HERMANO TAVARES

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Lattes
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Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina

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  • article 15 Citação(ões) na Scopus
    The need to consume: Hoarding as a shared psychological feature of compulsive buying and binge eating
    (2018) MATTOS, Cristiana Nicoli de; KIM, Hyoun S.; LACROIX, Emilie; REQUIAO, Marinalva; FILOMENSKY, Tatiana Zambrano; HODGINS, David C.; TAVARES, Hermano
    Introduction: Compulsive buying and binge eating are two frequently co-occurring psychiatric conditions. Hoarding, which is the psychological need to excessively gather and store items, is frequently associated with both compulsive buying severity and binge eating severity. In the present study, we explored whether different dimensions of hoarding are a shared feature of compulsive buying and binge eating. Method: Participants consisted of 434 people seeking treatment for compulsive buying disorder. Registered psychiatrists confirmed the diagnosis of compulsive buying through semi-structured clinical interviews. Participants also completed measures to assess compulsive buying severity, binge eating severity, and dimensions of hoarding (acquisition, difficulty discarding, and clutter). Two-hundred and seven participants completed all three measures. Results: Significant correlations were found between compulsive buying severity and the acquisition dimension of hoarding. Binge eating severity was significantly correlated with all three dimensions of hoarding. Hierarchical regression analysis found that compulsive buying severity was a significant predictor of binge eating severity. However, compulsive buying severity no longer predicted binge eating severity when the dimensions of hoarding were included simultaneously in the model. Clutter was the only subscale of hoarding to predict binge eating severity in step two of the regression analysis. Conclusion: Our results suggest that the psychological need to excessively gather and store items may constitute a shared process that is important in understanding behaviors characterized by excessive consumption such as compulsive buying and binge eating.
  • article 23 Citação(ões) na Scopus
    Gender Differences in Compulsive Buying Disorder: Assessment of Demographic and Psychiatric Co-Morbidities
    (2016) MATTOS, Cristiana Nicoli de; KIM, Hyoun S.; REQUIAO, Marinalva G.; MARASALDI, Renata F.; FILOMENSKY, Tatiana Z.; HODGINS, David C.; TAVARES, Hermano
    Compulsive buying is a common disorder found worldwide. Although recent research has shed light into the prevalence, etiology and clinical correlates of compulsive buying disorder, less is known about gender differences. To address this empirical gap, we assessed potential gender differences in demographic and psychiatric co-morbidities in a sample of 171 compulsive buyers (20 men and 151 women) voluntarily seeking treatment in Sao Paulo, Brazil. A structured clinical interview confirmed the diagnosis of compulsive buying. Of the 171 participants, 95.9% (n = 164) met criteria for at least one co-morbid psychiatric disorder. The results found that male and female compulsive buyers did not differ in problem severity as assessed by the Compulsive Buying Scale. However, several significant demographic and psychiatric differences were found in a multivariate binary logistic regression. Specifically, male compulsive buyers were more likely to report being non-heterosexual, and reported fewer years of formal education. In regards to psychiatric co-morbidities, male compulsive buyers were more likely to be diagnosed with sexual addiction, and intermittent explosive disorder. Conversely, men had lower scores on the shopping subscale of the Shorter PROMIS Questionnaire. The results suggest that male compulsive buyers are more likely to present with co-morbid psychiatric disorders. Treatment planning for compulsive buying disorder would do well to take gender into account to address for potential psychiatric co-morbidities.
  • article 59 Citação(ões) na Scopus
    Body Dysmorphic Disorder in Patients Seeking Abdominoplasty, Rhinoplasty, and Rhytidectomy
    (2016) BRITO, Maria Jose Azevedo de; NAHAS, Fabio Xerfan; CORDAS, Taki Athanassios; TAVARES, Hermano; FERREIRA, Lydia Masako
    Background: Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures. Methods: Three hundred patients of both sexes divided into three groups (abdominoplasty, n = 90; rhinoplasty, n =151; and rhytidectomy, n =59) were classified as having (n =51, n =79, and n =25, respectively) or not having (n =39, n =72, and n =34, respectively) body dysmorphic disorder symptoms, based on the Body Dysmorphic Disorder Examination, which was administered preoperatively. Results: Prevalence rates of body dysmorphic disorder symptoms in the abdominoplasty, rhinoplasty, and rhytidectomy groups were 57, 52, and 42 percent, respectively. Significant between-group differences were observed regarding age (p < 0.001), body mass index (p = 0.001), and onset of body dysmorphic disorder symptoms (p < 0.001). Within-group differences in body dysmorphic disorder severity were observed in the abdominoplasty (p < 0.001), rhinoplasty (p < 0.001), and rhytidectomy (p = 0.005) groups. Body dysmorphic disorder severity was significantly associated with degree of body dissatisfaction (mean Body Dysmorphic Disorder Examination total scores; p < 0.001), avoidance behaviors (p< 0.001), sexual abuse (p = 0.026), suicidal ideation (p < 0.001), and suicide attempt (p = 0.012). Conclusions: Abdominoplasty candidates showed the highest prevalence; rhytidectomy candidates exhibited the highest percentage of severe cases, and rhinoplasty candidates had the lowest percentage of severe cases.
  • article 3 Citação(ões) na Scopus
    Dual diagnosis of obsessive compulsive and compulsive buying disorders: Demographic, clinical, and psychiatric correlates
    (2018) KIM, Hyoun S.; HODGINS, David C.; TORRES, Albina R.; FONTENELLE, Leonardo F.; ROSARIO, Maria Conceicao do; MATHIS, Maria Alice de; FERRAO, Ygor A.; MIGUEL, Euripedes C.; TAVARES, Hermano
    Aim: The present research assessed the rates as well as the demographic, clinical, and psychiatric correlates associated with comorbid obsessive-compulsive disorder (OCD) and compulsive buying disorder (CBD). Method: Participants were drawn from a large (N = 993) multi-center study of people seeking treatment for their OCD. The diagnoses of psychiatric disorders were made using the Structured Clinical Interview for DSM by registered psychologists and psychiatrists. The clinical correlates, including the severity and presence of OCD symptoms and dimensions were assessed using psychometrically sound measures. Results: 75 (7.5%) participants met criteria for comorbid CBD. The results of binary logistic regression found that women were more likely to present with comorbid CBD, whereas being a student was a protective factor. The presence of hoarding dimension, poorer insight, social phobia, binge eating disorder, internet use disorder and kleptomania were significantly associated with comorbid CBD. Conclusion: The results suggest that individuals with a dual diagnosis of OCD and CBD may represent a unique clinical population that warrants tailored interventions. Specifically, they were more likely to present with other psychiatric disorders characterized by high levels of impulsivity and compulsivity. Targeting psychological mechanisms common to impulsivity-compulsivity disorders may enhance treatment utility in this dual diagnosis population.
  • article 11 Citação(ões) na Scopus
    Gambling onset and progression in a sample of at-risk gamblers from the general population
    (2014) CARNEIRO, Elizabeth; TAVARES, Hermano; SANCHES, Marcos; PINSKY, Ilana; CAETANO, Raul; ZALESKI, Marcos; LARANJEIRA, Ronaldo
    The goal of this study was to investigate gambling-related behavior, onset and progression in a sample of at-risk gamblers from the community. A national household survey was conducted in Brazil, covering individuals 14 years old or older. Subjects were screened for at-risk gambling, those testing positive answered a questionnaire about gambling progression, preferred games and DSM-IV pathological gambling criteria. Out of 3007 respondents, 118 were considered at-risk gamblers according to the Lie/Bet Questionnaire. According to the DSM-IV, 32.7% and 24.9% of those were considered problem and pathological gamblers, respectively. Early at-risk gamblers (onset prior to 20 years of age), were more likely to be male, to prefer non-commercially structured games, and to chase losses while gambling. Young pathological gamblers (under 35 years of age) progressed faster from regular to problem gambling (roughly 2 years) than mature pathological gamblers (12 years). Such findings had not been described before because previous reports focused mostly on clinical samples that lack young, male, early-onset gamblers. Gambling programs have not satisfactorily covered this segment of gamblers. Outreach strategies and early interventions should be provided to prevent these individuals from rapidly evolving into pathological gambling.
  • article 8 Citação(ões) na Scopus
    Major depressive disorder and depressive symptoms in intermittent explosive disorder
    (2018) MEDEIROS, Gustavo C.; SEGER, Liliana; GRANT, Jon E.; TAVARES, Herman
    It is estimated that between 1.7 and 2.6 million people have had intermittent explosive disorder (IED) during their life in the United States alone. Co-occurring psychiatric disorders are very common in IED, being major depressive disorder arguably the most common. The objective of this study was to examine the clinical correlates of IED and depressive manifestations in 74 treatment-seeking subjects. After controlling for confounders, there were associations between major depressive disorder and severity of depressive symptoms, and (a) higher assault scores, (b) more severe hostile behavior and (c) worse social adjustment. Management of depressive symptoms may be an important for IED treatment.
  • article 32 Citação(ões) na Scopus
    Sexual Compulsivity Scale, Compulsive Sexual Behavior Inventory, and Hypersexual Disorder Screening Inventory: Translation, Adaptation, and Validation for Use in Brazil
    (2016) SCANAVINO, Marco de T.; VENTUNEAC, Ana; RENDINA, H. Jonathon; ABDO, Carmita H. N.; TAVARES, Hermano; AMARAL, Maria L. S. do; MESSINA, Bruna; REIS, Sirlene C. dos; MARTINS, Joao P. L. B.; GORDON, Marina C.; VIEIRA, Julie C.; PARSONS, Jeffrey T.
    Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha >.75), presented high temporal stability (>.76), discriminated between patients and controls, and presented strong (rho > .81) correlations with the Sexual Addiction Screening Test (except for the violence domain = .40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (rho between .43 and .55). The sensitivity of the HDSI was 71.93 % and the specificity was 100 %. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated (rho > .85). The findings support the conceptualization of hypersexuality as a cluster of problematic symptoms that are highly consistent across a variety of measures.
  • article 3 Citação(ões) na Scopus
    Group therapy for excoriation disorder: Psychodrama versus support therapy
    (2019) GULASSA, Daniel; AMARAL, Roberta; OLIVEIRA, Edgar; TAVARES, Hermano
    BACKGROUND: Excoriation disorder (ED) is characterized by recurring excoriation of the skin resulting in tissue damage, usually associated with emotional deregulation. Psychotherapy is a valuable treatment; however, no studies emphasize the patients' interactional aspect, nor the potential benefit of group treatment. METHODS: We recruited a convenience sample of 38 individuals with ED according to DSM-5 criteria, in which 19 individuals proceeded to treatment, 10 with psychodrama group therapy (PGT), and 9 with support group therapy (SGT) in an open pilot study. RESULTS: The entire sample presented improvement of skin excoriation on both self-report and clinician rating and improvement of social adjustment; however, there was no difference between groups (ie, time x group interaction). Also, there was no relevant change for anxiety, depression, or emotional regulation throughout treatment. Emotional deregulation was associated with excoriation severity as well as depression, anxiety, and social maladjustment, both at the beginning and end of treatment. CONCLUSIONS: Although both groups showed improvement of skin picking, the results contradict our primary hypothesis that PGT would have a superior efficacy to SGT for patients with ED. The findings encourage future studies of group interventions for ED in larger samples with a focus on emotional regulation enhancement.
  • article 65 Citação(ões) na Scopus
    Patients with mild to moderate body dysmorphic disorder may benefit from rhinoplasty
    (2014) FELIX, Gabriel Almeida Arruda; BRITO, Maria Jose Azevedo de; NAHAS, Fabio Xerfan; TAVARES, Hermano; CORDAS, Taki Athanassios; DINI, Gal Moreira; FERREIRA, Lydia Masako
    Body dysmorphic disorder (BDD) is one of the most common psychiatric conditions found in patients seeking cosmetic surgery. BDD is also a challenge for plastic surgeons because it is still an underdiagnosed mental disorder. The aims of this study were to prospectively investigate whether patients with mild to moderate BDD are suitable for rhinoplasty, and to assess BDD severity and patient satisfaction with the surgical outcome 1 year after the intervention. All women (n = 116) seeking rhinoplasty at a university hospital between September 2009 and August 2010 were recruited for the study and assessed for BDD. The final sample consisted of 31 patients aged 32 (standard deviation (SD), 10) years with mild to moderate BDD who underwent rhinoplasty. The participants were assessed preoperatively (baseline) and 1 year postoperatively with the Body Dysmorphic Disorder Examination (BDDE). Most patients (22/31, 71%) were of African descent. Socio-demographic variables and the extent of the nasal deformities had no effect on the severity of BDD symptoms and patient satisfaction with surgery outcome. At the 1-year postoperative follow-up, there was a significant decrease from baseline in BDDE scores and time spent by patients worrying about their appearance; 25 (25/31, 81%) patients experienced complete remission from BDD and 28 (28/31, 90%) were satisfied with the results of surgery. Rhinoplasty may be indicated in the treatment of female patients with mild to moderate BDD.
  • article 10 Citação(ões) na Scopus
    The impact of an exercise program as a treatment for gambling disorder: A randomized controlled trial
    (2018) PENNA, Ana Claudia; KIM, Hyoun S.; BRITO, Antonio Marcelo Cabrita de; TAVARES, Hermano
    Physical activity has been shown to lead to an array of improvements in physical and psychological functioning. It is unknown, however, whether an exercise program may have utility as a standalone treatment of gambling disorder due to the paucity of studies, small sample sizes and lack of control groups. The aim of the present research was to address these empirical gaps by conducting a randomized controlled trial testing the effects of exercise for the treatment of gambling disorder compared to an active control group (stretching). The primary outcomes were gambling severity and psychiatric comorbidities, while the secondary outcome consisted of gambling craving. Fifty-nine participants with a confirmed diagnosis of gambling disorder underwent eight weeks of exercise, consisting of 50-min sessions (10-min stretching plus 40-min running at 70-85% of the estimated maximum heart rate for age, twice a week) (n = 32) or 50-min group stretching sessions twice a week (n = 27). Gambling-related constructs were measured using psychometrically sound measures. Psychiatric co-morbidities were assessed using structured clinical interviews. Cooper's test and heart rate monitors were used to ensure participants met the target heart rate. The results found an overall time effect on both primary and secondary outcomes. No significant differences were observed between the treatment and control group in gambling severity. Conversely, greater improvements in psychiatric comorbidities were observed for the treatment group. The results suggest that exercise may represent a cost-effective and accessible adjunctive intervention in the treatment of co-occurring psychiatric comorbidities among people with GD.