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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Assunto: Psychology, Developmental ×

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  • conferenceObject
    CATEGORICAL AND DIMENSIONAL ASSESSMENT OF NUCLEUS ACCUMBENS AND AMYGDALA CONNECTIVITY IN DISRUPTIVE BEHAVIOR DISORDERS AND ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)
    (2017) DIAS, Taciana G. Costa; SATO, Joao R.; FAIR, Damien A.; SALUM, Giovanni A.; ROHDE, Luis A.; BRESSAN, Rodrigo A.; PAN, Pedro M.; JACKOWSKI, Andrea P.; POLANCZYK, Guilherme V.
  • article 6 Citação(ões) na Scopus
  • article 5 Citação(ões) na Scopus
    Long-term outcome of children and adolescents with obsessive-compulsive disorder: a 7-9-year follow-up of a randomized clinical trial
    (2020) FATORI, Daniel; POLANCZYK, Guilherme V.; MORAIS, Rosa Magaly Campelo Borba de; ASBAHR, Fernando R.
    Pediatric obsessive-compulsive disorder (OCD) is an impairing disorder frequently associated with long-term persistence. Long-term follow-up studies that investigated psychopathological trajectories after initial treatment are scarce. The present study is a 7-9-year follow-up of a randomized clinical trial (RCT) that tested the efficacy of group cognitive-behavioral therapy (CBT) and sertraline for children with OCD (n = 40), and aimed to describe long-term outcomes of pediatric OCD and identify predictors of these outcomes. Thirty-five participants who were included in the original study were recruited for follow-up evaluations. Participants underwent a comprehensive assessment of demographic and clinical characteristics comprised of the Structured Clinical Interview for DSM Disorders (SCID) and/or Kiddie-Schedule of Affective Disorders and Schizophrenia Present-Lifetime (K-SADS-PL), and the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Thirty-three participants had a complete psychiatric assessment at follow-up (mean age 21 years, SD 3.2; 65% male). At follow-up, 13 (39.4%) participants had an OCD diagnosis, 10 (30.3%) had a diagnosis of any mental disorder (excluding OCD), and 10 (30.3%) did not have any diagnosis of mental disorder. In total, 23 participants (69.7%) had at least one mental disorder (including OCD). Among those without OCD (n = 20), 60.6% had a mental disorder. The following characteristics at follow-up were associated with OCD diagnosis: YBOCS total score (p < 0.001), global functioning (p = 0.008), and presence of any anxiety disorder (p = 0.027). Being treated with GCBT or sertraline during the original RCT did not predict OCD at follow-up. New treatment strategies should consider the role of psychopathological trajectories using a dynamic approach to combine or change interventions to enhance prognosis.
  • article 153 Citação(ões) na Scopus
    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.
  • article 63 Citação(ões) na Scopus
    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, Argyris
    Objective: 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.
  • article 24 Citação(ões) na Scopus
    Associations between ADHD and emotional problems from childhood to young adulthood: a longitudinal genetically sensitive study
    (2020) STERN, Adi; AGNEW-BLAIS, Jessica C.; DANESE, Andrea; FISHER, Helen L.; MATTHEWS, Timothy; V, Guilherme Polanczyk; WERTZ, Jasmin; ARSENEAULT, Louise
    Background Attention deficit/hyperactivity disorder (ADHD) is associated with emotional problems, and their co-occurrence often leads to worse outcomes. We investigated the developmental associations between ADHD and emotional problems from childhood to early adolescence and examined the genetic and environmental contributions to their developmental link. We further tested whether this developmental association remained across the transition to young adulthood. Methods We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a cohort of 2,232 British twins. In childhood, ADHD and emotional problems were assessed at ages 5, 7, 10 and 12 with mothers' and teachers' reports. At age 18, we used self-reported symptoms according to DSM-5 criteria for ADHD, and DSM-IV for anxiety and depression. Results Longitudinal analyses showed that earlier ADHD was associated with later emotional problems consistently across childhood. However, earlier emotional problems were not associated with later ADHD symptoms. The developmental association between ADHD and later emotional problems in childhood was entirely explained by common genetic factors. Consistent with results in childhood, earlier symptoms of ADHD were associated with later emotional problems during the transition to young adulthood. Conclusions Our findings demonstrate that ADHD symptoms are predictors of the development of emotional problems, from childhood up to young adulthood, through shared genetic influences. Interventions targeting ADHD symptoms might prevent the development of emotional problems. Clinicians treating youth with ADHD must be aware of their risk for developing emotional problems and ought to assess, monitor and treat emotional problems alongside ADHD symptoms from childhood to adulthood.
  • conferenceObject
    TRAJECTORIES OF PEDIATRIC OCD SEVERITY DURING EVIDENCE-BASED TREATMENT AS A PREDICTOR OF A 3-5 YEAR PROGNOSIS: A FOLLOW-UP STUDY
    (2019) FATORI, Daniel; LUZ, Leticia; POLANCZYK, Guilherme; ASBAHR, Fernando R.
  • article 5 Citação(ões) na Scopus
    Attention-deficit/hyperactivity disorder from preschool to school age: change and stability of parent and teacher reports
    (2023) OVERGAARD, Kristin Romvig; OERBECK, Beate; FRIIS, Svein; PRIPP, Are Hugo; AASE, Heidi; BIELE, Guido; INGEBORGRUD, Christine Baalsrud; V, Guilherme Polanczyk; ZEINER, Pal
    Identifying attention-deficit/hyperactivity disorder (ADHD) in pre-schoolers may improve their development if treated, but it is unclear whether ADHD symptoms from this age are stable enough to merit treatment. We aimed to investigate the stability of parent- and teacher-reported ADHD symptoms and ADHD classified above the diagnostic symptom thresholds, including for hyperactivity-impulsivity (HI), inattention and combined presentations from age 3 to 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. At child age 3 years, parents were interviewed and teachers rated ADHD symptoms. At age 8 years, parents (n = 783) and teachers (n = 335) reported ADHD symptoms by the Child Symptom Inventory-4. We found a significant reduction in the mean number of parent-reported ADHD and HI symptoms from age 3 to 8 years, but otherwise similar mean numbers. Parent-reported ADHD symptoms were moderately correlated between ages, while correlations were low for teachers. A total of 77/108 (71%) of the children classified with parent-reported HI presentation at age 3 years were no longer classified within any ADHD presentation at age 8 years, the only clear trend across time for either informant. There was a low to moderate parent-teacher-agreement in the number of reported symptoms, and very low informant agreement for the classified ADHD presentations. Overall, clinicians should exercise caution in communicating concern about HI symptoms in preschool children. Age 3 years may be too early to apply the ADHD diagnostic symptom criteria, especially if parents and teachers are required to agree.
  • conferenceObject
  • 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.