ALEXANDRE ANDRADE LOCH
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
LIM/27 - Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina
16 resultados
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conferenceObject Association between Childhood Adversity and Ultra-High Risk for Psychosis Status in a Populational Sample of Sao Paulo, Brazil(2017) LOCH, Alexandre; ALVES, Tania Maria; FREITAS, Elder Lanzani; HORTENCIO, Lucas; ANDRADE, Julio Cesar; BILT, Martinus Theodorus van de; FONTONI, Marcos Roberto; SERPA, Mauricio; CHIANCA, Camille; GATTAZ, Wagner Farid; ROESSLER, Wulf- Hearing spirits? Religiosity in individuals at risk for psychosis-Results from the Brazilian SSAPP cohort(2019) LOCH, Alexandre Andrade; FREITAS, Elder Lanzani; HORTENCIO, Lucas; CHIANCA, Camille; ALVES, Tania Maria; SERPA, Mauricio Henriques; ANDRADE, Julio Cesar; BILT, Martinus Theodorus van de; GATTAZ, Wagner Farid; ROESSLER, WulfIn the last decades, biological and environmental factors related to psychosis were investigated in individuals at ultra-risk for psychosis (UHR) to predict conversion. Although religion relates to psychosis in a variety of ways, it is understudied in subclinical samples. Therefore, we assessed the interplay between religion and prodromal symptoms in 79 UHR and 110 control individuals. They were interviewed with the Duke University Religion Index and the Structured Interview for Prodromal Syndromes (SIPS). Organizational religious activity, a measure of how often someone attends churches/temples, was positively related to perceptual abnormalities/hallucinations (Spearman's rho = 0.262, p = 0.02). This relationship was replicated in a path analysis model (beta = 0342, SE = 0.108, p = 0.002), as well as a link between organizational religious activity and lower ideational richness (beta = 0.401. SE = 0.105, p = 0.000) with no influence of sex, age, religious denomination, or socioeconomic class. Intrinsic religious activity was negatively correlated with suspiciousness (SIPS P2) (beta = -0.028, SE = 0.009, p = 0.002), and non-organizational religious activity was correlated with higher ideational richness (N5) (beta = -0220,SE = 0.097, p = 0.023). We hypothesize that subjects with subclinical psychosis may possibly use churches and other religious organizations to cope with hallucinations. Indeed, Brazil is characterized by a religious syncretism and a strong influence of Spiritism in the popular culture. The mediumistic idea that some might be able to hear and/or see spirits is probably employed to explain subclinical hallucinations in the lay knowledge. Our results emphasize the importance of assessing religion and other region-specific aspects of various cultures when studying UHR individuals. This sort of assessment would enhance understanding of differences in conversion rates, and would help to transpose prevention programs from high-income countries to other settings.
- Motion energy analysis during speech tasks in medication-naive individuals with at-risk mental states for psychosis(2022) LOPES-ROCHA, Ana Caroline; CORCORAN, Cheryl Mary; ANDRADE, Julio Cesar; PERONI, Leonardo; HADDAD, Natalia Mansur; HORTENCIO, Lucas; SERPA, Mauricio Henriques; BILT, Martinus Theodorus van de; GATTAZ, Wagner Farid; LOCH, Alexandre AndradeMovement abnormalities are commonly observed in schizophrenia and at-risk mental states (ARMS) for psychosis. They are usually detected with clinical interviews, such that automated analysis would enhance assessment. Our aim was to use motion energy analysis (MEA) to assess movement during free-speech videos in ARMS and control individuals, and to investigate associations between movement metrics and negative and positive symptoms. Thirty-two medication-naive ARMS and forty-six healthy control individuals were filmed during speech tasks. Footages were analyzed using MEA software, which assesses movement by differences in pixels frame-by-frame. Two regions of interest were defined-head and torso-and mean amplitude, frequency, and coefficient of variability of movements for them were obtained. These metrics were correlated with the Structured Interview for Prodromal Syndromes (SIPS) symptoms, and with the risk of conversion to psychosis-inferred with the SIPS risk calculator. ARMS individuals had significantly lower mean amplitude of head movement and higher coefficients of movement variability for both head and torso, compared to controls. Higher coefficient of variability was related to higher risk of conversion. Negative correlations were seen between frequency of movement and most SIPS negative symptoms. All positive symptoms were correlated with at least one movement variable. Movement abnormalities could be automatically detected in medication-naive ARMS subjects by means of a motion energy analysis software. Significant associations of movement metrics with symptoms were found, supporting the importance of movement analysis in ARMS. This could be a potentially important tool for early diagnosis, intervention, and outcome prediction.
- Elevated neurotrophin-3 and neurotrophin 4/5 levels in unmedicated bipolar depression and the effects of lithium(2015) LOCH, Alexandre A.; ZANETTI, Marcus V.; SOUSA, Rafael T. de; CHAIM, Tiffany M.; SERPA, Mauricio H.; GATTAZ, Wagner F.; TEIXEIRA, Antonio L.; MACHADO-VIEIRA, RodrigoBackground: Bipolar disorder (BD) has been associated with diverse abnormalities in neural plasticity and cellular resilience. Neurotrophin-3 (NT-3) and neurotrophin-4/5 (NT-4/5) support synaptic neuronal survival and differentiation. NT-3 and NT-4/5 levels were found to be altered in BD, potentially representing a physiological response against cellular stress. However, the use of psychopharmacological agents and heterogeneous mood states may constitute important biases in such studies. Thus, we aimed to assess NT-3 and NT-4/5 levels in medication-free BD type I or II individuals in a current depressive episode, before and after 6weeks of lithium monotherapy and matched with healthy controls. Methods: Twenty-three patients with BD type I or II during a depressive episode and 28 healthy controls were studied. Patients were required to have a 21-item Hamilton Depression Rating Scale score >= 18 and had not undergone any psychopharmacological treatment for at least 6 weeks prior to study entry. Patients were treated with lithium for 6 weeks and plasma NT-3 and NT-4/5 levels were determined at baseline and end point using ELISA method. Results: Baseline plasma levels of both NT-3 and NT-4/5 were significantly increased in acutely depressed BD subjects in comparison to healthy controls (p = 0.040 and 0.039, respectively). The NT-3 and NT-4/5 levels did not significantly change after lithium treatment. NT-3 and NT-4/5 levels were positively correlated to illness duration in BD (p = 0.032 and 0.034, respectively). Conclusion: Our findings suggest that NT-3 and NT-4/5 levels are increased in the depressive phase of BD, which seems directly associated with illness duration. The increased levels of NT-3 and NT-4/5 may underlie a biological response to cellular stress associated with the course of BD.
- Cognitive Patterns and Conversion in a Representative Sample of Individuals at Risk for Psychosis(2022) HADDAD, Natalia Mansur; HORTENCIO, Lucas; ANDRADE, Julio Cesar; SERPA, Mauricio Henriques; ALVES, Tania Maria; BILT, Martinus Theodorus van de; ROSSLER, Wulf; GATTAZ, Wagner Farid; LOCH, Alexandre AndradeClinical high-risk (CHR) individuals belong to a heterogeneous group, of which only a few will cross the threshold for a clinical diagnosis. Cognitive disturbances are present in CHR subjects and may be indicative of transition. Our study aims to identify such deficits in a representative CHR for psychosis sample. Our sample comprised 92 CHR individuals and 54 controls from a representative cohort of the general population. They were followed up for a mean of 2.5 years, with 15 individuals converting to schizophrenia or other Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnoses. Neurocognitive assessment was performed with the University of Pennsylvania Computerized Neuropsychological Testing, and CHR status was assessed with the Structured Interview for Prodromal Syndromes (SIPS). Baseline scores were entered in a latent profile analysis model. Our study brought forward a four-class model on cognitive performance. One class displayed better performance, whereas the other three performed worse, all compared with controls. The class with lower executive function also had the highest score on disorganized communication (SIPS P5 = 1.36, p < 0.05), although unrelated to conversion. Among the low performers, the class significantly related to conversion (p = 0.023) had the highest score in decreased expression of emotion (SIPS N3 = 0.85, p < 0.05). Our study brings new and relevant data on non-help-seeking CHR individuals and the relationship between cognitive patterns and conversion. We have highlighted a specific cognitive signature, associated with negative symptoms, which represents a stable trait with presumed lower conversion to a psychiatric illness.
- A dopamine receptor D2 genetic polymorphism associated with transition to mental disorders in a cohort of individuals with at-risk mental state for psychosis(2023) MARQUES, Julia Hatagami; TALIB, Leda Leme; HORTENCIO, Lucas; ANDRADE, Julio Cesar; ALVES, Tania Maria; SERPA, Mauricio Henriques; YAMAMOTO, Guilherme Lopes; BILT, Martinus Theodorus van de; ROSSLER, Wulf; GATTAZ, Wagner Farid; LOCH, Alexandre AndradeObjectives: To test the association of 45 single nucleotide polymorphisms (SNPs) with transition to psychiatric disorders in a cohort of individuals at ultrahigh risk (UHR) mental state for psychosis.Methods: Through general population screening, 88 non-help-seeking UHR subjects and 130 healthy control individuals were genotyped for 45 SNPs related to psychosis. They were followed for a mean of 2.5 years, and conversion to psychotic and to general psychiatric disorders was assessed. Genotype frequencies between controls, converters, and non-converters were analyzed.Results: There were no differences in sociodemographics between controls and UHR. Also, UHR converters and non-converters had no differences in their baseline symptoms scores. The dopamine receptor D2 gene (DRD2) SNP rs6277 was significantly more common among UHR who transitioned to psychosis (p o 0.001) and to UHR who transitioned to any psychiatric disorders (p = 0.001) when compared to UHR who did not transition. The rs6277 T allele was related to psychiatric morbidity in a dose-response fashion, being significantly more frequent in UHR converters than UHR non-converters and control subjects (p = 0.003).Conclusion: Our findings suggest that rs6277 could potentially constitute a genetic marker of transition to psychiatric disorders in subjects with at-risk mental states, warranting further investigation in larger samples.
- Use of a Bayesian Network Model to predict psychiatric illness in individuals with 'at risk mental states' from a general population cohort(2022) LOCH, Alexandre Andrade; ARA, Anderson; HORTENCIO, Lucas; MARQUES, Julia Hatagami; TALIB, Leda Leme; ANDRADE, Julio Cesar; SERPA, Mauricio Henriques; SANCHEZ, Luciano; ALVES, Tania Maria; BILT, Martinus Theodorus van de; ROESSLER, Wulf; GATTAZ, Wagner FaridThe 'at risk mental state' (ARMS) paradigm has been introduced in psychiatry to study prodromal phases of schizophrenia. With time it was seen that the ARMS state can also precede mental disorders other than schizophrenia, such as depression and anxiety. However, several problems hamper the paradigm's use in preventative medicine, such as varying transition rates across studies, the use of non-naturalistic samples, and the multifactorial nature of psychiatric disorders. To strengthen ARMS predictive power, there is a need for a holistic model incorporating-in an unbiased fashion-the small-effect factors that cause mental disorders. Bayesian networks, a probabilistic graphical model, was used in a populational cohort of 83 ARMS individuals to predict conversion to psychiatric illness. Nine predictors-including state, trait, biological and environmental factors-were inputted. Dopamine receptor 2 polymorphism, high private religiosity, and childhood trauma remained in the final model, which reached an 85.51% (SD = 0.1190) accuracy level in predicting conversion. This is the first time a robust model was produced with Bayesian networks to predict psychiatric illness among at risk individuals from the general population. This could be an important tool to strengthen predictive measures in psychiatry which should be replicated in larger samples to provide the model further learning.
- Poverty, low education, and the expression of psychotic-like experiences in the general population of Sao Paulo, Brazil(2017) LOCH, Alexandre Andrade; CHIANCA, Camille; ALVES, Tania Maria; FREITAS, Elder Lanzani; HORTENCIO, Lucas; ANDRADE, Julio Cesar; BILT, Martinus Theodorus Van de; FONTONI, Marcos Roberto; SERPA, Mauricio H.; GATTAZ, Wagner Farid; ROESSLER, WulfThe aim of our study was to assess psychotic-like experiences in the general population aged 18-30 years old of the city of Sao Paulo, Brazil. A household survey was conducted with 1950 young-adults randomly drawn from the city's general population. The validated 92-item Portuguese version of the Prodromal Questionnaire (PQ) was used for face-to-face interviews. Latent class analysis was conducted. Mean age was of 24 years; 51.1% of the sample was of women. Mean total score on the PQ was 22.06 (SD = 17.16). Considering a suggested cut-off of 14 in the positive subscale, 30.8% of individuals were above the threshold for ultra-high risk for psychosis detection. Latent class analysis resulted in a three classes clusterization. Class 1 (20%; n = 390) had the highest overall PQ scores (mean = 49.31,SD = 10.783), class 2 (43%; n = 835) had intermediate scores (mean = 23.37,SD = 6.56), and class 3 (37%; n=721) had the lowest scores (mean= 5.81,SD = 3.74). Class 1 had significantly more individuals with less education and significantly more individuals with lower socioeconomic class. Poverty and low education might be associated with the psychotic expression in the general population, amplifying their actions on the psychosis gradient in developing countries. The psychosis continuum might be constituted by three distinct quantitatively different classes.
- Gesticulation in individuals with at risk mental states for psychosis(2023) LOPES-ROCHA, Ana Caroline; RAMOS, Willian Henrique de Paula; ARGOLO, Felipe; GONDIM, Joao Medrado; MOTA, Natalia Bezerra; ANDRADE, Julio Cesar; JAFET, Andrea Fontes; MEDEIROS, Matheus Wanderley de; SERPA, Mauricio Henriques; CECCHI, Guillermo; ARA, Anderson; GATTAZ, Wagner Farid; CORCORAN, Cheryl Mary; LOCH, Alexandre AndradeNonverbal communication (NVC) is a complex behavior that involves different modalities that are impaired in the schizophrenia spectrum, including gesticulation. However, there are few studies that evaluate it in individuals with at-risk mental states (ARMS) for psychosis, mostly in developed countries. Given our prior findings of reduced movement during speech seen in Brazilian individuals with ARMS, we now aim to determine if this can be accounted for by reduced gesticulation behavior. Fifty-six medication-naive ARMS and 64 healthy controls were filmed during speech tasks. The frequency of specifically coded gestures across four categories (and self-stimulatory behaviors) were compared between groups and tested for correlations with prodromal symptoms of the Structured Interview for Prodromal Syndromes (SIPS) and with the variables previously published. ARMS individuals showed a reduction in one gesture category, but it did not survive Bonferroni's correction. Gesture frequency was negatively correlated with prodromal symptoms and positively correlated with the variables of the amount of movement previously analyzed. The lack of significant differences between ARMS and control contradicts literature findings in other cultural context, in which a reduction is usually seen in at-risk individuals. However, gesture frequency might be a visual proxy of prodromal symptoms, and of other movement abnormalities. Results show the importance of analyzing NVC in ARMS and of considering different cultural and sociodemographic contexts in the search for markers of these states.
conferenceObject PERCEPTUAL ABNORMALITIES AND RELIGIOSITY IN ULTRA HIGH-RISK FOR PSYCHOSIS (UHR) INDIVIDUALS IN A LATIN AMERICAN POPULATIONAL SAMPLE RESULTS FROM THE SAO PAULO SSAPP COHORT(2018) LOCH, Alexandre; CHIANCA, Camille; FREITAS, Elder Lanzani; ANDRADE, Julio Cesar; ALVES, Tania Maria; SERPA, Mauricio Henriques; HORTENCIO, Lucas; BILT, Martinus Theodorus van de; GATTAZ, Wagner; ROSSLER, Wulf