Relationships between worry and depressive symptoms during two group therapies for generalized anxiety disorder / A inter-relação entre preocupações e sintomas depressivos em adultos com ansiedade generalizada

OBJECTIVE: Generalized anxiety disorder (GAD) is a chronic and disabling disorder associated with various impairments and shows a significant prevalence in the worldwide and Brazilian populations. This study aimed to investigate the longitudinal relationship of two symptoms relevant to the disorder (worry and depressive symptoms) in the context of a randomized clinical trial (RCT) by using a cross-lagged panel model (CLPM) analysis. METHODS: A total of 92 adult patients with GAD were randomized to receive ten sessions of either acceptance­based group behavioral therapy (ABBT) or nondirective supportive group therapy (NDST). Treatment had four time-point measures. Worries were measured using the Penn State Worry Questionnaire (PSWQ), and depression was measured using the Depression Anxiety Stress Scales (DASS-D). RESULTS: The NDST model revealed significant paths from worry to depression (first wave) and from depression to worry (second wave). There was no other significant cross-lagged effect. These data show that there was an influence between symptoms only during one of the treatment groups, and without a homogeneous and constant pattern in any of the cross-lagged routes. CONCLUSION: A supportive group psychotherapy potentially interferes with the pattern of the direct relationship between worries and depressive symptoms in adults with GAD.

OBJETIVO: O transtorno de ansiedade generalizada (TAG) é um diagnóstico crônico e incapacitante, associado a diversos prejuízos e com relevante prevalência na população mundial e na brasileira. Este estudo tem por objetivo investigar a relação longitudinal de duas manifestações relevantes para o transtorno (preocupação e sintomas depressivos), utilizando uma análise cross-lagged panel model (CLPM) por meio de dados de um ensaio clínico randomizado (ECR). MÉTODOS: Um total de 92 pacientes adultos com TAG foi randomizado para duas psicoterapias em grupo: terapia comportamental baseada em aceitação (TCBA) ou terapia de apoio não diretiva (TAND). Cada grupo teve duração de 10 sessões, distribuídas em 14 semanas. O tratamento teve quatro tempos de medida: linha de base, meio do tratamento, pós-tratamento e seguimento de três meses. As variáveis investigadas foram: preocupações, medidas pelo Penn State Worry Questionnaire (PSWQ), e sintomas depressivos, medidos pela Depression Anxiety Stress Scales (DASS-D). Os modelos CLMP foram gerados pelo programa Mplus. RESULTADOS: O modelo do grupo TAND revelou duas rotas significativas: preocupação para sintomas depressivos (primeira onda) e sintomas depressivos para preocupação (segunda onda). Não houve outro efeito cross-lagged que obteve significância estatística. Esses dados mostram que houve influência alternada entre os sintomas somente durante o período de um dos dois tratamentos testados, configurando um padrão heterogêneo das rotas cross-lagged. CONCLUSÃO: A psicoterapia suportiva em grupo potencialmente interfere no padrão da relação direta entre preocupação e sintomas depressivos em adultos com TAG.

Impulsivity influences food intake in women with generalized anxiety disorder

Objective: Eating behavior is affected by psychological and neurocognitive factors. However, little is known about this relationship in anxious patients. Our aim was to investigate the associations between impulsivity, inhibitory control, energy-dense food consumption, and body mass index (BMI) in women with generalized anxiety disorder (GAD). Methods: In this cross-sectional study, 51 adult females with GAD answered the Barratt Impulsiveness Scale (BIS-11) and participated in a go/no-go task using food images. Anthropometric measurements were evaluated. A food frequency questionnaire and a snack test were used to study eating behavior. Pearson correlation and multiple linear regression were performed to analyze the variables of interest, adjusted by age. Results: Impulsivity predicted intake of sugar (p = 0.016, 95%CI 0.67-6.05), total fat (p = 0.007, 95%CI 0.62-3.71), and saturated fat (p = 0.004, 95%CI 0.30-1.48). The snack test showed a positive correlation between presence of impulsivity and intake of biscuits (R = 0.296; p = 0.051). Response inhibition to food images in the go/no-go task paradigm did not predict BMI or food intake. Conclusion: Impulsivity was predictive of higher sugar and saturated fat intake in women diagnosed with GAD. Our findings add to the literature regarding the association between neuropsychological factors and food consumption in this specific population.

Memory and language impairments are associated with anxiety disorder severity in childhood

Abstract Introduction Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen's d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood.

Assessment of sleep quality of patients with panic disorder and generalized anxiety disorder during remission: a case-control study

Abstract Background Sleep disorders are common in psychiatric diseases. Panic disorder (PD) and generalized anxiety disorder (GAD) are two major anxiety disorders that are associated with sleep disorders. Objective We hypothesized that poor sleep quality continues in PD and GAD during remission. Therefore, in this study we aimed to compare the sleep quality of patients with PD and GAD to that of healthy controls. Methods The study included patients with PD (n = 42) and GAD (n = 40) who had been in remission for at least 3 months and healthy control volunteers (n = 45). The patients were administered the Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Results The total PSQI scores of the GAD group were significantly increased in comparison to those of the PD (p = 0.009) and control (p < 0.001) groups. The rate of poor sleep quality in GAD during remission (77.5%) was greater than that of the PD (47.6%) and control (51.1%) groups (p = 0.011). Discussion GAD is a chronic and recurrent disease. In this study, it was found that the deterioration in sleep quality of patients with GAD may continue during remission. In the follow-up and treatment of patients, it is appropriate to question about sleep symptoms and to plan interventions according to these symptoms.

The association between personal history and the outcomes of transobturator sling surgery

SUMMARY OBJECTIVE: This study aims to verify the association between risk factors for the onset of SUI and transobturator suburethral sling surgical treatment outcomes. PATIENTS AND METHODS: A retrospective study was conducted with 57 patients operated by the Pelvic Floor Surgery Service. Demographic data were compiled from the sample, the body mass index (BMI) was calculated, and the patients were divided according to the response to the surgical treatment. RESULTS: A total of 77.2% of the sample was cured or improved after surgical treatment. Out of the total sample, 75.4% of the women were postmenopausal, and 73.7% denied current or past smoking. The median age was 61 years, the median number of births was 4.0, the median BMI was 28.6 kg/m2, and 50.9% of the sample was classified as pre-obese. BMI, menopausal status, age, smoking, and sexual activity were not factors associated with the surgical outcome. However, parity equal to or greater than 5 was associated with worse postoperative results (p = 0.004). CONCLUSIONS: among risk factors associated with the emergence of SUI, only parity greater than 4 showed a negative impact on transobturator sling surgery outcomes.

RESUMO OBJETIVO: O estudo pretende verificar a associação entre fatores de risco relacionados ao surgimento da IUE com resultado do tratamento cirúrgico com sling suburetral transobturador. PACIENTES E MÉTODOS: Foi realizado estudo retrospectivo com 57 pacientes operadas pelo serviço de Cirurgia do Assoalho Pélvico da FMJ. Foram compilados dados demográficos da amostra, calculado o índice de massa corpórea (IMC) e as pacientes foram divididas de acordo com a resposta ao tratamento cirúrgico. RESULTADOS: 77,2% da amostra apresentou-se curada ou melhorada após o tratamento cirúrgico, 75,4% das mulheres se encontravam na pós-menopausa e 73,7% negaram tabagismo atual ou passado. A mediana de idade foi de 61 anos, a mediana do número de partos foi de 4,0 e a mediana do IMC foi de 28,6 kg/m2; 50,9% da amostra foi classificada como pré-obesa. O IMC, o status menopausal, a idade, o tabagismo e a manutenção da atividade sexual não foram fatores associados ao resultado cirúrgico. Porém, a paridade igual ou superior a 5 associou-se a piores resultados pós-operatórios (p=0,004). CONCLUSÕES: Entre os fatores de risco associados ao surgimento da IUE, apenas a paridade maior que 4 influenciou negativamente as taxas de melhora após cirurgia de sling transobturador.

Prevalence of depression and anxiety and their association with cardiovascular risk factors in Northeast Brasil primary care patients

SUMMARY BACKGROUND: Depression and anxiety disorders (DAD) are the most prevalent mental health conditions worldwide. Among the adult population served in basic care, it is estimated that depression affects about 14.3% of these individuals worldwide, and between 21.4% and 31% in Brasil. Anxiety affects up to 33.7% of the population during their lifetimes. OBJECTIVES: estimate the prevalence proportions of DAD among patients in a municipality in Northeast Brasil and study the association between DAD and cardiovascular risk factors. METHODS: a cross-sectional study with the medical records of patients from primary care centers in Jaboatão dos Guararapes, Pernambuco. Patients aged ≥ 18 years and regularly followed-up were included. Exclusion criteria: a history of traumatic brain injury, alcohol or drug abuse, previous stroke, medical conditions or medications that mimic DAD symptoms. Subjects were divided into two groups depending on the presence or absence of DAD, and cardiovascular risk factors were compared between groups. RESULTS: A total of 1030 subjects were initially included, of whom 215 (20%) were excluded. No-DAD subjects had more history of myocardial infarction and alcoholism. The prevalence of depression was 10.3%, anxiety disorder was 27.1%, and mixed DAD represented 4.5%. There was a significant association between DAD and hypertension (OR = 2.11; 95%CI: 1.16 -3.84; p=0.01), obesity (OR = 4.47; 95%CI: 1.74 -11.46; p=0.002), and hyperlipidemia (OR = 3.88; 95%CI: 1.81-8.3; p<0.001). CONCLUSION: DAD were associated with an increased risk for arterial hypertension, obesity, and hyperlipidemia.

RESUMO INTRODUÇÃO: Transtornos de ansiedade e depressão (TAD) são os distúrbios psiquiátricos mais comuns no mundo. Dentre a população adulta atendida na atenção básica, estima-se que a depressão afete cerca de 14,3% desses indivíduos mundialmente, podendo este valor ir de 21,4% a 31% no Brasil. A ansiedade afeta até 33,7% da população durante sua vida. OBJETIVO: Estimar a prevalência de TAD em pacientes da atenção primária em um município do Nordeste brasileiro e associar sua ocorrência com fatores de risco cardiovasculares. MÉTODOS: Um estudo de coorte transversal com análise de prontuário de pacientes atendidos em unidades de saúde da família de Jaboatão dos Guararapes, Pernambuco. Foram incluídos pacientes ≥18 anos e acompanhados regularmente. Critérios de exclusão: história de trauma crânio encefálico, abuso de álcool e drogas, acidente vascular cerebral prévio, doenças ou medicações que mimetizem sintomas de TAD. Os indivíduos foram divididos em dois grupos, a depender da presença ou não de TAD, e os fatores de risco cardiovascular foram comparados entre os grupos. RESULTADOS: De um total de 1.030 indivíduos recrutados, 215 (20%) foram excluídos. O grupo não TAD apresentou mais história de infarto do miocárdio e etilismo. A prevalência de depressão foi de 10,3%, a de ansiedade foi de 27,1% e a associação entre os dois foi de 4,5%. Houve associação significativa entre TAD e hipertensão (OR = 2,11; IC95: 1,16-3,84; p=0,01), obesidade (OR = 4,47; IC95%: 1,74-11,46; p=0,002) e dislipidemia (OR = 3,88; IC95%: 1,81-8,3; p<0,001). CONCLUSÃO: TAD estão associados com maior risco de hipertensão arterial, obesidade e dislipidemia.

Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil

Objective: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil. Methods: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher's exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis. Results: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively. Conclusion: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

Prevalence of anxiety disorders as a cause of workers' absence / Prevalencia de los trastornos de ansiedad como causa de absentismo de trabajadores / Prevalência dos transtornos de ansiedade como causa de afastamento de trabalhadores

ABSTRACT Objective: to analyze the prevalence of various anxiety disorders among mental and behavioral disorders as a cause for the leave of absence of workers in the state of Piauí. Method: transversal census-based study performed with data from the National Social Security Institute. Four-hundred twelve leaves of absence of workers due to anxiety disorders in the 2015-2016 biennium were included. Results: higher prevalence was found for mixed anxiety-depressed disorder (31.2%), followed by other anxious disorders (20.6%) and generalized anxiety (14.1%). Ages from 22 to 45 years old prevailed in the group of individuals with duration of absence greater than or equal to 41 days, with statistically significant difference (p < 0.001). There was no statistically significant association (p = 0.004) between rural activity and increased time of absence. Conclusion: the study draws attention to the prevalence of "other anxiety disorders" as the cause of leave of absence, with emphasis on mixed anxiety-depressed disorder.

RESUMEN Objetivo: analizar la prevalencia de los diversos trastornos de ansiedad entre los trastornos mentales y comportamentales como causa del absentismo laboral de trabajadores del estado de Piauí. Método: estudio transversal y censal realizado con datos del Instituto Nacional del Seguro Social de Brasil. Se incluyeron 412 absentismos de trabajadores por trastornos de ansiedad en el bienio 2015-2016. Resultados: se verificó mayor prevalencia para el trastorno mixto ansioso y depresivo (31,2%), seguido de otros trastornos ansiosos (20,6%) y ansiedad generalizada (14,1%). En el grupo de individuos con una duración de absentismo mayor o igual a 41 días, con una diferencia estadísticamente significativa (p < 0,001), prevaleció el grupo de edad de 22 a 45 años. Se observó una asociación estadísticamente significativa (p = 0,004) entre actividad rural y mayor tiempo de absentismo. Conclusión: el estudio llama la atención sobre la prevalencia de "otros trastornos ansiosos" como causa del absentismo laboral, con destaque para el trastorno mixto ansioso-depresivo.

RESUMO Objetivo: analisar a prevalência dos diversos transtornos de ansiedade entre os transtornos mentais e comportamentais como causa do afastamento laboral de trabalhadores do estado do Piauí. Método: estudo transversal e censitário realizado com dados do Instituto Nacional do Seguro Social. Incluíram-se 412 afastamentos de trabalhadores por transtornos de ansiedade no biênio 2015-2016. Resultados: verificou-se maior prevalência para o transtorno misto ansioso e depressivo (31,2%), seguido de outros transtornos ansiosos (20,6%) e ansiedade generalizada (14,1%). Prevaleceu a faixa etária de 22 a 45 anos no grupo de indivíduos com duração de afastamento maior ou igual a 41 dias, com diferença estatisticamente significativa (p < 0,001). Houve associação estatisticamente significativa (p = 0,004) entre atividade rural e maior tempo de afastamento. Conclusão: o estudo chama atenção para a prevalência de "outros transtornos ansiosos" como causa do afastamento laboral, com destaque para o transtorno misto ansioso depressivo.

Early psychiatric morbidity in a Brazilian sample of acute ischemic stroke patients

OBJECTIVE: Stroke is a major public health problem worldwide, and its neuropsychiatric sequelae are frequent and disabling. Furthermore, there is evidence that these sequelae impair recovery. Brazil has the highest stroke rates in Latin America, but data on the frequency of neuropsychiatric disorders in these patients are scarce. This study aimed to identify mental disorders among in-hospital patients with acute ischemic stroke. METHODS: The Mini International Neuropsychiatric Interview-Plus (MINI-Plus) was applied to 60 patients during the first week of hospitalization. RESULTS: Psychiatric disorders were diagnosed in 55% of the patients. A wide range of neuropsychiatric disorders have been identified, mainly mood and anxiety disorders. Specifically, we identified major depression (26.7%), alcohol abuse or dependence (11.7%), specific phobia (8.3%), generalized anxiety disorder (6.7%), psychosis (5.0%), social phobia (3.3%), adjustment disorder (3.3%) and panic disorder (1.7%). CONCLUSION: Psychiatric comorbidity should be evaluated as part of the rehabilitation of stroke patients and should be carefully examined by physicians.

Disfunciones temporomandibulares y su relación con trastornos de ansiedad en niños: un caso clínico / Temporomandibular joint dysfunctions and their relationship with anxiety disorders in children: report of a clinical case

La presencia de desórdenes temporomandibulares (TTM) en el niño es un tema controversial. Algunos autores sostienen su ausencia en la población infantil; sin embargo, otros han observado signos y síntomas de TTM en poblaciones pediátricas. Nosotros creemos que tales desórdenes pasan inadvertidos con frecuencia por la falta de un examen clínico completo y minucioso que incluya el estudio de la ATM como parte del sistema estomatognático y como revisión rutinaria en la clínica odontopediátrica. Ante las reiteradas consultas que recibimos en la asignatura Odontología Niños de la FOLP, surgió la inquietud de profundizar en el tema y decidimos realizar un trabajo de investigación denominado : "Disfunciones temporomandibulares y su relación con trastornos de ansiedad en una población infantil". El objetivo general de este trabajo fue determinar los signos y síntomas de los TTM y su relación con los distintos niveles de trastornos emocionales en una población infantil, con el propósito de brindar información a odontólogos y odontopediatras acerca de la importancia de realizar un correcto examen clínico de la ATM que nos alerte sobre la posibilidad de aparición de TTM en niños, sin dejar de estar atentos a los miedos o los diferentes grados de ansiedad que los niños pueden desarrollar y que contribuyen en buen grado a agravar o desencadenar el cuadro.

Chronotype and anxiety are associated in patients with chronic primary insomnia

Objective: To assess the interaction of chronotype with anxiety in patients with chronic primary insomnia. Methods: Sixty-four patients (50 women) with mean age 43.9±8.1 years were investigated with the Horne and Östberg Morningness-Eveningness Questionnaire (MEQ) and State-Trait Anxiety Inventory (STAI). Results: Significant negative correlations of chronotype-MEQ score with STAI state-anxiety (r = -0.40, p < 0.05), STAI trait-anxiety (r = -0.40, p < 0.05), and STAI pre-sleep state anxiety (r = -0.30, p < 0.05) were observed. Eveningness preference was associated with higher trait, state, and pre-sleep state anxiety. Conclusions: These results suggest that chronotype may be an important parameter to identifying the origin and significance of a vicious anxiety-insomnia-depression cycle in patients with chronic primary insomnia.

Salivary stress biomarkers and anxiety symptoms in children with and without temporomandibular disorders

Abstract The etiology of temporomandibular disorders (TMD), which are considered as a heterogeneous group of psychophysiological disturbances, remains a controversial issue in clinical dentistry. This study aimed to evaluate whether the salivary alpha-amylase (sAA), cortisol levels, and anxiety symptoms differ between children with and without TMD. Initially, 316 young subjects were screened in public schools (nonreferred sample); 76 subjects aged 7-14 years were selected and comprised the TMD and control groups with 38 subjects each matched by sex, age, and the presence/absence of sleep bruxism. Four saliva samples were collected: upon waking, 30 min and 1 h after awakening (fasting), and at night (at 8 PM) on 2 alternate days to examine the diurnal profiles of cortisol and sAA. Anxiety symptoms were screened using the Multidimensional Anxiety Scale for Children (MASC-Brazilian version). Shapiro-Wilk test, Student's t-test/Mann-Whitney U test, and correlation tests were used for data analysis. No significant differences were observed in the salivary cortisol area under the curve (AUCG mean ± SD = 90.22 ± 63.36 × 94.21 ± 63.13 µg/dL/min) and sAA AUCG (mean ± SD = 2544.52 ± 2142.00 × 2054.03 ± 1046.89 U/mL/min) between the TMD and control groups, respectively (p > 0.05); however, the clinical groups differed in social anxiety domain (t = 3.759; CI = 2.609, 8.496), separation/panic (t = 2.243; CI = 0.309, 5.217), physical symptoms (U = 433.500), and MASC total score (t = −3.527; CI = −23.062, −6.412), with a power of the test >80% and large effect size (d = 0.80), with no significant correlation between the MASC total score, cortisol, and sAA levels. Although children with TMD scored higher in anxiety symptoms, no difference was observed in the salivary stress biomarkers between children with and without TMD.

Prevalência de ansiedade e depressão em pacientes oncológicos e identificação de variáveis predisponentes / Prevalence of anxiety and depression in cancer patients and identifying predisposing variables / La prevalencia de ansiedad y depresión en pacientes con cáncer y la identificación de las variables que predisponen

Introdução: O diagnóstico de câncer pode ser acompanhado de transtornos psiquiátricos como a ansiedade e a depressão. Objetivo: Avaliar a ocorrência de depressão e ansiedade em paciente oncológicos, além de analisar as associações entre as variáveis clínicas e sociodemográficas e as comorbidades psiquiátricas. Método: Trata-se de um estudo transversal, analítico-descritivo, no qual foram selecionados de maneira aleatória prontuários de pacientes oncológicos em tratamento no hospital referência da Região Centro-Oeste de Minas Gerais. Os dados sociodemográficos e clínicos (gênero, idade, tipo de câncer, tipo de tratamento e tempo de tratamento) foram coletados, e a amostra foi triada para depressão e ansiedade, por meio do Hospital Anxiety and Depression Scale (HADS), já validada para o Brasil. Os dados obtidos foram interpretados por frequência absoluta e relativa. Posteriormente, foram analisadas as associações por meio do Teste Qui-Quadrado. Resultados: A amostra é formada por 233 pacientes, sendo 65% mulheres; 55% dos entrevistados no setor de quimioterapia; e 37% com até três anos de tratamento. Entre os entrevistados, foram encontrados 31,33% (IC 95%: 25,37-37,28) dos pacientes com ansiedade provável ou possível, e 26,18% (IC 95% 20,53-31,82) com depressão provável ou possível. Após correlação dos dados encontrados por meio do Qui-Quadrado, não se identificou diferença nos subgrupos, porém houve uma tendência maior a mulheres apresentarem depressão. Conclusão: A ansiedade e depressão são distúrbios prevalentes em pacientes oncológicos. Neste estudo, mais de um quarto dos pacientes demonstram componentes de transtorno psicológico (26,18% ansiedade e 31,33% depressão), tendo um predomínio de depressão em mulheres.

Introduction: The diagnosis of cancer can often be followed by psychiatric disorders such as anxiety and depression. Objective: to evaluate the occurrence of depression and anxiety in cancer patients, besides analyzing the association between clinical and sociodemographic variables and psychiatric comorbidities. Method: This was a cross-sectional, analytical-descriptive study based on randomly-selected charts of cancer patients undergoing treatment at the referral hospital in the central-western region of Minas Gerais. Sociodemographic and clinical data (gender, age, and type of cancer, type of treatment and time of treatment) were collected. The sample was screened for depression and anxiety by using the Hospital Anxiety and Depression Scale (HADS), already validated in Brazil. The obtained data were interpreted by absolute and relative frequency. Then, associations were analyzed using the Chi-Square Test. Results: The sample consisted of 233 patients, 65% of whom were women, 55% were interviewed in the chemotherapy sector and 37% with up to 3 years of treatment. Among the interviewees, 31.33% (IC 95%: 25.37-37.28) of the patients showed probable or possible anxiety and 26.18% (CI 95% 20.53-31.82) presented probable or possible depression. After correlation of the data found using the Chi-square, no difference was identified in the subgroups, but there is a higher tendency for women to have depression. Conclusion: Anxiety and depression are prevalent disorders in cancer patients. In this study, more than a quarter of the patients demonstrated components of psychological disorder (26.18% anxiety and 31.33% depression), with depression predominating in women.

Introducción: El diagnóstico de cáncer puede ser acompañado de trastornos psiquiátricos como ansiedad y depresión. Objetivo: Evaluar la incidencia de la depresión y la ansiedad en pacientes con cáncer, y analizar la asociación entre las variables clínicas y sociodemográficas y comorbilidades psiquiátricas. Método: Se trata de un estudio transversal, analítico-descriptivo, en el cual fueron seleccionados al azar los registros de pacientes en tratamiento oncológico en el hospital referencia de Minas Gerais, en la región del Medio Oeste de Brasil. Fueron recogidos los datos sociodemográficos y clínicos (sexo, edad, tipo de cáncer, el tipo de tratamiento y tiempo de tratamiento) y analizados de manera descriptiva por medio de una tabla de frecuencias. Una muestra fue seleccionada para la depresión y la ansiedad al utilizarse la Escala Hospitalaria de Ansiedad y Depresión (HADS), ya validada en Brasil. Los datos fueron interpretados por frecuencia absoluta y relativa. Luego fue analizada la asociación por medio de la prueba de chi-cuadrado. Resultados: La muestra es compuesta por 233 pacientes, entre los cuales 65% son mujeres, 55% están en la quimioterapia y el 37% presentan hasta 3 años de tratamiento. Entre los entrevistados, se encontró 31,33% (IC 95%: 25,37-37,28) de pacientes con ansiedad probable o posible y 26,18% (IC 95% 20,53-31,82) con la depresión probable o posible. Después de la correlación de los datos encontrados utilizando la prueba de Chi-cuadrado, no identificamos diferencias en los subgrupos sin embargo, hay una mayor tendencia a que las mujeres tengan depresión. Conclusión: La ansiedad y la depresión son trastornos frecuentes en los pacientes con cáncer. En este estudio, más de una cuarta parte de los pacientes tienen componentes de trastornos psicológicos (26,18% 31,33% de ansiedad y depresión), y hay una mayor tendencia a que las mujeres tengan depresión.

Niveles de ansiedad y su relación con los trastornos temporomandibulares / Anxiety levels and their relationship to temporomandibular disorders

El diagnóstico de los trastornos temporomandibulares es un tema muy controvertido dentro del campo de la salud, desde una perspectiva psicológica son muy escasas las referencias en este sentido, sobretodo las enfocadas a analizar los niveles de ansiedad en estos pacientes. En los últimos años se han realizado diferentes investigaciones que validan la inclusión de factores psicológicos como parte de la etiología del diagnóstico, dentro de los factorespsíquicos más asociados se presentan la ansiedad como rasgo y la ansiedad como estado. El propósito de este trabajo es presentar una revisión sobre la relación existente entre los niveles de ansiedad y los trastornos temporomandibulares.

The diagnosis of temporomandibulardisorders is very controversial within the fieldof health issue, from a psychological perspectiveare very few references in this regard,especially focused on analyzing anxiety levelsin these patients. In recent years there have beenvarious studies that validate the inclusionof psychological factors as part of the etiology,diagnosis, within the psychological factorsmost associated trait anxiety and state anxietyas presented. The purpose of this paper is topresent a review of the relationship betweenanxiety levels and temporomandibular disorders.

Identificação de transtornos de ansiedade em pacientes com suspeita de doença arterial coronariana / Identifying anxiety disorders in patients with suspected coronary artery disease

Devido ao aumento de pacientes nas emergênciasapresentando sintomas semelhantes aos de transtornode ansiedade (TA) e sintomas de doença arterial coronariana (DAC), buscou-se esclarecer a relação entre DAC e TA através de experiência vivenciada na emergência de hospital especializado e da literatura existente sobre o assunto. Foram analisados prontuários de 15 pacientes e realizada entrevista semi estruturada com cada um. Perceberam-se padrões cognitivos nesses pacientes e, como contribuição, sugeriu-se autilização de dois elementos auxiliares no diagnóstico de TA nas salas de emergência: a catastrofização e a hipervigilância.

Prompted by an upsurge of patients in emergency rooms presenting symptoms similar to those of anxiety disorder (AD) together with symptoms of coronary artery disease (CAD), an attempt was madeto clarify the relationship between CAD and AD through hands-on experience in a specialized hospital ER, in addition to the specialized literature on this subject. The medical records of fifteen patients were analyzed, followed by semi-structured interviews with each of them. Cognitive patterns were noted in these patients and, as a contribution, the use of two auxiliary elements is suggested for diagnosing AD in ERs: catastrophization and hypervigilance.

Ansiedade e coração / Anxiety and heart

A ansiedade patológica e suas repercussões fisiológicas não afligem apenas o bem-estar psíquico e a funcionalidade. A saúde geral também fica comprometida, com aumento da incidência de comorbidades clínicas. Entre estas, as mais significativamente associadas com ansiedade são as doenças da tireoide, doença do refluxo gastroesofágico, psoríase e, sobretudo, as doenças cardíacas. Estas são as mais importantes do ponto de vista de morbidade e mortalidade. Ansiedade e doença cardíaca não são meras comorbidades, mas exercem uma complexa interação, que discutiremos neste texto...

The pathological anxiety and the physiological rebounds don't attack well-being and the functionality only. General health is committed as well, whith medical comorbidity increase. Among these, the more associated significantly with anxiety are thyroid disease, gastroesophageal reflux disease, psoriasis, and mainly heart diseases. These are the mostly important point of view about morbidity and mortality. Anxiety and heart disease are not just comorbidity, but they act with a complex interaction which will be discussing in this paper...

Características vocais e emocionais de professores e não professores com baixa e alta ansiedade / Vocal and emotional features of teachers and non-teachers with low and high anxiety

Objetivo Comparar características vocais e emocionais em grupos de professores e não professores com baixa e alta ansiedade. Métodos Participaram do estudo 93 sujeitos, de ambos os gêneros, com idades entre 18 e 59 anos, divididos em quatro grupos: professores com baixa ansiedade (PBA), professores com alta ansiedade (PAA), não professores com baixa ansiedade (NPBA) e não professores com alta ansiedade (NPAA). Os parâmetros vocais foram mensurados por meio dos instrumentos Questionário de Sinais e Sintomas Vocais (QSSV), Protocolo de Qualidade de Vida em Voz (QVV), Índice de Desvantagem Vocal (IDV), além da gravação de fala e vogal sustentada, avaliada por três fonoaudiólogos, a partir da Escala Analógico-Visual (EAV). Para avaliação dos parâmetros emocionais, utilizou-se o Self-Report Questionnaire (SRQ) e o Inventário de Ansiedade Traço-Estado (IDATE). Resultados Constatou-se que os grupos com alta ansiedade relataram sintomas indicativos de alto nível de estresse e depressão, sendo que o grupo de professores apresentou maior número de sintomas emocionais. Quanto aos parâmetros vocais, observou-se que os professores com alta ansiedade expressaram maior número de sintomas vocais, maior comprometimento da qualidade de vida em voz, maior desvio global da qualidade vocal e alto índice de desvantagem vocal, quando comparados com os demais grupos. Conclusão Os indivíduos com alta ansiedade tiveram maior comprometimento emocional, vocal e na qualidade de vida, sobretudo aqueles que têm a voz como instrumento de trabalho, os professores. .

Purpose Compare vocal symptoms and emotional features in groups of teachers and non-teachers with low and high anxiety. Methods A total of 93 male and female participants aged between 18 and 59 years participated in the study and were divided into four groups: teachers with low anxiety, teachers with high anxiety, non-teachers with low anxiety, and non-teachers with high anxiety. Vocal parameters were measured by the instruments Vocal Signs and Symptoms Questionnaire, Voice-Related Quality of Life, Voice Handicap Index; and recorded speech and sustained vowels from the Visual Analog Scale were assessed by three speech-language pathologists. To assess emotional parameters, the Self-Report Questionnaire and the State-Trait Anxiety Inventory were used. Results Groups with high anxiety reported high levels of stress and depression symptoms, and teachers had symptoms that were more emotional. Teachers with high anxiety expressed a greater number of vocal symptoms, greater impairment of voice quality of life, greater overall change in voice quality, and higher voice handicap index when compared with the other groups. Conclusion Individuals with high anxiety displayed more emotional symptoms related to voice and vocal quality of life, especially if the voice was a work instrument, such as for teachers. .

Ansiedad, trastornos de ansiedad y sexualidad. La compleja interacción entre ansiedad y funcionamiento sexual / [Anxiety, anxiety disorders and sexuality. The complex relation between anxiety and sexual performance].

Anxiety and sexuality are in if same as inexhaustible as controversial universes. The relationship between them, a pair even more difficult to cover. This paper aims to describe the complex relationships existing between the different types of anxiety and its impact on sexuality.

Trastornos ansiosos y desórdenes temporomandibulares en funcionarios de un centro de salud familiar en la comuna de Concepción, Chile / Temporomandibular and anxiety disorders in workers of a family health center in the area of Concepción, Chile

Los trastornos temporomandibulares (TTMs) involucran los músculos de la masticación, articulación temporomandibular (ATM) y otras estructuras asociadas a la cavidad oral y representan un conjunto de disfunciones de la articulación, a la cual se le asocia una naturaleza multifactorial, condición que puede llegar a tener de un 50 a 93 por ciento de prevalencia en la población y cuya etiología es asociada a estrés y/o estados psicológicos alterados. Se efectuó un estudio descriptivo observacional de corte transversal con el objetivo de determinar la prevalencia de Trastornos Ansiosos y TTM, en funcionarios del Centro de Salud Familiar (CESFAM) Tucapel, sector Barrio Norte, en la comuna de Concepción. De los 97 funcionarios, 79 aceptaron voluntariamente a participar del estudio y todos trabajan directamente con pacientes en un sector con numerosos problemas socioeconómicos y laborales. Se aplicó una encuesta orientada a la pesquisa tanto de patologías psicológicas, como signos y síntomas de TTM, además de un examen extra e intraoral complementario. En los encuestados se encontró trastornos ansiosos y estados asociados a burnout en un 81 y 27,8 por ciento respectivamente, además había TTM en un 98.7 por ciento de origen multifactorial, pero presente en todos los individuos encuestados y examinados con trastornos ansiosos y estados asociados a burnout.

Temporomandibular disorders (TMDs) involve the muscles of mastication, temporomandibular joint (TMJ) and other structures associated with the oral cavity and represent a multifactorial nature of disorders associated to this joint, condition that is in the range of 50 to 93 percent of prevalence in the population and whose etiology is associated with stress and / or altered psychological states. The present study is a descriptive cross-sectional observational in order to determine the prevalence of anxiety disorders and TMD in workers of the Tucapel Family Health Center (CESFAM), Barrio Norte, in Concepción’s commune. Of the 97 staff, 79 agreed to take part voluntarily of the study, all of these people also work directly with patients at a sector with numerous socioeconomic and employment problems. A survey aimed toward the inquiry of psychological, TMD (signs and symptoms) and extra-intra oral complementary examination, was conducted. Anxiety disorders and burnout associated conditions were found (81 and 27.8 percent respectively), multifactorial TMD was also reported (98.7 percent) but present in all individuals with anxiety disorders and conditions associated to burnout.

[Psychiatric evaluation of patients with recurrent aphthous ulceration referred to oral disease department of Mashhad dental school-Iran [2006-2007]]

Recurrent aphthous ulcers [RAS] are one of the most common painful diseases affecting the oral mucosa. The psychological-emotional factors should be considered as predisposing factors. However, the association between psychiatric disorders and RAS has not been fully investigated in Iranian population. The purpose of this study was to determine the type and frequency of psychological disorders in patients with aphthous ulceration. Thirty five subjects of 50 patients suffering from RAS referred to oral medicine department of Mashhad dental school, were enrolled for this study. Demographic data and medical history as well as the number and type of the recurrent ulcers were obtained. The records of SCL9O questionnaire and interviews were analyzed by psychiatrist. Data obtained by personality evaluation and also the frequency of psychopathologic disease according to age, sex and duration of ulcers were described in tables and charts. 65.7% of 35 subjects were female; the average age range was 21-30 years. 74.3% of patients had psychiatric disorders and the others were normal. The most common psychiatric disorder was concurrent minor depression and anxiety. Psychiatric disorders were most common among women. The current study revealed that majority of patients with aphthous ulcers have some kinds of psychiatric disorders especially anxiety, depression and obsession compulsion. The results of this study proposed that all the medical staff should consider psychological disorders as etiologic factors for aphthous ulcers during their work up and treatment