Papers by David P Barreira
RESUMO: O objectivo do presente estudo é avaliar o efeito do género e do estado civil na antecipa... more RESUMO: O objectivo do presente estudo é avaliar o efeito do género e do estado civil na antecipação. É colocada a hipótese de que estas duas variáveis apresentem uma interacção, quando se avaliam as cognições antecipatórias. De modo a atingir os nossos objectivos seleccionamos duas amostras, uma composta por indivíduos do sexo feminino e outra por indivíduos do sexo masculino, com idades compreendidas entre os 15 e os 59 anos (N=350). Todos os indivíduos foram avaliados com o Questionário de Cognições Antecipatórias (QCA), que permite uma avaliação da gravidade das cognições antecipatórias. As medidas do QCA permitem uma clara discriminação entre os dois sexos e são influenciadas pelo estado civil. Este, encarado como factor de risco para a depressão, parece afectar mais o sexo masculino.
GE Portuguese Journal of Gastroenterology, Dec 1, 2021
Introduction: Lifestyle changes are the mainstay treatment of nonalcoholic fatty liver disease (N... more Introduction: Lifestyle changes are the mainstay treatment of nonalcoholic fatty liver disease (NAFLD). We aimed to assess the magnitude of weight loss in a group of NAFLD patients followed on a combined lifestyle intervention by a multidisciplinary team. Methods: Patients were assessed before and after a 12-month dietary intervention (Mediterranean diet aiming at weight loss). Patients who received a structured dietary plan along with general lifestyle recommendations were designated as the multidisciplinary treatment (MdT) group. Patients who declined follow-up still received general lifestyle recommendations and were designated as the conventional treatment group, being used as a control group. Results: From the 77 patients with documented NAFLD, 31.2% of patients were overweight and 55.8% obese; 66 patients constituted the MdT group and 11 the conventional treatment group. After 3 months, 89% of patients lost weight; at 6 months, 75.4% maintained the weight lost. At 12 months, 65% of patients still decreased their weight, with 92.2% of patients in the MdT group still maintaining a lower weight than baseline versus just 50% in the conventional group (p = 0.008). Only patients in the MdT group presented a weight loss higher than 10% (9.6%; n = 6). At 12 months patients in the MdT group presented an average reduction of 4.2 kg versus a reduction of just 0.6 kg in the conventional treatment group (p = 0.016). The MdT group, but not the conventional group, presented significant differences in liver enzymes at 12 months compared to baseline. Conclusion: Adherence to a multidisciplinary approach, compared to management solely by a hepatologist, in NAFLD patients, is effective with greater weight loss after a 12-month follow-up and a lower rate of weight gain recurrence.
This study focus on clinical features of the adolescence suicide attempters. In this way, the res... more This study focus on clinical features of the adolescence suicide attempters. In this way, the research evaluate the presence of depressive symptoms and disfunctional personality traits in adolescents with at least one suicide threat and a comparative study between genders was employed. Subjects were divided into two groups, one with female (n=12) and other with male adolescents (n=10), aged between 15 and 18 years. Data was collected by “Children’s Depression Inventory” and “MiniMult”. The findings suggest gender differences particularly with respect to diagnostic entities such as depression and pathological personality traits.
BACKGROUND The hepatitis C virus (HCV) is known to infect the brain, however findings on associat... more BACKGROUND The hepatitis C virus (HCV) is known to infect the brain, however findings on associated neuropsychiatric syndrome are controversial and the association itself remains unclear. Gender research in HCV infection is limited, failing to integrate the role of gender in neurocognitive syndrome. This study aimed to characterize psychological and neurocognitive profiles in HCV-infected patients before treatment and to describe gender differences in those profiles as well as the impact of disease severity. METHODS A total of 86 patients diagnosed with chronic hepatitis C were selected in the context of a multidisciplinary out-patient clinic. A semistructured interview was performed to collect social-demographic data and clinical characterization. Assessment was performed using the Hamilton anxiety scale (HAM-A), Hamilton depression scale (HAM-D), Beck depression inventory and a neuropsychological battery to measure attention, concentration, memory and executive functions component...
Frontiers in Endocrinology, 2018
Literature on depression and obesity describes the relevance of the hypothalamic pituitary adrena... more Literature on depression and obesity describes the relevance of the hypothalamic pituitary adrenal axis dysfunction, sympathetic nervous system (SNS) activation, and inflammatory processes as well as the interaction of genetic and environmental factors. Recent investigation in obesity highlights the involvement of several regulation systems, particularly in white adipose tissue. The hypothalamic pituitary adrenal axis, gonadal, growth hormone, leptin, sympathetic nervous system and adrenergic, dopaminergic, and serotoninergic central pathways, all seem interconnected and involved in obesity. From another perspective, the role of psychosocial chronic stressors, determining poor mental and physical health, is well documented. Empirical data can support biologically conceivable theories describing how perceptions of the external social environment are transduced into cellular inflammation and depression. Although in neurobiological models of depression, stress responses are associated with neuroendocrine and neuro-inflammatory processes, concerning similar pathways to those described in obesity, an integrating model is still lacking. The aim of this mini-review is to offer a reflexion on the interplay between the neuroendocrine dysfunctions related to chronic stress and the nature of the shared biologic mechanisms in the pathophysiology of both clinical entities, depression and obesity. We highlight dysfunctional answers of mind body systems that are usually activated to promote regulation and adaptation. Stress response, as a mediator between different level phenomena, may undertake the role of a plausible link between psychological and biological determinants of disease. Depression and obesity are major public health issues, urging for new insights and novel interventions and this discussion points to the need of a more in-depth approach.
Acta Médica Portuguesa, 2015
Keywords: Depression; Mental Health; Painting; Portugal; Social Isolation.
Psicologia, Saúde & …, 2001
RESUMO: O presente trabalho debruça-se sobre aspectos clínicos relativos à tentativa de suicídio ... more RESUMO: O presente trabalho debruça-se sobre aspectos clínicos relativos à tentativa de suicídio na adolescência. Assim, pesquisou-se a existência de sintomatologia depressiva, bem como de traços disfuncionantes da personalidade em adolescentes com história ...
Frontiers in Psychology, 2019
Background: Hepatitis C virus (HCV) infection involves changes not only from the point of view of... more Background: Hepatitis C virus (HCV) infection involves changes not only from the point of view of physical health, but also emotional, and social that have a significant impact on the quality of life of these patients. According to the literature review, it seems that there is an important association between psychosocial factors, in particular on a cognitive level and disease progression. The aim of this mini-review is to summarize recent literature looking at the associations between psychosocial and neurocognitive factors and HCV. Methods: PubMed/Medline was systematically searched for psychosocial and neurocognitive factors associated with hepatitis C, treatment adherence, and patient wellbeing. Results: Patients present with a range of extrahepatic symptoms including fatigue, anxiety, depression, and neurocognitive dysfunction. HCV's impact on quality of life and wellbeing has serious clinical and social implications. Conclusion: Hepatitis C and its management continue to have a profound impact on health and psychologic wellbeing. Considering the serious extrahepatic implications for individuals, it is imperative that healthcare professionals pay close attention to psychosocial and neurocognitive factors. The focus on combined clinical approaches could enhance understanding about the health and social impacts of hepatitis C along the life course.
Journal of Hepatology, 2018
World Journal of Gastroenterology, 2013
European Psychiatry, 2002
Objectives: to set differential personality profiles for subgroups of patients with panic disorde... more Objectives: to set differential personality profiles for subgroups of patients with panic disorder diagnoses through the Temperament and Character Inventory (TCI), and to test its ability to discriminate those patients with a personality disorder (PD). Method: 82 consecutive outpatients diagnosed of DSM-IV panic attacks with/without agoraphobia were administered DSMIV structured interviews (SCID, SCID-II) and TCI. T-tests, partial correlations, and linear regression analyses were conducted. Results: 1. Classification in terms of current/previous panic disorder diagnosis shows differences in TCI dimensions: Harm Avoidance and Self-directedness @=O,OOl; p=O,O32). No dimension is related to agoraphobia. 2. Presence/absence of comorbid current affective disorder shows differences only in Self-directedness (p=O,Ol5). 3. Regression analyses point to Reward Dependence as the only stable significant discriminant of PD @<O,OOl), though Selfdirectedness also reflects predictive power @==Q.OOl) as other variables leave the regression equation. Conclusions: the TCI reflects different temperamental profiles depending on emotional states. Nevertheless, presence of anxiety/depression shows distinct overall profiles (anxiety alfecting Harm Avoidance, and depression affecting Self-directedness). Besides, the TCI seems to clearly discriminate personality disorders in axis I disordered patients, becoming a very useful clinical tool.
European Psychiatry, 2002
Antipsychotic drugs affect sleep regulation during treatment and following withdrawal. Available ... more Antipsychotic drugs affect sleep regulation during treatment and following withdrawal. Available data are reviewed. Typical antipsychotics improve sleep efficiency and increase REM latency without changing the duration of sleep stages. Atypical antipsychotics exert varying effects on sleep due to differences in central receptor interactions. Open treatment with olanzapine reduced stage 1 sleep, and increased stage 2 sleep, delta sleep and REM density. Clozapine increased stage 2 sleep, reduced stage 1 sleep and lengthened REM latency. Improved sleep maintenance and an association between positive clinical results and prolonged stage 2 sleep were reported. Risperidone significantly improved subjective and objective sleep quality in young and elderly schizophrenics. Additionally, schizophrenics treated with risperidone appear to have significantly better night-time sleep quality and daytime functioning. Conclusion: Atypical antipsychotics have shown superior efficacy on sleep profile compared to conventional neuroleptics. Atypicals demonstrate beneficial effects on multiple aspects of sleep patterns, with most data being available for risperidone. The clinical utility of antipsychotics with favourable effects on sleep may extend to sleep-related problems in other patient groups, such as night-wandering in elderly patients with dementia.
European Neuropsychopharmacology, 2003
European Neuropsychopharmacology, 2003
European Neuropsychopharmacology, 2000
Frontiers in Psychiatry, 2017
The infection with hepatitis C virus (HCV) is one of the most important global chronic viral infe... more The infection with hepatitis C virus (HCV) is one of the most important global chronic viral infections worldwide. It is estimated to affect around 3% of the world population, about 170-200 million people. Great part of the infections are asymptomatic, the patient can be a chronic carrier for decades without knowing it. The most severe consequences of the chronic infection are liver cirrhosis and hepatocellular carcinoma, which appears in 20%-40% of the patients, leading to hepatic failure and death. The HCV was discovered 25 years ago in 1989, is a RNA virus and classified by the World Health Organization as an oncogenic one. Hepatocellular carcinoma is one of the most important cancers, the fifth worldwide in terms of mortality. It has been increasing in the Ocidental world, mainly due to chronic hepatitis C. Hepatitis C is not only a liver disease and a cause of cirrhosis, but also a mental, psychological, familiar, and social disease. The stigma that the infected person sometimes carries is tremendous having multiple consequences. The main cause is lack of adequate information, even in the health professionals setting. But, besides the "drama" of being infected, health professionals, family, society and the infected patients, must be aware of the chance of real cure and total and definitive elimination of the virus. The treatment for hepatitis C has begun in the last 80´s with a percentage of cure of 6%.
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Papers by David P Barreira