Daniel Las Casas - Academia.edu (original) (raw)

Papers by Daniel Las Casas

Cadernos De Saude Publica, 2017

There is a lack of information about alcohol use by transgender women. We estimated the prevalenc... more There is a lack of information about alcohol use by transgender women. We estimated the prevalence of dangerous alcohol use in the last 12 months by transgender women, who are known as travestis in Brazil, and we identified the associated risk factors. Three hundred travestis were recruited using Respondent Driving Sampling (RDS). We applied the Alcohol Use Disorders Identification Test (AUDIT). We controlled the sample by applying a weight to each interviewee. Three quarters (74.2%) of travestis were regular drinkers, half (48.7%) scored over eight in the AUDIT and 14.8% scored over 20. The risk factors for alcohol use were: aged over 24, low income and unprotected sex. The dangerous use of alcohol is prevalent among travestis. Given that this group has a greater risk of HIV infection and transmission, and that the dangerous use of alcohol was associated with unsafe sex, specific intervention strategies are required.

Translational Psychiatry, 2022

Larger thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and ch... more Larger thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and children with clinical-level symptoms within the general population. Particular thalamic subregions may drive these differences. The ENIGMA-OCD working group conducted mega- and meta-analyses to study thalamic subregional volume in OCD across the lifespan. Structural T 1 -weighted brain magnetic resonance imaging (MRI) scans from 2649 OCD patients and 2774 healthy controls across 29 sites (50 datasets) were processed using the FreeSurfer built-in ThalamicNuclei pipeline to extract five thalamic subregions. Volume measures were harmonized for site effects using ComBat before running separate multiple linear regression models for children, adolescents, and adults to estimate volumetric group differences. All analyses were pre-registered ( https://osf.io/73dvy ) and adjusted for age, sex and intracranial volume. Unmedicated pediatric OCD patients (<12 years) had larger lateral ( d = 0.46)...

Obsessive-compulsive disorder (OCD) is a common psychiatric condition classically characterized b... more Obsessive-compulsive disorder (OCD) is a common psychiatric condition classically characterized by obsessions (recurrent, intrusive and unwanted thoughts) and compulsions (excessive, repetitive and ritualistic behaviors or mental acts). OCD is heterogeneous in its clinical presentation and not all patients respond to first-line treatments. Several neurocircuit models of OCD have been proposed with the aim of providing a better understanding of the neural and cognitive mechanisms involved in the disorder. These models use advances in neuroscience and findings from neuropsychological and neuroimaging studies to suggest links between clinical profiles that reflect the symptoms and experiences of patients and dysfunctions in specific neurocircuits. Several models propose that treatments for OCD could be improved if directed to specific neurocircuit dysfunctions, thereby restoring efficient neurocognitive function and ameliorating the symptomatology of each associated clinical profile. Y...

ABSTRACTObjectiveHigher thalamic volume has been found in children with obsessive-compulsive diso... more ABSTRACTObjectiveHigher thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and children with clinical-level symptoms within the general population. Particular thalamic subregions may drive these differences. The ENIGMA-OCD working group conducted mega- and meta-analyses to study thalamic subregional volume in OCD across the lifespan.MethodStructural T1-weighted brain magnetic resonance imaging (MRI) scans from 2,649 OCD patients and 2,774 healthy controls across 29 sites (50 datasets) were processed using the FreeSurfer built-in ThalamicNuclei pipeline to extract five thalamic subregions. Volume measures were harmonized for site effects using ComBat before running separate multiple linear regression models for children, adolescents, and adults to estimate volumetric group differences. All analyses were preregistered (https://osf.io/73dvy) and adjusted for age, sex and intracranial volume.ResultsUnmedicated pediatric OCD patients (< 12 years) had l...

Molecular Psychiatry, 2021

An important challenge in mental health research is to translate findings from cognitive neurosci... more An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive–compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.

Nature Reviews Disease Primers, 2019

Obsessive–compulsive disorder (OCD) is a highly prevalent and chronic condition that is associate... more Obsessive–compulsive disorder (OCD) is a highly prevalent and chronic condition that is associated with substantial global disability. OCD is the key example of the ‘obsessive–compulsive and related disorders’, a group of conditions which are now classified together in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases, 11th Revision, and which are often underdiagnosed and undertreated. In addition, OCD is an important example of a neuropsychiatric disorder in which rigorous research on phenomenology, psychobiology, pharmacotherapy and psychotherapy has contributed to better recognition, assessment and outcomes. Although OCD is a relatively homogenous disorder with similar symptom dimensions globally, individualized assessment of symptoms, the degree of insight, and the extent of comorbidity is needed. Several neurobiological mechanisms underlying OCD have been identified, including specific brain circuits that underpin OCD. In addition, laboratory models have demonstrated how cellular and molecular dysfunction underpins repetitive stereotyped behaviours, and the genetic architecture of OCD is increasingly understood. Effective treatments for OCD include serotonin reuptake inhibitors and cognitive–behavioural therapy, and neurosurgery for those with intractable symptoms. Integration of global mental health and translational neuroscience approaches could further advance knowledge on OCD and improve clinical outcomes.This Primer by Stein and colleagues discusses the epidemiology, mechanisms, diagnosis and treatment of obsessive–compulsive disorder, which is a psychiatric disorder that is characterized by the presence of obsessions and compulsions.

Revista Produção e Desenvolvimento, 2016

This study aimed to analyze the processes of security management in a hospital in a big city at R... more This study aimed to analyze the processes of security management in a hospital in a big city at Rio de Janeiro’s State. The research method used was case study, strategy chosen by include both direct observation as a series of interviews. The obtained results allowed to highlight the importance of security management in a hospital, educate employees, assess risk scenarios, control the logistics flows of patients and contaminated products and waste.

AIP Conference Proceedings, 2018

The energy storage and fossil-backup (fossil-hybridization) systems of a concentrating solar powe... more The energy storage and fossil-backup (fossil-hybridization) systems of a concentrating solar power plant (CSP) provide a continuous production of energy all over the year and satisfy the grid demand even when the sun is not shining. One could ask about the behavior of the energy production, or the levelized energy cost, as a function of the energy storage and of the fossil-hybridization in such plants. This paper tries to answer this question. For this task, there have been performed numerous simulations on a central receiver plant with a fixed nominal power, varying the storage capacity and the level of hybridization. The results showed that these variables impact differently. For the thermal storage, from capacities ranging from 0h to 24h, there is a specific intermediary capacity, 15h, in which the levelized energy cost is minimum. But for the fossil-hybridization, this energy cost always decreases with the increment of the hybrid level. The results also showed that, if a given energy production is supported by a certain level of hybridization, its energy cost would be less than that supported by a storage system. This is due to the relatively high investment costs related to the storage system, and the relatively low cost of fuel.

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), Jan 2, 2017

Assessing the impact of disturbance events on cryptic or far-ranging marine mammal species is cri... more Assessing the impact of disturbance events on cryptic or far-ranging marine mammal species is critically important to stakeholderswho must balance project objectives with the environmental impacts of proposed activities. In recent years, considerable scientific interest in this topic has led to key discoveries relating to species-specific sensitivities, behavioral responses, and the physics of disturbance; however, we still lack the ability to predict the effect of potential disturbance events on a population. To better inform stakeholdersabout the likely consequences of a specific proposed activity, the PCAD (Population Consequences of Acoustic Disturbance) working group established a conceptual framework detailing the impact of disturbance events and how the effects cascade from individuals altering their behavior all the way to population-level demographic effects. The PCAD working group then developed a more rigorous analytical approach (New et al. Accepted). These methods require substantial pre-existing knowledge of foraging patterns, life-history schedules, and demographics. Therefore, it is essential to use well-studied species to validate the approach. This is best accomplished by selecting species that are as similar as possible to target species and are also extremely well-studied. We identified northern elephant seals and Atlantic bottlenose dolphins as the best species to parameterize the PCAD model. These species represent two life-history extremes (capital and income breeders), have clear taxonimic separation (pinnipeds and cetaceans), and both species have been studied intensively for several decades, providing unprecedented demographic data. These factors imply that they likely respond to disturbance in unique ways and by developing models for each system, we can effectively bound the input parameters (and expected outputs) for other species of interest. This will be an essential step to eventuallly apply the model to species for which much less is known. In the current project, we are focusing on several key opportunities. First, the combination of remarkable demographic data with "health" or body conditon data will allow us for the first time to assess the effects of a disturbance event through all of the transfer functions of the PCAD model. This will be done with both simulated, natural, and experimental disturbance events, giving us the power to estimate the effects of proposed disturbance activities while bounding the estimates with real-world values. We will also be focusing on some of the mechanistic aspects of the PCAD model. For example, by investigating fine-scale energetics via accelerometry or the role of the stress response in long-term Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

The Journal of clinical psychiatry, Jan 6, 2017

To evaluate the efficacy of serotonin reuptake inhibitor (SRI) augmentation with N-acetylcysteine... more To evaluate the efficacy of serotonin reuptake inhibitor (SRI) augmentation with N-acetylcysteine (NAC), a glutamate modulator and antioxidant medication, for treatment-resistant obsessive-compulsive disorder (OCD). We conducted a randomized, double-blind, placebo-controlled, 16-week trial of NAC (3,000 mg daily) in adults (aged 18-65 years) with treatment-resistant OCD, established according to DSM-IV criteria. Forty subjects were recruited at an OCD-specialized outpatient clinic at a tertiary hospital (May 2012-October 2014). The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores. To evaluate the variables group, time, and interaction effects for Y-BOCS scores at all time points, we used nonparametric analysis of variance with repeated measures. Secondary outcomes were the severity scores for anxiety, depression, specific OCD symptom dimensions, and insight. Both groups showed a significant reduction of baseline Y-BOCS scores at week 16: the NAC ...

Progress in neuro-psychopharmacology & biological psychiatry, Oct 30, 2017

Current research to explore genetic susceptibility factors in obsessive-compulsive disorder (OCD)... more Current research to explore genetic susceptibility factors in obsessive-compulsive disorder (OCD) has resulted in the tentative identification of a small number of genes. However, findings have not been readily replicated. It is now broadly accepted that a major limitation to this work is the heterogeneous nature of this disorder, and that an approach incorporating OCD symptom dimensions in a quantitative manner may be more successful in identifying both common as well as dimension-specific vulnerability genetic factors. As most existing genetic datasets did not collect specific dimensional severity ratings, a specific method to reliably extract dimensional ratings from the most widely used severity rating scale, the Yale-Brown Obsessive Compulsive Scale (YBOCS), for OCD is needed. This project aims to develop and validate a novel algorithm to extrapolate specific dimensional symptom severity ratings in OCD from the existing YBOCS for use in genetics and other neurobiological resear...

JAMA psychiatry, Aug 13, 2016

To the Editor In JAMA Psychiatry, Grant and colleagues 1 demonstrated the efficacy of N-acetylcys... more To the Editor In JAMA Psychiatry, Grant and colleagues 1 demonstrated the efficacy of N-acetylcysteine (NAC) in the treatment of excoriation disorder (ED). The same group had previously reported the benefits of NAC for adults with trichotillomania (TTM). 2 In both studies, NAC was used in monotherapy in otherwise treatment-free patients. In the DSM-5, ED and TTM were included under the umbrella of obsessive-compulsive disorder (OCD) and related disorders because of similarities regarding phenotypic expression and common putative neurobiological underpinnings between these disorders and OCD. When used for treatment-resistant OCD, NAC was not more effective than placebo as a selective serotonin reuptake inhibitor (SSRI) augmentation strategy. 3 In striking contrast with what we know about OCD, SSRIs have not been proved to be superior to placebo in TTM treatment. 2 As for ED, the evidence regarding the efficacy of SSRIs is still scarce. 1 So far, there are no US Food and Drug Administration-approved treatments for ED and TTM. The divergent results of the trials testing either SSRIs or NAC for ED/ TTM and OCD suggest that treatments may not be used interchangeably between OCD and related disorders. Despite the possible methodological issues related to the design of specific trials, do such heterogeneous results regarding treatment response relate to heterogeneous neurobiology between OCD and related disorders? Pathological grooming behaviors in animals are widely used in the literature as a common animal model of ED/TTM and OCD. However, findings derived from animal studies do not always confirm the association between grooming behavior and OCD. For example, no differences were observed in the results of the marble-burying test of rats with different levels of grooming behavior. 4 In addition, results from genetic studies also suggest that the neurobiology of pathological grooming may not be necessarily related to OCD. It had been demonstrated that Sapap3 knockout mice groomed themselves excessively. However, using family-based association analyses, Bienvenu et al 5 found that variation within the human equivalent of the Sapap3 gene appeared associated with ED/TTM, but not with OCD. The conflicting results regarding the efficacy of NAC for ED/TTM and OCD, in addition to the findings of translational studies, suggest that the neural basis of repetitive behaviors observed in patients with these disorders might not be the same. So far, similarities between ED/TTM and OCD do not seem to go beyond the characterization by repetitive behaviors and some degree of familial aggregation.

Revista de Medicina, 2012

Journal of Psychiatric Research, 2014

This study aimed to investigate the phenomenology of obsessiveecompulsive disorder (OCD), address... more This study aimed to investigate the phenomenology of obsessiveecompulsive disorder (OCD), addressing specific questions about the nature of obsessions and compulsions, and to contribute to the World Health Organization's (WHO) revision of OCD diagnostic guidelines. Data from 1001 patients from the Brazilian Research Consortium on ObsessiveeCompulsive Spectrum Disorders were used. Patients were evaluated by trained clinicians using validated instruments, including the Dimensional Yalee Brown ObsessiveeCompulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, and the Brown Assessment of Beliefs Scale. The aims were to compare the types of sensory phenomena (SP, subjective experiences that precede or accompany compulsions) in OCD patients with and without tic disorders and to determine the frequency of mental compulsions, the co-occurrence of obsessions and compulsions, and the range of insight. SP were common in the whole sample, but patients with tic disorders were more likely to have physical sensations and urges only. Mental compulsions occurred in the majority of OCD patients. It was extremely rare for OCD patients to have obsessions without compulsions. A wide range of insight into OCD beliefs was observed, with a small subset presenting no insight. The data generated from this large sample will help practicing clinicians appreciate the full range of OCD symptoms and confirm prior studies in smaller samples the degree to which insight varies. These findings also support specific revisions to the WHO's diagnostic guidelines for OCD, such as describing sensory phenomena, mental compulsions and level of insight, so that the worldwide recognition of this disabling disorder is increased.