KETTE DUALIBI RAMOS VALENTE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
17 resultados
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conferenceObject Depressive symptoms in patients with epilepsy during COVID-19 pandemic and its correlation with adequate medical care(2021) CARVALHO, Rachel Marin de; LUNARDI, Mariana dos Santos; CARNEIRO, Raquel Alencastro Veiga Domingues; ALESSI, Ruda; GIACOMINI, Felipe; LIN, Katia; VALENTE, KetteconferenceObject Impact of cognitive rehabilitation in juvenile myoclonic epilepsy: A novel study(2021) PAIVA, Maria Luisa; SERAFIM, Antonio de Padua; ALESSI, Ruda; VINCENTIIS, Silvia; LIMA, Ellen; NADRUZ, Patricia; VALENTE, KetteconferenceObject Polytherapy, frequent seizures, and bilateral tonic-clonic seizures influence on higher depressive and anxiety symptoms in temporal lobe epilepsy(2021) LIMA, Ellen Marise; GOIS, Juliana; PAIVA, Maria Luisa; VINCENTIIS, Silvia; MOSCHETTA, Sylvie; VALENTE, KettebookPart Métodos na avaliação em neurofisiologia(2021) PENTAGNA, Álvaro; FONSECA, Natascha Cardoso da; VINCENTIIS, Silvia de; VALENTE, Kette Dualibi Ramos- A novel scale for suspicion of psychogenic nonepileptic seizures: development and accuracy(2021) BARONI, Gislaine; MARTINS, William Alves; RODRIGUES, Jaqueline C.; PICCININI, Vitoria; MARIN, Cassia; MACHADO, Wagner de Lara; BANDEIRA, Denise R.; PAGLIOLI, Eliseu; VALENTE, Kette D.; PALMINI, AndreObjective: : The differential diagnosis between epileptic and psychogenic nonepileptic seizures (PNES) is challenging, yet suspicion of PNES is crucial to rethink treatment strategies and select patients for diagnostic confirmation through video EEG (VEEG). We developed a novel scale to prospectively suspect PNES. Methods: : First, we developed a 51-item scale in two steps, based upon literature review and panel expert opinion. A pilot study verified the applicability of the instrument, followed by a prospective evaluation of 158 patients (66.5% women, mean age 33 years) who were diagnosed for prolonged VEEG. Only epileptic seizures were recorded in 103 patients, and the other 55 had either isolated PNES or both types of seizures. Statistical procedures identified 15 items scored between 0 and 3 that best discriminated patients with and without PNES, with a high degree of consistency. Results: : Internal consistency reliability of the scale for suspicion of PNES was 0.77 with Cronbach's Alpha Coefficient and 0.95 with Rasch Item Reliability Index, and performance did not differ according to the patient's gender. For a cut-off score of 20 (of 45) points, area under the curve was 0.92 (95% IC: 0.87-0.96), with an accuracy of 87%, sensitivity of 89%, specificity of 85%, positive predictive value of 77%, and negative predictive value of 94% (95% IC) for a diagnosis of PNES. Conclusions: : The scale for suspicion of PNES (SS-PNES) has high accuracy to a reliable suspicion of PNES, helping with the interpretation of apparent seizure refractoriness, reframing treatment strategies, and streamlining referral for prolonged VEEG.
- Patients with epilepsy during the COVID-19 pandemic: Depressive symptoms and their association with healthcare access(2021) LUNARDI, Mariana Dos Santos; CARVALHO, Rachel Marin de; CARNEIRO, Raquel Alencastro Veiga Domingues; GIACOMINI, Felipe; VALENTE, Kette D.; LIN, KatiaBackground: The coronavirus disease 2019 (COVID-19) outbreak impacted the lives of worldwide people with epilepsy (PWE) in various aspects, particularly in those countries most significantly affected by this pandemic, such as Brazil. We aimed to investigate the prevalence of depressive symptoms in PWE and their correlation with epilepsy features and access to treatment. Methods: PWE were invited to answer a cross-sectional online-based survey to assess and rate depressive symptoms using the NDDI-E during the first year of the COVID-19 pandemic and its relation to multiple lifestyles epilepsy clinical aspects. Results: A total of 490 PWE were recruited. The prevalence of depressive symptoms during the COVID-19 pandemic was 35.3% (cutoff score > 15 on NDDI-E). The factors associated with higher NDDI-E scores were: female sex, increased seizure frequency, barriers to access to their treating physician and anti seizure medication, and unemployment. Regarding the pandemic impact on PWE healthcare, 29.2% reported restricted access to their medication, 46.1% barriers to access their physicians, 94.2% had their consultations canceled due to the pandemic, and 28.4% had seizure worsening in this period. Conclusion: The COVID-19 pandemic affected PWE access to the healthcare system. Depressive symptoms were more severe in patients with higher seizure frequency who had difficulties obtaining proper medical care. The COVID-19 pandemic may impact the healthcare and mental wellbeing of patients with chronic diseases such as epilepsy. Nevertheless, prospective studies on epilepsy and COVID-19 are still lacking.
bookPart Aplicabilidade da eletroencefalograia na clínica psiquiatrica(2021) VINCENTIIS, Sìlvia de; VALENTE, Kette Dualibi Ramos- The COVID-19 outbreak and PNES: The impact of a ubiquitously felt stressor(2021) VALENTE, Kette D.; ALESSI, Ruda; BARONI, Gislaine; MARIN, Rachel; SANTOS, Bernardo dos; PALMINI, AndreObjective: We aimed to assess frequency of functional seizures or psychogenic nonepileptic seizures (PNES) during the COVID-19 outbreak and to recognize possible factors associated with worsening in this population. Methods: In this cross-sectional study conducted during the second phase of the pandemic, adult patients with PNES documented by video-EEG and followed up in two tertiary epilepsy centers responded to a structured telephone survey. Data were gathered on demographics, clinical features and frequency of PNES, history of psychiatric comorbidity, access to treatment, as well as on anxiety (GAD-7 items) and depressive symptoms (NDDI-E). Results: Fifty-four patients (78% female; mean age of 31.36 years [SD = 10.6]) were contacted and 15 (28%) reported increased frequency of PNES during the pandemic. Higher scores of GAD-7 items (p < 0.001) and NDDI-E (p < 0.001) were associated with PNES worsening. There was strong evidence of a correlation between higher stress levels (p < 0.001) and poor sleep quality (p 0.005) with PNES aggravation. After regression, stress was the strongest predictor of PNES increased frequency. Significance: Patients with functional neurological disorders are vulnerable during ubiquitously felt stressors. However, the atmosphere of uncertainty did not affect these patients equally. Patients with PNES showing symptoms of anxiety and depression are at higher risk of seizure worsening. Early identification of this subset of patients may prevent this detrimental outcome.
- Cochrane systematic review and meta-analysis of the impact of psychological treatment on health-related quality of life in people with epilepsy: an update by the ILAE Psychology Task Force, highlighting methodological changes(2021) MICHAELIS, Rosa; TANG, Venus; NEVITT, Sarah J.; WAGNER, Janelle L.; MODI, Avani C.; LAFRANCE JR., W. Curt; GOLDSTEIN, Laura H.; GANDY, Milena; BRESNAHAN, Rebecca; VALENTE, Kette; DONALD, Kirsten A.; REUBER, MarkusClinical interest in using psychological interventions for people with epilepsy (PWE) aiming at decreasing mental health difficulties, improving health-related quality of life (HRQOL) and seizure-related outcomes, continues to grow. This article summarizes the 2020 update of the 2017 Cochrane Review and meta-analysis of psychological interventions for PWE, highlighting the reasons for major methodological modifications such as the recategorization of interventions and expanded risk of bias assessment. A 2020 literature search yielded 36 RCTs (n=3526) investigating psychological treatments for PWE with a validated HRQOL measure as an outcome. Twenty-seven trials were skills-based psychological interventions, whilst nine studies were education-only interventions. Among skills-based psychological interventions, 11 studies (n=643) used the Quality of Life in Epilepsy-31 (QOLIE-31) or other QOLIE inventories convertible to QOLIE-31 as an outcome measure and were pooled for meta-analysis. Significant mean changes were observed for the QOLIE-31 total score (mean improvement of 5.23 points; p < 0.001) and in six out of seven subscales (emotional well-being, energy and fatigue, overall QoL, seizure worry, medication and cognitive functioning). The mean changes in the QOLIE-31 total score and the overall QoL subscale exceeded the threshold of minimally important change (MIC), indicating clinically meaningful post-intervention improvement. These results provide moderate evidence that psychological treatments for adults and adolescents with epilepsy enhance HRQOL. In addition to the summary of the Cochrane review, we provide a detailed characterization of the interventions and patient populations of the meta-analyzed studies.
- Anxiety symptoms are the strongest predictor of quality of life in temporal lobe epilepsy(2021) LIMA, Ellen Marise; GOIS, Juliana; PAIVA, Maria Luisa; VINCENTIIS, Silvia; MOSCHETTA, Sylvie; VALENTE, Kette Dualibi RamosPurpose: It is established that the severity of depressive and anxiety symptoms is associated with poorer quality of life (QOL) in persons with drug-resistant epilepsy. We aimed to verify the presence of subsyndromic depressive episodes (SDEs) and subsyndromic anxiety episodes (SAEs) in persons with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) compared to healthy controls and to determine the impact of depressive and anxiety symptoms on patients & rsquo; QOL. Methods: We prospectively evaluated 35 persons with TLE-HS and 90 healthy controls. QOL was assessed by the Epilepsy Surgery Inventory (ESI) and QOL in Epilepsy Inventory-31 (QOLIE-31). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-X) were used to assess symptoms, and SDEs and SAEs diagnosis were made considering the total scores of BDI (<9) and STAI-Trait (<49), respectively. Results: Persons with TLE-HS had higher symptoms on BDI, STAI-S, and STAI-T. They have 3.011 greater odds of presenting SDEs and 7.056 times odds, SAEs. The depressive and anxiety symptoms, added in the model with epilepsy-related factors, accounted for a significant increase in the variance in several aspects of QOL. Anxiety trait symptoms are the most critical individual determinant of the QOL. Conclusion: Our results demonstrated that persons with TLE-HS had greater odds of presenting SDE and SAE than healthy controls. Besides, there was a relationship between anxiety and depressive symptoms and worse QOL in TLE-HS. It is essential to be aware of psychiatric symptoms, even though these symptoms do not meet the criteria to be considered a ""disorder.""