GIOVANI MISSIO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- The ARIQUELI study: potentiation of quetiapine in bipolar I nonresponders with lithium versus aripiprazole(2013) MISSIO, Giovani; MORENO, Doris Hupfeld; FERNANDES, Fernando; BIO, Danielle Soares; SOEIRO-DE-SOUZA, Marcio Gehardt; SANTOS JR., Domingos Rodrigues dos; DAVID, Denise Petresco; COSTA, Luis Felipe; DEMETRIO, Frederico Navas; MORENO, Ricardo AlbertoBackground: The treatment of bipolar disorder (BD) remains a challenge due to the complexity of the disease. Current guidelines represent an effort to assist clinicians in routine practice but have several limitations, particularly concerning long-term treatment. The ARIQUELI (efficacy and tolerability of the combination of lithium or aripiprazole in young bipolar non or partial responders to quetiapine monotherapy) study aims to evaluate two different augmentation strategies for quetiapine nonresponders or partial responders in acute and maintenance phases of BD treatment. Methods/Design: The ARIQUELI study is a single-site, parallel-group, randomized, outcome assessor-blinded trial. BD I patients according to the DSM-IV-TR, in depressive, manic/hypomanic or mixed episode, aged 18 to 40 years, are eligible. After diagnostic assessments, patients initiated treatment in phase I with quetiapine. Nonresponders or partial responders after 8 weeks are allocated into one of two groups, potentiated with either lithium (0.5 to 0.8 mEq/l) or aripiprazole (10 or 15 mg). Patients will be followed up for 8 weeks in phase I (acute treatment), 6 months in phase II (continuation treatment) and 12 months in phase III (maintenance treatment). Outcome assessors are blinded to the treatment. The primary outcome is the evaluation of changes in mean scores on the CGI-BP-M between baseline and the endpoint at the end of each study phase. Discussion: The ARIQUELI study is currently in progress, with patients undergoing acute treatment (phase I), potentiation (phase II) and maintenance (phase III). The study will be extended until January 2015. Trials comparing lithium and aripiprazole with potentiate treatment in young BD I nonresponders to quetiapine in monotherapy can provide relevant information on the safety of these drugs in clinical practice. Long-term treatment is an issue of great importance and should be evaluated further through more in-depth studies given that BD is a chronic disease.
conferenceObject Influence of childhood trauma on personality development in bipolar patients and healthy controls(2013) MONTEIRO, R.; BIO, D. Soares; SOEIRO-DE-SOUZA, M.; MISSIO, G.; MORENO, D.; MORENO, R. A.Objective: Bipolar disorder (BD) is characterized by high levels of childhood trauma and they can be detrimental in relation to the formation of personality. The aim of this study is to investigate the association between childhood trauma and BD personality compared to healthy controls (HC). Methods: A total of 27 euthimic BD patients, aged between 18 and 40 years old, were recruited at Hospital das Clinicas in São Paulo, Brazil. Twenty HC (predominantly medical students) aged between 18 and 35 years old, with no current or past history of psychiatric disorder, were recruited from the University of São Paulo. Information about early life stress was obtained using the Childhood Trauma Questionnaire (CTQ). Personality Formation was assessed through NEO-PI-R personality test – based on the Big Five personality traits: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience. Results: In the BD group the main significant associations were: physical abuse with concientiousness (p = 0.03); emotional neglect with agreeableness (p =0.03) and emotional abuse with conscientiousness (p = 0.04). There were no significant differences in HC group. Comparing BD and HC physical abuse was associated with concientiousness (p = 0.03) and emotion Neglecent was associated with agreeableness (p = 0.03). Discussion: Our results indicate that childhood trauma can be associated with personality traits in BD patients but not in HC, mainly regarding concientiousness and emotional neglect.- Gender effects of the COMT Val(158)Met genotype on verbal fluency in healthy adults(2013) SOEIRO-DE-SOUZA, Marcio Gerhardt; BIO, Danielle Soares; DAVID, Denise Petresco; MISSIO, Giovani; LIMA, Bruno; FERNANDES, Fernando; MACHADO-VIEIRA, Rodrigo; MORENO, Ricardo AlbertoCognitive performance in healthy individuals is associated with gender differences in specific tests; a female advantage has been demonstrated in language tests, whereas a male advantage has been demonstrated in spatial relation examinations. The prefrontal cortex (PFC) mediates important cognitive domains and is influenced by dopamine (DA) activity. The single nucleotide polymorphism (SNP) rs4680 in the catechol-O-methyltransferase (COMT) gene results in an amino acid substitution from valine (Val) to methionine (Met). The Met allele has been demonstrated to decrease COMT enzyme activity and improve PFC cognitive function. COMT regulates DA activity in the PFC and exhibits gender effects. The aim of the present study was to investigate the gender-specific effects of the COMT genotype on cognition in healthy young adults. Seventy-six healthy subjects were genotyped for COMT rs4680 and submitted to an extensive range of neuropsychological tests assessing aspects of PFC function. The COMT Met allele influenced the performance of executive function. The results revealed gender effects of the COMT rs4680 Met allele on verbal fluency, with positive effects in males and negative effects in females. This suggested that DA activity affects cognitive function in different ways, according to gender.