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)

Una mirada psicoanalítica a la melancolía y la depresión desde las películas melancolía, anticristo y ninfomaníaca / A psychoanalytic look at melancholy and depression from the movies Melancholy, Antichrist and Nymphomaniac

Depresión y melancolía son dos conceptos diferentes, existen pocos esclarecimientos sobre dónde empieza o termina su definición en el psicoanálisis, además en su concepción psicógena y/o somática, y las similitudes que comparten. Este artículo propone abordar estos dos conceptos desde la teoría, plantear una diferencia entre ambos, desde el cambio conceptual hasta las diferencias en los movimientos psíquicos, para posteriormente abordar la trilogía de la depresión de Lars von Trier: Melancolía, Anticristo y Ninfomaníaca, en la que los aspectos mencionados se ilustran desde la vivencia de la mujer, lo cual posibilita vislumbrar estos estados, sus exigencias y consecuencias para el devenir del ser humano.

Depression and melancholy are two different concepts, there are few clarifications about where their definition begins or ends in psychoanalysis, also in their psychogenic and / or somatic conception, and the similarities they share. This article aims to approach these two concepts from the theory, difference between them will be considered from the merely conceptual change to the differences in the psychic movements, to later approach the trilogy of the depression of Lars von Trier: Melancholy, Antichrist and Nymphomaniac, in which the mentioned aspects are illustrated from the experience of the woman, which makes it possible to look these states, their demands and consequences for the future of the human being.

O Pré-Natal Psicológico como Programa de Prevenção à Depressão Pós-Parto / The Psychological Prenatal Program as a Prevention Tool For Postpartum Depression / El Programa Prenatal Psicológico como Prevención de la Depresión Posparto

Resumo O pré-natal psicológico (PNP) é uma prática complementar ao pré-natal tradicional, voltado para maior humanização do processo gestacional, e se propõe a prevenir situações adversas potencialmente decorrentes desse processo. O objetivo da pesquisa foi avaliar a eficácia do PNP na prevenção à depressão pós-parto (DPP) em gestantes de alto risco internadas em um hospital público, em Brasília. Optou-se pelo delineamento metodológico da pesquisa-ação. A pesquisa foi realizada com 10 gestantes de alto risco, sendo que cinco delas participaram do PNP (grupo A) e cinco não participaram do PNP (grupo B). Os instrumentos utilizados foram: perfil gestacional, perfil puerperal, questionário avaliativo, sessões e materiais produzidos no grupo de PNP, Inventário Beck de Depressão e Ansiedade (BDI, BAI) e Escala COX. Foi utilizado como procedimento deste trabalho a análise mista dos resultados. Os resultados foram comparados entre os dois grupos e verificou-se que ambas colaboradoras encontravam-se vulneráveis, apresentando vários fatores de risco, portanto com tendência a desenvolver a DPP, entretanto, somente as colaboradoras do grupo B apresentaram DPP. Esses achados sugerem que o pré-natal psicológico associado a fatores de proteção presentes na história das grávidas pode ajudar a prevenir a DPP. Defende-se que a assistência psicológica na gestação, por meio da utilização do PNP, é importante instrumento psicoprofilático que deve ser implementado como uma política pública em contextos da saúde....(AU)

Abstract The Psychological prenatal program (PNP) is a complementary practice to traditional prenatal toward greater humanization of the gestational process, and aims to prevent potentially adverse situations during pregnancy and postpartum. The objective of the research was to investigate the effectiveness of the PNP in preventing postpartum depression (PPD) in high risk pregnant women in a public hospital in Brasilia. Action research methodology was chosen. The survey was conducted with 10 high-risk pregnant women: 05 of them participated in the PNP held in that maternity (group A) and 05 did not (group B). The instruments used were: gestational profile, puerperal profile, evaluative questionnaire, sessions and materials produced in the PNP group, Beck Depression and Anxiety Inventory (BDI, BAI) and COX Scale. This was a multi-methodological approach. The results were compared between the two groups and it was found that both groups of participants were vulnerable to develop PPD; however, only those in the control group (group B) showed PPD. These findings suggest that prenatal psychological factors associated with protection present in the history of pregnant women may help to prevent PPD. It is argued that psychological assistance during pregnancy, through the use of PNP, is a psycoprophylactic important tool that should be implemented as a public policy at health services and prenatal care....(AU)

Resumen El prenatal psicológico (PNP) es una práctica complementaria a la asistencia prenatal tradicional, volcado a una mayor humanización del proceso de gestación, y tiene como objetivo prevenir situaciones potencialmente adversas durante el embarazo y después del parto. El objetivo del estudio fue investigar la efectividad de la PNP en la prevención de la depresión posparto (PPD) en mujeres que tuvieron embarazo de alto riesgo en un hospital público de Brasilia. Fue elegida la metodología de investigación-acción. La encuesta se llevó a cabo con 10 mujeres que tenían embarazos de alto riesgo; 05 de ellas participaron en el PNP durante su maternidad (grupo A) y 05 no hicieron uso o participaron en el PNP (grupo B). Los instrumentos utilizados fueron: perfil gestacional, perfil puerperal, cuestionario de evaluación, sesiones y materiales producidos en el grupo del PNP, Inventario Beck de Depresión y Ansiedad (BDI, la BAI) y Escala de COX. Fue utilizado como procedimiento de este trabajo el análisis mixto de los resultados. Los resultados de los dos grupos se compararon y se encontró que todos los participantes eran vulnerables a desarrollar PPD; sin embargo, solo aquellos en el grupo control (grupo B) mostraron PPD. Estos hallazgos sugieren que los factores psicológicos prenatales asociados con la protección presente en la historia de las mujeres embarazadas pueden ayudar a prevenir el PPD. Se argumenta que la asistencia psicológica durante el embarazo, a través del uso del PNP, es una herramienta importante que debería implementarse como una política pública en los servicios de salud y atención prenatal....(AU)

Motivos e crenças de familiares frente ao tratamento do transtorno depressivo na infância: estudo qualitativo / Statements and beliefs of family face of treatment of depressive disorder in childhood: qualitative study / Declaración y creencias de la família ante el tratamento del transtorno depressivo en la infancia: estudo Cualitativo

Objetivou-se nesta pesquisa analisar os processos e as motivações que levaram os pais e responsáveis à percepção da depressão em suas crianças e à consequente procura de cuidado especializado, além de compreender a influência das crenças em saúde e dos hábitos culturais na procura de tratamento. Foram analisadas cinco entrevistas realizadas em um ambulatório de psiquiatria de um hospital universitário estatal. Utilizou-se metodologia qualitativa, estudo de caso, sob-referencial teórico do "Modelo de Crenças em Saúde". O estigma acerca da psiquiatria e loucura; a não aceitação da existência de depressão em crianças; o desconhecimento acerca da depressão e seus sintomas e as dificuldades diagnosticadas nesta idade são exemplos de fatores que retardam a procura ao tratamento. Em contrapartida, o conhecimento prévio acerca da doença; a ação de profissionais de saúde e educadores e a crença na efetividade do tratamento psiquiátrico possibilitam início precoce do tratamento.

The objective of this research was to examine the processes and motivations that lead parents and caregivers to the perception of depression in their children and the consequent demand for specialized care and understand the influence of health belief and cultural habits in seeking treatment. We analyzed interviews conducted in five psychiatric outpatient clinic in a state university hospital, 2005. We used qualitative methodology - case study - under the theoretical reference of the "Health Belief Model". The stigma about psychiatry and madness; not accepting the existence of depression in children; ignorance about depression and its symptoms and the diagnostic difficulties in this age are examples of factors that delay seeking treatment. In contrast, the prior knowledge about the disease, the action of health professionals and educators and the belief in the effectiveness of psychiatric treatment, allow early treatment.

El objetivo de esta investigación era examinar los procesos y las motivaciones qué llevan a los padres y cuidadores a la percepción de la depresión en sus hijos y la consiguiente demanda de atención especializada y comprender la influencia de las creencias y los hábitos culturales en la búsqueda de tratamiento. Se utilizó metodología cualitativa - estudio de caso - e referencia teórica del "Modelo de Creencias en Salud". El estigma de la psiquiatría y la locura; no aceptar la existencia de la depresión en niños; la ignorancia acerca de la depresión y sus síntomas y las dificultades de diagnóstico en esta edad son ejemplos de factores que retardan la busca de tratamiento. Por el contrario, el conocimiento previo acerca de la enfermedad, la acción de los profesionales sanitarios y educadores y la creencia en la eficacia del tratamiento psiquiátrico propician el tratamiento temprano.

Enfrentamento do pai frente à malformação congênita do filho antes e depois do nascimento / Father coping face to the congenital malformation of son before and after the birth / Enfrentamiento del padre delante de la malformación congénita del hijo antes y después del nacimiento

Todo casal idealiza um filho saudável, o que não ocorre quando existe uma malformação congênita. Poucos estudos consideram as expectativas e enfrentamento paternos diante da malformação de seu filho, objetivo deste estudo. Investigaram-se possíveis diferenças em indicadores de depressão e modos de enfrentamento em 12 pais divididos em dois grupos: grávidos e com filhos entre 3 e 5 anos. O diagnóstico da malformação ocorreu durante a gravidez de suas mulheres, atendidas em uma maternidade pública do Rio de Janeiro. Foram utilizados o Questionário “Momento da Notícia”, o Inventário de Depressão (BDI) das Escalas Beck e a Escala Modos de Enfrentamento de Problemas (EMEP). No total dos pais, constatou-se que66,7 % recebeu o diagnóstico por médicos, considerando a comunicação do diagnóstico como positiva. Observou-se que 75% dos pais reagiram negativamente, ainda que as repercussões da malformação para o casal tenham sido avaliadas como positiva por 83, 33% do total de pais.Sentimentos negativos, como tristeza, foram relatados por todos os pais, ainda que 91,2% dos pais de ambos os grupos apresentaram sinais mínimos de depressão. O enfrentamento mais prevalente pela EMEP para ambos os grupos foi o “Focalizado no Problema”, seguido de “Busca de práticas religiosas”. Embora sem diferenças entre os grupos, conclui-se que amalformação do filho representa impacto emocional no enfrentamento paterno.

Every couple idealizes a healthy son, which not happened when the congenital malformation exists. Few studies consider the paternal expectations and the father´s coping face to the son malformation, the aimof this study. We investigated differences on the indicators of depression and coping in 12 parents, divided into two groups: pregnant fathers and fathers with children from 3 to 5 years old. The diagnosis of the child´s malformation occurred during the pregnancy of their wives attended in apublic maternity hospital in the Rio de Janeiro city. The Questionnaire "Momento da Noticia” (Moment of diagnosis news), the DepressionInventory (BDI) of the Beck Scale, and the EMEP Scale (Ways of Coping withProblems Scale) were used. For all parents, it was found that 66.7% received the diagnosis by doctors, and considered the communication ofdiagnosis was positive. It was observed that 75% of parents reacted negatively, even if the repercussions of the malformation to the couple have been considered as positive by 83, 33% of parents. Negative feelings, such as sadness, were reported by all parents, even though 91.2% of the parents of both groups showed minimal signs of depression. The most prevalent way of coping by EMEP for both groups was the "Focused on the Problem", followed by "Search of religious practices". Although we did not find differences between the groups, we concluded that the malformation of the child has emotional impact on the father coping.

Cada pareja concibe un hijo sano, lo que no ocurre cuando hay una malformación congénita. Pocos estudios consideran las expectativas y afrontamiento de los padres antes de la malformación de su hijo, el objetivo de este estudio. Se investigaron las diferencias en los indicadores de depresión y afrontamiento en 12 padres, divididos en dos grupos: padres embarazados y padres con niños de 3 a 5 años de edad. El diagnóstico de lamalformación del niño ocurrió durante el embarazo de sus esposas atendidasen una maternidad pública de la ciudad de Río de Janeiro. El Cuestionario"Momento da Noticia", el Inventario de Depresión (BDI) de la Escala de BeckEscala Modos de Afrontamiento (EMEP), fueron utilizados. En todos los padres, para 66,7% el diagnóstico de la malformación fue dada por los médicos, dando se cuenta de la comunicación del diagnóstico como positivo. Se observó que el 75% de los padres reaccionó negativamente, aunque las repercusiones de la malformación en la pareja han sido evaluadas comopositivos por 83, 33% de los padres. Los sentimientos negativos, como la tristeza, fueron reportados por todos los padres, a pesar de que el 91,2% delos padres de ambos grupos mostraron signos mínimos de depresión. Elafrontamiento más frecuente por EMEP para ambos grupos fue el "Centradoen el problema", seguido de "Búsqueda de las prácticas religiosas". Aunqueno se encontraron diferencias entre los grupos, se concluye que la malformación del niño tiene impacto emocional en el afrontamiento de los padres.

Nurse's role in the context of childhood depression in CAPSi: Diagnostic approach of nursing / Atuação do enfermeiro no quadro de depressão infantil em CAPSi: Abordagem diagnóstica de enfermagem / El papel de la enfermera en el contexto de la depresión infantil en CAPSi: Enfoque diagnóstico de enfermeira

Objectives: To assess the signs and symptoms of depression in childhood and identify nursing diagnoses based on NANDA for this child and from this diagnostic approach, proposing strategies for child care on children's psychosocial Care Centers-CAPSi, thus contributing to the discussion of nurses regarding the care system for children with depression. Method: A qualitative, exploratory review of literature about depression and its characteristics in the child. Results: The analysis of the possible signs and symptoms of depression led to the construction of a frame where it suggests some nursing diagnoses compatible behaviors found in the syndrome. Conclusion: The nursing process provides different performances of nurses in CAPSi, allows formulating intervention strategies in order to improve the quality of life of children with depression and family.

Objetivos: Verificar os sinais e sintomas da depressão na infância e identificar os diagnósticos de enfermagem baseado em NANDA para essa criança e a partir dessa abordagem diagnóstica, propor estratégias de cuidado à criança em Centros de Atenção psicossocial infantil – CAPSi, colaborando assim para a discussão da enfermagem no que tange à sistematização da assistência à criança com depressão. Método: Estudo exploratório-qualitativo com revisão bibliográfica acerca da depressão e suas características na criança. Resultados: A análise dos possíveis sinais e sintomas de depressão possibilitou a construção de um quadro onde se sugere alguns diagnósticos de enfermagem compatíveis aos comportamentos encontrados na síndrome. Conclusão: O processo de enfermagem possibilita diferentes atuações do enfermeiro nos CAPSi, permite formular estratégias de intervenção com intuito de melhorar a qualidade de vida da criança com depressão e da família.

Objetivos: Evaluar los signos y síntomas de la depresión en la infancia e identificar los diagnósticos de enfermería basado en la NANDA para este niño y desde este enfoque diagnóstico, proponer estrategias para el cuidado de niños en centros de atención psicosocial de los niños - CAPSi, contribuyendo así a la discusión de enfermeras sobre el sistema de atención a los niños con depresión. Método: Una revisión cualitativa, exploratoria de la literatura sobre la depresión y sus características en el niño. Resultados: El análisis de los posibles signos y síntomas de la depresión llevó a la construcción de un marco donde se sugiere algunos diagnósticos de enfermería comportamientos compatibles se encuentran en el síndrome. Conclusión: El proceso de enfermería ofrece diferentes actuaciones de las enfermeras en CAPSi, permite formular estrategias de intervención con el fin de mejorar la calidad de vida de los niños con la depresión y la familia.

Sesgos de atención selectiva como factor de mantenimiento y vulnerabilidad a la depresión: una revisión crítica / Selective attentional biases as a maintenance and vulnerability factor in depression: a critical review

En este trabajo se revisan los estudios que han examinado la presencia de sesgos de atención selectiva en la depresión, comparando el rendimiento de personas con y sin depresión (clínica y subclínica) en tareas experimentales cognitivas. Los datos recientes mediante técnicas de registro de movimientos oculares indican que la depresión se caracteriza por la presencia de un procesamiento atencional sostenido hacia información negativa y una ausencia de sesgos a información positiva. Asimismo, se considera la evidencia empírica acerca del papel causal de estos sesgos en el inicio y mantenimiento de la depresión, la cual sugiere que estos sesgos atencionales hacia información negativa y positiva, asociados a un estilo de respuesta rumiativo y a estrategias ineficaces de regulación emocional, pueden ser marcadores estables de vulnerabilidad a la depresión. Las implicaciones clínicas de estos hallazgos y las futuras líneas de investigación en este campo son discutidas.

This review examines studies that have addressed the presence of selective attentional biases in depression (clinical and subclinical samples) in several experimental cognitive tasks. Current data using eye-tracking techniques indicate that depression is characterized by the presence of sustained attentional processing towards negative information and absence of biases towards positive information. Available empirical evidence about the causal role of these biases on the onset and maintenance of depression suggests that these biases, in association with a ruminative style and ineffective emotional regulation strategies, could be stable vulnerability markers of depression. Clinical implications of these findings and future research in this field are discussed.

Guía de atención integral para la detección temprana y diagnóstico del episodio depresivo y trastorno depresivo recurrente en adultos. Atención integral de los adultos con diagnóstico de episodio depresivo o trastorno depresivo recurrente Parte III: Tratamiento de la depresión resistente y la depresión con psicosis, tratamiento con terapia ocupacional y hospital día / Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder Part III: Treatment of Resistant Depression and Psychotic Depression, Occupational Therapy and Day Hospital Treatment

Introducción: El objetivo del presente artículo es presentar las recomendaciones basadas en la evidencia que surgieron como respuesta a una serie de preguntas clínicas con respecto al episodio depresivo y al trastorno depresivo recurrente, haciendo hincapié en los aspectos generales del tratamiento de la depresión resistente y la depresión con psicosis, el tratamiento con terapia ocupacional y el hospital día, con el fin de brindar parámetros de atención en salud basados en la mejor y más actualizada evidencia disponible para lograr los estándares mínimos de calidad en el abordaje de adultos con dichos diagnósticos. Método: Se elaboró una guía de práctica clínica bajo los lineamientos de la Guía Metodológica del Ministerio de la Protección Social. Se adaptaron las recomendaciones de las guías NICE90 y CANMAT para las preguntas que estas guías contestaban y se desarrollaron de novo para las preguntas no encontradas. Resultados: Se presentan las recomendaciones 23-25 correspondientes al manejo de la depresión...

Introduction: This article presents recommendations based on the evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder. Emphasis was given to general treatment issues of resistant depression and psychotic depression, occupational therapy and day hospital treatment so as to grant diagnosed adult patients the health care parameters based on the best and more updated evidence available and achieve minimum quality standards. Methodology:A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while denovo questions were developed. Results: Recommendations 23-25 corresponding to the management of depression are presented...

Validación convergente de la narrativa prototipo de la depresión en grupos de adultos intermedios y tardíos en Bucaramanga / Convergence validation of the narrative prototypic of the depression in groups of intermediate and delayed adults in Bucaramanga

El objetivo de esta investigación fue identificar el grado de validación de la narrativa prototipo de la depresión de un grupo de adultos intermedios y tardíos, clasificados como depresivos y otro grupo clasificado como no depresivo de la ciudad de Bucaramanga, diferenciándolos en el grado de su atribución de relación; por medio de una escala de validación convergente de la narrativa prototipo y su patología. Dicha muestra estuvo compuesta por 600 adultos intermedios y tardíos, hombres y mujeres entre los 40 y 75 años de edad, seleccionados de acuerdo con el SCID (Entrevista estructurada de trastornos mentales basada en el DSM-IV), que se utilizó para descartar otras patologías relacionadas con la depresión, y el test de Hamilton (Hamilton Depressión Rating Scale, o HRSD) para identificar el grado de gravedad de la depresión. A su vez, el SCID y el test de Hamilton constituyen los instrumentos de evaluación, así como la narrativa prototipo de la depresión, el instrumento de prueba. Los resultados de los análisis del Chi-cuadrado y el Gamma indicaron que los sujetos depresivos difieren de los no depresivos, atribuyendo a la narrativa prototipo de la depresión un mayor grado de relación con su vida que los sujetos no depresivos; por lo tanto, a mayor grado de identificación con la narrativa prototipo de la depresión del grupo clasificado como depresivo, menor será el grado de identificación con la narrativa prototipo de la muestra clasificada como no depresiva.

The objective of the present investigation work was to identify the validation degree of the narrative prototype of the depression of a group of depressive intermediate and delayed adults classified as a depressive and another group classified as non depressive of the city of Bucaramanga, differentiating them by the attribution of relation degree through a convergent validation scale from the narrative prototype and its pathology. This sample was composed by 600 intermediate and delayed adults, men and women between the 40 and 75 years old, which were selected according to the SCID (structured interview of mental upheavals based on the DSM-IV), that was used to discard other pathologies related to the depression and, the test of Hamilton (Hamilton Depression Scale Rating, or HRSD) to identify the degree of gravity of the depression, the SCID and the test of Hamilton as well constitute the instruments of evaluation, and the narrative prototype of the depression, the instrument of test. The results of the analyses of the Chi-square, and the Gamma, indicated that the depressive subjects differ from the nondepressive ones, attributing to the narrative prototype of the depression a greater degree of relation with their life that the nondepressive subjects, therefore, to greater degree of identification with the narrative prototype of the depression of the classified group as depressive minor will be the degree of identification with the narrative prototype of the sample classified like nondepressive.

Trastorno depresivo mayor en México: la relación entre la intensidad de la depresión, los síntomas físicos dolorosos y la calidad de vida

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SUMMARY Background: Major Depressive Disorder (MDD) is a disease associated to emotional, vegetative and physical symptoms, including for the latter those pain-related symptoms. MDD has a high prevalence rate with a substantial burden of illness, and it expected that by 2020 it will become the second cause of world disability. The diagnosis of MDD is difficult due to the high prevalence of painful physical symptoms, and also due to the fact these symptoms are more evident that the embedded emotional ones. Over 76% of patients with MDD, report painful physical symptoms observed, like headache, abdominal pain, back pain and unspecific-located pain; observing these symptoms can even predict depression severity. In addition, the likelihood of psychiatric disease increases, importantly, with the number of physical symptoms observed; moreover, the remission of physical symptoms predicts the complete remission in MDD. We present an observational, prospective study to examine the clinical profile of Mexican outpatients suffering MDD and determine the relationship between depression severity, painful physical symptoms in quality of life and depression. Methods: Adult patients with current episodes of MDD, treated with antidepressants were included. MDD was defined according to the criteria of the Statistical Manual of Mental Disorders - 4th Edition (DSM-IV) or in the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Patients should have been free of depression symptoms prior to the current episode for at least 2 months. Duration of current episode should not exceed two years. Treatment-resistant patients and those with other psychiatric diagnosis were excluded. Treatment-resistance was defined as: a) a failure to respond to treatment when two different antidepressants were employed at therapeutic doses for at least four weeks each, b) when the subject was previously treated with IMAO inhibitors, c) when electro-convulsive therapy (ECT) was previously employed. Other exclusion criteria comprise previous or current diagnosis of schizophrenia, schizophreniform or schizoaffective disorder, bipolar disorder, dementia or mental impairment. Patients were selected in 34 centers in Mexico. Patients were classified according to the presence (SFD+) or absence (SFD-) of painful physical symptoms using the Somatic Symptom Inventory (SSI); SFD+ was defined as scores ≥ 2 for the pain-related items in the SSI (items 2, 3, 9, 14, 19, 27 and 28). Visual Analogue Scale (VAS) quantified pain severity (cervical pain, headache, back pain, shoulder pain, interference of pain in daily activities and vigil-time with pain). HAMD17 and CGI-S determined depression severity, while the Quality of Life in Depression Scale (QLDS) quantified subjective well-being. Linear regression models were employed to compare groups for VAS, HAMD17, CGI-S, and QLDS, to fit the confusions or clinical predictors when needed. Proportions between groups were established with Fisher exact test or logistic regression. Significance levels were established at 0.005 due to the observational nature of the study. In the result tables, standard deviation (SD) is reported as a variation around the mean value as Mean ± SD, and 95% confidence intervals are denoted 95% IC. Results: A total of 313 patients were enrolled in the study. All of the enrolled patients were Mexican, almost them were women and had at least a previous MDD episode. Painful physical symptoms were reported by 73.7% of patients, these patients were classified into the SFD+ group. Neither statistical nor clinical significant differences between the SFD+ and SFD- groups were found when analyzing socio-demographic variables (age, gender, ethnical origin) and disease history variables (number of previous episodes of MDD, in the last 24 months, duration of current episode). At baseline, patients had a CGI-S mean score of 4.6 and HAMD17 of 26.3. HAMD17 mean score (27.1) in SFD+ patients was significantly higher (p<0.0001) than the SFD- patients (23.8), but nonsignificant differences between groups were found for the subscales central, Maier & retard. CGI-S scores were similar between SFD+ and SFD-; 4.6 and 4.5 respectively (p>0.05). Prevalent painful physical symptoms were also the most painful, when a five-point scale was employed to measure severity, and comprised muscular pain (84.9%), cervical pain (84.2%) and headache (83.5%). SFD+ patients had higher pain severity in all VAS scales (p<0.0001), with perceived severity scores twice as large when compared to SFDgroup. In particular, the global pain VAS reported average values of 49.0 and 19.7 for the SFD+ and SFD- groups respectively. Patients came to the first psychiatric consultation treated with psychotherapy (27.9%), antidepressants (37.3%), anxiolytics (28.6%) and analgesics (9.7%); more than 50% of all patients were not taking any drugs or receiving psychotherapy for treatment of MDD at baseline. Analgesics were used only by 9.7% of patients for the treatment of painful physical symptoms in their current MDD episode. No significant differences between groups were found when comparing the use of psychotherapy, antidepressants, anxiolytics, antipsychotics, mood stabilizers or analgesics. Quality of life was poor for all patients, but significantly worse in the SFD+ group than in the SFD- group (QLDS scores of 23.2 and 20.0 respectively, p<0.001). Discussion: The diagnosis and symptoms manifestation can be influenced by local socio-cultural factors, in particular cultural differences are associated with the prevalence of painful physical symptoms, but this finding is not consistent. The results of this study can be extrapolated to the MDD Mexican population, as selection criteria comprised only operative diagnosis criteria, and not enrollment into the study took place due to the presence of painful physical symptoms. Patients included into the study presented a moderate to severe disease as measured with the HAMD17 scores. The high prevalence of painful physical symptoms in patients with depression was confirmed in this study; it has been reported the patients report pain-related symptoms as the main (even the only) symptom when consulting general practitioners. Painful physical symptoms in MDD include headache, cervical pain, back pain or neck pain; the presence of painful physical symptoms in depression is associated to higher intakes medication, but in this study more than 50% of subjects were not receiving any treatment, including psychotherapy. The treatment of MDD is by no means optimal, as only 30%- 40% of these patients reach complete remission of symptoms with their first antidepressant. Psychological symptoms respond to antidepressant treatment, but in general, this is not the case for the physical symptoms. The lack of efficacy can be explained as a failure in the treatment of these painful physical symptoms. Resolving these symptoms is even a predictor for the complete remission of MDD; the evidence might suggest that treatment of emotional and physical manifestations of depression could improve successful-treatment rates. Conclusion: As found in other reports, a high prevalence of painful physical symptoms was found in MDD patients. Increase in pain severity is associated with higher HAMD17 scores but not CGI-S scores; this discrepancy in the final rates obtained with both scales suggests that both emotional and physical dimensions of MDD should be considered when the clinical assessment is performed. We concluded that clinical judgment of Mexican psychiatrists differs between their global impression and a semi-structured interview in the same patient and therefore is fundamental that the clinical evaluation consists of both emotional and physical manifestations as important components of MDD.