ABSTRACT
Abstract Objective To assess the association between brain-derived neurotrophic factor (BDNF) levels and acute stress disorder (ASD) in patients who have suffered physical trauma. Methods Data were collected at an emergency hospital in Porto Alegre, state of Rio Grande do Sul, southern Brazil. Participants were over 18 years of age, victims of physical trauma, and had been hospitalized for a minimum of 48 hours. A total of 117 hospitalized patients who agreed to participate in the research were grouped according to the shift in which blood was collected (38 subjects from the morning shift and 79 from the afternoon shift), had their BDNF levels measured and responded to other questionnaires. Respondents were further grouped by age into three ranges: 18-30, 31-50 and 51-70 years. Results We found a significant difference in the distribution of BDNF between the two shifts in which blood samples were collected, with the afternoon group having higher BDNF levels (U = 1906.5, p = 0.018). A difference was observed only between the 18-30 group and the 51-70 group in the afternoon shift (Umorning = 1107, pmorning = 0.575; Uafternoon = 7175, pafternoon = 0.028). Conclusions The population whose blood samples were collected in the afternoon showed significantly higher values of BDNF compared to those of the morning shift. This same population presented lower BDNF levels when associated with ASD subtypes A1, A2, and A. We hypothesize that the lower values of BDNF measured in the morning shift were due to a response to the circadian cycle of cortisol, whose action inhibits the expression of serum neurotrophins.
Resumo Objetivo Verificar a associação entre os níveis de fator neurotrófico derivado do cérebro (brain-derived neurotrophic factor [BDNF]) e transtorno de estresse agudo (TEA) em pacientes que sofreram trauma físico. Métodos Os dados foram coletados em um hospital de emergência de Porto Alegre, Rio Grande do Sul, Brasil. Os participantes eram maiores de 18 anos, vítimas de trauma físico e estavam hospitalizados por um período mínimo de 48 horas. Um total de 117 pacientes hospitalizados que concordaram em participar da pesquisa foram agrupados de acordo com o turno de realização da coleta de sangue (38 sujeitos no turno da manhã e 79 sujeitos no turno da tarde), tiveram seus níveis de BDNF medidos e responderam a outros questionários. Os entrevistados também foram agrupados por idade em três faixas etárias: 18-30, 31-50 e 51-70 anos. Resultados Encontramos uma diferença significativa na distribuição de BDNF entre os turnos, sendo que o grupo da tarde apresentou níveis maiores de BDNF (U = 1906,5, p = 0,018). Houve diferença entre o grupo de 18-30 anos e o de 51-70 anos no turno da tarde (Umanhã = 1107, pmanhã = 0,575; Utarde = 7175, ptarde = 0,028). Conclusões A população cuja coleta ocorreu à tarde apresentou valores significativamente maiores de BDNF em relação à coleta do turno da manhã. Esta mesma população apresentou menores níveis dessa neurotrofina quando associada com os subtipos A1, A2 e A de TEA. É possível hipotetizar que os menores valores de BDNF aferidos na coleta do turno da manhã se devam a uma resposta ao ciclo circadiano do cortisol, cuja ação inibe a expressão de neurotrofinas séricas.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Wounds and Injuries/psychology , Brain-Derived Neurotrophic Factor/metabolism , Brazil , Hydrocortisone/metabolism , Biomarkers/metabolism , Surveys and Questionnaires , Circadian Rhythm , Stress Disorders, Traumatic, Acute/blood , Emergency Service, Hospital , Emergency Treatment/methods , Hospitalization , Middle AgedABSTRACT
OBJECTIVE: To assess the association between brain-derived neurotrophic factor (BDNF) levels and acute stress disorder (ASD) in patients who have suffered physical trauma. METHODS: Data were collected at an emergency hospital in Porto Alegre, state of Rio Grande do Sul, southern Brazil. Participants were over 18 years of age, victims of physical trauma, and had been hospitalized for a minimum of 48 hours. A total of 117 hospitalized patients who agreed to participate in the research were grouped according to the shift in which blood was collected (38 subjects from the morning shift and 79 from the afternoon shift), had their BDNF levels measured and responded to other questionnaires. Respondents were further grouped by age into three ranges: 18-30, 31-50 and 51-70 years. RESULTS: We found a significant difference in the distribution of BDNF between the two shifts in which blood samples were collected, with the afternoon group having higher BDNF levels (U = 1906.5, p = 0.018). A difference was observed only between the 18-30 group and the 51-70 group in the afternoon shift (Umorning = 1107, pmorning = 0.575; Uafternoon = 7175, pafternoon = 0.028). CONCLUSIONS: The population whose blood samples were collected in the afternoon showed significantly higher values of BDNF compared to those of the morning shift. This same population presented lower BDNF levels when associated with ASD subtypes A1, A2, and A. We hypothesize that the lower values of BDNF measured in the morning shift were due to a response to the circadian cycle of cortisol, whose action inhibits the expression of serum neurotrophins.
Subject(s)
Brain-Derived Neurotrophic Factor/metabolism , Stress Disorders, Traumatic, Acute/blood , Wounds and Injuries/psychology , Adolescent , Adult , Aged , Biomarkers/metabolism , Brazil , Circadian Rhythm , Emergency Service, Hospital , Emergency Treatment/methods , Female , Hospitalization , Humans , Hydrocortisone/metabolism , Male , Middle Aged , Surveys and Questionnaires , Young AdultABSTRACT
INTRODUCTION: Acute stress disorder (ASD) encompasses a set of symptoms that can arise in individuals after exposure to a traumatic event. This study assessed the defense mechanisms used by victims of physical trauma who developed ASD. METHOD: This was a controlled cross-sectional study of 146 patients who suffered physical trauma and required hospitalization. A structured questionnaire was used to evaluate ASD symptoms based on DSM-5 diagnostic criteria, in addition to the Defense Style Questionnaire (DSQ). RESULTS: Ten participants (6.85%) received a positive diagnosis of ASD, and 136, (93.15%) a negative diagnosis. The majority of the sample consisted of men with median age ranging from 33.50 to 35.50. The most prevalent defense mechanisms among the 10 patients with ASD were cancellation and devaluation, which belong to the neurotic and immature factors, respectively. Positive associations between the presence of symptoms from criterion B of the DSM-5 and defense mechanisms from the DSQ were found. These included the mechanisms of undoing, projection, passive aggression, acting out, autistic fantasy, displacement, and somatization. CONCLUSION: Patients with ASD employed different defense mechanisms such as undoing and devaluation when compared to patients not diagnosed with ASD. These results mark the importance of early detection of ASD symptoms at a preventative level, thereby creating new possibilities for avoiding exacerbations related to the trauma, which represents an important advance in terms of public health.
Subject(s)
Defense Mechanisms , Stress Disorders, Traumatic, Acute/psychology , Adult , Cross-Sectional Studies , Emergency Medical Services , Female , Humans , Male , Middle Aged , Stress Disorders, Traumatic, Acute/diagnosis , Stress Disorders, Traumatic, Acute/epidemiology , Stress Disorders, Traumatic, Acute/therapy , Surveys and Questionnaires , Young AdultABSTRACT
Abstract Introduction: Acute stress disorder (ASD) encompasses a set of symptoms that can arise in individuals after exposure to a traumatic event. This study assessed the defense mechanisms used by victims of physical trauma who developed ASD. Method: This was a controlled cross-sectional study of 146 patients who suffered physical trauma and required hospitalization. A structured questionnaire was used to evaluate ASD symptoms based on DSM-5 diagnostic criteria, in addition to the Defense Style Questionnaire (DSQ). Results: Ten participants (6.85%) received a positive diagnosis of ASD, and 136, (93.15%) a negative diagnosis. The majority of the sample consisted of men with median age ranging from 33.50 to 35.50. The most prevalent defense mechanisms among the 10 patients with ASD were cancellation and devaluation, which belong to the neurotic and immature factors, respectively. Positive associations between the presence of symptoms from criterion B of the DSM-5 and defense mechanisms from the DSQ were found. These included the mechanisms of undoing, projection, passive aggression, acting out, autistic fantasy, displacement, and somatization. Conclusion: Patients with ASD employed different defense mechanisms such as undoing and devaluation when compared to patients not diagnosed with ASD. These results mark the importance of early detection of ASD symptoms at a preventative level, thereby creating new possibilities for avoiding exacerbations related to the trauma, which represents an important advance in terms of public health.
Resumo Introdução: O transtorno de estresse agudo (TEA) reúne um conjunto de sintomas que pode surgir nos indivíduos após exposição a um evento traumático. Este estudo verificou a relação entre o estilo defensivo e o desenvolvimento de TEA e seus sintomas em uma amostra de pacientes que sofreram trauma físico. Métodos: Este estudo transversal controlado envolveu 146 pacientes que sofreram trauma físico e necessitaram hospitalização. Um questionário estruturado foi utilizado para avaliar sintomas de TEA, baseado nos critérios diagnósticos do DSM-5, além do Questionário de Estilo Defensivo (Defense Style Questionnaire - DSQ). Resultados: Dez (6,85%) pacientes tiveram diagnóstico positivo para TEA, e 136 (93,15%), diagnóstico negativo. A maioria da amostra foi composta por homens com idade mediana variando de 33,50 a 35,50. Nos 10 pacientes positivos para TEA, destacou-se a maior utilização de mecanismos de defesa de anulação e desvalorização, pertencentes ao fator neurótico e ao fator imaturo, respectivamente. Foram observadas associações positivas entre presença de sintomas de TEA do critério B do DSM-5 e os mecanismos de defesa do DSQ, sobretudo nos mecanismos de anulação, projeção, agressão passiva, acting out, fantasia autística, deslocamento e somatização. Conclusão: Pacientes com TEA utilizaram mais mecanismos de defesa do tipo anulação e desvalorização quando comparados aos pacientes sem diagnóstico de TEA. Ressalta-se a importância da detecção precoce de sintomas de TEA a fim de evitar outros agravos relacionados ao trauma, o que representa uma importante evolução em termos de saúde pública.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Defense Mechanisms , Stress Disorders, Traumatic, Acute/psychology , Cross-Sectional Studies , Surveys and Questionnaires , Stress Disorders, Traumatic, Acute/diagnosis , Stress Disorders, Traumatic, Acute/therapy , Stress Disorders, Traumatic, Acute/epidemiology , Emergency Medical Services , Middle AgedABSTRACT
INTRODUCTION: The Clinical Outcome in Routine Evaluation - Outcome Measurement (CORE-OM) was developed in the 1990s, with the aim of assessing the efficacy and effectiveness of mental health treatments. OBJECTIVE: To adapt the CORE-OM for use in the Brazilian population. METHOD: The instrument was translated and adapted based on the international protocol developed by the CORE System Trust which contains seven steps: translation, semantic equivalence analysis, synthesis of the translated versions, pre-testing in the target population, data analysis and back translation. RESULTS: After semantic analysis, modifications were necessary in seven of the 34 original items. Changes were made to avoid repetition of words and the use of terms difficult to understand. Internal consistency analysis showed evidence of score stability in the CORE-OM adapted to Brazilian Portuguese. CONCLUSION: The instrument was successfully adapted to Brazilian Portuguese, and its semantic and conceptual properties were equivalent to those of the original instrument.
Subject(s)
Outcome Assessment, Health Care/methods , Psychotherapy/methods , Adolescent , Adult , Aged , Brazil , Cross-Cultural Comparison , Educational Status , Female , Humans , Male , Middle Aged , Reproducibility of Results , Self Report , Translations , Young AdultABSTRACT
O trabalho refere-se à elaboração do projeto de pesquisa realizado para conclusão do curso de Informação Científica e Tecnológica em Saúde da Escola GHC/ FIOCRUZ. Trata-se de um estudo quantitativo do tipo transversal, realizado com pacientes vítimas de acidente de trabalho típico internadas no Hospital de Pronto Socorro Municipal de Porto Alegre (HPS-POA). A amostra será coletada no período de fevereiro a julho de 2013, tendo por objetivo verificar as causas de estresse em pacientes vítimas de acidente de trabalho típico que encontram-se internados no HPS-POA. No referencial teórico serão abordados temas tais como fatores psicossociais do trabalho, acidente de trabalho, aspectos psicodinâmicos do trabalho, tendo como enfoque principal a informação científica e tecnológica em saúde. Após a conclusão do estudo, os dados serão divulgados, de acordo com a Política Nacional de Informação Científica e Tecnológica, favorecendo a discussão de ações de atenção integral, no ambiente hospitalar, ao paciente vítima de acidente de trabalho.
Subject(s)
Male , Female , Humans , Brazil , Burnout, Professional , Public Health , Unified Health SystemABSTRACT
Este artigo aborda a relação materno-filial em meninas adolescentes com anorexia nervosa. O tema é tratado por meio de conceitos da psicopatologia psicanalítica na integração com aspectos da relação mãe e filha. A metodologia utilizada foi de um estudo de caso explanatório. Os sujeitos de pesquisa foram duas meninas anoréxicas e suas mães. As duplas de mãe e filha foram escolhidas ao acaso, no Hospital de Clínicas de Porto Alegre e responderam a uma entrevista semi-estruturada. As categorias analisadas foram a configuração familiar, a dinâmica da relação materno-filial e o papel materno na construção da subjetividade da menina anoréxica. A partir da análise destas categorias, concluiu-se que as mães não permitiram que suas filhas se constituíssem enquanto sujeitos separados destas. O pai, por sua vez, também não exerce sua função paterna na relação familiar, permitindo que mãe e filha vivessem uma relação narcísica. Deste modo, a anorexia desenvolve-se como uma tentativa desesperada da menina na direção de tornar-se independente e criar um sentido de self diferente de sua mãe.