Protocolos de atendimentos as urgências psiquiá- tricas no atendimento pré-hospitalar: revisão integrativa da literatura / Care protocols for psychiatric emergencies in pre- hospital care: integrative literature review / Protocolos para la atención de urgencias psiquiar-trick en el servicio prehospital: examen integrativo de la literatura

Objetivo: identificar na literatura o conhecimento produzido acerca de protocolos de atendimentos as Urgências Psiquiátricas no atendimento pré-hospitalar. Método: Estudo de revisão integrativa realizada entre os meses de fevereiro e abril de 2023 nas seguintes base de dados : Literatura Latino-Americana e do Caribe em Ciências da Saúde; Medical Literature Analysis and Retrieval System Online; Cumulative Index to Nursing and Allied Health Literature ; EMBASE; Web of Science e US National Library of Medicine e pelos sites das secretarias de Estado da Saúde de todos os estados brasileiros, utilizando combinações com os seguintes Descritores em Ciência da Saúde: Assistência Pré-hospitalar ; Protocolos; Serviços de Emergência Psiquiátrica, combinados por meio do operador booleano "AND" em seis bases de dados, visando responder à seguinte questão: "Quais as publicações relacionadas aos protocolos de atendimentos as Urgências Psiquiátricas no atendimento pré-hospitalar?". Resultados: Foram construídos cinco protocolos que contemplam os seguintes procedimentos: atendimento as urgências psiquiátricas, agitação e situação de violência, contenção física, comportamento suicida e urgências envolvendo substancias psicoativas. Conclusão: acredita-se que a construção do procedimento operacional padrão possa ser utilizado como um recurso fundamental para que as equipes de atendimento pré-hospitalar consigam planejar e executar suas atividades com segurança.

Objective: to identify in the literature the knowledge produced about protocols for Psychiatric Urgencies in pre-hospital care. Method: Integrative review study carried out between February and April 2023 in the following databases: Latin American and Caribbean Literature in Health Sciences; Medical Literature Analysis and Retrieval System Online; Cumulative Index to Nursing and Allied Health Literature; BASE; Web of Science and US National Library of Medicine and the websites of the State Health Departments of all Brazilian states, using combinations with the following Health Science Descriptors: Prehospital Care ; Protocols; Psychiatric Emergency Services, combined through the Boolean operator "AND" in six databases, aiming to answer the following question: "What are the publications related to the protocols of Psychiatric Urgencies in pre-hospital care?". Results: Five protocols were created, covering the following procedures: attendance to psychiatric emergencies, agitation and violent situations, physical restraint, suicidal behavior and emergencies involving psychoactive substances. Conclusion: it is believed that the construction of the standard operating procedure can be used as a fundamental resource for pre-hospital care teams to be able to plan and carry out their activities safely.

Propósito: identificar en la literatura el conocimiento producido sobre los protocolos de tratamiento a las Urgencias Psiquiátricas en atención prehospitalaria. Método: Estudio de revisión integrada realizado entre febrero y abril de 2023 en las siguientes bases de datos: Literatura Latinoamericana y Caribeña en Ciencias de la Salud; Sistema de Análisis y Recuperación de Literatura Médica en Línea; Índice Acumulativo de Literatura de Enfermería y Salud Aliada; EMBASE; Web of Science y Biblioteca Nacional de Medicina de los Estados Unidos y los sitios web de las Secretarías de Estado de Salud de todos los estados brasileños, utilizando combinaciones con los siguientes descriptores de Ciencias Médicas: Asistencia hospitalaria; Protocolos; Servicios de emergencia psiquiátrica, combinados por el operador booleano "AND" en seis bases de datos, con el objetivo de responder a la siguiente pregunta: "¿Qué publicaciones se relacionan con los protocolos de atención a emergencias psiquiátricas en atención prehospitalaria?". Resultados: Se construyeron cinco protocolos que cubren los siguientes procedimientos: atención a emergencias psiquiátricas, agitación y situación de violencia, confinamiento físico, comportamiento suicida y emergencias con sustancias psicoactivas. Conclusión: Se considera que la construcción del procedimiento operativo estándar puede utilizarse como recurso fundamental para que los equipos de atención prehospitalaria puedan planificar y llevar a cabo sus actividades de forma segura.

N-acetylcysteine as an adjunctive treatment for smoking cessation: a randomized clinical trial.

OBJECTIVE: This randomized controlled trial examined the efficacy and safety of N-acetylcysteine as an adjunctive treatment for smoking cessation. METHODS: Heavy smokers were recruited from smoking cessation treatment for this 12- week randomized controlled trial. Eligible tobacco use disorder outpatients (n=34) were randomized to N-acetylcysteine or placebo plus first-line treatment. Abstinence was verified by exhaled carbon monoxide (COexh). The assessment scales included the Fagerström Test for Nicotine Dependence, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Minnesota Nicotine Withdrawal Scale, and the Medication Adherence Rating Scale. We also assessed anthropometrics, blood pressure, lipid profile, and soluble tumor necrosis factor receptor (sTNF-R) levels 1 and 2. RESULTS: First-line treatment for smoking cessation plus adjunctive N-acetylcysteine or placebo significantly reduced COexh (p < 0.01). In the N-acetylcysteine group, no significant changes were found in nicotine withdrawal symptoms, depressive and anxiety symptoms, anthropometric measures, blood pressure, or glucose compared to placebo. However, there was a significant reduction in sTNF-R2 levels between baseline and week 12 in the N-acetylcysteine group. CONCLUSIONS: These findings highlight the need to associate N-acetylcysteine with first-line treatment for smoking cessation, since combined treatment may affect inflammation and metabolism components. CLINICAL TRIAL REGISTRATION: NCT02420418.

Risk factors for suicidal behavior in a university population in Brazil: A retrospective study.

The present study aimed to evaluate whether variables related to personal and academic characteristics, past history, habits, and addictions were associated with suicidal behavior. Medical records of patients attending the Outpatient Psychiatry Department at the State University of Maringá between July 2016 and December 2017 were included in this retrospective study. The studied population was divided into two groups: 80 employees and 158 students. After performing the univariate analysis using Pearson's chi-square test or Fischer's exact test, the variables with p < 0.30 were included in a multivariate analysis using the binary logistic regression's backward stepwise method. The covariates 'childhood and adolescence maltreatment' and 'treatment phase' were highlighted. The first variable acts as a predictor of suicide attempt, increasing its likelihood by 9.86 times in employees and 5.62 times in students. On the other hand, the treatment phase represents a risk in patients in the adjustment phase and it serves as a predictor of SITBs in employees and students, increasing its likelihood by 7.68 and 8.66 times, respectively.

Three-Dimensional Quantification of the Facet Evolution of Pt Nanoparticles in a Variable Gaseous Environment.

Pt nanoparticles play an essential role in a wide variety of catalytic reactions. The activity of the particles strongly depends on their three-dimensional (3D) structure and exposed facets, as well as on the reactive environment. High-resolution electron microscopy has often been used to characterize nanoparticle catalysts but unfortunately most observations so far have been either performed in vacuum and/or using conventional (2D) in situ microscopy. The latter however does not provide direct 3D morphological information. We have implemented a quantitative methodology to measure variations of the 3D atomic structure of nanoparticles under the flow of a selected gas. We were thereby able to quantify refaceting of Pt nanoparticles with atomic resolution during various oxidation-reduction cycles. In a H2 environment, a more faceted surface morphology of the particles was observed with {100} and {111} planes being dominant. On the other hand, in O2 the percentage of {100} and {111} facets decreased and a significant increase of higher order facets was found, resulting in a more rounded morphology. This methodology opens up new opportunities toward in situ characterization of catalytic nanoparticles because for the first time it enables one to directly measure 3D morphology variations at the atomic scale in a specific gaseous reaction environment.

Depressed female smokers have higher levels of soluble tumor necrosis factor receptor 1.

AIM: To examine clinical and biomarkers in depressed female smokers, in order to better clarify the process that link mood disorders, childhood trauma and smoking in women. METHODS: The clinical sample comprised women with unipolar or bipolar depression, divided into subgroups of smokers and never-smoker. The control groups comprised two subgroups non-depressed women, separated into smokers and never-smokers. A structured questionnaire was used to assess socio-demographic and clinical data. The following scales were used: 17-item version Hamilton Depression Rating Scale, Hamilton Anxiety Rating scale (HAM-A), Sheehan disability scale, the Child Trauma Questionnaire. The following biomarkers were investigated: lipid profile, including total cholesterol, high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol, triglycerides the Castelli's Risk indexes I and II; and cytokines, including interleukins (IL)-1ß, IL-6, IL-10, IL-12, soluble tumor necrosis factor receptor 1 (sTNF-R1). RESULTS: Depressed female smokers showed a number of significant positive correlations: emotional neglect and sTNF-R1 (p = 0.02); waist circumference and sTNF-R1 (p = 0.001); body mass index and sTNF-R1 (p < 0.01); HAM-A and sTNF-R1 (p = 0.03); IL-1ß and sTNF-R1 (p < 0.01); IL-10 and sTNF-R1 (p = 0.001); IL-12 and sTNF-R1 (p < 0.01);Castelli index I and sTNF-R1 (p < 0.01); Castelli index II and sTNF-R1 (p < 0.01); and a significantly negative correlation between HDLc and sTNF-R1(p = 0.014). CONCLUSION: This study suggests that depressed female smokers who experienced more childhood trauma and had more anxiety symptoms are associated with the activation of inflammatory processes and alterations in components of lipid profile.

Effects of adjunctive N-acetylcysteine on depressive symptoms: Modulation by baseline high-sensitivity C-reactive protein.

Outcomes in a RCTs of 12 weeks of theclinical efficacy of N-acetylcysteine (NAC) as an adjunctive treatment on depression and anxiety symptoms and its effects on high-sensitivity C-reactive protein (hs-CRP) levels. A wide array of measures were made. The 17-item version of the Hamilton Depression Rating Scale (HDRS17); the Hamilton Anxiety Rating Scale (HAM-A); Sheehan Disability Scale; Quality of Life; Clinical Global Impression (CGI); anthropometrics measures; and vital signs and biochemical laboratory. There were no significant differences among the groups regarding demographic, clinical features, use of medication, metabolic syndrome and comorbidities. From baseline to week 12, individuals receiving NAC, versus placebo, had a statistically significant reduction in depressive symptoms on HDRS17 (p < 0.01) and anxiety symptoms on HAM-A (p = 0.04), but only for individuals with levels of hs-CRP > 3 mg/L at baseline. Individuals receiving NAC with baseline levels of hs-CRP > 3 mg/L, had more significant reduction in uric acid levels compared to individuals with baseline levels of hs-CRP ≤ 3 mg/L on week 12. Participants receiving placebogained significantly more weight during the 12 weeks for baseline levels of hs-CRP ≤ 3 mg/L and hs-CRP > 3 mg/L, and individuals receiving NAC in both groups did not have significant weight change during the 12 weeks. No individuals were withdrawn from the study because of adverse event. NAC group exhibited significantly greater reduction on hs-CRP levels than placebo group from baseline to week 12. TRIAL REGISTRATION: clinicaltrials.gov Identifier; NCT02252341.

Panicolytic-like effect of tramadol is mediated by opioid receptors in the dorsal periaqueductal grey.

Tramadol is a synthetic opioid prescribed for the treatment of moderate to severe pain, acting as agonist of µ-opioid receptors and serotonin (5-HT) and noradrenaline (NE) reuptake inhibitor. This study evaluated the effects of tramadol in rats submitted to the elevated T-maze (ETM), an animal model that evaluates behavioural parameters such as anxiety and panic. Male Wistar rats were intraperitoneally (i.p.) treated acutely with tramadol (16 and 32mg/kg) and were submitted to the ETM. Tramadol (32mg/kg) promoted a panicolytic-like effect. Considering that dorsal periaqueductal grey (dPAG) is the main brain structure related to the pathophysiology of panic disorder (PD), this study also evaluated the participation of 5-HT and opioid receptors located in the dPAG in the panicolytic-like effect of tramadol. Seven days after stereotaxic surgery for implantation of a cannula in the dPAG, the animals were submitted to the test. To assess the involvement of 5-HT1A receptors on the effect of tramadol, we combined the 5-HT1A receptor antagonist, WAY100635 (0.37nmol), microinjected intra-dPAG, 10min prior to the administration of tramadol (32mg/kg, i.p.). WAY100635 did not block the panicolytic-like effect of tramadol. We also associated the non-selective opioid receptor antagonist, naloxone, systemically (1mg/kg, i.p.) or intra-dPAG (0.5nmol) administered 10min prior to tramadol (32mg/kg, i.p.). Naloxone blocked the panicolytic-like effect of tramadol in both routes of administrations, showing that tramadol modulates acute panic defensive behaviours through its interaction with opioid receptors located in the dPAG.

Prevalência de transtornos depressivos e de ansiedade em pacientes obesos submetidos à cirurgia bariátrica / Prevalence of depression and anxiety disorders in obese patients who underwent bariatric surgery

A obesidade mórbida está relacionada a muitos transtornos psiquiátricos e possui como opção terapêutica a cirurgia bariátrica. Objetivo: caracterizar a prevalência de transtornos depressivos e de ansiedade em pacientes submetidos à cirurgia bariátrica no Hospital Universitário Regional de Maringá e do Centro de Cirurgia de Obesidade de Maringá. Métodos: o estudo foi realizado com 50 pacientes obesos mórbidos submetidos à Cirurgia Bariátrica em diferentes períodos: pré-operatório, um mês de pós-operatório, três meses de pós-operatório e seis meses de pós-operatório. A avaliação do Transtorno Depressivo foi realizada pela aplicação do Inventário de Depressão de Beck, sendo outro instrumento utilizado neste trabalho a Escala Hospitalar de Ansiedade e Depressão (HAD). Resultados: a prevalência de quadros sugestivos de ansiedade foi: 40% (20 pacientes) no pré-operatório, 18% no primeiro mês pós-operatório, 8% no terceiro mês pós-operatório e 14% no sexto mês pós-operatório. Quadros sugestivos de depressão foram encontrados em: 26% (13 pacientes) no pré-operatório, 10% no primeiro mês pós-operatório e no terceiro mês pós-operatório e 8% no sexto mês pós-operatório. Conclusão: Os níveis de Ansiedade foram altos no pré-operatório, diminuíram no 1º e 3º mês pós-operatório e voltaram a subir no sexto mês, atingindo níveis mais altos que no terceiro mês.

Morbid obesity is associated to several psychiatric disorders and bariatric surgery is a therapeutic option. Current research characterizes the prevalence of depression and anxiety disorders in patients who underwent bariatric surgery at the Regional Hospital of Maringá and at the Obesity Surgery Center of Maringá, Maringá PR Brazil. Study was undertaken with 50 morbid obese patients who underwent bariatric surgery and comprised different periods, namely, pre-surgery, one month after surgery, three months after surgery and six months after surgery. Depressive disorder was evaluated by Beck's Depression Inventory and by the Hospital Scale of Anxiety and Depression (HAD). Results show prevalence of anxiety in 40% (20) of patients during the pre-surgery period; 18% during the 1st post-surgery month; 8% during the 3rd post-surgery month and 14% during the 6th post-surgery month. High rates of depression were found in 26% (13) of patients in the pre-surgery period; 10% in the 1st and 3rd post-surgery month and 8% in the 6th post-surgery month. Levels of anxiety were actually high in the pre-operative period but they decreased in the 1st and 3rd months after surgery. However, a rise during the 6th month was reported which reached higher levels than that during the 3rd month.

A prática da hidroginástica como tratamento complementar para pacientes com transtorno de ansiedade / The practice of hydrogymnastics as a complementary treatment for patients with anxiety disorders

Objetivo: Analisar a efetividade da hidroginástica, como auxiliar terapêutico à redução do nível de ansiedade, em mulheres diagnosticadas com transtorno de ansiedade. Métodos: Este ensaio clínico teve a participação de pacientes com ansiedade, sendo a depressão a comorbidade existente, do programa de Residência Médica em Psiquiatria do Hospital Universitário de Maringá, todas em tratamento com medicamentos (n = 16: grupo experimental = 8; grupocontrole = 8). O experimento foi realizado na piscina aquecida do Departamento de Educação Física da Universidade Estadual de Maringá. O delineamento do estudo foi elaborado com duas sessões de hidroginástica por semana, durante 12 semanas. Os instrumentos utilizados foram: o Inventário de Ansiedade de Beck (BAI) e o Perfil de Estado de Humor (POMS). Para análise estatística, foram utilizados o teste de Friedman, o Teste de Wilcoxon, o Teste de Mann- Whitney e Comparações Múltiplas, adotando significância em 5%. Resultados: Os escores do transtorno de ansiedade tiveram redução no grupo experimental, após 12 semanas de intervenção (19,12 ± 3,12 para 8,37 ± 4,60 pontos, P = 0,0005*), e no grupo-controle (17,87 ± 14,32 para 12,12 ± 9,58 pontos, P = 0,254). Para o perfil do estado de humor, o grupo experimental evidenciou perfil de saúde mental positiva, enquanto o grupo-controle demonstrou perfil negativo de estado de humor. Conclusões: Portanto, as pacientes do grupo experimental evidenciaram significativa redução do nível de ansiedade em relação às pacientes do grupocontrole, que utilizaram apenas o tratamento convencional com medicamentos. Para o perfil do estado de humor, foram encontradas alterações no decorrer do estudo; o grupo-controleexperimentou alteração negativa de humor durante o ensaio clínico, enquanto os pacientes do grupo experimental evidenciaram perfil positivo de estado de humor com redução da tensão, depressão, raiva, confusão e aumento do vigor.

Objective: To analyze the effectiveness of hydrogymnastics as a therapeutic method to the reduction of anxiety in females diagnosed with anxiety disorder. Methods: This clinical survey had as participants, patients with anxiety, being the depression the existent comorbidade, from PsychiatryMedia Residence Program of the Academical Hospital of Maringá, all had medical treatment (n = 16: experimental group = 8; control group = 8). The experiment was accomplished in the warm swimming pool of the Department of Physical Education of the State University of Maringá. The design of the study was developed with two hydrogymnastics sessions per week, during 12 weeks. The instruments used in the data collection were: Beck's Anxiety Inventory (BAI) and the Profile of Mood States (POMS). As to statistics analysis the Friedman test, Wilcoxon test, Mann-Whitney test and Multiple Comparisons were used, with a significance of 5%. Results: Results show that anxiety disorder scores decreased in the experimental group after 12 weeks of intervention (19.12 ± 3.12 to 8.37 ± 4.60, P = 0.0005*) and control group (17.87 ± 14.32 to 12.12 ± 9.58, P = 0.254). As for mood stateprofile experimental group evidenced a positive mental health profile, while control group showed a negative mood state profile. Conclusions: It may be concluded that patients from experimental group evidenced significant reduction in anxiety level in relation to control group patients whomused only the conventional medicine treatment. For mood state profile changes were found throughout the study, being that control group experimented negative mood changes during the clinical survey while experimental group patients evidenced positive mood state profile with reduction on tension, depression, anger confusion and enhancement on vigor.

Plasmon resonance in silver nanoparticles arrays grown by atomic terrace low-angle shadowing.

The plasmonic properties of aligned silver nanoparticles grown by atomic terrace low-angle shadowing (ATLAS) were studied by optical transmission spectroscopy. ATLAS is a novel nanofabrication technique that combines the advantages of self-assembly with control of the nanostructure features. The silver nanoarrays were optically characterized and distinct optical responses with strong polarization dependence were obtained indicating the existence of a strong near-field coupling between the particles. We found that different morphologies gave rise to a similar optical response due to the local contributions to the overall response. Numerical model based on discrete dipole approximation was used to give a qualitative insight into the studied phenomena.

Influência do exercício físico no humor e na depressão clínica em mulheres / Physical exercise´s influence in mood and clinical depression in women

Este ensaio clínico objetivou verificar as alterações ocorridas no Perfil do estado de humor em pacientes depressivas, após intervenção baseada em um programa de exercícios físicos. O estudo teve a participação de 18 mulheres (GE igual 09 e GC igual 09) com idade média de 43,33 mais ou menos 3,56 anos, com diagnóstico de depressão moderada. Durante 12 semanas foram realizadas 02 sessões semanais de exercício físico regular, baseado na hidroginástica, com duração de 50 minutos para cada sessão. O quadro clínico de depressão medido pela escala de Hamilton apresentou redução significativa para o grupo experimental (pré-teste 32,66 mais ou menos 3,12 e pós-teste 24,88 mais ou menos 2,13, p-valor 0,007), enquanto o grupo de controle, tratado apenas com antidepressivos, permaneceu estável (31,11 mais ou menos 3,51 para 30,22 mais ou menos 3,04, p igual 0,059). O quadro clínico de depressão medido pela escala de Hamilton se manteve em concordância com o POMS (préteste 32,66 mais ou menos 3,12 e pós-teste 24,88 mais ou menos 2, 13, p-valor 0,007). O programa de exercícios físicos regulares mostrou ter efeito positivo nas respostas agudas (após cada sessão) sobre os fatores do perfil do estado de humor e crônicas (após 12 semanas) nos níveis de depressão em mulheres com depressão moderada.

The aim of this clinical assay was to verify the occured alterations in the Profile of the state of mood in depressive patients, after intervention based on a program of physical exercises. The study had the participation of 18 women (EG equal 09 and CG equal 09) with 43,33 more or less 3,56 years, with diagnosis of moderate depression. During of 12 weeks it was aplicated 02 weekly sessions of regular physical exercise, based in the water activity, with duration of 50 minutes for each session. The clinical depression measured for the Hamilton’s Scale presented significant reduction for the experimental group (3,12 pre-test 32,66 more or less and24,88 after-test more or less 2, 13, p-value 0,007 ), while the control group, dealt only with antidepressants was remained steady (31.11 more or less 3.51 for 30,22 more or less 3,04, p equal 0,059). The clinical depression measured for the scale of Hamilton if kept in agreement with the POMS (3,12 pre-test 32,66 more or less and 24,88 after-test more or less 2, 13, p-value 0,007 ). The program of regular physical exercises showed to have positive effect in acute answers (after session) on the factors profile of mood states and cornics answers (after 12 weeks) on levels of depression in women with moderate depression.

Prevalência dos transtornos mentais em pacientes atendidos no ambulatório da residência médica de psiquiatria da Universidade Estadual de Maringá / Prevalence of mental disorders in patients treated at the psychiatry residency clinic at the State University of Maringá

Objetivo: caracterizar o perfil dos pacientes no Ambulatório de Psiquiatria da Residência do Hospital Universitário Regional de Maringá, por idade, sexo, cor, religião, escolaridade, estado civil, profissão, avaliando a prevalência dos transtornos mentais. Métodos: pesquisa nos prontuários dos pacientes atendidos neste serviço, entre maio de 2002 e dezembro de 2005. Foram utilizados a Análise Multivariada (análise de Correspondência) e o aplicativo Statistica 7.8, para caracterizar o diagnóstico. Resultados: A depressão correspondeu a 29% dos diagnósticos, seguida pela categoria Transtorno Afetivo Bipolar com 16%. Constatou-se que a maioria dos pacientes é do sexo feminino (68,19%), com idade média de 40,28 anos e desvio-padrão de 15,24 anos. A cor branca predomina com 70,87%, assim como os casados que totalizam 52%. Conclusão: foi registrada alta taxa de utilização do serviço de saúde por pessoas com diagnóstico de transtorno depressivo, transtorno bipolar e transtornos ansiosos, correspondendo a 60% dos pacientes

Objective: to build a profile of patients treated in the Psychiatry Residency Clinic at the Regional University Hospital of Maringá as for age, gender, ethnicity, religion, education level, marital status and profession, and evaluate the prevalence of mental disorders among them. Methods: research of the medical records of patients treated at the location, between May 2002 and December 2005. In order to reach a diagnosis, the study made use of Multivariate Analysis (Correspondence Analysis) and the Statistica 7.8 software application. Results: Depression comprised 29% of diagnoses, followed by bipolar affective disorder with 16%. It was observed that the majority of patients were women (68.19%), with an average age of 40.28 ± 15.24 years. Caucasian patients were the majority (70.87%), and 52% of patients were married. Conclusion: It was observed that 60% of patients who looked for treatment were diagnosed with depression, bipolar or anxiety disorders

A prática de exercícios físicos regulares como terapia complementar ao tratamento de mulheres com depressão / The regular physical exercises practice as complementary therapy to the treatment of depressed women

OBJETIVO: Analisar a efetividade do exercício físico como complemento terapêutico no tratamento da depressão. MÉTODOS: Este ensaio clínico teve a participação de pacientes mulheres atendidas pelo SUS no Hospital Universitário de Maringá em tratamento com antidepressivos (n = 18: GC = 9; GE = 9). O delineamento do estudo foi elaborado com duas sessões de hidroginástica/semana, durante 12 semanas. O instrumento utilizado foi a Escala de Hamilton para Depressão, aplicado ao início, após 12 semanas de intervenção e após 6 meses de finalização do ensaio clínico. Para análise estatística, utilizaram-se os Testes de Wilcoxon e de Mann-Whitney. RESULTADOS: Os escores de depressão reduziram-se no grupo experimental após 12 semanas (32,66 ± 3,12 para 24,88 ± 2,13 pontos, p = 0,007*) e não ocorreu diferença estatisticamente significativa no grupo controle (31,11 ± 3,51 para 30,22 ± 3,04 pontos, p = 0,059). Após 6 meses, não houve diferenças estatisticamente significativas para o grupo controle (31,11 ± 3,51 para 30,22 ± 2,81 pontos, p = 0,201). No entanto, o grupo experimental regressou aos níveis iniciais de depressão (32,66 ± 3,12 para 29,66 ± 1,22 ponto, p = 0,027*). CONCLUSÃO: Neste estudo preliminar, as pacientes submetidas à prática de exercícios físicos associada ao tratamento convencional para depressão evidenciaram melhora significativa em relação àquelas que não praticaram exercícios físicos. Os efeitos dos exercícios físicos sobre os sintomas depressivos desapareceram com a interrupção dos exercícios físicos na avaliação do seguimento de 6 meses.

OBJECTIVE: To analyze the effective of the physical exercise as therapeutical complement in the depressions treatment. METHODS: This clinical assay had the participation of womens patient taken care of for the SUS in the Maringás University Hospital in treatment with antidepressants (n = 18: GC = 9; GE = 9). The research design was elaborated with two sessions of water exercise/week, during 12 weeks. The instrument used was Hamiltons Scale for Depression, applied to the beginning and after 12 weeks of the clinical assay. For statistics analysis the tests of Wilcoxon and Mann-Whitney were used. RESULTS: The depression level reduced in the experimental group after 12 weeks (32.66 ± 3.12 to 24.88 ± 2.13 points, p = 0.007*) and no differences were found in control group (31.11 ± 3.51 to 30.22 ± 3.04 points, p = 0.059). After 6 months, it havent significant statistical differences for the control group (31.11 ± 3.51 for 30.22 ± 2.81 points, p = 0.201). However, the experimental group returned next to the initiates levels of depression (32.66 ± 3.12 for 29.66 ± 1.22 point, p = 0.027*). CONCLUSION: In this preliminary study the patients submitted to the physical exercises pratice associated to the conventional treatment to depression had evidenced a significant improvement to that they hadn't pratice physical exercises. The physical effects of the exercises on the depressive symptoms disapeared with the interruption of the physical exercise in the evaluation follow up of 6 months.

Estudo comparativo sobre a prevalência de sintomas depressivos em idosos hospitalizados, institucionalizados e residentes na comunidade / Comparative study on depression symptoms in hospitalized, day-care and in-home elderly

A depressão no idoso e suas conseqüências vêm atraindo crescente atenção científica e clínica a medida que a população mundial envelhece. Com o objetivo de investigar características quantitativas e qualitativas dos sintomas depressivos em diferentes populações de idosos, entrevistamos idosos hospitalizados, institucionalizados e residentes na comunidade, representados por amostras de trinta idosos com 60 anos ou mais. O instrumento escolhido para a investigação dos sintomas depressivos foi a Escala de Hamilton para Avaliação de Depressão - versão adaptada por Blacker (HAM-D). Os idosos asilados apresentaram escores mais altos na HAM-D, condizentes com depressão grave e muito grave. A menor prevalência de sintomas depressivos foi encontrada entre os idosos residentes em domicílio. As mulheres apresentaram uma maior porcentagem de sintomas depressivos muito graves. Os resultados do presente trabalho apontam para a importância de se dedicar a atenção adequada à saúde mental do idoso objetivando o diagnóstico e o tratamento desta enfermidade tão freqüente

Prevalência da sintomatologia depressiva em idosos em uma área de saúde da família no município de Maringá, Estado do Paraná / Depressive symptoms in seniors’ population in Maringá, PR

Verificar a prevalência da sintomatologia depressiva na população de idosos com idade superior a 60 anos, numa área adstrita do PSF, no município de Maringá, Estado do Paraná. Foi realizado um estudo transversal, utilizando o Inventário para Depressão de Beck. A população estudada foi de 451 indivíduos, da qual foi utilizada uma amostra de 123 pessoas correspondendo a 27,3 por cento do total. Obtiveram-se os seguintes resultados: 1) idade média 69 ± 8 anos; 2) disforia: 15,1 por cento dos homens e 17,2 por cento das mulheres (p=0,7590); depressão: 34 por cento dos homens e 37,7 por cento das mulheres (p=0,6942); 3) a prevalência de “depressão” foi 4,8 vezes maior que a população brasileira e 2,1 vezes a dos idosos americanos. Assim, a sintomatologia depressiva foi altamente prevalente na amostra de idosos estudada, de uma área de PSF