ABSTRACT
OBJECTIVE: Post-stroke major depressive episode is very frequent, but underdiagnosed. Researchers have investigated major depressive episode symptomatology, which may increase its detection. This study was developed to identify the depressive symptoms that better differentiate post-stroke patients with major depressive episode from those without major depressive episode. METHOD: We screened 260 consecutive ischemic stroke patients admitted to the neurology clinic of a university hospital. Seventy-three patients were eligible and prospectively evaluated. We assessed the diagnosis of major depressive episode using the Structured Clinical Interview for DSM-IV and the profile of depressive symptoms using the 31-item version of the Hamilton Depression Rating Scale. For data analysis we used cluster analyses and logistic regression equations. RESULTS: Twenty-one (28.8%) patients had a major depressive episode. The odds ratio of being diagnosed with major depressive episode was 3.86; (95% CI, 1.23-12.04) for an increase of one unit in the cluster composed by the domains of fatigue/interest and retardation, and 2.39 (95% CI, 1.21-4.71) for an increase of one unit in the cluster composed by the domains of cognitive, accessory and anxiety symptoms. The domains of eating/weight and insomnia did not contribute for the major depressive episode diagnosis. CONCLUSION: The domains of retardation and interest/fatigue are the most relevant for the diagnosis of major depressive episode after stroke.
Subject(s)
Depressive Disorder, Major/diagnosis , Intellectual Disability/diagnosis , Mental Fatigue/diagnosis , Stroke/psychology , Adult , Aged , Cluster Analysis , Diagnosis, Differential , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Middle Aged , Prospective Studies , Psychiatric Status Rating Scales , Sex Factors , Young AdultABSTRACT
OBJECTIVE: Post-stroke major depressive episode is very frequent, but underdiagnosed. Researchers have investigated major depressive episode symptomatology, which may increase its detection. This study was developed to identify the depressive symptoms that better differentiate post-stroke patients with major depressive episode from those without major depressive episode. METHOD: We screened 260 consecutive ischemic stroke patients admitted to the neurology clinic of a university hospital. Seventy-three patients were eligible and prospectively evaluated. We assessed the diagnosis of major depressive episode using the Structured Clinical Interview for DSM-IV and the profile of depressive symptoms using the 31-item version of the Hamilton Depression Rating Scale. For data analysis we used cluster analyses and logistic regression equations. RESULTS: Twenty-one (28.8 percent) patients had a major depressive episode. The odds ratio of being diagnosed with major depressive episode was 3.86; (95 percent CI, 1.23-12.04) for an increase of one unit in the cluster composed by the domains of fatigue/interest and retardation, and 2.39 (95 percent CI, 1.21-4.71) for an increase of one unit in the cluster composed by the domains of cognitive, accessory and anxiety symptoms. The domains of eating/weight and insomnia did not contribute for the major depressive episode diagnosis. CONCLUSION: The domains of retardation and interest/fatigue are the most relevant for the diagnosis of major depressive episode after stroke.
OBJETIVO: O episódio depressivo maior após acidente vascular cerebral é muito frequente, mas é subdiagnosticado. Pesquisas têm investigado a sintomatologia do episódio depressivo maior pós-acidente vascular cerebral, o que pode facilitar sua identificação. Este estudo foi desenvolvido para identificar os sintomas depressivos que melhor diferenciam pacientes com episódio depressivo maior daqueles sem episódio depressivo maior após o acidente vascular cerebral. MÉTODO: Foram triados consecutivamente 260 pacientes com acidente vascular cerebral admitidos à enfermaria de neurologia de um hospital universitário, dos quais 73 pacientes foram acompanhados. Para investigar o diagnóstico de episódio depressivo maior foi utilizada a Entrevista Clinica Estruturada para DSM-IV e para a sintomatologia depressiva a Escala de Avaliação para Depressão de Hamilton, versão 31 itens. Para a análise dos dados foi utilizada a análise de clusters e regressão logística. RESULTADOS: Vinte e um (28,8 por cento) pacientes tiveram episódio depressivo maior. O odds ratio para o diagnóstico de episódio depressivo maior foi 3,86; (95 por cento IC, 1,23-12,04) para um aumento de uma unidade no cluster dos domínios interesse/fadiga e lentificação, e 2,39 (95 por cento IC, 1,21-4,71) para um aumento de uma unidade no cluster de domínios de sintomas cognitivos, acessórios e ansiedade. Os domínios apetite/peso e insônia não contribuíram para o diagnóstico de episódio depressivo maior. CONCLUSÃO: Os domínios de lentificação e interesse/fadiga são os mais relevantes para o diagnóstico do episódio depressivo maior após acidente vascular cerebral.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Depressive Disorder, Major/diagnosis , Mental Fatigue/diagnosis , Intellectual Disability/diagnosis , Stroke/psychology , Cluster Analysis , Diagnosis, Differential , Diagnostic and Statistical Manual of Mental Disorders , Prospective Studies , Psychiatric Status Rating Scales , Sex Factors , Young AdultABSTRACT
Este trabalho propõe padrão de aplicação e estudo normativo da Torre de Hanói (ToH) para população brasileira. Participaram 60 estudantes de 13 a 16 anos. Foram feitos treinos com 3 e 4 peças, 5 vezes cada um. Os resultados sugerem que houve efeito de aprendizagem, com queda do número de movimentos e do tempo. No primeiro treino com 4 peças, houve aumento dos movimentos e do tempo, que foi decrescendo com os treinos, sugerindo que aplicação repetida de ToH automatiza a resposta, requer uso do planejamento, da flexibilidade mental e busca de nova estratégia de sucesso. (AU)
This study proposes a standard application and normative data of Tower of Hanoi (ToH) for Brazilian population. 60 students, age 13 to 16, had participated. They did made trials with 3 and 4 pieces, 5 times each one. The results indicated that it had been learning effect, with the increase of number of movements and time. On the first trial with 4 pieces, it had been a time and movement increase, which was decreasing with the trials, suggesting that repeated application of ToH automatizes the response, and also requires planning, shifting and of new solution searching. (AU)
