Navegando por Palavras-chave "depression"

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    Ansiedade, depressão e qualidade de vida em pacientes com glomerulonefrite familiar ou doença renal policística autossômica dominante
    (Sociedade Brasileira de Nefrologia, 2011-06-01) Barros, Bruna Paes de [UNIFESP]; Nishiura, José Luiz [UNIFESP]; Heilberg, Ita Pfeferman [UNIFESP]; Mastroianni Kirsztajn, Gianna [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Psychological aspects and quality of life are often evaluated in patients under renal replacement therapy, but studies about anxiety, de>pression, and quality of life in familial renal diseases are lacking. OBJECTIVES: To evaluate the frequency of anxiety, depression, and quality of life (QOL) and their eventual associations with the main laboratory, clinical, socioeconomic, and cultural parameters in familial glomerulonephritis (GN) or autosomal dominant polycystic kidney disease (ADPKD). METHODS: Ninety adult patients (52 familial GN and 38 ADPKD) completed the questionaires of State Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and QOL-Short-Form SF-36, and were also submitted to a short interview. RESULTS: Moderate anxiety was detected in both groups. Depression was found in 34.6% of familial GN and 60.5% of ADPKD patients. Anxiety and depression were more associated with female gender in familial GN, and with poorer schooling in ADPKD. Patients of both groups presented two quality of life unfavorable dimensions: emotional role function and general health perception. In addition, quality of life was worse among females, unmarried, and Caucasian subjects, and those individuals with a poorer educational level. CONCLUSION: The use of these instruments allows one to appreciate the frequency and levels of anxiety, depression, and quality of life in patients with familial renal diseases that could affect their compliance to treatment. These findings can contribute to planning a better multidisciplinary assistance to such groups of patients.
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    Anti-inflammatory agents in the treatment of bipolar depression: a systematic review and meta-analysis
    (Wiley-Blackwell, 2016) Rosenblat, Joshua D.; Kakar, Ron; Berk, Michael; Kessing, Lars V.; Vinberg, Maj; Baune, Bernhard T.; Mansur, Rodrigo B. [UNIFESP]; Brietzke, Elisa [UNIFESP]; Goldstein, Benjamin I.; McIntyre, Roger S.
    ObjectiveInflammation has been implicated in the risk, pathophysiology, and progression of mood disorders and, as such, has become a target of interest in the treatment of bipolar disorder (BD). Therefore, the objective of the current qualitative and quantitative review was to determine the overall antidepressant effect of adjunctive anti-inflammatory agents in the treatment of bipolar depression. MethodsCompleted and ongoing clinical trials of anti-inflammatory agents for BD published prior to 15 May 15 2015 were identified through searching the PubMed, Embase, PsychINFO, and Clinicaltrials.gov databases. Data from randomized controlled trials (RCTs) assessing the antidepressant effect of adjunctive mechanistically diverse anti-inflammatory agents were pooled to determine standard mean differences (SMDs) compared with standard therapy alone. ResultsTen RCTs were identified for qualitative review. Eight RCTs (n = 312) assessing adjunctive nonsteroidal anti-inflammatory drugs (n = 53), omega-3 polyunsaturated fatty acids (n = 140), N-acetylcysteine (n = 76), and pioglitazone (n = 44) in the treatment of BD met the inclusion criteria for quantitative analysis. The overall effect size of adjunctive anti-inflammatory agents on depressive symptoms was -0.40 (95% confidence interval -0.14 to -0.65, p = 0.002), indicative of a moderate and statistically significant antidepressant effect. The heterogeneity of the pooled sample was low (I-2 = 14%, p = 0.32). No manic/hypomanic induction or significant treatment-emergent adverse events were reported. ConclusionsOverall, a moderate antidepressant effect was observed for adjunctive anti-inflammatory agents compared with conventional therapy alone in the treatment of bipolar depression. The small number of studies, diversity of agents, and small sample sizes limited interpretation of the current analysis.
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    Are Major Depressive Disorder and Diabetes Mellitus Amyloidogenic Conditions?
    (Bentham Science Publ Ltd, 2014-01-01) Baskaran, Anusha; Carvalho, Andre F.; Mansur, Rodrigo Barbachan [UNIFESP]; McIntyre, Roger S.; Queens Univ; Univ Hlth Network; Univ Fed Ceara; Universidade Federal de São Paulo (UNIFESP); Univ Toronto
    Major depressive disorder (MDD) and diabetes mellitus (DM) have reciprocal relationship and share common pathophysiological mechanisms in the central nervous system. Depression and diabetes negatively affect cognitive function and are independent risk factors for mild cognitive impairment and Alzheimers disease (AD). It has been hypothesized that alterations in the production and processing of amyloid beta (A beta) may be the principal pathological process in AD. Furthermore, it has been increasingly demonstrated that a long preclinical course precedes AD. A derivative of this observation is the hypothesis that a convergent pathophysiological substrate subserving MDD and DM may promote beta amyloid (A beta) deposition. The present paper will review evidence linking MDD and DM to A beta accumulation, with a particular emphasis on original reports that report on levels of A beta 40, A beta 42 and the A beta 40/42 ratio in plasma, serum, or cerebrospinal fluid of individuals with MDD and DM. The overarching goal herein is to press the point that MDD and DM are amyloidogenic and consequently represent modifiable risk factors for AD in later life. The prognostic intervention and prevention opportunity suggested by this notion is that: 1) increased rates of mood disorders and DM in an aging population will increase the population attributable risk for AD ascribed to these conditions, 2) improved outcomes in mood disorders and DM by effective treating to target may exert a salutary influence on underlying dementia promoting processes, 3) novel and repurposed medications that are capable of normalizing pathophysiological processes in MDD and DM could decrease the vulnerability towards AD.
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    Assessment of Depression, Anxiety, Quality of Life, and Coping in Long-Standing Multiple Endocrine Neoplasia Type 2 Patients
    (Mary Ann Liebert, Inc, 2017) Rodrigues, Karine C.; Toledo, Rodrigo A.; Coutinho, Flavia L.; Nunes, Adriana B.; Maciel, Rui M. B. [UNIFESP]; Hoff, Ana O.; Tavares, Marcos C.; Toledo, Sergio P. A. [UNIFESP]; Lourenco, Delmar M., Jr.
    Background: Data on psychological harm in multiple endocrine neoplasia type 2 (MEN2) are scarce. Objectives: The aim of this study was to assess anxiety, depression, quality of life, and coping in long-standing MEN2 patients. Patients and Methods: Patients were 43 adults (age >= 18 years) with clinical and genetic diagnosis of MEN2 and long-term follow-up (10.6 +/- 8.2 years
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    Associação entre ansiedade, estresse e depressão com variáveis sociodemográfica e clínica em pacientes com insuficiência cardíaca atendidos ambulatorialmente
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-29) Cirelli, Melissa Alves [UNIFESP]; Barros, Alba Lucia Bottura Leite de Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Cardiovascular diseases (CVD) are the main cause of morbidity and mortality in Brazil and all over the world, thereby constituting a severe public health problem. Various studies highlight the relevance of the relationship of the psychic changes with the increase in the incidence and progression of CVD, where one of them is heart failure (HF). The identification of psychic changes in patients with HF should be investigated with the purpose of characterizing these patients for the accomplishment of effective interventions that influence the reduction of hospitalizations and improve the quality of life. Objective: To analyze the level of stress and anxiety, as well as depression symptoms, in individuals with HF treated in outpatient clinics. To describe the sociodemographic and clinical profile of individuals with HF treated in outpatient clinics. To check the correlation among the stress, anxiety and depression scales and if there is an association of the sociodemographic and clinical variables with the level of stress and anxiety, or even with the depression symptoms. Method: This is a cross-sectional study, which was held between April 2014 and August 2015 at the Outpatient Clinic for Cardiomyopathies of the São Paulo Hospital, totaling 309 patients. The sample was calculated by the statistics of Z-test, based on three main study questionnaires: Beck Anxiety Inventory, Beck Depression Inventory and Perceived Stress Scale. Data collection took place by means of these validated questionnaires, which were self-administered in a single day before the medical consultation. In order to collect the sociodemographic and clinical variables, we used an instrument employed in research for patients with coronary failure, and this instrument was adapted by the researchers for patients with HF. Results: There was a predominance of males, whites and Catholics, with family income from one to three minimum wages and with four to seven years of schooling. The sample revealed the following average scales: 16.14 for stress, 8.57 for anxiety and 10.87 for depression. The correlations between the stress and depression scales (0.49) and the stress and anxiety scales (0.47) were moderate, and the correlation between anxiety and depression ranged from moderate to high (0.63). We observed that stress was related to gender (p<0.012), ethnicity (p<0), housing type (p<0.035); religion (p<0); family income (p<0); Functional Class (FC) 2 (p<0.027), former alcoholic (p<0.034), former smoker (p<0.01) and obesity III (p<0.041). Anxiety was associated with gender (p<0.002), ethnicity (p<0); housing type (p<0.024); religion (p<0); family income (p<0.013); occupation (p<0.002); FC2 (p<0), Chagas? disease (p<0.002) and Chagas? cardiomyopathy (p<0.036). Moreover, depression was associated with ethnicity (p<0); housing type (p<0); religion (p<0); family income (p<0.007); occupation (p<0.046); FC2 (p<0.001), Chagas? disease (p<0.01) and Peripartum cardiomyopathy (p<0.021). Conclusion: The levels of anxiety, stress, and depression in patients with FC I and II who are treated in outpatient clinics are low. The scales show positive correlations with each other, but the anxiety and depression scales showed a correlation ranging from moderate to high. The family income less than one MW was related to anxiety, stress and depression, the female gender with anxiety and stress, FC II was related to stress and depression. Medical records of Chagas? disease and being out of work or away were factors related to anxiety and depression.
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    Associação entre Transtorno Disfórico Pré-menstrual e Transtornos Depressivos
    (Associação Brasileira de Psiquiatria - ABP, 1999-06-01) Pires, Maria Laura Nogueira [UNIFESP]; Calil, Helena Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Premenstrual Dysphoric Disorder (PMDD) is characterised by a myriad of emotional symptoms and behavioural alterations, which occur with a cyclic temporal pattern associated with the pre-menstrual period. The validity of an isolated psychiatric diagnostic category for PMDD remains controversial. However, research results have been showing a specific association between pre-menstrual changes and depressive disorder. The present review has as objective to sintethise the results on similarity between depressive symptoms in PMDD and in the depressive disorders, comorbidity, family history and biological variables. Evidences suggesting that the pre-menstrual symptoms would be expression of a vulnerability to the development of dysphoric states (depression and anxiety) as well as diagnostic implications of such proposals are discussed.
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    Associations between oral health-related quality of life and emotional statuses in children and preadolescents
    (Wiley-Blackwell, 2012-10-01) Barbosa, T. S.; Castelo, P. M. [UNIFESP]; Leme, M. S.; Gaviao, M. B. D.; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)
    Oral Diseases (2012) 18, 639647 Objectives: To evaluate the associations between oral health-related quality of life (OHRQoL) and emotional statuses in children and preadolescents. Methods: One hundred and forty-five Brazilian students (814 years) were clinically examined for caries, gingivitis, fluorosis, malocclusions, and temporomandibular disorders (TMD). OHRQoL was measured using two global ratings of oral health (OH) and overall well-being (OWB). the Revised Childrens Manifest Anxiety Scale (R-CMAS) and Childrens Depression Inventory (CDI) were used to assess anxiety and depression, respectively. SalivCezannea was collected 30 min after waking and at night to determine the diurnal decline in salivary cortisol (DDSC). the results were analyzed using non-paired t test/one-way ANOVA, Pearsons correlation test, and multiple linear regression analyses. Results: 1114-year-old participants had higher CDI scores (P < 0.01) and DDSC concentrations (P < 0.001). Participants with fewer caries and without gingivitis had higher DDSC concentrations (P < 0.05). TMD patients had higher DDSC concentrations and OWB ratings (P < 0.001). Girls had higher Revised Childrens Manifest Anxiety Scale (RCMAS) scores (P < 0.01). There was positive correlation between RCMAS and CDI scores and OWB ratings (P < 0.05). the OH model retained age (beta =0.312; P < 0.001) and the OWB model retained TMD (beta = 0.271; P < 0.001) and CDI scores (beta=0.175; P < 0.05). Conclusions: Children and preadolescents with poor emotional well-being are more sensitive to the impacts of OH and its effects on OWB.
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    Avaliação da sintomatologia depressiva em enfermeiros da estratégia de saúde da família do município de Guarulhos/SP
    (Universidade Federal de São Paulo (UNIFESP), 2016-05-25) Fernandes, Daniella Marques [UNIFESP]; Marcolan, Joao Fernando Marcolan [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Depression is considered to be one of the greatest public health problems in the world, resulting in lost workdays, poorer work performance, and greater causes of withdrawal. Objectives: To verify the presence of depressive symptomatology in nurses of the Family Health Strategy of the city of Guarulhos / SP; Identify the intensity of this symptomatology; To know the triggering factors of this symptomatology and to evaluate the nurses' perception of their psychological suffering and working conditions. Method: Exploratory-descriptive study, quantitative method, performed with nurses of the Family Health Strategy of the city of Guarulhos / SP. A semi-structured sociodemographic questionnaire and psychometric scales were used to evaluate the depressive symptomatology: Beck Depression Inventory, Montgomery & Asberg Depression Scale, and Hamilton Depression Scale. Fisher's exact test and Student's t-test were used for the statistical analysis. Results: Sample comprised of 59 nurses. The predominant profile was female (91.53%). Most of the participants presented depressive symptoms on the scales with 40.67% for the IDB scale, 89.83% for the HAM-D scale and 91.53% for the MADRS scale of the total interviewees. The main factors pointed out by the nurses for their illness were related to the working conditions. Most of the nurses did not perceive themselves to be ill or that such a situation affected the quality of care provided. The intensity of the predominant depressive symptomatology was mild to moderate and the results of the observation scales were congruent and divergent for the self-assessment scale. In the Beck scale there was a low result for depressive symptomatology and this is believed to be due to the omission or nonperception of the symptoms by the interviewees. All of them were oriented on presented symptomatology and referred to specialized care. Most of the nurses pointed to working conditions as a promoter of illness, with emphasis on factors related to the number of nurses' assignments, work overload, lack of organizational structure, lack of human resources, excessive collection and lack Of valuation of nurses. Conclusion: There was a high prevalence of depressive symptoms in the sample studied. The data found in this study should be reflected on interventions to improve the quality of life at work to promote workers' mental health and reduce harmful effects.
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    As bases neurobiológicas do transtorno bipolar
    (Faculdade de Medicina da Universidade de São Paulo, 2005-01-01) Machado-Vieira, Rodrigo; Bressan, Rodrigo Affonseca [UNIFESP]; Frey, Benício; Soares, Jair C.; Fundação Faculdade Federal de Ciências Médicas de Porto Alegre Programa de Transtornos de Humor; Hospital Presidente Vargas; Stanley Foundation Research Unit of Porto Alegre; Hospital Espírita; Universidade Federal de São Paulo (UNIFESP); Institute of Psychiatry, King's College London; Universidade Federal do Rio Grande do Sul Hospital de Clínicas de Porto Alegre Departamento de Bioquímica; University of Texas Health Science Center Department of Psychiatry Division of Mood and Anxiety Disorders
    In this article, the authors review relevant aspects related to the neurobiological basis of bipolar disorder. This illness has been associated with complex biochemical and molecular changes in brain circuits linked to neurotransmission and intracellular signal transduction pathways, and changes on neurons and glia have been proposed to be directly associated with clinical presentation of mania and depression. In the same context, dysfunctions on brain homeostasis and energy metabolism have been associated with alterations on circadian rythms, behavior and mood in human and animal models of bipolarity. In the recent years, advances on techniques of neuroimaging, molecular biology and genetics has provided new insights about the biology of bipolarity. The authors emphasize that bipolar disorder has been shown to be directly associated with dysfunctions on neural adaptative mechanisms, promoting neural stress. The resulted stress, even that do not lead to cell death, may limit the neuroplasticity and neurotrophism in neurons and glia, which in turn may facilitate the arousal of this pervasive illness.
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    Behavioral differences between subgroups of rats with high and low threshold to clonic convulsions induced by DMCM, a benzodiazepine inverse agonist
    (Elsevier B.V., 2005-11-01) Contó, Marcos Brandão [UNIFESP]; Carvalho, JGB de; Venditti, Marco Antonio Campana [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    In epileptic patients, there is a high incidence of psychiatric comorbidities, such as anxiety. Gamma-aminobutyric acid (GABA) ionotropic receptor GABA(A)/benzodiazepine allosteric site is involved in both epilepsy and anxiety. This involvement is based on the fact that benzodiazepine allosteric site agonists are anticonvulsant and anxiolytic drugs; on the other hand, benzodiazepine inverse agonists are potent convulsant and anxiogenic drugs. the aim of this work was to determine if subgroups of rats selected according to their susceptibility to clonic convulsions induced by a convulsant dose 50% (CD50) of DMCM, a benzodiazepine inverse agonist, would differ in behavioral tests commonly used to measure anxiety (elevated plus-maze, open field) and depression (forced swimming test). in the first experiment, subgroups of adult male Wistar rats were selected after a single dose of DMCM and in the second experiment they were selected after two injections of DMCM given after an interval of 1 week. Those rats presenting full clonic convulsions were termed Low Threshold rats to DMCM-induced clonic convulsions (LTR) and those not having clonic convulsions High Threshold rats to DMCM-induced clonic convulsions (HTR). in both experiments, only those rats presenting full clonic convulsions induced by DMCM and those not showing any signs of motor disturbances were used in the behavioral tests. the results showed that the LTR subgroup selected after two injections of a CD50 of DMCM spent a significantly lower time in the open arms of the elevated plus-maze and in the off the walls area of the open field; moreover, this group also presented a higher number of rearings in the open field. There were no significant differences between HTR and LTR subgroups in the forced swimming test. LTR and HTR subgroups selected after only one injection of DMCM did not differ in the three behavioral tests. To verify if the behavioral differences between HTR and LTR subgroups of rats selected after two injections of DMCM were due to the clonic convulsion, another experiment was carried out in which subgroups of rats susceptible and nonsusceptible to clonic convulsions induced by a CD50 of picrotoxin, a GABA(A) receptor channel blocker, were selected and submitted to the elevated plus-maze and open field tests. the results obtained did not show any significant differences between these two subgroups in the elevated plus-maze and open field tests. in another approach to determine the relation between fear/anxiety and susceptibility to clonic convulsions, subgroups of rats were selected in the elevated plus-maze as more or less fearful/anxious. the CD50 for clonic convulsions induced by DMCM was determined for each of these two subgroups. the results showed a significantly lower CD50 for the more fearful/anxious subgroup, which means a higher susceptibility to clonic convulsions induced by DMCM. the present findings show a relation between susceptibility to clonic convulsions and fear/anxiety and vice versa which may be due to differences in the assembly of GABA(A)/allosteric benzodiazepine site receptors in regions of the brain. (c) 2005 Elsevier Inc. All rights reserved.
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    Binge-eating disorder in Brazilian women on a weight-loss program
    (North Amer Assoc Study Obesity, 2002-11-01) Borges, Maria Beatriz Ferrari [UNIFESP]; Jorge, Miguel Roberto [UNIFESP]; Morgan, Christina Marcondes [UNIFESP]; Silveira, Dartiu Xavier da [UNIFESP]; Custódio, Osvladir [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To examine binge-eating disorder (BED) and its association with obesity, weight patterns, and psychopathology in a Brazilian sample of female participants of a weight-loss program in Sdo Paulo, Brazil.Research Methods and Procedures: Two hundred and seventeen overweight (body mass index greater than or equal to 25 kg/m(2)) women, ages 15 to 59 years, enrolled in the Weight Watchers Program were recruited for the study at a program branch meeting after completing the Questionnaire on Eating and Weight Patterns-Revised, Beck Depression Inventory, and the Toronto Alexithymia Scale-20. Participants were categorized into four groups: those who met questionnaire criteria for BED, those who met questionnaire criteria for bulimia nervosa (BN), those that reported binge eating but did not meet all the criteria for any eating disorder (BE), and those with no eating disorder symptoms (No ED). Groups were compared on measures of weight, depressive symptoms, and alexithymia.Results: Binge eating was frequently reported by women in this study (BED, 16.1%; BN, 4.6%; BE, 22.6%). BED women had significantly higher body mass index, greater highest weight ever, and more frequent weight cycling than the No ED group. BED women also reported more depressive symptoms than BE and No ED women, and were more alexithymic than the No ED group. BE women presented more frequent weigh cycling and were also more depressed and alexithymic than the No ED group.Discussion: BED is not uncommon in overweight Brazilian women, and similar to North American and European samples, it is associated with overweight and higher levels of psychopathology in this population.
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    The brain decade in debate: V-neurobiology of depression
    (Elsevier B.V., 2002-04-01) Barros, HMT; Calil, Helena M. [UNIFESP]; Guimaraes, F. S.; Soares, J. C.; Andreatini, R.; Univ Fed Parana; Univ Pittsburgh; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Fundacao Fac Ciencias Porto Alegre
    This paper is a transcription of a virtual symposium on the neurobiology of depression, which was organized by the Brazilian Society for Neuroscience and Behavior (SBNeC). There is a consensus that the monoaminergic theory is still valid, but its initial formulation suffered several modifications to explain more recent findings. Moreover, it is naive to suppose that depression has only one substratum and probably various neurotransmitter systems should be involved. Although nowadays the focus is mainly put on the serotonin (5-HT) system, there are several evidences suggesting an important role for other systems. It is expected that neuroimaging research with more specific tracers will give important information on this subject. the hormonal modulation is another important aspect of this picture, particularly in relation to the gender differences observed in depression. the neurobiological relationship between mania and depression states is also discussed. the intracellular transduction mechanisms are a growing field in depression research, representing the central focus of the molecular theory of depression, and it is indicated as the most fruitful theory to the development of really new drugs to treat depression. (C) 2001 Elsevier Science Inc. All rights reserved.
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    Cerebrospinal fluid GABA levels in chronic migraine with and without depression
    (Elsevier B.V., 2006-05-23) Vieira, DSS; Naffah-Mazacoratti, M. G.; Zukerman, E.; Soares, CAS; Alonso, E. O.; Faulhaber, MHW; Cavalheiro, E. A.; Peres, MFP; Universidade Federal de São Paulo (UNIFESP)
    Psychiatric comorbidity is one of the key elements in chronic migraine (CM) management. Depression is particularly common in these patients, occurring in up to 85%. Preclinical studies have suggested that gamma-aminobutyric acid (GABA) levels may be decreased in animal models of depression. Also, clinical studies have reported low level in mood disorder patients for both plasma and cerebrospinal fluid (CSF) GABA. We hypothesized that low GABA levels in the brain might be related to the depression associated with CM. We studied 14 chronic migraine patients, with or without depression, compared to age-and sex-matched controls. CSF GABA levels were measured by HPLC. CSF GABA levels showed significant lower levels in depressed patients than those without depression. No difference was found when comparing patients versus controls. A GABA deficiency may be the underlying mechanism of depression in CM. Hence, preventive therapies modulating GABA neurotransmission could be used in CM associated with depression. (c) 2006 Elsevier B.V. All rights reserved.
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    Child Abuse, Depression, and Methylation in Genes Involved With Stress, Neural Plasticity, and Brain Circuitry
    (Elsevier B.V., 2014-04-01) Weder, Natalie; Zhang, Huiping; Jensen, Kevin; Yang, Bao Zhu; Simen, Arthur; Jackowski, Andrea [UNIFESP]; Lipschitz, Deborah; Douglas-Palumberi, Heather; Ge, Margrat; Perepletchikova, Francheska; O'Loughlin, Kerry; Hudziak, James J.; Gelernter, Joel; Kaufman, Joan; Yale Univ; Universidade Federal de São Paulo (UNIFESP); Univ Vermont
    Objectives: To determine whether epigenetic markers predict dimensional ratings of depression in maltreated children. Method: A genome-wide methylation study was completed using the Iliumina 450K BeadChip array in 94 maltreated and 96 healthy nontraumatized children with saliva-derived DNA. the 450K BeadChip does not include any methylation sites in the exact location as sites in candidate genes previously examined in the literature, so a test for replication of prior research findings was not feasible. Results: Methylation in 3 genes emerged as genome-wide-significant predictors of depression: DNA-Binding Protein Inhibitor ID-3 (ID3); Glutamate Receptor, Ionotropic N-methy1-D-aspartate (NMDA) 1 (GRIM); and Tubulin Polymerization Promoting Protein (TPPP) (p <5.0 x 10(-7), all analyses). These genes are all biologically relevant with ID3 involved in the stress response, GRIM involved in neural plasticity, and TPPP involved in neural circuitry development. Methylation in CpG sites in candidate genes were not predictors of depression at significance levels corrected for whole genome testing, but maltreated and control children did have significantly different 13 values after Bonferroni correction at multiple methylation sites in these candidate genes (e.g., BDNF, NR3C1, FKBP5). Conclusions: This study suggests that epigenetic changes in ID3, GRIN1, and TPPP genes, in combination with experiences of maltreatment, may confer risk for depression in children. the study adds to a growing body of literature supporting a role for epigenetic mechanisms in the pathophysiology of stress-related psychiatric disorders. Although epigenetic changes are frequently long lasting, they are not necessarily permanent. Consequently, interventions to reverse the negative biological and behavioral sequelae associated with child maltreatment are briefly discussed.
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    Chronic light deprivation inhibits appetitive associative learning induced by ethanol and its respective c-Fos and pCREB expression
    (Cambridge Univ Press, 2014-11-01) Varela, Patricia [UNIFESP]; Escosteguy-Neto, João Carlos [UNIFESP]; Coelho, Carolina Tesone [UNIFESP]; Mello, Luiz Eugenio Araujo de Moraes [UNIFESP]; Silveira, Dartiu Xavier da [UNIFESP]; Santos-Junior, Jair Guilherme [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fac Ciencias Med São Paulo
    To address the role of mixed anxiety/mood disorder on appetitive associative learning, we verify whether previous chronic light deprivation changes ethanol-induced conditioned place preference and its respective expression of c-Fos and pCREB, markers of neuronal activity and plasticity. the experimental group was maintained in light deprivation for 24 h for a period of 4 wk. Subsequently, it was adapted to a standard light-dark cycle for 1 wk. As a control, some mice were maintained in standard cycle for a period of 4 wk (Naive group). Then, all animals were submitted to behavioral tests to assess emotionality: elevated plus maze; open field; and forced swim. After that, they were submitted to ethanol-induced conditioned place preference. Ninety minutes after the place preference test, they were perfused, and their brains processed for c-Fos and pCREB immunohistochemistry. Light deprivation induced anxiety-like trait (elevated plus maze), despair (forced swim), and hyperlocomotion (open field), common features seen in other animal models of depression. Ethanol-induced conditioned place preference was accompanied by increases on c-Fos and pCREB in the hippocampus, prefrontal cortex and striatum. Interestingly, mice previously submitted to light deprivation did not develop either acquisition and/or expression of ethanol-induced conditioned place preference or increases in c-Fos and pCREB. Therefore, chronic light deprivation mimics several behavioral aspects of other animal models of depression. Furthermore, it could be useful to study the neurochemical mechanisms involved in the dual diagnosis. However, given its likely deleterious effects on appetitive associative memory, it should be used with caution to investigate the cognitive aspects related to the dual diagnosis.
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    The Clinical Correlates of Reported Childhood Sexual Abuse: An Association Between Age at Trauma Onset and Severity of Depression and PTSD in Adults
    (Routledge Journals, Taylor & Francis Ltd, 2010-01-01) Schoedl, Aline Ferri [UNIFESP]; Pupo Costa, Mariana Cadrobbi [UNIFESP]; Mari, Jair J. [UNIFESP]; Mello, Marcelo Feijo [UNIFESP]; Tyrka, Audrey R.; Carpenter, Linda L.; Price, Lawrence H.; Universidade Federal de São Paulo (UNIFESP); Brown Univ
    This study investigated the relationship between the age of self-reported sexual abuse occurrence and the development of post-traumatic stress disorder and/or depressive symptoms in adulthood. Subjects were evaluated for the presence of post-traumatic stress disorder and/or depressive symptoms as well as for a self-reported history of sexual abuse before the age of 18. Results found that relative risk of having severe post-traumatic stress disorder symptoms was 10 times higher in patients reporting sexual abuse after age 12 than in those reporting sexual abuse before age 12. Relative risk of having severe depressive symptoms was higher for those abused before the age of 12 than for those abused after the age of 12. Findings suggest that the impact of reported sexual abuse at different stages of development may lead to distinct psychiatric symptoms in adulthood.
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    Clinical variables related to the diagnostic stability of demential syndromes
    (Cambridge Univ Press, 2017) de Moraes, Fabiano Moulin [UNIFESP]; Ferreira Bertolucci, Paulo Henrique [UNIFESP]
    Background: Assigning a diagnosis to a patient with dementia is important for the present treatment of the patient and caregivers, and scientific research. Nowadays, the dementia diagnostic criteria are based on clinical information regarding medical, history, physical examination, neuropsychological tests, and supplementary exams and, therefore, subject to variability through time. Methods: A retrospective observational study to evaluate variables related to clinical diagnostic stability in dementia syndromes in at least one year follow up. From a sample of 432 patients, from a single university center, data were collected regarding sociodemographic aspects, Clinical Dementia Rating, physical examination, neuropsychological tests, and supplementary exams including a depression triage scale. Results: From this sample, 113 (26.6%) patients have their diagnosis changed, most of them adding a vascular component to initial diagnosis or depression as comorbidity or main disease. Our findings show that many factors influence the diagnostic stability including the presence of symmetric Parkinsonism, initial diagnosis of vascular dementia, presence of diabetes and hypertension, the presence of long term memory deficit in the neuropsychological evaluation, and normal neuroimaging. We discuss our findings with previous findings in the literature. Conclusion: Every step of the clinical diagnosis including history, vascular comorbidities and depression, physical examination, neuropsychological battery, and neuroimaging were relevant to diagnosis accuracy.
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    Co-morbidade psiquiátrica em dependentes de substâncias psicoativas: resultados preliminares
    (Associação Brasileira de Psiquiatria - ABP, 1999-09-01) Silveira, Dartiu Xavier da [UNIFESP]; Jorge, Miguel Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Proper psychiatric evaluations are seldom performed on drug addicts. Failure in recognizing dual diagnosed patients frequently results in inadequate treatment interventions. The objective of the present study was to evaluate the incidence of psychiatric disorders in drug addicts. METHODS: Psychiatric morbidity was studied within a sample of 50 drug dependent men randomly selected from an outward treatment facility. Research Diagnostic Criteria (RDC) were used for diagnostic assessment. RESULTS: Lifetime and current prevalence of some mental disorder were of 77% and 72 %, respectively. Thirty-two percent of the subjects presented a depression diagnosis at the time and 44 % met diagnostic criteria for lifetime diagnosis of depression. Depressive disorders somehow seemed to precede drug dependence in 77,3 % of the cases. Also, frequencies of other psychiatric disorders were higher among addicts than within the community. Results from this study were compared with similar international studies. CONCLUSION: The link between psychopathology and drug dependence justifies the importance of specific strategies for the treatment of dual diagnosed addicts.
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    Co-occurrence of chronic physical pain and psychiatric morbidity in a community sample of older people
    (Wiley-Blackwell, 2007-09-01) Blay, Sergio Luis; Andreoli, Sergio Baxter; Dewey, Michael E.; Gastal, Fabio Leite; Universidade Federal de São Paulo (UNIFESP); Kings Coll London
    Background Knowledge about co-occurrence of the most frequent chronic pain symptoms with psychiatric morbidity in older people is very limited. Objective To study the association of psychiatric morbidity and painful physical conditions in people aged 60 years and over. Method Population-based random sample of 7,040 household residents, aged 60 years and over, in Brazil. Results the overall prevalence of pain conditions is 76%. Age-sex specific prevalence of chronic pain conditions such as back pain,joint, abdominal, chest, headaches, reported by respondents ranged from 11.6% up to 5 1.1%. in logistic regression models, chest pain, head pain, back pain, joint pain and abdominal pain emerged as predictors of psychiatric morbidity. the odds of psychiatric morbidity are also affected by income, ethnicity, origin (urban/rural), and marital status. Conclusion the association of chronic painful conditions and psychiatric morbidity in late life is statistically strong in this surveyed population. Copyright (c) 2007 John Wiley & Sons, Ltd.
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    Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients
    (Nature Publishing Group, 2009-08-01) Duarte, Priscila Silveira [UNIFESP]; Miyazaki, Maria Cristina; Blay, Sergio Luis [UNIFESP]; Sesso, Ricardo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Sch Med Sao Jose Rio Preto
    Depression is an important target of psychological assessment in patients with end-stage renal disease because it predicts their morbidity, mortality, and quality of life. We assessed the effectiveness of cognitive-behavioral therapy in chronic hemodialysis patients diagnosed with major depression by the Mini International Neuropsychiatric Interview (MINI). in a randomized trial conducted in Brazil, an intervention group of 41 patients was given 12 weekly sessions of cognitive-behavioral group therapy led by a trained psychologist over 3 months while a control group of 44 patients received the usual treatment offered in the dialysis unit. in both groups, the Beck Depression Inventory, the MINI, and the Kidney Disease and Quality of Life-Short Form questionnaires were administered at baseline, after 3 months of intervention or usual treatment, and after 9 months of follow-up. the intervention group had significant improvements, compared to the control group, in the average scores of the Beck Depression Inventory overall scale, MINI scores, and in quality-of-life dimensions that included the burden of renal disease, sleep, quality of social interaction, overall health, and the mental component summary. We conclude that cognitive-behavioral group therapy is an effective treatment of depression in chronic hemodialysis patients.