DSpace Collection: LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica
https://observatorio.fm.usp.br/handle/OPI/3687
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica2024-03-29T07:03:53ZLongitudinal Description and Prediction of Smoking Among Borderline Patients: An 18 Year Follow-Up Study
https://observatorio.fm.usp.br/handle/OPI/58279
Title: Longitudinal Description and Prediction of Smoking Among Borderline Patients: An 18 Year Follow-Up Study
Authors: BRANAS, Marcelo J. A. A.; FRANKENBURG, Frances R.; TEMES, Christina M.; FITZMAURICE, Garrett M.; ZANARINI, Mary C.
Abstract: Objective: The objectives of this study were (1) to compare smoking between recovered and non-recovered patients with borderline personality disorder (BPD) over the course of 18 years and (2) to assess baseline predictors of tobacco use in patients with BPD. Methods: A total of 264 borderline patients were interviewed concerning their smoking history beginning at the 6-year follow-up wave in a longitudinal study of the course of BPD (McLean Study of Adult Development) and re -interviewed at 2-year intervals over the next 18 years. Initial data collection of the larger study happened between June 1992 and December 1995, and the DSM-III-R and the Revised Diagnostic Interview for Borderlines (DIB-R) were used as the diagnostic instruments for BPD.Results: Recovered patients had a 48% lower prevalence of smoking than non -recovered patients at 6-year follow-up (a significant difference; P=.01). Also, the rate of decline in smoking for the recovered group was 68% and was significantly faster (P= .008) than for the non-recovered group over the subsequent 18 years. Alcohol abuse or dependence (relative risk [RR]=1.22; 95% CI,1.06-1.40; P=.005), lower levels of education (RR=1.28; 95% CI,1.15-1.42; P<.001), and higher levels of the defense mechanism of denial (RR=1.08; 95% CI,1.03-1.13; P=.002) were significant predictors of smoking in borderline patients in multivariate analyses.Conclusions: Taken together, the results of this study suggest that recovery status was an important element in the prevalence of smoking among borderline patients over time. They also suggest that smoking was predicted by 3 factors: prior psychopathology, demographics, and psychological maturity.2023-01-01T00:00:00ZPatient Health Questionnaire-9 Item Pairing Predictiveness for Prescreening Depressive Symptomatology: Machine Learning Analysis
https://observatorio.fm.usp.br/handle/OPI/58278
Title: Patient Health Questionnaire-9 Item Pairing Predictiveness for Prescreening Depressive Symptomatology: Machine Learning Analysis
Authors: GLAVIN, Darragh; GRUA, Eoin Martino; NAKAMURA, Carina Akemi; SCAZUFCA, Marcia; SANTOS, Edinilza Ribeiro dos; WONG, Gloria H. Y.; HOLLINGWORTH, William; PETERS, Tim J.; ARAYA, Ricardo; VEN, Pepijn Van de
Abstract: Background: Anhedonia and depressed mood are considered the cardinal symptoms of major depressive disorder. These are the first 2 items of the Patient Health Questionnaire (PHQ)-9 and comprise the ultrabrief PHQ-2 used for prescreening depressive symptomatology. The prescreening performance of alternative PHQ-9 item pairings is rarely compared with that of the PHQ-2.Objective: This study aims to use machine learning (ML) with the PHQ-9 items to identify and validate the most predictive 2-item depressive symptomatology ultrabrief questionnaire and to test the generalizability of the best pairings found on the primary data set, with 6 external data sets from different populations to validate their use as prescreening instruments.Methods: All 36 possible PHQ-9 item pairings (each yielding scores of 0-6) were investigated using ML-based methods with logistic regression models. Their performances were evaluated based on the classification of depressive symptomatology, defined as PHQ-9 scores >= 10. This gave each pairing an equal opportunity and avoided any bias in item pairing selection.Results: The ML-based PHQ-9 items 2 and 4 (phq2&4), the depressed mood and low-energy item pairing, and PHQ-9 items 2 and 8 (phq2&8), the depressed mood and psychomotor retardation or agitation item pairing, were found to be the best on the primary data set training split. They generalized well on the primary data set test split with area under the curves (AUCs) of 0.954 and 0.946, respectively, compared with an AUC of 0.942 for the PHQ-2. The phq2&4 had a higher AUC than the PHQ-2 on all 6 external data sets, and the phq2&8 had a higher AUC than the PHQ-2 on 3 data sets. The phq2&4 had the highest Youden index (an unweighted average of sensitivity and specificity) on 2 external data sets, and the phq2&8 had the highest Youden index on another 2. The PHQ-2 >= 2 cutoff also had the highest Youden index on 2 external data sets, joint highest with the phq2&4 on 1, but its performance fluctuated the most. The PHQ-2 >= 3 cutoff had the highest Youden index on 1 external data set. The sensitivity and specificity achieved by the phq2&4 and phq2&8 were more evenly balanced than the PHQ-2 >= 2 and >= 3 cutoffs.Conclusions: The PHQ-2 did not prove to be a more effective prescreening instrument when compared with other PHQ-9 item pairings. Evaluating all item pairings showed that, compared with alternative partner items, the anhedonia item underperformed alongside the depressed mood item. This suggests that the inclusion of anhedonia as a core symptom of depression and its presence in ultrabrief questionnaires may be incompatible with the empirical evidence. The use of the PHQ-2 to prescreen for depressive symptomatology could result in a greater number of misclassifications than alternative item pairings.2023-01-01T00:00:00ZTreatment Gap of Mental Disorders in Sao Paulo Metropolitan Area, Brazil: Failure and Delay in Initiating Treatment Contact After First Onset of Mental and Substance Use Disorders
https://observatorio.fm.usp.br/handle/OPI/58271
Title: Treatment Gap of Mental Disorders in Sao Paulo Metropolitan Area, Brazil: Failure and Delay in Initiating Treatment Contact After First Onset of Mental and Substance Use Disorders
Authors: FRANCA, Mariane Henriques; WANG, Yuan-Pang; ANDRADE, Laura Helena; VIANA, Maria Carmen
Abstract: An under-studied crucial step in the health-related help-seeking process is making prompt contact with a treatment provider when a mental disorder strikes. This study aims to provide data on patterns and predictors of failure and delay in making initial treatment contact after the first onset of a mental disorder among adult residents in Sao Paulo, Brazil. A representative face-to-face household survey was conducted among 5,037 respondents aged 18 + years to assess lifetime psychiatric diagnosis, treatment contact, and delay using the World Mental Health Composite International Diagnostic Interview. Cumulative lifetime probability curves show that most people with lifetime disorders eventually make treatment contact, and this is more frequent among those with mood (94.4%) than anxiety (63.6%) and substance use disorders (46.4%). Median delay of treatment contact ranged from 3 to 13 years for mood, 1 to 36 years for anxiety, and 8 to 14 for substance use disorders. Earlier onset was associated with lower probabilities of treatment contact for most disorders (10 out of 15). Failure to promptly seek/receive treatment is a pervasive aspect of the unmet need for mental health care in Brazil.2023-01-01T00:00:00ZDrug overdose deaths in Brazil between 2000 and 2020: an analysis of sociodemographics and intentionality
https://observatorio.fm.usp.br/handle/OPI/58113
Title: Drug overdose deaths in Brazil between 2000 and 2020: an analysis of sociodemographics and intentionality
Authors: BIANCO, Marina Costa Moreira; TARDELLI, Vitor S.; BROOKS, Emily Rose; ARECO, Kelsy C. N.; TARDELLI, Adalberto O.; BANDIERA-PAIVA, Paulo; SANTAELLA, Julian; SEGURA, Luis E.; CASTALDELLI-MAIA, Joao M.; MARTINS, Silvia S.; FIDALGO, Thiago M.
Abstract: Objectives: To examine drug overdose records in Brazil from 2000 to 2020, analyzing trends over time in overdoses and overall sociodemographic characteristics of the deceased.Methods: Using data from the Brazilian Mortality Information System (Sistema de Informac,oes sobre Mortalidade), we identified records from 2000-2020 in which the underlying cause-of-death was one of the following codes: X40-X45 (accidental poisoning), X60-X65 (intentional poisoning), or Y10-Y15 (undetermined intentionality poisoning). The Brazilian dataset included 21,410 deaths. We used joinpoint regression analysis to assess changes in trends over time.Results: People who died of drug overdoses in Brazil between 2000 and 2020 had a mean age of 38.91 years; 38.45% were women, and 44.01% were identified as White. Of the overdose deaths, 44.70% were classified as intentional and 32.12% were classified as unintentional. Among the identified drugs, stimulants were the most common class. However, most records did not report which drug was responsible for death.Conclusion: Sociodemographic trends in overdose deaths in Brazil must guide country-specific policies. Nevertheless, data collection protocols must be improved, particularly regarding the drug used in overdoses.2023-01-01T00:00:00Z