GUILHERME VANONI POLANCZYK

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Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • bookPart
    Tratamento do transtorno de déficit de atenção/hiperatividade em adultos
    (2021) FARHAT, Luis C.; MATTOS, Paulo; ROHDE, Luis Augusto; POLANCZYK, Guilherme Vanoni
  • article 11 Citação(ões) na Scopus
    Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis
    (2021) MASSUTI, Rafael; MOREIRA-MAIA, Carlos Renato; CAMPANI, Fausto; SONEGO, Marcio; AMARO, Julia; AKUTAGAVA-MARTINS, Glaucia Chiyoko; TESSARI, Luca; V, Guilherme Polanczyk; CORTESE, Samuele; ROHDE, Luis Augusto
    A controversy exists on whether there is an over or underuse of medications for Attention-Deficit/Hyperactivity Disorder (ADHD). We conducted the first meta-analysis to estimate the rate of ADHD pharmacological treatment in both diagnosed and undiagnosed individuals. Based on a pre-registered protocol (CRD42018085233), we searched a broad set of electronic databases and grey literature. After screening 25,676 abstracts, we retained 36 studies including 104,305 subjects, from which 18 studies met our main analysis criteria. The pooled pharmacological treatment rates were 19.1 % and 0.9 % in school-age children/adolescents with and without ADHD, respectively. We estimated that for each individual using medication without a formal ADHD diagnosis, there are three patients with a formal diagnosis who might benefit from medication but do not receive it in the US. Our results indicate both overtreatment/misuse of medication in individuals without ADHD and pharmacological undertreatment in youths with the disorder. Our findings reinforce the need for public health policies improving education on ADHD and discussions on the benefits and limitations of ADHD medications.
  • article 7 Citação(ões) na Scopus
    A smartphone-assisted brief online cognitive-behavioral intervention for pregnant women with depression: a study protocol of a randomized controlled trial
    (2021) ZUCCOLO, Pedro Fonseca; XAVIER, Mariana O.; MATIJASEVICH, Alicia; POLANCZYK, Guilherme; FATORI, Daniel
    BackgroundPregnancy is strongly associated with increased risk for depression. Approximately 25% of pregnant women develop depression. Treatment for depression during pregnancy has several complexities: the use of psychiatric medications during pregnancy might result in developmental problems in the child and must be used with caution. Psychosocial interventions are effective, but they require specialized professionals. Low- and middle-income countries (LMIC) such as Brazil do not have enough mental health professionals needed to meet this demand. In this context, smartphone-based interventions show immense potential. We developed Motherly, a smartphone application (app) designed to treat maternal depression. We aim to test the efficacy of Motherly in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression.MethodsWe will conduct a 2-arm parallel-randomized controlled clinical trial in which 70 pregnant women aged between 16 and 40years with depression will be randomized to intervention or active control. The intervention group will have access to Motherly, a smartphone app based on three concepts: psychoeducation, behavior monitoring, and gaming elements. Motherly is composed of a package of interventions composed of modules: mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and educational content. The main focus of Motherly is delivering behavioral activation (BA), a brief and structured psychological treatment. The app allows participants to schedule and engage in, and monitor activities according to a plan to avoid acting exclusively according to their mood. The active control group will have access to a simplified version of the app consisting of educational content about various aspects of pregnancy, maternal physical and mental health, and infant development (BA, activity scheduling, sleep hygiene, among other functionalities, will not be present in this version). Both groups will receive four sessions of brief CBT in 8weeks. Participants will be evaluated by assessors blind to randomization and allocation status. Assessments will occur at baseline (T0), midpoint (T1, week 4-5), posttreatment (T2, week 8), and follow-up (T3, when the child is 2 months old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8weeks).DiscussionThe potential of digital technology to deliver mental health interventions has been increasingly recognized worldwide. There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can promote maternal and child health and well-being. In particular, we aim to treat depression, for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression are especially relevant because of the potential to circumvent barriers that prevent pregnant women from accessing mental health care.Trial registrationClinicalTrials.gov NCT04495166. Prospectively registered on July 29, 2020.
  • article 485 Citação(ões) na Scopus
    The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder
    (2021) V, Stephen Faraone; BANASCHEWSKI, Tobias; COGHILL, David; ZHENG, Yi; BIEDERMAN, Joseph; BELLGROVE, Mark A.; NEWCORN, Jeffrey H.; GIGNAC, Martin; SAUD, Nouf M. Al; MANOR, Iris; ROHDE, Luis Augusto; YANG, Li; CORTESE, Samuele; ALMAGOR, Doron; STEIN, Mark A.; ALBATTI, Turki H.; ALJOUDI, Haya F.; ALQAHTANI, Mohammed M. J.; ASHERSON, Philip; ATWOLI, Lukoye; BOLTE, Sven; BUITELAAR, Jan K.; CRUNELLE, Cleo L.; DALEY, David; DALSGAARD, Soren; DOEPFNER, Manfred; ESPINET, Stacey; FITZGERALD, Michael; FRANKE, Barbara; GERLACH, Manfred; HAAVIK, Jan; HARTMAN, Catharina A.; HARTUNG, Cynthia M.; HINSHAW, Stephen P.; HOEKSTRA, Pieter J.; HOLLIS, Chris; KOLLINS, Scott H.; KOOIJ, J. J. Sandra; KUNTSI, Jonna; LARSSON, Henrik; LI, Tingyu; LIU, Jing; MERZON, Eugene; MATTINGLY, Gregory; MATTOS, Paulo; MCCARTHY, Suzanne; MIKAMI, Amori Yee; MOLINA, Brooke S. G.; NIGG, Joel T.; PURPER-OUAKIL, Diane; OMIGBODUN, Olayinka O.; V, Guilherme Polanczyk; POLLAK, Yehuda; POULTON, Alison S.; RAJKUMAR, Ravi Philip; REDING, Andrew; REIF, Andreas; RUBIA, Katya; RUCKLIDGE, Julia; ROMANOS, Marcel; RAMOS-QUIROGA, J. Antoni; SCHELLEKENS, Arnt; SCHERES, Anouk; SCHOEMAN, Renata; SCHWEITZER, Julie B.; SHAH, Henal; V, Mary Solanto; SONUGA-BARKE, Edmund; SOUTULLO, Cesar; STEINHAUSEN, Hans-Christoph; SWANSON, James M.; THAPAR, Anita; TRIPP, Gail; GLIND, Geurt van de; BRINK, Wim van den; OORD, Saskia Van der; VENTER, Andre; VITIELLO, Benedetto; WALITZA, Susanne; WANG, Yufeng
    Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and pre-vent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. Methods: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. Results: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.
  • article 3 Citação(ões) na Scopus
    A mixed methods study of clinician reported challenges in the assessment of ADHD and treatment decisions for children with ADHD in Brazil
    (2021) HONORIO NETO, Fabiola; CAMARGO, Ana Paula; POLANCZYK, Gilherme; ADAMIS, Dimitrios; MCNICHOLAS, Fiona
    Objective: This ADHD national survey has obtained original data on the assessment and treatment of attention deficit hyperactivity disorder (ADHD) reported by Brazilian paediatricians and child psychiatrists; and has compared their practice. Method: The study questionnaire was delivered to 165 neuro/community paediatricians and 272 child and adolescent psychiatrists. Quantitative and qualitative data were collected and analysed. Results: Paediatricians assess children with a suspected ADHD, but do not feel confident to prescribe methylphenidate alone. Both paediatricians and child psychiatrists consider combined treatment of medication and psychotherapy more effective. Clinicians want to involve other professionals in the medical decisions but experience difficulties accessing specialist services, especially in public practice. Conclusion: This study showed the impact of the public-private mix in the delivery of and access to appropriate assessment and treatment services for children with ADHD in Brazil.
  • bookPart
    Tratamento do transtorno de déficit de atenção/hiperatividade
    (2021) FARHAT, Luis C.; ROHDE, Luis Augusto; POLANCZYK, Guilherme Vanoni
  • bookPart
    Saúde emocional da criança
    (2021) POLANCZYK, Guilherme V.
  • bookPart
    Desenvolvimento na infância normal
    (2021) MEDEIROS FILHO, Mauro Victor de; MARANHãO, Pedro Henrique silva; POLANCZYK, Guilherme Vanoni
  • article 7 Citação(ões) na Scopus
    A randomized controlled trial testing the efficacy of a Nurse Home Visiting Program for Pregnant Adolescents
    (2021) FATORI, Daniel; ZUCCOLO, Pedro Fonseca; SHEPHARD, Elizabeth; BRENTANI, Helena; MATIJASEVICH, Alicia; FERRARO, Alexandre Archanjo; FRACOLLI, Lislaine Aparecida; CHIESA, Anna Maria; LECKMAN, James; MIGUEL, Euripedes Constantino; POLANCZYK, Guilherme V.
    To test the efficacy of a nurse home visiting program (HVP) on child development, maternal and environmental outcomes in the first years of life. We conducted a randomized controlled trial to test the efficacy of Primeiros Lacos, a nurse HVP for adolescent mothers living in a poor urban area of SAo Paulo, Brazil. Eighty adolescent mothers were included and randomized to receive either Primeiros Lacos (intervention group, n=40) or healthcare as usual (control group, n=40). Primeiros Lacos is a home visiting intervention delivered by trained nurses that starts during the first 16 weeks of pregnancy and continues to the child's age of 24 months. Participants were assessed by blind interviewers at 8-16 weeks of pregnancy (baseline), 30 weeks of pregnancy, and 3, 6, 12, and 24 months of child's age. We assessed oscillatory power in the mid-range alpha frequency via electroencephalography when the children were aged 6 months. Child development was measured by the Bayley Scales of Infant Development Third Edition (BSID-III). Weight and length were measured by trained professionals and anthropometric indexes were calculated. The home environment and maternal interaction with the child was measured by the Home Observation and Measurement of the Environment. Generalized estimating equation models were used to examine intervention effects on the trajectories of outcomes. Standardized effect sizes (Cohen's d) were calculated using marginal means from endpoint assessments of all outcomes. The trial was registered at clinicaltrial.gov: NCT02807818. Our analyses showed significant positive effects of the intervention on child expressive language development (coefficient=0.89, 95% CI [0.18, 1.61], p=0.014), maternal emotional/verbal responsivity (coefficient=0.97, 95% CI [0.37, 1.58], p=0.002), and opportunities for variety in daily stimulation (coefficient=0.37, 95% CI [0.09, 0.66], p=0.009). Standardized effect sizes of the intervention were small to moderate. Primeiros Lacos is a promising intervention to promote child development and to improve the home environment of low-income adolescent mothers. However, considering the limitations of our study, future studies should be conducted to assess Primeiros Lacos potential to benefit this population.Clinical Trial Registration: The study was registered at clinicaltrial.gov (Registration date: 21/06/2016 and Registration number: NCT02807818).
  • article 6 Citação(ões) na Scopus
    Promoting mother-infant relationships and underlying neural correlates: Results from a randomized controlled trial of a home-visiting program for adolescent mothers in Brazil
    (2021) ALARCAO, Fernanda Speggiorin Pereira; SHEPHARD, Elizabeth; FATORI, Daniel; AMAVEL, Renata; CHIESA, Anna; FRACOLLI, Lislaine; MATIJASEVICH, Alicia; BRENTANI, Helena; NELSON, Charles A.; LECKMAN, James; MIGUEL, Euripedes Constantino; V, Guilherme Polanczyk
    Poverty and teenage pregnancy are common in low-and-middle-income countries and can impede the development of healthy parent-child relationships. This study aimed to test whether a home-visiting intervention could improve early attachment relationships between adolescent mothers and their infants living in poverty in Brazil. Analyses were conducted on secondary outcomes from a randomized controlled trial (NCT0280718) testing the efficacy of a home-visiting program, Primeiros Lacos, on adolescent mothers' health and parenting skills and their infants' development. Pregnant youth were randomized to intervention (n = 40) or care-as-usual (CAU, n = 40) from the first trimester of pregnancy until infants were aged 24 months. Mother-infant attachment was coded during a mother-infant interaction when the infants were aged 12 months. Electrophysiological correlates of social processing (mean amplitude of the Nc component) were measured while infants viewed facial images of the mother and a stranger at age 6 months. Infants in the intervention group were more securely attached and more involved with their mothers than those receiving CAU at 12 months. Smaller Nc amplitudes to the mother's face at 6 months were associated with better social behavior at 12 months. Our findings indicate that the Primeiros Lacos Program is effective in enhancing the development of mother-infant attachment.