Ansiedade e Depressão: rastreio entre profissionais da estratégia de saúde da família na Amazônia / Anxiety and Depression: screening among family health strategy professionals in the Amazon / Ansiedad y Depresión: tamizaje entre profesionales de estrategias de salud familiar en la Amazonía

Objetivo: realizar rastreamento de depressão e transtorno de ansiedade generalizada entre profissionais da Estratégia de Saúde da Família em um município no interior da Amazônia. Método:estudo transversal desenvolvido com 63 profissionais atuantes em 12 equipes de ESF na cidade de Santarém, Pará, Brasil. Foram utilizadas ferramentas validadas e adaptadas transculturalmente: o Patient ́s Health Questionaire ­9 e o Generalizes Anxiety Disorder ­7. Os dados foram analisados a partir de ferramentas da estatística descritiva (frequências absolutas e relativas) a partir do software Microsoft Excel 2018. Resultados:Houve predomínio de indivíduos do sexo feminino, na idade de 40 a 44 anos e raça/cor pardo. O estado civil predominante foi casado, a categoria profissional mais representada na amostra foram os agentes comunitários de saúde e o a maioria dos participantes possuía nível superior completo. 57.1% tiveram rastreamento positivo para depressão e 42.1% para ansiedade. Conclusão:Observou-se elevada frequência de ansiedade e depressão entre os profissionais incluídos na amostra. Nossos dados reforçam a necessidade de ações preventivas na área de saúde mental visando reduzir os impactos dos fatores de risco. Além disso, é fundamental a realização de grandes estudos voltados à investigação dos fatores associados à saúde mental dos trabalhadores da saúde no Brasil

Objective: To screen for depression and generalized anxiety disorder among Family Health Strategy professionals in a municipality in the interior of the Amazon. Method:A cross-sectional study was carried out with 63 professionals working in 12 FHS teams in the city of Santarém, Pará, Brazil. Cross-culturally adapted and validated tools were used: the Patient's Health Questionnaire -9 and the Generalized Anxiety Disorder -7. The data was analyzed using descriptive statistics tools (absolute and relative frequencies)using Microsoft Excel 2018 software. Results:There was a predominance of females, aged between 40 and 44 and of brown race/color. The predominant marital status was married, the most represented professional category in the sample were community health agents and the majority of participants had completed higher education. 57.1% were screened positive for depression and 42.1% for anxiety. Conclusion:There was a high frequency of anxiety and depression among the professionals included in the sample. Our data reinforces the need for preventive action in the area of mental health in order to reduce the impact of risk factors. In addition, it is essential to carry out large-scale studies investigating the factors associated with the mental health of health workers in Brazil.

Objetivo: Detectar depresión y ansiedad generalizada en profesionales de la Estrategia Salud de la Familia de un municipio del interior de la Amazonia. Método:Se realizó un estudio transversal con 63 profesionales que trabajan en 12 equipos de la ESF en la ciudad de Santarém, Pará, Brasil. Se utilizaron instrumentos validados y adaptados transculturalmente: el Cuestionario de Salud del Paciente -9 y el Trastorno de Ansiedad Generalizada -7. Los datos se analizaron mediante herramientas de estadística descriptiva (frecuencias absolutas y relativas) utilizando el software Microsoft Excel 2018. Resultados:Hubo un predominio de mujeres, con edades comprendidas entre 40 y 44 años y de raza/color moreno. El estado civil predominante fue casado, la categoría profesional más representada en la muestra fue la de agentes de salud comunitarios y la mayoría de los participantes habían completado estudios superiores. El 57,1% dieron positivo en depresión y el 42,1% en ansiedad. Conclusión:Hubo una elevada frecuencia de ansiedad y depresión entre los profesionales incluidos en la muestra. Nuestros datos refuerzan la necesidad de acciones preventivas en el área de la salud mental para reducir el impacto de los factores de riesgo. Además, es fundamental la realización de grandes estudios dirigidos a investigar los factores asociados a la salud mental de los trabajadores de la salud en Brasil

Pathway to Holistic Care of Psychiatric Illness in National Servicemen Presenting in Primary Healthcare

@#This is a case study of a 22-year-old National Serviceman presenting with the main complaint of insomnia. This case demonstrates possible gaps in the integration of care between public and National Service healthcare. We illustrate a pathway which primary physicians may use to improve communication with National Service healthcare.

The Diagnostic Value of Malondialdehyde, Superoxide Dismutase and Catalase Activity in Drug Naïve, First Episode, Non-Smoker Generalized Anxiety Disorder Patients

OBJECTIVE: Generalized anxiety disorder (GAD) is a common anxiety disorder. Although lots of research done to reveal neurobiological basis of GAD, it is still unclear. Diagnosis of GAD depends on subjective complaints of patients, thus the need for a biological marker is constantly emerging. In this study, we aimed to investigate diagnostic value of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in GAD. METHODS: We evaluated MDA, SOD, and CAT levels in peripheral blood of 46 patients and 45 controls. MDA was measured with Ohkawa’s methods, SOD was measured with Fridovich method, and CAT was measured with Beutler’s method. RESULTS: MDA was significantly increased in patients than controls, medians 4.05 nmol/mg and 1.71 nmol/mg respectively, p < 0.001; SOD and CAT activity was significantly decreased in patients than controls, medians of SOD were 159.07 U/mg and 301.87 U/mg, p < 0.001 respectively, medians for CAT were 138.47 U/mg and 160.60 U/mg respectively. We found high correlation between Hamilton Anxiety Rating Scale and SOD, MDA r values were 0.723 and 0.715 respectively, p < 0.001 for both. Receiver operator characteristic (ROC) curve analysis showed high diagnostic performance for MDA and SOD, low diagnostic performance for CAT, areas under curve were 1.0, 1.0, and 0.648 respectively. CONCLUSION: Our results reveal possible diagnostic value of MDA, less likely of SOD but not CAT. Future studies should investigate diagnostic value of oxidants and antioxidantn enzymes in larger samples and include diagnostic value of these parameters.

A study on prevalence of psychiatric comorbidity in female patients with breast cancer.

Background: The growing awareness of the psychological impact of the diagnosis and treatment of cancer on quality of life has created the need for deeper insights into the adjustment process, its disorders, and effective strategies for the treatment of psychiatric morbidity. Objectives: The study was conducted to find out the prevalence of psychiatric comorbidity among the female breast cancer patients admitted in Surgery or Radiotherapy units of a tertiary care hospital. Material & Methods: The sample was taken from sixty female non pregnant, non lactating breast cancer patients consenting for study admitted in Guru Gobind Singh Medical College, Faridkot aged between 18-60 years. The patients for study were screened by General Health Questionnaire (GHQ 12). After screening the patients who were found to have positive psychological stress, were further interviewed individually and final diagnosis was made on the basis of DSM-IV-TR criteria for mental disorders. Results: The number of patients with psychiatric morbidity was found in 45% of breast cancer patients. The clinical diagnosis as per DSM-IV criteria’s in majority of the patients (59.25%) was Adjustment Disorder. Major Depressive disorder was found in 22.2% patients. Generalised Anxiety Disorder was found in 14.8% patients. Somatoform Disorder was found in 3.7% patients. More number of patients with advanced stage of cancer (21) were found to be having diagnosable psychiatric illness than patients with early stage of cancer (6). Conclusions: The results of the study have implications for clinical training, practice and policy initiatives. Integrating mental health into general health care, effective mass media coverage, networking between mental health-professionals and other health professionals, community-based health services are required.