Quality of Life and Depression Conditions of Women with Gestational Diabetes during Pregnancy and Postpartum Period / Qualidade de vida e condições de depressão em mulheres com diabetes gestacional durante a gravidez e o período pós-parto

Abstract Objective The study was conducted to determine the quality of life and depression of women with gestational diabetes during pregnancy and the postpartum period. Methods 100 pregnant women with gestational diabetes and 100 healthy pregnant women were included in the present study. Data were obtained from pregnant women in their third trimester who agreed to take part in the study. The data was collected during the third trimester and six to eight weeks after the baby was born. The data were obtained by socio-demographic characteristics form, postpartum data collection form, the MOS 36 Item Short Form Health Survey and Center for Epidemiologic Studies Depression Scale (CESD). Results The mean age of pregnant women with gestational diabetes in the study was the same as the average age of healthy pregnant women. The CESD score of pregnant women with gestational diabetes was 26,77 ± 4,85 while the corresponding score was 25,19 ± 4,43 for healthy women. Additionally, the score in the postpartum period was 32.47 ± 5.94 for pregnant women with gestational diabetes and 35.47 ± 8.33 for healthy pregnant women. CESD scores were found to be higher than the cut-off score of 16 in both groups, and the mean scores increased during the postpartum period. Conclusion During the postpartum period, the quality of life of pregnant women with gestational diabetes was affected more negatively than healthy pregnant women. Depressive symptoms of women with both gestational diabetes and healthy pregnancy were found to be high in pregnancy and postpartum periods.

Resumo Objetivo O estudo foi realizado para determinar a qualidade de vida e depressão de mulheres com diabetes gestacional durante a gravidez e período pós-parto. Métodos 100 gestantes com diabetes gestacional e 100 gestantes saudáveis incluídas no presente estudo. Os dados foram obtidos de mulheres grávidas no terceiro trimestre que concordaram em participar do estudo. Os dados foram coletados durante o terceiro trimestre e seis a oito semanas após o nascimento do bebê. Os dados foram obtidos por meio do formulário de características sociodemográficas formulário de coleta de dados pós-parto MOS 36 Item Short Form Health Survey e Center for Epidemiologic Studies Depression Scale (CESD). Resultados A idade média das gestantes com diabetes gestacional no estudo foi igual à idade média das gestantes saudáveis. O escore CESD de gestantes com diabetes gestacional foi de 26 77 ± 4 85 enquanto o escore correspondente foi de 25 19 ± 4 43 para mulheres saudáveis. Além disso o escore no pós-parto foi de 32 47 ± 5 94 para gestantes com diabetes gestacional e 35 47 ± 8 33 para gestantes saudáveis. Os escores do CESD foram maiores do que o ponto de corte de 16 em ambos os grupos e os escores médios aumentaram durante o período pós-parto. Conclusão Durante o período pós-parto a qualidade de vida de gestantes com diabetes gestacional foi mais afetada negativamente do que gestantes saudáveis. Os sintomas depressivos de mulheres com diabetes gestacional e gravidez saudável foram elevados na gravidez e nos períodos pós-parto.

Análise do nível de atividade física, depressão, ansiedade e estresse segundo o sexo em adolescentes escolares: estudo transversal / Analysis of the physical activity level, depression, anxiety and stress according to sex in adolescent students: cross-sectional study / Análisis del nivel de actividad física, depresión, ansiedad y estrés según sexo en estudiantes adolescentes: estudio transversal

Objetivo: comparar o nível de atividade física e sintomas de depressão, ansiedade e estresse segundo o sexo em adolescentes escolares. Métodos: estudo transversal com estudantes do ensino médio de escolas públicas. Utilizou-se na coleta de dados: Questionário sociodemográfico e de estilo de vida, Questionário Internacional de Atividade Física (IPAQ) e Escala de Depressão, Ansiedade e Estresse para Adolescentes (EDAE-A). Testes qui-quadrado de Pearson ou exato de Fisher e o Modelo Linear Generalizado Univariado foram utilizados na análise. Resultados: participaram 516 adolescentes, 214 do sexo masculino e 302 do feminino. Ambos os sexos apresentam prática de atividades físicas menor que o recomendado para adolescentes. Participantes do sexo masculino apresentam maior prática de atividade física fora da escola em comparação aos do sexo feminino, predominando o futebol (33,0%). Participantes do sexo feminino apresentaram maior gravidade dos níveis de depressão (p = 0,002), ansiedade (p = 0,013) e estresse (p = 0,004) em comparação aos do sexo masculino (d de Cohen fraco). Conclusão: não há diferença do nível de atividade física em adolescentes escolares segundo o sexo.Adolescentes do sexo masculino apresentam maior prática de atividades físicas fora da escola, e adolescentes do sexo feminino apresentam maior gravidade dos níveis de depressão, ansiedade e estresse.

Objective: to compare the level of physical activity and symptoms of depression, anxiety and stress according to sex in school adolescents. Methods: cross-sectional study with students from public high schools. For data collection were used: Sociodemographic and lifestyle questionnaire, International Physical Activity Questionnaire (IPAQ) and Depression Anxiety Stress Scale for Youth (DASS-Y). Pearson's chi-square or Fisher's exact tests and the univariate General Linear Model were used in the analysis. Results:participation of 516 adolescents, 214 male and 302 female adolescents. Both sexes present less physical activity practice than that recommended for adolescents. Male participants have a greater practice of physical activity outside of school compared to female adolescents, predominantly soccer (33.0%). Female participants had more severe levels of depression (p = 0.002), anxiety (p = 0.013) and stress (p = 0.004) compared to male adolescents (weak Cohen's d). Conclusion: there is no difference in the level of physical activity in school adolescents according to sex. Male adolescents present greater practice of physical activities outside of school. Female adolescents present higher levels of depression, anxiety and stress.

Objetivo: comparar el nivel de actividad física y síntomas de depresión, ansiedad y estrés según sexo en adolescentes escolares. Métodos: estudio transversal con estudiantes de escuelas secundarias públicas. Para la recolección de datos se utilizaron: Cuestionario Sociodemográfico y de Estilo de Vida, Cuestionario Internacional de Actividad Física (IPAQ) y Escala de Depresión, Ansiedad y Estrés para Adolescentes (EDAE-A). En el análisis se utilizaron las pruebas chi-cuadrado de Pearson o exacta de Fisher y el Modelo Lineal General Univariado. Resultados: participación de 516 adolescentes, 214 hombres y 302 mujeres. Ambos sexos presentan una menor práctica de actividad física que la recomendada para los adolescentes. Los participantes del sexo masculino tienen una mayor práctica de actividad física extraescolar en comparación con las adolescentes del sexo femenino, predominando el fútbol (33,0%). Las mujeres participantes tenían niveles más severos de depresión (p = 0,002), ansiedad (p = 0,013) y estrés (p = 0,004) en comparación con los hombres (d de Cohen pequeña). Conclusión: no existe diferencia en el nivel de actividad física en adolescentes escolares según el sexo. Los adolescentes hombres presentan mayor práctica de actividades físicas fuera de la escuela. Las adolescentes mujeres presentan mayores niveles de depresión, ansiedad y estrés.

Benefits of Mindfulness Training on the Mental Health of Women During Pregnancy and Early Motherhood: A Randomized Controlled Trial / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to evaluate the effects of a mindfulness-based psychosomatic intervention on depression, anxiety, fear of childbirth (FOC), and life satisfaction of pregnant women in China.@*METHODS@#Women experiencing first-time pregnancy ( n = 104) were randomly allocated to the intervention group or a parallel active control group. We collected data at baseline (T0), post-intervention (T1), 3 days after delivery (T2), and 42 days after delivery (T3). The participants completed questionnaires for the assessment of the levels of depression, anxiety, FOC, life satisfaction, and mindfulness. Differences between the two groups and changes within the same group were analyzed at four time points using repeated-measures analysis of variance.@*RESULTS@#Compared with the active control group, the intervention group reported lower depression levels at T2 ( P = 0.038) and T3 ( P = 0.013); reduced anxiety at T1 ( P = 0.001) and T2 ( P = 0.003); reduced FOC at T1 ( P < 0.001) and T2 ( P = 0.04); increased life satisfaction at T1 ( P < 0.001) and T3 ( P = 0.015); and increased mindfulness at T1 ( P = 0.01) and T2 ( P = 0.006).@*CONCLUSION@#The mindfulness-based psychosomatic intervention effectively increased life satisfaction and reduced perinatal depression, anxiety, and FOC.

PrÚ-natal psicol?gico na prevenšNo de depressNo perinatal e ansiedade / Psychological prenatal in the prevention of perinatal depression and anxiety / PsicologÝa prenatal en la prevenci?n de la depresi?n y la ansiedad perinatales

Este estudo objetivou investigar os efeitos da implementašNo de um programa de prÚ-natal psicol?gico (PROM+E) na prevenšNo de sintomatologia depressiva e ansiosa, com base na terapia cognitivo-comportamental, em 60 gestantes atendidas em servišos obstÚtricos p?blicos ou privados, com idades entre 18 e 44 anos (M = 28,77; DP = 7,18 ), alocadas em dois grupos: intervenšNo (n = 27) e controle (n = 33). O primeiro participou de nove encontros semanais, em grupo, alÚm de uma visita domiciliar no inÝcio do puerpÚrio. Na comparašNo intergrupo, as participantes do PROM+E apresentaram redušNo significativa dos sintomas ansiosos e depressivos quando comparadas ao grupo controle, aos 30 dias do puerpÚrio. Na comparašNo intragrupo, no PROM+E esses sintomas diminuÝram com o tempo, com significÔncia aos 30 e 90 dias p?s-parto.

This study aimed to investigate the effects of the implementation of a psychological prenatal program (PROM+E) on the prevention of depressive and anxious symptoms in 60 pregnant women who attended public or private obstetric services, aged between 18 and 44 years old (M = 28,77; DP = 7,18), allocated in two groups: intervention (n = 27) and control (n = 33). The first group participated in nine weekly group meetings, as well as a home visit at the beginning of the postpartum period. In the intergroup comparison, the PROM+E participants had a significant reduction in anxious and depressive symptoms compared to the control group at 30 days of puerperium. In the intragroup comparison, in the PROM+E these symptoms decreased with time, with significance at 30 and 90 days postpartum.

Este estudio tuvo como objetivo investigar los efectos de la implementaci?n de un programa prenatal psicol?gico en terapia cognitivo-comportamental (PROM+E) en la prevenci?n de sÝntomas depresivos y ansiosos en 60 mujeres embarazadas atendidas en servicios obstÚtricos p?blicos o privados, con edades entre los 18 y 44 a?os (M = 28,77; DP = 7,18 ), asignadas en dos grupos: intervenci?n (n = 27) y control (n = 33). El primer grupo particip? en nueve reuniones de grupo semanales, asÝ como en una visita a domicilio al principio del periodo posparto. En la comparaci?n intergrupal, las participantes del PROM+E tuvieron una reducci?n significativa de los sÝntomas ansiosos y depresivos en comparaci?n con el grupo de control a los 30 dÝas del puerperio. En la comparaci?n intragrupo, en el PROM+E estos sÝntomas disminuyeron con el tiempo, con significaci?n a los 30 y 90 dÝas del puerperio.

Cannabidiol prevents depressive-like behaviors through the modulation of neural stem cell differentiation / 医学前沿

Chronic stress impairs radial neural stem cell (rNSC) differentiation and adult hippocampal neurogenesis (AHN), whereas promoting AHN can increase stress resilience against depression. Therefore, investigating the mechanism of neural differentiation and AHN is of great importance for developing antidepressant drugs. The nonpsychoactive phytocannabinoid cannabidiol (CBD) has been shown to be effective against depression. However, whether CBD can modulate rNSC differentiation and hippocampal neurogenesis is unknown. Here, by using the chronic restraint stress (CRS) mouse model, we showed that hippocampal rNSCs mostly differentiated into astrocytes under stress conditions. Moreover, transcriptome analysis revealed that the FoxO signaling pathway was involved in the regulation of this process. The administration of CBD rescued depressive-like symptoms in CRS mice and prevented rNSCs overactivation and differentiation into astrocyte, which was partly mediated by the modulation of the FoxO signaling pathway. These results revealed a previously unknown neural mechanism for neural differentiation and AHN in depression and provided mechanistic insights into the antidepressive effects of CBD.

Prática de lazer em adolescentes e fatores associados: implicações para o cuidado / Práctica de actividades recreativas en adolescentes y factores asociados: consecuencias para el cuidado / Leisure practice in adolescents and associated factors: implications for care

Resumo Objetivo Relacionar a realização de práticas de atividades de lazer com qualidade de vida, bem-estar subjetivo, ansiedade e depressão em adolescentes. Métodos Estudo quantitativo, transversal analítico, desenvolvido com 272 adolescentes do ensino médio de três escolas públicas estaduais de uma capital da região centro-oeste. A coleta de dados ocorreu no mês de maio de 2019, mediante autoaplicação de quatro instrumentos: escala de bem-estar subjetivo, escala hospitalar de ansiedade e depressão, questionário de qualidade de vida kidscren-52 e questionário sociodemográfico. A associação entre as variáveis independentes foi verificada por meio do teste t-student e qui-quadrado de fischer. Resultados Quase a metade dos adolescentes (49,6%) realizava alguma atividade de lazer, e nestes foi verificado escores mais baixo para depressão (p=0,008), mais alto nos afetos positivos do bem-estar subjetivo (p=<0,001), e para algumas dimensões da qualidade de vida, tais como saúde e atividade física (p=<0,001), sentimentos (p=0,0046), estado emocional (p=0,033), autonomia e tempo livre (p=0,007), aspecto financeiro (p=0,001) e amigos e apoio social (p=0,002). Não houve associação significante entre a prática de atividade de lazer com os escores de ansiedade, afetos negativos e satisfação com a vida. Conclusão A prática de atividades de lazer por adolescentes é baixa e associa-se a menores escores para depressão e escores mais altos para algumas dimensões da qualidade de vida e bem-estar subjetivo.

Resumen Objetivo Relacionar la práctica de actividades recreativas con calidad de vida, bienestar subjetivo, ansiedad y depresión en adolescentes. Métodos Estudio cuantitativo, transversal analítico, llevado a cabo con 272 adolescentes de tres escuelas secundarias públicas regionales de una capital de la región centro-oeste. La recopilación de datos se realizó en el mes de mayo de 2019, mediante la autoaplicación de cuatro instrumentos: escala de bienestar subjetivo, escala hospitalaria de ansiedad y depresión, cuestionario de calidad de vida KIDSCREEN-52 y cuestionario sociodemográfico. La asociación entre las variables independientes se verificó a través del test-T student y ji cuadrado de Fischer. Resultados Casi la mitad de los adolescentes (49,6 %) realizaba alguna actividad recreativa, en los que se verificó puntuación más baja de depresión (p=0,008), más alta en los afectos positivos de bienestar social subjetivo (p=<0,001), y en algunas dimensiones de calidad de vida, tales como salud y actividad física (p=<0,001), sentimientos (p=0,0046), estado emocional (p=0,033), autonomía y tiempo libre (p=0,007), aspecto financiero (p=0,001) y amigos y apoyo social (p=0,002). No hubo relación significativa entre la práctica de actividades recreativas y la puntuación de ansiedad, afectos negativos y satisfacción con la vida. Conclusión La práctica de actividades recreativas de adolescentes es baja y se relaciona con una menor puntuación de depresión y una mayor puntuación en algunas dimensiones de la calidad de vida y el bienestar subjetivo.

Abstract Objective To relate the performance of leisure activity practices with quality of life, subjective well-being, anxiety, and depression in adolescents. Methods This is a quantitative, cross-sectional, analytical study, developed with 272 high school adolescents from three public schools in a center-western capital. Data collection occurred in May 2019 through self-application of four instruments: subjective well-being scale, hospital anxiety and depression scale, kidscren-52 quality of life questionnaire and sociodemographic questionnaire. The association among the independent variables was verified by Student's t-test and Fischer's chi-square test. Results Almost half of adolescents (49.6%) performed some leisure activity and it was verified lower scores for depression (p=0.008), higher in the positive affects of subjective well-being (p=<0.001), and for some dimensions of quality of life, such as health and physical activity (p=<0.001), feelings (p=0.0046), emotional status (p=0.033), autonomy and free time (p=0.007), financial aspect (p=0.001) and friends and social support (p=0.002). There was no significant association between leisure activity and anxiety scores, negative affects and life satisfaction. Conclusion The practice of leisure activities by adolescents is low and is associated with lower scores for depression and higher scores for some dimensions of quality of life and subjective well-being.

Prevalencia de depresión durante la COVID-19 en estudiantes de medicina de una universidad privada mexicana / Prevalence of depression during the COVID-19 in medicine students from a private Mexican university

Introducción: Durante la pandemia de COVID-19 las autoridades sanitarias tomaron medidas de confinamiento e implementaron actividades educativas a distancia. Estos cambios, aunados al aislamiento social, han provocado alteraciones mentales, como la depresión, en los estudiantes de medicina. Objetivo: Determinar la prevalencia de depresión durante la COVID-19 en estudiantes de medicina de una universidad privada de México. Métodos: Se realizó un estudio descriptivo, cuantitativo, transversal y no experimental, en febrero de 2021, de 278 alumnos de cuarto, sexto y octavo semestres de la Universidad Xochicalco, campus Mexicali, Baja California, de México. Se utilizó la escala de Zung como instrumento para medir la depresión y para el análisis estadístico se emplearon medidas de tendencia central y de dispersión; mientras que para la diferencia de variables nominales la prueba de X². Resultados: El promedio de edad fue de 20,80 años, con predominio del sexo femenino (61,7 %) y una prevalencia de depresión de 17,0 % (depresión ligera), principalmente en los estudiantes del cuarto semestre. Por su parte, 31,6 % de los alumnos presentaron COVID-19; en tanto, 85,2 % tuvo algún familiar contagiado y 25,5 % de ellos, familiares fallecidos. Conclusiones: Existe ligera depresión en los estudiantes del mencionado centro universitario, por lo cual el personal del Departamento de Psicología ha tenido que adaptarse a esta nueva normalidad para poder brindarles todo el apoyo que requieren en estos tiempos de pandemia y confinamiento, de ahí que se impone un mejor conocimiento sobre las afectaciones mentales para incidir en su prevención y en el tratamiento adecuado.

Introduction: During the pandemic of COVID-19 health authorities took confinement measures and implemented distance educational activities. These changes, along with the social isolation, have caused mental disorders, as depression, in medicine students. Objective: To determine the prevalence of depression during COVID-19 in medicine students from a private university of Mexico. Methods: A descriptive, quantitative, cross-sectional and non experimental study of 278 students from fourth, sixth and eighth semesters from the University Xochicalco, campus Mexicali, Baja California, Mexico, was carried out on February, 2021. The Zung scale was used as instrument to measure the depression and for the statistical analysis measures of central tendency and dispersion were used; while for the difference of nominal variables the chi-squared test was used. Results: The average age was 20.84 ± 1.74 years, with prevalence of the female sex (61.7 %) and a prevalence of depression at 17.0 % (mild depression), mainly in the students from fourth semester. On the other hand, 31.6 % of the students presented COVID-19; as long as, 85.2 % had some relative with the disease and 25.5 of them, had dead relatives. Conclusions: There is mild depression in the students from the university center abovementioned, reason why the Psychology Department staff has had to adapt to this new normality to be able to offer them the whole support required in these times of pandemic and confinement, so a better knowledge on the mental disorders to impact in its prevention and in the appropriate treatment is imposed.

The Effect of Psychotherapy on Anxiety, Depression, and Quality of Life of Patients with Heart Failure: A Randomized Clinical Trial

Abstract Background Patients with heart failure often experience depression, anxiety, and impacts on quality of life. Psychotherapeutic interventions have been used for chronic conditions, including cardiovascular diseases, showing improvement in mental health. However, no studies have assessed the effects of a psychological intervention using psychoanalysis on patients with heart failure. Objective To assess the effect of short-term psychotherapy on depressive symptoms, anxiety, and quality of life of patients seen at a specialty clinic. Method A randomized clinical trial with scales to assess outcomes before and after psychotherapy, under the perspective of psychoanalysis, with 12 weekly sessions. The Beck Depression Inventory, the Beck Anxiety Inventory, and the Minnesota Living with Heart Failure Questionnaire were used. The mean initial and final scores for quality of life, anxiety, and depression were compared using Student's t-test for independent samples when distribution was normal, or Mann-Whitney test when distribution was non-normal. A bivariate p-value < 0.05 was considered statistically significant for all analyses. Results This study involved 32 patients, 50% were female, mean age was 64.3±11.6, and most participants were New York Heart Association (NYHA) functional class I (56.3%). For anxiety (p = 0.196), there was no statistically significant difference between groups. For quality of life and depression, there was a statistical difference (p = 0.009 and 0.035, respectively), with a medium effect (Cohen's d = 0.593) on quality of life. Conclusion Short-term psychotherapy in outpatients with heart failure showed an impact on depression and quality of life but did not improve anxiety. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Prevalência, severidade e fatores associados à depressão em estudantes universitários / Prevalence, severity and factors associated with depression in university students / Prevalencia, severidad y factores asociados a la depresión en estudiantes universitarios

OBJETIVO: identificar a prevalência, a severidade e os fatores associados à depressão entre estudantes universitários no Distrito Federal. MÉTODO: estudo transversal realizado com 521 estudantes universitários, com idade entre 18 e 60 anos. Os sintomas depressivos foram avaliados através da escala Patient Health Questionnaire-9 (PHQ-9). Utilizou-se estatística descritiva e o teste do qui-quadrado. RESULTADOS: dentre os 521 indivíduos estudados, houve predomínio do sexo feminino. A prevalência de sintomas depressivos foi de 521 (96,6%) estudantes universitários, sendo 31,3% com depressão suave, 23,4%, depressão mínima, 13,1% depressão moderadamente grave, 9,6% depressão grave e 9,2% depressão moderada. A renda familiar e o semestre cursado são fatores associados para a severidade da depressão. CONCLUSÃO: a prevalência da depressão no ambiente universitário é comum, sendo uma proporção alta e preocupante. É crucial o rastreamento da depressão, sua severidade e seus fatores associados, a fim de estimular reflexão sobre a temática e pensar em estratégias de intervenção para a prevenção e promoção da saúde mental.

OBJECTIVE: to identify the prevalence, severity and factors associated with depression among university students in the Federal District. METHOD: a cross-sectional study carried out with 521 university students, aged between 18 and 60 years old. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. Descriptive statistics and the chi-square test were used. RESULTS: among the 521 individuals studied, there was predominance of females. The prevalence of depressive symptoms was 521 (96.6%) university students; 31.3% with mild depression; 23.4%, minimal depression, 13.1%, moderately severe depression; 9.6%, severe depression; and 9.2%, moderate depression. Family income and the semester attended are associated factors for the severity of depression. CONCLUSION: the prevalence of depression in the university environment is common, being at a high and worrying proportion. It is crucial to track depression, its severity and its associated factors, in order to stimulate reflection on the theme and to think of intervention strategies for the prevention and promotion of mental health.

OBJETIVO: identificar la prevalencia, la gravedad y los factores asociados a la depresión entre los estudiantes universitarios del Distrito Federal. MÉTODO: estudio transversal realizado con 521 estudiantes universitarios, con edades comprendidas entre 18 y 60 años. Los síntomas depresivos se evaluaron mediante la escala del Patient Health Questionnaire-9 (PHQ-9). Se utilizó estadística descriptiva y la prueba de chi-cuadrado. RESULTADOS: Entre los 521 individuos estudiados, predominó el sexo femenino. La prevalencia de síntomas depresivos fue de 521 (96.6%) estudiantes universitarios, 31.3% con depresión leve, 23.4%, depresión mínima, 13.1% depresión moderadamente severa, 9.6% depresión severa y 9, 2% de depresión moderada. Los ingresos familiares y el semestre asistido son factores asociados para la gravedad de la depresión. CONCLUSIÓN: la prevalencia de depresión en el entorno universitario es común, siendo una proporción alta y preocupante. Es crucial rastrear la depresión, su gravedad y sus factores asociados, para estimular la reflexión sobre el tema y pensar en estrategias de intervención para la prevención y promoción de la salud mental.

WeChat-based education and rehabilitation program in unprotected left main coronary artery disease patients after coronary artery bypass grafting: an effective approach in reducing anxiety, depression, loss to follow-up, and improving quality of life

This study aimed to investigate the effect of WeChat-based education and rehabilitation program (WERP) on anxiety, depression, health-related quality of life (HRQoL), major adverse cardiac/cerebrovascular events (MACCE)-free survival, and loss to follow-up rate in unprotected left main coronary artery disease (ULMCAD) patients after coronary artery bypass grafting (CABG). In this randomized controlled study, 140 ULMCAD patients who underwent CABG were randomly assigned to WERP group (n=70) or control care (CC) group (n=70). During the 12-month intervention period, anxiety and depression (using hospital anxiety and depression scale (HADS)) and HRQoL (using 12-Item Short-Form Health Survey (SF-12)) were assessed longitudinally. During the total 36-month follow-up period (12-month intervention and 24-month non-intervention periods), MACCE and loss to follow-up were recorded. During the intervention period, HADS-anxiety score at month 9 (M9) (P=0.047) and month 12 (M12) (P=0.034), anxiety rate at M12 (P=0.028), and HADS-D score at M12 (P=0.048) were all reduced in WERP group compared with CC group. As for HRQoL, SF-12 physical component summary score at M9 (P=0.020) and M12 (P=0.010) and SF-12 mental component summary score at M9 (P=0.040) and M12 (P=0.028) were all increased in WERP group compared with CC group. During the total follow-up period, WERP group displayed a trend of longer MACCE-free survival than that in CC group but without statistical significance (P=0.195). Additionally, loss to follow-up rate was attenuated in WERP group compared with CC group (P=0.033). WERP serves as an effective approach in optimizing mental health care and promoting life quality in ULMCAD patients after CABG.

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain

Current first-line treatments for major depressive disorder (MDD) include pharmacotherapy and cognitive-behavioral therapy. However, one-third of depressed patients do not achieve remission after multiple medication trials, and psychotherapy can be costly and time-consuming. Although non-implantable neuromodulation (NIN) techniques such as transcranial magnetic stimulation, transcranial direct current stimulation, electroconvulsive therapy, and magnetic seizure therapy are gaining momentum for treating MDD, the efficacy of non-convulsive techniques is still modest, whereas use of convulsive modalities is limited by their cognitive side effects. In this context, we propose that NIN techniques could benefit from a precision-oriented approach. In this review, we discuss the challenges and opportunities in implementing such a framework, focusing on enhancing NIN effects via a combination of individualized cognitive interventions, using closed-loop approaches, identifying multimodal biomarkers, using computer electric field modeling to guide targeting and quantify dosage, and using machine learning algorithms to integrate data collected at multiple biological levels and identify clinical responders. Though promising, this framework is currently limited, as previous studies have employed small samples and did not sufficiently explore pathophysiological mechanisms associated with NIN response and side effects. Moreover, cost-effectiveness analyses have not been performed. Nevertheless, further advancements in clinical trials of NIN could shift the field toward a more "precision-oriented" practice.

Intervención de enfermería para disminuir la depresión en pacientes con diálisis peritoneal en un hospital de Veracruz / Nursing intervention to reduce depression in patients with peritoneal dialysis in a Veracruz hospital

Introducción: la depresión en personas con enfermedad renal crónica (ERC) tiene efectos en el cumplimiento y aceptación del régimen terapéutico empleado. Objetivo: evaluar la eficacia de una intervención psicoeducativa de enfermería en la disminución de los síntomas de depresión en pacientes adscritos al Programa de Diálisis Peritoneal del Hospital General de Zona No.32 de Minatitlán, Veracruz. Metodología: estudio cuasi experimental; la muestra se integró con 8 pacientes y el muestreo se estableció por conveniencia. Se utilizó el inventario de depresión de Beck II y se aplicó una intervención de enfermería. Resultados: participaron más mujeres (75%), con 50% que utiliza DPA y 50% DPCA. La depresión mínima (37.5%) y la depresión leve (37.5%) predominaron antes de la intervención; luego de la intervención predominó el grado de depresión mínima (87.5%). La media fue de 14.88 en la prueba preliminar y 5.88 en la posterior (p = 0.007). Conclusiones: la intervención de enfermería mostró eficacia al disminuir los grados de depresión en los pacientes con ERC.

Introduction: Depression in a person with chronic kidney disease (CKD), has an impact on the fulfillment and acceptance of the therapeutic regimen used. Objective: To evaluate the efficacy of a psychoeducational nursing intervention to reduce depression symptoms in patients assigned to the peritoneal dialysis program of the General Hospital of Zone No.32 of Minatitlán, Ver. Methods: Quasi-experimental, study. Sample was 8 patients. Sampling was by Convenience. The Beck-II Depression Inventory was used; a nursing psychoeducational intervention was applied. Results: Most of the participants were women (75%); 50% uses DPA and 50% DPCA. Minimum depression (37.5%) and mild depression (37.5%) predominated before the intervention; after intervention, the minimum depression level predominated (87.5%). The average in the Pretest was 14.88 and 5.88 in the Posttest (p = .007). Conclusion: The nursing psychoeducational intervention showed efficacy to decrease depression levels in the group of CKD patients studied.

Validação do diagnóstico autodeclarado de depressão em participantes da Coorte de Universidades Mineiras (Projeto CUME) / Validation of the self-reported diagnosis of depression in participants of the Cohort of Universities of Minas Gerais (CUME Project)

Introdução: A depressão é um importante problema de saúde pública, sendo considerada a principal causa de incapacidade globalmente. A prevalência desta doença, em 2015, foi estimada em 4,4%, correspondendo a 322 milhões de casos em todo mundo. No Brasil, estima-se que 5,8% da população tenha depressão. Além da incapacidade provocada pela doença, ela está associada à maior ocorrência de suicídio e também é fator de risco para o desenvolvimento de doenças crônicas não transmissíveis. Nesse contexto, a Coorte de Universidades Mineiras (CUME) tem, dentre um dos seus objetivos, avaliar a relação da depressão com hábitos de vida e desfechos crônicos de saúde em egressos de universidades federais do Estado de Minas Gerais. Entretanto, o diagnóstico de depressão tem sido autodeclarado pelos participantes, necessitando ser validado para melhoria da qualidade das evidências científicas produzidas pelo referido projeto. Objetivo: Validar o diagnóstico autodeclarado de depressão de participantes do projeto CUME. Métodos: Participaram deste estudo transversal, 79 pessoas que responderam ao primeiro questionário de seguimento do projeto, entre março e agosto de 2018 (43 com e 36 sem o autorrelato de depressão). Uma equipe de quatro psiquiatras aplicou o DSM5, utilizando como referência a entrevista clínica estruturada para os transtornos mentais (SCID-5-CV), em consulta presencial dos participantes entre outubro e novembro de 2019. Foram calculados o percentual de concordância, sensibilidade, especificidade, valor preditivo positivo (VPP) e valor preditivo negativo (VPN) entre os diagnósticos autodeclarado de depressão e aquele confirmado pelo psiquiatra, além da aplicação do teste Kappa. Também, avaliou-se os percentuais de falsos positivos e negativos produzidos pelo diagnóstico autodeclarado em relação àquele diagnosticado pelo psiquiatra. Resultados: A maioria dos participantes era do sexo feminino (82,3%), adulto jovem (60,8% entre 20 e 39 anos), sem união estável (54,4%), com pós-graduação (75,9%) e trabalhadores em atividade (72,2%), não fumantes (69,6%), inativos/insuficientemente ativos (69,6%). Ainda, altas proporções dos participantes referiram consumo pesado episódico de bebidas alcoólicas (36,7%) e ingestão inadequada de carboidratos (50,6%) e de lipídios (78,5%). Não houve diferenças estatísticas para as variáveis de acordo com o autorrelato ou não de depressão. A concordância entre os diagnósticos de depressão foi de 81,0%, com sensibilidade de 80,6%, especificidade de 81,4%, VPP de 78,4%, VPN de 83,3% e valor Kappa de 0,62. Adicionalmente, foram observados 18,6% e 19,4%, respectivamente, de falsos positivos e de falsos negativos. Conclusão: O diagnóstico autodeclarado de depressão pelos participantes do projeto CUME apresenta boa acurácia, sendo válido para utilização em estudos sobre esse desfecho em saúde nesta população.

Introduction: Depression is an important public health problem, being globally considered to be the main cause of incapability. The prevalence of this disease, in 2015, was estimated in 4.4%, corresponding to 322 million cases all around the world. In Brazil, it is estimated that 5.8% of the population suffer from depression. Besides the incapability caused by the disease, it is associated with a greater occurrence of suicide and it is also a risk factor for the development of noncommunicable diseases. In this context, the Cohort of Universities of Minas Gerais (CUME) has, as one of its objectives, to evaluate the relationship between depression, lifestyle and chronic health outcomes in federal university graduates in the state of Minas Gerais. However, the depression diagnoses have been selfdeclared by the participants, making it necessary to be validated in order to increase the quality of the scientific evidences produced by that project. Objective: To validate the self-declared diagnoses of depression given by participants in the CUME project. Methods: In this cross-sectional study, were included 79 participants who answered to the project's follow-up questionnaire, between March and August of 2018 (43 with and 36 without self-report depression). A team of four psychiatrists applied the DSM5, using the structured clinical interview for mental disorders (SCID-5-CV) as a reference, during appointments in person with the participants between October and November of 2019. The percentage of agreement, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) have been calculated between the self-reported depression diagnoses and those confirmed by the psychiatrists, besides the Kappa test application. The percentage of false positives and false negatives produced by the self-reported diagnoses in relation to those given by the psychiatrists has also been calculated. Results: The majority of the participants were female (82.3%), young adult (60.8% between 20 and 39 years of age), with no common-law marriage (54%), with postgraduate studies (75.9%) and currently employed (72.2%), non-smokers (69.6%), sedentary/insufficiently physically active (69.6%). In addition, high proportions of participants reported binge drinking (36.7%) and inadequate ingestion of carbohydrates (50.6%) and lipids (78.5%). There were no statistical differences for variables according to self-report of depression or non-depression. The agreement between the diagnose of depression was 81.0% with sensitivity of 80.6%, specificity of 81.4%, PPV of 78,4%, NPV of 83,3% and Kappa value of 0.62. Additionally, 18.6% and 19.4% of false positive and false negative were observed, respectively. Conclusion: The depression diagnoses self-declared by the participants of the CUME project presents good accuracy, being valid for utilization in studies about this health outcome in this population.

Noise and sleep quality: study among physical education instructors / Ruído e qualidade do sono: estudo entre instrutores de educação física

ABSTRACT This study ivestigated the association between noise and impaired sleep quality in 150 physical education instructors, in bodybuilding gyms. Two questionnaires were applied: evaluation of subjective sleep quality and analysis of explanatory variables. Noise exposure was analyzed. For the data analysis, was used the technique of non-conditional logistic regression, to obtain the values of the adjusted odds ratios (OR) of the significant variables. Two proper adjustment models stood out. The first model presented the significant variables: incorrect performance of the meals (OR = 2.58, 95% CI 1.08 to 6.02); skin color - black ou brown (OR = 0.53, 95% CI 0.25 to 1.12) and exposure to noise level above or equal to 80 dB(A) (OR = 1.90; 95% CI 0.87 to 4.12). The second model presented the significant variables: incorrect performance of the meals (OR = 2.35, 95% CI 0.1 to 5.56); exposure level standardized above or equal to 80 dB(A) (OR = 2.03, 95% CI 0.92 to 4.47) and use 0of drugs for depression/anxiety (OR = 0.26; 95% CI 0.53 to 1.33). This research identified the variables that were significantly associated with impaired sleep quality, as exposure to noise, contributing to the adoption of preventive measures.

RESUMO Este estudo investigou a associação entre ruído e qualidade prejudicada do sono em 150 instrutores de educação física, em academias de musculação. Dois questionários foram aplicados: avaliação da qualidade subjetiva do sono e sobre variáveis explanatórias. A exposição ao ruído foi avaliada. Para a análise dos dados, utilizou-se a técnica de regressão logística não-condicional, para obter os valores das Razões de Chances (RC) das variáveis significativas. Dois modelos finais se destacaram. O primeiro apresentou as variáveis significativas: realização incorreta das refeições (RC = 2,58, IC 95% 1,08 a 6,02); cor da pele - preta ou parda (RC = 0,53; IC 95% 0,25 a 1,12) e exposição ao ruído acima ou igual a 80 dB(A) (RC = 1,90; IC95% 0,87 a 4,12). O segundo modelo apresentou as variáveis significativas: realização incorreta das refeições (RC = 2,35, IC 95% 0,1 a 5,56); nível de exposição padronizado acima ou igual a 80 dB (A) (RC = 2,03, IC 95% 0,92 a 4,47) e uso de medicamentos para depressão/ansiedade (RC = 0,26; IC95% 0,53 a 1,33). Esta pesquisa identificou as variáveis que se associaram significativamente com a qualidade do sono prejudicada, como a exposição ao ruído, contribuindo para a adoção de medidas preventivas.

Moderate-Intensity Walking Training Improves Depressive Symptoms and Pain in Older Adults with Good Quality of Life: A Controlled Randomized Trial

Abstract Background: Walking training can be an adequate choice to improve physical and psychological conditions in the elderly. Studies have reported positive changes in the quality of life, depressive symptoms and pain. However, baseline characteristics of volunteers have been controlled, and some of previous studies have not investigated these parameters concomitantly. Objectives: To assess the effects of moderate-intensity walking on quality of life, depressive symptoms and physical pain in physically active elderly individuals. Methods: Sixty-nine subjects were recruited and allocated into two groups: training group (n = 40) and control group (n = 29). All were evaluated for quality of life, depressive symptoms and pain. Training group underwent 40 minutes of walking (50-70% of maximum heart rate), 3 days a week for 12 weeks. For statistical analysis, we used the Kolmogorov-Smirnov test, Student's t-test and Split-Plot ANOVA with Bonferroni post hoc, Pearson correlation. Significance level was set at 5%. Results: After 12 weeks of training, depressive symptoms and physical pain significantly reduced in the training group (2.7 ± 2.4 to 1.9 ± 1.8 and 4.3 ± 3.1 to 2.8 ± 2.9, respectively) compared with baseline values, and remained unchanged in the control group. There was a positive, moderate correlation between depressive symptoms and pain (r = 0.30). Conclusion: physically active elderly individuals with good quality of life show improved depressive symptoms after a short-term moderate-intensity walking training program.

Sintomas depressivos em mulheres com câncer de mama submetidas à quimioterapia e radioterapia: uma revisão integrativa / Depressive symptoms in women with breast cancer submitted to chemotherapy and radiotherapy - an integrating review / Sintomas depresivos en mujeres con cáncer de mama sometidas a la quimioterapia y radioterapia - una revisión integrativa

Objetivo: Identificar na literatura a ocorrência de depressão em mulheres com câncer de mama submetidas ao tratamento quimioterápico e radioterápico. Método: Tratou-se de uma revisão integrativa, utilizando os descritores: câncer de mama e depressão. Foram realizadas buscas nas bases de dados LILACS, SciELO e Pubmed, referente ao período de 2005 a 2018. Resultados: Após a aplicação dos critérios de inclusão e exclusão compuseram a pesquisa vinte e dois artigos. Observou-se que os sintomas depressivos foram comuns em mulheres com câncer de mama e submetidas aos tratamentos quimioterápicos e radioterápicos, variando de 51,5% a 95%. A prevalência de depressão maior variou de 1,78% a 12,40%, na literatura estudada. A depressão interferiu negativamente na adesão ao tratamento e na qualidade de vida dessas pacientes. Conclusão: O paciente oncológico precisa de apoio emocional prestado pela enfermagem e equipe multiprofissional, contribuindo para reduzir as complicações cognitivas, afetivas e comportamentais decorrentes do tratamento.(AU)

Objective: To identify in the literature the occurrence of depression in women with breast cancer submitted to chemotherapeutic and radiotherapeutic treatment. Method: This was an integrative review using the descriptors: breast cancer and depression. Were searched the LILACS, SciELO e Pubmed databases for the period 2005 to 2018. Results: After applying the inclusion and exclusion criteria, twenty-two articles were included in the study. It was observed that depressive symptoms were common in women with breast cancer and submitted to chemotherapeutic and radiotherapeutic treatments ranging from 51.5% to 95%. The prevalence of major depression ranged from 1.78% to 12.40% in the literature. Depression negatively interfered with treatment adherence and quality of life in these patients. Conclusion: The cancer patient needs emotional support provided by the nursing and multiprofessional team, contributing to reduce the cognitive, affective and behavioral complications resulting from the treatment.(AU)

Objetivo: Identificar en la literatura la ocurrencia de depresión en mujeres con cáncer de mama sometidas al tratamiento quimioterápico y radioterápico. Método: Se trata de una revisión integrativa, utilizando los descriptores: cáncer de mama y depresión. Se realizaron búsquedas en las bases de datos LILACS, SciELO e Pubmed, referente al período de 2005 a 2018. Resultados: Después de la aplicación de los criterios de inclusión y exclusión compusieron la investigación veintidós artículos. Se observó que los síntomas depresivos fueron comunes en mujeres con cáncer de mama y sometidas a los tratamientos quimioterápicos y radioterápicos, variando del 51,5% al 95%. La prevalencia de depresión mayor varió de 1,78% a 12,40%, en la literatura estudiada. La depresión interfirió negativamente en la adhesión al tratamiento y en la calidad de vida de esas pacientes. Conclusión: El paciente oncológico necesita apoyo emocional prestado por la enfermería y equipo multiprofesional, contribuyendo para reducir las complicaciones cognitivas, afectivas y comportamentales derivadas del tratamiento.(AU)

Psychometric properties of two adolescent depression scales in a colombian community sample: ADRS and RCADS -major depression / Propiedades psicométricas de dos escalas de depresión para adolescentes en una muestra comunitaria colombiana: ADRS y RCADS -depresión mayor

Abstract Depression can occur at all ages; however, when it begins early in life, prognosis is less favorable. Early identification and treatment provision need valid and reliable tools to assess depression in children and adolescents. The present study aimed at analyzing, in a Colombian community sample, the psychometric properties of two brief depression scales, using Classical Test Theory methods: The Adolescent Depression Rating Scale (ADRS) self-report version and the Revised Child Anxiety and Depression Scale (RCADS) - Major Depression Subscale. Analyses of both scales showed most item-scale and item-item correlations to be moderate and significant. Internal consistency was significant and adequate for both, ADRS (.67) and RCADS- Major Depression (.71). For ADRS, a two-factor solution explained 37.39% of variance while a one-single factor explained 25.99%. For RCADS-Major Depression, a two-factor solution explained 41.81% of variance while a one-single factor explained 29.14%. Construct validity was satisfactory, as both scales showed moderate and significant correlations with the convergent (RCADS-Generalized Anxiety) and the discriminant (KADS-11) criteria; yet, correlations with the former were stronger. Results provide further evidence in favor of the ADRS and the RCADS-Major Depression as effective tools to assess depressive symptoms in children and adolescents.

Resumen La depresión puede presentarse a cualquier edad; sin embargo, cuando ocurre en etapas tempranas de la vida el pronóstico es menos favorable. La identificación y el tratamiento tempranos necesitan herramientas válidas y confiables para evaluar la depresión en niños y adolescentes. El presente estudio analizó, en una muestra comunitaria colombiana, las propiedades psicométricas de dos escalas breves de depresión, utilizando métodos de la Teoría Clásica de los Test: Escala de Valoración de Depresión Adolescente (ADRS) versión de auto-reporte y la Escala de Ansiedad y Depresión Infantil Revisada (RCADS)- Subescala de Depresión Mayor. El análisis de las dos escalas mostró correlaciones ítem-ítem e ítemescala, moderadas y significativas. La consistencia interna fue significativa y adecuada para ambas escalas, ADRS (0.67) y RCADS-Depresión Mayor (0.71). Para ADRS, dos factores explicaron 37.39% de la varianza, mientras que la solución de un solo factor explicó 25.99% de la varianza. Para RCADS-Depresión Mayor, dos factores explicaron el 41.81% de varianza y un factor único explicó 29.14%. La validez de constructo fue satisfactoria, ambas escalas mostraron correlaciones moderadas y significativas con el criterio convergente (KADS-11) y el criterio discriminante (RCADS-Ansiedad Generalizada); aunque más fuertes en el primer caso. Los resultados evidencian que ADRS y RCADS-Depresión Mayor son herramientas efectivas para la valoración de síntomas depresivos en niños y adolescentes.

Fatores de adesão e permanência de idosos com diabetes tipo 2 a um programa de exercício físico / Factors influencing the initiation and continuation of physical exercise programs by elderly individuals with type 2 diabetes

Introdução: Grande parte dos idosos com diabetes tipo 2 não praticam exercício físico regular. Objetivos: Identificar os fatores que influenciam idosos com diabetes tipo 2 a praticarem exercícios físicos. Métodos: Trata-se de um estudo descritivo e analítico, transversal quantitativo. A amostra foi composta por 49 idosos, com diagnóstico de diabetes tipo 2. Foram aplicados questionários sobre adesão, permanência e desistência ao exercício e sintomas depressivos. Para análise dos dados foi calculado o alpha de Cronbach e foi realizada análise fatorial e correlação dos dados. Resultados: Os motivos para aderir a um programa de exercício físico foram indicação de amigos e familiares, intenção de melhorar a autoestima ou a autoimagem, indicação médica; e os motivos para permanecer ativo foram aliviar tensão, fazer amigos, desenvolver competências, queimar calorias, manter a flexibilidade. Conclusão: Os fatores extrínsecos são os que mais influenciaram idosos com diabetes mellitus tipo 2 a aderir a um programa de exercícios físico e a se manterem na prática.

Introduction: A great proportion of elderly people with type 2 diabetic do not regularly practice any type of physical exercise. Objectives: To identify factors that influence elderly people with type 2 diabetes to exercise. Methods: A descriptive and analytical cross-sectional quantitative study was conducted. The sample consisted of 49 elderly individuals diagnosed with type 2 diabetes. Questionnaires were applied regarding beginning, continuing and quitting exercise programs, as well as depressive symptoms. For the data analysis, Cronbach's alpha was calculated, and factor analysis and correlation of the data were performed. Results: The following reasons for beginning a physical exercise program were discovered: encouragement by friends and family, desire to improve self-esteem or self-image and medical referral. The reasons for staying active were to relieve tension, make friends, develop skills, obtain self-reward, burn calories and maintain flexibility. Conclusion: The results showed that extrinsic factors are the ones that most influence elderly people with type 2 diabetes to begin a physical exercise program and to continue with it.

The effect of music therapy on hemodialysis patients' quality of life and depression symptoms / O efeito da musicoterapia na qualidade de vida e nos sintomas de depressão de pacientes em hemodiálise

ABSTRACT Introduction: The sources of stress involved in chronic kidney disease (CKD) can lead to depressive states, directly affecting the hemodialysis patient's quality of life (QOL). There are few reports and studies on therapeutic interventions that aim to minimize depressive symptoms in these patients and an even greater shortage of studies using music therapy. Objective: This study evaluated the effect of music therapy on QOL and depressive symptoms in hemodialysis patients. Method: This was a music therapy intervention study in which 23 patients were evaluated regarding QOL and depression symptoms at two distinct stages - before and after the intervention. Eight sessions of music therapy were conducted, with two weekly sessions and an average duration of 75 minutes. The intervention was conducted by the music therapist herself, using specific music therapy techniques, besides voice and guitar to conduct harmonic and rhythmic support for the groups' sound-music production. Results: The patients showed a significant reduction in depression symptoms (p < 0.001) and better QOL results, with significant differences in the following dimensions: functional capacity (p = 0.011), pain (p = 0.036), general health (p = 0.01), vitality (p = 0.004), mental health (p = 0.012), symptom and problem list (p = 0.01), and overall health (p = 0.01). Conclusions: Intervention with music therapy constitutes an effective option in the treatment and prevention of depressive symptoms and improved QOL of HD patients.

RESUMO Introdução: Fontes de estresse representadas pela doença renal crônica (DRC) podem gerar estados de depressão, interferindo diretamente na qualidade de vida (QV) dos pacientes em hemodiálise (HD). Poucos são os relatos e estudos de intervenção terapêutica visando minimizar os sintomas depressivos nesses pacientes, com maior escassez de trabalhos utilizando a musicoterapia. Objetivo: O presente estudo avaliou o efeito da musicoterapia na QV e nos sintomas depressivos em pacientes em HD. Método: Estudo de intervenção musicoterapêutica, no qual 23 pacientes foram avaliados quanto à QV e sintomas de depressão em duas fases distintas: pré e pós-intervenção. Foram realizadas duas sessões em grupo por semana, com duração de 75 minutos, em um período de quatro semanas. A intervenção foi realizada por um musicoterapeuta, que utilizou técnicas específicas da musicoterapia, além da voz e do violão para conduzir apoio rítmico e harmônico na produção sonoro-musical dos grupos. Resultados: Os pacientes apresentaram redução significativa dos sintomas de depressão (p<0,001) e melhores resultados na QV, com diferenças estatísticas significantes nas dimensões: capacidade funcional (p=0,011), dor (p=0,036), estado geral de saúde (p=0,01), vitalidade (p=0,004), saúde mental (p=0,012), lista de sintomas e problemas (p=0,01) e saúde global (p=0,01). Conclusões: A intervenção com musicoterapia constitui-se opção efetiva no tratamento e prevenção de sintomas depressivos e na melhora da QV de pacientes em HD.