Isabella Souza - Academia.edu (original) (raw)

Papers by Isabella Souza

Research paper thumbnail of ADHD: the impact when not diagnosed

Jornal Brasileiro De Psiquiatria, 2008

ADHD is a highly prevalent disorder in childhood with social, academic and familial difficulties ... more ADHD is a highly prevalent disorder in childhood with social, academic and familial difficulties when not diagnosed and treated correctly. The aim of this case report is to demonstrate the impairment of ADHD among generations of the same family.

Research paper thumbnail of The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder

Arquivos De Neuro-psiquiatria, 2004

OBJECTIVE: To assess the effect of methylphenidate on the diagnosis of oppositional-defiant disor... more OBJECTIVE: To assess the effect of methylphenidate on the diagnosis of oppositional-defiant disorder (ODD) comorbid with attention-deficit hyperactivity disorder (ADHD). METHOD: We conducted an open-label study in which 10 children and adolescents with a dual diagnosis of ODD and ADHD were assessed for their ODD symptoms and treated with methylphenidate. At least one month after ADHD symptoms were under control, ODD symptoms were reevaluated with the Parent form of the Children Interview for Psychiatric Syndromes (P-ChIPS). RESULTS: Nine of the 10 patients no longer fulfilled diagnostic criteria for ODD after they were treated with methylphenidate for ADHD. CONCLUSION: Methylphenidate seems to be an effective treatment for ODD, as well as for ADHD itself. The implications for the treatment of patients with ODD not comorbid with ADHD needs further investigation.

Research paper thumbnail of Inattention, hyperactivity, oppositional-defiant symptoms and school failure

Arquivos De Neuro-psiquiatria, 2008

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is associated with school failure. In... more BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is associated with school failure. Inattention has been mainly implicated for this association. Oppositional-defiant disorder's (ODD) impact on academic performance remains controversial, because of the high comorbidity between ODD and ADHD. OBJECTIVE: To understand the role of inattention (IN), hyperactivity (H/I) and ODD in school failure. METHOD: Parents and teachers filled out SNAP-IV questionnaires for 241 / 6th grade students. The associations of the scores of oppositional-defiant (OP), H/I and IN symptoms with school year failure were calculated. RESULTS: IN was strongly correlated with school failure. H/I and OP were not associated with school failure, when controlled for IN. CONCLUSION: OP and H/I symptoms do not play an important role in school failure, when controlled for IN symptoms. Our study supports the cross-cultural role of IN as a major predictor of school failure.

Research paper thumbnail of Dificuldades no diagnóstico de TDAH em crianças

Jornal Brasileiro De Psiquiatria, 2007

Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder among school age c... more Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder among school age children. Once understood as a common and mild disorder restricted to childhood, ADHD is now recognized as an important condition because of its poor outcome and strong association with comorbidities. Pervasive disorders and cognitive deficits, as well as learning disorders, are complex conditions and their co-ocurrence with ADHD is commonly associated with marked impairments and disabilities. These patients need more attention and personalized treatment strategies. The aim of this article is to establish a discussion about these differential diagnoses, which are a challenge in clinical practice.

Research paper thumbnail of Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Arquivos De Neuro-psiquiatria, 2005

OBJECTIVE: To evaluate the prevalence of anxiety disorders in a clinical referred sample of child... more OBJECTIVE: To evaluate the prevalence of anxiety disorders in a clinical referred sample of children and adolescents with attention deficit/hyperactivity disorder (ADHD). METHOD: 78 children and adolescents with ADHD according to DSM-IV criteria were investigated with a semi-structured interview (P-CHIPS), complemented by clinical interviews with the children or adolescents and their parents. Their IQ was calculated with neuropsychological testing. RESULTS: A high prevalence of anxiety disorders (23.05%) was found in the sample. Generalized anxiety disorder was the most prevalent disorder (12,8%), followed by social phobia (3,84%) and separation anxiety disorder (3,8%). Two children showed more than one anxiety disorder. CONCLUSION: Children and adolescents with ADHD seem to be more prone to have comorbid anxiety disorders, at least in clinical samples referred to specialized units.

Research paper thumbnail of Transtorno desafiador de oposição: uma revisão de correlatos neurobiológicos e ambientais, comorbidades, tratamento e prognóstico

Revista Brasileira De Psiquiatria, 2004

Transtorno desafiador de oposição (TDO) é uma entidade diagnóstica independente, mas é freqüentem... more Transtorno desafiador de oposição (TDO) é uma entidade diagnóstica independente, mas é freqüentemente estudada em conjunto com transtorno de déficit de atenção/hiperatividade (TDAH) ou com transtorno de conduta (TC). O objetivo deste artigo é o de fazer uma revisão das evidências existentes, obtidas por meio da base de dados PubMed, sobre achados neurobiológicos no transtorno desafiador de oposição, funcionamento familiar e escolar, comorbidades, prognóstico e opções terapêuticas para transtorno desafiador de oposição. A evidência de correlatos hormonais, genéticos e neurofuncionais de transtorno desafiador de oposição, a conexão com a família, as relações e desempenho escolares, a associação com transtornos do humor, ansiosos e disruptivos, o risco de evolução para transtorno de conduta e de persistência de sintomas de transtorno desafiador de oposição são descritos. Uma revisão do efeito da Terapia Cognitivo-Comportamental e tratamento farmacológico é apresentada. A análise das evidências disponíveis mostra que o impacto de transtorno desafiador de oposição não deve ser ignorado e que o transtorno desafiador de oposição deve ser devidamente abordado. O impacto do tratamento de transtorno desafiador de oposição no prognóstico de longo prazo dos pacientes ainda precisa ser determinado.

Research paper thumbnail of A Brazilian version of the "Children's Interview for Psychiatric Syndromes" (ChIPS) A versão brasileira do "Childrens Interview for Psychiatric Syndromes" (ChIPS

palavras-chave P-ChIPS, tradução, entrevista clínica. Recebido em 22/1/2009 Aprovado em 7/5/2009 ... more palavras-chave P-ChIPS, tradução, entrevista clínica. Recebido em 22/1/2009 Aprovado em 7/5/2009 resumo objetivo: O avanço em pesquisa em psiquiatria da infância e adolescência no Brasil depende da existência de instrumentos para a investigação de síndromes psiquiátricas adaptadas à Língua Portuguesa. Este artigo descreve um cuidadoso processo de tradução do Children´s Interview for Psychiatric Syndromes para o uso em pesquisa no Brasil. métodos: O Children´s Interview for Psychiatric Syndromes tem uma versão para pais (P-ChIPs) e uma versão para as crianças (ChIPs). Nesse artigo, as seções do P-ChIPs referentes ao transtorno do déficit de atenção, transtorno opositivo-desafiador, transtorno de conduta, mania/ hipomania, anorexia nervosa, bulimia nervosa e transtorno psicótico foram traduzidas para a língua portuguesa. As seções do ChIPs referentes ao transtorno do uso de substâncias, ansiedade social, fobias específicas, transtorno obsessivo-compulsivo, transtorno de ansiedade generalizada, ansiedade de separação, estresse pós-traumático e depressão/distimia também foram adaptadas. Cada seção foi traduzida por dois tradutores independentes e depois discutida em um comitê composto por especialistas na área de psiquiatria e linguística. resultado: A versão final, abrangendo as síndromes psiquiátricas, foi definida. Conclusão: O P-ChIPS traduzido é um instrumento que pode ser utilizado na avaliação de crianças e adolescentes. abstraCt Objective: The advance of research in child and adolescent psychiatry in Brazil heavily depends on the existence of instruments for the investigation of psychiatric syndromes adapted to Brazilian Portuguese. Methods: This article describes a careful process of translation of the Children's Interview for Psychiatric Syndromes for the purpose of use in research in Brazil. The Children's Interview for Psychiatric Syndromes has a version for parents (P-ChIPs) and a version for children (ChIPS). In this article, the sections of P-ChIPS referring to attention-deficit hyperactivity disorder, oppositional-defiant disorder, conduct disorder, mania/hypomania, anorexia nervosa, bulimia nervosa and psychotic disorders were translated to Brazilian Portuguese. The sections of the ChIPS referring to substance use disorders, social anxiety disorder, specific phobias, obsessive-compulsive disorder, generalized anxiety disoder, separation anxiety disorder, post-traumatic disorders

Research paper thumbnail of Attention-Deficit/Hyperactivity Disorder and comorbidity in Brazil

European Child & Adolescent Psychiatry, 2004

Objective: The aim of this study was to compare the pattern of comorbidity in referred samples of... more Objective: The aim of this study was to compare the pattern of comorbidity in referred samples of Attention-Deficit/Hyperactivity Disorder (ADHD) patients from two different geographic areas in Brazil. Methods: The diagnoses of ADHD and comorbid conditions, according to DSM-IV criteria, were achieved in both clinics through semi-structured interview methodology, complemented by clinical interviews with the children or adolescents and their parents. Results: We assessed 343 ADHD children and adolescents in Porto Alegre (capital of the southernmost state of the country) and 78 ADHD youths in Rio de Janeiro (capital of a southestern state). Although a significant difference in the prevalence of ADHD without comorbidity was detected between the two groups (p = 0.02), no significant difference was detected in the profile of comorbidities between them. Main ADHD comorbidities in both samples were: a) Oppositional Defiant Disorder (Porto Alegre = 39.1%; Rio de Janeiro = 51.3 %); b) Anxiety Disorders (Porto Alegre = 24.2%; Rio de Janeiro = 30.8 %); c) Conduct Disorder (Porto Alegre = 13.7%; Rio de Janeiro = 17.9 %); and d) Major Depression and/or Dysthymia (Porto Alegre = 11.4%; Rio de Janeiro = 10.3 %). Conclusions: Our results from clinical samples in a developing country with a diverse culture suggest the crosscultural validity of the ADHD comorbidity profile.

Research paper thumbnail of Comorbidade em crianças e adolescentes com transtorno do déficit de atenção: resultados preliminares

Arquivos De Neuro-psiquiatria, 2001

RESUMO -Trinta e quatro crianças e adolescentes com idades entre 6 e 16 anos, com diagnóstico de ... more RESUMO -Trinta e quatro crianças e adolescentes com idades entre 6 e 16 anos, com diagnóstico de transtorno do déficit de atenção com hiperatividade (TDAH) segundo a DSM-IV, foram examinadas e avaliadas quanto a comorbidade com outros transtornos psiquiátricos através do questionário padronizado P-CHIPS aplicado aos pais. Observou-se expressiva ocorrência de transtornos comórbidos (85,7%), sendo o transtorno opositivodesafiador (20,6%) e o transtorno de conduta (39,2%) os mais comuns. Pelo menos dois outros diagnósticos que não o de TDAH puderam ser observados em 57% da amostra. A depressão maior pode ser diagnosticada em quatro casos e quadros ansiosos (transtorno de ansiedade generalizada, ansiedade de separação e fobias) foram observados em 34,3% da amostra. A presença de comorbidade altera de modo significativo o prognóstico da enfermidade e pode sugerir estratégias terapêuticas específicas dependendo de cada caso. A comorbidade frequente também pode sugerir a necessidade do uso de entrevistas diagnósticas que contemplam outros transtornos psiquiátricos.

Research paper thumbnail of ADHD: the impact when not diagnosed

Jornal Brasileiro De Psiquiatria, 2008

ADHD is a highly prevalent disorder in childhood with social, academic and familial difficulties ... more ADHD is a highly prevalent disorder in childhood with social, academic and familial difficulties when not diagnosed and treated correctly. The aim of this case report is to demonstrate the impairment of ADHD among generations of the same family.

Research paper thumbnail of The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder

Arquivos De Neuro-psiquiatria, 2004

OBJECTIVE: To assess the effect of methylphenidate on the diagnosis of oppositional-defiant disor... more OBJECTIVE: To assess the effect of methylphenidate on the diagnosis of oppositional-defiant disorder (ODD) comorbid with attention-deficit hyperactivity disorder (ADHD). METHOD: We conducted an open-label study in which 10 children and adolescents with a dual diagnosis of ODD and ADHD were assessed for their ODD symptoms and treated with methylphenidate. At least one month after ADHD symptoms were under control, ODD symptoms were reevaluated with the Parent form of the Children Interview for Psychiatric Syndromes (P-ChIPS). RESULTS: Nine of the 10 patients no longer fulfilled diagnostic criteria for ODD after they were treated with methylphenidate for ADHD. CONCLUSION: Methylphenidate seems to be an effective treatment for ODD, as well as for ADHD itself. The implications for the treatment of patients with ODD not comorbid with ADHD needs further investigation.

Research paper thumbnail of Inattention, hyperactivity, oppositional-defiant symptoms and school failure

Arquivos De Neuro-psiquiatria, 2008

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is associated with school failure. In... more BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is associated with school failure. Inattention has been mainly implicated for this association. Oppositional-defiant disorder's (ODD) impact on academic performance remains controversial, because of the high comorbidity between ODD and ADHD. OBJECTIVE: To understand the role of inattention (IN), hyperactivity (H/I) and ODD in school failure. METHOD: Parents and teachers filled out SNAP-IV questionnaires for 241 / 6th grade students. The associations of the scores of oppositional-defiant (OP), H/I and IN symptoms with school year failure were calculated. RESULTS: IN was strongly correlated with school failure. H/I and OP were not associated with school failure, when controlled for IN. CONCLUSION: OP and H/I symptoms do not play an important role in school failure, when controlled for IN symptoms. Our study supports the cross-cultural role of IN as a major predictor of school failure.

Research paper thumbnail of Dificuldades no diagnóstico de TDAH em crianças

Jornal Brasileiro De Psiquiatria, 2007

Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder among school age c... more Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder among school age children. Once understood as a common and mild disorder restricted to childhood, ADHD is now recognized as an important condition because of its poor outcome and strong association with comorbidities. Pervasive disorders and cognitive deficits, as well as learning disorders, are complex conditions and their co-ocurrence with ADHD is commonly associated with marked impairments and disabilities. These patients need more attention and personalized treatment strategies. The aim of this article is to establish a discussion about these differential diagnoses, which are a challenge in clinical practice.

Research paper thumbnail of Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Arquivos De Neuro-psiquiatria, 2005

OBJECTIVE: To evaluate the prevalence of anxiety disorders in a clinical referred sample of child... more OBJECTIVE: To evaluate the prevalence of anxiety disorders in a clinical referred sample of children and adolescents with attention deficit/hyperactivity disorder (ADHD). METHOD: 78 children and adolescents with ADHD according to DSM-IV criteria were investigated with a semi-structured interview (P-CHIPS), complemented by clinical interviews with the children or adolescents and their parents. Their IQ was calculated with neuropsychological testing. RESULTS: A high prevalence of anxiety disorders (23.05%) was found in the sample. Generalized anxiety disorder was the most prevalent disorder (12,8%), followed by social phobia (3,84%) and separation anxiety disorder (3,8%). Two children showed more than one anxiety disorder. CONCLUSION: Children and adolescents with ADHD seem to be more prone to have comorbid anxiety disorders, at least in clinical samples referred to specialized units.

Research paper thumbnail of Transtorno desafiador de oposição: uma revisão de correlatos neurobiológicos e ambientais, comorbidades, tratamento e prognóstico

Revista Brasileira De Psiquiatria, 2004

Transtorno desafiador de oposição (TDO) é uma entidade diagnóstica independente, mas é freqüentem... more Transtorno desafiador de oposição (TDO) é uma entidade diagnóstica independente, mas é freqüentemente estudada em conjunto com transtorno de déficit de atenção/hiperatividade (TDAH) ou com transtorno de conduta (TC). O objetivo deste artigo é o de fazer uma revisão das evidências existentes, obtidas por meio da base de dados PubMed, sobre achados neurobiológicos no transtorno desafiador de oposição, funcionamento familiar e escolar, comorbidades, prognóstico e opções terapêuticas para transtorno desafiador de oposição. A evidência de correlatos hormonais, genéticos e neurofuncionais de transtorno desafiador de oposição, a conexão com a família, as relações e desempenho escolares, a associação com transtornos do humor, ansiosos e disruptivos, o risco de evolução para transtorno de conduta e de persistência de sintomas de transtorno desafiador de oposição são descritos. Uma revisão do efeito da Terapia Cognitivo-Comportamental e tratamento farmacológico é apresentada. A análise das evidências disponíveis mostra que o impacto de transtorno desafiador de oposição não deve ser ignorado e que o transtorno desafiador de oposição deve ser devidamente abordado. O impacto do tratamento de transtorno desafiador de oposição no prognóstico de longo prazo dos pacientes ainda precisa ser determinado.

Research paper thumbnail of A Brazilian version of the "Children's Interview for Psychiatric Syndromes" (ChIPS) A versão brasileira do "Childrens Interview for Psychiatric Syndromes" (ChIPS

palavras-chave P-ChIPS, tradução, entrevista clínica. Recebido em 22/1/2009 Aprovado em 7/5/2009 ... more palavras-chave P-ChIPS, tradução, entrevista clínica. Recebido em 22/1/2009 Aprovado em 7/5/2009 resumo objetivo: O avanço em pesquisa em psiquiatria da infância e adolescência no Brasil depende da existência de instrumentos para a investigação de síndromes psiquiátricas adaptadas à Língua Portuguesa. Este artigo descreve um cuidadoso processo de tradução do Children´s Interview for Psychiatric Syndromes para o uso em pesquisa no Brasil. métodos: O Children´s Interview for Psychiatric Syndromes tem uma versão para pais (P-ChIPs) e uma versão para as crianças (ChIPs). Nesse artigo, as seções do P-ChIPs referentes ao transtorno do déficit de atenção, transtorno opositivo-desafiador, transtorno de conduta, mania/ hipomania, anorexia nervosa, bulimia nervosa e transtorno psicótico foram traduzidas para a língua portuguesa. As seções do ChIPs referentes ao transtorno do uso de substâncias, ansiedade social, fobias específicas, transtorno obsessivo-compulsivo, transtorno de ansiedade generalizada, ansiedade de separação, estresse pós-traumático e depressão/distimia também foram adaptadas. Cada seção foi traduzida por dois tradutores independentes e depois discutida em um comitê composto por especialistas na área de psiquiatria e linguística. resultado: A versão final, abrangendo as síndromes psiquiátricas, foi definida. Conclusão: O P-ChIPS traduzido é um instrumento que pode ser utilizado na avaliação de crianças e adolescentes. abstraCt Objective: The advance of research in child and adolescent psychiatry in Brazil heavily depends on the existence of instruments for the investigation of psychiatric syndromes adapted to Brazilian Portuguese. Methods: This article describes a careful process of translation of the Children's Interview for Psychiatric Syndromes for the purpose of use in research in Brazil. The Children's Interview for Psychiatric Syndromes has a version for parents (P-ChIPs) and a version for children (ChIPS). In this article, the sections of P-ChIPS referring to attention-deficit hyperactivity disorder, oppositional-defiant disorder, conduct disorder, mania/hypomania, anorexia nervosa, bulimia nervosa and psychotic disorders were translated to Brazilian Portuguese. The sections of the ChIPS referring to substance use disorders, social anxiety disorder, specific phobias, obsessive-compulsive disorder, generalized anxiety disoder, separation anxiety disorder, post-traumatic disorders

Research paper thumbnail of Attention-Deficit/Hyperactivity Disorder and comorbidity in Brazil

European Child & Adolescent Psychiatry, 2004

Objective: The aim of this study was to compare the pattern of comorbidity in referred samples of... more Objective: The aim of this study was to compare the pattern of comorbidity in referred samples of Attention-Deficit/Hyperactivity Disorder (ADHD) patients from two different geographic areas in Brazil. Methods: The diagnoses of ADHD and comorbid conditions, according to DSM-IV criteria, were achieved in both clinics through semi-structured interview methodology, complemented by clinical interviews with the children or adolescents and their parents. Results: We assessed 343 ADHD children and adolescents in Porto Alegre (capital of the southernmost state of the country) and 78 ADHD youths in Rio de Janeiro (capital of a southestern state). Although a significant difference in the prevalence of ADHD without comorbidity was detected between the two groups (p = 0.02), no significant difference was detected in the profile of comorbidities between them. Main ADHD comorbidities in both samples were: a) Oppositional Defiant Disorder (Porto Alegre = 39.1%; Rio de Janeiro = 51.3 %); b) Anxiety Disorders (Porto Alegre = 24.2%; Rio de Janeiro = 30.8 %); c) Conduct Disorder (Porto Alegre = 13.7%; Rio de Janeiro = 17.9 %); and d) Major Depression and/or Dysthymia (Porto Alegre = 11.4%; Rio de Janeiro = 10.3 %). Conclusions: Our results from clinical samples in a developing country with a diverse culture suggest the crosscultural validity of the ADHD comorbidity profile.

Research paper thumbnail of Comorbidade em crianças e adolescentes com transtorno do déficit de atenção: resultados preliminares

Arquivos De Neuro-psiquiatria, 2001

RESUMO -Trinta e quatro crianças e adolescentes com idades entre 6 e 16 anos, com diagnóstico de ... more RESUMO -Trinta e quatro crianças e adolescentes com idades entre 6 e 16 anos, com diagnóstico de transtorno do déficit de atenção com hiperatividade (TDAH) segundo a DSM-IV, foram examinadas e avaliadas quanto a comorbidade com outros transtornos psiquiátricos através do questionário padronizado P-CHIPS aplicado aos pais. Observou-se expressiva ocorrência de transtornos comórbidos (85,7%), sendo o transtorno opositivodesafiador (20,6%) e o transtorno de conduta (39,2%) os mais comuns. Pelo menos dois outros diagnósticos que não o de TDAH puderam ser observados em 57% da amostra. A depressão maior pode ser diagnosticada em quatro casos e quadros ansiosos (transtorno de ansiedade generalizada, ansiedade de separação e fobias) foram observados em 34,3% da amostra. A presença de comorbidade altera de modo significativo o prognóstico da enfermidade e pode sugerir estratégias terapêuticas específicas dependendo de cada caso. A comorbidade frequente também pode sugerir a necessidade do uso de entrevistas diagnósticas que contemplam outros transtornos psiquiátricos.