BRUNO MENDONCA COELHO
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
Agora exibindo 1 - 3 de 3
- The role of gender in the structure of networks of childhood adversity(2018) COELHO, Bruno Mendonca; SANTANA, Geilson Lima; DUARTE-GUERRA, Leorides Severo; VIANA, Maria Carmen; NETO, Francisco Lotufo; ANDRADE, Laura Helena; WANG, Yuan-PangThe objective of present study is to investigate the relationship between different childhood adversities. The potential impact of early adversity on prevention programs is discussed. Data on twelve childhood adversities was collected from a representative sample of 5037 members of the general population living in a large metropolitan area. Data were analyzed through network analysis, to estimate and compare network connectivity and centrality measures by gender. Over half the respondents had been exposed to at least one adversity during their earlier developmental stage. Among adversity-exposed persons, 48.4% presented simultaneous adversities, most of which were related to 'family dysfunction' and 'maltreatment' (mean = 2.9 adversities). Women reported more adversities than men (59.0% vs. 47.6%). Although the 'global' network connectivity across adversities was similar in both genders, 'regional' distinctions in the network structure were found. While 'neglect' and 'parental death' were more important for women than men, 'parental mental disorders' was more important for men. Gender-related childhood adversities were clustered experiences. Adversities related to 'early family dysfunction' and 'maltreatment' were prominent features in the networks of both boys and girls. Differential preventive and intervention programs should take into account gender-related patterns of exposure and reporting patterns of early adversity.
- The epidemiology of personality disorders in the Sao Paulo Megacity general population(2018) SANTANA, Geilson Lima; COELHO, Bruno Mendonca; WANG, Yuan-Pang; CHIAVEGATTO FILHO, Alexandre Dias Porto; VIANA, Maria Carmen; ANDRADE, Laura HelenaIntroduction Most studies on the epidemiology of personality disorders (PDs) have been conducted in high-income countries and may not represent what happens in most part of the world. In the last decades, population growth has been concentrated in low-and middle-income countries, with rapid urbanization, increasing inequalities and escalation of violence. Our aim is to estimate the prevalence of PDs in the Sao Paulo Metropolitan Area, one of the largest megacities of the world. We examined sociodemographic correlates, the influence of urban stressors, the comorbidity with other mental disorders, functional impairment and treatment. Methods A representative household sample of 2,942 adults was interviewed using the WHO-Composite International Diagnostic Interview and the International Personality Disorder Examination-Screening Questionnaire. Diagnoses were multiply imputed, and analyses used multivariable regression. Results and discussion Prevalence estimates were 4.3% (Cluster A), 2.7% (Cluster B), 4.6% (Cluster C) and 6.8% (any PD). Cumulative exposure to violence was associated with all PDs except Cluster A, although urbanicity, migration and neighborhood social deprivation were not significant predictors. Comorbidity was the rule, and all clusters were associated with other mental disorders. Lack of treatment is a reality in Greater Sao Paulo, and this is especially true for PDs. With the exception of Cluster C, non-comorbid PDs remained largely untreated in spite of functional impairment independent of other mental disorders. Conclusion Personality disorders are prevalent, clinically significant and undertreated, and public health strategies must address the unmet needs of these subjects. Our results may reflect what happens in other developing world megacities, and future studies are expected in other low- and middle-income countries.
- Gender-related patterns of psychiatric disorder clustering among bariatric surgery candidates: A latent class analysis(2018) DUARTE-GUERRA, Leorides Severo; COELHO, Bruno Mendonca; SANTO, Marco Aurelio; LOTUFO-NETO, Francisco; WANG, Yuan-PangBackground: Psychiatric disorders tend to distribute unevenly in women and men with severe obesity. The current research aimed to identify homogeneous clusters of concurrent psychiatric disorders among patients seeking bariatric surgery, by gender. Methods: We recruited a consecutive sample of 393 candidates with obesity (311 women and 82 men) in a university-based bariatric center. Trained clinicians assessed psychiatric disorders through the Structured Clinical Interview for DSM-IV (SCID). Latent class analysis categorized pre-surgical patients into uniform clusters of co-occurring psychiatric disorders. Results: For both genders, the 3-class psychopathological clustering was the best-fitting solution. Among women, the latent classes were: (1) ""oligosymptomatic"", wherein 42% of patients showed low probability of psychiatric disorders; (2) ""bipolar with comorbidities"", in 33%; and (3) ""anxiety/depression"", in 25%. Among men, (1) ""bipolar with comorbidities"" was found in 47% of patients; (2) ""oligosymptomatic"", in 40%; and (3) ""anxiety/depression"", in 13%. For both genders, the probability of presenting eating disorders was higher in both ""bipolar"" and ""anxiety/depression"" classes. Substance use disorders was prominent among ""bipolar"" men. In comparison with ""oligosymptomatic"" class, the likelihood of higher BMI was observed among ""bipolar"" men and poorer work attainment among men with ""anxiety/depression"". Limitation: Participants was cross-sectionally drawn from a single bariatric center. Conclusions: Pre-surgical men and women with severe obesity were distributed in three comorbidity profiles and revealed analogous psychopathological patterns. The class of ""bipolar disorders"" most likely presented comorbidity with eating and substance use disorder. This natural clustering of psychiatric disorders among bariatric patients suggests gender-related therapeutic approaches and surgical outcomes.