Mario F Juruena | King's College London (original) (raw)

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Research paper thumbnail of Inserção de um hospital-dia na rede de atenção em saúde mental

Resumo - Objetivo: Descrever a insercao do Hospital-Dia do Hospital das Clinicas da Faculdade de ... more Resumo - Objetivo: Descrever a insercao do Hospital-Dia do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo, na rede de atencao em saude mental do Departamento Regional de Saude XIII, no Estado de Sao Paulo. Metodo: Estudo de caso associado as tecnicas da revisao documental. Foram visitadas 13 das 15 unidades de assistencia que compoem a rede de saude mental de Ribeirao Preto. Resultados: O Hospital-Dia e um dos equipamentos de saude especializado na estrutura de saude local e regional. O tratamento diferenciado entre os diversos servicos que referenciam o acesso para o Hospital-Dia e fator de tensao na gestao do sistema de saude. A falta de dialogo articulado com e entre as equipes de saude nos diferentes locais de assistencia nao permite o acompanhamento do itinerario terapeutico percorrido pelo paciente. Conclusoes: A capacidade instalada do hospital-dia pode deixar duvidas sobre o impacto produzido pela assistencia realizada. As evidencias da necessidade de acoes que considerem a integralidade e a intersetorialidade, pela restrita comunicacao entre os servicos e, a centralizacao dos atendimentos em um servico especializado em saude mental pode sugerir a fragilidade de uma rede de atencao em saude mental.

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Research paper thumbnail of Inclusion of Patients of a Mental Health Day Hospital: A Review

Psicologia, saúde & doenças, Nov 1, 2014

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Research paper thumbnail of Cognitive-Behavioral Therapy for the Bipolar Disorder Patients

InTech eBooks, Mar 14, 2012

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Research paper thumbnail of Molecular mechanisms of glucocorticoid receptor sensitivity and relevance to affective disorders

Acta Neuropsychiatrica, Dec 1, 2003

Changes in the hypothalamic–pituitary–adrenocortical (HPA) system are characteristic of depressio... more Changes in the hypothalamic–pituitary–adrenocortical (HPA) system are characteristic of depression, and in the majority of these patients these result in HPA axis hyperactivity. This is further supported by the reduced sensitivity to the inhibitory effects of the glucocorticoid, dexamethasone (DEX), on the production of adrenocorticotropic hormone (ACTH) and cortisol, during the DEX suppression test and the DEX-corticotropin-releasing hormone (DEX/CRH) test. Because the effects of glucocorticoids are mediated by intracellular receptors including, most notably, the glucocorticoid receptor (GR), several studies have examined the number and/or function of GRs in depressed patients. These studies have consistently demonstrated that GR function is impaired in major depression, resulting in reduced GR-mediated negative feedback on the HPA axis and increased production and secretion of CRH in various brain regions postulated to be involved in the causality of depression. This article summarizes the literature on GR in depression and on the impact of antidepressants on the GR in clinical and preclinical studies, and supports the concept that impaired GR signaling is a key mechanism in the pathogenesis of depression, in the absence of clear evidence of decreased GR expression. The data also indicate that antidepressants have direct effects on the GR, leading to enhanced GR function and increased GR expression. Hypotheses regarding the mechanism of these receptor changes involve non-steroid compounds that regulate GR function via second messenger pathways, such as cytokines and neurotransmitters. Moreover, we present recent evidence suggesting that membrane steroid transporters such as the multidrug resistance (MDR) p-glycoprotein, which regulate access of glucocorticoids to the brain, could be a fundamental target of antidepressant treatment. Research in this field will lead to new insights into the pathophysiology and treatment of affective disorders.

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Research paper thumbnail of Depresäo na infância

Acta méd. (Porto Alegre), 1985

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Research paper thumbnail of The Effects of Lithium on Oxidative Stress Parameters in Healthy Subjects

Biological Psychiatry, May 1, 2011

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Research paper thumbnail of HPA Axis in Depression and Type 2 Diabetes. Oxford University Press

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Research paper thumbnail of Prednisolone Suppression Test Predicts Outcome in Treatment Resistant Depression, but not Dexamethasone

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Research paper thumbnail of Early life stress in bipolar patients: HPA axis response to GR and MR challenges

Bipolar Disorders, Jul 1, 2016

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Research paper thumbnail of Ketamine’s pharmacokinetic and pharmacodynamic interactions with anticonvulsants, and their implications for psychiatry: A scoping review protocol

medRxiv (Cold Spring Harbor Laboratory), Feb 9, 2023

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Research paper thumbnail of Mirror-touch synesthesia in schizophrenia, a pathological condition?

Debates em Psiquiatria, Aug 19, 2022

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Research paper thumbnail of P.2.b.050 Mineralocorticoid receptor function a predictor of treatment response in depression with or without early life stress

European Neuropsychopharmacology, Oct 1, 2013

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Research paper thumbnail of Trauma and stressor-related disorders

Medicina, Feb 4, 2017

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Research paper thumbnail of Early life stress, depression and epigenetics

Vitamins and hormones, 2023

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Research paper thumbnail of The Role of Hypothalamic-Pituitary-Adrenal Axis in the Pathophysiology of Major Depression: A Translational Research Perspective of the Prednisolone Suppression Test

Springer eBooks, 2022

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Research paper thumbnail of Clinical, Research and Treatment Approaches to Affective Disorders

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Research paper thumbnail of Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations

Neuropsychiatric Disease and Treatment, Feb 1, 2023

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Research paper thumbnail of Reply to Skokou, M. Comment on “Keeler et al. Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review. Nutrients 2021, 13, 4158”

Nutrients, May 19, 2022

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Research paper thumbnail of A vulnerability in depressed with family history of depression and history of autoimmune disease

F1000Research, 2011

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Research paper thumbnail of Evaluación de las alteraciones estacionales en el humor y comportamiento en la ciudad de San Pablo

Acta Psiquiatrica Y Psicologica De America Latina, 2000

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Research paper thumbnail of Inserção de um hospital-dia na rede de atenção em saúde mental

Resumo - Objetivo: Descrever a insercao do Hospital-Dia do Hospital das Clinicas da Faculdade de ... more Resumo - Objetivo: Descrever a insercao do Hospital-Dia do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo, na rede de atencao em saude mental do Departamento Regional de Saude XIII, no Estado de Sao Paulo. Metodo: Estudo de caso associado as tecnicas da revisao documental. Foram visitadas 13 das 15 unidades de assistencia que compoem a rede de saude mental de Ribeirao Preto. Resultados: O Hospital-Dia e um dos equipamentos de saude especializado na estrutura de saude local e regional. O tratamento diferenciado entre os diversos servicos que referenciam o acesso para o Hospital-Dia e fator de tensao na gestao do sistema de saude. A falta de dialogo articulado com e entre as equipes de saude nos diferentes locais de assistencia nao permite o acompanhamento do itinerario terapeutico percorrido pelo paciente. Conclusoes: A capacidade instalada do hospital-dia pode deixar duvidas sobre o impacto produzido pela assistencia realizada. As evidencias da necessidade de acoes que considerem a integralidade e a intersetorialidade, pela restrita comunicacao entre os servicos e, a centralizacao dos atendimentos em um servico especializado em saude mental pode sugerir a fragilidade de uma rede de atencao em saude mental.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Inclusion of Patients of a Mental Health Day Hospital: A Review

Psicologia, saúde & doenças, Nov 1, 2014

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Cognitive-Behavioral Therapy for the Bipolar Disorder Patients

InTech eBooks, Mar 14, 2012

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Molecular mechanisms of glucocorticoid receptor sensitivity and relevance to affective disorders

Acta Neuropsychiatrica, Dec 1, 2003

Changes in the hypothalamic–pituitary–adrenocortical (HPA) system are characteristic of depressio... more Changes in the hypothalamic–pituitary–adrenocortical (HPA) system are characteristic of depression, and in the majority of these patients these result in HPA axis hyperactivity. This is further supported by the reduced sensitivity to the inhibitory effects of the glucocorticoid, dexamethasone (DEX), on the production of adrenocorticotropic hormone (ACTH) and cortisol, during the DEX suppression test and the DEX-corticotropin-releasing hormone (DEX/CRH) test. Because the effects of glucocorticoids are mediated by intracellular receptors including, most notably, the glucocorticoid receptor (GR), several studies have examined the number and/or function of GRs in depressed patients. These studies have consistently demonstrated that GR function is impaired in major depression, resulting in reduced GR-mediated negative feedback on the HPA axis and increased production and secretion of CRH in various brain regions postulated to be involved in the causality of depression. This article summarizes the literature on GR in depression and on the impact of antidepressants on the GR in clinical and preclinical studies, and supports the concept that impaired GR signaling is a key mechanism in the pathogenesis of depression, in the absence of clear evidence of decreased GR expression. The data also indicate that antidepressants have direct effects on the GR, leading to enhanced GR function and increased GR expression. Hypotheses regarding the mechanism of these receptor changes involve non-steroid compounds that regulate GR function via second messenger pathways, such as cytokines and neurotransmitters. Moreover, we present recent evidence suggesting that membrane steroid transporters such as the multidrug resistance (MDR) p-glycoprotein, which regulate access of glucocorticoids to the brain, could be a fundamental target of antidepressant treatment. Research in this field will lead to new insights into the pathophysiology and treatment of affective disorders.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Depresäo na infância

Acta méd. (Porto Alegre), 1985

Bookmarks Related papers MentionsView impact

Research paper thumbnail of The Effects of Lithium on Oxidative Stress Parameters in Healthy Subjects

Biological Psychiatry, May 1, 2011

Bookmarks Related papers MentionsView impact

Research paper thumbnail of HPA Axis in Depression and Type 2 Diabetes. Oxford University Press

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Prednisolone Suppression Test Predicts Outcome in Treatment Resistant Depression, but not Dexamethasone

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Early life stress in bipolar patients: HPA axis response to GR and MR challenges

Bipolar Disorders, Jul 1, 2016

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Ketamine’s pharmacokinetic and pharmacodynamic interactions with anticonvulsants, and their implications for psychiatry: A scoping review protocol

medRxiv (Cold Spring Harbor Laboratory), Feb 9, 2023

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Mirror-touch synesthesia in schizophrenia, a pathological condition?

Debates em Psiquiatria, Aug 19, 2022

Bookmarks Related papers MentionsView impact

Research paper thumbnail of P.2.b.050 Mineralocorticoid receptor function a predictor of treatment response in depression with or without early life stress

European Neuropsychopharmacology, Oct 1, 2013

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Trauma and stressor-related disorders

Medicina, Feb 4, 2017

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Early life stress, depression and epigenetics

Vitamins and hormones, 2023

Bookmarks Related papers MentionsView impact

Research paper thumbnail of The Role of Hypothalamic-Pituitary-Adrenal Axis in the Pathophysiology of Major Depression: A Translational Research Perspective of the Prednisolone Suppression Test

Springer eBooks, 2022

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Clinical, Research and Treatment Approaches to Affective Disorders

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations

Neuropsychiatric Disease and Treatment, Feb 1, 2023

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Reply to Skokou, M. Comment on “Keeler et al. Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review. Nutrients 2021, 13, 4158”

Nutrients, May 19, 2022

Bookmarks Related papers MentionsView impact

Research paper thumbnail of A vulnerability in depressed with family history of depression and history of autoimmune disease

F1000Research, 2011

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Evaluación de las alteraciones estacionales en el humor y comportamiento en la ciudad de San Pablo

Acta Psiquiatrica Y Psicologica De America Latina, 2000

Bookmarks Related papers MentionsView impact