Relación entre sobrecompromiso y síntomas somáticos en enfermeras de un hospital de II nivel en Perú

Objetivo : Determinar la relación entre sobrecompromiso y síntomas somáticos en enfermeras de un hospital de II nivel en Perú. Material y métodos : Investigación observacional, transversal y correlacional, con una muestra probabilística de 106 enfermeras. Se aplicó el Cuestionario de Siegrist y Meter para medir sobrecompromiso y desequilibrio esfuerzo recompensa, y el Cuestionario de Salud (PHQ15) para síntomas somáticos. Se construyó un modelo de regresión logística, considerando variables sociodemográficas y laborales. Resultados : En las enfermeras que presentaron síntomas somáticos moderados-graves, el 68,3% tuvo un nivel de sobrecompromiso alto. El modelo de regresión mostró que sobrecompromiso (OR = 6,25, p < 0,01), tiempo laboral (OR = 0,74, p < 0,01) y la condición de personal (nombrado o contratado, OR = 49,20, p < 0,01) influyeron en el nivel de síntomas somáticos. El modelo discriminó correctamente el 79% (IC 95%: 0,70 - 0,88) de los casos con síntomas somáticos, siendo el valor 0,43, el que se usò para la clasificaciòn en leve-mìnimo y moderado-grave con una sensibilidad de 73% y especificidad del 74%. Conclusión : Se corroboró una relación significativa entre sobrecompromiso y síntomas somáticos, con un modelo predictivo que logró un nivel elevado de discriminación para identificar personal de enfermería en riesgo.

SUMMARY Objective : To determine the relationship between over commitment and somatic symptoms among nurses in a type II hospital in Peru. Methods : A cross-sectional study with a probabilistic sample of 106 participants was carried-out. The Siegrist and Meter questionnaire was applied to measure over commitment and imbalance effort-recompense and the Health Questionnaire (PHQ15) was applied to evaluate somatic symptoms. A logistic regression model was built considering sociodemographic and labor variables. Results : The 68.3% of nurses that presented with moderate to severe somatic symptoms had a high level of over commitment. The regression model showed that over commitment (OR = 6.25, p < 0.01), time in the working place (OR = 0.74, p < 0.01) and labor status (staff or hired temporarily OR = 49.20, p < 0.01) influenced the level of somatic symptoms. The model discriminated well the 79% (95% CI: 95%: 0.70 - 0.88) of somatic cases. A value of 0.43 was selected to discriminate between mild to moderate-severe with a sensitivity of 73% and 74% specificity. Conclusions : A signifcant correlation between over commitment and somatic symptoms ws found. The regression model attained a high discriminative level to identify nurses at risk.

Validity and reliability of the depression and somatic symptoms scale for screening depression among patients with coronary heart disease / 中华行为医学与脑科学杂志

Objective:To assess the validity and reliability of the depression and somatic symptoms scale among patients with coronary heart disease.Methods:Totally 246 patients with coronary heart disease were assessed with depression and somatic symptoms scale (DSSS), Hamilton depression rating scale for depression (HAMD) and patients’ health questionnaire depression scale-9 item (PHQ-9). The structural validity was evaluated with exploratory factor analysis and confirmatory factor analysis. The validity as a screening tool was evaluated with the gold standard diagnosed by psychiatrists who were trained with the mini international neuropsychological interview (MINI) according to ICD-10. Receiver operating characteristic (ROC) curve was used to identify cutoff scores for depression. Cronbach α coefficient was used to evaluate the internal consistency.Results:Exploratory factor analysis yielded two factors: depression factor and somatic factor, and the cumulative variance was 51.8%. The fitting indexes of confirmatory factor analysis were as follows: χ2/ df=3.636, RMR=0.077, RMSEA=0.104, IFI=0.804, TLI=0.781, CFI=0.802. The intraclass correlation coefficient of DSSS and HAMD was 0.54. The area under ROC curve (AUC) was 0.828, and the best boundary value was 17 points (sensitivity and specificity: 81% and 75%, respectively). The total scores and subscale scores for internal consistency of DSSS were higher in the depression group than those in the non-depression group ( P<0.01). Cronbach α coefficient for internal consistency of DSSS was 0.917. Conclusion:The DSSS has good validity and reliability among patients with coronary heart disease for screening depression, and can be used to screen depression among patients with coronary heart disease in general hospital.

Chain mediating effect of anxiety, depression and metacognition between somatic symptoms and fear of disease progression among gynecological tumor patients / 中华行为医学与脑科学杂志

Objective:To explore the chain mediating effects of anxiety/depression and metacognition between somatic symptoms and fear of disease progression (FoP) in gynecological tumor patients.Methods:A total of 208 gynecological tumor patients were investigated by general demographic data, fear of progression questionnaire-short form(FoP-Q-SF), hospital anxiety and depression scale(HADS), metacognition questionnaire(MCQ) and somatic symptom scale(SSS). SPSS 25.0 was used for Pearson correlation analysis. The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The scores of FoP-Q-SF, depression, anxiety, MCQ and SSS were (32.41±10.43), (6.43±4.17), (7.51±4.10), (68.44±16.04), (20.58±15.70) respectively. 48.56% of gynecological tumor patients had dysfunctional fear of disease progression. Correlation analysis showed that FoP was significantly positively correlated with somatic symptoms ( r=0.394, P<0.01), anxiety ( r=0.640, P<0.01), depression ( r=0.533, P<0.01) and metacognition ( r=0.489, P<0.01). Mediating effect test showed that anxiety, depression and metacognition played a complete chain mediating role between somatic symptoms and FoP in gynecological tumor patients.The total effect of somatic symptoms on FoP was 0.320. Somatic symptoms indirectly affected FoP by influencing anxiety and metacognition, and the intermediary effect value was 0.242. Somatic symptoms indirectly affected FoP by influencing depression and metacognition, and the intermediary effect value was 0.212. Conclusion:Somatic symptoms can indirectly affect FoP through the chain mediation of anxiety/depression and metacognition.

Mental disorder caused by prion disease misdiagnosed as depressive episode：a case report / 四川精神卫生

This paper reported a case of a 29-year-old male patient with mental disorder caused by prion disease was misdiagnosed as depressive episode with somatic symptoms. The patient's symptoms were initially predominantly psychiatric， with progressive worsening of somatic symptoms， and he died more than 1 year after his first onset. Prion disease caused various manifestations of mental symptoms， which can easily lead to missed diagnosis and misdiagnosis. This paper discussed the case， in order to provide references for the clinical diagnosis of mental disorder caused by prion disease.

Functional somatic symptoms in patients with major depressive disorder in a tertiary care hospital

Background: Functional somatic symtpoms are common in patients with major depressive disorder. The aim of the research was to study the prevalence and typology of Functional Somatic Symptoms (FSS) in patients with depression. Methodology: A total of 50 patients participated in the study. They were assessed on Bradford Somatic Symptom inventory for Functional Somatic Symptoms (FSS), Beck Depression Inventory (BDI) for severity of depression, and Comprehensive Psychopathological Rating Scale? anxiety index (CPRS?AI) for anxiety symptoms. Results: The mean age of the study sample was 41.36 years (SD?12.79). Gender distribution was gender distribution (male ? 60% vs. females 40%). Majority of the symptoms were found in married (84%), Hindus (92%), and from nuclear family (58%). A more than half of the patients were from urban background (76%). The mean duration of illness at the time of assessment was 36 months. As per BDI severity score 36% have mild, 38% have moderate and 26% have severe depression. Total mean CPRS-AI is (8.78±4.46).The more common FSS as assessed on Bradford Somatic Inventory were severe headache (88%), feeling tired when not working (86%), lack of energy (weakness) much of the time (84%), pain in legs (82%), aches and pains all over the body (72%), mouth or throat getting dry (72%), head feeling heavy (70%), head feeling hot or burning (68%), pain or tension in neck and shoulder (66%), low back trouble (66%) and sweating a lot (64%). The prevalence and typology of FSS was to a certain extent influenced by the sociodemographic variables and severity of depression. Conclusion: Functional somatic symptoms are highly prevalent in depressed patients and hence deserve more attention while diagnosing depression

Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for somatic symptoms and related disorders / 四川精神卫生

The purpose of this paper is to compare the similarities and differences between the diagnostic criteria for somatic symptoms and related disorders in the International Classification of Diseases， eleventh edition （ICD-11） and the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. The clinical features of somatic symptoms and related disorders are prominent somatic symptoms that cause significant functional impairment and suffering. This paper discusses the similarities and differences between the two diagnostic systems in order to facilitate mastery of the corresponding content.

Los trastornos psicosomáticos en el niño y el adolescente / The psychosomatic disorders in children and adolescents

Los trastornos psicosomáticos se caracterizan por manifestaciones somáticas de origen no patológico y poseen una significativa prevalencia en niños y adolescentes; sin embargo, resulta difícil identificarlos, pues no existe un consenso adecuado para su diagnóstico y las investigaciones acerca del tema son insuficientes. Lo anterior condujo a efectuar el presente artículo, en el que se abordan aspectos etiopatogénicos y clinicoepidemiológicos que proporcionan los principales elementos para identificar dichos trastornos y establecer un diagnóstico acertado; asimismo se destaca que estas afecciones son frecuentes en poblaciones infantojuveniles con rasgos de introversión y/o antecedentes personales y familiares de enfermedades físicas y mentales, y que su causa es multifactorial, aunque entre los muchos factores sobresalen la vulnerabilidad al estrés, la disfunción familiar, la sobreprotección parental, así como también las situaciones precipitantes (acoso escolar, separación de los padres, abuso sexual) y las perpetuadoras; estas últimas están condicionadas por los beneficios primario y secundario que los menores obtienen de estos padecimientos.

The psychosomatic disorders are characterized by somatic signs of non-pathological origin which possess a significant prevalence in children and adolescents; however, it is difficult to identify them, because there is no appropriate consent for its diagnosis and the investigations about the topic are insufficient. That is the reason why we decided to carry out the present work, in which some etiopathogenic, clinical and epidemiological aspects are approached that provide the main elements to identify these disorders and to establish a good diagnosis; it is also relevant that these disorders are frequent in juvenile populations with introversion features and/or personal and family history of physical and mental diseases, with multifactorial cause, although among the many relevant factors we can mention vulnerability to stress, family dysfunction, parental overprotection, as well as the precipitant situations (school harassment, parents' separation, sexual abuse) and the permanent situations; the latter are conditioned by the primary and secondary benefits that minors obtain with these sufferings.

Somatic Symptoms in Depression and Their Correlation with Suicidality - A Cross-Sectional Study

Diagnostic criteria for MDD is based on psychological and vegetative symptoms. However, other somatic and pain symptoms are frequent in these patients. We wanted to study the prevalence of somatic symptoms in 1st episode of depression and assess its correlation with suicidality. METHODSPatients aged 18 – 65 yrs. attending psychiatry outpatient department and admitted in wards, meeting the inclusion criteria were included in the study. A total of 177 patients was included. Patients were assessed with sociodemographic proforma. M.I.N.I. was used to diagnose major depressive disorder and to rule out the presence of other comorbid psychiatric illness. PHQ - 15 was used to detect the presence of somatic symptoms. Suicidality was assessed with Beck’s Hopelessness Scale. Statistical analysis was done using SPSS. Descriptive statistics, Kruskal Wallis Test, Fisher's Exact Test, Chi - Squared Test, and Spearman correlation. RESULTSThere is 100 % prevalence of somatic symptoms in depression out of which Somatic Symptom Severity was minimal in 11.9 %, low in 54.2 %, medium in 32.2 %, and severe in 1.7 %. There was a strong positive correlation between PHQ - 15 Score and BHS Score, and this correlation was statistically significant (rho = 0.61, p = <0.001). CONCLUSIONSMany patients presenting predominantly with somatic complaints are misdiagnosed when they are evaluated in the primary care or medical clinics. In view of the high prevalence of somatic symptoms in depression, it is important to include these symptoms in the diagnostic criteria of depression, so as to increase the sensitivity and specificity of the diagnosis.

Relationship between Perceived Social Support and Severity of Symptoms in Persons with Somatoform Disorder.

Somatization is a common problem in primary health care leading to disproportionately heavy demands on health services. Patients with somatoform disorder account for about 20% of the workload in general practice. In somatoform disorder multiple or unexplained physical symptoms cause substantial disability in patients, while their psychiatric distress remains unrecognised and untreated. Studies have shown that good perceived social support improves the well-being of a person and also affects the outcome of treatment in somatoform disorder. Our study aimed at investigating relationship of severity of somatic symptoms and perceived social support in people with somatoform disorder.METHODSThis study is a cross-sectional single interview study in a tertiary care centre. All patients attending psychiatry OPD of R. G. Kar Medical College and Hospital, Kolkata, diagnosed with somatoform disorder (ICD-10) fulfilling inclusion and exclusion criteria were included in this study. Total 60 patients were selected. Inclusion criteria include patients aged between 18 to 60 years, both sexes and exclusion criteria include patients with mental retardation, epilepsy, any other neurological disorder and with co-morbid mental disorder. Patient Health Questionnaire-15 (PHQ-15) and Multidimensional scale of perceived social support assessment were used to assess severity of somatic symptoms and perceived social support respectively. Data was then analysed using standard statistical methods.RESULTSOur study revealed that women (93.33%) reported more somatic symptoms than men (6.66%). There was highly significant (p value=0.00) negative correlation (r=-0.76) between social support and severity of somatic symptoms i.e. patients who perceived high acuity of social support were reported to have less severity of somatic symptoms.

Analysis of the effect of early multi-dimensional cardiac rehabilitation nursing mode on patients after PCI / 中国实用护理杂志

Objective@#To investigate the effect of early multi-dimensional cardiac rehabilitation (CR) nursing mode on patients after percutaneous coronary intervention (PCI).@*Methods@#From August 2017 to July 2018, 100 patients with coronary heart disease (CHD) underwent PCI in the Department of Cardiology, the Third Affiliated Hospital of Sun Yat-sen University were selected as subjects. According to the random number table, the patients were divided into control group and observation group, 50 in each group. The control group received routine CR nursing intervention, and the observation group was given early multi-dimensional CR nursing mode for intervention. All patients were followed up for 6 months. The incidence of major cardiovascular adverse events (MACE) was observed 1 month and 6 months of follow-up. Patients with somatization were evaluated on the 2nd day after PCI and in the first month of follow-up using the Somatic Self-rating Scale (SSS). In the first month and the 6th month of follow-up, patient compliance was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8).@*Results@#During the study period, 3 patients were detached from each group, and there were 47 patients in both groups who completed the study. The incidence of MACE in the control group in 1 month and 6 months was 8.51% (4/47) and 4.26% (2/47), respectively. The incidence of MACE in the observation group was 10.64% (5/47) and 4.26%, (2/47) respectively. There was no significant difference in the incidence of MACE between the two groups (χ2 value was 0.123, 0.000, P>0.05). In the first month of follow-up, the SSS scores of the control group (34.32±6.59) and the observation group (31.04±7.04) were lower than those of the second day after surgery (37.21±6.19, 37.43±7.29), and the difference was statistically significant (t value was 4.633, 2.660, P<0.05). The SSS scores of the observation group were lower than those of the control group, and the difference was statistically significant (t value was 2.330, P<0.05). In the first month of follow-up, there was no significant difference in MMAS-8 score between the two groups (P>0.05). In the 6th month of follow-up, the MMAS-8 score (5.72±0.62) in the control group was lower than the first month of follow-up (6.93±0.54), and the difference was statistically significant (t value was 10.028, P<0.05). The MMAS-8 score of the control group was lower than that of the observation group (6.89±0.58), and the difference was statistically significant (t value was 9.490, P<0.05). There was no significant difference in MMAS-8 score between the observation group in the first month of follow-up and the sixth month of follow-up (P>0.05).@*Conclusion@#Early multi-dimensional CR nursing mode has a limited effect on improving the incidence of MACE in patients after PCI, but it can effectively reduce the somatization symptoms of patients and maintain good medication compliance.

Investigation of the mental health of patients with novel coronavirus pneumonia / 中华神经科杂志

Objective@#To evaluate the status and influencing factors of the mental health of patients with COVID-19 during isolation treatment.@* Methods@#From February 2nd to 16th, 2020, 106 COVID-19 patients were anonymously investigated for their mental health status using onlinequestionnaires (including Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-15 scales). The patients were from Tongji Hospital Affiliated to Tongji Medical College ofHuazhong University of Science and Technology. After data processing, SPSS19.0 was used for statistical analysis.@* Results@#Of the 106 COVID-19 patients, 46 were male and 60 were female, with an age of (35.90±11.92) years. The detection rates of depression, anxiety and somatic symptoms in those patients were 49.06% (52/106) , 56.60% (60/106) and 69.81% (74/106) respectively. The severe cases of depression (scale score greater than 19) , anxiety (scale score greater than 14) and somatic symptoms (scale score greater than 14) accounted for 9.43% (10/106) , 15.09% (16/106) and 20.75% (22/106) respectively. In addition, 67.92% (72/106) of the patients had sleep problems, 24.53% (26/106) had self-mutilating or suicidal thoughts, and 28.30% (30/106) required psychological counseling—all of which were at significantly higher percentages than those of the general population. Only 39.62% (42/106) of the examined patients had neither deression nor anxiety. By using the non-parametric test of rank conversion for analysis, and the results showed that both married patients and nucleic-acid-positive patients had more severe depressions, and both married patients and anoxemicpatients had more severe somatic symptoms.@*Conclusion@#This mental health assessment showed that depression, anxiety, and various somatic symptoms exist among the COVID-19 patients, and therefore early identification and intervention should be conducted to avoid extreme events such asself-mutilating or suicidal impulsivity, with a greater focus on both married patients and patients with severe symptoms.

Acute stress symptoms and related factors of traffic accident survivors / 中国心理卫生杂志

Objective:Traffic accidents is one of the most common causes of acute stress disorder (ASD), and it will affect the health of patients.This study aimed to investigate the acute stress symptoms and related factors in traffic accident survivors.Methods:A cross-sectional survey was conducted.The general information questionnaire, Acute Stress Disorders Scale (ASDS), Patient health questionnaire-9 (PHQ-9) and Patient' s Health Questionnaire (PHQ-15) were used to investigate survivors in admission 2-30 days.Results:Fourteen survivors had acute stress symptoms in 63 (22.2％) survivors.Stepwise multiple regression analysis showed that survivors with depression, more serious physical symptoms and whether alone when the accident happened was a common experience accounted for 66.8％ of the survivors' acute stress disorder.Conclusion:This study suggests the detection of acute stress symptoms in traffic accident survivors is higher, and there is a correlation with survivors' depression, physical symptoms, and whether alone when the accident happened.Acute stress symptoms could be screened in time for survivors with depressive and severe somatic symptoms.

Clinical characteristics and related factors of somatization symptoms in outpatients with psychiatric disorders of the department of cardiology in general hospitals / 中华心血管病杂志

Objective@#To explore the clinical characteristics and related factors of somatization symptoms in outpatients with psychiatric disorders of the cardiology department in general hospital.@*Methods@#Cross-sectional survey method was used in this study. From August 2017 to September 2018, 508 outpatients of our department with suspected mental disorders, who complained of physical discomfort and screened by the "Three Questions" method recommended by the Chinese Expert Consensus on Psychological Prescriptions of Cardiovascular Patients in 2014, were consecutively included. General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Patient Health Questionnaire-15 (PHQ-15) and self-made general demographic questionnaire (including age, sex, marital status, educational level, occupation, duration of disease, clinical diagnosis and the process of medical treatment for the main somatic symptoms in recent one year) were used to investigate these patients, under the assistance of unified training psychological consultants. The detection rate of anxiety and depression, the degree and distribution of somatization symptoms in outpatients with mental disorders were analyzed, and the related factors affecting the occurrence of somatization symptoms were screened by multivariate logistic regression.@*Results@#The selected patients were (51.3±10.1) years old, of which 37.8% (192/508) were males and 62.2% (316/508) were females. The total detection rate of anxiety/depression was 86.8% (441/508), and the detection rate of somatization symptoms was 93.1% (473/508). The number of positive symptom items in PHQ-15 was 8.0±2.7, and the detection rate of anxiety/depression was 78.6% (372/473) in patients with somatization symptoms. There were significant differences in the proportion of women, the average number of outpatient visits and hospitalizations in the past one year, GAD-7 score and PHQ-9 score among the patients with mild, moderate and severe somatization symptoms (all P<0.05). PHQ-15 score was positively correlated with GAD-7 score (r=0.524 5, P<0.001) and PHQ-9 score (r=0.574 9, P<0.001) in patients with somatization symptoms. Stepwise logistic regression analysis showed that total scores of PHQ-9 (OR=8.020, 95%CI 3.470-18.930, P<0.001) and GAD-7 (OR=6.526, 95%CI 2.903-13.045, P<0.001) and female (OR=4.440, 95%CI 1.059-9.073, P=0.011) were related factors of somatizations.@*Conclusions@#The incidence of somatization symptoms is high in patients with psychological disorders in outpatients of cardiology department in general hospital. Anxiety, depression and gender are the main related risk factors of somatization symptoms in this patient cohort. Degree of anxiety and depression increased in proportion to the severity of somatization symptoms. Anxiety, depression and female is related to somatization symptoms.

Correlation between somatic symptoms and social support in patients with depressive disorder / 中华全科医师杂志

Objective@#To investigate the prevalence of somatization symptoms and its correlation with social support in patients with depressive disorder.@*Methods@#Two hundred and fourteen hospitalized patients with depressive disorder were recruited. Patients were evaluated with Somatic Symptom Inventory (SSI), Perceived Social Support from Family Scale (PSS-Fa), Social Support Rating Scale (SSRS) and the general questionnaire.@*Results@#The average SSI scores of depressive patients was 49.63±15.53, with 26.2% (56/214) of the patients having moderate to severe level of somatic symptoms. The most common moderate to severe somatic symptoms in depressive patients were "feeling fatigued (61.3%, 131/214), weak (49.5%, 106/214), not feeling well (47.7%, 102/214), feeling faint or dizzy (48.6%, 104/214), or constipation (29.9%, 64/214)" . The average SSRS scores of patients was low (33.24±7.16). The SSI scores and its non-painful dimension (39.05±12.14) were significantly negatively correlated with family support (11.03±3.45) (r=-0.150, P=0.03; r=-0.153, P=0.02) .The SSI scores, and its somatization dimension scores (49.63±15.53) and painful dimension scores (10.58±4.18) were negatively correlated with the total scores of social support (33.24±7.16) (r=-0.164, P=0.02; r=-0.183, P=0.01; r=-0.136, P<0.05) and subjective support (19.14±4.81) (r=-0.167, P=0.02; r=-0.163, P=0.02; r=-0.177, P=0.01) . The SSI scores and its non-painful dimension of patients were negatively correlated with support utilization (r=-0.179, P=0.01; r=-0.194, P=0.01) .@*Conclusion@#Somatic symptoms are prevalent and severe in patients with depressive disorder. The somatic symptoms of depressive patients was closely correlated with decreased social support, especially low subjective support and support utilization.

Depressão materna e ajustamento conjugal de mães jovens e sua relação com a sintomatologia psicofuncional do bebê / Maternal depression and marital adjustment of young mothers and its relationship with baby's psychofunctional symptoms

Este estudo investigou a depressão materna e a percepção de ajustamento conjugal de mães jovens, para compreender a sua repercussão sobre a sintomatologia psicofuncional do bebê. Trata-se de estudo de casos contrastantes, transversal, no qual foram entrevistadas duas mães (20 a 21 anos) porto-alegrenses, cujos bebês tinham 8 e 11 meses. Foram aplicados também o R-DAS, a EPDS e o Symptom Check List, para avaliar, respectivamente, ajustamento conjugal, depressão materna e sintomas psicofuncionais do bebê. Os dados foram integrados na análise dos casos. Os resultados apontam que a percepção de ajustamento conjugal ruim e a presença de depressão materna podem repercutir sobre a sintomatologia psicofuncional do bebê, por meio de um processo de spillover, isto é, transbordamento dos desajustes conjugais sobre a relação parental. Esses achados são relevantes para a prática clínica, na busca de intervenções psicológicas que promovam a saúde mental de casais e bebês.(AU)

This study investigated maternal depression and perception of marital adjustment of young mothers, to understand its impact on the baby's psychofunctional symptoms. It is a transversal contrasting cases study, in which two mothers (20 and 21years), whose babies were 8 and 11 months old, from Porto Alegre/RS, were interviewed. R-DAS, EPDS and Symptom Check List were also applied to evaluate, respectively, marital adjustment, maternal depression and baby's psychofunctional symptoms. Data were integrated in the case analysis. The results suggest that perception of poor marital adjustment and presence of maternal depression may contribute to baby's psychofunctional symptoms, through a spillover process, i.e., the overflow of marital maladjustment on parental relationship. These findings are relevant to clinical practice, in searching for psychological interventions that promote the mental health of couples and babies.(AU)

Avaliação de sintomas psicofuncionais em bebês: revisão crítica da literatura sobre o uso do symptom checklist / Evaluation of psychofunctional symptoms in infants: a critical review of the literature on the use of the symptom checklist / Evaluación de síntomas psicofuncionales en los bebés: revisión crítica de la literatura sobre el uso de symptom checklist

Esse trabalho objetivou apresentar os estudos que utilizaram o Symptom Checklist (SCL) para avaliar sintomas psicofuncionais em bebês. Foram detalhados os países em que os trabalhos foram realizados, o delineamento dos estudos e as principais variáveis associadas. Para tanto, foi realizada uma revisão crítica da literatura, considerando trabalhos que utilizaram o SCL. Identificou-se que a prevalência de sintomas psicofuncionais em bebês ainda é um dado desconhecido tanto no Brasil quanto no exterior, ainda que exista um predomínio de estudos europeus. Embora o SCL possa ser usado em pesquisas com diversos tipos de delineamentos, destacaramse estudos longitudinais. Os achados também permitiram problematizar as propriedades psicométricas do instrumento. Sugere-se a realização de novos estudos, bem como uma ampliação no uso e na divulgação do SCL, uma vez que o instrumento permite uma avaliação compreensiva e detalhada da saúde e do desenvolvimento infantil.

This study aimed to present the studies that used the Symptom Checklist (SCL) to evaluate psychofunctional symptoms infants. Were detailed the countries that the studies were carried out, the design of the articles and the main variables associated. Therefore, a critical review of the literature was performed, considering works that used the SCL instrument. It was found that the prevalence of symptoms of infants, is still unknown in Brazil and abroad, although there is a predominance of studies in the European context. Although the SCL can be used in various types of research designs, longitudinal studies were predominant. The findings also allowed to question the psychometric properties of the instrument. It is suggested to carry out new studies, as well as an expansion in the use and divulgation of SCL, since the instrument allows a comprehensive and detailed assessment of health and child development.

Esta investigación tuvo como objetivo presentar los estudios que utilizaron el Symptom Checklist (SCL) para evaluar los síntomas psicofuncionales en bebés. Fueron detallados los países en los que el trabajo se lleva a cabo, el diseño de los estudios y las principales variables asociada. Por lo tanto, se realizó una revisión crítica de la literatura, teniendo en cuenta los estudios que utilizaron el SCL. Se encontró que la prevalencia de síntomas en los bebés psicofuncionales sigue siendo una incógnita tanto en Brasil como en el extranjero, aunque hay un predominio de los estudios europeos. Aunque el SCL se puede utilizar en la investigación de varios tipos de diseños, se destacaron estudios longitudinales. Los resultados también permiten a cuestionar las propiedades psicométricas del instrumento. Se sugiere conducir nuevos estudios, así como una expansión en el uso y divulgación de SCL, ya que el instrumento permite una evaluación completa y detallada de salud y desarrollo infantil

Effects of Pain and Somatic Symptoms on Elderly Depression Symptoms and Quality of Life / 우울ㆍ조울병

OBJECTIVES: The purpose of this study was to investigate the effects of pain and somatic symptoms on depressive symptoms and quality of life in the elderly population.METHODS: This study analyzed 147 elderly people living in a small city. This study used the Alcohol Use Disorder Identification Test (AUDIT-K), Short Geriatric Depression Scale (SGDS-K), Patient Health Questionnaire (PHQ-15), Geriatric Pain Measurement (GPM-K), World Health Organization Quality of Life (WHQQOL-BREF), and Multidimensional Scale of Perceived Social Support (MSPSS) as measuring tools for review of the elderly population. The student-t test and chi-square test were used to compare the characteristics of depression in the case of the participants. A hierarchical regression analysis was performed by the utilization of a Pearson's correlation test.RESULTS: Among the 147 elderly people studied, there were 43 (29.2%) who showed depressive symptoms. There was a difference in psychological variables according to depressive symptom between MSPSS (p < 0.01), GPM-K (p < 0.001), PHQ-15 (p < 0.001), and WHOQOL-BREF (p < 0.001). The quality of life of the elderly participants was significantly correlated with age (p < 0.05), annual income (p < 0.05), MSPSS (p < 0.01), and GPM-K (p < 0.01). As a note, the final regression model of the quality of life showed that 40.0% of the quality of life was related to high social support, low educational attainment, pain experienced by the participants and other characteristic physical symptoms.CONCLUSION: This study confirmed the effects of pain and somatic symptoms on the incidence of depression and quality of life in the elderly urban dwelling populations.

Biological mechanisms of somatic symptoms in depressive disorder / 中华行为医学与脑科学杂志

The symptoms of depressive disorder can be summarized into three dimensions:emotional symptoms,cognitive symptoms and somatic symptoms.Most patients with depressive disorders have various somatic symptoms.The existence of somatic symptoms is often related to the severity of the disease,poor efficacy,and prolonged disease duration.Depressive disorder with somatic symptoms may be a special subtype of depressive disorder.Therefore exploration for its biological mechanisms has an important significance in such patients.This article reviews the clinical characteristics,definitions,and biological mechanisms of somatic symptoms in depressive disorder,and hopes to contribute to an improved understanding of the pathology of depressive disorders.

Relevancia de la menopausia y del apoyo social en las diferencias en salud entre mujeres y hombres / Relevance of the Menopause and Social Support in Gender Differences in Health

RESUMEN Se analizó la relevancia de la menopausia y el apoyo social en las diferencias en salud entre mujeres y hombres mediante un estudio transversal realizado con 710 mujeres y 606 hombres de la población general española con edades entre 20 y 65 años. Se encontró que, aunque en la juventud apenas había diferencias entre hombres y mujeres, a partir de la perimenopausia las mujeres informaban de más insomnio y síntomas vasomotores que los hombres, así como de más dolor durante la postmenopausia. El apoyo social percibido se asociaba con mejor salud, sobre todo en las mujeres en postmenopausia y premenopausia.

ABSTRACT This study examined the relevance of the menopause and social support in gender differences in health. A cross-sectional survey of a general population sample comprising 710 women and 606 men, aged between 20 and 65 was carried out. No health differences were found between younger men and women. However, perimenopausal women reported more insomnia and vasomotor symptoms, as well as they reported more pain than men through the postmenopause. Perceived social support was associated with better health, especially in premenopausal and postmenopausal women.

Somatic Symptoms as Mediating Factors between the Perceived Social Support and the Health-Related Quality of Life in North Korean Defectors

OBJECTIVE: This study was conducted to examine the mediating effect of somatic symptoms between perceived social support and health-related quality of life among North Korean defectors living in South Korea. METHODS: A total of 200 North Korean defectors were assessed using the Multidimensional Scale of Perceived Social Support, the Short-Form 8-Item Health Survey, the Patient Health Questionnaire 15, the PTSD Checklist Civilian Version and the Patient Health Questionnaire 9. RESULTS: Somatic symptoms accounted for physical health-related quality of life after controlling for PTSD and depressive symptoms, but did not for mental health-related quality of life. Moreover, somatic symptoms mediated the relationship between perceived social support and physical and mental health-related quality of life, indicating that perceived social support indirectly affects physical and mental health-related quality of life through somatic symptoms in North Korean defectors. CONCLUSION: The results of this study suggest that not only intervention for PTSD or depressive symptoms but also for somatic symptoms might be effective to improve physical and mental health-related quality of life for North Korean defectors, especially those who have a lack of perceived social support.