GUILHERME VANONI POLANCZYK
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Research Review: Epidemiological modelling of attention-deficit/hyperactivity disorder and conduct disorder for the Global Burden of Disease Study 2010(2013) ERSKINE, Holly E.; FERRARI, Alize J.; NELSON, Paul; POLANCZYK, Guilherme V.; FLAXMAN, Abraham D.; VOS, Theo; WHITEFORD, Harvey A.; SCOTT, James G.BackgroundThe most recent Global Burden of Disease Study (GBD 2010) is the first to include attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) for burden quantification. We present the epidemiological profiles of ADHD and CD across three time periods for 21 world regions. MethodsA systematic review of global epidemiology was conducted for each disorder (based on a literature search of the Medline, PsycInfo and EMBASE databases). A Bayesian metaregression tool was used to derive prevalence estimates by age and sex in three time periods (1990, 2005 and 2010) for 21 world regions including those with little or no data. Prior expert knowledge and covariates were applied to each model to adjust suboptimal data. Final prevalence output for ADHD were adjusted to reflect an equivalent value if studies had measured point prevalence using multiple informants while final prevalence output for CD were adjusted to reflect a value equivalent to CD only. ResultsPrevalence was pooled for males and females aged 5-19years with no difference found in global prevalence between the three time periods. Male prevalence of ADHD in 2010 was 2.2% (2.0-2.3) while female prevalence was 0.7% (0.6-0.7). Male prevalence of CD in 2010 was 3.6% (3.3-4.0) while female prevalence was 1.5% (1.4-1.7). ADHD and CD were estimated to be present worldwide with ADHD prevalence showing some regional variation while CD prevalence remained relatively consistent worldwide. ConclusionsWe present the first prevalence estimates of both ADHD and CD globally and for all world regions. Data were sparse with large parts of the world having no estimates of either disorder. Epidemiological studies are urgently needed in certain parts of the world. Our findings directly informed burden quantification for GBD 2010. As mental disorders gained increased recognition after the first GBD study in 1990, the inclusion of ADHD and CD in GBD 2010 ensures their importance will be recognized alongside other childhood disorders.
- Dimensions of Oppositionalay in a Brazilian Communiiy Sample: Testing the DSM-5 Proposal and Etiological Links(2013) KRIEGER, Fernanda Valle; POLANCZYK, Guilherme Vanoni; GOODMAN, Robert; ROHDE, Luis Augusto; GRAEFF-MARTINS, Ana Soledade; SALUM, Giovanni; GADELHA, Ary; PAN, Pedro; STAHL, Daniel; STRINGARIS, ArgyrisObjective: Investigating dimensions of oppositional symptoms may help to explain heterogeneity of etiology and outcomes for mental disorders across development and provide further empirical justification for the DSM-5-proposed modifications of oppositional defiant disorder (ODD). However, dimensions of oppositionality have not previously been tested in samples outside Europe or the United States. In this study, we used a large Brazilian community sample to compare the fit of different models for dimensions of oppositional symptoms; to examine the association of psychiatric diagnoses and symptoms with dimensions of oppositionality; and to examine the associations between dimensions of oppositionality and parental history of mental disorders. Method: A Brazilian community sample of 2,512 children 6 through 12 years old were investigated in this study. Confirmatory factorial analyses were performed to compare the fit of alternative models, followed by linear and logistic regression analyses of associations with psychiatric diagnosis and parental history of psychopathology. Results: A three-factor model with irritable, headstrong, and hurtful dimensions fitted best. The irritable dimension showed a strong association with emotional disorders in the child (p < .001) and history of depression (p < .01) and suicidality (p < .05) in the mother. The headstrong dimension was uniquely associated with attention-deficit/hyperactivity disorder (ADHD) in the child (p < .001) and with maternal history of ADHD symptoms (p < .05). The hurtful dimension was specifically associated with conduct disorder (p < .05). Conclusions: Our findings from a large community sample of Brazilian children support a distinction between dimensions of oppositionality consistent with current DSM-5 recommendations and provide further evidence for etiological distinctions between these dimensions. J. Am. Acad. Child Adolesc. Psychiatry; 201352(4):389-400.
- Psychopharmacology and psychotherapy for the treatment of adults with ADHD-a systematic review of available meta-analyses(2013) MORIYAMA, Tais S.; POLANCZYK, Guilherme V.; TERZI, Fernanda S.; FARIA, Kauy M.; ROHDE, Luis A.Objective/Introduction Attention-deficit/hyperactivity disorder (ADHD) in adult life is a prevalent condition. We systematically reviewed the literature available by searching for meta-analyses assessing pharmacological and psychosocial interventions for adults with ADHD. Methods Using wide-ranging search terms, we retrieved 191 titles from the PubMed and Cochrane databases. Two independent evaluators judged all abstracts. Only meta-analyses about the treatment of adults with ADHD were included. Information from meta-analyses found was systematically extracted by 3 independent evaluators. Results Eight meta-analyses were identified. Results from those meta-analyses suggest that stimulants are effective in decreasing ADHD symptoms on a short-term basis with a medium to large effect size (ES). Short-acting stimulants might be superior to long-acting stimulants, but no data on difference in adherence are available for the comparison of these two types of formulation. Bupropion is superior to placebo but less effective than stimulants. No conclusions about the impact of psychosocial interventions can be drawn based on meta-analyses so far. Discussion The efficacy of stimulants in reducing ADHD symptoms for adults is well documented in meta-analyses, but there is a concerning lack of meta-analysis about other treatment interventions. Conclusion The available meta-analytic literature does not cover questions of essential clinical relevance for adults with ADHD.
bookPart 0 Citação(ões) na Scopus Integrating psychopharmacology and psychotherapy to treat children with ADHD(2013) MORIYAMA, T. S.; POLANCZYK, G. V.; TERZI, F. S.; FARIA, K. M.; DöPFNER, M.; ROHDE, L. A.- Irritability in children and adolescents: past concepts, current debates, and future opportunities(2013) KRIEGER, Fernanda Valle; LEIBENLUFT, Ellen; STRINGARIS, Argyris; POLANCZYK, Guilherme V.Irritability is defined as a low threshold to experience anger in response to frustration. It is one of the most common symptoms in youth and is part of the clinical presentation of several disorders. Irritability can present early in life and is a predictor of long-term psychopathology; yet, the diagnostic status of irritability is a matter of intense debate. In the present article, we address two main components of the debate regarding irritability in youth: the misdiagnosis of chronic irritability as pediatric bipolar disorder, and the proposal of a new diagnosis in the DSM-5, disruptive mood dysregulation disorder, whose defining symptoms are chronic irritability and temper outbursts.
- DRD4 Rare Variants in Attention-Deficit/Hyperactivity Disorder (ADHD): Further Evidence from a Birth Cohort Study(2013) TOVO-RODRIGUES, Luciana; ROHDE, Luis A.; MENEZES, Ana M. B.; POLANCZYK, Guilherme V.; KIELING, Christian; GENRO, Julia P.; ANSELMI, Luciana; HUTZ, Mara H.The dopamine receptor D4 (DRD4) is one of the most studied candidate genes for Attention-Deficit/Hyperactivity Disorder (ADHD). An excess of rare variants and non-synonymous mutations in the VNTR region of 7R allele in ADHD subjects was observed in previous studies with clinical samples. We hypothesize that genetic heterogeneity in the VNTR is an important factor in the pathophysiology of ADHD. The subjects included in the present study are members of the 1993 Pelotas Birth Cohort Study (N=5,249). We conducted an association study with the 4,101 subjects who had DNA samples collected. The hyperactivity-inattention scores were assessed through the parent version of the Strengths and Difficulties Questionnaire at 11 and 15 years of age. The contribution of allele's length and rare variants to high hyperactivity/inattention scores predisposition was evaluated by multivariate logistic regression. No effect of allele length was observed on high scores of hyperactivity-inattention. By contrast, when resequencing/haplotyping was conducted in a subsample, all 7R rare variants as well as non-synonymous 7R rare variants were associated with high hyperactivity/inattention scores (OR=2.561; P=0.024 and OR=3.216; P=0.008 respectively). A trend for association was observed with 4R rare variants. New coding mutations covered 10 novel motifs and many of them are previously unreported deletions leading to different stop codons. Our findings suggest a contribution of DRD4 7R rare variants to high hyperactivity-inattention scores in a population-based sample from a large birth cohort. These findings provide further evidence for an effect of DRD4 7R rare variants and allelic heterogeneity in ADHD genetic susceptibility.
- Threat bias in attention orienting: evidence of specificity in a large community-based study(2013) SALUM, G. A.; MOGG, K.; BRADLEY, B. P.; GADELHA, A.; PAN, P.; TAMANAHA, A. C.; MORIYAMA, T.; GRAEFF-MARTINS, A. S.; JARROS, R. B.; POLANCZYK, G.; ROSARIO, M. C. do; LEIBENLUFT, E.; ROHDE, L. A.; MANFRO, G. G.; PINE, D. S.Background. Preliminary research implicates threat-related attention biases in paediatric anxiety disorders. However, major questions exist concerning diagnostic specificity, effects of symptom-severity levels, and threat-stimulus exposure durations in attention paradigms. This study examines these issues in a large, community school-based sample. Method. A total of 2046 children (ages 6-12 years) were assessed using the Development and Well Being Assessment (DAWBA), Childhood Behavior Checklist (CBCL) and dot-probe tasks. Children were classified based on presence or absence of 'fear-related' disorders, 'distress-related' disorders, and behavioural disorders. Two dot-probe tasks, which differed in stimulus exposure, assessed attention biases for happy-face and threat-face cues. The main analysis included 1774 children. Results. For attention bias scores, a three-way interaction emerged among face-cue emotional valence, diagnostic group, and internalizing symptom severity (F=2.87, p<0.05). This interaction reflected different associations between internalizing symptom severity and threat-related attention bias across diagnostic groups. In children with no diagnosis (n=1411, mean difference=11.03, S.E.=3.47, df=1, p<0.001) and those with distress-related disorders (n=66, mean difference=10.63, S.E.=5.24, df=1, p<0.05), high internalizing symptoms predicted vigilance towards threat. However, in children with fear-related disorders (n=86, mean difference=-11.90, S.E.=5.94, df=1, p<0.05), high internalizing symptoms predicted an opposite tendency, manifesting as greater bias away from threat. These associations did not emerge in the behaviour-disorder group (n=211). Conclusions. The association between internalizing symptoms and biased orienting varies with the nature of developmental psychopathology. Both the form and severity of psychopathology moderates threat-related attention biases in children.
- The burden of childhood mental disorders(2013) POLANCZYK, Guilherme V.
- Advances and perspectives in child and adolescent psychiatry(2013) KIELING, Christian; POLANCZYK, Guilherme V.
- Developments and challenges in the diagnosis and treatment of ADHD(2013) DIAS, Taciana G. Costa; KIELING, Christian; GRAEFF-MARTINS, Ana Soledade; MORIYAMA, Tais S.; ROHDE, Luis A.; POLANCZYK, Guilherme V.Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often associated with other psychiatric comorbidities, functional impairments, and poor long-term outcomes. The objective of this selected review is to describe current advances and challenges in the diagnosis and treatment of ADHD. The disorder is associated with neurobiological underpinnings and is highly heterogeneous in various aspects, such as symptom profiles, cognitive impairments, and neurobiological and genetic features. The efficacy and safety of short-term pharmacological treatments across the life cycle is well studied, but further research investigating long-term treatment, impact of treatment in preschoolers, and non-pharmacological interventions is needed. Future research is also needed to better characterize the neurodevelopmental pathways of the disorder, linking clinical and neurobiological information, less investigated populations, and new interventions.