Influence of self-efficiency beliefs on the health and well-being of university students in COVID-19 / Influencia de las creencias de autoeficiencia en la salud y el bienestar de los estudiantes universitarios en COVID-19 / Influência das crenças de autoeficácia na saúde e bem-estar de estudantes universitários na COVID-19

ABSTRACT Objective: To analyze general self-efficacy beliefs in university students during the COVID-19 pandemic and their correlation with psychological well-being and anxiety and depressive symptoms. Method: Cross-sectional study, carried out with nursing, medicine and psychology students from a higher education institution in the state of São Paulo, Brazil. The sample consisted of 329 students and data collection took place through a questionnaire and scales, from August to December 2020. Mann-Whitney test and Spearman's correlation coefficient were used for analysis of the variables. Results: Participants' self-efficacy was median (34.3±7.5). Higher self-efficacy scores were correlated with better psychological well-being (p<0.001; r= -0.582) and absence of anxiety (p<0.001) and depressive (p<0.001) symptoms. Conclusion: High self-efficacy beliefs were associated with better mental health outcomes. Strengthening self-efficacy in universities can help improve students' health behaviors and prevent mental illness.

RESUMEN Objetivo: Analizar las creencias generales de autoeficacia en estudiantes universitarios durante la pandemia de COVID-19 y su correlación con el bienestar psicológico y la sintomatología ansiosa y depresiva. Método: Estudio transversal, realizado con estudiantes de enfermería, medicina y psicología de una institución de enseñanza superior del estado de São Paulo, Brasil. La muestra estuvo conformada por 329 estudiantes y la recolección de datos se realizó a través de cuestionario y escalas, de agosto a diciembre de 2020. Para el análisis de las variables se utilizó la prueba de Mann-Whitney y el coeficiente de correlación de Spearman. Resultados: La autoeficacia de los participantes fue mediana (34,3±7,5). Las puntuaciones más altas de autoeficacia se correlacionaron con un mejor bienestar psicológico (p<0,001; r= -0,582) y ausencia de síntomas de ansiedad (p<0,001) y depresivos (p<0,001). Conclusión: Las creencias de alta autoeficacia se asociaron con mejores resultados de salud mental. Fortalecer la autoeficacia en las universidades puede ayudar a mejorar los comportamientos de salud de los estudiantes y prevenir enfermedades mentales.

RESUMO Objetivo: Analisar as crenças de autoeficácia geral em universitários, durante a pandemia da covid-19 e sua correlação com bem-estar psicológico e sintomas ansiosos e depressivos. Método: Estudo transversal, desenvolvido com estudantes de enfermagem, medicina e psicologia de instituição de ensino superior do estado de São Paulo, Brasil. A amostra foi de 329 estudantes e a coleta de dados ocorreu por meio de questionário e escalas, de agosto a dezembro de 2020.Utilizaram-se o teste Mann-Whitney e coeficiente de correlação de Spearman para análise das variáveis. Resultados: A autoeficácia dos participantes foi mediana (34,3±7,5). Maiores escores de autoeficácia foram correlacionados a melhor estado de bem-estar psicológico (p<0,001; r= -0,582) e ausência de sintomas ansiosos (p<0,001) e depressivos (p<0,001). Conclusão: Crenças elevadas de autoeficácia foram associadas a melhores desfechos em saúde mental. O fortalecimento da autoeficácia nas universidades pode ajudar a melhorar os comportamentos de saúde dos estudantes e prevenir doenças mentais.

Caffeine Intake and Its Association with Mental Health Status among Pharmacy Students at UiTM Puncak Alam

@#Introduction: Caffeine is a psychoactive substance widely consumed over the past decades. The effect of caffeine can be either beneficial or harmful. It increases cognitive performances, including attention, alertness and concentration. However, high caffeine intake may also induce an anxiogenic effect, causing symptoms such as rapid heart rate, restlessness and nervousness. This study aimed to determine the association between caffeine intake and mental health disorders such as anxiety and depression among undergraduate pharmacy students at UiTM Puncak Alam. Methods: This was a cross-sectional study with stratified random convenience sampling. A total of 270 undergraduate pharmacy students in UiTM Puncak Alam, Selangor participated in this study. A set of questionnaires was distributed using the Google Form platform. Standard General Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) scoring were used to assess the level of anxiety and depression among the respondents, respectively. SPSS version 27.0 was used to analyse the data. Results: About 70.4% of the students consumed caffeine, while 29.6% of the students did not consume caffeine. No significant association was found between caffeine status and the mental health scoring of GAD-7 (χ2 =4.639, p=0.200) and PHQ-9 (χ2 =5.256, p=0.262). Conclusion: Non-daily consumption and a low dose of caffeine intake patterns are good practises to prevent the development of anxiety or depression conditions, although the associations were not significant. Public awareness on possible anxiogenic effect and mental related disorders due to caffeine consumption need to be initiated, as nowadays, the caffeine intake behaviour has become a trendy lifestyle among the young adults.

Intervention effect of health education combined with aerobic exercise on adolescent depression / 中国学校卫生

Objective@#To explore the intervention effect of health education combined with aerobic exercise on adolescent depression,and to provide a reference for depression prevention of adolescents.@*Methods@#A total of 84 adolescent patients with depression in Wuhan Mental Health Center were selected by convenient sampling method. They were divided into two groups according to the order of patients visits (n=42). The control group received routine health education. The experimental group received group health education of emotional intelligence, and cooperated with moderate intensity aerobic exercise. The changes of depression, emotional intelligence and serotonin (5-HT), cortisol and norepinephrine (NE) levels before and after intervention were compared between the two groups.@*Results@#Before intervention, there was no significant difference in scores of Hamilton Depression Scale (HAMD) and Social Disability Screening Schedule (SDSS) between the two groups (t=0.62，1.02，P>0.05). The scores of HAMD and SDSS in the experimental group were significantly lower than those before intervention (t=9.62, 10.05, P<0.05). The scores of HAMD and SDSS in the experimental group were significantly lower than those in the control group (t=-6.95，-7.32，P<0.05). The scores and total scores of emotional perception, self-management and other management in the experimental group after intervention were significantly higher than those before intervention (t=6.54, 7.21, 5.33 ，6.60, P<0.05). The scores of emotion perception, self-management, others’ management and total scores in the experimental group were significantly higher than those in the control group(P<0.05). compared with before intervention, the levels of 5-HT and NE in the experimental group after intervention were significantly higher, the levels of cortisol were significantly lower (t=4.62, 5.36，-16.54, P<0.05)，and the level of 5-HT and NE in the experimental group was significantly higher than that in the control group, and the level of cortisol was significantly lower than that in the control group (t=15.25，8.74，-26.54，P<0.05).@*Conclusion@#The implementation of emotional intelligence group health education and aerobic exercise can effectively reduce the level of 5-HT, improve the level of cortisol, enhance the emotional intelligence of adolescents with depression, and alleviate their depressive mood.

Prevalence and Associated Factors of Depression, Anxiety and Stress Among Doctors in North Borneo

@#Introduction: Doctors are known to deal with high occupational stress, causing increased risk of depression, anxiety and stress.Nevertheless, the prevalence and associatedfactors of depression, anxiety and stress among registered doctorsworking in 24 public hospitals in Sabah, Malaysia are not known yet. Methods: This cross-sectional study was conducted using convenient sampling from September-October 2018. The data of 21-item Depression Anxiety Stress Scale (DASS-21) was collected via online link anonymously. Results: Among 314 doctors, majority of them were females (62.1%), mean age 29 (SD 2.72), non-Sabahan (82.8%), Malays (46.8%), not married (78.3%) and medical officers (93.6%). Prevalence of severe/extremely severe anxiety symptoms was 27.4%,depression (22.9%) and stress (18.5%). Doctors perceiving themselves to be depressed, anxious and/or stressed were more likely to develop the corresponding symptoms. Females and Chinese were twice more likely to report anxiety symptoms. Being married had protective effect against depressive symptoms, while working in same hospital for longer time had a significant but weak protective effect against anxiety and stress symptoms. Conclusions: Mental health issue among doctors is substantial and need to be addressed effectively for the benefit of their life, patients and country.

Application of the ecological framework in depression: an approach whose time has come

Background: Depression is a common psychiatric disorder. It is a global health problem and a public health concern. There is a need to explore and conceptualize a workable and comprehensive model that facilitates the treatment and prevention of depression in the community. The ecological model that has been used in several health issues may be viewed as an option. Objective: This paper aims to propose an ecological model for depression; the model can describe a comprehensive approach in treating and rehabilitating people with depression. Discussion: Application of a community model in psychiatry was first recorded by Lambo. However, application of the ecological model in treatment, rehabilitation, and prevention of depression has not been recorded. We review and discuss the application of this model in this setting. Conclusion: This ecological approach may be a useful approach in treating and rehabilitating individuals with depression in the community. This may require some degree of community sensitization, empowerment and mental health advocacy.

Depressão, aspectos emocionais e sociais na vivência do aborto: comparação entre duas capitais Brasileiras / Depression, emotional and social aspects in the abortion context: a comparison between two brazilian capitals

OBJETIVO: Avaliar aspectos emocionais e sociais na vivência do aborto e o diagnóstico de depressão maior comparando mulheres de duas capitais brasileiras (São Paulo e Natal). MÉTODOS: Estudo transversal realizado de janeiro de 2009 a maio de 2010, envolvendo a realização de entrevistas semidirigidas com mulheres em situação de abortamento (interrupção até a 22a semana de gestação) atendidas em hospitais universitários de São Paulo (n = 166) e Natal (n = 150). Para o diagnóstico de depressão, foi aplicada a versão em português do instrumento Primary Care Evaluation of Mental Disorders (PRIME-MD). RESULTADOS: Não houve diferença significativa (p = 0,223) na proporção de abortamentos provocados: Natal (7,3 por cento) e São Paulo (12,0 por cento). O diagnóstico de depressão foi elevado nas mulheres em situação de abortamento, em proporção significativamente maior na cidade de Natal do que em São Paulo (50,7 por cento contra 32,5 por cento, respectivamente, p < 0,01). Quanto aos aspectos emocionais, não houve diferença na ocorrência de sentimentos de culpa (Natal 27,7 por cento; São Paulo 23,3 por cento; p = 0,447). A participação do companheiro foi satisfatória pelas mulheres em proporção semelhante nas capitais (Natal 62,0 por cento; São Paulo 59,0 por cento; p = 0,576). Não se constata diferença na proporção de mulheres que relatam ter sofrido violência, relacionada ou não ao aborto (Natal 22,9 por cento; São Paulo 16,6 por cento; p = 0,378). CONCLUSÃO: Embora não tenha sido constatada diferença entre os aspectos emocionais e sociais na comparação entre as duas capitais, verificou-se elevada proporção de mulheres com depressão maior, sendo mais frequente na cidade de Natal, o que denota a importância de suporte psicossocial nos serviços de atenção à saúde da mulher.

OBJECTIVE: To assess emotional and social aspects in the experience of abortion and the diagnosis of major depression, comparing women from two Brazilian cities (São Paulo - SP, Natal - RN). METHODS: A transversal study was carried out from January 2009 to May 2010, through semi-directed interviews with women undergoing an abortion (up to 22 weeks gestation) treated at university hospitals in São Paulo - SP (n = 166) and Natal - RN (n = 150). The Portuguese version of the Primary Care Evaluation of Mental Disorders (PRIME-MD) instrument was applied for the diagnosis of depression. RESULTS: There was no significant difference (p = 0.223) in the proportion of induced abortions when comparing the two capital cities: Natal (7.3 percent) and São Paulo (12.0 percent). The diagnosis of depression was high among women undergoing an abortion and was significantly higher in Natal than in São Paulo (50.7 percent vs. 32.5 percent, p < 0.01). Regarding emotional aspects, there was no difference in the occurrence of guilt feelings (Natal 27.7 percent; São Paulo 23.3 percent; p = 0.447). The partner's involvement was considered satisfactory by women in similar proportions in the two capitals (Natal 62.0 percent; São Paulo 59.0 percent, p = 0.576). No difference was found in the proportion of women who reported violence, related or not to the abortion (Natal 22.9 percent; São Paulo 16.6 percent; p = 0.378). CONCLUSION: Although there was no difference between the emotional and social aspects in the comparison between the two capitals, there was a high proportion of women with major depression, more frequent in the city of Natal than in São Paulo, which demonstrates the importance of psychosocial support in the women's healthcare system.

Medicalisation of Suicide

Medicalisation is the misclassification of non-medical problems as medical problems. A common form of medicalisation is the misclassification of normal distress as a mental disorder (usually a mood disorder). Suicide is medicalised when it is considered a medical diagnosis per se, when it is considered to be secondary to a mental disorder when no mental disorder is present, and when no mental disorder is present but the management of suicidal behaviour associated with distress is believed to be the sole responsibility of mental health professionals. In the West, psychological autopsies have led to the belief that all or almost all suicide is the result of mental disorder. However, there are reservations about the scientific status of such studies. The actions of psychological autopsy researchers, coroners/magistrates, police, policy writers, and grieving relatives all contribute. Medicalisation of suicide has the potential to distort research findings, and caution is recommended.

Perfil dos idosos com depressão em comunidade do município de Fortaleza / Profile of depressed aged in a city community of Fortaleza

A depressão em pacientes idosos tem se tornado problema comum, interferindo na sua qualidade de vida. Este problema de saúde tem sido bastante estudado, pois tem-se percebido a relação entre depressão e idade avançada e uma forma singular de depressão nos idosos. Este trabalho teve como objetivo identificar a presença de depressão nos pacientes idosos da comunidade atendida na área do Curió atendida na Unidade Básica de Saúde da Família Terezinha Parente, no município de Fortaleza, e avaliar a associação entre a doença e perfil socioeconômico e demográfico da população estudada. Trata-se de um estudo exploratório-descritivo com enfoque quantitativo. Os dados foram coletados por meio de questionário estruturado e da Escala de Depressão Geriátrica (EDG) com 15 itens aplicados em todos os pacientes idosos que aceitaram participar do estudo por agentes comunitários de saúde, os quais foram devidamente treinados para aplicá-los. A prevalência de depressão no presente estudo foi de 37,6% e a distribuição de casos entre os sexos foi de 84,4% para mulheres e 15,6% para homens na população estudada. A prevalência de depressão foi maior nos idosos mais jovens: 59,38% dos casos entre 60 e 69 anos, 37,5% entre 70 e 79 anos e 3,12% acima de 80 anos. Em relação à situação financeira dos idosos do presente estudo, verificou-se que apenas 9,4% dos idosos com depressão viviam com renda superior a dois salários-mínimos. Observou-se que 74,2% dos casos de depressão detectados nos idosos da amostra total moram em domicíliosmultigeracionais, ou seja, com filhos e netos. Dentre idosos com hipertensão ou diabetes, que são casos de depressão segundo a EDG, 10% apresentam diabetes mellitus, 55% apresentam hipertensão arterial sistêmica e 35% apresentam ambas as doenças. Com base no estudo realizado com idosos do bairro Curió, pode-se propor várias ações de promoção de saúde e prevenção de doenças para melhorar a qualidade de vida do idoso atendido nas Unidades Básicas de Saúde da Família do município de Fortaleza.

The depression in senior patients is a very common problem, interfering in their life quality There are many studies considering this health problem, as it has been noticed the relationship between depression and advanced age and a singular kind of depression in seniors. This study intended to identify cases of depression presence in senior patients assisted in the area of Curió Community in the Terezinha Parentein the city of Fortaleza and to evaluate the association between the disease and the socioeconomic and demographic profile of the studied population. It concerns an exploratory-descriptive study with quantitative focus. The data was collected through structured questionnaire and the Scale of Geriatric Depression (SGD) within 15 items which had been applied into in all volunteered patients above 60 years by the community agents which were properly trained to apply it. The prevalence of depression in the present study was of 37,6% and the distribution of cases between the genders was of 84,4% affecting for women and 15.6% affecting for men in the studied population. The prevalence of depression was bigger in aged the youngest ones with 59,38% of the cases between 60 and 69 years, 37.5% between 70 and 79 years and 3.12% above 80 years. In relation to the financial situation of the aged ones of the present study, it was verified that only 9.4% of the aged ones with depression lived with superior income the 2 minimumwage. It was observed that 74.2% of the detected cases of depression in the aged ones of the total sample live in multi generation environment, which means, seniors with children and grandchildren. Amongst aged with hipertension or diabetes, which are cases of depression according to SGD, 10% presents mellitus diabetes, 55% present hypertension and 35% present both the illnessess. Based in the study carried through in the aged ones of the Curió, it can be considered that some actions of health promotion and prevention of illnesses to improve the taken care of life quality quality of life of the aged one in the Basic Units of Health of the Family in the City of Fortaleza.

Depressão na Atenção Primária à Saúde / Depression in Primary Care

Dos pacientes assistidos em ambulatórios gerais, 10% a 25% são portadores depressão1, representando a segunda causa de consulta, ainda que freqüentemente ignorada ou subdiagnosticada. Médicos generalistas, e não psiquiatras, tratam a maioria dos pacientes com sintomas depressivos2. A depressão ocupa o segundo lugar entre as doenças mais incapacitantes nos países ocidentais3. Na maioria dos países em desenvolvimento, a deficiência na saúde mental é ainda inaceitável, sendo meta da OMS aprimorar o diagnóstico e o tratamento da depressão em ambulatórios gerais em todo o mundo. Várias estratégias comprovam ser custo-efetivas, sendo as principais: educação médica continuada, maior participação da enfermagem e melhor integração entre atenção primária e secundária (especialista psiquiatra)4. Para depressão leve a moderada, estudos de meta-análise mostraram que há pouca diferença de efetividade entre as modalidades terapêuticas e entre antidepressivos, sendo a continuação da terapia o mais importante fator de escolha. Os melhores resultados são obtidos quando há aliança terapêutica entre o profissional de saúde e o paciente e um tratamento adequado é mantido por período suficiente. Este estudo vem discorrer sobre a importância, diagnóstico e tratamento da depressão na atenção primária e propor estratégias para implementar uma rede efetiva de atendimento, articulada com a atenção secundária.

Ten to 25% of patients assisted in general outpatient care centers suffer from depression1. Although frequently ignored or underdiagnosed, depression is the second most frequent cause of consultations. In most cases, patients with symptoms of depression are assisted by general practitioners instead of psychiatrists2. Depression occupies the second place among the most disabling diseases in the western countries3. In most developing countries, mental healthcare is still unacceptably deficient, and one of the goals of the WHO is improving diagnosis and management of depression in general outpatient care centers all over the world. Several strategies prove cost-effective, mainly: continued medical education, more participation of the nursing personnel and better integration between primary and secondary care (psychiatrist)4. As demonstrated by metaanalytical studies, in the management of light or moderate depression there is little difference in efficiency between different treatment modalities and antidepressants. The most important factor is continuity of the treatment. The best results are achieved when there is therapeutic alliance between doctor and patient and when an adequate treatment is kept on for sufficient time5. This study discusses the importance, diagnosis and treatment of depression in primary care and proposes strategies for implementing a care network articulated with secondary care.