BERNARDO CARRAMAO GOMES
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
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conferenceObject Dysfunctional Family Structure of Children with Bipolar Disorder(2012) NADER, Edmir G.; KLEINMAN, Ana; GAMES, Bernardo C.; BRUSCAGIN, Claudia; SANTOS, Bernardo dos; LAFER, Beny; CAETANO, Sheila C.- Negative expressed emotion best discriminates families with bipolar disorder children(2013) NADER, Edmir G.; KLEINMAN, Ana; GOMES, Bernardo Carramao; BRUSCAGIN, Claudia; SANTOS, Bernardo dos; NICOLETTI, Mark; SOARES, Jair C.; LAFER, Beny; CAETANO, Sheila C.Background: Children and adolescents with bipolar disorder (BD) live in family environments with high levels of expressed emotion (EE), conflict, and tension; as well as low maternal warmth and cohesion. These family characteristics have been evaluated in research settings using different scales. Nonetheless, empirically supported assessment instruments are not always feasible to be used in clinical settings. Our aim was to identify the best characteristics that discriminate BD families from control by building a classifier with the main characteristics found from different scales. We also built a classifier based on the adjective check-list scale (ACL) because this scale would be the most feasible one to be used in clinical setting. Methods: We evaluated 33 families of pediatric BD patients and 29 control families. Two self-report scales, ACL and the Family Environment Scale (FES), and a direct interview scale, the Psychosocial Schedule for School Age Children-Revised (PSS-R), were administered. Results: BD families presented lower positive EE and higher negative EE, less cohesion, organization, greater conflict and control; lower rate of intact family, higher maternal and paternal tension compared to control families. Both classifiers demonstrated high accuracy. The offspring's EE toward the mother was the family characteristic that best discriminated BD from control families. Limitations: Small sample size and cross-sectional design. Conclusions: Families of BD children presented altered communication and functioning. The high accuracy of the ACL-based classifier highlights a feasible scale to be used in clinical settings. Further studies assessing prognosis associated with the patterns of communication in such families are needed.
- 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 Dysfunctional Family Environment in Children at High Risk for Bipolar Disorder(2012) MOREIRA, Carolina R. L.; FERREIRA, Guilherme S.; KLEINMAN, Ana; NADER, Edmir; GOMES, Bernardo C.; TEIXEIRA, Ana Maria; BUSATTO, Geraldo F.; LAFER, Beny; CAETANO, Sheila C.Background: Children of parents with bipolar disorder (BD) are at heightened risk for developing psychiatric disorders. Environmental influences including family traits have been established as risk factors for psychopathology in children of affectively disordered parents. Our study evaluated the environment of families with at least one parent with BD compared to the environment of families with no history of axis I major psychiatric disorders (FNH). In addition, we compared the environment of BD families with offspring with BD or other psychiatric diagnoses (OPD), BD families with unaffected offspring (UO), and FNH. Methods: We used the Family Environment Scale to evaluate 47 BD families with at least one parent with a DSM-IV BD type I diagnosis and 30 FNH. BD and healthy parents were assessed through the Structured Clinical Interview for DSM-IV (SCID). Offspring of BD and healthy parents were ascertained through the K-SADS-PL interview. Results: Families with BD parents presented lower levels of family cohesion (p=0.001), intellectual-cultural orientation (p=0.005), active-recreational orientation (p=0.002) and organization (p[[Unsupported Character - ˂]]0.001), and higher levels of conflict (p[[Unsupported Character - ˂]]0.001) and control (p=0.04) compared to FNH. Secondary analysesrevealed significant difference between OBD, UO and FNH 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) and organization (p=0,001). BD families with affected offspring showed higher levels of control (p=0.02) compared to BD families with unaffected offspring. Conclusions: Families with BD parent show dysfunctional interaction among members. Moreover, the presence of BD or other psychiatric diagnosis in BD offspring is associated to higher levels of control.