Asociación entre dependencia funcional y calidad de vida en pacientes adultos mayores oncológicos / Association between functional dependence and quality of life in older adult oncology patients

RESUMEN Introducción: La presencia de comorbilidades modula el proceso de envejecimiento, el diagnóstico de cáncer puede comprometer de manera importante la salud del adulto mayor, lo cual repercute en su calidad de vida. Objetivo: Determinar la asociación entre la dependencia funcional y la calidad de vida en pacientes oncológicos adultos mayores tratados con radioterapia. Métodos: Estudio analítico retrospectivo, realizado en 181 pacientes ambulatorios del Centro Médico Naval del Callao, Perú, varones, mayores de 60 años. Se valoró la dependencia funcional mediante los índices de Barthel y el de Lawton; y la calidad de vida mediante la escala de calidad de vida en adultos mayores de la Organización Mundial de la Salud (WHOQoL-Old). Resultados: Se encontró asociación estadísticamente significativa entre dependencia funcional y calidad de vida, tanto para las actividades básicas de la vida diaria (PR= 1,04 [IC 95 %; 1,01-1,07]) como para las actividades instrumentales de la vida diaria (PR= 1,08 (IC 95 %: 1,01 - 1,13). Conclusiones: En los pacientes adultos mayores oncológicos tratados con radioterapia, se encuentra asociación significativa entre dependencia funcional y una pobre calidad de vida.

ABSTRACT Introduction: The presence of comorbidities modulates the aging process, the diagnosis of cancer can significantly compromise the health of the elderly, which affects their quality of life. Objective: Determine the association between the functional dependence and the quality of life in elderly oncology patients treated with radiotherapy. Methods: Retrospective analytical study, carried out in 181 outpatients of Centro Médico Naval del Callao, Perú, male, older than 60 years. The functional dependence was assessed with Barthel index and Lawton scale; and the quality of life was assessed with World Health Organization Quality of Life-Older Adults Module (WHOQoL-Old). Results: A statistically significant association was found between functional dependence and quality of life, for both the basic activities of daily living (PR= 1.04 [IC 95 %: 1.01-1.07]), and the instrumental activities of daily living (PR= 1.08 [IC 95 %: 1.01 - 1.13]). Conclusion: There was significant association between the functional dependence and the poor quality of life in the elderly oncology patients treated with radiotherapy.

Déficits neuropsicológicos, intensidad sintomática y repercusión funcional en el trastorno por déficit de atención con hiperactividad / Neuropsychological deficits, symptom intensity and functional impairment in attention deficit hyperactivity disorder

Resumen Este estudio pretende contribuir a una mejor comprensión del trastorno por déficit de atención con hiperactividad (TDAH) examinado de manera exhaustiva la relación entre dos de los principales déficits cognitivos del trastorno (la atención y el control inhibitorio), la sintomatología (falta de atención e hipe ractividad/impulsividad) y la repercusión funcional en 85 niños/as y adolescentes con TDAH sin otros trastornos comórbidos. Encontramos, con independencia del funcionamiento intelectual general y de la edad, que i) un mayor déficit atencional e inhibitorio, predijo una mayor gravedad de los síntomas del TDAH, ii) un mayor déficit atencional e inhibitorio predijo un mayor deterioro funcional, pero no de una manera directa sino a través de los síntomas, y iii) una mayor severidad sintomática predijo una mayor repercusión funcional. Comenzar a explorar y comprender la complejidad del TDAH es clave para avanzar en nuestro conocimiento del trastorno y para la correcta toma de decisiones clínicas.

Abstract This study aims to contribute to a better understanding of at tention deficit hyperactivity disorder (ADHD) by comprehensively examining the relationship between two of the main cognitive deficits of the disorder (attention and inhibitory control), symptomatology (inattention and hyperactivity/impulsivity) and functional impairment in 85 children and adolescents with ADHD without other comorbid disorders. We found, independent of general intellectual functioning and age, that i) greater atten tional and inhibitory deficits predicted greater severity of ADHD symptoms, ii) greater attentional and inhibitory deficits predicted greater functional impairment, but not in a direct way but through symptoms, and iii) greater symptomatic severity predicted greater functional impairment. Beginning to explore and understand the com plexity of ADHD is key to advance our knowledge of the disorder and for correct clinical decision making.

O sentido do envelhecer para o idoso dependente / The meaning of aging for the dependent elderly

Resumo O envelhecimento constitui um fenômeno demográfico e uma questão econômica, social, política, cultural e ética. O objetivo deste ensaio é refletir sobre o envelhecimento e o sentido da velhice no sistema capitalista, sob o paradoxo que contrapõe lucro e necessidades humanas. A investigação efetuada sinaliza que sobre a pessoa idosa, com perdas de capacidades e incapacidades, recaem altos índices de negligências públicas e privadas. Isso exige a implementação de políticas específicas para a velhice, devido ao aumento tendencial de uma categoria de idosos/as, os dependentes. Em geral, as políticas têm atuado no sentido de reforçar os dados colhidos numa pesquisa realizada em 2019, em 6 estados brasileiros e no Distrito Federal, junto a uma população de 446.101 idosos/as, na qual se constataram descasos e maus tratos, mesmo com os avanços na legislação brasileira em vigor. Tais fatos endossam a percepção de imagens desvalorizadoras da velhice e do fato de ser velho/a, fazendo-se urgente uma ética global sob a perspectiva do cuidado que resgate valores democráticos essenciais a uma velhice com sentido.

Abstract Aging is a demographic phenomenon and an economic, social, political, cultural and ethical issue. The aim of this essay is to reflect on aging and the meaning of old age in the capitalist system, under the paradox that opposes profit and human needs. The investigation carried out indicates that the elderly, with loss of capacities and disabilities, have high rates of public and private negligence. This requires the implementation of specific policies for old age, due to the trend increase of a category of elderly people: the dependent. In general, policies have acted to reinforce the data collected in a survey conducted in 2019, in 6 Brazilian states and the Federal District, among a population of 446,101 elderly people, in which disregard and abuse were found, even with the advances in current Brazilian legislation. Such facts endorse the perception of devaluing images of old age and the fact of being old, making global ethics urgent from the perspective of care that rescues essential democratic values to meaningful old age.

Factores asociados con el deterioro cognoscitivo y funcional sospechoso de demencia en el adulto mayor en Lima Metropolitana y Callao / Factors associated with cognitive and functional impairment suggestive of dementia in elderly adults from Lima Metropolitana and Callao

Objetivos: Identificar los factores asociados con deterioro cognoscitivo y funcional sospechoso de demencia en adultos mayores residentes de Lima Metropolitana y Callao. Material y Métodos: Estudio analítico de base de datos secundario, realizado sobre un muestreo probabilístico de tres etapas en 1290 adultos de 60 a más años de edad. Resultados: El 17% de adultos mayores a quienes se administró el Mini-Mental Status Examination y el 14.7% mediante el Cuestionario de Pfeffer, presentaron deterioro cognitivo. Sin embargo, solo el 6.7% presentó deterioro cognitivo y funcional sospechoso de demencia. Según el modelo multivariado final, ser adulto mayor de 75 años a más (OR=7,80; p<0,001), estar desempleado (OR=6,88; p=0,026), tener menos de 8 años de educación (OR=2,97; p=0,003) y haber presentado un episodio depresivo en el último año (OR=5,58; p<0,001), son factores asociados con el deterioro cognoscitivo y funcional sospechoso de demencia. Las dimensiones de autocuidado (OR=0,59; p<0,001) y funcionamiento ocupacional (OR=0,73; p=0,001) de la escala de calidad de vida de Mezzich, son factores protectores contra el desarrollo de dicho deterioro. Conclusiones: La existencia de varios factores asociados con el deterioro cognoscitivo y funcional sospechoso de demencia, genera la necesidad de elaborar y aplicar programas preventivo-promocionales para lograr estilos de vida saludable, mejorar la condición educativa y promocionar posibilidades de empleo para adultos mayores.

Objectives: To identify factors associated with cognitive and functional impairment suggestive of dementia in elderly adults from Lima Metropolitana and Callao. Material and Methods: Secondary base analytical study, carried out in a three-phased probabilistic sample of 1290 elderly adults of 60 or more years of age. Results:17% of the elderly adults, to whom the Mini-Mental Status Examination was administered, and 14.7% through the Pfeffer Questionnaire, presented cognitive impairment. However, only 6.7% presented cognitive and functional impairment suggestive of dementia. According to multivariate analysis, being an adult over 75 years of age (OR=7,80; p<0,001),unemployed (OR=6,88; p=0,026) , having only primary or less than 8 years of education (OR=2,97; p=0,003), and having experienced a depressive episode in the last year (OR=5,58; p<0,001) are factors associated with cognitive and functional impairment quite suggestive of dementia. The dimensions of self-care (OR=0, 59; p<0,001) and occupational functioning (OR=0, 73; p=0,001), of the Mezzich's quality of life scale, are protective factors against the development of such impairment. Conclusions: The existence of certain risk factors for the development of cognitive and functional impairment suggestive of dementia, generates the need to elaborate and implement preventive-pr motional programs to achieve healthy lifestyles, improve the educational level, and promote the employability of older adults.

Cognitive performance and psychosocial functioning in patients with bipolar disorder, unaffected siblings, and healthy controls

Objective: To assess cognitive performance and psychosocial functioning in patients with bipolar disorder (BD), in unaffected siblings, and in healthy controls. Methods: Subjects were patients with BD (n=36), unaffected siblings (n=35), and healthy controls (n=44). Psychosocial functioning was accessed using the Functioning Assessment Short Test (FAST). A sub-group of patients with BD (n=21), unaffected siblings (n=14), and healthy controls (n=22) also underwent a battery of neuropsychological tests: California Verbal Learning Test (CVLT), Stroop Color and Word Test, and Wisconsin Card Sorting Test (WCST). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chi-square test; multivariate analysis of covariance was used to examine differences in neuropsychological variables. Results: Patients with BD showed higher FAST total scores (23.90±11.35) than healthy controls (5.86±5.47; p < 0.001) and siblings (12.60±11.83; p 0.001). Siblings and healthy controls also showed statistically significant differences in FAST total scores (p = 0.008). Patients performed worse than healthy controls on all CVLT sub-tests (p < 0.030) and in the number of correctly completed categories on WCST (p = 0.030). Siblings did not differ from healthy controls in cognitive tests. Conclusion: Unaffected siblings of patients with BD may show poorer functional performance compared to healthy controls. FAST scores may contribute to the development of markers of vulnerability and endophenotypic traits in at-risk populations.

A Study on the Predictors of Functional Status and the Overuse of OTC Medications among Elderly Population in a Sub-Urban Region of North Bengal.

Background: Functional status can be conceptualized as an individual’s ability to manage activities related to personal self-care and self-maintenance. Functional status assessment is fundamental aspect of geriatric examination especially in the context of over the counter (OTC) medications. This assessment helps clinicians and policymakers to design and implement interventions that help elderly to live safely and independently. The primary objective was to assess the prevalence of limitation in activities of daily living (ADL) and instrumental ADL (IADL) among elderly population. The secondary objective was to identify the use of OTC medications according to the therapeutic indications among them. Methods: A total of 200 community dwelling elderly persons residing in Sushrutanagar of North Bengal were interviewed using valid and reliable functional assessment scales namely Katz ADL and Lawton and Brody IADL. Statistical procedures for the analyses included descriptive ADL and IADL activity limitation was 15 % (30/200) and 85 % (170/200), respectively. Results: The results of logistic regression analysis revealed that advancing age (70 years and above), poor self-rated health and ailments namely musculoskeletal problems, cardiovascular diseases and cataract significantly predict functional limitation. 70% of the subjects consumed analgesics and 60% the antacids as OTC medications. Conclusion: With advancing age, various co-morbidities starts creeping up and the study subjects used the OTC medications to counteract the associated functional limitations as evident from this study. Cataract surgeries patients should be identified and operated upon so as to improve visual functioning and thus their functional ability. Further, factors affecting the use of OTC drugs in elderly subjects need further research.

Estado nutricional y funcionalidad en adultos mayores hospitalizados en unidad geriátrica de agudos del Hospital Naval Almirante Nef / Nutritional status and functionality in elderly hospitalized in an Acute Geriatric Unit of Hospital Naval Almirante Nef

Introducción: La desnutrición y la alteración en la funcionalidad son altamente prevalentes en adultos mayores hospitalizados y se asocia a resultados adversos. El objetivo principal de este trabajo fue evaluar la relación existente entre el estado nutricional y funcionalidad en adultos mayores hospitalizados en Unidad Geriátrica de Agudos (UGA) del Hospital Naval Almirante Nef. Pacientes y Métodos: Estudio descriptivo de corte transversal, que incluyó a adultos mayores (AM) hospitalizados en UGA entre 01 de Marzo 2014 y 01 de Mayo 2015. A los pacientes se les realizó valoración geriátrica integral y valoración nutricional con MNA SF y test para evaluar la presencia de anorexia. Se analizaron los datos con software STATA 10. Para evaluar significancia estadística se ocuparon las pruebas Chi2 y de Kruskal Wallis. Resultados: 97 pacientes ingresados, 1 excluido. Promedio de edad de 84,1 años, 52% mujeres. Índice de Barthel promedio de 74,02 puntos. Prevalencia de desnutrición de 20,83%. La asociación entre un peor estado nutricional y peor funcionalidad en ABVD resultó estadísticamente significativa (p: 0,005). Discusión: Aquellos pacientes que ingresaron a UGA con peor estado nutricional presentaban peor funcionalidad basal en las ABVD. La relación entre estado nutricional y funcionalidad es compleja y probablemente bidireccional. Conclusión: La alta prevalencia de desnutrición en AM recientemente hospitalizados se acompaña de peor funcionalidad basal en actividades básicas de la vida diaria.

Background: Malnutrition and functional impairment are highly prevalent in the hospitalized elderly and can lead to unfavorable outcomes. The purpose of this study was evaluate if there is a relation between nutritional status and functionality in elderly patients hospitalized in the Acute Geriatric Unit (AGU) of Hospital Naval Almirante Nef, Viña del Mar. Patients: Cross-sectional descriptive study wich included elderly patients hospitalized in the AGU between March 1, 2014 and May 1, 2015. Patients underwent a comprehensive geriatric assessment and nutritional assessment with MNA Short Form and an anorexy test. Data were analyzed with STATA 10 software. Chi2 and Kruskal Wallis tests were used to assess statistical significance. Results: A total of 97 patients, 1 excluded. Average age of 84,1 years, 52% female. Barthel index averaged 74,02 points. The prevalence of malnutrition was 20,83%. The association between poorer nutritional status and poorer functioning in basic activities of daily living was statistically significant (p: 0.005). Conclusions: Those patients who entered AGU with worse nutritional status presented worse baseline functionality in basic activities of daily living. The relationship between nutritional status and functionality is complex and probably bidirectional. The high prevalence of malnutrition in recently hospitalized elderly is accompanied by poorer baseline functionality in basic activities of daily living.

Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population

<p><b>INTRODUCTION</b>Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability.</p><p><b>METHODS</b>Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded.</p><p><b>RESULTS</b>362 subjects aged 60-93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = -0.227, p = 0.009) and JTHFT (r = -0.927, p < 0.001).</p><p><b>CONCLUSION</b>This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength.</p>

Suporte familiar ao idoso com comprometimento da funcionalidade: a perspectiva da família / Family support to elderly with commitment of functionality: a family perspective / Apoyo familiar para adulto mayor con compromiso de funcionalidad: una perspectiva familiar

Este estudo tem por objetivo caracterizar o suporte familiar ao idoso com comprometimento da capacidade funcional, segundo estratos socioeconômicos, na perspectiva do cuidador. O estudo foi realizado em quatro unidades de saúde, em Jequié-BA. Os dados foram colhidos por meio de entrevista semiestruturada e aplicação de questionário às famílias. Por meio da análise de conteúdo, emergiram as seguintes categorias: significado do comprometimento da capacidade funcional; relação familiar antes do comprometimento da capacidade funcional; relação familiar depois do comprometimento da capacidade funcional; percepção da família sobre as orientações da equipe de saúde; percepções e sentimentos de ser cuidador do idoso; avaliação sobre os limites e as potencialidades do suporte familiar; percepções sobre rede de suporte social. Entre os resultados encontrados, destacamos a constatação de falta de conhecimentos específicos e preparação das famílias para o cuidado prestado ao idoso dependente, e fragilidade de uma rede de suporte social e de saúde à família e ao idoso.

This study aims to characterize the family support the elderly with impaired functional capacity from the perspective of the caregiver. The study was conducted in four health units in Jequié-BA. Data were collected through semi-structured interview and questionnaire to the families. Through content analysis yielded the following categories: significance of impairment of functional capacity; family relationship before the impairment of functional capacity; family relationship after the impairment of functional capacity; family’s perception of the guidelines of the health team; perceptions and feelings to be caregivers for the elderly, assessment of the limits and potential of family support, perceptions of social support network. Among the findings highlight the finding of a lack of expertise and preparation of families to care for the dependent elderly and weakness of a network of social support and health to the family and the elderly.

Este estudio tiene como objetivo caracterizar el apoyo familiar a adultos mayores con deterioro de la capacidad funcional según los estratos socioeconómicos, desde la perspectiva del cuidador. El estudio fue realizado en cuatro unidades de salud en Jequié-BA. Los datos fueron recolectados a través de entrevista semi-estructurada y un cuestionario con las familias. A través de análisis de contenido emergieron las siguientes categorías: significado de la capacidad funcional deteriorada; relaciones familiares ante la disminución de la capacidad funcional, la relación de la familia después de deterioro de la capacidad funcional, la percepción de las orientaciones del equipo de salud de la familia; percepciones y sentimientos ser los cuidadores de las adultos mayores; revisión de los límites y el potencial de apoyo a la familia; percepciones de la red de apoyo social. Entre los resultados se destacan la constatación de la falta de experiencia y la preparación de las familias para cuidar a los adultos mayores dependientes y la fragilidad de una red de apoyo social y de salud para la familia y los adultos mayores.

Prevalence of Depression and Associated Risk Factors among the Elderly in Urban and Rural Field Practice Areas of a Tertiary Care Institution in Ludhiana.

Background: Depression, the most common psychiatric disorder among the elderly, is not yet perceived as an important health problem in India, where few population-based studies have addressed this problem. Objectives: To estimate the prevalence of depression and identify the associated risk factors in the elderly population. Materials and Methods: 3038 consenting elderly (>60 years old) rural and urban residents of both sexes from the fi eld practice areas were interviewed and examined in a cross-sectional study. Physical impairment in the subjects was assessed with the Everyday Abilities Scale for India (EASI), depression by the 15-item Geriatric Depression Scale (GDS-15), and cognitive impairment by the Mini-Mental State Examination (MMSE). Data were analyzed using Epi Info version-6 software. Statistical analysis included proportions, χ2-test, odds ratio, and its 95% confi dence interval. Multiple logistic regression was done using SPSS version 21. Results: The prevalence of depression in the study population was 8.9%. It was signifi cantly higher in urban residents, females, older elderly, nuclear families, in those living alone, those not working, illiterates, poor, functionally impaired, and cognitively impaired. In the multivariate analysis, unmarried/widowed status, unemployment, and illiteracy did not emerge as risk factors. Conclusions: Urban residence, female gender, higher age, nuclear family, poverty, and functional and cognitive impairment were found to be associated with depression even after controlling for other factors.

Functional Impairment and Executive Dysfunction of Children with Tourette Disorder : Comparison with Attention-Deficit Hyperactivity Disorder and Non-Affected Controls

OBJECTIVES: The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. METHODS: From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. RESULTS: No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. CONCLUSION: Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.

Clinical application of standardized rating scales for attention deficit hyperactivity disorder in school-age children / 中华实用儿科临床杂志

Attention deficit hyperactivity disorder(ADHD) is one of the most common psychiatric disorders among school-age children.The diagnosis and treatment of ADHD rely on a comprehensive evaluation of symptom,functional impairment and comorbidity.Therefore the standardized rating scales is widely used clinically.The standardized rating scales can be categorized into: Broad-band scales,evaluating the general misbehavior and sociopsychological functions andNarrow-band scales,evaluating ADHD specific symptoms,and also functional impairment rating scales.Useful comorbidity and functional impairment rating scales are in need domestically.This paper reviewed the published literature about the clinical application and progression of frequently-used rating scales for school-age ADHD evaluation,at home and abroad.

Quantitative measurement of impairment in ADHD: perspectives for research and clinical practice

BACKGROUND Functional impairment is needed to make an attention deficit hyperactivity disorder (ADHD) diagnosis, but there is a paucity of instruments addressing this issue. OBJECTIVE Perform psychometric analysis of a functional impairment scale (FIE). METHODS A sample of 320 individuals, including ADHD probands, their siblings and parents, filled the FIE. We analyzed psychometric properties for the entire sample and age groups. Factor structure was determined by a principal component factor analysis, using oblique rotation with Kaiser normalization and Eigenvalues higher than 1. Cronbach’s alpha and Spearman-Brown were calculated. RESULTS Family analysis revealed four components: a) “family life”, b) “self-perception”, c) “performance” and d) “social life”. Adults’ analysis revealed two components: a) “family life, social life and self-perception” and b) “performance”. Children showed the domains: a) “performance and social life”, b) “self-perception” and c) “family life” components. Cronbach’s alpha were above 0.9 in all components. DISCUSSION Results revealed up to four domains depending on the group considered. Different life demands might explain the variability of domains on the groups. .

Epidemiological study of depression among population above 60 years in Visakhapatnam, India.

Background: As the World’s population is ageing, there is growing interest in various morbidity patterns among the elderly. Depression and depressive symptoms are common in elder people. Often depression is difficult to recognize. Aims & Objective: The study aims to assess the prevalence of Depression among study population and its relationship with socio demographic factors, co-morbid illness and functional impairment. Material and Methods: A community based cross-sectional study was done in selected rural & urban field practice areas of Department of SPM by means of simple random sampling. 17,415 populations were screened from 3383 households in both rural and urban areas to identify 1200 elderly aged 60 and above were administered with pretested questionnaire incorporating geriatric depression scale for assessing Depression. Results: The prevalence of Depression among study population was 31.7% (317/1000). The prevalence was high in rural areas (36%), as compared to urban areas (27%) and increasing with increasing age. It was significantly high among females (37.5%), singles (46%), staying alone (65%), low socio-economic group (34%), those with stressful life events (71%). The most common illnesses among the study population with depression were osteoarthritis (43.9%) cataract (25.2%), hypertension (17.6%), diabetes (7.6%) and heart diseases (3.9%). It was observed that functional impairment was high among those who have depression (6.5%). Conclusion: Depression is relatively high in rural area, females, illiterates, singles and sufferers of stressful life events or chronic diseases. There is a significant functional impairment with presence of Depression.

Depresión en Pacientes con Enfermedad Crónica de Artritis Reumatoidea / Depression in Patients With Crronic Arthritis Rheumatoidea

En la Artritis Reumatoidea es frecuente la presencia constante de dolor que, junto a otros factores, puede tener como consecuencia la depresión que muchas veces no es diagnosticada. Para determinar la Prevalencia de Depresión en Enfermos Crónicos con Artritis Reumatoidea se realiza un estudio observacional, de corte transversal, llevado a cabo en 59 pacientes mayores de 15 años, con una edad promedio de 50+14 años, con un tiempo de evolución de la enfermedad de 9,87+9,15 años y un tiempo promedio de tratamiento de 4,5+5,59 años. Todos reunían al menos 4 criterios ACR para el diagnóstico de AR. La depresión fue diagnosticada utilizando el CET-DE (Alonso- Rodríguez 2006). Se encontró una prevalencia del 42% (25) de Depresión, relacionada con la capacidad funcional de los pacientes, con una tendencia al aumento de la Depresión en aquellos con peor capacidad funcional (31,5% in FH I-II; 56,3% in FH III and 80% in FH IV-V). Esa diferencia no fue, sin embargo, estadísticamente significativa (prueba x2). El tratamiento fue otro factor importante: hubo menos depresión en los pacientes tratados (38,5%) que en los que aún no lo estaban (71%).

In the Rheumatoid Arthritis the constant presence of pain, with other factors may carry to Depression, many times not really with an adequate diagnosis. In order to determinate Prevalence of Depression in chronic patients with Rheumatoid Arthritis an observational study is done, transversal in time, carried on 59 patients with more than 15 years, with an average age of 50+14 years, with 9,87+9,15 years of evolution time of the disease, and 4,5+5,59 years of treatment for their arthritis. All of them have at least four ACR diagnosis criteria for AR. Depression was diagnosed using de CET-DE (Alonso- Rodriguez 2006). A Depression prevalence of 42% (25) was found and it was related with the functional ability of patients: more Depression in those with more funtional impairment (31,5% in FH I-II; 56,3% in FH III and 80% in FH IV-V). This difference was not significative. Another important factor was the treatment: there was less depression in patients on treatment (38,5%) than in those not yet treated (71%).

Characteristics of PMS and PMDD in Female College Students / 정신신체의학

OBJECTIVES: We investigated the prevalence and functional impairment of premenstrual dysphoric disorder (PMDD) and premenstrual syndrome(PMS) in young women. METHODS: A total of 1063 female college students were recruited from two urban areas(Seoul and Suwon) of Korea. Questionnaires for sociodemographic data and risk factors of PMDD, attitude about menstruation, and the Premenstrual Symptoms Screening Tool(PSST) were applied. RESULTS: The prevalence of severe moderate to severe PMS and PMDD were 16.9% and 11.7%, respectively. There were differences in the alcohol and coffee consumption, severity of menstrual cramp, and family history of PMS among the moderate to severe PMS, PMDD, and no/mild PMS groups. Although some participants did not fulfill diagnostic criteria for PMDD, they showed significant functional impairment. Participants with negative attitude about menstruation reported premenstrual symptoms more frequently than those with positive or ambivalent attitude about menstruation. CONCLUSION: These results suggest that PMS and PMDD were prevalent and associated with functional impairment in young females. Some participants reported significant functional impairments although they did not meet the full DSM-IV diagnostic criteria for PMDD. Negative attitude about menstruation was associated with more premenstrual symptoms experiences.

Voxel-based morphometry findings in Alzheimer's disease: neuropsychiatric symptoms and disability correlations - preliminary results

INTRODUCTION: The role of structural brain changes and their correlations with neuropsychiatric symptoms and disability in Alzheimer's disease are still poorly understood. OBJECTIVE: To establish whether structural changes in grey matter volume in patients with mild Alzheimer's disease are associated with neuropsychiatric symptoms and disability METHODS: Nineteen Alzheimer's disease patients (9 females; total mean age =75.2 y old +4.7; total mean education level =8.5 y +4.9) underwent a magnetic resonance imaging (MRI) examination and voxel-based morphometry analysis. T1-weighted images were spatially normalized and segmented. Grey matter images were smoothed and analyzed using a multiple regression design. The results were corrected for multiple comparisons. The Neuropsychiatric Inventory was used to evaluate the neuropsychiatric symptoms, and the Functional Activities Questionnaire and Disability Assessment for Dementia were used for functional evaluation RESULTS: A significant negative correlation was found between the bilateral middle frontal gyri, left inferior temporal gyrus, right orbitofrontal gyrus, and Neuropsychiatric Inventory scores. A negative correlation was found between bilateral middle temporal gyri, left hippocampus, bilateral fusiform gyri, and the Functional Activities Questionnaire. There was a positive correlation between the right amygdala, bilateral fusiform gyri, right anterior insula, left inferior and middle temporal gyri, right superior temporal gyrus, and Disability Assessment for Dementia scores CONCLUSIONS: The results suggest that the neuropsychiatric symptoms observed in Alzheimer's disease patients could be mainly due to frontal structural abnormalities, whereas disability could be associated with reductions in temporal structures.

Os prejuízos funcionais de pessoas com transtorno de ansiedade social: uma revisão: [revisão] / Functional impairment of persons with social anxiety disorder: a review: [revision]

O transtorno de ansiedade social caracteriza-se pelo medo acentuado e persistente de situações sociais ou de desempenho, podendo influenciar a vida cotidiana dos portadores. Objetiva-se identificar, na literatura indexada, estudos empíricos com instrumentos de avaliação que abordem os prejuízos funcionais experimentados por pessoas com transtorno de ansiedade social no desempenho de atividades cotidianas e analisar as implicações de tais dificuldades. Procedeu-se a uma busca sistemática junto às bases de dados indexadas, identificando dez artigos, que foram agrupados em dois conjuntos: a) os relativos à proposição de instrumentos de avaliação e análise das qualidades psicométricas (n = 4); e b) os relativos ao impacto do transtorno de ansiedade social para a qualidade de vida e para as atividades cotidianas (n = 6). Os estudos psicométricos ressaltaram a pouca atenção dada a instrumentos validados para avaliar especificamente os prejuízos funcionais. Os trabalhos relativos ao impacto na qualidade de vida e nas atividades cotidianas constataram a presença de insatisfação com a vida e com a saúde em pacientes com transtorno de ansiedade social. A análise da literatura apontou para a importância da avaliação dos prejuízos funcionais do transtorno de ansiedade social no funcionamento cotidiano, por meio de medidas objetivas. Destaca-se a relevância de tais avaliações no planejamento e na intervenção de atividades voltadas ao transtorno de ansiedade social no contexto das práticas multidisciplinares de saúde mental.

Social anxiety disorder is characterized by strong and persistent fear of social situations, impairing the daily life of affected people. The objective of the present work was to identify empirical studies involving instruments that assess the functional impairment experienced by persons with social anxiety disorder in the execution of daily activities and to analyze the implications of such difficulties. A systematic search of indexed databases was performed. Ten articles were identified and assigned to two groups: a) papers dealing with the proposal of instruments for the evaluation and analysis of psychometric qualities (n = 4); and b) papers dealing with the impact of social anxiety disorder on the quality of life and on daily activities (n = 6). The psychometric studies emphasized the little attention paid to instruments validated in order to specifically evaluate functional impairment, and the papers dealing with the impact on quality of life and on daily activities detected the presence of dissatisfaction with life and health in patients with social anxiety disorder. Analysis of the literature stressed the importance of evaluating the functional impairment caused by social anxiety disorder in daily functioning using objective measurements. The relevance of such evaluations for planning and interventions focusing on social anxiety disorder in the context of multidisciplinary mental health practice is highlighted.