Bayesian Networks for Prescreening in Depression: Algorithm Development and Validation.

BACKGROUND: Identifying individuals with depressive symptomatology (DS) promptly and effectively is of paramount importance for providing timely treatment. Machine learning models have shown promise in this area; however, studies often fall short in demonstrating the practical benefits of using these models and fail to provide tangible real-world applications. OBJECTIVE: This study aims to establish a novel methodology for identifying individuals likely to exhibit DS, identify the most influential features in a more explainable way via probabilistic measures, and propose tools that can be used in real-world applications. METHODS: The study used 3 data sets: PROACTIVE, the Brazilian National Health Survey (Pesquisa Nacional de Saúde [PNS]) 2013, and PNS 2019, comprising sociodemographic and health-related features. A Bayesian network was used for feature selection. Selected features were then used to train machine learning models to predict DS, operationalized as a score of ≥10 on the 9-item Patient Health Questionnaire. The study also analyzed the impact of varying sensitivity rates on the reduction of screening interviews compared to a random approach. RESULTS: The methodology allows the users to make an informed trade-off among sensitivity, specificity, and a reduction in the number of interviews. At the thresholds of 0.444, 0.412, and 0.472, determined by maximizing the Youden index, the models achieved sensitivities of 0.717, 0.741, and 0.718, and specificities of 0.644, 0.737, and 0.766 for PROACTIVE, PNS 2013, and PNS 2019, respectively. The area under the receiver operating characteristic curve was 0.736, 0.801, and 0.809 for these 3 data sets, respectively. For the PROACTIVE data set, the most influential features identified were postural balance, shortness of breath, and how old people feel they are. In the PNS 2013 data set, the features were the ability to do usual activities, chest pain, sleep problems, and chronic back problems. The PNS 2019 data set shared 3 of the most influential features with the PNS 2013 data set. However, the difference was the replacement of chronic back problems with verbal abuse. It is important to note that the features contained in the PNS data sets differ from those found in the PROACTIVE data set. An empirical analysis demonstrated that using the proposed model led to a potential reduction in screening interviews of up to 52% while maintaining a sensitivity of 0.80. CONCLUSIONS: This study developed a novel methodology for identifying individuals with DS, demonstrating the utility of using Bayesian networks to identify the most significant features. Moreover, this approach has the potential to substantially reduce the number of screening interviews while maintaining high sensitivity, thereby facilitating improved early identification and intervention strategies for individuals experiencing DS.

A Cross-Sectional Analysis of Parental Behavior and Adolescent Mental Health in Mexico: Insights into Excessive Alcohol Intake, Tobacco Use, Suicidal Behavior, and Depressive Symptomatology.

Depression, suicidal behavior, excessive alcohol intake, and tobacco use are the main mental health problems in adolescents. To address these problems, it is necessary to understand the many factors associated with them, including parental factors. The aim of this study was to assess the associations between parental behavior and mental health problems in adolescents in Mexico. Data from the National Health and Nutrition Survey (ENSANUT) 2018-2019, representative for Mexico, were used. Households in which a parent-adolescent child pairing was identified (regardless of family type) were selected; n = 8758 households. The four outcomes of interest that were measured in the adolescents were: excessive alcohol intake, tobacco use, suicidal behavior, and depressive symptomatology. Logistic regression models using the adjusted odds ratio (AOR) and 95% confidence interval (95% CI) were estimated. Adolescents whose parents used alcohol or tobacco and reported depressive symptoms and suicidal behavior were more likely to present these behaviors themselves (AOR = 1.47, 95% CI: 1.17-1.85; AOR = 2.26, 95% CI: 1.51-3.39; AOR = 2.61, 95% CI: 1.88-3.61; AOR = 1.74, 95% CI: 1.16-2.61, respectively). Child sexual abuse was also strongly associated with the four outcomes of interest in adolescents (AOR = 1.89, 95% CI: 1.06-3.36 for excessive alcohol intake; AOR = 2.97, 95% CI: 1.49-5.91 for tobacco use; AOR = 5.15, 95% CI: 3.27-8.09 for depressive symptoms; AOR = 6.71, 95% CI: 4.25-10.59 for suicidal behavior). The family constitutes the central nucleus of care for children and adolescents; therefore, any effort to promote adolescent mental health must necessarily involve their parents and family.

Transcultural Pilot Study of the Efficacy of Reminiscence Therapy for Mexican and Spanish Older Adults with Different Levels of Cognitive Decline.

The main objective for this study is to analyze the impact of a positive reminiscence therapy program (REMPOS) in cognitive functioning and depressive symptomatology for older adults in different vital situations (healthy aging, mild cognitive impairment, and Alzheimer's disease).This is a transcultural comparative study (older people from Spain and Mexico). A randomized design with pre-posttest measurement and twelve groups was formulated, during a period of six months of intervention (3 in Mexico and 3 in Spain). The design had: 6 experimental groups with REMPOS intervention (3 in Mexico and 3 in Spain) during a period of six months and 6 control groups that received cognitive stimulation.While a key aspect of this study is the cross-cultural differences, an important part is to determine whether each experimental group had similar results in terms of the change in magnitude between the pre and post analysis. In general, intervention significantly improved cognitive function and decreased depressive symptoms.These findings provide further evidence about the efficacy of the REMPOS therapy between different types of aging and both geographical and cultural contexts (Spain and Mexico).

Depression Disorders in Mexican Adolescents: A Predictive Model.

Depression is a type of mood disorder that can impact individuals of any age. A variety of factors, including biological, psychological, and environmental factors, can contribute to the likelihood of developing depression. If the environment in which a person exists does not support its occurrence, the disorder may not manifest. The current research follows a retrospective, correlational approach, utilizing a non-probability sample of 557 high school students from public schools in Mexico City. This sample includes 181 males and 376 females, aged between 15 and 18 years, with an average age of 15.66 and a standard deviation of 0.68. The main objective of this research is to identify the variables that serve as risk factors for the development of depressive disorders in Mexican adolescents in high school. The data show that 78% of the adolescents in the total sample were at risk of depression, which is consistent with what has been reported by other researchers. The regression model shows that alcohol and drug consumption is associated with and influences the emergence and presence of depressive symptomatology and major depressive disorder. Adolescents with different sexual orientations than heterosexuals are twice as likely to suffer depression and emotional dysregulation. It was confirmed that the developmental stage and adolescence contributes as a context that favors the evolution of such a symptomatology.

Long-term functional ability trajectories and mental health among older people before and after the COVID-19 pandemic onset in Chile.

OBJECTIVES: Despite the advances in understanding the complex association between functional abilities and mental health in old age, studies have overlooked two important aspects. First, traditionally, research has employed cross-sectional designs, measuring limitations at a single time point. Second, most gerontological studies on this field have been conducted before the COVID-19 pandemic onset. This study aims to explore the association between diverse long-term functional ability trajectories across late adulthood and old age, and older people's mental health in Chile, before and after the COVID-19 pandemic onset. METHODS: We use data from the population-representative and longitudinal 'Chilean Social Protection Survey', sequence analysis to reconstruct functional ability trajectory types from 2004 to 2018, and bivariate and multivariate analyses to measure their association with depressive symptoms in early 2020 (N = 891) and late 2020 (N = 672). We analyzed four age groups defined by their age at baseline (2004): people aged 46-50, 51-55, 56-60, and 61-65. RESULTS: Our findings indicate that erratic or equivocal patterns of functional limitations across time (with people transiting back and forth between low and high levels of limitations) show the worst mental health outcomes, both before and after the pandemic onset. Prevalence of people with depression increased after the COVID-19 onset in most groups, being particularly high among those with previous equivocal functional ability trajectories. CONCLUSIONS: The relationship between functional ability trajectories and mental health calls for a new paradigm, moving away from age as the main policy guide, and highlighting the need to adopt strategies to improve population-level functional status as an efficient policy to address the challenges of population aging.

Psycho-Emotional Factors Associated with Depressive Symptoms during Lockdown Due to the COVID-19 Pandemic in the Mexican Population.

The COVID-19 pandemic has had a significant impact on mental health, leading to the increase of depressive symptoms. Identifying these symptoms and the factors associated with them in women and men will allow us to understand possible mechanisms of action and develop more specific interventions. An online survey was conducted from 1 May to 30 June 2020 using snowball sampling; the final sample comprised 4122 adult inhabitants of Mexico; 35% of the total sample displayed moderate-to-severe depressive symptoms, with a greater proportion of depression being among female respondents. A logistic regression analysis revealed that individuals under 30 years of age, those with high levels of stress due to social distancing, those with negative emotions, and those who reported a significant impact of the pandemic on their lives have a higher risk of depression. Women with a history of mental health treatment and men with a history of chronic disease were also more likely to experience depressive symptoms. Social environment and sex are factors that intervene in the development of depressive symptoms, meaning that appropriate early identification and intervention models should be designed for the care of men and women in highly disruptive situations such as the recent pandemic.

Predicting depressive symptoms in middle-aged and elderly adults using sleep data and clinical health markers: A machine learning approach.

OBJECTIVES: Comorbid depression is a highly prevalent and debilitating condition in middle-aged and elderly adults, particularly when associated with obesity, diabetes, and sleep disturbances. In this context, there is a growing need to develop efficient screening methods for cases based on clinical health markers for these comorbidities and sleep data. Thus, our objective was to detect depressive symptoms in these subjects, considering general biomarkers of obesity and diabetes and variables related to sleep and physical exercise through a machine learning approach. METHODS: We used the National Health and Nutrition Examination Survey (NHANES) 2015-2016 data. Eighteen variables on self-reported physical activity, self-reported sleep habits, sleep disturbance indicative, anthropometric measurements, sociodemographic characteristics and plasma biomarkers of obesity and diabetes were selected as predictors. A total of 2907 middle-aged and elderly subjects were eligible for the study. Supervised learning algorithms such as Lasso penalized Logistic Regression (LR), Random Forest (RF) and Extreme Gradient Boosting (XGBoost) were implemented. RESULTS: XGBoost provided greater accuracy and precision (87%), with a proportion of hits in cases with depressive symptoms above 80%. In addition, daytime sleepiness was the most significant predictor variable for predicting depressive symptoms. CONCLUSIONS: Sleep and physical activity variables, in addition to obesity and diabetes biomarkers, together assume significant importance to predict, with accuracy and precision of 87%, the occurrence of depressive symptoms in middle-aged and elderly individuals.

Health-Related Quality of Life and Depressive Symptomatology in High School Students during the Lockdown Period Due to SARS-CoV-2.

The objectives of this study were to evaluate and compare the prevalence of health-related quality of life and depressive symptomatology in high school students during the lockdown period due to the SARS-CoV-2 pandemic. A cross-sectional survey was conducted with students attending the High School Education System of the University of Guadalajara, Jalisco, México. Through a Google Forms survey, students answered their perceptions of health-related quality of life and depressive symptomatology. The outcome variable was the presence of depressive symptoms, assessed using the Children's Depression Inventory (CDI). Cronbach's alpha coefficient was 0.8 in both surveys. A total of 1446 students participated (women, 64.9%; mean age of 16.1 ± 0.9 years). Among the students, 22% manifested clinical depressive symptoms (24.4 ± 5.0), and males showed lower scores on health-related quality of life and depressive symptoms (44.9 ± 11.9, p = 0.005) (12 ± 7.7, p = <0.001) compared to their female peers (45.2 ± 10.6, p = 0.005) (13.7 ± 7.5, p = <0.001), respectively. During the lockdown due to the SARS-CoV-2 pandemic, a high prevalence of depressive symptomatology was identified in our students with in addition to a low perception of health-related quality of life in dimensions, mood and emotions, and peers and social support.

Evaluación de un protocolo de intervención en Terapia Sistémica Breve para personas expuestas a un evento estresante reciente / Evaluation of a Brief Systemic Therapy intervention protocol for people who have experienced a recent stressful event

Resumen Los eventos altamente estresantes son sucesos que potencialmente generan consecuencias negativas en las personas afectadas, como síntomas postraumáticos y depresivos. El presente estudio evalúa un protocolo de intervención preventiva, orientado a personas que han vivido un evento altamente estresante reciente, basado en la Terapia Sistémica Breve. Cuatro terapeutas aplicaron el protocolo a cuatro usuarias. Se entrevistó a estas ocho personas acerca de su experiencia en la aplicación y recepción del protocolo. Mediante escalas de fiabilidad y validez contrastada se evaluaron los cambios pre-post en sintomatología postraumática, sintomatología depresiva, crecimiento postraumático y satisfacción con la vida; también se midió la relación terapéutica. Los resultados muestran apreciaciones positivas en terapeutas y usuarias, el desarrollo de una relación terapéutica adecuada y avances en tres de los cuatro indicadores cuantitativos de cambio. Se concluye que el protocolo está en condiciones de utilizarse en estudios controlados.

Abstract Highly stressful events are occurrences that potentially create negative consequences for the affected people, such as post-traumatic and depressive symptoms. This study assesses a preventive intervention protocol, aimed to people who have lived a recent highly stressful event, based on the Brief Systemic Therapy. Four therapists applied the protocol to four female users. These eight persons were interviewed about the experience in relation to the application and reception of the protocol. Through contrasted reliability and validity scales, pre and post changes in posttraumatic symptomatology, depressive symptomatology, posttraumatic growth and satisfaction with life were assessed; the therapeutic relation was also measured. The results show positive appraisals in therapists and female users, the development of a proper therapeutic relation and progress in three out of four quantitative change indicators. It is concluded that the protocol is suitable to be used in controlled studies.

Depressive symptoms in child caregivers of very old Mexican Americans.

OBJECTIVE: To study the effects of disability, cognitive impairment, and neuropsychiatric disturbance among older Mexican Americans on depressive symptoms in their children caregivers. METHODS: This study utilizes data from Wave 7 (2010-2011) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE). The final sample included 200 adult children caregivers that provided direct personal care with activities of daily living (ADL) (e.g. bathing, toileting, dressing, etc.) to their older parents (average age = 87). We analyzed the influence of ADL disability, cognition (MMSE), and neuropsychiatric symptoms (NPI) of the care recipient on depressive symptoms of the adult child caregiver. A cross-sectional multivariable linear regression analysis was conducted to examine the effect of neuropsychiatric disturbance on caregiver depressive symptoms. RESULTS: Presence of care recipient NPI symptoms was associated with higher depressive symptoms for caregivers. Additional characteristics associated with caregiver depressive symptoms were not being married, and higher perceived social stress. ADL disability of the care recipient, cognitive functioning of the care recipient, or caregiver health status alone did not have a significant effect on depressive symptoms of the caregiver. CONCLUSIONS: In a Mexican American familistic culture, disability and cognitive impairment might be better tolerated by families but neuropsychiatric behavioral symptoms related to dementia may take an increased toll on family member caregivers. The need to provide respite services, mental health resources and community services for caregivers of care recipients with neuropsychiatric symptoms is of paramount importance to alleviate depressive symptoms and burden among caregivers.

Hypnotic intervention in people with fibromyalgia: A randomized controlled trial.

Fibromyalgia affects the quality of life of the patients, as well as their family. It also affects their social, labor, physical, and psychological dynamics. We aimed to evaluate the effectiveness of audio-recorded hypnosis in ameliorating fibromyalgia symptoms. We enrolled 97 individuals with fibromyalgia (mean age: 45 years) and randomly distributed them to two groups (48 in the experimental group and 47 in the control group). Individuals in both groups maintained their standard pharmacological treatment and continued their usual physical or psychological activities. The experimental group received an audio-recorded hypnosis intervention in the first session; subsequently, they received another audio hypnosis session to use for daily practice for a month. We evaluated the pre- and post-intervention pain intensity, pain interference, fatigue intensity, fatigue interference, depressive symptomatology, and satisfaction with life. We found that the self-administered audio-recorded hypnotic intervention significantly decreased the intensity and interference of pain and fatigue, as well as the depressive symptomatology. Audio-recorded clinical hypnosis techniques could provide an effective, practical, and economical alternative for reducing fibromyalgia-related symptoms.

Avaliação de Bem-Estar Psicológico e Sintomas Depressivos em Idosos Saudáveis / Evaluation of Psychological Well-Being and Depressive Symptoms in Healthy Elderly People / Evaluación de Bienestar Psicológico y Sintomas Depresivos en Los Idosos Saludables

O objetivo deste trabalho foi avaliar a relação entre bem-estar psicológico e a presença de sintomas depressivos em idosos saudáveis. Os instrumentos utilizados foram: ficha de dados sociodemográficos, EDEP e BDI-II. Os dados foram analisados com o auxílio do SPSS, por meio de frequências, média, desvio padrão e correlações de Spearman. A amostra foi composta por 64 idosos, com média de idade de 69,61 (DP=7,58) e média de escolaridade de 4,59 anos de estudo (DP=2,61). Os resultados indicaram correlação inversa, moderada e significativa entre sintomatologia depressiva e os domínios autonomia, ambiente e relações positivas com os outros, encontrou-se ainda correlação inversa e fraca entre sintomatologia depressiva e crescimento pessoal. Acredita-se que escolaridade e atividade física podem ser fatores protetivos para depressão e bem-estar psicológico no envelhecimento. Por fim, levanta-se a hipótese de haver uma retroalimentação entre as variáveis que se correlacionaram entre si de forma significativa neste estudo. (AU)

The main objective of this study was to evaluate the relationship between psychological well-being and depressive symptoms in healthy elderly people. The instruments used were: sociodemographic data questionnaire, EDEP and BDI-II. The data were analyzed in the SPSS using mean and SD, and Spearman correlations. The sample consisted of 64 elderly, with a mean age of 69.61 years (SD=7.58) and a mean educational level of 4.59 years (SD=2.61). The results indicate an inverse, moderate and significant correlation between depressive symptomatology and the domains: autonomy, environment, and positive relationships with others. There was also an inverse and weak correlation between depressive symptomatology and personal growth domain. It is believed that education level can be a protective factor for depression and psychological well-being in aging. Finally, the hypothesis is that there is a feedback cycle between the significantly correlated variables in this study. (AU)

El objetivo de este trabajo fue evaluar la relación entre bienestar psicológico y la presencia de síntomas depresivos en ancianos sanos. Los instrumentos utilizados fueron: ficha de datos sociodemográficos, EDEP y BDI-II. Los datos fueron analizados con la ayuda del SPSS, por medio de frecuencias, media, desviación estándar y correlaciones de Spearman. La muestra fue compuesta por 64 ancianos, siendo la media de edad fue 69,61 (+7,58) y la media de escolaridad fue de 4,59 años de estudio (+2,61). Los resultados indicaron correlación inversa, moderada y significativa entre sintomatología depresiva y los dominios autonomía, ambiente y relaciones positivas con los demás, se encontró una correlación inversa y débil entre sintomatología depresiva y crecimiento personal. Se cree que la escolaridad y la actividad física son factores protectores para la depresión y el bienestar psicológico en el envejecimiento. Por último, se plantea la hipótesis de que hay una retroalimentación entre las variables que se correlacionaron entre sí de forma significativa en este estudio. (AU)

Análise de estrutura interna do Inventário de Depressão Maior (MDI) / Internal structure analysis of the Major Depression Inventory (MDI) / Análisis de estructura interna del Inventario de Depresión Mayor (MDI)

O objetivo do estudo foi avaliar as qualidades psicométricas do Inventário de Depressão Maior (MDI). O MDI foi aplicado em 714 estudantes universitários e em 12 pessoas com diagnóstico de depressão. Realizaram-se análises de estrutura interna via TCT e TRI, bem como confiabilidade, sensibilidade e especificidade. A solução unidimensional foi a mais coerente teoricamente e os parâmetros via TCT adequados, com confiabilidade de 0,89. Já, via TRI, nem todos os parâmetros adequados foram respeitados, tais como índices de infit e outfit, além de categorias de respostas não discriminativas. Os índices de acurácia também demonstraram limitações, principalmente com relação aos falsos negativos (especificidade de 63,9). Assim, sugere-se a realização de novos estudos analisando-se os dados via TRI, bem como um grupo clínico maior, diagnosticados com entrevista estruturada padrão.

The objective of the study was to evaluate the psychometric qualities of the Major Depression Inventory (MDI). The MDI was applied to 714 university students and 12 people diagnosed with depression. Internal structure analyses were performed using TCT and IRT, as well as reliability, sensitivity, and specificity. The one-dimensional solution was the most coherent theoretically and the parameters via suitable TCT, with a reliability of 0.89. Already, via IRT, not all appropriate parameters were respected, such as infit and outfit indexes, as well as categories of non-discriminative responses. Accuracy indexes also showed limitations, especially concerning false negatives (specificity of 63.9). Thus, it is suggested to perform new studies analyzing the data via IRT, as well as a larger clinical group, diagnosed with a standard structured interview.

El objetivo del estudio fue evaluar las calidades psicométricas del Inventario de Depresión Mayor (MDI). El MDI fue aplicado en 714 estudiantes universitarios y en 12 personas con diagnóstico de depresión. Se realizaron análisis de estructura interna vía TCT y TRI, así como confiabilidad, sensibilidad y especificidad. La solución unidimensional fue la más coherente teóricamente y los parámetros vía TCT adecuados, con confiabilidad de 0,89. En cambio, a través de TRI, no se respetaron todos los parámetros adecuados, tales como índices de infit y outfit, además de categorías de respuestas no discriminatorias. Los índices de exactitud también demostraron limitaciones, principalmente con relación a los falsos negativos (especificidad de 63,9). Así, se sugiere la realización de nuevos estudios analizando los datos vía TRI, así como un grupo clínico mayor, diagnosticados con entrevista estructurada estándar.

Relación entre automanejo y síntomas depresivos en personas con diabetes e hipertensión / Relationship between self-management and depressive symptoms in persons with diabetes and hypertension / Relação entre automanejo e sintomas depressivos em pessoas com diabetes e hipertensão

Resumen Introducción: Las personas con diabetes e hipertensión experimentan con mayor frecuencia sintomatología depresiva, lo cual contribuye a un inadecuado automanejo de la enfermedad, que implica tareas como: la toma de la medicación, asistir a las consultas médicas, el conocimiento de signos y síntomas, además de la toma de decisiones. Objetivo: Por lo anterior, el objetivo de este trabajo es identificar la relación entre automanejo en general y sus dimensiones con síntomas depresivos en personas con diabetes e hipertensión. Método: Estudio transversal-correlacional con n=205 pacientes con diagnóstico de diabetes (100) e hipertensión (105). Muestreo no probabilístico por conveniencia. Se utilizó la estadística descriptiva y r de Pearson. Se aplicaron los instrumentos Partners in Health (PIH) y The Patient Health Questionnaire (PHQ-8). Resultados: Se encontró correlación estadísticamente significativa entre la sintomatología depresiva y el automanejo (r=-0.308 ρ<0.001). Discusión y Conclusiones: Se concluye que la sintomatología depresiva se relaciona con el automanejo de la enfermedad de la siguiente manera: a mayor automanejo menor sintomatología de depresión, o a mayor sintomatología depresiva menor automanejo; dicha relación confirma que ambas variables se afectan mutuamente y/o mantienen una relación estrecha.

Abstract Introduction: Persons with diabetes and hypertension frequently suffer from depression as well, a situation which contributes to an inadequate management of the condition in terms of medication, medical consultations, signs, and decision making. Objective: To identify the relationship between general self-management and depression symptoms in persons with diabetes and hypertension. Method: This is a transversal and correlational study with a sample of 205 patients, 100 with a main diagnosis of diabetes, and 105 with a main diagnosis of hypertension. The sampling process was non-probabilistic and by convenience. Descriptive statistics, including Pearson's r were calculated. The Partners in Health (PIH) and Patient Health Questionnaire (PHQ-8) instruments were administered. Results: A statistically significant correlation between depression symptoms and diabetes and hypertension self-management was found (r=-0.308 ρ<0.001). Discussion and conclusions: Depression symptoms were related to how diabetes and hypertension are self-managed in a way that, the more self-management, the less depression symptoms, or the more depression symptoms, the less self-management.

Resumo Introdução: As pessoas com diabetes e hipertensão experimentam com maior frequência a sintomatologia depressiva, o qual contribui a um inadequado automanejo da doença, que envolve tarefas como: a toma da medicação, assistir às consultas médicas, o conhecimento de signos e sintomas, além da toma de decisões. Objetivo: Pelo anterior, o objetivo deste trabalho é identificar a relação entre automanejo em geral e suas dimensões com sintomas depressivos em pessoas com diabetes e hipertensão. Método: Estudo transversal-correlacional com n=205 pacientes com diagnóstico de diabetes (100) e hipertensão (105). Amostragem não probabilística por conveniência. Utilizou-se a estatística descritiva e r de Pearson. Aplicaram-se os instrumentos Partners in Health (PIH) e The Patient Health Questionnaire (PHQ-8). Resultados: Encontrou-se correlação estatisticamente significativa entre a sintomatologia depressiva e o automanejo (r=-0.308 ρ<0.001). Discussão e Conclusões: Conclui-se que a sintomatologia depressiva relaciona-se com o automanejo da doença da seguinte maneira: a maior automanejo, menor sintomatologia de depressão, ou a maior sintomatologia depressiva, menor automanejo; esta relação confirma que ambas variáveis afetam-se mutuamente e/ou mantem uma relação estreita.

Evidências de validade para a escala Baptista de depressão versão hospital-ambulatório (EBADEP-HOSP-AMB) / Validity evidence for the Baptista developmental scale hospital-ambulatory version (EBADEP-HOSP-AMB) / Evidencias de validez para la escala Baptista de depresión versión hospital-ambulatorio (EBADEP-HOSP-AMB)

O objetivo do estudo foi buscar evidências de validade baseadas na relação com variáveis externas para a Escala Baptista de Depressão Versão Hospital-Ambulatório (EBADEP-HOSP-AMB). Participaram 210 pacientes renais crônicos em hemodiálise, com idades entre 18 e 82 anos (M=53,40; DP=14,40), sendo 112 (53,3%) do sexo masculino. Foram aplicados um questionário sociodemográfico/saúde, juntamente com a EBADEP-HOSP-AMB, a Escala Hospitalar de Ansiedade e Depressão (HADS) e a Escala de Pensamentos Depressivos (EPD). As aplicações ocorreram de forma individual durante as sessões de hemodiálise. Foi verificada a relação entre os instrumentos além de possíveis diferenças de média em função das variáveis sociodemográficas. Os principais resultados indicaram correlações significativas de magnitudes moderadas a altas entre os instrumentos. Também foi observado que as mulheres e aqueles que relataram ter diagnóstico de depressão obtiveram escores mais elevados na maioria das escalas apresentando mais sintomatologia depressiva e pensamentos depressivos, bem como ansiedade (AU).

The purpose of the study was to seek validity evidence based on the relationship with external variables for the Hospital-Ambulatory Depression Baptist Scale (EBADEPHOSP-AMB). A total of 210 chronic kidney patients undergoing hemodialysis, aged 18-82 years (M=53.40, SD=14.40), 112 (53.3%) males participated. A sociodemographic/health questionnaire was applied, along with the EBADEP-HOSPAMB, the Hospital Anxiety and Depression Scale (HADS) and the Depressive Thoughts Scale (EPD). The applications occurred individually during the hemodialysis sessions. The relationship between the instruments was verified, besides possible differences of mean according to the sociodemographic variables. The main results indicated significant correlations of moderate to high magnitudes between the instruments. It was also observed that women and those who reported having a diagnosis of depression scored higher on most scales presenting more depressive symptomatology and depressive thoughts as well as anxiety (AU).

El objetivo del estudio fue buscar evidencias de validez basadas en la relación con variables externas para la Escala Baptista de Depresión Versión Hospital-Ambulatorio (EBADEP-HOSP-AMB. Participaron un total de 210 pacientes renales crónicos en hemodiálisis, con edades entre 18 y 82 años (M=53,40; DP=14,40), siendo 112 (53,3%) del sexo masculino. Se aplicó un cuestionario sociodemográfico / salud, junto con EBADEP-HOSP-AMB, la Escala Hospitalaria de Ansiedad y Depresión (HADS) y la Escala de Pensamientos Depresivos (EPD). Los cuestionarios fueron aplicados de forma individual durante las sesiones de hemodiálisis. Se verificó la relación entre los instrumentos además de posibles diferencias de promedio en función de las variables sociodemográficas. Los principales resultados indicaron correlaciones significativas de magnitudes moderadas a altas entre los instrumentos. También se observó que las mujeres y aquellos que reportaron tener diagnóstico de depresión obtuvieron puntuaciones más altas en la mayoría de las escalas presentando más sintomatología depresiva y pensamientos depresivos, así como ansiedad (AU.

Sintomatologia depressiva no termo da gestação, em mulheres de baixo risco / Depressive symptomatology at full-term pregnancy in low risk women

RESUMO Objetivos Calcular a prevalência de sintomatologia depressiva pré-natal em grávidas de baixo risco, no termo da gestação, avaliar seus preditores e desfechos materno-fetais. Para tal, avaliar-se-á a aplicabilidade da Escala de Rastreio de Depressão Pós-Parto (PDSS 24) nessa fase da gravidez. Métodos A PDSS 24 e um questionário sociodemográfico, psicossocial e médico (antecedentes obstétricos e patológicos) foram autoaplicados a 403 grávidas (37-40 semanas de gestação), com idade média de 30,5 anos (DP = 4,67). Por meio do processo clínico, foram recolhidos dados de resultados materno-fetais. Resultados A PDSS 24 possui propriedades psicométricas adequadas para a deteção de sintomatologia depressiva pré-natal. A prevalência de sintomatologia depressiva pré-natal foi de 41,7%. Grávidas com níveis de escolaridade inferiores, não casadas, cuja gravidez não foi planejada e com antecedentes de acontecimentos de vida significativos apresentam risco duas vezes superior de sintomatologia depressiva no período pré-natal. Grávidas cujo apoio social percebido ao longo da gravidez não correspondeu ao desejado e com história prévia de depressão apresentam cerca de três vezes maior risco sintomatologia depressiva no período pré-natal. Para desfechos materno-fetais (pré-eclâmpsia, restrição de crescimento fetal, Apgar 1º/5º minuto, tipo de parto, percentil de peso, oligoâminos e necessidade de cuidados intensivos), as diferenças foram não significativas. Conclusão O rastreio da depressão pré-natal deve ser realizado na gravidez. Porém, no termo da gestação o uso da PDSS 24 como ferramenta de deteção de sintomatologia depressiva deve ser feito com cautela. A elevada prevalência de sintomas relacionados com o sono nessa fase da gestação pode conduzir ao sobre diagnóstico, usando a PDSS 24.

ABSTRACT Objectives The aims of the study were to estimate the prevalence of depressive symptomatology in full-term pregnancy (low risk), evaluate their predictors and maternal-fetal outcomes. To this end, the applicability of Postpartum Depression Screening Scale (PDSS 24) will be evaluated, at full-term pregnancy. Methods PDSS 24 and a sociodemographic, psychosocial, pathological and obstetrical background questionnaire were self-administered to 403 pregnant women (37-40 weeks gestation), with a mean age of 30.5 years (SD = 4.67). Data from maternal, fetal and neonatal outcomes were collected from the patient clinical process. Results PDSS 24 revealed adequate psychometric properties to screening depressive symptomatology in full-term pregnancy. The prevalence of depressive symptomatology was 41.7%. Pregnant women with lower study levels, who weren't married, whose pregnancy was unplanned and with a previous history of significant life events present twice the risk to present depressive symptomatology. Pregnant women who hadn't received the desired social support in pregnancy and with a history of depression present about a 3-fold increased risk to present depressive symptomatology. For maternal-fetal outcomes (pre-eclampsia, fetal growth restriction, Apgar score at 1st/5th minute, type of delivery, weight percentile, oligohydramnios and need for neonatal intensive care), the differences were not significant. Conclusion Screening for prenatal depression should be conducted during pregnancy. However, in full-term pregnancy women, the use of PDSS 24 as a screening tool for depressive symptomatology should be done with caution. The high prevalence of sleep-related symptoms, in full-term pregnancy, may lead to overdiagnosis, using PDSS 24.

Evidências de estrutura interna da Escala Baptista de Depressão: Versão Idoso (EBADEP-ID) / Evidence of the internal structure of the Baptista Depression Scale: Elderly Version (EBADEP-ID)

O objetivo do presente estudo foi investigar propriedades psicométricas da Escala Baptista de Depressão-Versão Idoso (EBADEP-ID). Participaram da pesquisa 244 idosos do estado do Piauí, sem diagnóstico de depressão, com faixa etária variando de 60 a 96 anos (M= 68,85; DP= 9,19), sendo 67,9% do sexo feminino. Os principais resultados indicaram que dos 30 itens iniciais a escala foi reduzida para uma versão mais breve de 15 itens. A escala apresentou uma melhor adequação com uma solução de dois fatores, ambos apresentando valores adequados de alfa de Cronbach (F1: 0,90 e F2: 0,88). Por fim, conclui-se que a EBADEP-ID demonstrou evidências de validade de estrutura interna aceitáveis.

The objective of the present study was to investigate the psychometric properties of the Depression-Elderly Baptista Scale (EBADEP-ID). A total of 244 elderly people from the state of Piauí, with no diagnosis of depression, ranging in age from 60 to 96 years (M = 68.85, SD = 9.19), 67.9% of them female. The main results indicated that of the 30 initial items the scale was reduced to a shorter version of 15 items. The scale was better suited to a two-factor solution, both presenting adequate values of Cronbach’s alpha (F1: 0.90 and F2: 0.88). Finally, it is concluded that EBADEP-ID has demonstrated evidence of acceptable internal structure validity.

The association between substance use and depressive symptomatology in nursing university students in Mexico.

The present study represents an ex post facto non-experimental study of undergraduate nursing students (N = 1,176) residing in Mexico whereby we examined the association between substance use and depressive symptomatology. The sample was composed primarily of women (70.1%), between the ages of 18 and 23 years (89.5%). Outcomes suggest a significant association between current clinically relevant depressive symptomatology 3-month marijuana, alcohol, and sedative use. Additionally, current depressive symptomatology was significantly associated with lifetime alcohol and sedative use. Lastly, current depressive symptomatology was significantly associated with both moderate/high risk level due to alcohol and sedative use. The present study is innovative as it examines possible associations between depressive symptomatology and 10 classes of substances concurrently for a group that is largely understudied, further contributing to the international literature in this area. Findings are discussed with regards to study limitations.

Positive and Negative Affect Schedule (PANAS): Psychometric Properties and Discriminative Capacity in Several Chilean Samples.

We evaluated the factor structure, reliability, and discriminative capacity of the Positive and Negative Affect Schedule (PANAS) questionnaire in four different samples: two general adult populations (N = 1,548, N = 964), one adolescent population (N = 1,044), and young people with depressive symptomatology (N = 307). Exploratory factor analyses (EFAs) were performed with subsamples from Studies 1 (n = 773) and 2 (n = 527), finding that the two- and three-factor solutions had a good fit. In a confirmatory factor analysis, the two-factor solution resulted in an adequate fit in a second set of subsamples from both studies (n = 775, n = 517). In Study 3, we found good convergent and divergent validity with adequate and significant correlations found for depression (Beck's Depression Inventory), anxiety (State-Trait Anxiety Inventory), and neuroticism and extroversion (Big Five Inventory). In Study 4, the results of an EFA performed in a subsample (n = 154) found that the two- and three-factor solutions were appropriate with the former solution being confirmed in a second subsample (n = 153). Reliability was α = .85 for positive affect and α = .87 for negative affect. The PANAS questionnaire showed adequate indicators of validity and reliability in adult and adolescent populations as well as in a sample with depressive symptoms.

Depression and chronic kidney disease: an integrative literature review / Depressão e doença renal crônica: revisão integrativa da literatura / Depresión y enfermedad renal crónica: revisión integrativa de la literatura

Brazilian and international scientific studies on depression and chronic kidney disease published between 2006 and 2016 in the PsycINFO and LILACS databases were analyzed. In total, 269 publications were analyzed against the inclusion and exclusion criteria, so that 21 articles remained for analysis. The studies were evaluated for the year of publication, periodicals, objectives, sample, results, associated constructs, and instruments of depression. The prevalence of depressive symptoms varied from 7.8% to 83.49%. Also, most samples were small and included both sexes. The year with most publications was 2011, and the Beck Depression Inventory was used in 66.67% of the studies. It is important to evaluate depression using instruments that take into account the specificities of the context in order to reduce bias and to permit a correct identification of the depressive symptoms in this population.

Foram analisadas produções científicas nacionais e internacionais a respeito da depressão e da doença renal crônica entre os anos de 2006 e 2016, nas bases PsycINFO e LILACS. Analisaram-se 269 publicações, e, depois da adoção de critérios de inclusão e exclusão, restaram 21. Os estudos foram avaliados quanto a ano de publicação, periódicos, objetivos, amostra, resultados, construtos associados e instrumentos de depressão. Verificou-se que a prevalência de sintomatologia depressiva variou de 7,8% a 83,49%, além de grande parte das amostras ser de tamanho reduzido e incluir ambos os sexos. O ano com mais publicações foi 2011, e o Beck Depression Inventory foi utilizado em 66,67% dos estudos. É importante avaliar a depressão com instrumentos que levem em conta as especificidades do contexto, de forma a reduzir vieses e permitir a identificação correta da sintomatologia depressiva nessa população.

Se analizaron producciones científicas brasilenas e internacionales sobre la depresión y la enfermedad renal crónica entre los anos 2006 y 2016, en las bases PsycINFO y LILACS. 269 publicaciones fueron analizadas ante los criterios de inclusión y exclusión, restando 21 artículos para análisis. Los estudios fueron evaluados en cuanto al ano de publicación, periódicos, objetivos, muestra, resultados, constructos asociados e instrumentos de depresión. Se verificó que la prevalencia de sintomatologia depresiva varía de 7,8% a 83,49%, además de que gran parte de las muestras eran de tamano reducido e incluían ambos sexos. El ano con más publicaciones fue 2011 y el Beck Depression Inventory fue utilizado en el 66,67% de los estudios. Es importante evaluar la depresión con instrumentos que tengan en cuenta las especificidades del contexto para reducir sesgos y permitir la identificación correcta de la sintomatología depresiva en esa población.