RICARDO ALBERTO MORENO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- ESPECTRA: Searching the Bipolar Spectrum in Eating Disorder patients(2011) CAMPOS, Rodolfo N.; ANGST, Jules; CORDAS, Taki A.; MORENO, Ricardo A.Background: Bipolar Disorder (BD) is a chronic, recurrent and highly prevalent illness. Despite the need for correct diagnosis to allow proper treatment, studies have shown that reaching a diagnosis can take up to ten years due to the lack of recognition of the broader presentations of BD. Frequent comorbidities with other psychiatric disorders are a major cause of misdiagnosis and warrant thorough evaluation. Methods/Design: ESPECTRA (Occurrence of Bipolar Spectrum Disorders in Eating Disorder Patients) is a single-site cross-sectional study involving a comparison group, designed to evaluate the prevalence of bipolar spectrum in an eating disorder sample. Women aged 18-45 years will be evaluated using the SCID-P and Zurich criteria for diagnosis and the HAM-D, YOUNG, SCI-MOODS, HCL-32, BIS-11, BSQ, WHOQoL and EAS instruments for rating symptoms and measuring clinical correlates. Discussion: The classificatory systems in psychiatry are based on categorical models that have been criticized for simplifying the diagnosis and leading to an increase in comorbidities. Some dimensional approaches have been proposed aimed at improving the validity and reliability of psychiatric disorder assessments, especially in conditions with high rates of comorbidity such as BD and Eating Disorder (ED). The Bipolar Spectrum (BS) remains under-recognized in clinical practice and its definition is not well established in current diagnostic guidelines. Broader evaluation of psychiatric disorders combining categorical and dimensional views could contribute to a more realistic understanding of comorbidities and help toward establishing a prognosis.
- Creativity and executive function across manic, mixed and depressive episodes in bipolar I disorder(2011) SOEIRO-DE-SOUZA, Marcio Gerhardt; DIAS, Vasco Videira; BIO, Danielle Soares; POST, Robert M.; MORENO, Ricardo A.Introduction: Creativity is a complex construct involving affective and cognitive components. Bipolar Disorder (BD) has been associated with creativity and is characterized by a wide range of affective and cognitive symptoms. Although studies of creativity in BD have tended to focus on creativity as a trait variable in medicated euthymic patients, it probably fluctuates during symptomatic states of BD. Since creativity is known to involve key affective and cognitive components, it is plausible to speculate that cognitive deficits and symptoms present in symptomatic BD could interfere with creativity. Material and methods: Sixty-seven BD type I patients medication free, age 18-35 years and experiencing a maniac, mixed, or depressive episodes, were assessed for creativity, executive functioning, and intelligence. Results: Manic and mixed state patients had higher creativity scores than depressive individuals. Creativity was influenced by executive function measures only in manic patients. Intelligence did not influence creativity for any of the mood episode types. Conclusion: We propose that creativity in BD might be linked to the putative hyperdopaminergic state of mania and be dependent on intact executive function. Future studies should further explore the role of dopaminergic mechanisms in creativity in BD.
- Analysis of a possible association between oral lichen planus and drug intake. A controlled study(2011) HIROTA, Silvio-K; MORENO, Ricardo-A; SANTOS, Carlos-H R. dos; SEO, Juliana; MIGLIARI, Dante-AObjectives: To investigate whether daily systemic and/or topical medication contributes to the development of oral lichen planus (OLP) lesions. Study Design: The study involved 110 OLP patients and 76 control subjects, matched by age, race and sex. The analyzed data included medical records, drug intake and topical medication. Criteria for analysis of drug intake included: (1) ATC-code drug classification; (2) number of different drugs used daily in the categories of monopharmacy (1 drug), minor polypharmacy (2-4 drugs), and major polypharmacy (> 5 drugs); and (3) drugs implicated in lichenoid reactions (DILRs). Results: Sixty (54.5%) of the 110 OLP patients reported daily medication (prior to the appearance of the OLP lesion) compared to 52 (68.4%) of the 76 control subjects. No statistical difference was found between the two groups in terms of systemic diseases, number of medicated individuals in the categories of mono-and polypharmacy, nor use of DILRs (P > 0.05). Regarding the clinical forms and site of involvement, a statistically significant difference was only found for the clinical erosive form of OLP, seen more frequently in non-DILR (P = 0.04) and nonmedicated OLP patients (P = 0.02) than in DILR OLP patients. Daily use of topical oral medication was reported by 2 (1.8%) OLP patients and 1 (1.3%) control subject. Conclusions: It seems that the use of systemic medication does not lead to a significant increase in the incidence of OLP lesions. For their part, lichenoid drug reactions are likely to occur only in a very low percentage of patients.
- Personality traits in bipolar disorder type I: a sib-pair analysis(2011) ALMEIDA, Karla Mathias; NERY, Fabiano G.; MORENO, Ricardo Alberto; GORENSTEIN, Clarice; LAFER, BenyObjective: The aim of this study was to compare temperament and character traits among patients with bipolar disorder (BD), their siblings, and healthy controls (HCs) in order to examine whether personality traits are related to the genetic vulnerability to develop BD. Methods: Using the Temperament and Character Inventory, we assessed 204 subjects: 67 euthymic outpatients with bipolar disorder type I, 67 siblings without BD, and 70 HCs. Results: Scores on harm avoidance, novelty seeking, and selftranscendence were significantly higher among patients with BD than among HCs, whereas those on self-directedness and cooperativeness were significantly lower. Siblings showed higher scores on harm avoidance and lower scores on self-directedness than did HCs. As some of the siblings presented at least one lifetime psychiatric disorder other than BD (n = 35), we examined the subset of siblings who had no lifetime psychiatric disorder (n = 32). This group showed statistically higher harm avoidance scores than HCs. Conclusions: Our results suggest that the harm avoidance temperament trait and, to a lesser extent, the self-directedness character trait may represent vulnerability factors for BD.
article 4 Citação(ões) na Scopus Validity and reliability of the Structured Clinical Interview for Mood Spectrum - Brazilian Version (SCIMOODS-VB)(2011) RATZKE, Roberto; MORENO, Doris Hupfeld; GORENSTEIN, Clarice; MORENO, Ricardo AlbertoObjective: The aim of this study was to translate the Structured Clinical Interview for Mood Spectrum into Brazilian Portuguese, measuring its reliability, validity, and defining scores for bipolar disorders. Method: Questionnaire was translated (into Brazilian Portuguese) and back-translated into English. Sample consisted of 47 subjects with bipolar disorder, 47 with major depressive disorder, 18 with schizophrenia and 22 controls. Inter-rater reliability was tested in 20 subjects with bipolar disorder and MDD. Internal consistency was measured using the Kuder Richardson formula. Forward stepwise discriminant analysis was performed. Scores were compared between groups; manic (M), depressive (D) and total (T) threshold scores were calculated through receiver operating characteristic (ROC) curves. Results: Kuder Richardson coefficients were between 0.86 and 0.94. Intraclass correlation coefficient was 0.96 (Cl 95 % 0.93-0.97). Subjects with bipolar disorder had higher M and T, and similar D scores, when compared to major depressive disorder (ANOVA, p < 0.001). The sub-domains that best discriminated unipolar and bipolar subjects were manic energy and manic mood. M had the best area under the curve (0.909), and values of M equal to or greater than 30 yielded 91.5% sensitivity and 74.5% specificity. Conclusion: Structured Clinical Interview for Mood Spectrum has good reliability and validity. Cut-off of 30 best differentiates subjects with bipolar disorder vs. unipolar depression. A cutoff score of 30 or higher in the mania subdomain is appropriate to help make a distinction between subjects with bipolar disorder and those with unipolar depression.