LAURA HELENA SILVEIRA GUERRA DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Age of Onset and Lifetime Projected Risk of Psychotic Experiences: Cross-National Data From the World Mental Health Survey(2016) MCGRATH, John J.; SAHA, Sukanta; AL-HAMZAWI, Ali O.; ALONSO, Jordi; ANDRADE, Laura; BORGES, Guilherme; BROMET, Evelyn J.; BROWNE, Mark Oakley; BRUFFAERTS, Ronny; ALMEIDA, Jose M. Caldas de; FAYYAD, John; FLORESCU, Silvia; GIROLAMO, Giovanni de; GUREJE, Oye; HU, Chiyi; JONGE, Peter de; KOVESS-MASFETY, Viviane; LEPINE, Jean Pierre; LIM, Carmen C. W.; NAVARRO-MATEU, Fernando; PIAZZA, Maria; SAMPSON, Nancy; POSADA-VILLA, Jose; KENDLER, Kenneth S.; KESSLER, Ronald C.Background: Given the early age of onset (AOO) of psychotic disorders, it has been assumed that psychotic experiences (PEs) would have a similar early AOO. The aims of this study were to describe (a) the AOO distribution of PEs, (b) the projected lifetime risk of PEs, and (c) the associations of PE AOO with selected PE features. Methods: Data came from the WHO World Mental Health (WMH) surveys. A total of 31 261 adult respondents across 18 countries were assessed for lifetime prevalence of PE. Projected lifetime risk (at age 75 years) was estimated using a 2-part actuarial method. AOO distributions were described for the observed and projected estimates. We examined associations of AOO with PE type metric and annualized PE frequency. Results: Projected lifetime risk for PEs was 7.8% (SE = 0.3), slightly higher than lifetime prevalence (5.8%, SE = 0.2). The median (interquartile range; IQR) AOO based on projected lifetime estimates was 26 (17-41) years, indicating that PEs commence across a wide age range. The AOO distributions for PEs did not differ by sex. Early AOO was positively associated with number of PE types (F = 14.1, P <.001) but negatively associated with annualized PE frequency rates (F = 8.0, P <.001). Discussion: While most people with lifetime PEs have first onsets in adolescence or young adulthood, projected estimates indicate that nearly a quarter of first onsets occur after age 40 years. The extent to which late onset PEs are associated with (a) late onset mental disorders or (b) declining cognitive and/or sensory function need further research.
- The Bidirectional Associations Between Psychotic Experiences and DSM-IV Mental Disorders(2016) MCGRATH, John J.; SAHA, Sukanta; AL-HAMZAWI, Ali; ANDRADE, Laura; BENJET, Corina; BROMET, Evelyn J.; BROWNE, Mark Oakley; ALMEIDA, Jose M. Caldas de; CHIU, Wai Tat; DEMYTTENAERE, Koen; FAYYAD, John; FLORESCU, Silvia; GIROLAMO, Giovanni de; GUREJE, Oye; HARO, Josep Maria; HAVE, Margreet ten; HU, Chiyi; KOVESS-MASFETY, Viviane; LIM, Carmen C. W.; NAVARRO-MATEU, Fernando; SAMPSON, Nancy; POSADA-VILLA, Jose; KENDLER, Kenneth S.; KESSLER, Ronald C.Objective: While it is now recognized that psychotic experiences are associated with an increased risk of later mental disorders, we lack a detailed understanding of the reciprocal time-lagged relationships between first onsets of psychotic experiences and mental disorders. Using data from World Health Organization World Mental Health (WMH) Surveys, the authors assessed the bidirectional temporal associations between psychotic experiences and mental disorders. Method: The WMH Surveys assessed lifetime prevalence and age at onset of psychotic experiences and 21 common IDSM-IV mental disorders among 31,261 adult respondents from 18 countries. Discrete-time survival models were used to examine bivariate and multivariate associations between psychotic experiences and mental disorders. Results: Temporally primary psychotic experiences were significantly associated with subsequent first onset of eight of the 21 mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, social phobia, posttraumatic stress disorder, adult separation anxiety disorder, bulimia nervosa, and alcohol abuse), with odds ratios ranging from 1.3 (95% CI=1.2-1.5) for major depressive disorder to 2.0 (95% CI=1.5-2.6) for bipolar disorder. In contrast, 18 of 21 primary mental disorders were significantly associated with subsequent first onset of psychotic experiences, with odds ratios ranging from 1.5 (95% CI=1.0-2.1) for childhood separation anxiety disorder to 2.8 (95% CI=1.0-7.8) for anorexia nervosa. Conclusions: While temporally primary psychotic experiences are associated with an elevated risk of several subsequent mental disorders, these data show that most mental disorders are associated with an elevated risk of subsequent psychotic experiences. Further investigation of the underlying factors accounting for these time-order relationships may shed light on the etiology of psychotic experiences.
- Exploring the latent trait of opioid use disorder criteria among frequent nonmedical prescription opioid users(2016) CASTALDELLI-MAIA, Joao Mauricio; ANDRADE, Laura H.; KEYES, Katherine M.; CERDA, Magdalena; PILOWSKY, Daniel J.; MARTINS, Silvia S.Background: There is a need to explore the dimensional and categorical phenotypes of criteria of opioid use disorder among frequent nonmedical users of prescription opioids (NMUPO) users. Methods: We used pooled data of 2011-2012 National Survey on Drug Use and Health to examine reliability and phenotypic variability in the diagnosis of OUD secondary to NMUPO in a nationally representative sample of 18+ years-old frequent past-year NMUPO users (120+ days, n = 806). Through exploratory factor analysis (EFA) and latent class analysis (LCA), we examined 10 past-year OUD criteria. We examined associations between the latent classes and sociodemographic/psychiatric/NMUPO correlates. Results: OUD criteria were unidimensional, and a three-class model was the overall best fitting solution for characterizing individuals into phenotypes along this unidimensional continuum: a ""non-symptomatic class"" (40.7%), ""Tolerance-Time spent class"" (29.0%) with high probability of endorsing Tolerance/Time Spent criteria, and a ""High-moderate symptomatic class"" (30.1%). The last class was significantly associated with being male, having insurance and obtaining prescription opioids (PO) nonmedically via ""doctor shopping"" as compared to the non-symptomatic class. ""Tolerance Time spent class"" was significantly associated with being younger (18-25 years) and obtaining PO nonmedically from family/friends as compared to the non-symptomatic class. Conclusion: This study revealed the different characteristics and routes of access to PO of different classes of frequent NMUPO users. It is possible that these groups may respond to different interventions, however such conclusions would require a clinical study.
- Mental disorders among college students in the World Health Organization World Mental Health Surveys(2016) AUERBACH, R. P.; ALONSO, J.; AXINN, W. G.; CUIJPERS, P.; EBERT, D. D.; GREEN, J. G.; HWANG, I.; KESSLER, R. C.; LIU, H.; MORTIER, P.; NOCK, M. K.; PINDER-AMAKER, S.; SAMPSON, N. A.; AGUILAR-GAXIOLA, S.; AL-HAMZAWI, A.; ANDRADE, L. H.; BENJET, C.; CALDAS-DE-ALMEIDA, J. M.; DEMYTTENAERE, K.; FLORESCU, S.; GIROLAMO, G. de; GUREJE, O.; HARO, J. M.; KARAM, E. G.; KIEJNA, A.; KOVESS-MASFETY, V.; LEE, S.; MCGRATH, J. J.; O'NEILL, S.; PENNELL, B. -E.; SCOTT, K.; HAVE, M. ten; TORRES, Y.; ZASLAVSKY, A. M.; ZARKOV, Z.; BRUFFAERTS, R.Background Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Method The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). Results One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.
- Do Childhood Adversities Predict Suicidality? Findings from the General Population of the Metropolitan Area of Sao Paulo, Brazil(2016) COELHO, Bruno Mendonaca; ANDRADE, Laura Helena; BORGES, Guilherme; SANTANA, Geilson Lima; VIANA, Maria Carmen; WANG, Yuan-PangBackground Childhood adversities have been associated with a number of medical and psychiatric outcomes. However, the reported effects that specific childhood adversities have on suicidality vary across studies. Method This was a cross-sectional, stratified, multistage area probability investigation of a general population in Brazil, designated the Sao Paulo Megacity Mental Health Survey. The World Mental Health Composite International Diagnostic Interview was applied in 5037 individuals >= 18 years of age, in order to assess 12 different adversities occurring during childhood and/or adolescence, as well as to look for associations between those adversities and subsequent suicidality in different age strata. Results Over half of the respondents reported at least one childhood adversity. Only physical abuse was consistently associated with suicide attempts in all subsequent life stages (OR = 2.1). Among adults 20-29 years of age, the likelihood of a suicide attempt was correlated with parental divorce, whereas suicidal ideation was associated with prior sexual abuse. Among adults over 30 years of age, physical illness and economic adversity emerged as relevant childhood adversities associated with suicide attempts, whereas sexual abuse, family violence, and economic adversity were associated with suicidal ideation. Conclusion Childhood adversities, especially physical abuse, are likely associated with unfavorable consequences in subsequent years. For suicidality across a lifespan, the role of different childhood adversities must be examined independently.
bookPart Epidemiologia dos Transtornos Mentais(2016) ANDRADE, Laura Helena Silveira Guerra de; WANG, Yuan-Pang; JúNIOR, Geilson Lima Santana; COêLHO, Bruno Mendonça; SILVEIRA, Camila Magalhães; SIU, Erica Rosanna; CAMPANHA, Angela Maria; PELUSO, Marco Aurélio Monteiro; VIANA, Maria CarmenconferenceObject Subthreshold bipolar symptomatology in MDD in the Sao Paulo megacity population-based study(2016) MORENO, D.; ANDRADE, L. H.