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1.
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1359809

ABSTRACT

Tecnologia: Duloxetina e outros antidepressivos disponíveis no Sistema Único de Saúde (amitriptilina, nortriptilina, clomipramina, fluoxetina e bupropiona). Indicação: Tratamento do primeiro episódio depressivo no transtorno de depressão maior em adultos. Pergunta: A duloxetina é mais eficaz e tolerável que a amitriptilina, nortriptilina, clomipramina, fluoxetina e bupropiona para o tratamento do primeiro episódio de depressão maior em adultos? Métodos: Revisão rápida de evidências (overview) de revisões sistemáticas, com levantamento bibliográfico realizado na base de dados PUBMED, utilizando estratégia estruturada de busca. A qualidade metodológica das revisões sistemáticas foi avaliada com AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews). Resultados: Foi selecionada 1 revisão sistemática, que atendia aos critérios de inclusão. Conclusão: Os antidepressivos, comparados ao placebo, tinham maior taxa de resposta, taxa de remissão e taxa de descontinuação devido a efeitos colaterais, no tratamento de curto prazo. Duloxetina tinha taxa de resposta similar a amitriptilina, clomipramina, fluoxetina e bupropiona. Duloxetina e amitriptilina tinham maior taxa de remissão que fluoxetina. Comparando-se as taxas de abandono de tratamento devido a efeitos colaterais, clomipramina era menos seguro, amitriptilina, bupropiona e duloxetina eram parecidos entre si, e fluoxetina era o antidepressivo mais seguro


Technology: Duloxetine and other antidepressants available in the Brazilian Public Health System (amitriptyline, nortriptyline, clomipramine, fluoxetine and bupropion). Indication: Treatment of the first depressive episode in adult major depressive disorder. Question: Is duloxetine more effective and tolerable than amitriptyline, nortriptyline, clomipramine, fluoxetine and bupropion for the treatment of first episode of major depression in adults? Methods: Rapid response review of evidence (overview) from systematic reviews, with a bibliographic search in the PUBMED database, using a structured strategy. The methodological quality of systematic reviews was assessed with AMSTAR-2 (Methodological Quality Assessment of Systematic Reviews). Results: One systematic review was selected, which met the inclusion criteria. Conclusion: In short-term treatment, antidepressants, compared to placebo, had a higher rate of response, rate of remission and rate drop-out due to side effects. Duloxetine had a similar response rate to amitriptyline, clomipramine, fluoxetine and bupropion. Duloxetine and amitriptyline had higher remission rates than fluoxetine. Comparing rates of dropout due to side effects, clomipramine had the worst rates, amitriptyline, bupropion, and duloxetine were similar to each other, and fluoxetine had the better rates


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Depressive Disorder, Major/drug therapy , Duloxetine Hydrochloride/therapeutic use , Antidepressive Agents , Unified Health System , Fluoxetine/therapeutic use , Bupropion/therapeutic use , Clomipramine/therapeutic use , Amitriptyline/therapeutic use , Nortriptyline/therapeutic use
2.
Rev. Ciênc. Plur ; 8(1): e25741, 2022. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1348355

ABSTRACT

Introdução:Pacientes com depressão maior geralmente respondem ao tratamento com medicamentos antidepressivos, no entanto em 10% a 30% dos casos há apenas uma resposta parcial ou nenhuma resposta, entre os fatores que podem influenciar encontra-se o perfil das enzimas hepáticas metabolizadoras dos antidepressivos, tal como a CYP2C19.Objetivo:Caracterizar os indivíduos quanto ao perfil genético dospolimorfismos CYP2C19*2 ou CYP2C19*17 em pacientes com transtorno depressivo maior (TDM) tratados com citalopram ou escitalopram e compará-los em relação a adesão ao tratamento, sintomas de depressão e qualidade de vida.Metodologia:Trata-se de um estudo transversal realizado com 29 pacientes com TDM. Amostras de sangue foram coletadas para genotipagem de CYP2C19 por discriminação alélica TaqMan®. Após caracterização do perfil genético, os indivíduos foram comparados quanto aos dados demográfico e socioeconômico, adesão ao tratamento (TestedeMorisky-Green),sintomas de depressão (escala de Hamilton) e qualidade de vida (WHOQoL-BREF).Resultados:Quatro pacientes (13.8%) apresentaram polimorfismo para CYP2C19*2 e 10 pacientes (34.4%) para CYP2C19*17, com maior prevalência de CYP2C19*17 (p>0.05). Nenhuma associação significativa de características socioeconômicas, demográficas e clínicas entre os genótipos do CYP2C19.No TestedeMorisky-Green, aadesão moderada ao tratamento foi predominante nos pacientes CYP2C19*2 e CYP2C19*17 (p>0.05). Não foi observada associação entre sintomas de depressão e polimorfismos genéticos (p>0.05). Uma associação significativa entre o genótipo polimórfico CC do CYP2C19*17 com a satisfação com a saúde, enquanto o genótipo CT foi associado ao estado "nem satisfeito/nem insatisfeito" (p<0.05). A maioria dos indivíduos CYP2C19*2 e CYP2C19*17 relatou "necessidade de melhorar" em relação aos domínios de qualidade de vida físico, psicológico, social e ambiental (p>0.05).Conclusões:Os pacientes apresentaram maior prevalência do polimorfismo CYP2C19*17, com moderada adesão ao tratamento. Alguns pacientes, mesmo sob efeito da medicação, apresentaram sintomas de depressão moderado a intenso e relataram uma indefinição na satisfação da sua qualidade de vida (AU).


Introduction:Patients with major depression usually respond to treatment with antidepressant drugs, however in 10% to 30% of cases there is only a partial response or no response, among the factors that can influence is the profile of liver enzymes metabolizing antidepressants, such as CYP2C19.Objective:To characterize the individuals regarding the genetic profile ofCYP2C19*2or CYP2C19*17 polymorphisms in patients with major depressive disorder (MDD) treated with citalopram or escitalopram, and to compare themaccording to treatment adherence, symptoms of depression and quality of life.Methodology:This is cross-sectionalstudy carried out with 29 patients with MDD. Blood samples were collected for CYP2C19 genotyping by TaqMan® allelic discrimination. After characterization of the genetic profile, the individuals were compared regarding the demographic and socioeconomic data, treatment adherence (Morisky-GreenTest), symptoms of depression (Hamilton scale) and quality of life (WHOQoL-BREF).Results:Four patients showed (13.8%) CYP219*2 and 10 patients (34.4%) CYP219*17 polymorphisms.,withhigher prevalence of CYP219*17 (p>0.05). No association between socioeconomic, demographic, and clinical features with CYP2C19 genotypes was observed. In Morisky-GreenTest, moderate adherence to treatment was predominant for CYP2C19*2 and CYP219*17 patients (p>0.05). No statistically significant association was observed between symptoms of depression and genetic polymorphisms (p>0.05). A significant association between polymorphic CC genotype of CYP219*17 with health satisfaction, while the CT genotype was associated with "neither satisfied/nor dissatisfied" status (p<0.05). Most of the CYP2C19*2 and CYP2C19*17 subjects reported "need to improve" or "regular" regarding physical, psychological, social, and environmental domainsof quality of life(p>0.05).Conclusions:The patients showed a higher prevalence of CYP219*17 polymorphism, with moderate treatment adherence. Some subjects, even under the effect of the medication, presented moderate to intense symptoms of depression, and reported a lack of definition in the satisfaction of their quality of life (AU).


Introducción:Los pacientes con depresión mayor responder al tratamiento con antidepresivos, en 10% al 30% de los casos existe una respuesta parcial o nula, entre los factores que pueden influir se encuentra el perfil de enzimas hepáticas metabolizadoras de antidepresivos, como CYP2C19.Objetivo: Caracterizar a los individuos en cuanto al perfil genético depolimorfismos CYP2C19 *2 o CYP2C19 * 17 en pacientes con trastorno depresivo mayor (TDM) tratados con citalopram o escitalopram y compararlos en relaciónpara la adherencia al tratamiento, síntomas de depresión y la calidad de vida.Metodología: Estudio transversalcon 29 pacientes con TDM. Se recogieron muestras de sangre para la determinación del genotipo CYP2C19 mediante discriminación alélica TaqMan®, los individuos fueron comparados en cuanto a los datosdemográficosy socioeconómicos, adherencia (Prueba de Morisky-Green), síntomas de depresión (escala de Hamilton) y calidad de vida (WHOQoL-BREF).Resultados: Cuatro pacientes (13,8%) con polimorfismo CYP2C19*2 y 10 (34,4%) con CYP2C19 * 17,(p> 0,05). No existe una asociación significativa de las características socioeconómicas, demográficas y clínicas con los genotipos CYP2C19. La adherencia moderada al tratamiento fue predominante en los pacientes con CYP2C19*2 y CYP2C19*17 (p> 0,05). No hubo asociación entre síntomas de depresión y polimorfismos genéticos (p> 0.05). Una asociación significativa entre el genotipo polimórfico CYP2C19 * 17 CC con la satisfacción con la salud, mientras que el genotipo CT se asoció con el estado "ni satisfecho / no insatisfecho" (p <0.05). La mayoría de CYP2C19 * 2 y CYP2C19 * 17 individuos informaron "necesidad de mejorar" en relación con los dominios físico, psicológico, social y ambientalde calidad de vida(p> 0,05).Conclusiones: Los pacients mostraron una mayor prevalencia del CYP2C19 * 17, con adherencia moderada al tratamiento, síntomas de depresión moderada a intensay informaron una falta de definición en la satisfacción de su calidad de vida (AU).


Subject(s)
Humans , Citalopram/pharmacology , Depression/drug therapy , Depressive Disorder, Major/drug therapy , Cytochrome P-450 CYP2C19/pharmacology , Antidepressive Agents/pharmacology , Quality of Life , Brazil , Cross-Sectional Studies/methods , Drug Therapy
3.
Rev. habanera cienc. méd ; 20(4): e3967, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289628

ABSTRACT

Introducción: el suicidio es un grave problema de salud pública mundial, más de 800,000 personas se suicidan cada año y entre 10 y 20 millones lo intentan cada año. Ha sido considerado como una conducta prevenible y el intento es un predictor clínicamente relevante que está presente en un tercio de los suicidios consumados, así como padecer un trastorno mental es otro factor de riesgo para el suicido. Objetivo: determinar la relación entre los intentos de suicidio y los trastornos mentales. Material y Métodos: se realizó una búsqueda en las bases de datos; Dialnet, Redalyc, Scielo, Biblioteca Virtual en Salud (BVS), PubMed, Science Direct y Google Académico, en español e inglés y limitada a las publicaciones entre 01 de enero 2010 y 31 de diciembre de 2020. Desarrollo: la prevalencia de vida del intento de suicidio en pacientes con Trastorno Bipolar es del 33,9 por ciento, en pacientes con Trastorno Depresivo Mayor es del 31 por ciento, y en pacientes con Esquizofrenia es del 26,8 por ciento. Conclusiones: los pacientes con trastorno bipolar y trastorno depresivo mayor, presentan mayor porcentaje de intentos de suicidio. Aunado a una comorbilidad psiquiátrica (consumo de alcohol, consumo de tabaco y trastorno de la personalidad límite), más intentos de suicidio previos, aumenta el riesgo del comportamiento suicida(AU)


Introduction: Suicide is a serious global public health problem. More than 800,000 people commit suicide every year and between 10 and 20 million people attempt suicide annually. Suicide has been considered a preventable behavior and suicide attempt is a clinically relevant predictor which is present in one-third of consummated suicides. Besides, having a mental disorder is another risk factor for suicide. Objective: To determine the relationship between suicide attempts and mental disorders such as depressive and anxiety disorders, bipolar disorder, substance-related disorders, schizophrenia and other psychotic disorders, personality disorders, and eating disorders. Material and Methods: A search was performed in Dialnet, Redalyc, Scielo, Virtual Health Library (VHL), PubMed, Science Direct, and Google Scholar databases in Spanish and English. It was limited to publications between January 1, 2010 and December 31, 2020. Development: The lifetime prevalence of suicide attempt is 31 percent in patients with Bipolar Disorder; 33,9 percent in patients with Major Depressive Disorder and 26.8 percent in patients with Schizophrenia. Conclusions: Patients with bipolar disorder and major depressive disorder have higher rates of suicide attempts. Coupled with psychiatric comorbidity (alcohol consumption, smoking, borderline personality disorder), more previous suicide attempts increase the risk of suicidal behavior(AU)


Subject(s)
Humans , Male , Female , Suicide/psychology , Suicide, Attempted/psychology , Behavior , Bipolar Disorder/prevention & control , Comorbidity , Depressive Disorder, Major , Mental Disorders , Suicide, Attempted/prevention & control , Suicide, Attempted/statistics & numerical data , Prevalence , Risk Factors
4.
SMAD, Rev. eletrônica saúde mental alcool drog ; 17(2): 64-71, abr.-jun. 2021. ilus, tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1290026

ABSTRACT

OBJETIVO: verificar a prevalência do Transtorno Depressivo Maior em pessoas com dependência química. MÉTODO: estudo transversal com a aplicação da entrevista estruturada para os transtornos do DSM-V em 183 indivíduos internados em comunidades terapêuticas de acolhimento para dependentes químicos, localizadas no sul de Santa Catarina, durante o de ano de 2019. RESULTADOS: todos os participantes não realizaram consulta psiquiátrica ao ingressar na instituição e a maioria não realizou consulta psiquiátrica regular (94,5%). Constatou-se que 89 participantes (55,3%) possuíam critérios diagnósticos para o Transtorno Depressivo Maior e 59,1% destes possuíam adicção ao álcool (p<0,028). CONCLUSÃO: o diagnóstico do transtorno depressivo deve-se consolidar como uma variável importante para a eficácia do tratamento, visto que sua prevalência é elevada e possui repercussões sobre a qualidade do tratamento e tempo de institucionalização.


OBJECTIVE: to verify the prevalence of Major Depressive Disorder in people with chemical dependence. METHOD: cross-sectional study with the application of the structured interview for the DSM-V disorders in 183 individuals admitted to therapeutic communities for chemical dependents, located in the south of Santa Catarina, during the year 2019. RESULTS: All participants did not have a psychiatric consultation when entering the institution and the majority did not have a regular psychiatric consultation (94.5%). It was found that 89 participants (55.3%) had diagnostic criteria for Major Depressive Disorder and 59.1% of these had alcohol addiction (p<0.028). CONCLUSION: the diagnosis of depressive disorder should be consolidated as an important variable for the effectiveness of treatment, since its prevalence is high and has repercussions on the quality of treatment and time of institutionalization.


OBJECTIVO: verificar la prevalencia del transtorno depressivo major en personas con adicción. METODO: estudio transversal con aplicación de la entrevista estructurada para los transtornos del DSM-V en 183 personas internadas en comunides de tratamiento de adicción en el departamento de Santa Catarina durante el ano de 2019. RESULTADOS: la totalidad de los pacientes no realizaron cita con psiquiatra al ingressar en las instituiciones y la mayoria no realiza visitas regulares al psiquiatra (94,5%). Se observó que 89 participantes (55,3%) tenian critérios diagnósticos para depressión y 59,1% de ellos eram adictos al álcohol (p<0,028). CONCLUSIÓN: el diagnóstico del transtorno depressivo debe consolidarse como una variable importante para la eficácia del tratamiento, pues su prevalencia es elevada y pose repercursiones sobre la calidad del tratamiento y el tiempo de permanencia en las comunidades.


Subject(s)
Humans , Male , Female , Rehabilitation Centers , Surveys and Questionnaires , Health Surveys , Substance-Related Disorders/epidemiology , Depressive Disorder, Major
5.
Frontiers of Medicine ; (4): 528-540, 2021.
Article in English | WPRIM | ID: wpr-888738

ABSTRACT

Major depressive disorder (MDD) causes great decrements in health and quality of life with increments in healthcare costs, but the causes and pathogenesis of depression remain largely unknown, which greatly prevent its early detection and effective treatment. With the advancement of neuroimaging approaches, numerous functional and structural alterations in the brain have been detected in MDD and more recently attempts have been made to apply these findings to clinical practice. In this review, we provide an updated summary of the progress in translational application of psychoradiological findings in MDD with a specified focus on potential clinical usage. The foreseeable clinical applications for different MRI modalities were introduced according to their role in disorder classification, subtyping, and prediction. While evidence of cerebral structural and functional changes associated with MDD classification and subtyping was heterogeneous and/or sparse, the ACC and hippocampus have been consistently suggested to be important biomarkers in predicting treatment selection and treatment response. These findings underlined the potential utility of brain biomarkers for clinical practice.


Subject(s)
Brain/diagnostic imaging , Depressive Disorder, Major/diagnostic imaging , Humans , Magnetic Resonance Imaging , Neuroimaging , Quality of Life
6.
Rev. cienc. salud ; 19(3): 1-32, 2021. ilus, tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1367519

ABSTRACT

Introducción: en el contexto latinoamericano se está generando evidencia sobre el empleo de instrumentos derivados de la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud en psiquiatría y salud mental. Este estudio corresponde a la primera investigación de carácter explicativo en población con trastornos mentales graves en tres países de Sudamérica. El objetivo es determinar un modelo explicativo de discapacidad en una muestra de personas con trastornos mentales graves en contacto con servicios ambulatorios de psiquiatría en Chile, Colombia y Ecuador. Materiales y métodos: se llevó a cabo un estudio multicéntrico, observacional, correlacional, de corte transversal, a partir de un muestreo probabilístico en Colombia y un muestreo por conveniencia en Chile y Ecuador. En total, participaron 803 adultos con trastornos mentales graves, en contacto con servicios ambulatorios de psiquiatría en Concepción (Chile), Cali (Colombia) y Quito (Ecuador). Resultados: el 91.3 % de la muestra presentó algún grado de discapacidad. El modelo multivariado final incluyó las variables explicativas país (Colombia; ß = 6.724); edad (ß = −0.163); escolaridad (ß = −0.5029); síntomas actuales de depresión (ß = 23.26); episodio psicótico (ß = 4.795); episodio hipomaniaco/maniaco (ß = 7.498; t = 3.711); tener práctica religiosa (ß = −2.834), y tener cuidador (ß = 10.363). Obtuvo un coeficiente de determinación de 0.3275 (F [23, 760] = 16.09; p < 0.001, R²∆ = 30.71), que explica el 32.75 % de la discapacidad de las personas de la muestra de los tres países participantes. Conclusiones: en un modelo multivariado de discapacidad para trastornos mentales graves, los síntomas actuales y la presencia de cuidador son las principales variables explicativas de discapacidad


Introduction: Currently, evidence is being generated on the use of the International Classification of Functioning, Disability, and Health-derived tools in psychiatry and mental health. This study corresponds to the first investigation of explanatory character about a wide range of persons with severe mental disorders in three countries of South America. Aim: This study aims to determine an explanatory model of disability in a population with severe mental disorders in contact with outpatient psychiatry services in Chile, Colombia, and Ecuador. Materials and methods: A multicenter, observational, correlational, cross-sectional study was carried out based on a probabilistic sampling in Colombia and a convenience sampling in Chile and Ecuador. A total of 803 adults with severe mental disorders participated, who were in contact with outpatient psychiatry services in Concepción (Chile), Cali (Colombia), and Quito (Ecuador). Results: Some degree of disability was presented by 91.3% of participants. The final multivar-iate model included the explanatory variables country (Colombia; ß = 6.724); age (ß = −0.163); schooling (ß = −0.5029); current depression symptoms (ß = 23.26), psychotic episode (ß = 4.795); hypomanic/manic episode (ß = 7,498; t = 3,711); to have religious practice (ß = −2.834); and to have a caregiver (ß = 10.363); a coefficient of determination of 0.3275 (F [23, 760] = 16.09; p < 0.001M R2∆ = 30.71) was obtained, explain-ing a 32.75% disability in participants from the three participating countries. Conclusions: Current symp-toms and the presence of a caregiver are the main explanatory variables of the disability burden in a multivariate model of disability for severe mental disorders


Introdução: atualmente, no contexto latino-americano, estão sendo geradas evidências sobre o uso de instrumentos derivados da Classificação Internacional de Funcionalidade, da Deficiência e da Saúde em psiquiatria e saúde mental. Este estudo corresponde à primeira pesquisa explicativa em uma popula-ção com transtornos mentais graves em três países da América do Sul. Objetivo: determinar um modelo explicativo da deficiência em uma amostra de pessoas com transtornos mentais graves em contato com serviços psiquiátricos ambulatoriais no Chile, Colômbia e Equador. Materiais e métodos: foi realizado um estudo multicêntrico, observacional, correlacional, transversal, a partir de uma amostra probabilística na Colômbia e uma amostra de conveniência no Chile e Equador. No total participaram 803 adultos com transtornos mentais graves, em contato com serviços psiquiátricos ambulatoriais em Concepción (Chile), Cali (Colômbia) e Quito (Equador). Resultados: 91,3% da amostra apresentou algum grau de deficiência. O modelo multivariado final incluiu as variáveis explicativas país (Colômbia; ß = 6,724); idade (ß = −0,163); escolaridade (ß = −0,5029); sintomas atuais de depressão (ß = 23,26); episódio psicótico (ß = 4,795); episódio hipomaníaco/maníaco (ß = 7,498; t = 3,711); ter prática religiosa (ß = −2,834), e ter cuidador (ß= 10,363). Obteve coeficiente de determinação de 0,3275 (F[23, 760] = 16,09; p < 0,001; R2∆ = 30,71), explicando 32,75% da deficiência das pessoas da amostra dos três países participantes. Conclusões: em um modelo multiva-riado de deficiência para transtornos mentais graves, os sintomas atuais e a presença de um cuidador são as principais variáveis explicativas da deficiência


Subject(s)
Humans , Mental Disorders , Schizophrenia , Bipolar Disorder , Chile , Cross-Sectional Studies , Colombia , Depressive Disorder, Major , Disability Evaluation , Ecuador , Ambulatory Care
7.
Article in English | LILACS, BBO | ID: biblio-1289992

ABSTRACT

ABSTRACT OBJECTIVE To identify factors associated with major depressive disorder (MDD) in detention officers. METHODS This cross-sectional study included all detention officers from the largest prison complex in the state of Bahia, Brazil. A self-reported questionnaire collected sociodemographic, occupational and health data. The outcome variable - MDD - was evaluated by the Patient Health Questionnaire-9 (PHQ-9) and classified by the cut-off point ≥ 10 method and the algorithm method. The association measure used was the prevalence ratio (PR). Following Cox multivariate regression, the variables were divided into two blocks: sociodemographic characteristics and work, in that order. Only variables with adjusted PR (PRadj) ≥ 1.30 were selected to compose the final models. RESULTS The MDD prevalence by the cut-off point ≥ 10 (simple) and algorithm method in the 401 officers investigated was 18.8% and 9.3%, respectively. MDD prevalence by cut-off point ≥ 10 was higher in female officers (PRadj = 2.77), who suffered threat from factions (PRadj = 2.05), did not report institutional training for the position (PRadj = 1.38), stated that the environment and working conditions interfered in their physical health (PRadj = 3.51) and performed stress-generating activities (PRadj in increasing gradient). MDD prevalence by the algorithm method was higher in female agents (PRadj = 3.45), with tertiary education (PRadj = 1.71), who stated that the environment and working conditions interfered in their physical health (PRadj = 6.33), suffered threat from factions (PRadj = 2.14), did not report institutional training (PRadj = 1.50) and have frequent contact with inmates at work (PRadj = 1.48). CONCLUSION The high MDD prevalence in these detention officers was associated with sociodemographic factors and, especially, aspects of their work.


RESUMO OBJETIVO Identificar fatores associados a transtorno depressivo maior (TDM) em agentes penitenciários. MÉTODOS Este estudo de corte transversal incluiu todos os agentes penitenciários do maior complexo prisional do estado da Bahia (Brasil). Num questionário autoaplicado, coletaram-se informações sociodemográficas, ocupacionais e de saúde. A variável de desfecho - TDM - foi avaliada pelo Patient Health Questionnaire-9 (PHQ-9) e classificada pelo método do ponto de corte ≥ 10 e pelo método de algoritmo. A razão de prevalência (RP) foi a medida de associação utilizada. Conforme regressão multivariada de Cox, as variáveis foram inseridas em dois blocos: características sociodemográficas e aspectos do trabalho, nessa ordem. Apenas as variáveis com RP ajustada (RPaj) ≥ 1,30 foram selecionadas para compor os modelos finais. RESULTADOS Nos 401 agentes investigados, a prevalência de TDM pelo ponto de corte ≥ 10 (simples) e pelo método de algoritmo foi de 18,8% e 9,3%, respectivamente. A prevalência de TDM pelo ponto de corte ≥ 10 foi maior em agentes do sexo feminino (RPaj = 2,77), que sofreram ameaça de facções (RPaj = 2,05), que não referiram treinamento institucional para o cargo (RPaj = 1,38), que afirmaram que o ambiente e as condições de trabalho interferiam na sua saúde física (RPaj = 3,51) e que exerciam atividades geradoras de tensão (RPaj em gradiente crescente). A prevalência de TDM pelo método de algoritmo foi mais elevada em agentes do sexo feminino (RPaj = 3,45), com escolaridade superior (RPaj = 1,71), que afirmaram que o ambiente e as condições de trabalho interferiam na sua saúde física (RPaj = 6,33), que sofreram ameaça de facções (RPaj = 2,14), que não referiram treinamento institucional (RPaj = 1,50) e que têm contato frequente com internos no trabalho (RPaj = 1,48). CONCLUSÃO A alta prevalência de TDM nesses agentes penitenciários associou-se a aspectos sociodemográficos e, principalmente, a aspectos do seu trabalho.


Subject(s)
Humans , Female , Depressive Disorder, Major/epidemiology , Prisons , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors
8.
An. Fac. Cienc. Méd. (Asunción) ; 53(3): 41-52, 20201201.
Article in Spanish | LILACS | ID: biblio-1177483

ABSTRACT

Existen varios trastornos mentales que se relacionan con el consumo del alcohol y otras drogas, cierto número de personas desarrollan un patrón evolutivo al abuso, sea este persistente o esporádico, produce perturbaciones o limitaciones clínicamente significativas con variadas manifestaciones en el hogar, la escuela y el trabajo. Se determinó la frecuencia y asociación entre trastornos psiquiátricos, patrones de consumo de sustancias y variables sociodemográficas en estudiantes de medicina de la Universidad Nacional de Asunción. El diseño de estudio fue observacional, analítico, corte transversal, La población estuvo constituida por 626 estudiantes de la carrera de medicina del primero al quinto curso, que fueron seleccionados por un muestreo no probabilístico por conveniencia. Se aplicaron 3 cuestionarios que abarcaban tres aspectos: datos sociodemográficos, abuso de drogas y diagnóstico psiquiátrico. Los datos fueron analizados mediante GNU Perfect Statistics Professionally Presented y Epi Info. Se concluyó que el trastorno más frecuente fue el Trastorno por Abuso de drogas, seguido del Trastorno Obsesivo-Compulsivo y el Trastorno Depresivo Mayor. La sustancia más consumida fue el alcohol, seguido del tabaco y la marihuana. Esta última fue la única que se asoció con todas las sustancias. El consumo de alcohol presentó asociación con TOC, Fobia Social y Ansiedad; los consumidores de benzodiacepinas presentaron mayor riesgo de Trastorno Depresivo, Trastorno por Estrés Postraumático, Bulimia, Pánico, Agorafobia, Ansiedad y Trastorno de Somatización. Se recomienda la implementación de políticas de educación preventiva, así como estudios prospectivos para evaluar relaciones de causalidad en las asociaciones encontradas.


There are several mental disorders that are related to the consumption of alcohol and other drugs, a number of people develop an evolutionary pattern of abuse, whether it is persistent or sporadic, it produces clinically significant disturbances or limitations with various manifestations at home, school and the job. The frequency and association between psychiatric disorders, patterns of substance use and socio-demographic variables in medical students of the National University of Asunción was determined. The study design was observational, analytical, cross-sectional. The population consisted of 626 medical students from the first to the fifth year, who were selected by a non-probabilistic convenience sampling. 3 questionnaires were applied that covered three aspects: sociodemographic data, drug abuse and psychiatric diagnosis. The data was analyzed using GNU Perfect Statistics Professionally Presented and Epi Info. It was concluded that the most frequent disorder was Drug Abuse Disorder, followed by Obsessive-Compulsive Disorder and Major Depressive Disorder. The most used substance was alcohol, followed by tobacco and marijuana. The latter was the only one that was associated with all substances. Alcohol consumption was associated with OCD, Social Phobia and Anxiety; Benzodiazepine users had a higher risk of Depressive Disorder, Post-Traumatic Stress Disorder, Bulimia, Panic, Agoraphobia, Anxiety and Somatization Disorder. The implementation of preventive education policies is recommended, as well as prospective studies to evaluate causal relationships in the associations found.


Subject(s)
Anxiety , Stress Disorders, Post-Traumatic , Cannabis , Depressive Disorder, Major , Ethanol , Mental Disorders , Obsessive-Compulsive Disorder , Students , Causality , Prospective Studies , Surveys and Questionnaires , Sampling Studies
9.
Rev. chil. infectol ; 37(5): 555-562, nov. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144250

ABSTRACT

Resumen Introducción: Aproximadamente 50% de las personas con infección por VIH padecen de alguna patología neuro-psiquiátrica. Características intrínsecas del virus, sus complicaciones, tratamiento y el contexto socio-cultural de los infectados facilitan el desarrollo de estas co-morbilidades, que determinan, en parte, el curso y pronóstico de las personas con infección por VIH. Objetivo: Introducir en la fisiopatología, características clínicas y manejo de la patología neuro-psiquiática en la infección por VIH, centrándose en dos de sus cuadros de mayor prevalencia: el trastorno neuro-cognitivo asociado al VIH (HAND) y el trastorno depresivo mayor (TDM). Desarrollo: En general, la detección y el tratamiento precoz de la patología neuropsiquiátrica en personas con infección por VIH mejora la calidad de vida de los pacientes, el curso clínico de la infección y mejora la adherencia al tratamiento anti-retroviral, lo que constituye una herramienta importante en el control de la propagación del VIH.


Abstract Background: The prevalence of neuropsychiatric disorders in HIV infected individuals is around 50%. Despite this, these diseases are often underdiagnosed and undertreated. Direct effects of the virus, opportunistic infections, adverse effects of antiretroviral therapy and the sociocultural context of the infected persons, contribute to the development of HIV associated neurocognitive disorder (HAND) and major depressive disorder (MDD), both of which have an impact in quality of life and disease progression. Aim: To introduce physicians in the pathophysiology, clinical features and management of psychiatric disease in seropositive patients. Content: Early detection and treatment of neuropsychiatric comorbidity in HIV infected individuals improve clinical outcomes, quality of life and is an important milestone in the control of the pandemic.


Subject(s)
Humans , HIV Infections/complications , HIV Infections/drug therapy , HIV Infections/epidemiology , Depressive Disorder, Major/etiology , Depressive Disorder, Major/epidemiology , Quality of Life , Comorbidity , Prevalence
10.
Rev. colomb. psiquiatr ; 49(2): 68-75, abr.-jun. 2020. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1115646

ABSTRACT

RESUMEN Introducción: El Trastorno depresivo mayor (TDM) es una enfermedad multifactorial en la que, por interacción con diversas variables, se incrementa la vulnerabilidad a padecerla. Diversos modelos han explicado las interacciones, como el de diátesis-estrés. Vivir eventos estresantes no siempre lleva a la aparición del TDM, y se ha planteado que la atribución y la valoración de los eventos estresantes podrían ser un mejor predictor de la aparición de los síntomas. Objetivo: Determinar la asociación y el poder predictivo de la frecuencia y la valoración de eventos vitales estresantes en la presencia de sintomatología del TDM. Métodos: Estudio de casos y controles con 120 pacientes psiquiátricos y 120 personas de la población general. Se utilizó una entrevista clínica estructurada y el Cuestionario de Sucesos Vitales de Sandín y Chorot. Los datos se analizaron con pruebas no paramétricas y regresión logística binaria. Resultados: El grupo de casos obtuvo significativamente más altos en afecto negativo, frecuencia de eventos estresantes, nivel de estrés percibido, valoración negativa de la situación y percepción de no control. El modelo de regresión logística binaria indicó que la baja percepción de control frente al evento estresante es el factor más determinante, seguido por la evaluación negativa del evento. Conclusiones: Las atribuciones realizadas sobre los eventos estresantes son determinantes en la presentación del TDM, en especial la valoración del control percibido frente a los sucesos vitales, en concordancia con los modelos etiológicos del TDM de diátesis cognitiva al estrés.


ABSTRACT Introduction: Major depressive disorder (MDD) is a multifactorial disease in which, due to the interaction of several variables, the vulnerability of suffering from it increases. Several models, such as the diathesis-stress model, have explained these interactions. However, experiencing stressful events does not always lead to the development of MDD, and the attribution and appraisal of stressful events contributing to further development of depression symptoms has been considered as a possible explanation. Objective: To determinate the association and the predictive power of the frequency and appraisal of stressful life events to predict MDD symptomatology. Methods: Case-control study with 120 psychiatric patients and 120 people from the general population. A structured clinical interview and the life events questionnaire (Sandín and Chorcot) were used to evaluate the sample. The data were analysed with non-parametric tests and binary logistic regression. Results: The psychiatric patients reported significantly higher levels of negative affect, frequency of stressful life events, perceived stress, negative appraisal of the situation and lack of perceived control. The binary logistic regression model indicated that poor perception of control of the stressful event is the most determining factor, followed by negative evaluation of the situation. Conclusions: The attributions that are made regarding a stressful event are variables that predict MDD, specifically the assessment of the perceived control over the situation. These results concur with the aetiological models of MDD, such as the cognitive diathesis-stress model.


Subject(s)
Humans , Female , Pregnancy , Adult , Middle Aged , Aged , Psychiatric Status Rating Scales , Depressive Disorder, Major , Signs and Symptoms , Stress, Psychological , Power, Psychological , Disaster Vulnerability , Depression , Disease Susceptibility
11.
Rev. Méd. Clín. Condes ; 31(2): 105-113, mar.-abr. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1223378

ABSTRACT

INTRODUCCIÓN La comorbilidad médica en pacientes con trastornos del estado de ánimo tiende a convertirse en un problema de salud pública clínica y global cada vez más importante. Varias patologías médicas específicas están asociadas con un mayor riesgo de padecer trastornos del estado de ánimo y, por otra parte, los trastornos del estado de ánimo están asociados con un aumento de la morbilidad y mortalidad debidas a condiciones médicas comórbidas. En este artículo se revisan las comorbilidades médicas que más comúnmente se asocian a los trastornos afectivos (enfermedades cardiovasculares, obesidad y síndrome metabólico) examinando sus posibles implicaciones bidireccionales. MÉTODOS Se ha realizado una revisión no sistemática y búsqueda de la literatura científica sobre la asociación entre las tres enfermedades médicas más frecuentes en trastorno depresivo mayor y trastorno bipolar (enfermedades cardiovasculares, obesidad, síndrome metabólico) entre enero de 1995 y noviembre de 2019. RESULTADOS La evidencia sugiere que la comorbilidad entre estas tres enfermedades médicas y los trastornos del estado de ánimo es muy frecuente; la presencia de las primeras empeora significativamente el pronóstico y el manejo terapéutico de las segundas y viceversa, comparten mecanismos fisiopatológicos e implican una etiología aparentemente bidireccional. CONCLUSIONES La presencia de estas enfermedades médicas concurrentes en un individuo con un trastorno del estado de ánimo se asocia con una presentación de enfermedad más compleja. En muchos casos, estas comorbilidades pueden preceder a la aparición de los trastornos del estado de ánimo, aunque en la mayoría de los casos parecen seguir a la aparición de los trastornos del estado de ánimo. Para los profesionales, la evidencia apoya inequívocamente las recomendaciones para la vigilancia rutinaria de las comorbilidades según un enfoque multidisciplinar.


INTRODUCTION Medical comorbidity in patients with mood disorders tends to become an increasingly important clinical and global public health problem. On one hand, several specific medical pathologies are associated with an increased risk of mood disorders and on the other hand, mood disorders are associated with increased morbidity and mortality due to comorbid medical conditions. This article reviews the medical comorbidities that are most commonly associated with affective disorders (cardiovascular diseases, obesity and metabolic syndrome) examining their possible bidirectional implications. METHODS A non-systematic review about the association between the three most common medical diseases in major depressive disorder and bipolar affective disorder (cardiovascular diseases, obesity, metabolic syndrome) has been carried out from January 1995 to November 2019. RESULTS The evidence suggests that comorbidity between these three medical diseases and mood disorders is very prevalent. The presence of medical disease significantly worsens the prognosis and therapeutic management of the mood disorders and vice versa. In many cases, these comorbidities may precede the onset of mood disorders, although in most cases they appear to follow the onset of mood disorders. CONCLUSIONS the presence of these concurrent medical diseases in an individual with a mood disorder is associated with a more complex disease presentation. For professionals, the evidence unequivocally supports recommendations for routine surveillance of comorbidities according to a multidisciplinary approach.


Subject(s)
Humans , Cardiovascular Diseases/epidemiology , Health , Mood Disorders/epidemiology , Metabolic Diseases/epidemiology , Obesity/epidemiology , Bipolar Disorder/epidemiology , Cardiovascular Diseases/psychology , Comorbidity , Metabolic Syndrome/psychology , Depressive Disorder, Major/epidemiology , Obesity/psychology
12.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 6-13, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055355

ABSTRACT

Objective: To test the feasibility and to present preliminary results of a neuroimaging protocol to evaluate adolescent depression in a middle-income setting. Methods: We assessed psychotropic medication-free adolescents (age range 14-16 years) with a diagnosis of major depressive disorder (MDD). Participants underwent a comprehensive clinical evaluation and both structural and functional magnetic resonance imaging (fMRI). In this pilot study, a preliminary single-group analysis of resting-state fMRI (rs-fMRI) data was performed, with a focus on the default mode network (DMN), cognitive control network (CCN), and salience network (SN). Results: The sample included 29 adolescents with MDD (mean age 16.01, SD 0.78) who completed the protocol. Only two participants were excluded due to MRI quality issues (head movement), and were not included in the analyses. The scans showed significant connectivity between the medial prefrontal cortex and posterior cingulate cortex (DMN), the ACC and anterior insula (SN), and the lateral prefrontal cortex and dorsal parietal cortex (CCN). Conclusion: We demonstrated the feasibility of implementing a complex neuroimaging protocol in a middle-income country. Further, our preliminary rs-fMRI data revealed patterns of resting-state connectivity consistent with prior research performed in adolescents from high-income countries.


Subject(s)
Humans , Male , Adolescent , Magnetic Resonance Imaging/methods , Depressive Disorder, Major/diagnostic imaging , Neuroimaging/methods , Quality Control , Socioeconomic Factors , Brazil , Cerebral Cortex/diagnostic imaging , Feasibility Studies , Surveys and Questionnaires , Reproducibility of Results , Depressive Disorder, Major/physiopathology , Neural Pathways , Neuropsychological Tests
14.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 14-21, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1055366

ABSTRACT

Objective: This study aimed to determine if personality disorder (PD) predicted functional outcomes in patients with major depressive disorder (MDD). Methods: Data (n=71) from a double-blind, randomized, placebo-controlled 12-week trial assessing the efficacy of 200 mg/day adjunctive minocycline for MDD were examined. PD was measured using the Standardized Assessment of Personality Abbreviated Scale. Outcome measures included Clinical Global Impression - Improvement (CGI-I), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Social and Occupational Functioning Scale (SOFAS), and Range of Impaired Functioning (RIFT). Analysis of covariance was used to examine the impact of PD (dichotomized factor [≥ 3] or continuous measure) on the outcome measures-treatment group correlation. Results: PD was identified in 69% of the sample. After adjusting for age, sex, and baseline scores for each of the outcome measures, there was no significant difference between participants with and without PD on week 12 scores for any of the outcome measures (all p > 0.14). Conclusion: In this secondary analysis of a primary efficacy study, PD was a common comorbidity among those with MDD, but was not a significant predictor of functional outcomes. This study adds to the limited literature on PD in randomized controlled trials for MDD. Clinical trial registration: ACTRN12612000283875.


Subject(s)
Humans , Male , Female , Adult , Aged , Personality Disorders/psychology , Depressive Disorder, Major/psychology , Depressive Disorder, Major/drug therapy , Minocycline/administration & dosage , Antidepressive Agents/administration & dosage , Personal Satisfaction , Personality Tests , Psychiatric Status Rating Scales , Quality of Life , Comorbidity , Placebo Effect , Double-Blind Method , Treatment Outcome , Self Report , Middle Aged
15.
Article in English | AIM, AIM | ID: biblio-1263513

ABSTRACT

Objective: Self-esteem has been identified as a strong predictor of depression and maladaptive behaviours in adolescents. Two relational models (A and B) were tested on the antecedent and consequent variables of self-esteem.Methods: A representative sample of 610 Spanish adolescents (52% boys) ranging in age from 11 to 16 years of age (mean age = 13.38 years, SD = 1.70 years) was used. The participants completed a battery of instruments measuring self-esteem, self-concept, importance of self-concept domains, depression symptoms, and problem behaviour. Covariance structure analysis (path analysis) from LISREL 8.54 was employed.Results: Model B presented a better fit (χ2difference (A­B) = 160.29, p < 0.001). Perceived social support (parents and classmates), and perceptions of competence in domains deemed important were positively related to self-esteem. While both self-esteem and social support (parents and classmates) were negatively related to depression symptoms, only social support (parents and teacher) appeared negatively related to behavioural problems.Conclusions: While self-esteem constitutes a strong correlate of affective symptoms in Spanish adolescents, it is unrelated to maladaptive behaviour. Social support emerged as an important protective factor. Concrete proposals for future research and prevention are discussed


Subject(s)
Behavior , Depressive Disorder, Major , Social Determinants of Health
16.
Article in English | AIM, AIM | ID: biblio-1263515

ABSTRACT

Objective: Leftward cradling bias is thought to facilitate optimal interaction between mother and infant. There is mixed evidence indicating this bias may be disrupted by depression. This study investigated the relationship between depressive symptoms and preferred cradling side (i.e., cradling bias) in nulliparous women.Method: Six hundred and nineteen females, aged 18 to 25 years, were asked to imagine cradling an infant to soothe it. This instruction was given on four separate occasions. Participants also completed the Beck Depression Inventory-II. All data were collected via an online survey.Results: As the number of depressive symptoms increased, leftward cradling decreased. Although this relationship was not statistically significant, a pattern emerged: As depressive symptoms increased, so too did the likelihood of cradling to the right. Furthermore, those scoring highest on depressive symptoms were more likely to cradle inconsistently to the left, consistently to the right, or show no bias, when compared to those scoring lower on depressive symptoms.Conclusions: Theory suggests that leftward cradling is facilitated by right hemisphere processes involved in relating to others. A relationship between affective symptoms such as depressive symptoms and reduced leftward cradling bias supports this argument. It is argued that leftward cradling facilitates optimal interactions between cradler and infant. Consequently, disruptions of leftward cradling have implications for child development


Subject(s)
Depression , Depressive Disorder, Major , Pregnant Women
17.
Article in English | WPRIM | ID: wpr-827419

ABSTRACT

Major depressive disorder (MDD) is a main type of mood disorder, characterized by significant and lasting depressed mood. Until now, the pathogenesis of MDD is not clear, but it is certain that biological, psychological, and social factors are involved. Childhood trauma is considered to be an important factor in the development of this disease. Previous studies have found that nearly half of the patients with MDD have experienced childhood trauma, and different types of childhood trauma, gender, and age show different effects on this disease. In addition, the clinical characteristics of MDD patients with childhood trauma are also different, which often have more severe depressive symptoms, higher risk of suicide, and more severe cognitive impairment. The response to antidepressants is also worse. In terms of biological mechanisms and marker characteristics, the serotonin transporter gene and the FKBP prolyl isomerase 5 have been shown to play an important role in MDD and childhood trauma. Moreover, some brain imaging and biomarkers showed specific features, such as changes in gray matter in the dorsal lateral prefrontal cortex, and abnormal changes in hypothalamic-pituitary-adrenal axis function.


Subject(s)
Child , Depressive Disorder, Major , Gray Matter , Humans , Hypothalamo-Hypophyseal System , Pituitary-Adrenal System , Suicide
18.
Article in English | LILACS | ID: biblio-1058895

ABSTRACT

ABSTRACT INTRODUCTION Depression is the leading cause of disability around the world, and it has been increasingly affecting young people. This study evaluates the prevalence and factors associated with major depression in university students, with emphasis on the influence of the academic field, chosen study area and the environment they are inserted. METHODS A census of students who entered the university in the first semester of 2017 was held at a university in Southern Brazil. The outcome of major depressive episode was evaluated using the Patient Health Questionnaire-9, considered when the individual had five or more depressive symptoms for at least one week. Its prevalence was estimated, and the associated factors were examined by the hierarchical multivariable analysis using the Poisson regression model. RESULTS A total of 32% (95% confidence interval 29.9-34.2) of university students presented a major depressive episode, and the problem was more frequent among women (prevalence ratio [PR] = 1.59); people aged 21 to 23 years (PR = 1.24); those with a family history of depression (PR = 1.27); minorities' sexual orientation (homosexuals, PR = 1.64, and bisexuals, PR = 1.69); who lived with friends or colleagues (PR = 1.36); students in the area of applied social and human sciences (PR = 1.28), and linguistics, language and literature, and art (PR = 1.25). The worst academic performance (PR = 2.61), alcohol abuse (PR = 1.25), and illicit drug use (PR = 1.30) were also positively associated with major depressive episode. CONCLUSION In addition to individual, family, and behavioral aspects, already described as risk factors for major depressive episodes in the general population, academic aspects also influence the occurrence of depression among university students. Considering the high prevalence of major depressive episode and its negative impact on health, public and institutional policies are necessary to focus on students' mental health promotion and care.


RESUMO INTRODUÇÃO A depressão é a principal causa de incapacidade em todo o mundo, atingindo cada vez mais os jovens. Este estudo avalia a prevalência e fatores associados ao episódio depressivo maior em universitários, com ênfase na influência do meio acadêmico, área de estudo escolhida pelo universitário e ambiente onde ele está inserido. METODOLOGIA Realizou-se um censo dos universitários ingressantes do primeiro semestre de 2017 em uma universidade do sul do Brasil. O desfecho episódio depressivo maior foi avaliado a partir do questionário Patient Health Questionnaire-9, considerado quando o indivíduo apresentava cinco ou mais sintomas depressivos por pelo menos uma semana. Sua prevalência foi estimada e os fatores associados foram examinados pela análise multivariável hierarquizada utilizando a regressão de Poisson com seleção para trás. RESULTADOS Um total de 32% (intervalo de confiança de 95% 29,9-34,2) dos universitários apresentou episódio depressivo maior, e o problema foi mais frequente entre indivíduos do sexo feminino (razão de prevalências [RP] = 1,59), de 21 a 23 anos de idade (RP = 1,24), com histórico familiar de depressão (RP = 1,27), com orientação sexual de minorias (homossexuais, RP = 1,64, e bissexuais, RP = 1,69), que moravam com amigos ou colegas (RP = 1,36), estudantes da área das ciências sociais aplicadas e humanas (RP = 1,28) e de linguística, letras e artes (RP = 1,25). O pior desempenho acadêmico (RP = 2,61), o uso abusivo de álcool (RP = 1,25) e o consumo de drogas ilícitas (RP = 1,30) também estiveram positivamente associados ao episódio depressivo maior. CONCLUSÃO Além dos aspectos individuais, familiares e comportamentais, semelhantes aos já descritos como fatores de risco para episódio depressivo maior na população em geral, aspectos acadêmicos também influenciam a ocorrência de depressão entre universitários. Considerando a alta prevalência de episódio depressivo maior e seu impacto negativo na saúde, são necessárias políticas públicas e institucionais que enfoquem a promoção da saúde e atenção à demanda de saúde mental dos estudantes.


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Students/psychology , Depressive Disorder, Major/epidemiology , Socioeconomic Factors , Universities , Brazil/epidemiology , Sex Factors , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Depressive Disorder, Major/diagnosis
19.
Ciênc. Saúde Colet ; 25(6): 2083-2092, Mar. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1101050

ABSTRACT

Resumo O objetivo deste estudo é estimar a prevalência de depressão e seus fatores associados em idosos residentes da zona rural do município de Rio Grande/RS. Neste estudo transversal de base populacional realizado com 994 idosos (≥ 60 anos), cuja amostragem foi baseada no Censo Demográfico de 2010, utilizou-se o "Patient Health Questionnaire 9" (PHQ-9) para o rastreio de Episódio Depressivo Maior (EDM). Foram realizadas análises descritiva, bivariada e multivariável, com uso de regressão logística. A prevalência geral para o rastreio de Episódio Depressivo Maior foi de 8,1%. As variáveis independentemente associadas com depressão foram: sexo feminino, uso contínuo de medicamentos, doenças crônicas, índice de massa corporal e pior percepção de saúde. A criação de programas de atendimento direcionados aos idosos da área rural, visando rastreamento, diagnóstico precoce de depressão e manutenção do tratamento, englobando diversos fatores relacionados à saúde, são ações importantes que devem ser fomentadas pelo sistema de saúde.


Abstract The aim of this study is to estimate the prevalence of depression and its associated factors in elderly residents of the rural area of Rio Grande/RS. In this cross-sectional population-based study performed with 994 elderly (≥ 60 years), whose sampling was based on the 2010 Demographic Census, the Patient Health Questionnaire 9 (PHQ-9) was used for Major Depressive Episode (EDM) screening. Descriptive, bivariate and multivariate analyses were performed using logistic regression. The overall prevalence for Major Depressive Episode screening was 8.1%. The variables independently associated with depression were: female gender, continuous use of medications, chronic diseases, body mass index and worse health perception. The creation of programs target at the elderly in the rural area, aimed at screening, early diagnosis of depression and maintenance of treatment, encompassing several factors related to health, are important actions that must be fostered by the health system.


Subject(s)
Humans , Female , Adult , Depression/diagnosis , Depression/epidemiology , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Rural Population , Socioeconomic Factors , Brazil/epidemiology , Prevalence , Cross-Sectional Studies
20.
Cad. Saúde Pública (Online) ; 36(2): e00154319, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1055635

ABSTRACT

Resumo: Embora se reconheça que depressão e ansiedade resultem em incapacidades, bem como em prejuízos laborais e para os sistemas de saúde, pesquisas de base populacional são escassas no Brasil. Este estudo avaliou a prevalência de transtornos mentais em adolescentes, jovens e adultos e sua relação com características sociodemográficas em cinco coortes de nascimento (RPS): Ribeirão Preto (São Paulo), Pelotas (Rio Grande do Sul) e São Luís (Maranhão), Brasil. Episódio depressivo, risco de suicídio, fobia social e transtorno de ansiedade generalizada foram avaliados usando-se o Mini International Neuropsychiatric Interview. Intervalos de confiança bootstrap foram estimados e prevalências estratificadas por sexo e nível socioeconômico no programa R. Foram incluídos 12.350 participantes das coortes. Episódio depressivo maior atual foi mais prevalente em adolescentes de São Luís (15,8%; IC95%: 14,8-16,8) e nos adultos de Ribeirão Preto (12,9%; IC95%: 12,0-13,9). As maiores prevalências para risco de suicídio ocorreram nos adultos de Ribeirão Preto (13,7%; IC95%:12,7-14,7), fobia social e ansiedade generalizada nos jovens de Pelotas com 7% (IC95%: 6,3-7,7) e 16,5% (IC95%: 15,4-17,5), respectivamente. As menores prevalências de risco de suicídio ocorreram nos jovens de Pelotas (8,8%; IC95%: 8,0-9,6), fobia social nos jovens de Ribeirão Preto (1,8%; IC95%: 1,5-2,2) e ansiedade generalizada nos adolescentes de São Luís (3,5%; IC95%: 3,0-4,0). Em geral, os transtornos mentais foram mais prevalentes nas mulheres e naqueles com menor nível socioeconômico, independentemente do centro e idade, reforçando a necessidade de maior investimento em saúde mental no Brasil, sem desconsiderar determinantes de gênero e socioeconômicos.


Resumen: A pesar de que se reconozca que la depresión y ansiedad provoquen incapacidades, así como perjuicios laborales y problemas para los sistemas de salud, las investigaciones de base poblacional son escasas en Brasil. Este estudio evaluó la prevalencia de trastornos mentales en adolescentes, jóvenes y adultos, y su relación con características sociodemográficas en cinco cohortes de nacimiento (RPS), en Ribeirão Preto (São Paulo), Pelotas (Rio Grande do Sul) y São Luís (Maranhão), Brasil. Episodio depresivo, riesgo de suicidio, fobia social y trastorno de ansiedad generalizada se evaluaron usando el Mini International Neuropsychiatric Interview. Se estimaron los intervalos de confianza bootstrap y las prevalencias fueron estratificadas por sexo y nivel socioeconómico en el programa R. Se incluyeron a 12.350 participantes de las cohortes. Un episodio actual depresivo mayor fue más prevalente en adolescentes de São Luís (15,8%; IC95%: 14,8-16,8) y en adultos de Ribeirão Preto (12,9%; IC95%: 12,0-13,9). Las mayores prevalencias para el riesgo de suicidio se produjeron en los adultos de Ribeirão Preto (13,7%; IC95%:12,7-14,7), fobia social y ansiedad generalizada en los jóvenes de Pelotas con 7% (IC95%: 6,3-7,7) y 16,5% (IC95%: 15,4-17,5), respectivamente. Las menores prevalencias de riesgo de suicidio se produjeron en los jóvenes de Pelotas (8,8%; IC95%: 8,0-9,6), fobia social en los jóvenes de Ribeirão Preto (1,8%; IC95%: 1,5-2,2) y ansiedad generalizada en los adolescentes de São Luís (3,5%; IC95%: 3,0-4,0). En general, los trastornos mentales fueron más prevalentes en las mujeres y en aquellos con menor nivel socioeconómico, independientemente del centro y edad, reforzando la necesidad de una mayor inversión en salud mental en Brasil, sin desconsiderar determinantes de género y socioeconómicos.


Abstract: Although depression and anxiety are known to result in disabilities and workplace and health system losses, population-based studies on this problem are rare in Brazil. The current study assessed the prevalence of mental disorders in adolescents, youth, and adults and the relationship to sociodemographic characteristics in five birth cohorts (RPS) in Ribeirão Preto (São Paulo State), Pelotas (Rio Grande do Sul State), and São Luís (Maranhão State), Brazil. Major depressive episode, suicide risk, social phobia, and generalized anxiety disorder were assessed with the Mini International Neuropsychiatric Interview. Bootstrap confidence intervals were estimated and prevalence rates were stratified by sex and socioeconomic status in the R program. The study included 12,350 participants from the cohorts. Current major depressive episode was more prevalent in adolescents in São Luís (15.8%; 95%CI: 14.8-16.8) and adults in Ribeirão Preto (12.9%; 95%CI: 12.0-13.9). The highest prevalence rates for suicide risk were in adults in Ribeirão Preto (13.7%; 95%CI: 12.7-14.7), and the highest rates for social phobia and generalized anxiety were in youth in Pelotas, with 7% (95%CI: 6.3-7.7) and 16.5% (95%CI: 15.4-17.5), respectively. The lowest prevalence rates of suicide risk were in youth in Pelotas (8.8%; 95%CI: 8.0-9.6), social phobia in youth in Ribeirão Preto (1.8%; 95%CI: 1.5-2.2), and generalized anxiety in adolescents in São Luís (3.5%; 95%CI: 3.0-4.0). Mental disorders in general were more prevalent in women and in individuals with lower socioeconomic status, independently of the city and age, emphasizing the need for more investment in mental health in Brazil, including gender and socioeconomic determinants.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Mental Disorders/epidemiology , Anxiety , Socioeconomic Factors , Suicide , Brazil/epidemiology , Prevalence , Cohort Studies , Cities , Depressive Disorder, Major , Phobia, Social
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