Comportamento suicida no transtorno afetivo bipolar e características sociodemográficas, clínicas e neuroanatômicas associadas

BACKGROUND: Bipolar patients have a higher risk of suicide when compared with the general population and other psychiatric disorders. The aim of this article is to review the social-demographic, clinical and neuroanatomical aspects of suicidal behavior in bipolar patients. METHODS A non-systematic review of literature through PsycoInfo, Lilacs, Medline and PubMed eletronic databases was conducted, using the keywords: "suicide attempt", "suicidal behavior", "suicide" "bipolar disorder", "suicide risk factor," "neuroimaging", and "suicide neurobiology." RESULTS: Several clinical and sociodemographics characteristics have been associated with suicide attempts in bipolar patients, but results are conflicting. Regarding to neuroimaging, the data are rare, and the results are inconsistent, with reports of white matter hyperintensities and changes in structure and function of the prefrontal cortex. DISCUSSION: Given that suicide is a potentially preventable cause of death, the understanding of neurobiological and clinical correlates of suicidal behavior can be useful in reducing rates of attempt suicide in bipolar patients.CONTEXTO: Pacientes com transtorno bipolar possuem risco maior de suicídio, quando comparados com a população geral e com outros transtornos psiquiátricos. Este artigo tem como objetivo revisar os aspectos sociodemográficos, clínicos e neuroanatômicos associados ao comportamento suicida em pacientes com transtorno bipolar com história de tentativa de suicídio. MÉTODOS: Revisão não sistemática da literatura, por meio dos indexadores eletrônicos: PsycoInfo, Lilacs,Medline e PubMed, utilizando-se as palavras-chave: "attempt suicide", "suicidal behavior", "suicide", "bipolar disorder", "suicide risk factor", "neuroimaging" e "suicide neurobiology". RESULTADOS: Diversas características sociodemográficas e clínicas têm sido associadas às tentativas de suicídio em pacientes bipolares, porém os resultados são ainda conflitantes. Em relação aos achados de neuroimagem, os dados também são escassos e inconsistentes. Destes, a hiperintensidade periventricular em substância branca e as alterações na estrutura e função do córtex pré-frontal são os mais descritos. CONCLUSÕES: Considerando que o suicídio é uma causa potencialmente evitável de morte, a compreensão dos correlatos clínicos e neurobiológicos do comportamento suicida pode ser útil na prevenção desse comportamento. Sendo assim, estudos que avaliem melhor os fatores de risco para o comportamento suicida nessa população são necessários

Prevalência de sobrepeso e obesidade em pacientes com Transtorno Bipolar na cidade de Salvador / Prevalence of overweight and obesity in patients with Bipolar Disorder in the city of Salvador

O objetivo foi apresentar a prevalência de sobrepeso e obesidade numa população de adultos com Transtorno Bipolar, em Salvador. Trata-se de um estudo observacional que analisou 181 pacientes, cuja prevalência conjunta de sobrepeso e obesidade foi de 67%. Sendo que homens apresentaram taxas de prevalência de sobrepeso e obesidade de 68,8%, com igual prevalência para as duas classificações e as mulheres apresentaram taxa de sobrepeso de 33,3% e obesidade de 36,7%, que somadas chegam a 70%

Neuroplasticity in Bipolar Disorder: Insights from Neuroimaging

Background: Advances in neuroimaging techniques have produced evidence about disrupted frontolimbic circuits related to emotional regulation. These neuroimaging studies may suggest impairments in cellular plasticity in bipolar disorder (BD) patients. However, the long-term use of mood stabilizers may restore these dysfunctions by neurotrophic effect

Social support and bipolar disorder

Background Bipolar disorder is a chronic condition that affects the functioning of its carriers in many different ways, even when treated properly. Therefore, it’s also important to identify the psychosocial aspects that could contribute to an improvement of this population’s quality of life.Objective Carry out a literature review on the role of social support in cases of bipolar disorder.Method A research on the following online databases PubMed, Lilacs and SciELO was conducted by using the keywords “social support” or “social networks” and “mood disorders” or “bipolar disorder” or “affective disorder,” with no defined timeline.Results Only 13 studies concerning the topic of social support and BD were found in the search for related articles. Generally speaking, the results show low rates of social support for BD patients.Discussion Despite the growing interest in the overall functioning of patients with bipolar disorder, studies on social support are still rare. Besides, the existing studies on the subject use different methodologies, making it difficult to establish data comparisons

Lack of association of indoleamine 2,3-dioxygenase polymorphisms with interferon-alpha-related depression in hepatitis C

Background: Major depression is a frequent adverse effect of interferon-alpha (IFN-alpha) therapy. Although the indoleamine 2,3-dioxygenase (IDO) enzyme seems to be involved in the pathophysiology of IFN-alpha-induced depression, no pharmacogenetic study has investigated Whether variation in the IDO gene modifies vulnerability to this adverse effect.Methods: A cross-sectional study assessing 277 hepatitis C patients recruited in two specialized outpatient clinics of Brazil. They were interviewed with the Mini International Neuropsychiatric Interview (MINI) approximately 1 month after the end of IFN-alpha plus ribavirin therapy. Genomic DNA of individuals was extracted from venous blood. Three IDO single-nucleotide polymorphisms (SNPs) were genotyped (rs3824259; rs10089084 and rs35099072).Results: MINI indicated that 21.3% of the sample met criteria for a major depressive episode during the course of IFN-alpha therapy. No association with the diagnosis of a major depressive episode during the course of IFN-alpha therapy was observed genotype or allele-wise (p > 0.05). Current major depression and/or current anxiety disorder was significantly associated with IFN-alpha-related depression (p 0.05).Conclusions: Our results suggest no influence of the variants in the IDO gene and the diagnosis of interferon-alpha-related depression in the Brazilian population. Interferon-alpha-related depression may impose persistent psychopathology on at least 15% of the depressed patients even 2 years after antiviral therapy termination. the cross-sectional design is a limitation of our study, predisposing memory bias. Prospective pharmacogenetic studies are warranted to continue investigation of the impact of IDO polymorphisms on the development of IFN-alpha-induced depression. (C) 2011 Elsevier Inc. All rights reserved.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Univ Fed Bahia, Sch Med, Dept Neurosci & Mental Hlth, BR-41170290 Salvador, BA, BrazilUniv Fed Bahia, Univ Hosp, Psychiat Serv, BR-41170290 Salvador, BA, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, LiNC, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Inst Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Psychobiol, São Paulo, BrazilUniv Fed Bahia, Sch Med, Dept Gastroenterol, BR-41170290 Salvador, BA, BrazilUniversidade Federal de São Paulo, Sch Med, Hepatitis Unit, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Hosp São Paulo, São Paulo, BrazilHarvard Univ, Sch Publ Hlth, Dept Soc Human Dev & Hlth, Cambridge, MA 02138 USAUniversidade Federal de São Paulo, Sch Med, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, LiNC, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Inst Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Hepatitis Unit, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Hosp São Paulo, São Paulo, BrazilCNPq: 471592/2008-0CNPq: 142262/2008-0Web of Scienc

Hepatitis C Virus Infection as a Traumatic Experience

Objective The purpose of this study was to evaluate whether individuals consider their HCV infection to be a potentially traumatic experience. Additionally, we investigated its association with Post-Traumatic Stress Disorder (PTSD) and the impact of PTSD diagnosis on health-related quality of life (HRQoL) in HCV infected subjects. Methods We conducted a cross-sectional survey of 127 HCV-infected outpatients recruited at a University Hospital in Salvador, Brazil. All subjects answered an orally-administered questionnaire to gather clinical and socio-demographic data. We investigated traumatic experiences and the subject's perception of the disease using the Trauma History Questionnaire. PTSD and other psychiatric diagnoses were assessed through the Mini International Neuropsychiatric Interview-Brazilian Version 5.0.0 (M.I.N.I. PLUS). HRQoL was assessed using Short-Form 36 (SF-36). Results Approximately 38.6% of the patients considered hepatitis C to be a traumatic experience. Of these, 60.7% had a PTSD diagnosis. PTSD was associated with significant impairment in quality of life for individuals in seven SF-36 domains as shown bymultivariate analysis: Role-Physical (β: −24.85; 95% CI: −42.08; −7.61), Bodily Pain (β: −19.36; 95% CI: −31.28; −7.45), General Health (β: −20.79; 95% CI: −29.65; −11.92), Vitality (β: −11.92; 95% CI: −20.74; −3.1), Social Functioning (β: −34.73; 95% CI: −46.79; −22.68), Role-Emotional (β: −26.07; 95% CI: −44.61; −7.53), Mental Health (β: −17.46; 95% CI: −24.38; −10.54). Conclusion HCV is frequently a traumatic experience and it is strongly associated with PTSD diagnosis. PTSD significantly impaired HRQoL