Departamento de Psiquiatria - FM/MPS

URI Permanente desta comunidade

O Departamento de Psiquiatria da Faculdade de Medicina da Universidade de São Paulo (FMUSP) abrange as áreas de Graduação, Internato, Residência Médica, Pós-Graduação lato sensu e Pós-Graduação stricto sensu, bem como estágios de curta e longa duração para profissionais médicos e de áreas afins. Na graduação, responde por um módulo de Psiquiatria na disciplina de Bases Fisiológicas da Clínica Médica e pelas disciplinas de Bases Humanísticas da Medicina, Psicologia Médica e Psiquiatria Clínica.

Além de atuar nas áreas de ensino e assistência, tem alta produtividade científica na FMUSP, exercendo liderança nacional de pesquisas básica e clínica em áreas de transtornos do humor, transtornos de ansiedade, esquizofrenia, psiquiatria geriátrica, genética e epidemiologia, além de liderar grupos nacionais de pesquisa, como o Consórcio Brasileiro de Pesquisa dos Transtornos do Espectro Obsessivo-Compulsivo (C-TOC).


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Scopus: 95


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article 0 Citação(ões) na Scopus
Adolescent Screen Use: Problematic Internet Use and the Impact of Gender
(2024) NISKIER, Sheila Rejane; SNAYCHUK, Lindsey A.; KIM, Hyoun S.; SILVA, Thiago T. da; VITALLE, Maria Sylvia de Souza; TAVARES, Hermano
Objective The relationship between screen use and problematic internet use (PIU; i.e., internet addiction) amongst adolescents has not been sufficiently explored. Further, there is even less research on how gender is associated with this relationship. The goal of the study was to examine adolescent screen use, PIU, and its impact on day-to-day routines of adolescents.Methods Participants were recruited from an outpatient pediatric clinic in Sao Paulo, Brazil. A total of 180 adolescents completed questionnaires related to their screen use, extracurricular activities, and symptoms of PIU. Univariate and multivariate statistics were used to determine correlates and predictors of PIU, and to explore gender differences.Results A total of 26.1% of adolescents met the criteria for PIU. There were no significant differences between boys and girls in PIU severity. However, there were significant gender differences in preferred use of the Internet, with boys being more likely to access the Internet to play video games (odds ratio [OR]=27.1) and girls being more likely to socialize with friends (OR=4.51). PIU severity increased proportionally to the number of hours of use of all screen devices with moderate-to-large effect sizes (eta 2=0.060-0.157). Using screens during meals and missing extracurricular activities were both associated with PIU. Conclusion Though gender was not associated with PIU, both excessive use of screen devices during meals and neglect of offline extracurriculars activities were identified as risk factors for PIU. Prevention measures should consider the impact of gender and associated patterns of motivation and Internet use.
article 0 Citação(ões) na Scopus
Spiritist anomalous experience is not associated with psychosis
(2024) MOREIRA-ALMEIDA, Alexander; COSTA, Marianna de Abreu; GATTAZ, Wagner Farid
article 0 Citação(ões) na Scopus
Lithium and disease modification: A systematic review and meta-analysis in Alzheimer's and Parkinson's disease
(2024) SINGULANI, Monique Patricio; FERREIRA, Ana Flavia Fernandes; FIGUEROA, Paulina Sepulveda; CUYUL-VASQUEZ, Ivan; TALIB, Leda Leme; BRITTO, Luiz Roberto; FORLENZA, Orestes Vicente
The role of lithium as a possible therapeutic strategy for neurodegenerative diseases has generated scientific interest. We systematically reviewed and meta-analyzed pre-clinical and clinical studies that evidenced the neuroprotective effects of lithium in Alzheimer's (AD) and Parkinson's disease (PD). We followed the PRISMA guidelines and performed the systematic literature search using PubMed, EMBASE, Web of Science, and Cochrane Library. A total of 32 articles were identified. Twenty-nine studies were performed in animal models and 3 studies were performed on human samples of AD. A total of 17 preclinical studies were included in the meta-analysis. Our analysis showed that lithium treatment has neuroprotective effects in diseases. Lithium treatment reduced amyloid-beta and tau levels and significantly improved cognitive behavior in animal models of AD. Lithium increased the tyrosine hydroxylase levels and improved motor behavior in the PD model. Despite fewer clinical studies on these aspects, we evidenced the positive effects of lithium in AD patients. This study lends further support to the idea of lithium's therapeutic potential in neurodegenerative diseases.
article 0 Citação(ões) na Scopus
Tai Chi Chuan evidence related to impulsivity and impulse related disorders: A scoping review
(2024) SILVA, Djanira Ribeiro da; ROHDE, Ciro Blujus dos Santos; TAVARES, Hermano
Background: The purpose of this study was to review the evidence for the potential of Tai Chi Chuan (TCC) as a model of meditative movement in benefiting people with impulsivity related disorders and provide guidance for future research. Methods: A scoping review of the literature was conducted in five databases. Eligibility criteria were original articles reporting TCC based interventions or included TCC techniques and provided any assessment on impulsivity or related measures, impulse control disorders, or other psychiatric disorders related to impulsivity (e.g., addictive disorders, ADHD, and other conduct disorders). Twenty-eight out of 304 studies initially retrieved were reviewed. The reports concentrated mostly on neurodegenerative conditions, cognitive decline, and substance use disorders (SUD). Results: TCC had several positive effects in cognitive domains resulting in improvements in memory, executive functions, inhibitory control, attention, and verbal fluency. These improvements in memory, executive function, including inhibitory control and attention, and verbal fluency were associated with changes in the brain plasticity, resting activity, and other neurobiological markers. Conclusion: Albeit no study was found on the use of TCC in impulse control disorders or impulse related conditions, other than SUD, the findings suggest that considering the behavioral impact of TCC, especially the improvement of executive functions, it could be a valuable therapeutic tool for approaching impulse control related disorders.
article 1 Citação(ões) na Scopus
Availability of Electroconvulsive Therapy in Public Health Services in the Last Decade in Brazil
(2024) MAZUCCO, Julia Pellizon; SMAIRA, Sumaia Inaty; SILVA, Antonio Geraldo da; BRUNONI, Andre Russowsky; GALLUCCI-NETO, Jose
ObjectiveTo identify the current treatment options for electroconvulsive therapy (ECT) therapy in public services linked to the Unified Health System in Brazil and compare them with data published in 2012 based on their availability.MethodsIn this retrospective observational study, we mapped institutions that perform ECT under public health services in Brazil. A questionnaire was administered to active and inactive service centers between August 2022 and June 2023.ResultsWe identified 16 institutions that performed ECT, including 12 linked to public universities and 4 with various links. In the last decade, 2 new public services that perform ECT in the country have emerged, whereas 4 services have ceased function. In 2022, the number of individuals treated with ECT per 100,000 population was 1.86, whereas the number of procedures performed per 100,000 people was 6.55.ConclusionsAlthough 2 new public ECT services have been identified, 4 have turned inactive. Most services are linked to public universities, and inactive service points to financial issues as the main factor in service interruption. Brazil has one of the lowest rates of individuals treated with ECT per 100,000 population compared with countries in North America and Europe. Thus, it is essential to raise awareness to improve ECT adoption rates and bring it out of the shadows in Brazil.
article 0 Citação(ões) na Scopus
Neuropsychiatric symptoms and ApoE genotype in older adults without dementia: a cross-sectional study
(2024) STELLA, Florindo; PAIS, Marcos Vasconcelos; LOUREIRO, Julia Cunha; CORDEIRO, Augusto Magno Tranquezi; TALIB, Leda Leme; FORLENZA, Orestes Vicente
Background: The ApoE genotype and neuropsychiatric symptoms (NPS) are known risk factors for cognitive decline in older adults. However, the interaction between these variables is still unclear. The aim of this study was to determine the association between the presence of the ApoE epsilon 4 allele and the occurrence of NPS in older adults without dementia. Methods: In this cross-sectional investigation we determined the apolipoprotein E (ApoE) genotype of 74 older adults who were either cognitively normal (20.3% / Clinician Dementia Rating Scale (CDR): 0) or had mild cognitive impairment (MCI: 79.7% / CDR: 0.5). We used a comprehensive cognitive assessment protocol, and NPS were estimated by the Neuropsychiatric Inventory-Clinician Rating Scale (NPI-C), Mild Behavioural Impairment-Checklist (MBI-C), Hamilton Rating Scale for Depression (HAM-D), and Apathy Inventory. Results: ApoE epsilon 4 carriers had higher MBI-C total scores than ApoE epsilon 4 noncarriers. Correlations between NPS and ApoE genotype were observed for two NPI-C domains, although in opposite directions: the ApoE epsilon 4 allele was associated with a 1.8 unit decrease in the estimated aberrant motor disturbance score and with a 1.3 unit increase in the estimated appetite/eating disorders score. All fitted models were significant, except for the one fitted for the domain delusions from the NPI-C. Among individuals with amnestic MCI, epsilon 4 carriers presented higher depression score (HAM-D) than noncarriers; in turn, epsilon 4 noncarriers exhibited higher aggression score (NPI-C) than epsilon 4 carriers. Conclusions: Our analyses showed associations between NPS and the presence of the ApoE epsilon 4 allele in two NPI-C domains, despite the sample size. Furthermore, compared to noncarriers, the presence of the ApoE epsilon 4 correlated positively with appetite/eating disorders and negatively with aberrant motor disturbance domain. Examination of the amnestic MCI group displayed significant, although weak, associations. Therefore, epsilon 4 carriers exhibited higher depression scores according to the HAM-D scale compared to epsilon 4 noncarriers. Conversely, epsilon 4 noncarriers had higher scores in the aggression domain of the NPI-C than epsilon 4 carriers.
article 0 Citação(ões) na Scopus
Increases in functional connectivity between the default mode network and sensorimotor network correlate with symptomatic improvement after transcranial direct current stimulation for obsessive-compulsive disorder
Background: Non-invasive neuromodulation is a promising intervention for obsessive-compulsive disorder (OCD), although its neurobiological mechanisms of action are still poorly understood. Recent evidence suggests that abnormalities in the connectivity of the default mode network (DMN) and the supplementary motor area (SMA) with other brain regions and networks are involved in OCD pathophysiology. We examined if transcranial direct current stimulation (tDCS) alters these connectivity patterns and if they correlate with symptom improvement in treatment-resistant OCD. Methods: In 23 patients from a larger clinical trial (comparing active tDCS to sham) who underwent pre- and posttreatment MRI scans, we assessed resting-state functional MRI (rs-fMRI) data. The treatment involved 30-minute daily tDCS sessions for four weeks (weekdays only), with the cathode over the SMA and the anode over the left deltoid. We conducted whole-brain connectivity analysis comparing active tDCS-treated to sham-treated patients. Results: We found that active tDCS, but not sham, led to connectivity increasing between the DMN and the bilateral pre/postcentral gyri ( p = 0.004, FDR corrected) and temporal-auditory areas plus the SMA ( p = 0.028, FDR corrected). Also, symptom improvement was directly associated with connectivity increasing between the left lateral sensorimotor network and the left precuneus ( r = 0.589, p = 0.034). Limitations: Limited sample size (23 participants with resting-state neuroimaging), inability to analyze specific OCD symptom dimensions (e.g., harm, sexual/religious, symmetry/checking, cleaning/contamination). Conclusions: These data offer novel information concerning functional connectivity changes associated with noninvasive neuromodulation interventions in OCD and can guide new brain stimulation interventions in the framework of personalized interventions.
article 10 Citação(ões) na Scopus
Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: data, with critical re-analysis, from the Global Burden of Disease study
(2023) CORTESE, Samuele; SONG, Minjin; FARHAT, Luis C.; YON, Dong Keon; LEE, Seung Won; KIM, Min Seo; PARK, Seoyeon; OH, Jae Won; LEE, San; CHEON, Keun-Ah; SMITH, Lee; GOSLING, Corentin J.; POLANCZYK, Guilherme V.; LARSSON, Henrik; ROHDE, Luis A.; FARAONE, Stephen V.; KOYANAGI, Ai; DRAGIOTI, Elena; RADUA, Joaquim; CARVALHO, Andre F.; SHIN, Jae Il; SOLMI, Marco
Data on incidence, prevalence and burden of ADHD are crucial for clinicians, patients, and stakeholders. We present the incidence, prevalence, and burden of ADHD globally and across countries from 1990 to 2019 from the Global Burden of Disease (GBD) study. We also: (1) calculated the ADHD prevalence based on data actually collected as opposed to the prevalence estimated by the GBD with data imputation for countries without prevalence data; (2) discussed the GBD estimated ADHD burden in the light of recent meta-analytic evidence on ADHD-related mortality. In 2019, GBD estimated global age-standardized incidence and prevalence of ADHD across the lifespan at 0.061% (95%UI = 0.040-0.087) and 1.13% (95%UI = 0.831-1.494), respectively. ADHD accounted for 0.8% of the global mental disorder DALYs, with mortality set at zero by the GBD. From 1990 to 2019 there was a decrease of -8.75% in the global age-standardized prevalence and of -4.77% in the global age-standardized incidence. The largest increase in incidence, prevalence, and burden from 1990 to 2019 was observed in the USA; the largest decrease occurred in Finland. Incidence, prevalence, and DALYs remained approximately 2.5 times higher in males than females from 1990 to 2019. Incidence peaked at age 5-9 years, and prevalence and DALYs at age 10-14 years. Our re-analysis of data prior to 2013 showed a prevalence in children/ adolescents two-fold higher (5.41%, 95% CI: 4.67-6.15%) compared to the corresponding GBD estimated prevalence (2.68%, 1.83-3.72%), with no significant differences between low- and middle- and high-income countries. We also found meta-analytic evidence of significantly increased ADHD-related mortality due to unnatural causes. While it provides the most detailed evidence on temporal trends, as well as on geographic and sex variations in incidence, prevalence, and burden of ADHD, the GBD may have underestimated the ADHD prevalence and burden. Given the influence of the GBD on research and policies, methodological issues should be addressed in its future editions.
article 0 Citação(ões) na Scopus
Attention-deficit/hyperactivity disorder (Vol 10, pg 11, 2024)
(2024) FARAONE, Stephen V.; BELLGROVE, Mark A.; BRIKELL, Isabell; CORTESE, Samuele; HARTMAN, Catharina A.; HOLLIS, Chris; NEWCORN, Jeffrey H.; PHILIPSEN, Alexandra; POLANCZYK, Guilherme V.; RUBIA, Katya; SIBLEY, Margaret H.; BUITELAAR, Jan K.
article 0 Citação(ões) na Scopus
Association of mental health symptoms with the migraine-tension-type headache spectrum in the Brazilian longitudinal study of adult health
(2024) MERCANTE, Juliane Prieto Peres; OLIVEIRA, Arao Belitardo; PERES, Mario Fernando Prieto; WANG, Yuan-Pang; BRUNONI, Andre Russowsky; LOTUFO, Paulo Andrade; BENSENOR, Isabela Martins; GOULART, Alessandra Carvalho
Objective: To investigate the relationship between mental health symptoms and the migraine-tension-type headache (TTH) spectrum in middle-aged adults from the Brazilian Longitudinal Study of Adult Health (ELSABrasil study). Methods: In this cross-sectional analysis (baseline data: 2008-2010), it was evaluated the relationship between each mental health symptom assessed by the Clinical Interview Schedule-Revised (CIS-R) questionnaire and headache subtypes (migraine and TTH) according to international criteria. It was performed binary logistic regression models, with estimated odds ratios (OR) with their respective 95% confidence intervals (CI) adjusted for confounders including migraine attack frequency. Results: Among 13,916 participants, 70.1% reported any major primary headache subtype within the last year. The most common subtype was definite TTH (33.4%), followed by probable migraine (21.0%), definite migraine (8.5%), and probable TTH (7.2%). Our main findings indicated positive associations between anxiety-related symptoms and the migraine-tension type headache (TTH) spectrum with a clear trend toward definite migraine more than tension-type headache. The presence of somatic symptoms presented a high likelihood for the associations with headaches, mainly definite migraine (OR: 7.9, 95% CI: 6.4-9.8), probable migraine (OR: 4.5, 95% CI 3.7-5.4) and probable TTH (OR: 3.0, 95% CI: 2.3-3.8). Other symptoms associated with headache disorders included fatigue, panic, irritability, anxiety symptoms, concentration problems, forgetfulness, depressive symptoms, and worry. The effect of associations remained significant after controlling for headache attack frequency. Conclusion: This study provides evidence of consistent associations between mental health symptoms and primary headache disorders, with a higher burden of anxiety-based symptoms observed in people with migraine than those with TTH.