Rodrigo Nicolato

Federal University of Minas Gerais, Cidade de Minas, Minas Gerais, Brazil

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Publications (75)131.23 Total impact

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    ABSTRACT: Background: The prevalence of antenatal depression (AD) among pregnant women varies according to the populations under study and the periods of evaluation. This paper investigated patterns of AD prevalence and risk factors in a Brazilian sample. Methods: Using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale, the Beck Depression Inventory, and the Mini-International Neuropsychiatric Interview-Plus (MINI), 148 pregnant women were assessed in their second and third trimesters. Bivariate and multivariate analyses were used to determine the prevalence of and the significant risk factors for AD across both trimesters (p<0.05). Results: The prevalence of AD using the MINI was 13.5% and 10.1% in the second and third trimester, respectively. Prevalence rates using the symptom scales were even higher. In our bivariate analysis, lifetime major depression was the main AD risk factor (p<0.001), along with the number of sons (p=0.02) and intimate partner abuse (p=0.03). After adjustment for confounding factors, only lifetime major depression (p<0.001) and intimate partner abuse (p=0.02) remained as independent risk factors. There were no statistically significant differences in the AD prevalence rates and risk factors found when comparing across trimesters. Limitations: The study is limited by possible selection bias introduced by the method of recruitment and the number of women lost to follow up. Conclusion: AD prevalence rates found are close to the worldwide rates. Lifetime major depression was the main risk factor for AD in our study.
    No preview · Article · Mar 2016 · Journal of Affective Disorders
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    ABSTRACT: Objective: Approximately one-half of all patients affected by bipolar disorder present with psychotic features on at least one occasion. Several studies have found that alterations in the activity of mesolimbic and prefrontal regions are related to aberrant salience in psychotic patients. The aim of the present study was to investigate the structural correlates of a history of hallucinations in a sample of euthymic patients with bipolar I disorder (BD-I). Methods: The sample consisted of 21 euthymic patients with BD-I and no comorbid axis I DSM-IV-TR disorders. Voxel based morphometry (VBM) was used to compare patients with and without a lifetime history of hallucinations. Preprocessing was performed using the Diffeomorphic Anatomical Registration through Exponentiated Lie Algebra (DARTEL) algorithm for VBM in SPM8. Images were processed using optimized VBM. Results: The main finding of the present study was a reduction in gray matter volume in the right posterior insular cortex of patients with BD-I and a lifetime history of hallucinations, as compared to subjects with the same diagnosis but no history of hallucinations. Conclusions: This finding supports the presence of abnormalities in the salience network in BD patients with a lifetime history of hallucinations. These alterations may be associated with an aberrant assignment of salience to the elements of one's own experience, which could result in psychotic symptoms.
    Full-text · Article · Jan 2016 · Revista Brasileira de Psiquiatria

  • No preview · Article · Jan 2016 · International Journal of Geriatric Psychiatry
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    ABSTRACT: Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer's disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity.
    Full-text · Article · Aug 2015 · Frontiers in Aging Neuroscience
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    ABSTRACT: Suicide is one of the major causes of preventable death. We evaluated suicidality among pregnant women who participated in prenatal care in Brazil. A total of 255 patients were assessed using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Mini-International Neuropsychiatric Interview (MINI) Plus. Thereafter, Stata 12 was used to identify the significant predictors of current suicide risk (CSR) among participants using univariate and multivariate analyses (p < 0.05). According to MINI Plus module C, the lifetime suicide attempt rate was 12.55 %. The overall CSR was 23.53 %, distributed across risk levels of low (12.55 %), moderate (1.18 %), and high (9.80 %). Our rates approximate those found in another Brazilian study (18.4 %). Antenatal depression (AD), lifetime bipolar disorder, and any current anxiety disorder (as measured using the MINI) as well as BDI scores ≥15 and EPDS scores ≥11 were identified as positive risk factors in a univariate analysis (p < 0.001). These factors changed after a multivariate analysis was employed, and only years of education [odds ratio (OR) = 0.45; 95 % confidence intervals (CIs) = 0.21-0.99], AD (OR = 3.42; 95 % CIs = 1.37-8.53), and EPDS scores ≥11 (OR = 4.44; 95 % CIs = 1.97-9.97) remained independent risk factors. AD and other psychiatric disorders were the primary risk factors for suicidality, although only the former remained an independent factor after a multivariate analysis. More than 10 years of education and EPDS scores ≥11 were also independent factors; the latter can be used as a screening tool for suicide risk.
    No preview · Article · Jul 2015 · Archives of Women s Mental Health
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    ABSTRACT: Previous studies suggest that executive functions influence the performance on visuoconstructional tasks. This study aims to investigate whether the relationship between planning ability and the copy of complex figures is mediated by distinct components of executive functions (i.e., working memory, inhibitory control and cognitive flexibility). We included a 129 older adults with Alzheimer’s disease ( n =36, AD), mild cognitive impairment (MCI, n =67), and with no evidence of cognitive impairment (controls, n =26). We evaluated the mediation effect of planning abilities, working memory, cognitive flexibility and inhibitory control on visuoconstructional tasks using a multiple mediation models. We found a significant direct effect of planning on visuoconstructional abilities and a partial mediation effect of working memory and cognitive flexibility on visuoconstructional abilities. The present results indicate that the performance on visuoconstructional task is mediated by multiple interrelated executive functions components, in particular working memory and cognitive flexibility. ( JINS , 2015, 21 , 392–398)
    Full-text · Article · Jun 2015 · Journal of the International Neuropsychological Society
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    ABSTRACT: Facial emotion recognition (FER) is one of the many cognitive deficits reported in bipolar disorder (BD) patients. The aim of this study was to investigate neuroanatomical correlates of FER impairments in BD type I (BD-I). Participants comprised 21 euthymic BD-I patients without Axis I DSM IV-TR comorbidities and 21 healthy controls who were assessed using magnetic resonance imaging and the Penn Emotion Recognition Test (ER40). Preprocessing of images used DARTEL (diffeomorphic anatomical registration through exponentiated Lie algebra) for optimized voxel-based morphometry in SPM8. Compared with healthy subjects, BD-I patients performed poorly in on the ER40 and had reduced gray matter volume (GMV) in the left orbitofrontal cortex, superior portion of the temporal pole and insula. In the BD-I group, the statistical maps indicated a direct correlation between FER on the ER40 and right middle cingulate gyrus GMV. Our findings are consistent with the previous studies regarding the overlap of multiple brain networks of social cognition and BD neurobiology, particularly components of the anterior-limbic neural network. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · May 2015 · Psychiatry Research: Neuroimaging
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    ABSTRACT: Bipolar disorder (BD) is common in clinical psychiatric practice, and several studies have estimated its prevalence to range from 0.5 to 5% in community-based samples. However, no systematic review and meta-analysis of the prevalence of BD type 1 and type 2 has been published in the literature. We carried out a systematic review and meta-analysis of the lifetime and 1-year prevalence of BD type 1 and type 2 and assessed whether the prevalence of BD changed according to the diagnostic criteria adopted (DSM-III, DSM-III-R vs. DSM-IV). We searched MEDLINE, Scopus, Web of Science, PsycINFO, and the reference lists of identified studies. The analyses included 25 population- or community-based studies and 276,221 participants. The pooled lifetime prevalence of BD type 1 was 1.06% (95% confidence interval [95%CI] 0.81-1.31) and that of BD type 2 was 1.57% (95%CI 1.15-1.99). The pooled 1-year prevalence was 0.71% (95%CI 0.56-0.86) for BD type 1 and 0.50% (95%CI 0.35-0.64) for BD type 2. Subgroup analysis showed a significantly higher lifetime prevalence of BD type 1 according to the DSM-IV criteria compared to the DSM-III and DSM-IIIR criteria (p < 0.001). This meta-analysis confirms that estimates of BD type 1 and type 2 prevalence are low in the general population. The increase in prevalence from DSM-III and DSM-III-R to DSM-IV may reflect different factors, such as minor changes in diagnostic operationalization, use of different assessment instruments, or even a genuine increase in the prevalence of BD.
    Full-text · Article · May 2015 · Revista Brasileira de Psiquiatria
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    ABSTRACT: Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.
    Full-text · Article · Mar 2015
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    ABSTRACT: Antenatal depression (AD) can have devastating consequences. No existing scales are specifically designed to measure it. Common practice is to adapt scales originally developed for other circumstances. We designed this study to validate and determine the psychometric values for AD screening in Brazil. We collected clinical and socio-demographic data in the second gestational trimester. The following instruments were also administered during that period: MINI-PLUS, EPDS, BDI and HAM-D. At the time of assessment, 17.34% of the patients were depressed, and 31.98% met the diagnostic criteria for lifetime major depression. All instruments showed an area under the curve in a receiver operating characteristic analysis greater than 0.85, with the BDI achieving a 0.90 and being the best-performing screening instrument. A score ≥11 on the EPDS (81.58% sensitivity, 73.33% specificity), ≥15 on the BDI (82.00% sensitivity, 84.26% specificity) and ≥9 on the HAM-D (87.76% sensitivity, 74.60% specificity) revealed great dichotomy between depressed and non-depressed patients. Spearman׳s rank correlation coefficients (ρ) among the scales had good values (EPDS vs. BDI 0.79; BDI vs. HAM-D 0.70, and EPDS vs. HAM-D 0.67). This study was transversal, assessing only women in the second gestational trimester. Results may be applicable only to the Brazilian population since psychometric properties may vary with the population under study. Major depression can amplify somatic symptomatology, affecting depressive rating scale data. AD is highly prevalent in Brazil. To address the problem of under-recognition, physicians can use the EPDS, BDI and HAM-D to identify AD. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Feb 2015 · Journal of Affective Disorders

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  • No preview · Article · Jan 2015
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    ABSTRACT: Examine the association between polymorphisms in the AKT1 and AKTIP genes and late-onset depression (LOD). Major depressive disorder is one of the most prevalent neuropsychiatric diseases. LOD is a disorder that starts after 65 years old. AKT1 is a downstream enzyme that has been implicated in the pathogenesis of neurotransmitter-related disorders, such as depression. The identification of a novel AKT1-binding protein (AKTIP) was pointed as an important new target. AKTIP binds directly to AKT1, enhancing the phosphorylation of regulatory sites, and this modulation are affected by AKT1 activation. The association of AKT1 and AKTIP polymorphisms with depressive symptoms was not investigated in LOD. Genotype tagSNPs in the AKT1 and AKTIP in LOD patients and controls. An academic medical center. Sample composed by 190 outpatients with LOD and 77 healthy individuals. The participants were evaluated using Diagnostic and Statistical Manual IV criteria, MINI-PLUS and the Geriatric Depression Scale. Our findings suggested an association between the tagSNP rs3730358 homozygous A/A (p = 0.006) and LOD. A strong association of allele A and increased association for LOD was demonstrated with tagSNP rs3730358 (p-value = 0.003). Limitation include composition of our control group, where the exclusion criteria generated a kind of super-healthy older group what might have produced a hidden stratification when compared with the LOD. This study is the first one to establish the association of the AKT1/AKTIP genes and LOD, and further studies are necessary to clarify the functional role of these proteins. Copyright © 2013 John Wiley & Sons, Ltd.
    No preview · Article · Apr 2014 · International Journal of Geriatric Psychiatry
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    ABSTRACT: Background: Sensorimotor deficits are an important phenomenological facet observed in patients with bipolar disorder (BD). However, there is little research on this topic. We hypothesize that the MPraxis test can be used to screen for motor impairments in BD aiming movements. Method: The MPraxis, which is a quick and easy-to-apply computerized test, measures sensorimotor control. During the test, the participant must move the computer mouse cursor over an ever-shrinking green box and click on it once. We predict that the MPraxis test is capable of detecting differences in sensorimotor performance between patients with BD and controls. We assessed 21 euthymic type I BD patients, without DSM-IV-TR Axis I comorbidity, and 21 healthy controls. Results and conclusions: Compared to the controls, the patients with BD presented a lower response time in their movements in all conditions. Our results showed sensorimotor deficits in BD and suggested that the MPraxis test can be used to screen for motor impairments in patients with euthymic BD.
    Full-text · Article · Mar 2014 · Revista Brasileira de Psiquiatria
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    ABSTRACT: Objective: To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods: In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. Results: Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (> 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. Conclusion: The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD.
    Full-text · Article · Jan 2014 · Revista Brasileira de Psiquiatria
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    ABSTRACT: The neuropsychological exam plays a central role in the assessment of elderly patients with cognitive complaints. It is particularly relevant to differentiate patients with mild dementia from those subjects with mild cognitive impairment. Formal education is a critical factor in neuropsychological performance; however, there are few studies that evaluated the psychometric properties, especially criterion related validity, neuropsychological tests for patients with low formal education. The present study aims to investigate the validity of an unstructured neuropsychological assessment protocol for this population and develop cutoff values for clinical use. A protocol composed by the Rey-Auditory Verbal Learning Test, Frontal Assessment Battery, Category and Letter Fluency, Stick Design Test, Clock Drawing Test, Digit Span, Token Test and TN-LIN was administered to 274 older adults (96 normal aging, 85 mild cognitive impairment and 93 mild Alzheimer`s disease) with predominantly low formal education. Factor analysis showed a four factor structure related to Executive Functions, Language/Semantic Memory, Episodic Memory and Visuospatial Abilities, accounting for 65% of explained variance. Most of the tests showed a good sensitivity and specificity to differentiate the diagnostic groups. The neuropsychological protocol showed a significant ecological validity as 3 of the cognitive factors explained 31% of the variance on Instrumental Activities of Daily Living. The study presents evidence of the construct, criteria and ecological validity for this protocol. The neuropsychological tests and the proposed cutoff values might be used for the clinical assessment of older adults with low formal education.
    Full-text · Article · Oct 2013 · PLoS ONE
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    ABSTRACT: Objective: Depressive pseudodementia (DPD) is a clinical condition characterized by depressive symptoms followed by cognitive and functional impairment characteristics of dementia. Memory complaints are one of the most related cognitive symptoms in DPD. The present study aims to assess the verbal learning profile of elderly patients with DPD. Methods: Ninety-six older adults (34 DPD and 62 controls) were assessed by neuropsychological tests including the Rey auditory-verbal learning test (RAVLT). A multivariate general linear model was used to assess group differences and controlled for demographic factors. Results: Moderate or large effects were found on all RAVLT components, except for short-term and recognition memory. Conclusion: DPD impairs verbal memory, with large effect size on free recall and moderate effect size on the learning. Short-term storage and recognition memory are useful in clinical contexts when the differential diagnosis is required.
    Full-text · Article · Sep 2013 · Arquivos de neuro-psiquiatria
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    ABSTRACT: Background Planning is a component of executive functions and refers to the ability to establish the best way to achieve a specific goal, considering the hierarchy of steps necessary to achieve it. There are two types of planning. The preplanning or look-ahead occurs before the initiation of the behavior to achieve the goal, involving elaboration of a sequence of steps and their consequences. While online planning occurs when planning and execution are commingled. The Tower of London (TOL) is a classic measure of planning. Complex Figure tests, like the Taylor Complex Figure (TCF), measures spatial abilities, visioconstruction and planning skills. The objective of the present study is to investigate the influence of planning measured by TOL in the quality of the copy of a simplified version of the TCF (sTCF). Methods A heterogeneous group composed of 101 elderly with Clinical Dementia Rating ranging between 0 and 1, with a mean age of 72.67 (SD = 9.59 years) and mean education of 4.46 (SD = 3.951 years), performed the TOL , the copy of sTCF and the Mini-Mental State Examination (MMSE). Bivariate correlations were used to assess which variables are related to the sTCF being significant values used in a linear regression model to evaluate the interference of these on the visioconstruction task. The total sample was divided into three groups related to the effectiveness of planning, paired by age, education and MMSE, using percentiles accumulated total score of TOL (G1 = <16, 16-85 = G2, G3 => 85) and were compared by ANOVA using the Tukey HSD correction. Results No correlation was found between sex and sTCF (p = 0.432). Age, education, MMSE and TOL were used in a stepwise regression with sTCF as a dependent variable, where TOL represented 25% of the explained variance while the addition of the other variables only 8%. There were significant differences in the performance of the three groups in the copy of sTCF (G1-G2: p <0.001; G1-G3: p <0.001; G2-G3: p = 0.032). Conclusions The results indicates that the planning ability influences the quality of the copy of sTCF independent of general cognition, age and education.
    Full-text · Conference Paper · Jul 2013
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    Full-text · Chapter · Jan 2013
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    ABSTRACT: Objective: to evaluate the utilization of the Edinburgh Postnatal depression scale (EPds) as an antepartum depression (aPd) screening tool in the public health system. Method: the scale was administered between the 4th and 6th month of pregnancy to 90 pregnant women whose prenatal appointments occurred at a public maternity hospital located in the municipality of belo horizonte, southeastern brazil, from 2011 to 2012. all participants were submitted to a structured psychiatric interview (mini-Plus 5.0), used as gold standard for APD diagnosis. The EPDS sensitivity and specificity were calculated, and the receiver operating characteristic (ROC) curve was used to find the best instrument cut-off point to discriminated pregnant women with APD symptoms. Reliability was calculated by Cronbach's coeffcient α of internal consistency. Results: aPd was diagnosed in 20 women (22.2% of the total sample). the area under the curve (auc) in a roc analysis was 0.84, indicating that EPds has a good capacity to discriminate women with depression symptoms on antepartum period. Using 09 as the cut-off point, the scale's sensibility was 0.80, the specificity 0.70, and the positive preditive value, 0.43. Conclusions: the psychometric properties of the scale indicated it as an interesting screening tool for antepartum depression and its disseminated use in sistema Único de saúde (sus - national health system) could have positive impacts, with a significant increase in the recognition, diagnosis and treatment of antepartum depression.
    No preview · Article · Jan 2013

Publication Stats

379 Citations
131.23 Total Impact Points

Institutions

  • 2001-2015
    • Federal University of Minas Gerais
      • • Faculty of Medicine
      • • Departamento de Farmacologia
      • • Institute of Biological Sciences
      Cidade de Minas, Minas Gerais, Brazil
  • 2012
    • Unimed Belo Horizonte
      Cidade de Minas, Minas Gerais, Brazil
  • 2008-2009
    • Universidade Federal de Ouro Preto
      Ouro Preto, Minas Gerais, Brazil
  • 2007-2009
    • Fundação Hospitalar do Estado de Minas Gerais
      Cidade de Minas, Minas Gerais, Brazil
  • 2005
    • Universidade José do Rosário Vellano – UNIFENAS
      Rio Preto, São Paulo, Brazil