Cristiana Castanho de Almeida Rocca

University of São Paulo, San Paulo, São Paulo, Brazil

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Publications (9)18.9 Total impact

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    ABSTRACT: Objective:Children of parents with bipolar disorder (BD) are at heightened risk for developing mood and other psychiatric disorders. We proposed to evaluate the environment of families with at least one parent with BD type I (BDF) with affected offspring (aBDF) and unaffected offspring (uBDF) compared with control families without a history of DSM-IV Axis I disorder (CF).Method:We used the Family Environment Scale (FES) to evaluate 47 BDF (aBDF + uBDF) and 30 CF. Parents were assessed through the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Diagnosis of the offspring was determined through the Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) interview.Results:There were statistically significant differences between aBDF, uBDF and CF in cohesion (p = 0.003), intellectual-cultural orientation (p = 0.01), active-recreational orientation (p = 0.007), conflict (p = 0.001), control (p = 0.01), moral-religious emphasis (p = 0.01) and organization (p = 0.001). The aBDF showed higher levels of control (p = 0.02) when compared to the uBDF.Conclusions:Families with a BD parent presented more dysfunctional interactions among members. Moreover, the presence of BD or other psychiatric disorders in the offspring of parents with BD is associated with higher levels of control. These results highlight the relevance of psychosocial interventions to improve resilience and family interactions.
    Australian and New Zealand Journal of Psychiatry 10/2013; · 3.29 Impact Factor
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    Clinics (São Paulo, Brazil) 01/2011; 66(10):1847-8. · 1.59 Impact Factor
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    Cristiana Castanho de Almeida Rocca, Luciana Gerchmann, Lena Nabuco de Abreu, Beny Lafer
    Revista Brasileira de Psiquiatria 06/2010; 32(2):200-1. · 1.86 Impact Factor
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    Cristiana Castanho de Almeida Rocca, Eveline van den Heuvel, Sheila C Caetano, Beny Lafer
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    ABSTRACT: Literature review of the controlled studies in the last 18 years in emotion recognition deficits in bipolar disorder. A bibliographical research of controlled studies with samples larger than 10 participants from 1990 to June 2008 was completed in Medline, Lilacs, PubMed and ISI. Thirty-two papers were evaluated. Euthymic bipolar disorder presented impairment in recognizing disgust and fear. Manic BD showed difficult to recognize fearful and sad faces. Pediatric bipolar disorder patients and children at risk presented impairment in their capacity to recognize emotions in adults and children faces. Bipolar disorder patients were more accurate in recognizing facial emotions than schizophrenic patients. Bipolar disorder patients present impaired recognition of disgust, fear and sadness that can be partially attributed to mood-state. In mania, they have difficult to recognize fear and disgust. Bipolar disorder patients were more accurate in recognizing emotions than depressive and schizophrenic patients. Bipolar disorder children present a tendency to misjudge extreme facial expressions as being moderate or mild in intensity. Affective and cognitive deficits in bipolar disorder vary according to the mood states. Follow-up studies re-testing bipolar disorder patients after recovery are needed in order to investigate if these abnormalities reflect a state or trait marker and can be considered an endophenotype. Future studies should aim at standardizing task and designs.
    Revista Brasileira de Psiquiatria 07/2009; 31(2):171-80. · 1.86 Impact Factor
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    ABSTRACT: The purpose of the present study was to assess the social skills of euthymic patients with bipolar disorder. A group of 25 outpatients with bipolar disorder type I were evaluated in comparison with a group of 31 healthy volunteers who were matched in terms of level of education, age, sex and intelligence. Both groups were assessed using a self-report questionnaire, the Brazilian Inventario de Habilidades Sociais (IHS, Social Skills Inventory). Two Wechsler Adult Intelligence Scale subtests (Picture Arrangement and Comprehension) were also used in order to assess subject ability to analyse social situations and to make judgements, respectively. Patients with bipolar disorder had lower IHS scores for the domains that assessed conversational skills/social self-confidence and social openness to new people/situations. Patients with anxiety disorders had high scores for the domain that assessed self-confidence in the expression of positive emotions. No differences were found between patients and controls in performance on the Wechsler Adult Intelligence Scale Picture Arrangement and Comprehension subtests. Euthymic patients with bipolar disorder present inhibited and overattentive behaviour in relation to other people and their environment. This behaviour might have a negative impact on their level of social functioning and quality of life.
    Australian and New Zealand Journal of Psychiatry 09/2008; 42(8):686-92. · 3.29 Impact Factor
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    ABSTRACT: To study the executive functioning in euthymic bipolar patients in comparison to healthy controls and to examine the relationship between neuropsychological deficits and clinical variables. Twenty-five euthymic bipolar patients and 31 controls underwent a battery of executive tasks including mental flexibility, inhibitory control and verbal fluency tests. There were no significant differences between bipolar patients and controls in relation to mental flexibility and inhibitory control. However, patients performed worse than controls on verbal fluency tests. Poor performances on the Stroop Test and the Hayling and Brixton Tests--part A were associated to lifetime occurrence of psychotic symptoms, prior number of episodes, and previous hospitalizations. In our study, only verbal fluency tests differentiated bipolar euthymic patients from healthy controls. Patients who showed deficits in information processing speed and inhibitory control had more episodes and hospitalizations and lifetime occurrence of psychotic symptoms.
    Journal of Affective Disorders 05/2008; 107(1-3):187-92. · 3.30 Impact Factor
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    ABSTRACT: Mixed episodes have been described as more severe than manic episodes, especially due to their longer duration and their association with higher rates of suicide attempts, hospitalization and psychotic symptoms. The purpose of this study was to compare the severity between mixed and pure manic episodes according to DSM-IV criteria, through the evaluation of sociodemographic data and clinical characteristics. Twenty-nine bipolar I patients presenting acute mixed episodes were compared to 20 bipolar I patients with acute manic episodes according to DSM-IV criteria. We analyzed (cross-sectionally) episode length, presence of psychotic symptoms, frequency of suicide attempts and hospitalization, Young Mania Rating Scale scores, Hamilton Depression Rating Scale scores and the Clinical Global Assessment Scale scores. Young Mania Rating Scale scores were higher in manic episodes than in mixed episodes. There were no differences in gender frequency, CGI scores and rates of hospitalization, suicide attempts and psychotic symptoms, when mixed and manic episodes where compared. Patients with mixed episodes were younger. In our sample, mixed states occurred at an earlier age than manic episodes. Contrary to previous reports, we did not find significant differences between manic and mixed episodes regarding severity of symptomatology, except for manic symptoms ratings, which were higher in acute manic patients. In part, this may be explained by the different criteria adopted on previous studies.
    Revista Brasileira de Psiquiatria 07/2007; 29(2):130-3. · 1.86 Impact Factor
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    Cristiana C A Rocca, Beny Lafer
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    ABSTRACT: Systematic literature review of the controlled studies published in the last 15 years on neuropsychological deficits in Bipolar Disorder. Bibliographical research was completed through Medline, Lilacs, PubMed and ISI, specifically for 1990 to 2005 period. Selected studies were organized beginning with the comparison among the selected sample (bipolar versus other pathology versus control healthy). We included only controlled studies with a patient sample larger than 10, and 73 papers were found, being that 53 selected for this systematic review. Patients with Bipolar Disorder present difficulties in several cognitive domains which partially persist even after acute episodes acute episodes. The deficits impaired basically the executive functions. When compared to schizophrenia, bipolar patients present milder deficits in the neuropsychological tests, which may explain differences in terms of disease outcome and specific circuitry abnormalities. There was a positive correlation between cognitive deficits and number of episodes or hospitalizations. The medications used for mood stabilization can produce a negative impact on cognition. The abnormalities suggest a dysfunction in specific frontostriatal circuits, and may partially explain the difficulties in the psychosocial adaptation of these patients. Future studies should evaluate the effectiveness of neuropsychological rehabilitation programs, which seek through cognitive training to minimize the impact of these deficits in the every day life.
    Revista Brasileira de Psiquiatria 10/2006; 28(3):226-37. · 1.86 Impact Factor
  • Cristiana Castanho de Almeida. Rocca, Beny orient. Lafer
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    ABSTRACT: Este estudo investigou o funcionamento executivo em pacientes bipolares eutímicos, comparando os resultados obtidos aos de um grupo de sujeitos controles. Vinte e cinco pacientes bipolares eutímicos e 31 controles foram avaliados por uma bateria de provas neuropsicológicas e um questionário auto-aplicativo sobre as habilidades sociais. Houve uma diferença significativa na prova de fluência verbal, com menor produtividade para o grupo de pacientes. Foi encontrada associação entre o número de internações, presença de sintomas psicóticos ao longo da vida e os resultados dos testes neuropsicológicos. No Inventário de Habilidades Sociais, pacientes bipolares pontuaram menos nos itens que avaliavam as habilidades de "conversação e desenvoltura social" e, "auto-exposição a desconhecidos e situações novas" Tese (Doutorado).