RICARDO ALBERTO MORENO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Lithium efficacy in bipolar depression with flexible dosing: A six-week, open-label, proof-of-concept study(2014) MACHADO-VIEIRA, Rodrigo; ZANETTI, Marcus V.; SOUSA, Rafael T. De; SOEIRO-DE-SOUZA, Marcio G.; MORENO, Ricardo A.; BUSATTO, Geraldo F.; GATTAZ, Wagner F.Lithium has a narrow therapeutic index with a subtle balance between effectiveness and adverse effects. Current guidelines recommend the use of lithium as a treatment for acute bipolar depression; however, the therapeutic range for the treatment has not been fully defined. Recently, the adjunctive lower lithium dose in bipolar depression has revealed potential efficacy; however, no study has investigated it predominantly in monotherapy. In this open-label, proof-of-concept study, 31 individuals with bipolar disorder during a depressive episode were randomized and 29 were followed up for six weeks with flexible lithium dosing. All subjects had a 21-item Hamilton Rating Scale for Depression (HAM-D) score of >= 18 at baseline. Subjects were divided into two groups, with higher (Li >= 0.5 mEq/l) or lower (Li <0.5 mEq/l) blood lithium levels. Response and remission rates were evaluated using the HAM-D scores. Following 6 weeks of lithium treatment, the remission rate for all patients was 62.0%. The plasma lithium levels did not impact the clinical response. However, subjects with higher blood lithium levels had an increased prevalence of nausea, restlessness, headaches and cognitive complaints. The results indicate that the lithium dose for the treatment of bipolar depression in an individual should be based on the clinical efficacy and side-effects. In the context of personalized psychiatric treatments, it is necessary to evaluate the therapeutic action of lithium with individual regimens in order to develop more tolerable and effective treatment approaches.
- Influence of personality traits in coping skills in individuals with bipolar disorder(2014) SOUZA, Erika Leonardo de; GRASSI-OLIVEIRA, Rodrigo; BRIETZKE, Elisa; SANVICENTE-VIEIRA, Breno; DARUY-FILHO, Ledo; MORENO, Ricardo AlbertoBackground: Bipolar disorder is marked by alterations in coping skills which in turn impacts the disease course. Personality traits are associated with coping skills and for this reason it has been suggested that personality traits of patients with BD may have influence over their coping skills. Objective: To investigate possible associations between coping skills and personality in individuals with bipolar disorder (BD). Methods: Thirty-five euthymic subjects with BD were compared with 40 healthy controls. Coping skills were evaluated using Ways of Coping Checklist Revised and Brief-COPE. Personality traits were assessed by Neo Personality Inventory. MANCOVA was used for between groups comparison. Results: Regarding coping, individuals with BD reported more frequent use of emotion-focused strategies than problem-focused strategies, and high levels of neuroticism and low levels of extroversion and conscientiousness on personality measures. Neuroticism influenced negatively the use of problem-focused strategies, and positively emotion-focused coping. Conscientiousness influenced the use of problem-focused strategies in both groups. There was a significant difference between emotion focused coping and personality traits between BD and control groups. Discussion: Personality traits seem to modulate coping skills and strategies in BD which may be took into account for further interventions.
conferenceObject Prefrontal cortex gamma-aminobutyric acid levels in bipolar I disorder determined using proton magnetic resonance spectroscopy(2014) SOEIRO-DE-SOUZA, M.; OTADUY, M. C. G.; MORENO, R. A.; MORENO, D. H.; VALLADA, H.- Association study between COMT (158)Met and creativity scores in bipolar disorder and healthy controls(2014) SOEIRO-DE-SOUZA, Marcio Gerhardt; POST, Robert; MACHADO-VIEIRA, Rodrigo; PRADO, Carolina Martins do; MORENO, Ricardo Alberto; AKISKAL, Hagop; AKISKAL, Kareen K.Background: Bipolar disorder (BD) patients have been reported to be associated higher creativity abilities, and recent data tend to support the hypothesis that dopaminergic system that could be associated with creativity. Catechol-O-methyltransferase (COMT) is one of the major enzymes involved in the metabolic degradation of dopamine. The COMT gene polymorphism (rs4680 or Val(158)Met) Met allele is reported to cause decreased activity of this enzyme in prefrontal cortex and improve performance in several cognitive domains. Objective: The objective of this study was to evaluate the influence of Val(158)Met on creativity in BD type I and healthy controls. Methods: Ninety-seven healthy volunteers and 120 BD type I were genotyped for COMT rs4680 and tested for creativity (Barrow Welsh Art Scale - BWAS) and intelligence Wechsler Abbreviated Scale of Intelligence (WASI). Results: COMT Met allele positively influenced creativity scores in healthy controls but not in BD subjects during mood episodes and euthymia. The presence of allele Met did not influence IQ scores. No influence of IQ total score on creativity was observed. Limitations: control group presented higher IQ scores and euthymic group was under medication use. Discussion: Our research suggests positive effect of COMT rs4680 (allele Met) on creativity scores in healthy controls. One possible interpretation is that creativity is more likely to be associated with lesser degrees of bipolarity. The fact that the same results were not observed in BD may be associated to dysfunctions in the dopaminergic system that characterizes this disorder. Further studies with larger samples and other types of BD should explore the role of the dopaminergic system in creativity.
- Facial emotion recognition and its correlation with executive functions in bipolar I patients and healthy controls(2014) DAVID, Denise Petresco; SOEIRO-DE-SOUZA, Marcio Gerhardt; MORENO, Ricardo Alberto; BIO, Danielle SoaresIntroduction: The ability to recognize facial emotions is altered in patients with Bipolar Disorder (BD) during mood episodes and even in euthymia, while cognitive functioning is similarly impaired. This recognition is considered a fundamental skill for successful social interaction. However, it is unclear whether the ability to recognize facial emotions is correlated with the cognitive deficits observed in BD. Objective: The objective of this study was to evaluate Facial Emotion Recognition (PER) and its correlation with executive function (FE) in BD I patients during mania, depression and euthymia compared to healthy controls. Material and methods: A total of 110 patients with BD I, 18-40 years old were included (41 in manic episode; 31 in depressive episode and 38 euthymic). Patients were assessed for FER and EF (Wisconsin card sorting test - WCST), along with 96 healthy volunteers (18-40 years old) recruited from the University of Sao Paulo. Results: The results showed that BD l patients had lower FER performance compared to controls on fear subtests, happiness, the surprise Lest, and E'ER total scores. Moreover, BD l manic patients showed poorer performance for EF compared to controls. Six out of the seven variables of the WCST correlated with E'ER in both healthy controls and BD euthymic subjects but not in BD patients during mood episodes. Conclusion: Cognitive deficits and difficulties recognizing facial emotions are present in all mood episodes in BD l patients, even during remission. Although FER is not considered a cognitive domain, these results suggest that, along with EF, it has a complementary function. Hence, further studies should investigate this issue in larger samples and verify whether these similarities also occur at a neurobiological level.
- Leukocyte telomerase activity and antidepressant efficacy in bipolar disorder(2014) SOEIRO-DE-SOUZA, Marcio Gerhardt; TEIXEIRA, Antonio L.; MATEO, Elvis C.; ZANETTI, Marcus V.; RODRIGUES, Flavia G.; PAULA, Vanessa J. de; BEZERRA, Julia F.; MORENO, Ricardo A.; GATTAZ, Wagner F.; MACHADO-VIEIRA, RodrigoTelomeres are DNA-protein complexes that cap linear DNA strands, protecting DNA from damage. Recently, shorten telomeres length has been reported in bipolar disorder (BD) and depression. The enzyme telomerase regulates telomerase length, which has been associated with cellular viability; however it is not clear how telomerase may be involved in the pathophysiology and therapeutics of BD. In the present study, leukocyte telomerase activity was assessed in 28 medication-free BD depressed individuals (DSM-IV-TR criteria) at baseline and after 6 weeks of lithium therapy (n=21) also matching with 23 healthy controls. There was no difference between telomerase activity in subjects with BD depression (before or after lithium) and controls. Improvement of depressive symptoms was negatively associated with telomerase. activity after 6 weeks of lithium therapy. This is the first study describing telomerase activity in BD research. Overall, telomerase activity seems not directly involved in the pathophysiology of short-term BD. Lithium's antidepressant effects may involve regulation at telomerase activity. Further studies with larger samples and long-term illness are also warranted.