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
4 resultados
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- Schizophrenia, Not a Psychotic Disorder: Bleuler Revisited(2019) LOCH, Alexandre AndradeCurrent diagnostic criteria delineate schizophrenia as a discrete entity essentially defined by positive symptoms. However, the role of positive symptoms in psychiatry is being questioned. There is compelling evidence that psychotic manifestations are expressed in the population in a continuum of varying degrees of severity, ranging from normality to full-blown psychosis. In most cases, these phenomena do not persist, but they constitute risk factors for psychiatric disorders in general. Psychotic symptoms are also present in most non-psychotic psychiatric diagnoses, being a marker of severity. Research revealed that hallucinations and delusions appear to have distinct, independent biological underpinnings-in the general population, in psychotic, and in non-psychotic disorders as well. On the other hand, negative symptoms were seen to be far more restricted to schizophrenia, have other underlying pathophysiology than positive symptoms, predict outcome and treatment response in schizophrenia, and start before the first psychotic outbreak. The current work discusses the concept of schizophrenia, suggesting that a greater emphasis should be put on cases where psychotic symptoms emerge in a premorbid subtly increasing negative/cognitive symptoms background. In those cases, psychosis would have a different course and outcome while psychosis occurring in the absence of such background deterioration would be more benign-probably having no, or a milder, underlying degenerative process. This reformulation should better drive psychopathological classification, face positive symptoms as epiphenomenon of the schizophrenia process, and dishevel stigma from schizophrenia and from delusions and hallucinations.
- 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.
- COGNITIVE PATTERNS ASSOCIATED WITH CHILDHOOD TRAUMA AND RISK FOR PSYCHOSIS IN A POPULATIONAL SAMPLE-A LATENT PROFILE ANALYSIS(2019) LOCH, Alexandre; ANDRADE, Julio Cesar; FREITAS, Elder Lanzani; BILT, Martinus Theodorus van de; CHIANCA, Camille; HORTENCIO, Lucas; SERPA, Mauricio Henriques; GATTAZ, Wagner Farld; ROSSLER, Wulf
- Disclosing the diagnosis of schizophrenia: A pilot study of the 'Coming Out Proud' intervention(2019) SETTI, Viviane Piagentini Candal; LOCH, Alexandre Andrade; MODELLI, Arlete; ROCCA, Cristiana Castanho de Almeida; HUNGERBUEHLER, Ines; BILT, Martinus Theodorus van de; GATTAZ, Wagner Farid; ROESSLER, WulfBackground: Schizophrenia is one of the most stigmatized psychiatric disorders, and disclosing it is often a source of stress to individuals with the disorder. The Coming Out Proud (COP) group intervention is designed to reduce the stigma's negative impact and help participants decide if they want to disclose their disorder. Aims: To assess the effect of the COP intervention in individuals with the diagnosis of schizophrenia. Methods: A pilot study of 3 2-hour group lessons (6-12 participants) per week. Individuals were selected from three specialized outpatient services in Sao Paulo, Brazil; 46 people were willing to participate, 11 dropped out during the intervention and 4 were excluded due to low intelligence quotient (IQ), resulting in a final sample of 31 participants. Outcomes were assessed before (T0/baseline) and after (T1/directly) after the COP intervention, and at 3-week follow-up (T2/3 weeks after T1). We applied eight scales, of which four scales are analyzed in this article (Coming Out with Mental Illness Scale (COMIS), Cognitive Appraisal of Stigma as a Stressor (CogApp), Self-Stigma of Mental Illness Scale-Short Form (SSMIS) and Perceived Devaluation-Discrimination Questionnaire (PDDQ)). Results: People who completed the COP intervention showed a significant increase in the decision to disclose their diagnosis (22.5% in T0 vs 67.7% in T2). As to the perception of stigma as a stressor, mean values significantly increased after the intervention (T0 = 3.83, standard deviation (SD) = .92 vs T2 = 4.44, SD = 1.05; p = .006). Two results had marginal significance: self-stigma was reduced (T0 = 3.10, SD = 1.70 vs T2 = 2.73, SD = 1.87; p = .063), while perceived discrimination increased (T0 = 2.68, SD = .55 vs T2 = 2.93, SD = .75; p = .063). Conclusion: This study suggests that the COP group intervention facilitated participants' disclosure decisions, and the increasing awareness of stigma as a stressor in life may have facilitated their decision to eventually disclose their disorder. The results raise questions that require further analysis, taking sociocultural factors into account, as stigma is experienced differently across cultures.