ARTHUR GUERRA DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
73 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 73
- Perceptions of and Attitudes Toward Antidepressants Stigma Attached to Their Use-A Review(2011) CASTALDELLI-MAIA, Joao Mauricio; SCOMPARINI, Luciana Burim; ANDRADE, Arthur Guerra de; BHUGRA, Dinesh; ALVES, Tania Correa de Toledo Ferraz; D'ELIA, GilbertoThe aim of this study was to ascertain whether there is any evidence of stigma related to the use of antidepressants. Using the PubMed and MEDLINE databases, we searched for the terms stigma, antidepressants, and depression. A protocol was developed to extract information from the papers, which were identified and explored further. Thirty-two papers were identified. We found that the stigma against depression differs from stigma against the use of antidepressants. Stigma against depression does not impact on therapeutic adherence to antidepressant use. Stigma related to antidepressant use appears to be linked with perceived emotional weakness, severity of illness, an inability to deal with problems, and a lack of belief in the therapeutic efficacy of antidepressants. Stigma against medication can be a useful target for interventions, just like the stigma related to depression. However, clinicians must be careful in avoiding the medicalization of symptoms.
- In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern(2018) CASTALDELLI-MAIA, Joao Mauricio; NICASTRI, Sergio; CERDA, Magdalena; KIM, June H.; OLIVEIRA, Lucio Garcia de; ANDRADE, Arthur Guerra de; MARTINS, Silvia S.Introduction and AimsGiven a scenario of intense discussion about the legal situation of cannabis users worldwide, this paper aims to investigate the role of cannabis within a drug use sequencing pattern. Design and MethodsData came from a representative sample of college students from 27 Brazilian capitals (n=12711). We analysed the patterns of transition from/to the first use of cannabis to/from the first use of alcohol, tobacco and seven other illegal drugs. Survival analysis methods were used to analyse age of onset data on all potential drug pairs. Drugs that were not specified as the target drug pair tested in each survival model were included as time-varying covariates in all models. ResultsWe found significant transitions from alcohol [adjusted hazard ratio (aHR)=1.41, 95% confidence interval (CI) 1.15-1.73, P<0.001] and inhalants (aHR=1.56, 95% CI 1.26-1.93, P<0.001) to cannabis. Moreover, we found significant transitions from cannabis to alcohol (aHR=2.40, 95% CI 1.47-3.91, P<0.001), cocaine (aHR=7.47, 95% CI=4.26-13.09, P<0.001), prescription opioids (aHR=2.16, 95% CI 1.29-3.63, P<0.01) and tranquilisers (aHR=1.51, 95% CI 1.11-2.06, P<0.01). Discussion and ConclusionsOverall, our findings point to a strategic role of cannabis within drug first use sequence pattern. We had an important and unexpected findingthe bi-directional relationship between alcohol and cannabis. In addition, the first use of cannabis still precedes the first use of cocaine and non-medical use of tranquilisers and prescription opioids. [Castaldelli-Maia JM, Nicastri S, Cerda M, Kim JH, Oliveira LG, Andrade AG, Martins, SS. In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern. Drug Alcohol Rev 2017;00:000-000]
- Is self-reported 7-day point prevalence abstinence an useful measure for smoking cessation effectiveness among individuals with mental disorders?(2023) LIMA, Danielle Ruiz; DAVANSO, Lucas Carvalho; CARVALHO, Carlos Felipe Cavalcanti; GUIMARAES-PEREIRA, Bruna Beatriz Sales; LORETO, Aline Rodrigues; FRALLONARDO, Fernanda Piotto; ISMAEL, Flavia; ANDRADE, Arthur Guerra de; CASTALDELLI-MAIA, Joao MauricioSmoking rates among individuals with mental disorders are higher compared to general population. We aimed to investigate the effectiveness of a smoking cessation treatment among individuals with and without mental disorders. Self-report 7-day point prevalence was used to assess abstinence status among 'intention to treat' (n = 1,213) and 'completers-only' (n = 578) samples. Participants were distributed in (1) ND-only; (2) ND and other substance use disorder (ND-SUD); (3) ND associated with mental disorder but no other SUD (ND-MD); and (4) co-morbid ND, SUD and MD (ND-SUMD). The treatment program was composed by six weeks of group Cognitive Behavioral Therapy (CBT) and medical consultations. Multivariate logistic regression models were applied. Rates of abstinence between ND-only and both ND-MD and ND-SUMD differed in the 'intention-to-treat' sample, with the former group showing the best rate (62.5%, 48% and 45.4% respectively). ND-SUD had the second-best rate of abstinence (56.1%). Differences between groups were not observed among 'completers-only'. Self-report 7-day point prevalence abstinence is economical and reliable to be used in low to middle-income countries. In this study, it showed that the 6-week smoking cessation treatment had a positive effect among completers, which supports the importance of investing in treatment to decrease smoking prevalence in this population.
- Drinking Patterns and Alcohol Use Disorders in Sao Paulo, Brazil: The Role of Neighborhood Social Deprivation and Socioeconomic Status(2014) SILVEIRA, Camila Magalhaes; SIU, Erica Rosanna; ANTHONY, James C.; SAITO, Luis Paulo; ANDRADE, Arthur Guerra de; KUTSCHENKO, Andressa; VIANA, Maria Carmen; WANG, Yuan-Pang; MARTINS, Silvia S.; ANDRADE, Laura HelenaBackground: Research conducted in high-income countries has investigated influences of socioeconomic inequalities on drinking outcomes such as alcohol use disorders (AUD), however, associations between area-level neighborhood social deprivation (NSD) and individual socioeconomic status with these outcomes have not been explored in Brazil. Thus, we investigated the role of these factors on drink-related outcomes in a Brazilian population, attending to male-female variations. Methods: A multi-stage area probability sample of adult household residents in the Sao Paulo Metropolitan Area was assessed using the WHO Composite International Diagnostic Interview (WMH-CIDI) (n = 5,037). Estimation focused on prevalence and correlates of past-year alcohol disturbances [heavy drinking of lower frequency (HDLF), heavy drinking of higher frequency (HDHF), abuse, dependence, and DMS-5 AUD] among regular users (RU); odds ratio (OR) were obtained. Results: Higher NSD, measured as an area-level variable with individual level variables held constant, showed an excess odds for most alcohol disturbances analyzed. Prevalence estimates for HDLF and HDHF among RU were 9% and 20%, respectively, with excess odds in higher NSD areas; schooling (inverse association) and low income were associated with male HDLF. The only individual-level association with female HDLF involved employment status. Prevalence estimates for abuse, dependence, and DSM-5 AUD among RU were 8%, 4%, and 8%, respectively, with excess odds of: dependence in higher NSD areas for males; abuse and AUD for females. Among RU, AUD was associated with unemployment, and low education with dependence and AUD. Conclusions: Regular alcohol users with alcohol-related disturbances are more likely to be found where area-level neighborhood characteristics reflect social disadvantage. Although we cannot draw inferences about causal influence, the associations are strong enough to warrant future longitudinal alcohol studies to explore causal mechanisms related to the heterogeneous patterns of association and male-female variations observed herein. Hopefully, these findings may help guide future directions for public health.
- The DSM-5 and the diagnosis of substance use disorders: Reflection about validity of the new criteria and possible ""missing pieces' in the puzzle(2015) LIMA, Danielle Ruiz; GONCALVES, Priscila Dib; MALBERGIER, Andre; AMARAL, Ricardo; ANDRADE, Arthur G.; CUNHA, Paulo Jannuzzi
- Gender differences in drinking patterns and alcohol-related problems in a community sample in Sao Paulo, Brazil(2012) SILVEIRA, Camila Magalhaes; SIU, Erica Rosanna; WANG, Yuan-Pang; VIANA, Maria Carmen; ANDRADE, Arthur Guerra de; ANDRADE, Laura HelenaOBJECTIVE: To investigate drinking patterns and gender differences in alcohol-related problems in a Brazilian population, with an emphasis on the frequency of heavy drinking. METHODS: A cross-sectional study was conducted with a probability adult household sample (n = 1,464) in the city of Sao Paulo, Brazil. Alcohol intake and ICD-10 psychopathology diagnoses were assessed with the Composite International Diagnostic Interview 1.1. The analyses focused on the prevalence and determinants of 12-month non-heavy drinking, heavy episodic drinking (4-5 drinks per occasion), and heavy and frequent drinking (heavy drinking at least 3 times/week), as well as associated alcohol-related problems according to drinking patterns and gender. RESULTS: Nearly 22% (32.4% women, 8.7% men) of the subjects were lifetime abstainers, 60.3% were non-heavy drinkers, and 17.5% reported heavy drinking in a 12-month period (26.3% men, 10.9% women). Subjects with the highest frequency of heavy drinking reported the most problems. Among subjects who did not engage in heavy drinking, men reported more problems than did women. A gender convergence in the amount of problems was observed when considering heavy drinking patterns. Heavy and frequent drinkers were twice as likely as abstainers to present lifetime depressive disorders. Lifetime nicotine dependence was associated with all drinking patterns. Heavy and frequent drinking was not restricted to young ages. CONCLUSIONS: Heavy and frequent episodic drinking was strongly associated with problems in a community sample from the largest city in Latin America. Prevention policies should target this drinking pattern, independent of age or gender. These findings warrant continued research on risky drinking behavior, particularly among persistent heavy drinkers at the non-dependent level.
- The role of neurocognitive functioning, substance use variables and the DSM-5 severity scale in cocaine relapse: A prospective study(2019) LIM, Danielle Ruiz; GONCALVES, Priscila Dib; OMETTO, Mariella; MALBERGIER, Andre; AMARAL, Ricardo Abrantes; SANTOS, Bernardo dos; CAVALLET, Mikael; CHAIM-AVANCINI, Tiffany; SERPA, Mauricio Henriques; FERREIRA, Luiz Roberto Kobuti; DURAN, Fabio Luis de Souza; ZANETTI, Marcus Vinicius; NICASTR, Sergio; BUSATTO, Geraldo Filho; ANDRAD, Arthur Guerra; CUNH, Paulo JannuzziBackground: The severity of substance use disorder (SUD) is currently defined by the sum of DSM-5 criteria. However, little is known about the validity of this framework or the role of additional severity indicators in relapse prediction. This study aimed to investigate the relationship between DSM-5 criteria, neurocognitive functioning, substance use variables and cocaine relapse among inpatients with cocaine use disorder (CUD). Methods: 128 adults aged between 18 and 45 years were evaluated; 68 (59 males, 9 females) had CUD and 60 (52 males, 8 females) were healthy controls. For the group with CUD, the use of other substances was not an exclusion criterion. Participants were tested using a battery of neurocognitive tests. Cocaine relapse was evaluated 3 months after discharge. Results: Scores for attention span and working memory were worse in patients compared to controls. Earlier onset and duration of cocaine use were related to poorer inhibitory control and global executive functioning, respectively; recent use was related to worse performance in inhibitory control, attention span and working memory. More DSM-5 criteria at baseline were significantly associated with relapse. Conclusions: Recent cocaine use was the most predictive variable for neurocognitive impairments, while DSM-5 criteria predicted cocaine relapse at three months post treatment. The integration of neurocognitive measures, DSM-5 criteria and cocaine use variables in CUD diagnosis could improve severity differentiation. Longitudinal studies using additional biomarkers are needed to disentangle the different roles of severity indicators in relapse prediction and to achieve more individualized and effective treatment strategies for these patients.
- Pharmacological Treatment of Alcohol Cravings(2023) MARIN, Matheus Cheibub David; PEDRO, Maria Olivia Pozzolo; PERROTTE, Giuliana; MARTINS-DA-SILVA, Anderson S.; LASSI, Dangela L. S.; BLAAS, Israel Kanaan; CASTALDELLI, Fernando Ikeda; SANTOS, Maria Beatriz Brisola dos; KORTAS, Guilherme Trevizan; CAMPOS, Marcela Waisman; TORALES, Julio; VENTRIGLIO, Antonio; PERICO, Cintia de Azevedo-Marques; NEGRAO, Andre B.; LEOPOLDO, Kae; ANDRADE, Arthur Guerra de; MALBERGIER, Andre; CASTALDELLI-MAIA, Joao Mauricio(1) Background: The treatment of substance addiction is challenging and has persisted for decades, with only a few therapeutic options. Although there are some recommendations for specific treatments for Alcohol Use Disorder (AUD), there is no specific medication used to treat alcohol cravings, which could benefit millions of patients that are suffering from alcoholism. Cravings, or the urge to use drugs, refer to the desire to experience the effects of a previously experienced psychoactive substance. (2) Methods: We included original studies of alcohol abuse or dependence extracted from a controlled, blind, pharmacological treatment study which presented measures and outcomes related to alcohol cravings. (3) Results: Specific drugs used for the treatment of alcoholism, such as Naltrexone and Acamprosate, have had the best results in relieving craving symptoms, as well as promoting abstinence. Baclofen and anticonvulsants such as Gabapentin and Topiramate have shown good results in promoting abstinence and the cessation of cravings. (4) Conclusions: Specific drugs used for the treatment of alcoholism to obtain the best results can be considered the gold standard for promoting abstinence and relieving cravings. Anticonvulsants and Baclofen also had good results, with these medications being considered as second-line ones. Varenicline is an option for alcohol dependents who also concomitantly ingest tobacco.
- Investigating the Dimensional Diagnosis of ICD-11 Nicotine Dependence(2018) CASTALDELLI-MAIA, Joao Mauricio; MARTINS, Silvia S.; STORR, Carla L.; VIANA, Maria C.; ANDRADE, Laura H.; ANDRADE, Arthur G.We investigated the dimensionality and possible measurement bias of ICD-11 Nicotine Dependence (ND) criteria in a sample of smokers from a middle-income country. Data are from the Sao Paulo Megacity Project (part of World Mental Health Surveys) collected between 2005 and 2007 (n = 5,037). The current analyses were restricted to the 1,388 participants who smoked at least once a week for 2 months in their lifetime. Item response theory (IRT) was used to investigate the severity and discrimination properties of 8 selected criteria. Additionally, differential criteria functioning (DCF) with sociodemographic characteristics (income, gender, age, employment status, marital status, and education) was investigated. All analyses were performed in Mplus software taking into account complex survey design features. IRT results indicated that the criterion Given Up had the lowest probability of endorsement (highest severity). The criterion Larger/Longer had the highest probability of endorsement (lowest severity), but the highest value of discrimination. Physical Withdrawal had the lowest discrimination property. No DCF was found both at criterion-and disorder-level, which would tear measurement bias. The absence of measurement bias in all sociodemographic, psychiatric, and medical subgroups gives psychometrical support to this set of criteria for ICD-11 ND diagnosis.
- DSM-5 Alcohol Use Disorder Criteria in ""Crazy Heart"" (2009)-A Media Content Analysis with Teaching Purposes(2014) SILVA JR., Rubens Dantas da; BHUGRA, Dinesh; ANDRADE, Arthur Guerra de; LOTUFO-NETO, Francisco; CASTALDELLI-MAIA, Joao MauricioObjective The movie Crazy Heart (2009) draws our attention to alcohol disorders as it has a large number of scenes which portray alcohol consumption and fulfill the new DSM-5 Alcohol Use Disorder (DSM-5-AUD) criteria. In view of the recent launch of DSM-5, this is an appropriate opportunity to explore alcohol consumption in a large number of scenes employing the DSM-5-AUD criteria to study this. Methods We use media content analysis to identify DSM-5 AUD criteria as portrayed by the main protagonist of the movie Bad Blake in a structured manner. We studied his behavior and attitudes in the context of the film structure and storyline. Results The severity continuum of DSM-5 AUD can be demonstrated through the trajectory of the character Bad Blake. In the course of the movie, there is some reference to all the DSM-5-AUD criteria, which can be applied to this character within the 21 scenes selected for this study. Conclusion This film can therefore be helpful and used to introduce students and trainees to the DSM-5-AUD criteria. It also allows teachers to discuss with their students and trainees the options of treatment including decision to quit drinking (total abstinence) and the recovery and relapse of this chronic condition.