Depression prevalence in adolescents.

INTRODUCTION: This study aimed to know the prevalence of depressive manifestations in adolescents and the sociodemographic variables associated with them. DESIGN: observational, descriptive, cross-sectional study. LOCATION: three urban teaching centers. PARTICIPANTS: 389 students of obligatory secondary education from 12 to 16 years who answered the questionnaire freely and anonymously. MEASUREMENTS: Questionnaire of Depression for Children (CDS), self-applicable, validated in their Spanish adaptation for their individual and collective administration. Family APGAR questionnaire. Variables regarding sociodemographic, academic yield and presence of chronic illnesses circumstances. RESULTS: 10 children were excluded because they answered in an incomplete way. In the 379 study subjects, 39 had a score on the CDS in the depressive range (decatype > or = 8): 10.29 % (95 % CI: 7.2 %-13.3 %). In the bivariate analysis, we only found differences for the presentation of depressive symptoms in connection with the existence of family dysfunction diagnosed by the APGAR test: 24.4 % versus 6.1 % (p < 0.0001). In the logistic regression analysis, the model that best predicts the presence of one diagnosis of depression includes the family dysfunction variable, with an OR = 4.27 (95 % CI: 1.98- 9.21) for mild dysfunction and OR = 14.44 (95 % CI: 4.61- 45.17) for serious dysfunction, and sibling number with OR 0.56 (95 % CI: 0.33-0.93). CONCLUSIONS: Prevalence of depressive manifestations among adolescents is high, being more frequent in members of dysfunctional families, while a greater number of siblings would have a protective effect.

[Detection of bulimia nervosa in primary health care consultations]. / Detección de bulimia nerviosa en las consultas de Atención Primaria.

INTRODUCTION: To estimate the prevalence of bulimia nervosa and bulimic behavior in women who come to Primary Health Care consultations, using the DSM-IV criteria. DESIGN: Descriptive, observational study Setting. Primary Health Care. PARTICIPANTS: Women over 14 years who come to general medicine consultations. Selection by systematic sampling of 175 women (proportion expected: 4%; confidence index: 95%; accuracy: 3%). MAIN MEASURES: Examination, by semi-structured interview, of diagnostic criteria of bulimia (recurrent binge eating, compensatory behaviors and excessive concern about weight or body image), socio-demographic variables and variables on morbidity (health problems according to CIPSAP-2-defined). RESULTS: Prevalence of bulimia was 5.3% (95% CI: 2.4-9.7), there being recurrent binge-eating in 23.4%. Among the compensatory behaviors, fasting (13.5%), intense exercise (8.2%) and self-induced vomiting (4.7%) were the most frequent. In women with bulimia, a background of anorexia and establishment of goals to lose weight appeared more frequently (p <0.05). Their average age was significantly lower (p <0.05) (31.2 14.7 SD). By logistic regression, the associated variables with the presence of bulimia were age (OR: 0.94), existence of previous psychiatric morbidity (OR: 9.0) and having previously set goals to lose weight (OR:7.3). CONCLUSIONS: In the women who came to the Primary Health Care consultations, prevalence of bulimia is greater than that described in the general female population. This disorder is more frequent in younger women and in those who present a background of psychiatric morbidity. Examination of the diagnostic criteria makes its detection easy in Primary Health Care consultations.

[Major depression in consumers of benzodiazepines]. / Depresión mayor en consumidores de benzodiacepinas.

OBJECTIVE: To determine the proportion of benzodiazepines consumers who present a mayor depressive disorder and to observe the clinical evolution after restoring an antidepressive treatment. DESIGN: An observational design with a transversal character to determine the prevalence of the depression and a pre and after intervention to observe the answer to the treatment. SETTING: Primary Care. PATIENTS: Patients of the Centro de Salud Zona IV of Albacete who consume benzodiazepines (size of the sample: 91 subjects, selected by means of a consecutive pattern in three medical offices of general practice). INTERVENTION: To install an antidepressive treatment. MEASUREMENTS AND MAIN RESULTS: We explored the presence of nuclear symptoms of depression by means of a interview. The other analyzed variables were: the cognitive state, the characteristics of the consume of benzodiazepines, the problems of health, the intake of other medicines, the frequentation, the installation of the antidepressive treatment and the sociodemographic characteristics. The patients diagnosed of mayor depression were interviewed again after one month and after three months. 37 patients presented criterion of mayor depression (40.7%) (CI 95%: 30.5-51.5). In these an antidepressive treatment was restored, corresponding to selective serotonin reuptake inhibitors in the 91.9% of the occasions. The proportion of depressive patients was higher in women (p = 0.04) and under the diagnosed people we observed a lower period of benzodiazepines consume (p = 0.02), although with a much higher daily consume (p = 0.01). Among the 37 patients who initiated the treatment, only 7 presented adverse reaction. 28 patients were appraised after one month, presenting 6 of them 5 or more nuclear symptoms of depression. CONCLUSIONS: The high proportion of mayor depressive frames can justify the systematic investigation of such disorder in benzodiazepines consumers, specially in women and in patients with a high intake. The identification of the nuclear symptoms can be considered as a useful technique to orientate a mayor depression and to evaluate also the results of an antidepressive treatment.

[Knowledge and use of contraceptive methods by the female population in a health-care district]. / Conocimiento y uso de métodos anticonceptivos por la población femenina de una zona de salud.

BACKGROUND: The use of contraceptives is related to factors including those of a demographic, social, economic, educational and ideological nature. The purpose of our study is that of ascertaining with what contraceptive methods the women of child-bearing age assigned to a given health care center are familiar, in addition to prevalence of the use thereof. METHODS: Based on the health care card listing, 389 of the 5800 women of child-bearing age (15-45 years old) assigned to the health care center in question were selected by means of a systematic sampling. After sending them a letter notifying them of the reason for this study, they were contacted by telephone to fill out the survey, which included questions regarding their knowledge and use of contraceptive methods, their sociocultural characteristics and sexual activity. Appointments at the health center were made with those women who did not have telephones. RESULTS: 178 women were contacted, 166 of whom took part in the survey (42.7% response rate). 86 of these women (51.8%; CI: 44.2-59.4%) were using some means of contraception. Nevertheless, among women at risk of unwanted pregnancies, the prevalence of use was 70.5% (CI: 62.4-78.6%), being worthy of special mention the fact that solely 45.4% of the women within the 40-45 age group were using contraceptives, revealing a frequency significantly lower than the other age groups. The methods known to the greatest degree were the condom (90.4%), oral contraceptives (89.2%) and the IUD (78.3%), the knowledge of other means being scant. CONCLUSIONS: The rate of use of contraceptive methods among women at risk of unwanted pregnancy is acceptable, although strikingly low among the women in the 40-45 age group. The methods known most were the condom, oral contraceptives and the intrauterine device.