Publications by authors named "Evandro Coutinho"

Background: Severe psychomotor agitation and aggression often require immediate pharmacological intervention, but clear evidence-based recommendations for choosing among the multiple options are lacking. To address this gap, we plan a systematic review and individual-participant-data network meta-analysis to investigate their comparative effectiveness in real-world emergency settings with increased precision.

Methods: We will include randomized controlled trials investigating intramuscular or intravenous pharmacological interventions, as monotherapy or in combination, in adults with severe psychomotor agitation irrespective of the underlying diagnosis and requiring rapid tranquilization in general or psychiatric emergency settings.

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Cumulative trauma is usually devastating and can lead to severe psychological consequences, including posttraumatic stress disorder (PTSD). Exposure to various types of traumas, particularly during childhood, can be even more deleterious than the sheer number of events experienced. This epidemiological study is the first to investigate the impact of discrete childhood traumatic exposure on the risk of developing lifetime PTSD in a representative sample of the general population of the two biggest Brazilian cities.

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Objective: Medication non-adherence is frequently reported in patients with major depressive disorder (MDD). The objective of this review is to consolidate data on the prevalence of non-adherence to antidepressant in MDD.

Methods: A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and the protocol was registered in PROSPERO under the number CRD42021199987.

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Internet-delivered cognitive-behavioral therapy (I-CBT) is effective in treating post-traumatic stress disorder (PTSD) symptoms, offering enhanced accessibility and cost-effectiveness. However, it's important to note that these technologies may not be suitable for all age groups. Therefore, we conducted a systematic review and meta-analysis to determine if the effectiveness of I-CBT in treating PTSD varies based on the patients' mean age.

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Article Synopsis
  • The study focuses on measuring handgrip strength and the prevalence of dynapenia (weakness) among older adults in different regions of Brazil, aiming to understand how these factors relate to disabilities in daily activities, depression, and executive dysfunction.
  • Data was collected from over 8,800 non-institutionalized Brazilians aged 50 and older, revealing that dynapenia is most common in the North and Northeast regions, with notable overlaps with disabilities and mental health issues.
  • Results indicated significant regional disparities, showing worse health indicators in the North and Northeast, where nearly half of those with executive dysfunction also had dynapenia, while lower overlaps were found in the South.
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HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic disabling disease. However, there is a lack of an adequate and specific health measurement instrument validated and with good performance to assess their degree of physical disability. This led us to carry out this study and to evaluate the performance of Fiocruz's National Institute of Infectious Diseases (IDS) disability scale, a specific instrument for HAM/TSP.

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To assess sexual desire in patients with treatment-resistant depression (TRD). Baseline data were analyzed from an ongoing cohort study at an outpatient clinic specializing in TRD treatment in Brazil. The cohort comprised consecutive patients with the diagnosis of TRD who sought treatment at this center between November 2015 and January 2021.

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Background: Posttraumatic stress disorder (PTSD) is a prevalent and disabling multisystem disorder, with significant physical and psychiatric morbidity and poor quality of life (QOL). Although peritraumatic reactions - tonic immobility and dissociation - are established predictors of PTSD severity and development, there is a dearth of investigation assessing the impact of peritraumatic reactions on QOL of PTSD patients. Quality of life has become increasingly important in health care and research as a reliable outcome measure.

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Background: Most international guidelines suggest that benzodiazepines (BDZs) may be inefficient or iatrogenic in the aftermath of a potentially traumatic event (PTE). The goal of this study was to assess the strength of the evidence on whether the use of BDZs in the aftermath of a PTE negatively affects the incidence and severity of post-traumatic stress disorder (PTSD).

Methods: We systematically scrutinized the ISI Web of Knowledge, MEDLINE, SCOPUS, and PTSDpubs electronic databases in addition to citation searching.

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The aim of this study was to estimate the prevalence of sexual dysfunction in depressive disorders in individuals not in pharmacological treatment. For this purpose, we performed a systematic review and meta-analysis using the PRISMA guidelines, and the review was registered in PROSPERO (registration number CRD42020179709). Studies that evaluated sexual function and dysfunction in major depressive disorder (MDD) and persistent depressive disorder (PDD) were identified through searches in PubMed/Medline, Web of Science, PsychINFO, Scopus, and Scielo.

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Objectives: To compare musculoskeletal changes on a physical examination (PE), ultrasound (US) and magnetic resonance imaging (MRI) of the hands and wrists of patients with Chikungunya fever (CF).

Methods: The sample consisted of 30 patients in the chronic phase of CF. The sites analyzed were the interphalangeal (IP), metacarpophalangeal (MCP) and wrist/mediocarpal (WMC) joints and periarticular soft tissue.

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The objective of this review is to provide an updated synthesis of studies in individuals with eating disorders that examined the following components of binge eating episodes (BEEs): caloric intake, episode duration, and also the association of BEE size with psychopathology. A systematic review and meta-analysis were performed following the PRISMA guidelines. Searches were conducted on PubMed, PsycINFO, Scopus, SciELO, ScienceDirect and ProQuest databases.

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Objectives: Tinnitus is the perception of sound in ears or head without corresponding external stimulus. Despite the great amount of literature concerning tinnitus treatment, there are still no evidence-based established treatments for curing or for effectively reducing tinnitus intensity. Sham-controlled studies revealed beneficial effects using repetitive transcranial magnetic stimulation (rTMS).

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There is an increasing interest in the study of the aggregation of risk factors for noncommunicable chronic diseases. However, there are no studies among adolescents stratified by alcohol use. This study investigated the aggregation of cardiovascular risk factors in adolescents considering the use or not of alcohol.

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Objective: In recent decades there has been an increase in the use of antidepressants (AD) and a decrease in the use of benzodiazepines (BDZ). Prevalence, cumulative incidence, and factors associated with the incidence of AD and BDZ use in a Brazilian population were estimated in this article.

Methods: Data were collected with a self-administered questionnaire in a cohort of employees from a university in Rio de Janeiro.

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Purpose: To estimate the prevalence of intermittent explosive disorder (IED) in comorbidity with other psychiatric disorders and to describe the temporal sequencing of disorders in the São Paulo Metropolitan Area, Brazil.

Methods: Data from the São Paulo Megacity Mental Health Survey, a population-based study of 5037 adult individuals, were analyzed. The World Health Organization Composite International Diagnostic Interview (CID 3.

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Objective: To translate, establish the diagnostic accuracy, and standardize the Brazilian Portuguese version of the European Cross-Cultural Neuropsychological Test Battery (CNTB) considering schooling level.

Methods: We first completed an English-Brazilian Portuguese translation and back-translation of the CNTB. A total of 135 subjects aged over 60 years - 65 cognitively healthy (mean 72.

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Article Synopsis
  • - The study investigates the effectiveness of various first-line medications (diuretics, CCB, BB, ACEI, ARB) in treating obesity-related hypertension and their impact on heart and stroke risk in overweight or obese patients.
  • - A review of 16 clinical trials revealed that diuretics outperform CCB and ACEI in preventing heart failure and stroke, while CCB are better than beta-blocker atenolol in reducing stroke risk and overall mortality.
  • - The findings suggest that diuretics are the preferred choice for hypertensive individuals with excess weight, while CCB are effective for preventing cardiovascular diseases, excluding heart failure.
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This study aimed to analyze the aggregation of alcohol consumption, smoking, excess weight, and short sleep in Brazilian adolescents. This was a cross-sectional multicenter study conducted with teens participating in the Study of Cardiovascular Risk Factors in Adolescents (ERICA in Portuguese). The sample consisted of adolescents that answered the complete questionnaires on sleep, tobacco, and alcoholic beverages, in addition to having their weight and height measured.

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Background: This study investigated the patterns of comorbidity between PTSD and depression, other anxiety disorders, alcohol-related disorders using the DSM-IV and ICD-10 criteria. The temporal sequence of the comorbid diagnoses was also investigated.

Methods: We used data from a large population-based survey carried out between 2007 and 2008 in the two largest cities in Brazil: São Paulo and Rio de Janeiro.

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Examining clinical features of depressive episodes may help elucidating the nature of association between depression and obesity, related to specific symptoms such as appetite and weight changes. This meta-analysis of observational studies evaluated whether subtypes of depression are associated with specific anthropometric profiles in adults. We searched MEDLINE, LILACS, PsycINFO, Scopus, Web of Science databases, and Grey Literature for articles published up to October 2016 that examined depressive subtypes and adiposity measures among adults.

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Background: This study aimed to compare the effects of aerobic training (AT), strength training (ST) and low-intensity exercise in a control group (CG) as adjunct treatments to pharmacotherapy for major depressive disorder (MDD) in older persons.

Methods: Older persons clinically diagnosed with MDD (n = 27) and treated with antidepressants were blindly randomized into three groups: AT, ST and a CG. All patients were evaluated prior to and 12 weeks after the intervention.

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Bariatric surgery has been recognized as the gold standard treatment for severe obesity. Although postbariatric surgery patients usually achieve and maintain substantial weight loss, a group of individuals may exhibit weight regain. Several factors are proposed to weight regain, including psychiatric comorbidity.

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