Mario F Juruena

Mario F Juruena
King's College London | KCL · Department of Psychological Medicine

MD, MSc, Dip CBT, MPhil, PhD
Dr Juruena's research is psychopharmacology, psychoneuroendocrinology, clinical trials in Stress and Affective Disorders

About

177
Publications
68,562
Reads
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4,003
Citations
Citations since 2016
69 Research Items
2655 Citations
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20162017201820192020202120220100200300400500
20162017201820192020202120220100200300400500
20162017201820192020202120220100200300400500
Introduction
Dr Juruena is currently a Clinical Reader in Translational Psychiatry at the Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, Dept of Psychological Medicine at King’s College London, UK. He is a Consultant Psychiatrist at South London and Maudsley NHS Foundation Trust (SLaM) and National Affective Disorder Service (NADS), currently the lead consultant for the Maudsley Advanced Treatment Service for Difficult to Treat Depression and Bipolar Disorders
Additional affiliations
December 2017 - present
King's College London
Position
  • Lecturer
February 2016 - present
King's College London
Position
  • Research Fellow Royal Society/The Academy of Medical Sciences
November 2010 - present
King's College London
Position
  • Visiting Senior Lecturer at the Institute of Psychiatry

Publications

Publications (177)
Article
Full-text available
Background: Evidence indicates that early life stress (ELS) can induce persistent changes in the hypothalamic-pituitary-adrenal (HPA) axis to respond to stress in the adult life that leads to depression. These appear to be related to the impairment of HPA hormones through binding to glucocorticoid (GR) and mineralocorticoid receptors (MR). The aim...
Article
Full-text available
Early life stress (ELS; sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect) has been the focus of numerous studies. It has been associated with the onset and the severity of psychiatric disorders in adults. The objective of this study was to review the literature on ELS associated with psychiatric disorders in ad...
Article
People with severe depressive illness have raised levels of cortisol and reduced glucocorticoid receptor function. To obtain a physiological assessment of hypothalamic-pituitary-adrenal (HPA) axis feedback status in an in-patient sample with depression and to relate this to prospectively determined severe treatment resistance. The prednisolone supp...
Article
Patients with major depression show hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, but the mechanisms underlying this abnormality are still unclear. We have compared two synthetic glucorticoids, dexamethasone and prednisolone, in their ability to suppress the hypothalamic-pituitary-adrenal (HPA) axis in depressed patients. Dexamethasone p...
Article
Full-text available
Previously, we have shown that in vitro antidepressants modulate glucocorticoid receptor (GR) function and expression, and have suggested that these effects could be relevant for the mechanism of action of antidepressants. To further clarify the interaction between antidepressants and glucocorticoids, we evaluated the in vitro effect of the tricycl...
Article
Full-text available
Few studies have assessed biomarkers for the differentiation of major depressive disorder (MDD) and bipolar disorder (BD). However, some elements of depression such as hormones and receptors of the renin–angiotensin–adrenal system (RAAS), the hypothalamus–pituitary–adrenal (HPA) axis, and history of early-life stress (ELS) could be considered for d...
Article
Full-text is available: https://authors.elsevier.com/a/1fl2V55vZ61XC Background Sexual violence is a traumatic event that can trigger post-traumatic stress disorder (PTSD) and generate biological responses to stress characterized by inhibiting the hypothalamic-pituitary axis (HPA), altering immune activity, and changing the structure and function...
Article
Full-text available
Introduction: The mirror-touch synesthesia is a condition where a touch perception in another person's body induces the person who is observed to feel being touched in the same way. Case report: A single 22-year-old man came to the medical appointment in a private psychiatric clinic. Since his adolescence, he refers to auditive hallucinations,...
Article
Full-text available
In response to our narrative review, which suggested the use of the glutamatergic n-methyl-D-aspartate (NMDA) receptor antagonist ketamine as a potential treatment for anorexia nervosa (AN) [...]
Chapter
Glucocorticoids mediate their actions, including feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis, through two distinct corticosteroid receptor subtypes: mineralocorticoid receptors (MR) and glucocorticoid receptors (GR). Dexamethasone, specifically the dexamethasone suppression test (DST), was the first and most studied glucoco...
Chapter
Hormones have a crucial part in the progress and manifestation of a wide variety of different behaviors. Of all the neuroendocrine axes, the hypothalamus–pituitary–adrenal (HPA) axis has been the most extensively studied. There is evidence that disturbance in the HPA axis, the primary stress hormone system, could increase treatment resistance and r...
Article
Full-text available
Anorexia nervosa (AN) is a highly complex disorder to treat, especially in severe and en‐ during cases. Whilst the precise aetiology of the disorder is uncertain, malnutrition and weight loss can contribute to reductions in grey and white matter of the brain, impairments in neuroplasticity and neurogenesis and difficulties with cognitive flexibilit...
Article
Background Patients with psychotic disorders show higher rates of the metabolic syndrome (MS) between the cluster of severe mental illnesses. Depressive symptoms can worsen outcomes of individuals with psychotic disorders. However, research on the association between MS and depression in psychotic disorders and their relevance to outcomes is lackin...
Article
Evidence indicates that early life stress (ELS) may act as a risk factor for the development and maintenance of adulthood severe mental health disorders due to persistent dysregulation within the hypothalamic-pituitary-adrenal (HPA) axis. It is now broadly accepted that psychological stress may change the internal homeostatic state of an individual...
Article
Full-text available
Background: Sexual assault is implicated in several adverse psychological and physical health outcomes, including posttraumatic stress disorder (PTSD) and depression. Neurobiological research has shown variations related to the hypothalamic-pituitary-adrenal (HPA) axis, immune alterations, metabolic function, and brain circuitry. Although these me...
Article
The biological bases of bipolar disorder include aspects related, among others, to neurohormonal pathways, neurotransmission, signal transduction, regulation of gene expression, oxidative stress, neuroplasticity, and changes in the immune system. There is still a gap in understanding its complex neurobiology and, consequently, developing new treatm...
Article
Full-text available
The Pan American Health Organization advises that health systems have not yet adequately responded to the burden of mental disorders, indicating that there is a great distance between the needed and the provided treatment worldwide. Poor treatment quality is another serious problem in health systems. Beyond health services support, people with ment...
Book
Bipolar disorder is a common, complex and costly mental health disorder, which sits at the heart of the practice of clinical psychiatry. Effective treatments (pharmacological, psychological and brain stimulation based) have all been discovered serendipitously. With the huge advances in basic neuroscience the way is now clear for novel treatments to...
Article
Full-text available
Objective: to analyze the association between Burnout, stress, mental suffering and other personal and work factors associated with this syndrome. Method: cross-sectional, descriptive and correlational study with 282 health professionals from the emergency services of the city of Ribeirão Preto, Brazil, collected from October 2015 to March 2016. T...
Article
Full-text available
Early-life stress (ELS) is associated with a higher risk of psychopathologies in adulthood, such as depression, which may be related to persistent changes in the hypothalamic-pituitary-adrenal (HPA) axis. This study aimed to evaluate the effects of ELS on the functioning of the HPA axis in clinical and experimental situations. Clinically, patients...
Preprint
Full-text available
Objective: to confirm the factorial validity of the Maslach Burnout Inventory – Human Services Survey version in a sample of health professionals from the emergency services. Method: a quantitative, exploratory, descriptive and analytical study. Two hundred and eighty-two health professionals participated in the study. For data collection, a socio...
Preprint
Objective: to analyze the association between Burnout, stress, mental suffering and other personal and work factors associated with this syndrome. Método: cross-sectional, descriptive and correlational study with 282 health professionals from the emergency services of the city of Ribeirão Preto, Brazil, collected from October 2015 to March 2016. Th...
Article
Research has suggested a relationship between early life stress, and depression in particular longer episodes of depression with treatment resistant outcomes. However, the underlying mechanisms for this association remain poorly understood. Molecular studies indicate that, in general, the hereditary character of psychiatric disorders are polygenic,...
Article
Full-text available
Background: Posttraumatic stress disorder (PTSD) is a prevalent, chronic, and severe disorder related to traumatic events. Women are disproportionately affected by PTSD than men and are more at risk in the occurrence of sexual assault victimization. Estimates suggest that 50% of women develop PTSD following sexual assault and successful clinical ma...
Article
Crack-cocaine offers a higher risk of abuse than intranasal and intravenous use of cocaine. Yet, current treatments remain disappointing and our understanding of the mechanism of crack-cocaine neurotoxicity is still incomplete. Magnetic resonance images studies on brain changes of crack-cocaine addicts show divergent data. The present study investi...
Article
Full-text available
Recent genome-wide association studies have demonstrated that the genetic burden associated with depression correlates with depression severity. Therefore, conducting genetic studies of patients at the most severe end of the depressive disorder spectrum, those with treatment-resistant depression and who are prescribed electroconvulsive therapy (ECT...
Article
Full-text available
Background: Depressive illness is associated with significant adverse consequences for patients and their families, and for society. Clinical challenges are encountered in the management of patients suffering from depression whether they are designated difficult-to-treat or treatment-resistant. Prospective serial depression treatment trials have s...
Article
Full-text available
Ayahuasca is a South American psychoactive plant brew used as traditional medicine in spiritual and in cultural rituals. This is a review of the current understanding about the pharmacological mechanisms that may be interacting in ayahuasca. Searches were performed using PubMed, PsycINFO, and Web of Science databases and 16 papers were selected. As...
Preprint
BACKGROUND Posttraumatic stress disorder (PTSD) is a prevalent, chronic, and severe disorder related to traumatic events. Women are disproportionately affected by PTSD than men and are more at risk in the occurrence of sexual assault victimization. Estimates suggest that 50% of women develop PTSD following sexual assault and successful clinical man...
Chapter
For both research and clinical purposes, scales are often used to measure various phenomena, such as anxiety, depression, quality of life, and other mental states. The use of psychiatric scales in clinical practice is widely known and can be useful as a part of diagnostic evaluations, to identify the presence or absence of a given mental disorder,...
Chapter
Substantial evidence from various studies suggests a preeminent role for early adverse experiences in the development of psychopathology. The most recent studies reviewed here suggest that early life stressors are associated with an increased risk for anxiety disorders in adulthood. Early life stress predisposes individuals to develop a number of p...
Chapter
Bipolar disorders are severe and have a high prevalence; despite this, the neurobiological mechanisms are far from being elucidated, and this limits the development of new treatments. Although the aetiology of bipolar disorders is not yet fully understood, it is accepted that the disorder(s) may result from the interaction between genetic factors t...
Chapter
Hormones have a crucial part in the progress and manifestation of a wide variety of different behaviors. The main influence of the neuroendocrine system on behavior is its action on the neurobiology of neuropsychiatric disorders and its relationship with the pharmacodynamics of medicines. Of all the neuroendocrine axes, the hypothalamic-pituitary-a...
Article
The hypothalamic-pituitary-adrenal axis has been implicated in the pathophysiology of depressive disorders. HSD11B1 encodes 11β-hydroxysteroid dehydrogenase type1 enzyme, responsible for converting cortisone to cortisol. Genetic polymorphisms in HSD11B1 may impact in depression outcome and risk of suicide. This study aimed to assess whether HSD11B1...
Article
Objective: Seasonal Affective Disorder (SAD) is a form of cyclic mood disorder that tends to manifest as winter depression. SAD has anecdotally been described as a hypocortisolemic condition. However, there are no systematic reviews on SAD and Hypothalamic-Pituitary-Adrenal (HPA) axis function. This review intends to summarize these findings. Met...
Article
It is estimated that comorbidity between depression and chronic pain reaches more than half of the depressed adult patients around the world. Evidence indicates that some stressors, such as early-life stress (ELS), mediate the co-occurrence of depression and chronic pain. This study aimed to assess whether ELS or any of its subtypes could be consid...
Article
Numerous studies have researched the aggravating and maintainer effect of Early Life Stress in patients adults with psychiatric disorders. This study examined the relationship between depression and subtypes of early life stress among 81 psychiatric patients treated at the inpatient Day Hospital Unit of a University General Hospital. Psychiatric di...
Conference Paper
Full-text available
Background Ayahuasca is a South American psychoactive plant-brew used traditionally for religious or ceremonial purposes. Its use has been rapidly spreading into the West accompanied by claims of its therapeutic ability to treat an extraordinarily broad range of physical and psychological conditions. Studies have begun investigating some of the pot...
Article
Full-text available
Background: Childhood sexual abuse (CSA) is a prevalent subtype of early life stress associated with changes in immunological and neuroendocrine systems leading to inflammatory responses of the organism and increasing several inflammatory and immune markers. We aimed to conduct a systematic review concerning the association between CSA and indicato...
Article
Full-text available
Objective: To identify the therapeutic practices of a Day Hospital Mental Health directed support to social support networks for people with mental disorders. Methodology: Qualitative, exploratory, descriptive study associated with participant observation techniques, interviews and documentary review carried out from March 31 to April 17, 2014, in...
Article
Anxiety is widely known to compose symptoms of a considerable number of psychiatric disorders. A previous report suggested a facial expression for anxiety. To replicate and expand on this subject, we tested the accuracy with which observers would match an apparent risk-assessment facial behavior with potentially threatening fictitious scenarios. In...
Article
Depressive symptoms are present in the depressive mood state of bipolar disorder (BPD) and major depression disorder (MDD). Often, in clinical practice, BPD patients are misdiagnosed with MDD. Therefore, genetic biomarkers could contribute to the improvement of differential diagnosis between BPD and MDD. This systematic and critical review aimed to...
Chapter
Considerable evidence from various studies suggests a preeminent role for early adverse experiences in the development of psychopathology, especially depression. The most recent studies reviewed herein suggest that early life stressors are associated with an increased risk for mood disorders in adulthood. This review examines the emerging literatur...
Article
Full-text available
Background: Peritraumatic dissociation has become increasingly important for both the diagnosis and the prognosis of Post-traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD). Changes in inflammatory mediators, immune-related genes and alterations of the hypothalamic-pituitary adrenal axis are suggestive findings that support the role o...
Article
Full-text available
RESUMO: O objetivo deste estudo é problematizar a questão do estigma das pessoas com transtornos mentais em sua relação com a política de saúde mental vigente no Brasil, na perspectiva de sua inclusão social. Método: Artigo teórico baseado na matriz normativa da Política Nacional de Saúde Mental publicada até dezembro de 2013 e nos estudos publ...
Article
Full-text available
Abstract – To describe the therapeutic approaches of the Mental Health Day Hospital in care and psychosocial rehabilitation of its users. Case Study of the techniques associated with document review and participant observation in Day Hospital, Clinical Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, in the period from 31/3...
Article
Background The link between the abnormalities of the Hypothalamic-pituitary-adrenal (HPA) axis and depression has been one of the most consistently reported findings in psychiatry. At the same time, multiple studies have demonstrated a stronger association between the increased activation of HPA-axis and melancholic, or endogenous depression subtyp...
Article
Full-text available
Objetivos: a) Descrever a inserção do Hospital-Dia/Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto/Universidade de São Paulo, na rede de atenção em saúde mental do Departamento Regional de Saúde XIII, no Estado de São Paulo; b) Identificar os mecanismos de gestão voltados para a intersetorialidade e integralidade da atenção. Método...
Article
Full-text available
BACKGROUND: In the treatment of mental patients is essential to support the family and the community. On the one hand, the family-support therapies for understanding the illness of the phenomenon, demystifying the disease and its forms of treatment and on the other, the incentive mechanisms to social support networks, as forms of support in the per...
Article
Full-text available
A recent article by Kwan and colleagues could elegantly demonstrate the necessary interaction between neuronal serotonin (5-HT) systems and the hypothalamic-pituitary-adrenal (HPA) axis through glucocorticoid receptors (GR), producing an adequate stress response, in this case, responding to hypoxia with an increase in hematopoietic stem and progeni...
Article
Full-text available
RESUMO Esta revisão tem o objetivo de introduzir aspectos históricos, epidemiológicos e etiológicos do transtor-no bipolar, além de apresentar a caracterização e curso da doença e algumas questões relativas ao diagnóstico, tratamento e prognóstico. O Transtorno Bipolar (TB) é caracterizado por graves alterações de humor, que envolvem períodos de hu...
Article
Full-text available
O objetivo deste artigo é introduzir o aluno de graduação na área da saúde, em especial o aluno de Medicina, no campo da psicofarmacoterapia para o tratamento dos transtornos mentais. Para isso, serão revisados os principais psicofármacos utilizados na atualidade, seus mecanismos de ação, suas indica- ções e contra-indicações, seus efeitos colatera...
Article
Full-text available
Os Transtornos relacionados a traumas e a estressores são quadros psiquiátricos relacionados a exposi- ção a um evento traumático ou estressante, resultando em sofrimento psicológico relevante, prejuízo social, profissional e em outras áreas importantes da vida do indivíduo. A apresentação clínica de tais transtornos é caracterizada por sintomas de...
Article
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Os Transtornos da personalidade são padrões psicológicos de difícil diagnóstico que exigem uma avaliação criteriosa por parte do profissional da saúde mental. A relação médico-paciente também se configura como fator de extrema importância para o manejo destes quadros. Dentro deste contexto, é imprescindível orientar os alunos das áreas de graduação...
Article
Full-text available
ABSTRACT Depression is a common, recurrent and chronic disease with a high prevalence in the world population. It is a disease that affects the individual organism as a whole, affecting, in addition to mood, cognitive, neuroendocrine and physiological functions, impairing personal, social and laboral well-being. Depression is multifactorial (intrin...
Article
N.B, Bosaipo, M.P. Foss, A.H. Young and M.F. Juruena. Neuropsychological Changes in Melancholic or Non-Melancholic Depression: A Systematic Review. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 201x. There is not a consensus as to whether neuropsychological profiling can distinguish depressive subtypes. We aimed to systematically review and critically analy...
Poster
Full-text available
O Burnout tem ocupado uma posição relevante entre os problemas de saúde que afetam os profissionais de saúde por estar associado ao absenteísmo, incapacidades, enfermidades e por reduzir o bem-estar laboral. Pode ser gerador de graves consequências e estar relacionada aos diversos fatores.
Article
Full-text available
Introduction:: Since the second half of the twentieth century the discussions about mental patient care reveal ongoing debate between two health care paradigms: the biomedical/biopsychosocial paradigm and the psychosocial paradigm. The struggle for hegemony over the forms of care, on how to deal optimally with the experience of becoming ill is und...