Evaluación de un protocolo de intervención en Terapia Sistémica Breve para personas expuestas a un evento estresante reciente / Evaluation of a Brief Systemic Therapy intervention protocol for people who have experienced a recent stressful event

Resumen Los eventos altamente estresantes son sucesos que potencialmente generan consecuencias negativas en las personas afectadas, como síntomas postraumáticos y depresivos. El presente estudio evalúa un protocolo de intervención preventiva, orientado a personas que han vivido un evento altamente estresante reciente, basado en la Terapia Sistémica Breve. Cuatro terapeutas aplicaron el protocolo a cuatro usuarias. Se entrevistó a estas ocho personas acerca de su experiencia en la aplicación y recepción del protocolo. Mediante escalas de fiabilidad y validez contrastada se evaluaron los cambios pre-post en sintomatología postraumática, sintomatología depresiva, crecimiento postraumático y satisfacción con la vida; también se midió la relación terapéutica. Los resultados muestran apreciaciones positivas en terapeutas y usuarias, el desarrollo de una relación terapéutica adecuada y avances en tres de los cuatro indicadores cuantitativos de cambio. Se concluye que el protocolo está en condiciones de utilizarse en estudios controlados.

Abstract Highly stressful events are occurrences that potentially create negative consequences for the affected people, such as post-traumatic and depressive symptoms. This study assesses a preventive intervention protocol, aimed to people who have lived a recent highly stressful event, based on the Brief Systemic Therapy. Four therapists applied the protocol to four female users. These eight persons were interviewed about the experience in relation to the application and reception of the protocol. Through contrasted reliability and validity scales, pre and post changes in posttraumatic symptomatology, depressive symptomatology, posttraumatic growth and satisfaction with life were assessed; the therapeutic relation was also measured. The results show positive appraisals in therapists and female users, the development of a proper therapeutic relation and progress in three out of four quantitative change indicators. It is concluded that the protocol is suitable to be used in controlled studies.

Avaliação de Bem-Estar Psicológico e Sintomas Depressivos em Idosos Saudáveis / Evaluation of Psychological Well-Being and Depressive Symptoms in Healthy Elderly People / Evaluación de Bienestar Psicológico y Sintomas Depresivos en Los Idosos Saludables

O objetivo deste trabalho foi avaliar a relação entre bem-estar psicológico e a presença de sintomas depressivos em idosos saudáveis. Os instrumentos utilizados foram: ficha de dados sociodemográficos, EDEP e BDI-II. Os dados foram analisados com o auxílio do SPSS, por meio de frequências, média, desvio padrão e correlações de Spearman. A amostra foi composta por 64 idosos, com média de idade de 69,61 (DP=7,58) e média de escolaridade de 4,59 anos de estudo (DP=2,61). Os resultados indicaram correlação inversa, moderada e significativa entre sintomatologia depressiva e os domínios autonomia, ambiente e relações positivas com os outros, encontrou-se ainda correlação inversa e fraca entre sintomatologia depressiva e crescimento pessoal. Acredita-se que escolaridade e atividade física podem ser fatores protetivos para depressão e bem-estar psicológico no envelhecimento. Por fim, levanta-se a hipótese de haver uma retroalimentação entre as variáveis que se correlacionaram entre si de forma significativa neste estudo. (AU)

The main objective of this study was to evaluate the relationship between psychological well-being and depressive symptoms in healthy elderly people. The instruments used were: sociodemographic data questionnaire, EDEP and BDI-II. The data were analyzed in the SPSS using mean and SD, and Spearman correlations. The sample consisted of 64 elderly, with a mean age of 69.61 years (SD=7.58) and a mean educational level of 4.59 years (SD=2.61). The results indicate an inverse, moderate and significant correlation between depressive symptomatology and the domains: autonomy, environment, and positive relationships with others. There was also an inverse and weak correlation between depressive symptomatology and personal growth domain. It is believed that education level can be a protective factor for depression and psychological well-being in aging. Finally, the hypothesis is that there is a feedback cycle between the significantly correlated variables in this study. (AU)

El objetivo de este trabajo fue evaluar la relación entre bienestar psicológico y la presencia de síntomas depresivos en ancianos sanos. Los instrumentos utilizados fueron: ficha de datos sociodemográficos, EDEP y BDI-II. Los datos fueron analizados con la ayuda del SPSS, por medio de frecuencias, media, desviación estándar y correlaciones de Spearman. La muestra fue compuesta por 64 ancianos, siendo la media de edad fue 69,61 (+7,58) y la media de escolaridad fue de 4,59 años de estudio (+2,61). Los resultados indicaron correlación inversa, moderada y significativa entre sintomatología depresiva y los dominios autonomía, ambiente y relaciones positivas con los demás, se encontró una correlación inversa y débil entre sintomatología depresiva y crecimiento personal. Se cree que la escolaridad y la actividad física son factores protectores para la depresión y el bienestar psicológico en el envejecimiento. Por último, se plantea la hipótesis de que hay una retroalimentación entre las variables que se correlacionaron entre sí de forma significativa en este estudio. (AU)

Análise de estrutura interna do Inventário de Depressão Maior (MDI) / Internal structure analysis of the Major Depression Inventory (MDI) / Análisis de estructura interna del Inventario de Depresión Mayor (MDI)

O objetivo do estudo foi avaliar as qualidades psicométricas do Inventário de Depressão Maior (MDI). O MDI foi aplicado em 714 estudantes universitários e em 12 pessoas com diagnóstico de depressão. Realizaram-se análises de estrutura interna via TCT e TRI, bem como confiabilidade, sensibilidade e especificidade. A solução unidimensional foi a mais coerente teoricamente e os parâmetros via TCT adequados, com confiabilidade de 0,89. Já, via TRI, nem todos os parâmetros adequados foram respeitados, tais como índices de infit e outfit, além de categorias de respostas não discriminativas. Os índices de acurácia também demonstraram limitações, principalmente com relação aos falsos negativos (especificidade de 63,9). Assim, sugere-se a realização de novos estudos analisando-se os dados via TRI, bem como um grupo clínico maior, diagnosticados com entrevista estruturada padrão.

The objective of the study was to evaluate the psychometric qualities of the Major Depression Inventory (MDI). The MDI was applied to 714 university students and 12 people diagnosed with depression. Internal structure analyses were performed using TCT and IRT, as well as reliability, sensitivity, and specificity. The one-dimensional solution was the most coherent theoretically and the parameters via suitable TCT, with a reliability of 0.89. Already, via IRT, not all appropriate parameters were respected, such as infit and outfit indexes, as well as categories of non-discriminative responses. Accuracy indexes also showed limitations, especially concerning false negatives (specificity of 63.9). Thus, it is suggested to perform new studies analyzing the data via IRT, as well as a larger clinical group, diagnosed with a standard structured interview.

El objetivo del estudio fue evaluar las calidades psicométricas del Inventario de Depresión Mayor (MDI). El MDI fue aplicado en 714 estudiantes universitarios y en 12 personas con diagnóstico de depresión. Se realizaron análisis de estructura interna vía TCT y TRI, así como confiabilidad, sensibilidad y especificidad. La solución unidimensional fue la más coherente teóricamente y los parámetros vía TCT adecuados, con confiabilidad de 0,89. En cambio, a través de TRI, no se respetaron todos los parámetros adecuados, tales como índices de infit y outfit, además de categorías de respuestas no discriminatorias. Los índices de exactitud también demostraron limitaciones, principalmente con relación a los falsos negativos (especificidad de 63,9). Así, se sugiere la realización de nuevos estudios analizando los datos vía TRI, así como un grupo clínico mayor, diagnosticados con entrevista estructurada estándar.

Relación entre automanejo y síntomas depresivos en personas con diabetes e hipertensión / Relationship between self-management and depressive symptoms in persons with diabetes and hypertension / Relação entre automanejo e sintomas depressivos em pessoas com diabetes e hipertensão

Resumen Introducción: Las personas con diabetes e hipertensión experimentan con mayor frecuencia sintomatología depresiva, lo cual contribuye a un inadecuado automanejo de la enfermedad, que implica tareas como: la toma de la medicación, asistir a las consultas médicas, el conocimiento de signos y síntomas, además de la toma de decisiones. Objetivo: Por lo anterior, el objetivo de este trabajo es identificar la relación entre automanejo en general y sus dimensiones con síntomas depresivos en personas con diabetes e hipertensión. Método: Estudio transversal-correlacional con n=205 pacientes con diagnóstico de diabetes (100) e hipertensión (105). Muestreo no probabilístico por conveniencia. Se utilizó la estadística descriptiva y r de Pearson. Se aplicaron los instrumentos Partners in Health (PIH) y The Patient Health Questionnaire (PHQ-8). Resultados: Se encontró correlación estadísticamente significativa entre la sintomatología depresiva y el automanejo (r=-0.308 ρ<0.001). Discusión y Conclusiones: Se concluye que la sintomatología depresiva se relaciona con el automanejo de la enfermedad de la siguiente manera: a mayor automanejo menor sintomatología de depresión, o a mayor sintomatología depresiva menor automanejo; dicha relación confirma que ambas variables se afectan mutuamente y/o mantienen una relación estrecha.

Abstract Introduction: Persons with diabetes and hypertension frequently suffer from depression as well, a situation which contributes to an inadequate management of the condition in terms of medication, medical consultations, signs, and decision making. Objective: To identify the relationship between general self-management and depression symptoms in persons with diabetes and hypertension. Method: This is a transversal and correlational study with a sample of 205 patients, 100 with a main diagnosis of diabetes, and 105 with a main diagnosis of hypertension. The sampling process was non-probabilistic and by convenience. Descriptive statistics, including Pearson's r were calculated. The Partners in Health (PIH) and Patient Health Questionnaire (PHQ-8) instruments were administered. Results: A statistically significant correlation between depression symptoms and diabetes and hypertension self-management was found (r=-0.308 ρ<0.001). Discussion and conclusions: Depression symptoms were related to how diabetes and hypertension are self-managed in a way that, the more self-management, the less depression symptoms, or the more depression symptoms, the less self-management.

Resumo Introdução: As pessoas com diabetes e hipertensão experimentam com maior frequência a sintomatologia depressiva, o qual contribui a um inadequado automanejo da doença, que envolve tarefas como: a toma da medicação, assistir às consultas médicas, o conhecimento de signos e sintomas, além da toma de decisões. Objetivo: Pelo anterior, o objetivo deste trabalho é identificar a relação entre automanejo em geral e suas dimensões com sintomas depressivos em pessoas com diabetes e hipertensão. Método: Estudo transversal-correlacional com n=205 pacientes com diagnóstico de diabetes (100) e hipertensão (105). Amostragem não probabilística por conveniência. Utilizou-se a estatística descritiva e r de Pearson. Aplicaram-se os instrumentos Partners in Health (PIH) e The Patient Health Questionnaire (PHQ-8). Resultados: Encontrou-se correlação estatisticamente significativa entre a sintomatologia depressiva e o automanejo (r=-0.308 ρ<0.001). Discussão e Conclusões: Conclui-se que a sintomatologia depressiva relaciona-se com o automanejo da doença da seguinte maneira: a maior automanejo, menor sintomatologia de depressão, ou a maior sintomatologia depressiva, menor automanejo; esta relação confirma que ambas variáveis afetam-se mutuamente e/ou mantem uma relação estreita.

Evidências de validade para a escala Baptista de depressão versão hospital-ambulatório (EBADEP-HOSP-AMB) / Validity evidence for the Baptista developmental scale hospital-ambulatory version (EBADEP-HOSP-AMB) / Evidencias de validez para la escala Baptista de depresión versión hospital-ambulatorio (EBADEP-HOSP-AMB)

O objetivo do estudo foi buscar evidências de validade baseadas na relação com variáveis externas para a Escala Baptista de Depressão Versão Hospital-Ambulatório (EBADEP-HOSP-AMB). Participaram 210 pacientes renais crônicos em hemodiálise, com idades entre 18 e 82 anos (M=53,40; DP=14,40), sendo 112 (53,3%) do sexo masculino. Foram aplicados um questionário sociodemográfico/saúde, juntamente com a EBADEP-HOSP-AMB, a Escala Hospitalar de Ansiedade e Depressão (HADS) e a Escala de Pensamentos Depressivos (EPD). As aplicações ocorreram de forma individual durante as sessões de hemodiálise. Foi verificada a relação entre os instrumentos além de possíveis diferenças de média em função das variáveis sociodemográficas. Os principais resultados indicaram correlações significativas de magnitudes moderadas a altas entre os instrumentos. Também foi observado que as mulheres e aqueles que relataram ter diagnóstico de depressão obtiveram escores mais elevados na maioria das escalas apresentando mais sintomatologia depressiva e pensamentos depressivos, bem como ansiedade (AU).

The purpose of the study was to seek validity evidence based on the relationship with external variables for the Hospital-Ambulatory Depression Baptist Scale (EBADEPHOSP-AMB). A total of 210 chronic kidney patients undergoing hemodialysis, aged 18-82 years (M=53.40, SD=14.40), 112 (53.3%) males participated. A sociodemographic/health questionnaire was applied, along with the EBADEP-HOSPAMB, the Hospital Anxiety and Depression Scale (HADS) and the Depressive Thoughts Scale (EPD). The applications occurred individually during the hemodialysis sessions. The relationship between the instruments was verified, besides possible differences of mean according to the sociodemographic variables. The main results indicated significant correlations of moderate to high magnitudes between the instruments. It was also observed that women and those who reported having a diagnosis of depression scored higher on most scales presenting more depressive symptomatology and depressive thoughts as well as anxiety (AU).

El objetivo del estudio fue buscar evidencias de validez basadas en la relación con variables externas para la Escala Baptista de Depresión Versión Hospital-Ambulatorio (EBADEP-HOSP-AMB. Participaron un total de 210 pacientes renales crónicos en hemodiálisis, con edades entre 18 y 82 años (M=53,40; DP=14,40), siendo 112 (53,3%) del sexo masculino. Se aplicó un cuestionario sociodemográfico / salud, junto con EBADEP-HOSP-AMB, la Escala Hospitalaria de Ansiedad y Depresión (HADS) y la Escala de Pensamientos Depresivos (EPD). Los cuestionarios fueron aplicados de forma individual durante las sesiones de hemodiálisis. Se verificó la relación entre los instrumentos además de posibles diferencias de promedio en función de las variables sociodemográficas. Los principales resultados indicaron correlaciones significativas de magnitudes moderadas a altas entre los instrumentos. También se observó que las mujeres y aquellos que reportaron tener diagnóstico de depresión obtuvieron puntuaciones más altas en la mayoría de las escalas presentando más sintomatología depresiva y pensamientos depresivos, así como ansiedad (AU.

Sintomatologia depressiva no termo da gestação, em mulheres de baixo risco / Depressive symptomatology at full-term pregnancy in low risk women

RESUMO Objetivos Calcular a prevalência de sintomatologia depressiva pré-natal em grávidas de baixo risco, no termo da gestação, avaliar seus preditores e desfechos materno-fetais. Para tal, avaliar-se-á a aplicabilidade da Escala de Rastreio de Depressão Pós-Parto (PDSS 24) nessa fase da gravidez. Métodos A PDSS 24 e um questionário sociodemográfico, psicossocial e médico (antecedentes obstétricos e patológicos) foram autoaplicados a 403 grávidas (37-40 semanas de gestação), com idade média de 30,5 anos (DP = 4,67). Por meio do processo clínico, foram recolhidos dados de resultados materno-fetais. Resultados A PDSS 24 possui propriedades psicométricas adequadas para a deteção de sintomatologia depressiva pré-natal. A prevalência de sintomatologia depressiva pré-natal foi de 41,7%. Grávidas com níveis de escolaridade inferiores, não casadas, cuja gravidez não foi planejada e com antecedentes de acontecimentos de vida significativos apresentam risco duas vezes superior de sintomatologia depressiva no período pré-natal. Grávidas cujo apoio social percebido ao longo da gravidez não correspondeu ao desejado e com história prévia de depressão apresentam cerca de três vezes maior risco sintomatologia depressiva no período pré-natal. Para desfechos materno-fetais (pré-eclâmpsia, restrição de crescimento fetal, Apgar 1º/5º minuto, tipo de parto, percentil de peso, oligoâminos e necessidade de cuidados intensivos), as diferenças foram não significativas. Conclusão O rastreio da depressão pré-natal deve ser realizado na gravidez. Porém, no termo da gestação o uso da PDSS 24 como ferramenta de deteção de sintomatologia depressiva deve ser feito com cautela. A elevada prevalência de sintomas relacionados com o sono nessa fase da gestação pode conduzir ao sobre diagnóstico, usando a PDSS 24.

ABSTRACT Objectives The aims of the study were to estimate the prevalence of depressive symptomatology in full-term pregnancy (low risk), evaluate their predictors and maternal-fetal outcomes. To this end, the applicability of Postpartum Depression Screening Scale (PDSS 24) will be evaluated, at full-term pregnancy. Methods PDSS 24 and a sociodemographic, psychosocial, pathological and obstetrical background questionnaire were self-administered to 403 pregnant women (37-40 weeks gestation), with a mean age of 30.5 years (SD = 4.67). Data from maternal, fetal and neonatal outcomes were collected from the patient clinical process. Results PDSS 24 revealed adequate psychometric properties to screening depressive symptomatology in full-term pregnancy. The prevalence of depressive symptomatology was 41.7%. Pregnant women with lower study levels, who weren't married, whose pregnancy was unplanned and with a previous history of significant life events present twice the risk to present depressive symptomatology. Pregnant women who hadn't received the desired social support in pregnancy and with a history of depression present about a 3-fold increased risk to present depressive symptomatology. For maternal-fetal outcomes (pre-eclampsia, fetal growth restriction, Apgar score at 1st/5th minute, type of delivery, weight percentile, oligohydramnios and need for neonatal intensive care), the differences were not significant. Conclusion Screening for prenatal depression should be conducted during pregnancy. However, in full-term pregnancy women, the use of PDSS 24 as a screening tool for depressive symptomatology should be done with caution. The high prevalence of sleep-related symptoms, in full-term pregnancy, may lead to overdiagnosis, using PDSS 24.

Evidências de estrutura interna da Escala Baptista de Depressão: Versão Idoso (EBADEP-ID) / Evidence of the internal structure of the Baptista Depression Scale: Elderly Version (EBADEP-ID)

O objetivo do presente estudo foi investigar propriedades psicométricas da Escala Baptista de Depressão-Versão Idoso (EBADEP-ID). Participaram da pesquisa 244 idosos do estado do Piauí, sem diagnóstico de depressão, com faixa etária variando de 60 a 96 anos (M= 68,85; DP= 9,19), sendo 67,9% do sexo feminino. Os principais resultados indicaram que dos 30 itens iniciais a escala foi reduzida para uma versão mais breve de 15 itens. A escala apresentou uma melhor adequação com uma solução de dois fatores, ambos apresentando valores adequados de alfa de Cronbach (F1: 0,90 e F2: 0,88). Por fim, conclui-se que a EBADEP-ID demonstrou evidências de validade de estrutura interna aceitáveis.

The objective of the present study was to investigate the psychometric properties of the Depression-Elderly Baptista Scale (EBADEP-ID). A total of 244 elderly people from the state of Piauí, with no diagnosis of depression, ranging in age from 60 to 96 years (M = 68.85, SD = 9.19), 67.9% of them female. The main results indicated that of the 30 initial items the scale was reduced to a shorter version of 15 items. The scale was better suited to a two-factor solution, both presenting adequate values of Cronbach’s alpha (F1: 0.90 and F2: 0.88). Finally, it is concluded that EBADEP-ID has demonstrated evidence of acceptable internal structure validity.

Depression and chronic kidney disease: an integrative literature review / Depressão e doença renal crônica: revisão integrativa da literatura / Depresión y enfermedad renal crónica: revisión integrativa de la literatura

Brazilian and international scientific studies on depression and chronic kidney disease published between 2006 and 2016 in the PsycINFO and LILACS databases were analyzed. In total, 269 publications were analyzed against the inclusion and exclusion criteria, so that 21 articles remained for analysis. The studies were evaluated for the year of publication, periodicals, objectives, sample, results, associated constructs, and instruments of depression. The prevalence of depressive symptoms varied from 7.8% to 83.49%. Also, most samples were small and included both sexes. The year with most publications was 2011, and the Beck Depression Inventory was used in 66.67% of the studies. It is important to evaluate depression using instruments that take into account the specificities of the context in order to reduce bias and to permit a correct identification of the depressive symptoms in this population.

Foram analisadas produções científicas nacionais e internacionais a respeito da depressão e da doença renal crônica entre os anos de 2006 e 2016, nas bases PsycINFO e LILACS. Analisaram-se 269 publicações, e, depois da adoção de critérios de inclusão e exclusão, restaram 21. Os estudos foram avaliados quanto a ano de publicação, periódicos, objetivos, amostra, resultados, construtos associados e instrumentos de depressão. Verificou-se que a prevalência de sintomatologia depressiva variou de 7,8% a 83,49%, além de grande parte das amostras ser de tamanho reduzido e incluir ambos os sexos. O ano com mais publicações foi 2011, e o Beck Depression Inventory foi utilizado em 66,67% dos estudos. É importante avaliar a depressão com instrumentos que levem em conta as especificidades do contexto, de forma a reduzir vieses e permitir a identificação correta da sintomatologia depressiva nessa população.

Se analizaron producciones científicas brasilenas e internacionales sobre la depresión y la enfermedad renal crónica entre los anos 2006 y 2016, en las bases PsycINFO y LILACS. 269 publicaciones fueron analizadas ante los criterios de inclusión y exclusión, restando 21 artículos para análisis. Los estudios fueron evaluados en cuanto al ano de publicación, periódicos, objetivos, muestra, resultados, constructos asociados e instrumentos de depresión. Se verificó que la prevalencia de sintomatologia depresiva varía de 7,8% a 83,49%, además de que gran parte de las muestras eran de tamano reducido e incluían ambos sexos. El ano con más publicaciones fue 2011 y el Beck Depression Inventory fue utilizado en el 66,67% de los estudios. Es importante evaluar la depresión con instrumentos que tengan en cuenta las especificidades del contexto para reducir sesgos y permitir la identificación correcta de la sintomatología depresiva en esa población.

Efectos a largo plazo de los síntomas depresivos en una tarea de memoria de trabajo con y sin interferencia atencional / Long-term effects of depressive symptoms on a task of visual working memory with and without attentional interference

La neurobiología de la depresión involucra cambios estructurales del sistema nervioso relacionados con procesos cognitivos como la memoria y la atención. El objetivo del presente estudio fue evaluar el efecto a largo plazo de la sintomatología depresiva (SD) en una tarea de memoria de trabajo visual con y sin interferencia atencional en estudiantes universitarios. Se utilizó un diseño factorial de 2 X 2 en el cual las variables independientes fueron la condición clínica (con SD y sin SD) y la versión del Memonum (con o sin interferencia de color). Memonum es un software para evaluar memoria de trabajo por medio de la retención de dígitos directos, en dos versiones: una blanco-negro (sin interferencia) y otra con un distractor atencional de color (con interferencia). Para la evaluación de la SD, 76 universitarios respondieron al CES-D, luego se les aplicó aleatoriamente una u otra versión de la prueba Memonum (con o sin interferencia de color), 2 semanas después de la detección de síntomas. De manera general, la SD no alteró a largo plazo el desempeño de los participantes en tareas de memoria de trabajo visual con o sin interferencia atencional. Sin embargo, se pudo establecer que la utilización de las estrategias para la ejecución de la tarea mnemónica dependió de la condición clínica, y la agrupación fue la menos usada por los participantes con SD.

The neurobiology of depression involves structural changes in the nervous system associated with cognitive processes such as memory and attention. This study sought to evaluate the long-term effect of depressive symptomatology (DS) using a task of visual working memory with or without attentional interference in college students. A 2 X 2 factorial design was used wherein the independent variables were the clinical condition (with and without DS) and the Memonum version (with and without interference of color). The Memonum consists of software to evaluate working memory through retention of direct digits, in two versions: a black-white (without interference) and another with a color attentional distractor (with interference). Depressive symptomatology was evaluated by applying the CES-D to 76 undergraduates. Two week after the diagnosis of DS, the test version was randomly applied (with or without attentional interference). The DS did not alter long-term performance of the tasks involved in visual working memory with or without attentional interference. However, it was found that the use of strategies for mnemonic task performance depended on the clinical condition, being the strategy of grouping the least used by the participants with DS.

Relación parental, autoestima y sintomatologia depresiva en jóvenes adultos. Implicaciones de los conflictos interparentales, coalición y triangulación / Parental relationships, self-esteem and depressive symptoms in young adults. Implications of interparental conflicts, coalition and triangulation

El presente estudio se propone examinar la asociación entre la calidad de la relación con los padres, la autoestima y la sintomatología depresiva, en una muestra de 584 jóvenes portugueses entre 18 y 30 años de edad. También se evalúa el papel mediador de los conflictos, en la asociación entre la calidad de la relación con los padres y la autoestima. La evaluación se ha hecho mediante los instrumentos Network Relationship Inventory, Children's Perception oflnterparental Conflict Scale, Loyalty Conflict Scale, Self-Esteem Scale y Depression Scale. Los resultados determinan que la calidad de la relación con ambos padres disminuye el efecto del conflicto interparental, tal como de la coalición y la triangulación a los hijos. Para la madre, los conflictos ejercen un papel mediador entre la calidad de la relación con la madre y la autoestima. Los conflictos ejercen también un efecto negativo en la sintomatología depresiva. En el padre, se verifica una mediación de la autoestima por parte de la calidad de la relación con el padre y la sintomatología depresiva. El estudio destaca la necesidad de intervención en las competencias de los padres, para prevenir el desarrollo psicopatológico en los jóvenes.

The present study examines the associations between quality of relationships with parents, self-esteem and depressive symptomatology in a sample of584 Portuguese young adults, 18 to 30 aged. In addition, it tests the mediating role of interparental conflict in the association between quality of the relationship with parents and self-esteem. Evaluation was done through the Network Relationship Inventory, the Children's Perception of Interparental Conflict Scale, Loyalty Conflict Scale, the Self-Esteem Scale and the Depression Scale. The results indicated that the quality of the relationship with both parents decreases the effect of interparental conflict such as coalition and triangulation in young adults. Interparental conflict plays a mediating role between the quality of mother relationship and self-esteem. The conflicts have a negative effect on depression. Regarding the father relationship, self-esteem plays a meditating role in the association between quality of father relationship and depressive symptomatology. The study emphasizes intervention in parenting competencies to prevent psychopathology in youth development.

Stress ocupacional e avaliação cognitiva: um estudo com forças de segurança / Occupational stress and cognitive appraisal: a study with security forces

Este estudo analisa a experiência de stress laboral numa amostra de profissionais de segurança pública, observando igualmente a importância dos processos de avaliação cognitiva do modelo transacional (Lazarus, 1991, 2000) no ajustamento aos contextos de trabalho. Foram incluídos 196 profissionais de segurança pública, que responderam a um protocolo de avaliação sobre stress ocupacional, avaliação cognitiva primária e secundária, burnout e sintomatologia depressiva. Os resultados apontaram experiências laborais mais negativas nos profissionais casados, nos que não praticavam exercício físico, nos que exerciam maioritariamente funções no exterior das instalações de trabalho, nos que trabalhavam mais horas por semana e nos que possuíam categorias profissionais mais baixas. Os processos de avaliação cognitiva foram determinantes na explicação da experiência de stress ocupacional, burnout e sintomatologia depressiva. O stress ocupacional e a avaliação cognitiva foram variáveis importantes na predição do burnout. Em conclusão, os resultados evidenciaram a importância das variáveis pessoais e profissionais na experiência de stress laboral, bem como a adaptabilidade do modelo transacional no estudo do stress laboral nesta classe de profissionais.

This study analyzes the occupational stress in a sample of security forces, also observing the importance of cognitive appraisals of the transactional model (Lazarus, 1991, 2000) in adjustment to work contexts. The study included 196 police officers who responded to the following measures: sources of professional stress, primary and secondary cognitive appraisals, burnout, and depressive symptomatology. The results indicated more negative professional experiences in participants who were married, who did not engage in physical activities, performed their jobs mainly outside the workplace, worked higher numbers of hours per week, and had the lowest professional categories. The processes of cognitive appraisal were determinant in the explanation of occupational stress, burnout, and depressive symptomatology. The occupational stress and cognitive appraisal dimensions were predictors of burnout. The results highlighted the importance of personal and professional variables in the explanation of the participants' professional experiences and the usefulness of the transactional model in studying occupational stress.

Factores asociados con la síntomatología depresiva en adolescentes michoacanos: El papel de la migración familiar y los recursos individuales, familiares y sociales / Factors associated with depressive symptomatology in adolescents: The role of family migration and individual, family and social resources

Introduction In order to understand what is happening with adolescents' emotional lives, this research analyzed factors associated with depressive symptomatology taking into account their personal, social and family resources and the experience of migration on their family. Material and methods The sample included 360 adolescents (50.6% women and 49.4% men; mean age=13.5, SD=.68) from ten different regions of Michoacan, Mexico. The instruments were CES-D-R (a=.93), Affective Resources Scale (a=.82), Social Resources Scale (a=.77), and Family Resources Scale (a=.81). The tests were performed in the classroom, with the agreement of the participants. Results A linear regression analysis was used. The main result was that 42% of variance of depressive symptomatology is explained by risk and protection factors. The risk factors were being a woman, difficulties in sadness management and in anger management, and inability to ask for help to the social support networks and migration of the mother. The protective factors were self-control and expression in the family. Conclusions The affective, social and family resources should be strengthened to promote wellbeing in adolescents.

Introducción Con la intención de comprender qué está pasando con la vida emocional de los adolescentes, esta investigación pretende identificar los factores asociados con la sintomatología depresiva tomando en cuenta los recursos individuales, familiares y sociales, así como la experiencia de migración en la familia. Material y métodos La muestra fue seleccionada por cuota con un número equivalente de participantes de cada una de las diez regiones socioeconómicas de Michoacán. En total participaron 360 estudiantes del segundo grado de secundaria (50.6% mujeres y 49.4% hombres), con una edad promedio de 13.5 años. Se utilizaron los siguientes instrumentos: CES-D-R (a=.93), Escala de Recursos Afectivos (a=.82), Escala de Recursos Sociales (a=.77); y para medir los recursos familiares se utilizó la Escala de Evaluación de Interrelaciones Familiares [ERI] con una consistencia interna de a=.81. Se realizó un análisis de regresión múltiple lineal. Resultados El resultado central fue que el 42% de la varianza de la sintomatología depresiva puede explicarse por los siguientes factores de riesgo y de protección. Entre los factores de riesgo se encuentran: ser mujer, las dificultades para manejar la tristeza y el enojo, así como la incapacidad para buscar ayuda con la red de apoyo social y la migración de la madre. Como factores de protección están: el autocontrol y la expresión en la familia. Conclusiones Por lo tanto, los recursos individuales, familiares y sociales deben fortalecerse para promover un mayor estado de bienestar psicosocial en los adolescentes.

Sociodemographic and personal factors related to depressive symptomatology in the Mexican population aged 12 to 65 / Fatores sociodemográficos e pessoais relacionados à sintomatologia depressiva na população mexicana entre 12 e 65 anos

OBJECTIVE: To describe the prevalence of depressive symptoms in the Mexican population, aged 12 to 65 years, by identifying the main related socio-demographic and personal factors. METHODS: Data are drawn from the National Survey on Addictions 2008 (ENA 2008), a random, probabilistic, multistage study. A randomly selected sub-sample of 22,962 persons answered the section on depressive symptomatology, measured with the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS: The total prevalence for depressive symptomatology was 5.1%; the prevalence was 7.5% for women and 2.5% for men. For women, more evidence of depressive symptoms was seen in the central region, whereas for men, symptoms were homogeneous across the country. Factors related to the presence of depressive symptoms include being divorced (in women) or widowed (in men), having lower educational attainment, perceiving one's place of residence as unsafe, displaying alcohol abuse or dependence, being a regular drug consumer (in men) and having been sexually abused (males and females). CONCLUSIONS: The regional distribution of depressive symptomatology in women indicates the need for region-specific prevention programs that take into account the different social problems that affect women's emotional well-being. More research is also needed to support the early identification and intervention of men suffering from depression.

OBJETIVO: Conhecer a prevalência de sintomas depressivos a nível nacional na população de 12 a 65 anos e identificar os principais fatores sociodemográficos e pessoais associados. MÉTODO: Os dados foram obtidos da Pesquisa Nacional de Adições (ENA 2008), um estudo aleatório e probabilístico. Uma sub-amostra de 22.962 indivíduos responderam a seção de sintomas depressivos medida com a Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D). RESULTADOS: A prevalência de sintomas depressivos foi de 5,2%; 7,5% em mulheres e 2,5% em homens. Entre as mulheres, os sintomas se apresentaram mais na região central do país e, entre os homens, a distribuição geográfica foi homogênea. Os fatores que se associaram aos sintomas depressivos foram estar divorciado (mulheres) ou viúvo (homens), ter nível educacional inferior, sentir sua residência como um local não seguro, apresentar dependência de álcool, ser usuário regular de drogas (homens) e abuso sexual. CONCLUSÕES: A distribuição regional de sintomatologia depresiva em mulheres indica a necessidade regional de orientação para prevenção, levando em conta que as distintas problemáticas sociais podem afetar seu bem-estar emocional. Entre os homens, mais estudos são necessários para identificação precoce da depressão.

Memoria declarativa congruente con sintomatología depresiva / Consistent declarative memory with depressive symptomatology

Introducción: Algunos estudios han sugerido que el recuerdo potenciado de eventos negativos en personas que presentan trastornos depresivos parece ser un factor importante en la Etiología, curso y sostenimiento de la depresión. Objetivo: Evaluar la memoria emocional en Personas con y sin sintomatología depresiva, mediante una prueba auditivo-visual. Método: Se evaluaron 73 estudiantes universitarios, hombres y mujeres, con edades entre los 18 y 40 años, distribuidos en dos grupos: con sintomatología depresiva (32) y sin sintomatología Depresiva (40), utilizando la Escala del Centro de Estudios Epidemiológicos para Depresión(CES-D) y un punto de corte de 20. Resultados: No se encontraron diferencias significativas Entre el recuerdo libre de los voluntarios con y sin sintomatología depresiva, a pesar de que Ambos asignaron un valor emocional más alto a la versión emocional de la prueba auditivo-Visual y de asociarla a la emoción de tristeza. Conclusión: Las personas con sintomatología Depresiva no presentaron el efecto de potenciación mnemónica generalmente asociado al Contenido de la versión emocional de la prueba; por lo tanto, no se comprobó la hipótesis De congruencia emocional...

Introduction: Some studies have suggested that potentiated remembrance of negative events on people with depressive disorders seems to be an important factor in the etiology, course and maintenance of depression. Objective: Evaluate the emotional memory in people with and without depressive symptomatology by means of an audio-visual test. Methodology: 73 university students were evaluated, male and female, between 18 and 40 years old, distributed in two groups: with depressive symptomatology (32) and without depres-sive symptomatology (40), using the Scale from the Center of Epidemiologic Studies for Depression (CES-D, English Abbreviation) and a cutting point of 20. Results: There were not meaningful differences between free and voluntary recalls, with and without depressive symptomatology, in spite of the fact that both groups had granted a higher emotional value to the audio-visual test and that they had associated it with emotional sadness. Conclusion: People with depressive symptomatology did not exhibit the effect of mnemonic potentiation generally associated to the content of the emotional version of the test; therefore, the hypothesis of emotional consistency was not validated...

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Introduction Mental health can have different meanings in indigenous communities, which is why understanding mental problems requires studying the context. Knowledge of mental health in these communities sheds light on the population's perception of how they live and experience the stressful events that cause depressive symptomatology. The aim of this article is to analyze the link between the symptoms expressed in an indigenous population and the symptoms evaluated using the Depression Scale of the Center for Epidemiological Studies (CES-D) and its link with socio-demographic variables. Method The sample comprises indigenous women from the Mezquital Valley who attended medical consultations and were referred for psychological treatment since they were considered to be suffering from emotional malaise due to their inability to cope with living with a relative who was a heavy drinker. A mixed method that explores meanings was used to analyze the information. This method involves the analysis of quantitative and qualitative data that complement each other in order to understand the cultural context and influences. The quantitative analysis consisted of obtaining the score for depressive symptomatology and its link with socio-demographic variables such as academic achievement, age, occupation and marital status. Presence (experiencing the symptom in the week prior to the interview, regardless of the number of days) and persistence (experiencing the symptom from five to seven days) were analyzed. Results and discussion Sixty-two per cent obtained high scores for depressive symptomatology. The qualitative data indicate that the women expressed feelings that correspond to items in the CES-D. Working and being young constitute a protective factor that provides women with a social life and a degree of independence. The effectiveness of the CES-D as a screening instrument means that it can be applied in primary health care to alert professionals and ensure timely referral. Conclusion The CES-D scale is suitable for measuring depressive symptomatology in Mexico's indigenous population. However, these findings must be treated with caution because of the population's meanings and representations of health and illness.

Introducción En las comunidades indígenas la salud mental puede tener significados diferentes por lo que la comprensión de los problemas mentales requiere del estudio del contexto. Su conocimiento favorecería entender desde la perspectiva de la población cómo viven y experimentan los eventos estresantes que les ocasiona sintomatología depresiva. El objetivo de este artículo es analizar la relación entre los síntomas expresados en una población indígena, los síntomas evaluados con la Escala de Depresión del Centro de Estudios Epidemiologicos (CES-D)y su relación con variables sociodemográficas. Método El Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, ha venido trabajando por más de diez años en los problemas relacionados con el consumo de alcohol en la comunidad indígena otomí del Estado de Hidalgo. Este trabajo es uno de los realizados en este campo. En este caso la muestra se integra por mujeres indígenas del Valle del Mezquital que asistieron a la consulta médica, y que fueron canalizadas a la atención psicológica por considerar que tenían malestares emocionales por no saber cómo enfrentar la situación de convivir con un familiar consumidor excesivo de alcohol. Para el análisis de la información se utilizó el método mixto, consistente en el análisis de datos cuantitativos y cualitativos que se complementan entre sí para comprender el contexto y explorar los significados y las influencias culturales. El análisis cuantitativo consistió en obtener el puntaje de la sintomatología depresiva y su relación con variables sociodemográficas de escolaridad, edad, ocupación y estado civil. Se analizó la presencia (experimentar el síntoma durante la semana previa a la aplicación sin importar el número de días) y la persistencia (padecer el síntoma de cinco a siete días). Resultados y discusión El 62% tuvo puntuaciones altas de sintomatología depresiva. Los datos cualitativos indican que las mujeres expresan sentimientos que corresponden a los reactivos de la CES-D. Trabajar y ser joven es un factor protector para la sintomatología, brinda a las mujeres una vida social y una esporádica independencia. La efectividad de la CES-D como instrumento de tamizaje, permite su aplicación en el nivel de atención primaria para alertar al profesional y hacer una canalización adecuada. Conclusión La escala de CES-D es adecuada para medir la sintomatología depresiva en una población indígena de México. Sin embargo, la interpretación deberá realizarse con cautela por los significados y representaciones del proceso salud-enfermedad en esta población específica.

Self-esteem, depressive symptomatology, and suicidal ideation in adolescents: results of three studies / Autoestima, sintomatología depresiva e ideación suicida en adolescentes: resultados de tres estudios

Summary: Suicidal behavior has different levels: ideation, contemplation, planning and preparation, attempt, and consummation. Likewise, suicidal behavior comprises all the actions aimed at achieving suicide. During adolescence there is a tendency to a reduction of emotional well-being. Thus, adolescents may engage in dangerous behavior, extreme narcissism and individualization, exclusion and social isolation. Another element playing an important role during adolescence is self-esteem. Low self-esteem could lead to apathy, isolation, and passivity. Conversely, high self-esteem is associated with more active lives, a greater control over circumstances, less anxiety and greater capacity to cope with internal and external stress. Although there are other factors that could predispose adolescents towards suicidal behavior, certain studies have identified depressive symptomatology as the most powerful and independent risk factor in suicidal ideation and it has been argued that it should be regarded as an expression of severe depression. The purpose of this study is to explore the existence of a relationship between low self-esteem and depressive symptomatology with suicidal ideation and to explore if gender has an effect in this interaction. Data were obtained from three different samples of Mexican adolescent students. The instruments used were the Rosenberg Self-Esteem Scale, the CES-D, and the Roberts Suicidal Ideation Scale. Women showed a higher frequency of low self-esteem than men in two studies. In another, men had a significantly higher frequency of low self-esteem. Regarding depressive symptomatology, women obtained higher scores than men. No significant differences were found in one study. The percentages of high suicidal ideation displayed greater variability by gender and by study. Among the subjects who reported high suicide ideation, a greater proportion of women tended to have low self-esteem, though these differences were not significant in any study. Over half of the women in each study reported higher suicidal ideation and depressive symptomatology than men, with significant differences only among junior high students in two studies. The exploration of the link between depressive symptomatology and high suicidal ideation showed significant differences by gender, a finding which might be linked to the fact that women are more allowed to express their depressive or fatalistic feelings and thoughts or death wishes, whereas among men this type of ideas are perceived as a sign of weakness. Gender-related differences in low self-esteem were only found in one study; men had a higher percentage than women. The comparison of low self-esteem in subjects with high suicidal ideation did not reveal any statistical difference by gender, despite it has been identified as a risk factor for suicidal behavior. In the other hand, results of depressive symptomatology concurred with international literature about this being a determinant factor in the presence of suicidal ideation in women. Considering the objective of this study, three main conclusions can be suggested. First, low self-esteem is not significantly linked to suicidal ideation, perhaps because it is a risk factor more associated with suicidal behavior. Second, depressive symptomatology was related to suicidal ideation, and although this relationship and the one between depressive symptomatology and self-esteem have been reported before, it is important to note that there seems to be a domino effect among these problems. This effect could begin with depressive symptoms linked to suicidal ideation, which in turn could affect self-esteem, and subsequently trigger suicidal behavior. And third, differences between men and women raise the question of whether these are caused by intrinsic characteristics in a biological-genetic substrate inherent to each gender or whether they are determined by the cultural context and the formative patterns existing in the groups to which the subjects belong.

Resumen: El problema del suicidio ha cobrado mayor relevancia en años recientes. Esto se debe a la magnitud que ha alcanzado. El suicidio tiene un carácter multifactorial, es complejo, dinámico y creciente en nuestro país. A su vez, la autoestima baja y el malestar depresivo se han vinculado con la conducta suicida en la adolescencia; los individuos vulnerables enfrentados a factores estresantes o que implican riesgo pueden llegar a presentar ideación o alguna conducta suicida. El malestar depresivo se ha identificado como el factor de riesgo más importante para la ideación suicida. Esta se presenta de manera diferente en hombres y en mujeres, por lo que se cree que su impacto está matizado por las características de los roles de género. El propósito de este estudio es explorar si la autoestima baja y la sintomatología depresiva se relacionan con la ideación suicida, y si el sexo surte un efecto sobre esta interacción. Los datos se obtuvieron de tres estudios con adolescentes estudiantes mexicanos. En el primero (secundaria, 1992-1993, Delegación Tlalpan), se utilizó un muestreo no probabilístico. La muestra incluyó a 423 adolescentes (56% hombres y 44% mujeres, con una media de edad de 13.86±1.2 años). En el segundo (secundaria y bachillerato, 1996-1997, Delegación Coyoacán) participaron 816 adolescentes: 406 de secundaria (49% hombres y 51% mujeres, con una media de edad de 13.27±1.1 años), y 410 de bachillerato (51% hombres y 49% mujeres, con una media de edad de 17±4.3 años). El muestreo fue no probabilístico. El tercero (secundaria, 1998-1999, Centro Histórico) incluyó a 936 estudiantes (54% hombres y 46% mujeres, con una media de edad de 13.7±1.8 años). El muestreo fue no probabilístico. Los tres estudios fueron transversales. El instrumento incluyó la Escala de Autoestima de Rosenberg, la CES-D y la Escala de Ideación Suicida de Roberts. Se calcularon los puntos de corte para cada escala por sexo para identificar a los sujetos con baja autoestima, sintomatología depresiva e ideación suicida alta. En dos estudios, las mujeres alcanzaron frecuencias más altas de autoestima baja, aunque las diferencias no fueron significativas. En el de 1999, los hombres tuvieron una frecuencia de autoestima baja significativamente más elevada que las mujeres. A su vez éstas alcanzaron puntajes significativamente más altos de sintomatología depresiva en los estudios de 1996 y 1999. En el caso de la ideación suicida, sólo hubo diferencias significativas en el estudio de 1999. Las mujeres con ideación suicida mostraron porcentajes más elevados de autoestima baja (diferencia no significativa) y de sintomatología depresiva (con diferencias significativas en los estudios de 1996 y 1999) que los hombres. La comparación de autoestima baja en los sujetos con ideación suicida no reveló diferencias significativas por sexo, a pesar de que éste se ha identificado como un factor de riesgo importante para la conducta suicida. Por otro lado, los resultados de sintomatología depresiva coinciden con lo reportado a nivel internacional en el sentido de considerar el sexo como un elemento determinante para la presencia de ideación suicida en las mujeres. Teniendo en consideración el objetivo de este trabajo, se pueden señalar tres conclusiones: la autoestima baja no se asoció significativamente con la ideación suicida; esto se puede deber a que ésta es un factor de riesgo más relacionado con la conducta. Asimismo, la sintomatología depresiva se asoció con la ideación suicida, y aunque ésta y la que se da entre la sintomatología y la autoestima ya se han reportado, es importante señalar que parece haber un efecto en cadena entre estas problemáticas. Este efecto se originaría en los síntomas depresivos ligados con la ideación suicida, la cual puede afectar a la autoestima y ésta, a su vez, dispararía la conducta suicida. Finalmente, las diferencias entre hombres y mujeres dejan abierto el debate sobre si éstas se originan en factores biológicos inherentes al sexo o si están determinadas por los patrones de formación influidos por su parte por elementos contextuales caracterizados culturalmente.

Una medida breve de la sintomatología depresiva (CESD-7)

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Summary: Depression is a mental health condition with a high prevalence in the population, low rates of detection in the health system, and a significant influence in the quality of life of individuals, affecting their family and social contexts. Because of this, research focusing on the development of instruments to measure depression has been an active area of research with a growing development in the Latin American context. In this paper, we present a brief version of the Center for Epidemiological Studies-Depression Scale (CESD-20), and analyze its psychometric properties, factorial structure, and construct validity in a sample of Spanish adult population. Our aim is to provide researchers and professionals of Spanish-speaking countries with an instrument that allows to obtain relevant information about the mental health of individuals in a reliable and efficient way. The CESD-20 was originally designed to evaluate the severity of depressive symptomatology in adult population and has shown excellent properties among both adult and adolescent populations. The CESD evaluates depressed mood, positive affect, somatic and retarded activity and negative perception of interpersonal relationships during the last week. There is extensive literature about the factorial structure of the original instrument. In this sense, there is a general agreement among researches about the usefulness of using a summed up score of the 20 items to reflect depressive symptomatology. This global score is used as an indicator of the individual risk of developing clinic depression rather than to classify depressed individuals. The Spanish version of the original CESD-20 has been consistently validated in different populations, but so far a brief version in this language has not been avaliable to researchers. In this study we explore the internal consistency and factorial structure of a 7-item version (CESD-7), as well as its construct validity. To analyze the construct validity of the CESD-7 we explore the relationships of the scale scores with two variables of the physiological and social context, respectively. On the one hand, we explore the relationship between health perceptions and both the original and brief versions of the CESD. On the other hand, we analyze the relationship between social integration and the two versions of the CESD. There is extensive empirical evidence about the relationship of depression with physical health and social integration. In this sense, there is a general agreement as to the association between poor health conditions and higher levels of depression over time. Likewise, the levels of social integration have been traditionally regarded as antecedents of depression. Therefore, we expect that both the original and brief versions of the CESD would be negatively associated with physical health and social integration. Moreover, the statistical relationships among these constructs would not be different when analyzed with the original or brief versions of the CESD. This would indicate that the brief version might be used as a substitute of the long one. Method: Participants For this study we used data from a two-wave panel design with repeated measures in a community sample of Spanish adult population. In the first panel, 1051 participants of both sexes with ages ranging from 18 to 80 years completed the questionnaires. Participants in this panel were selected from a cross-section of representative neighbourhoods from a one million metropolitan area (Valencia, Spain). Participants completed questionnaires refering to their mental health, physical health, and social integration. Age, sex, educational level, and household income of participants were also coded. After six months, almost 75% (N = 740) of the respondents completed the same questionnaires in the second panel. Attrition analyses between respondents and drop-outs showed nonsignificant differences in socio-demographic variables. A 54% of the respondents were women. The mean age was 39 years. Average educational level was high school (full-time education until 18 years) and average household income was 21500 euros (26000 US dollars, approximately). Instruments Original version of the CESD (CESD-20). The original Spanish version of the CESD-20 used in this paper was adapted by the authors in previous works. Previous research with the CESD-20 scores of the translated version showed a high degree of internal consistency and construct validity. Brief version of the CESD (CESD-7). Based on the available literature, we selected seven items that showed the highest validity to classify cases of depression. Items for the revised measure included dysphoric mood (items 3, 6, and 18), motivation (item 7), concentration (item 5), loss of pleasure (item 16), and poor sleep (item 11 ). As indicated above, we also measured health perceptions and social integration to further analyze the construct validity of this brief scale. Two instruments were selected: Health Perception. We used the General Health Perception Questionaire developed by Davies and Ware to obtain information about the health status as appraised by the individual. The GHPQ includes 29 items with five category responses ranging from totally disagree to totally agree (e. g., "My health condition is excellent") that provides a global score with higher scores indicating better health perceptions. Social Integration. To measure social integration we used the Social Integration in the Community Scale. This is a five-item scale that measures the sense of belonging and/or identification to a community or neighbourhood (e.g., "I feel identified with my community"). A higher score represents a higher level of social integration. Results: Results showed that the CESD-7 can be described as undidimensional and that this one-factor structure remains mostly invariant after six months. Internal consistency was adequate (α' ≥ .82) in both panels. As for the validity of the brief version, we estimated several regression models for both the CESD-20 and CESD-7 as dependent variables. Predictors in these equations were: previous levels of depression, socio-demographic variables, physical health and social integration. Results showed a moderate relationship between measures of depression across time (CESD-20, β = 0.12, p < .001; CESD-7, β = 0.13, p < .001), and also that the CESD-20 and CESD-7 scores in panel two were significantly associated with sex, social integration, and physical health almost with the same strength for both versions. Also, non-significant associations were found for age, educational level, and household income for both versions. These results suggested that using the CESD-7 instead of the CESD-20 did not substantially change the results of linear regression models. Discussion. The results of this study indicate that the brief version of the CESD (CESD-7) has an adequate reliability and validity and that this brief measure is virtually equivalent to the original version (CESD-20) when used as a dependent variable in several linear regression models. Thus, both the original and brief versions scores were negatively and significantly associated with previous levels of good health conditions (perceived health) and social integration even after controlling for previous levels of depression in panel 1. There is extensive research showing that women report more depressive symptomatology than men. Also, physical health has been related with depression. Regarding social integration, there is also a vast array of empirical evidence relating it to the mental health of the individual. In our study, we found these expected associations both for the original CESD-20 and the brief version (CESD-7). According to the results obtained in this study, we encourage researchers to use this brief measure of depression when survey space is limited or a fast and reliable measure of depression is needed.

Psychosocial and Obstetric Predictors of Depressive Symptomatology at Postpartum 4 Weeks / 대한산부인과학회지

OBJECTIVE: The aim of this study was to examine the psychosocial and obstetric predictors of depressive symptomatology at postpartum 4 weeks in Korea. METHODS: At their 1-week and 4-week postpartum visits, 61 postpartum women completed the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Check List-90-Revised (SCL-90-R). Data related to the psychiatric and obstetric characteristics, pregnancy and delivery related events were collected from the standardized medical records. 42 women with no history of pregnancy or delivery within the previous 6 months were selected as the control group. The postpartum group was divided into the depressive and non-depressive subgroups, according to their EPDS and BDI results at postpartum 4 weeks. RESULTS: Compared to the control group, the mean score of the BDI at postpartum 4 weeks was significantly higher in the postpartum group. The percentages of women having experienced severe emotional stress during pregnancy and of smokers and drinkers before pregnancy were significantly higher in the postpartum depressive subgroup (EPDS >or=10 and BDI >or=10) when compared to the postpartum non-depressive subgroup. The percentage of women having experienced depressive symptoms at postpartum 1 week was also significantly higher in the depressive subgroup. A depressive symptomatology at postpartum 1 week was identified as a significant risk factor for depressive symptoms at postpartum 4 weeks. CONCLUSION: The results of this study suggest that screening for depressive symptomatology in the immediate postpartum period might provide an effective means of detecting women at risk of developing postpartum depression in Korea. The finding that severe emotional stress experienced during pregnancy is associated with the development of postpartum depressive symptoms confirms the results of previous studies.

Prevalence of Cognitive Impairment and Depressive Symptomatology of the Elderly in a Long-term Institution / 신경정신의학

OBJECTIVES: This study was to investigate the prevalence of cognitive impairment and depressive symptomatology among the long-term institutionalized elderly people. METHODS: Mini-Mental state Examination-Korean version(MMSE-K), short portable Mental State Questionnaire(SPMSQ), Short version of Geriatric Depression Scale(SGDS), and the Center for Epidemiologic Studies Depression(CES-D) were administered to 169 elderly residents in an institution, 'Got Dong Rae'. RESULTS: One hundred fifty-three(males=72, females=79, and missing=2) completed the entire examination. Age ranged from 60 to 102 years and the mean of age was 74.17+/-8.27(males 71.76+/-8.14,females 76.14+/-7.78)years. Duration of education ranged from 0 to 16 years and the mean of duration of education was 3.04+/-3.93(males 4.13+/-4.23,females 2.01+/-3.38)years. The prevalence of cognitive impairment was estimated as 56.2% by MMSE-K or = 10 and 23.5% by CES-D > or = 25. In the case of using SGDS > or = 8 as cutoff-point to screen mild as well as severe depressive symptomatology, the prevalence was 39.2%. It was identical to the result achieved by using CES-D > or = 20. Significant correlations were observed between MMSE-K and SPMSQ, between SGDS and CES-D, between MMSE-K and CES-D, between MMSE-K and SGDS, and between SPMSQ and SGDS. CONCLUSION: The prevalences of cognitive impairment and depressive symptomatology were high in institutionalized elderly people. This results suggests that more intensive mental health care in needed for long-term institutionalized elderly people.