Browsing by Author "Macedo, A"
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- Da Doença Mental à ViolênciaPublication . Cabral, AS; Macedo, A; Vieira, DNResumo: Os comportamentos violentos no âmbito da doença mental têm sido motivo de intenso debate e crescente investigação. A complexidade da questão e a sua importância clínica e social moveram-nos na elaboração do presente artigo, com o qual pretendemos, a partir de uma revisão da literatura existente, a contextualização daquela relação à luz dos actuais conhecimentos científicos.
- Da Psiquiatria ao DireitoPublication . Cabral, AS; Macedo, A; Vieira, DNApós uma breve introdução, é feito um enquadramento jurídico-penal da doença mental, bem como uma descrição sumária do conceito de inimputabilidade. É ainda considerada a questão da aplicação das medidas de segurança, citando-se a contribuição dos autores que mais se têm salientado neste campo e as actuais perspectivas sobre o tema.
- A fundamental distinction in early neural processing of implicit social interpretation in schizophrenia and bipolar disorderPublication . Madeira, N; Martins, R; Valente Duarte, J; Costa, G; Macedo, A; Castelo-Branco, MBackground: Social cognition impairment is a key phenomenon in serious mental disorders such as schizophrenia (SCZ) and bipolar disorder (BPD). Although genetic and neurobiological studies have suggested common neural correlates, here we hypothesized that a fundamental dissociation of social processing occurs at an early level in these conditions. Methods: Based on the hypothesis that key structures in the social brain, namely the temporoparietal junction, should present distinctive features in SCZ and BPD during low-level social judgment, we conducted a case-control study in SCZ (n = 20) and BPD (n = 20) patients and controls (n = 20), using task-based fMRI during a Theory of Mind (ToM) visual paradigm leading to interpretation of social meaning based on simple geometric figures. Results: We found opposite neural responses in two core ToM regions: SCZ patients showed social content-related deactivation (relative to controls and BPD) of the right supramarginal gyrus, while the opposite pattern was found in BPD; reverse patterns, relative to controls and SCZ, were found in the left posterior superior temporal gyrus, a region involved in inferring other's intentions. Receiver-operating-characteristic curve analysis showed 88% accuracy in discriminating the two clinical groups based on these neural responses. Conclusions: These contrasting activation patterns of the temporoparietal junction in SCZ and BPD represent mechanistic differences of social cognitive dysfunction that may be explored as biomarkers or therapeutic targets.
- Mitochondrial Alterations in Fibroblasts of Early Stage Bipolar Disorder PatientsPublication . Marques, AP; Resende, R; Silva, DF; Batista, M; Pereira, D; Wildenberg, B; Morais, S; Macedo, A; Pais, C; Melo, JB; Madeira, N; Pereira, CFThis study aims to evaluate whether mitochondrial changes occur in the early stages of bipolar disorder (BD). Using fibroblasts derived from BD patients and matched controls, the levels of proteins involved in mitochondrial biogenesis and dynamics (fission and fusion) were evaluated by Western Blot analysis. Mitochondrial membrane potential (MMP) was studied using the fluorescent probe TMRE. Mitochondrial morphology was analyzed with the probe Mitotracker Green and mitophagy was evaluated by quantifying the co-localization of HSP60 (mitochondria marker) and LC3B (autophagosome marker) by immunofluorescence. Furthermore, the activity of the mitochondrial respiratory chain and the glycolytic capacity of controls and BD patients-derived cells were also studied using the Seahorse technology. BD patient-derived fibroblasts exhibit fragmented mitochondria concomitantly with changes in mitochondrial dynamics and biogenesis in comparison with controls. Moreover, a decrease in the MMP and increased mitophagy was observed in fibroblasts obtained from BD patients when compared with control cells. Impaired energetic metabolism due to inhibition of the mitochondrial electron transport chain (ETC) and subsequent ATP depletion, associated with glycolysis stimulation, was also a feature of BD fibroblasts. Overall, these results support the fact that mitochondrial disturbance is an early event implicated in BD pathophysiology that might trigger neuronal changes and modification of brain circuitry.
- Morphometry and gyrification in bipolar disorder and schizophrenia: A comparative MRI studyPublication . Madeira, N; Duarte, JV; Martins, R; Costa, GN; Macedo, A; Castelo-Branco, MSchizophrenia is believed to be a neurodevelopmental disease with high heritability. Differential diagnosis is often challenging, especially in early phases, namely with other psychotic disorders or even mood disorders. such as bipolar disorder with psychotic symptoms. Key pathophysiological changes separating these two classical psychoses remain poorly understood, and current evidence favors a more dimensional than categorical differentiation between schizophrenia and bipolar disorder. While established biomarkers like cortical thickness and grey matter volume are heavily influenced by post-onset changes and thus provide limited possibility of accessing early pathologies, gyrification is assumed to be more specifically determined by genetic and early developmental factors. The aim of our study was to compare both classical and novel morphometric features in these two archetypal psychiatric disorders. We included 20 schizophrenia patients, 20 bipolar disorder patients and 20 age- and gender-matched healthy controls. Data analyses were performed with CAT12/SPM12 applying general linear models for four morphometric measures: gyrification and cortical thickness (surface-based morphometry), and whole-brain grey matter/grey matter volume (voxel-based morphometry - VBM). Group effects were tested using age and gender as covariates (and total intracranial volume for VBM). Voxel-based morphometry analysis revealed a schizophrenia vs. control group effect on regional grey matter volume (p < 0.05, familywise error correction) in the right globus pallidus. There was no group effect on white matter volume when correcting for multiple comparisons neither on cortical thickness. Gyrification changes in clinical samples were found in the left supramarginal gyrus (BA40) - increased and reduced gyrification, respectively, in BPD and SCZ patients - and in the right inferior frontal gyrus (BA47), with a reduction in gyrification of the SCZ group when compared with controls. The joint analysis of different morphometric features, namely measures such as gyrification, provides a promising strategy for the elucidation of distinct phenotypes in psychiatric disorders. Different morphological change patterns, highlighting specific disease trajectories, could potentially generate neuroimaging-derived biomarkers, helping to discriminate schizophrenia from bipolar disorder in early phases, such as first-episode psychosis patients.
- Pathways from paranoid conviction to distress: exploring the mediator role of Fears of Compassion in a sample of people with psychosisPublication . Martins, MJ; Castilho, P; Carvalho, CB; Pereira, AT; Carvalho, D; Bajouco, M; Madeira, N; Santos, V; Macedo, A
- Perfeccionismo e perturbações do espectro obsessivo-compulsivo: resultados preliminaresPublication . Maia, BR; Pereira, AT; Soares, MJ; Bos, SC; Cabral, AS; Valente, J; Macedo, A; Pocinho, F; Azevedo, MH
- Perfectionism in obsessive-compulsive and eating disordersPublication . Maia, BR; Soares, MJ; Gomes, A; Marques, M; Pereira, AT; Cabral, AS; Valente, J; Bos, SC; Pato, ML; Pocinho, F; Azevedo, MH; Macedo, AOBJETIVO: Este estudo tem dois objetivos principais. Primeiro, avaliar as dimensões do perfeccionismo no transtorno obsessivo-compulsivo e nos transtornos alimentares em comparação com duas amostras controle: psiquiátrica (depressão/ansiedade) e não clínica. Segundo, avaliar se o perfeccionismo é um traço de personalidade especificamente relacionado com estas diferentes condições clínicas. MÉTODO: 39 pacientes com transtorno obsessivo-compulsivo, 24 com transtornos alimentares, 65 com um diagnóstico de depressão e/ou ansiedade (todos estes pacientes encontravam-se em regime de ambulatório) e 70 controles não clínicos completaram a versão portuguesa da Multidimensional Perfectionism Scale. RESULTADOS: Comparativamente à amostra não clínica, todas as amostras clínicas apresentaram níveis significativamente mais elevados na Multidimensional Perfectionism Scale total, no Perfeccionismo Auto-Orientado e no Perfeccionismo-Socialmente-Prescrito. Não houve diferenças estatisticamente significativas no Perfeccionismo-Auto-Orientado e na Multidimensional Perfectionism Scale total nas três amostras clínicas. No entanto, a amostra com transtornos alimentares apresentou níveis significativamente mais elevados de Perfeccionismo-Socialmente-Prescrito, comparativamente à transtornos alimentares e à amostra psiquiátrica (depressão/ansiedade). CONCLUSÃO: O perfeccionismo revelou estar associado a uma grande variedade de condições psicopatológicas. Contudo, as diferenças encontradas entre a amostra de transtornos alimentares, de transtorno obsessivo-compulsivo e a psiquiátrica no Perfeccionismo-Socialmente-Prescrito necessitam de investigação subsequente no sentido de clarificar a especificidade desta dimensão com os transtornos alimentares.
- Personality, cognitive emotion regulation and insomniaPublication . Amaral, AP; Bos, SC; Soares, MJ; Pereira, AT; Marques, M; Madeira, N; Nogueira, V; Bajouco, M; Macedo, A
- Perturbações Psicóticas e Conduta Criminal – um contributo empíricoPublication . Cabral, AS; Macedo, A; Valente, J; Soares, MJ; Vieira, DN; Azevedo, MHAo longo do tempo, a opinião pública tem-se deparado, com o pesado estereótipo de que a doença mental está intimamente relacionada com a prática de comportamentos violentos. Contudo, estudos recentes mostram que a violência não caracteriza toda e qualquer doença mental e que a criminalidade dos doentes mentais só representa uma pequena proporção da criminalidade geral. Acredita-se que a identificação de factores que sejam preditores de comportamentos violentos nestes doentes não é um simples exercício académico, mas sim um importante meio de orientar e acompanhar o doente mental, promovendo a sua reabilitação e protegendo a sociedade. Surgiu assim o principal objectivo deste estudo: efectuar uma análise comparativa de um conjunto de variáveis demográficas e clínicas numa população de doentes com perturbações psicóticas formada por dois grupos distintos, um com antecedentes de comportamentos criminais e outro sem história prévia de comportamentos criminais, no sentido de compreender quais as características que distinguiam os pacientes do primeiro grupo. Nas conclusões finais são discutidas algumas das implicações dos resultados obtidos no desbravar de novos caminhos na interface da doença mental com violência.