Associação entre ansiedade e depressão em brasileiros durante o isolamento social da pandemia de covid-19 / Association between anxiety and depression in brazilians during the social isolation of the COVID-19 pandemic / Asociación entre ansiedad y depresión en brasileños durante el aislamiento social por la pandemia del COVID-19

O objetivo deste estudo é analisar a associação entre ansiedade e depressão durante o isolamento social da pandemia de covid-19 no Brasil. Dados de 1.053 adultos brasileiros entre 18 e 59 anos foram coletados por meio de questionário online, entre abril e maio de 2020, para este estudo transversal. Foi utilizada a Escala Hospitalar de Ansiedade e Depressão, e foram analisados fatores sociodemográficos e econômicos. Houve 37% e 20% de risco moderado e alto de ansiedade, respectivamente. Foi observada uma relação direta entre ansiedade e ser do sexo feminino (OR: 1,55; IC95%: 1,02-2,34), ser mais jovem (OR: 4,78; IC95%: 2,71-8,42, para pessoas entre 18-28 anos) e ter rendimentos mais baixos (OR: 1,51; IC95%: 1,69-1,96). Os resultados foram na mesma direção para a depressão, e, adicionalmente, foi demonstrada associação entre isolamento social (parcial ou total) e depressão (OR: 1,42; IC95%: 1,01-2,01). Este estudo encontrou uma associação entre mulheres, populações mais jovens e indivíduos de menor renda e o risco de sofrer ansiedade e depressão durante o confinamento decretado devido à pandemia de covid-19. Além disso, o isolamento social foi associado ao risco de depressão.

The aim of this study is to analyze the association between anxiety and depression during the social isolation for COVID-19 in Brazil. Data of 1,053 Brazilian adults between 18 and 59 years old were gathered by an online questionnaire, between April and May 2020, for this cross-sectional study. The Hospital Anxiety and Depression Scale was used and sociodemographic and economic factors were analyzed. There was a 37% and 20% of moderate and high risk of anxiety, respectively. A direct relationship was observed between anxiety and being female (OR: 1.55; 95%CI: 1.02-2.34), younger (OR: 4.78; 95% CI: 2.71-8.42, for people between 18-28 years old), and having lower incomes (OR: 1.51, 95%CI: 1.69-1.96). Results were in the same vein for depression and, additionally, an association between social isolation (partial or total) and depression was shown (OR: 1.42; 95%CI: 1.01-2.01). This study reported an association between women, younger populations, and subjects with lower incomes and the risk of suffering anxiety and depression during the confinement due to the COVID-19 pandemic. In addition, social isolation was associated with risk of depression.

El objetivo de este estudio es analizar la asociación entre ansiedad y depresión durante el aislamiento social por la pandemia del COVID-19 en Brasil. Se recolectaron datos de 1.053 adultos brasileños, de entre 18 y 59 años de edad, mediante un cuestionario en línea, entre abril y mayo de 2020, para este estudio transversal. Se utilizó la Escala de Ansiedad y Depresión Hospitalaria, y se analizaron factores sociodemográficos y económicos. Hubo el 37% de riesgo moderado de ansiedad y el 20% de riesgo alto. Se observó una relación directa entre la ansiedad y ser mujer (OR: 1,55; IC 95%: 1,02-2,34), ser más joven (OR: 4,78; IC 95%: 2,71-8,42 para personas de entre 18 y 28 años) y tener menores ingresos (OR: 1,51; IC 95%: 1,69-1,96). Los resultados fueron los mismos para la depresión y, además, se demostró una asociación entre el aislamiento social (parcial o total) y la depresión (OR: 1,42; IC 95%: 1,01-2,01). Este estudio encontró una asociación entre ser mujer, poblaciones más jóvenes y personas de bajos ingresos con el riesgo de experimentar ansiedad y depresión durante el confinamiento por la pandemia del COVID-19. Además, el aislamiento social se asoció con el riesgo de depresión.

Cuidadores familiares de pessoas com demência: um estudo exploratório randomizado utilizando a Terapia de Aceitação e Compromisso em grupo / Family caregivers of people with dementia: an exploratory randomized study using Group Acceptance and Commitment Therapy

Introdução: Estima-se que a prevalência de sintomas ansiosos em cuidadores familiares de pessoas com demência é igual ou maior do que a prevalência de sintomas depressivos, embora a ansiedade tenha sido pouco explorada na literatura voltada para este público. Estudos têm demonstrado que a Terapia de Aceitação e Compromisso (ACT) pode ser utilizada com cuidadores familiares, com efeitos positivos sobre sintomas ansiosos. Entretanto, a ACT ainda não foi avaliada no formato em grupo e tampouco em países em desenvolvimento para este público. Objetivos: O trabalho foi subdividido em dois estudos. O objetivo do Estudo 1 foi revisar a literatura através de uma meta-análise e avaliar quantitativamente a eficácia da ACT em grupo, presencialmente, nos sintomas de ansiedade e depressão de adultos com 18 anos ou mais. O objetivo do Estudo 2 foi adaptar e avaliar os efeitos da ACT, em grupo, nos sintomas de ansiedade de cuidadores familiares de pessoas com demência. Método: No Estudo 1, quatro bases de dados foram pesquisadas em agosto/2018 e uma busca atualizada foi realizada em novembro/2021. Foram incluídos 48 estudos clínicos randomizados (3292 participantes: ansiedade = 34 ECRs; depressão = 40 ECRs). O Estudo 2, é um estudo exploratório randomizado, realizado em um único centro, não-cego. Cinquenta e sete cuidadores familiares de pessoas com demência foram randomizados para o grupo intervenção (n = 29) ou lista de espera (n = 28). O grupo intervenção participou de oito sessões de ACT em grupo, realizadas por vídeo conferência, semanalmente. Os participantes responderam aos questionários de avaliação de ansiedade, depressão, flexibilidade psicológica, qualidade de vida e sobrecarga, em três momentos diferentes: semanas 0, 9 e 20. Análises de regressão múltipla foram realizadas para comparar os escores dos participantes do grupo intervenção e controle, na semana 9 e 20. Os escores da linha de base foram usados como controle nas análises de intenção de tratamento (ITT) e dos participantes que participaram em pelo menos seis sessões de intervenção. Resultados: No Estudo 1 o tamanho de efeito para sintomas ansiosos foi de médio a grande (g=0,52, p < 0,001; 95% IC=0,30 ­ 0,73), já o tamanho de efeito para sintomas depressivos foi de pequeno a médio (g=0,47, p < 0,001; 95% IC=0,31 ­ 0,64). A amostra do Estudo 2 foi composta em sua maioria mulheres, de baixo a médio nível socioeconômico, com uma idade média de 52 anos e mediana de escolaridade de 15 anos. Participantes do grupo intervenção apresentaram pontuações mais baixas para sintomas de ansiedade e depressão, comparados com participantes do grupo controle. Este resultado foi encontrado nas semanas 9 e 20, tanto na análise de ITT, quanto na análise daqueles que completaram seis sessões ou mais. Apenas os participantes que participaram de pelo menos seis sessões, apresentaram redução da sobrecarga nas semanas 9 e 20, além de apresentarem melhora na qualidade de vida na semana 9. Os resultados não indicaram efeitos da intervenção na flexibilidade psicológica. Conclusão: Este estudo oferece evidências a favor da utilização da ACT em grupo, com familiares de pessoas com demência, auxiliando na redução dos sintomas ansiosos e depressivos.

Background: The prevalence of anxiety symptoms is estimated to be equal to or higher than the prevalence of depressive symptoms in family carers of people with dementia. However, anxiety is currently somehow neglected in the carer literature. Previous studies demonstrated that Acceptance and Commitment Therapy (ACT) is effective for treating anxiety symptoms in family carers of people with dementia, but the vast majority of these studies were conducted in developed countries. Objectives: The thesis was divided into two studies. Study 1 was a meta-analysis which aimed to quantitatively examine the efficacy of group-based ACT, delivered face-to-face, on anxiety and depressive symptoms in adults aged 18 or older. The Study 2 adapted and investigated the effectiveness of an ACT group intervention on the anxiety symptoms in Brazilian family carers of people with dementia. Method: In Study 1, four electronic databases were searched in August, 2018 and an update search was conducted in November, 2021. Forty-eight randomised controlled trials (RCTs) were included in this review (3292 participants: anxiety = 34 RCTs, depression = 40 RCTs). Study 2 was a single-centre, unblinded, double-arm exploratory randomised trial. Fifty-seven family carers of people with dementia presenting with mild to severe anxiety symptoms were randomised to the intervention group (n = 29) or waiting list group (n = 28). The intervention group received eight weekly sessions of group ACT, delivered through videoconference. Participants completed the measure of anxiety and depressive symptoms, caregiver burden, psychological flexibility and quality of life at Weeks 0, 9 and 20. Multiple linear regression analyses were performed to evaluate whether there was a significant difference in scores between the intervention and control groups, at weeks 9 and 20, while controlling for the baseline scores using both intention-to-treat (ITT) and completers data analyses. Results: In Study 1 the overall effect size for anxiety symptoms was medium-to-large (g = 0.52, p < 0.001; 95% CI =0.30­0.73), while the overall effect size was small-to-medium for depressive symptoms (g = 0.47, p < 0.001; 95% CI = 0.31­0.64). In Study 2 Participants were mostly women, from low- to middle-income socioeconomic levels, with a mean age of 52 years and median education of 15 years. Participants in the intervention group had lower scores of anxiety and depression symptoms compared to participants in the control condition at weeks 9 and 20 in both the ITT and completer analyses. Only participants who attended six or more sessions (i.e., completer sample) demonstrated reduced caregiver burden at both follow-up points. The completer sample also showed improvement in quality of life at week 9. The results did not show any effect of the intervention on psychological flexibility. Conclusion: This study provides evidence supporting the use of group ACT, delivered through videoconference, with family carers of people with dementia to help them cope better with anxiety and depressive symptoms.

Association between Anxiety and Sleepiness in Medical Students of the University of Guadalajara (Mexico) / Asociación entre ansiedad y somnolencia diurna en estudiantes de medicina de la Universidad de Guadalajara (México) / Associação entre ansiedade e sonolência diurna em estudantes de medicina da Universidade de Guadalajara (México)

Introduction: Medical students could potentially be considered as a vulnerable group in terms of increased risk for anxiety and sleep disorders. This could be caused by high academic demands, and high levels of stress. There is little information, however, when it comes to the relationship between anxiety and exces-sive daytime sleepiness among medical students, and the potentially negative effects this relationship could have upon student health and academic performance. The objective was to identify the association between anxiety and excessive daytime sleepiness in medical students of the University of Guadalajara (Mexico). Materials and methods: A cross-sectional study was carried out, evaluating 173 students between January and April of 2019. The Epworth Sleepiness Scale was used for the determination of excessive day-time sleepiness, while the anxiety symptoms were measured using the Beck Anxiety Inventory. According to the cut-off points for the Epworth scales, the cut-off point was from 10 and for the Beck anxiety inventory it was 8. Chi square and Fisher's exact test were used for statistical analysis. A value of p<0.05 was consid-ered statistically significant. Results: Statistically significant differences were found between the students when comparing the presence and absence of excessive daytime sleepiness and anxiety with a value of p = 0.036 and Odds Ratio of 2.161. Conclusion: A high prevalence of anxiety and insomnia was found in the group of medical students which was evaluated. Additionally, it was found that students who suffer from anxiety are more likely to develop excessive daytime sleepiness

Introducción: los estudiantes de medicina pueden ser considerados un grupo vulnerable para presentar ansiedad y trastornos del sueño, debido a las altas exigencias académicas y al estrés; sin embargo, se cuenta con pocos datos sobre la relación entre la ansiedad y la somnolencia en estudiantes de medicina, relación que podría generar complicaciones tanto académicas como de salud. El objetivo fue la asociación entre ansiedad y somnolencia excesiva diurna en estudiantes de medicina de la Universidad de Guadalajara (México). Materiales y métodos: estudio transversal con 173 estudiantes entre enero y abril del 2019. Para la determinación de somnolencia excesiva diurna se aplicó la Escala de Somnolencia de Epworth (punto de corte = 10), mientras que para evaluar los síntomas de ansiedad excesiva se utilizó el Inventario de Ansiedad de Beck (punto de corte = 8). Se emplearon chi cuadrado y la prueba exacta de Fisher para el análisis estadístico. Se consideró estadísticamente significativo un valor de p < 0.05. Resultados: se encontraron diferencias estadísticamente significativas entre los estudiantes al comparar la presencia y la ausencia de somnolencia y ansiedad con un valor de p = 0.036 y un odds ratio de 2.161. Conclusión: hay una alta prevalencia de ansiedad e insomnio en los estudiantes de medicina evaluados, y aquellos con ansiedad tienen mayor probabilidad de desarrollar somnolencia excesiva diurna

Introdução: estudantes de medicina podem ser potencialmente considerados um grupo vulnerável em ter-mos de risco aumentado para ansiedade e distúrbios do sono. Isso pode ser causado por altas demandas acadêmicas e altos níveis de estresse. No entanto, há poucas informações sobre a relação entre ansiedade e sonolência diurna excessiva entre estudantes de medicina e os efeitos potencialmente negativos que essa relação pode ter sobre a saúde e o desempenho acadêmico dos alunos. O objetivo foi identificar a associação entre ansiedade e sonolência diurna excessiva em estudantes de medicina da Universidade de Guadalajara (Mêxico). Materiais e métodos: estudo transversal, avaliando 173 alunos entre janeiro e abril de 2019. A Escala de Sonolência de Epworth (ponto de corte = 10) foi utilizada para a determina-ção da sonolência diurna excessiva, enquanto os sintomas de ansiedade foram medidos por meio do Inventário de Ansiedad de Beck (ponto de corte = 8). Qui-quadrado e prova exata Fisher foram usados para análise estatística. Um valor de p < 0,05 foi considerado estadísticamente significativo. Resultados:foram encontradas diferenças estatisticamente significantes entre os alunos ao comparar a presença e ausência de sonolência diurna excessiva e ansiedade com um valor de p = 0,036 e um Odds Ratio de 2,16. Conclusão: foi encontrada alta prevalência de ansiedade e insônia no grupo de estudantes de medicina avaliados. Além disso, verificou-se que os alunos que sofrem de ansiedade têm maior probabilidade de desenvolver sonolência diurna excessiva

Sintomas ansiosos e depressivos em idosos na atenção primária à saúde em Maceió ­ AL / Anxiety and depression symptoms in older adults in Primary Health Care in Maceió ­ AL

Objetivo: Analisar a ocorrência de sintomas ansiosos e depressivos em idosos atendidos na atenção primária à saúde. Métodos: Trata-se de um estudo transversal e não probabilístico realizado com 171 idosos com idade entre 60-94 anos atendidos em unidade de saúde atenção primária. Os idosos responderam um questionário sociodemográfico, Escala de Depressão Geriátrica (GDS-15) e Inventário de Ansiedade Geriátrica (GAI).Resultados: Os resultados demonstram uma alta prevalência de indivíduos do sexo feminino 72,5%. Além disso, identificou-se que idosos com idade entre 60-69 anos e baixa escolaridade apresentam maiores "sintomas depressivos". Os fatores "ser divorciado" e "baixa escolaridade" foram associados a "sintomas ansiosos" nos idosos. Conclusão: Os fatores sociodemográficos têm demonstrado bastante influência na ocorrência dos sintomas depressivos e ansiosos entre a população idosa. [au]

Objective: To analyze the occurrence of anxiety and depression symptoms in older adults treated in Primary Health Care. Method: This is a cross-sectional and non-probabilistic study carried out with 171 older adults aged 60-94 years old treated in a Primary Health Care unit. The aged individuals answered a sociodemographic questionnaire, the Geriatric Depression Scale (GDS-15) and the Geriatric Anxiety Inventory (GAI). Results: The results show high prevalence of the symptoms in females (72.5%). In addition to that, it was identified that older adults aged 60-69 years old and with low schooling levels present higher levels of "depression symptoms". "Being divorced" and "low schooling" were factors associated with "anxiety symptoms" in older adults. Conclusion: The sociodemographic factors have proved to be quite influential in the occurrence of depression and anxiety symptoms among older adults [au]

Ansiedad, Depresión y Adaptación Psicosocial en Pacientes Adultos con DM tipo 2 / Anxiety, Depression and Psychosocial Adaptation in Adult Patients with type 2 DM

Resumen Objetivo: Analizar la relación entre la presencia de síntomas de ansiedad, síntomas depresivos y la adaptación psicosocial a la enfermedad en personas con diagnóstico de DM2 que acuden a una unidad de primer nivel de atención en Tabasco, México. Material y Métodos: Estudio descriptivo correlacional; muestra integrada por 103 adultos de 20 a 60 años, con diagnóstico de DMT2. Muestreo por conveniencia. Resultados: 32% presentó síntomas de ansiedad moderada y 68% síntomas leves; 90.3% refirió síntomas depresivos. Se halló una correlación negativa significativa entre síntomas de ansiedad y cuidado de la salud (p=<0.000) que sugiere entre más síntomas de ansiedad peor adaptación. Síntomas de ansiedad y ambiente laboral mostraron una correlación negativa y significativa (p=0.000), que sugiere peor adaptación a más síntomas ansiedad. En contraste, la correlación entre síntomas de depresión y ambiente laboral, mostró relación positiva y significativa (0.530, p=<0.000) que indica entre más síntomas de depresión peor es la adaptación. Conclusiones: Los participantes mostraron síntomas de ansiedad entre leve y moderada, alto porcentaje mostró síntomas de depresión moderada y alta. Los síntomas de ansiedad y cuidado de salud, mostraron correlación negativa, síntomas de depresión y ambiente laboral se correlacionaron de forma positiva. Estos resultados tienen implicaciones para los proveedores de cuidado de personas con DM2.

Abstract Objective: to analyze the relationship between the presence of anxiety symptoms, depressive symptoms and psychosocial adaptation in people with a diagnosis of DM2 who attend a first level care unit in Tabasco, Mexico. Material and Methods: descriptive correlational study; sample made up of 103 adults between 20 and 60 years old, diagnosed with T2DM. Sampling for convenience. Results: 32% had moderate anxiety symptoms and 68% mild symptoms; 90.3% referred depressive symptoms. A significant negative correlation was found between anxiety symptoms and health care (p = <.000) that suggests the more anxiety symptoms the worse the adaptation. Symptoms of anxiety and work environment showed a negative and significant correlation (p = .000), which suggests worse adaptation to more anxiety symptoms, In contrast, the correlation between symptoms of depression and work environment, showed a positive and significant relationship (.530, p = <.000) which indicates the more depression symptoms the worse the adaptation. Conclusions: participants showed symptoms of anxiety between mild and moderate, a high percentage showed symptoms of moderate and high depression. Symptoms of anxiety and health care showed a negative correlation, symptoms of depression and work environment were positively correlated. These results have implications for caregivers of people with DM2

Association between Social Anxiety Symptoms and Suicidal Risk in College Students / 우울ㆍ조울병

BACKGROUND: Social anxiety and suicide are serious common problems in college students. However, there are few studies on the relationship between social anxiety symptoms and suicidal risk. Therefore, we evaluated the associationbetween social anxiety symptoms and suicidal risk in college students.METHODS: A total of 579 college students were recruited for a college-based cross-sectional survey in the Jeju area. The participants completed a questionnaire gathering sociodemographic information; they also completed the Korean Social Avoidance and Distress Scale (SADS) to assess social anxiety symptoms and the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms. To obtain information regarding suicidal risk, we administered the Korean version of the Suicide module of the Mini International Neuropsychiatric Interview (M.I.N.I.).RESULTS: The prevalence of higher levels of social anxiety symptoms among college students was 28.0% (n=162). A higher level of social anxiety symptoms resulted in a 2.10-times higher suicidal risk after adjusting for depression in college students (95% confidence interval, 1.05-4.23; p=0.037).CONCLUSION: Based on the results of this study, social anxiety symptoms should be managed and controlled to prevent suicidality in Korean college students.

Stress sources and anxiety symptoms of medical graduate students: the mediating role of negative emotion and the moderating role of social support / 中华行为医学与脑科学杂志

Objective@#To explore the relationship between stress sources and anxiety symptoms of medical graduate students, as well as the mediating role of negative emotion and the moderating role of social support.@*Methods@#A questionnaire survey was conducted among 1 216 medical students of 16 medical colleges in 13 provinces (municipalities directly under the Central Government) by using graduate stressors scale, Hopkins symptom checklist, the positive and negative affect scale and perceived social support scale.Correlation analysis, regression analysis, SPSS-process mediation and adjustment methods were used for data processing.@*Results@#(1) The whole average score of stress source was (2.45±0.54), and the scores of anxiety symptoms, negative emotions and social support were (1.68±0.59), (2.26±0.70) and (5.28 ±1.01). (2) There was a positive correlation between stress and anxiety symptoms (r=0.37, P<0.01), and negative emotion (r=0.38, P<0.01) and a negative correlation between stress source and social support (r=-0.20, P<0.01). (3) Negative emotion plays a significant partial mediating role between stressors and anxiety symptoms (indirect effect value=0.24, SE=0.02, 95%CI: 0.20-0.28), accounted for 58.54% of the total effect.(4) Social support moderated the effects of stressors on negative emotion (R2=0.24) and the effects of stressors on anxiety symptoms (R2=0.44).@*Conclusion@#Negative emotion plays a partial intermediary role in stress sources and anxiety symptoms, and social support plays a multiple moderating role.

Sintomas depressivos, de ansiedade e de estresse em habitantes de munícipio realocado por barragem / Depressive symptoms, anxiety and stress in population in municipality reallocated by dam / Síntomas depresivos, ansiedad y el estrés de la población en el municipio de reubicado por presa

O aumento da necessidade de energia elétrica faz com que a instalação de usinas hidrelétricas seja um investimento importante; entretanto, os impactos ambientais e humanos decorrentes da instalação de barragens precisam ser apropriadamente avaliados. Buscou-se investigar a prevalência de sintomas depressivos, de ansiedade e de estresse de uma população que passou pelo processo de realocação devido à construção de uma barragem para usina hidrelétrica (n=50) em comparação com um município onde não houve este processo (n=50). Foi identificado que, vinte anos após a instalação da barragem e realocação do município, os escores de sintomas depressivos, de ansiedade e de estresse estão na faixa da população não clínica, e foram mais elevados no município de comparação do que no município onde a barragem foi instalada. Estudos sobre a instalação de barragens e realocação humana precisam considerar, além dos impactos ambientais, seus reflexos sobre a saúde mental das pessoas.

The increased need for electricity, especially with less environmental impact, makes the installation of hydroelectric plants an essential alternative. However, environmental and human impacts of the dam installation need to be evaluated in depth. We had investigated the prevalence of depressive, anxiety and stress symptoms of a population that has passed by the relocation process due to construction of a dam for hydroelectric power plant (n=50) compared to another county which had not been passed by this process (n=50). It was identified that scores of depressive symptoms, anxiety and stress are in the range of non-clinical population twenty years after the relocation of the city, and were higher in the county where the dam was not installed. Studies on the impact of the installation of dams and human allocation need to consider the assessment of depressive symptoms, anxiety and stress to identify possible impacts on the mental health.

La mayor necesidad de energía eléctrica hace que la instalación de centrales hidroeléctricas es una inversión importante; Sin embargo, los impactos ambientales y humanos derivados de la instalación de presas deben ser evaluados correctamente. Hemos tratado de investigar la prevalencia de síntomas depresivos, ansiedad y el estrés de una población que pasa el proceso de reubicación debido a la construcción de una presa para hidroeléctricas (n=50) en comparación con un municipio donde no había este processo (n=50). Se identificó que veinte años después de la instalación de la presa y la reubicación de la ciudad, las puntuaciones de los síntomas de depresión, la ansiedad y el estrés están en el rango de la población no clínica, y fueron mayores en el municipio de la comparación. Los estudios sobre la instalación de presas y reubicación humana deben tener en cuenta, además de los impactos ambientales, sus efectos sobre la salud mental.

Padrão de uso de internet por adolescentes e sua relação com sintomas depressivos e de ansiedade / Adolescent internet patterns use and depressive and anxiety symptoms / El uso de los patrones de Internet de los adolescentes y los síntomas depresivos y de ansiedad

A dependência de internet é uma condição que se caracteriza por apresentar fatores físicos e psicológicos, e usualmente apresenta comorbidade. Os adolescentes, por sua vez, são o grupo etário mais suscetível para apresentar sintomas de dependência de internet. O presente estudo teve como objetivo investigar o padrão de uso de internet e sua relação com sintomas depressivos e de ansiedade em adolescentes, tendo sido aplicados o Internet Addiction Test (IAT), Escala de Rastreamento Populacional para Depressão do Centro de Estudos Epidemiológicos (CES-D), Inventário de Ansiedade Traço (IDATE) e o Levantamento de Intensidade de Sintomas Depressivos (LIS-D) numa amostra de 150 adolescentes. Foi possível identificar que a prevalência de sintomas depressivos e de ansiedade ficou dentro da faixa não-clínica; contudo, 61,33 % (n=92) dos adolescentes apresentaram risco de dependência. A análise de variância das faixas do IAT identificou diferenças de sintomas depressivos e de ansiedade; contudo, não foram identificadas correlações positivas estatisticamente significativas entre os escores do IAT e os sintomas depressivos e de ansiedade. É fundamental investigar o padrão de uso de internet no adolescente e a presença ou não de comorbidade, para que seja possível encaminhar precocemente o adolescente para acompanhamento psicológico.

Internet addiction is a condition characterized by physical and psychological factors, and usually presents comorbidity. Teenagers are the most likely age group to experience symptoms of Internet addiction. This study aims to investigate the pattern of Internet use and its relationship to symptoms of depression and anxiety in adolescents. The Internet Addiction Test (IAT), Population Screening Scale for Depression Epidemiological Studies Center (CES- D), Trait Anxiety Inventory (STAI) and the Depressive Symptoms Intensity Survey (LIS-D) were applied to a sample of 150 adolescents. It was observed that the prevalence of depression and anxiety symptoms was within the non-clinical range; however, addiction was identified in 61,33% (n=92) of the adolescents. Variance analysis of IAT tracks identified differences in depression symptoms and anxiety; however, there were no statistically significant positive correlations between the scores of IAT and depression and anxiety symptoms. It is essential to investigate the pattern of Internet use in adolescents and the presence or absence of comorbidity, so that teenagers can be sent early on to counseling.

La dependencia a internet es una condición que se caracteriza por presentar factores psíquicos y físicos, y normalmente presenta comorbilidad. A su vez los adolescentes son un grupo etario más susceptible para presentar síntomas de dependencia a internet. El presente estudio tuvo como objetivo investigar el uso patrón de internet y su relación con los síntomas depresivos y ansiosos en adolescentes, a través del Test de Adicción a Internet (IAT), Escala de Rastreo Poblacional para Depresión del Centro de Estudios Epidemiológicos (CES-D), Inventario de Rasgos de Ansiedad (IDATE) y el Inventario de Intensidad de Síntomas de Depresión (LIS-D), con una muestra de 150 adolescentes. Fue posible identificar que la prevalencia de síntomas depresivos y de ansiedad se mantuvo dentro de la línea no-clínica. Sin embargo, 61.33% (n=92) de los adolescentes presentaron riesgo de dependencia. El análisis de varianza de las trayectorias del IAT identificó diferencias en los síntomas depresivos y de ansiedad; no obstante, no fueron identificados correlaciones positivas estadísticamente significativas entre las puntuaciones del IAT y los síntomas depresivos y de ansiedad. Es fundamental investigar el patrón de uso de internet en el dolescente y la presencia o no de comorbilidad, para que sea posible encaminar precozmente el adolescente y poder tener acompañamiento psicológico.

Influencing factors of anxiety symptoms in patients with depression / 中国神经精神疾病杂志

Objective To investigate the status of depression with anxiety symptoms, and analyze the influencing factors of anxiety symptoms from demographic data and social psychological factors. Methods Hamilton depression rat?ing scale (HAMD), Hamilton anxiety rating scale (HAMA), Eysenck personality questionnaire (EPQ), life event scale (LES), trait coping style questionnaire (TCSQ) and social support scale (SSS) were used to evaluate 729 patients with de?pression. According to HAMA scores, patients were divided into non anxiety symptoms group (HAMA14). Social psychological factors were compared between two groups, and the influencing fac?tors of anxiety symptoms were analyzed. Results The incidence of anxiety symptoms in depression was 58.85% (429/729), and 119 cases (16.32%) were certainly without anxiety symptoms. Compared with the group without anxiety symp?toms, the anxiety symptoms group had higher scores on neuroticism, psychoticism, negative life events and negative cop?ing style (P<0.001), but lower scores on introversion and extroversion (P=0.010). Degree of depression (OR=9.255, 95%CI:4.726~18.127), neuroticism (OR=1.595, 95%CI:1.197~2.125), negative life events (OR=1.009, 95%CI:1.001~1.017) and negative coping style (OR=1.046, 95%CI:1.013~1.080) were the risk factors of anxiety symptoms (P<0.05). Conclu?sion The incidence of anxiety symptoms in patients with depression is high. Patients with higher degree of depression and typical neurotic personality experiencing more negative life events and those with tendency to adopt negative coping style are more susceptible to anxiety symptoms.

Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ2 test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.

Violencia escolar y su relación con síntomas ansiosos / Bullying and its association with anxiety symptoms

INTRODUCCIÓN: Violencia escolar es la persecución física o psicológica de un alumno o alumna contra otro, convirtiéndolo en víctima de repetidos ataques. Es un importante marcador de riesgo de conductas antisociales futuras, y se relaciona con mayor prevalencia de síntomas ansiosos. OBJETIVO: Establecer si existe asociación entre la presencia de ansiedad patológica y la práctica de violencia escolar. MATERIAL Y MÉTODOS: Estudio descriptivo observacional y transversal. Se estudió a 166 alumnos de cuarto a octavo básico, de un colegio particular subvencionado de la comuna de Lo Barnechea, en Santiago de Chile. De ellos, 77 fueron hombres y 89 mujeres, entre 9 y 16 años. Se aplicó la escala de Autoreporte de Ansiedad para Niños y Adolescentes (AANA) y el cuestionario de Maltrato entre Iguales por Abuso de Poder (MIAP). Además, se recopilaron datos tales como sexo, edad, número de personas que viven en el hogar y si vive o no con sus padres. RESULTADOS: De los estudiantes evaluados, el 46,99 por ciento clasificó como testigo de violencia escolar, 19,28 por ciento víctima, 10,84 por ciento agresor, 10,84 por ciento víctima-agresor, y un 12,05 por ciento no clasificó en ninguna categoría. Se obtuvo un 36,1 por ciento de prevalencia de ansiedad patológica en el total de individuos; un 41,67 por ciento en agresores y 30,61 por ciento en no agresores, con chi-cuadrado P > 0,05.DISCUSIÓN: La prevalencia de ansiedad patológica en agresores de violencia escolar es mayor que en quienes no la practican; sin embargo, esta asociación no llega a valores estadísticamente significativos.

INTRODUCTION: Bullying is the physical or psychological persecution of one student against another, making him a victim of recurrent attacks. It is one of the most important risk markers for future antisocial behavior, which has also been associated with higher prevalence of anxiety symptoms. OBJECTIVE: Establish if there is an association between pathological anxiety and bullying. METHODS: This is a descriptive, observational and transversal study. 166 students from fourth to eight grades were studied from a semi private school from Lo Barnechea, Santiago, Chile. From this population, 77 were male and89 female, between 9 and 16 years old. The Anxiety Scale for Children and Adolescents (AAA) and the Survey of High School Bullying Abuse of Power questionnaires were applied. Also, data such as sex, age, number of people who are living in their homes and whether they live with their parents or not was collected. RESULTS: From the students evaluated, 46.99 percent classified as bullying witnesses, 19.28 percent as victims, 10.84 percent as aggressors, 10.84 percent aggressor-victim and 12.05 percent didn't classify in any category. A 36.1 percent prevalence of pathologic anxiety was obtained from the totality of individuals. In the aggressor category 41.67 percent had pathological anxiety and 30.61 percent in non-aggressors, with a chi-square P > 0.05. DISCUSSION: Prevalence of pathological anxiety is higher in the aggressor than in the non-aggressor group, however this association is statistically non-significant

Relación entre los cambios del ambiente laboral ocasionados postevento sísmico del 27 febrero 2010 y la presencia de ansiedad y estrés laboral en el profesional de enfermería / Relationship between the change of work environment caused by 27 february 2010 seismic post-event and the presence of anxiety and stress in professional nursing

Objetivo: Determinar la relación entre síntomas de ansiedad y estrés laboral en el profesional de enfermería de dos establecimientos hospitalarios de la Provincia de Ñuble con los cambios en el ambiente laboral postevento sísmico. Método: Estudio cuantitativo, correlacional, en 64 profesionales de enfermería. Se aplicó el Maslach Burnout Inventory, la escala de Ansiedad y Depresión de Goldberg y un cuestionario para identificar los cambios en el ambiente laboral postevento sísmico. Resultados: El 56,25% de los sujetos presentó síntomas de ansiedad, un 59,38% de depresión, el 84,38% un nivel medio de estrés. La modificación del espacio físico fue el cambio más estresante. El cambio en la calidad de los insumos utilizados, patología de los usuarios y en el flujograma de atención se asocian estadísticamente con la presencia de ansiedad en los profesionales de enfermería. Conclusión: El evento sísmico ocasionó diversas modificaciones en el ambiente laboral, cuyos cambios pueden ser relacionados con la generación de ansiedad en el profesional de enfermería, que es un pilar fundamental de todas las atenciones de salud; por tanto, en la medida que tengan buena salud mental sus prestaciones serán más efectivas, eficaces y oportunas, incrementando la calidad en la atención a los usuarios.

Objective: Determine the relationship between symptoms of anxiety and occupational stress in nursing professionals of two hospitals of the Province of Ñuble with changes in the work environment by seismic post-event. Method: quantitative and correlational study in 64 nurses. The Maslach Burnout Inventory, the Anxiety and Depression Scale of Goldberg and a questionnaire to identify changes in the work environment in seismic post-event, were applied. Results: 56.25% of the subjects had symptoms of anxiety, 59.38% of depression, 84.38% an average stress level. Modification of the physical space was the most stressful change. The change in the quality of supplies used, pathology of user and attention flowchart, associate statistically with the presence of anxiety in nurses. Conclusion: The seismic event caused several changes in the work environment, and those changes can be related to the generation of anxiety in the nursing professional, who is a cornerstone of all health care, therefore, as having good mental health their services will be more effective, efficient and timely, increasing the quality of care to users.

Interaction between a serotonin transporter gene promoter region polymorphism and stress predicts anxiety symptoms in adolescents: a multi-wave longitudinal study / 中华行为医学与脑科学杂志

Objective To explore the interaction between a serotonin transporter gene promoter region polymorphism(5-HTTPR) and stress in predicting anxiety symptoms.Methods Through random cluster sampling,a total of 252 healthy adolescents participated in this study.During the initial assessment,all participants completed the Adolescent Life Events Questionnaire (ALEQ) and Multidimensional Anxiety Scale for Children (MASC) to assess their levels of stress and anxiety and were genotyped for the 5-HTTLPR polymorphism.Participants subsequently completed MASC and ALEQ once every three months during the subsequent 24 months.A multilevel model was used to investigate the interaction between 5-HTTLPR and stress that predict anxiety symptoms.Results The results indicated no major effect of 5-HTTLPR in males (β=0.80,P＞0.05)or females(β=-0.21,P＞0.05).There were major effects of stress in males(β=0.30,P＜0.01) and females (β=0.33,P＜0.01)and a significant interaction between 5-HTTLPR and stress.Females with at least one 5-HTTLPR S allele(β=0.11,P＜ 0.01)and males with at least one 5-HTTLPR L allele(β=-0.10,P＜0.01)exhibited more anxiety symptoms under stressful situations.Conclusion The interaction between 5-HTTLPR and stress can predict anxiety symptoms in adolescents.There are gender differences on the 5-HTTLPR × stress interaction.

Prevalence and Clinical Correlates of Insomnia in Depressive Disorders: The CRESCEND Study

OBJECTIVE: To investigate the prevalence, clinical manifestations, and clinical correlates of insomnia in a large cohort of Korean patients with depressive disorders. METHODS: We recruited 944 patients with depressive disorders from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Psychometric scales were used to assess depression (HAMD), anxiety (HAMA), psychotic symptoms (BPRS), global severity (CGI-S), and functioning (SOFAS). Insomnia levels were determined by adding the scores for all items on the HAMD insomnia subscale. The clinical characteristics of the patients with 'low insomnia' (summed score or =4) were compared using statistical analyses. A logistic regression model was constructed to identify factors associated with 'high insomnia' status. RESULTS: Symptoms of insomnia were present in 93% of patients, while simultaneous early, middle, and late insomnia affected 64.1%. The high insomnia patients were characterized by significantly greater age, higher symptom levels (including core, gastrointestinal somatic and anxiety symptoms, and suicidal ideation), higher global severity and incidence of physical disorders, and greater insight. Explanatory factors of 'high insomnia' status were older age, higher gastrointestinal somatic and anxiety symptom levels, higher global severity, and greater insight. CONCLUSION: In clinical psychiatry, insomnia has been significantly underdiagnosed and undertreated. It affects most patients with depressive disorders, and is indicative of the global severity of depression. Active efforts to diagnose and treat insomnia in patients with depressive disorders should be strongly encouraged. Further research is needed to improve the diagnosis and treatment of insomnia in depressive patients.

Suicidal Ideation of Patients in the Acute Stage of Stroke / 신경정신의학

OBJECTIVES: The presence of psychiatric disorders including depression and anxiety disorders is considered to be the most important risk factor of suicide. Also, suicidal risk is known to be increased in patients who have serious medical illnesses. Like in patients with other medical illness, some authors reported that suicidal risk is increased in patients with stroke. But there have been no reports with Korean patients. The aim of this study is to investigate the frequency of suicidal ideation of patients in the acute stage of stroke, and to examine the demographic characteristics, and psychiatric and neurological symptoms between the patients with and without suicidal ideation. METHODS: Seventy seven hospitalized stroke patients at the Hallym Stroke Center from July of 1999 to June of 2000 were included in this study. Beck Suicidal Ideation Scale(BSIS) was used to evaluate suicidal ideation. Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI) for depression and anxiety, and Social Support Scale(SSS) for social support system of the stroke patients were used. Neurologic disabilities were rated with National Institutes of Health Stroke Scale(NIHSS) and Barthel's Index. RESULTS: Thirty five percent(N=27) of the stroke patients reported severe suicidal ideation. Scores of BDI, BAI and SSS were higher in the patients with severe suicidal ideation than their counterpart. There were no differences in Barthel's index score and NIHSS between two groups. Most patients with severe suicidal ideation had depressive or anxiety symptoms. But patients without depressive or anxiety symptoms also reported severe suicidal ideation. CONCLUSIONS: Thirty five percent of stroke patients in acute stage of their illness have severe suicidal ideation that requires careful psychiatric evaluation and intervention. Inclusion of routine assessment of suicidal ideation in these patients is recommended.