Navegando por Palavras-chave "Bipolar"

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    Cross validation with the mood disorder questionnaire (MDQ) of an instrument for the detection of hypomania in Brazil: the 32 item hypomania symptom check-list, first Revision (HCI-32-R-1)
    (Elsevier B.V., 2012-11-01) Teixeira Leao, Ines Alice [UNIFESP]; Del Porto, Jose Alberto; Universidade Federal de São Paulo (UNIFESP); Mil Hosp
    Background: Bipolar disorders are frequently diagnosed and treated as unipolar depression initially and accurate diagnosis is often delayed by 8 to 10 years. It has been demonstrated that the bipolar spectrum disorders are associated with notable disability and that the current diagnostic gold standard, the Structured Clinical Interview for DSM-IV (SCID) is not sufficiently sensitive to the diagnosis of hypomania or subthreshold manic states. There is a need for better and simpler ways to identify these conditions.Methods: Hirschfeld et al. (2000) developed and tested a self-report scale for bipolar disorder: the Mood Disorder Questionnaire (MDQ). Recently, another scale has been developed by Angst to assess hypomanic symptoms and to increase the detection of suspected and of manifest, but undertreated, cases of bipolar disorders. in this Brazilian study, 200 patients with the putative diagnosis of depression were interviewed using the Structured Clinical Interview for DSM-IV, Axis I Disorders Clinician Version (SCID-CV; First et al., 1997), as modified by Benazzi and Akiskal (2003) to increase the sensitivity to BP II disorders. Before the interview patients were screened by both HCI-32-R-1 and MDQ and asked to complete them.Results: the HCI-32-R-1 showed a sensitivity of 79.8% and a specificity of 60.5% for the cut-off of 14. A sensitivity of 68.1% and a specificity of 63% were obtained for the Mood Disorder Questionnaire for the cut-off of 7. Limitations: Although not showing a good specificity, the MDQ seems to be a useful instrument for the screening phase, in which it is important that cases are recognized. the HCI-32-R-1 does not distinguish between BP I and BP II disorders. the sample size of patients should be increased in further studies.Conclusions: the HCI-32-R-1 demonstrated two main factors identified as active-elated hypomania and risk-taking/irritable hypomania and showed to be a sensitive instrument for hypomanic symptoms. It is a simple and easy-to-use tool for the self-assessment of hypomanic symptoms and may be a valuable supplement to the clinician's interview. the Mood Disorder Questionnaire is a useful screening instrument for bipolar I, bipolar II disorders and other manifestations of bipolar spectrum. As such, this scale might increase the detection of under-treated cases of bipolar disorders. Further studies are needed to verify the accuracy of these tools in non-psychiatric settings and in the general population. (C) 2011 Elsevier B.V. All rights reserved.
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    Estudo prospectivo randomizado do tratamento endoscópico da coloproctopatia actínica crônica hemorrágica: eletrocauterização com plasma de argônio versus bipolar
    (Universidade Federal de São Paulo (UNIFESP), 2010-02-24) Lenz Tolentino, Luciano Henrique [UNIFESP]; Ferrari, Angelo Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Chronic radiation coloproctopathy (CRCP) is a well-recognized complication of radiotherapy. Rectal bleeding is the most common symptom of radiation injury and the optimal endoscopic treatment of bleeding due to CRCP is still controversial. Aim: To compare the efficacy and safety of bipolar eletrocauterization (BEC) and argon plasma eletrocauterization (APE) in the management of bleeding from CRCP. Methods: Thirty patients with active bleeding from telangiectasias were enrolled, randomized into two groups (15 BEC and 15 APE) and classified according to Saunders score. Power settings were 50 W for BEC and 40 W for APE. Initial treatment was performed after a complete colonoscopy to rule out synchronous lesions and follow-up was performed with flexible sigmoidoscopies. Success was defined as eradication of all telangiectasias. Failure was defined whenever more than seven sessions or other therapies were necessary for treatment of bleeding. Complications were divided into three different groups: sensory (anal pain, abdominal pain and/or fever), hemorrhagic (worsening of bleeding during treatment, bleeding from ulcers) and anatomic/motor (tapered feces, stenosis and/or pseudopolyps). Results: Mean age was 67.4 years (range 33-82), with 14 women and 16 men. There was no significant difference regarding the number of sessions in both groups (p = 0.313). There were no significant differences regarding sensory (p = 0.245) hemorrhagic (p = 0.169) or anatomic/motor (p = 0.700) complications between both groups. However, the overall complication rate was significantly higher in EB group (p = 0.020). Only one failure was observed in each group (p = 1.000). There was also no significant difference regarding relapse (p = 1.000) Conclusions: BEC and APE are equally effective in patients with bleeding telangiectasias from CRCP. Nevertheless, APE is safer than EB.
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    Repurposing of anti-diabetic agents for the treatment of cognitive impairment and mood disorders
    (Assoc Brasil Polimeros, 2016) Cha, D. S.; Vahtra, M.; Ahmed, J.; Kudlow, P. A.; Mansur, R. B. [UNIFESP]; Carvalho, A. F.; McIntyre, R. S.
    Impairments in cognitive function represent a consistent, non-specific, and clinically significant feature in metabolic, mood, and dementing disorders. The foregoing observation is instantiated by evidence demonstrating that these disorders share pathophysiological mechanisms including, but not limited to, aberrant insulin signaling, inflammation, and glucocorticoid activity. Moreover, these mechanisms have been consistently reported to increase vulnerability to and/or exacerbate impairments in cognitive function. Notwithstanding evidence suggesting a bidirectional relationship between disturbances in the metabolic milieu, mood, and increased risk for dementia, efficacious treatments that target cognitive impairments in these populations do not presently exist. Taken together, it is proposed that anti-diabetic agents may aid the management of mood disorders and future risk for dementia through disease modification by targeting underlying pathophysiological mechanisms (e.g., aberrant metabolic function) rather than focusing solely on symptom mitigation. The current aim is to provide a brief narrative review of extant studies that report on the potential neurotherapeutic effects of anti-diabetic agents on disturbances in mood and impairments in cognitive function.
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    Social disability of Brazilian mood disorder patients
    (Associação Brasileira de Divulgação Científica, 2004-11-01) Tucci, Adriana Marcassa [UNIFESP]; Kerr-Corrêa, Florence; Dias, Rogério S.; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual Paulista (UNESP)
    Mood disorders cause many social problems, often involving family relationships. Few studies are available in the literature comparing patients with bipolar, unipolar, dysthymic, and double depressive disorders concerning these aspects. In the present study, demographic and disease data were collected using a specifically prepared questionnaire. Social adjustment was assessed using the Disability Adjustment Scale and family relationships were evaluated using the Global Assessment of Relational Functioning Scale. One hundred patients under treatment for at least 6 months were evaluated at the Psychiatric Outpatient Clinic of the Botucatu School of Medicine, UNESP. Most patients were women (82%) more than 50 (49%) years old with at least two years of follow-up, with little schooling (62% had less than 4 years), and of low socioeconomic level. Logistic regression analysis showed that a diagnosis of unipolar disorder (P = 0.003, OR = 0.075, CI = 0.014-0.403) and dysthymia (P = 0.001, OR = 0.040, CI = 0.006-0.275) as well as family relationships (P = 0.002, OR = 0.953, CI = 0914-0.992) played a significant role in social adjustment. Unipolar and dysthymic patients presented better social adjustment than bipolar and double depressive patients (P < 0.001), results that were not due to social class. These patients, treated at a teaching hospital, may represent the severest mood disorder cases. Evaluations were made knowing the diagnosis of the patients, which might also have influenced some of the results. Social disabilities among mood disorder patients are very frequent and intensive.