ARTHUR GUERRA DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- 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.
- 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.
- DSM-5 Post-Traumatic Stress Disorder Criteria in ""Precious"" (2009): Media Content Analysis for Educational Purposes(2017) RAMOS, Laura Dip; GUIMARAES, Fernanda Severo; VENTRIGLIO, Antonio; ANDRADE, Arthur Guerra de; BHUGRA, Dinesh; LOTUFO-NETO, Francisco; CASTALDELLI-MAIA, Joao Mauricio
- Using selected scenes from Brazilian films to teach about substance use disorders, within medical education(2012) CASTALDELLI-MAIA, Joao Mauricio; OLIVEIRA, Hercilio Pereira; ANDRADE, Arthur Guerra; LOTUFO-NETO, Francisco; BHUGRA, DineshCONTEXT AND OBJECTIVES: Themes like alcohol and drug abuse, relationship difficulties, psychoses, autism and personality dissociation disorders have been widely used in films. Psychiatry and psychiatric conditions in various cultural settings are increasingly taught using films. Many articles on cinema and psychiatry have been published but none have presented any methodology on how to select material. Here, the authors look at the portrayal of abusive use of alcohol and drugs during the Brazilian cinema revival period (1994 to 2008). DESIGN AND SETTING: Qualitative study at two universities in the state of Sao Paulo. METHODS: Scenes were selected from films available at rental stores and were analyzed using a specifically designed protocol. We assessed how realistic these scenes were and their applicability for teaching. One author selected 70 scenes from 50 films (graded for realism and teaching applicability = 8). These were then rated by another two judges. Rating differences among the three judges were assessed using nonparametric tests (P < 0.001). Scenes with high scores (= 8) were defined as ""quality scenes"". RESULTS: Thirty-nine scenes from 27 films were identified as ""quality scenes"". Alcohol, cannabis, cocaine, hallucinogens and inhalants were included in these. Signs and symptoms of intoxication, abusive/harmful use and dependence were shown. CONCLUSIONS: We have produced rich teaching material for discussing psychopathology relating to alcohol and drug use that can be used both at undergraduate and at postgraduate level. Moreover, it could be seen that certain drug use behavioral patterns are deeply rooted in some Brazilian films and groups.
- Neural Correlates of Depressive Symptoms in Smokers - A Systematic Review of Imaging Studies(2017) GONZALEZ, Michele de Oliveira; GOUDRIAAN, Anna E.; PERICO, Cintia de Azevedo-Marques; CAMPOS, Marcela Waisman; ANDRADE, Arthur Guerra de; BHUGRA, Dinesh; CASTALDELLI-MAIA, Joao MauricioThis review aims to summarize neuroimaging studies in order to better understand the neural correlates of depressive symptoms in tobacco smokers. Using the keywords depressive OR depression AND tobacco OR nicotine OR smok(*) OR cigarette AND neuroimage OR magnetic resonance OR smri OR structural magnetic resonance OR fmri OR functional magnetic resonance OR pet OR positron emission tomography, literature search was conducted in PubMed, Web of Science and PsycINFO databases. The first and the last author read the abstracts of all the studies found in the search (n = 179). The inclusion and exclusion criteria were applied and 150 articles were excluded. Then, both authors assessed the remaining 29 studies for eligibility and 16 studies were included in the present review. In the phase of active/chronic smoking, depressive symptoms are characterized as comorbidity related to an enhancement of dopamine release, and smokers have decreased Monoamine oxidase A (MAO-A). Stimuli-related functional magnetic resonance imaging (Stimuli-fMRI) studies also show that there is a positive correlation between the level of depressive symptoms and a greater response to general negative stimuli in active/chronic smokers. In the withdrawal phase, depressive symptoms are related to the withdrawal syndrome and increased MAO-A. Stimuli-fMRI studies show that there is a negative correlation between level of depressive symptoms and reactivity to negative stimuli in recent abstinent smokers. Major areas of the reward system such as the striatum and areas related to impulse control are activated to a greater extent in depressive smokers compared to non-depressed smokers.
- Does ragging play a role in medical student depression - Cause or effect?(2012) CASTALDELLI-MAIA, Joao Mauricio; MARTINS, Silvia Saboia; BHUGRA, Dinesh; MACHADO, Marcelo Polazzo; ANDRADE, Arthur Guerra de; ALEXANDRINO-SILVA, Clovis; BALDASSIN, Sergio; ALVES, Tania Correa de Toledo FerrazBackground: Medical students experience a lot of stress what may contribute to symptoms of depression. In this study we set out to look at the environmental factors which may be contributing in one medical school in Brazil. Methods: We assessed depressive symptoms using Beck's Depression Inventory in 465 and 267 medical students in 2001 and 2006 respectively. We explored possible social and environmental causes using qualitative data. Results: Nearly 15% scored above the cut off for depression in both the samples. Males in the pre-clinical stage in 2006 showed an increase in depressive symptoms than males in the same cycle in 2001 (aOR = 7.36 [95% CI = 0.85-63.5] p = 0.07). Qualitative data confirmed that factors such as ragging and low social involvement were correlated with depressive symptoms in pre-clinical stage males. Limitations: The sample size was small both for quantitative and qualitative aspects of the study. Conclusions: It appears that ragging plays an important role in the genesis of depressive symptoms in medical students.
- Experimentation with tobacco during adolescence as a factor influencing treatment of smoking in adulthood. A retrospective cohort(2019) CHAIM, Carolina Hanna; SIU, Erica Rosanna; CARVALHO, Carlos Felipe Cavalcanti; FRALLONARDO, Fernanda Piotto; ISMAEL, Flavia; ANDRADE, Arthur Guerra de; VENTRIGLIO, Antonio; TORALES, Julio; BHUGRA, Dinesh; CASTALDELLI-MAIA, Joao MauricioBACKGROUND: There are still few studies on predictors of smoking cessation in Brazilian samples. Experimentation with tobacco during adolescence (ETA) may be one of the important predictors. OBJECTIVE: This study aimed, within the context of a treatment-seeking group of subjects, to test the hypothesis that ETA negatively affects the outcome of smoking cessation during adulthood. DESIGN AND SETTING: Retrospective (historic) cohort study conducted at a psychosocial care center in Sao Paulo, Brazil, between 2007 and 2010. METHODS: Data on sociodemographics, smoking and medical profiles were obtained through self-report questionnaires that were completed at the baseline and at any follow-up appointment. Logistic regression models were constructed to describe factors associated with the outcome of smoking cessation, measured according to the self-reported four-week success rate among 367 outpatient smokers. RESULTS: ETA was found to be associated with not quitting smoking through the treatment (odds ratio = 0.57; 95% confidence interval = 033-0.96; P < 0.05), even after adjustment for dependence level, sociode-mographics, nicotine patch use and number of years of smoking. CONCLUSIONS: Early exposure to nicotine may lead to higher risk of continuing smoking after treatment, in adulthood.
- Adolescent Characters and Alcohol Use Scenes in Brazilian Movies, 2000-2008(2016) CASTALDELLI-MAIA, Joao Mauricio; ANDRADE, Arthur Guerra de; LOTUFO-NETO, Francisco; BHUGRA, DineshQuantitative structured assessment of 193 scenes depicting substance use from a convenience sample of 50 Brazilian movies was performed. Logistic regression and analysis of variance or multivariate analysis of variance models were employed to test for two different types of outcome regarding alcohol appearance: The mean length of alcohol scenes in seconds and the prevalence of alcohol use scenes. The presence of adolescent characters was associated with a higher prevalence of alcohol use scenes compared to nonalcohol use scenes. The presence of adolescents was also associated with a higher than average length of alcohol use scenes compared to the nonalcohol use scenes. Alcohol use was negatively associated with cannabis, cocaine, and other drugs use. However, when the use of cannabis, cocaine, or other drugs was present in the alcohol use scenes, a higher average length was found. This may mean that most vulnerable group may see drinking as a more attractive option leading to higher alcohol use.
- Substance Use and Misuse in Brazilian Movies (2000-2008)(2013) CASTALDELLI-MAIA, Joao Mauricio; BHUGRA, Dinesh; ANDRADE, Arthur Guerra de; LOTUFO-NETO, FranciscoConsidering the absence of data on the appearance of drugs other than alcohol and tobacco in movie scenes, we decided to study the prevalence of portrayal of illicit drug use in a convenience sample of 50 Brazilian Movies. A total of 192 scenes (12h49'03 '') meeting the inclusion criteria were identified and assessed in a structured manner. Despite several limitations regarding the nature of this comparison, we found that scenes show substance use and misuse almost similar to that in the general population, mainly alcohol (especially among people of low socioeconomic status), cannabis and inhalants. Main differences were found in cocaine and tranquilizers (over-and underexposure in movies, respectively).
- Depression in medical students: Cluster symptoms and management(2013) BALDASSIN, Sergio; SILVA, Nilson; ALVES, Tania Correa de Toledo Ferraz; CASTALDELLI-MAIA, Joao Mauricio; BHUGRA, Dinesh; NOGUEIRA-MARTINS, Maria Cezira Fantini; ANDRADE, Arthur Guerra de; NOGUEIRA-MARTINS, Luiz AntonioBackground: Rates of depression among medical students have been shown to be high and related to year of study and other factors. We report on cluster of symptoms related to depression and their association with other difficulties in specific domains. Methods: 481 (Response rate=79.8%) medical students completed a questionnaire about areas of difficulty in the medical school (studies, leisure, colleagues, professors, and patients), and Beck Depression Inventory (BDI). We studied correlation among areas of difficulty and clusters of BDI along with year in the course. Results: Two areas which contributed most difficulty were studies and leisure. The significant associations for studies were seen between somatic cluster of depressive symptoms and the level of the course. Difficulties associated with leisure activities and with colleagues were correlated with the affective cluster of symptoms of depression. Activities related to clinical matters especially working with patients in the internship year were associated with somatic clusters. The different associations confirmed that rather than relying on scores emphasis should be placed on clusters of symptoms. Limitations: Sample from a single medical school. Conclusions: Although the clusters are associated with specific difficulties, it is important that educators and health professionals are aware of streesors the medical students face. The correlations if confirmed in future studies with qualitative factors could guide the development of more specific therapeutic or curriculum interventions.