Résumé
Introducción: Las urgencias psiquiátricas en la edad pediátrica constituyen un problema de salud pública. Objetivo: Describir las urgencias psiquiátricas y la conducta seguida, en el momento de su evaluación, en pacientes atendidos en consulta de urgencia. Métodos: Estudio observacional, descriptivo y transversal, en 340 pacientes examinados en el Hospital Pediátrico "Juan Manuel Márquez", de enero a abril de 2019. Se utilizó un instrumento validado en estudios anteriores y se realizó entrevista a pacientes y familiares. El procesamiento y análisis de los datos se realizó con el SPSS 21 y estadígrafos descriptivos. Para la comparación de frecuencias observadas y esperadas de una variable se empleó la prueba binomial, y la Ji-cuadrada, con una probabilidad de 0,5 por ciento. Resultados: El 53,8 por ciento de los pacientes declararon entre 15 y 19 años; 50,3 por ciento varones. El 61,2 por ciento presentaban antecedentes patológicos psiquiátricos y 40,3 por ciento procedía de medios familiares problemáticos. Entre los principales motivos de consulta destacaron la conducta suicida y el consumo de sustancias psicoactivas. El 25 por ciento de los pacientes requirió hospitalización, el resto se derivó a la atención ambulatoria. En más de 60 por ciento se utilizaron psicofármacos. Conclusiones: Predominaron en el estudio los adolescentes, masculinos, con antecedentes patológicos personales de enfermedad psiquiátrica, procedentes de medios familiares conflictivos, con diagnóstico de trastornos del comportamiento, conducta suicida, trastornos afectivos, psicosis y trastornos adictivos; entre estos últimos, se diagnosticó la patología dual. Solo la cuarta parte requirió hospitalización y en la mayoría se usaron psicofármacos (AU)
Introduction: Psychiatric emergencies in pediatric age constitute a public health problem. Objective: To describe the psychiatric emergencies and the behavior followed, at the time of their evaluation, in patients attended in an emergency consultation. Methods: Observational, descriptive and cross-sectional study in 340 patients examined at Juan Manuel Márquez Pediatric Hospital, from January to April 2019. An instrument validated in previous studies was used and interviews were conducted with patients and relatives. Data processing and analysis was performed with SPSS 21 and descriptive statistics were used. For the comparison of observed and expected frequencies of a variable, the binomial test and the Chi-square, with a probability of 0.5 percent were used. Results: 53.8 percent of patients were between 15 and 19 years old, and 50.3 percent were male. 61.2 percent had a psychiatric pathological history and 40.3 percent came from problematic family environments. Among the main reasons for consultation were suicidal behaviour and the consumption of psychoactive substances. 25 pecent of patients required hospitalization, the rest were referred to outpatient care. Psychotropic drugs were used in more than 60 percent. Conclusions: In the study predominated adolescents, males, with a personal pathological history of psychiatric illness, from conflictive family environments, diagnosed with behavioral disorders, suicidal behavior, affective disorders, psychosis and addictive disorders; among the latter, dual pathology was diagnosed. Only a quarter required hospitalization and most used psychotropic drugs(AU)
Sujets)
Humains , Mâle , Femelle , Enfant , Adolescent , Urgences/épidémiologie , Psychoanaleptiques/usage thérapeutique , Épidémiologie Descriptive , Études transversales , Trouble dépressif/épidémiologie , Idéation suicidaire , Étude d'observation , Soins ambulatoires/méthodes , HospitalisationRésumé
Introducción: La depresión es un trastorno del ánimo frecuente, cuya recurrencia altera su manejo y pronóstico. El objetivo del trabajo es describir la tasa de egreso hospitalario (TEH) por episodio depresivo recurrente (EDR) entre 2018-2021 en Chile, según sexo, edad y gravedad. Materiales y métodos: Estudio observacional y transversal que considera los egresos hospitalarios por EDR en el período 2018-2021 en Chile (N=1551). Se utilizaron las bases de datos del Departamento de Estadísticas e Información de Salud y el Instituto Nacional de Estadística. Las variables estudiadas fueron sexo, grupo etario y gravedad. No requirió aprobación de comité de ética. Resultados: Se observó la menor TEH en 2020 con 1,91 egresos por cada 100.000 habitantes. Las mujeres sobresalieron durante todo el período con una TEH de 3,68 egresos por cada 100.000 habitantes. Destacó el grupo de 15 a 19 años con la mayor TEH en ambos sexos con 5,3 egresos por cada 100.000 habitantes. Respecto a gravedad, las hospitalizaciones se concentraron en pacientes de diagnóstico no especificado. Discusión: La pandemia de COVID 19 podría explicar la disminución de la TEH en 2020, al reducirse el diagnóstico y hospitalización por EDR; presumiblemente debido al fenómeno de reconversión de camas. La TEH es mayor en el sexo femenino, lo cual es concordante con la literatura. El predominio del grupo de 15 a 19 años discrepa de la evidencia, la cual indica que suele concentrarse en individuos de 25 a 64 años. Conclusión: Las TEH por EDR se concentraron en mujeres jóvenes. Es relevante conocer la epidemiología local para focalizar los recursos en la detección oportuna de factores de riesgo, para evitar episodios graves y disminuir su recurrencia.
Introduction: Depression is a common mood disorder, whose recurrence alters its management and prognosis. The aim of the paper is to describe the hospital discharge rate (HED) for recurrent depressive episode (RDE) between 2018-2021 in Chile, according to sex, age and severity. Materials and methods: Observational and cross-sectional study considering hospital discharges due to DRE in the period 2018-2021 in Chile (N=1551). The databases of the Department of Health Statistics and Information and the National Institute of Statistics were used. The variables studied were sex, age group and severity. Ethics committee approval was not required. Results: The lowest HTE was observed in 2020 with 1.91 discharges per 100,000 inhabitants. Females stood out during the entire period with an HTE of 3.68 discharges per 100,000 population. The 15-19 years age group stood out with the highest HTE in both sexes with 5.3 admissions per 100,000 inhabitants. In terms of severity, hospitalizations were concentrated in patients with unspecified diagnosis. Discussion: The COVID 19 pandemic could explain the decrease in HTE in 2020, with a reduction in diagnosis and hospitalization for RDE, presumably due to the bed conversion phenomenon. HTE is higher in the female sex, which is consistent with the literature. The predominance of the 15 to 19 years age group disagrees with the evidence, which indicates that it tends to be concentrated in individuals aged 25 to 64 years. Conclusion: HTE due to DRE was concentrated in young women. It is important to know the local epidemiology in order to focus resources on the timely detection of risk factors to avoid serious episodes and reduce their recurrence.
Sujets)
Humains , Mâle , Femelle , Enfant , Adolescent , Adulte , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Jeune adulte , Trouble dépressif/épidémiologie , Service hospitalier de psychiatrie , Épidémiologie Descriptive , Hospitalisation/statistiques et données numériques , Service hospitalier des dossiers médicauxRésumé
Introducción: el Trastorno por Déficit de Atención con Hiperactividad, también conocido por sus siglas TDAH, es considerado como un trastorno del neurodesarrollo. Diversos estudios reportan que la persistencia de los síntomas durante la adultez se da en el 50-70% de niños con TDAH. Respecto del área académica, la literatura menciona que esta patología en la población universitaria oscila entre un 10 a 25% de estudiantes, en particular los de Medicina Humana. Materiales y métodos: estudio piloto con diseño Cross-sectional, para explorar las variables mencionadas en los estudiantes de todo el territorio peruano se agruparon los departamentos en cinco macro regiones, se utilizaron los cuestionarios ASRS V1.1 y DASS-21. Resultados: se contó muestra total de 250 participantes para la prueba piloto (50 por cada macro región), respecto del TDAH, 33,6% presentó resultados sugestivos. La prevalencia de trastornos del estado anímico fue del 81,6%, dentro de ellos la ansiedad fue más prevalente (70,4%), seguido por la depresión (62,8%) y el estrés (57,6%). Se encontró asociación entre el TDAH y los siguientes: trastorno anímico (PR=1,3 IC(95%) ), depresión (PR=1,51 IC(95%) ), ansiedad (PR=1,47 IC(95%) ) y estrés (PR=1,87 IC(95%) ). Conclusiones: el presente estudio piloto nos ha permitido probar satisfactoriamente el desempeño del instrumento y la técnica propuesta por el diseño metodológico en el estudio primario, confirmado con la obtención de cifras estimadas coherentes con lo descrito por la literatura, y confirmando la asociación entre las variables de interés.
Introduction: Attention Deficit Hyperactivity Disorder, also known by its acronym ADHD, is considered a neurodevelopmental disorder. Several studies report that the persistence of symptoms during adulthood occurs in 50-70% of children with ADHD. Regarding the academic area, the literature mentions that this pathology in the university population ranges from 10 to 25% of students, in particular those of human medicine. Materials and methods: pilot study with Cross-sectional design, to explore the variables mentioned in students from all over the Peruvian territory, the departments were grouped into 5 macro regions, the ASRS V1.1 and DASS-21 questionnaires were used. Results: a total sample of 250 participants was counted for the pilot test (50 for each macro region), regarding ADHD, 33.6% presented suggestive results. The prevalence of mood disorders was 81.6%, among them, anxiety was more prevalent (70.4%), followed by depression (62.8%) and stress (57.6%). An association was found between ADHD and the following: Mood disorder (PR=1.3 CI (95%) ). Depression (PR=1.51 CI (95%) ). Anxiety (PR=1.47 CI (95%) ). and Stress (PR=1.87 CI (95%) ). Conclusions: the present pilot study has allowed us to satisfactorily test the performance of the instrument and the technique proposed by the methodological design in the primary study, confirmed by obtaining estimated figures consistent with what is described in the literature, and confirming the association between the variables of interest.
Sujets)
Humains , Mâle , Femelle , Adolescent , Adulte , Jeune adulte , Trouble déficitaire de l'attention avec hyperactivité/psychologie , Trouble déficitaire de l'attention avec hyperactivité/épidémiologie , Étudiant médecine/psychologie , Troubles de l'humeur/épidémiologie , Troubles anxieux/épidémiologie , Pérou/épidémiologie , Échelles d'évaluation en psychiatrie , Stress psychologique/épidémiologie , Projets pilotes , Études transversales , Trouble dépressif/épidémiologieRésumé
ABSTRACT Purpose: Our goal was to analyze the prevalence of depression and anxiety among patients with glaucoma and to identify risk factors related to these disorders. Methods: A cross-sectional study was carried out between August 2016 and August 2017 at the Hospital das Clínicas of Universidade Estadual de Campinas and at the Hospital Oftalmológico de Brasília to evaluate the prevalence of depressive and anxiety disorders among patients diagnosed with glaucoma. All patients underwent a complete ophthalmologic examination with standard automated perimetry to confirm the diagnosis of glaucoma. All participants were asked to complete the Hospital Anxiety and Depression Scale questionnaire. Results: One hundred and twenty-nine patients were included in the study. Seventy-four were men (57.36%) and 55 (42.64%) were women. The mean age of the patients was 70.14 ± 15.8 years. Ninety participants were white (69.77%) and 38 (29.46%) were black. The study demonstrated a prevalence of depression and/or anxiety at 10.08%. Logistic regression revealed that women were at higher risk for anxiety and/or depression (OR: 5.25, p=0.015) and patients with a larger number of comorbidities also were at higher risk for anxiety and/or depressive disorders (OR: 2.82, p=0.038). Conclusion: A significant proportion of patients with glaucoma present with depression and/or anxiety. Females and patients with comorbidities are at greater risk for these disorders.
RESUMO Objetivo: Avaliar a prevalência de transtornos de depressão e ansiedade em pacientes com glaucoma e identificar fatores de riscos associados. Métodos: Estudo transversal em pacientes com glaucoma, avaliados durante Agosto de 2016 e Agosto de 2017 no Hospital das Clínicas da Universidade de Campinas e no Hospital Oftalmológico de Brasília. Todos pacientes foram submetidos à exame oftalmológico completo para confirmar o diagnóstico de glaucoma. Todos pacientes preencheram o questionário "Hospital Anxiety and Depression Scale". Resultados: Foram incluídos 129 pacientes no estudo, sendo 74 homens (57.36%) e 55 (42.64%) mulheres, 90 pacientes eram brancos (69.77%) e 38 (29.46%) eram negros. A idade média foi de 70.14 ± 15.8 anos. O estudo demonstrou uma prevalência de 10.08% de transtornos depressivo e/ou ansiedade. A regressão logística demonstrou que mulheres apresentam maior risco de desenvolver transtornos depressivos e/ou ansiedade (Risco relativo: 5.25, p=0.015), assim como pacientes com maior número de comorbidades clínicas (Risco relativo: 2.82, p=0.038). Conclusão: Uma proporção significativa dos pacientes com glaucoma podem apresentar transtornos de depressão e/ou ansiedade. Pacientes com glaucoma do sexo feminino e que apresentem maiores comorbidades clínicas apresentam maior risco de apresentar esses transtornos.
Sujets)
Humains , Mâle , Femelle , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Glaucome , Trouble dépressif , Anxiété/épidémiologie , Troubles anxieux/épidémiologie , Glaucome/complications , Glaucome/épidémiologie , Prévalence , Études transversales , Enquêtes et questionnaires , Dépression/étiologie , Dépression/épidémiologie , Trouble dépressif/épidémiologieRésumé
Abstract Introduction The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors. Objective To ascertain whether a cesarean birth mediates the impact of infant complications on the birth experience of adolescent mothers. Methods Using a secondary analysis of data collected from 303 postpartum adolescents previously evaluated for depression and post-traumatic stress, we employed counterfactual causal analysis to determine if delivery type mediated the birth experience at different levels of depression. Noted limitations pertain to methodological assumptions and computational feasibility as well as potential sample bias. Results We found that the mediating effect of delivery mode depended on the adolescent's depression level as well as on the specific operationalization of the birth experience. At low levels of depression, the odds of a negative birth appraisal were reduced by around 30% when operationalized as a single item subjective rating. In contrast, at high levels of depression, the odds of a negative birth experience increased by 80% when operationalized as an Impact of Event Scale (IES) subconstruct. Conclusion Depression level plays a pivotal role in moderating how delivery mode mediates the birth experience. The direction of impact also depends on how the birth experience is operationalized.
Sujets)
Adolescent , Adulte , Femelle , Humains , Grossesse , Jeune adulte , Grossesse de l'adolescente/statistiques et données numériques , Césarienne/psychologie , Césarienne/statistiques et données numériques , Trouble dépressif/épidémiologie , Traumatisme psychologique/épidémiologie , Causalité , Études longitudinales , Dépression du postpartum/épidémiologieRésumé
Abstract Objective To evaluate the prevalence of Internet addiction (IA) and its associated factors among students at an Educational Institution in Southern Brazil. Method This is a cross-sectional study, targeting a sample of students aged from 14 to 20 years. They were selected by random sampling to be representative of the 4038 students enrolled at the institute at the time. IA was assessed using the Internet Addiction Test (IAT). Screening for anxiety and/or depressive disorders was performed using the Well-Being Index (WHO-5). Results The prevalence of IA was 50.8% and the rate was higher among individuals who had screened positive for depressive or anxiety disorders than among those who had not (p = 0.003). There was an association between IA and access to certain types of content, such as gaming (p = 0.010), work and study related content (p = 0.030), and using the internet to access sexual content (p < 0.001). Conclusion Further studies are needed to confirm the high prevalence of IA and explore factors associated with it in samples with similar characteristics to ours. The associations between this dependency and positive screening for anxiety and/or depressive disorders and the types of content accessed are an alert to the existence of these important relationships and illustrate the importance of studying them further. Knowledge about these associations provides an opportunity to implement measures for prevention, such as psychoeducation, and to offer adequate treatment.
Sujets)
Adolescent , Adulte , Femelle , Humains , Mâle , Jeune adulte , Troubles anxieux/épidémiologie , Étudiants/statistiques et données numériques , Trouble dépressif/épidémiologie , Dépendance à Internet/épidémiologie , Établissements scolaires , Brésil/épidémiologie , Comorbidité , Prévalence , Études transversalesRésumé
La depresión y la obesidad son patologías altamente prevalentes y corresponden a los principales problemas de salud pública. Estas patologías tienen un gran impacto en la morbilidad y mortalidad de los pacientes y afectan la salud y el bienestar de quienes las padecen, así como también afectan en el aspecto socioeconómico consecuencia del deterioro funcional y el gasto de recursos en salud ocasionados. Resultados de estudios epidemiológicos, ensayos clínicos y meta-análisis apoyan la asociación entre los estados depresivos y la obesidad, ya que ambos ocurren conjuntamente en todas las razas de poblaciones evaluadas. El objetivo es abordar la evidencia con respecto a 4 aspectos: (1) obesidad y respuesta a los antidepresivos, (2) trastornos depresivos y su impacto sobre la progresión de la obesidad, (3) tratamiento de la obesidad y el impacto sobre los resultados entre pacientes con trastornos depresivos, (4) el tratamiento de los trastornos depresivos y su impacto sobre los resultados de la obesidad. La evidencia existente apoya la asociación entre obesidad y los resultados adversos para la salud en individuos con trastornos depresivos. Además, destaca el concepto que el tratamiento de una de las dos enfermedades (obesidad o trastornos depresivos) es relevante para mejorar el curso de la otra patología. Puede ser beneficioso explorar dirigidamente la presencia de un trastorno depresivo en sujetos con sobrepeso u obesidad, así como el aumento de peso en personas con depresión. Conocer el efecto de los fármacos antidepresivos sobre el peso corporal es también relevante para facilitar la adherencia al tratamiento en el largo plazo.
Depression and obesity are highly prevalent illness and a mayor public health concern. These diseases have a great impact on morbidity and mortality of patients and affect the health and well-being of those who suffer them, as well as being affected in the socioeconomic aspect as a result of the functional deterioration and the spending of resources. Results of epidemiological studies, clinical trials and meta-analysis support the association between mood disorders and obesity, since both occur together in all the populations evaluated. The objective is to address the evidence regarding four aspects: (1) obesity and response to antidepressants, (2) depressive disorders and their effect on the progression of obesity, (3) treatment of obesity and the effect on outcomes among patients with depressive disorders, (4) the treatment of depressive disorders and their effect on obesity outcomes. Existing evidence supports the association between obesity and adverse health outcomes in individuals with depressive disorders. In addition, it highlights the concept that the treatment of one of the two diseases (obesity or depressive disorders) is relevant to improve the course of the other disease. It may be beneficial to explore the presence of a depressive disorders in overweight or obese subjects, as well as weight gain in subjects with depression. Knowing the effect of antidepressant drugs on body weight is relevant to facilitate adherence to long-term treatment.
Sujets)
Humains , Trouble dépressif/psychologie , Trouble dépressif/épidémiologie , Obésité/psychologie , Obésité/épidémiologie , Poids , Indice de masse corporelle , Trouble dépressif/physiopathologie , Trouble dépressif/traitement médicamenteux , Surpoids , Antidépresseurs/usage thérapeutique , Obésité/physiopathologie , Obésité/thérapieRésumé
Objective: Depression has been associated with hepatitis C, as well as with its treatment with proinflammatory cytokines (i.e., interferon). The new direct-acting antiviral agents (DAAs) have minimal adverse effects and high potency, with a direct inhibitory effect on non-structural viral proteins. We studied the incidence and associated factors of depression in a real-life prospective cohort of chronic hepatitis C patients treated with the new DAAs. Methods: The sample was recruited from a cohort of 91 patients with hepatitis C, of both sexes, with advanced level of fibrosis and no HIV coinfection, consecutively enrolled during a 6-month period for DAA treatment; those euthymic at baseline (n=54) were selected. All were evaluated through the depression module of the Patient Health Questionnaire (PHQ-9-DSM-IV), at three time points: baseline, 4 weeks, and end-of-treatment. Results: The cumulative incidence (95%CI) of major depression and any depressive disorder during DAA treatment was 13% (6.4-24.4) and 46.3% (33.7-59.4), respectively. No differences were observed between those patients with and without cirrhosis or ribavirin treatment (p > 0.05). Risk factors for incident major depression during DAA treatment included family depression (relative risk 9.1 [1.62-51.1]), substance use disorder (11.0 [1.7-73.5]), and baseline PHQ-9 score (2.1 [1.1-3.1]). Conclusions: The findings of this study highlight the importance of screening for new depression among patients receiving new DAAs, and identify potential associated risk factors.
Sujets)
Humains , Mâle , Femelle , Adulte , Sujet âgé , Antiviraux/usage thérapeutique , Hépatite C/psychologie , Hépatite C/traitement médicamenteux , Trouble dépressif/épidémiologie , Échelles d'évaluation en psychiatrie , Ribavirine/usage thérapeutique , Espagne/épidémiologie , Facteurs temps , Modèles logistiques , Incidence , Études prospectives , Facteurs de risque , Résultat thérapeutique , Hépatite C/épidémiologie , Adulte d'âge moyenRésumé
Objective: to analyze the occurrence of leave of absence due to depression among workers. Method: census, descriptive-analytical study, with retrospective collection. Population composed of 2,267 workers on leave due to depression with data from the Unified Benefits Information System. The independent variables were: sex, age group, income; county, origin, number of leaves of absence and type of benefit. For data analysis, descriptive statistics were used and the chi-square and Fisher's exact tests were applied. The variables that presented a value of p≤0.20 were submitted to logistic regression. Results: there was a predominance of females, age ≥50 years, from the capital, with income of one to two minimum wages, urban origin and single removal. Single leaves of absence occurred mainly due to a mild depressive episode and the benefit granted to the significant majority was social security sickness benefit. Among those who were on leave of absence more than once, the main cause was recurrent depressive disorder, a current mild episode and, in terms of benefit, social security sickness benefit. There was a statistical association between total time and absence from work. In logistic regression, it was found that the time ≥60 days, was 3.1 times longer in recurrent depressive disorder. Conclusion: there were an expressive quantitative number of absences due to depression, in which it was observed, especially, that the absence time remained long.
Objetivo: analisar a ocorrência de afastamentos das atividades laborais motivados pela depressão. Método: estudo censitário, descritivo-analítico, com coleta retrospectiva. População composta por 2267 trabalhadores afastados por depressão com dados procedentes do Sistema Único de Informações de Benefícios. As variáveis independentes foram: sexo, faixa etária, renda, município, procedência, quantidade de afastamentos e tipo de benefício. Para a análise dos dados, utilizou-se a estatística descritiva e foram aplicados os testes qui-quadrado e exato de Fisher. As variáveis que apresentaram valor de p≤0,20 foram submetidas à regressão logística. Resultados: houve a predominância do sexo feminino, idade ≥50 anos, da capital, com renda de um a dois salários mínimos, procedência urbana e único afastamento. Os afastamentos únicos ocorreram, principalmente, por episódio depressivo leve e o benefício concedido para a expressiva maioria foi o auxílio-doença previdenciário. Entre os que se afastaram mais de uma vez, a principal causa foi o transtorno depressivo recorrente, episódio atual leve e, quanto ao benefício, foi o auxílio-doença previdenciário. Houve associação estatística entre o tempo total e os afastamentos ao trabalho. Na regressão logística, verificou-se que o tempo ≥60 dias foi 3,1 vezes maior no transtorno depressivo recorrente. Conclusão: verificou-se um quantitativo expressivo de ocorrência de afastamentos devido à depressão no qual se observou, especialmente, que o tempo de afastamento manteve-se longo.
Objetivo: analizar la ocurrencia de ausencias laborales por depresión. Método: estudio censal, descriptivo analítico, con recogida de datos retrospectiva. Población compuesta por 2267 trabajadores con ausencias laborales por depresión, con datos procedentes del Sistema Único de Informaciones de Beneficios. Las variables independientes fueron: sexo, intervalo etario, renta, municipio, procedencia, cantidad de licencias médicas y tipo de beneficio. Para el análisis de los datos, se utilizaron estadística descriptiva y se aplicaron las pruebas chi-cuadrado y exacta de Fisher. Las variables que presentaron valor de p≤0,20 fueron sometidas a regresión logística. Resultados: predominó el sexo femenino, edad ≥50 años, de la capital, renta de uno a dos salarios mínimos, procedencia urbana y única ausencia laboral.. Principalmente, las ausencias únicas ocurrieron por episodio depresivo leve y el beneficio, para la expresiva mayoría, fue el auxilio por enfermedad de la seguridad social. Entre los que obtuvieron licencias médicas más de una vez, la principal causa fue el trastorno depresivo recurrente, episodio actual leve; en cuanto al beneficio, el auxilio por enfermedad fue de la seguridad social. Hubo asociación estadística entre el tiempo total y las ausencias laborales.. En la regresión logística, se verificó que el tiempo ≥60 días fue 3,1 veces mayor en el trastorno depresivo recurrente. Conclusión: se verificó una cantidad expresiva de ocurrencia de ausencias, debido a la depresión, en la cual se observó, especialmente, que el tiempo de ausencia se mantuvo extenso.
Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Facteurs socioéconomiques , Modèles logistiques , Santé au travail , Congé maladie/statistiques et données numériques , Trouble dépressif/épidémiologie , AbsentéismeRésumé
ABSTRACT: Objective: Antidepressant use is increasing worldwide, but national data on psychotropic drug use by depressed patients in Brazil is lacking. Methodology: Between 2013 and 2014, a representative sample of urban adult individuals were asked if they had a diagnosis of chronic disease, had a medical indication for drug treatment, and were taking chronic medications at the time for each reported diagnosis. We analyzed the frequencies of reported depression and the medications related to this disease. Results: Overall, 6.1% of respondents reported depression. The prevalence increased with age - 9.5% among the elders - was higher among women (8.9%) and in the south of the country (8.9%). As a single disease, the prevalence of depression was higher among young people (17.6%). Among those with multimorbidity, the prevalence of depression rose to 25.7%. Of those who reported depression, 81.3% had medical indication for treatment and 90.3% were under treatment - this proportion was lower among young people (84.5%) and those living in the poorest region (78.6%). Antidepressants accounted for 47.2% of psychotropic drugs taken by respondents with depression, with regional differences - only 30% used antidepressants in the North. Polypharmacy was reported by 22% of those with depression and other chronic diseases. Conclusion: Depression in Brazil, is common among young adults as a single chronic disease and highly prevalent among people with chronic multimorbidity, especially the young. The treatment gap was larger among young people and in the less developed regions of the country.
RESUMO: Objetivo: O uso de antidepressivos está aumentando em todo o mundo, mas faltam dados nacionais sobre o uso de drogas psicotrópicas por pacientes deprimidos no Brasil. Metodologia: Entre 2013 e 2014, uma amostra representativa de indivíduos adultos urbanos foi questionada sobre a presença diagnóstica de doença crônica, a indicação médica para tratamento medicamentoso e o uso de medicamentos crônicos à época de cada diagnóstico relatado. Foram analisadas as frequências de depressão relatada e os medicamentos relacionados a essa doença. Resultados: No geral, 6,1% dos entrevistados relataram depressão. A prevalência aumentou com a idade (9,5% entre os idosos) foi maior entre as mulheres (8,9%) e no sul do país (8,9%). Como doença única, a prevalência de depressão foi maior entre os jovens (17,6%). Entre aqueles com multimorbidade, a prevalência de depressão subiu para 25,7%. Dos que relataram depressão, 81,3% tinham indicação médica para tratamento e 90,3% estavam em tratamento - essa proporção foi menor entre os jovens (84,5%) e os que moram na região mais pobre (78,6%). Os antidepressivos representaram 47,2% dos medicamentos psicotrópicos tomados pelos entrevistados com depressão, com diferenças regionais - apenas 30% usavam antidepressivos no Norte. Polifarmácia foi relatada por 22% das pessoas com depressão e outras doenças crônicas. Conclusão: A depressão no Brasil é comum entre adultos jovens como doença crônica única e altamente prevalente entre as pessoas com multimorbidade crônica, principalmente os jovens. A lacuna de tratamento foi maior entre os jovens e nas regiões menos desenvolvidas do país.
Sujets)
Humains , Mâle , Femelle , Adulte , Jeune adulte , Psychoanaleptiques/usage thérapeutique , Population urbaine/statistiques et données numériques , Trouble dépressif/traitement médicamenteux , Trouble dépressif/épidémiologie , Autorapport , Antidépresseurs/usage thérapeutique , Facteurs socioéconomiques , Brésil/épidémiologie , Études transversales , Répartition par sexe , Répartition par âge , Polypharmacie , Adulte d'âge moyenRésumé
Abstract Background: Rosacea may result in emotional distress and anxiety. However, data on the presence of generalized anxiety disorder in rosacea patients are scarce. Objective: The aim of the study was to detect the frequency and level of anxiety and depression in patients with rosacea. Methods: A total of 194 consecutive rosacea patients and 194 age- and sex-matched controls were enrolled. Severity of rosacea was assessed in patients according to the criteria of the National Rosacea Society Ethics Committee. Both patients and controls were evaluated by the Generalized Anxiety Disorder 7-item scale, and severity was measured by the Generalized Anxiety Disorder-Adult. Results: Individuals who were diagnosed with an anxiety and/or depressive disorder were more common in patient group (24.7% vs. 7.2%, p < 0,01). Female patients were particularly at risk for having generalized anxiety disorder (OR = 2.8; 95% CI 1.15-7.37; p = 0.02). Study limitations: Single center study and limited sample size. Conclusions: Rosacea patients show greater risk of having anxiety disorders, including generalized anxiety disorder. Female patients, those with lower educational levels, those with phymatous subtype, untreated patients, and patients with prior psychiatric morbidity may be at particular risk for anxiety. It is essential to consider the psychological characteristics of patients to improve their well-being.
Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Troubles anxieux/étiologie , Troubles anxieux/épidémiologie , Rosacée/complications , Rosacée/épidémiologie , Trouble dépressif/étiologie , Trouble dépressif/épidémiologie , Échelles d'évaluation en psychiatrie , Qualité de vie , Études cas-témoins , Modèles logistiques , Prévalence , Études transversales , Analyse de variance , Niveau d'instructionRésumé
Resumen: Objetivo: Identificar posibles cambios en la frecuencia de manifestaciones sindromáticas sugerentes de problemas de salud mental en población infantil mexicana empleando el Cuestionario Breve de Tamizaje y Diagnóstico (CBTD), a lo largo de 15 años. Material y métodos: Se analiza información de diferentes estudios en población general, escuelas y práctica médica. La estimación obtenida en la Ciudad de México fue utilizada como población de referencia para comparación. Resultados: Se apreciaron incrementos notables respecto a la prevalencia de síndromes como el déficit de atención e hiperactividad, y conducta oposicionista y explosiva, así como manifestaciones de ansiedad y depresivas. Estas últimas resultaron más frecuentes en la edad escolar tardía. Las alteraciones en el lenguaje y la epilepsia también mostraron incremento en diferentes grupos de edad. Conclusiones: Se discuten los hallazgos a la luz de estudios longitudinales en la literatura, así como de reportes de población adolescente en nuestro país.
Abstract: Objective: To identify possible changes in the frequency of psychopathological syndromes in Mexican children population over a 15-year period using the Brief Screening and Diagnostic Questionnaire (CBTD in Spanish). Materials and methods: Information gathered from different studies on the general population, schools and medical general practice are analyzed. Results from the Mexico City study were used as base rates for comparisons. Results: Higher prevalence of externalizing syndromes such as attention deficit and hyperactivity, oppositional and explosive conduct were very evident. Also, anxiety and depressive syndromes showed a notable increase. Prevalence of abnormal language and probable epilepsy were also increased on different age-groups. Conclusions: Findings are discussed in light of longitudinal reports in the literature as well as on reports in adolescent population in Mexico.
Sujets)
Humains , Mâle , Femelle , Enfant d'âge préscolaire , Enfant , Troubles anxieux/épidémiologie , Santé mentale , Troubles déficitaires de l'attention et du comportement perturbateur/épidémiologie , Trouble dépressif/épidémiologie , Priorités en santé , Trouble déficitaire de l'attention avec hyperactivité/épidémiologie , Prévalence , Enquêtes de santé/méthodes , Répartition par sexe , Trouble de la conduite/épidémiologie , Épilepsie/épidémiologie , Troubles du langage/épidémiologie , Mexique/épidémiologieRésumé
SUMMARY OBJECTIVE: This study aims to verify the association between risk factors for the onset of SUI and transobturator suburethral sling surgical treatment outcomes. PATIENTS AND METHODS: A retrospective study was conducted with 57 patients operated by the Pelvic Floor Surgery Service. Demographic data were compiled from the sample, the body mass index (BMI) was calculated, and the patients were divided according to the response to the surgical treatment. RESULTS: A total of 77.2% of the sample was cured or improved after surgical treatment. Out of the total sample, 75.4% of the women were postmenopausal, and 73.7% denied current or past smoking. The median age was 61 years, the median number of births was 4.0, the median BMI was 28.6 kg/m2, and 50.9% of the sample was classified as pre-obese. BMI, menopausal status, age, smoking, and sexual activity were not factors associated with the surgical outcome. However, parity equal to or greater than 5 was associated with worse postoperative results (p = 0.004). CONCLUSIONS: among risk factors associated with the emergence of SUI, only parity greater than 4 showed a negative impact on transobturator sling surgery outcomes.
RESUMO OBJETIVO: O estudo pretende verificar a associação entre fatores de risco relacionados ao surgimento da IUE com resultado do tratamento cirúrgico com sling suburetral transobturador. PACIENTES E MÉTODOS: Foi realizado estudo retrospectivo com 57 pacientes operadas pelo serviço de Cirurgia do Assoalho Pélvico da FMJ. Foram compilados dados demográficos da amostra, calculado o índice de massa corpórea (IMC) e as pacientes foram divididas de acordo com a resposta ao tratamento cirúrgico. RESULTADOS: 77,2% da amostra apresentou-se curada ou melhorada após o tratamento cirúrgico, 75,4% das mulheres se encontravam na pós-menopausa e 73,7% negaram tabagismo atual ou passado. A mediana de idade foi de 61 anos, a mediana do número de partos foi de 4,0 e a mediana do IMC foi de 28,6 kg/m2; 50,9% da amostra foi classificada como pré-obesa. O IMC, o status menopausal, a idade, o tabagismo e a manutenção da atividade sexual não foram fatores associados ao resultado cirúrgico. Porém, a paridade igual ou superior a 5 associou-se a piores resultados pós-operatórios (p=0,004). CONCLUSÕES: Entre os fatores de risco associados ao surgimento da IUE, apenas a paridade maior que 4 influenciou negativamente as taxas de melhora após cirurgia de sling transobturador.
Sujets)
Humains , Mâle , Femelle , Adulte , Sujet âgé , Troubles anxieux/complications , Troubles anxieux/épidémiologie , Soins de santé primaires/statistiques et données numériques , Maladies cardiovasculaires/psychologie , Maladies cardiovasculaires/épidémiologie , Trouble dépressif/complications , Trouble dépressif/épidémiologie , Facteurs socioéconomiques , Brésil/épidémiologie , Modèles logistiques , Prévalence , Études transversales , Facteurs de risque , Répartition par sexe , Répartition par âge , Statistique non paramétrique , Adulte d'âge moyenRésumé
SUMMARY BACKGROUND: Depression and anxiety disorders (DAD) are the most prevalent mental health conditions worldwide. Among the adult population served in basic care, it is estimated that depression affects about 14.3% of these individuals worldwide, and between 21.4% and 31% in Brasil. Anxiety affects up to 33.7% of the population during their lifetimes. OBJECTIVES: estimate the prevalence proportions of DAD among patients in a municipality in Northeast Brasil and study the association between DAD and cardiovascular risk factors. METHODS: a cross-sectional study with the medical records of patients from primary care centers in Jaboatão dos Guararapes, Pernambuco. Patients aged ≥ 18 years and regularly followed-up were included. Exclusion criteria: a history of traumatic brain injury, alcohol or drug abuse, previous stroke, medical conditions or medications that mimic DAD symptoms. Subjects were divided into two groups depending on the presence or absence of DAD, and cardiovascular risk factors were compared between groups. RESULTS: A total of 1030 subjects were initially included, of whom 215 (20%) were excluded. No-DAD subjects had more history of myocardial infarction and alcoholism. The prevalence of depression was 10.3%, anxiety disorder was 27.1%, and mixed DAD represented 4.5%. There was a significant association between DAD and hypertension (OR = 2.11; 95%CI: 1.16 -3.84; p=0.01), obesity (OR = 4.47; 95%CI: 1.74 -11.46; p=0.002), and hyperlipidemia (OR = 3.88; 95%CI: 1.81-8.3; p<0.001). CONCLUSION: DAD were associated with an increased risk for arterial hypertension, obesity, and hyperlipidemia.
RESUMO INTRODUÇÃO: Transtornos de ansiedade e depressão (TAD) são os distúrbios psiquiátricos mais comuns no mundo. Dentre a população adulta atendida na atenção básica, estima-se que a depressão afete cerca de 14,3% desses indivíduos mundialmente, podendo este valor ir de 21,4% a 31% no Brasil. A ansiedade afeta até 33,7% da população durante sua vida. OBJETIVO: Estimar a prevalência de TAD em pacientes da atenção primária em um município do Nordeste brasileiro e associar sua ocorrência com fatores de risco cardiovasculares. MÉTODOS: Um estudo de coorte transversal com análise de prontuário de pacientes atendidos em unidades de saúde da família de Jaboatão dos Guararapes, Pernambuco. Foram incluídos pacientes ≥18 anos e acompanhados regularmente. Critérios de exclusão: história de trauma crânio encefálico, abuso de álcool e drogas, acidente vascular cerebral prévio, doenças ou medicações que mimetizem sintomas de TAD. Os indivíduos foram divididos em dois grupos, a depender da presença ou não de TAD, e os fatores de risco cardiovascular foram comparados entre os grupos. RESULTADOS: De um total de 1.030 indivíduos recrutados, 215 (20%) foram excluídos. O grupo não TAD apresentou mais história de infarto do miocárdio e etilismo. A prevalência de depressão foi de 10,3%, a de ansiedade foi de 27,1% e a associação entre os dois foi de 4,5%. Houve associação significativa entre TAD e hipertensão (OR = 2,11; IC95: 1,16-3,84; p=0,01), obesidade (OR = 4,47; IC95%: 1,74-11,46; p=0,002) e dislipidemia (OR = 3,88; IC95%: 1,81-8,3; p<0,001). CONCLUSÃO: TAD estão associados com maior risco de hipertensão arterial, obesidade e dislipidemia.
Sujets)
Humains , Mâle , Femelle , Adulte , Sujet âgé , Troubles anxieux/complications , Troubles anxieux/épidémiologie , Soins de santé primaires/statistiques et données numériques , Maladies cardiovasculaires/psychologie , Maladies cardiovasculaires/épidémiologie , Trouble dépressif/complications , Trouble dépressif/épidémiologie , Facteurs socioéconomiques , Brésil/épidémiologie , Modèles logistiques , Prévalence , Études transversales , Facteurs de risque , Répartition par sexe , Répartition par âge , Statistique non paramétrique , Adulte d'âge moyenRésumé
Abstract This study investigates the suicidal ideation and the possible causes for suicidal behaviour in the elderly. Subjects were 150 patients aged 65 and older who were evaluated using the sociodemographic data collection forms, Geriatric Depression Scale (GDS), Suicidal Ideation Scale (SIS), Reasons for Living Inventory (RLI), and Beck Hopelessness Scale (BHS). Of 150 patients, 72.7% were women and 27.3% were men, ages ranged from 65 to 88 years. Suicidal ideation was noted in 30.7% of patients. When the mean of BHS total score between patients with and without suicidal ideation and the mean of BHS subscale's feelings and expectations regarding the future and loss of motivation and hope in terms of subscales were evaluated between the groups with and without suicidal ideation, the scores had a significant difference. When RLI was evaluated in terms of total scores, the suicidal ideation mean score was 243.74 ± 32.28, while the non-suicidal ideation mean score was 267.27 ± 24.36. There was a significant relationship between the two groups. We found low level of education, low level of reasons for living and higher psychiatric morbidity (generalized anxiety disorder and comorbid depressive disorder) in with suicidal ideation in the elderly.
Resumo Este estudo tem por objetivo investigar os fatores que levam à ideação suicida e às possíveis causas para o comportamento suicida em idosos. Foram estudados 150 pacientes com idade igual ou superior a 65 anos, que foram avaliados utilizando os formulários de coleta de dados sociodemográficos, Escala de Depressão Geriátrica (EDG), Escala de Ideação Suicida (EIS), Inventário de Razões para Viver (IRV) e Escala de Desesperança de Beck (EDB). De 150 pacientes, 72,7% eram mulheres e 27,3% homens , com idades de 65 a 88 anos. A ideação suicida foi observada em 30,7% dos pacientes . Ao se avaliar a média da pontuação total de EBD entre pacientes com e sem ideação suicida e a média dos sentimentos e expectativas da subescala EBD em relação ao futuro e perda de motivação e esperança em termos de subescalas entre os grupos com e sem ideação suicida, a pontuação teve uma diferença significativa. Quando o IRV foi avaliado em termos de pontuações totais, o escore médio de ideação suicida foi de 243,74 ± 32,28, enquanto o escore médio de ideação não suicida foi de 267,27 ± 24,36. Houve uma relação significativa entre os dois grupos. Fatores de risco para ideação suicida em idosos foram desesperança, baixo nível de educação, baixo nível de razões para viver, distúrbio de ansiedade generalizada e transtorno depressivo comórbido.
Sujets)
Humains , Mâle , Femelle , Sujet âgé , Sujet âgé de 80 ans ou plus , Troubles anxieux/épidémiologie , Suicide/psychologie , Trouble dépressif/épidémiologie , Idéation suicidaire , Échelles d'évaluation en psychiatrie , Turquie , Études transversalesRésumé
Introduction: Among the most ordinary clinical manifestations of Multiple Sclerosis (MS) are depression and the presence of Lower Urinary Tract Symptoms (LUTS). Both can compromise a person's quality of life. The objective of this research was to identify the major urinary symptoms and correlate them with quality of life and with depressive symptoms in women with MS. Methods: This was an observatory, descriptive and correlational study, with nonprobabilistic sampling by convenience. This research included women over 18 years old who displayed LUT symptoms and who had been diagnosed with Relapsing-Remitting MS. Assessment consisted of an anamnesis card, the Kurtzke Expanded Disability Status Scale (EDSS), the Incontinence Impact Questionnaire-7 (IIQ-7-BR), the Urogenital Distress Inventory-6 (UDI-6-BR), the Beck Depression Inventory-2 (BDI-II) and the Multiple Sclerosis Quality of Life Questionnaire - Portuguese version (MSQOL-54). Results: 41 women participated in the study, with average age of 50.1 (± 9.45) and average of 4.11 in the EDSS. The most common urinary symptom was urinary urgency (78%). There was no correlation between the severity of the urinary symptom and quality of life. Moderate and significant negative correlation (r = -0.561 p < 0.001) was found between depression and the physical component of quality of life and strong negative correlation (r = -0.729 p < 0.001) was found between depression and the mental component. Conclusions: The most prevalent urinary symptom was urinary urgency. A strong correlation was found between symptoms of depression and quality of life and there was no correlation between urinary symptoms and quality of life.
Sujets)
Humains , Femelle , Adulte , Adulte d'âge moyen , Qualité de vie , Sclérose en plaques/épidémiologie , Trouble dépressif/épidémiologie , Symptômes de l'appareil urinaire inférieur/épidémiologieRésumé
Objectives: To study the prevalence of psychiatric disorders in adolescents with and without type 1 diabetes, the factors associated with its presence, and to test the reliability of a screening tool for use in clinical settings. Methods: Eighty-one adolescents were enrolled in this case-control study, including 36 diabetic participants and 45 controls. Clinical and sociodemographic data were collected and psychiatric symptoms and diagnoses were obtained from adolescents and their parents using a screening tool (Strengths & Difficulties Questionnaire) and a semi-structured interview (Development and Well-Being Assessment). Results: Psychiatric disorders were identified in 22.2% of the sample (30.56% among diabetic adolescents vs. 15.56% of controls: OR = 2.39, 95%CI 0.82-6.99; p = 0.11). Overweight (body mass index percentile ≥ 85) was the only factor associated with psychiatric disorder (OR = 3.07; 95%CI 1.03-9.14; p = 0.04). Compared to the semi-structured interview, the screening instrument showed 80% sensitivity, 96% specificity, 88.9% positive predictive value and 92.3% negative predictive value for the presence of psychiatric diagnoses in adolescents. Conclusion: Psychiatric morbidity was high in this sample of adolescents, especially among those with diabetes. Routine use of the Strengths and Difficulties Questionnaire can help with early detection of psychiatric disorders in this at-risk group.
Sujets)
Humains , Mâle , Femelle , Enfant , Adolescent , Dépistage de masse/méthodes , Diabète de type 1/psychologie , Troubles mentaux/épidémiologie , Troubles anxieux/diagnostic , Troubles anxieux/épidémiologie , Facteurs socioéconomiques , Brésil/épidémiologie , Études cas-témoins , Dépistage de masse/psychologie , Prévalence , Enquêtes et questionnaires , Trouble dépressif/diagnostic , Trouble dépressif/épidémiologie , Entretien psychologique , Troubles mentaux/psychologieRésumé
Post-stroke depression (PSD) is a very common complication that leads to increased physical disability, poor functional outcome, and higher mortality. Therefore, early detection and treatment are very important. Since there are currently no specific guidelines for this disorder in China, the purpose of this study was to develop PSD guidelines and provide suggestions for clinicians and related workers.
Sujets)
Humains , Accident vasculaire cérébral/psychologie , Trouble dépressif/diagnostic , Trouble dépressif/thérapie , Psychothérapie , Facteurs temps , Indice de gravité de la maladie , Chine/épidémiologie , Facteurs de risque , Guides de bonnes pratiques cliniques comme sujet , Survivants/psychologie , Dépression/étiologie , Trouble dépressif/traitement médicamenteux , Trouble dépressif/épidémiologie , Autorapport , Réadaptation après un accident vasculaire cérébral/normes , Antidépresseurs/usage thérapeutiqueRésumé
Objective: to assess the characteristics associated withtemporomandibular disorders (TMD) and their impacton oral health-related quality of life (OHRQoL) of institutionalizedelderly people. Subjects and method: itwas a cross-sectional study performed in 30 private institutionsfor the elderly. The data collected included theTMD questionnaire and clinical evaluation assessed bythe Research Diagnostic Criteria/TemporomandibularDisorders (RDC/TMD), as well as the OHIP-49 questionnairefor OHRQoL. Results: twenty-four institutionsaccepted to participate in the study (n = 375 with 133fit for answering both questionnaires). Considering thecharacteristics, tinnitus was the most frequent symptomreported, while 98.5% of the research participants didnot present myofascial pain. Disc displacement wasobserved in 26.3%, while 93% of individuals did notpresent chronic pain. Severe depression was found in23.3% of the elderly with 24.1% presenting moderatelevels of non-specific physical symptoms, includingpain. Poisson regression analysis showed that the characteristicsreported were associated with a negativeimpact on OHRQoL. Conclusion: the domain-specificanalysis showed that all domains were affected negativelyby TMD characteristics and higher levels of depressionare associated with a negative impact on OHRQoL. (AU)
Objetivo: avaliar as características associadas às disfunções temporomandibulares (DTM) e seu impacto na qualidade de vida relacionada a saúde bucal (OHRQoL) em idosos institucionalizados. Sujeitos e método: este foi um estudo transversal, realizado em trinta instituições privadas de idosos. Os dados coletados incluíram um questionário e uma avaliação clínica de DTM por meio do instrumento Research Diagnostic Criteria/ Temporomandibular Disorders (RDC/TMD) e do questionário OHIP 49 para OHRQoL. Resultados: vinte e quatro instituições autorizaram a realização do estudo, (n = 375 com 133 idosos aptos a responder ambos os questionários). Dentre as características, o agravo mais frequentemente relatado foi a ocorrência de zumbido no ouvido, enquanto 98,5% dos participantes da pesquisa não apresentaram dor miofascial. Deslocamento de disco foi observado em 26,3%, enquanto 93% dos indivíduos não apresentaram dor crônica. Depressão severa foi encontrada em 23,3% dos idosos avaliados, com 24,1% apresentando grau moderado de sintomas físicos não específicos, incluindo dor. Análise da regressão de Poisson apresentou que as características relatadas estiveram associadas a impacto negativo na qualidade de vida relacionada à saúde bucal. Conclusão: realizando a análise por domínios, todos os domínios foram negativamente afetados pelas características da DTM, e os níveis maiores de depressão estão associados a um impacto negativo na OHRQoL. (AU)