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The association between childhood trauma, cognitive functioning and brain morphology in patients with bipolar disorder type I

Grant number: 14/03233-9
Support type:Scholarships in Brazil - Doctorate
Effective date (Start): June 01, 2014
Effective date (End): September 30, 2017
Field of knowledge:Humanities - Psychology - Human Development Psychology
Cooperation agreement: Coordination of Improvement of Higher Education Personnel (CAPES)
Principal Investigator:Ricardo Alberto Moreno
Grantee:Danielle Soares Bio
Home Institution: Instituto de Psiquiatria Doutor Antonio Carlos Pacheco e Silva (IPq). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Introduction: Patients with Bipolar Disorder (BD) have high rates of childhood abuse (30 % to 50 %) and striking neuropsychological deficits (attention, processing speed, verbal learning, memory and FE). Cognitive deficits and exposure to childhood trauma have been associated with worse clinical outcome, worse prognosis, impairment in psychosocial adjustment and impairment in global functioning. Whereas poor parenting and traumatic experiences can affect neurodevelopment and neuroplasticity, is valid research on the association between traumatic experiences in childhood and cognition of patients with BD. Objective: To investigate the cognitive profile and brain morphology in young patients with BD I differs according to whether or not exposure to abuse and / or neglect in childhood. Method: This was a case-control study in which cases will be considered those euthymic patients with BD I and those with severe cognitive impairment or changes in brain morphology (n = 41) and those controls will be considered euthymic patients with BD I and mild cognitive impairment or no changes in brain morphology (n = 41). The presence or absence of exposure to childhood trauma will be defined from the cutoff of the Childhood Trauma Questionnaire (CTQ) and the severity of cognitive impairment and the presence or absence of changes in brain morphology will be established from the comparison of results in young patients with BD I and found in subjects without psychiatric illness (n = 82) . The subjects will be aged between 18 and 40 years old and will be attended at the Affective Disorders Program (GRUDA), Institute of Psychiatry, Hospital das Clinicas, Faculty of Medicine, University of São Paulo (IPQ - HC - USP). The subjects will be clinically evaluated by a psychiatrist specializing in mood disorders and specific training for the application of diagnostic instruments and symptomatology, as to whether the inclusion criteria. In the sequel, will clarify the objectives and procedures of the study and patients receive the Term of Free and Informed Consent Form. After signing it, the subject will be submitted to the instruments described above in a single meeting, which lasted approximately three hours. The instruments will be applied by a licensed psychologist specializing in neuropsychology. After neuropsychological assessment, the subjects will be forwarded to the realization of magnetic resonance imaging at the Institute of Radiology, Faculty of Medicine, University of São Paulo. (AU)