ABSTRACT
Background: the aim of this study is to understand the diagnostic process undertaken by psychiatrists and psychologists regarding adjustment disorder (AD) in their clinical practice and how they differentiate it from major depressive episode (MDE).Methods: A hermeneutic study using grounded theory techniques was carried out. Semi-structured interviews were conducted with twelve psychiatrists and eight psychologists in Colombia, and transcribed verbatim. Initial line-by-line coding was performed, followed by focused and axial coding to construct categories explaining the professionals' reasoning process.Results: The clinical reasoning of professionals regarding AD was understood through four major categories. (1) Difficulty in addressing the experience of stressful events, as there is a risk of pathologizing and medicalizing them. (2) Mental health diagnoses are necessary but not apodictic. (3) The diagnostic category of AD allows for the description of a fluctuating depressive and anxious syndrome occurring in reaction to a stressful event, whose abnormality criteria are based on intersubjective knowledge of the patient's life history and consequential reasoning regarding the need for professional support. (4) The AD label could potentially protect against overdiagnosis of MDE and overuse of antidepressants. Many clinicians in their practice thus subordinate the diagnosis of MDE to ensuring it is not AD, contrary to what is outlined in diagnostic manuals.Conclusion: This study allowed us to understand the clinical reasoning of psychiatrists and psychologists about AD as a diagnosis that inherently indicates the need to work on coping and intervene in the stressor and should be considered as a diagnostic possibility in the same hierarchy as MDE in reactive syndromes, rather than a residual category.
Clinicians use consequential and intersubjective reasoning to diagnose Adjustment Disorder (AD).Systemic pressures lead to overdiagnosis of Major Depressive Episode (MDE) and excessive antidepressant use.AD should be recognized as a valid non-residual diagnostic category.
Subject(s)
Adjustment Disorders , Clinical Reasoning , Grounded Theory , Psychiatry , Humans , Female , Adjustment Disorders/diagnosis , Adjustment Disorders/psychology , Male , Adult , Depressive Disorder, Major/diagnosis , Psychology , Colombia , Middle Aged , Qualitative Research , Interviews as Topic , Diagnosis, Differential , PsychiatristsABSTRACT
INTRODUCTION: Major depressive disorder is related to unfavourable outcomes in patients with severe comorbidities. In transplant patients, major depression is associated with worse clinical outcomes. CASE REPORT: We present the case of a 55-year-old man with a heart transplant due to heart failure of ischaemic origin. Six months after the transplant he developed depressed mood, anhedonia and suicidal ideation with a score of 20/27 on the PHQ-9 depression screening scale. After receiving mirtazapine 30â¯mg/night for a week and persisting with a high suicide risk, it was decided to administer ketamine infusion for 24â¯h, with which a significant improvement in mood was observed, and the disappearance of suicidal ideation 24â¯h after the infusion. DISCUSSION: Depression in transplant patients is a factor associated with graft loss and post-transplant mortality, in addition to favouring other negative outcomes such as deep vein thrombosis. CONCLUSIONS: Ketamine infusion was shown to be an effective and safe option to treat major depression with suicidal risk in a heart transplant patient.
ABSTRACT
Experimentar ansiedad frente a exámenes desencadena una respuesta emocional acompañada de cambios fisiológicos que el estudiante siente ante una situación percibida como amenazante, específicamente ante una evaluación, examen escrito u oral; actualmente, se la cataloga dentro de las fobias específicas. El individuo que busca evitar o eludir dicho escenario cae en la conducta de procrastinación. Esto afecta su rendimiento académico y acarrea consecuencias graves de salud mental, el estudiante comienza a percibirse afectado en su autovalia, autoestima y en su ambiente social, que muchas veces lo lleva a contraer trastorno depresivo e ideación suicida. El presente artículo es un estudio de revisión bibliográfica y su objetivo fue describir la experiencia de la. ansiedad frente a exámenes como fobia específica situacional, las consecuencias de dicho padecimiento, su comorbilidad con otros trastornos psicológicos y los tratamientos disponibles. Fueron analizados y comparados unos 26 artículos científicos, basados en ensayos controlados de manera aleatoria, otros son estudios controlados de caso único, publicados en importantes revistas electrónicas de impacto. La búsqueda se realizó utilizando las palabras clave. Como conclusión, se destacó la importancia del conocimiento de esta patología, a fin de realizar un diagnóstico precoz y prevención en psicoterapia, evitando así un mayor deterioro en la salud mental de los estudiantes. No obstante, es necesaria la realización de más investigación controlada al respecto.
Experiencing test anxiety triggers an emotional response accompanied by physiological changes that the student feels in a situation perceived as threatening, specifically in the face of an evaluation, written or oral exam; Currently, it is classified as a specific phobia. The individual who seeks to avoid or avoid this scenario falls into procrastination behavior. This affects their academic performance and has serious mental health consequences. The student begins to feel affected in his or her self-worth, self-esteem, and social environment, which often leads him or her to contract a depressive disorder and suicidal ideation. This article is a bibliographic review study regarding experiencing test anxiety as a situational specific phobia, the consequences of said condition, its comorbidity with other psychological disorders and the available treatments. Some 26 scientific articles were analyzed and compared, based on randomized controlled trials, others are controlled single case studies, published in important impact electronic journals. The search was carried out using keywords. In conclusion, the importance of knowledge of this pathology was highlighted, in order to make an early diagnosis and prevention in psychotherapy, thus avoiding further deterioration in the mental health of students. However, more controlled research is needed in this regard.
Subject(s)
Test Anxiety/psychology , StudentsABSTRACT
Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors - cognitive overgeneralisation, rumination and social problem-solving - as mediating factors in the relationship between childhood trauma and symptoms of depression.Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants (N = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling.Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies.Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problem-solving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma.
Since the relationship between childhood trauma and depression is not straightforward, the study addresses a significant gap in the understanding of the relationship between childhood trauma and depression symptoms by focusing on cognitive factors as potential mediators among depressed patients.Childhood trauma not only has a direct positive effect on depression symptoms but also indirectly influences depression through self-overgeneralisation and rumination, which contribute to elevated depression, while effective social problem-solving strategies act as a protective factor, leading to decreased depression symptoms.The significance of above cognitive overgeneralisation factors in shaping the relationship between childhood trauma and depression symptoms suggests that therapeutic interventions targeting these cognitive factors might be hold promise in improving mental health outcomes for this vulnerable population.
Subject(s)
Adverse Childhood Experiences , Humans , Young Adult , Adult , Cross-Sectional Studies , Depression , Iran/epidemiology , CognitionABSTRACT
Introduction: Depression is related with poor musclestrength, and deficiencies of microelements such as Zinc (Zn).Otherwise, Zn is related with muscle strength, but there is noevidence of the relations between muscle strength and Znlevels in depression. Objective: To determine the association between serum Zn levels, handgrip muscle strength, and depression. Methods: An observational, analytical case-control study. 102 depressive patients hospitalized at the San Juan de DiosClinic in Manizales, and 36 controls with no personal historyof mental illness were evaluated for depression severity,serum Zn levels, and handgrip muscle strength. The groupswere matched by sex, age, educational level, and socioeco-nomic stratum. The severity of depression was assessed us-ing the MontgomeryAsberg Rating Scale (MADRS). Serum Znlevels were determined, and handgrip muscle strength wasassessed using dynamometer. Descriptive analysis, logistic reression and linear models were performed with depressionand severity of depression as dependent variables. Results: Lower Zn levels and reduced handgrip musclestrength were related to the presence of depression with thelogistic model. Lower handgrip muscle strength and severityof depression were associated with the linear model. Conclusion: An association was found between depressionand low Zn levels, and an inverse association between severityof depression and handgrip muscle strength. Future studiesshould investigate causality, and to evaluate the relationshipbetween depression, muscle strength and nutritional status.(AU)
Introducción: La depresión se encuentra relacionada con una disminución de la fuerza muscular y deficiencia de microelementos como el Zinc (Zn). De otra parte, el Zn está relacionado con la fuerza muscular, sin embargo, no hay evidencia si existe una asociación entre fuerza muscular y Zn en depresión. Objetivo: Determinar la asociación entre niveles séricos de Zn, fuerza muscular y depresión. Metodología: Se realizó un estudio observacional, analítico de casos y controles. Participaron 102 pacientes hospitalizados en la Clínica San Juan de Dios de Manizales y 36 controles sin historia personal de enfermedad mental. Fueron evaluados la severidad de la depresión, los niveles séricos de Zn y la fuerza de agarre manual. Los grupos fueron pareados por edad, sexo, escolaridad y estrato socioeconómico. La severidad de la depresión se evaluó con la escala de depresión Montgomery-Asberg (MADRS), se determinaron niveles séricos de Zn y la fuerza muscular fue evaluada con por dinamometría. Se realizo un análisis descriptivo, y modelos de regresión logística y regresión lineal con depresión y severidad de la depresión como variables dependientes.Resultados: El modelo de regresión logística encontró una asociación entre los niveles bajos de Zn y la fuerza muscular con la presencia de depresión. El modelo de regresión lineal encontró una relación entre menor fuerza de agarre y severidad de la depresión.Conclusión: Existe una asociación entre depresión y niveles bajos de Zn, y una relación inversamente proporcional entre severidad de la depresión y menor fuerza muscular. Estudios en el futuro deben investigar relaciones de causalidad y evaluar la relación entre depresión, fuerza muscular y estado nutricional.(AU)
Subject(s)
Humans , Male , Female , Muscle Strength , Zinc/administration & dosage , Depressive Disorder, Major , Depression , Blood Specimen Collection , Case-Control Studies , ColombiaABSTRACT
Objetivo: realizar rastreamento de depressão e transtorno de ansiedade generalizada entre profissionais da Estratégia de Saúde da Família em um município no interior da Amazônia. Método:estudo transversal desenvolvido com 63 profissionais atuantes em 12 equipes de ESF na cidade de Santarém, Pará, Brasil. Foram utilizadas ferramentas validadas e adaptadas transculturalmente: o Patient Ìs Health Questionaire 9 e o Generalizes Anxiety Disorder 7. Os dados foram analisados a partir de ferramentas da estatística descritiva (frequências absolutas e relativas) a partir do software Microsoft Excel 2018. Resultados:Houve predomínio de indivíduos do sexo feminino, na idade de 40 a 44 anos e raça/cor pardo. O estado civil predominante foi casado, a categoria profissional mais representada na amostra foram os agentes comunitários de saúde e o a maioria dos participantes possuía nível superior completo. 57.1% tiveram rastreamento positivo para depressão e 42.1% para ansiedade. Conclusão:Observou-se elevada frequência de ansiedade e depressão entre os profissionais incluídos na amostra. Nossos dados reforçam a necessidade de ações preventivas na área de saúde mental visando reduzir os impactos dos fatores de risco. Além disso, é fundamental a realização de grandes estudos voltados à investigação dos fatores associados à saúde mental dos trabalhadores da saúde no Brasil
Objective: To screen for depression and generalized anxiety disorder among Family Health Strategy professionals in a municipality in the interior of the Amazon. Method:A cross-sectional study was carried out with 63 professionals working in 12 FHS teams in the city of Santarém, Pará, Brazil. Cross-culturally adapted and validated tools were used: the Patient's Health Questionnaire -9 and the Generalized Anxiety Disorder -7. The data was analyzed using descriptive statistics tools (absolute and relative frequencies)using Microsoft Excel 2018 software. Results:There was a predominance of females, aged between 40 and 44 and of brown race/color. The predominant marital status was married, the most represented professional category in the sample were community health agents and the majority of participants had completed higher education. 57.1% were screened positive for depression and 42.1% for anxiety. Conclusion:There was a high frequency of anxiety and depression among the professionals included in the sample. Our data reinforces the need for preventive action in the area of mental health in order to reduce the impact of risk factors. In addition, it is essential to carry out large-scale studies investigating the factors associated with the mental health of health workers in Brazil.
Objetivo: Detectar depresión y ansiedad generalizada en profesionales de la Estrategia Salud de la Familia de un municipio del interior de la Amazonia. Método:Se realizó un estudio transversal con 63 profesionales que trabajan en 12 equipos de la ESF en la ciudad de Santarém, Pará, Brasil. Se utilizaron instrumentos validados y adaptados transculturalmente: el Cuestionario de Salud del Paciente -9 y el Trastorno de Ansiedad Generalizada -7. Los datos se analizaron mediante herramientas de estadística descriptiva (frecuencias absolutas y relativas) utilizando el software Microsoft Excel 2018. Resultados:Hubo un predominio de mujeres, con edades comprendidas entre 40 y 44 años y de raza/color moreno. El estado civil predominante fue casado, la categoría profesional más representada en la muestra fue la de agentes de salud comunitarios y la mayoría de los participantes habían completado estudios superiores. El 57,1% dieron positivo en depresión y el 42,1% en ansiedad. Conclusión:Hubo una elevada frecuencia de ansiedad y depresión entre los profesionales incluidos en la muestra. Nuestros datos refuerzan la necesidad de acciones preventivas en el área de la salud mental para reducir el impacto de los factores de riesgo. Además, es fundamental la realización de grandes estudios dirigidos a investigar los factores asociados a la salud mental de los trabajadores de la salud en Brasil
Subject(s)
Phobic Disorders , Depressive Disorder, Major , Primary Health Care , EpidemiologyABSTRACT
El presente artículo pretende ampliar la información clínica y de neuroimagen del síndrome de Cotard, presentar el abordaje terapéutico, así como las limitaciones en su práctica. Se presenta el caso de una paciente de 54 años con antecedente de trastorno bipolar que ingresó a una institución de salud mental, con una clínica depresiva con tendencia a la clinofilia, acompañado por delirio nihilista y de culpa. Se inició el tratamiento farmacológico con antipsicóticos, antidepresivos y un estabilizador del ánimo con la consecuente resolución del cuadro y mejora en la calidad de vida. En la actualidad, queda mucho por conocer acerca de esta entidad clínica. La neuroimagen funcional y la clínica, serán los pilares que nos permitan dilucidar las complejidades fisiopatológicas y lograr avances en su clasificación, diagnóstico y manejo integral. (AU)
The present article aims to expand the clinical and neuroimaging information of Cotard Syndrome, present therapeutic approaches, as well as the limitations in its practice. The case of a 54-year-old patient with a history of bipolar disorder who was admitted to a mental health institution with a depressive clinical presentation characterized by clinophilia, accompanied by nihilistic and guilt delusions, is presented. Pharmacological treatment was initiated with antipsychotics, antidepressants, and a mood stabilizer, resulting in the resolution of the condition and an improvement in the quality of life. Currently, much remains to be known about this clinical entity. Functional neuroimaging and clinical assessment will be the pillars that allow us to elucidate the physiopathological complexities and make advances in its classification, diagnosis, and comprehensive management. (AU)
Subject(s)
Humans , Female , Adult , Bipolar Disorder/drug therapy , Depressive Disorder, Major/drug therapy , Psychotic Disorders/drug therapy , Neuroimaging , Antipsychotic Agents , Antidepressive AgentsABSTRACT
Introducción. La adherencia a los antidepresivos es fundamental para obtener buenos resultados en el tratamiento de la depresión. El objetivo del actual estudio fue evaluar la adherencia, aceptabilidad y tolerabilidad de venlafaxina XR a dosis de 300 mg/día, administrada en uno o dos comprimidos, tras un periodo de tratamiento de 6 ± 2 meses en pacientes con trastorno depresivo mayor (TDM). Metodología. Estudio observacional, transversal, de práctica clínica habitual en el que participaron 590 pacientes con TDM que asistían a consultas de centros públicos o privados de toda España, de los cuales 361 y 229 recibieron uno (300 mg) o dos comprimidos (150+150 mg o 225+75 mg) de venlafaxina XR, respectivamente. Los datos del estudio se obtuvieron de la entrevista con el paciente, de la historia clínica y de cuestionarios validados. Resultados. El método Haynes-Sackett y el cuestionario de Morisky-Green revelaron que la adherencia al tratamiento fue similar en ambos grupos. Los pacientes que recibieron la dosis de venlafaxina XR en un comprimido mostraron mayor satisfacción con el tratamiento según el cuestionario TSQM9. La escala MADRS reveló que en el 23% de los pacientes el TDM había remitido, y solo en el 9% se mantenía grave, en el 26% era moderado y en el 42% leve. Igual resultado se obtuvo con el cuestionario PHQ-9. En general, los pacientes mostraron buena tolerabilidad a la venlafaxina XR a dosis altas con las dos pautas de administración, y los efectos adversos más comunes fueron la disfunción sexual, sudoración y estreñimiento. Conclusiones. La adherencia al tratamiento con venlafaxina XR de 300 mg/día en uno o dos comprimidos fue similar. Los pacientes que recibieron un solo comprimido mostraron mayor satisfacción con el tratamiento. El perfil de seguridad de venlafaxina XR 300 mg fue favorable. No se produjeron abandonos, ni elevaciones clínicamente significativas de la presión arterial que condicionaran la pauta de uso. (AU)
Background. Adherence to antidepressants is essential for good outcomes when treating depressive disorders. The objective of the current study was to evaluate the adherence, acceptability and tolerability of venlafaxine XR at a dose of 300 mg/day, administered in one or two tablets, after a treatment period of 6 ± 2 months in patients with major depressive disorder (MDD). Subjects and methods. Observational, cross-sectional study of routine clinical practice in 590 outpatients with MDD who attended at public or private centers all over country, of whom 361 and 229 received one (300 mg) or two tablets (150+150 mg o 225+75 mg) of venlafaxine XR, respectively. The study data were obtained from the interview with the patient, the clinical history and validated questionnaires. Results. The Haynes-Sackett method and the MoriskyGreen questionnaire revealed that adherence to treatment was similar in both groups. The patients who received the dose of venlafaxine XR in one tablet showed greater satisfaction with the treatment according to the TSQM-9 questionnaire. The MADRS scale revealed that in 23% of the patients the MDD had remitted, and only in 9% it remained severe, in 26% it was moderate and in 42% mild. The same result was obtained with the PHQ-9 questionnaire. In general, the patients showed good tolerability to high doses of venlafaxine XR with both dosing regimens, and the most common adverse effects were sexual dysfunction, sweating and constipation. Conclusions. Adherence to treatment with venlafaxine XR 300 mg/day in one or two tablets was similar. Patients who received a single tablet showed greater satisfaction with the treatment. The safety profile of high dose venlafaxine was favorable and there was dropouts or clinically significant elevations that affected the dosing regimen. (AU)
Subject(s)
Humans , Treatment Adherence and Compliance , Venlafaxine Hydrochloride/administration & dosage , Venlafaxine Hydrochloride/therapeutic use , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/therapy , Drug ToleranceABSTRACT
Resumo Objetivo Identificar a raça/cor autorreferida por mulheres com 60 dias de pós-parto; identificar a prevalência do indicativo de transtorno depressivo nessas mulheres e verificar a associação entre o indicativo de transtorno depressivo e o quesito raça/cor autorreferida. Métodos Estudo transversal desenvolvido em um município do interior paulista. Foram utilizados, para a coleta de dados, um instrumento com dados sociodemográficos e a Escala de Depressão Pós-Natal de Edimburgo. Os dados foram analisados utilizando-se o Statistical Package for Social Sciences, SPSS, versão 17.0. Resultados Participaram deste estudo 186 mulheres, 60,8% referiram ser da cor parda, 24,2% apresentaram indicativo de transtorno depressivo e, entre estas, 81,7% eram da raça negra. O indicativo de transtorno depressivo associou-se às variáveis: número de filhos (p=0,006), gestação planejada (p=0,04) e tipo de parto (p< 0,001). Conclusão Os resultados deste estudo contribuem para maior visibilidade da temática da saúde mental das mulheres, especificamente das mulheres negras, pois, mesmo que não tenha sido identificada associação significativa dentre aquelas que apresentaram indicativo de transtorno depressivo, a maioria era da raça negra.
Resumen Objetivo Identificar la raza/color autodeclarado por mujeres con 60 días de posparto, identificar la prevalencia de indicios de trastorno depresivo en esas mujeres y verificar la relación entre los indicios de trastorno depresivo y el ítem raza/color autodeclarado. Métodos Estudio transversal realizado en un municipio del interior paulista. Para la recopilación de datos, se utilizó un instrumento con datos sociodemográficos y la Escala de Depresión Posnatal de Edimburgo. Para analizar los datos se utilizó el Statistical Package for Social Sciences, SPSS, versión 17.0. Resultados Participaron en el estudio 186 mujeres, el 60,8 % declararon ser de color pardo, el 24,2 % presentó indicios de trastorno depresivo y, entre ellas, el 81,7 % era de raza negra. Los indicios de trastorno depresivo se relacionaron a las variables: número de hijos (p=0,006), embarazo planeado (p=0,04) y tipo de parto (p< 0,001). Conclusión Los resultados de este estudio contribuyen para una mayor visibilidad del tema de salud mental de las mujeres, específicamente de mujeres negras, ya que, aunque no se haya identificado una relación significativa entre las que presentaron indicios de trastorno depresivo, la mayoría era de raza negra.
Abstract Objective To identify the race/color self-reported by women 60 days postpartum; to identify the prevalence of signs of depressive disorder among these women and to verify the association between signs of depressive disorder and the self-reported race/color. Methods Cross-sectional study carried out in a noncapital city in the state of São Paulo. An instrument with sociodemographic data and the Edinburgh Postnatal Depression Scale were used for data collection. Data was analyzed using the Statistical Package for Social Sciences, SPSS, version 17.0. Results A total of 186 women participated in this study, 60.8% reported being brown, 24.2% had signs of depressive disorder and, among these, 81.7% were black. Signs of depressive disorder were associated with the variables: number of children (p=0.006), planned pregnancy (p=0.04) and type of delivery (p< 0.001). Conclusion The results of this study contribute to greater visibility of the issue of women's mental health, specifically of black women, because even though no significant association was identified among those who showed signs of depressive disorder, most were black.
ABSTRACT
Es difícil estimar la verdadera presencia del trastorno disfórico premenstrual (TDPM). Las expectativas de las mujeres influyen en los síntomas del TDPM, lo que podría aumentar su vulnerabilidad a la depresión. Este estudio pretendió estimar la presencia de TDPM en un grupo de mujeres comparando su autodiagnóstico con la evaluación clínica; diferenciar los síntomas y su intensidad entre TDPM y su forma subsindrómica, así como determinar sus consecuencias sociolaborales y relacionales. Se analizan las diferencias entre TDPM y trastorno depresivo mayor (TDM) identificando una posible vulnerabilidad cognitiva a la depresión. En un diseño ex-post facto, participaron 105 mujeres, 85 de la población general (Medad= 23,60; DT 3,05) y 20 mujeres con TDM, (Medad= 25,15; DT 3,51). Para el autodiagnóstico, completaron varios autoinformes y los indicadores de criterios TDPM A, B, C (APA) y D (por autor). El diagnóstico clínico se realizó mediante entrevista semiestructurada siguiendo los criterios del DSM-5. El TDPM se sobreestimó cuando fue autoinformado (51,76%) contrastando con la evaluación clínica (5,88%). La vulnerabilidad cognitiva a la depresión para el TDPM no fue apoyada. (AU)
True premenstrual dysphoric disorder (PMDD) is hard to diagnose. It has been suggested that womens expectations influence the symptoms of this disorder, which could increase their vulnerability to depression. This study aimed to estimate PMDD in a group of women by comparing their self-diagnosis with clinical evaluation; differentiate between PMDD symptoms and their intensity and its subthreshold form, determining its social-employment and relational consequences, finding differences in symptoms and vulnerability to depression; and identifying possible cognitive vulnerability to depression in PMDD. 105 women participated, 85 from the general population and 20 women with Major Depressive Disorder were selected. For the self-diagnosis, they filled out several self-reports and PMDD Criteria Indicators A, B, C (APA) and D (by author). The clinical diagnosis was made using a semi-structured interview following DSM-5 criteria. PMDD was overestimated when it was self-reported (51,76%) compared to clinical evaluation (5,88%). Therefore, retrospective and self-reported evaluation could bias what they remember and overestimate the indicators of the disorder and their severity. Cognitive vulnerability to depression for PMDD was not supported. (AU)
Subject(s)
Humans , Female , Young Adult , Adult , Premenstrual Dysphoric Disorder/diagnosis , Disaster Vulnerability , Depressive Disorder, Major , Interviews as Topic , Diagnostic Self Evaluation , Premenstrual Dysphoric Disorder/etiology , SpainABSTRACT
Esta é uma revisão da literatura que tem como objetivo elucidar as alterações do sono em pacientes adultos com depressão, principalmente sem outras comorbidades ou condições especiais, e estabelecer a relação entre distúrbios do sono e depressão, com foco no Transtorno Depressivo Maior. A metodologia envolve uma revisão integrativa da literatura dos últimos 15 anos (2009-2023) nas bases de dados Biblioteca Virtual em Saúde (BVS) e Pubmed, utilizando as palavras-chave "distúrbios do sono", "depressão" e "adultos". Os resultados mostram um total de 240 artigos, dos quais 26 foram selecionados e 12 foram incluídos na análise. A discussão destaca o interesse recente em estudar as associações entre distúrbios do sono e transtornos depressivos, bem como a natureza global da pesquisa. A relação entre sono e saúde mental, bem como a classificação e relação entre distúrbios do sono, também são discutidos. Os achados indicam que distúrbios do sono são prevalentes em pacientes com depressão, sendo a insônia um fator de risco significativo para o desenvolvimento da depressão. A relação bidirecional entre sono e depressão é destacada, com a depressão afetando o sono e o sono afetando a depressão. A importância de estudar os mecanismos por trás dessa relação é enfatizada, pois pode ajudar os psiquiatras a gerenciar de forma mais eficaz a comorbidade de depressão e distúrbios do sono. O tratamento adequado dos distúrbios do sono também pode desempenhar um papel vital na melhoria do prognóstico e na prevenção da recorrência da depressão.
This is a literature review that aims to elucidate the sleep alterations in adult patients with depression, primarily without other comorbidities or special conditions, and establish the relationship between sleep disturbances and depression, with a focus on Major Depressive Disorder. The methodology involves an integrative review of the literature from the last 15 years (2009-2023) on the databases Biblioteca Virtual em Saúde (BVS) and Pubmed, using the keywords "sleep disorders," "depression," and "adults." The results show a total of 240 articles, 26 of which were selected and 12 of which were included in the analysis. The discussion highlights the recent interest in studying the associations between sleep disturbances and depressive disorders, as well as the global nature of the research. The relationship between sleep and mental health, as well as the classification and relationship between sleep disturbances, are also discussed. The findings indicate that sleep disturbances are prevalent in patients with depression, with insomnia being a significant risk factor for the development of depression. The bidirectional relationship between sleep and depression is highlighted, with depression affecting sleep and sleep affecting depression. The importance of studying the mechanisms behind this relationship is emphasized, as it can help psychiatrists manage the comorbidity of depression and sleep disturbances more effectively. Adequate treatment of sleep disturbances may also play a vital role in improving the prognosis and preventing the recurrence of depression.
Esta es una revisión de la literatura que tiene como objetivo dilucidar las alteraciones del sueño en pacientes adultos con depresión, principalmente sin otras comorbilidades o condiciones especiales, y establecer la relación entre las alteraciones del sueño y la depresión, con un enfoque en el Trastorno Depresivo Mayor. La metodología consiste en una revisión integradora de la literatura de los últimos 15 años (2009-2023) en las bases de datos Biblioteca Virtual em Saúde (BVS) y Pubmed, utilizando las palabras clave "sleep disorders," "depression," y "adults." Los resultados muestran un total de 240 artículos, de los cuales 26 fueron seleccionados y 12 incluidos en el análisis. La discusión destaca el reciente interés por estudiar las asociaciones entre las alteraciones del sueño y los trastornos depresivos, así como el carácter global de la investigación. También se analiza la relación entre el sueño y la salud mental, así como la clasificación y la relación entre los trastornos del sueño. Los resultados indican que las alteraciones del sueño son prevalentes en pacientes con depresión, siendo el insomnio un factor de riesgo significativo para el desarrollo de la depresión. Se destaca la relación bidireccional entre sueño y depresión, en la que la depresión afecta al sueño y el sueño a la depresión. Se subraya la importancia de estudiar los mecanismos que subyacen a esta relación, ya que puede ayudar a los psiquiatras a gestionar la comorbilidad de la depresión y los trastornos del sueño de forma más eficaz. El tratamiento adecuado de los trastornos del sueño también puede desempeñar un papel vital en la mejora del pronóstico y la prevención de la recurrencia de la depresión.
ABSTRACT
Objetivo:Elucidar o quadro clínico do transtorno depressivo maior (TDM) e verificar a associação dessa condição com polimorfismos do gene IL6. Método:Tratou-se de uma revisão sistemática com a busca de artigos originais nas bases de dados Scopus, Web of Science, PubMed e BVS, os quais trouxeram informações sobre variantes genéticas que tinham relação com polimorfismos do gene IL6. Estudos que não apresentaram dados completos, inclusive dados estatísticos, revisões, meta-análises e resumos, foram excluídos. Resultados:Foram encontrados 54 artigos nas bases de dados. Utilizou-se a plataforma Rayyan para retirar as duplicatas e ler os resumos para seleçãoinicial. Restaram 12 artigos, onde os que eram de acesso livre foram encaminhados para leitura completa, totalizando 5 artigos para essa revisão. Conclusão:Evidências sugerem uma condição sistêmica no TDM e dados demonstram alterações inflamatórias. Dadoque na maior parte dos estudos pacientes com TDM tiveram estados inflamatórios mais elevados, parece haver relação entre a IL-6 e o transtorno. A IL-6 induz alterações no cérebro, ativação de microglia e controla a saúde dos neurônios, podendo tornar tangível uma relação dos polimorfismos com a doença, mas ainda não existem muitos estudos na área
Objective:To elucidate the clinical picture of major depressive disorder (MDD) and to verify the association of this condition with polymorphisms of the IL6 gene. Method:This was a systematic review with the search of original articles in the databases Scopus, Web of Science, PubMed and VHL, which brought information about genetic variants that were related to polymorphisms of the IL6 gene. Studies that did not present complete data, including statistical data, reviews, meta-analyses and abstracts, were excluded. Results:A total of 54 articles were found in the databases. The Rayyan platform was used to remove the duplicates and read the abstracts for initial selection. There were 12 articles, where those that were freely accessible were sent for full reading, totaling 5 articles for this review. Conclusion:Evidence suggests a systemic condition in MDD and data demonstrate inflammatory changes. Given that in most studies patients with MDD had higher inflammatory states, there seems to be a relationship between IL-6 and the disorder. IL-6 induces changes in the brain, activation of microglia and controls the health of neurons, and may make tangible a relationship between polymorphisms and the disease, but there are not many studies in the area.
Objetivo: Dilucidar el cuadro clínico del trastorno depresivo mayor (TDM) y verificar la asociación de esta condición con polimorfismos del gen IL6. Método: Se trata de una revisión sistemática con búsqueda de artículos originales en las bases de datos Scopus, Web of Science, PubMed y BVS, que aportaron información sobre variantes genéticas relacionadas con polimorfismos del gen IL6. Se excluyeron los estudios que no presentaron datos completos, incluidos datos estadísticos, revisiones, metanálisis y resúmenes. Resultados:Se encontraron un total de 54 artículos en las bases de datos. La plataforma Rayyan se utilizó para eliminar los duplicados y leer los resúmenes para la selección inicial. Hubo 12 artículos, donde aquellos que eran de libre acceso fueron enviados para lectura completa, totalizando 5 artículos para esta revisión. Conclusión:La evidencia sugiere una condición sistémica en el TDM y los datos demuestran cambios inflamatorios. Dado que en la mayoría de los estudios los pacientes con TDM tenían estados inflamatorios más altos, parece haber una relación entre la IL-6 y el trastorno. La IL-6 induce cambios en el cerebro, la activación de la microglía y controla la salud de las neuronas, y puede hacer tangible una relación entre los polimorfismos y la enfermedad, pero no hay muchos estudios en el área.
Subject(s)
Polymorphism, Genetic , Receptors, Interleukin-6 , Depressive Disorder, MajorABSTRACT
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.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Depressive Disorder/epidemiology , Psychiatric Department, Hospital , Epidemiology, Descriptive , Hospitalization/statistics & numerical data , Medical Records Department, HospitalABSTRACT
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.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit Disorder with Hyperactivity/epidemiology , Students, Medical/psychology , Mood Disorders/epidemiology , Anxiety Disorders/epidemiology , Peru/epidemiology , Psychiatric Status Rating Scales , Stress, Psychological/epidemiology , Pilot Projects , Cross-Sectional Studies , Depressive Disorder/epidemiologyABSTRACT
Objetivo: conhecer os níveis de depressão e sintomas depressivos em angolanos com HIV. Método: estudo descritivo e misto, com estratégia exploratória sequencial, em período pré-pandêmico em um hospital público de Angola. Realizou-se entrevistas semiestruturadas, com aplicação do Inventário de Depressão de Beck. Para fins de análise, considerou o conceito de depressão a partir da classificação internacional de doenças. Resultados: prevaleceu depressão leve a moderada para ambos os sexos e estado civil. No G1, a maioria além da tristeza ou infelicidade não conseguem suportar a angústia, alguns verbalizam ter consciência de que os choros não os levará a ter vida anterior desta realidade. Agora se sentem irritados o tempo todo e não sentem mais prazer nas coisas como antes. No G2, expressaram ideias e sentimentos suicidas, estavam desanimados quanto ao futuro, percebem-se fracassados mais do que uma pessoa sem a doença, e adiam a tomada de decisão mais do que o costume. Conclusão: embora não tenha prevalecido formas severas (graves) de depressão, a ocorrência de sintomas negativos em variadas esferas da vida pode evoluir, especialmente no contexto angolano.
Objective:to know the levels of depression and depressive symptoms in Angolans with HIV. Method: descriptive and mixed study, with sequentialexploratory strategy, in the pre-pandemic period in a public hospital in Angola. Semi-structured interviews were carried out, with the application of the Beck Depression Inventory. For analysis purposes, it considered the concept of depression from the international classification of diseases. Results: mild to moderate depression prevailed for both sexes and marital status. In G1, the majority, in addition to sadness or unhappiness, cannot bear the anguish, some verbalize being aware that crying will not lead them to have a previous life in this reality. Now they feel irritable all the time and they don't enjoy things the way they used to. In G2, they expressed suicidal ideas and feelings, were discouraged about the future, perceived themselves as failures more than a person without the disease, and postponed decision-making more than usual. Conclusion: although severe forms of depression have not prevailed, the occurrence of negative symptoms in various spheres of life can evolve, especially in the angolan context.
Objetivo:conocer los niveles de depresión y síntomas depresivos en angoleños con VIH. Método:estudo descriptivo y misto, con estratégia exploratória secuencial, en el período pré-pandêmico en un hospital público de Angola. Se realizaron entrevistas semiestructuradas, con la aplicación del Inventario de Depresión de Beck. Para efectos de análisis, se consideró el concepto de depresión de la clasificación internacional de enfermedades. Resultados:predominó la depresión leve a moderada para ambos sexos y estado civil. En G1, la mayoría, además de la tristeza o la infelicidad, no pueden soportar la angustia, algunos verbalizan siendo conscientes de que el llanto no los llevará a tener una vida anterior en esta realidad. Ahora se sienten irritables todo el tiempo y no disfrutan las cosas como antes. En G2 expresaron ideas y sentimientos suicidas, estaban desanimados sobre el futuro, se percibían como fracasados más que una persona sin la enfermedad y postergaban la toma de decisiones más de lo habitual. Conclusión:aunque no han prevalecido formas severas de depresión, la aparición de síntomas negativos en diversas esferas de la vida puede evolucionar, especialmente en el contexto angoleño.
Subject(s)
Mental Health , HIV Seropositivity , Depression , Depressive Disorder , AngolaABSTRACT
Este trabajo propone un sistema de diagnóstico del trastorno depresivo para el Centro de Salud Juan Pablo II. En este centro los especialistas aplican como método de evaluación el cuestionario BDI-II (Inventario de Depresión de Beck), que limita el proceso de diagnóstico porque solo contempla la sumatoria de un puntaje como resultado final. Por lo tanto, para mejorar el método de evaluación se propone la construcción de un modelo de diagnóstico basado en redes neuronales y la adaptación del cuestionario BDI-II recopilando ítems del cuestionario asociados a sus respectivos factores establecidos: emocional, cognitivo, físico y de motivación siendo las variables de entrada de la primera capa. El modelo tiene tres capas ocultas y finalmente se obtendrá una capa de salida con el diagnostico general y específico que detallará el resultado del paciente a fin de que el especialista realice un plan personalizado de tratamiento que se ajuste mejor a las necesidades del paciente(AU)
This work proposes a diagnostic system for depressive disorder for the Juan Pablo II Health Center where the specialists apply the BDI-II questionnaire (Beck's Depression Inventory) as evaluation method, which limits the diagnostic process because it only contemplates the sum of a score as a final result. Therefore, to improve the evaluation method, the construction of a diagnostic model based on neural networks and the adaptation of the BDI-II collecting questionnaire items associated with their respective established factors: emotional, cognitive, physical and motivation, being the input variables of the first layer, having three hidden layers and finally an output layer will be sought with the general and specific diagnosis that details the result of the patient so that the specialist can make a personalized treatment plan that better adjusts to the patient needs(AU)
Subject(s)
Humans , Male , Female , Medical Informatics Applications , Surveys and Questionnaires , Neural Networks, Computer , Depressive Disorder/diagnosis , PeruABSTRACT
The alternative model for the classification of personality disor-ders presented in the DSM-5 is based on the hypothesis of continuity be-tween normal personality and personality disorders. The main objective of this study is to analyze the relationship between depressive symptomatolo-gy and the domains and facets of the PID-5, especially the Depressivity facet. A convenience sample of the general population (N = 453) was used. Participants responded to the PID-5 and the CES-D. In a multiple regression model including all the PID-5 facets, only Depressivity and An-hedonia had a significant individual effect on predicting the CES-D score. Correlation analysis suggested that Depressivity and Anhedonia could be considered as defining the depressive traits of personality disorders and supported the continuity between these disorders and depressive sympto-matology. A Taxometric Analysis with the Depressivity facet and CES-D score as indicators supported the dimensional nature of depressivity in a broad sense (depressive traits/ depressive symptomatology).(AU)
El modelo alternativo para la clasificación de los trastornos de la personalidadpresentado en el DSM-5 se basa en la hipótesis de conti-nuidad entre la personalidad normal y los trastornos de la personalidad. El objetivo principal de este estudio es analizar la relación entre la sintomato-logía depresiva y los dominios y facetas del PID-5, especialmente la faceta Depresión. Se utilizó una muestra de conveniencia de la población general (N = 453). Los participantes respondieron al PID-5 y a la CES-D. En un modelo de regresión múltiple que incluía todas las facetas de PID-5, solo la Depresión y la Anhedonia tuvieron un efecto individual significativo en la predicción de la puntuación CES-D. El análisis de correlación sugirió que la Depresión y la Anhedonia podrían considerarse como la definición de los rasgos depresivos de los trastornos de la personalidad y apoyó la conti-nuidad entre estos trastornos y la sintomatología depresiva. Un análisis ta-xométrico con la faceta Depresión y la puntuación CES-D como indicado-res respaldó la naturaleza dimensional de la depresión en un sentido amplio (rasgos depresivos / sintomatología depresiva).(AU)
Subject(s)
Humans , Depression/diagnosis , Depression/drug therapy , Depressive Disorder/diagnosis , Depressive Disorder/drug therapy , Personality Disorders , Data Interpretation, Statistical , Psychology , Psychology, Clinical , Behavioral MedicineABSTRACT
Objective: Endocannabinoid system (ES) seems to be altered in patients with depression. Cardiorespiratory fitness (CRF) may be an interacting factor inthe relationship between ES biomarkers and depressive symptoms in people diagnosed with depression. The aim was to study the role of CRF on thepossible association between ES biomarkers and depressive symptoms in 73 adults diagnosed with depression. Method: This study examine the outcomes of cardiorespiratory fitness and plasma levels of the lipid mediators; anandamide (AEA) and 2-arachidonoylglycerol (2-AG) sampled from 73 adults diagnosed with depression.Results: Patients with high CRF level had significant and inverse association among depressive symptoms and 2-AG serum levels ( : -0.013; 95% CI: -β: -0.013; 95% CI: -0.262 to -0.000; R²=22.6; P<0.001).Conclusions: Higher CRF levels could have a protective role on depressive symptoms by increases in 2-AG.(AU)
Objetivo: El sistema endocannabinoide (SE) parece estar alterado en pacientes con depresión. La capacidad cardiorrespiratoria (CRF) puede ser un factor que interactúe en la relación entre los biomarcadores del SE y los síntomas depresivos en personas diagnosticadas de depresión. El objetivo de este trabajo es estudiar el papel del CRF en la posible asociación entre los biomarcadores de ES y los síntomas depresivos en 73 adultos diagnosticados de depresión. Método: Este estudio examina los resultados de la aptitud cardiorrespiratoria y los niveles plasmáticos de los mediadores lipídicos; anandamida (AEA) y 2-araquidoilglicerol (2-AG) en 73 adultos diagnosticados de depresión.Resultados: Los pacientes con alto nivel de CRF tuvieron una asociación significativa e inversa entre los síntomas depresivos y los niveles séricos de 2-AG ( : -0,013; IC 95%: -0,262 a -0,000; R²=22,6; P<0,001). β: -0.013; 95% CI: -Conclusiones: Los niveles más altos de CRF podrían tener un papel protector sobre los síntomas depresivos por el aumento de 2-AG.(AU)
Objetivo: O sistema endocannabinoide (ES) parece ser alterado em doentes com depressão. A aptidão cardiorrespiratória (CRF) pode ser um factor deinteracção na relação entre os biomarcadores SE e os sintomas depressivos em pessoas diagnosticadas com depressão. O objetivo deste estudo foiestudar o papel da CRF na possível associação entre biomarcadores de ES e sintomas depressivos em 73 adultos diagnosticados com depressão. Métodos: Este estudo examina resultados de aptidão cardiorrespiratória e níveis plasmáticos de mediadores lipídicos; anandamida (AEA) e 2-arachidonoylglycerol (2-AG) em 73 adultos diagnosticados com depressão.Resultados: Os doentes com CRF elevado tinham uma associação inversa significativa entre sintomas depressivos e níveis séricos 2-AG ( : -0,013; 95%β: -0.013; 95% CI: -CI: -0,262 a -0,000; R²=22,6; P<0,001).Conclusões: Níveis mais elevados de CRF poderiam ter um papel protector nos sintomas depressivos, aumentando o 2-AG.(AU)
Subject(s)
Humans , Adult , Sports , Endocannabinoids , Depression , Cardiorespiratory Fitness , Depressive Disorder , Sports Medicine , BiomarkersABSTRACT
RESUMEN: El objetivo de la investigación fue describir la producción científica sobre estudios psicométricos de instrumentos de tamizaje para la depresión en población peruana. Para ello, se realizó un estudio descriptivo de la literatura científica en Scopus, Web of Science, PubMed y SciELO, con descriptores para depresión, propiedades psicométricas y Perú. Luego del proceso de revisión se incluyeron 22 estudios. Se encontraron validaciones de instrumentos de tamizaje en adultos mayores, adultos, adultos con depresión, mujeres adultas, mujeres embarazadas, profesionales de salud, estudiantes universitarios, estudiantes de secundaria y niños. El Patient Health Questionnaire (PHQ-9) fue el instrumento más estudiado. A pesar de que los estudios psicométricos cubren la mayoría de las poblaciones, quedan pendientes los pueblos originarios y poblaciones clínicas. El PHQ-9, por sus características, podría implementarse en las políticas de salud mental del Perú.
ABSTRACT The aim of the research was to describe the scientific output of psychometric studies on screening instruments for depression in the Peruvian population. We carried out a descriptive study of the scientific literature in Scopus, Web of Science, PubMed and SciELO, with descriptors for depression, psychometric properties, and Peru. After the review process, we included 22 studies. We found validations of screening instruments for older adults, adults, adults with depression, adult women, pregnant women, health professionals, university students, high school students and children. The Patient Health Questionnaire (PHQ-9) was the most widely used instrument. Psychometric studies cover most populations; however, native people and clinical populations remain to be studied. The PHQ-9, due to its characteristics, could be implemented in mental health policies in Peru.
Subject(s)
Humans , Male , Female , Pregnancy , Child , Adult , Young Adult , Psychometrics , Mass Screening/statistics & numerical data , Depression/diagnosis , Validation Studies as Topic , Peru , Bibliometrics , Mental Health , Evaluation Studies as TopicABSTRACT
RESUMEN Introducción: el abuso sexual en la infancia se define como una experiencia traumática que puede llevar a la víctima a padecer complicaciones mentales, sexuales, físicas, interpersonales y comportamentales, nefastas para la salud. Además, constituye un factor de riesgo que desencadena el trastorno depresivo mayor en mujeres. Presentación del caso: se trata de una paciente femenina de 17 años de edad que sufrió abuso sexual a los siete años de edad. La paciente ingresa en una primera ocasión el 5 marzo de 2018 por intento suicida y trastorno depresivo al tener contacto con la persona que efectuó el acto. Pasados 17 días la paciente vuelve a ser ingresada por presentar un cuadro de trastorno depresivo mayor y egresa nueve días después por buena evolución. El 7 de agosto ingresa por tercera vez por trastorno depresivo mayor e intento suicida nuevamente. La paciente fue tratada con Imipramina de 25 mg dos veces al día y con tratamiento psicoterapéutico, al cual respondió adecuadamente. La paciente se encuentra psicológicamente estable. Conclusiones: el abuso sexual en la niñez constituye un factor de riesgo desencadenante del trastorno depresivo mayor. La atención especial mediante apoyo y estudios psicológicos de los pacientes, y el tratamiento de fármacos antidepresivos es de vital importancia para la recuperación de víctimas sometidas a acoso sexual con ideación e intento suicidas.
ABSTRACT Introduction: childhood sexual abuse is defined as a traumatic experience that can lead the victim to suffer mental, sexual, physical, interpersonal and behavioral complications harmful to health. It is also a risk factor for major depressive disorder in women. With this case, the authors aim to share experiences to the diagnosis; treatment and prevention of these health problems by disseminating them to the medical community. Case report: a 17-year-old female patient who was sexually abused at the age of 7 years. The patient is admitted on a first occasion on March 5, 2018 for suicide attempt and depressive disorder upon contact with the person who performed the act. After 17 days, the patient was admitted again for major depressive disorder and was discharged 9 days later due to good evolution. On August 7, she was admitted for a third time for major depressive disorder and another suicide attempt. The patient was treated with Imipramine 25 mg twice a day and psychotherapeutic treatment, responding satisfactorily. The patient is psychologically stable at present. Conclusions: sexual abuse in childhood constitutes a risk factor triggering major depressive disorder. Special attention through support and psychological studies of the patients and treatment with antidepressant drugs is of vital importance for the recovery of victims subjected to sexual harassment with suicidal ideation and attempt.