Follow-up of a cohort of victims of violence derived from an epidemiological study: analysis outcomes, related to brain structures, genetics, and neuropsychological function, and clinical features

Abstract

We intend to follow-up a cohort of victims of violence, based on an epidemiological study at São Paulo city, that developed (n=43 cases) or not (n= 101 controls) posttraumatic stress disorder (PTSD), and 81 cases with PTSD that looked up for treatment at the outpatient clinic of the program for treatment and study of violence of the Federal university of São Paulo (PROVE)-UNIFESP, and 42 victims of violence, without PTSD. The total sample has 267 subjects, being 124 cases and 143 controls. We will have two subsamples of PTSD patients, from spontaneous and by chance (nested-based case), providing further intra group comparisons. All subjects were administered up to two-years an evaluation battery with socio demographic, clinical, abuse antecedents, subsample performed neuropsychological evaluation, magnetic resonance imaging studies to evaluate volume of specific brain regions, functional brain imaging studies to evaluate dopamine transporter receptor concentration, hypothalamic-pituitary-adrenal axis evaluation using the prednisolone suppression test, candidate genes evaluation (BDNF, glucocorticoid receptors, dopaminergic, serotoninergic systems). All patients with PTSD received treatment based on international guidelines. We intend to evaluate the cohort outcome, after at least two years on the former case-control study, related to their clinical status: remission, relapse, death, non-adherence to treatment and its reasons, and re-evaluate some neuropsychological functions. This cohort evaluation, born from a "nested case control sample" and a spontaneous sample, will produce a original data of great relevance to our reality here in Brazil. (AU)