ABSTRACT
OBJECTIVES: Accumulating evidence shows depression as a risk factor for frailty, but studies are mainly population-based and widely differ in their assessment of either depression or frailty. We investigated the association between depression and frailty among geriatric outpatients using different assessment instruments for both conditions. METHOD: Among 315 geriatric outpatients (mean age 72.1 years, 68.3% female sex) participating the MiMiCS-FRAIL cohort study, major and subthreshold depression were measured with psychiatric diagnostic interview according to DSM-5 criteria (SCID-5) as well as with instruments to screen and measure severity of depressive symptoms (GDS-15 and PHQ-9). Frailty was assessed according to a screening instrument (FRAIL-BR) and a multidimensional Frailty Index (FI-36 items). Multiple logistic and linear regression were performed to assess the association between depression (independent variable) and frailty (dependent variable) adjusted for confounders. RESULTS: Frailty prevalence in patients with no, subthreshold or major depressive disorder increases from either 14.5%, 46.5% to 65.1% when using the FRAIL-BR questionnaire, and from 10.2%, 20.9%, to 30.2% when using the FI-36 index. These association remain nearly the same when adjusted for covariates. Both the FRAIL-BR and the FI-36 were strongly associated with major depressive disorder, subthreshold depression, and depressive symptoms by PHQ-9 and GDS-15. CONCLUSION: Late life depression and frailty are associated in a dose-dependent manner, irrespective of the used definitions. Nonetheless, to avoid residual confounding, future research on underlying biological mechanisms should preferably be based on formal psychiatric diagnoses and objectively assessment frailty status.
Subject(s)
Depressive Disorder, Major , Frailty , Aged , Cohort Studies , Depression/epidemiology , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Female , Frail Elderly , Frailty/diagnosis , Frailty/epidemiology , Geriatric Assessment , Humans , MaleABSTRACT
In Brazilian archaeological shellmounds, many species of land snails are found abundantly distributed throughout the occupational layers, forming a contextualized set of samples within the sites and offering a potential alternative to the use of charcoal for radiocarbon dating analyses. In order to confirm the effectiveness of this alternative, one needs to prove that the mollusk shells reflect the atmospheric carbon isotopic concentration in the same way charcoal does. In this study, 18 terrestrial mollusk shells with known collection dates from 1948 to 2004 AD, around the nuclear bombs period, were radiocarbon dated. The obtained dates fit the SH1-2 bomb curve within less than 15 years range, showing that certain species from the Thaumastus and Megalobulimus genera are reliable representatives of the atmospheric carbon isotopic ratio and can, therefore, be used to date archaeological sites in South America.
Subject(s)
Carbon Radioisotopes/metabolism , Carbon/metabolism , Environmental Monitoring/methods , Snails/metabolism , Animals , Atmosphere , Snails/classification , Species SpecificityABSTRACT
OBJECTIVES: To analyze the frequency of binge eating disorder (BED) and of the main psychiatric disorders associated with morbid obesity in individuals on the waiting list for bariatric surgery. METHOD: Cross sectional study. Interviews with patients from the Surgery for Obesity Program of Oswaldo Cruz University Hospital were conducted evaluating socio-demographic profile, quality of life (SF-36 scale), BED (Binge Eating Scale BES) and psychiatric disorders (M.I.N.I./DSM-IV). RESULTS: 67 out of 400 patients enrolled in the program were interviewed (16.8%). The BMI varied from 36.1 to 81.8 kg/m(2) (average 48.5 +/- 8.8). All have associated diseases, the most frequent being systemic arterial hypertension, sleeping disorders and osteopathies. The most frequent psychiatric disorders were: 47.8% generalized anxiety disorder, 29.9% major depressive disorder, single episode, 34.3% recurrent major depressive disorder. In this group 56.7% showed BED (25.4% moderate and 31.3% severe) and the worse scores in all the domains of quality of life (SF-36 scale). CONCLUSIONS: High prevalence of BED. The compulsive eaters showed a higher number of obesity treatments, higher prevalence of actual major depression, and the worse scores in all the domains of the SF-36 scale. Considering the ample range of psychopathology associated with BED and the greater probability of jeopardizing the surgery results it is very important to improve the detection of these disorders in order to provide adequate treatment.
Subject(s)
Anxiety Disorders/epidemiology , Bariatric Surgery , Bulimia Nervosa/epidemiology , Depressive Disorder, Major/epidemiology , Obesity, Morbid/psychology , Adult , Body Mass Index , Brazil/epidemiology , Bulimia Nervosa/psychology , Comorbidity , Diagnostic and Statistical Manual of Mental Disorders , Epidemiologic Methods , Female , Humans , Male , Middle Aged , Obesity, Morbid/surgery , Psychiatric Status Rating Scales , Quality of Life , Socioeconomic Factors , Time Factors , Waiting ListsABSTRACT
OBJETIVOS: Avaliar a freqüência de transtorno da compulsão alimentar periódica (TCAP) e dos principais transtornos psiquiátricos associados à obesidade mórbida em indivíduos à espera de cirurgia bariátrica. MÉTODOS: Estudo de corte transversal. Foram entrevistados pacientes do programa de cirurgia da obesidade do Hospital Universitário Oswaldo Cruz e avaliados o perfil sócio-demográfico, a qualidade de vida (escala SF-36), o TCAP (Binge Eating Scale BES) e os transtornos psiquiátricos (Mini International Neuropsychiatry Interview M.I.N.I./DSM-IV). RESULTADOS: Dos 400 pacientes inscritos no programa, 67 (16,8 por cento) foram entrevistados. O IMC variou de 36,1 a 81,8 kg/m² (média 48,5 ± 8,8). Todos os entrevistados apresentavam doenças associadas, sendo a HAS, os distúrbios do sono e as osteopatias as mais freqüentes. Os transtornos psiquiátricos mais freqüentes foram: 47,8 por cento transtorno de ansiedade generalizada; 29,9 por cento depressão atual e 34,3 por cento depressão no passado. Verificou-se TCAP em 56,7 por cento dos pacientes (25,4 por cento TCAP moderado e 31,3 por cento, grave) e esses apresentaram os piores escores em todos os domínios de qualidade de vida da escala SF-36. CONCLUSÕES: Constatou-se elevada prevalência de TCAP. Grupo com TCAP apresentou maior número de tratamentos realizados com objetivo de perder peso, elevada prevalência de depressão maior no momento da avaliação, piores escores em todos os domínios da escala de qualidade de vida SF-36. Visto que os portadores de TCAP apresentam vasta psicopatologia e maior probabilidade de comprometimento nos resultados da cirurgia, deve-se aprimorar a detecção desses distúrbios a fim de proporcionar-lhes o tratamento adequado.
OBJECTIVES: To analyze the frequency of binge eating disorder (BED) and of the main psychiatric disorders associated with morbid obesity in individuals on the waiting list for bariatric surgery. METHOD: Cross sectional study. Interviews with patients from the Surgery for Obesity Program of Oswaldo Cruz University Hospital were conducted evaluating socio-demographic profile, quality of life (SF-36 scale), BED (Binge Eating Scale BES) and psychiatric disorders (M.I.N.I./DSM-IV). RESULTS: 67 out of 400 patients enrolled in the program were interviewed (16.8 percent). The BMI varied from 36.1 to 81.8 kg/m² (average 48.5 ± 8.8). All have associated diseases, the most frequent being systemic arterial hypertension, sleeping disorders and osteopathies. The most frequent psychiatric disorders were: 47.8 percent generalized anxiety disorder, 29.9 percent major depressive disorder, single episode, 34.3 percent recurrent major depressive disorder. In this group 56.7 percent showed BED (25.4 percent moderate and 31.3 percent severe) and the worse scores in all the domains of quality of life (SF-36 scale). CONCLUSIONS: High prevalence of BED. The compulsive eaters showed a higher number of obesity treatments, higher prevalence of actual major depression, and the worse scores in all the domains of the SF-36 scale. Considering the ample range of psychopathology associated with BED and the greater probability of jeopardizing the surgery results it is very important to improve the detection of these disorders in order to provide adequate treatment.
