Evaluación de la autoescala de Zung y Conde en el diagnóstico de depresión en población geriátrica / Evaluation of the Zung and Conde self-scale in the diagnosis of depression in the geriatric population

RESUMEN Fundamento: los adultos mayores son vulnerables a padecer síntomas depresivos. Es importante su detección precoz y tratamiento oportuno. Dentro de los instrumentos más utilizados en la literatura médica para la evaluación de la sintomatología depresiva se encuentra la autoescala de Zung y Conde. Objetivo: determinar la capacidad diagnóstica de la autoescala de Zung y Conde para síntomas depresivos en población geriátrica cubana. Métodos: desde el enfoque cuantitativo se realizó un estudio descriptivo, con diseño transversal, entre mayo de 2019 y marzo de 2020. El universo estuvo constituido por 12 223 adultos mayores del municipio Holguín. Se seleccionaron 100 adultos mayores a través de un muestreo probabilístico. Se consideraron como variables las sociodemográficas, el funcionamiento cognitivo, síntomas depresivos y la capacidad diagnóstica para los síntomas depresivos de la autoescala. Se utilizaron la entrevista semiestructurada, la autoescala de depresión de Zung y Conde, el Mini-examen del estado mental de Folstein, el índice de Katz y la escala de Lawton. Los resultados se procesaron en los paquetes estadísticos EPIDAT 3.1 y MedCalc. Resultados: en general el instrumento mostró una sensibilidad y especificidad moderadas para el diagnóstico de síntomas depresivos. El punto de corte con mayor área bajo la curva fue ≥41. Conclusiones: la autoescala de depresión de Zung y Conde demostró tener una buena capacidad diagnóstica del posible padecimiento de síntomas depresivos en población geriátrica cubana. El punto de corte para una mejor relación sensibilidad-especificidad fue a partir de 41.

ABSTRACT Background: elderly are vulnerable of suffering from depressive symptoms. Its early detection and timely treatment is important. One of the most widely used instruments in the medical literature for the evaluation of depressive symptoms is the Zung and Conde self-scale. Objective: to determine the diagnostic capacity of the Zung and Conde self-scale for depressive symptoms in a Cuban geriatric population. Methods: from the quantitative approach, a descriptive study was carried out, with a cross-sectional design, between May 2019 and March 2020. The universe was made up of 12,223 elderly people from the Holguín municipality. 100 elderly were selected through probability sampling. Socio-demographic variables, cognitive functioning, depressive symptoms, and diagnostic capacity for depressive symptoms of the Zung and Conde self-scale were considered as variables. The semi-structured interview, the Zung and Conde depression self-scale, the Folstein Mini-Examination of Mental State (M.M.S.E), the Katz index and the Lawton scale were used. The results were processed in the EPIDAT 3.1 and MedCalc statistical packages. Results: in general, the instrument showed moderate sensitivity and specificity for the diagnosis of depressive symptoms. The cut-off point with the largest area under the curve was ≥41. Conclusions: the Zung and Conde depression self-scale showed a good diagnostic capacity for the possible suffering of depressive symptoms in the Cuban geriatric population. The cut-off point for a better sensitivity-specificity relationship was from 41.

La depresión como enfermedad: en defensa del modelo biomédico en psiquiatría / In defense of the biomedical model in psychiatry. the case of depression

Defining what is meant by "mental illness" has three dimensions: (i) the ontological dimension, which attempts to answer the question of what is a mental illness in itself, (ii) the scientific dimension, which attempts to identify its causes, and (iii) the practical dimension, which will seek a treatment. This article uses depression to examine how various conceptual alternatives in contemporary literature attempted to tackle the problem of what is a mental illness. After evaluating the scope of their proposals in the three dimensions mentioned above, it is concluded that the biomedical model could become a good candidate for developing a useful framework for understanding, having a scientific explanation and treating depression.

Study on Criteria for Commonly-Seen TCM Syndromes of Depression / 中医杂志

Objective:To establish criteria of commonly-seen TCM syndromes of depression.Methods:Consultation of specialists,clinical epidemiological survey,scores of syndrome degree rating and statistical analysis of multiple factors were adopted to establish the criteria for main syndrome differentiation of 5 commonly-seen TCM syndromes of depression.Results:Of 1977 cases of depression,1731 cases were stagnation of the liver-Qi,stagnation of the liver-Qi and deficiency of the spleen,stagnation of the liver-Qi and phlegm,deficiency of both the heart and spleen,and Yin-deficiency of both the liver and kidney.And according to statistical analysis,the criteria for main syndrome differentiation of the 5 syndromes were established.Conclusion:Commonly-seen syndromes of depression have common cause of disease and pathogenesis.Stagnation of the liver-Qi is basic syndrome,and in clinical manifestation of various syndromes emotional depression is common main syndrome,but various syndromes still have other main syndrome.