Abstract
Posttraumatic stress disorder is triggered by an external event that threatening individual physical integrity, leading to characteristics symptoms of reviviscence, avoidance/numbing and hyperarousal. Despite the external adverse event, some predisposing factors are present presupposing multicausality. Once PTSD is installed, it has chronic features leading to important functional impairment. Many biological dysfunctions have been described associated with PTSD, including an altered stress response system suggesting a corresponding increase allostatic load. We hypothesized that this increased allostatic load will lead to neurodegeneration that we will call neuroprogression. We propose to evaluate if there are a correspondence between clinical and neurobiological functioning associated to disease progression. We will evaluate and follow-up 120 outpatients with PTSD triggered by sexual abuse. We choose the event as it is often at our city, and as it is a high risk factor for PTSD development. We will have also a control group with 120 subjects without history of trauma or abuse and without psychiatric diagnostic paired by gender and age. Subjects will be evaluate at inclusion related to sociodemographic data, diagnostic, history of child maltreatment, for symptoms severity, functioning and quality of life, also they will classified by time-interval between trauma and symptoms onset until their firs evaluation for the present study. All patients will receive standard treatment for PTSD according to violence program guideline. Many evaluations will be executed including biological markers as: genetics, biochemical, molecular and image. Neuropsychological data and sleep evaluation will be performed, at inclusion and at each six months during one-year period. Patients will be enrolled on a head-to-head randomized controlled clinical trial to compare efficacy of two treatments known as effective in PTSD: fluoxetine Interpersonal therapy (IPT) during 12-weeks. Non responders will enrolled on a cross-over second phase, when those on IPT will receive fluoxetine, and those receiving medication will receive IPT. Crossing response and remission data with biomarker could be useful as predictive biomarkers of therapeutic response. (AU)
Scientific publications
(11)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
OLIVEIRA-WATANABE, THAUANA TORRES;
RAMOS-LIMA, LUIS FRANCISCO;
ZYLBERSTAJN, CECILIA;
CALSAVARA, VINICIUS;
COIMBRA, BRUNO MESSINA;
MACIEL, MARIANA RANGEL;
FREITAS, LUCIA HELENA MACHADO;
MELLO, MARCELO FEIJO;
MELLO, ANDREA FEIJO.
Validation of the Brazilian-Portuguese Version of the Clinician Administered Post Traumatic Stress Disorder Scale-5.
FRONTIERS IN PSYCHIATRY,
v. 12,
JUN 22 2021.
Web of Science Citations: 0.
COIMBRA, BRUNO MESSINA;
YEH, MARY;
D'ELIA, ANA TERESA;
MACIEL, MARIANA RANGEL;
CARVALHO, CAROLINA MUNIZ;
MILANI, ANA CAROLINA;
MOZZAMBANI, ADRIANA;
JURUENA, MARIO;
BELANGERO, SINTIA IOLE;
JACKOWSKI, ANDREA PAROLIN;
POYARES, DALVA;
MELLO, ANDREA FEIJO;
MELLO, MARCELO FEIJO.
Posttraumatic Stress Disorder and Neuroprogression in Women Following Sexual Assault: Protocol for a Randomized Clinical Trial Evaluating Allostatic Load and Aging Process Acceleration.
JMIR RESEARCH PROTOCOLS,
v. 9,
n. 11
NOV 2020.
Web of Science Citations: 0.
PROENCA, CECILIA R.;
MARKOWITZ, JOHN C.;
PRADO, EUTHYMIA A.;
BRAGA, ROSALY;
COIMBRA, BRUNO M.;
MELLO, THAYS F.;
MACIEL, MARIANA R.;
PUPO, MARIANA;
POVOA, JULIANA;
MELLO, ANDREA F.;
MELLO, MARCELO F.
Attrition in Interpersonal Psychotherapy Among Women With Post-traumatic Stress Disorder Following Sexual Assault.
FRONTIERS IN PSYCHOLOGY,
v. 10,
SEP 13 2019.
Web of Science Citations: 0.
XAVIER, GABRIELA;
SPINDOLA, LETICIA M.;
OTA, VANESSA K.;
CARVALHO, CAROLINA M.;
MAURYA, PAWAN KUMAR;
TEMPAKU, PRISCILA F.;
MORETTI, PATRICIA N.;
MAZOTTI, DIEGO R.;
SATO, JOAO RICARDO;
BRIETZKE, ELISA;
MIGUEL, EURIPEDES CONSTANTINO;
GRASSI-OLIVEIRA, RODRIGO;
MARI, JAIR;
BRESSAN, RODRIGO A.;
GADELHA, ARY;
PAN, PEDRO M.;
BELANGERO, SINTIA IOLE.
Effect of male-specific childhood trauma on telomere length.
JOURNAL OF PSYCHIATRIC RESEARCH,
v. 107,
p. 104-109,
DEC 2018.
Web of Science Citations: 2.