JULIANA BELO DINIZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Brain activation during fear extinction recall in unmedicated patients with obsessive-compulsive disorder(2023) DINIZ, Juliana Belo; BAZAN, Paulo Rodrigo; PEREIRA, Carlos Alberto de Braganca; SARAIVA, Erlandson Ferreira; RAMOS, Paula Roberta Camargo; OLIVEIRA, Amanda Ribeiro de; REIMER, Adriano Edgar; HOEXTER, Marcelo Queiroz; MIGUEL, Euripedes Constantino; SHAVITT, Roseli Gedanke; BATISTUZZO, Marcelo CamargoSpecific brain activation patterns during fear conditioning and the recall of previously extinguished fear responses have been associated with obsessive-compulsive disorder (OCD). However, further replication studies are necessary. We measured skin-conductance response and blood oxygenation level-dependent responses in unmedicated adult patients with OCD (n = 27) and healthy participants (n = 22) submitted to a two-day fear conditioning experiment comprising fear conditioning, extinction (day 1) and extinction recall (day 2). During conditioning, groups differed regarding the skin conductance reactivity to the aversive stimulus (shock) and regarding the activation of the right opercular cortex, insular cortex, putamen, and lingual gyrus in response to conditioned stimuli. During extinction recall, patients with OCD had higher responses to stimuli and smaller differences between responses to conditioned and neutral stimuli. For the entire sample, the higher the response delta between conditioned and neutral stimuli, the greater the dACC activation for the same contrast during early extinction recall. While activation of the dACC predicted the average difference between responses to stimuli for the entire sample, groups did not differ regarding the activation of the dACC during extinction recall. Larger unmedicated samples might be necessary to replicate the previous findings reported in patients with OCD.
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment(2023) OLIVEIRA, Marcos Vinicius Sousa de; BARROS, Pedro Macul Ferreira de; MATHIS, Maria Alice de; BOAVISTA, Rodrigo; CHACON, Priscila; ECHEVARRIA, Marco Antonio Nocito; FERRAO, Ygor Arzeno; VATTIMO, Edoardo Felippo de Queiroz; LOPES, Antonio Carlos; TORRES, Albina Rodrigues; DINIZ, Juliana Belo; FONTENELLE, Leonardo F.; ROSARIO, Maria Conceicao do; SHAVITT, Roseli Gedanke; MIGUEL, Euripedes Constantino; SILVA, Renata de Melo Felipe da; COSTA, Daniel Lucas da ConceiaoObjectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD).Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological interven-tion for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first -line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part II: cognitive-behavioral therapy(2023) MATHIS, Maria Alice de; CHACON, Priscila; BOAVISTA, Rodrigo; OLIVEIRA, Marcos Vinicius Sousa de; BARROS, Pedro Macul Ferreira de; ECHEVARRIA, Marco Antonio Nocito; FERRAO, Ygor Arzeno; VATTIMO, Edoardo Filippo de Queiroz; LOPES, Antonio Carlos; TORRES, Albina Rodrigues; DINIZ, Juliana Belo; FONTENELLE, Leonardo; ROSARIO, Maria Conceicao do; SHAVITT, Roseli Gedanke; SILVA, Renata de Melo Felipe da; CONSTANTINO, Euripedes; COSTA, Daniel Lucas da ConceicaoObjectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD).Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association.Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD.Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD.