La relación entre la transición a la menopausia y los trastornos del estado de ánimo / The relationship between menopause transition and mood disorders

Este estudio tuvo como objetivo examinar la relación entre la transición a la menopausia y los trastornos del estado de ánimo, específicamente la ansiedad y la depresión. Se llevó a cabo una revisión narrativa de la literatura relevante sobre la transición a la menopausia y los trastornos del estado de ánimo. Se revisaron estudios que se enfocaron en el impacto de los cambios hormonales durante la menopausia en el bienestar psicológico y se evaluaron diversas opciones de tratamiento para los trastornos del estado de ánimo. La disminución de los niveles hormonales de estrógenos y progesterona durante la menopausia puede llevar a diversos cambios psicológicos, como ansiedad y depresión. La terapia hormonal con estrógenos solo o en combinación con progesterona puede mejorar los síntomas depresivos en mujeres en la menopausia, pero este tratamiento no está exento de riesgos. Otros tratamientos no hormonales, como la terapia cognitivo-conductual, el ejercicio y una buena higiene del sueño, también pueden ser efectivos para manejar los trastornos del estado de ánimo. Se concluyó que existe una compleja interacción entre factores hormonales, biológicos y psicosociales para desarrollar intervenciones efectivas que mejoren el bienestar psicológico de las mujeres en la menopausia.

This study aimed to examine the relationship between menopause transition and mood disorders, specifically anxiety and depression. The authors conducted a narrative review of relevant literature on menopause transition and mood disorders. They reviewed studies that focused on the impact of hormonal changes during menopause on psychological well-being and evaluated various treatment options for mood disorders. The decline in estrogen and progesterone hormone levels during menopause can lead to various psychological changes, such as anxiety and depression. Hormonal therapy with estrogen alone or in combination with progesterone can improve depressive symptoms in menopausal women, but this treatment is not without risks. Other non-hormonal treatments, such as cognitive-behavioral therapy, exercise, and good sleep hygiene, can also be effective in managing mood disorders. The study highlights the need for recognition of the complex interplay between hormonal, biological, and psychosocial factors in developing effective interventions to improve the psychological well-being of menopausal women. Further research is needed to fully understand the potential relationship between menopause transition and mood disorders.

Disfunción tiroidea y trastornos del ánimo: revisión del estado del arte / Thyroid dysfunction and mood disorders: review of the state of the art

La relación entre función tiroidea y trastornos del ánimo se ha observado desde hace más de 50 años. Las hormonas tiroideas, actúan en el cerebro modulando génicamente proteínas asociadas a la fisiopatología de los trastornos del ánimo y potenciando los sistemas de neurotransmisión serotoninérgica y noradrenérgica. En el tratamiento de un episodio depresivo, la normalización de hormonas tiroideas es fundamental, y debe realizarse en todo paciente con sintomatología anímica, especialmente en aquellos con respuestas insuficientes a tratamiento, que requieren niveles de hormonas más estrictos que lo recomendado para población general. En pacientes eutiroideos, la potenciación con triyodotironina ha sido probada, pero también se ha utilizado T4 en altas dosis en casos resistentes, en que se postula que pudiese existir un estado de resistencia a hormonas tiroideas, no reflejado en los niveles hormonales periféricos evaluados rutinariamente. Las enzimas deiodasas, el receptor de hormona tiroidea, y el transportador de hormona tiroidea en la barrera hematoencefálica son blancos a investigar. Los objetivos de la presente revisión son ofrecer orientaciones respecto del uso de hormonas tiroideas en pacientes con trastornos del ánimo, una puesta al día sobre la relación entre hormonas tiroídeas y sistema nervioso central, y las interacciones entre psicofármacos y función tiroidea.

The relationship between thyroid function and mood disorders has been observed for more than 50 years. Thyroid hormones act in the brain genetically modulating proteins associated with the pathophysiology of mood disorders and potentiating the serotonergic and noradrenergic neurotransmission systems. In the treatment of a depressive episode, the normalization of thyroid hormones is essential, and should be performed in all patients with mood symptoms, especially in those with insufficient responses to treatment, which require more stringent hormone levels than recommended for the general population. In euthyroid patients, potentiation with triiodothyronine has been proven, but T4 has also been used in high doses in resistant cases, in which it is postulated that there might be a state of resistance to thyroid hormones, not reflected in the peripheral hormonal levels evaluated routinely. The enzymes deiodasas, the thyroid hormone receptor, and the thyroid hormone transporter in the blood brain barrier are white to investigate. The objectives of this review are to provide guidance regarding the use of thyroid hormones in patients with mood disorders, an update on the relationship between thyroid hormones and central nervous system, and the interactions between psychoactive drugs and thyroid function.

Atividade física de vida diária, capacidade de exercício e qualidade de vida de pacientes com doença de Crohn em remissão induzida por infliximabe: um estudo preliminar / Physical activity in daily life, exercise capacity and quality of life in patients with crohn's disease on infliximab-induced remission: a preliminary study

ABSTRACT BACKGROUND: Physical activity in daily life and exercise capacity have not been assessed in patients with Crohn's disease to date. OBJECTIVE: To evaluate the physical activity in daily life, exercise capacity, quality of life, and prevalence of mood disorders in patients with moderate-to-severe Crohn's disease on infliximab-induced remission and the possible associations among variables. METHODS: A cross-sectional preliminary study was conducted. Twenty-six patients with Crohn's disease and 20 controls were selected. Participants underwent evaluation of physical activity in daily life (triaxial accelerometer), exercise capacity (shuttle walk test), handgrip strength, quality of life, and presence of mood disorders. RESULTS: The number of steps taken (7446±3081 vs 7898±2487), active time (80.6±42 vs 89.7±24.3min), shuttle walk test distance [665 (405) vs 710 (409) m] and handgrip strength [31 (15) vs 29 (20) kgf did not show any difference between the patients with Crohn's disease and the controls. The time spent lying down [95.8 (68.8) vs 60.9 (74.7) min] was greater and some domains of the quality of life were superior in the patients with Crohn's disease. No correlation was observed between the physical activity in daily life and quality of life or presence of mood disorders in patients with Crohn's disease. CONCLUSION: Patients with Crohn's disease on infliximab-induced remission, despite to more time spent lying down, they have the same level of physical activity in daily life and exercise capacity min compared with the controls.

RESUMO CONTEXTO: A atividade física na vida diária e a capacidade de exercício não tem sido avaliada em pacientes com doença de Crohn. OBJETIVO: Avaliar a atividade física na vida diária, capacidade de exercício, qualidade de vida e distúrbios de humor em pacientes com doença de Crohn moderada-grave em remissão induzida pelo infliximabe, e as possíveis associações entre essas variáveis. MÉTODOS: Este foi um estudo preliminar transversal, envolvendo 26 pacientes com doença de Crohn e 20 controles. Os participantes realizaram as seguintes avaliações: atividade física na vida diária por meio de um acelerômetro triaxial, capacidade de exercício (teste de Shuttle), força de preensão palmar, qualidade de vida e distúrbios do humor. RESULTADOS: O número de passos registrados (7446±3081 vs 7898±2487), o tempo ativo (80,6±42,0 vs 89,7±24,3min), a distância caminhada no teste de Shuttle 665 (405) vs 710 (409) m, e a força de preensão manual 31(15) vs 29 (20) kgf não mostraram diferenças entre os pacientes com doença de Crohn e os controles, respectivamente. O tempo gasto na posição deitada 95.8 (68.8) vs 60.9 (74.7) min, e alguns domínios da qualidade de vida foram maiores nos pacientes com doença de Crohn. Nenhuma correlação foi observada entre a atividade física na vida diária e a qualidade de vida ou distúrbios do humor nos pacientes com doença de Crohn. CONCLUSÃO: Pacientes com doença de Crohn em remissão induzida por infliximabe, apesar de passarem mais tempo deitados, apresentam mesmo nível de atividade física e capacidade de exercício quando comparados aos controles.

Evaluation of affective temperament and anxiety-depression levels in fibromyalgia patients: a pilot study

Objective: Fibromyalgia (FM) patients have higher rates of depression and anxiety disorders than healthy controls. Affective temperament features are subclinical manifestations of mood disorders. Our aim was to evaluate the affective temperaments of FM patients and investigate their association with depression and anxiety levels and clinical findings. Methods: This cross-sectional study included FM patients and healthy controls. The Hospital Anxiety and Depression Scale (HADS) was used to determine patient anxiety and depression levels, and the Temperament Scale of Memphis, Pisa and San Diego, self-administered version was applied to assess affective temperaments in all subjects. Disease severity was assessed in FM patients with the Fibromyalgia Criteria and Severity Scales and the Fibromyalgia Impact Questionnaire (FIQ). Differences between groups were evaluated using Student's t-tests. Correlations among parameters were performed. Results: This study involved 38 patients with FM (30 female) and 30 healthy controls (25 female). Depressive, anxious and cyclothymic temperaments were significantly higher in FM patients than healthy controls. Statistically significant positive correlations were found between HADS depression score and all temperaments except hyperthymic, as well as between HADS anxiety score and cyclothymic and anxious temperaments. HADS depression and anxiety scores were correlated with symptom severity. We found a higher risk of depression and anxiety among FM patients with higher FIQ scores. Conclusion: This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders.

The association between social skills deficits and family history of mood disorder in bipolar I disorder

Objective: To compare social skills and related executive functions among bipolar disorder (BD) patients with a family history of mood disorders (FHMD), BD patients with no FHMD and healthy control (HCs). Methods: We evaluated 20 euthymic patients with FHMD, 17 euthymic patients without FHMD, and 31 HCs using the Social Skills Inventory (SSI) and a neuropsychological battery evaluating executive function, inhibitory control, verbal fluency and estimated intelligence. Results: Both BD groups had lower SSI scores than controls. Scores for one subfactor of the social skills questionnaire, conversational skills and social performance, were significantly lower among patients with FHMD than among patients without FHMD (p = 0.019). Both groups of BD patients exhibited significant deficits in initiation/inhibition, but only BD patients with FHMD had deficits in verbal fluency, both compared to HC. There were no associations between social skills questionnaire scores and measures of cognitive function. Conclusion: Euthymic BD patients have lower social skills and executive function performance than HC. The presence of FHMD among BD patients is specifically associated with deficits in conversational and social performance skills, in addition to deficits in verbal fluency. Both characteristics might be associated with a common genetically determined pathophysiological substrate.

Cortical correlates of affective syndrome in dementia due to Alzheimer’s disease / Correlatos corticais da síndrome afetiva na demência da doença de Alzheimer

Neuropsychiatric symptoms in Alzheimer’s disease (AD) are prevalent, however their relationship with patterns of cortical atrophy is not fully known. Objectives To compare cortical atrophy’s patterns between AD patients and healthy controls; to verify correlations between neuropsychiatric syndromes and cortical atrophy. Method 33 AD patients were examined by Neuropsychiatric Inventory (NPI). Patients and 29 controls underwent a 3T MRI scanning. We considered four NPI syndromes: affective, apathy, hyperactivity and psychosis. Correlations between structural imaging and neuropsychiatric scores were performed by Freesurfer. Results were significant with a p-value < 0.05, corrected for multiple comparisons. Results Patients exhibited atrophy in entorhinal cortices, left inferior and middle temporal gyri, and precuneus bilaterally. There was correlation between affective syndrome and cortical thickness in right frontal structures, insula and temporal pole. Conclusion Cortical thickness measures revealed atrophy in mild AD. Depression and anxiety symptoms were associated with atrophy of right frontal, temporal and insular cortices. .

Os sintomas neuropsiquiátricos na doença de Alzheimer (DA) são prevalentes, porém suas relações com padrões de atrofia cortical não são totalmente compreendidas. Objetivos Comparar padrões de atrofia cortical entre DA e controles; verificar se há correlações entre sintomas neuropsiquiátricos e atrofia cortical. Método 33 pacientes com DA foram examinados pelo Inventário Neuropsiquiátrico. Os pacientes e 29 controles foram submetidos à RNM. Consideramos quatro síndromes: afetiva, apatia, hiperatividade e psicose. Correlações entre imagens estruturais e os scores foram feitas pelo Freesurfer. Os resultados foram significantes com um valor de p < 0,05, corrigido para múltiplas comparações. Resultados Pacientes exibiram atrofia nos córtices entorrinais, giros temporal médio e inferior esquerdos, e precuneo bilateralmente. Houve correlação entre síndrome afetiva e espessura cortical em estruturais frontais direitas, ínsula e polo temporal. Conclusão Medidas de espessura cortical revelaram atrofia na DA. Sintomas de depressão e ansiedade foram associados à atrofia dos córtices frontal direito, temporal e ínsula. .

Consejos farmacéuticos a pacientes con trastornos de humor / Pharmacist counseling for patients with mood disorders

Introducción: la atención farmacéutica consiste en la interacción directa del farmacéutico con el usuario a fin de lograr una farmacoterapia racional y obtener resultados definidos y mensurables, encaminados a la mejoría de la calidad de vida del paciente. La depresión es considerada una de las diez principales causas de incapacidad en el mundo, la cual limita el funcionamiento físico, personal y social. Sin embargo, pocas personas afligidas con estos problemas de salud reciben el tratamiento adecuado y orientaciones acerca de la enfermedad y tratamiento. Objetivo: evaluar el servicio de la atención farmacéutica mediante consejo farmacéutico sobre la efectividad y adhesión a la farmacoterapia. Métodos: se seleccionaron 19 pacientes, con edad entre 15 y 82 años, con trastornos de humor, atendidos en el Centro de Atención Psicosocial y Ambulatorio de UNIFENAS, Brasil. Se realizaron citas domiciliares, durante las cuales se les dieron a los pacientes orientaciones acerca de la enfermedad, reacciones adversas, interacciones medicamentosas, duración del tratamiento e importancia de adhesión a este. El inventario de depresión de Beck y la prueba de Morisky para evaluar la adhesión fueron aplicados antes y después del consejo farmacéutico. Resultados: la mayoría fueron mujeres, católicas, con hasta nueve años de estudio. Al comparar los resultados de la aplicación del inventario de depresión de Beck antes y después del consejo del farmacéutico, hubo una diferencia estadísticamente significativa (p= 0,0354), con reducción de aproximadamente 6 puntos en el escore de Beck (24,22 para 18). El nivel de adhesión entre los pacientes aumentó, pues el número de pacientes con alta adhesión pasó de 21,06 por ciento a 42,10 por ciento. Conclusiones: los resultados sugieren que el consejo farmacéutico puede ser útil para lograr mejores resultados de adhesión y efectividad al tratamiento(AU)

Introduction: pharmaceutical care is the direct interaction of the pharmacist and the user in order to achieve rational drug therapy and to obtain defined measurable results aimed at improving the life quality of the patient. Depression is considered one of the ten main causes of disability worldwide since it restricts the physical, social and personal functioning of the individual. However, few people having these health problems receive proper treatment and directions about their disease and therapy. Objective: to evaluate the pharmaceutical care service through counseling on the effectiveness of and adherence to drug therapy. Methods: nineteen patients were selected, aged 15 to 82 years and with mood disorders. They were all seen at the Psychosocial and Outpatient Care Center of UNIFENAS in Brazil. They were visited at home to give instructions to them about their disease, adverse reactions, and drug interactions, length of treatment and importance of adherence to therapy. Beck depression inventory and Morisky´s test were used to evaluate adherence to treatment before and after the pharmacist counseling. Results: most of patients were Catholic women, who had been under study for up to 9 years. When comparing the results of the application of the Beck depression inventory before and after the pharmacist counseling, there was observed an statistically significant difference ((p= 0.0354), with a reduction of roughly 6 point in Beck´s score (24,22 for 18). The adherence to treatment rate increased since the number of patients who showed high rate of adherence to therapy rose from 21.06 percent to 42.10 percent. Conclusions: the results suggest that the pharmacist counseling could be a useful method to achieve better outcomes in adherence to and effectiveness of treatment(AU)

Trauma infantil e sua associação com transtornos do humor na vida adulta: uma revisão sistemática / Childhood trauma and its association with mood disorders in adulthood: a systematic review / Trauma infantil y su asociación con los trastornos del humor en la vida adulta: una revisión sistemática

Eventos estressores traumáticos na infância ocorrem comumente em situações de maus-tratos e estão associados a prejuízos psicológicos e a transtornos mentais, entre eles os transtornos do humor. Este estudo apresenta uma revisão sistemática da literatura visando a identificar achados que descrevam associações entre trauma na infância e transtornos do humor na vida adulta. Uma busca de palavras-chave foi realizada nas bases de dados Scielo, Web of Science, PsychInfo, LILACS e Pubmed. Dez artigos preencheram os critérios de inclusão estabelecidos. Todos os artigos encontrados apontavam relações significativas entre traumas na infância e diferentes tipos de transtornos do humor. Estudos mostram ainda que, nos casos em que há esse tipo de associação, também são encontradas comorbidades psiquiátricas, pior sintomatologia e prognóstico...

Traumatic events, when occur in childhood, which commonly happen in situations of maltreatment, are associated with different types of psychological and mental disorders, among them, Mood Disorders. This study presents a systematic review of the literature, which aims to identify findings that describe associations between childhood trauma and Mood Disorders in adulthood. A search for key words was performed in the database: Scielo, Web of Science, PsychInfo, Pubmed and LILACS. Ten articles met the inclusion criteria established for the present study. All studies found indicated significant relationships between childhood trauma and different types of Mood Disorders. Studies also show that in cases in where there is this kind of association, are different psychiatric comorbidities, worse symptoms and prognosis...

Eventos estresantes traumáticos en la infancia se producen comúnmente en situaciones de abuso y están asociados con daños psicológicos y trastornos mentales, entre ellos los trastornos del humor. Este estudio presenta una revisión sistemática de la literatura para identificar resultados que describan las asociaciones entre el trauma de la infancia y los trastornos del humor en la vida adulta. Una búsqueda de palabras clave se realizó en la base de datos: Scielo, Web of Science, PsychInfo, PubMed y LILACS. Diez artículos cumplieron con los criterios de inclusión establecidos. Todos los artículos encontrados indicaban relaciones significativas entre trauma infantil y los diferentes tipos de trastornos del humor. Los estudios también muestran que en los casos en los que hay este tipo de asociación, también aparecen co-morbidades psiquiátricas, peor sintomatología y pronóstico...

Prevalence of Mood and Anxiety Disorders in Opioid Addicts.

Introduction: Substance use disorders and mood and anxiety disorders are widespread among the general population. Methods: This study assessed the rate of current mood disorders and anxiety disorders in outdoor opioid addicts. The data were collected from five hundred opioiddependent patients who were seeking treatment from outdoor dept. of civil hospital, Gurdaspur. The Research version of structured clinical interview for DSM-IV Axis I Disorders was used. Results: The majority (23%) were self employed and 20% were unemployed. 25% had education till the level of high school, 15% were illiterate. 326(65.2%) subjects were diagnosed as having mood disorders, of those 274 (29%) had substance induced depression, 41 (8.2%) had major depression, 5 (1%) had dysthymia, 5 (1%) bipolar mood disorder type I, and 2 (0.4%) were diagnosed as having bipolar mood disorder type II. 138 (27.6%) subjects were diagnosed as having substance-induced anxiety disorders, and 88 (17.6%) as having generalized anxiety disorder. Of the participants 218 (43.6%) reported more than 5 years use of opioid abuse. Conclusions: Due to high rates of mood disorders in opioid-dependent subjects, psychiatric treatment services should be open and accessible to the patients, especially those who voluntarily seek help and treatment to reduce the rate of mood disorders and reduce relapse of substance abuse also.

Oscilação do humor em pacientes com doença de Crohn: incidência e fatores associados / Mood swings in patients with Crohn's disease: incidence and associated factors

OBJETIVO: Avaliar em portadores de doença de Crohn (DC) a incidência de oscilação do humor (OH) e os possíveis fatores associados à mesma. MÉTODOS: Estudo prospectivo longitudinal com 50 pacientes (60% sexo feminino; média de idade de 40,6 a) com diagnóstico de DC acompanhados por 16 meses. A atividade clínica foi avaliada pelo índice de atividade da DC. Utilizaram-se os instrumentos de autoavaliação do estado psicológico (Inventário de Depressão de Beck e subescala de ansiedade da Escala Hospitalar de Ansiedade e Depressão) para diagnóstico de transtorno de humor. Os instrumentos foram aplicados na inclusão no estudo e, a seguir, em intervalos de quatro meses. RESULTADOS: O fenótipo inflamatório foi o mais comum (86%), 36% tinham história prévia de cirurgia relacionada com DC; 82% estavam em remissão clínica na inclusão. OH ocorreu em 58% dos pacientes; 28% evoluíram com sintomas depressivos e/ou ansiosos a partir do humor normal de base e 30% normalizaram o humor depressivo e/ou ansioso de base. Em 38% dos pacientes com OH não houve mudança na atividade clínica da doença (p = 0,015), enquanto 20% tiveram alteração na atividade da DC. Sexo feminino e ausência de cirurgia prévia relacionada com complicações da DC foram associadas à maior incidência de OH (p = 0,04 para ambos). CONCLUSÃO: Neste estudo, verificou-se elevada incidência (58%) de OH em pacientes com DC. O sexo feminino e ausência de cirurgia prévia por complicações da DC foram associadas à maior incidência de OH. Avaliação psicológica periódica pode ser útil para detecção e abordagem de OH em pacientes com DC.

OBJECTIVE: To assess the incidence of mood swings (MS) and possible associated factors in patients with Crohn's disease (CD). METHODS: Prospective longitudinal study of 50 patients (60% females; mean age 40.6 years) with a diagnosis of CD over a 16-month follow-up. Clinical activity was assessed by the CD activity index. Psychological status self-report tools (Beck Depression Inventory and the anxiety subscale of the Hospital Anxiety and Depression Scale) were used for mood disorder diagnosis. The tools were applied at baseline and at four-month intervals thereafter. RESULTS: The inflammatory phenotype was the most common (86%); 36% had a previous history of surgery related to CD; 82% were in clinical remission at baseline. MS occurred in 58% of patients; 28% had progression of depression and/or anxiety symptoms from baseline normal mood, and 30% had baseline depressive and/or anxious mood normalized. In 38% of patients with MS, no change in the disease clinical activity could be found (p = 0.015), whereas 20% had a change in CD activity. Female gender and absence of previous surgery related to CD complications were associated with higher MS incidence (p = 0.04 for both). CONCLUSION: In this study, a high MS incidence (58%) was found in patients with CD. Female gender and absence of previous surgery from CD complications were associated with a higher MS incidence. Periodic psychological assessment could be useful to detect and approach MS in patients with CD.

Desrregulación emocional, ¿una variable del temperamento y desorden ansioso en su esencia? / Emotional dysregulation, a temperamental trait and anxiety disorder in its essence?

La Desrregulación Emocional ha sido propuesta como una entidad nosográfica por su relevancia clínica, al ser un diagnóstico diferencial de una enfermedad bipolar. El objetivo de este trabajo es evaluar, en un grupo de pacientes, la psicopatología de la desrregulación emocional y analizar sus historias del desarrollo. En el presente trabajo se analiza una serie clínica de pacientes, recopilados en el transcurso de 10 años y vistos desde la perspectiva del desarrollo, hecho que está ausente en la bibliografía actual. Postulamos como hechos centrales de esta condición psicopatológica, una variable del temperamento y desde el punto de vista clínico, como un cuadro en esencia, en la línea ansiosa.

Emotional dysregulation has been proposed as a nosographic entity because of its clinical relevance, and as a differential diagnosis of bipolar disorder. The aim of this paper is to evaluate the psychopathological development of a group of child with emotion dysregulation. In this paper, we analyze a clinical series of patients collected over 10 years, seen from the perspective of development, a fact that is absent in the current literature. We can conclude that the emotional dysregulation is a disorder that has, as main features, characteristics of temperament, and is a disorder related with anxiety from the clinical point of view.

The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil

OBJECTIVE: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. METHODS: A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. RESULTS: Children with mood disorders alone had the highest rate of adherence (79.5 percent); those with substance abuse disorders alone had the lowest (40 percent); and those with both disorders had an intermediate rate of adherence (50 percent). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6 percent and 72.9 percent, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. CONCLUSIONS: Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth.

Incidence of Mood Disorders among Referred Indoor Patients.

Consultation-Liaison (C-L) Psychiatry is a growing area of research in psychiatry where a large number of patients having main complaints of psychiatric symptoms in the non-psychiatric wards. So diagnosis of these cases fully depends upon referrals. In spite of the high prevalence of Psychiatric morbidities in India, the overall referral rate was 1.48 %(4) .This study is aimed to find out the incidence of mood disorders among referred indoor patients from Medicine & allied departments of Medical College, Kolkata. The study was done using psychiatric referrals from General medicine and allied department. The study may sensitize all medical professionals and it will contribute towards improvements of mental health at all levels of health care institutions.

PMK: validade preditiva do PMK em relação à presença de sintomas psicopatológicos / PMK: criteria-related validity regarding psychopathologic symptoms

O Psicodiagnóstico Miocinético (PMK) é considerado uma técnica útil na avaliação de seis fatores da personalidade no Brasil. Tendo como base a teorização proposta por Mira y Lopes, manifestações extremas dessas dimensões estão relacionadas a indícios de sintomas psicopatológicos. Este trabalho teve como objetivo principal investigar a capacidade preditiva das medidas do PMK em relação ao diagnóstico de transtorno de humor. Para tal, compararam-se as medidas no PMK de 31 indivíduos com diagnóstico de transtorno mental e 31 controles pareados nas variáveis sociodemográficas. Foi utilizada a estatística de Wilcoxon e os resultados indicaram que não houve diferenças entre os grupos. Conclui-se que as medidas de personalidade baseadas no PMK, tal como calculadas no presente estudo, não foram sensíveis à presença de tendências depressivas constitucionais conforme sua fundamentação teórica. Na literatura brasileira, não foram encontrados estudos atuais que tiveram o propósito de compreender a capacidade do PMK em diferenciar grupos-critérios em termos de sintomas psicopatológicos. Por isso, verifica-se a necessidade do desenvolvimento de visão conceitual crítica e metodologicamente consistente dos parâmetros psicométricos do PMK no intuito de legitimar a interpretação proposta por Mira y Lopez para o uso do instrumento em diferentes contextos da avaliação psicológica.

Psicodiagnóstico Miocinético (PMK) is considered a useful technique for the evaluation of six personality factors in Brazil. Based on the theory proposed by Mira y Lopez, extreme manifestations of these dimensions are related to signs of psychopathology. This study aimed to investigate the predictive ability of measures of the PMK in the diagnosis of mood disorder. To this end, we compared measures of PMK in 31 individuals diagnosed with mental disorder and 31 controls matched on sociodemographic variables. We used Wilcoxon test and the results showed no differences between groups. It is concluded that measures of personality as calculated in this study were not sensitive to the presence of mental disorders of mood. In the Brazilian literature, current studies that had the purpose of understanding the PMK's capacity in differentiating group-criteria in psychopathological symptoms have not been found. New psychometric studies should be conducted to justify the interpretation suggested by Mira y Lopez.

Prevalencia de malestar psicológico en estudiantes de enfermería relacionada con factores sociodemográficos, académicos y familiares / Prevalence of psychological distress in nursing students associated with sociodemographic, academic and family factores

Estudio descriptivo correlacional realizado con el objetivo de medir la prevalencia y nivel de síntomas de malestar psicológico y su relación con variables sociodemográficas, familiares y académicas, en estudiantes de pregrado de la carrera de Enfermería. Se aplicó el Cuestionario de Salud General de Goldberg de 12 ítemes a 228 estudiantes, previo consentimiento informado. Entre los resultados, se obtuvo una prevalencia de 36 por ciento de malestar psicológico; los síntomas más frecuentes fueron: agobio y tensión, falta de concentración, menor capacidad para disfrutar de la vida diaria, sentirse deprimido, pérdida de sueño e incapacidad para enfrentar problemas. El malestar psicológico se asoció significativamente con: menor tiempo destinado a recreación, preocupación económica, más de diez horas diarias de estudio personal, procedencia de provincia, percepción de bajo nivel socioeconómico, percepción de pobre apoyo familiar, promedio de notas inferior a cinco y mediana satisfacción con la carrera. Se concluye que existe una alta prevalencia de malestar psicológico entre los estudiantes de enfermería, relacionado con características propias del estudiante de orden personal, académico y familiar.

Descriptive correlational study conducted with the aim to measure the prevalence and level of psychological distress symptoms and its relationship with sociodemographic, family and academic variables, in undergraduate Nursing students. The Goldberg General health Questionnaire of 12 items was applied to 228 students, previous informed consent, fnding a 36 percent prevalence of psychological distress. The most frequent symptoms were: overwhelmed and tension, lack of concentration, reduced ability to enjoy daily life, feeling depressed, loss of sleep and incapacity to cope with problems. The psychological discomfort was significantly associated with: less time for recreation, economic concern, more than ten hours of personal study, mostly coming from province, low socioeconomic level perception, poor family support perception, average grade below fve and medium satisfaction with the career. It was concluded that there is a high prevalence of psychological distress among students of nursing related to student’s personal, academic and family characteristics.

Perfil de humor de mulheres com fibromialgia / Profile's mood in women with fibromyalgia

OBJETIVO: O objetivo deste estudo foi verificar o perfil dos estados de humor de mulheres com fibromialgia, bem como analisar sua associação com características sociodemográficas e clínicas. MÉTODOS: Cento e seis participantes responderam ao Questionário Sociodemográfico e Clínico (QSDC) e à Escala de Humor de Brunel (BRUMS). O QSDC é constituído por perguntas sobre dados pessoais e aspectos clínicos, enquanto o BRUMS avalia o humor por meio de seis fatores, a saber: tensão, depressão, raiva, vigor, fadiga e confusão mental. Os dados foram tratados com estatística descritiva e por meio dos testes de Kruskal-Wallis e Mann-Whitney. RESULTADOS: As variáveis negativas do humor estiveram em níveis elevados, em especial a tensão, a depressão, a fadiga e a confusão mental, enquanto o vigor esteve baixo. Verificou-se ainda que as participantes mais jovens que trabalham com diagnóstico de depressão e, principalmente, as que possuíam maior número de sintomas relacionados à fibromialgia apresentavam humor mais deprimido do que seus pares. CONCLUSÃO: Mulheres com fibromialgia apresentaram tendência de humor deprimido, sendo que essa característica se apresentou associada a fatores sociodemográficos e clínicos.

OBJECTIVE: The aim of this study was to verify the association between mood states with clinical and sociodemographic characteristics of women with fibromyalgia. METHODS: One hundred six participants answered the Sociodemographic and Clinical Questionnaire (QSDC) and the Brunel Mood Scale (BRUMS). The QSDC is composed of questions about personal and clinical aspects, while BRUMS evaluates mood state over six components: tension, depression, anger, vigor, fatigue and mental confusion. Data was treated with descriptive statistics and the Kruskal-Wallis and Mann-Whitney test. RESULTS: The negative mood variables whore elevated, especially the tension, depression, fatigue and mental confusion, while the vigor was considered in low-level. It was also found that younger participants, who work, with a diagnosis of depression and particularly those having increased symptoms related to fibromyalgia had more depressed mood than their peers. CONCLUSION: Women with fibromyalgia had a trend toward depressed mood, and this feature is presented associated with sociodemographic and clinical factors.

Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ) / Confiabilidade e validação da versão brasileira do Questionário de Hipomania (HCL-32 VB) comparado ao Questionário de Transtornos de Humor (MDQ)

OBJECTIVE: Bipolar disorders are often not recognized and undertreated. The diagnosis of current or past episodes of hypomania is of importance in order to increase diagnostic certainty. The Hypomania Checklist-32 is a self-applied questionnaire aimed at recognizing these episodes. As part of the international collaborative effort to develop multi-lingual versions of the Hypomania Checklist-32, we aimed to validate the Brazilian version and to compare its psychometric properties with those of the Mood Disorder Questionnaire. METHOD: Adult outpatients with bipolar disorder I (n = 37), bipolar disorder II (n = 44) and major depressive disorder (n = 42) of a specialized mood disorder unit were diagnosed according to DSM-IV-TR using a modified version of the SCID. We analyzed the internal consistency and discriminative ability of the Hypomania Checklist-32 Brazilian version in relation to the Mood Disorder Questionnaire. RESULTS: The internal consistency of the Brazilian Hypomania Checklist-32, analyzed using Cronbach's alpha coefficient, was 0.86. A score of 18 or higher in the Hypomania Checklist-32 Brazilian version distinguished between bipolar disorder and major depressive disorder, with a sensitivity of 0.75 and a specificity of 0.58, compared to 0.70 and 0.58, respectively, for the Mood Disorder Questionnaire (score > 7). The Hypomania Checklist-32 Brazilian version showed a dual factor structure characterized by "active/elated" and "risk-taking/irritable" items. Hence, the Hypomania Checklist-32 Brazilian version was found to have a higher sensitivity but the same specificity as the Mood Disorder Questionnaire. CONCLUSION: The Brazilian version of the Hypomania Checklist-32 has adequate psychometric properties and helps discriminating bipolar disorder from major depressive disorder (but not bipolar disorder I from bipolar disorder II) with good sensitivity and specificity indices, similar to those of the Mood Disorder Questionnaire.

OBJETIVO: O transtorno bipolar muitas vezes não é reconhecido e deixa de ser tratado adequadamente. O diagnóstico de episódios atuais ou passados é importante, a fim de aumentar a certeza diagnóstica. O Questionário de Autoavaliação de Hipomania-32 é um questionário autoaplicável para o rastreamento desses episódios. Como parte do desenvolvimento em vários idiomas do Questionário de Autoavaliação de Hipomania-32, nós objetivamos validar a versão brasileira e comparar suas propriedades psicométricas com o Questionário de Transtornos do Humor. MÉTODO: Em uma unidade especializada em transtornos do humor foram selecionados pacientes ambulatoriais adultos com transtorno bipolar I (n = 37), transtorno bipolar II (N = 44) e transtorno depressivo maior (N = 42) de acordo com a DSM-IV-TR, utilizando uma versão modificada do SCID. Analisou-se a consistência interna e capacidade discriminativa do Questionário de Autoavaliação de Hipomania-32 versão brasileira comparada ao Questionário de Transtornos do Humor. RESULTADOS: A consistência interna do Questionário de Autoavaliação de Hipomania-32 versão brasileira é boa, com alfa de Cronbach 0,86. Um escore de 18 ou mais no Questionário de Autoavaliação de Hipomania-32 versão brasileira distingue entre o transtorno bipolar e o transtorno depressivo maior com uma sensibilidade de 0,75 e especificidade de 0,58, e para o Questionário de Transtornos do Humor, para um escore de 7 ou mais, de 0,70 e 0,58, respectivamente. O Questionário de Autoavaliação de Hipomania-32 mostrou uma estrutura caracterizada pela predominância de dois fatores (ativação/elação e irritabilidade/correr riscos). Assim, o Questionário de Autoavaliação de Hipomania-32 versão brasileira tem maior sensibilidade, mas a mesma especificidade que o Questionário de Transtornos do Humor. CONCLUSÃO: A versão brasileira do Questionário de Autoavaliação de Hipomania-32 possui propriedades psicométricas adequadas e ajuda a discriminar o transtorno bipolar do transtorno depressivo maior (mas não transtorno bipolar I de transtorno bipolar II), com boa sensibilidade e especificidade, semelhante ao Questionário de Transtornos do Humor.