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
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
- Detecting at-risk mental states for psychosis (ARMS) using machine learning ensembles and facial features(2023) LOCH, Alexandre Andrade; GONDIM, Joao Medrado; ARGOLO, Felipe Coelho; LOPES-ROCHA, Ana Caroline; ANDRADE, Julio Cesar; BILT, Martinus Theodorus van de; JESUS, Leonardo Peroni de; HADDAD, Natalia Mansur; CECCHI, Guillermo A.; MOTA, Natalia Bezerra; GATTAZ, Wagner Farid; CORCORAN, Cheryl Mary; ARA, AndersonAims: Our study aimed to develop a machine learning ensemble to distinguish ""at-risk mental states for psychosis"" (ARMS) subjects from control individuals from the general population based on facial data extracted from video-recordings.Methods: 58 non-help-seeking medication-naive ARMS and 70 healthy subjects were screened from a general population sample. At-risk status was assessed with the Structured Interview for Prodromal Syndromes (SIPS), and ""Subject's Overview"" section was filmed (5-10 min). Several features were extracted, e.g., eye and mouth aspect ratio, Euler angles, coordinates from 51 facial landmarks. This elicited 649 facial features, which were further selected using Gradient Boosting Machines (AdaBoost combined with Random Forests). Data was split in 70/30 for training, and Monte Carlo cross validation was used.Results: Final model reached 83 % of mean F1-score, and balanced accuracy of 85 %. Mean area under the curve for the receiver operator curve classifier was 93 %. Convergent validity testing showed that two features included in the model were significantly correlated with Avolition (SIPS N2 item) and expression of emotion (SIPS N3 item).Conclusion: Our model capitalized on short video-recordings from individuals recruited from the general population, effectively distinguishing between ARMS and controls. Results are encouraging for large-screening purposes in low-resource settings.
- Cultural adaptation of the mental health first aid guidelines for depression in Brazil: a Delphi expert consensus study (vol 23, 76, 2023)(2023) REQUENA, Simone Scotti; ASSUMPCAO, Thais Alves; PERES, Carlos Henrique Mesquita; CERQUEIRA, Amanda Vidotto; LOCH, Alexandre Andrade; LI, Wenjing; REAVLEY, Nicola J.
- Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries(2023) FEKIH-ROMDHANE, Feten; DAHER-NASHIF, Suhad; STAMBOULI, Manel; ALHUWAILAH, Amthal; HELMY, Mai; SHUWIEKH, Hanaa Ahmed Mohamed; LEMINE, Cheikh Mohamed Fadel Mohamed; RADWAN, Eqbal; SAQUIB, Juliann; SAQUIB, Nazmus; FAWAZ, Mirna; ZARROUQ, Btissame; NASER, Abdallah Y.; OBEID, Sahar; SALEH, Maan; HAIDER, Sanad; MILOUD, Lahmer; BADRASAWI, Manal; HAMDAN-MANSOUR, Ayman; BARBATO, Mariapaola; BAKHIET, Aisha Motwakil; KHALIL, Najat Sayem; ADAWI, Samir; GREIN, Fatheya; LOCH, Alexandre Andrade; CHEOUR, Majda; HALLIT, SouheilBackground Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. Method The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 +/- 10.80 years, 77.1% females). Results Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta =.005; p <.001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. Conclusion Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.
- Cultural adaptation of the mental health first aid guidelines for depression in Brazil: a Delphi expert consensus study(2023) REQUENA, Simone Scotti; ASSUMPCAO, Thais Alves; PERES, Carlos Henrique Mesquita; CERQUEIRA, Amanda Vidotto; LOCH, Alexandre Andrade; LI, Wenging; REAVLEY, Nicola J.BackgroundDepression is a significant contributor to disability in Brazil, with most Brazilians affected by depression receiving no treatment. As the community, including family and friends, plays a crucial role in providing support for someone with depression, it is important that evidence-based resources are available to support people who wish to help. The aim of this study was to culturally adapt the English-language mental health first aid guidelines for assisting a person with depression for the Brazilian culture.MethodsA Delphi expert consensus study was conducted, with two expert panels; health professionals (n = 29) and people with lived experience of depression (n = 28). One hundred and seventy-four statements from the English-language guidelines were translated into Brazilian Portuguese and administered as a survey. Participants were asked to rate statements based on how appropriate those statements were for the Brazilian culture and to suggest new statements if appropriate.ResultsData were collected over two survey rounds. Consensus was achieved on 143 statements. A total of 133 statements were adopted from the English-language guidelines, whereas 10 new endorsed statements were generated from suggestions of the two expert panels.ConclusionsThere were similarities between the English-language and Brazilian guidelines, mainly related to family involvement and the value of empathy. More research on dissemination and incorporation of the guidelines into the Mental Health First Aid (MHFA) training course for Brazil is required.
- 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.
- Inequality and barriers in psychosis prevention: A systematic review on clinical high-risk for psychosis studies from developing countries(2023) LOCH, Alexandre Andrade; LOPES-ROCHA, Ana Caroline; FEKIH-ROMDHANE, Feten; BILT, Martinus Theodorus van de; PABLO, Gonzalo Salazar de; FUSAR-POLI, PaoloBackground: The clinical high-risk for psychosis (CHR) paradigm is one of the best studied preventive paradigms in psychiatry. However, most studies have been conducted in high-income countries. It is unclear if knowledge from such countries applies to low and middle-income countries (LAMIC), and if there are specific limitations hindering CHR research there. Our aim is to systematically review studies on CHR from LAMIC. Methods: A multistep PRISMA-compliant literature search was performed in PubMed and Web of Science for articles published until 1/03/2022, conducted in LAMIC, addressing the concept and correlates of CHR. Study characteristics as well as limitations were reported. Corresponding authors of the included studies were invited to answer an online poll. Quality assessment was done with the MMAT. Results: A total of 109 studies were included in the review: none from low-income countries, 8 from lower middle-income countries, and 101 from upper middle-income countries. The most frequent limitations were small sample size (47.9%), cross-sectional design (27.1%), and follow-up issues (20.8%). Mean quality of included studies was of 4.4. Out of the 43 corresponding authors, 12 (27.9%) completed the online poll. They cited further limitations as few financial resources (66.7%), no involvement of population (58.2%) and cultural barriers (41.7%). Seventy five percent researchers reported that CHR research should be conducted differently in LAMIC compared to high-income countries, due to structural and cultural issues. Stigma was mentioned in three out of five sections of the poll. Discussion: Results show the discrepancy of available evidence on CHR in LAMIC, given the shortage of resources in such countries. Future directions should aim to increase the knowledge on individuals at CHR in such settings, and to address stigma and cultural factors that may play a role in the pathways toward care in psychosis.
- 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.
- Plasma levels of neurotrophin 4/5, NGF and pro-BDNF influence transition to mental disorders in a sample of individuals at ultra-high risk for psychosis(2023) LOCH, Alexandre Andrade; PINTO, Marcel Tavares Camilo; ANDRADE, Julio Cesar; JESUS, Leonardo Peroni de; MEDEIROS, Matheus Wanderley de; HADDAD, Natalia Mansur; BILT, Martinus Theodorus van de; TALIB, Leda Leme; GATTAZ, Wagner FaridBackground: Neurotrophins (NTs) and their precursors (pro-NTs) are polypeptides with important roles in neuronal development, differentiation, growth, survival and plasticity, as well as apoptosis and neuronal death. Imbalance in NT levels were observed in schizophrenia spectrum disorders, but evidence in ultra-high risk for psychosis (UHR) samples is scarce. Methods: A naturalistic sample of 87 non-help-seeking UHR subjects and 55 healthy controls was drawn from the general population. Blood samples were collected and NT-3, NT-4/5, BDNF, pro-BDNF, NGF, pro-NGF were analyzed through enzyme linked immunosorbent assay (ELISA). Information on cannabis and tobacco use was also collected. Logistic regression models and path analysis were used to control for confounders (tobacco, age, cannabis use). Results: NT-4/5 was significantly decreased, and pro-BDNF was significantly increased in UHR individuals compared to controls. Cannabis use and higher NGF levels were significantly related to transition to psychiatric disorders among UHR subjects. Increased pro-BDNF and decreased NT-4/5 influenced transition by the mediation of perceptual abnormalities. Conclusions: Our study shows for the first time that NTs are altered in UHR compared to healthy control individuals, and that they can be a predictor of transition to psychiatric illnesses in this population. Future studies should employ larger naturalistic samples to confirm the findings.
- Suicide risk among individuals at Ultra-High Risk (UHR) of psychosis in a developing North African country: A 12-month naturalistic prospective cohort study from the TRIP project(2023) FEKIH-ROMDHANE, Feten; ABASSI, Bouthaina; GHRISSI, Farah; LOCH, Alexandre Andrade; CHERIF, Wissal; DAMAK, Rahma; ELLINI, Sana; HALLIT, Souheil; CHEOUR, MajdaBackground: The limited studies that focused on suicidality in individuals at Ultra-High Risk (UHR) of psychosis were predominantly cross-sectional, emerging from Western countries. We aimed to examine suicide risk among Tunisian UHR and First Episode Psychosis (FEP) patients at baseline, and to evaluate the evolution and correlates of suicidal ideation over a 12-month period in the UHR group exclusively.Methods: 35 UHR (aged 22.8 & PLUSMN; 4.0 years, 45.7% male) and 33 FEP (aged 27.3 & PLUSMN; 4.8 years, 63.6% male) participants were included. The Comprehensive Assessment of at Risk Mental States, the Positive and Negative Syndrome Scale (PANSS), The Rosenberg Self-Esteem Scale, and The Multidimensional Scale of Perceived Social Support were used.Results: No significant differences were found between the UHR and the FEP groups with regard to levels of suicidal ideation at baseline. Suicidal ideation scores showed a significant decrease over time in UHR participants (p=.014; & eta;2=0.242). An increase in total PANSS scores at 1 year (Beta=0.03; p=.048; 95%CI 0.001, 0.060; & eta;2=0.182) significantly increased suicidal ideation scores at 1 year in the UHR group.Conclusion: Our findings contribute to the limited body of evidence on this topic by providing new prospective data from a population, country and region that has never been researched previously.
- Suicide literacy mediates the path from religiosity to suicide stigma among Muslim community adults: Cross-sectional data from four Arab countries(2023) FEKIH-ROMDHANE, Feten; DAHER-NASHIF, Suhad; STAMBOULI, Manel; ALHUWAILAH, Amthal; HELMY, Mai; SHUWIEKH, Hanaa Ahmed Mohamed; LEMINE, Cheikh Mohamed Fadel Mohamed; RADWAN, Eqbal; SAQUIB, Juliann; SAQUIB, Nazmus; FAWAZ, Mirna; ZARROUQ, Btissame; NASER, Abdallah Y.; OBEID, Sahar; SALEH, Maan; HAIDER, Sanad; MILOUD, Lahmer; BADRASAWI, Manal; HAMDAN-MANSOUR, Ayman; BARBATO, Mariapaola; BAKHIET, Aisha; SAYEM, Najat; ADAWI, Samir; GREIN, Fatheya; LOCH, Alexandre Andrade; CHEOUR, Majda; HALLIT, SouheilBackground:The majority of research attention has been devoted to the link between religiosity and suicide risk, and a considerable amount of studies has been carried out on how stigma impacts individuals with mental health problems of different kinds. However, the interplay between religiosity, suicide literacy and suicide stigma has seldom been empirically researched, especially quantitatively. We sought through this study to redress the imbalance of research attention by examining the relationship between religiosity and suicide stigma; and the indirect and moderating effects of suicide literacy on this relationship. Method: A cross-sectional web-based survey was conducted among Arab-Muslim adults originating from four Arab countries (Egypt: N=1029, Kuwait: N=2182, Lebanon N=781, Tunisia N=2343; Total sample: N=6335). The outcome measures included the Arabic Religiosity Scale which taps into variation in the degree of religiosity, the Stigma of Suicide Scale-short form to the solicit degree of stigma related to suicide, and the Literacy of Suicide Scale explores knowledge and understanding of suicide. Results: Our Mediation analyses findings showed that literacy of suicide partially mediated the association between religiosity and stigmatizing attitude toward suicide. Higher religiosity was significantly associated with less literacy of suicide; higher literacy of suicide was significantly associated with less stigma of suicide. Finally, higher religiosity was directly and significantly associated with more stigmatization attitude toward suicide. Conclusion: We contribute the literature by showing, for the first time, that suicide literacy plays a mediating role in the association between religiosity and suicide stigma in a sample of Arab-Muslim community adults. This preliminarily suggests that the effects of religiosity on suicide stigma can be modifiable through improving suicide literacy. This implies that interventions targeting highly religious individuals should pay dual attention to increasing suicide literacy and lowering suicide stigma.