BERNARDO CARRAMAO GOMES
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Cognitive behavioral rehabilitation for bipolar disorder patients: A randomized controlled trial(2019) GOMES, Bernardo C.; ROCCA, Cristiana C.; BELIZARIO, Gabriel O.; FERNANDES, Francy de B. F.; VALOIS, Iolanda; OLMO, Giselle C.; FACHIN, Raquel V. P.; FARHAT, Luis C.; LAFER, BenyObjectives Bipolar disorder is frequently associated with cognitive impairment even during euthymia. Previous studies have reported significant impairments in functional and quality of life outcomes and a possible relationship between these variables and cognitive performance. Cognitive rehabilitation interventions have been proposed to address these outcomes but positive results are still scarce. The objective of the present study is to evaluate the efficacy of a new intervention developed to address both cognitive and functional impairment. Methods Thirty-nine individuals were included in this randomized controlled trial. All participants were evaluated by the Cambridge Neuropsychological Test Automated Battery (CANTAB) and completed functional and quality of life (QOL) scales. Patients were randomized to either treatment as usual (TAU) or Cognitive Behavior Rehabilitation (CBR), an add-on treatment delivered in 12 weekly group sessions. All individuals were revaluated after 12 weeks. Results A total of 39 bipolar type I or II patients were included in the analysis, 19 in the TAU group and 20 in the CBR condition. At the entrance of the study, both groups were statistically similar regarding clinical, socio-demographics and cognitive variables. After the end of the intervention, CBR individuals had significantly improved reaction time, visual memory and emotion recognition. In contrast, individuals in the CBR did not present a statistically change in functional and QOL scores after the 12-week intervention. Conclusions CBR intervention showed promising results in improving some of the commonly impaired cognitive domains in BD. A longer follow-up period may be necessary to detect changes in functional and QOL domains.
- Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder(2016) GOMES, Bernardo C.; KLEINMAN, Ana; CARVALHO, Andrea Ferrari; PEREIRA, Tatiana Couto F.; GURGEL, Ana Paola; LAFER, Beny; BUSATTO, Geraldo F.; CAETANO, Sheila C.; ROCCA, Cristiana Castanho de AlmeidaBackground: There have been few studies investigating quality of life (QoL) in pediatric bipolar disorder (BD) patients and none comparing it with that observed in unaffected offspring of parents with BD and healthy controls. Methods: The self-report Youth Quality of Life Instrument-Research version (YQoL-R) was administered in 26 pediatric BD patients, 17 unaffected offspring of parents with BD, and 24 individuals with no history of DSM-IV Axis I psychiatric disorders. All diagnoses were determined through interviews based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Results: There were statistical differences among the groups for all YQoL-R domains. Pairwise comparisons showed that perceived QoL was significantly worse in the BD group than in the unaffected offspring and healthy subjects, a difference that persisted even when only euthymic subjects were analyzed. There were no significant differences between the unaffected offspring and healthy subjects for any YQoL-R domain. Limitations: Our sample was small. There was no QoL report from subjects parents nor data about family environment or BD parents' mood state. Conclusions: There is a need for studies to investigate in greater detail the relationship between QoL and psychological resilience, particularly in the unaffected offspring of parents with BD.
conferenceObject Cognitive behavioral rehabilitation for bipolar disorder patients: A randomized controlled trial(2019) GOMES, B.; ROCCA, C.; BELIZARIO, G.; FERNANDES, F.; VALOIS, I.; OLMO, G.; FACHIN, R.; FARHAT, L. C.; LAFER, B.conferenceObject Hostility expression in pediatric bipolar disorder, healthy offspring and controls(2017) ROCCA, C.; GOMES, B.; BELIZARIO, G.; KLEINMAN, A.; ABREU, L.; CAETANO, S.; LAFER, B.; BUSATTO, G.- Cognitive-behavioral rehabilitation vs. treatment as usual for bipolar patients: study protocol for a randomized controlled trial(2017) GOMES, Bernardo Carramao; ROCCA, Cristiana Castanho; BELIZARIO, Gabriel Okawa; LAFER, BenyBackground: Bipolar disorder (BD) is commonly associated with cognitive and functional impairments even during remission periods, and although a growing number of studies have demonstrated the benefits of psychotherapy as an add-on to pharmacological treatment, its effectiveness appears to be less compelling in severe presentations of the disorder. New interventions have attempted to improve cognitive functioning in BD patients, but results have been mixed. Methods: The study consists of a clinical trial comparing a new structured group intervention, called ""CognitiveBehavioral Rehabilitation,""with treatment as usual (TAU) for bipolar patients. The new approach is a combination of cognitive behavioral strategies and cognitive remediation exercises, consisting of 12 weekly group sessions of 90 min each. To be included in the study, patients must be diagnosed with BD type I or II, aged 18-55 years, in full or partial remission, and have an IQ of at least 80. A comprehensive neuropsychological battery, followed by mood, social functioning, and quality of life assessments will occur in three moments: pre and post intervention and 12 months later. The primary outcome of the study is to compare the time, in weeks, that the first full mood episode appears in patients who participated in either group of the study. Secondary outcome will include improvement in cognitive functions. Discussion: This is the first controlled trial assessing the validity and effectiveness of the new ""Cognitive-Behavioral Rehabilitation""intervention in preventing new mood episodes and improving cognitive and functional impairments.
- Dysfunctional family environment in affected versus unaffected offspring of parents with bipolar disorder(2013) FERREIRA, Guilherme S.; MOREIRA, Carolina R. L.; KLEINMAN, Ana; NADER, Edmir C. G. P.; GOMES, Bernardo Carramao; TEIXEIRA, Ana Maria A.; ROCCA, Cristiana C. Almeida; NICOLETTI, Mark; SOARES, Jair C.; BUSATTO, Geraldo F.; LAFER, Beny; CAETANO, Sheila C.Objective: Children of parents with bipolar disorder (BD) are at heightened risk for developing mood and other psychiatric disorders. We proposed to evaluate the environment of families with at least one parent with BD type I (BDF) with affected offspring (aBDF) and unaffected offspring (uBDF) compared with control families without a history of DSM-IV Axis I disorder (CF). Method: We used the Family Environment Scale (FES) to evaluate 47 BDF (aBDF + uBDF) and 30 CF. Parents were assessed through the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Diagnosis of the offspring was determined through the Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) interview. Results: There were statistically significant differences between aBDF, uBDF and CF in cohesion (p = 0.003), intellectual-cultural orientation (p = 0.01), active-recreational orientation (p = 0.007), conflict (p = 0.001), control (p = 0.01), moral-religious emphasis (p = 0.01) and organization (p = 0.001). The aBDF showed higher levels of control (p = 0.02) when compared to the uBDF. Conclusions: Families with a BD parent presented more dysfunctional interactions among members. Moreover, the presence of BD or other psychiatric disorders in the offspring of parents with BD is associated with higher levels of control. These results highlight the relevance of psychosocial interventions to improve resilience and family interactions.
conferenceObject Cognitive-behavioral rehabilitation vs treatment as usual for bipolar patients - a randomized controlled trial(2017) GOMES, B.; ROCCA, C. Castanho de Almeida; BELIZARIO, G. Okawa; GISELLE, C.; VALOIS, I.; FACHIN, R. de Vargas Penteado; FERNANDES, F.; LAFER, B.conferenceObject Cognitive-behavioral rehabilitation vs. treatment as usual for bipolar patients preliminary results(2018) GOMES, B. C.; ROCCA, C. C. D. A.; BELIZARIO, G. O.; LAFER, B.