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
7 resultados
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- 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.
- Expanding the heuristic neurocircuit-based taxonomy to guide treatment for OCD: reply to the commentary ""Probing the genetic and molecular correlates of connectome alterations in obsessive-compulsive disorder""(2022) SHEPHARD, Elizabeth; STERN, Emily R.; HEUVEL, Odile A. van den; COSTA, Daniel L. C.; BATISTUZZO, Marcelo C.; GODOY, Priscilla B. G.; LOPES, Antonio C.; BRUNONI, Andre R.; HOEXTER, Marcelo Q.; SHAVITT, Roseli G.; REDDY, Y. C. Janardhan; LOCHNER, Christine; STEIN, Dan J.; SIMPSON, H. Blair; MIGUEL, Euripedes C.
- Measurement Fidelity of Clinical Assessment Methods in a Global Study on Identifying Reproducible Brain Signatures of Obsessive-Compulsive Disorder(2023) SHAVITT, Roseli G.; SHESHACHALA, Karthik; HEZEL, Dianne M.; WALL, Melanie M.; BALACHANDER, Srinivas; LOCHNER, Christine; NARAYANASWAMY, Janardhanan C.; COSTA, Daniel L. C.; MATHIS, Maria Alice de; BALKOM, Anton J. L. M. van; JOODE, Niels T. de; NARAYAN, Madhuri; HEUVEL, Odile A. van den; STEIN, Dan J.; MIGUEL, Euripedes C.; SIMPSON, Helen Blair; REDDY, Y. C. JanardhanObjective: To describe the steps of ensuring measurement fidelity of core clinical measures in a five-country study on brain signatures of obsessive-compulsive disorder (OCD). Method: We collected data using standardized instruments, which included the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Dimensional YBOCS (DYBOCS), the Brown Assessment of Beliefs Scale (BABS), the 17-item Hamilton Depression Scale (HAM-D), the Hamilton Anxiety Scale (HAM-A), and the Structured Clinical Interview for DSM-5 (SCID). Steps to ensure measurement fidelity included translating instruments, developing a clinical decision manual, and continuing reliability training with 11-13 transcripts of each instrument by 13 independent evaluators across sites over 4 years. We use multigroup confirmatory factor analysis (MGCFA) to report interrater reliability (IRR) among the evaluators and factor structure for each scale in 206 participants with OCD. Results: The overall IRR for most scales was high (ICC > 0.94) and remained good to excellent throughout the study. Consistent factor structures (configural invariance) were found for all instruments across the sites, while similarity in the factor loadings for the items (metric invariance) could be established only for the DYBOCS and the BABS. Conclusions: It is feasible to achieve measurement fidelity of clinical measures in multisite, multilinguistic global studies, despite the challenges inherent to such endeavors. Future studies should not only report IRR but also consider reporting methods of standardization of data collection and measurement invariance to identify factor structures of core clinical measures.
- 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.
- Clinical characteristics of probands with obsessive-compulsive disorder from simplex and multiplex families(2024) LIMA, Monicke; SARAIVA, Leonardo C.; RAMOS, Vanessa R.; OLIVEIRA, Melaine C.; COSTA, Daniel L. C.; V, Thomas Fernandez; CROWLEY, James J.; STORCH, Eric A.; SHAVITT, Roseli G.; MIGUEL, Euripedes C.; CAPPI, CarolinaGenetic and non-genetic factors contribute to obsessive-compulsive disorder (OCD), with strong evidence of familial clustering. Genomic studies in psychiatry have used the concepts of families that are ""simplex"" (one affected) versus ""multiplex"" (multiple affected). Our study compares demographic and clinical data from OCD probands in simplex and multiplex families to uncover potential differences. We analyzed 994 OCD probands (501 multiplex, 493 simplex) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinicians administered the Structured Clinical Interview for DSM-IV (SCID-IV) to diagnose, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess severity, and Dimensional Yale-Brown ObsessiveCompulsive Scale (DY-BOCS) to assess symptom dimensionality. Demographics, clinical history, and family data were collected. Compared to simplex probands, multiplex probands had earlier onset, higher sexual/religious and hoarding dimensions severity, increased comorbidity with other obsessive-compulsive-related disorders (OCRD), and higher family history of psychiatric disorders. These comparisons provide the first insights into demographic and clinical differences between Latin American simplex and multiplex families with OCD. Distinct clinical patterns may suggest diverse genetic and environmental influences. Further research is needed to clarify these differences, which have implications for symptom monitoring and management.