Common mental disorders among civil aviation flight attendants.

INTRODUCTION: The purpose of the current study was to estimate the prevalence of common mental disorders (CMDs) among Brazilian civil aviation flight attendants and to investigate associations between CMDs and sociodemographic and work-related variables. METHODS: This was a quantitative cross-sectional study conducted between October 2009-October 2010 using a self-reporting questionnaire about sociodemographic and work-related data and a screening instrument for the detection of psychiatric morbidity. RESULTS: A total of 453 flight attendants were evaluated. The prevalence of CMDs was found to be 29.8% (N = 135/453; 95% CI 25.7-34.10%). Female flight attendants presented higher prevalence (36.0%) than male flight attendants (19.7%). The prevalence among individuals who had completed their training more than 5 yr earlier was 35.7% versus 19.2% among those who had qualified less than 5 yr earlier. In the final adjusted model, only the following variables maintained a statistically significant association: sex (OR 2.83); regular physical activity practice (OR 1.68); time since completion of training (OR 2.56); involvement with religious belief (OR 1.66); and type of flight route (OR 1.71). DISCUSSION: Flight attendants are subjected to stressful situations determined both by specific occupational risks and by the form of work organization. Studies with civil aviation pilots found lower values for CMD prevalence (6.7%). This shows that although both categories are classified as aircrew members and share various similarities of occupational risks, they are also, at the same time, profoundly different regarding their professional profiles.

Common mental disorders among civil aviation pilots.

INTRODUCTION: The purpose of this study was to estimate the prevalence of suspected cases of common mental disorders (CMD) on Brazilian civil aviation pilots and to investigate associations between CMD, demographics, and labor variables. METHODS: A quantitative cross-sectional study was conducted on 807 working pilots between October 2009 and October 2010 using a self-administered questionnaire to obtain sociodemographic data and information about workload. CMD prevalence was estimated with the Self-Reporting Questionnaire-20 items (SRQ-20). Multiple logistic regression was used in statistical data analyses. RESULTS: The overall prevalence of CMD was 6.7% with the cutoff point of 8 used in this study, i.e., scores greater than or equal to 8 in SRQ-20 define positive cases. Using alternative cutoffs, the prevalence was 9.2% (cut off point 7) or 12% (cutoff point 6). Among the individuals who did not exercise, 10.2% presented suspected CMD. Among those with a heavy workload, 23.7% presented scores indicating suspected CMD. Only variables relating to workload and the practice of physical activity were significantly correlated with the estimate of CMD after multivariate analysis. Regular physical exercise afforded a possible protective effect against suspected cases of CMD, while there was a higher prevalence of suspected cases among subjects with heavy workloads. DISCUSSION: The inclusion of the topic of mental health among the targets and priorities of civil aviation in Brazil is imperative. Addressing issues such as the regular practice of physical activity and workload can contribute to achieving a better balance between flight safety and productivity.

[Psychotic syndrome developing into dementia as a clinical manifestation of mitochondrial DNA deletion]. / Síndrome psicótica evoluindo com demência como manifestação clinica de deleção do DNA mitocondrial.

The manifestations of mitochondrial disease are variable, affecting more frequently the organs with high aerobic metabolism in which they are more abundant, for example the nervous system. The beginning of symptoms in general is observed at childhood, but some patients presented on adult age. We present an atypical case associated with mitochondrial DNA deletion. A 39-years-old man with psychiatric symptoms that configured initial clinical picture and only after 12 years of the beginning of symptoms neurological alterations became noticeable. The diagnosis of mitochondrial illness was confirmed by muscle biopsy being documented mitochondrial DNA deletion.

[Psychosocial aspects of work and commonmental disorders among civil aviation pilots.] / Aspectos psicossociais do trabalho e transtornos mentais comuns em pilotos civis.

This study aimed to investigate associations between psychosocial aspects of work and prevalence of common mental disorders (CMD) among Brazilian civil aviation pilots. This was a quantitative cross-sectional study using the self-administered Job Content Questionnaire (JCQ) and Self-Reporting Questionnaire (SRQ-20). A total of 778 pilots answered the questionnaires. Multiple logistic regression showed a strong association with highly demanding work and prevalence of CMD, compared to pilots with less demanding work as the reference group (adjusted OR = 29.0). In the final adjusted model, only variables related to workload and physical activity maintained statistically significant associations. The expected CMD prevalence in pilots with highly demanding work, heavy workload, and no regular physical exercise was 39.7%, compared to the subgroup with less demanding work, regular physical exercise, and light workload, which showed an expected prevalence of 0.4%. Working conditions can be considered potential contributing factors to CMD, with probable impact on flight safety.

Aspectos psicossociais do trabalho e transtornos mentais comuns em pilotos civis / Psychosocial aspects of work and commonmental disorders among civil aviation pilots / Aspectos psicosociales del trabajo ytrastornos mentales comunes en pilotos civiles

O objetivo foi investigar a associação entre aspectos psicossociais do trabalho e prevalência de transtornos mentais comuns (TMC) em pilotos da aviação civil brasileira. Estudo transversal quantitativo utilizando os instrumentos de autopreenchimento Job Content Questionnaire (JCQ) e Self-Reporting Questionnaire (SRQ-20). Foram avaliados 778 pilotos. No modelo de regressão logística múltipla se observa forte associação entre alta exigência e prevalência de TMC, quando comparada com baixa exigência, definida como referência (OR ajustado = 29,0). No modelo ajustado final permaneceram estatisticamente associadas às variáveis carga de trabalho e prática regular de exercício físico. A prevalência esperada de TMC nos pilotos do subgrupo de alta exigência, com carga pesada de trabalho e que não realizavam exercícios físicos, foi de 39,7%, enquanto que para os indivíduos de baixa exigência, que praticam exercícios e têm carga leve de trabalho foi de 0,4%. As condições de trabalho podem ser consideradas como potenciais fatores contribuintes para o surgimento de TMC, com provável impacto na segurança de voo.

This study aimed to investigate associations between psychosocial aspects of work and prevalence of common mental disorders (CMD) among Brazilian civil aviation pilots. This was a quantitative cross-sectional study using the self-administered Job Content Questionnaire (JCQ) and Self-Reporting Questionnaire (SRQ-20). A total of 778 pilots answered the questionnaires. Multiple logistic regression showed a strong association with highly demanding work and prevalence of CMD, compared to pilots with less demanding work as the reference group (adjusted OR = 29.0). In the final adjusted model, only variables related to workload and physical activity maintained statistically significant associations. The expected CMD prevalence in pilots with highly demanding work, heavy workload, and no regular physical exercise was 39.7%, compared to the subgroup with less demanding work, regular physical exercise, and light workload, which showed an expected prevalence of 0.4%. Working conditions can be considered potential contributing factors to CMD, with probable impact on flight safety.

El objetivo fue investigar la asociación entre los factores psicosociales en el trabajo y la prevalencia de trastornos mentales comunes (TMC), en los pilotos de aviación civil brasileños. Estudio transversal con instrumentos cuantitativos Job Content Questionnaire (JCQ) y Self-Reporting Questionnaire (SRQ-20). Se evaluaron 778 pilotos. En el modelo de regresión logística múltiple se observó una fuerte asociación entre la alta demanda y TMC, en comparación con los de baja, que se define como referencia (OR ajustada = 29,0). En las variables del modelo ajustado final se mantuvo estadísticamente asociada la carga de trabajo y la práctica de ejercicio físico regular. La prevalencia esperada de TMC en el subgrupo de alta demanda, con gran carga de trabajo y sin ejercicio físico con regularidad fue del 39,7%, mientras que para las personas de baja demanda, deportistas y con carga ligera de trabajo fue del 0,4%. Las condiciones de trabajo pueden ser considerados como posibles factores que contribuyen a la aparición de TMC, con posibles repercusiones en la seguridad del vuelo.

Síndrome psicótica evoluindo com demência como manifestação clinica de deleção do DNA mitocondrial / Psycothic syndrome developing into dementia as a clinical manifestation of mitochondrial DNA deletion

As manifestações das doenças mitocondriais são variadas, acometendo, mais freqüentemente, órgãos com alto metabolismo aeróbico em que são mais abundantes, como, por exemplo, o sistema nervoso. O início dos sintomas em geral é observado na infância havendo relatos de início na idade adulta. Apresentamos caso atípico de doença mitocondrial associada à deleção do DNA mitocondrial em um homem de 39 anos com sintomas psiquiátricos configuraram quadro clínico inicial e somente 12 anos após o início dos sintomas surgiram alterações neurológicas. O diagnóstico da doença mitocondrial foi confirmado por biópsia de músculo sendo documentada deleção do DNA mitocondrial.

The manifestations of mitochondrial disease are variable, affecting more frequently the organs with high aerobic metabolism in which they are more abundant, for example the nervous system. The beginning of symptoms in general is observed at chilhood, but some patients presented on adult age. We present an atypical case associated with mitochondrial DNA deletion. A 39-years-old man with psychiatric symptoms that configured initial clinical picture and only after 12 years of the beginning of symptoms neurological alterations became noticeable. The diagnosis of mitochondrial illness was confirmed by muscle biopsy being documented mitochondrial DNA deletion.

Síndrome de Burnout em cuidados paliativos / Burnout Syndrome in palliative care

A Síndrome de Burnout é considerada atualmente um importante problema psicossosial que afeta profissionais de diversas áreas. Ela ocorre em função da cronificação do estresse laborativo e traz consigo efeitos negativos nos níveis individual, profissional, familiar e social. A equipe de saúde que trabalha em unidade de cuidados paliativos acompanhando pacientes terminais é considerada grupo de risco para desenvolvimento da síndrome de burnout. A vulnerabilidade na unidade de cuidados paliativos exacerbada porque profissionais se envolvem e investem nos pacientes e são constantemente expostos a experiências de perda e percepção de sua própria mortalidade.