ROSELI GEDANKE SHAVITT
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
41 resultados
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conferenceObject PHARMACOGENETICS OF ANTIDEPRESSANT RESPONSE IN OBSESSIVE-COMPULSIVE AND RELATED DISORDERS(2017) ZAIL, Gwyneth; CAPPI, Carolina; PHILLIPS, Katharine; GONCALVES, Vanessa; ZAI, Clement; SHAVITT, Roseli; MIGUEL, Euripedes; RICHTER, Margaret (Peggy); KENNEDY, James L.conferenceObject Early Life Adverse Experiences and Obsessive-Compulsive Disorder: A Study With Patients, Siblings and Controls(2018) COSTA, Fabiana; CAPPI, Carolina; BATISTUZZO, Marcelo; SHAVITT, Roseli; REQUENA, Guaraci; MIGUEL, Euripedes; HOEXTER, Marcelo- 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.
- The Child Behavior Checklist-Obsessive-Compulsive Subscale Detects Severe Psychopathology and Behavioral Problems Among School-Aged Children(2017) SAAD, Laura O.; ROSARIO, Maria C. do; CESAR, Raony C.; BATISTUZZO, Marcelo C.; HOEXTER, Marcelo Q.; MANFRO, Gisele G.; SHAVITT, Roseli G.; LECKMAN, James F.; MIGUEL, Euripedes C.; ALVARENGA, Pedro G.Objective: The aims of this study were (1) to assess obsessive-compulsive symptoms (OCS) dimensionally in a school-aged community sample and to correlate them with clinical and demographical variables; (2) to determine a subgroup with significant OCS ""at-risk for OCD'') using the Child Behavior Checklist (CBCL-OCS) and (3) to compare it with the rest of the sample; (4) To review the CBCL-OCS subscale properties as a screening tool for pediatric OCD. Methods: Data from the Brazilian High Risk Cohort were analyzed. The presence and severity of OCS were assessed through the CBCL-OCS subscale. DSM-IV psychiatric diagnoses were obtained by the Developmental and Well-Being Assessment. Behavioral problems were assessed using the Strengths and Difficulties Questionnaire, the Youth Strengths Inventory, and the CBCL internalizing and externalizing behavior subscales. Results: A total of 2512 (mean age: 8.86 +/- 1.84 years; 55.0% male) children were included. Moderate correlations were found between OCS severity and functional impairment (r = 0.36, p < 0.001). Children with higher levels of OCS had higher rates of psychiatric comorbidity and behavioral problems (p < 0.001). A score of 5 or higher in the CBCL-OCS scale determined an ""at-risk for OCD'' subgroup, comprising 9.7% of the sample (n = 244), with behavioral patterns and psychiatric comorbidities (e.g., tics [odds ratios, OR = 6.41, p < 0.001]), anxiety disorders grouped [OR = 3.68, p < 0.001] and depressive disorders [OR = 3.0, p < 0.001] very similar to those described in OCD. Sensitivity, specificity, positive predictive value, and negative predictive value of the CBCL-OCS for OCD diagnosis were, respectively, 48%, 91.5%; 15.1%, and 98.2%. Conclusions: The dimensional approach suggests that the presence of OCS in children is associated with higher rates of comorbidity, behavioral problems, and impairment. The ""at-risk for OCD'' group defined by the CBCL revealed a group of patients phenotypically similar to full blown OCD.
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 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, Joao- Personality measures after gamma ventral capsulotomy in intractable OCD(2018) PAIVA, Raquel R.; BATISTUZZO, Marcelo C.; MCLAUGHLIN, Nicole C.; CANTERAS, Miguel M.; MATHIS, Maria E. de; REQUENA, Guaraci; SHAVITT, Roseli G.; GREENBERG, Benjamin D.; NOREN, Georg; RASMUSSEN, Steven A.; TAVARES, Hermano; MIGUEL, Euripedes C.; LOPES, Antonio C.; HOEXTER, Marcelo Q.Background: Neurosurgeries such as gamma ventral capsulotomy (GVC) are an option for otherwise intractable obsessive-compulsive disorder (OCD) patients. In general, clinical and neuropsychological status both improve after GVC. However, its consequences on personality traits are not well-studied. The objective of this study was to investigate personality changes after one year of GVC in intractable OCD patients. Methods: The personality assessment was conducted using the Revised NEO Personality Inventory (NEO PI-R) and Cloninger's Temperament and Character Inventory (TCI) in 14 intractable OCD patients before and one year after GVC. Comparisons of personality features between treatment responders (n = 5) and non-responders (n = 9) were performed. Multiple linear regression was also used for predicting changes in clinical and global functioning variables. Results: Overall, no deleterious effect was found in personality after GVC. Responders had a reduction in neuroticism (p = 0.043) and an increase in extraversion (p = 0.043). No significant changes were observed in nonresponders. Increases in novelty seeking and self-directedness, and decreases in persistence and cooperativiness predicted OCD symptom improvement. Similary, improvement in functioning was also predicted by hgher novelty seeking and self-directedness after GVC, whereas better functioning was also associated with lower reward dependence and cooperativeness after surgery. Conclusions: The pattern of changes in personality traits after GVC was generally towards that observed in nonclinical population, and does not raise safety concerns.
conferenceObject 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.conferenceObject THE DOWREGULATION EXPRESSION OF PROLINE OXIDASE GENE IMBALANCE GLUTAMATE IN BRAINS OF THE SUBJECTS WITH OBSESSIVE COMPULSIVE DISORDER A POST MORTEM STUDY(2017) OLIVEIRA, Katia de; LISBOA, Bianca Cristina Garcia; CARREIRA, Luzia Lima; GOUVEIA, Gisele Rodrigues; MORETTO, Ariane Cristine; NEVES, Ricardo de Caires; PASQUA-LUCCI, Carlos Augusto; GRINBERG, Lea Tenenholz; JACOB-FILHO, Wilson; LAFER, Beny; MIGUEL, Euripedes Constantino; SHAVITT, Roseli Gedanke; HOEXTER, Marcelo Queiroz; PEREIRA, Carlos Alberto de Bragranca; BRENTANI, Helena- International prescribing practices in obsessive-compulsive disorder (OCD)(2016) BRAKOULIAS, Vlasios; STARCEVIC, Vladan; BELLOCH, Amparo; DELL'OSSO, Liliana; FERRAO, Ygor A.; FONTENELLE, Leonardo F.; LOCHNER, Christine; MARAZZITI, Donatella; MARTIN, Andrew; MATSUNAGA, Hisato; MIGUEL, Euripedes C.; REDDY, Y. C. Janardhan; ROSARIO, Maria C. do; SHAVITT, Roseli G.; SUNDAR, Arumugham Shyam; STEIN, Dan Joseph; VISWASAM, KirupamaniObjectivesTo assess rates of psychotropic medication use in patients with obsessive-compulsive disorder (OCD) in seven different countries on five continents and to compare these with international treatment guidelines. MethodsResearchers in the field of OCD were invited to contribute summary statistics on the characteristics of their patients with OCD and on their incidence of psychotropic use. Consistency of summary statistics across countries was evaluated. ResultsThe data came from Brazil (n=955), Italy (n=750), South Africa (n=555), Japan (n=382), Australia (n=213), India (n=202) and Spain (n=82). The majority (77.9%; n=2445) of the total sample of 3139 participants received a psychotropic medication. Consistent with international guidelines, selective serotonin reuptake inhibitors (SSRIs) were most commonly used (73.5%, n=1796), but their use ranged from 59% in Australia to 96% in Japan. Clomipramine use varied from 5% in Japan and South Africa to 26% in India and Italy. Atypical antipsychotic use ranged from 12% in South Africa to 50% in Japan. ConclusionsPharmacotherapy for OCD varied significantly across sites. Prospective studies are required to determine the cultural, pharmacoeconomic and pharmacogenomic factors that may play a role in the variation in prescribing practices internationally and whether these variations influence treatment outcomes.