BERNARDO CARRAMAO GOMES
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
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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.- Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I(2012) ABREU, Lena Nabuco de; NERY, Fabiano G.; HARKAVY-FRIEDMAN, Jill M.; ALMEIDA, Karla Matias de; GOMES, Bernardo Carramao; OQUENDO, Maria A.; LAFER, BenyBackground: The association between suicidal behavior and quality of life (QoL) in bipolar disorder (BD) is poorly understood. Worse QoL has been associated with suicide attempts and suicidal ideation in schizophrenic patients, but this relationship has not been investigated in BD. This study tested whether a history of suicide attempts was associated with poor QoL in a well-characterized sample of patients with BD, as has been observed in other psychiatric disorders and in the general population. Methods: One hundred eight patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BD type I (44 with previous suicide attempts, 64 without previous suicide attempts) were studied. Quality of life was assessed using the World Health Organization's Quality of Life Instrument Short Version. Depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale-17 items and the Young Mania Rating Scale. Results: Patients with BD and previous suicide attempts had significantly lower scores in all the 4 domains of the World Health Organization's Quality of Life Instrument Short Version scale than did patients with BD but no previous suicide attempts (physical domain P=.001; psychological domain P <.0001; social domain P=.001, and environmental domain P=.039). In the euthymic subgroup (n=70), patients with previous suicide attempts had significantly lower scores only in the psychological and social domains (P=.020 and P=.004). Limitations: This was a cross-sectional study, and no causal associations can be assumed. Conclusions: Patients with BD and a history of previous suicide attempts seem to have a worse QoL than did patients who never attempted suicide. Poorer QoL might be a marker of poor copying skills and inadequate social support and be a risk factor for suicidal behavior in BD. Alternatively, poorer QoL and suicidal behavior might be different expressions of more severe BD.
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.