Instituto de Psiquiatria - HC/IPq

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O Instituto de Psiquiatria (IPq) da Faculdade de Medicina da Universidade de São Paulo - Hospital das Clínicas (FMUSP-HC), inaugurado em 1952, é um dos sete institutos que compõe o Hospital das Clínicas e é, hoje, na América Latina, um dos maiores e mais importantes hospitais universitários de Psiquiatria, atuando em três grandes áreas de atividade: pesquisa, ensino e assistência em saúde neuropsiquiátrica. Além disso, tem alta produção de pesquisas e publicações em meios de divulgação significativos na área médica.

Exerce atividades de prevenção, tratamento e reabilitação dos transtornos neuropsiquiátricos, além de validar e difundir modelos eficientes de intervenção, de maneira a promover a saúde da população. O IPq abriga o Departamento de Psiquiatria da FMUSP, coordenando os cursos de graduação e pós-graduação da Faculdade, atuando na supervisão da pesquisa e das atividades didáticas de educação continuada.

Site oficial: http://ipqhc.org.br

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article 1 Citação(ões) na Scopus
Translation and psychometric evaluation of the Hebrew version of Psy-Flex to assess psychological flexibility
(2024) GUR, Ayelet; MOUADEB, Daniella; REICH, Ari; ATAR, Limor
Objectives: An up-and-coming concept that is gaining traction in the study of psychological states is psychological flexibility. This term refers to the individual's ability to be fully present in real time, think with openness, and act in a way that promotes his or her life in ways important to the individual. To the best of our knowledge, no previous study in Israel has utilized PsyFlex, a measurement tool for assessing psychological flexibility, and a Hebrew version of the tool has not been validated. This study aims to validate Psy-Flex-Heb by applying established validation protocols and leveraging insights from prior research on psychological flexibility measurements. The investigation delves into the associations between Psy-Flex-Heb and key psychological variables such as well-being, sense of meaning in life, and mindfulness. Additionally, the study rigorously examines and confirms the one-dimensional factor structure of PsyFlex-Heb. Methods: In this study, we conducted a psychometric evaluation by translating Psy-Flex into Hebrew (Psy-Flex-Heb) and examining its internal consistency and psychometric properties in 103 participants from the general population. Results: The reliability of Psy-Flex-Heb scores based on Cronbach's alpha was 0.91. Confirmatory Factor Analysis showed that Psy-Flex-Heb fit a one -factor model. We found significant correlations between Psy-Flex-Heb, psychological flexibility (measured by. Acceptance and Action Questionnaire - version 2 [AAQ-II]), well-being, meaning in life, and mindfulness. Conclusions: The results strengthen the one-dimensional construct of psychological flexibility and show Psy-Flex-Heb is a reliable measure that can be useful in both research and practice.
article 1 Citação(ões) na Scopus
Development and initial validation of the cannabis-related psychosis risk literacy scale (CPRL): a multinational psychometric study
(2024) FEKIH-ROMDHANE, Feten; ALHUWAILAH, Amthal; SHUWIEKH, Hanaa Ahmed Mohamed; STAMBOULI, Manel; HAKIRI, Abir; CHEOUR, Majda; LOCH, Alexandre Andrade; HALLIT, Souheil
Background Public education efforts to address and reduce potential harms from cannabis use in Arab countries are either slow or inexistent, and do not follow the steadily increasing trends of cannabis use in Arab youth. Several decades of research on substance use, it can be suggested that being aware of, and knowing about, psychosis risk related to cannabis can at least limit the consumption of the substance. Motivated by a lack of measures specifically designed to measure literacy about cannabis-related psychosis risk in younger populations, and based on an extensive literature review, we aimed to create and validate a new self-report scale to assess the construct, the Cannabis-related Psychosis Risk Literacy Scale (CPRL), in the Arabic language. Method A cross-sectional study was carried-out during the period from September 2022 to June 2023, enrolling 1855 university students (mean age of 23.26 +/- 4.96, 75.6% females) from three Arab countries (Egypt, Kuwait and Tunisia). Results Starting from an initial pool of 20 items, both Exploratory Factor Analysis and Confirmatory Factor Analysis suggested that the remaining 8 items loaded into a single factor. The scale demonstrated good internal consistency, with both McDonald omega and Cronbach's alpha values exceeding 0.7 (omega = 0.85 / alpha = 0.85). The CPRL showed measurement invariance across gender and country at the configural, metric, and scalar levels. Concurrent validity of the CPRL was established by correlations with less favourable attitudes towards cannabis (r = -.14; p <.001). In addition, higher literacy levels were found in students who never used cannabis compared to lifetime users (4.18 +/- 1.55 vs. 3.44 +/- 1.20, t(1853) = 8.152, p <.001). Conclusion The newly developed CPRL scale offers a valid and reliable instrument for assessing and better understanding literacy about cannabis-related psychosis risk among Arabic-speaking young adults. We believe that this new scale is suitable as a screening tool of literacy, as an instrument for measuring the effect of public education interventions aimed at promoting cannabis-related psychosis risk literacy among young people, and as a research tool to facilitate future studies on the topic with a wider application.
article
Impact of the COVID-19 pandemic on the symptomatology and routine of medicated patients with obsessivecompulsive disorder
(2024) ALMEIDA, Natalia B.; MAZIERO, Maria Paula; TANAMATIS, Tais; COSTA, Danel Lucas da Conceicao; SHAVITT, Roseli G.; HOEXTER, Marcelo Q.; BATISTUZZO, Marcelo C.
OBJECTIVES: To study the impact of coronavirus disease 2019 on the routine of patients with obsessive-compulsive disorder (OCD) and changes in symptoms and suicidal-related behavior, mainly in those with cleaning symptoms.
METHODS: In this cross-sectional study, 58 patients completed an online self-report questionnaire that included the Obsessive-Compulsive Inventory-Revised, Coronavirus Stress and Traumatic Events Scale, Coronavirus Health Impact Survey, Beck Anxiety and Beck Depression inventories, and Suicide-Related Behaviors Questionnaire. Comparisons were made with another pre-pandemic sample (n=524) regarding the last three measures.
RESULTS: During the pandemic, the patients spent more days inside their homes (chi(2) = 33.39, p = 0.007), changed their alcohol consumption patterns (chi(2) = 87.6, p < 0.001), and increased social media usage (chi(2) = 68.83, p < 0.001). Participants with cleaning symptoms did not significantly differ from the others in relation to stress, anxiety/depressive symptoms, or suicidal-related behaviors. Finally, our sample did not differ from an equivalent OCD sample assessed before the pandemic in terms of anxiety and depressive symptom severity or suicidal-related behaviors.
CONCLUSION: Overall, patients with OCD showed no lifestyle changes associated with higher stress levels during the pandemic. Patients with and without cleaning symptoms and patients before and during the pandemic presented similar results.
article 0 Citação(ões) na Scopus
Mitigating jaw osteonecrosis: bioactive glass and pericardial membrane combination in a rat model
(2024) PELLICANO, Alexandre Antonio; BENITES, Bernar M.; PASCHOA, Amanda F. N.; OLIVEIRA, Laura C.; CAMPOS, Ana Carolina P.; MARTINS, Daniel O.; REAL, Caroline C.; FARIA, Daniele de Paula; FONSECA, Felipe P.; MARTINEZ, Raquel R. C.; PAGANO, Rosana L.; FREGNANI, Eduardo R.
Objectives Bisphosphonates (BFs) show clinical effectiveness in managing osteoporosis and bone metastases but pose risks of bisphosphonate-related jaw osteonecrosis (BRONJ). With no established gold standard for BRONJ treatment, our focus is on symptom severity reduction. We aimed to assess the preventive effects of bioactive glass and/or pericardial membrane in a preclinical BRONJ model, evaluating their potential to prevent osteonecrosis and bone loss post-tooth extractions in zoledronic acid (ZA)-treated animals.Methods Rats, receiving ZA or saline biweekly for four weeks, underwent 1st and 2nd lower left molar extractions. Pericardial membrane alone or with F18 bioglass was applied post-extractions. Microarchitecture analysis and bone loss assessment utilized computerized microtomography (CT) and positron emission tomography (PET) with 18F-FDG and 18F-NaF tracers. Histological analysis evaluated bone injury.Results Exclusive alveolar bone loss occurred post-extraction in the continuous ZA group, inducing osteonecrosis, osteolysis, osteomyelitis, and abscess formation. Concurrent pericardial membrane with F18 bioglass application prevented these outcomes. Baseline PET/CT scans showed no discernible uptake differences, but post-extraction 18F-FDG tracer imaging revealed heightened glucose metabolism at the extraction site in the ZA-treated group with membrane, contrasting the control group.Conclusion These findings suggest pericardial membrane with F18 bioglass effectively prevents BRONJ in the preclinical model.
article 0 Citação(ões) na Scopus
The performance of K6 as a screening tool for mood disorders: A population-based study of the Sao Paulo metropolitan area
(2024) BRUZEGUINI, Meirielli Vieira; CORASSA, Rafael Bello; WANG, Yuan-Pang; ANDRADE, Laura Helena; SARTI, Thiago Dias; VIANA, Maria Carmen
Aim: The use of screening instruments allows the detection of psychological and behavioural manifestations there are often not identified in users of health services. We evaluated the performance of the Kessler Psychological Distress Scale (K6) in identifying mood disorders (MD), using the Composite International Diagnostic Interview (CIDI) as gold-standard, in a population-based sample (n = 5037) of adult residents of metropolitan Sao Paulo.Methods: Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated to assess the performance of K6 in detecting 30-day CIDI MD. All cut-points for each disorder were analysed using the Youden index and the area under the receiver operating characteristic curve (AUC), and the best cut-points were identified. Cronbach's alpha was calculated to assess internal consistency.Results: In total, 5.5% respondents screened positive for any MD (95% IC 4.84-6.14). A good detection performance was observed for all MD, with AUC values for any MD of 0.91 (95% IC 0.89-0.92), ranging from 0.80 (95% CI 0.71-0.98) for minor depression to 0.93 (95% CI 0.87-0.98) for bipolar I disorder. Best cut-points for each MD were identified, with overall sensitivity and specificity of 88.8% and 80.2%, respectively. Cronbach's alpha was 0.83.Conclusions: K6 is a good screening tool for MD in the Brazilian population. It is a brief and easy to use instrument that can promote the early identification and treatment of MD, reducing the burden of mental illness.
article 0 Citação(ões) na Scopus
Association between Sleep Problems and Psychopathologies among Preschoolers: A Brazilian Cross-Sectional Study
(2024) RAFIHI-FERREIRA, Renatha El; ALCKMIN-CARVALHO, Felipe; ROCHA, Marina Monzani da; CAMPOLI, Thiago Soares; OLLENDICK, Thomas Hubert
Objective To evaluate the relationship between sleep problems and psychopathologies in Brazilian preschool children. Materials and Methods The present is a cross-sectional study with162 children: 81 with sleep problems referred for treatment (mean age: 3.67 years), matched by gender/age with 81 participants without sleep problems. Sleep problems were identified through a clinical interview with a specialist. Psychopathologies were evaluated using the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Results Having sleep problems was a predictor of all forms of psychopathologies on the CBCL scales, except for the withdrawn scale. Aggressive behavior, depression/anxiety, affective problems, and oppositional defiant disorder were associated with presence of sleep problems. Conclusion Given the probable bidirectionality of the association between sleep problems and psychopathologies in children, it is suggested that regular assessments of both phenomena should be performed in children referred for treatment of sleep problems and mental health problems in general.
article 0 Citação(ões) na Scopus
Cognitive performance of post-covid patients in mild, moderate, and severe clinical situations
(2024) SERAFIM, Antonio de Padua; SAFFI, Fabiana; SOARES, Amanda Rafaella A.; MORITA, Alessandra Mara; ASSED, Mariana Medeiros; TOLEDO, Sandro de; ROCCA, Cristiana C. A.; DURAES, Ricardo S. S.
Background Studying individuals with varying symptoms, from mild to severe, can provide valuable insights into the spectrum of cognitive outcomes after COVID-19. We investigated the cognitive performance of adults who recovered from the novel coronavirus disease (COVID-19) without prior cognitive complaints, considering mild (not hospitalized), moderate (ward), and severe (intensive care unit) symptoms.Methods This cross-sectional study included 302 patients who recovered from COVID-19 (mild, n = 102; moderate, n = 102; severe, n = 98). We assessed intellectual quotient (IQ), attention, memory, processing speed, visual-constructive ability, as well as symptoms of depression, anxiety, and stress, at least eighteen months after infection. The mean length of hospitalization was M days=8.2 (SD = 3.9) and M days=14.4 (SD = 8.2) in the moderate and severe groups, respectively.Results Cognitive difficulties were present in all three groups: mild (n = 12, 11.7%), moderate (n = 40, 39.2%), and severe (n = 48, 48.9%). Using Multinomial Logistic Regression and considering the odds ratio, our results indicated that a one-point increase in sustained attention, visual memory, and working memory might decrease the odds of being categorized in the severe group by 20%, 24%, and 77%, respectively, compared to the mild group.Conclusions Our findings provide empirical evidence regarding the long-term cognitive effects of COVID-19, particularly in individuals experiencing severe manifestations of the disease. We also highlighted the need for a comprehensive, multidimensional approach in rehabilitation programs to address the enduring cognitive impacts of COVID-19.
article
Assessing harmonized intelligence measures in a multinational study
(2024) DESERISY, Mariah; WALL, Melanie M.; GOLDBERG, Terry E.; BATISTUZZO, Marcelo C.; KEYES, Katherine; JOODE, Niels T. de; LOCHNER, Christine; MARINCOWITZ, Clara; NARAYAN, Madhuri; ANAND, Nitin; RAPP, Amy M.; STEIN, Dan J.; SIMPSON, H. Blair; MARGOLIS, Amy E.
Studies examining the neurocognitive and circuit-based etiology of psychiatric illness are moving toward inclusive, global designs. A potential confounding effect of these associations is general intelligence; however, an internationally validated, harmonized intelligence quotient (IQ) measure is not available. We describe the procedures used to measure IQ across a five-site, multinational study and demonstrate the harmonized measure's cross-site validity. Culturally appropriate intelligence measures were selected: four short-form Wechsler intelligence tests (Brazil, Netherlands, South Africa, United States) and the Binet Kamat (India). Analyses included IQ scores from 255 healthy participants (age 18-50; 42% male). Regression analyses tested between-site differences in IQ scores, as well as expected associations with sociodemographic factors (sex, socioeconomic status, education) to assess validity. Harmonization (e.g., a priori selection of tests) yielded the compatibility of IQ measures. Higher IQ was associated with higher socioeconomic status, suggesting good convergent validity. No association was found between sex and IQ at any site, suggesting good discriminant validity. Associations between higher IQ and higher years of education were found at all sites except the United States. Harmonized IQ scores provide a measure of IQ with evidence of good validity that can be used in neurocognitive and circuit-based studies to control for intelligence across global sites.
article 0 Citação(ões) na Scopus
Neuroinflammation in the prefrontal-amygdala-hippocampus network is associated with maladaptive avoidance behaviour
(2024) ANTUNES, Geiza Fernanda; GOUVEIA, Flavia Venetucci; KUROKI, Mayra Akemi; MARTINS, Daniel Oliveira; PAGANO, Rosana de Lima; CAMPOS, Ana Carolina Pinheiro; MARTINEZ, Raquel Chacon Ruiz
Maladaptive avoidance behaviour is often observed in patients suffering from anxiety and trauma- and stressor-related disorders. The prefrontal-amygdala-hippocampus network is implicated in learning and memory consolidation. Neuroinflammation in this circuitry alters network dynamics, resulting in maladaptive avoidance behaviour. The two-way active avoidance test is a well -established translational model for assessing avoidance responses to stressful situations. While some animals learn the task and show adaptive avoidance (AA), others show strong fear responses to the test environment and maladaptive avoidance (MA). Here, we investigated if a distinct neuroinflammation pattern in the prefrontal-amygdala-hippocampus network underlies the behavioural difference observed in these animals. Wistar rats were tested 8 times and categorized as AA or MA based on behaviour. Brain recovery followed for the analysis of neuroinflammatory markers in this network. AA and MA presented distinct patterns of neuroinflammation, with MA showing increased astrocyte, EAAT-2, IL-1 beta, IL -17 and TNF- alpha in the amygdala. This neuroinflammatory pattern may underlie these animals ' fear response and maladaptive avoidance. Further studies are warranted to determine the specific contributions of each inflammatory factor, as well as the possibility of treating maladaptive avoidance behaviour in patients with psychiatric disorders with anti-inflammatory drugs targeting the amygdala.
article 0 Citação(ões) na Scopus
Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries
(2024) GEWIRTZ-MEYDAN, A.; KOOS, M.; NAGY, L.; KRAUS, S. W.; DEMETROVICS, Z.; POTENZA, M. N.; BALLESTER-ARNAL, R.; BATTHYANY, D.; BERGERON, S.; BILLIEUX, J.; BURKAUSKAS, J.; CARDENAS-LOPEZ, G.; CARVALHO, J.; CASTRO-CALVO, J.; CHEN, L.; CIOCCA, G.; CORAZZA, O.; CSAKO, R.; FERNANDEZ, D. P.; FUJIWARA, H.; FERNANDEZ, E. F.; FUSS, J.; GABRHELIK, R.; GJONESKA, B.; GOLA, M.; GRUBBS, J. B.; HASHIM, H. T.; ISLAM, M. S.; ISMAIL, M.; JIMENEZ-MARTINEZ, M. C.; JURIN, T.; KALINA, O.; KLEIN, V.; KOLTO, A.; LEE, S. -k.; LEWCZUK, K.; LIN, C. -y.; LOCHNER, C.; LOPEZ-ALVARADO, S.; LUKAVSKA, K.; MAYTA-TRISTAN, P.; MILLER, D. J.; OROSOVA, O.; OROSZ, G.; PONCE, F. P.; QUINTANA, G. R.; GARZOLA, G. C. Quintero; RAMOS-DIAZ, J.; RIGAUD, K.; ROUSSEAU, A.; SCANAVINO, M. De Tubino; SCHULMEYER, M. K.; SHARAN, P.; SHIBATA, M.; SHOIB, S.; SIGRE-LEIROS, V.; SNIEWSKI, L.; SPASOVSKI, O.; STEIBLIENE, V.; STEIN, D. J.; STRONG, C.; UENSAL, B. C.; VAILLANCOURT-MOREL, M. -p.; HOUT, M. C. Van; BOTHE, B.
Objectives: This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use. Study design: The study design is a cross-sectional self -report study conducted across 42 countries. Methods: A cross-sectional, self -report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set. Results: The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior. Conclusions: The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high -risk individuals and tailoring culturally sensitive suicide prevention strategies.