KARLA MATHIAS DE ALMEIDA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- A Sib-Pair analysis of impulsivity in bipolar disorder type I(2013) ALMEIDA, Karla Mathias de; NERY, Fabiano Goncalves; MORENO, Ricardo Alberto; GORENSTEIN, Clarice; LAFER, BenyObjective: The aim of this study was to compare impulsivity among patients with bipolar disorder, their siblings, and healthy controls in order to examine whether impulsivity in bipolar disorder is related to genetic liability for the illness. Methods: Using the Barratt Impulsiveness Scale, we assessed 204 subjects: 67 euthymic outpatients with bipolar disorder type I, 67 siblings without bipolar disorder, and 70 healthy controls. Results: Impulsivity scores were higher among patients with bipolar disorder than among healthy controls. Siblings showed higher motor impulsivity scores than did healthy controls. Conclusions: Our results suggest that motor impulsivity may be a vulnerability marker for bipolar disorder. Our data may contribute to further improve preventive strategies in subjects at high risk for bipolar disorder.
- Facial emotion recognition in euthymic patients with bipolar disorder and their unaffected first-degree relatives(2016) FERNANDES, Franey de Brito Ferreira; GIGANTE, Alexandre Duarte; BERUTTIA, Mariangeles; AMARAL, Jose Antonio; ALMEIDA, Karla Mathias de; ROCCA, Cristiana Castanho de Almeida; LAFER, Beny; NERY, Fabiano GoncalvesBackground: Facial emotion recognition (FER) is an important task associated with social cognition because facial expression is a significant source of non-verbal information that guides interpersonal relationships. Increasing evidence suggests that bipolar disorder (BD) patients present deficits in FER and these deficits may be present in individuals at high genetic risk for BD. The aim of this study was to evaluate the occurrence of FER deficits in euthymic BD patients, their first-degree relatives, and healthy controls (HC) and to consider if these deficits might be regarded as an endophenotype candidate for BD. Methods: We studied 23 patients with DSM-IV BD type I, 22 first-degree relatives of these patients, and 27 HC. We used the Penn Emotion Recognition Tests to evaluate tasks of FER, emotion discrimination, and emotional acuity. Patients were recruited from outpatient facilities at the Institute of Psychiatry of the University of Sao Paulo Medical School, or from the community through media advertisements, had to be euthymic, with age above 18 years old and a diagnosis of DSM-IV BD type I. Results: Euthymic BD patients presented significantly fewer correct responses for fear, and significantly increased time to response to recognize happy faces when compared with HC, but not when compared with first-degree relatives. First-degree relatives did not significantly differ from HC on any of the emotion recognition tasks. Conclusion: Our results suggest that deficits in FER are present in euthymic patients, but not in subjects at high genetic risk for BD. Thus, we have not found evidence to consider FER as an endophenotype candidate for BD.
- Structured physical exercise for bipolar depression: an open-label, proof-of concept study(2023) LAFER, Beny; DUARTE, Cicera Claudinea; GREVE, Julia Maria D'Andrea; SILVA, Paulo Roberto dos Santos; ALMEIDA, Karla Mathias de; BELIZARIO, Gabriel Okawa; NEVES, Lucas MeloBackgroundPhysical exercise (PE) is a recommended lifestyle intervention for different mental disorders and has shown specific positive therapeutic effects in unipolar depressive disorder. Considering the similar symptomatology of the depressive phase in patients with bipolar disorder (BD) and unipolar depressive disorder, it is reasonable to suggest that PE may also be beneficial for bipolar depression. However, there is an absence of studies evaluating the antidepressant effect of a structured PE intervention in BD.MethodsThis is an open-label, single-arm study trial. Fifteen patients with a diagnosis of BD Type I or Type II, presenting a depressive episode were included in the study. After physical and functional evaluation, patients participated in supervised training sessions with aerobics followed by strength exercises, three times per week, for 12 weeks (36 training sessions). Depressive and manic symptoms were assessed at baseline and 2, 4, 8, and 12 weeks. Additionally, quality of Life and functioning were assessed at baseline and 4, 8, and 12 weeks). Finally, we tested cardiorespiratory fitness, muscle strength and body composition at baseline and week-12.ResultsThe mean (+/- SD) Montgomery Asberg Depression Rating Scale (MADRS) score at baseline was 23.6 +/- 8.3 points and after 12 weeks of PE the mean score was 10.2 +/- 4.8 points. Nine patients (82%) presented an antidepressant response defined as a reduction of more than 50% of depressive symptoms at week 12 with five of those patients (45%) presenting criteria for full remission. A large and significant Cohen's D Effect Size (pre-post) was verified for MADRS reduction [1.98 (95% Confidence interval = 0.88 to 3.08)]. We did not detect a significant change in manic symptoms, functioning, and quality of life during the 12-week follow-up. At week-12, all patients increased their muscular strength (one repetition maximal test - 1RM) and reduced the percentage of body fat (spectral bioelectrical impedance analysis).ConclusionsThis study, using rigorous criteria and a structured intervention, provides valid pilot data, showing the feasibility of a structured PE intervention for the treatment of depressive symptoms in BD, and suggesting a potential adjunctive antidepressant effect. Moreover, PE showed a positive impact on muscle strength and body composition. This should be further verified by randomized controlled studies.
- Personality traits in bipolar disorder type I: a sib-pair analysis(2011) ALMEIDA, Karla Mathias; NERY, Fabiano G.; MORENO, Ricardo Alberto; GORENSTEIN, Clarice; LAFER, BenyObjective: The aim of this study was to compare temperament and character traits among patients with bipolar disorder (BD), their siblings, and healthy controls (HCs) in order to examine whether personality traits are related to the genetic vulnerability to develop BD. Methods: Using the Temperament and Character Inventory, we assessed 204 subjects: 67 euthymic outpatients with bipolar disorder type I, 67 siblings without BD, and 70 HCs. Results: Scores on harm avoidance, novelty seeking, and selftranscendence were significantly higher among patients with BD than among HCs, whereas those on self-directedness and cooperativeness were significantly lower. Siblings showed higher scores on harm avoidance and lower scores on self-directedness than did HCs. As some of the siblings presented at least one lifetime psychiatric disorder other than BD (n = 35), we examined the subset of siblings who had no lifetime psychiatric disorder (n = 32). This group showed statistically higher harm avoidance scores than HCs. Conclusions: Our results suggest that the harm avoidance temperament trait and, to a lesser extent, the self-directedness character trait may represent vulnerability factors for BD.
- Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I(2012) ABREU, Lena Nabuco de; NERY, Fabiano G.; HARKAVY-FRIEDMAN, Jill M.; ALMEIDA, Karla Matias de; GOMES, Bernardo Carramao; OQUENDO, Maria A.; LAFER, BenyBackground: The association between suicidal behavior and quality of life (QoL) in bipolar disorder (BD) is poorly understood. Worse QoL has been associated with suicide attempts and suicidal ideation in schizophrenic patients, but this relationship has not been investigated in BD. This study tested whether a history of suicide attempts was associated with poor QoL in a well-characterized sample of patients with BD, as has been observed in other psychiatric disorders and in the general population. Methods: One hundred eight patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BD type I (44 with previous suicide attempts, 64 without previous suicide attempts) were studied. Quality of life was assessed using the World Health Organization's Quality of Life Instrument Short Version. Depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale-17 items and the Young Mania Rating Scale. Results: Patients with BD and previous suicide attempts had significantly lower scores in all the 4 domains of the World Health Organization's Quality of Life Instrument Short Version scale than did patients with BD but no previous suicide attempts (physical domain P=.001; psychological domain P <.0001; social domain P=.001, and environmental domain P=.039). In the euthymic subgroup (n=70), patients with previous suicide attempts had significantly lower scores only in the psychological and social domains (P=.020 and P=.004). Limitations: This was a cross-sectional study, and no causal associations can be assumed. Conclusions: Patients with BD and a history of previous suicide attempts seem to have a worse QoL than did patients who never attempted suicide. Poorer QoL might be a marker of poor copying skills and inadequate social support and be a risk factor for suicidal behavior in BD. Alternatively, poorer QoL and suicidal behavior might be different expressions of more severe BD.