BRUNO MENDONCA COELHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
8 resultados
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bookPart Diagnóstico em psiquiatria: desde os primórdios até as classificações contemporâneas(2021) WANG, Yuan-Pang; SANTANA, Geilson Lima; CôELHO, Bruno Mendonça; ANDRADE, Laura Helena Silveira Guerra dearticle 0 Citação(ões) na Scopus Assessing skills in psychiatry: a methodological challenge(2011) COELHO, Bruno Mendonca; SANTANA, Geilson Lima- Correlates and prevalence of post-traumatic stress disorders in the Sa tilde o Paulo metropolitan area, Brazil(2022) COELHO, Bruno Mendonca; SANTANA, Geilson Lima; DANTAS, Heloisa de Souza; VIANA, Maria Carmen; ANDRADE, Laura Helena; WANG, Yuan-PangBackground: Post-traumatic stress disorder (PTSD) is a debilitating condition, which generates an extensive burden. We aimed to investigate in a huge metropolitan area, the prevalence of traumatic experiences, the development of PTSD, and its predictors. Methods: Traumatic experiences and PTSD were assessed in 5037 adult individuals of the general population. Cross-tabulations method assessed the prevalence of traumatic events and PTSD. Logistic regression models investigated predictors of lifetime and 12-month odds of PTSD and the conditional probability of developing PTSD for specific traumas. Results: Lifetime and 12-month diagnoses of PTSD were found in 3.2% and 1.6% of the sample. 'Witnessing anyone being injured or killed, or unexpectedly seeing a dead body' (35,7%) and 'being mugged or threatened with a weapon' (34.0%) were the two most reported traumas. The commonest events before PTSD onset were 'sudden unexpected death of a loved one' (34.0%), 'interpersonal violence' (31.0%), and 'threats to the physical integrity of others' (25.0%). Experiences related to ""interpersonal violence "" presented the highest conditional probability for PTSD (range 2.2-21.2%). Being 'sexually assaulted or molested' (21.2% total; 22.3% women; 0.0% men) and being 'raped' (18.8% total; 18.4% women; 20.1% men) were the two experiences with the highest odds for PTSD. While being female was a predictor of less exposure to any event (OR = 0.69), females were more prone to develop lifetime PTSD after exposure to an event (OR = 2.38). Conclusion: Traumatic events are frequent in the general population and a small group of traumatic events accounts for most cases of subsequent PTSD.
- The role of gender in the structure of networks of childhood adversity(2018) COELHO, Bruno Mendonca; SANTANA, Geilson Lima; DUARTE-GUERRA, Leorides Severo; VIANA, Maria Carmen; NETO, Francisco Lotufo; ANDRADE, Laura Helena; WANG, Yuan-PangThe objective of present study is to investigate the relationship between different childhood adversities. The potential impact of early adversity on prevention programs is discussed. Data on twelve childhood adversities was collected from a representative sample of 5037 members of the general population living in a large metropolitan area. Data were analyzed through network analysis, to estimate and compare network connectivity and centrality measures by gender. Over half the respondents had been exposed to at least one adversity during their earlier developmental stage. Among adversity-exposed persons, 48.4% presented simultaneous adversities, most of which were related to 'family dysfunction' and 'maltreatment' (mean = 2.9 adversities). Women reported more adversities than men (59.0% vs. 47.6%). Although the 'global' network connectivity across adversities was similar in both genders, 'regional' distinctions in the network structure were found. While 'neglect' and 'parental death' were more important for women than men, 'parental mental disorders' was more important for men. Gender-related childhood adversities were clustered experiences. Adversities related to 'early family dysfunction' and 'maltreatment' were prominent features in the networks of both boys and girls. Differential preventive and intervention programs should take into account gender-related patterns of exposure and reporting patterns of early adversity.
- The Influence of Parental Psychopathology on Offspring Suicidal Behavior across the Lifespan(2015) SANTANA, Geilson Lima; COELHO, Bruno Mendonca; BORGES, Guilherme; VIANA, Maria Carmen; WANG, Yuan Pang; ANDRADE, Laura HelenaSuicide tends to occur in families, and parental psychopathology has been linked to offspring suicidal behaviors. This study explores the influence of parental mental disorders across the lifespan. Data are from the Sao Paulo Megacity Mental Health Survey, a cross-sectional household study with a representative sample of the adult population living in the Sao Paulo Metropolitan Area, Brazil (N=2,942). Survival models examined bivariate and multivariate associations between a range of parental disorders and offspring suicidality. After controlling for comorbidity, number of mental disorders and offspring psychopathology, we found that parental psychopathology influences suicidal behaviors throughout most part of the life cycle, from childhood until young adult years. Generalized anxiety disorder (GAD) and antisocial personality were associated with offspring suicidal ideation (OR 1.8 and 1.9, respectively), panic and GAD predicted suicidal attempts (OR 2.3 and 2.7, respectively), and panic was related to the transition from ideation to attempts (OR 2.7). Although noticed in many different stages of the lifespan, this influence is most evident during adolescence. In this period, depression and antisocial personality increased the odds of suicidal ideation (OR 5.1 and 3.2, respectively), and depression, panic disorder, GAD and substance abuse predicted suicidal attempts (OR varying from 1.7 to 3.8). In short, parental disorders characterized by impulsive-aggression and anxiety-agitation were the main predictors of offspring suicidality across the lifespan. This clinically relevant intergenerational transmission of suicide risk was independent of offspring mental disorders, and this underscores the need for a family approach to psychopathology.
- The epidemiology of personality disorders in the Sao Paulo Megacity general population(2018) SANTANA, Geilson Lima; COELHO, Bruno Mendonca; WANG, Yuan-Pang; CHIAVEGATTO FILHO, Alexandre Dias Porto; VIANA, Maria Carmen; ANDRADE, Laura HelenaIntroduction Most studies on the epidemiology of personality disorders (PDs) have been conducted in high-income countries and may not represent what happens in most part of the world. In the last decades, population growth has been concentrated in low-and middle-income countries, with rapid urbanization, increasing inequalities and escalation of violence. Our aim is to estimate the prevalence of PDs in the Sao Paulo Metropolitan Area, one of the largest megacities of the world. We examined sociodemographic correlates, the influence of urban stressors, the comorbidity with other mental disorders, functional impairment and treatment. Methods A representative household sample of 2,942 adults was interviewed using the WHO-Composite International Diagnostic Interview and the International Personality Disorder Examination-Screening Questionnaire. Diagnoses were multiply imputed, and analyses used multivariable regression. Results and discussion Prevalence estimates were 4.3% (Cluster A), 2.7% (Cluster B), 4.6% (Cluster C) and 6.8% (any PD). Cumulative exposure to violence was associated with all PDs except Cluster A, although urbanicity, migration and neighborhood social deprivation were not significant predictors. Comorbidity was the rule, and all clusters were associated with other mental disorders. Lack of treatment is a reality in Greater Sao Paulo, and this is especially true for PDs. With the exception of Cluster C, non-comorbid PDs remained largely untreated in spite of functional impairment independent of other mental disorders. Conclusion Personality disorders are prevalent, clinically significant and undertreated, and public health strategies must address the unmet needs of these subjects. Our results may reflect what happens in other developing world megacities, and future studies are expected in other low- and middle-income countries.
- Do Childhood Adversities Predict Suicidality? Findings from the General Population of the Metropolitan Area of Sao Paulo, Brazil(2016) COELHO, Bruno Mendonaca; ANDRADE, Laura Helena; BORGES, Guilherme; SANTANA, Geilson Lima; VIANA, Maria Carmen; WANG, Yuan-PangBackground Childhood adversities have been associated with a number of medical and psychiatric outcomes. However, the reported effects that specific childhood adversities have on suicidality vary across studies. Method This was a cross-sectional, stratified, multistage area probability investigation of a general population in Brazil, designated the Sao Paulo Megacity Mental Health Survey. The World Mental Health Composite International Diagnostic Interview was applied in 5037 individuals >= 18 years of age, in order to assess 12 different adversities occurring during childhood and/or adolescence, as well as to look for associations between those adversities and subsequent suicidality in different age strata. Results Over half of the respondents reported at least one childhood adversity. Only physical abuse was consistently associated with suicide attempts in all subsequent life stages (OR = 2.1). Among adults 20-29 years of age, the likelihood of a suicide attempt was correlated with parental divorce, whereas suicidal ideation was associated with prior sexual abuse. Among adults over 30 years of age, physical illness and economic adversity emerged as relevant childhood adversities associated with suicide attempts, whereas sexual abuse, family violence, and economic adversity were associated with suicidal ideation. Conclusion Childhood adversities, especially physical abuse, are likely associated with unfavorable consequences in subsequent years. For suicidality across a lifespan, the role of different childhood adversities must be examined independently.
- Association between childhood adversities and psychopathology onset throughout the lifespan: Findings from a large metropolitan population(2021) COELHO, Bruno Mendonca; ANDRADE, Laura Helena; SANTANA, Geilson Lima; VIANA, Maria Carmen; WANG, Yuan-PangBackground: Childhood adversities (ECA) are deleterious experiences that can occur during individuals' development, which has been associated with several negative health outcomes. Aim: Analyze the effect of ECA on the onset of DSM-IV disorders throughout life. Method: The Composite International Diagnostic Interview (CIDI) was used in a stratified, multistage area probability sample of 5037 individuals aged 18 or more to assess the presence of childhood adversities, 20 psychiatric disorders and their ages of onset. Discrete-time survival models were performed to estimate the odds of disorder onset. Data are from the Sao Paulo Megacity Mental Health Survey, the Brazilian branch of the World Mental Health Survey Initiative. Findings: 53.6% of the sample experienced at least one ECA, and parental death (16.1%) and physical abuse (16%) were the most reported occurrences. Parental mental illness (OR = 1.99 to 2.27) and family violence (OR = 1.55 to 1.99) were the adversities most consistently associated with psychopathology across all age groups, while economic adversities (OR = 2.71 to 3.30) and parent criminality (OR = 1.72 to 1.77) were associated with psychopathology in individuals whose onset of disorder occurred from age 13 years on. Parental mental disorders and economic adversities were the strongest and most consistent predictors of all four classes of psychopathologies examined in multivariate models controlled for the clustering of adversities. Physical abuse was associated with externalizing disorders, while sexual abuse with internalizing disorders. Interpretation: Childhood adversities were consistently associated with mental disorders. Economic adversities and parent mental disorders were predictive of psychopathology even if controlled for type (additive) and type and number of adversities (interactive models). Parental mental disorder and family violence were the main predictors of psychopathology onset across all age groups. Parental mental disorder was the only adversity that predicted all classes of disorders investigated.