JULIANA BELO DINIZ
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
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
- Differential prefrontal gray matter correlates of treatment response to fluoxetine or cognitive-behavioral therapy in obsessive-compulsive disorder(2013) HOEXTER, Marcelo Q.; DOUGHERTY, Darin D.; SHAVITT, Roseli G.; D'ALCANTE, Carina C.; DURAN, Fabio L. S.; LOPES, Antonio C.; DINIZ, Juliana B.; BATISTUZZO, Marcelo C.; EVANS, Karleyton C.; BRESSAN, Rodrigo A.; BUSATTO, Geraldo F.; MIGUEL, Euripedes C.Nearly one-third of patients with obsessive-compulsive disorder (OCD) fail to respond to adequate therapeutic approaches such as serotonin reuptake inhibitors and/or cognitive-behavioral therapy (CBT). This study investigated structural magnetic resonance imaging (MRI) correlates as potential pre-treatment brain markers to predict treatment response in treatment-naive OCD patients randomized between trials of fluoxetine or CBI Treatment-naive OCD patients underwent structural MRI scans before randomization to a 12-week clinical trial of either fluoxetine or group-based CBT. Voxel-based morphometry was used to identify correlations between pretreatment regional gray matter volume and changes in symptom severity on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Brain regional correlations of treatment response differed between treatment groups. Notably, symptom improvement in the fluoxetine treatment group (n=14) was significantly correlated with smaller pretreatment gray matter volume within the right middle lateral orbitofrontal cortex (OFC), whereas symptom improvement in the CBT treatment group (n=15) was significantly correlated with larger pretreatment gray matter volume within the right medial prefrontal cortex (mPFC). No significant a priori regional correlations of treatment response were identified as common between the two treatment groups when considering the entire sample (n=29). These findings suggest that pretreatment gray matter volumes of distinct brain regions within the lateral OFC and mPFC were differentially correlated to treatment response to fluoxetine versus CBT in OCD patients. This study further implicates the mPFC in the fear/anxiety extinction process and stresses the importance of lateral portions of the OFC in mediating fluoxetine's effectiveness in OCD. Clinical registration information: http://clinicaltrials.gov-NCT00680602.
conferenceObject Serotonin reuptake inhibitor augmentation with n-acetylcysteine in treatment resistant ocd: a double-blind randomized controlled trial(2015) COSTA, D. L. C.; DINIZ, J. B.; JOAQUIM, M.; ACCIARITO, A. C.; RODRIGUES, B.; ODA, E.; REQUENA, G.; MIGUEL, E. C.; SHAVITT, R. Gedanke- Dissecting the Yale-Brown Obsessive-Compulsive Scale severity scale to understand the routes for symptomatic improvement in obsessive-compulsive disorder(2017) COSTA, Daniel L. da Conceicao; BARBOSA, Veronica S.; REQUENA, Guaraci; SHAVITT, Roseli G.; PEREIRA, Carlos A. de Braganca; DINIZ, Juliana B.We aimed to investigate which items of the Yale-Brown Obsessive-Compulsive Severity Scale best discriminate the reduction in total scores in obsessive-compulsive disorder patients after 4 and 12 weeks of pharmacological treatment. Data from 112 obsessive-compulsive disorder patients who received fluoxetine (<= 80 mg/day) for 12 weeks were included. Improvement indices were built for each Yale-Brown Obsessive-Compulsive Severity Scale item at two timeframes: from baseline to week 4 and from baseline to week 12. Indices for each item were correlated with the total scores for obsessions and compulsions and then ranked by correlation coefficient. A correlation coefficient. >= 0.7 was used to identify items that contributed significantly to reducing obsessive-compulsive disorder severity. At week 4, the distress items reached the threshold of 0.7 for improvement on the obsession and compulsion subscales although, contrary to our expectations, there was greater improvement in the control items than in the distress items. At week 12, there was greater improvement in the time, interference, and control items than in the distress items. The use of fluoxetine led first to reductions in distress and increases in control over symptoms before affecting the time spent on, and interference from, obsessions and compulsions. Resistance did not correlate with overall improvement. Understanding the pathway of improvement with pharmacological treatment in obsessive-compulsive disorder may provide clues about how to optimize the effects of medication.
conferenceObject Fear conditioning and BDNF levels and genotype in obsessive-compulsive disorder patients pre and post treatment with sertraline: preliminary results(2015) DINIZ, J.; CAPPI, C.; COSTA, D.; REIMER, A.; OLIVEIRA, A. De; BRANDAO, M.; HOEXTER, M.; MIGUEL, E.; SHAVITT, R.conferenceObject Different Brain Activation in Patients With OCD Compared to Healthy Participants During Conditioning: An fMRI Fear Extinction Paradigm(2021) DINIZ, Juliana; BAZAN, Paulo; PEREIRA, Carlos Alberto; SARAIVA, Erlandson; RAMOS, Paula; OLIVEIRA, Amanda; REIMER, Adriano; BRANDAO, Marcus; HOEXTER, Marcelo; SHAVITT, Roseli; MIGUEL, Euripedes; BATISTUZZO, Marcelo- Trajectory in obsessive-compulsive disorder comorbidities(2013) MATHIS, Maria Alice de; DINIZ, Juliana B.; HOUNIE, Ana G.; SHAVITT, Roseli G.; FOSSALUZA, Victor; FERRAO, Ygor; LECKMAN, James F.; PEREIRA, Carlos de Braganca; ROSARIO, Maria Conceicao do; MIGUEL, Euripedes C.The main goal of this study is to contribute to the understanding of the trajectory of comorbid disorders associated with obsessive-compulsive disorder (OCD) according to the first manifested psychiatric disorder and its impact in the clinical course of OCD and subsequent psychiatric comorbidities. One thousand and one OCD patients were evaluated at a single time point. Standardized instruments were used to determine the current and lifetime psychiatric diagnoses (Structured Clinical Interview for DSM-IV Axis I and for impulse-control disorders) as well as to establish current obsessive-compulsive, depressive and anxiety symptom severity (Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale, Beck Depression and Anxiety Inventories and the OCD Natural History Questionnaire). To analyze the distribution of comorbidities according to age at onset Bayesian approach was used. Five hundred eight patients had the first OC symptom onset till the age of 10 years old. The first comorbidity to appear in the majority of the sample was separation anxiety disorder (17.5%, n=175), followed by ADHD (5.0%, n=50) and tic disorders (4.4%, n=44). OCD patients that presented with separation anxiety disorder as first diagnosis had higher lifetime frequency of post-traumatic stress disorder (p=0.003), higher scores in the Sexual/Religious dimension (p=0.04), Beck Anxiety (p<0.001) and Depression (p=0.005) Inventories. OCD patients that initially presented with ADHD had higher lifetime frequencies of substance abuse and dependence (p<0.001) and worsening OCD course (p=0.03). OCD patients that presented with tic disorders as first diagnosis had higher lifetime frequencies of OC spectrum disorders (p=0.03). OCD is a heterogeneous disorder and that the presence of specific comorbid diagnoses that predate the onset of OCD may influence its clinical presentation and course over the lifetime.
conferenceObject Orbitofrontal Thickness as a Measure for Treatment Response Classification in Obsessive-Compulsive Disorder(2014) HOEXTER, Marcelo; DINIZ, Juliana; LOPES, Antonio; BATISTUZZO, Marcelo; SHAVITT, Roseli; DOUGHERTY, Darin; DURAN, Fabio; BRESSAN, Rodrigo; BUSATTO, Geraldo; MIGUEL, Euripedes; SATO, JoaoconferenceObject Fear of dying and fear of guilt: panic disorder/agoraphobia comorbidity in obsessive-compulsive disorder(2013) COSTA, D. L. C.; DINIZ, J. B.; FERRAO, Y. A.; ROSARIO-CAMPOS, M. C.; MIGUEL, E. C.; SHAVITT, R. G.; TORRES, A. R.; FONTENELLE, L. F.- Can early improvement be an indicator of treatment response at twelve weeks in obsessive-compulsive disorder?(2012) COSTA, D.; DINIZ, J. B.; JOAQUIM, M.; BORCATO, S.; VALERIO, C.; MIGUEL, E. C.; SHAVITT, R. G.
- 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.