MONICA KAYO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
13 resultados
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bookPart Tratamento da esquizofrenia(2021) LOUZã, Mário Rodrigues; KAYO, Monica; VIZZOTTO, Adriana Dias Barbosa; MELZER-RIBEIRO, Débora Luciana; SARNO, Elaine Scapaticio Di; OLIVEIRA, Graça Maria Ramos de; NAPOLITANO, Isabel Cristina; GOMES, Mônica Lopes; ELKIS, Helio- Efficacy of electroconvulsive therapy augmentation for partial response to clozapine: a pilot randomized ECT - sham controlled trial(2017) MELZER-RIBEIRO, Debora Luciana; RIGONATTI, Sergio Paulo; KAYO, Monica; AVRICHIR, Belquiz S.; RIBEIRO, Rafael Bernardon; SANTOS, Bernardo dos; FORTES, Marisa; ELKIS, HelioBackground: Thirty percent of schizophrenia patients are treatment-resistant. Objective: This is a single-blinded sham-controlled trial to assess the efficacy of electroconvulsive therapy (ECT) as augmentation strategy in patients with clozapine-resistant schizophrenia. Methods: Twenty three subjects were randomly assigned to 12 sessions of ECT (N = 13) or placebo (Sham ECT) (N = 10). The primary outcome was improvement on psychotic symptoms as measured by the mean reduction of the PANSS positive subscale. The assessments were performed by blind raters. Results: At baseline both groups were similar, except for negative and total symptoms of the PANSS, which were higher in the Sham group. At the endpoint both groups had a significant decrease from basal score. In the ECT group the PANSS total score decreased 8.78%, from 81.23 to 74.75 (p - 0.042), while the positive subscale had a mean reduction of 19% (19.31 to 16.17, p = 0.006). In the Sham group, the mean reduction of PANSS total score was 15.27% (96.80 to 87.43; p = 0.036), and the PANSS positive subscale decreased 27.81% (22.90 to 19.14, p = 0.008). The CGI score in ECT group decreased 23.0% (5.23 to 4.17; p = 0.001) and decreased 24.31% in the Sham ECT group (5.80 to 4.86; p = 0.004). Discussion: In this pilot study, we found no difference between the groups.
- Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review(2015) SAMARA, Myrto T.; LEUCHT, Claudia; LEEFLANG, Mariska M.; ANGHELESCU, Ion-George; CHUNG, Young-Chul; CRESPO-FACORRO, Benedicto; ELKIS, Helio; HATTA, Kotaro; GIEGLING, Ina; KANE, John M.; KAYO, Monica; LAMBERT, Martin; LIN, Ching-Hua; MOELLER, Hans-Juergen; PELAYO-TERAN, Jose Maria; RIEDEL, Michael; RUJESCU, Dan; SCHIMMELMANN, Benno G.; SERRETTI, Alessandro; CORRELL, Christoph U.; LEUCHT, StefanObjective: How long clinicians should wait before considering an antipsychotic ineffective and changing treatment in schizophrenia is an unresolved clinical question. Guidelines differ substantially in this regard. The authors conducted a diagnostic test meta-analysis using mostly individual patient data to assess whether lack of improvement at week 2 predicts later nonresponse. Method: The search included EMBASE, MEDLINE, BIOSIS, PsycINFO, Cochrane Library, CINAHL, and reference lists of relevant articles, supplemented by requests to authors of all relevant studies. The main outcome was prediction of nonresponse, defined as <50% reduction in total score on either the Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS) (corresponding to at least much improved) from baseline to endpoint (4-12 weeks), by <20% PANSS or BPRS improvement (corresponding to less than minimally improved) at week 2. Secondary outcomes were absent cross-sectional symptomatic remission and <20% PANSS or BPRS reduction at endpoint. Potential moderator variables were examined by meta regression. Results: In 34 studies (N=9,460) a <20% PANSS or BPRS reduction at week 2 predicted nonresponse at endpoint with a specificity of 86% and a positive predictive value (PPV) of 90%. Using data for observed cases (specificity=86%, PPV=85%) or lack of remission (specificity=77%, PPV=88%) yielded similar results. Conversely, using the definition of <20% reduction at endpoint yielded worse results (specificity=70%, PPV=55%). The test specificity was significantly moderated by a trial duration of <6 weeks, higher baseline illness severity, and shorter illness duration. Conclusions: Patients not even minimally improved by week 2 of antipsychotic treatment are unlikely to respond later and may benefit from a treatment change.
- Efficacy of olanzapine in comparison with clozapine for treatment-resistant schizophrenia: evidence from a systematic review and meta-analyses(2013) SOUZA, Juliano S.; KAYO, Monica; TASSELL, Ivson; MARTINS, Camila Bertini; ELKIS, HelioIntroduction. Clozapine is considered the gold standard for the treatment of patients with treatment-resistant schizophrenia (TRS); however, randomized controlled trials (RCT) of olanzapine showed efficacy similar to clozapine in patients with TRS. Methods. A systematic review was conducted comparing clozapine with olanzapine in patients with TRS. Meta-analyses were performed for single outcome measures. Response to treatment was measured by the percentage of responders, or mean change or endpoint values of psychotic symptoms scales. Effect sizes were shown as relative risks (RR), or standardized mean differences, with 95% confidence intervals. Findings. Seven RCT were included, comprising 648 patients. Five meta-analyses were performed. Olanzapine and clozapine had similar effects on dropout rates (RR=0.93, CI95% = 0.77-1.12), PANSS total endpoints (SMD=0.21, CI95% = -0.04-0.46), and PANSS total mean changes (SMD=0.08, CI95% = -0.01-0.027). Clozapine was superior to olanzapine for PANSS positive (SMD=0.51, CI95% = 0.17-0.86) and negative (SMD=0.50, CI95% = 0.16-0.85) subscales. There was a trend toward high doses of olanzapine producing higher effect sizes for this drug. Conclusions. The results of this study suggest that clozapine is significantly more efficacious than olanzapine in improving positive and negative symptoms in TRS patients.
bookPart Síndrome de burnout em profissões não assistenciais(2015) KAYO, Mônica- Does lack of improvement in the first two weeks predict treatment resistance in recent-onset psychosis?(2012) KAYO, Monica; TASSELL, Ivson; HIROCE, Vivian; MENEZES, Anny; ELKIS, Helio
conferenceObject PILOT DOUBLE BLIND, PLACEBO CONTROLLED AND RANDOMIZED STUDY TO ASSESS ELECTROCONVULSIVE THERAPY EFFICACY AS AUGMENTING STRATEGY TO CLOZAPINE IN SUPER-REFRACTORY SCHIZOPHRENIA(2015) MELZER-RIBEIRO, Debora Luciana; RIGONATTI, Sergio Paulo; KAYO, Monica; RIBEIRO, Rafael Bernardon; AVRICHIR, Belquiz; FORTES, Marisa; CAMARGO, Maria Emilia; ELKIS, HeliobookPart Transtorno do espectro da esquizofrenia e outros transtornos psicóticos(2018) ELKIS, Helio; MORIYAMA, Tais S.; LOUZã NETO, Mario Rodrigues; KAYO, MonicaconferenceObject IQ MEASURE: RELATION WITH REFRACTORY SCHIZOPHRENIA(2012) OLIVEIRA, Graca Maria R.; KAYO, Monica; ISO, Sandra M. K.; ELKIS, HeliobookPart Esquizofrenia(2021) ELKIS, Helio; KAYO, Monica; FREITAS, Rosana Ramos de; OLIVEIRA, Graça Maria Ramos de; LEITE, Samuel Araujo; FORTES, Marisa; PANTAROTTO, Ivania; LOUZã, Mario Rodrigues