Stressful life events severity in patients with first and recurrent depressive episodes.

BACKGROUND: Stressful life events are associated with depression and their role in first onset and recurrences is a promising but controversial perspective of research. The objective is to analyze the role of number of previous episodes and life events exposure in a large sample of primary care depressive patients taking into account life events severity. METHOD: 10,257 patients with DSM-IV criteria for a current single or recurrent major depressive episode were recruited by 2,056 general practitioners in a cross-sectional epidemiological study. Patients answered the Montgomery-Asberg Depression Rating Scale, the Patient Health Questionnaire and the Social Readjustment Rating Scale (SRRS). Stressful life events were categorized into three levels of severity (severe, moderate and mild). All relevant confounding variables were analyzed: age, gender, depression severity, somatic symptoms severity and length of episode. RESULTS: We found a significant positive correlation with number of episodes and depression severity. There was no significant correlation of SRRS scores with age, gender and length of episode. ANOVA exploring life events severity with regard to number of episodes showed statistically differences in SRRS total score, moderate life events and mild life events (F = 15.14, p < 0.001) but not for severe life events. CONCLUSIONS: Prevention and treatment strategies for recurrent depression need to manage life stressful events during mild and long-term periods and not just in the initial recurrences of the disease.

Características sociodemográficas y psicopatológicas del paciente hiperfrecuentados en atención primaria / Sociodemographic and psychopathological features of frequent attenders in Primary Care

Objetivo. Determinar las características sociodemográficas, clínicas y psicopatológicas de un grupo de pacientes hiperfrecuentadores comparándolo con otro grupo de normofrecuentadores en tres centros de atención primaria. Método. La muestra está compuesta por 232 hiperfrecuentadores (definidos por un número de consultas igual o superior a 12 en el último año) y 93 normofrecuentadores. Los instrumentos utilizados son: un cuestionario de elaboración propia para la evaluación de las características sociodemográficas y clínicas y el Cuestionario de Salud General de Goldberg en su versión de 28 ítems (GHQ-28).Resultados. La regresión logística muestra que el aumento de edad, un nivel educativo bajo, la presencia de enfermedad crónica (diabetes e hipertensión), un diagnóstico psiquiátrico y presencia de sintomatología psicopatológica «menor» establecen diferencias significativas en el grupo de hiperfrecuentadores frente al grupo de normofrecuentadores. No existen diferencias significativas entre hombres y mujeres. Conclusión. Los pacientes hiperfrecuentadores presentan altas tasas de quejas físicas, mentales y sociales. La edad, determinadas enfermedades crónicas y la psicopatología son los factores más importantes en relación a la hiperfrecuentación (AU)

Objective. To determine the sociodemographic and clinical characteristics of frequent attenders and compare them with another group of routine attenders in three primary care centers. Method. The sample is composed by 232 frequent attenders (defined by number of consultations in the last year of 12 or more) and 93 routine attenders. The instruments used are: a questionnaire for the evaluation of the sociodemographic and clinical characteristics and the 28-item Goldberg General Health Questionnaire (GHQ-28).Results. The logistic regression shows that increase of age, low level of education, presence of chronic disease, psychiatric diagnosis and presence of psychopathological «minor» symptomatology establish significant differences in the group of frequent attenders in relation to the routine attenders group. There are no significant differences between men and women. Conclusion. Frequent attenders present higher rates of physical, mental and social complaints. Age, some chronic conditions and psychopathology are the most important factors for frequent attendance (AU)

Calidad de vida y personalidad en la enfermedad inflamatoria / Quality of life and personality in inflammatory bowel disease

En este artículo se revisan estudios recientes que analizan la relación entre calidad de vida relacionada con la salud (CVRS) y la personalidad con la enfermedad infl amatoria intestinal (EII). La CVRS es especialmente importante en el caso de las enfermedades crónicas, ya que el alivio de los síntomas, el retraso en su progresión y las mejorías en la calidad funcional son objetivos estratégicos del tratamiento. Algunos estudios muestran que la CVRS en pacientes con EII es signifi cativamente más baja que en la población general. Hay pocos estudios que relacionen la personalidad con la EII y no hay homogeneidad en los resultados. Los trastornos de personalidad más prevalentes en la EII son el trastorno de personalidad por evitación y el trastorno obsesivo compulsivo de la personalidad. Se presentan algunos resultados de un estudio longitudinal que corroboran una peor CVRS en estos pacientes y la presencia de uno o más trastornos de la personalidad en un 57% de la muestra (AU)

The present article reviews recent studies analyzing the association between healthrelated quality of life (HRQoL) and personality in infl ammatory bowel disease (IBD). HRQoL is especially important in chronic diseases, since the strategic goals of treatment are to relieve symptoms, delay progression and improve functional quality. Some studies show that HRQoL in patients with IBD is signifi cantly lower than that in the general population. Few studies have analyzed the association between personality and IBD and the results are contradictory. The most prevalent personality disorders in IBD are avoidant personality disorder and obsessive-compulsive personality disorder. Some results of a longitudinal study corroborating impaired HRQoL in these patients and the presence of one or more personality disorders in 57% of the sample are discussed (AU)

Sociodemographic and psychopathological features of frequent attenders in Primary Care.

OBJECTIVE: To determine the sociodemographic and clinical characteristics of frequent attenders and compare them with another group of routine attenders in three primary care centers. METHOD: The sample is composed by 232 frequent attenders (defined by number of consultations in the last year of 12 or more) and 93 routine attenders. The instruments used are: a questionnaire for the evaluation of the sociodemographic and clinical characteristics and the 28-item Goldberg General Health Questionnaire (GHQ-28). RESULTS: The logistic regression shows that increase of age, low level of education, presence of chronic disease, psychiatric diagnosis and presence of psychopathological <> symptomatology establish significant differences in the group of frequent attenders in relation to the routine attenders group. There are no significant differences between men and women. CONCLUSION: Frequent attenders present higher rates of physical, mental and social complaints. Age, some chronic conditions and psychopathology are the most important factors for frequent attendance.