HERMANO TAVARES

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Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 27
  • article 30 Citação(ões) na Scopus
    Trichotillomania and its clinical relationship to depression and anxiety
    (2017) GRANT, Jon E.; REDDEN, Sarah A.; MEDEIROS, Gustavo C.; ODLAUG, Brian L.; CURLEY, Erin E.; TAVARES, Hermano; KEUTHEN, Nancy J.
    Objective: Trichotillomania (TTM) is associated with high rates of co-occurring depression and anxiety disorders. What the co-occurrence of TTM, depression or anxiety disorders means clinically and cognitively, however, has garnered little research attention.Methods: About 530 adults with TTM were examined on a variety of clinical measures including symptom severity, psychosocial measures of functioning, psychiatric comorbidity and neurocognitive testing assessing motor inhibition and cognitive flexibility. Clinical features and cognitive functioning were compared between TTM patients with current comorbid major depressive disorder (MDD), a current anxiety disorder, both MDD and an anxiety disorder, or neither.Results: Of 530 participants, 58 (10.3%) had MDD only, 97 (18.3%) had an anxiety disorder only, 58 (10.3%) had both MDD and an anxiety disorder, and 317 (59.8%) had neither. For almost all clinical measures, those with MDD only reported worse symptoms than those with an anxiety disorder only, and the combination of MDD and an anxiety disorder reported the worst level of symptom severity.Conclusions: These results suggest that adults with TTM and co-occurring MDD and anxiety disorders exhibit unique clinical differences. The clinical differences may also have treatment implications.
  • article 44 Citação(ões) na Scopus
    Compulsive sexual behavior and psychopathology among treatment-seeking men in Sao Paulo, Brazil
    (2013) SCANAVINO, Marco de Tubino; VENTUNEAC, Ana; ABDO, Carmita Helena Najjar; TAVARES, Hermano; AMARAL, Maria Luiza Sant'Ana do; MESSINA, Bruna; REIS, Sirlene Caramello dos; MATTINS, Joao Paulo Lian Branco; PARSONS, Jeffrey T.
    This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in Sao Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in Sao Paulo, Brazil.
  • article 2 Citação(ões) na Scopus
    Treatment effects and adherence of sexually compulsive men in a randomized controlled trial of psychotherapy and medication
    (2023) SCANAVINO, Marco D. T.; GUIRADO, Alia Garrudo; MARQUES, Joao Miguel; AMARAL, Maria Luiza Sant'Ana Do; MESSINA, Bruna; REIS, Sirlene Caramello Dos; BARROS, Vivian Boschesi; ABDO, Carmita Helena Najjar; TAVARES, Hermano; PARSONS, Jeffrey T.
    Background: Little attention has been given to efficacious treatment and adherence to treatment of compulsive sexual behavior (CSB). Aims: Randomized controlled trial investigated short-term psycho -dynamic group therapy followed by relapse prevention group (STPGP-RPGT) and pharmacological treatment (PT) for CSB men on sexual compulsivity and adherence. Method: 135 men, 38 (SD = 9) years old on average, were randomly assigned to 1) STPGP-RPGT; 2) PT; 3) Both. Participants completed measures at baseline, 25th, and 34th week. 57 (42.2%) participants dropped out between baseline and 25th week, and 68 (50.4%) between baseline and 34th week. 94 (69.6%) did not adhere (80% pills taken or attended 75% therapy sessions). Results: A significant interaction effect was found between time and group (F (4, 128) = 2.62, P = 0.038, ES = 0.08), showing who received PT improved less in sexual compulsivity than those who received STPGP-RPGT (t = 2.41; P = 0.038; ES = 0.60) and PT thorn STPGP-RPGT (t = 3.15; P = 0.007, ES = 0.74). Adherent participants improved more in sexual compulsivity than non-adherent at the 25th week (t = 2.82; P = 0.006, ES = 0.65) and 34th week (t = 2.26; P = 0.027, ES = 0.55), but there was no interaction effect, F (2, 130) = 2.88; P = 0.06; ES = 0.04). The most reported behavior (masturbation) showed greater risk of non-adherence (72.6%). Discussion and conclusions: Adherent participants improved better than non-adherent. Participants who received psychotherapy improved better than those who received PT. Methodological limitations preclude conclusions on efficacy.
  • article 88 Citação(ões) na Scopus
    Compulsive features in behavioural addictions: the case of pathological gambling
    (2012) EL-GUEBALY, Nady; MUDRY, Tanya; ZOHAR, Joseph; TAVARES, Hermano; POTENZA, Marc N.
    Aims To describe, in the context of DSM-V, how a focus on addiction and compulsion is emerging in the consideration of pathological gambling (PG). Methods A systematic literature review of evidence for the proposed re-classification of PG as an addiction. Results Findings include: (i) phenomenological models of addiction highlighting a motivational shift from impulsivity to compulsivity associated with a protracted withdrawal syndrome and blurring of the ego-syntonic/ego-dystonic dichotomy; (ii) common neurotransmitter (dopamine, serotonin) contributions to PG and substance use disorders (SUDs); (iii) neuroimaging support for shared neurocircuitries between behavioural and substance addictions and differences between obsessivecompulsive disorder (OCD), impulse control disorders (ICDs) and SUDs; (iv) genetic findings more closely related to endophenotypic constructs such as compulsivity and impulsivity than to psychiatric disorders; (v) psychological measures such as harm avoidance identifying a closer association between SUDs and PG than with OCD; (vi) community and pharmacotherapeutic trials data supporting a closer association between SUDs and PG than with OCD. Adapted behavioural therapies, such as exposure therapy, appear applicable to OCD, PG or SUDs, suggesting some commonalities across disorders. Conclusions PG shares more similarities with SUDs than with OCD. Similar to the investigation of impulsivity, studies of compulsivity hold promising insights concerning the course, differential diagnosis and treatment of PG, SUDs, and OCD.
  • article 138 Citação(ões) na Scopus
    Responsible Gambling: General Principles and Minimal Requirements
    (2011) BLASZCZYNSKI, Alex; COLLINS, Peter; FONG, Davis; LADOUCEUR, Robert; NOWER, Lia; SHAFFER, Howard J.; TAVARES, Hermano; VENISSE, Jean-Luc
    Many international jurisdictions have introduced responsible gambling programs. These programs intend to minimize negative consequences of excessive gambling, but vary considerably in their aims, focus, and content. Many responsible gambling programs lack a conceptual framework and, in the absence of empirical data, their components are based only on general considerations and impressions. This paper outlines the consensus viewpoint of an international group of researchers suggesting fundamental responsible gambling principles, roles of key stakeholders, and minimal requirements that stakeholders can use to frame and inform responsible gambling programs across jurisdictions. Such a framework does not purport to offer value statements regarding the legal status of gambling or its expansion. Rather, it proposes gambling-related initiatives aimed at government, industry, and individuals to promote responsible gambling and consumer protection. This paper argues that there is a set of basic principles and minimal requirements that should form the basis for every responsible gambling program.
  • article 1 Citação(ões) na Scopus
    Cross-cultural comparison of compulsive stealing (kleptomania)
    (2015) GRANT, Jon E.; ODLAUG, Brian L.; MEDEIROS, Gustavo; CHRISTIANINE, Aparecida R.; TAVARES, Hermano
  • article 7 Citação(ões) na Scopus
    Gambling Disorder Due to Brazilian Animal Game (""Jogo do bicho''): Gambling Behavior and Psychopathology
    (2016) MEDEIROS, Gustavo; GRANT, Jon; TAVARES, Hermano
    Gambling is currently widespread across the globe and despite legally restricted, it is significantly common in Brazil. A traditional and common form of gambling in Brazil is the Brazilian animal game (BAG)-""Jogo do bicho'' in Portuguese. In 2013, BAG activities collected approximately 19 billion Brazilian reais-equivalent to more than 8 billon American dollars, a figure almost 60 % higher than legal lotteries. Although a common form of gambling, the gambling behavior and psychopathology of gambling disorder (GD) associated with BAG has never been systematically studied. The aim of this study is to conduct, the first research approaching GD due to BAG. We assessed 897 participants of whom 63 subjects (7.0 %) presented with GD due to BAG and 834 with GD associated with other forms of gambling. After comparing these two groups, major differences were found in demographics, gambling behavior elements and psychopathological variables. This research reinforces the need for further research on BAG and the need for specific approaches in GD. The particularities of BAG may affect treatment strategies as, for example, suggest some adaptations in social and psychotherapeutic approaches. We also highlight the need to acknowledge the ""hidden'' BAG as a potential addictive game.
  • conferenceObject
    Increased Insula Activity Is Associated with Improved Mood in Healthy Subjects on Clomipramine
    (2015) BUSATTO, Geraldo; PHILLIPS, Mary L.; CERQUEIRA, Carlos T.; ZILBERMAN, Monica; LOBO, Daniela; HENNA, Elaine; TAVARES, Hermano; AMARO, Edson; LEITE, Claudia C.; GORENSTEIN, Clarice; GENTIL, Valentim; ALMEIDA, Jorge R. C.
  • article 3 Citação(ões) na Scopus
    Dual diagnosis of obsessive compulsive and compulsive buying disorders: Demographic, clinical, and psychiatric correlates
    (2018) KIM, Hyoun S.; HODGINS, David C.; TORRES, Albina R.; FONTENELLE, Leonardo F.; ROSARIO, Maria Conceicao do; MATHIS, Maria Alice de; FERRAO, Ygor A.; MIGUEL, Euripedes C.; TAVARES, Hermano
    Aim: The present research assessed the rates as well as the demographic, clinical, and psychiatric correlates associated with comorbid obsessive-compulsive disorder (OCD) and compulsive buying disorder (CBD). Method: Participants were drawn from a large (N = 993) multi-center study of people seeking treatment for their OCD. The diagnoses of psychiatric disorders were made using the Structured Clinical Interview for DSM by registered psychologists and psychiatrists. The clinical correlates, including the severity and presence of OCD symptoms and dimensions were assessed using psychometrically sound measures. Results: 75 (7.5%) participants met criteria for comorbid CBD. The results of binary logistic regression found that women were more likely to present with comorbid CBD, whereas being a student was a protective factor. The presence of hoarding dimension, poorer insight, social phobia, binge eating disorder, internet use disorder and kleptomania were significantly associated with comorbid CBD. Conclusion: The results suggest that individuals with a dual diagnosis of OCD and CBD may represent a unique clinical population that warrants tailored interventions. Specifically, they were more likely to present with other psychiatric disorders characterized by high levels of impulsivity and compulsivity. Targeting psychological mechanisms common to impulsivity-compulsivity disorders may enhance treatment utility in this dual diagnosis population.
  • article 11 Citação(ões) na Scopus
    Gambling onset and progression in a sample of at-risk gamblers from the general population
    (2014) CARNEIRO, Elizabeth; TAVARES, Hermano; SANCHES, Marcos; PINSKY, Ilana; CAETANO, Raul; ZALESKI, Marcos; LARANJEIRA, Ronaldo
    The goal of this study was to investigate gambling-related behavior, onset and progression in a sample of at-risk gamblers from the community. A national household survey was conducted in Brazil, covering individuals 14 years old or older. Subjects were screened for at-risk gambling, those testing positive answered a questionnaire about gambling progression, preferred games and DSM-IV pathological gambling criteria. Out of 3007 respondents, 118 were considered at-risk gamblers according to the Lie/Bet Questionnaire. According to the DSM-IV, 32.7% and 24.9% of those were considered problem and pathological gamblers, respectively. Early at-risk gamblers (onset prior to 20 years of age), were more likely to be male, to prefer non-commercially structured games, and to chase losses while gambling. Young pathological gamblers (under 35 years of age) progressed faster from regular to problem gambling (roughly 2 years) than mature pathological gamblers (12 years). Such findings had not been described before because previous reports focused mostly on clinical samples that lack young, male, early-onset gamblers. Gambling programs have not satisfactorily covered this segment of gamblers. Outreach strategies and early interventions should be provided to prevent these individuals from rapidly evolving into pathological gambling.