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Obsessive-compulsive disorder (OCD) is a common psychiatric condition classically characterized by obsessions (recurrent, intrusive and unwanted thoughts) and compulsions (excessive, repetitive and ritualistic behaviors or mental acts). OCD is heterogeneous in its clinical presentation and not all patients respond to first-line treatments. Several neurocircuit models of OCD have been proposed with the aim of providing a better understanding of the neural and cognitive mechanisms involved in the disorder. These models use advances in neuroscience and findings from neuropsychological and neuroimaging studies to suggest links between clinical profiles that reflect the symptoms and experiences of patients and dysfunctions in specific neurocircuits. Several models propose that treatments for OCD could be improved if directed to specific neurocircuit dysfunctions, thereby restoring efficient neurocognitive function and ameliorating the symptomatology of each associated clinical profile. Yet, there are several important limitations to neurocircuit models of OCD. The purpose of the current review is to highlight some of these limitations, including issues related to the complexity of brain and cognitive function, the clinical presentation and course of OCD, etiological factors, and treatment methods proposed by the models. We also provide suggestions for future research to advance neurocircuit models of OCD and facilitate translation to clinical application.

https://doi.org/10.1590/1516-4446-2020-1709

Factor structure of the Dimensional Yale-Brown Obsessive-Compulsive Scale in a large sample of adults with obsessive-compulsive disorder
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Batistuzzo, Marcelo C.

; Fontenelle, Leonardo

; Ferrão, Ygor A.

; Rosário, Maria C.

; Miguel, Euripedes C.

; Fatori, Daniel

Brazilian Journal of Psychiatry

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Fev 2022, Volume 44 Nº 1 Páginas 57 - 60

Resumo: En | Texto: En | PDF: En

Objectives: Although the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) is a widely used instrument for assessing different obsessive-compulsive symptom dimensions, its factor structure has never been studied in a Brazilian population. Thus, we aimed to assess the goodness-of-fit indexes and factor loadings of two higher-order models of the DY-BOCS using confirmatory factor analysis (CFA) in a large obsessive-compulsive disorder (OCD) sample. Methods: We tested two CFA models in a sample of 955 adults with OCD who had been assessed with the DY-BOCS in a cross-sectional multi-site study. The first model encompassed the symptom checklist (present or absent), whereas the second focused on items related to severity scores. Results: Both models presented adequate goodness-of-fit indexes. The comparative fit index, Tucker-Lewis index, and omega were > 0.9, while the root mean square error of approximation was ≤ 0.06 for both models. Factor loadings for each item of each dimension are presented and discussed. Conclusion: Higher-order factor models showed adequate goodness-of-fit indexes, indicating that they appropriately measured OCD dimensions in this Brazilian population.

https://doi.org/10.1590/1516-4446-2021-2088

Mental health interventions following COVID-19 and other coronavirus infections: a systematic review of current recommendations and meta-analysis of randomized controlled trials
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Damiano, Rodolfo F.

; Di Santi, Talita

; Beach, Scott

; Pan, Pedro M.

; Lucchetti, Alessandra L.

; Smith, Felicia A.

; Forlenza, Orestes V.

; Fricchione, Gregory L.

; Miguel, Eurípedes C.

; Lucchetti, Giancarlo

Brazilian Journal of Psychiatry

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Dez 2021, Volume 43 Nº 6 Páginas 665 - 678

Resumo: En | Texto: En | PDF: En

Objective: To review the most common mental health strategies aimed at alleviating and/or preventing mental health problems in individuals during the coronavirus disease 2019 (COVID-19) and other coronavirus pandemics. Methods: We conducted a systematic review of the literature assessing three databases (PubMed, SCOPUS, and PsycINFO). A meta-analysis was performed with data from randomized controlled trials (RCTs). For non-RCT studies, a critical description of recommendations was performed. Results: From a total of 2,825 articles, 125 were included. Of those, three RCTs were included in the meta-analysis. The meta-analysis revealed that the interventions promoted better overall mental health outcomes as compared to control groups (standardized mean difference [SMD] = 0.87 [95%CI 0.33-1.41], p < 0.001, I2 = 69.2%), but did not specifically improve anxiety (SMD = 0.98 [95%CI -0.17 to 2.13], p > 0.05; I2 = 36.8%). Concerning the systematic review, we found a large body of scientific literature proposing recommendations involving psychological/psychiatric interventions, self-care, education, governmental programs, and the use of technology and media. Conclusions: We found a large body of expert recommendations that may help health practitioners, institutional and governmental leaders, and the general population cope with mental health issues during a pandemic or a crisis period. However, most articles had a low level of evidence, stressing the need for more studies with better design (especially RCTs) investigating potential mental health interventions during COVID-19. PROSPERO registration: CRD42020190212.

https://doi.org/10.1590/1516-4446-2020-1582

Predictors of gaming disorder in children and adolescents: a school-based study
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Ferreira, Felipe de M.

; Bambini, Beatriz B.

; Tonsig, Gabriela K.

; Fonseca, Lais

; Picon, Felipe A.

; Pan, Pedro M.

; Salum, Giovanni A.

; Jackowski, Andrea

; Miguel, Eurípedes C.

; Rohde, Luis A.

; Bressan, Rodrigo A.

; Gadelha, Ary

Brazilian Journal of Psychiatry

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Jun 2021, Volume 43 Nº 3 Páginas 289 - 292

Resumo: En | Texto: En | PDF: En

Objective: To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample. Methods: We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses. Results: Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder. Conclusion: Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.

https://doi.org/10.1590/1516-4446-2020-0964 336 downloads

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Resumo: En | Texto: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries
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Cirillo, Alessandra

; Diniz, Elton

; Gadelha, Ary

; Asevedo, Elson

; Axelrud, Luiza K.

; Miguel, Eurípedes C.

; Rohde, Luis Augusto

; Bressan, Rodrigo A.

; Pan, Pedro

; Mari, Jair de J.

Brazilian Journal of Psychiatry

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Ago 2020, Volume 42 Nº 4 Páginas 442 - 448

Resumo: En | Texto: En | PDF: En

Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscience to study how genes and the environment shape typical and atypical brain functioning. The objective of this study was to review key studies on population neuroscience from low- and middle-income countries (LMICs) and to identify potential gaps vis-à-vis studies conducted in high-income countries. Methods: We conducted a systematic review to search for longitudinal cohort studies investigating the development of psychiatric disorders in children and adolescents in LMICs. We performed an electronic search in the EMBASE and MEDLINE databases from inception to July 5th, 2019. Results: We found six cohorts from four countries that met our search criteria: three cohorts from Brazil, one from China, one from South Africa, and one from Mauritius. Relevant examples of findings from these studies are reported. Conclusion: Our results demonstrate the impact of the valuable science output these cohort designs promote, allowing LMICs to have a share in frontline global psychiatry research. National and international funding agencies should invest in LMIC population neuroscience in order to promote replication and generalization of research from high-income countries.

https://doi.org/10.1590/1516-4446-2019-0761 584 downloads

No evidence of attentional bias toward angry faces in patients with obsessive-compulsive disorder
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Skinazi, Michele

; de Mathis, Maria A.

; Cohab, Tatiana

; de Marco e Souza, Marina

; Shavitt, Roseli G.

; Miguel, Euripedes C.

; Hoexter, Marcelo Q.

; Batistuzzo, Marcelo C.

Brazilian Journal of Psychiatry

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Mai 2019, Volume 41 Nº 3 Páginas 257 - 260

Resumo: En | Texto: En | PDF: En

Objective: Although attentional bias (AB) toward angry faces is well established in patients with anxiety disorders, it is still poorly studied in obsessive-compulsive disorder (OCD). We investigated whether OCD patients present AB toward angry faces, whether AB is related to symptom severity and whether AB scores are associated with specific OCD symptom dimensions. Method: Forty-eight OCD patients were assessed in clinical evaluations, intelligence testing and a dot-probe AB paradigm that used neutral and angry faces as stimuli. Analyses were performed with a one-sample t-test, Pearson correlations and linear regression. Results: No evidence of AB was observed in OCD patients, nor was there any association between AB and symptom severity or dimension. Psychiatric comorbidity did not affect our results. Conclusion: In accordance with previous studies, we were unable to detect AB in OCD patients. To investigate whether OCD patients have different brain activation patterns from anxiety disorder patients, future studies using a transdiagnostic approach should evaluate AB in OCD and anxiety disorder patients as they perform AB tasks under functional neuroimaging protocols.

https://doi.org/10.1590/1516-4446-2018-0130 672 downloads

Obsessive-compulsive symptoms in children with first degree relatives diagnosed with obsessive-compulsive disorder
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Chacon, Priscila

; Bernardes, Elisa

; Faggian, Lívia

; Batistuzzo, Marcelo

; Moriyama, Tais

; Miguel, Eurípedes C.

; Polanczyk, Guilherme V.

Brazilian Journal of Psychiatry

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Dez 2018, Volume 40 Nº 4 Páginas 388 - 393

Resumo: En | Texto: En | PDF: En

Objective: A first-degree relative affected by obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) in childhood is an important risk factor for developing the disorder in adulthood. The relationship between a family history of OCD and the presence of OCS and its correlates in childhood is not well established. Methods: A total of 66 children whose parents or siblings have been diagnosed with OCD were assessed for the presence of OCS and clinical correlates. Results: Three children (4.5%) were reported to have received an OCD diagnosis and another 26 (39.4%) were identified as having OCS. Children with OCS had higher rates of coercive behavior and came from families with lower socioeconomic status. Contamination/cleaning dimension symptoms in the proband were associated with OCS in the assessed children. Conclusion: OCS are frequent among family members of individuals with OCD and are associated with socioeconomic status, coercive behaviors and proband contamination/cleaning symptoms. Future longitudinal studies should test the risk of developing OCD in association with these characteristics.

https://doi.org/10.1590/1516-4446-2017-2321 2356 downloads

Prevalence, clinical correlates and maternal psychopathology of deliberate self-harm in children and early adolescents: results from a large community study
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Simioni, André R.

; Pan, Pedro M.

; Gadelha, Ary

; Manfro, Gisele G.

; Mari, Jair J.

; Miguel, Eurípedes C.

; Rohde, Luis A.

; Salum, Giovanni A.

Brazilian Journal of Psychiatry

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Jan 2018, Volume 40 Nº 1 Páginas 48 - 55

Resumo: En | Texto: En | PDF: En

Objectives: Little is known about the prevalence and correlates of deliberate self-harm (DSH) in children from low- and middle-income countries. We investigated the prevalence of DSH and its clinical and maternal psychopathological associations in Brazilian children (n=2,508, ages 6-14y) in a community-based study. Methods: Participants of the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders (HRC) and their mothers were assessed in structured interviews. Current (last month) and lifetime DSH were estimated, including analysis stratified by age groups. Logistic regressions were performed to investigate the role of the children’s clinical diagnoses and maternal psychopathology on DSH prevalence estimates, adjusting for potential confounding factors. Results: The prevalence of current DSH was 0.8% (children 0.6%, adolescents 1%) and lifetime DSH was 1.6% (1.8% and 1.5%, respectively). Current and lifetime DSH were more frequent in children with depression, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), even in multiple models accounting for demographic variables and co-occurring psychiatric disorders. Maternal anxiety disorder was strongly associated with current and lifetime DSH in offspring; whereas current DSH, specifically in young children, was associated with maternal mood disorder. Conclusion: Diagnoses of depression, ADHD and ODD were consistently associated with DSH, as was having a mother with anxiety disorder.

https://doi.org/10.1590/1516-4446-2016-2124 1621 downloads

10.

When the past is present
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Torres, Albina R.

; Costa, Daniel L.C.

; Miguel, Eurípedes C.

Brazilian Journal of Psychiatry

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Dez 2017, Volume 39 Nº 4 Páginas 284 - 285

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/1516-4446-2017-2422 676 downloads

11.

Specific and social fears in children and adolescents: separating normative fears from problem indicators and phobias
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Laporte, Paola P.

; Pan, Pedro M.

; Hoffmann, Mauricio S.

; Wakschlag, Lauren S.

; Rohde, Luis A.

; Miguel, Euripedes C.

; Pine, Daniel S.

; Manfro, Gisele G.

; Salum, Giovanni A.

Brazilian Journal of Psychiatry

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Jun 2017, Volume 39 Nº 2 Páginas 118 - 125

Resumo: En | Texto: En | PDF: En

Objective: To distinguish normative fears from problematic fears and phobias. Methods: We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. Results: According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. Conclusion: These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.

https://doi.org/10.1590/1516-4446-2016-2064 2770 downloads

12.

Prevalence of psychiatric disorders among children and adolescents from four Brazilian regions
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Paula, Cristiane S.

; Coutinho, Evandro S.

; Mari, Jair J.

; Rohde, Luis A.

; Miguel, Euripedes C.

; Bordin, Isabel A.

Brazilian Journal of Psychiatry

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Jun 2015, Volume 37 Nº 2 Páginas 178 - 179

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/1516-4446-2014-1606 5207 downloads

13.

Early interventions to prevent mental disorders - learning lessons from the field of psychosis
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Moriyama, Taís S.

; Miguel, Eurípedes C.

; Leckman, James

Brazilian Journal of Psychiatry

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Out 2011, Volume 33 Supl. 2 Páginas s125 - s128

Resumo: En | Texto: En | PDF: En

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14.

O Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para a Infância e Adolescência: um novo paradigma para a Psiquiatria Brasileira tendo como foco as nossas crianças e o seu futuro Adolescência
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Miguel, Euripedes C.

; Mercadante, Marcos T.

; Grisi, Sandra

; Rohde, Luiz A.

Brazilian Journal of Psychiatry

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Jun 2009, Volume 31 Nº 2 Páginas 85 - 88

Resumo: Pt | Texto: Pt | PDF: Pt

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15.

A Revista Brasileira de Psiquiatria agora tem o seu próprio site!
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Bressan, Rodrigo A.

; Miguel, Euripedes C.

; Mercadante, Marcos T.

; Rohde, Luis Augusto

; Mari, Jair J.

; Tavares, Hermano

Brazilian Journal of Psychiatry

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Jun 2006, Volume 28 Nº 2 Páginas 88 - 88

Resumo: Pt | Texto: Pt | PDF: Pt

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