peper-Nascimento
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Jenelle A Richards
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Alexandre Paim Diaz
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY. USA
| | - Luciane B Ceretta
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Gabriela S Keller
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil. Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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Braule Pinto ALDC, Serpa ALDO, Guatimosim RF, Costa DS, de Paula JJ, da Silva AG, Diaz AP, de Miranda DM, Malloy-Diniz LF. Longitudinal profile of post-traumatic symptoms in HealthCare Workers during COVID-19 pandemic: A latent transition model. J Psychiatr Res 2023; 168:230-239. [PMID: 37922597 DOI: 10.1016/j.jpsychires.2023.10.031] [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: 01/09/2023] [Revised: 08/03/2023] [Accepted: 10/14/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Pandemics have the potential to be considered traumatic event, increasing the risk of developing post-traumatic stress symptoms (PTSS) in HealthCare Workers (HCW). However, few longitudinal studies have evaluated the impact of prolonged exposure to the risk imposed by COVID-19. Our aim was to identify subgroups of HCW with profiles of PTSS, how this profile changed during the pandemic and which variables were related to these changes. METHODS We evaluated the levels of PTSS and psychological distress in a Brazilian HealthCare Workers' sample (n = 1398) in three waves of assessment: from May to June 2020 (Wave 1), December 2020 to February 2021 (Wave 2) and May to August 2021 (Wave 3), using Latent Profile Analysis (LPA) to identify subgroups with different profiles of symptms, and then, Latent Transition Analysis (LTA) was applied to examine changes in symptom profiles over time, including gender, psychiatric diagnosis history, and pandemic-related fears as covariates. RESULTS two profiles were identified: high-PTSS profile (Wave 1-23%; Wave 2-64% and Wave 3-73%) and a low-PTSS (Wave 1-77%; Wave 2-36% and Wave 3-27%). Being female, fear of contamination, and fearing financial problems were strong predictors of changes in the profile. In addition, the participants had a high probability of being in the high-PTSS in the long run. CONCLUSION These results suggests that targeted interventions can mitigate the impact of pandemic. Providing financial support, and psychological support can be beneficial for those with psychiatric diagnoses and experiencing bereavement.
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Affiliation(s)
- André Luiz de Carvalho Braule Pinto
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Ensino e Pesquisa (DENPE), Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Alexandre Luiz de Oliveira Serpa
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; SCNLab, Centro de Ciências Biológicas e da Saúde e do Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, Brazil.
| | - Rafaela Ferreira Guatimosim
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Danielle Souza Costa
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Jonas Jardim de Paula
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Antônio Geraldo da Silva
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Associação Brasileira de Psiquiatria (ABP), Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Faculdade de Medicina da Universidade do Porto, Portugal.
| | - Alexandre Paim Diaz
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Associação Brasileira de Psiquiatria (ABP), Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester, New York, USA.
| | - Débora Marques de Miranda
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Leandro Fernandes Malloy-Diniz
- SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Lima CNC, Kovács EHC, Mirza S, Del Favero-Campbell A, Diaz AP, Quevedo J, Argue BMR, Richards JG, Williams A, Wemmie JA, Magnotta VA, Fiedorowicz JG, Soares JC, Gaine ME, Fries GR. Association between the epigenetic lifespan predictor GrimAge and history of suicide attempt in bipolar disorder. Neuropsychopharmacology 2023; 48:954-962. [PMID: 36878995 PMCID: PMC10156727 DOI: 10.1038/s41386-023-01557-9] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/07/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
Bipolar disorder (BD) has been previously associated with premature mortality and aging, including acceleration of epigenetic aging. Suicide attempts (SA) are greatly elevated in BD and are associated with decreased lifespan, biological aging, and poorer clinical outcomes. We investigated the relationship between GrimAge, an epigenetic clock trained on time-to-death and associated with mortality and lifespan, and SA in two independent cohorts of BD individuals (discovery cohort - controls (n = 50), BD individuals with (n = 77, BD/SA) and without (n = 67, BD/non-SA) lifetime history of SA; replication cohort - BD/SA (n = 48) and BD/non-SA (n = 47)). An acceleration index for the GrimAge clock (GrimAgeAccel) was computed from blood DNA methylation (DNAm) and compared between groups with multiple general linear models. Differences in epigenetic aging from the discovery cohort were validated in the independent replication cohort. In the discovery cohort, controls, BD/non-SA, and BD/SA significantly differed on GrimAgeAccel (F = 5.424, p = 0.005), with the highest GrimAgeAccel in BD/SA (p = 0.004, BD/SA vs. controls). Within the BD individuals, BD/non-SA and BD/SA differed on GrimAgeAccel in both cohorts (p = 0.008) after covariate adjustment. Finally, DNAm-based surrogates revealed possible involvement of plasminogen activator inhibitor 1, leptin, and smoking pack-years in driving accelerated epigenetic aging. These findings pair with existing evidence that not only BD, but also SA, may be associated with an accelerated biological aging and provide putative biological mechanisms for morbidity and premature mortality in this population.
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Affiliation(s)
- Camila N C Lima
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
| | - Emese H C Kovács
- Department of Neuroscience and Pharmacology, The University of Iowa, 51 Newton Rd, 52242, Iowa City, IA, USA
| | - Salahudeen Mirza
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Institute of Child Development, University of Minnesota, 51 E River Rd, 55455, Minneapolis, MN, USA
| | - Alexandra Del Favero-Campbell
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
| | - Alexandre Paim Diaz
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Joao Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA
| | - Benney M R Argue
- Pharmaceutical Sciences and Experimental Therapeutics, The University of Iowa, 180 South Grand Ave, 52242, Iowa City, IA, USA
| | - Jenny Gringer Richards
- Department of Radiology, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Aislinn Williams
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, 169 Newton Rd, 52242, Iowa City, IA, USA
| | - John A Wemmie
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Vincent A Magnotta
- Department of Radiology, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Jess G Fiedorowicz
- University of Ottawa Brain and Mind Research Institute, Ottawa Hospital Research Institute, 501 Smyth, K1H 8L6, Ottawa, ON, Canada
| | - Jair C Soares
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA
| | - Marie E Gaine
- Pharmaceutical Sciences and Experimental Therapeutics, The University of Iowa, 180 South Grand Ave, 52242, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, 169 Newton Rd, 52242, Iowa City, IA, USA
| | - Gabriel R Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA.
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA.
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA.
- Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, 7000 Fannin, 77030, Houston, TX, USA.
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Marques da Rocha MC, Malloy-Diniz LF, Romano-Silva MA, Joaquim RM, Serpa ALDO, Paim Diaz A, de Paula JJ, Costa DS, da Silva AG, Pinto ALDCB, de Miranda DM. Decision-making styles during stressful scenarios: The role of anxiety in COVID-19 pandemic. Front Psychiatry 2023; 14:1105662. [PMID: 37091714 PMCID: PMC10115220 DOI: 10.3389/fpsyt.2023.1105662] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/23/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Decision-making is not purely rational but highlighted by the influence of intuitive and emotional processes. Recently, researchers have focused more attention on understanding which environmental and personal features influence decision-making processes, and how. Objective and methods On this study, we investigate whether Trait Anxiety moderates the impact of Post-Traumatic Stress (PTS) symptoms reported during COVID-19 pandemic on decision-making styles. Results The study included 1,358 Brazilian participants (80% women) aged between 20 and 74 (M = 41.11; SD = 11.23) who responded to an online survey between May and August of the year 2021 of COVID-19 pandemic to The State-Trait Anxiety Inventory, The Decisions Styles Scale, The Impact of Event Scale - Revised and questions related to COVID-19. Through moderation analysis, we observed that experiencing PTS is associated with a higher tendency to biased/heuristic decision-making processes. Discussion Trait Anxiety seems to influence how people respond to PTS symptoms on decision-making related processes. Subjects with higher Trait Anxiety reported lower tendency to appeal to rationality, especially under higher reported levels of PTS. Meanwhile, lower Trait Anxiety subjects exhibited more reason-based decision-making under higher rates of PTS. This work contributes to a deeper understanding of the interplay among environmental and individual differences on decision-making styles and helps to identify factors of vulnerability for poorer cognitive functioning on stressful scenarios.
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Affiliation(s)
- Mariana Castro Marques da Rocha
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro Fernandes Malloy-Diniz
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Department of Psychiatry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Rui Mateus Joaquim
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
| | | | - Alexandre Paim Diaz
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
| | - Jonas Jardim de Paula
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Department of Psychiatry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Antônio Geraldo da Silva
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - André Luiz de Carvalho Braule Pinto
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- SAMBE - Instituto de Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Braule Pinto ALDC, Guatimosim RF, Loureiro FF, Serpa ALDO, Costa DS, Diaz AP, Joaquim RM, Baldaçara LR, Alves Maria GDS, da Silva AG, de Miranda DM, Malloy-Diniz LF. Longitudinal invariance and validity of the Impact of Event Scale-Revised under COVID-19 pandemic in a Brazilian sample. Psychol Assess 2022; 34:791-802. [PMID: 35708924 DOI: 10.1037/pas0001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the Impact Event Scale-Revised is widely used, its factor structure is still controversial. In addition, its longitudinal measurement invariance (LMI) remains uninvestigated. In this sense, we carried out three studies to investigate its psychometric properties. In Study 1, we evaluated the factorial structure of the scale comparing the different models existing in the literature in Brazilian samples who responded to the instrument during the COVID-19 pandemic. In Study 2, we provide support for a five-factor model throughout convergent validity with psychological distress and sleep problems, and criterion validity between people with diagnostic of mental disorders. Finally, we evaluated the LMI over a 6-month interval. The results indicated that the five-factor model has excellent goodness of fit and holds strict longitudinal invariance. Additionally, internal consistency and stability coefficients indicate that the scale is appropriate to measure posttraumatic stress symptomatology) in nonclinical samples across multiple assessments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Rafaela Ferreira Guatimosim
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Fabiano Franca Loureiro
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | | | - Danielle Souza Costa
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Alexandre Paim Diaz
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Rui Mateus Joaquim
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Leonardo Rodrigo Baldaçara
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Gustavo Dos Santos Alves Maria
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Antônio Geraldo da Silva
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Débora Marques de Miranda
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Leandro Fernandes Malloy-Diniz
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
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Wolfenberger T, Diaz AP, Bockmann T, Selvaraj S, Sanches M, Soares JC. Predominant polarity and associated post-traumatic stress disorder in patients with comorbid bipolar disorder and borderline personality disorder: a cross-sectional study. Braz J Psychiatry 2022; 44:557-558. [PMID: 35904414 PMCID: PMC9561839 DOI: 10.47626/1516-4446-2021-2418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022]
Affiliation(s)
- Taylor Wolfenberger
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Houston, TX, USA. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Alexandre Paim Diaz
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Houston, TX, USA. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Taya Bockmann
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Houston, TX, USA
| | - Sudhakar Selvaraj
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Houston, TX, USA. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Marsal Sanches
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Houston, TX, USA. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Houston, TX, USA. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Diaz AP, Fernandes BS, Teixeira AL, Mwangi B, Hasan KM, Wu MJ, Selvaraj S, Suen P, Zanao TA, Brunoni AR, Sanches M, Soares JC. White matter microstructure associated with anhedonia among individuals with bipolar disorders and high-risk for bipolar disorders. J Affect Disord 2022; 300:91-98. [PMID: 34936916 PMCID: PMC8828704 DOI: 10.1016/j.jad.2021.12.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/28/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Anhedonia - a key symptom of depression - is highly associated with poorer outcomes and suicidal behavior. Alterations in the circuitry of reward-related brain regions have been robustly associated with anhedonia in unipolar depression, but not bipolar disorder (BD). We investigated white matter microstructures associated with anhedonia in participants with BD types I and II and first-degree relatives of patients with BD (BD-siblings). METHODS Eighty participants (BD types I and II: 56 [70%], and BD-siblings: 24 [30%]) underwent diffusion tensor imaging (DTI); Fractional anisotropy (FA) of different tracts were computed. Anhedonia was assessed using item 8, ("inability to feel'') of the MADRS scale. General linear models were used to compare the FA of different tracts in participants with and without anhedonia controlling for several clinical and demographic variables. RESULTS The mean age of the sample was 37 (± 11) years old, and 68.8% were female. Participants with anhedonia (32.5%) presented lower mean FA in the left uncinate fasciculus (UF) (p = 0.005), right temporal endings of the superior longitudinal fasciculus (SLFT) (p = 0.04), and in the left and right parietal endings of the superior longitudinal fasciculus (SLFP) (p = 0.003, and p = 0.04, respectively). Similar comparisons between participants with or without current depressive episodes and between participants with or without inner tension according to the MADRS did not show significant differences, specificity of the findings for anhedonia. CONCLUSIONS Lower FA in the left UF and SLF are potential neuroimaging markers of anhedonia in individuals with BD and high-risk for BD.
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Affiliation(s)
- Alexandre Paim Diaz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Road, Suite 3130, Houston, TX 77054, United States.
| | - Brisa S. Fernandes
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Antonio Lucio Teixeira
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Benson Mwangi
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Khader M. Hasan
- The University of Texas Health Science Center at Houston, Department of Diagnostic and Interventional Imaging, Diffusion MRI Research Lab, Houston, Texas
| | - Mon-Ju Wu
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Sudhakar Selvaraj
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Paulo Suen
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Tamires Araujo Zanao
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Andre R. Brunoni
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marsal Sanches
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Jair C. Soares
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
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Serpa ALDO, Pinto ALB, Diaz AP, Romano-Silva MA, Costa DDS, Joaquim RM, de Paula JJ, Guatimosim R, da Silva AG, de Miranda DM, Malloy-Diniz LF. The mental health of Brazilian healthcare professionals during the COVID-19 pandemic: a longitudinal study. Brazilian Journal of Psychiatry 2022; 44:401-408. [PMID: 36166636 PMCID: PMC9375670 DOI: 10.47626/1516-4446-2021-2347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/14/2022] [Indexed: 11/26/2022]
Abstract
Objective: To compare the distress level among Brazilian healthcare professionals during the coronavirus disease 2019 (COVID-19) pandemic and estimate risks by sex, age, and occupation. Methods: In a longitudinal cohort design, a nationally distributed online survey was used to collect data from 10,490 active healthcare professionals who worked during the pandemic. Participants were mostly female, aged 18 to 82 years; 13 different health professions and all states of Brazil were represented. Results: The most frequent professions were psychology, dentistry, and nursing. The Brief Symptom Inventory (BSI) score suggested an increased distress perception among health professionals. Females showed poorer mental health than males, but the absolute rise in Global Severity Index (GSI) score was larger in males than in females. Younger adults reported more symptoms of psychological distress than older adults. The most impacted age group was between 30-39 years. Nurse technicians presented the highest risk of distress. Conclusion: Health professionals are essential to overcoming the pandemic; thus, their mental health status should be monitored, and features associated with increased distress should be identified. Our findings suggest distress risk should be stratified by occupation, age, and sex. Health professionals showed an increased distress perception. Women, individuals between the ages of 30 and 39, nursing personnel, and physicians were more likely to report distress compared with other health professionals.
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Affiliation(s)
- Alexandre Luiz de Oliveira Serpa
- Laboratório de Neurociência Cognitiva e Social, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil
- Meta Cognitiv, São Paulo, SP, Brazil
- Correspondence: Alexandre Luiz de Oliveira Serpa, Rua Piauí, 181, 10° andar, CEP 01302-907, São Paulo, SP, Brazil. E-mail:
| | - André Luiz Braule Pinto
- Laboratório de Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Alexandre Paim Diaz
- Grupo de Saúde Mental Baseada em Evidências, Departamento de Saúde Mental, UFMG, Belo Horizonte, MG, Brazil
| | - Marco Aurélio Romano-Silva
- Laboratório de Medicina Molecular, Departamento de Saúde Mental, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil
| | - Danielle de Souza Costa
- Laboratório de Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rui M. Joaquim
- Laboratório de Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Jonas Jardim de Paula
- Laboratório de Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rafaela Guatimosim
- Laboratório de Pesquisa em Neurociência Clínica, UFMG, Belo Horizonte, MG, Brazil
- Fundação Mineira de Educação e Cultura, Belo Horizonte, MG, Brazil
| | | | | | - Leandro F. Malloy-Diniz
- Grupo de Saúde Mental Baseada em Evidências, Departamento de Saúde Mental, UFMG, Belo Horizonte, MG, Brazil
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Nascimento F, Diaz AP, Sanches M, Fenoy AJ, Soares JC, Quevedo J. Concomitant deep brain stimulation and vagus nerve stimulation for treatment-resistant depression: a case report. Braz J Psychiatry 2021; 43:679-680. [PMID: 34878002 PMCID: PMC8639022 DOI: 10.1590/1516-4446-2021-0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022]
Affiliation(s)
- Flavio Nascimento
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Alexandre Paim Diaz
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Marsal Sanches
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Albert J Fenoy
- Department of Neurosurgery, McGovern Medical School, UTHealth, Houston, TX, USA
| | - Jair C Soares
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Joao Quevedo
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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Joaquim RM, Pinto AL, Guatimosim RF, de Paula JJ, Souza Costa D, Diaz AP, da Silva AG, Pinheiro MI, Serpa AL, Miranda DM, Malloy-Diniz LF. Bereavement and psychological distress during COVID-19 pandemics: The impact of death experience on mental health. Current Research in Behavioral Sciences 2021. [DOI: 10.1016/j.crbeha.2021.100019] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Diaz AP, Soares JC, Brambilla P, Young AH, Selvaraj S. Corrigendum to "Journal Metrics in psychiatry: What do the rankings tell us?". Journal of Affective Disorders. 287C (2021) 354- 358. J Affect Disord 2021; 291:416. [PMID: 34059321 DOI: 10.1016/j.jad.2021.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Alexandre Paim Diaz
- Louis. A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054
| | - Jair C Soares
- Louis. A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Sudhakar Selvaraj
- Louis. A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054.
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Loch AA, Diaz AP, Pacheco-Palha A, Wainberg ML, da Silva AG, Malloy-Diniz LF. Editorial: Stigma's Impact on People With Mental Illness: Advances in Understanding, Management, and Prevention. Front Psychol 2021; 12:715247. [PMID: 34305768 PMCID: PMC8299415 DOI: 10.3389/fpsyg.2021.715247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Alexandre Andrade Loch
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Alexandre Paim Diaz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | | | - Milton L Wainberg
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Antonio Geraldo da Silva
- Faculdade de Medicina, Universidade Do Porto, Porto, Portugal.,Brazilian Psychiatry Association - Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, Brazil
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Diaz AP, Soares JC, Brambilla P, Young AH, Selvaraj S. Journal Metrics in Psychiatry: What do the rankings tell us? J Affect Disord 2021; 287:354-358. [PMID: 33819734 DOI: 10.1016/j.jad.2021.03.039] [Citation(s) in RCA: 5] [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: 05/27/2020] [Revised: 01/28/2021] [Accepted: 03/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Metrics of journal's impact factor may suggest the journal's influence in a particular field, but they have been used inadvertently as a measure of the journal and individual publications' scientific quality. METHODS We assessed how scientific journals in the field of psychiatry and mental health are ranked (top 20) according to the scores of distinct metrics (Eigenfactor score, Google Scholar Metrics, Journal Citation Reports, Scimago Journal & Country Rank, and Source Normalized Impact per Paper), described their main characteristics and perfomed a spearman's correlation analyses to investigate to which extent these metrics are associated. We also discussed the limitations of dealing with these metrics and the rankings they provide as a proxy of the journal's quality. RESULTS Only 5 (12.5%) journals appear in all metrics (JAMA Psychiatry, American Journal of Psychiatry, Molecular Psychiatry, Schizophrenia Bulletin, and the Journal of Child Psychology and Psychiatry), more than one-third of the journals show up in only one and less than half (42.5%) appear in three or more. Only JAMA Psychiatry is in one of the first five positions of all metrics. No journal ranked in the same position across the metrics. On the other hand, we found the correlations between all the metrics were statistically significant. LIMITATIONS The metrics included are not exhaustive. CONCLUSIONS Although each metric provides a particular ranking, they are highly correlated. Rankings also change according to distinct subject categories in which they are assessed. We suggest less emphasis should be given to Journal Metrics to infer journal's quality.
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Affiliation(s)
- Alexandre Paim Diaz
- Louis. A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054
| | - Jair C Soares
- Louis. A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Sudhakar Selvaraj
- Louis. A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054.
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Serpa ALDO, Costa DS, Ferreira CDMC, Pinheiro MIC, Diaz AP, de Paula JJ, Miranda DM, da Silva AG, Malloy-Diniz LF. Psychometric properties of the Brief Symptom Inventory support the hypothesis of a general psychopathological factor. Trends Psychiatry Psychother 2021; 44:e20210207. [PMID: 33760429 PMCID: PMC9972890 DOI: 10.47626/2237-6089-2021-0207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/15/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The existence of a general factor related to psychiatric symptoms is supported by studies using a variety of methods in both clinical and non-clinical samples. OBJECTIVES This study aims to evaluate the replicability of the internal structure of the Brief Symptom Inventory in a large Brazilian sample. METHODS Participants were 6,427 Brazilian subjects (81% female). Mean age was 42.1 years (standard deviation [SD] = 13.6, Min = 13, Max = 80). All participants completed the online version of the Brief Symptom Inventory. This scale presents a general score (GSI) and nine specific clusters of symptoms (depression, anxiety, phobic anxiety, interpersonal sensibility, psychoticism, paranoid ideation, obsessive-compulsive behavior, hostility, and somatization symptoms). RESULTS Confirmatory factor analysis was performed to assess the factor structure of the BSI. The results showed that the best-fitting model was a bifactor solution and the general factor was the main dimension explaining most of the reliable variability in the data. CONCLUSION The findings suggest that the BSI's internal structure was replicated in a non-clinical sample and that the general factor is the most reliable score. However, it is necessary to better understand the meaning of the general factor scores in a non-clinical sample to increase interpretability of scores.
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Affiliation(s)
- Alexandre Luiz de Oliveira Serpa
- Laboratório de Neurociências Cognitiva e SocialUniversidade Presbiteriana MackenzieSão PauloSPBrazilLaboratório de Neurociências Cognitiva e Social, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil.,MetacognitivSão PauloSPBrazilMetacognitiv, São Paulo, SP, Brazil.
| | - Danielle Souza Costa
- Laboratório de NeurociênciasFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrazilLaboratório de Neurociências, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | | | - Mayra Isabel C. Pinheiro
- SGTESMinistério da SaúdeBrasíliaDFBrazil Secretaria de Gestão do Trabalho e da Educação na Saúde (SGTES), Ministério da Saúde, Brasília, DF, Brazil.
| | - Alexandre Paim Diaz
- Department of Psychiatry and Behavioral SciencesThe University of Texas Health Science Center at HoustonHoustonTXUSA Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Jonas Jardim de Paula
- MetacognitivSão PauloSPBrazilMetacognitiv, São Paulo, SP, Brazil.,Departamento de PsicologiaFaculdade de Ciências Médicas de Minas GeraisBelo HorizonteMGBrazilDepartamento de Psicologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Debora Marques Miranda
- Departamento de PediatriaFaculdade de MedicinaUFMGBelo HorizonteMGBrazilDepartamento de Pediatria, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil.
| | - Antônio Geraldo da Silva
- Associação Brasileira de PsiquiatriaRio de JaneiroRJBrazilAssociação Brasileira de Psiquiatria, Rio de Janeiro, RJ, Brazil.,Universidade do PortoPortoPortugalUniversidade do Porto, Porto, Portugal.
| | - Leandro Fernandes Malloy-Diniz
- Universidade FUMECBelo HorizonteMGBrazilUniversidade FUMEC, Belo Horizonte, MG, Brazil.,Departamento de Saúde MentalFaculdade de MedicinaUFMGBelo HorizonteMGBrazilDepartamento de Saúde Mental, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil.
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Diaz AP, Cuellar VA, Vinson EL, Suchting R, Durkin K, Fernandes BS, Scaini G, Kazimi I, Zunta-Soares GB, Quevedo J, Sanches M, Soares JC. The Greater Houston Area Bipolar Registry-Clinical and Neurobiological Trajectories of Children and Adolescents With Bipolar Disorders and High-Risk Unaffected Offspring. Front Psychiatry 2021; 12:671840. [PMID: 34149481 PMCID: PMC8211873 DOI: 10.3389/fpsyt.2021.671840] [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: 02/24/2021] [Accepted: 05/05/2021] [Indexed: 12/02/2022] Open
Abstract
The aims of this article are to discuss the rationale, design, and procedures of the Greater Houston Area Bipolar Registry (HBR), which aims at contributing to the effort involved in the investigation of neurobiological mechanisms underlying bipolar disorder (BD) as well as to identify clinical and neurobiological markers able to predict BD clinical course. The article will also briefly discuss examples of other initiatives that have made fundamental contributions to the field. This will be a longitudinal study with participants aged 6-17 at the time of enrollment. Participants will be required to meet diagnostic criteria for BD, or to be offspring of a parent with BD. We will also enroll healthy controls. Besides clinical information, which includes neurocognitive performance, participants will be asked to provide blood and saliva samples as well as to perform neuroimaging exams at baseline and follow-ups. Several studies point to the existence of genetic, inflammatory, and brain imaging alterations between individuals at higher genetic risk for BD compared with healthy controls. Longitudinal designs have shown high conversion rates to BD among high-risk offspring, with attempts to identify clinical predictors of disease onset, as well as clarifying the burden associated with environmental stressors. The HBR will help in the worldwide effort investigating the clinical course and neurobiological mechanisms of affected and high-risk children and adolescents with BD.
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Affiliation(s)
- Alexandre Paim Diaz
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Valeria A Cuellar
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Elizabeth L Vinson
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Robert Suchting
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Kathryn Durkin
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Brisa S Fernandes
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Giselli Scaini
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Iram Kazimi
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Methodist Hospital, Houston, TX, United States
| | - Giovana B Zunta-Soares
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - João Quevedo
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, United States.,Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Marsal Sanches
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jair C Soares
- Center of Excellence on Mood Disorders, McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
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da Silva AG, Miranda DM, Diaz AP, Teles ALS, Malloy-Diniz LF, Palha AP. Mental health: why it still matters in the midst of a pandemic. ACTA ACUST UNITED AC 2020; 42:229-231. [PMID: 32267344 PMCID: PMC7236155 DOI: 10.1590/1516-4446-2020-0009] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Antônio Geraldo da Silva
- Universidade do Porto, Porto, Portugal. Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil. Asociación Psiquiátrica de América Latina (APAL), Brasília, DF, Brazil
| | | | - Alexandre Paim Diaz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | - Antônio Pacheco Palha
- Universidade do Porto, Porto, Portugal. Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil. Asociación Psiquiátrica de América Latina (APAL), Brasília, DF, Brazil
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19
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Borges GBM, Eidt I, Zilli LN, Michels AMMP, Diaz AP. Defense mechanisms and quality of life of medical students according to graduation phase. Trends Psychiatry Psychother 2020; 42:74-81. [DOI: 10.1590/2237-6089-2019-0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 06/27/2019] [Indexed: 11/22/2022]
Affiliation(s)
| | - Ingrid Eidt
- Universidade Federal de Santa Catarina, Brazil
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Diaz AP, da Silva AG. Dissemination science for prevention of adverse health outcomes from cannabis use. Braz J Psychiatry 2019; 41:477-478. [PMID: 31826095 PMCID: PMC6899359 DOI: 10.1590/1516-4446-2019-4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Alexandre Paim Diaz
- Núcleo de Psiquiatria, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
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21
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Areas FZ, Schwarzbold ML, Diaz AP, Rodrigues IK, Sousa DS, Ferreira CL, Quevedo J, Lin K, Kupek E, Ritter C, Dal Pizzol F, Walz R. Predictors of Hospital Mortality and the Related Burden of Disease in Severe Traumatic Brain Injury: A Prospective Multicentric Study in Brazil. Front Neurol 2019; 10:432. [PMID: 31105642 PMCID: PMC6494964 DOI: 10.3389/fneur.2019.00432] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/09/2019] [Indexed: 01/08/2023] Open
Abstract
Traumatic brain injury (TBI) is a worldwide social, economic, and health problem related to premature death and long-term disabilities. There were no prospective and multicentric studies analyzing the predictors of TBI related mortality and estimating the burden of TBI in Brazil. To address this gap, we investigated prospectively: (1) the hospital mortality and its determinants in patients admitted with severe TBI we analyzed in three reference centers; (2) the burden of TBI estimated by the years of life lost (YLLs) due to premature death based on the hospital mortality considering the hospital mortality. Between April 2014 and January 2016 (22 months), all the 266 patients admitted with Glasgow coma scale (GCS), ≤ 8 admitted in three TBI reference centers were included in the study. These centers cover a population of 1,527,378 population of the Santa Catarina state, Southern Brazil. Most patients were male (n = 230, 86.5%), with a mean (SD) age of 38 (17) years. Hospital mortality was 31.1% (n = 83) and independently associated with older age, worse cranial CT injury by the Marshall classification, the presence of subarachnoid hemorrhage in the CT, lower GCS scores and abnormal pupils at admission. The final multiple logistic regression model including these variables showed an overall accuracy for hospital mortality of 77.9% (specificity 88.6%, sensitivity 53.8%, PPV 67.7%, and NPV 81.1%). The estimated annual incidence of hospitalizations and mortality due to severe TBI were 9.5 cases and 5.43 per 100,000 inhabitants, respectively. The estimated YLLs in 22 months, in the 2 metropolitan areas were 2,841, corresponding to 1,550 YLLs per year and 101.5 YLLs per 100,000 people every year. The hospital mortality did not change significantly since the end of the 1990s and was similar to other centers in Brazil and Latin America. Significant predictors of hospital mortality were the same as those of studies worldwide, but their strength of association seemed to differ according to countries income. Present study results question the extrapolation of TBI hospital mortality models for high income to lower- and middle-income countries and therefore have implications for TBI multicentric trials including countries with different income levels.
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Affiliation(s)
- Fernando Zanela Areas
- Centro de Neurociências Aplicadas, Universidade Federal de Santa Catarina, Hospital Universitário, Florianópolis, Brazil.,Programa de Pós-Graduação em Neurociências, UFSC, Florianópolis, Brazil
| | - Marcelo Liborio Schwarzbold
- Centro de Neurociências Aplicadas, Universidade Federal de Santa Catarina, Hospital Universitário, Florianópolis, Brazil.,Programa de Pós-Graduação em Neurociências, UFSC, Florianópolis, Brazil.,Programa de Pós-Graduação em Ciências Médicas, UFSC, Florianópolis, Brazil.,Serviço de Psiquiatria, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Alexandre Paim Diaz
- Centro de Neurociências Aplicadas, Universidade Federal de Santa Catarina, Hospital Universitário, Florianópolis, Brazil.,Serviço de Psiquiatria, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Igor Kunze Rodrigues
- Programa de Pós-Graduação em Ciências Médicas, UFSC, Florianópolis, Brazil.,Serviço de Neurocirurgia, HU, UFSC, Florianópolis, Brazil.,Serviço de Neurocirurgia, Hospital Regional de São José Homero de Miranda Gomes, São José, Brazil
| | - Daniel Santos Sousa
- Programa de Pós-Graduação em Ciências Médicas, UFSC, Florianópolis, Brazil.,Serviço de Neurocirurgia, Hospital Governado Celso Ramos, Florianópolis, Brazil
| | - Camila Leite Ferreira
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | - João Quevedo
- Laboratório de Neurociências, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma, Brazil.,Department of Psychiatry and Behavioral Sciences McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Katia Lin
- Centro de Neurociências Aplicadas, Universidade Federal de Santa Catarina, Hospital Universitário, Florianópolis, Brazil.,Programa de Pós-Graduação em Ciências Médicas, UFSC, Florianópolis, Brazil.,Serviço de Neurologia, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Emil Kupek
- Programa de Pós-Graduação em Ciências Médicas, UFSC, Florianópolis, Brazil.,Departmento de Saúde Pública, UFSC, Florianópolis, Brazil
| | - Cristiane Ritter
- Hospital São José, Criciúma, Brazil.,Laboratório de Fisiopatologia Experimental, Programa de Pós-Graduação em Ciências da Saúde, UNESC, Criciúma, Brazil
| | - Felipe Dal Pizzol
- Programa de Pós-Graduação em Ciências Médicas, UFSC, Florianópolis, Brazil.,Hospital São José, Criciúma, Brazil.,Laboratório de Fisiopatologia Experimental, Programa de Pós-Graduação em Ciências da Saúde, UNESC, Criciúma, Brazil
| | - Roger Walz
- Centro de Neurociências Aplicadas, Universidade Federal de Santa Catarina, Hospital Universitário, Florianópolis, Brazil.,Programa de Pós-Graduação em Neurociências, UFSC, Florianópolis, Brazil.,Programa de Pós-Graduação em Ciências Médicas, UFSC, Florianópolis, Brazil.,Serviço de Neurologia, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
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Zingano BDL, Guarnieri R, Diaz AP, Schwarzbold ML, Wolf P, Lin K, Walz R. Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) and The State-Trait Anxiety Inventory (STAI) accuracy for anxiety disorders detection in drug-resistant mesial temporal lobe epilepsy patients. J Affect Disord 2019; 246:452-457. [PMID: 30599368 DOI: 10.1016/j.jad.2018.12.072] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/18/2018] [Accepted: 12/23/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is the most prevalent type of surgically remediable epilepsy and highly associated with psychiatric comorbidities. This study aimed to evaluate Hospital anxiety and depression scale-anxiety subscale (HADS-A) and The State-Trait Anxiety Inventory - Trait subscale (STAI-T) accuracy for detection of anxiety disorders in patients with drug-resistant MTLE-HS. METHODS One hundred three consecutive patients with drug-resistant MTLE-HS were enrolled. Diagnosis was based on the anamnesis, neurological examination, video-electroencephalogram (VEEG) analyses, and magnetic resonance imaging (MRI). Psychiatric interviews were based on DSM-IV-TR criteria and ILAE Commission of Psychobiology classification as a gold standard; HADS-A and STAI-T were used as psychometric diagnostic tests, and receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores. RESULTS The areas under the curve (AUCs) were higher than 0.7 (0.6-0.8) for both scales. The STAI-T cutoff point of ˃53 and the HADS-A cutoff point of ˃7 showed both around of 80% (44.4-97.7) sensitivity and 80% (66.9-86.9) and 60% (46.5-68.6) of specificity, respectively. In this sample the prevalence of anxiety disorders was 11.7% and both scales showed a high negative predictive value such as 96% (87.1-99.0) but low positive predictive value such as 30% (22.1-45.2) and 20% (15.0-27.2) respectively. LIMITATIONS The small number of cases in the diagnostic population; the results are only applied to drug resistant MTLE-HS; the psychiatric diagnosis were not based on a structured psychiatric interview; possible observer bias in 7 illiterate patients; the antidepressant treatment was not controlled. CONCLUSIONS In MTLE-HS, STAI-T and HADS-A had a similar and low positive predictive value and high negative predictive value. The implications for the HADS-A and STAI-T usefulness for anxiety disorders screening in patients with other epilepsies types deserve further investigations. If replicated in other populations, these findings may have important relevance for the presurgical screening of anxiety disorders in MTLE-HS patients who are candidates to epilepsy surgery.
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Affiliation(s)
- Bianca de Lemos Zingano
- Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Serviço de Psiquiatria, Hospital Governador Celso Ramos (HGCR), Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), HU, UFSC, Florianópolis, SC, Brazil.
| | - Ricardo Guarnieri
- Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), HU, UFSC, Florianópolis, SC, Brazil; Serviço de Psiquiatria, HU-UFSC, Florianópolis, SC, Brazil
| | - Alexandre Paim Diaz
- Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), HU, UFSC, Florianópolis, SC, Brazil; Serviço de Psiquiatria, HU-UFSC, Florianópolis, SC, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade do Sul de Santa Catarina (UNISUL), Palhoça, SC, Brazil
| | - Marcelo Libório Schwarzbold
- Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), HU, UFSC, Florianópolis, SC, Brazil; Serviço de Psiquiatria, HU-UFSC, Florianópolis, SC, Brazil
| | - Peter Wolf
- Serviço de Neurologia, HU-UFSC, Florianópolis, SC, Brazil; Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil; Danish Epilepsy Center, Dianalund, Denmark
| | - Katia Lin
- Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), HU, UFSC, Florianópolis, SC, Brazil; Serviço de Neurologia, HU-UFSC, Florianópolis, SC, Brazil; Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil
| | - Roger Walz
- Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), HU, UFSC, Florianópolis, SC, Brazil; Serviço de Neurologia, HU-UFSC, Florianópolis, SC, Brazil; Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil
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23
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da Silva AG, Malloy-Diniz LF, Garcia MS, Figueiredo CGS, Figueiredo RN, Diaz AP, Palha AP. Cognition As a Therapeutic Target in the Suicidal Patient Approach. Front Psychiatry 2018; 9:31. [PMID: 29487542 PMCID: PMC5816899 DOI: 10.3389/fpsyt.2018.00031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 11/12/2017] [Accepted: 01/26/2018] [Indexed: 12/16/2022] Open
Abstract
The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt suicide. Understanding cognitive changes in patients who attempt suicide open an important perspective in the approach of patients with mental disorders. Identifying cognitive deficits in these patients, along with personality traits, depressive symptoms, and suicidal cognitive schemas may indicate to the psychiatrist the need for emergency care. Behavioral and cognitive interventions have been associated with reductions in suicide ideation, as well as suicide attempts in different populations.
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Affiliation(s)
| | | | - Marina Saraiva Garcia
- Molecular Medicine Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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24
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Hohl A, Zanela FA, Ghisi G, Ronsoni MF, Diaz AP, Schwarzbold ML, Dafre AL, Reddi B, Lin K, Pizzol FD, Walz R. Luteinizing Hormone and Testosterone Levels during Acute Phase of Severe Traumatic Brain Injury: Prognostic Implications for Adult Male Patients. Front Endocrinol (Lausanne) 2018; 9:29. [PMID: 29487565 PMCID: PMC5816813 DOI: 10.3389/fendo.2018.00029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/07/2017] [Accepted: 01/22/2018] [Indexed: 12/28/2022] Open
Abstract
Traumatic brain injury (TBI) is a worldwide core public health problem affecting mostly young male subjects. An alarming increase in incidence has turned TBI into a leading cause of morbidity and mortality in young adults as well as a tremendous resource burden on the health and welfare sector. Hormone dysfunction is highly prevalent during the acute phase of severe TBI. In particular, investigation of the luteinizing hormone (LH) and testosterone levels during the acute phase of severe TBI in male has identified a high incidence of low testosterone levels in male patients (36.5-100%) but the prognostic significance of which remains controversial. Two independent studies showed that normal or elevated levels of LH levels earlier during hospitalization are significantly associated with higher mortality/morbidity. The association between LH levels and prognosis was independent of other predictive variables such as neuroimaging, admission Glasgow coma scale, and pupillary reaction. The possible mechanisms underlying this association and further research directions in this field are discussed. Overall, current data suggest that LH levels during the acute phase of TBI might contribute to accurate prognostication and further prospective multicentric studies are required to develop more sophisticated predictive models incorporating biomarkers such as LH in the quest for accurate outcome prediction following TBI. Moreover, the potential therapeutic benefits of modulating LH during the acute phase of TBI warrant investigation.
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Affiliation(s)
- Alexandre Hohl
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Serviço de Endocrinologia e Metabologia, Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Fernando Areas Zanela
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriela Ghisi
- Serviço de Endocrinologia e Metabologia, Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Marcelo Fernando Ronsoni
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Serviço de Endocrinologia e Metabologia, Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Alexandre Paim Diaz
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Serviço de Psiquiatria, Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Marcelo Liborio Schwarzbold
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Serviço de Psiquiatria, Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Alcir Luiz Dafre
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Departamento de Bioquímica, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Benjamin Reddi
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Kátia Lin
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Serviço de Neurologia, Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Felipe Dal Pizzol
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Laboratório de Fisiopatologia Experimental, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, Brazil
| | - Roger Walz
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Serviço de Neurologia, Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- *Correspondence: Roger Walz,
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25
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Pauli C, de Oliveira Thais MER, Guarnieri R, Schwarzbold ML, Diaz AP, Ben J, Linhares MN, Markowitsch HJ, Wolf P, Wiebe S, Lin K, Walz R. Decline in word-finding: The objective cognitive finding most relevant to patients after mesial temporal lobe epilepsy surgery. Epilepsy Behav 2017; 75:218-224. [PMID: 28867574 DOI: 10.1016/j.yebeh.2017.08.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/24/2017] [Accepted: 08/04/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to investigate the following: i) the objective impairment in neuropsychological tests that were associated with the subjective perception of cognitive function decline in Brazilian patients who underwent mesial temporal lobe epilepsy (MTLE) surgery and ii) the predictive variables for those impaired objective neuropsychological tests. METHODS Forty-eight adults with MTLE (27 right HS and 23 male) were divided according to their perception of changes (Decline or No-decline) of cognitive function domain of the QOLIE-31 questionnaire applied before and 1year after the ATL. The mean (SD) of changes in the raw score difference of the neuropsychological tests before and after the ATL was compared between Decline and No-decline groups. Receiver Operating Characteristic curves, sensitivity, specificity, and predictive values were used to assess the optimum cutoff points of neuropsychological test score changes to predict patient-reported subjective cognitive decline. KEY FINDINGS Six (12.5%) patients reported a perception of cognitive function decline after ATL. Among the 25 cognitive tests analyzed, only changes in the Boston Naming Test (BNT) were associated with subjective cognitive decline reported by patients. A reduction of ≥8 points in the raw score of BNT after surgery had 91% of sensitivity and 45% specificity for predicting subjective perception of cognitive function decline by the patient. Left side surgery and age older than 40years were more associated with an important BNT reduction with overall accuracy of 91.7%, 95% predictive ability for no impairment, and 75% for impairment of cognitive function. SIGNIFICANCE Impairment in word-finding seems to be the objective cognitive finding most relevant to Brazilian patients after mesial temporal lobe epilepsy surgery. Similar to American patients, the side of surgery and age are good predictors for no decline in the BNT, but shows a lower accuracy to predict its decline. If replicated in other populations, the results may have wider implications for the surgical management of patients with drug-resistant MTLE.
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Affiliation(s)
- Carla Pauli
- Serviço de Neurocirurgia, Hospital Governador Celso Ramos, Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | | | - Ricardo Guarnieri
- Serviço de Neurocirurgia, Hospital Governador Celso Ramos, Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Serviço de Psiquiatria, Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil
| | - Marcelo Liborio Schwarzbold
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Serviço de Psiquiatria, Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil
| | - Alexandre Paim Diaz
- Serviço de Neurocirurgia, Hospital Governador Celso Ramos, Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Serviço de Psiquiatria, Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil
| | - Juliana Ben
- Serviço de Neurocirurgia, Hospital Governador Celso Ramos, Florianópolis, SC, Brazil
| | - Marcelo Neves Linhares
- Serviço de Neurocirurgia, Hospital Governador Celso Ramos, Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Departamento de Cirurgia, Serviço de Neurocirurgia, HU-UFSC, Florianópolis, SC, Brazil; Centro de Epilepsia de Santa Catarina (CEPESC), HU-UFSC, Florianópolis, SC, Brazil
| | | | - Peter Wolf
- Serviço de Neurologia, Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil; Centro de Epilepsia de Santa Catarina (CEPESC), HU-UFSC, Florianópolis, SC, Brazil; Danish Epilepsy Centre, Dianalund, Denmark
| | - Samuel Wiebe
- Department of Clinical Neurosciences, University of Calgary, Canada
| | - Katia Lin
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Serviço de Neurologia, Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil; Centro de Epilepsia de Santa Catarina (CEPESC), HU-UFSC, Florianópolis, SC, Brazil
| | - Roger Walz
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Serviço de Neurologia, Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil; Centro de Epilepsia de Santa Catarina (CEPESC), HU-UFSC, Florianópolis, SC, Brazil.
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Niehues GD, Balan AB, Prá VB, Pellizzaro RS, da Silva PRA, Niehues MD, Costa AP, Schwarzbold ML, Diaz AP. Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study. Trends Psychiatry Psychother 2017; 39:158-164. [PMID: 28767928 DOI: 10.1590/2237-6089-2016-0053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 04/03/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS). Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. OBJECTIVE To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. METHODS In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico) and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10) diagnoses during the study period were considered to be possible confounders. RESULTS A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75). CONCLUSION Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.
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Affiliation(s)
| | | | - Vinicius Brum Prá
- Instituto de Psiquiatria de Santa Catarina (IPQ/SC), São José, SC, Brazil
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Pauli C, Schwarzbold ML, Diaz AP, de Oliveira Thais MER, Kondageski C, Linhares MN, Guarnieri R, de Lemos Zingano B, Ben J, Nunes JC, Markowitsch HJ, Wolf P, Wiebe S, Lin K, Walz R. Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study. Epilepsia 2017; 58:755-763. [PMID: 28332703 DOI: 10.1111/epi.13721] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate prospectively the independent predictors of a minimum clinically important change (MCIC) in quality of life (QOL) after anterior temporal lobectomy (ATL) for drug-resistant mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) in Brazilian patients. METHODS Multiple binary logistic regression analysis was performed to identify the clinical, demographic, radiologic, and electrophysiologic variables independently associated with MCIC in the Quality of Life in Epilepsy-31 Inventory (QOLIE-31) overall score 1 year after ATL in 77 consecutive patients with unilateral MTLE-HS. RESULTS The overall QOLIE-31 score and all its subscale scores increased significantly (p < 0.0001) 1 year after ATL. In the final logistic regression model, absence of presurgical diagnosis of depression (adjusted odds ratio [OR] 4.4, 95% confidence interval [CI] 1.1-16.1, p = 0.02) and a complete postoperative seizure control (adjusted OR 4.1, 95% CI 1.2-14.5, p = 0.03) were independently associated with improvement equal to or greater than the MCIC in QOL after ATL. The overall model accuracy for MCIC improvement in the QOL was 85.6%, with a 95.2% of sensitivity and 46.7% of specificity. SIGNIFICANCE These results in Brazilian patients reinforce the external validation of previous findings in Canadian patients showing that presurgical depression and complete seizure control after surgery are independent predictors for meaningful improvement in QOL after ATL, and have implications for the surgical management of MTLE patients.
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Affiliation(s)
- Carla Pauli
- Center for Epilepsy Surgery of Santa Catarina State (CEPESC), Governador Celso Ramos Hospital (HGCR), Florianópolis, Santa Catarina, Brazil.,Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Marcelo Liborio Schwarzbold
- Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Psychiatric Division, Department of Internal Medicine, HU, UFSC, Florianópolis, Santa Catarina, Brazil
| | - Alexandre Paim Diaz
- Center for Epilepsy Surgery of Santa Catarina State (CEPESC), Governador Celso Ramos Hospital (HGCR), Florianópolis, Santa Catarina, Brazil.,Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Psychiatric Division, Department of Internal Medicine, HU, UFSC, Florianópolis, Santa Catarina, Brazil
| | | | - Charles Kondageski
- Center for Epilepsy Surgery of Santa Catarina State (CEPESC), Governador Celso Ramos Hospital (HGCR), Florianópolis, Santa Catarina, Brazil.,Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Department of Surgery, HU, UFSC, Florianópolis, Santa Catarina, Brazil
| | - Marcelo Neves Linhares
- Center for Epilepsy Surgery of Santa Catarina State (CEPESC), Governador Celso Ramos Hospital (HGCR), Florianópolis, Santa Catarina, Brazil.,Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Department of Surgery, HU, UFSC, Florianópolis, Santa Catarina, Brazil
| | - Ricardo Guarnieri
- Center for Epilepsy Surgery of Santa Catarina State (CEPESC), Governador Celso Ramos Hospital (HGCR), Florianópolis, Santa Catarina, Brazil.,Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Psychiatric Division, Department of Internal Medicine, HU, UFSC, Florianópolis, Santa Catarina, Brazil
| | - Bianca de Lemos Zingano
- Center for Epilepsy Surgery of Santa Catarina State (CEPESC), Governador Celso Ramos Hospital (HGCR), Florianópolis, Santa Catarina, Brazil.,Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Juliana Ben
- Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Jean Costa Nunes
- Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Laboratory of Neuropathology, Pathology Division, HU, UFSC, Florianópolis, Santa Catarina, Brazil
| | | | - Peter Wolf
- Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Neurology Division, Department of Internal Medicine, HU, UFSC, Florianópolis, Santa Catarina, Brazil.,Danish Epilepsy Centre, Dianalund, Denmark
| | - Samuel Wiebe
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Katia Lin
- Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Neurology Division, Department of Internal Medicine, HU, UFSC, Florianópolis, Santa Catarina, Brazil
| | - Roger Walz
- Center for Applied Neurosciences (CeNAp), University Hospital (HU), Federal University of Santa Catarina State (UFSC), Florianópolis, Santa Catarina, Brazil.,Neurology Division, Department of Internal Medicine, HU, UFSC, Florianópolis, Santa Catarina, Brazil
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Moritz B, Schwarzbold ML, Guarnieri R, Diaz AP, Rodrigues ALS, Dafre AL. Effects of ascorbic acid on anxiety state and affect in a non-clinical sample. Acta Neurobiol Exp (Wars) 2017. [DOI: 10.21307/ane-2017-068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Moritz B, Schwarzbold ML, Guarnieri R, Diaz AP, S Rodrigues AL, Dafre AL. Effects of ascorbic acid on anxiety state and affect in a non-clinical sample. Acta Neurobiol Exp (Wars) 2017; 77:362-372. [PMID: 29369301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED Objective Given that the literature data indicates that ascorbic acid may have an anxiolytic effect, we hypothesized that a single oral administration of ascorbic acid could acutely affect emotional states. Methods The effects of acid ascorbic supplementation on anxiety and other emotional states were evaluated by the State‑Trait Anxiety Inventory (STAI), and Visual Analogue Mood Scale (VAMS). Immediately before, and 2 hours after receiving a single ascorbic acid dose (1000 mg) or placebo, 142 graduate students were evaluated by the STAI and VAMS in a randomized, double‑blind, placebo‑controlled trial. Results No changes from basal levels were observed in the STAI state‑anxiety or VAMS scores. However, the ingestion of ascorbic acid by the 25% more anxious healthy subjects (women; 14 control and 23 ascorbic acid), as defined by the STAI trait‑anxiety scale, produced a significant reduction from baseline anxiety scores in the STAI state‑anxiety scale and VAMS anxiety subscale. The study evaluated a small sample with narrow sociodemographic characteristics, composed mainly of healthy young females (> 94%) enrolled in post‑graduation courses, without controlling diet, physical activity, and formal psychiatric diagnosis. CONCLUSIONS Despite the sample size limitation, this study provides the first evidence of an acute anxiolytic effect of ascorbic acid. Broader population studies are required to evaluate the clinical relevance of presented data.
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Affiliation(s)
- Bettina Moritz
- Department of Biochemistry, Federal University of Santa Catarina, Florianópolis, Brazil;
| | | | - Ricardo Guarnieri
- University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Alexandre Paim Diaz
- Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil; University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ana Lúcia S Rodrigues
- Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Alcir Luiz Dafre
- Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
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Lopes MW, Leal RB, Guarnieri R, Schwarzbold ML, Hoeller A, Diaz AP, Boos GL, Lin K, Linhares MN, Nunes JC, Quevedo J, Bortolotto ZA, Markowitsch HJ, Lightman SL, Walz R. A single high dose of dexamethasone affects the phosphorylation state of glutamate AMPA receptors in the human limbic system. Transl Psychiatry 2016; 6:e986. [PMID: 27959333 PMCID: PMC5290343 DOI: 10.1038/tp.2016.251] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/15/2016] [Indexed: 12/28/2022] Open
Abstract
Glucocorticoids (GC) released during stress response exert feedforward effects in the whole brain, but particularly in the limbic circuits that modulates cognition, emotion and behavior. GC are the most commonly prescribed anti-inflammatory and immunosuppressant medication worldwide and pharmacological GC treatment has been paralleled by the high incidence of acute and chronic neuropsychiatric side effects, which reinforces the brain sensitivity for GC. Synapses can be bi-directionally modifiable via potentiation (long-term potentiation, LTP) or depotentiation (long-term depression, LTD) of synaptic transmission efficacy, and the phosphorylation state of Ser831 and Ser845 sites, in the GluA1 subunit of the glutamate AMPA receptors, are a critical event for these synaptic neuroplasticity events. Through a quasi-randomized controlled study, we show that a single high dexamethasone dose significantly reduces in a dose-dependent manner the levels of GluA1-Ser831 phosphorylation in the amygdala resected during surgery for temporal lobe epilepsy. This is the first report demonstrating GC effects on key markers of synaptic neuroplasticity in the human limbic system. The results contribute to understanding how GC affects the human brain under physiologic and pharmacologic conditions.
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Affiliation(s)
- M W Lopes
- Department of Biochemistry, Federal University of Santa Catarina, Floranópolis, Brazil
| | - R B Leal
- Department of Biochemistry, Federal University of Santa Catarina, Floranópolis, Brazil,Center for Applied Neuroscience, Hospital Universitário, Federal University of Santa Catarina, Florianópolis, Brazil
| | - R Guarnieri
- Center for Applied Neuroscience, Hospital Universitário, Federal University of Santa Catarina, Florianópolis, Brazil,Epilepsy Center of Santa Catarina, Federal University of Santa Catarina, Florianópolis, Brazil,Neurosurgery Unit, Governador Celso Ramos Hospital, Florianópolis, Brazil
| | - M L Schwarzbold
- Center for Applied Neuroscience, Hospital Universitário, Federal University of Santa Catarina, Florianópolis, Brazil,Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
| | - A Hoeller
- Department of Biochemistry, Federal University of Santa Catarina, Floranópolis, Brazil
| | - A P Diaz
- Center for Applied Neuroscience, Hospital Universitário, Federal University of Santa Catarina, Florianópolis, Brazil,Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
| | - G L Boos
- Anesthesiology Division, Hospital Governador Celso Ramos, Florianópolis, Brazil
| | - K Lin
- Center for Applied Neuroscience, Hospital Universitário, Federal University of Santa Catarina, Florianópolis, Brazil,Epilepsy Center of Santa Catarina, Federal University of Santa Catarina, Florianópolis, Brazil,Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
| | - M N Linhares
- Center for Applied Neuroscience, Hospital Universitário, Federal University of Santa Catarina, Florianópolis, Brazil,Neurosurgery Unit, Governador Celso Ramos Hospital, Florianópolis, Brazil,Department of Surgery, HU, Federal University of Santa Catarina, Florianópolis, Brazil
| | - J C Nunes
- Pathology Division, HU, Federal University of Santa Catarina, Florianópolis, Brazil
| | - J Quevedo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA,Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
| | - Z A Bortolotto
- Laboratory of Neurosciences, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, Brazil,Centre for Synaptic Plasticity, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - H J Markowitsch
- Physiological Psychology, University of Bielefeld, Bielefeld, Germany
| | - S L Lightman
- Centre for Synaptic Plasticity, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK,Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - R Walz
- Center for Applied Neuroscience, Hospital Universitário, Federal University of Santa Catarina, Florianópolis, Brazil,Epilepsy Center of Santa Catarina, Federal University of Santa Catarina, Florianópolis, Brazil,Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil,Departamento de Clínica Médica, 3 andar, Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis CEP 88.040-970, Brazil. E-mail:
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Diaz AP, Freitas FC, de Oliveira Thais ME, da Silva Areas FZ, Schwarzbold ML, Debona R, Nunes JC, Guarnieri R, Martinez-Ramirez D, Prediger RD, Wagle Shukla A, Linhares MN, Walz R. Erratum to: Variables associated with physical health-related quality of life in Parkinson's disease patients presenting for deep brain stimulation. Neurol Sci 2016; 37:1839-1840. [PMID: 27562296 DOI: 10.1007/s10072-016-2695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Alexandre Paim Diaz
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive Unit 24, New York, NY, 10032, USA. .,Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil. .,Unidade de Distúrbios do Movimento, Hospital Governador Celso Ramos (HGCR), Florianópolis, SC, Brazil.
| | - Fernando Cini Freitas
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.,Unidade de Distúrbios do Movimento, Hospital Governador Celso Ramos (HGCR), Florianópolis, SC, Brazil
| | - Maria Emília de Oliveira Thais
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Fernando Zanela da Silva Areas
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Marcelo Liborio Schwarzbold
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.,Departamento de Clínica Médica, CCS, HU, UFSC, Florianópolis, SC, Brazil
| | - Rodrigo Debona
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Jean Costa Nunes
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.,Laboratório de Neuropatologia, Serviço de Patologia, HU, UFSC, Florianópolis, Brazil
| | - Ricardo Guarnieri
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Daniel Martinez-Ramirez
- Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 3450 Hull Road, Gainesville, FL, 32607, USA
| | - Rui Daniel Prediger
- Departamento de Farmacologia, Centro de Ciências Biológicas (CCB), UFSC, Florianópolis, SC, Brazil
| | - Aparna Wagle Shukla
- Department of Neurology, Center for Movement Disorders and Neurorestoration, University of Florida, 3450 Hull Road, Gainesville, FL, 32607, USA
| | - Marcelo Neves Linhares
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.,Unidade de Distúrbios do Movimento, Hospital Governador Celso Ramos (HGCR), Florianópolis, SC, Brazil
| | - Roger Walz
- Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.,Departamento de Clínica Médica, CCS, HU, UFSC, Florianópolis, SC, Brazil
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Diaz AP, Freitas FC, de Oliveira Thais ME, da Silva Areas FZ, Schwarzbold ML, Debona R, Nunes JC, Guarnieri R, Martinez-Ramirez D, Prediger RD, Wagle Shukla A, Linhares MN, Walz R. Variables associated with physical health-related quality of life in Parkinson’s disease patients presenting for deep brain stimulation. Neurol Sci 2016; 37:1831-1837. [DOI: 10.1007/s10072-016-2681-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 07/20/2016] [Indexed: 11/29/2022]
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Schwab B, Daniel HS, Lutkemeyer C, Neves JALL, Zilli LN, Guarnieri R, Diaz AP, Michels AMMP. Variables associated with health-related quality of life in a Brazilian sample of patients from a tertiary outpatient clinic for depression and anxiety disorders. Trends Psychiatry Psychother 2015; 37:202-8. [DOI: 10.1590/2237-6089-2015-0013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/07/2015] [Indexed: 11/22/2022]
Abstract
Introduction: Health-related quality of life (HRQOL) assessment tools have been broadly used in the medical context. These tools are used to measure the subjective impact of the disease on patients. The objective of this study was to evaluate the variables associated with HRQOL in a Brazilian sample of patients followed up in a tertiary outpatient clinic for depression and anxiety disorders. Method: Cross-sectional study. Independent variables were those included in a sociodemographic questionnaire and the Hospital Anxiety and Depression Scale (HADS) scores. Dependent variables were those included in the short version of the World Health Organization Quality of Life (WHOQOL-BREF) and the scores for its subdomains (overall quality of life and general health, physical health, psychological health, social relationships, and environment). A multiple linear regression analysis was used to find the variables independently associated with each outcome. Results: Seventy-five adult patients were evaluated. After multiple linear regression analysis, the HADS scores were associated with all outcomes, except social relationships (p = 0.08). Female gender was associated with poor total scores, as well as psychological health and environment. Unemployment was associated with poor physical health. Conclusion: Identifying the factors associated with HRQOL and recognizing that depression and anxiety are major factors are essential to improve the care of patients.
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Diaz AP, Schwarzbold ML, Guarnieri R, de Oliveira Thais MER, Freitas FC, da Silva Areas FZ, Linhares MN, Walz R. Letter to the Editor: Early noninvasive brain stimulation after severe TBI. J Neurosurg 2015; 123:476-7. [DOI: 10.3171/2014.12.jns142425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Vieira FCDF, Ronsoni MF, Hohl A, Claudino LS, Diaz AP, Schwarzbold ML, Guarnieri R, Nunes JC, Lin K, Walz R. How predictable is the erectile function of patients with epilepsy? Epilepsy Behav 2015; 47:61-5. [PMID: 26043165 DOI: 10.1016/j.yebeh.2015.04.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 03/09/2015] [Revised: 03/23/2015] [Accepted: 04/29/2015] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is often reported by patients with epilepsy and may be related to endocrine system abnormalities, side effects of antiepileptic drugs, psychiatric comorbidities, and family or social difficulties. AIMS This study aimed to identify independent predictor factors for ED in patients with epilepsy. MAIN OUTCOME MEASURES the five-question form of the International Index of Erectile Function (IIEF-5). METHODS Independent predictive factors for ED evaluated by the IIEF-5 questionnaire in 36 patients (mean age: 39 years) with focal epilepsy (mean: 6 seizures/month) were identified by multiple linear regression analysis. RESULTS Eight (21.1%) patients were asymptomatic. Among the symptomatic patients, 11 (28.9%) had mild dysfunction, 10 (26.3%) had moderate dysfunction, and 9 (23.7%) showed severe ED. The multiple linear regression model including family income (B=0.005; p=0.05), education levels in years (B=0.54; p=0.03), depressive symptoms determined by HADS depression subscale (B=-0.49; p=0.03), and prolactin levels (B=-0.45; p=0.07) showed a moderate association (r=0.64) with the IIEF questionnaire and explained 41% (r(2)=0.41) of its variation. CONCLUSIONS Erectile dysfunction is highly prevalent in patients with focal epilepsies. Education, depressive symptoms, and prolactin levels can predict erectile dysfunction in up to 41% of patients with epilepsy. This preliminary report justifies further efforts to make a large sample size study to identify independent biomarkers and therapeutic targets for ED treatment in patients with epilepsy.
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Affiliation(s)
| | - Marcelo Fernando Ronsoni
- Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Alexandre Hohl
- Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Lúcia Sukis Claudino
- Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Serviço de Neurologia, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Alexandre Paim Diaz
- Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Ambulatório de Transtornos Psiquiátricos Resistentes ao Tratamento Farmacológico (REFRACTA), Serviço de Psiquiatria, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Centro de Epilepsia do Estado de Santa Catarina (CEPES), Hospital Governador Celso Ramos, Florianópolis, Brazil
| | - Marcelo Libório Schwarzbold
- Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Ambulatório de Transtornos Psiquiátricos Resistentes ao Tratamento Farmacológico (REFRACTA), Serviço de Psiquiatria, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Ricardo Guarnieri
- Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Ambulatório de Transtornos Psiquiátricos Resistentes ao Tratamento Farmacológico (REFRACTA), Serviço de Psiquiatria, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Centro de Epilepsia do Estado de Santa Catarina (CEPES), Hospital Governador Celso Ramos, Florianópolis, Brazil
| | - Jean Costa Nunes
- Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Unidade de Neuropatologia, Serviço de Patologia, HU, UFSC, Florianópolis, Brazil
| | - Kátia Lin
- Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Serviço de Neurologia, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil
| | - Roger Walz
- Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil; Serviço de Neurologia, Departamento de Clínica Médica, HU, UFSC, Florianópolis, Brazil.
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Hohl A, Ronsoni MF, Debona R, Ben J, Schwarzbold ML, Diaz AP, Thais MERDO, Linhares MN, Latini A, Prediger RD, Pizzol FD, Walz R. Role of hormonal levels on hospital mortality for male patients with severe traumatic brain injury. Brain Inj 2014; 28:1262-9. [PMID: 24841415 DOI: 10.3109/02699052.2014.915986] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 11/13/2022]
Abstract
INTRODUCTION Changes in hormone blood levels during the acute phase of traumatic brain injury (TBI) have been described in the literature. The objective was to investigate the association among several hormones plasma levels in the acute phase of severe TBI and the hospital mortality rate of male patients. METHODS The independent association among plasma levels of TSH, LH, FSH, GH, free T4, cortisol, IGF-1 and total testosterone was measured 10 hours and 30 hours after severe TBI and the hospital mortality of 60 consecutive male patients was evaluated. RESULTS At least one hormonal level abnormality was demonstrated in 3.6-73.1% of patients. The multiple logistic regressions showed a trend for an independent association among hospital mortality and normal or elevated LH levels measured at 10 hours (OR = 3.7, 95% CI = 0.8-16.3, p = 0.08) and 30 hours (OR = 3.9, 95% CI = 0.9-16.7, p = 0.06). Admission with abnormal pupils and a lower Glasgow Coma Score also were independently associated with hospital mortality. CONCLUSION The hormonal changes are frequent in the acute phase of severe TBI. The hormones plasma levels, excepting the LH, are not highly consistent with the hospital mortality of male patients.
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Nunes JC, Costa Bergamaschi EN, Freitas FC, Diaz AP, Queiroz LP, Debona R, Prediger RDS, Linhares MN, Lin K, Walz R. Prevalence of headache in patients with Parkinson's disease and its association with the side of motor symptom onset. Neurol Sci 2013; 35:595-600. [PMID: 24197331 DOI: 10.1007/s10072-013-1571-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/26/2013] [Indexed: 11/25/2022]
Abstract
We compared the lifetime prevalence and the prevalence of headache during the previous year in patients with Parkinson's disease (PD) and control subjects. We also investigated the association between the side of PD symptom onset and the side of the headache. We interviewed 98 consecutive patients with an established diagnosis of PD between December 2010 and January 2012. The control group consisted of the 98 oldest sex-matched individuals from the nationwide Brazilian headache database. PD patients showed a significantly lower prevalence (40.8%) of headache in the previous year than controls (69.4%) (adjusted OR 0.5, CI 95% 0.2-0.9, p = 0.03). PD patients also showed a lower prevalence of headache throughout life (74.5%) than controls (93.9%) (adjusted OR 0.2, CI 95% 0.1-0.6, p = 0.01). Considering only patients who presented headache during the previous year, PD patients showed a higher association with occurrence of migraine than tension-type headache compared with controls (adjusted OR 3.3, CI 95% 1.2-8.9, p = 0.02). The headache side was ipsilateral to the side of PD onset in 21 patients (84%), with a concordance of 85.7% on the left side and 81.8% on the right side (p < 0.01). The prevalence of primary headache was significantly lower in patients with PD than controls. The predominant side of headache was ipsilateral to the side of initial motor signs of PD.
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Affiliation(s)
- Jean Costa Nunes
- Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Governador Celso Ramos (HGCR), Florianópolis, SC, Brazil,
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Thais MERDO, Cavallazzi G, Schwarzbold ML, Diaz AP, Ritter C, Petronilho F, Hohl A, Prediger RDS, Linhares MN, Pizzol FD, Walz R. Plasma levels of oxidative stress biomarkers and long-term cognitive performance after severe head injury. CNS Neurosci Ther 2013; 18:606-8. [PMID: 22759269 DOI: 10.1111/j.1755-5949.2012.00346.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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de Oliveira Thais MER, Cavallazzi G, Formolo DA, de Castro LD, Schmoeller R, Guarnieri R, Schwarzbold ML, Diaz AP, Hohl A, Prediger RDS, Mader MJ, Linhares MN, Staniloiu A, Markowitsch HJ, Walz R. Limited predictive power of hospitalization variables for long-term cognitive prognosis in adult patients with severe traumatic brain injury. J Neuropsychol 2012; 8:125-39. [DOI: 10.1111/jnp.12000] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 09/16/2012] [Accepted: 09/16/2012] [Indexed: 11/27/2022]
Affiliation(s)
| | - Gisele Cavallazzi
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - Douglas Afonso Formolo
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - Lucas D'Ávila de Castro
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - Roseli Schmoeller
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - Ricardo Guarnieri
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
- Centro de Epilepsia do Estado de Santa Catarina (CEPESC); Hospital Governador Celso Ramos; Florianópolis Santa Catarina Brazil
| | - Marcelo Liborio Schwarzbold
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - Alexandre Paim Diaz
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
- Centro de Epilepsia do Estado de Santa Catarina (CEPESC); Hospital Governador Celso Ramos; Florianópolis Santa Catarina Brazil
| | - Alexandre Hohl
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - Rui D. S. Prediger
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
- Departamento de Farmacologia; Centro de Ciências Biológicas; Universidade Federal de Santa Catarina, UFSC; Florianópolis Santa Catarina Brazil
| | - Maria Joana Mader
- Hospital de Clínicas; Universidade Federal do Paraná; Curitiba Paraná Brazil
| | - Marcelo Neves Linhares
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
- Centro de Epilepsia do Estado de Santa Catarina (CEPESC); Hospital Governador Celso Ramos; Florianópolis Santa Catarina Brazil
- Unidade de Neurocirurgia; Serviço de Cirurgia; HU, UFSC; Florianópolis Santa Catarina Brazil
| | | | | | - Roger Walz
- Centro de Neurociências Aplicadas (CeNAp); Hospital Universitário (HU); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
- Centro de Epilepsia do Estado de Santa Catarina (CEPESC); Hospital Governador Celso Ramos; Florianópolis Santa Catarina Brazil
- Departamento de Clínica Médica; HU, UFSC; Florianópolis Santa Catarina Brazil
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Diaz AP, Schwarzbold ML, Thais ME, Hohl A, Bertotti MM, Schmoeller R, Nunes JC, Prediger R, Linhares MN, Guarnieri R, Walz R. Psychiatric Disorders and Health-Related Quality of Life after Severe Traumatic Brain Injury: A Prospective Study. J Neurotrauma 2012; 29:1029-37. [DOI: 10.1089/neu.2011.2089] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alexandre Paim Diaz
- Instituto de Psiquiatria do Estado de Santa Catarina (IPQ), São José, Santa Catarina, Brazil
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Ambulatório de Transtornos Psiquiátricos Resistentes ao Tratamento Farmacológico (REFRACTA), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Marcelo Liborio Schwarzbold
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Ambulatório de Transtornos Psiquiátricos Resistentes ao Tratamento Farmacológico (REFRACTA), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Maria Emilia Thais
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Alexandre Hohl
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Melina More Bertotti
- Serviço de Neurocirurgia, Hospital Governador Celso Ramos, Florianópolis, Brazil
| | - Roseli Schmoeller
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Jean Costa Nunes
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Rui Prediger
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Laboratório Experimental de Doenças Neurodegenerativas, Departamento de Farmacologia, Centro de Ciências Biológicas, UFSC, Florianópolis, Brazil
| | - Marcelo Neves Linhares
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Departamento de Cirurgia, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Serviço de Neurocirurgia, Hospital Governador Celso Ramos, Florianópolis, Brazil
| | - Ricardo Guarnieri
- Ambulatório de Transtornos Psiquiátricos Resistentes ao Tratamento Farmacológico (REFRACTA), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Departamento de Cirurgia, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Roger Walz
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
- Departamento de Clínica Médica, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
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Schneider Soares FM, Menezes de Souza N, Libório Schwarzbold M, Paim Diaz A, Costa Nunes J, Hohl A, Nunes Abreu da Silva P, Vieira J, Lisboa de Souza R, Moré Bertotti M, Schoder Prediger RD, Neves Linhares M, Bafica A, Walz R. Interleukin-10 is an independent biomarker of severe traumatic brain injury prognosis. Neuroimmunomodulation 2012; 19:377-85. [PMID: 23075771 DOI: 10.1159/000342141] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [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: 05/09/2012] [Accepted: 07/24/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cytokines have been shown to be involved in traumatic brain injury (TBI). We investigated the independent association between serum levels of IL-10 and TNF-α and hospital mortality of patients with severe TBI. METHODS Serum IL-10 and TNF-α levels were determined after a median period (interquartile range (IQ) 25-75) of 10 h (IQ 5-18) after severe TBI in 93 consecutive patients and in randomly selected patients with mild (n = 18) and moderate (n = 16) TBI. In patients with severe TBI, additional blood samples were analyzed 30 h (IQ 22-37) and 68 h (IQ 55-78) after TBI. Age, gender, computed tomography findings, Glasgow Coma Scale score (GCS) and pupil reactions at admission, associated trauma and hospital mortality were collected. RESULTS Elevated serum levels of IL-10, but not TNF-α, correlated significantly with GCS severity (R(2) coefficient, p < 0.0001) and were found to be associated with hospital mortality in patients with severe TBI. Elevated IL-10 remained associated with mortality (p = 0.01) in a subset of patients with isolated severe TBI (n = 74). Multiple logistic regression analysis showed that higher IL-10 levels (>90 pg/ml) at 10 or 30 h after TBI were 6 times (odds ratio (OR) 6.2, 95% confidence interval (CI) 1.2-25.1, p = 0.03) and 5 times (OR 5.4, 95% CI 1.2-25.1, p = 0.03), respectively, more frequently associated with hospital mortality than lower levels (<50 pg/ml), independently of age, GCS as well as pupil reactions at admission and associated trauma. CONCLUSIONS Serum IL-10 levels may be a useful marker for severe TBI prognosis.
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Gullo JDS, Bertotti MM, Silva CCP, Schwarzbold M, Diaz AP, Soares FMS, Freitas FC, Nunes J, Pinheiro JT, Morato EF, Prediger RD, Linhares MN, Walz R. Hospital mortality of patients with severe traumatic brain injury is associated with serum PTX3 levels. Neurocrit Care 2011; 14:194-9. [PMID: 20972645 DOI: 10.1007/s12028-010-9462-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a worldwide cause of morbidity and mortality. Pentraxin 3 (PTX3) is a humoral component of the innate immune system which has been studied as a marker of inflammatory, infections or cardiovascular pathologies. To investigate the association between serum levels of PTX3 and the hospital mortality of patients with severe TBI. METHODS The independent association between serum PTX3 levels after severe TBI (Glasgow Coma Scale, GCS ≤ 8) and hospital mortality was analyzed in a prospective study of 83 consecutive patients by a multiple logistic regression analysis. The leukocyte count in the same sample was analyzed as another marker of inflammatory response. RESULTS The mean age of patients was 35 years and 85% were male. Serum PTX3 levels were determined 18.0 (SD ± 17.0) h after TBI. Patients who died showed a mean serum PTX3 level of 9.95 μg/ml (SD ± 6.42) in comparison to 5.46 μg/ml (SD ± 4.87) of the survivor group (P = 0.007). Elevated serum PTX3 levels remain significantly associated with mortality (P = 0.04) in the subset of patients with isolated TBI (n = 34). There were no differences in the leukocytes count measured in the same blood sample used for PTX3 determination in survivors and non-survivors (P = 0.56). The final multiple logistic regression model including age, pupillary examination, GCS, associated trauma, and PTX3 levels shows that serum levels of PTX3 which were higher than 10 μg/ml were independently associated with the patients mortality (adjusted OR 3.06, CI 95% 1.03-9.15, P = 0.04). CONCLUSIONS Serum PTX3 levels after severe TBI are independently associated with higher hospital mortality and may be a useful marker of TBI and its prognosis.
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Affiliation(s)
- Jackson da Silva Gullo
- Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
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Diaz AP, Scalco MZ, Schwarzbold ML, Formolo DA, Stoppe Júnior A. Cognitive performance of long-term institutionalized elderly patients with schizophrenia: A case control study. Dement Neuropsychol 2011; 5:99-103. [PMID: 29213730 PMCID: PMC5619304 DOI: 10.1590/s1980-57642011dn05020007] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cognitive impairment is inherent to the ageing process. Several studies suggest that patients with late-life schizophrenia have more marked cognitive impairment. Objective The aim of this study was to compare the cognitive performance of elderly institutionalized patients with schizophrenia and institutionalized elderly control patients without neurological or psychiatric diseases, matched for age, educational level and institutionalization time. Methods The Cambridge Examination for Mental Disorders of the Elderly (CAMCOG) was used to test 10 institutionalized elderly patients with schizophrenia. Results were compared with those of 10 institutionalized control patients with history of Hansen's disease. Results Patients with schizophrenia showed a worse performance in terms of total CAMCOG score and on its subtests of orientation, language, abstraction, and memory (p≤0.05). Patients with schizophrenia also disclosed a non-significant trend toward lower scores on the MMSE and on calculus. Conclusion Findings demonstrated that schizophrenia was associated to worse cognitive impairment in long-term institutionalized elderly patients compared with institutionalized patients without neurological or psychiatric diseases.
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Affiliation(s)
- Alexandre Paim Diaz
- Núcleo de Pesquisas em Neurologia Experimental e Clínica (NUPNEC), Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil and Instituto de Psiquiatria de Santa Catarina, São José SC, Brazil
| | - Monica Zavaloni Scalco
- Department of Psychiatry, University of Toronto and Whitby Mental Health Centre, Seniors Program, Canada
| | - Marcelo Libório Schwarzbold
- Núcleo de Pesquisas em Neurologia Experimental e Clínica (NUPNEC), Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil
| | - Douglas Affonso Formolo
- Núcleo de Pesquisas em Neurologia Experimental e Clínica (NUPNEC), Departamento de Clínica Médica, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil
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Affiliation(s)
- A Mesa
- Department of Anesthesiology, University of South Florida, Tampa 33612, USA
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Miguel R, Behrmann H, Diaz AP. Postdural puncture headaches in special patient populations. Anesth Analg 1999; 89:264. [PMID: 10389830 DOI: 10.1097/00000539-199907000-00069] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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