PEDRO FONSECA ZUCCOLO
Projetos de Pesquisa
Unidades Organizacionais
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- A smartphone-assisted brief online cognitive-behavioral intervention for pregnant women with depression: a study protocol of a randomized controlled trial(2021) ZUCCOLO, Pedro Fonseca; XAVIER, Mariana O.; MATIJASEVICH, Alicia; POLANCZYK, Guilherme; FATORI, DanielBackgroundPregnancy is strongly associated with increased risk for depression. Approximately 25% of pregnant women develop depression. Treatment for depression during pregnancy has several complexities: the use of psychiatric medications during pregnancy might result in developmental problems in the child and must be used with caution. Psychosocial interventions are effective, but they require specialized professionals. Low- and middle-income countries (LMIC) such as Brazil do not have enough mental health professionals needed to meet this demand. In this context, smartphone-based interventions show immense potential. We developed Motherly, a smartphone application (app) designed to treat maternal depression. We aim to test the efficacy of Motherly in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression.MethodsWe will conduct a 2-arm parallel-randomized controlled clinical trial in which 70 pregnant women aged between 16 and 40years with depression will be randomized to intervention or active control. The intervention group will have access to Motherly, a smartphone app based on three concepts: psychoeducation, behavior monitoring, and gaming elements. Motherly is composed of a package of interventions composed of modules: mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and educational content. The main focus of Motherly is delivering behavioral activation (BA), a brief and structured psychological treatment. The app allows participants to schedule and engage in, and monitor activities according to a plan to avoid acting exclusively according to their mood. The active control group will have access to a simplified version of the app consisting of educational content about various aspects of pregnancy, maternal physical and mental health, and infant development (BA, activity scheduling, sleep hygiene, among other functionalities, will not be present in this version). Both groups will receive four sessions of brief CBT in 8weeks. Participants will be evaluated by assessors blind to randomization and allocation status. Assessments will occur at baseline (T0), midpoint (T1, week 4-5), posttreatment (T2, week 8), and follow-up (T3, when the child is 2 months old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8weeks).DiscussionThe potential of digital technology to deliver mental health interventions has been increasingly recognized worldwide. There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can promote maternal and child health and well-being. In particular, we aim to treat depression, for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression are especially relevant because of the potential to circumvent barriers that prevent pregnant women from accessing mental health care.Trial registrationClinicalTrials.gov NCT04495166. Prospectively registered on July 29, 2020.
- A global challenge: maternal depression and offspring mental disorders(2020) FATORI, Daniel; ZUCCOLO, Pedro Fonseca; POLANCZYK, Guilherme V.
- A randomized controlled trial testing the efficacy of a Nurse Home Visiting Program for Pregnant Adolescents(2021) FATORI, Daniel; ZUCCOLO, Pedro Fonseca; SHEPHARD, Elizabeth; BRENTANI, Helena; MATIJASEVICH, Alicia; FERRARO, Alexandre Archanjo; FRACOLLI, Lislaine Aparecida; CHIESA, Anna Maria; LECKMAN, James; MIGUEL, Euripedes Constantino; POLANCZYK, Guilherme V.To test the efficacy of a nurse home visiting program (HVP) on child development, maternal and environmental outcomes in the first years of life. We conducted a randomized controlled trial to test the efficacy of Primeiros Lacos, a nurse HVP for adolescent mothers living in a poor urban area of SAo Paulo, Brazil. Eighty adolescent mothers were included and randomized to receive either Primeiros Lacos (intervention group, n=40) or healthcare as usual (control group, n=40). Primeiros Lacos is a home visiting intervention delivered by trained nurses that starts during the first 16 weeks of pregnancy and continues to the child's age of 24 months. Participants were assessed by blind interviewers at 8-16 weeks of pregnancy (baseline), 30 weeks of pregnancy, and 3, 6, 12, and 24 months of child's age. We assessed oscillatory power in the mid-range alpha frequency via electroencephalography when the children were aged 6 months. Child development was measured by the Bayley Scales of Infant Development Third Edition (BSID-III). Weight and length were measured by trained professionals and anthropometric indexes were calculated. The home environment and maternal interaction with the child was measured by the Home Observation and Measurement of the Environment. Generalized estimating equation models were used to examine intervention effects on the trajectories of outcomes. Standardized effect sizes (Cohen's d) were calculated using marginal means from endpoint assessments of all outcomes. The trial was registered at clinicaltrial.gov: NCT02807818. Our analyses showed significant positive effects of the intervention on child expressive language development (coefficient=0.89, 95% CI [0.18, 1.61], p=0.014), maternal emotional/verbal responsivity (coefficient=0.97, 95% CI [0.37, 1.58], p=0.002), and opportunities for variety in daily stimulation (coefficient=0.37, 95% CI [0.09, 0.66], p=0.009). Standardized effect sizes of the intervention were small to moderate. Primeiros Lacos is a promising intervention to promote child development and to improve the home environment of low-income adolescent mothers. However, considering the limitations of our study, future studies should be conducted to assess Primeiros Lacos potential to benefit this population.Clinical Trial Registration: The study was registered at clinicaltrial.gov (Registration date: 21/06/2016 and Registration number: NCT02807818).
- Instrumental activities of daily living performance in healthy and cognitively intact seniors from a Brazilian sample and its relation to age and other socio-demographic variables(2012) ZUCCOLO, Pedro Fonseca; AVILA, Renata; NAKANO, Eduardo Y.; LITVOC, Julio; LOPES, Marcos A.; BOTTINO, Cassio M. C.Background: Studies on functional capacity in community-dwelling older people have shown associations between declines in instrumental activities of daily living (IADL) and several factors. Among these, age has been the most consistently related to functional capacity independent of other variables. We aimed at evaluating the performance of a sample of healthy and cognitively intact Brazilian older people on activities of daily living and to analyze its relation to social-demographic variables. Methods: We conducted a secondary analysis of data collected for previous epidemiological studies with community-dwelling subjects aged 60 years or more. We selected subjects who did not have dementia or depression, and with no history of neurological diseases, heart attack, HIV, hepatitis or arthritis (n = 1,111). Functional capacity was assessed using the Brazilian version of the Older American Resources and Services Questionnaire (BOMFAQ). ADL performance was analyzed according to age, gender, education, and marital status (Pearson's chi(2), logistic regression). Results: IADL difficulties were present in our sample, especially in subjects aged 80 years or more, with lower levels of education, or widowed. The logistic regression analysis results indicated that ""higher age"" and ""lower education"" (p <= 0.001) remained significantly associated with IADL difficulty. Conclusions: Functional decline was present in older subjects even in the absence of medical conditions and cognitive impairment. Clinicians and researchers could benefit from knowing what to expect from older people regarding IADL performance in the absence of medical conditions.
- Children and adolescents' emotional problems during the COVID-19 pandemic in Brazil(2023) ZUCCOLO, Pedro Fonseca; CASELLA, Caio Borba; FATORI, Daniel; SHEPHARD, Elizabeth; SUGAYA, Luisa; GURGEL, Wagner; FARHAT, Luis Carlos; ARGEU, Adriana; TEIXEIRA, Monike; OTOCH, Luara; V, Guilherme PolanczykBrazil has been severely affected by the COVID-19 pandemic with one of the largest numbers of youth impacted by school closure globally. This longitudinal online survey assessed emotional problems in children and adolescents aged 5-17 years living in Brazil during the COVID-19 pandemic. Recruitment occurred between June to November 2020 and participants were invited for follow-up assessments every 15 days until June 2021. Participants were 5795 children and adolescents living across the country with mean age of 10.7 (SD 3.63) years at recruitment; 50.5% were boys and 69% of white ethnicity. Weighted prevalence rates of anxiety, depressive and total emotional symptoms at baseline were 29.7%, 36.1% and 36%, respectively. Longitudinal analysis included 3221 (55.6%) participants and revealed fluctuations in anxiety and depressive symptoms during one year follow-up, associated with periods of social mobility and mortality. Emotional problems significantly increased in July and September 2020 and decreased from December 2020 to February 2021 and then significantly increased in May 2021 relative to June 2020. Older age, feeling lonely, previous diagnosis of mental or neurodevelopmental disorder, previous exposure to traumatic events or psychological aggression, parental psychopathology, and sleeping less than 8/h a day were associated with increased rates of anxiety and depressive symptoms at baseline and over time. Food insecurity and less social contact with family and peers were associated with baseline anxiety and depressive symptoms, and lowest socio-economic strata, chronic disease requiring treatment and family members physically ill due to COVID-19 were associated with increasing rates over time. The pandemic severely affected youth, particularly those from vulnerable populations and in moments of increased mortality and decreased social mobility. Results underscore the need for allocation of resources to services and the continuous monitoring of mental health problems among children and adolescents.
bookPart O exame neuropsicológico e os diferentes contextos de aplicação(2014) CAMARGO, Candida Helena Pires de; BOLOGNANI, Silvia Adriana Prado; ZUCCOLO, Pedro Fonseca- Brief internet-delivered cognitive-behavioural intervention for children and adolescents with symptoms of anxiety and depression during the COVID-19 pandemic: a randomised controlled trial protocol(2022) CASELLA, Caio Borba; ZUCCOLO, Pedro Fonseca; SUGAYA, Luisa; SOUZA, Aline Santana de; OTOCH, Luara; ALARCAO, Fernanda; GURGEL, Wagner; FATORI, Daniel; V, Guilherme PolanczykBackground The COVID-19 pandemic has had major impacts in many different spheres, including mental health. Children and adolescents are especially vulnerable because their central nervous system is still in development and they have fewer coping resources than do adults. Increases in the prevalence of depressive and anxiety symptomatology have been reported worldwide. However, access to mental health care is limited, especially for the paediatric population and in low- and middle-income countries. Therefore, we developed a brief internet-delivered cognitive-behavioural intervention for children and adolescents with symptoms of anxiety and depression. The aim of this proposed study is to test the efficacy of the intervention. Methods We will conduct a two-arm, parallel randomised controlled trial involving children and adolescents (8-11 and 12-17 years of age, respectively) with symptoms of anxiety, depression or both, according to the 25-item Revised Child Anxiety and Depression Scale (t-score > 70). A total of 280 participants will be randomised to the intervention group or the active control group, in a 1:1 ratio. Those in the intervention group will receive five weekly sessions of cognitive-behavioural therapy via teleconference. The sessions will focus on stress responses, family communication, diaphragmatic breathing, emotions, anger management, behavioural activation and cognitive restructuring. Participants in both groups will have access to 15 videos covering the same topics. Participant-guardian pairs will be expected to attend the sessions (intervention group), watch the videos (control group) or both (intervention group only). A blinded assessor will collect data on symptoms of anxiety, depression and irritability, at baseline, at the end of the intervention and 30 days thereafter. Adolescents with access to a smartphone will also be invited to participate in an ecological momentary assessment of emotional problems in the week before and the week after the intervention, as well as in passive data collection from existing smartphone sensors throughout the study. Discussion Internet-delivered interventions play a major role in increasing access to mental health care. A brief, manualised, internet-delivered intervention might help children and adolescents with anxiety or depressive symptomatology, even outside the context of the COVID-19 pandemic.