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1.
Actas esp. psiquiatr ; 41(6): 340-348, nov.-dic. 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-116978

RESUMO

Introducción: La literatura sugiere que existen factores que explican la asociación entre insatisfacción conyugal y Depresión Mayor. Analizamos si la personalidad actúa como factor determinante en la asociación entre insatisfacción conyugal y la aparición de un Primer Episodio de Depresión Mayor (PEDM). Además, estudiamos si hay factores de personalidad específicos que se relacionen con la insatisfacción conyugal en función de la evolución del PEDM. Metodología: Administramos la Escala de Hamilton para la Depresión y la Escala de Ajuste Diádico en el momento del diagnóstico del trastorno depresivo (T1) y seis meses más tarde (T2), en seis centros ambulatorios. Participaron 59matrimonios con un cónyuge diagnosticado de PEDM y otro cónyuge sano. Además, los pacientes deprimidos completaron el Inventario de Personalidad NEO-PIR. Resultados: Hay factores de personalidad que median entre el PEDM y la insatisfacción conyugal. El “neuroticismo” media tanto en T1 como en T2. Sin embargo, la relación entre los factores de personalidad y la insatisfacción conyugal depende de la evolución del episodio. Si éste ha remitido enT2, la personalidad puede no asociarse con la interacción conyugal, pero si persiste, la “apertura” y la “responsabilidad” se asocian con menor insatisfacción conyugal. Conclusiones: El “neuroticismo” es el factor de personalidad más importante como mediador entre insatisfacción conyugal y la evolución de un PEDM (AU)


Introduction: Prior research suggests that some factors account for the association between marital dissatisfaction and Major Depression. We examined whether personality determines the association between marital dissatisfaction and a First Episode of Major Depression (FEMD), and whether specific personality factors are linked to marital dissatisfaction depending on the outcome of the FEMD. Methods: The Hamilton Rating Scale for Depression and the Dyadic Adjustment Scale were administered both at baseline (T1) and six months later (T2), at 6 outpatient settings. We counted on the participation of 59 married couples with one member fulfilling DSM-IV criteria for a FEMD, and a healthy partner. Depressed participants also completed the NEO Personality Inventory-Revised. Results: Certain personality factors mediate the association of a FEMD and Marital Dissatisfaction. “Neuroticism” mediates the association both at T1 and T2. However, the relationship between personality factors and Marital Dissatisfaction depends on the outcome of the Episode. If it has remitted by T2, personality might not be associated with marital interaction. However, if depression persists, “openness” and “conscientiousness” are related to less marital dissatisfaction. Conclusion: The most important mediating personality factor between marital dissatisfaction and a First Episode of Major Depression is “neuroticism” (AU)


Assuntos
Humanos , Transtorno Depressivo Maior/psicologia , Determinação da Personalidade , Transtornos Neuróticos/psicologia , Casamento/psicologia , Conflito Familiar/psicologia , Relações Familiares , Perfil de Impacto da Doença , Satisfação do Paciente
2.
Actas Esp Psiquiatr ; 41(6): 340-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24203506

RESUMO

INTRODUCTION: Prior research suggests that some factors account for the association between marital dissatisfaction and Major Depression. We examined whether personality determines the association between marital dissatisfaction and a First Episode of Major Depression (FEMD), and whether specific personality factors are linked to marital dissatisfaction depending on the outcome of the FEMD. METHODS: The Hamilton Rating Scale for Depression and the Dyadic Adjustment Scale were administered both at baseline (T1) and six months later (T2), at 6 outpatient settings. We counted on the participation of 59 married couples with one member fulfilling DSM-IV criteria for a FEMD, and a healthy partner. Depressed participants also completed the NEO Personality Inventory-Revised. RESULTS: Certain personality factors mediate the association of a FEMD and Marital Dissatisfaction. "Neuroticism" mediates the association both at T1 and T2. However, the relationship between personality factors and Marital Dissatisfaction depends on the outcome of the Episode. If it has remitted by T2, personality might not be associated with marital interaction. However, if depression persists, "openness" and "conscientiousness" are related to less marital dissatisfaction. CONCLUSION: The most important mediating personality factor between marital dissatisfaction and a First Episode of Major Depression is "neuroticism".


Assuntos
Transtorno Depressivo Maior/psicologia , Relações Familiares , Casamento/psicologia , Satisfação Pessoal , Personalidade , Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
3.
Soc Psychiatry Psychiatr Epidemiol ; 44(12): 1051-65, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19288035

RESUMO

INTRODUCTION: This paper presents the results of a study on the psychometric properties of an authorized Spanish version of the McMaster Family Assessment Device, a self-report measure of family functioning. MATERIALS AND METHODS: The study sample comprised 60 psychiatric patients and their family member and 60 controls, without mental health problems, and their family member. RESULTS: Compared to other studies, all subscales displayed adequate temporal stability and acceptable reliability. While the instrument discriminated well between the two groups of families on all subscales, the results nevertheless indicated limitations in the inter-item discriminant capacity of the "Roles" subscale. Factor analysis resulted in a three-factor model that does not coincide with the established structure of this instrument. CONCLUSION: Proposals to improve and adapt questionnaire are discussed with a view to make it applicable to cultures other than the one it was developed. Theoretical models relating to psychosocial aspects such as family functioning, albeit compatible in some areas, should be viewed with caution in cultures different to that in which the model originates.


Assuntos
Relações Familiares , Família/psicologia , Transtornos Mentais/diagnóstico , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Controle Comportamental/psicologia , Cultura , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Transtorno Distímico/diagnóstico , Transtorno Distímico/psicologia , Análise Fatorial , Feminino , Nível de Saúde , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Inventário de Personalidade , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Espanha , Traduções
4.
Med Clin (Barc) ; 130(13): 487-91, 2008 Apr 12.
Artigo em Espanhol | MEDLINE | ID: mdl-18423166

RESUMO

BACKGROUND AND OBJECTIVE: To validate the best alternative cut-off point of a Spanish version of the Eating Attitudes Test (EAT-40) for the screening of eating disorders cases in the general population. SUBJECTS AND METHOD: The translated questionnaire was administered to a representative sample of 2,734 female students who ranged in age from 13 to 22 years. Participants who scored above 21 points were interviewed, as were a random sample of participants who scored 21 or below. Internal and external validity parameters were estimated for different alternative cut-off scores below the usual EAT score of 30. RESULTS: The best diagnostic prediction was obtained with a cut-off score of 21 points (sensitivity: 73.3%; specificity: 85.1%). A positive predictive value of 20% and a negative predictive value of 98.4% were obtained. CONCLUSIONS: The best diagnostic prediction in a non-clinical setting is obtained with a cut-off score of 21, below that recommended by the authors of the questionnaire.


Assuntos
Atitude , Comportamento Alimentar , Alimentos , Programas de Rastreamento/métodos , Inquéritos e Questionários , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/epidemiologia , Feminino , Humanos , Masculino , Vigilância da População/métodos , Sensibilidade e Especificidade
5.
Med. clín (Ed. impr.) ; 130(13): 487-491, abr. 2008. ilus, tab
Artigo em Es | IBECS | ID: ibc-72130

RESUMO

Fundamento y objetivo: Validar un punto de corte alternativo de la versión española del Eating Attitudes Test (EAT-40) para el cribado de casos de trastornos de la conducta alimentaria en la población general. Sujetos y método: Se administró el cuestionario traducido a una muestra representativa de 2.734 mujeres estudiantes de entre 13 y 22 años de edad. Se entrevistó a las participantes cuya puntuación en el cuestionario fue superior a 21 y a una muestra aleatoria del resto. Se estimaron los parámetros de validez interna y externa obtenidos con puntos de corte distintos de 30, que es el utilizado habitualmente en el EAT. Resultados: La mejor predicción diagnóstica se obtuvo con 21 puntos (sensibilidad del 73,3% y especificidad del 85,1%). El valor predictivo positivo fue del 20% y el valor predictivo negativo, del 98,4%. Conclusiones: La mejor predicción diagnóstica del EAT-40 en un entorno no clínico se obtiene con un punto de corte de 21 puntos, algo inferior al recomendado por los autores del cuestionario (AU)


Background and objective: To validate the best alternative cut-off point of a Spanish version of the Eating Attitudes Test (EAT-40) for the screening of eating disorders cases in the general population. Subjects and method: The translated questionnaire was administered to a representative sample of 2,734 female students who ranged in age from 13 to 22 years. Participants who scored above 21 points were interviewed, as were a random sample of participants who scored 21 or below. Internal and external validity parameters were estimated for different alternative cut-off scores below the usual EAT score of 30. Results: The best diagnostic prediction was obtained with a cut-off score of 21 points (sensitivity: 73.3%; specificity: 85.1%). A positive predictive value of 20% and a negative predictive value of 98.4% were obtained. Conclusions: The best diagnostic prediction in a non-clinical setting is obtained with a cut-off score of 21, below that recommended by the authors of the questionnaire (AU)


Assuntos
Humanos , Feminino , Adulto , Inquéritos e Questionários , Programas de Rastreamento , Comportamento Alimentar/classificação , Comportamento Alimentar/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Sensibilidade e Especificidade , Valor Preditivo dos Testes , Inquéritos e Questionários/classificação , Inquéritos e Questionários/normas , Comportamento Alimentar/ética
6.
Psiquiatr. biol. (Ed. impr.) ; 14(2): 47-52, mar. 2007. ilus, tab
Artigo em Es | IBECS | ID: ibc-64482

RESUMO

El objetivo principal es describir la situación basal de los pacientes con depresión atendidos en atención primaria (AP) en España. Se utilizan los datos de 2 estudios observacionales, prospectivos y multicéntricos. El primero fue realizado por 882 médicos de AP sobre pacientes con síntomas depresivos y una puntuación mínima de 14 en la escala de Hamilton para la depresión de 17 ítems (HAM-D17). En el segundo estudio participaron 2.119 médicos de AP, e incluyó a pacientes deprimidos con puntuaciones mínimas de 17 en la escala HAM-D17. La muestra total se compone de 10.997 pacientes (4.300 del estudio 1 y 6.697 del estudio 2). Los síntomas depresivos más frecuentes encontrados con intensidad moderada son: insomnio medio (56,5%), impacto en el trabajo y otras actividades (53,6%), ansiedad psíquica (50,5%), estado de ánimo deprimido (45,3%), síntomas somáticos generales (69,5%) y gastrointestinales (60,6%), ansiedad somática (48,8%) y síntomas genitales (43,2%). Por el contrario, se aprecia una baja frecuencia de algunos síntomas clásicamente relacionados con cuadros más graves: ideación suicida, pérdida de peso y vivencias de culpa. Este perfil clínico podría justificar el infradiagnóstico y el manejo deficiente de la depresión en la atención médica no especializada (AU)


The primary aim of this study was to describe the baseline status of depressed patients attending primary care centers in Spain. Data from 2 observational, prospective, multicenter studies were analyzed. The first study was carried out by 882 primary care physicians in patients with depressive symptoms and a minimum score of 14 on the 17-item Hamilton Depression Rating Scale (HAM-D17). The second study was performed by 2,119 primary care physicians and included depressed patients with a minimum score of 17 on the HAM-D17. The final sample was composed of 10,997 patients (4,300 from study 1 and 6,697 from study 2). The most frequently reported depressive symptoms of moderate intensity were moderate insomnia (56.5%), impact on work and activities (53.6%), psychic anxiety (50.5%), depressed mood (45.3%), general somatic symptoms (69.5%), gastrointestinal symptoms (60.6%), somatic anxiety (48.8%), and genital symptoms (43.2%). In contrast, a low prevalence was observed of some symptoms usually associated with greater severity of the disorder: suicidal ideation, weight loss, and feelings of guilt. This clinical profile could explain the under-diagnosis and poor management of depression in non-specialized medical care (AU)


Assuntos
Humanos , Transtorno Depressivo/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Ansiedade/epidemiologia , Transtornos do Humor/epidemiologia , Estudos Epidemiológicos
7.
Psiquiatr. biol. (Ed. impr.) ; 13(5): 158-166, ago.-sept. 2006. tab, graf
Artigo em Es | IBECS | ID: ibc-048852

RESUMO

IntroducciÓn: Durante la depresión se producen cambios en la respuesta inmunitaria natural. Conocer mejor estas alteraciones en el laboratorio podría ayudarnos como complemento en el diagnóstico clínico de la depresión. El objetivo fue seleccionar qué parámetros inmunitarios pueden ser más útiles como marcadores biológicos de la depresión. Sujetos y método: Hemos estudiado distintos parámetros inmunitarios de 42 pacientes deprimidos durante la fase aguda y después de la respuesta al tratamiento, y los comparamos con un grupo de 20 controles sanos. Los parámetros estudiados fueron: recuento de monocitos y de células natural killer (NK), expresión de moléculas de superficie monocitaria HLA-II, CD14, y CD16, producción de citocinas monocitarias (IL-1ß, IL-6, y TNF-alfa), actividad oxidativa e índice de fagocitosis monocitarios, y actividad citotóxica de células NK. Resultados: En los pacientes deprimidos se produjo un aumento de monocitos CD16+, células NK, capacidad oxidativa monocitaria y producción de las citocinas estudiadas (IL-1ß, IL-6 y TNF-alfa), y un descenso de la expresión de HLA-II y del índice de fagocitosis monocitario. De estos parámetros, el índice de fagocitosis (especificidad del 90%; valor predictivo negativo del 99%) y, en menor medida, la producción de TNF-alfa (especificidad del 85%; valor predictivo negativo del 98,9%) fueron los que más podrían ayudar en el diagnóstico clínico de la depresión. Conclusiones: Los resultados indican que el índice de fagocitosis y la producción de TNF-alfa podrían ser marcadores biológicos útiles en la depresión, tanto para el diagnóstico como para el seguimiento evolutivo


Introduction: Immune function is altered in adult patients with depression. Laboratory assessment of these alterations could aid clinical diagnosis of depression. Objectives: To assess which immune parameters are the most reliable biological markers of depression. Subjects and method: We studied immune function in 42 depressed patients during the acute depressive phase and after treatment response, and compared it to that of 20 healthy controls. The following immune parameters were evaluated: monocyte and natural killer (NK) cell count; monocyte surface molecule expression (HLA-II, CD14, and CD16); monocyte cytokine proinflammatory production (interleukin [IL]-1ß, IL-6, and tumor necrosis factor [TNF]-alpha); respiratory burst capacity and monocyte phagocytic index; and NK cytotoxic activity. Results: Depressed patients showed an increase of CD16+ monocytes, NK cell count, respiratory burst activity, and monocyte cytokine production (IL-1ß, IL-6, and TNF-alpha). Depressed patients also showed a decrease in HLA-II molecule expression and phagocytic index. The monocyte phagocytic index (specificity = 90%, and negative predictive value = 99%), and to a lesser extent, TNF-alpha production (specificity = 90%, and negative predictive value = 99%) could be the most reliable immune parameters in the clinical diagnosis of depression. Conclusions: Our results suggest that the monocyte phagocytic index and TNF-alpha production are reliable biological markers of depression


Assuntos
Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Humanos , Transtorno Depressivo/diagnóstico , Imunidade Inata/fisiologia , Psiconeuroimunologia , Biomarcadores/análise , Citocinas/análise , Monócitos , Células Matadoras Naturais
8.
Actas esp. psiquiatr ; 34(1): 48-54, ene. 2006. ilus, tab
Artigo em Es | IBECS | ID: ibc-047350

RESUMO

En la práctica clínica son tres los términos para caracterizar a los pacientes esquizofrénicos que no mejoran con medicación antipsicótica: resistencia al tratamiento, tratamiento refractario y no respondedores. La resistencia al tratamiento no es sinónima de cronicidad ni de severidad o gravedad, de tal manera que para que un paciente sea considerado resistente deben tenerse en cuenta varios puntos: a) si la esquizofrenia es primaria o secundaria; b) la naturaleza de la misma; c) si hubo o no historia de abuso de sustancias; d) cumplimiento y tolerancia de los tratamientos, y e) presencia de signos neurológicos menores. Los criterios mayoritariamente aceptados para definir la resistencia al tratamiento en la esquizofrenia fueron desarrollados inicialmente por Kane en 1988. Actualmente para la evaluación de los niveles de falta de respuesta o resistencia al tratamiento se utiliza la Brief Psychiatric Rating Scale (BPRS) y la Independent Living Skills Survey (ILSS). Para alcanzar una evolución terapéutica favorable en ensayos con fármacos antipsicóticos en pacientes esquizofrénicos resistentes al tratamiento se deben seguir las siguientes directrices: Identificar claramente los síntomas y utilizar fármacos en dosificación adecuada y tiempo suficiente Tener en cuenta que la resistencia al tratamiento puede confundirse bien con intolerancia a la medicación, no adherencia al tratamiento, un inadecuado apoyo social o bien un tratamiento psicosocial inapropiado. Agotar la utilización de fármacos solos antes que tratamientos farmacológicos combinados. Prevenir los efectos extrapiramidales mediante una apropiada elección del tratamiento primario. Mantener una actitud terapéutica positiva


In the clinical practice, there are three different terms to designate schizophrenic patients who do not improve with antipsychotic medication: treatmentresistant, treatment-refractory and non-respondent patients. Treatment resistance is neither a synonym of chronicity nor of severity nor seriousness. Therefore, for a patient to be considered resistant, several points must be taken into account. These points are: a) whether the schizophrenia is primary or secondary; b) its nature; c) presence of previous substance abuse; d) treatment compliance and tolerance, and e) presence of minor neurological signs. The most widely accepted criteria to define pharmacological treatment resistance in schizophrenia were initially developed around 1988 by Kane. Nowadays, the BPRS and Independent Living Skills Survey (ILSS) are the scales used to assess the levels of lack or response or of treatment resistance. To attain a suitable therapeutic evolution in schizophrenics resistant to treatment in antipsychotic medication assays, the following guidelines must be considered: Identifying the symptoms clearly and using medication with a suitable dose and duration. Taking into account that treatment resistance can be mistaken for treatment intolerance, non-compliance to treatment, inappropriate social support or inappropriate psychosocial treatment. Using up all single therapeutic agents before applying multiple agents. Preventing extrapyramidal effects by means of an adequate choice of the primary treatment. Maintaining a positive therapeutic attitude


Assuntos
Humanos , Antipsicóticos/uso terapêutico , Resistência a Medicamentos , Esquizofrenia/tratamento farmacológico , Escalas de Graduação Psiquiátrica Breve , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Testes Neuropsicológicos
9.
Eur Psychiatry ; 20(2): 179-85, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15797704

RESUMO

PURPOSE: To estimate the overall annual incidence and age group distribution of eating disorders in a representative sample of adolescent female residents of Navarra, Spain. METHODS: We studied a representative sample of 2734 adolescent Navarran females between 13 and 22 years of age who were free of any eating disorder at the start of our study. Eighteen months into the study, we visited the established centers and the eating attitudes test (EAT-40) and eating disorder inventory (EDI) Questionnaires were administered to the entire study population. We obtained a final response of 92%. All adolescents whose EAT score was over 21 points and a randomized sample of those who scored 21 or below, were interviewed. Any person meeting the DSM-IV diagnostic criteria for Anorexia Nervosa (AN), Bulimia Nervosa (BN) or eating disorder not otherwise specified (EDNOS) was considered a case. RESULTS: We detected 90 new cases of eating disorders. Taking into consideration the randomly selected group whose EAT score was 21 points or below, we estimated the overall weighted incidence of eating disorders to be 4.8% (95% CI: 2.8-6.8), after 18 months of observation, in which EDNOS predominated with an incidence of 4.2% (95% CI: 2.0-6.3). The incidence of AN was 0.3% (95% CI: 0.2-0.5), while that of BN was also found to be 0.3% (95% CI: 0.2-0.5). The highest incidence was observed in the group of adolescents between 15 and 16 years of age. CONCLUSIONS: The overall incidence of ED in a cohort of 2509 adolescents after 18 months of follow-up was 4.8% (95% CI: 2.8-6.8), with EDNOS outweighing the other diagnoses. The majority of new cases of eating disorders were diagnosed between ages 15 and 16.


Assuntos
Bulimia/etnologia , Adolescente , Adulto , Distribuição por Idade , Imagem Corporal , Bulimia/epidemiologia , Área Programática de Saúde , Manual Diagnóstico e Estatístico de Transtornos Mentais , Análise Fatorial , Feminino , Seguimentos , Humanos , Incidência , Espanha/epidemiologia , Inquéritos e Questionários
10.
Psychiatry Res ; 128(3): 259-65, 2004 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-15541783

RESUMO

Several studies have reported immune changes during depression, but the results have not been fully consistent. Some of these changes could be related to the presence of melancholic features. A total of 42 depressed patients (melancholic [MEL] and nonmelancholic [non-MEL]) and 20 healthy controls participated in the study. We detected a higher CD4+ lymphocyte subset in MEL patients than in controls during the depressive state, which disappeared after clinical remission. We also found an increase in interleukin-2 (IL-2) production both in MEL and non-MEL patients, but these values did not differ from control values after clinical remission. Some of these changes may be related to the melancholic characteristics of depression.


Assuntos
Contagem de Linfócito CD4 , Transtorno Depressivo Maior/imunologia , Transtorno Depressivo/imunologia , Células Matadoras Naturais/imunologia , Linfocinas/sangue , Adulto , Idoso , Relação CD4-CD8 , Transtorno Depressivo/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Escherichia coli/imunologia , Feminino , Humanos , Interleucina-2/sangue , Interleucina-4/sangue , Lipopolissacarídeos/imunologia , Ativação Linfocitária/imunologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Psiconeuroimunologia , Valores de Referência
11.
J Affect Disord ; 78(3): 243-7, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15013249

RESUMO

BACKGROUND: The studies on monocytic function during depression are controversial. A better knowledge of affective disorders may improve the differential diagnosis of depression subtypes. Our goals are to examine if there are differences in monocytic function in patients with major depression and dysthymia. METHOD: Twenty-two depressed patients (12 dysthymia and 10 major depression) and 15 healthy controls participated in the study. We analyzed monocyte count, monocyte subsets (CD14+, CD16+, and HLA class-II+), respiratory burst activity, phagocytic index and the interleukin (IL)-1beta, IL-6 and tumor necrosis factor (TNFalpha) production. RESULTS: Depressed patients showed elevated IL-1beta (P<0.05) and IL-6 (P<0.01), elevated monocytic respiratory burst activity (P<0.01); and reduced surface molecule expression HLA class-II and phagocytosis (P<0.01) compared with controls. We found no differences in any monocytic parameters between dysthymia and major depression. LIMITATIONS: The small sample size and the short wash-out reduce the reliability of the results. CONCLUSIONS: Major depression and dysthymia show similar signs of both monocytic activation and suppression. These alterations may be due to the depressive syndrome and not to the characteristics of depression subtypes studied.


Assuntos
Transtorno Depressivo/imunologia , Transtorno Distímico/imunologia , Monócitos/fisiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Transtorno Depressivo/diagnóstico , Diagnóstico Diferencial , Transtorno Distímico/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Int J Psychiatry Clin Pract ; 7(3): 193-7, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-24922182

RESUMO

BACKGROUND Quality of Life (QoL) assessments are common in medicine and, recently, in psychiatry, mostly in patients with chronic mental illness. We evaluated QoL in depressed outpatients treated with venlafaxine-XR over a period of 24 weeks. METHOD We evaluated 833 patients with DSM-IV major depression using the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Montgomery-Åsberg Depression Rating Scale (MÅDRS), and the QoL in Depression Scale (QLDS). The patients received venlafaxine-XR and we evaluated them after 4, 8, and 24 weeks of treatment. RESULTS HAM-D scores decreased from a baseline of 24.6 - 6.3 to 6.0 - 5.5 (mean - SD; P <0.0001) after 24 weeks. HAM-A scores decreased from a baseline of 32.3 - 7.9 to 6.8 - 6.8 ( P <0.0001) after 24 weeks. QLDS scores decreased from a baseline of 25.8 - 5.8 to 6.6 - 7.5 ( P <0.0001) after 24 weeks, indicating improvement in QoL. The response after 4 weeks was also significant and continued improving during the study. Venlafaxine-XR was shown to be safe and well tolerated. DISCUSSION Open-label venlafaxine-XR was safe, effective, well tolerated, and improved not only depression and anxiety symptoms, but also QoL, in outpatients with major depression. This study has the limitations of any non-randomized, non-blinded multiple-site clinical trial.

13.
Hum Brain Mapp ; 17(2): 116-30, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12353245

RESUMO

Deficits in sustained attention have been frequently described in schizophrenia. The neuroanatomical basis reported previously have included altered levels of activation in cingulate and prefrontal cortex, but the contribution of further regions remains unclear. We explored the full neuroanatomy underlying the sustained attentional deficits observed in naïve schizophrenics compared with controls. Participants included 10 controls and 11 patients. The experimental design included rest, auditory stimulation using clicks, and two counting tasks. Subjects were instructed to mentally count the clicks, and then to count forward at the same frequency they heard previously when listening to the clicks. Relative cerebral blood flow (relCBF) was measured by means of PET (15)O-water. Differences were observed between both groups at superior temporal cortex, superior parietal gyrus, and cerebellum during tasks requiring listening. During all counting conditions, additionally to supplementary motor area (SMA), dorsolateral prefrontal cortex (DLPCF), precentral gyrus, cingulate, cerebellum, and inferior parietal (IP) gyrus, patients engaged other frontal structures including inferior, medial, and superior frontal areas. When counting with no auditory stimulation (C; requires components of working memory and time estimation), significant differences were observed in the level of activation of frontal and IP regions. Our naïve patients presented abnormal activation of auditory associative pathways. They failed to activate prefrontal and parietal regions at a similar level during tasks requiring increased cognitive effort, and they required a higher activation of inferior frontal regions to properly respond to cognitive demands.


Assuntos
Atenção/fisiologia , Mapeamento Encefálico , Encéfalo/anatomia & histologia , Encéfalo/fisiopatologia , Potenciais Evocados Auditivos/fisiologia , Esquizofrenia/fisiopatologia , Adulto , Percepção Auditiva/fisiologia , Encéfalo/fisiologia , Feminino , Humanos , Masculino , Memória/fisiologia , Lobo Parietal/anatomia & histologia , Lobo Parietal/fisiologia , Lobo Parietal/fisiopatologia , Tomografia Computadorizada de Emissão
14.
Int J Eat Disord ; 31(3): 261-73, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11920987

RESUMO

OBJECTIVE: To study the relationship of self-esteem and personality factors with eating disorders (ED). METHODS: A region-wide representative sample of 2862 girls 12-21 years old from Navarre (Spain) participated in the baseline assessment of a prospective study. A two-stage procedure was used, consisting in a first screening phase followed by a psychiatrist interview (DSM-IV criteria). Multivariable logistic regression models were used to examine the association of self-esteem (36-item scale) and personality characteristics (Eysenck inventory) with psychiatrist-diagnosed ED while controlling for potential confounders. RESULTS: Strong associations for ED were found with low self-esteem (adjusted odds ratio [adjOR] for the lowest quartile: 7.98, 95% CI: 3.4-18.8) and high levels of neuroticism (adjOR for the highest quartile: 9.49, 95% Cl: 3.7-24.5). DISCUSSION: Our results, although based on a cross-sectional design, support the potential role of neuroticism and low self-esteem in the onset of ED.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Personalidade , Autoimagem , Adolescente , Adulto , Criança , Estudos Transversais , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Modelos Logísticos , Análise Multivariada , Transtornos Neuróticos/psicologia , Prevalência , Fatores de Risco , Espanha/epidemiologia
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