Assess the Depression and Quality of Life among Women Suffering from Selected Gynaecological Cancers Attending Oncology Units of Selected Hospitals

Backgrounds: Gynecological cancers are significant and probable life-threatening diseases that harm patients' physical and psychological health. The leading cause of death in female抯 psychological problems like depression endure and can cause an extra burden during their treatment. Therefore, this study helps evaluate depression and well-being among gynaecological malignancies. Methods: Women's depression was evaluated by a standardized CES-D Scale and QOL by WHOQOL Bref scale, a sample of 100 women with cancers admitted at HSK and Kerudi cancer hospital, Bagalkot was selected using a purposive sampling technique, descriptive survey design was adopted. Statistical data were tested and scrutinized using descriptive and inferential analysis. Results: 100% of women had moderate depression. The mean percentage of depression score was 61.45% with mean and SD (37�9). Of the women, 71 % had moderate, 21%had poor, and 8% had good QOL. The mean percentage of QOL of women was 48.1% with mean and SD (62.5�.1). A Strong relation was found between depression scores with your family members known to you (?=4.52, p<0.05), Area of residence (?=3.88, p<0.05), and whether you have undergone previously any surgery for the treatment of cancer (?=8.93, p<0.05). No association was found between QOL scores with study variables. A Negative correlation (r=-0.27, p<.05) was found between depression and Total QOL scores. Conclusion: Most patients have moderate depression and moderate QOL. This study is effective in identifying depression and QOL

Propiedades psicométricas de instrumentos de evaluación de aspectos psicosociales en adolescentes de México / Psychometric Properties of Instruments for Assessing Psychosocial Aspects in Adolescents from México

Resumen El estudio tuvo como objetivo analizar las propiedades psicométricas de las escalas de Ideación Suicida de Roberts, de Depresión del Centro de Estudios Epidemiológicos [CES-D] de Radloff, de Autoestima de Rosenberg, y de Impulsividad, Relación con Papá y Relación con Mamá, las tres de Climent, Aragón y Plutchick. Se realizó un estudio no experimental, de tipo transversal ex-post facto con 4,759 adolescentes de ambos sexos del estado de Chiapas, México. La confiabilidad evaluada a través del coeficiente alpha de Cronbach reportó índices superiores a .700 para todos los instrumentos, excepto para la Escala de Impulsividad. Los análisis factoriales exploratorios realizados mostraron arreglos de ítems semejantes, más no iguales, a los reportados en otros estudios en los que se han aplicado estos instrumentos, confirmando la validez de los constructos teóricos en los que se basó su diseño. Las Escalas analizadas son válidas para su uso en adolescentes de México, considerando los puntos de corte establecidos para cada una de ellas.

Abstract The study aims to analyze the psychometric properties of Roberts' Suicidal Ideation Scale, Radloff´ Center for Epidemiologic Studies Depression Scale [CES-D], Radloff, Rosenberg Self-Esteem, and Impulsiveness, Dad Relationship and Mom Relationship, the three of Climent, Aragón & Plutchick. A non-experimental, cross-sectional, ex post facto study was performed with 4,759 adolescents of both sexes in Chiapas, Mexico. Reliability through Cronbach's alpha coefficient reported higher rates to .700 for all instruments, except for Impulsiveness Scale. The exploratory factor analyzes showed items such arrangements, but not identical, to those reported in other studies where these instruments have been administered, confirming the validity of the theoretical constructs on which its design was based. The scales are valid for use in adolescents from México, considering the cut-off points established for each of these tools.

Depressive disorder and psychosocial indicators in high school and college students from Mexico City: data from two censuses / Trastorno depresivo e indicadores psicosociales en estudiantes de bachillerato y de licenciatura de la Ciudad de México: datos de dos censos

Abstract Introduction Almost 5% of the Mexican general population (18-65 years old) has suffered depression once in their lives, and 2% of them more than once without receiving treatment. Objetive To measure the prevalence of depressive disorder and to calculate its relationship with psychosocial indicators. Method Data were collected through two censuses with high school and college students from a university in Mexico City (n = 116 214). Participants completed the CES-D and other scales. Multivariate logistic regression models were used. Results The prevalence of depressive disorder was 16%. Predictors of depressive disorder were: having suffered psychological or sexual violence, having a family member who had been injured during an assault, history of depression in the family, poor quality in family and social relationships, among others. Discussion and conclusion The prevalence of depressive disorder increases with age. As prevention and treatment at an early age are essential, intervention and monitoring strategies must be created and systematized taking gender and other elements into account, such as the relationship with the parents, violence, and a history of depression in the family.

Resumen Introducción Casi el 5% de la población general de México (18-65 años) ha sufrido depresión una vez en su vida y 2% la ha sufrido más de una vez sin haber recibido tratamiento. Objetivo Medir la prevalencia del trastorno depresivo y calcular su relación con algunos indicadores psicosociales. Método Los datos fueron recolectados por medio de dos censos con estudiantes de bachillerato y de licenciatura en la Ciudad de México (n = 116 214). Los participantes completaron el CES-D y otras escalas. Se usaron modelos de regresión logística multivariable. Resultados La prevalencia del trastorno depresivo fue del 16%. Los predictores del trastorno depresivo fueron: haber sufrido violencia psicológica o sexual, tener un miembro de la familia que hubíera sido herido durante un asalto, antecedentes de depresión en la familia, mala calidad en las relaciones familiares y sociales, entre otros. Discusión y conclusión La prevalencia del trastorno depresivo aumenta con la edad. Como la prevención y el tratamiento a una edad temprana son esenciales, se deben crear y sistematizar estrategias de intervención y monitoreo que tomen en cuenta el género y otros elementos, como la relación con los padres, violencia e historia de depresión en la familia.

Prevalencia del riesgo de depresión y factores asociados en estudiantes de medicina de una universidad privada en Quito / Prevalence of the risk of depression and associated factors in medical students of a private university in Quito

Objetivo: estimar la prevalencia del riesgo de depresión e identificar factores asociados en estudiantes de medicina. Metodología: se entregó la encuesta del CES-D a 312 estudiantes de medicina de una universidad privada en Quito. La prevalencia del riesgo de depresión fue calculada mediante estadística descriptiva; se realizaron modelos de regresión logística binaria y multinominal para encontrar factores de riesgo. Los datos se procesaron con el programa IBM-SPSS Statistics Versión 20. Resultados: la prevalencia de estudiantes con riesgo de depresión fue de 55,8% (IC 95% 50%-61%), la prevalencia en mujeres fue 58.9% y en hombres, 51.2% (Valor P 0.18). Los factores de riesgo asociados a un aumento de la probabilidad de depresión fueron: edad menor a 20 años (ORa 2.42; IC 1.48-3.96), promedio de calificaciones menor a 2.99 (ORa 7.24, IC 1.49-35.3), promedio de calificaciones entre 3.00 y 3.19 (ORa 2.04; IC 1.03-3.99), antecedente de depresión familiar (ORa 1.80; IC1.00-3.24); mientras que, vivir con alguien en el hogar es protector (ORa 0.40; IC 0.20-0.80). Conclusiones: más de la mitad de estudiantes están en riesgo de depresión, siendo más frecuente en mujeres. Ser joven, tener un promedio de calificaciones bajo y antecedente familiar de depresión aumentan la probabilidad de riesgo de depresión; vivir con alguien en el hogar, la reduce. Las universidades deben realizar programas de vigilancia para reducir y disminuir el impacto de este problema.

Estructura dimensional de la escala ces-d-10 en estudiantes rurales / Dimensional structure of the ces-d-10 scale in rural students

El desempeño psicométrico de los instrumentos de medición en salud suele variar de una población a otra1. A este principio se suma el de la necesidad constante de revisar el conjunto de ítems que miden constructos conceptualmente cambiantes2, como el de episodio depresivo. La intención de este trabajo es mostrar hallazgos de desempeño de la Escala para Depresión del Centro para Estudios Epidemiológicos en Depresión, versión de 10 ítems (CES-D-10)3, en una muestra rural, habitualmente omitida en la mayoría de la investigaciones4,5.

The association between depressive symptoms and fall accidents among middle-aged and elderly people in China

BACKGROUND@#Depressive symptoms are a worldwide health problem. However, the research about the effect of depressive symptoms on the fall among the Chinese mid-aged and elderly people is lacking. Therefore, this study aims to investigate the association between depressive symptoms and fall accidents among middle-aged and elderly people in China.@*METHODS@#This study was conducted based on 12,527 sets of data from China Health and Retirement Longitudinal Survey (CHARLS). The 2011 depressive symptoms data and the 2013 fall data were chosen for this study. The depressive symptom-related data was assessed by the Chinese version of Center for Epidemiologic Studies Depression scales (CES-D). Individuals were divided into subgroups according to gender (male or female), age (45-59, middle-aged or ≥ 60, elderly people), and residence (rural or urban). The odds ratios (ORs) were compared between subgroups using multivariable logistic regression analysis method.@*RESULTS@#The adjusted OR value (OR = 1.19 [95% CI 1.07-1.33]) shows there is a significant association between depressive symptoms and subsequent fall accidents. The ORs of the female, elderly people, rural, and urban subgroups are 1.31 (95% CI 1.11-1.55), 1.24 (95% CI 1.08-1.43), 1.17 (95% CI 1.02-1.33), and 1.25 (95% CI 1.04-1.49), respectively, which reveals that this association is also statistically significant in these subgroups.@*CONCLUSIONS@#This study shows that there is a significant association between depressive symptoms and their subsequent fall accidents among the Chinese middle-aged and elderly people.

Depressive symptoms and its related factors among the physical disabled aged 45 years or older: The data from 2013 China Health and Retirement Longitudinal Study / 中国心理卫生杂志

Objective:By exploring the epidemic level and related factors of depressive symptoms,to provide the references for improving mental health of the physical disabled.Methods:The data were from the 2013 China Health and Retirement Longitudinal Study database.Persons with self-reported physical disabled were selected as subjects,and a total of 974 valid ones were obtained,with the average age of (62 ± 10) yeats.The depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D),with the cut-off score of equal or higher than 10 as having depressive symptom.The independent variables included age,gender,education level,marital status,urban and rural areas,self-rated general health,self-rated heating,self-rated memorizing,life satisfaction,smoking,drinking,sleep duration,chronic diseases,activity of daily life,social activity,family support,and disability periods.Chi-square test was used to analyze the effect of each factor on prevalence of depressive symptoms.Binary logistic regression was used to analyze the effect of multi-factors.Results:The prevalence of depressive symptom among the physical disabled was 46.1％.The subjects who were female,single,suffered from chronic disease,without family support,short-time sleeper were more likely to have depressive symptoms than the controls (OR =1.35,1.62,1.60,1.67,2.58;P ＜0.05).The subjects who had better self-rated general health,better self-rated hearing,better self-rated memorizing,better life satisfaction were less likely to have depressive symptoms than the controls (OR =0.38,0.53,0.47,0.09;P ＜ 0.05).Conclusion:It suggests that the prevalence of depressive symptoms is higher among the physical disabled aged 45 years of age or older.It should take appropriate measures to reduce emotinal problems for them.

Contributing Factors for the Registration Rates within Emergency Department Based Post-suicidal Care Program

PURPOSE: This study was conducted to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). METHODS: This prospective observational study was conducted between January and September 2015 at the academic ED in the tertiary urban hospital. The variables examined included gender, age, address, type of insurance, history of previous psychiatric disease, suicide methods, number of previous attempts, CES-D (The Center for Epidemiologic Studies-Depression Scale), and disposition at ED. Univariate and multivariate logistic regression analysis were conducted to identify factors affecting the registration rate for the community-based post suicidal care program. RESULTS: Overall, 331 suicides were investigated, 61 (18.4%) of which were registered in the post-suicide care program. Factors such as a intervention by psychiatric physician (OR: 3.287, 95%; CI: 1.207-9.624) and levels of depression by CES-D score of 16?24 (OR: 3.635; CI: 1.055-12.526) were significantly correlated with registration for the program. CONCLUSION: The registration rate for the community-based post suicidal care program was influenced by frequent intervention by a psychiatric physician and levels of depression by CES-D score of 16-24.

Contributing Factors for the Registration Rates within Emergency Department Based Post-suicidal Care Program

PURPOSE: This study was conducted to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). METHODS: This prospective observational study was conducted between January and September 2015 at the academic ED in the tertiary urban hospital. The variables examined included gender, age, address, type of insurance, history of previous psychiatric disease, suicide methods, number of previous attempts, CES-D (The Center for Epidemiologic Studies-Depression Scale), and disposition at ED. Univariate and multivariate logistic regression analysis were conducted to identify factors affecting the registration rate for the community-based post suicidal care program. RESULTS: Overall, 331 suicides were investigated, 61 (18.4%) of which were registered in the post-suicide care program. Factors such as a intervention by psychiatric physician (OR: 3.287, 95%; CI: 1.207-9.624) and levels of depression by CES-D score of 16?24 (OR: 3.635; CI: 1.055-12.526) were significantly correlated with registration for the program. CONCLUSION: The registration rate for the community-based post suicidal care program was influenced by frequent intervention by a psychiatric physician and levels of depression by CES-D score of 16-24.

Efectos a largo plazo de los síntomas depresivos en una tarea de memoria de trabajo con y sin interferencia atencional / Long-term effects of depressive symptoms on a task of visual working memory with and without attentional interference

La neurobiología de la depresión involucra cambios estructurales del sistema nervioso relacionados con procesos cognitivos como la memoria y la atención. El objetivo del presente estudio fue evaluar el efecto a largo plazo de la sintomatología depresiva (SD) en una tarea de memoria de trabajo visual con y sin interferencia atencional en estudiantes universitarios. Se utilizó un diseño factorial de 2 X 2 en el cual las variables independientes fueron la condición clínica (con SD y sin SD) y la versión del Memonum (con o sin interferencia de color). Memonum es un software para evaluar memoria de trabajo por medio de la retención de dígitos directos, en dos versiones: una blanco-negro (sin interferencia) y otra con un distractor atencional de color (con interferencia). Para la evaluación de la SD, 76 universitarios respondieron al CES-D, luego se les aplicó aleatoriamente una u otra versión de la prueba Memonum (con o sin interferencia de color), 2 semanas después de la detección de síntomas. De manera general, la SD no alteró a largo plazo el desempeño de los participantes en tareas de memoria de trabajo visual con o sin interferencia atencional. Sin embargo, se pudo establecer que la utilización de las estrategias para la ejecución de la tarea mnemónica dependió de la condición clínica, y la agrupación fue la menos usada por los participantes con SD.

The neurobiology of depression involves structural changes in the nervous system associated with cognitive processes such as memory and attention. This study sought to evaluate the long-term effect of depressive symptomatology (DS) using a task of visual working memory with or without attentional interference in college students. A 2 X 2 factorial design was used wherein the independent variables were the clinical condition (with and without DS) and the Memonum version (with and without interference of color). The Memonum consists of software to evaluate working memory through retention of direct digits, in two versions: a black-white (without interference) and another with a color attentional distractor (with interference). Depressive symptomatology was evaluated by applying the CES-D to 76 undergraduates. Two week after the diagnosis of DS, the test version was randomly applied (with or without attentional interference). The DS did not alter long-term performance of the tasks involved in visual working memory with or without attentional interference. However, it was found that the use of strategies for mnemonic task performance depended on the clinical condition, being the strategy of grouping the least used by the participants with DS.

Validation Of The Malay-Translated Version Of The Center For Epidemiological Study – Depression Scale (CES-D)

Objective: This study aims to establish the validity and reliability of the Malaytranslated version of the CES-D. Methods: This study employed a cross-sectional study design. The participants were female inmates (n=90) from local prisons which were selected based on purposive-selective sampling. The analyses include face validation, factor analysis, and reliability testing. A test-retest was conducted within a one-week interval. Results: The mean score for depression among the participants is 18.97 (SD=6.51). Further descriptive analysis showed that 58.9% of them scored above the mean score, which is considered high. Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Malay-translated version of the CES-D. Furthermore, the factor analysis showed similar factor loadings to the original English version. The total internal consistency of the translated version, which was measured by Cronbach’s alpha coefficient, was equal to 0.75. The test-retest reliability of the total score, measured by Pearson’s correlation was equal to 0.69. Conclusions: Face validity, construct validity, and reliability analysis were found satisfactory for the Malay-translated version of the CES-D. The Malay-translated version of the CES-D was found valid and reliable to be used in future studies, with comparable properties to the original version and to previous studies.

Memoria declarativa congruente con sintomatología depresiva / Consistent declarative memory with depressive symptomatology

Introducción: Algunos estudios han sugerido que el recuerdo potenciado de eventos negativos en personas que presentan trastornos depresivos parece ser un factor importante en la Etiología, curso y sostenimiento de la depresión. Objetivo: Evaluar la memoria emocional en Personas con y sin sintomatología depresiva, mediante una prueba auditivo-visual. Método: Se evaluaron 73 estudiantes universitarios, hombres y mujeres, con edades entre los 18 y 40 años, distribuidos en dos grupos: con sintomatología depresiva (32) y sin sintomatología Depresiva (40), utilizando la Escala del Centro de Estudios Epidemiológicos para Depresión(CES-D) y un punto de corte de 20. Resultados: No se encontraron diferencias significativas Entre el recuerdo libre de los voluntarios con y sin sintomatología depresiva, a pesar de que Ambos asignaron un valor emocional más alto a la versión emocional de la prueba auditivo-Visual y de asociarla a la emoción de tristeza. Conclusión: Las personas con sintomatología Depresiva no presentaron el efecto de potenciación mnemónica generalmente asociado al Contenido de la versión emocional de la prueba; por lo tanto, no se comprobó la hipótesis De congruencia emocional...

Introduction: Some studies have suggested that potentiated remembrance of negative events on people with depressive disorders seems to be an important factor in the etiology, course and maintenance of depression. Objective: Evaluate the emotional memory in people with and without depressive symptomatology by means of an audio-visual test. Methodology: 73 university students were evaluated, male and female, between 18 and 40 years old, distributed in two groups: with depressive symptomatology (32) and without depres-sive symptomatology (40), using the Scale from the Center of Epidemiologic Studies for Depression (CES-D, English Abbreviation) and a cutting point of 20. Results: There were not meaningful differences between free and voluntary recalls, with and without depressive symptomatology, in spite of the fact that both groups had granted a higher emotional value to the audio-visual test and that they had associated it with emotional sadness. Conclusion: People with depressive symptomatology did not exhibit the effect of mnemonic potentiation generally associated to the content of the emotional version of the test; therefore, the hypothesis of emotional consistency was not validated...

Propiedades psicométricas de la CES-D/IS en población universitaria de la ciudad de Durango, México / Psychometric properties of CES-D/IS in university population in Durango city, México

Introduction Depression has been frequently related with suicidal behavior. Evidences of depressive symptoms in adolescents and young people with suicidal ideation or suicidal intention have been showed in several studies. For that reason, it is necessary to have an adequate instrument to measure and identify some characteristics associated with self-destructive behavior in university students. Objective To evaluate the psychometric properties of CES-D/IS in students at the University Juarez of the State of Durango (UJED). Material and Methods The universe of study selected for the schooling period of 2008 consisted of 943 students from 13 academic units. CES-D/IS scale was applied. Before the interview informed consent was obtained from all the participants and they were informed about the nature and scope of the study. Exploratory factor analysis was conducted to evaluate the instrument validity, and Cronbach alpha for internal consistency. Further analysis included Student t-test and Mann-Withney U test. A p-value below 0.05 was considered to indicate statistical significance. The data were analyzed with SPSS, version 15 and R v 2.7.2. Results The total scale showed a high value of internal consistency (α=0.89), and similar results for academic areas, for age and sex. Factor analysis showed a four-factor structure that accounted for 45.5% of variance Conclusions CES-D/IS scale has adequate psychometric properties in reliability and in validity.

Introducción La depresión es un aspecto que constantemente se ha relacionado con la conducta suicida. La sintomatología depresiva ha sido evidenciada en varios estudios donde ha estado presente en adolescentes y jóvenes con pensamientos e intentos de suicidio. Por esta razón es de suma prioridad e interés el contar con un instrumento válido y confiable para la identificación y la medición de características relacionadas con la conducta autodestructiva en estudiantes universitarios. Objetivo Evaluar las propiedades psicométricas de la CES-D/IS, mediante su aplicación a estudiantes de nivel licenciatura de la Universidad Juárez del estado de Durango (UJED). Material y métodos El estudio incluyó a 943 estudiantes de 13 unidades académicas durante el periodo escolarizado de 2008. Se aplicó la escala CES-D/ IS. Se solicitó a los participantes el consentimiento informado y se les aseguró el manejo confidencial de los datos. Para medir la validez del instrumento se utilizó el análisis factorial exploratorio, se evaluó la consistencia interna mediante el coeficiente alfa de Cronbach, se emplearon estadísticos descriptivos, t de Student y U de Mann-Whitney para inferencias al 0.05. Los datos se procesaron con los paquetes estadísticos SPSS v15 y R v 2.7.2. Resultados La escala presentó una consistencia interna de α=0.89. El índice resultó homogéneo cuando se analizó por área de estudio, edad y sexo. El análisis factorial mostró cuatro factores con el 45.5% de la varianza explicada. Conclusiones La escala CES-D/IS, presentó buenas propiedades tanto en su confiabilidad como en su validez.

Frecuencia de los síntomas depresivos entre adultos mayores de la Ciudad de México / Frequency of depressive symptoms among older adults in Mexico City

Introduction Depression in the elderly is of interest because of its relationship with increased demand for health services, as well as the low frequency of diagnosis. Objective To determine the frequency of depressive symptoms (DS) among elderly beneficiaries in Mexico City by the revised scale of depression of the Center for Epidemiologic Studies of the United States (CES-DR) and the Yesavage Geriatric Depression Scale (GDS). Materials and methods In the first phase of the study we evaluated the presence of significant DS with the 30-item GDS. Those with scores of 11 or more were considered positive and were included in the second phase. In this phase were added a random sample with negative scores. All participants completed the second phase of the revised CES-DR. The 80 percentile was used in this study with a cut-off of 57 points. Results A total of 7449 elderly were included in the first phase. The prevalence of reported significant DS with the GDS was 21.7% (n = 1.616) (IC-95%, 20.4-23.0). The sample for the second phase included 2 923 elderly. The mean age was 70.8 years, 61.7% were women. Twelve percent (95% CI, 9.2-15.3) showed significant DS of major depression, 7.5% (95% CI, 6.3-8.9) was rated as probable, 17.2% (95% CI, 13.022.3) possible, 2.6% (95% CI, 2.2-3.1) sub-threshold depression episode and 60.7% (95% CI, 56.2-65.1) with no significant DS episodes of major depression. Significant frequency of major depression SD is presented using the GDS and CESDR was 6.5% (95% CI, 3.3-12.4). Conclusions The expression of the identified significant SD CES-DR is different from what is reported to the GDS. The CES-DR is more sensitive and specific to identify the presence of depressive symptoms.

Introducción La depresión en el anciano resulta de interés por su relación con el incremento de la demanda de servicios de salud, así como por su baja frecuencia de diagnóstico. Objetivo Determinar la frecuencia de los síntomas depresivos (SD) entre ancianos derechohabientes de la Ciudad de México, mediante la escala revisada de depresión del Centro de Estudios Epidemiológicos de los Estados Unidos (CES-DR) y la Escala de Depresión Geriátrica de Yesavage (GDS). Materiales y métodos En la primera fase del estudio se evaluó la presencia de SD significativos con la GDS de 30 ítems. Aquéllos con puntaje de 11 o más fueron considerados como positivos y se incluyeron en la segunda fase. En esta fase se agregó una muestra aleatoria con puntajes negativos. Todos los participantes en la segunda fase completaron la versión revisada del CES-DR. El percentil 80 se utilizó en este estudio con un punto de corte de 57 puntos. Resultados Un total de 7449 adultos mayores fueron incluidos en la primera fase. La prevalencia de SD significativos reportada con el GDS fue de 21.7% (n=1,616) (IC-95%, 20.4-23.0). La muestra para la segunda fase incluyó 2923 adultos mayores. La media de edad fue de 70.8 años, el 61.7% eran mujeres. El 12.0% (IC-95%, 9.2-15.3) presentó SD significativos de depresión mayor, 7.5% (IC-95%, 6.3-8.9) fue calificado como probable, 17.2% (IC-95%, 13.0-22.3) como posible, 2.6% (IC-95%, 2.2-3.1) con episodio de depresión sub-umbral y 60.7% (IC-95%, 56.265.1) sin SD significativos de episodios de depresión mayor. La frecuencia de SD significativos de depresión mayor que se presentó utilizando el GDS y el CESDR fue de 6.5% (IC-95%, 3.3-12.4). Conclusiones La expresión de SD significativos identificada con el CES-DR es diferente a lo que se reporta con el GDS. La CES-DR permite identificar la presencia de síntomas de depresión de manera más sensible y específica.

Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D) en México: análisis bibliométrico / Center of Epidemiological Studies of Depression Scale (CES-D) in Mexico: bibliometric analysis

The CES-D is a screening instrument to measure depressive symptoms during the last week. It is useful and easy to use because no trained staff is needed to administer and score it. Interest in depression has been consistent in Mexico in recent years, and the CES-D is one of the most used scales. The goal of this paper is to present a bibliometric analysis of scientific papers reporting data obtained with the scale; the papers had to be published in a scientific journal with a reviewing board, a group of peer reviewers and be ISNN registered. Materials were found in EBSCOhost and Google Scholar databases. 80 papers were published between 1986 and 2011. An average of three papers was published every year. Most of the studies were developed in Mexico City and nationwide; there was a bi-national study, a multinational one, and four in several states combined. The journals with the highest number of papers were: SALUD MENTAL, Salud Pública de México, and Revista Mexicana de Psicología. There were 17 institutions involved in coordinating the studies; six of them were international. 41% of the studies were conducted with adolescents, 32% with women, and 90% in urban contexts. There are some areas which need further study to build a more comprehensive understanding about the distribution and characteristics of depressive symptoms and hence new studies must be designed to include understudied groups and populations.

La Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D) es un instrumento de tamizaje para la detección de casos de depresión con base en su sintomatología durante la última semana. La CES-D ha demostrado ser una herramienta útil y económica en formato autoaplicable en virtud de que no requiere personal especializado para su calificación y es autoaplicable. Reconocida la importancia de la depresión, el interés por su investigación ha sido consistente en México durante las últimas décadas y la CES-D ha sido uno de los instrumentos más empleados. El objetivo de este trabajo es presentar un análisis bibliométrico de las publicaciones científicas sobre su uso en México. Los artículos seleccionados tenían que estar publicados en revistas científicas con comité editorial, cuerpo académico de dictaminadores e ISSN. Las búsquedas se hicieron en EBSCOhost y Google Académico. Se analizaron 80 artículos, desde 1986 hasta julio de 2011. El promedio por año fue de tres artículos; 2007 y 2008 fueron los años con más publicaciones. La mayor cantidad de investigaciones se ha realizado en el Distrito Federal y a nivel nacional; hay una investigación binacional, otra multinacional y cuatro en entidades federativas combinadas. Las revistas con mayor cantidad de publicaciones fueron: SALUD MENTAL (27 artículos), Salud Pública de México (11 artículos) y la Revista Mexicana de Psicología (cinco artículos). Diecisiete instituciones (con predominio del Instituto Nacional de Psiquiatría Ramón de la Fuente) han sido responsables de las investigaciones; seis de ellas, a nivel internacional. 41.25% con adolescentes, 32.5% con mujeres y 90% en contextos urbanos, con predominio en la población general y en adolescentes estudiantes. Existen áreas por explorar para contar con un panorama más completo sobre las características y distribución de la sintomatología depresiva, por lo que habría que diseñar estudios con grupos y poblaciones menos explorados.

Aplicación del análisis estadístico de datos censurados para el manejo de respuestas incompletas en la escala CES-D / Application of censored-data analysis for managing CES-D incomplete responses

Purpose To provide an example of censored data analysis in the management of CED-S missing data, using a data set of a study conducted with Mexican rural women. Material and Methods Data used for this exercise were collected in a cross-sectional study with 416 women in the Mexican region known as the Mixteca Baja. Using a Survival Analysis (SA) focus we present a general description of the scores, along with the estimation of association patterns between those scores and the independent variables departing from Cox's proportional risk model. A comparison is made of these results and those obtained through a regression analysis. Results Using only the information from observations with complete data, the average CES-D score was 11.0 and the prevalence of symptoms above the cut-off point (16) was 23.2%. Twenty-six percent of the women did not respond to at least one item. When conducting the SA, the estimated mean score of the scale was 14.0. Survival above the cut-off point corresponded to an estimated prevalence of 21%. Conclusions SA is useful in the management of data sets with missing data in scales such as the CES-D. In this example, the increased percentage of observations with missing data produced a loss of precision in the estimators. The differences in mean item scores between observation with complete and incomplete data suggested a non-random, no-response pattern, if this is not taken into consideration it could bias the estimation in the scale mean and its association with other variables. Conducting SA we were able to use the information of most women participating in the study, including those who did not respond to all items in the scale.

Objetivo Ejemplificar el uso del análisis de datos censurados en el manejo de datos incompletos de la CES-D utilizando una base de datos de un estudio con mujeres rurales de México. Material y Método Los datos analizados se recogieron en un estudio transversal con 416 mujeres de la Mixteca Baja, al sur de México. Con un enfoque de Análisis de Supervivencia (AS), se presenta una descripción general del comportamiento de las puntuaciones de la CES-D junto con la estimación de patrones de asociación entre esos puntajes y variables independientes a partir del modelo de riesgos proporcionales de Cox, y se hace una comparación entre estos resultados y los obtenidos de un modelo de regresión lineal. Resultados Utilizando sólo la información de las observaciones con datos completos, la puntuación promedio de la CES-D fue de 11.0 y la preva-lencia de síntomas por arriba del punto de corte (16) fue de 23.2%. El 25.2% de las mujeres no contestó al menos un reactivo. Al hacer el AS, el promedio estimado de la puntuación fue de 14.8. La supervivencia por encima del punto de corte corresponde a una prevalencia estimada del 21%. Conclusiones El AS es útil en el manejo de bases que presentan datos faltantes por ejemplo en escalas como CES-D. En nuestro ejemplo, el elevado porcentaje de observaciones con respuestas faltantes ocasionó una pérdida de precisión en los estimadores. Las diferencias de puntuaciones promedio por reactivo entre observaciones con datos perdidos y completos sugieren un patrón de no-respuesta que no es aleatorio, y que de no tomarse en cuenta podría sesgar la estimación, tanto del promedio de la escala como de su asociación con otras variables. El AS utilizó la información de casi la totalidad de las participantes en el estudio incluyendo aquellas que no respondieron todos los reactivos de la escala.

Detección de depresión en mujeres embarazadas mexicanas con la CES-D / Depression screening in Mexican pregnant women with the CES-D

Prenatal depressive symptoms, due to their high prevalence (22% to 37%) and negative consequences on the health of the mother, the baby and the course of pregnancy, require early detection to provide support and treatment. The CES-D is a scale to identify symptoms of depression that is easy and quick to apply and has adequate validity among expectant mothers. The purpose of the study was to analyze the validity and reliability of the CES-D in pregnant Mexican women, as well as its sensitivity, specificity and predictive values using the SCID as the gold standard. Method The study was based on the secondary analysis of data. A sample of 98 pregnant women attending antenatal care in health center was selected because they displayed depressive symptoms or previous depression. Results The internal consistency of the CES-D was α=0.81. Factor analysis, which assessed the construct validity, yielded four interpretable factors (depressive affect, lack of energy/somatic symptoms, interpersonal relationships and positive affect), which accounted for 49.10% of the variance. The ROC curve analyses, showed an AUC of 0.81; for a cutoff point of >16, showed 100% sensitivity and 19.6% specificity; and sensitivity of 80.0% and specificity of 76.1% for a >28 cut-off point. Conclusions The CES-D showed excellent internal and construct validity in Mexican pregnant women and appeared to be a suitable tool for detecting depressive symptoms -a requisite for implementing preventive actions. However, it was less accurate, but still acceptable, when diagnosing major depression according to DSM-IV criteria with a score of >28.

La sintomatología depresiva prenatal, por su alta prevalencia (22% a 37%) y consecuencias negativas sobre la salud de la madre, el producto y el curso del embarazo, requiere de detección oportuna para proporcionar apoyo y tratamiento adecuados. La CES-D es una escala para identificar síntomas de depresión, de fácil y rápida aplicación y con validez adecuada en gestantes. El objetivo del trabajo fue analizar la validez y confiabilidad de la CES-D en mujeres mexicanas embarazadas, así como la sensibilidad, especificidad y valores predictivos usando el SCID como estándar de oro. Método El estudio se basó en un análisis secundario de datos. Se obtuvo una muestra de 98 mujeres embarazadas en la sala de espera de un centro de salud que proporcionaba atención prenatal. Fueron seleccionadas por presentar sintomatología depresiva (CES-D>16) o historia de depresión. Resultados La consistencia interna de la CES-D fue de α=0.81. El análisis factorial, que valoró la validez de constructo, mostró que cuatro factores pudieron ser interpretados (afecto depresivo, falta de energía/síntomas somáticos, relaciones interpersonales y afecto positivo), que explicaron 49.10% de la varianza. En el análisis de la curva COR, se obtuvo un ABC de 0.81; para punto de corte >16, mostró 100% de sensibilidad y 20.9% de especificidad y para la puntuación >28, sensibilidad de 80.0% y especificidad de 76.1%. Conclusiones Se encontró que la CES-D tiene excelente validez interna y de constructo en gestantes mexicanas y que es una herramienta adecuada para la detección de sintomatologia depresiva (CES-D>16) -requisito indispensable para instrumentar acciones preventivas-, sin embargo fue menos precisa, aunque adecuada para diagnosticar depresión mayor según criterios del DSM-IV aun en el punto de corte más parsimonioso (>28).

An Investigation of the Relationship between Senior Doctor's Support and Resident's Depressive State / General Medicine

<b>Background:</b> A depressive state for residents during residency training is a serious problem. Enhancement of senior doctor's support is considered to be one preventive measure, but it is uncertain whether onset of a new depressive state during training is related to senior doctors' support.<br><b>Methods:</b> A dual questionnaire survey was conducted in 2003 on 608 first-year residents at 40 teaching hospitals in Japan. Residents who had not been in a depressive state at the time of the first survey-using the Center for Epidemiologic Studies-Depression (CES-D) Scale, but were in a depressive state at the time of the second survey were defined as “residents in a new-onset depressive state.” The degree of senior doctors' support was assessed with Senior Doctor's Support Scale (SDSS), then adjusted OR and 95% CI of the residents in a new-onset depressive state were computed with a multivariate logistic regression model.<br><b>Results:</b> 82 residents (24.4%) were determined to be “residents in the new-onset depressive state.” The mean CES-D Score of Low SDSS Score Group (n=24), Middle SDSS Score Group (n=100), and High SDSS Score Group (n=152) were 20.0 (SD=9.9), 13.8 (SD=8.7), and 11.0 (SD=8.0), respectively (p<0.001). With logistic regression, residents who could fall into a depressive state during residency training were considered to be those who achieve middle SDSS Score (OR: 3.04, 95% CI: 1.45-4.80) and low SDSS score (OR: 17.89, 95% CI: 4.83-66.30).<br><b>Conclusion:</b> Because onset of residents' depressive state is related to senior doctors' support, we should enhance support during residency training.

A estrutura fatorial da Escala CES-D em estudantes universitários brasileiros / Factor structure of the CES-D Scale in brazilian undergraduate students

A escala Center for Epidemiologic Studies (CES-D) é um dos instrumentos mais utilizados no mundo inteiro para aavaliação da sintomatologia depressiva em diversas faixas etárias. O objetivo do presente estudo foi testar de formaconfirmatória diferentes estruturas teoricamente plausíveis para a CES-D em uma amostra universitária, partindo de umaversão brasileira já existente da escala. Os participantes foram 266 univeristários (média de idades=20,69; DP=2,40) deuma universidade do Rio Grande do Sul. Os resultados mostraram que uma estrutura com quatro fatores, semelhante àencontrada no estudo original do instrumento, apresentou o melhor ajuste aos dados. Um modelo modificado de quatrofatores sem dois itens com baixas comunalidades também se mostrou adequado. A consistência interna das subescalas (αde Cronbach) variou de 0,65 a 0,86. Aspectos complexos da estrutura fatorial do instrumento e potencialidades do mesmosão discutidos ao final.

Center for Epidemiologic Studies scale (CES-D) is among the most used instruments for assessing depressivesymptomatology in different age groups around the world. The aim of this work was to use confirmatory strategies toevaluate theoretically plausible concurrent structures for CES-D in a Brazilian undergraduate sample, based on a previoustranslated version of the instrument. Participants were 266 (mean age=20,69; SD=2,40) undergraduate students enrolledin a university from Rio Grande do Sul. Results showed that a four-factor structure, similar to the one found in theinstrument’s original study, showed the best fit to the data. A modified, four-factor model also showed reasonable fit tothe data. Internal consistencies for the four subscales (Cronbach’s α) ranged from 0,65 to 0,86. Complex issuesconcerning the instrument’s factor structure, as well as CES-D potential applications are discussed.

Confiabilidad y validez de la escala de depresión CES-D en un censo de estudiantes de nivel medio superior y superior, en la Ciudad de México / Reliability and validity of the depression scale CES-D in high school and college students from Mexico city: Results from a census

Introduction Depression and its symptoms are becoming one of the most important health problems worldwide. The impact of depression on the productive life of people, and the burden it represents because of its co-morbidity, is growing. Some authors estimate that depression is the second cause for the global loss of years of healthy life and the first one in developed countries. An increasing proportion of teenage population has mental health issues. Depression and its symptoms are among the most common, but they are not an epidemic problem yet, although spread enough as to maintain interest in its current impact and in its negative consequences over individual health. Depression has a prominent place among mood disorders in Mexico (4.5%), and women are who mostly suffer it (5.8%), which has remained consistent over time. Different difficult situations occur during adolescence along with depression, depressive mood, and depressive symptoms. This situation may be related to changes and processes that occur during this period when individuals cope with situations they cannot handle, which in turn become stressful. Therefore, it is necessary to study and to work with adolescents in order to be able to differentiate affective, cognitive, somatic, and behavioral expressions, which are proper to this stage, from those possibly caused by an illness that could have negative consequences. Adolescent depression influences mood and the way individuals live unpleasant or annoying experiences, thus it affects almost every aspect of life and becomes a risk factor for psychiatric and behavioral problems. However, there are some areas that need more research, for example: the specific characteristics and expressions of the problem including gender comparisons and using designs with special groups. Data show that depression is growing in adolescents; therefore it is a priority to work on detection and prevention to reduce its impact on mental health and to develop cost-effective intervention strategies. One way to do this is using valid-reliable screening tools because they are cheap, and methodologically-logistically useful. The Center for Epidemiological Studies Depression Scale (CES-D) has been used in different studies with Mexican adolescents, and has proven to have good psychometric characteristics. The CES-D has never been used with an entire population in a great scale study. The objective of this paper is to measure the validity and reliability of the scale (construct, concurrent, and external validity, as well as internal consistency) in a population of high school and college freshman students from Mexico City. Method Design. The study was a census made with high school and college freshman students during 2009. Data were collected in 22 schools. Population. A sample of 58568 students participated in the census. The mean age was 1 7 years old (±2.7). Most of the students lived in homes with one to four other persons at the moment of the study (55.4%); 86% said that only their father worked at that moment, and 59.4 said that only the mother; 79.7% of the students lived with both parents, and 1 7.9% only with their mother; 57403 students (98.0% of the population) completed the CES-D in the age range of 14-24 years: 27264 (47.5%) men, and 30139 (52.5%) women. Instrument. The Automated Medical Examination (Examen Médico Automatizado-EMA) is a diagnostic questionnaire designed by the General Directorate of Medical Services (Dirección General de Servicios Médicos) of the Universidad Nacional Autónoma de México (UNAM). It is a questionnaire with four self-report forms that collect information about the physical and mental health, the family, and the general context of every student. This information is used to create a diagnosis of vulnerability and a predictive profile for developing prevention programs, as well as research protocols that help in promoting a culture for health care. The CES-D was included for the measurement in 2009. Results Overall internal consistency was adequate (α=.83). Internal consistency was tested by sex; the coefficient was higher for women (α=.84). Factor analysis generated a four-factor solution (explained variance 54.1%); each factor had good internal consistency and theoretical agreement. The scale showed a significant discriminative power for opposite scores (z=-l44.121, p<.001), and a positive significant correlation with the Okasha Suicidality Scale (rΦ=.325, p = .000). A cut-off point of 16 or higher was established to identify students with high depressive symptomatology. 14.7% of the participants in this study had high depressive symptomatology (11.1% men, 1 7.9% women). Conclusions The CES-D is a valid and reliable epidemiological instrument for different populations. Since depression is a complex and dynamic phenomenon, it is important to evaluate the psychometric properties of any instrument used to measure it. The results of this study showed that the CES-D maintains its internal consistency as well as good concurrent-external validity. Coefficients are higher for women and they increase with age; thus, it would be necessary to refine some aspects to measure younger subjects in a more consistent manner. The data proved that CES-D is a useful instrument for distinguishing different levels of depressive symptomatology; this is relevant because the scale is often used in collective contexts, allowing systematic monitoring of depression with good cost-effective results. Monitoring is also important to keep acceptable levels of emotional wellbeing in student population. Development and refinement of instruments such as the CES-D would potentially lead to opportune and reliable detection of adolescents who may be at risk for suffering mental health problems. This would facilitate implementing more stable and continuous prevention and attention programs to reduce the negative impact of depression in the short term.

Introducción La depresión y sus manifestaciones sintomatológicas son parte de los principales problemas de salud entre la población mundial y su impacto en la vida productiva ha aumentado con respecto a otras enfermedades. En México, esta tendencia y sus consecuencias negativas en el desarrollo hacia la adultez justifican la necesidad de atenderla y prevenirla. A través de instrumentos de tamizaje válidos y confiables como la Escala de Depresión del Centro de Estudios Epidemiológicos [Center for Epidemiological Studies of Depression Scale: CES-D) diseñada en 1977 por Radloff, ha sido posible detectar posibles casos clínicos de depresión en diversos estudios con adolescentes escolares. Sin embargo, hasta ahora no se había documentado su comportamiento en una población de estudiantes a gran escala. Método El levantamiento de la información se realizó en agosto de 2009, previo al inicio del ciclo escolar. Se obtuvo información de 57403 alumnos, de los cuales 47.5% fueron hombres y 52.5% mujeres, con una edad promedio de 17 años (±2.7). Instrumento. La CES-D se incorporó en los formatos del Examen Médico Automatizado (EMA) quese utilizaron para realizar el levantamiento censal entre los alumnos de nuevo ingreso a bachillerato o licenciatura. Resultados Consistencia inferna y validez de constructo. La consistencia interna de la escala global mostró un índice satisfactorio (α=0.83). Los índices de contabilidad fueron adecuados para todos los grupos de edad. El análisis factorial con extracción de componentes principales y rotación oblicua arrojó una estructura de cuatro factores con valores Eigen mayores a uno, que explican 54.1% de la varianza; los coeficientes de consistencia interna y concordancia teórica resultaron satisfactorios: Afecto deprimido, Afecto positivo, Somatización e Interpersonal (como un indicador integrado por sólo dos reactivos). Validez concurrente por medio de grupos contrastados. En la prueba de grupos contrastados se compararon los puntajes globales de la CES-D que se situaron por debajo del percent i I 25 versus aquéllos por arriba del percentil 75. Se utilizó una comparación de promedios de Mann-Whitney, que mostró diferencias estadísticamente significativas entre los cuartiles contrastados (z = -144.121, p<.001). Validez externa. Se analizó mediante su asociación con la Escala de Expectativas de Vivir-Morir de Okasha (que también se aplica en el EMA), obteniendo una correlación positiva y significativa entre quienes tuvieron sintomatología depresiva elevada y quienes manifestaron deseos de morir (rΦ, = 0.325, p = .000). Detección de sintomatología depresiva elevada. La definición operacional de la sintomatología depresiva elevada se definió con el punto de corte (PC) de la CES-D con base en la media más una desviación estándar (PC> 1 6) con lo que se detectó una frecuencia de sintomatología depresiva elevada de 14.7% (n = 8,197): 11.1% en varones y 1 7.9% en mujeres. Conclusiones Los resultados muestran que en poblaciones tan grandes como la del presente estudio, la CES-D es una herramienta útil y adecuada, breve y fácil de aplicar y analizar para establecer un monitoreo que dé respuesta a una de las necesidades más apremiantes en la población escolar: la detección de la sintomatología depresiva elevada como un aspecto importante del malestar emocional. Sirve, además, para determinar la magnitud de la problemática y arribar a su prevención y, de ser el caso, instrumentar acciones para su tratamiento. La relevancia de los resultados obtenidos radica en que se trata de población escolar que puede llegar a requerir atención y prevención oportunas en salud mental en etapas tempranas de la enfermedad, incluso antes de la confirmación diagnóstica en los servicios especializados. Esta detección deriva en beneficios para la población escolar y en estrategias funcionales de atención adecuada y costo-efectivas.