DANIEL LUCAS DA CONCEICAO COSTA
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
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Latency to treatment seeking in patients with obsessive-compulsive disorder: Results from a large multicenter clinical sample(2022) CONCEICA, Daniel Lucas da; CAMPOS, Adriano Polpo de; PEREIRA, Carlos Alberto de Braganca; TORRES, Albina R.; SANTOS, Allan Christiano dos; REQUENA, Guaraci; FERRA, Ygor ArzenoThis study aimed to identify the factors associated with a delay in treatment-seeking among patients with obsessive-compulsive disorder (OCD), a disabling neuropsychiatric disorder. To achieve this purpose, we conducted a cross-sectional study examining latency to treatment (LTT) and its associated correlates in 863 patients with OCD. We defined LTT as the time lag between the awareness of discomfort and/or impairment caused by symptoms and the beginning of OCD-specific treatment. To determine the socio-demographic and clinical characteristics associated with LTT, we built an interval-censored survival model to simultaneously assess the relationship between all variables, representing the best fit to our data format. The results of our study showed that approximately one-third of OCD patients sought treatment within two years of symptom awareness, onethird between two and nine years, and one-third after ten or more years. Median LTT was 4.0 years (mean = 7.96, SD = 9.54). Longer LTT was associated with older age, early onset of OCD symptoms, presence of contamination/cleaning symptoms and full-time employment. Shorter LTT was associated with the presence of aggression symptoms and comorbidity with hypochondriasis. The results of our study confirm the understanding that LTT in OCD is influenced by several interdependent variables - some of which are modifiable. Strategies for reducing LTT should focus on older patients, who work in a full-time job, and on individuals with early onset of OCD and contamination/cleaning symptoms.
- World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part I: Anxiety disorders(2023) BANDELOW, Borwin; ALLGULANDER, Christer; BALDWIN, David S.; COSTA, Daniel Lucas da Conceicao; DENYS, Damiaan; DILBAZ, Nesrin; DOMSCHKE, Katharina; ERIKSSON, Elias; FINEBERG, Naomi A.; HATTENSCHWILER, Josef; HOLLANDER, Eric; KAIYA, Hisanobu; KARAVAEVA, Tatiana; KASPER, Siegfried; KATZMAN, Martin; KIM, Yong-Ku; INOUE, Takeshi; LIM, Leslie; MASDRAKIS, Vasilios; MENCHON, Jose M.; MIGUEL, Euripedes C.; MOLLER, Hans-Jurgen; NARDI, Antonio E.; PALLANTI, Stefano; PERNA, Giampaolo; RUJESCU, Dan; STARCEVIC, Vladan; STEIN, Dan J.; TSAI, Shih-Jen; AMERINGEN, Michael Van; VASILEVA, Anna; WANG, Zhen; ZOHAR, JosephAim This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders (published in 2002, revised in 2008). Method A consensus panel of 33 international experts representing 22 countries developed recommendations based on efficacy and acceptability of available treatments. In total, 1007 RCTs for the treatment of these disorders in adults, adolescents, and children with medications, psychotherapy and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medications. Result This paper, Part I, contains recommendations for the treatment of panic disorder/agoraphobia (PDA), generalised anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, mixed anxiety disorders in children and adolescents, separation anxiety and selective mutism. Selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line medications. Cognitive behavioural therapy (CBT) is the first-line psychotherapy for anxiety disorders. The expert panel also made recommendations for patients not responding to standard treatments and recommendations against interventions with insufficient evidence. Conclusion It is the goal of this initiative to provide treatment guidance for these disorders that has validity throughout the world.
- World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part II: OCD and PTSD(2023) BANDELOW, Borwin; ALLGULANDER, Christer; BALDWIN, David S.; COSTA, Daniel Lucas da Conceicao; DENYS, Damiaan; DILBAZ, Nesrin; DOMSCHKE, Katharina; HOLLANDER, Eric; KASPER, Siegfried; MOELLER, Hans-Juergen; ERIKSSON, Elias; FINEBERG, Naomi A.; HAETTENSCHWILER, Josef; KAIYA, Hisanobu; KARAVAEVA, Tatiana; KATZMAN, Martin A.; KIM, Yong-Ku; INOUE, Takeshi; LIM, Leslie; MASDRAKIS, Vasilios; MENCHON, Jose M.; MIGUEL, Euripedes C.; NARDI, Antonio E.; PALLANTI, Stefano; PERNA, Giampaolo; RUJESCU, Dan; STARCEVIC, Vladan; STEIN, Dan J.; TSAI, Shih-Jen; AMERINGEN, Michael Van; VASILEVA, Anna; WANG, Zhen; ZOHAR, JosephAim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008. Method: A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments. Result: The present paper (Part II) contains recommendations based on published randomised controlled trials (RCTs) for the treatment of OCD (n = 291) and PTSD (n = 234) in children, adolescents, and adults. The accompanying paper (Part I) contains the recommendations for the treatment of anxiety disorders. For OCD, first-line treatments are selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT). Internet-CBT was also superior to active controls. Several second-line medications are available, including clomipramine. For treatment-resistant cases, several options are available, including augmentation of SSRI treatment with antipsychotics and other drugs. Other non-pharmacological treatments, including repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS) and others were also evaluated. For PTSD, SSRIs and the SNRI venlafaxine are first-line treatments. CBT is the psychotherapy modality with the best body of evidence. For treatment-unresponsive patients, augmentation of SSRI treatment with antipsychotics may be an option. Conclusion: OCD and PTSD can be effectively treated with CBT and medications.
- Early intervention for obsessive compulsive disorder: An expert consensus statement(2019) FINEBERG, Naomi A.; DELL'OSSO, Bernardo; ALBERT, Umberto; MAINA, Giuseppe; GELLER, Daniel; CARMI, Lior; SIREAU, Nick; WALITZA, Susanne; GRASSI, Giacomo; PALLANTI, Stefano; HOLLANDER, Eric; BRAKOULIAS, Vlasios; MENCHON, Jose M.; MARAZZITI, Donatella; IOANNIDIS, Konstantinos; APERGIS-SCHOUTE, Annemieke; STEIN, Dan J.; CATH, Danielle C.; VELTMAN, Dick J.; AMERINGEN, Michael Van; FONTENELLE, Leonardo F.; SHAVITT, Roseli G.; COSTA, Daniel; DINIZ, Juliana B.; ZOHAR, JosephObsessive-compulsive disorder (OCD) is common, emerges early in life and tends to run a chronic, impairing course. Despite the availability of effective treatments, the duration of untreated illness (DUI) is high (up to around 10 years in adults) and is associated with considerable suffering for the individual and their families. This consensus statement represents the views of an international group of expert clinicians, including child and adult psychiatrists, psychologists and neuroscientists, working both in high and low and middle income countries, as well as those with the experience of living with OCD. The statement draws together evidence from epidemiological, clinical, health economic and brain imaging studies documenting the negative impact associated with treatment delay on clinical outcomes, and supporting the importance of early clinical intervention. It draws parallels between OCD and other disorders for which early intervention is recognized as beneficial, such as psychotic disorders and impulsive-compulsive disorders associated with problematic usage of the Internet, for which early intervention may prevent the development of later addictive disorders. It also generates new heuristics for exploring the brain-based mechanisms moderating the 'toxic' effect of an extended DUI in OCD. The statement concludes that there is a global unmet need for early intervention services for OC related disorders to reduce the unnecessary suffering and costly disability associated with under-treatment. New clinical staging models for OCD that may be used to facilitate primary, secondary and tertiary prevention within this context are proposed.
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment(2023) OLIVEIRA, Marcos Vinicius Sousa de; BARROS, Pedro Macul Ferreira de; MATHIS, Maria Alice de; BOAVISTA, Rodrigo; CHACON, Priscila; ECHEVARRIA, Marco Antonio Nocito; FERRAO, Ygor Arzeno; VATTIMO, Edoardo Felippo de Queiroz; LOPES, Antonio Carlos; TORRES, Albina Rodrigues; DINIZ, Juliana Belo; FONTENELLE, Leonardo F.; ROSARIO, Maria Conceicao do; SHAVITT, Roseli Gedanke; MIGUEL, Euripedes Constantino; SILVA, Renata de Melo Felipe da; COSTA, Daniel Lucas da ConceiaoObjectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD).Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological interven-tion for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first -line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part II: cognitive-behavioral therapy(2023) MATHIS, Maria Alice de; CHACON, Priscila; BOAVISTA, Rodrigo; OLIVEIRA, Marcos Vinicius Sousa de; BARROS, Pedro Macul Ferreira de; ECHEVARRIA, Marco Antonio Nocito; FERRAO, Ygor Arzeno; VATTIMO, Edoardo Filippo de Queiroz; LOPES, Antonio Carlos; TORRES, Albina Rodrigues; DINIZ, Juliana Belo; FONTENELLE, Leonardo; ROSARIO, Maria Conceicao do; SHAVITT, Roseli Gedanke; SILVA, Renata de Melo Felipe da; CONSTANTINO, Euripedes; COSTA, Daniel Lucas da ConceicaoObjectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD).Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association.Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD.Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD.