Navegando por Palavras-chave "Psychiatric disorders"

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    Are personality traits of juvenile myoclonic epilepsy related to frontal lobe dysfunctions? A proton MRS study
    (Wiley-Blackwell, 2009-05-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Lin, Katia [UNIFESP]; Lin, Jaime [UNIFESP]; Peruchi, Mirella M. [UNIFESP]; Caboclo, Luis Otavio S. F. [UNIFESP]; Guaranha, Mirian S. B. [UNIFESP]; Guilhoto, Laura M. F. F. [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Personality traits characterized by emotional instability and immaturity, unsteadiness, lack of discipline, hedonism, frequent and rapid mood changes, and indifference toward one's disease have been associated with patients who have juvenile myoclonic epilepsy (JME). Literature data demonstrate worse seizure control and more psychosocial dysfunctions among patients with JME who have those traits. in this controlled study we performed a correlation analysis of psychiatric scores with magnetic resonance spectroscopy (MRS) values across JME patients, aiming to verify the existence of a possible relation between frontal lobe dysfunction and the prevalence of personality disorders (PDs) in JME.Sixteen JME patients with cluster B PDs, 41 JME patients without any psychiatric disorder, and 30 healthy controls were submitted to a psychiatric evaluation and to a quantitative multivoxel MRS of thalamus; insula; cingulate gyrus; striatum; and frontal, parietal, and occipital lobes. Groups were homogeneous according to age, gender, and manual dominance. Psychiatric evaluation was performed through the Scheduled Clinical Interview for DSM-IV, Axis I and II (SCID I and II, respectively).A significant reduction of N-acetyl-aspartate over creatinine (NAA/Cr) ratio was observed mainly in the left frontal lobe in the JME and PD group. in addition, a significant increase in the glutamate-glutamine over creatinine GLX/Cr ratio was also observed in this referred region in the same group.These data support the hypothesis that PDs in JME could represent neuronal dysfunction and possibly a more severe form of this epileptic syndrome.
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    Are psychiatric disorders exclusion criteria for video-EEG monitoring and epilepsy surgery in patients with mesial temporal sclerosis?
    (Elsevier B.V., 2013-05-01) Conceicao, Priscila Oliveira da [UNIFESP]; Nascimento, Pedro Paulo [UNIFESP]; Mazetto, Lenon [UNIFESP]; Alonso, Neide Barreira [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Araujo Filho, Gerardo Maria de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Epilepsy surgery (ES) is a treatment option for patients with refractory temporal lobe epilepsy (TLE). However, psychiatric disorders (PDs) have been a contraindication for presurgical evaluation in many epilepsy centers. the aim of this study was to evaluate the safety of video-EEG (VEEG) and surgical outcome in patients with refractory TLE and mesial temporal sclerosis (TLE-MTS) associated with PDs. We retrospectively analyzed the clinical, sociodemographic, and VEEG data and surgery outcome of patients with refractory TLE-MTS who underwent ES over the period of 2002 to 2011 and compared data between those with and without PDs. Psychiatric evaluation was performed through DSM-IV and ILAE criteria. Safety during presurgical evaluation was analyzed by the rate of adverse events (AEs). Patients' quality of life (QOL) was measured through ESI-55 and the surgical outcome through Engel's classification. Data from 145 patients were included. the mean VEEG length (93 h) was not affected by PDs. Among patients with PDs, 4.91% (3/61) had AEs, and 13.11% (8/61) had psychogenic nonepileptic seizures (PNESs). Among patients without PDs, 4.76% (4/84) had AEs, and 5.95% (5/84) had PNESs. in the first two follow-up years, of the 94 patients who underwent ES, 65.85% (27/41) with PDs and 67.92% (36/53) without PDs became free of disabling seizures (Engel I). No significant differences were observed in the patients' QOL between both groups after surgery. the rate of AEs and seizure outcome did not differ significantly between both groups, reinforcing the idea that PDs should not be absolute exclusion criteria for VEEG monitoring and epilepsy surgery among patients with TLE-MTS. (C) 2013 Elsevier Inc. All rights reserved.
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    Clinical correlates of social adjustment in patients with obsessive-compulsive disorder
    (Elsevier B.V., 2012-10-01) Rosa, Ana Carolina; Diniz, Juliana Belo; Fossaluza, Victor; Torres, Albina Rodrigues; Fontenelle, Leonardo Franklin; De Mathis, Alice Simoes; Rosario, Maria da Conceicao [UNIFESP]; Miguel, Euripedes Constantino; Shavitt, Roseli Gedanke; Universidade de São Paulo (USP); Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP)
    Background: Patients with obsessive-compulsive disorder (OCD) frequently show poor social adjustment, which has been associated with OCD severity. Little is known about the effects that age at symptom onset, specific OCD symptoms, and psychiatric comorbidities have on social adjustment. the objective of this study was to investigate the clinical correlates of social functioning in OCD patients.Methods: Cross-sectional study involving 815 adults with a primary DSM-IV diagnosis of OCD participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were assessed with the Social Adjustment Scale, the Medical Outcomes Study 36-item Short-Form Health Survey, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Clinical correlates of social adjustment were assessed with generalized linear models with gamma distribution.Results: Poor overall social functioning was associated with greater OCD severity (p = 0.02); hoarding symptoms (p = 0.004); sexual/religious obsessions (p = 0.005); current major depressive disorder (p = 0.004); current post-traumatic stress disorder (p = 0.002); and current eating disorders (p = 0.02). Poor social adjustment was also associated with impaired quality of life.Conclusions: Patients with OCD have poor social functioning in domains related to personal relationships and professional performance. Hoarding symptoms and sexual/religious obsessions seem to have the strongest negative effects on social functioning. Early age at OCD symptom onset seems to be associated with professional and academic underachievement and impairment within the family unit, whereas current psychiatric comorbidity worsen overall social functioning. in comparison with quality of life, social adjustment measures seem to provide a more comprehensive overview of the OCD-related burden. (C) 2012 Elsevier B.V. All rights reserved.
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    A critical and descriptive approach to interictal behavior with the Neurobehavior Inventory (NBI)
    (Elsevier B.V., 2012-11-01) Oliveira, Guilherme Nogueira M. de; Kummer, Arthur; Marchetti, Renato Luiz; Araujo Filho, Gerardo Maria de [UNIFESP]; Salgado, Joao Vincius; David, Anthony S.; Teixeira, Antonio Lúcio [UNIFESP]; Hosp Felicio Rocho; Universidade Federal de Minas Gerais (UFMG); Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Kings Coll London
    Purpose: the purpose of this study was to test the psychometric properties of the Neurobehavior Inventory (NBI) in a group of temporal lobe epilepsy (TLE) patients from a tertiary care center, correlating its scores with the presence of psychiatric symptoms.Methods: Clinical and sociodemographic data from ninety-six TLE outpatients were collected, and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured psychiatric interview (MINI-PLUS), Neurobehavior Inventory (NBI), and Hamilton Depression Rating Scale (HAM-D).Results: Some traits evaluated by the NBI showed adequate internal consistency (mean inter-item correlation between 0.2 and 0.4) and were frequent, such as religiosity (74%) and repetitiveness (60.4%). Principal component analysis showed three factors, named here as emotions (Factor 1), hyposexuality (Factor 2), and unusual ideas (Factor 3). Depressive symptoms on HAM-D showed a strong association with emotions and hyposexuality factors. When patients with left TLE and right TLE were compared, the former exhibited more sadness (p=0.017), and the latter, a greater tendency toward sense of personal destiny (p=0.028).Conclusion: Depression influences NBI scoring, mainly emotionality and hyposexuality traits. Neurobehavior Inventory subscales can be better interpreted with an appropriate evaluation of comorbid mood and anxiety disorders. Compromise in left temporal mesial structures is associated with increased tendency toward sad affect, whereas right temporal pathology is associated with increased beliefs in personal destiny. (C) 2012 Elsevier Inc. All rights reserved.
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    Educação Física e Saúde Mental: Percepção de alunos da Educação Física sobre o papel e inserção da profissão no NAPS
    (Universidade Federal de São Paulo (UNIFESP), 2014-12-10) Rizzetto, Renata Silva [UNIFESP]; Braga-Campos, Florianita Coelho [UNIFESP]; http://lattes.cnpq.br/1629546162394732; http://lattes.cnpq.br/1318270904775004; Universidade Federal de São Paulo (UNIFESP)
    Este trabalho tem como tema a Educação física e a Saúde Mental. Esse estudo teve como objetivo analisar a percepção dos alunos de educação física que realizaram intervenções na rede de saúde mental de Santos no eixo Trabalho em Saúde da Universidade Federal de São Paulo (UNIFESP), em relação ao papel e inserção da educação física nos Núcleos de Apoio Psicossocisal (NAPS). Embora o Eixo Comum (Trabalho em Saúde) tem como objetivo o trabalho em equipe interdisciplinar com alunos dos seis cursos atuando juntamente, este trabalho discutirá como as participações da educação física são vistas nesta composição. Foi realizada uma entrevista semiestruturada com oito voluntários, e posteriormente foram transcritas e analisadas para recolher os depoimentos. Para a análise de dados as informações obtidas foram dividas em categorias não – apriorísticas, permitindo analisar de forma qualitativa os elementos apresentados. Foram destacados as falas dos entrevistados à partir dos aspectos mais comentados pelos autores durante estudo de referenciais teóricos sobre a temática. Os temas que se mostraram centrais foram: a vivência do comum a equipe multiprofissional do NAPS, articulação do serviço de saúde mental, papel e inserção da educação física nos NAPS. Foi possível encontrar diversos aspectos em comum citados pelos voluntários, sendo que os mesmos não apresentavam discordância em seus depoimentos em relação as temáticas abordadas. Após analisar todos os dados e realizado a discussão, conclui-se que a prática das novas concepções de cuidar e conviver com usuários no NAPS, não segue a transformação proposta. Que a oferta de outras atividades e quantidade de trabalhadores oferecidas nos NAPS é escassa, e a concepção de território em que esta o serviço e o local que os usuários estão inseridos não é considerada. Além de afirmar que a Educação Física tem importante papel a desenvolver na equipe de saúde mental, mas a sua presença na equipe multiprofissional do NAPS não é reconhecida.
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    Effects of the brain-derived neurotropic factor variant Val66Met on cortical structure in late childhood and early adolescence
    (Pergamon-Elsevier Science Ltd, 2018) Araujo, Celia Maria de [UNIFESP]; Zugman, Andre [UNIFESP]; Swardfager, Walter; Belangero, Sintia Iole [UNIFESP]; Ota, Vanessa Kiyomi [UNIFESP]; Spindola, Leticia Maria [UNIFESP]; Hakonarson, Hakon; Pellegrino, Renata; Gadelha, Ary [UNIFESP]; Salum, Giovanni Abrahao; Pan, Pedro Mario [UNIFESP]; Moura, Luciana Monteiro [UNIFESP]; Del Aquilla, Marco [UNIFESP]; Picon, Felipe Almeida; Amaro, Edson, Jr.; Sato, Joao Ricardo; Brietzke, Elisa [UNIFESP]; Grassi-Oliveira, Rodrigo; Rohde, Luis Eduardo Paim; Miguel, Euripedes Constantino; Bressan, Rodrigo Affonseca [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]
    Background: The brain-derived neurotrophic factor (BDNF) Val66Met polymorphism (rs6265) has been associated with several neuropsychiatric disorders and regional structural brain changes in adults, but little is known about Val66Met's effect on brain morphology during typical or atypical neurodevelopment. Windows of vulnerability to psychopathology may be associated with the different alleles of the Val66Met polymorphism during childhood and adolescence. Methodology: We investigated the effect of Val66Met on cortical thickness in MRI scans of 718 children and adolescents (6-12 years old) with typical development, and in those meeting DSM criteria for a psychiatric disorder. Results: Val66Met had a significant effect on cortical thickness. Considering the typically developing group, Met carriers presented thicker parietal and occipital lobes and prefrontal cortices compared to Val homozygotes. Met carriers with psychiatric disorders presented thicker medial and lateral temporal cortices than Val homozygotes. Furthermore, a significant genotype x psychiatric diagnosis interaction was found: Met-carriers with a psychiatric diagnosis presented thinner bilateral prefrontal cortices than Val homozygotes. Conclusion: This study provides evidence that Val66Met is associated with cortical maturation in children and adolescents with and without psychiatric disorders.
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    Fine motor ability and psychiatric disorders in youth
    (Springer, 2018) Mendes, Lorenna Sena Teixeira; Manfro, Gisele Gus; Gadelha, Ary [UNIFESP]; Pan, Pedro Mario [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Rohde, Luis Augusto; Salum, Giovanni Abrahao
    Impaired fine motor ability has been linked to several domains of psychopathology. However, studies validating the specificity of this association among several categorical psychiatric disorders are still needed. The aim of this study was to assess differences in fine motor ability performance among four non-overlapping groups of psychiatric disorders and a group of typical developing comparisons (TDC). Our sample consisted of 2035 subjects aged 6-14-year-old. Diagnoses of psychiatric disorders were performed with the Development and Well-Being Assessment (DAWBA). Five non-overlapping groups without comorbidity were formed: phobic disorders (n = 101), distress disorders (n = 82), attention deficit hyperactivity disorder (ADHD) (n = 133), oppositional defiant disorder/conduct disorder (ODD/CD) (n = 52) and one group of typical developing comparisons (TDC) (n = 1667). Fine motor ability was evaluated by three tasks: sequential finger-thumb opposition, Oseretsky, and pronation/supination tests. Each task was assessed by total time to perform the movement and levels of accuracy, fluency, symmetry, precision, and coordination. We found that, when compared to TDC, the ADHD group performed more poorly in total fine motor ability (mean difference = - 0.28
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    The integrity of corpus callosum and cluster B personality disorders: A quantitative MRI study in juvenile myoclonic epilepsy
    (Elsevier B.V., 2010-04-16) Araujo Filho, Gerardo Maria de [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Lin, Katia [UNIFESP]; Silva, Ivaldo [UNIFESP]; Guaranha, Mirian S. B. [UNIFESP]; Guilhoto, Laura M. F. F. [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Evidence suggests increased prevalence of cluster B personality disorders (PD) among patients with juvenile myoclonic epilepsy (JME), which has been associated with worse seizure control and more psychosocial dysfunctions. A preliminary voxel-based morphometry study demonstrated corpus callosum (CC) volume reduction in patients with JME and cluster B PD, particularly in the posterior midbody and isthmus. in this study we aimed to follow up these results with region of interest analysis. Sixteen JME patients with cluster B PD, 38 JME patients without any psychiatric disorder, and 30 demographically matched healthy controls submitted to a psychiatric evaluation and a magnetic resonance imaging scan. the total and regional callosal areas were obtained from the midsagittal slice using a semi-automated program. Psychiatric evaluation was performed through SCID-I and -II. Significant reductions in the posterior region of the CC were observed in the JME with PD group relative to the other groups. These data support previous findings of callosal reductions in cluster B PD, as well as a possible involvement of CC in patients with JME and such personality characteristics. (C) 2010 Elsevier Inc. All rights reserved.
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    Juvenile myoclonic epilepsy: Psychiatric comorbidity and impact on outcome
    (Elsevier B.V., 2013-07-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Juvenile myoclonic epilepsy (JME) is a well-defined age-related idiopathic epilepsy syndrome. Past studies have emphasized the difficulties in the treatment of patients with JME, which have been attributed to some specific psychiatric, psychological, and psychosocial characteristics. These aspects have aroused a significant amount of interest in the last two decades. in this article, the available studies that investigated the prevalence of psychiatric disorders (PDs) in JME and its impact on seizure outcome were reviewed in order to provide an update to clinicians about these two important aspects associated with this common epilepsy syndrome. the review disclosed a high prevalence of PDs in patients with JME, particularly mood, anxiety, and personality disorders. in addition, most recent studies have also observed that overall prevalence of PDs in JME has not shown statistically significant differences when compared with TLE, an epilepsy syndrome where the psychiatric aspects are most frequently studied. Taken together, data regarding the prevalence of PDs and their possible consequences on seizure outcome on JME indicate that special attention should be directed to psychological disturbances and psychiatric symptoms in this epilepsy syndrome. the early recognition and treatment of psychiatric symptoms, as well as psychological disturbances and psychosocial difficulties, should be considered fundamental to JME prognosis.This article is part of a supplemental special issue entitled Juvenile Myoclonic Epilepsy: What is it Really? (C) 2013 Elsevier Inc. All rights reserved.
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    Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis
    (W B Saunders Co Ltd, 2012-10-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Gomes, Francinaldo Lobato [UNIFESP]; Mazetto, Lenon [UNIFESP]; Marinho, Murilo Martinez [UNIFESP]; Tavares, Igor Melo [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: the association between pre-surgical psychiatric disorders (PDs) and worse seizure outcome in patients with refractory epilepsy submitted to surgery has been increasingly recognized in the literature. the present study aimed to verify the impact of pre- and post-surgical PD on seizure outcome in a series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS).Method: Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohip-pocampectomy (CAH) were analyzed. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV and ILAE criteria. the outcome subcategory Engel IA was considered as corresponding to a favorable prognosis. A multivariate logistic regression model was applied to identify possible risk factors associated with a worse seizure outcome.Results: Pre-surgical PDs, particularly major depressive disorder (MDD), anxiety and psychotic disorders, were common, being found in 47 patients (40.8%). Fifty-six patients (48.7%) were classified as having achieved an Engel IA one year after CAH. According to the logistic regression model, the presence of pre-surgical MDD (OR = 5.23: p = 0.003) appeared as the most important risk factor associated with a non-favorable seizure outcome.Conclusion: Although epilepsy surgery may be the best treatment option for patients with refractory TLE-MTS, our findings emphasize the importance of performing a detailed psychiatric examination as part of the pre-surgical evaluation protocol. (C) 2012 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
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    Neuropeptidases in psychiatric disorders
    (Elsevier, 2021) Nani, João Victor; Almeida, Priscila G. C.; Hayashi, Mirian [UNIFESP]; http://lattes.cnpq.br/5559309395232147; http://lattes.cnpq.br/1198445675076270; http://lattes.cnpq.br/2938015553073591
    Psychiatric disorders (PDs), such as schizophrenia (SCZ), bipolar disorder (BD), and major depression disorder (MDD) are characterized by disturbances in the functioning of the CNS. These mental disorders have attracted the attention of researchers from different areas due to their high prevalence and extremely debilitating clinical characteristics. In spite of the many similarities observed among the PDs, not only in symptoms but also in the etiology as well, there is still a lack of knowledge in the biochemical and/or molecular pathways underlying each of these pathologies, in which better understanding could potentially help improve the diagnosis and possibilities for treatment. Several groups, including ours, have demonstrated that neuropeptidases and neuropeptidergic systems could play a fundamental role for the susceptibility of PDs such as SCZ, due to their involvement in the neurodevelopmental process (and consequent brain formation) and their recent association to disease progression. In this article, we bring an update of the main findings on neuropeptidases, such as Nuclear distribution element like-1 (NDEL1), angiotensin I-converting enzyme (ACE), and prolyl oligopeptidase (POP), with a detailed discussion on how they could be involved in the etiology of PDs. The main findings in the literature regarding alterations in neuropeptidase activity in different biological samples of patients with PDs, as well as in animal models, are presented here in order to draw the attention of general readers to the possibility of targeting this system for the discovery of new targets and/or development of novel therapies and gaining a deeper understanding of the molecular mechanisms underlying complex diseases such as PDs.
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    Personality traits related to juvenile myoclonic epilepsy: MRI reveals prefrontal abnormalities through a voxel-based morphometry study
    (Elsevier B.V., 2009-06-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Lin, Katia [UNIFESP]; Guaranha, Mirian S. B. [UNIFESP]; Guilhoto, Laura M. F. F. [UNIFESP]; Silva, Henrique Hattori da [UNIFESP]; Sales Ferreira Caboclo, Luis Otavio [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Studies involving juvenile myoclonic epilepsy (JME) patients have demonstrated an elevated prevalence of cluster B personality disorders (PD) characterized as emotional instability, immaturity, unsteadiness, lack of discipline, and rapid mood changes. We aimed to verify a possible correlation between structural brain abnormalities in magnetic resonance image (MRI) and the PD in JME using voxel-based morphometry (VBM). Sixteen JME patients with cluster B PD, 38 JME patients without psychiatric disorders, and 30 healthy controls were Submitted to a psychiatric evaluation through SCID I and II and to a MRI scan. Significant reduction in thalami and increase in mesiofrontal and frontobasal regions' volumes were observed mainly in JME patients with PD. Structural alterations of the orbitofrontal cortex (OFC), involved in regulation of mood reactivity, impulsivity, and social behavior, were also observed. This study supports the hypothesis of frontobasal involvement in the pathophysiology of cluster B PD related to JME. (C) 2009 Elsevier Inc. All rights reserved.
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    Pre-surgical predictors for psychiatric disorders following epilepsy surgery in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis
    (Elsevier B.V., 2012-11-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Mazetto, Lenon [UNIFESP]; Gomes, Francinaldo Lobato [UNIFESP]; Marinho, Murilo Martinez [UNIFESP]; Tavares, Igor Melo [UNIFESP]; Sales Ferreira Caboclo, Luis Otavio [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Psychiatric outcomes of patients submitted to epilepsy surgery have gained particular interest given the high prevalence of pre-surgical psychiatric disorders (PD) in this population. the present study aimed to verify the possible pre-surgical predictors for psychiatric disorders following epilepsy surgery in a homogeneous series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohippocampectomy were included. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV criteria. Pre-surgical PD - particularly mood, anxiety and psychotic disorders - were diagnosed in 47 patients (40.8%). Twenty-seven patients (54% of those with pre-surgical PD) demonstrated a remission of psychiatric symptoms on post-surgical psychiatric evaluation. Eleven patients (9.6%) developed de novo PD. the presence of pre-surgical depression (OR= 3.32; p=0.008), pre-surgical interictal psychosis (OR = 4.39; p=0.009) and epileptiform discharges contralateral to the epileptogenic zone (OR = 2.73; p = 0.01) were risk factors associated with post-surgical PD. Although epilepsy surgery is considered to be the best treatment option for patients with refractory TLE-MTS, the relatively high psychiatric comorbidities observed in surgical candidates and their possible negative impact on post-surgical outcomes require a careful pre-surgical evaluation of clinical, sociodemographic and psychiatric factors. (C) 2012 Elsevier B.V. All rights reserved.
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    Prevalence of psychiatric disorders in a Brazilian birth cohort of 11-year-olds
    (Dr Dietrich Steinkopff Verlag, 2010-01-01) Anselmi, Luciana; Fleitlich-Bilyk, Bacy; Menezes, Ana Maria Baptista; Araujo, Cora Luiza Pavin; Rohde, Luis Augusto Paim [UNIFESP]; Universidade Federal de Pernambuco (UFPE); Univ Fed Rio Grande do Sul; Universidade Federal de São Paulo (UNIFESP)
    Objective To estimate the prevalence of psychiatric disorders in preadolescents aged 11-12 years from a birth cohort in a southern Brazilian city.Methods This is a cross-sectional investigation nested in a cohort study with a two-phase design: screening and diagnosis. in the screening phase, 4,452 preadolescents and their mothers were interviewed with the Strengths and Difficulties Questionnaire (SDQ). in the diagnostic phase, all preadolescents with a positive SDQ (n = 122) and their mothers answered the Development and Well-Being Assessment for Children and Adolescents (DAWBA). A sample randomly selected among the cohort participants with a negative SDQ served as a control group (158 subjects and their mothers) and was also assessed using the DAWBA.Results After adjustment for the performance of the screening instrument, 10.8% (95% CI 7.1-14.5) of the preadolescents showed at least one psychiatric disorder according to either the DSM-IV or the ICD-10. the most prevalent disorders were disruptive behavior (prevalence rates were 8.5% according to the DSM-IV and 7.1% according to the ICD-10) and anxiety disorders (prevalence rates were 6.0% according to the DSM-IV and 6.2% according to the ICD-10).Conclusion Both overall and individual prevalence rates of psychiatric disorders found in this study are in the same range of other international studies, although slightly higher than findings from developed countries. the results corroborate previous findings from other epidemiological studies in children and adolescents suggesting the universality of psychiatric disorders across cultures.
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    Psychiatric comorbidity in patients with two prototypes of focal versus generalized epilepsy syndromes
    (W B Saunders Co Ltd, 2011-06-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Mazetto, Lenon [UNIFESP]; Silva, Joyce Macedo da [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The frequency of psychiatric disorders (PD) in a homogeneous series of patients with temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS) compared to patients with juvenile myoclonic epilepsy (JME) was evaluated, aiming to determine the frequency of PD and possible differences in psychiatric diagnoses between these two epileptic syndromes. Data from 248 patients with refractory TLE-MTS and from 124 JME patients were reviewed and compared. There was a high prevalence of PD in both groups of epilepsy patients, present in 100 TLE-MTS (41%) and in 58 JME patients (46.7%). Mood (23.7%), anxiety (13.7%) and psychotic (11.6%) disorders were the most frequent diagnoses in TLE-MTS group, while mood and anxiety disorders (25% and 21%, respectively) were the most common PD among JME. Psychoses were significantly associated with TLE-MTS (p = 0.01). These observations are concordant with our previous study, reforcing the existence of a possible anatomic correlation of PD and brain structures involved in both epilepsy syndromes. (C) 2011 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
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    Psychoses of epilepsy: A study comparing the clinical features of patients with focal versus generalized epilepsies
    (Elsevier B.V., 2011-04-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Silva, Joyce Macedo da [UNIFESP]; Mazetto, Lenon [UNIFESP]; Marchetti, Renato Luis; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    In the literature, psychosis of epilepsy (POE) has been described as one of the most frequent psychiatric comorbidities of epilepsy, occurring particularly in association with temporal lobe epilepsy. However, the presence of such psychiatric disorders among patients with idiopathic generalized epilepsies has also been mentioned. in this study, we evaluated the clinical features of psychotic disorders in a series of patients with temporal lobe epilepsy related to mesial temporal sclerosis (TLE-MTS) and juvenile myoclonic epilepsy with the aim of describing and comparing the clinical patterns of the psychotic symptoms in such frequent and important epilepsy syndromes. POE occurred most frequently in patients with TLE-MTS (P=0.01), but no differences were observed between the groups with respect to the subtypes and core symptoms of psychoses. the clinical implications of POE in both epilepsy syndromes are discussed. (C) 2011 Elsevier Inc. All rights reserved.
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    Transtornos psiquiátricos na epilepsia: uma proposta de classificação elaborada pela comissão de neuropsiquiatria da ILAE
    (Liga Brasileira de Epilepsia (LBE), 2008-09-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Rosa, Vivianne Pellegrino [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: The relationship between psychiatric disorders (PD) and epilepsy is among the most frequent and important aspects of epileptology. PD are present in all epileptic syndromes and contribute to increase the difficulties in treating these patients. OBJECTIVE: We reviewed the classifications for the PD in epilepsy and highlighted the proposal by the ILAE Commission on Neuropsychiatry. CONCLUSION: The classification proposal by the ILAE attempted to separate disorders comorbid with epilepsy and those that reflect ongoing epileptiform activity from epilepsy-specific disorders and are based on clinical and descriptive symptoms rather than in etiological classification. It also presents clear and operational criteria that could be of greater utility for future studies of PD in epilepsy.
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    Women who smoke and stop during pregnancy: who are they?
    (Instituto de Medicina Integral Prof. Fernando Figueira, 2008-03-01) Reis, Liane G.; Silva, Cláudio Jerônimo da [UNIFESP]; Trindade, Arlene; Abrahão, Margarida; Silva, Vilma Aparecida da; Universidade Federal Fluminense Instituto Biomédico; Universidade Federal de São Paulo (UNIFESP); Universidade Federal Fluminense Departamento de Fisiologia e Farmacologia
    OBJECTIVES: to identify factors involved in not stopping smoking in spite of being pregnant. METHODS: standardized interviews were applied to 486 pregnant women in the pre-natal clinics of four health centers in the city of Rio de Janeiro, Brazil, between April 2003 and February 2004. Every time a smoker was identified, an additional interview, which included the Edinburgh Postnatal Depression Scale, the Fagerströn scale for nicotine dependence, and the Screening Questionnaire for Adult Mental Disorders, was carried out. RESULTS: the prevalence of smoking, in the initial stages of pregnancy was 21.1%. Most smokers presented a low level of nicotine dependence. Thirty-six percent of them stopped smoking by the first trimester of the present pregnancy without any specific medical intervention. Important differences between those who were able to stop and those who were not were alcohol intake and number of previous attempts at abstinence. Women who stopped smoking drank less during gestation. CONCLUSIONS: stopping smoking during pregnancy seems to be linked to a non-specific drive towards the well-being of the fetus. The number of previous attempts at abstinence was positively related to stopping at the beginning of pregnancy. In spite of the prevalence of the problem, there is still inadequate support for smokers in the prenatal services.