BENY LAFER
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
- Association between history of suicide attempts and family functioning in bipolar disorder(2016) BERUTTI, Mariangeles; DIAS, Rodrigo Silva; PEREIRA, Vivian Alves; LAFER, Beny; NERY, Fabiano G.Objectives: To investigate the association between history of suicide attempts (SA) and family functioning in bipolar disorder (BD) patients. Methods: Thirty-one BD type I patients with lifetime history of SA, 31 BD type I with no lifetime history of SA, participating in the Outpatient Clinic of the Bipolar Disorder Program at the Institute of Psychiatry of the University of Sao Paulo Medical School were recruited for this study. We used the Family Assessment Device (FAD) to evaluate family functioning. We compared these two groups on demographic and clinical variables to identify which variables were associated with family functioning impairment. Fifty-one relatives of the same patients were also asked to complete a FAD. Results: BD patients with SA presented more psychiatric hospitalizations, higher frequency of psychotic symptoms, and higher scores on depressive, manic, and suicidal ideation than BD patients without SA. BD patients with SA presented significantly higher scores in several subscales of the FAD, including Problem Solving (p=0.042), Communication (p=0.009), Roles (p=0.006), and General Functioning (p=0.025), when compared with BD patients without SA. Relatives of BD patients with SA presented significantly higher scores in Communication, Roles, Affective Responsiveness, and General Functioning than relatives of BD patients without SA. Limitations: Cross-sectional study and long time elapsed since last SA. Conclusion: History of SA in BD is associated with worse family functioning in several domains of FAD, including Problem Solving, Communication, Roles, and General Functioning. As suicide attempts are routinely assessed in clinical practice, these findings may help to identify patients with poorer family functioning and may suggest a role for environmental risk factors in suicidal behavior among BD patients.
bookPart Instrumentos de avaliação de mania(2016) CAETANO, Sheila C.; LAFER, Beny- Internet use by patients with bipolar disorder: Results from an international multisite survey(2016) BAUER, Rita; CONELL, Joern; GLENN, Tasha; ALDA, Martin; ARDAU, Raffaella; BAUNE, Bernhard T.; BERK, Michael; BERSUDSKY, Yuly; BILDERBECK, Amy; BOCCHETTA, Alberto; BOSSINI, Letizia; CASTRO, Angela M. Paredes; CHEUNG, Eric Y. W.; CHILLOTTI, Caterina; CHOPPIN, Sabine; ZOMPO, Maria Del; DIAS, Rodrigo; DODD, Seetal; DUFFY, Anne; ETAIN, Bruno; FAGIOLINI, Andrea; HERNANDEZ, Miryam Fernandez; GARNHAM, Julie; GEDDES, John; GILDEBRO, Jonas; GONZALEZ-PINTO, Ana; GOODWIN, Guy M.; GROF, Paul; HARIMA, Hirohiko; HASSEL, Stefanie; HENRY, Chantal; HIDALGO-MAZZEI, Diego; KAPUR, Vaisnvy; KUNIGIRI, Girish; LAFER, Beny; LARSEN, Erik R.; LEWITZKA, Ute; LICHT, Rasmus W.; LUND, Anne Hvenegaard; MISIAK, Blazej; MONTEITH, Scott; MUNOZ, Rodrigo; NAKANOTANI, Takako; NIELSEN, Rene E.; O'DONOVAN, Claire; OKAMURA, Yasushi; OSHER, Yamima; PIOTROWSKI, Patryk; REIF, Andreas; RITTER, Philipp; RYBAKOWSKI, Janusz K.; SAGDUYU, Kemal; SAWCHUK, Brett; SCHWARTZ, Elon; SCIPPA, Angela M.; SLANEY, Claire; SULAIMAN, Ahmad H.; SUOMINEN, Kirsi; SUWALSKA, Aleksandra; TAM, Peter; TATEBAYASHI, Yoshitaka; TONDO, Leonardo; VIETA, Eduard; VINBERG, Maj; VISWANATH, Biju; VOLKERT, Julia; ZETIN, Mark; WHYBROW, Peter C.; BAUER, MichaelThere is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.
- Association between duration of untreated bipolar disorder and clinical outcome: data from a Brazilian sample(2016) MEDEIROS, Gustavo C.; SENCO, Sofia B.; LAFER, Beny; ALMEIDA, Karla M.Objective: Bipolar disorder (BD) is often left untreated for long periods, and this delay in treatment correlates with unfavorable prognosis. The present study sought to assess the magnitude of duration of untreated bipolar disorder (DUB) in Brazil. We hypothesized that DUB would be longer in Brazil than in developed countries, and would be associated with poor clinical outcomes. Methods: One hundred and fifty-two psychiatric outpatients were evaluated for BD diagnosis, demographics, DUB, and clinical outcomes. Results: The mean age and mean DUB were, respectively, 38.9 +/- 10.8 and 10.4 +/- 9.8 years. An extended DUB was associated with early onset of BD (p < 0.001), depression as first mood episode (p = 0.04), and presence of BD in a first-degree relative (p = 0.012). Additionally, a longer DUB was associated with poorer clinical outcomes, such as elevated rates of rapid cycling (p = 0.004) and anxiety disorders (p = 0.016), as well as lower levels of current full remission (p = 0.021). Conclusion: As DUB may be a modifiable variable, better medical education regarding mental health, more structured medical services, and population-wide psychoeducation might reduce the time between onset and proper management of BD, thus improving outcome.
- Online information seeking by patients with bipolar disorder: results from an international multisite survey(2016) CONELL, Jorn; BAUER, Rita; GLENN, Tasha; ALDA, Martin; ARDAU, Raffaella; BAUNE, Bernhard T.; BERK, Michael; BERSUDSKY, Yuly; BILDERBECK, Amy; BOCCHETTA, Alberto; BOSSINI, Letizia; CASTRO, Angela Marianne Paredes; CHEUNG, Eric Yat Wo; CHILLOTTI, Caterina; CHOPPIN, Sabine; ZOMPO, Maria Del; DIAS, Rodrigo; DODD, Seetal; DUFFY, Anne; ETAIN, Bruno; FAGIOLINI, Andrea; GARNHAM, Julie; GEDDES, John; GILDEBRO, Jonas; GONZALEZ-PINTO, Ana; GOODWIN, Guy M.; GROF, Paul; HARIMA, Hirohiko; HASSEL, Stefanie; HENRY, Chantal; HIDALGO-MAZZEI, Diego; KAPUR, Vaisnvy; KUNIGIRI, Girish; LAFER, Beny; LAM, Chun; LARSEN, Erik Roj; LEWITZKA, Ute; LICHT, Rasmus; LUND, Anne Hvenegaard; MISIAK, Blazej; PIOTROWSKI, Patryk; MONTEITH, Scott; MUNOZ, Rodrigo; NAKANOTANI, Takako; NIELSEN, Rene E.; O'DONOVAN, Claire; OKAMURA, Yasushi; OSHER, Yamima; REIF, Andreas; RITTER, Philipp; RYBAKOWSKI, Janusz K.; SAGDUYU, Kemal; SAWCHUK, Brett; SCHWARTZ, Elon; SCIPPA, Angela Miranda; SLANEY, Claire; SULAIMAN, Ahmad Hatim; SUOMINEN, Kirsi; SUWALSKA, Aleksandra; TAM, Peter; TATEBAYASHI, Yoshitaka; TONDO, Leonardo; VIETA, Eduard; VINBERG, Maj; VISWANATH, Biju; VOLKERT, Julia; ZETIN, Mark; ZORRILLA, Inaki; WHYBROW, Peter C.; BAUER, MichaelBackground: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.
- Decreased Brain-Derived Neurotrophic Factor in Older Adults with Bipolar Disorder(2016) SOARES, Aline T.; ANDREAZZA, Ana C.; REJ, Soham; RAJJI, Tarek K.; GILDENGERS, Ariel G.; LAFER, Beny; YOUNG, L. Trevor; MULSANT, Benoit H.Objectives: Decreased levels of brain derived neurotrophic factor (BDNF) have been found in adult patients with bipolar disorder (BD) compared with a comparison group, yet there are no data specifically examining this in geriatric patients. The objective of this study was to examine whether euthymic late-life BD patients have lower BDNF levels than healthy comparators. Design: Cross-sectional study. Setting: Clinics at the University of Pittsburgh and the Centre for Addiction and Mental Health (Toronto). Participants: Older patients with BD (age >= 50 years, N = 118) and similarly aged healthy comparators (N = 76). There were both BD type I (N = 91) and type II (N = 27) patients. Measurements: Serum BDNF levels were assessed in BD patients and healthy comparators. Results: We found lower levels of BDNF in patients with BD than in healthy comparators (9.0 +/- 6.2 versus 12.3 +/- 8.9 pg/mu g, t((192)) = -3.01, p = 0.002), which remained even after controlling for age, sex, lithium use, and site (F-(1,F-176) = 4.32, p = 0.039). This decrease was found specifically in patients with BD type I (8.0 +/- 5.5 versus 12.3 +/- 8.9 pg/mu g, t((165)) = 3.7, Bonferroni p < 0.001), but not type II (12.0 +/- 7.5 versus 12.3 +/- 8.9 pg/mu g, t((101)) = 0.14, Bonferroni p = 1.0). Conclusions: Older patients with BD have lower serum levels of BDNF compared with similarly aged comparators. These effects appear to be specific to patients with BD type I. Future studies are needed to investigate the impact of reduced BDNF levels on cognition, mood, and other aspects of BD throughout the life course.
conferenceObject The impact of CACNA1C risk allele on prefrontal age-related cortical thinning in bipolar I disorder(2016) SOEIRO-DE-SOUZA, M.; MORENO, R.; NERY, F.; MACHADO-VIEIRA, R.; CHAIM, K.; LAFER, B.; OTADUY, M.; VALLADA, H.- Facial emotion recognition in euthymic patients with bipolar disorder and their unaffected first-degree relatives(2016) FERNANDES, Franey de Brito Ferreira; GIGANTE, Alexandre Duarte; BERUTTIA, Mariangeles; AMARAL, Jose Antonio; ALMEIDA, Karla Mathias de; ROCCA, Cristiana Castanho de Almeida; LAFER, Beny; NERY, Fabiano GoncalvesBackground: Facial emotion recognition (FER) is an important task associated with social cognition because facial expression is a significant source of non-verbal information that guides interpersonal relationships. Increasing evidence suggests that bipolar disorder (BD) patients present deficits in FER and these deficits may be present in individuals at high genetic risk for BD. The aim of this study was to evaluate the occurrence of FER deficits in euthymic BD patients, their first-degree relatives, and healthy controls (HC) and to consider if these deficits might be regarded as an endophenotype candidate for BD. Methods: We studied 23 patients with DSM-IV BD type I, 22 first-degree relatives of these patients, and 27 HC. We used the Penn Emotion Recognition Tests to evaluate tasks of FER, emotion discrimination, and emotional acuity. Patients were recruited from outpatient facilities at the Institute of Psychiatry of the University of Sao Paulo Medical School, or from the community through media advertisements, had to be euthymic, with age above 18 years old and a diagnosis of DSM-IV BD type I. Results: Euthymic BD patients presented significantly fewer correct responses for fear, and significantly increased time to response to recognize happy faces when compared with HC, but not when compared with first-degree relatives. First-degree relatives did not significantly differ from HC on any of the emotion recognition tasks. Conclusion: Our results suggest that deficits in FER are present in euthymic patients, but not in subjects at high genetic risk for BD. Thus, we have not found evidence to consider FER as an endophenotype candidate for BD.
- Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder(2016) GOMES, Bernardo C.; KLEINMAN, Ana; CARVALHO, Andrea Ferrari; PEREIRA, Tatiana Couto F.; GURGEL, Ana Paola; LAFER, Beny; BUSATTO, Geraldo F.; CAETANO, Sheila C.; ROCCA, Cristiana Castanho de AlmeidaBackground: There have been few studies investigating quality of life (QoL) in pediatric bipolar disorder (BD) patients and none comparing it with that observed in unaffected offspring of parents with BD and healthy controls. Methods: The self-report Youth Quality of Life Instrument-Research version (YQoL-R) was administered in 26 pediatric BD patients, 17 unaffected offspring of parents with BD, and 24 individuals with no history of DSM-IV Axis I psychiatric disorders. All diagnoses were determined through interviews based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Results: There were statistical differences among the groups for all YQoL-R domains. Pairwise comparisons showed that perceived QoL was significantly worse in the BD group than in the unaffected offspring and healthy subjects, a difference that persisted even when only euthymic subjects were analyzed. There were no significant differences between the unaffected offspring and healthy subjects for any YQoL-R domain. Limitations: Our sample was small. There was no QoL report from subjects parents nor data about family environment or BD parents' mood state. Conclusions: There is a need for studies to investigate in greater detail the relationship between QoL and psychological resilience, particularly in the unaffected offspring of parents with BD.
- Serum BDNF levels in unaffected first-degree relatives of patients with bipolar disorder(2016) NERY, Fabiano G.; GIGANTE, Alexandre D.; AMARAL, Jose A.; FERNANDES, Francy B.; BERUTTI, Mariangeles; ALMEIDA, Karla M.; STERTZ, Laura; BRISTOT, Giovana; KAPCZINSKI, Flavio; LAFER, BenyObjective: Unaffected relatives of bipolar disorder (BD) patients have been investigated for the identification of endophenotypes in an attempt to further elucidate the pathophysiology of the disease. Brain-derived neurotrophic factor (BDNF) is considered to be implicated in the pathophysiology of BD, but its role as an endophenotype has been poorly studied. We investigated abnormal serum BDNF levels in BD patients, in their unaffected relatives, and in healthy controls. Methods: BDNF levels were obtained from 25 DSM-IV bipolar I disorder patients, 23 unaffected relatives, and 27 healthy controls. All BD patients were in remission. The unaffected subjects were first-degree relatives of the proband who had no lifetime DSM-IV diagnosis of axis I disorder. BDNF serum levels were determined by sandwich ELISA using monoclonal BDNF-specific antibodies. Results: There were no statistical differences in BDNF levels among BD patients, relatives, and healthy controls. Conclusion: Serum BDNF levels may not indicate high genetic risk for BD, possibly acting as state markers rather than trait markers of the disease.