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1.
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
2.
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
3.
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
4.
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
5.
Trends psychiatry psychother. (Impr.) ; 41(4): 369-374, Oct.-Dez. 2019. tab
Article in English | LILACS | ID: biblio-1059183

ABSTRACT

Abstract Objective To explore and describe sociodemographic characteristics, crack consumption patterns, and psychiatric comorbidities of female crack users receiving treatment at therapeutic communities. Methods This was a cross-sectional, descriptive, quantitative study. Forty-six women who abstained from crack use were assessed using a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and a profile of crack use questionnaire. Descriptive statistical analyses were conducted. Results Participants had a mean age of 31.02 years (standard deviation [SD] = 7.73), most were single (76.1%), white (67.4%) and had complete or incomplete elementary education (43.5%). Before treatment, 65.2% of the women reported using crack every day; 46.3% smoked between 10 to 30 crack rocks per week. Mean treatment time was 63.56 days (SD = 75.85), with a mean of 80.41 days of abstinence (SD = 74.52) and 3.37 previous treatments (SD = 5.49). Mean age upon crack use initiation was 22.61 years (SD = 8.06), and the most frequent motivation to start using crack was curiosity (78.3%). The mean lifetime duration of crack use was 82.26 months (SD = 74.76), and the physical complications most frequently reported were weight loss (93.5%), followed by sleep problems (87%). In this study, the most prevalent psychiatric diagnoses were major depressive episode (60.87%), followed by post-traumatic stress disorder (52.17%) and generalized anxiety disorder (13.07%). Conclusions Overall, a pattern of high consumption of crack was observed. The results show a high frequency of mood and anxiety disorders, with the highest frequencies found for major depressive episode and post-traumatic stress disorder.


Resumo Objetivo Explorar e descrever características sociodemográficas, padrão de consumo e comorbidades psiquiátricas em mulheres usuárias de crack recebendo tratamento em comunidades terapêuticas. Método Estudo transversal, descritivo e quantitativo. Quarenta e seis mulheres abstinentes de crack responderam a um questionário sociodemográfico, ao Mini-Exame do Estado Mental (MEEM), à Entrevista Estruturada do DSM-IV para Transtornos do Eixo I (SCID-I) e a um questionário sobre padrão de consumo de crack. Foram realizadas análises estatísticas descritivas dos dados. Resultados As participantes tinham média de 31,02 anos [desvio padrão (DP) = 7,73], eram na maioria solteiras (76,1%), brancas (67,4%) e tinham ensino fundamental completo ou incompleto (43,5%). Antes do tratamento, 65,2% das mulheres relataram usar crack todos os dias; 46,3% fumavam entre 10 e 30 pedras de crack por semana. O tempo médio de tratamento foi de 63,56 dias (DP = 75,85), com média de 80,41 dias em abstinência (DP = 74,52) e 3,37 (DP = 5,49) tratamentos anteriores. A idade média de início do uso de crack foi de 22,61 anos (DP = 8,06), e a motivação mais frequente para iniciar o uso de crack foi a curiosidade (78,3%). A duração média de uso de crack na vida foi de 82,26 meses (DP = 74,76), e as complicações físicas mais frequentemente relatadas foram perda de peso (93,5%), seguida por problemas de sono (87%). Neste estudo, os diagnósticos mais prevalentes foram episódio depressivo maior (60,87%), seguido por transtorno de estresse pós-traumático (52,17%) e transtorno de ansiedade generalizada (13,07%). Conclusões Em geral, observamos um padrão de alto consumo de crack. Os resultados mostram alta frequência de transtornos de humor e ansiedade, com maiores frequências para episódio depressivo maior e transtorno de estresse pós-traumático.


Subject(s)
Humans , Female , Adult , Young Adult , Cocaine Smoking/epidemiology , Anxiety Disorders/epidemiology , Sleep Wake Disorders/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Brazil/epidemiology , Weight Loss , Comorbidity , Cross-Sectional Studies , Surveys and Questionnaires , Crack Cocaine , Marital Status , Depressive Disorder, Major/epidemiology , Educational Status , Cocaine Smoking/psychology , Cocaine Smoking/therapy , Mental Status and Dementia Tests , Interview, Psychological
6.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 396-402, Sept.-Oct. 2019. tab
Article in English | LILACS | ID: biblio-1039105

ABSTRACT

Objective: To assess the prevalence of depression and sociodemographic, behavioral, and health-related risk factors therefor in a southern Brazilian city. Methods: Population-based, cross-sectional study of adults from Rio Grande, state of Rio Grande do Sul, Brazil. Individuals (n=1,295) were selected using a multistage sampling procedure. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for major depressive episodes (MDEs). We used a conceptual causal framework to organize and assess risk factors for MDE and calculated prevalence ratios (PR) using regression models. Results: The prevalence of MDE was 8.4% (95%CI 6.0-10.7) for men and 13.4% (95%CI 11.0-15.8) for women. For men, physical inactivity (PR 2.34, 95%CI 1.09-5.00) and perceived stress (PR 20.35, 95%CI 5.92-69.96) were associated with MDE. In women, MDE prevalence was higher among those in the first tertile of economic index (PR 2.61, 95%CI 1.53-4.45), with 0-8 years of schooling (PR 2.25, 95%CI 1.24-4.11), alcohol users (PR 1.91, 95%CI 1.21-3.02), those physically inactive (PR 2.49, 95%CI 1.22-5.09), with the highest perceived stress (PR 9.17, 95%CI 3.47-24.23), with another mental disorder (PR 1.85, 95%CI 1.32-2.59), and with more noncommunicable diseases (PR 1.85, 95%CI 1.06-3.22). Conclusion: Women had a higher prevalence of depression, and socioeconomic disadvantages were important for the occurrence of MDE; however, for men, only physical inactivity and stress were important predictors, suggesting possible different causal pathways for each sex.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Depressive Disorder, Major/etiology , Depressive Disorder, Major/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Poisson Distribution , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Sex Distribution , Age Distribution , Middle Aged
7.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 433-436, Sept.-Oct. 2019. tab
Article in English | LILACS | ID: biblio-1039109

ABSTRACT

Objective: To evaluate the association between social and health contextual variables, and between major depressive episodes (MDE) and suicidal thoughts in Brazilian adults. Methods: This population-based cross-sectional study used data from the 2013 National Health Survey (Pesquisa Nacional de Saúde). The Patient Health Questionnaire was used to evaluate the presence of MDE and suicidal thoughts. We used number of Family Health Strategy teams (FHS) per 20,000 state population, number of Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) per 1,000 state population, gross domestic product (GDP), and Gini index for each Brazilian state as contextual variables. Multilevel logistic regression models were used to calculate OR and the intraclass correlation coefficient (ICC). Results: Prevalence of MDE and suicidal thoughts was 4.1% (95%CI 3.8-4.4) and 3.8% (95%CI 3.5-4.1), respectively. Multilevel regression models showed an ICC of 1.1% for MDE (95%CI 0.5-2.3) and 1.3% for suicidal thoughts (95%CI 0.6-2.6). Neither GDP, Gini, FHS, or CAPS showed evidence of association with the outcomes. Conclusions: In general, contextual variables, within each Brazilian state, do not seem to affect the prevalence of MDE and suicidal thoughts.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Depressive Disorder, Major/etiology , Depressive Disorder, Major/epidemiology , Suicidal Ideation , Socioeconomic Factors , Brazil/epidemiology , Logistic Models , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Health Surveys , Sex Distribution , Age Distribution , Multilevel Analysis , Middle Aged
8.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(4): 316-323, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1011503

ABSTRACT

Objective: To estimate the prevalence of major depressive episode (MDE) in patients with presumptive pulmonary tuberculosis (pre-PTB, defined by cough lasting ≥ 3 weeks) and compare it between patients with pulmonary tuberculosis (PTB) and without PTB. Methods: Patients with pre-PTB (n=260) were screened for depression using the Patient Health Questionnaire (PHQ-9). Those individuals with scores ≥ 10 were subsequently assessed with the depression module of the Mini International Neuropsychiatric Interview (MINI-Plus) to confirm diagnosis. Associations of categorical variables with PTB and MDE were calculated using the chi-square test and OR. Results: PTB was confirmed in 98 patients (37.7%). A high proportion of both groups (active PTB and no PTB) screened positive for depression (60.2 vs. 62.1%, respectively). Among 159 patients who screened positive for depression, a subset of 97 (61.0%) were further evaluated with the MINI-Plus; current MDE was confirmed in 54.6% (53/97). On univariate and multivariate analysis, female sex was the only factor associated with the diagnosis of current MDE (p = 0.04). Conclusion: The prevalence of MDE was high among individuals with prolonged respiratory symptoms, independent of PTB diagnosis. This is consistent with other studies of depression in primary care in Brazil.


Subject(s)
Humans , Male , Female , Adult , Tuberculosis, Pulmonary/complications , Depression/complications , Depression/psychology , Depressive Disorder, Major/complications , Depressive Disorder, Major/psychology , Primary Health Care , Socioeconomic Factors , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Depression/diagnosis , Depression/epidemiology , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Middle Aged
9.
Clin. biomed. res ; 39(4): 292-300, 2019.
Article in Portuguese | LILACS | ID: biblio-1053537

ABSTRACT

Introdução: A associação entre depressão e fatores de risco cardiovascular é recorrente. O aumento de risco em deprimidos está relacionado à fatores como obesidade, sedentarismo, dislipidemia, alcoolismo e tabagismo. O objetivo deste trabalho foi identificar a presença de fatores de risco para o desenvolvimento de doenças cardiovasculares em pacientes com quadro de depressão internados em um hospital do sul do Brasil. Métodos: Estudo transversal que envolveu adultos de ambos os sexos internados por episódio depressivo. O estado nutricional foi avaliado pelas medidas antropométricas de peso, altura e circunferência da cintura. Um questionário foi aplicado englobando perfil sociodemográfico, histórico familiar de doenças, consumo de produtos de tabaco e de álcool, atividade física, além do questionário autoaplicável para medida da severidade da depressão. Para avaliação do risco cardiovascular global, foi calculado o escore de Framingham. Os testes qui-quadrado de Pearson (χ2 ) ou exato de Fisher foram utilizados para testar a associação entre as variáveis categóricas, considerando o nível de significância quando p ≤ 0,05 e IC95%. Resultados: Foram avaliados 54 indivíduos, predominantemente mulheres (n = 32), com idade média de 40,2 ± 10,8 anos. A depressão foi classificada como grave na maioria dos pacientes (n = 29). Fatores de risco relacionados ao nível de atividade física (sedentarismo), dislipidemia e estado nutricional (sobrepeso e obesidade) estiveram presentes em 81,5%, 73,1% e 66,7% da amostra, respectivamente. Percentual de risco obtido por meio do escore de Framingham foi encontrado acima do normal em 42,9% dos indivíduos. Depressão leve associou-se positivamente aos pacientes com magreza/eutrofia e, ao serem estratificados como severos e não-severos, o primeiro grupo teve associação positiva com histórico familiar de excesso de peso e hipertensão. Conclusões: Diversos fatores de risco cardiovascular foram encontrados, alertando para a importância do cuidado integral da saúde do paciente e avaliação destes indicadores. (AU)


Introduction: The association between depression and cardiovascular risk factors is recurrent. Increased risk of depression is related to factors such as obesity, sedentary lifestyle, dyslipidemia, alcoholism, and smoking. The aim of this study was to identify the presence of risk factors for the development of cardiovascular disease in patients with depression admitted to a hospital in southern Brazil. Methods: A cross-sectional study involving adults of both sexes hospitalized for a depressive episode. Nutritional status was assessed by the anthropometric measurements of weight, height and waist circumference. A questionnaire was applied covering sociodemographic data, family history of diseases, consumption of tobacco and alcohol products, and physical activity, in addition to a self-administered questionnaire to measure the severity of depression. The Framingham risk score was calculated for global cardiovascular risk evaluation. Pearson's chi-square test (χ2 ) or Fisher's exact Test were used to test the association between categorical variables, considering the level of significance at p ≤ 0.05 and 95% CI. Results: Fifty-four individuals were evaluated, most were women (n = 32), with a mean age of 40.2 ± 10.8 years were evaluated. Depression was classified as severe in most patients (n = 29). Risk factors related to the physical activity level (sedentary lifestyle), dyslipidemia and nutritional status (overweight and obesity) were present in 81.5%, 73.1% and 66.7% of the sample, respectively. Percentage of risk obtained by the Framingham risk score was found above normal in 42.9% of the individuals. Mild depression was positively associated with thin/eutrophic patients and, when stratified as severe and non-severe, the first group had a positive association with family history of overweight and hypertension. Conclusions: Several cardiovascular risk factors were found, alerting to the importance of integral health care for patients and evaluation of these indicators. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Nutritional Status , Depressive Disorder, Major/epidemiology , Motor Activity , Comorbidity , Risk Factors , Depressive Disorder, Major/diagnosis
10.
Arch. Health Sci. (Online) ; 24(4): 20-24, 22/12/2017.
Article in Portuguese | LILACS | ID: biblio-1046743

ABSTRACT

Introdução: A depressão exerce um impacto importante na qualidade de vida dos idosos, sendo imprescindível a compreensão dos fatores de risco para o desenvolvimento da doença, para que profissionais de saúde atuem no planejamento e implementação de ações direcionadas à promoção de saúde desse público. Objetivo:Analisar a prevalência de transtorno depressivo maior em idosos atendidos em um centro de referência do norte de Minas Gerais, avaliando associações com fatores de risco sociodemográficos. Material e Métodos: Realizou-se um estudo transversal e documental, a partir de 3362 prontuários de pacientes atendidos no Centro de Referência em Montes Claros, Minas Gerais, Brasil, no período entre janeiro de 2008 e dezembro de 2011. Para análise do quadro de depressão, foram utilizados dados do diagnóstico a partir do DSM-IV. Foram realizados testes de qui-quadrado e exato de Fisher para determinar fatores sociodemográficos associados àocorrência de depressão. Resultados:Odiagnóstico de transtorno depressivo maior esteve presente na maioria dos idosos (56,8%). Foi encontrada associação estatisticamente significativa na presença de transtorno depressivo maior em idosos do sexo feminino (p<0,001), não casados (p<0,001) e não alfabetizados (p<0,002). Não houve relação estatisticamente significativa entre as variáveis idade e presença de transtorno depressivo maior nos idosos estudados (p=0,599). Conclusão:Aalta prevalência do transtorno depressivo maior nos idosos desta pesquisa, bem como a identificação dos fatores associados chama atenção para necessidade de políticas de atenção voltadas para prevenção e detecção precoce do transtorno depressivo maior, de forma a atender a suas demandas e proporcionar uma longevidade com qualidade de vida.


Introduction: Depression has an important impact on thequality of life of older people. It is imperative to understand the risk factors to the development of the disease. This understanding is critical to health professionals,once they have to plan and implement actions aimed at health promotion for that population. Objective: Analyze the prevalence of major depressive disorder in older peopleattending a reference center in the North of Minas Gerais State, in order to establish associations among the disorder andsociodemographic risk factors.Material andMethods:We conducted a cross-sectionaland documentary study from 3362 records of patients treated at a Reference Center in the city of Montes Claros, Minas Gerais State, Brazil from January 2008 to December 2011. For depression condition analysis, we used the categorical classification of mental disorders (DSM-IV). We used Fisher's exact test and chi-square test to determine sociodemographic factors associated with depression.Results: The majority of older people (56.8%) were diagnosed with major depressive disorder. A statistically significant association was found between major depressive disorder and female (p <0.001), unmarried (p<0.001) and non-literate (p<0.002)older people. There was no statistically significant relation between age and the presence of major depressive disorder (p=0.599).Conclusion: The high prevalence of major depressive disorder found among older people, as well as the identification of associated factors, draws attention to the need for attention policies aimed at prevention and early detection of major depressive disorder in order to meet their demands and provide longevity with quality of life.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Aged/statistics & numerical data , Depression/epidemiology , Depressive Disorder, Major/epidemiology , Aging , Deinstitutionalization
11.
Trends psychiatry psychother. (Impr.) ; 39(4): 276-279, Oct.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-1043513

ABSTRACT

Abstract Introduction Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. Objectives To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. Methods We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Results Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). Conclusion GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.


Resumo Introdução A depressão geriátrica (DG) é um transtorno prevalente que permanece sendo subdiagnosticado. Ferramentas validadas para rastreio de DG em idosos muito idosos na prática clínica são necessárias, especialmente em países em desenvolvimento. Objetivos Avaliar a acurácia diagnóstica da Escala de Depressão Geriátrica (Geriatric Depression Scale, GDS-15) em uma população de idosos muito idosos residentes na comunidade. Métodos Foram avaliados, com a GDS-15, 457 indivíduos nãodemenciados, residentes na comunidade, com idade ≥75 anos. O diagnóstico definitivo de depressão maior foi realizado através da entrevista semiestruturada Mini International Neuropsychiatric Interview (MINI), de acordo com os critérios do DSM-IV. Resultados Cinquenta e dois indivíduos (11,4%) foram diagnosticados com episódio depressivo maior. A área sob a curva receiver operating characteristic (ROC) foi de 0,908 (p<0,001). Utilizando-se o ponto de corte 5/6 (não-deprimido/deprimido), 84 (18,4%) indivíduos foram considerados deprimidos pela GDS-15 (coeficiente de kappa = 53,8%, p<0,001). O ponto de corte 4/5 atingiu a melhor combinação entre sensibilidade (86,5%) e especificidade (82,7%) (índice de Youden = 0,692), com valor preditivo negativo robusto (0,9802) e razoável valor preditivo positivo (0,3819). Conclusão A GDS-15 demonstrou boa acurácia para o rastreio de depressão maior nesta amostra de base populacional de idosos muito idosos com baixa escolaridade. Os resultados do presente estudo indicam que o ponto de corte 4/5 mostrou-se mais adequado para utilização nesta população.


Subject(s)
Humans , Male , Female , Aged, 80 and over , Psychiatric Status Rating Scales , Geriatric Assessment , Depressive Disorder, Major/diagnosis , Interview, Psychological , Cross-Sectional Studies , ROC Curve , Area Under Curve , Depressive Disorder, Major/epidemiology , Educational Status , Independent Living
12.
Ciênc. Saúde Colet ; 22(9): 3061-3075, Set. 2017. tab
Article in Portuguese | LILACS | ID: biblio-890463

ABSTRACT

Resumo O suicídio é um sério problema de saúde pública em todo o mundo. O avanço da idade está diretamente associado ao aumento da incidência de câncer e as limitações físicas e funcionais decorrentes da doença são fatores associados ao comportamento suicida em idosos. Este estudo teve por objetivo revisar criticamente a literatura sobre os fatores de risco associados ao suicídio em pacientes idosos com câncer, publicada entre 2000 e 2015. Foram examinados os determinantes psicossociais de risco e a psicopatologia em 20 artigos selecionados. Os estudos consistentemente identificam um conjunto de fatores que têm sido associados ao comportamento suicida em idosos com câncer, que incluem comprometimento físico e mental (particularmente depressão maior), isolamento social e o modo como esses fatores e outros interagem entre si. Dada a importância do tema, novas pesquisas se fazem necessárias para examinar se a educação do profissional de saúde e o incremento de suas habilidades de avaliação e manejo do risco suicida poderiam ter efeitos positivos na redução das taxas de suicídio observadas entre idosos com câncer. Considerações para estudos futuros encorajam a adoção de intervenções baseadas em evidências empíricas para o manejo individualizado do paciente oncológico idoso.


Abstract Suicide is a serious public health problem worldwide. Increasing age is directly associated with the rising rates of cancer and physical and functional limitations are important factors regarded as being associated with suicidal behavior among the elderly. This study sought to conduct a critical review of the literature on the risk factors associated with suicide among elderly cancer patients published between 2000 and 2015. Psychosocial precipitants of risks and psychopathology in 20 selected articles were conducted. The studies consistently identified a number of factors that have been considered to be associated with suicidal behavior among the elderly diagnosed with cancer. These include physical and mental health constraints (particularly major depression), social isolation, and the manner in which these factors and others interact. Further research is needed given the importance of the issue and to examine whether further education for healthcare providers and their abilities in suicide risk assessment and management could have positive effects on reducing the suicide rates among elderly patients with cancer. Considerations for upcoming studies encourage the adoption of empirically supported interventions for individualized management of the elderly cancer patient.


Subject(s)
Humans , Aged , Suicide/psychology , Suicidal Ideation , Neoplasms/psychology , Social Isolation/psychology , Public Health , Risk Factors , Age Factors , Risk Assessment/methods , Depressive Disorder, Major/psychology , Depressive Disorder, Major/epidemiology
13.
Rev. bras. psiquiatr ; 39(3): 208-215, July-Sept. 2017. tab
Article in English | LILACS | ID: biblio-899364

ABSTRACT

Objective: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil. Methods: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants' mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR). Results: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93). Conclusions: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.


Subject(s)
Humans , Male , Female , Pregnancy , Adolescent , Adult , Pregnancy Complications/epidemiology , Diet Surveys/statistics & numerical data , Feeding Behavior , Mental Disorders/epidemiology , Anxiety Disorders/epidemiology , Socioeconomic Factors , Severity of Illness Index , Brazil/epidemiology , Candy/statistics & numerical data , Prevalence , Cross-Sectional Studies , Phaseolus , Depressive Disorder, Major/epidemiology , Food Preferences , Fruit
14.
Trends psychiatry psychother. (Impr.) ; 39(2): 106-109, Apr.-June 2017. tab
Article in English | LILACS | ID: biblio-904573

ABSTRACT

Abstract Introduction Female sexual dysfunction (FSD) in depression albeit common is strikingly understudied. The condition, if addressed properly, can be readily cured, improving the quality of life of the patient. Methods A consecutive sample of drug-naïve married female patients with depression was assessed. Depression was diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D), and sexual dysfunction, the Female Sexual Function Index (FSFI). Results Sexual dysfunction was found in 90% of the patients in our study. Patients with medical comorbidities showed a significant decrease in the desire subset of the FSFI (Mann-Whitney U=11.0, p=0.009), however there was no significant association with other subsets. Patients who expressed passive death wishes had higher scores on all indicators of sexual function and a significantly higher score in the orgasm subset of the FSFI (Mann-Whitney U=11.0, p=0.009). Conclusion The study showed a high prevalence of FSD in depressed females regardless of type and severity of depression. Depression with medical comorbidities was associated with a significant decrease in desire. Patients who expressed passive death wishes showed improved sexual function and significantly better orgasm.


Resumo Introdução Disfunção sexual feminina (DSF) na depressão, apesar de comum, é pouco estudada. Se tratada adequadamente, a condição pode ser prontamente curada, aumentando a qualidade de vida da paciente. Métodos Foi avaliada uma amostra consecutiva de mulheres casadas, virgens de tratamento, com depressão. A depressão foi diagnosticada utilizando a Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). A gravidade da depressão foi avaliada utilizando a Escala de Avaliação de Depressão de Hamilton (HAM-D), e a disfunção sexual, com o Índice da Função Sexual Feminina (Female Sexual Function Index, FSFI). Resultados Foi observada disfunção sexual em 90% das pacientes do estudo. As pacientes com comorbidades médicas mostraram uma diminuição significativa no subdomínio desejo da FSFI (Mann-Whitney U=11,0, p=0,009), porém não houve associação significativa com os outros subdomínios. Pacientes que expressaram desejos passivos de morte apresentaram escores mais altos em todos os indicadores de função sexual e um escore significativamente mais alto no subdomínio orgasmo da FSFI (Mann-Whitney U=11,0, p=0,009). Conclusão O estudo revelou uma alta prevalência de DSF em mulheres deprimidas, independentemente do tipo e da severidade da depressão. A depressão com comorbidades médicas foi associada a uma diminuição significativa do desejo. Pacientes que expressaram desejos passivos de morte mostraram função sexual melhor e orgasmo significativamente melhor.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Sexual Dysfunction, Physiological/epidemiology , Sexual Dysfunctions, Psychological/epidemiology , Depressive Disorder, Major/epidemiology , Psychiatric Status Rating Scales , Sexual Dysfunction, Physiological/complications , Severity of Illness Index , Marriage , Comorbidity , Prevalence , Cross-Sectional Studies , Sexual Dysfunctions, Psychological/complications , Depressive Disorder, Major/complications , Depressive Disorder, Major/psychology , Suicidal Ideation , Middle Aged
15.
Rev. méd. Chile ; 145(3): 335-343, Mar. 2017. graf, tab
Article in Spanish | LILACS | ID: biblio-845545

ABSTRACT

Background: Depression is considered the second leading cause of disability worldwide. Aim: To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE). Material and Methods: Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women). Patients were assessed as outpatients every three months at three psychiatric care centers of Chile. Clinical interviews were carried out using DSM-IV diagnostic criteria checklists and the Hamilton Depression Scale was applied. Results: Most patients were referred from primary care. The mean time lapse for referral to the secondary level was 10.8 months. Most patients had episodes that were recurrent, severe, with a high rate of psychosis, with suicide attempts and melancholic features and with psychiatric and medical comorbidities. Remission rate was 27.5%. In only 16 % of patients, the episode lasted six months or less. The group with recurrent episodes had different age, sex and clinical features. Conclusions: MDD treated at the secondary care level is severe and its symptoms are intense. The time lapse prior to referral was prolonged. Primary care management and referral of these patients should be studied more closely.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Depressive Disorder, Major/drug therapy , Antidepressive Agents/therapeutic use , Psychiatric Status Rating Scales , Recurrence , Socioeconomic Factors , Chile , Longitudinal Studies , Treatment Outcome , Depressive Disorder, Major/epidemiology , Ambulatory Care
16.
Arq. bras. cardiol ; 108(3): 217-227, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-838704

ABSTRACT

Abstract Background: Major Depressive Disorder (MDD) is one of the most common mental illnesses in psychiatry, being considered a risk factor for Acute Coronary Syndrome (ACS). Objective: To assess the prevalence of MDD in ACS patients, as well as to analyze associated factors through the interdependence of sociodemographic, lifestyle and clinical variables. Methods: Observational, descriptive, cross-sectional, case-series study conducted on patients hospitalized consecutively at the coronary units of three public hospitals in the city of Rio de Janeiro over a 24-month period. All participants answered a standardized questionnaire requesting sociodemographic, lifestyle and clinical data, as well as a structured diagnostic interview for the DSM-IV regarding ongoing major depressive episodes. A general log-linear model of multivariate analysis was employed to assess association and interdependence with a significance level of 5%. Results: Analysis of 356 patients (229 men), with an average and median age of 60 years (SD ± 11.42, 27-89). We found an MDD point prevalence of 23%, and a significant association between MDD and gender, marital status, sedentary lifestyle, Killip classification, and MDD history. Controlling for gender, we found a statistically significant association between MDD and gender, age ≤ 60 years, sedentary lifestyle and MDD history. The log-linear model identified the variables MDD history, gender, sedentary lifestyle, and age ≤ 60 years as having the greatest association with MDD. Conclusion: Distinct approaches are required to diagnose and treat MDD in young women with ACS, history of MDD, sedentary lifestyle, and who are not in stable relationships.


Resumo Fundamento: O transtorno depressivo maior (TDM) é um dos distúrbios mentais mais comuns em psiquiatria, sendo um fator de risco para síndrome coronariana aguda (SCA). Objetivo: Avaliar a prevalência de TDM em pacientes com SCA, assim como analisar os fatores associados através da interdependência de variáveis sociodemográficas, clínicas e de estilo de vida. Métodos: Estudo observacional, descritivo e transversal conduzido em pacientes hospitalizados consecutivamente nas unidades coronarianas de três hospitais públicos na cidade do Rio de Janeiro num período de 24 meses. Todos os participantes responderam a um questionário padrão sobre dados sociodemográficos, clínicos e de estilo de vida, assim como participaram de uma entrevista clínica estruturada do DSM-IV sobre episódio depressivo maior atual. Aplicou-se um modelo log-linear de análise multivariada para avaliar associação e interdependência, com nível de significância de 5%. Resultados: Análise de 356 pacientes (229 homens) com idade média e mediana de 60 anos (DP ± 11,42; 27-89). Encontrou-se uma prevalência pontual de TDM de 23%, e significativa associação de TDM com as variáveis sexo, estado civil, sedentarismo, classificação Killip e história de TDM. Ao controlar por sexo, observou-se associação estatisticamente significativa entre TDM e sexo, idade ≤ 60 anos, sedentarismo e história de TDM. O modelo log-linear identificou as variáveis história de TDM, sexo, sedentarismo e idade ≤ 60 anos como tendo a maior associação com TDM. Conclusão: Os resultados indicam a necessidade de abordagens distintas para diagnosticar e tratar TDM em mulheres jovens com SCA, história de TDM, sedentarismo e que não estejam em relações estáveis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Depressive Disorder, Major/complications , Depressive Disorder, Major/epidemiology , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/psychology , Acute Coronary Syndrome/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Sex Factors , Prevalence , Cross-Sectional Studies , Interviews as Topic , Multivariate Analysis , Surveys and Questionnaires , Risk Factors , Age Factors , Sex Distribution , Sedentary Behavior , Inpatients/statistics & numerical data
17.
Rev. saúde pública ; 51(supl.1): 8s, 2017. tab
Article in English | LILACS | ID: biblio-845914

ABSTRACT

ABSTRACT OBJECTIVE To evaluate the prevalence of health-related behaviors according to presence and type of depression in Brazilian adults. METHODS Based on a sample of 49,025 adults (18 to 59 years) from the National Survey on Health 2013 (PNS 2013), we estimated the prevalence of health-related behaviors (smoking; passive smoking; frequent or risky alcohol consumption; leisure time physical activity; time watching TV; and eating pattern indicators), according to the presence of depression (minor and major), evaluated by the Patient Health Questionnaire – 9 (PHQ-9), and the report of depressive mood (in up to seven days or more than seven days) over a two-week period. Prevalence ratios were estimated by Poisson regression. RESULTS Evaluated by the PHQ-9 scale, 9.7% of the Brazilian adults had depression and 3.9% presented major depression. About 21.0% reported depressive mood and, in 34.9% of them, that feeling has been present for more than seven days. In individuals with major depression (PHQ-9), higher prevalence was found in almost all unhealthy behaviors analyzed, in particular, smoking (PR = 1.65), passive smoking (PR = 1.55), risk alcohol consumption (PR = 1.72), TV for ≥ 5 hours/day (PR = 2.13), consumption of fat meat (PR = 1.43) and soft drink (PR = 1.42). The prevalence ratios tended to be lower in those with minor depression. Similar results were observed in adults with depressive mood. CONCLUSIONS This study detected relevant association between depression and health behaviors, in particular for smoking and physical activity. The associations found with the PHQ were similar to those observed with the application of a single question about depressive mood. Our results indicate the importance of assessing the presence of depression and the frequency and severity of symptoms when implementing actions for the promotion of healthy behaviors.


RESUMO OBJETIVO Avaliar a prevalência de comportamentos relacionados à saúde segundo a presença e tipo de depressão em adultos brasileiros. MÉTODOS Com base em amostra de 49.025 adultos (18 a 59 anos) da Pesquisa Nacional de Saúde 2013, foram estimadas as prevalências de comportamentos relacionados à saúde (tabagismo, fumo passivo, consumo frequente ou de risco de álcool, atividade física de lazer, horas de TV e indicadores de padrão alimentar), segundo a presença de depressão (menor e maior), avaliada pela escala PHQ-9, e o relato de humor depressivo (em até sete dias ou em mais de sete dias) em um período de duas semanas. Razões de prevalências foram estimadas por meio de regressão de Poisson. RESULTADOS Avaliados pela escala PHQ-9, 9,7% dos adultos brasileiros apresentaram depressão, e 3,9%, depressão maior. Cerca de 21,0% relataram humor depressivo e em 34,9% deles esse sentimento esteve presente por mais de sete dias. Nos indivíduos com depressão maior (PHQ-9), foram constatadas prevalências mais elevadas de quase todos os comportamentos não saudáveis analisados, principalmente tabagismo (RP = 1,65), fumo passivo (RP = 1,55), consumo de risco de álcool (RP = 1,72), horas de TV ≥ 5 h/dia (RP = 2,13), consumo de carne gordurosa (RP = 1,43) e refrigerante (RP = 1,42). As razões de prevalência tenderam a ser menores na depressão menor. Resultados similares foram observados nos adultos com humor depressivo. CONCLUSÕES O estudo detectou relevante associação entre depressão e comportamentos de saúde, em especial, para tabagismo e atividade física. As associações encontradas com o uso do PHQ foram similares às observadas com a aplicação de uma única pergunta sobre humor depressivo. Os resultados do estudo sinalizam a importância da avaliação da presença de depressão e da frequência e gravidade dos sintomas quando da implementação de ações para a promoção de comportamentos saudáveis.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Depression/epidemiology , Depressive Disorder, Major/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Depressive Disorder, Major/diagnosis , Health Behavior , Health Behavior/classification , Health Knowledge, Attitudes, Practice , Prevalence , Risk Factors
18.
Rev. bras. anestesiol ; 65(6): 491-496, Nov.-Dec. 2015. tab, graf
Article in Portuguese | LILACS | ID: lil-769891

ABSTRACT

BACKGROUND AND OBJECTIVES: Epidural catheter bacteria filters are barriers in the patient-controlled analgesia/anaesthesia for preventing contamination at the epidural insertion site. The efficiency of these filters varies according to pore sizes and materials. METHOD: The bacterial adhesion capability of the two filters was measured in vitro experiment. Adhesion capacities for standard Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) strains of the two different filters (Portex and Rusch) which have the same pore size were examined. Bacterial suspension of 0.5 Mc Farland was placed in the patient-controlled analgesia pump, was filtered at a speed of 5 mL/h. in continuous infusion for 48 h and accumulated in bottle. The two filters were compared with colony counts of bacteria in the filters and bottles. At the same time, the filters and adhered bacteria were monitored by scanning electron microscope. RESULTS: Electron microscopic examination of filters showed that the Portex filter had a granular and the Rusch filter fibrillary structure. Colony counting from the catheter and bottle showed that both of the filters have significant bacterial adhesion capability (p < 0.001). After the bacteria suspension infusion, colony countings showed that the Portex filter was more efficient (p < 0.001). There was not any difference between S. aureus and P. aeruginosa bacteria adhesion. In the SEM monitoring after the infusion, it was physically shown that the bacteria were adhered efficiently by both of the filters. CONCLUSION: The granular structured filter was found statistically and significantly more successful than the fibrial. Although the pore sizes of the filters were same - of which structural differences shown by SEM were the same - it would not be right to attribute the changes in the efficiencies to only structural differences. Using microbiological and physical proofs with regard to efficiency at the same time has been another important aspect of this experiment.


JUSTIFICATIVA E OBJETIVOS: Os filtros antibacterianos para cateter epidural são barreiras da analgesia/anestesia controlada pelo paciente para evitar a contaminação do local de inserção epidural. A eficácia desses filtros varia de acordo com o material e o tamanho dos poros. MÉTODO: A capacidade de aderência bacteriana dos dois filtros foi medida em experimento in vitro. Avaliamos a capacidade de aderência das cepas padrão de Staphylococcus aureus (ATCC 25923) e Pseudomonas aeruginosa (ATCC 27853) de dois filtros diferentes (Portex e Rusch), mas com poros do mesmo tamanho. Uma suspensão bacteriana grau 0,5 de McFarland foi colocada na bomba de analgesia controlada pelo paciente e filtrada a uma velocidade de 5 mL/h em infusão contínua por 48 horas e acumulada em frasco. Os dois filtros foram comparados com contagens de colônias de bactérias nos filtros e frascos. Ao mesmo tempo, os filtros e as bactérias aderidas foram monitorados com microscópio eletrônico de varredura. RESULTADOS: O exame dos filtros por microscópico eletrônico mostrou que a estrutura do filtro Portex era granulada e a do filtro Rusch fibrilar. A contagem de colônias do cateter e do frasco mostrou que ambos os filtros tinham uma capacidade de adesão bacteriana significativa (p < 0,001). Após a infusão da suspensão bacteriana, as contagens de colônias mostraram que o filtro Portex foi mais eficiente (p < 0,001). Não houve qualquer diferença entre as adesões de bactérias S. aureus e P. aeruginosa. Na monitoração por MEV após a infusão, ficou fisicamente evidente que as bactérias foram aderidas de modo eficaz por ambos os filtros. CONCLUSÃO: O filtro com estrutura granular foi estatística e significativamente mais bem- sucedido do que o filtro com estrutura fibrilar. Embora o tamanho dos poros dos filtros fosse igual - as diferenças estruturais mostradas pelo MEV eram semelhantes -, não seria justo atribuir as alterações de eficiência apenas às diferenças estruturais. O uso ao mesmo tempo de provas microbiológicas e físicas para avaliar a eficácia foi outro aspecto importante deste experimento.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Cognition Disorders/therapy , Depressive Disorder, Major/therapy , Executive Function/physiology , Psychotherapy/methods , Comorbidity , Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Depressive Disorder, Major/epidemiology , Severity of Illness Index , Treatment Outcome
20.
Rev. Esc. Enferm. USP ; 49(6): 1023-1031, Dec. 2015. tab, graf
Article in Portuguese | LILACS, BDENF | ID: lil-767802

ABSTRACT

Abstract OBJECTIVE Discussing the factors associated with major depression and suicide risk among nursing professionals. METHOD An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. RESULTS 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high level of education, low family income, work overload, high stress, insufficient autonomy and a sense of professional insecurity and conflict in the family and workrelationship. Suicide risk was correlated with the presence of symptoms of depression, high levels of emotional exhaustion, depersonalization and low personal accomplishment; characteristics of Burnout Syndrome. CONCLUSION Suicide risk among nursing professionals is associated with symptoms of depression and correlated with Burnout Syndrome, which can affect work performance.


Resumen OBJETIVO Discutir sobre los factores asociados con la depresión mayor y el riesgo de suicidio entre profesionales de enfermería. MÉTODO Revisión integradora en las bases de datos PubMed/MEDLINE, LILACS, SciELO y BDENF, entre el año 2003 y el 2015. RESULTADOS Se seleccionaron 20 artículos publicados, la mayoría entre el 2012 y el 2014, con significativa producción en Brasil. Los profesionales de enfermería son vulnerables a la depresión cuando jóvenes, casados, realizan trabajo nocturno y tienen varios empleos, y cuando presentan alto nivel educativo, bajos ingresos familiares, sobrecarga de trabajo, estrés elevado, insuficiente autonomía y sentimiento de inseguridad profesional, conflictos en la relación familiar y laboral. El riesgo de suicidio fue correlacionado con la presencia de síntomas de depresión, alto nivel de agotamiento emocional, despersonalización y baja realización personal; características del Síndrome de Burnout. CONCLUSIÓN El riesgo de suicidio entre los profesionales de enfermería está asociado con los síntomas depresivos y los correlacionados con el Síndrome de Burnout, perjudicando el desempeño profesional.


Resumo OBJETIVO Discutir sobre os fatores associados à depressão maior e risco de suicídio entre profissionais de enfermagem. MÉTODO Revisão integrativa em bases de dados PubMed/MEDLINE, LILACS, SciELO e BDENF, entre 2003 e 2015. RESULTADOS Selecionaram-se 20 artigos publicados, a maioria entre 2012 e 2014, com significativa produção no Brasil. Os profissionais de enfermagem são vulneráveis à depressão quando jovens, casados, realizam trabalho noturno e possuem vários empregos, e quando apresentam alto nível educacional, baixa renda familiar, sobrecarga de trabalho, estresse elevado, insuficiente autonomia e sentimento de insegurança profissional, conflitos no relacionamento familiar e no trabalho. Risco de suicídio foi correlacionado com a presença de sintomas de depressão, alto nível de exaustão emocional, despersonalização e baixa realização pessoal; características da Síndrome de Burnout. CONCLUSÃO Risco de suicídio entre os profissionais de enfermagem está associado a sintomas depressivos e os correlacionados com a Síndrome de Burnout, prejudicando o desempenho profissional.


Subject(s)
Humans , Depressive Disorder, Major/epidemiology , Nursing , Occupational Diseases/epidemiology , Suicide/statistics & numerical data , Risk Factors
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