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
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conferenceObject FREQUENCY AND PERSISTENCE OF PSYCHIATRIC DISORDERS AMONG SEVERELY OBESE PATIENTS: COMORBIDITY BETWEEN MOOD, ANXIETY, AND EATING DISORDERS(2016) Duarte-Guerra; COELHO, B. M.; SANTO, M. A.; LOTUFO-NETO, F.; WANG, Y. P.- Psychiatric Disorders Among Obese Patients Seeking Bariatric Surgery: Results of Structured Clinical Interviews(2015) DUARTE-GUERRA, Leorides Severo; COELHO, Bruno Mendonca; SANTO, Marco Aurelio; WANG, Yuan-PangObesity and psychiatric disorders are burdensome health problems commonly observed in general population and clinical samples. However, non-standardized assessment and small size of the sample might hamper conclusions of the investigations. The objective of this study is to replicate previous findings on frequency of psychiatric disorders and associated factors among obese patients seeking bariatric surgery, assessed through standardized interview. The sample was comprised of 393 treatment-seeking obese patients (79.1 % women; mean age 43.0 years, mean BMI 47.8 kg/m(2)) recruited from a university-based bariatric center. Trained clinicians ascertained the psychiatric diagnosis of the participants through structured clinical interview for DSM-IV Axis I diagnosis (SCID-I). The current rate of any psychiatric disorders was 57.8 % (58.5 % men vs. 57.6 % women). The current anxiety disorders were the most frequent diagnosis (46.3 %) among those participants with current disorder. Age and educational level were associated with the likelihood of presenting current psychiatric disorders. The lifetime rate of any psychiatric disorders was 80.9 % (81.7 men vs. 80.7% women). Lifetime affective disorders were the most frequent diagnosis (total 64.9%; bipolar disorders 35.6% and depressive disorders 29.3%). About half of the sample presented 3 or more concurrent disorders among those respondents presenting any lifetime psychiatric disorders. Psychiatric disorders are frequent conditions among obese patients before bariatric surgery. Systematic assessment of patients in the pre-surgical phase is recommended. Prognostic implications of psychiatric disorders on surgery outcome should be demonstrated in follow-up study.
- Morbidity persistence and comorbidity of mood, anxiety, and eating disorders among preoperative bariatric patients(2017) DUARTE-GUERRA, Leorides Severo; COELHO, Bruno Mendonca; SANTO, Marco Aurelio; LOTUFO-NETO, Francisco; WANG, Yuan-PangThe current study investigates the patterns of disease persistence and comorbidity of psychiatric disorders among patients with class III obesity in pre-operative period. For 393 treatment-seeking patients with severe obesity recruited from a bariatric center, we ascertained their psychiatric diagnosis through Structured Clinical Interview for DSM-IV (SCID-I). Following, the frequency, persistence and comorbidity pattern of psychiatric disorders in this sample were determined. Current psychiatric disorders were observed in over half of patients during preoperative period, being anxiety disorders the most frequent diagnosis. For lifetime disorders, mood disorders were the most frequent diagnosis. Most of the sample presented 2 or more concurrent lifetime psychiatric disorders. While mood and eating disorders were frequent conditions, anxiety disorders were the most persistent conditions (the highest one month-to-lifetime prevalence ratio) and were significantly correlated with bipolar, depressive and eating disorders. Psychiatric disorders are frequent and enduring conditions among patients looking for bariatric surgery. Comorbid anxiety, mood, and eating disorders are remarkable features in treatment-seeking patients with obesity. Prognostic implications of preoperative psychiatric disorders on surgery outcome should be demonstrated prospectively in intervention studies.
- Association between childhood adversities and psychopathology onset throughout the lifespan: Findings from a large metropolitan population(2021) COELHO, Bruno Mendonca; ANDRADE, Laura Helena; SANTANA, Geilson Lima; VIANA, Maria Carmen; WANG, Yuan-PangBackground: Childhood adversities (ECA) are deleterious experiences that can occur during individuals' development, which has been associated with several negative health outcomes. Aim: Analyze the effect of ECA on the onset of DSM-IV disorders throughout life. Method: The Composite International Diagnostic Interview (CIDI) was used in a stratified, multistage area probability sample of 5037 individuals aged 18 or more to assess the presence of childhood adversities, 20 psychiatric disorders and their ages of onset. Discrete-time survival models were performed to estimate the odds of disorder onset. Data are from the Sao Paulo Megacity Mental Health Survey, the Brazilian branch of the World Mental Health Survey Initiative. Findings: 53.6% of the sample experienced at least one ECA, and parental death (16.1%) and physical abuse (16%) were the most reported occurrences. Parental mental illness (OR = 1.99 to 2.27) and family violence (OR = 1.55 to 1.99) were the adversities most consistently associated with psychopathology across all age groups, while economic adversities (OR = 2.71 to 3.30) and parent criminality (OR = 1.72 to 1.77) were associated with psychopathology in individuals whose onset of disorder occurred from age 13 years on. Parental mental disorders and economic adversities were the strongest and most consistent predictors of all four classes of psychopathologies examined in multivariate models controlled for the clustering of adversities. Physical abuse was associated with externalizing disorders, while sexual abuse with internalizing disorders. Interpretation: Childhood adversities were consistently associated with mental disorders. Economic adversities and parent mental disorders were predictive of psychopathology even if controlled for type (additive) and type and number of adversities (interactive models). Parental mental disorder and family violence were the main predictors of psychopathology onset across all age groups. Parental mental disorder was the only adversity that predicted all classes of disorders investigated.
- 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.