EURIPEDES CONSTANTINO MIGUEL FILHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
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conferenceObject Attentional Bias to Symmetry and Cleaning Features in Obsessive-Compulsive Disorder: A Pilot Study(2015) MATHIS, Maria Alice De; SALUM, Giovanni; MORAES, Ivanil; BATISTUZZO, Marcelo; MARCO, Marina De; TOLEDO, Maria Cecilia; REQUENA, Guaraci; ABEND, Rany; BAR-HAIM, Yair; MIGUEL, Euripedes; SHAVITT, Roseli- Polyenvironmental and polygenic risk scores and the emergence of psychotic experiences in adolescents(2021) V, Gabrielle de Oliveira S. Navarro; FONSECA, Lais; TALARICO, Fernanda; SPINDOLA, Leticia; SANTORO, Marcos L.; OTA, Vanessa K.; COGO-MOREIRA, Hugo; MARI, Jair; ROHDE, Luis A.; MIGUEL, Euripedes C.; BRESSAN, Rodrigo A.; PAN, Pedro M.; GADELHA, Ary; I, Sintia BelangeroPsychotic experiences (PE) are forms of hallucinations and delusions neither reaching the intensity and functional impairment required to be regarded as full psychotic symptoms nor a psychotic disorder. Here we investigated the ability to predict PE using multiple models (regressions, mediation and moderation) using polygenic risk score for psychotic experiences (PE-PRS), polygenic risk score for schizophrenia (SCZ-PRS), and polyenvironmental risk score (PERS) in youth from a Brazilian sample. The scores were not able to predict outcome, either when both scores were combined (PERS + PE-PRS and PERS + SCZ-PRS) or separately. Our results show that there is no association between PE and PRS or PERS among adolescents in our Brazilian sample. The lack of association may be a result of the absence of better representativeness regarding genetic and environmental factors of our population.
- Obsessive-compulsive symptoms are associated with psychiatric comorbidities, behavioral and clinical problems: a population-based study of Brazilian school children(2016) ALVARENGA, Pedro G.; ROSARIO, Maria C. do; CESAR, Raony C.; MANFRO, Gisele G.; MORIYAMA, Tais S.; BLOCH, Michael H.; SHAVITT, Roseli G.; HOEXTER, Marcelo Q.; COUGHLIN, Catherine G.; LECKMAN, James F.; MIGUEL, Euripedes C.Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an ""at-risk"" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 +/- A 1.84 years; 55.0 % male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.
- Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder(2021) SHEPHARD, Elizabeth; STERN, Emily R.; HEUVEL, Odile A. van den; COSTA, Daniel L. C.; BATISTUZZO, Marcelo C.; GODOY, Priscilla B. G.; LOPES, Antonio C.; BRUNONI, Andre R.; HOEXTER, Marcelo Q.; SHAVITT, Roseli G.; REDDY, Y. C. Janardhan; LOCHNER, Christine; STEIN, Dan J.; SIMPSON, H. Blair; MIGUEL, Euripedes C.An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.
conferenceObject Associations Between Medial Prefrontal Cerebral Metabolic Features and Clinical Characteristics in Obsessive-compulsive Disorder(2016) BATISTUZZO, Marcelo C.; HOEXTER, Marcelo; COSTA, Fabiana; SHAVITT, Roseli; LOPES, Antonio C.; CAPPI, Carolina; VATTIMO, Edoardo; MATHIS, Alice de; DINIZ, Juliana B.; HENNING, Anke; PASTORELLO, Bruno; MIGUEL, Euripedes C.; OTADUY, Maria C.- Obsessive-compulsive symptom dimensions in a population-based, cross-sectional sample of school-aged children(2015) ALVARENGA, Pedro G.; CESAR, Raony C.; LECKMAN, James F.; MORIYAMA, Tais S.; TORRES, Albina R.; BLOCH, Michael H.; COUGHLIN, Catherine G.; HOEXTER, Marcelo Q.; MANFRO, Gisele G.; POLANCZYK, Guilherme V.; MIGUEL, Euripedes C.; ROSARIO, Maria C. doBackground: Obsessive-compulsive disorder can be expressed as four potentially overlapping obsessive-compulsive symptom (OCS) dimensions (OCSD) (""symmetry/ordering"", ""contamination/cleaning"", ""aggressive/sexual/religious"" and ""collecting/hoarding""). In clinical samples, some dimensions are more familial and associated with increased psychiatric comorbidity and malfunctioning. However, data concerning OCS and OCSD are scarce in non-clinical samples, particularly among children. The present study aims to estimate: (1) the prevalence and sex/age distribution of OCS/OCSD in a community-based sample of schoolchildren; (2) the association between OCS and additional clinical factors; and (3) the degree of familial aggregation of OCS/OCSD. Methods: OCS and OCSD were evaluated in 9937 Brazilian school-children (6-12 years-old) and their biological relatives using the Family History Screen. Data analyses included gradient estimated equations and post-hoc tests. Results: We included data on 9937 index-children, 3305 siblings (13-18 years-old), and 16,218 parents. Biological mothers were the informants in 87.6% of the interviews. OCS were present in 14.7% of the index-children; 15.6% of their siblings; 34.6% of their mothers and 12.1% of their fathers. The prevalence of OCS and each of the OCSD gradually increased from ages 6 to 12 years. Overall, OCS in children were associated with the presence of other psychiatric symptoms, as well as behavioral/school impairment. OCS and each of the four OCSD aggregated significantly within families. Conclusions: OCS are prevalent and associated with psychiatric symptoms and clinical impairment among school-aged children. OCSD aggregate within families in a dimension-specific fashion. These findings suggest a natural continuum between OCS and OCD with regard to their dimensional character.
conferenceObject Lateral Insertion of Leads and Treatment Outcomes in Ventral Capsule/Ventral Striatum Deep Brain Stimulation for Obsessive-Compulsive Disorder(2020) LOPES, Antonio; GODINHO, Fabio; MURAKAMI, Mario; IGLESIO, Ricardo; LEEMANS, Alexander; FONOFF, Erich; MIGUEL, Euripedes; TEIXEIRA, Manoel; ARANTES, Paula- Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries(2020) CIRILLO, Alessandra; DINIZ, Elton; GADELHA, Ary; ASEVEDO, Elson; AXELRUD, Luiza K.; MIGUEL, Euripedes C.; ROHDE, Luis Augusto; BRESSAN, Rodrigo A.; PAN, Pedro; MARI, Jair de J.Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscience to study how genes and the environment shape typical and atypical brain functioning. The objective of this study was to review key studies on population neuroscience from low- and middle-income countries (LMICs) and to identify potential gaps vis-a-vis studies conducted in high-income countries. Methods: We conducted a systematic review to search for longitudinal cohort studies investigating the development of psychiatric disorders in children and adolescents in LMICs. We performed an electronic search in the EMBASE and MEDLINE databases from inception to July 5th, 2019. Results: We found six cohorts from four countries that met our search criteria: three cohorts from Brazil, one from China, one from South Africa, and one from Mauritius. Relevant examples of findings from these studies are reported. Conclusion: Our results demonstrate the impact of the valuable science output these cohort designs promote, allowing LMICs to have a share in frontline global psychiatry research. National and international funding agencies should invest in LMIC population neuroscience in order to promote replication and generalization of research from high-income countries.
- Defining clinical severity in adults with obsessive-compulsive disorder(2015) STORCH, Eric A.; NADAI, Alessandro S. De; ROSARIO, Maria Conceicao do; SHAVITT, Roseli G.; TORRES, Albina R.; FERRAO, Ygor A.; MIGUEL, Euripedes C.; LEWIN, Adam B.; FONTENELLE, Leonardo F.Objective: The Yale Brown Obsessive Compulsive Scale (Y-BOCS) is the most commonly used instrument to assess the clinical severity of obsessive compulsive symptoms. Treatment determinations are often based on Y-BOCS score thresholds. However, these benchmarks are not empirically based, which may result in non-evidence based treatment decisions. Accordingly, the present study sought to derive empirically-based benchmarks for defining obsessive compulsive symptom severity. Method: Nine hundred fifty-four adult patients with obsessive compulsive disorder (OCD), recruited through the Brazilian Research Consortium on Obsessive Compulsive Spectrum Disorders, were evaluated by experienced clinicians using a structured clinical interview, the Y-BOCS, and the Clinical Global Impressions Severity scale (CGI-Severity). Results: Similar to results in treatment-seeking children with OCD, our findings demonstrated convergence between the Y-BOCS and global OCD severity assessed by the CGI-Severity (Nagelkerke R-2 = .48). Y-BOCS scores of 0-13 corresponded with 'mild symptoms' (CGI-Severity = 0-2), 14-25 with 'moderate symptoms' (CGI-Severity = 3), 26-34 with 'moderate-severe symptoms' (CGI-Severity = 4) and 35-40 with 'severe symptoms' (CGI-Severity = 5-6). Neither age nor ethnicity was associated with Y-BOCS scores, but females demonstrated more severe obsessive compulsive symptoms than males (d = .34). Time spent on obsessions/compulsions, interference, distress, resistance, and control were significantly related to global OCD severity although the symptom resistance item pairing demonstrated a less robust relationship relative to other components of the Y-BOCS. Conclusions: These data provide empirically-based benchmarks on the Y-BOCS for defining the clinical severity of treatment seeking adults with OCD, which can be used for normative comparisons in the clinic and for future research.
- Gene expression changes associated with trajectories of psychopathology in a longitudinal cohort of children and adolescents(2020) OTA, Vanessa Kiyomi; SANTORO, Marcos Leite; SPINDOLA, Leticia Maria; PAN, Pedro Mario; SIMABUCURO, Andressa; XAVIER, Gabriela; VIEIRA-FONSECA, Tamiris; ZANARDO, Evelin Aline; SANTOS, Felipe Rodolfo Camargo dos; SCHAFER, Julia Luiza; KULIKOWSKI, Leslie Domenici; GALANTE, Pedro A. F.; ASPRINO, Paula Fontes; BRIETZKE, Elisa; GRASSI-OLIVEIRA, Rodrigo; ROHDE, Luis Augusto; MIGUEL, Euripedes Constantino; GADELHA, Ary; MARI, Jair Jesus; BRESSAN, Rodrigo Affonseca; SALUM, Giovanni Abrahao; BELANGERO, Sintia IoleWe aimed to identify blood gene expression patterns associated to psychopathological trajectories retrieved from a large community, focusing on the emergence and remission of general psychiatric symptoms. Hundred and three individuals from the Brazilian High-Risk Cohort Study (BHRCS) for mental disorders were classified in four groups according to Child Behavior Checklist (CBCL) total score at the baseline (w0) and after 3 years (w1): low-high (L-H) (N = 27), high-low (H-L) (N = 12), high-high (H-H) (N = 34) and low-low (L-L) groups (N = 30). Blood gene expression profile was measured using Illumina HT-12 Beadchips, and paired analyses comparing w0 and w1 were performed for each group. Results: 98 transcripts were differentially expressed comparing w0 and w1 in the L-H, 33 in the H-L, 177 in the H-H and 273 in the L-L. Of these, 66 transcripts were differentially expressed exclusively in the L-H; and 6 only in the H-L. Cross-Lagged Panel Models analyses revealed that RPRD2 gene expression at w1 might be influenced by the CBCL score at w0. Moreover, COX5B, SEC62, and NDUFA2 were validated with another technique and were also differentially regulated in postmortem brain of subjects with mental disorders, indicating that they might be important not only to specific disorders, but also to general psychopathology and symptoms trajectories. Whereas genes related to metabolic pathways seem to be associated with the emergence of psychiatric symptoms, mitochondrial inner membrane genes might be important over the course of normal development. These results suggest that changes in gene expression can be detected in blood in different psychopathological trajectories.