Neurotrophic factors, clinical features and gender differences in depression.

Recent studies have evaluated the role of brain-derived neurotrophic factor (BDNF) in mood disorders; however, little is known about alterations in nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF). The aim of this study was to evaluate differences among serum neurotrophic factors (BDNF, NGF and GDNF) in depressed patients and healthy controls and to verify the association between serum neurotrophic levels and clinical characteristics in a young, depressed population stratified by gender. This is a cross-sectional study with depressed patients and population controls 18-29 years of age. The concentrations of neurotrophic factors were determined by the ELISA method. The diagnosis of depression and the duration of the disease were assessed by the Structured Clinical Interview according to the diagnostic and statistical manual of mental disorders. Depression severity was measured with the 17-item Hamilton Rating Scale for Depression, and the severity of anxiety symptoms was measured using the Hamilton Anxiety Rating Scale. Serum BDNF and GDNF were lower in major depressive disorder (MDD) patients compared to controls (p ≤ 0.001). Serum NGF levels were higher in MDD patients versus controls (p ≤ 0.001). BDNF was associated with the duration of disease only in women (p = 0.005). GDNF was not associated with clinical characteristics in either gender. In women, NGF was associated with the severity of depressive symptoms (p = 0.009), anxiety (p = 0.011) and disease duration (p = 0.005). NGF was associated with disease duration in men (p = 0.026). Our results demonstrated that significant neurochemical differences in NGF and BDNF, but not in GDNF, were associated with the clinical features of MDD when patients were stratified by gender.

Trauma precoce e transtornos de humor em jovens / Early trauma and mood disorders in youngsters

OBJETIVO: Verificar vivências precoces de abuso e negligência na infância entre jovens com transtorno bipolar (TB), transtorno depressivo maior (TDM) e controles populacionais. MÉTODO: Estudo de caso-controle aninhado a um estudo transversal de base populacional. A confirmação do diagnóstico foi realizada por meio de entrevista clínica estruturada para transtornos de eixo I do DSM-IV (SCID) e os eventos traumáticos foram verificados pelo Questionário sobre traumas na infância (CTQ). RESULTADOS: A amostra foi composta por 231 jovens, sendo 95 indivíduos no grupo controle, 82 com TDM e 54 com TB (32 do tipo I e 22 do tipo II). A prevalência de trauma na infância foi de 42,2%, sendo 54,7% entre aqueles com TB, 62,2% entre os jovens com TDM e 18,1% entre o grupo controle. Os jovens com TB ou TDM apresentaram maiores médias no CTQ total e entre seus componentes quando comparados aos jovens do grupo controle, exceto o componente abuso sexual, em que se observou diferença estatística apenas entre o grupo controle e o grupo de jovens com transtorno bipolar. CONCLUSÃO: O relato de vivências traumáticas precoces foi mais presente entre os jovens com transtornos de humor do que na população geral, confirmando o que a literatura traz sobre o tema. Nesse sentido, as vivências de trauma na infância parecem contribuir para o aparecimento dos transtornos de humor.

OBJECTIVE: To verify early experiences of childhood abuse and neglect among young with bipolar disorder (BD), major depression (MDD), and controls. METHOD: Case-control study nested to a population-based cross-sectional study. The diagnosis was performed via the structured clinical interview for DSM-IV Axis I Disorders (SCID). Traumatic events were analyzed using the Portuguese version - Questionário sobre Traumas na Infância (CTQ) - based on the Childhood Trauma Questionnaire. RESULTS: The sample comprised 231 adolescents with 95 individuals in the control group, 82 with MDD and 54 with BD (32 of type I and 22 type II). The prevalence of trauma or violence in childhood was 42.2%; among those, 54.7% had BD, 62.2% had MDD and 18.1% were in the control group. Young people with BD or MDD obtained higher means in total CTQ and among their components when compared with those in the control group. DISCUSSION: Reports on early traumatic experiences were more frequent among young people with mood disorders than in the general population, corroborating the literature on the subject. In this sense, the traumatic experiences during childhood seemed to contribute to the onset of the disorder.

Prevalência de depressão em usuários de unidades de atenção primária / Prevalence of depression in users of primary care settings

CONTEXTO: A depressão é um importante problema de saúde global e vem causando impacto negativo na vida dos indivíduos e na de suas famílias, além de elevar a demanda dos serviços de saúde.OBJETIVO: Verificar a prevalência de depressão e de fatores associados em indivíduos com idade superior a 14 anos que buscaram atendimento na atenção primária.MÉTODOS: Estudo transversal em três Unidades Básicas de Saúde vinculadas à Universidade Católica de Pelotas. A depressão, os transtornos de ansiedade e o risco de suicídio foram avaliados por meio da Mini International Neuropsychiatric Interview (MINI), enquanto os fatores associados, como idade, gênero, vive ou não com o/a companheiro/a, escolaridade e uso de substâncias psicoativas, foram avaliados por meio de questionário sociodemográfico.RESULTADOS: A prevalência de depressão foi de 23,9% (n = 256), apresentando-se mais evidente nas mulheres, com 4 a 7 anos de escolaridade, de classe socioeconômica D ou E, que abusam ou são dependentes de álcool, com algum transtorno de ansiedade e com risco de suicídio (p < 0,050).CONCLUSÃO: Diante de tais resultados, salientamos a inserção de cuidados em saúde mental por meio de avaliações diagnósticas e de protocolos de atendimento que abarquem a depressão e suas comorbidades na atenção primária.

BACKGROUND: Depression, an important global health problem, negatively impacts the lives of individuals and their families beyond simply increasing the demand for health services.OBJECTIVE: To assess the prevalence of depression and associated mental health issues in individuals older than 14 years of age seeking primary care.METHODS: A cross-sectional study was conducted in three primary care units involved with the Catholic University of Pelotas. Depression, anxiety disorders, and suicide risk were assessed using the Mini International Neuropsychiatric Interview (MINI). Factors such as age, gender, solitary living, education, and psychoactive substance use were evaluated using a sociodemographic questionnaire.RESULTS: The overall prevalence of depression was 23.9% (n = 256). Depression was more prevalent in women with only 4-7 years of education, in women who belong to socioeconomic class D or E, in those who abuse or are dependent on alcohol, or in women who showed an anxiety disorder or suicide risk (p < 0.050).DISCUSSION: Based on these findings, we emphasize the integration of mental health care into primary care through diagnostic evaluations and treatment protocols that cover depression and its comorbidities.

Prevalência e fatores associados a porte de arma e envolvimento em agressão física entre adolescentes de 15 a 18 anos: estudo de base populacional / Prevalence of weapons possession and associated factors and involvement in physical aggression among adolescents 15 to 18 years of age: a population-based study

Objetivo do estudo foi avaliar a prevalência e fatores associados a porte de arma e envolvimento em agressão física entre adolescentes de 15 a 18 anos na cidade de Pelotas, Rio Grande do Sul, Brasil. Estudo transversal de base populacional com uma amostra representativa de 960 adolescentes entre 15 e 18 anos, residentes na cidade de Pelotas. Sortearam-se, aleatoriamente, 90 setores censitários a partir dos 448 da cidade, e foram visitados 86 domicílios de cada setor. Para análise estatística utilizou-se a regressão de Poisson. A prevalência dos comportamentos estudados na presente amostra foi de 22,8 por cento para participação em brigas com agressão física e 9,6 por cento para porte de armas nos últimos 12 meses. Conclui-se que jovens do sexo masculino que utilizam álcool e/ou drogas ilícitas e apresentam transtornos psiquiátricos menores mostraram maior probabilidade de portar armas e de envolverem-se em brigas com agressão física.

This cross-sectional, population-based study aimed to evaluate the prevalence of weapons possession and associated factors and involvement in physical aggression among adolescents 15 to 18 years of age (n = 960) in the city of Pelotas, Rio Grande do Sul State, Brazil. Ninety of the city's 448 census tracts were selected, and 86 houses in each tract were visited. The statistical analysis used Poisson regression. Prevalence rates in the sample were 22.8 percent for involvement in fights with physical aggression and 9.6 percent for weapons possession in the previous 12 months. The study concluded that young males that use alcohol and/or illegal drugs and present minor psychiatric disorders show a higher probability of weapons possession and involvement in physical fights.

[Prevalence of weapons possession and associated factors and involvement in physical aggression among adolescents 15 to 18 years of age: a population-based study]. / Prevalência e fatores associados a porte de arma e envolvimento em agressão física entre adolescentes de 15 a 18 anos: estudo de base populacional.

This cross-sectional, population-based study aimed to evaluate the prevalence of weapons possession and associated factors and involvement in physical aggression among adolescents 15 to 18 years of age (n = 960) in the city of Pelotas, Rio Grande do Sul State, Brazil. Ninety of the city's 448 census tracts were selected, and 86 houses in each tract were visited. The statistical analysis used Poisson regression. Prevalence rates in the sample were 22.8% for involvement in fights with physical aggression and 9.6% for weapons possession in the previous 12 months. The study concluded that young males that use alcohol and/or illegal drugs and present minor psychiatric disorders show a higher probability of weapons possession and involvement in physical fights.

Psychopathology of cocaine dependent patients in a therapeutic community.

OBJECTIVE AND METHODS: Male patients in a therapeutic community (n=102) from a city in southern Brazil, with a primary diagnosis of cocaine dependence, were evaluated with Exner's Comprehensive System for the Rorschach, with the objective of describing personality psychopathology. RESULTS: High lambdas were present in 62% of patients. 60.8% of the patients scored positive in the Coping Deficit Index; 22.5% in the Depression Index. Other constellations were infrequently present (<5%). CONCLUSIONS: A positive CDI, a measure of difficulty in the management of complexities and poor social skills, may have treatment-matching implications, such as the selection of interventions targeted at interpersonal difficulties. Personality assessment should be considered in such patients.