Cognitive performance during senescence in untreated congenital isolated GH deficiency.

Individuals with untreated isolated GH deficiency (IGHD) due to a mutation in the GHRH receptor gene from Itabaianinha Brazil have increased insulin sensitivity, normal life expectancy, and an extended health span, i.e. the period of life free from disabilities. We hypothesize that their prolonged health span is accompanied by a delayed cognitive decline in senescence. To test this hypothesis, we have administered the Literacy-Independent Cognitive Assessment (LICA) to 15 IGHD individuals aged over 50 years and 15 controls matched by age, sex, years of education, and percentage of illiteracy. All individuals were negative for HIV and syphilis serology, and there were no differences in serum levels of folate, vitamin B12 and TSH between the two groups, while free T4 was higher in the IGHD group. IGHD subjects had a higher total LICA score than controls, 215 (22.7) vs 204.2 (18.1), without reaching statistical significance. Scores of memory, visuoconstruction, language and calculation were similar between the two groups, with better attention (9.5 (1.4) vs 8.3 (1.1), P = 0.01) and executive function (38.3 (4.8) vs 35.1 (2.5), P = 0.03) scores in IGHD. MANCOVA revealed that group (but no age) had a significant effect on the LICA variables (partial eta squared of 0.455, power of 0.812, P = 0.02). This effect is verified on attention (partial eta squared 0.216, power of 0.749, P = 0.01) and executive function (partial eta squared 0.154, power of 0.570, P = 0.03. In conclusion, IGHD in senescence is associated with similar total cognitive performance but better attention and executive function than controls.

Fear of Covid-19, anxiety, and depression during the pandemic: A network analysis

Introduction: Covid-19 has generated several psychological impacts on people's lives and brought new challenges for dealing with the pandemic's repercussions. Objective: The objective was to analyse the relationship between the symptoms of fear of Covid-19, anxiety, and depression using different samples extracted at three distinct time-points. This study performed a network analysis of the fear of Covid-19 and anxiety- and depression -related symptoms based on data collected during the Covid-19 pandemic. Method: Three yearly cross-sectional surveys were conducted based on independent samples (2020-2022) of Brazilian adults (Time-point 1, Time-point 2, and Time-point 3 with 1,520, 1,523, and 1,517 participants, respectively). The Fear of Covid-19 Scale, the Generalised Anxiety Disorder Scale (7 items), and the Patient Health Questionnaire (9 items) were applied. The network structure invariance, the global strength invariance, and the strength of centrality index between the samples were compared. Results: Items from the three instruments had high values (>70%) in all samples (excluding the fear of Covid-19 at Time-point 3). Depression and anxiety symptoms increased, while fear-related behaviours decreased. Network analysis indicates that networks became progressively more parsimonious, and few edges connected different scales. Network comparisons revealed similar structures, but key differences were found: Time-point 1 showed significantly higher global connectivity, and changes in edge weights were observed only within the scales. Conclusions: Our findings suggest that the pandemic had a greater disorganising impact at its beginning, with a continuous increase in the mental health symptomatology and a reduction in the ratio between fear and anxiety and/or depression.

Introducción: El COVID-19 generó varios impactos psicológicos en la vida de las personas imponiendo nuevos desafíos para confrontar la pandemia. Objetivo: Analizar la relación entre los síntomas de miedo al COVID-19, ansiedad y depresión utilizando diferentes muestras extraídas durante tres períodos de tiempo distintos. Fueron analizadas redes del miedo y los síntomas de ansiedad y depresión usando datos recolectados durante la pandemia de COVID-19. Método: Tres encuestas transversales anuales basadas en muestras independientes (2020-2022) de adultos brasileños (punto temporal 1, punto temporal 2 y punto temporal 3 con 1520, 1523 y 1517 participantes, respectivamente). Se aplicaron la Escala de Miedo al COVID-19, la Escala de Trastorno de Ansiedad Generalizada (7 ítems) y el Cuestionario de Salud del Paciente (9 ítems). Se compararon la invariancia de la estructura de la red, la invariancia de la fuerza global y la fuerza del índice de centralidad entre los tres puntos temporales. Resultados: Los ítems de los tres instrumentos tuvieron valores altos (> 70 %) en todos los puntos temporales (excluyendo el miedo al COVID-19 en el punto temporal 3). A lo largo de los tres puntos temporales, los síntomas de depresión y ansiedad aumentaron, mientras que el miedo disminuyó. Las redes se volvieron progresivamente más parsimoniosas y pocas aristas conectaron diferentes escalas, con estructuras similares. Conclusiones: La pandemia tuvo un mayor impacto desorganizador en su inicio, con un aumento continuo de la sintomatología de salud mental y una disminución de la relación entre miedo y ansiedad o depresión.

Adaptação e evidências de validade do Deliberate Self-Harm Inventory - versão simplificada (DSHI-s) / Adaptation and evidence of validity of the Deliberate Self-harm Inventory - short version (DSHI-s) / Adaptación y evidencias de validez del Deliberate Self-Harm Inventory - versión simplificada (DSHI-s)

Esta pesquisa adaptou e analisou as evidências de validade da versão simplificada do Deliberate Self-Harm Inventory (DSHI-s) para o português. Participaram 160 estudantes do ensino médio. Aplicou-se um questionário sociodemográfico, o Questionário de Impulso, Autodano e Ideação Suicida na Adolescência (QIAIS-A) e a versão traduzida do DSHI-s (nomeado como Inventário de Autolesão Deliberada - reduzido - IAD-r). A análise dos dados foi conduzida por meio dos softwares SPSS e Factor. O resultado da análise fatorial exploratória indicou uma estrutura final para o IAD-r composta por 15 itens distribuídos em um fator e a escala apresentou boa consistência interna (alfa de Cronbach=0,95; ômega de McDonald=0,95). Constataram-se, também, evidências de validade convergente do IAD-r com o QIAIS-A (índice de correlação=0,775; p<0,001). Portanto, os presentes achados demonstraram evidências de validade do IAD-r, pois foram obtidas características psicométricas satisfatórias para mensuração de comportamentos autolesivos em adolescentes. (AU)

This research adapted to Portuguese and analyzed the validity evidence of the simplified version of the Deliberate Self-Harm Inventory (DSHI-s). Participants included 160 high school students. A sociodemographic questionnaire, the Questionnaire of Impulse, Self-harm and Suicidal Ideation in Adolescence (QIAIS-A), and the translated version of the DSHI-s (Deliberate Self-Injury Inventory - reduced - IAD-r) were applied. Data analysis was conducted using SPSS and Factor. The result of the Exploratory Factor Analysis indicated a final structure for the IAD-r composed of 15 items and one factor, and the scale showed good internal consistency (Cronbach's Alpha=.95; McDonald's Omega=.95). There was also evidence of convergent validity of the IAD-r with the QIAIS-A (correlation index=.775; p<.001). Therefore, the current findings allow attesting that the IAD-r showed satisfactory validity evidence for measuring self-injurious behaviors in adolescents. (AU)

Esta investigación adaptó y analizó evidencias de validez de la versión simplificada del Deliberate Self-Harm Inventory (DSHI-s) para portugués. Participaron 160 estudiantes de secundaria. Se aplicó un cuestionario sociodemográfico, el Cuestionario de Impulso, Autolesiones e Ideación Suicida en la Adolescencia (QIAIS-A) y la versión traducida del DSHI-s (denominado Inventario de Autolesiones Deliberadas - reducido - IAD-r). El análisis de los datos se realizó con el software SPSS y Factor. El resultado del Análisis Factorial Exploratorio indicó una estructura final para el IAD-r con 15 ítems distribuidos en un factor, y la escala mostró una buena consistencia interna (Alfa de Cronbach=0,95; Omega de McDonald's=0,95). También hubo evidencias de validez convergente del IAD-r con el QIAIS-A (índice de correlación=0,775; p<0,001). Por lo tanto, los presentes hallazgos demuestran evidencias de la validez del IAD-r, ya que se obtuvieron características psicométricas satisfactorias para medir conductas autolesivas en adolescentes. (AU)

Adaptação transcultural e evidências de validade do questionário de credibilidade/expectativa / Cross-cultural adaptation and evidence of validity of the credibility/expectatncy questionnaire / Adaptación transcultural y evidencias de validez del cuestionario de credibilidad/expectativa

Este estudo teve como objetivos adaptar o Questionário de Credibilidade/Expectativa (QCE) (Credibility/Expectancy Questionnaire-CEQ) para o contexto brasileiro, avaliar suas propriedades psicométricas e apresentar as relações entre a credibilidade-expectativa do tratamento e variáveis sociodemográficas da amostra. Participaram 217 adultos, que declararam realizar acompanhamento psicológico, recrutados por meio de mídias sociais. Utilizou-se o QCE, o Teste de Orientação da Vida e um questionário sociodemográfico. O resultado da análise fatorial exploratória indicou uma estrutura unidimensional para o QCE. A fim de evitar duplicidade de medida e prezar pela parcimônia, dois itens foram excluídos da versão final, fazendo com que o instrumento em português brasileiro seja composto por 4 itens. O alfa de Cronbach foi 0,87 e os índices de ajuste do modelo foram satisfatórios. Observou-se associação positiva e estatisticamente significativa entre o QCE e o TOV-R. Concluiu-se que o QCE apresentou características psicométricas apropriadas para uso em amostras brasileiras. (AU)

This study aimed to adapt the Credibility/Expectancy Questionnaire (CEQ) to the Brazilian context, evaluate its psychometric properties, and present the relationships between the credibility-expectation of the treatment and the sociodemographic variables of the sample. Participants included 217 adults, who declared to be were undergoing psychological counseling and were recruited via social media. The CEQ, the Life Orientation Test, and a sociodemographic questionnaire were used. The result of the Exploratory Factor Analysis indicated a one-dimensional structure for the CEQ. To avoid duplication of measurement and for practical purposes, two items were excluded from the final version, therefore the instrument was composed of 4 items in the Brazilian Portuguese version. Cronbach's alpha was 0.87 and the model fit indices were satisfactory. There was a positive and statistically significant association between the CEQ and the LOT-R. We concluded that the CEQ showed appropriate psychometric characteristics for use in Brazilian samples. (AU)

Este estudio tuvo como objetivo adaptar el Cuestionario de Credibilidad/Expectativa (CCE) (Credibility/Expectancy Questionnaire-CEQ) para el contexto brasileño, evaluar sus propiedades psicométricas y presentar las relaciones entre la credibilidad-expectativa del tratamiento y las variables sociodemográficas de la muestra Participaron 217 adultos que declararon estar en seguimiento psicológico, reclutados a través de las redes sociales. Se utilizaron el CCE, el Test de Orientación Vital y un cuestionario sociodemográfico. El resultado del Análisis Factorial Exploratorio indicó una estructura unidimensional para el CCE. Para evitar la duplicidad de medidas y preservar la parsimonia, dos ítems fueron excluidos de la versión final, con lo que el instrumento en portugués brasileño quedó compuesto por 4 ítems. El alfa de Cronbach fue de 0,87 y los índices de ajuste del modelo fueron satisfactorios. Se observó una asociación positiva y estadísticamente significativa entre CCE y TOV-R. Se concluyó que el CCE presenta características psicométricas apropiadas para su uso en muestras brasileñas. (AU)

Burden of disease due to amphetamines, cannabis, cocaine, and opioid use disorders in South America, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019.

BACKGROUND: South America's substance use profile, poverty, income inequality, and cocaine-supplier role make it a unique place for substance use research. This study investigated the burden of disease attributable to amphetamine use disorder, cannabis use disorder (CAD), cocaine use disorder, and opioid use disorder (OUD) in South America from 1990 to 2019, on the basis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: GBD 2019 estimated the incidence, prevalence, mortality, years of life lost (YLL), years of life lived with disability (YLD), and disability-adjusted life-years (DALYs) due to substance use disorders in each of the 12 South American countries (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Suriname, Uruguay, and Venezuela). Data were modelled using standardised tools (ie, the Cause of Death Ensemble model, spatio-temporal Gaussian process regression, and disease modelling meta-regression) to generate estimates of each quantity of interest by sex, location, and year. The analysis included comparisons by sex and country, and against regional and global estimates. FINDINGS: In 2019, the highest amphetamine use disorder burden per 100 000 population in South America was in Peru (66 DALYs). CAD DALY rates per 100 000 in South America were stable between 1990 and 2019, except in Chile and Colombia, which had the highest rates in 2019 (19 DALYs for Chile and 18 DALYs for Colombia). OUD DALYs per 100 000 increased during the period in Brazil and Peru, which in 2019 had the highest rates in South America (82 DALYs for Brazil and 70 DALYs for Peru). In 2019, Brazil had the highest cocaine use disorder DALYs per 100 000 (45 DALYs), nearly double its rate in 1990. DALY rates were higher in males than females for each substance use disorder, except in Paraguay. The overall burden of substance use disorders was higher in males than in females, mainly because of cocaine use disorder and CAD, whereas for amphetamine use disorder, the difference between sexes was minimal, and for OUD there was no difference. For males and females, the highest rate of substance use disorders DALYs per 100 000 was for OUD except in Argentina (in males, 58 DALYs for cocaine use disorder vs 52 DALYs for OUD) and in Paraguay (in females, 77 for amphetamine use disorder vs 50 for OUD). CAD DALY rates were generally the lowest among the substance use disorders for males and females. Amphetamine use disorder YLD rates were reasonably stable throughout the period and were highest in Peru, Paraguay, and Uruguay (>40 YLD per 100 000). For CAD, YLD rates were stable in all countries except Chile and Colombia. Cocaine use disorder YLD rates per 100 000 for the top four countries (Argentina, Uruguay, Chile, and Brazil) increased from 1990 to 2010 (eg, from 19 to 33 in Brazil), but decreased between 2010 and 2019 (eg, from 36 to 31 in Chile). For OUD, YLD rates showed a slight increase in most countries apart from Brazil, which increased from 52 in 1990 to 80 in 2019 and was top among the countries. Amphetamine use disorder YLL rates per 100 000 were highest in Suriname and Peru during the period, although in Suriname it increased from 2·7 in 2010 to 3·2 in 2019, whereas in Peru it decreased from 2·1 to 1·7. The highest YLL rate for cocaine use disorder was in Brazil, which increased from 3·7 in 1990 to 18·1 in 2019. Between 2000 and 2019, Chile and Uruguay showed the highest OUD YLL rates (11·6 for Chile and 10·9 for Uruguay). A high incidence of CAD was found in Chile, Colombia, Guyana, and Suriname. There were high incidences of amphetamine use disorder in Paraguay, cocaine use disorder in Argentina, and OUD in Ecuador. A decrease in annual prevalence for substance use disorders during the period was observed in Venezuela (amphetamine use disorder, CAD, and OUD), Brazil (CAD and amphetamine use disorder), Colombia (amphetamine use disorder and cocaine use disorder), Peru (amphetamine use disorder and cocaine use disorder), Chile and Suriname (amphetamine use disorder), Uruguay (CAD), and Bolivia (OUD). Overall, the cocaine use disorder burden stabilised then decreased. OUD was less prevalent than other substance use disorders but its burden was the highest. INTERPRETATION: The decrease in the burden of cocaine use disorder probably reflects the success of national standardised treatment programmes. Programmes for amphetamine use disorder, CAD, and OUD management should be improved. We did not find an increase in CAD burden in Uruguay, the country with the highest degree of cannabis decriminalisation in the region. Countries in South America should improve monitoring of substance use disorders, including regular surveys to provide more accurate data on which to base policy decisions. FUNDING: The Bill & Melinda Gates Foundation.

Avaliação da relação entre eventos traumáticos infantis e comportamentos autolesivos em adolescentes / Evaluation of the relationship between childhood traumatic events and self-injurious behavior in adolescents / Evaluación de la relación entre eventos traumáticos infantiles y comportamiento autolesivo en adolescentes

Esta pesquisa teve como objetivo verificar a relação entre eventos traumáticos (ET) na infância e a ocorrência de comportamentos autolesivos em adolescentes. Os instrumentos utilizados foram o Questionário sobre Traumas na Infância (QUESI) e o Inventário de Autolesão Deliberada - reduzido (IAD-r). Participaram 494 estudantes do ensino médio de ambos os sexos e idade entre 15 e 18 anos (M = 16,4). Destes, 58,5% afirmaram ter sofrido abuso emocional de forma recorrente e 19,0% e 59,5% assumiram já ter sofrido abuso sexual e físico, respectivamente. Quanto à prática de autolesão, 65,0% revelaram já ter se engajado em comportamentos autolesivos. De acordo com a análise de Regressão Logística Binomial, todos os tipos de ET exibiram associação significativa com a prática de comportamentos autolesivos. A análise de moderação a respeito da interação entre a ocorrência de ET infantis e a prática de autolesão revelou ausência de moderação pelo sexo e pela idade. Porém, quanto ao abuso físico, o efeito de moderação da idade apresentou significância estatística limítrofe e indicou que os adolescentes mais novos, de 15 e 16 anos, que sofreram este tipo de abuso na infância, foram mais susceptíveis à prática autolesiva. Portanto, as altas taxas de ET e de autolesão encontradas nesta pesquisa revelam a gravidade do problema. Espera-se que esta investigação possa contribuir para a elaboração de intervenções para prevenção e controle dos fatores de risco que acometem a população infanto-juvenil.(AU)

This research aimed to verify the relationship between traumatic events (TE) in childhood and the occurrence of self-injurious behavior in adolescents. The instruments used were the Childhood Trauma Questionnaire (QUESI) and the Deliberate Self-Injury Inventory - reduced (IAD-r). The sample was composed of 494 high school students of both genders and aged between 15 and 18 years old (M = 16.4). Of those, 58.5% declared to have suffered recurring emotional abuse and 19.0% declared to have suffered sexual abuse and 59.5% physical abuse. Regarding the practice of self-harm, 65.0% reported having already engaged in self-injurious behaviors. According to the Binomial Logistic Regression analysis, all types of TE were associated with the practice of self-injurious behaviors. The moderation analysis between the occurrence of childhood TE and self-injury showed no moderation by sex or age. However, regarding physical abuse, the moderating effect of age showed borderline statistical significance and indicated that younger adolescents, 15 and 16 years old, who suffered this type of abuse in childhood, were more susceptible to self-injurious behavior. Therefore, the high rates of TE and self-injury found in this research reveal the seriousness of the problem. It is hoped for this investigation to contribute to the development of interventions to prevent and control risk factors that affect children and adolescents.(AU)

Esta investigación tuvo como objetivo verificar la relación entre eventos traumáticos (ET) en la infancia y la ocurrencia de conductas autolesivas en adolescentes. Los instrumentos utilizados fueron el Cuestionario de Trauma Infantil (QUESI) y el Inventario de Autolesiones Deliberadas -reducido (IAD-r). Participaron 494 estudiantes de la secundaria, de ambos sexos y con edades entre 15 y 18 años (M = 16,4). De estos, el 58,5% afirmaron haber sufrido maltrato emocional de forma recurrente, el 19,0% dijeron haber sufrido maltrato sexual y el 59,5%, maltrato físico. En cuanto a la práctica de la autolesión, el 65,0% informaron haber realizado conductas autolesivas. El análisis de Regresión Logística Binomial mostró que todos los tipos de ET tuvieron una asociación significativa con la práctica de conductas autolesivas. El análisis de la moderación respecto a la interacción entre la ocurrencia de ET infantil y la práctica de la autolesión reveló una ausencia de moderación por sexo o edad. En cuanto al maltrato físico, el efecto moderador de la edad mostró una significación estadística marginal e indicó que los adolescentes más jóvenes, de 15 y 16 años, que sufrieron este tipo de maltrato en la infancia, son más susceptibles a la práctica de autolesiones. Por lo tanto, las altas tasas de ET y autolesiones encontradas en esta investigación revelan la gravedad del problema. Se espera que esta investigación contribuya con el desarrollo de intervenciones para la prevención y control de los factores de riesgo que afectan a niños y adolescentes.(AU)

Meta-worry, anxiety, and depression in the coronavirus 2019 (COVID-19) pandemic: Brazil, June 2020 / Metapreocupación, ansiedad y depresión en la pandemia de coronavirus (COVID-19): Brasil, junio de 2020

Abstract Introduction Threats to mental health and psychological well-being have been considered among the most challenging dimensions to deal with the COVID-19 pandemic. Objective To track the occurrence of significant anxiety and depression symptoms and the level of worry among residents in Brazil in June 2020. Method The final sample totaled 4,805 participants from all Brazilian states. A sociodemographic and health questionnaire (with questions related to COVID-19), the translated versions of the Meta-Worry Questionnaire, and the 4-item Patient Health Questionnaire (PHQ-4) were used. Inferential analyses were computed using the Multinomial Logistic Regression (backward stepwise) in which the PHQ-4 findings were stratified into four categories: no symptoms, only anxiety symptoms, only depression symptoms, and both symptoms. Results Research findings have shown that there are characteristics that predict greater exposure to significant symptoms of anxiety and depression (gender, age, and level of worry), with level of worry being the variable with the greatest impact on the model. Discussion and conclusion These data found during the COVID-19 pandemic intra-crisis period allow for early prediction of the negative outcomes associated with the pandemic, such as common mental disorders, and allocating interventions to help people to rationally deal with the stress related to this moment, regulating their emotions, and improving their overall mental health.

Resumen Introducción Las amenazas a la salud mental y el bienestar psicológico se han considerado entre las dimensiones más desafiantes de abordar en la pandemia de COVID-19. Objetivo Rastrear la ocurrencia de síntomas significativos de ansiedad y depresión y el nivel de preocupación entre los residentes en Brasil en junio de 2020. Método La muestra final totalizó 4,805 participantes de todos los estados brasileños. Se utilizó un cuestionario sociodemográfico y de salud (con preguntas relacionadas con el COVID-19), las versiones traducidas del Cuestionario Meta-Preocupación y el Cuestionario de Salud del Paciente de 4 ítems (PHQ-4). Los análisis inferenciales se calcularon utilizando la regresión logística multinomial (backward stepwise) en la que los hallazgos de PHQ-4 se estratificaron en cuatro categorías: sin síntomas, solo síntomas de ansiedad, solo síntomas de depresión y ambos síntomas. Resultados Los hallazgos de la investigación han demostrado que existían características que predecían una mayor exposición a síntomas significativos de ansiedad y depresión (género, edad y nivel de preocupación), siendo el nivel de preocupación la variable de mayor impacto en el modelo. Discusión y conclusión Los datos finales permiten la predicción temprana de los resultados negativos asociados con la pandemia, como los trastornos mentales comunes, y la asignación de intervenciones para ayudar a las personas a enfrentar racionalmente el estrés relacionado con este momento mediante una regulación de sus emociones y un mejoramiento de su salud mental.

Evidências de validade da GAD-7 em adolescentes brasileiros / Evidence of validity of the GAD-7 Scale in brazilian adolescents / Evidencias de validez de la escala GAD-7 en adolescentes brasileños

O objetivo deste estudo foi investigar evidências validade para a escala Generalized Anxiety Disorder (GAD-7) em adolescentes brasileiros, bem como validade concorrente para esta escala e apresentar a distribuição social do Transtorno de Ansiedade Generalizada (TAG). Participaram 302 adolescentes, com idades entre 15 e 19 anos, de ambos os sexos. Aplicou-se o questionário sociodemográfico, a GAD-7, a Hospital Anxiety and Depression Scale (HADS) e o Patient Health Questionnaire (PHQ-9). Os resultados da Análise Fatorial Exploratória (AFE) atestaram a unidimensionalidade da GAD-7 e indicaram consistência interna satisfatória. As evidências de validade concorrente apresentaram associações estatisticamente significativas e positivas entre a GAD-7 e as escalas PHQ-9 e HADS-A. Quanto à distribuição social, aproximadamente metade da amostra apresentou a ocorrência de sintomatologia positiva para TAG, sendo mais comum para o sexo feminino e em adolescentes mais jovens. Esses dados sugerem que a GAD-7 apresenta adequadas propriedades psicométricas para rastreamento de ansiedade em adolescentes. (AU)

This study aimed to investigate evidence of validity of the Generalized Anxiety Disorder scale (GAD-7) in Brazilian adolescents, analyze the concurrent validity of the scale, and present the social distribution of Generalized Anxiety Disorder (GAD) in this sample. Participants included 302 adolescents between 15 and 19 years old. A sociodemographic questionnaire, the GAD-7, the Hospital Anxiety and Depression Scale (HADS), and the Patient Health Questionnaire (PHQ-9) were applied. The results of the Exploratory Factor Analysis (EFA) attested to the unidimensionality of GAD-7 and the internal consistency was considered satisfactory. The concurrent validity evidence demonstrated statistically significant and positive associations between the GAD-7 and the PHQ-9 and HADS-A scales. Positive symptoms for GAD in adolescents occurred in almost half of the sample, being more common in girls and younger adolescents. The study concluded that GAD-7 has adequate psychometric properties to screen for anxiety in adolescents. (AU)

El objetivo del estudio fue investigar la evidencia de validez de la escala Generalized Anxiety Disorder (GAD-7) en adolescentes brasileños, analizar la validez concurrente de la escala y presentar la distribución social del trastorno de ansiedad generalizada (TAG). Participaron 302 adolescentes entre 15 y 19 años. Se aplicaron el cuestionario sociodemográfico, el GAD-7, la Hospital Anxiety and Depression Scale (HADS) y el Patient Health Questionnaire (PHQ-9). Los resultados del Análisis Factorial Exploratorio (AFE) atestiguan la unidimensionalidad de GAD-7 y indicaron una consistencia interna satisfactoria. La evidencia de validez concurrente demostró asociaciones estadísticamente significativas y positivas entre GAD-7 y las escalas PHQ-9 y HADS-A. En cuanto a la distribución social, aproximadamente la mitad de la muestra demonstró la ocurrencia de síntomas positivos para el TAG, siendo más común para mujeres y adolescentes más jóvenes. Estos dados sugieren que GAD-7 tiene propiedades psicométricas adecuadas para rastrear la ansiedad en los adolescentes. (AU)

Communication Apprehension Among Health Professions Students in Brazil.

Objective. To determine the levels of communication apprehension experienced by health professions students in Brazil.Method. A cross-sectional study of dentistry, pharmacy, medicine, and nursing students at a Brazilian university was conducted from December 2019 to May 2020. The students were invited to complete the Personal Report of Communication Apprehension (PRCA-24) and provide demographic data. Univariate and bivariate analyses were conducted.Results. A total of 644 health students answered the survey, and 25.5% were classified as having high communication apprehension. Male participants had significantly lower PRCA-24 scores than female participants. No significant differences were found between PRCA-24 scores by age category or academic year. Medical students had significantly lower mean PRCA-24 scores than pharmacy students.Conclusion. The prevalence of communication apprehension was high among health professions students. Women and pharmacy students had the highest communication apprehension scores. Health educators should consider the effects of communication apprehension on students and use adequate interventions during communication skills training to alleviate this apprehension.

Non-suicidal self-injury and suicidal behavior during the COVID-19 pandemic in Brazil.

This study sought to determine the explanatory variables behind suicidal behavior and non-suicidal self-injury during the early months of the COVID-19 pandemic in Brazil. The sample comprised 4797 adults, who filled out a series of standardized instruments and additional questions on COVID-19 exposure (self and others), self-injury, and suicidal behavior. One in 10 participants reported self-injury, and three in 10 had considered or attempted suicide. The factors associated with self-injury and suicidal behavior were lower educational level, younger age, chronic diseases, and anxiety. The factors associated with suicidal behavior were regular employment, living alone, and Black ethnicity.

The Fear of COVID-19 Scale adaptation and validation / Adaptação e validação da Escala de Medo da COVID-19

This study aimed to adapt and raise evidences of validity based on the internal structure, on the relationship with other variables, and on the content of the Fear of COVID-19 Scale (FCV-19S) in Brazilian Portuguese. We performed the Confirmatory Factor Analysis of the scale, its invariance analysis by gender, and established norms for interpreting the instrument's scores. Participants were 1,000 adults of both genders. The findings showed all fit indices as satisfactory, confirming the scale's one-dimensionality and its invariance. Results also demonstrated convergent validity between the FCV-19S and the stress of the subjects. Moreover, the stratification of the intensity of fear (mild, moderate and severe) was determined based on the standardization of scores. We concluded that FCV-19S presents sufficient evidence to support its use to assess the fear of Covid-19S in Brazil.

Este estudo objetivou adaptar e levantar evidências de validade com base na estrutura interna, na relação com outras variáveis e de conteúdo da Escala de Medo da COVID-19 (EMC-19, Fear of COVID-19 Scale) para português brasileiro. Para tanto, realizou-se a Análise Fatorial Confirmatória da medida e sua análise de invariância por sexo; ademais, estabeleceu--se normas para interpretação dos escores do instrumento. Fizeram parte da pesquisa 1.000 adultos, de ambos os sexos. Os resultados evidenciaram que todos os índices de ajuste foram satisfatórios, confirmando a unidimensionalidade da escala, bem como sua invariância. Constatou-se, ainda, que houve validade convergente entre a EMC-19 e o estresse dos participantes. Além disso, foram propostos estratos de classificação da intensidade do medo (leve, moderado e severo) com base na normatização dos escores. Por fim, concluiu-se que a EMC-19 apresenta evidências suficientes que recomendam a sua utilização para medida do medo da COVID-19 no Brasil.

Depressão em pessoas sob aprisionamento no sistema carcerário: revisão integrativa / Depression among the incarcerated population: an integrative review / La dépression chez les personnes incarcérées dans le système pénitentiaire: une revue intégrative / Depresión en personas aprisionadas en el sistema penitenciario: revisión integrativa

Resumo Esta revisão integrativa objetivou reunir estudos sobre a depressão em pessoas sob aprisionamento no sistema carcerário. As bases de dados pesquisadas foram PePSIC, PsycINFO, SciELO e Web of Science. As ferramentas de suporte para a extração dos artigos selecionados foram o programa computacional StArt e as recomendações Prisma. Os termos usados na busca eletrônica foram "inmate", "prison", "prisoner", "penitentiary" e "depression". A amostra final foi composta por 10 estudos primários, os quais atenderam aos critérios de inclusão e à questão norteadora da revisão. Dentre os achados, a ocorrência de depressão foi evidente em todos os artigos selecionados, e o Inventário de Depressão de Beck foi o instrumento mais utilizado. Por fim, percebeu-se que a identificação precoce de sintomatologia depressiva pode minimizar prejuízos físicos e mentais na população em encarceramento.

Abstract This integrative review analyzed studies about depression among people imprisoned in the prison system. Bibliographic search was conducted on the PePSIC, PsycINFO, SciELO and Web of Science databases. Papers were selected following the PRISMA recommendations, and then extracted using the StArt software. The search strategy used the terms "inmate," "prison," "prisoner," "penitentiary" and "depression," The final sample included 10 primary studies that met the inclusion criteria and answered the research question. All selected articles indicated the occurrence of depression, assessed by the Beck Depression Inventory. Finally, early identification of depressive symptoms can minimize physical and mental harm in the incarcerated population.

Résumé Cette revue intégrative a analysé les études sur la dépression chez les personnes incarcérées dans le système pénitentiaire. Une recherche bibliographique a été menée sur les bases de données PePSIC, PsycINFO, SciELO et Web of Science. Les articles ont été sélectionnés en suivant les recommendations PRISMA, puis extraits à l'aide du logiciel StArt. La stratégie de recherche utilisait les termes "détenu", "prison", "prisonnier", "pénitencier" et "dépression". L'échantillon final comprenait 10 études primaires répondant aux critères d'inclusion et à la question de recherche. Tous les articles sélectionnés indiquaient la survenue d'une dépression, évaluée par l'inventaire de dépression de Beck. Enfin, l'identification précoce des symptômes dépressifs peut minimiser les dommages physiques et mentaux au sein de la population carcérale.

Resumen Esta revisión integradora tuvo como objetivo reunir estudios sobre la depresión en personas encarceladas en el sistema penitenciario. Las bases de datos buscadas fueron PePSIC, PsycINFO, SciELO y Web of Science. Se utilizaron el programa informático StArt como herramienta de apoyo para la extracción de los artículos seleccionados y las recomendaciones PRISMA. Los términos utilizados en la búsqueda electrónica fueron: "inmate", "prison", "prisoner", "penitentiary" y "depression". La muestra final estaba compuesta por 10 estudios primarios, que cumplían los criterios de inclusión y la pregunta guía de la revisión. Entre los hallazgos, la depresión fue evidente en todos los artículos seleccionados y el Inventario de Depresión de Beck fue el instrumento más utilizado. Finalmente, se percibió que la identificación temprana de la sintomatología depresiva puede minimizar los daños físicos y mentales en la población encarcelada.

Anxiety, beliefs and covid-19 in two periods of the pandemic in Brazil: a comparative study / Ansiedad, creencias y Covid-19 en dos períodos de la pandemia en Brasil: un estudio comparativo

Abstract This research compared evocations regarding the term "coronavirus" during two different periods in the Covid-19 pandemic in Brazil in 2020 - March (beginning of the pandemic in the country) and June (Brazil as the epicenter of the pandemic) -, considering the presence or absence of anxiety symptoms in participants. The methodology adopted the free evocation technique and the Generalized Anxiety Disorder (GAD-2) symptom scale. The sample was composed of 5,961 women and 1,153 men. Participant selection was relegated to convenience sampling by means of an online questionnaire. Results showed that the coronavirus had differential impacts among the groups that were assessed and according to the time of data collection. In general, in March, people with anxiety symptoms had a more catastrophic view of the future, while people without those symptoms had a less unfavorable repertoire to adjust to the situation. In June, both groups reported a negative view of the scenario, indicating a decrease or exhaustion in their capacity for psychological adjustment. This suggests the possibility of an increase of some conditions that result in adaptive impairment, exhaustion, and mental illness. Finally, it is important to understand people's beliefs about the coronavirus at different times of the pandemic because it is a favorable period for the emergence and/or intensification of mental disorders.

Resumen Esta investigación comparó evocaciones sobre el término "coronavirus" en dos períodos diferentes durante la pandemia de COVID-19 en Brasil - en marzo (inicio de la pandemia en el país) y en junio (Brasil como epicentro de la pandemia) de 2020. Se consideró la presencia o la ausencia de síntomas de ansiedad en los participantes. En los métodos, se utilizó la técnica de evocación libre y la escala de síntomas de Trastorno de Ansiedad Generalizada (GAD-2). En total, 5961 mujeres y 1153 hombres participaron en el estudio. La selección de los participantes se realizó mediante una muestra de conveniência com un cuestionario online. Los resultados mostraron que el coronavirus se sintió de manera diferente entre los grupos que fueron evaluados y según el momento de la recolección de los datos. En general, en marzo, las personas con síntomas de ansiedad tenían una visión más catastrófica del futuro, mientras que las personas sin esos síntomas evidenciaban un repertorio menos desfavorable para ajustarse a la situación. En junio, ambos grupos reportaron una visión negativa del escenario, lo que indica una disminución o agotamiento en la capacidad de ajuste psicológico. Esto sugiere la posibilidad de un aumento de algunas condiciones que resultan en deterioro adaptativo, agotamiento y enfermedad mental. Finalmente, es importante comprender las creencias sobre el coronavirus en diferentes momentos de la pandemia, porque es un período favorable para la aparición y/o intensificación de los trastornos mentales.

Correction: Brazilian version of the Personal Report of Communication Apprehension: Cross-cultural adaptation and psychometric evaluation among healthcare students.

[This corrects the article DOI: 10.1371/journal.pone.0246075.].

Adaptação e propriedades psicométricas da versão brasileira da Escala de Frustração e Desconforto / Adaptación y propiedades psicométricas de la versión brasileña de la Escala de frustración y malestar / Adaptation and Psychometric Properties of the Brazilian Version of the Frustration Discomfort Scale

A Escala de Frustração e Desconforto (efd) avalia as crenças de intolerância à frustração. Este trabalho objeti-vou: adaptar esse instrumento para o contexto brasileiro; buscar evidências de validade de conteúdo, de estrutura interna e com base na relação com variáveis externas e, por fim, verificar a relação entre os níveis de intolerância à frustração com gênero e idade dos participantes. A amostra foi composta por 293 indivíduos, com idade média de 21.6 anos (dp= 3.57). Foram aplicados a efd, o Patient Health Questionnaire-4 (phq-4) e um questionário sociodemográfico. Os resultados da análise fatorial exploratória indicaram a pertinência de so-lução fatorial composta por duas dimensões. Quanto a consistência interna, foram verificados bons índices para ambos os fatores e para a escala. Observou-se associação positiva e estatisticamente significativa entre a efd e o phq-4, atestando a validade baseada na relação com variáveis externas. Não foram identificadas diferenças estatisticamente significativas nos níveis de intolerância à frustração em razão do gênero e idade. Baseado nes-ses achados, conclui-se que a versão adaptada da efdapresentou propriedades psicométricas satisfatórias, sendo adequada para investigação da intolerância à frustração, possibilitando que pesquisadores e profis-sionais investiguem como esse construto se manifesta na população brasileira e como ele se relaciona com variáveis associadas à saúde mental

La Escala de Frustración y Malestar (efm) evalúa las creencias de intolerancia a la frustración. Este trabajo tuvo como objetivo adaptar este instrumento al contexto brasileño; buscar evidencias de validez de contenido, de estructura interna, y en función de la relación con variables externas y, finalmente, verificar la relación entre los niveles de intolerancia a la frustración con el género y la edad de los participantes. La muestra estuvo formada por 293 individuos, con una edad promedio de 21.6 años (de = 3.57). Se aplicó el efm, el Patient Health Questionnaire-4 (phq-4) y un cuestionario sociodemográfico. Los resultados del análisis factorial exploratorio indicaron la relevancia de una solución factorial compuesta por dos dimensiones. En cuanto a la consistencia interna, se encontraron buenos índices para ambos factores y para la escala. Hubo asociación positiva y estadísticamente significativa entre el efmy el phq-4, lo que da fe de la validez en función de la relación con variables externas. No se identificaron diferencias estadísticamente significativas en los niveles de intolerancia a la frustración por género y edad. Con base en estos hallazgos, se concluye que la versión adaptada del efm tuvo propiedades psicométricas satisfactorias, apta para la investigación de la intolerancia a la frustración, permitiendo a investigadores y profesionales investigar cómo este constructo se manifiesta en la población brasileña y cómo se relaciona con las variables asociadas con la salud mental

The Frustration Discomfort Scale (fds) assesses beliefs about frustration intolerance. This study aimed at adap-ting this instrument to the Brazilian context, providing evidence for content validity of internal structure, and based on the relationship with external variables. In addition, we verified the relationship of the level of frustration intolerance with the gender and age of the participants. The sample consisted of 293 individuals, with an average age of 21.6 years(SD = 3.57). The fds, the Patient Health Questionnaire-4 (phq-4), and a so-ciodemographic questionnaire were applied. The explo-ratory factor analysis results indicated the best solution to be a structure with two dimensions. Good indexes of internal confidence were found for both factors and the whole scale. A positive and statistically significant association was observed between the fds and phG-4, which attests to the validity based on its relationship to external variables. No statistically significant differen-ces of frustration tolerance were identified for gender or age. Based on these findings, we conclude that the adapted version of the fds has satisfactory psychometric properties and is suitable for investigating intolerance to frustration, enabling researchers and professionals to investigate how this construct is manifested in the Brazilian population and how it relates to variables as-sociated with mental health

Meta-worry, anxiety and depression in the COVID-19 pandemic / Metapreocupação, ansiedade e depressão na pandemia de COVID-19: Brasil, Junho de 2020.

This research analyzed associations between meta-concerns and anxious and depressive symptoms at the beginning of the COVID-19 pandemic in Brazil. 2,042 individuals participated, aged 18-78 years. A sociodemographic questionnaire, the 4-item Patient Health Questionnaire and the Meta-Worry Questionnaire were answered online. Four Logistic Regression models were used to estimate the effect of independent variables on anxiety and depression symptoms. The variables being younger, not having a steady income, feeling ill, and exhibiting a high level of meta-worries increased the chances of showing symptoms. It was concluded that providing care in the face of psychological suffering is fundamental in combating COVID-19, since factors of susceptibility to the development of mental disorders were detected at the beginning of the pandemic in Brazil.

Esta pesquisa analisou associações entre metapreocupações e sintomatologias ansiosa e depressiva no início da pandemia de COVID-19 no Brasil. Participaram do estudo 2.042 indivíduos, com idades entre 18-78 anos. Um questionário sociodemográfico, o 4-item Patient Health Questionnaire e o Meta-Worry Questionnaire foram respondidos online. Quatro modelos de Regressão Logística foram utilizados para estimar o efeito das variáveis independentes sobre as sintomatologias ansiosa e depressiva. As variáveis ser mais jovem, não ter renda fixa, perceber-se doente e exibir alto nível de metapreocupações ampliaram as chances de sintomas ansiosos e/ou depressivos. Concluiu-se que prover cuidado frente ao sofrimento psicológico é fundamental no combate à COVID-19, pois foram detectados fatores de suscetibilidade ao desenvolvimento de transtornos mentais no começo da pandemia no Brasil.

Factor structure and invariance analysis of the center for epidemiologic studies depression scale - revised (CESD-R) in a Brazilian population / Estrutura Fatorial e Análise de Invariância da Center for Epidemiologic Studies Depression Scale - Revised (CESD-R) em uma População Brasileira

Abstract Introduction: The Center for Epidemiologic Studies Depression Scale - Revised (CESD-R) was developed to provide an efficient screening scale for depression syndrome, mimicking the original CESD, one of the most widely used screening tools to measure depressive symptoms globally. This investigation examined the factor structure of the CESD-R with a non-clinical Brazilian population. Method: We performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of two adult samples, and also conducted invariance analysis by sex and place of residence of the participants. The full sample consisted of 1,427 adults, divided into two groups. The first sample (n = 400) was used for the EFA and the second sample (n = 1027) for the CFA. Results: The EFA indicated an internal structure composed of a single factor, which explained 53.2% of the variance. The CFA attested to the unidimensionality of the measure. Fit indices and reliability indicators showed values higher than expected, without modifications in the initial structure. The model was invariant in relation to the variables investigated at four different levels (configural, metric, scalar, and strict). Conclusions: Our findings support the utility of the CESD-R and suggest its validity for application to the Brazilian population in general.

Resumo Introdução: A Center for Epidemiologic Studies Depression Scale - Revised (CESD-R) foi elaborada para fornecer um eficiente diagnóstico de sintomas de depressão, seguindo a proposta original da CESD, que é uma das escalas para rastreamento da depressão mais utilizadas mundialmente. Esta pesquisa avaliou a estrutura fatorial da CESD-R em uma população não-clínica no Brasil. Método: Realizaram-se análises fatoriais exploratória (AFE) e confirmatória (AFC) com duas amostras compostas por adultos. Também foi verificada a invariância do modelo por sexo e local de residência do participante. A amostra total foi composta por 1427 adultos, tendo sido dividida em duas subamostras. A primeira subamostra (n = 400) foi utilizada para a AFE e a segunda (n = 1027) para a AFC. Resultados: A AFE indicou uma estrutura interna composta por um único fator, que explicou 53.2% de variância. A AFC atestou unidimensionalidade da medida. Os índices de ajuste e indicadores de confiabilidade apresentaram valores acima do esperado, sem modificações na estrutura inicial. O modelo foi invariante em relação às variáveis investigadas em quatro diferentes níveis (configural, métrico, escalar e estrito). Conclusões: Os presentes achados suportam a utilidade da CESD-R e sugerem sua validade para aplicação na população brasileira.

Brazilian version of the Personal Report of Communication Apprehension: Cross-cultural adaptation and psychometric evaluation among healthcare students.

INTRODUCTION: Communication apprehension (CA) refers to an individual's level of fear or anxiety toward either real or anticipated communication with another person or persons. The Personal Report of Communication Apprehension (PRCA-24) is the most widely used measure of CA, even among healthcare students. OBJECTIVE: This study aimed to undertake a cross-cultural adaptation of this scale, translate it into Brazilian Portuguese, and examine its psychometric properties among healthcare students. METHODS: The translation and cross-cultural adaptation procedures were undertaken with the objective of establishing compatibility between the original and translated scales. The content validity of the scale was established based on the feedback of a multidisciplinary expert committee. Its psychometric properties were evaluated using a convenience sample of 616 healthcare students. Its construct validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Its internal consistency was examined by computing Cronbach's alpha and McDonald's omega coefficients. Its criterion validity was examined against the Interpersonal Communication Competence Scale (ICCS). RESULTS: The adapted scale demonstrated acceptable content validity. EFA showed that it was undergirded by one dimension, and this observation was confirmed by the results of CFA. The scale demonstrated excellent internal consistency. Its convergent validity was examined by conducting correlation analysis, and scores on the adapted PRCA-24 were negatively correlated with scores on the ICCS. CONCLUSION: The Brazilian version of the PRCA-24 has satisfactory psychometric properties and is, therefore, suitable for use with Brazilian healthcare students. It can be used to assess their communication needs for the purpose of designing tailored training programs.

Kessler Psychological Distress Scale: internal structure and relation to other variables / Escala Kessler de Distresse Psicológico: estrutura interna e relação com outras variáveis / Escala Kessler de Malestar Psicológico: estructura interna y relación con otras variables

This study aimed to present validity evidence based on internal structure of the Kessler Scale of Psychological Distress (K10), to show its relations with the Perceived Stress Scale (PSS-10), and to present a social distribution of distress in the present sample. Participated in the study 717 residents of Aracaju, State of Sergipe, by means of household data collection. A sociodemographic questionnaire, K10, and PSS-10 were used as instruments. Exploratory Factor Analysis was performed using the Factor software, which indicated the scale unidimensionality, explaining 69.9% of the variance. Cronbach's alpha was 0.93, and the model adjustment indices were satisfactory. A positive and statistically significant association between K10 and PSS-10 was observed. Regarding the social distribution, the levels of distress were higher in women, patients with chronic diseases, users of controlled drugs, and unemployed participants. It was concluded that K10 presented robust psychometric properties for the detection of distress in general population. (AU)

Este estudo objetivou apresentar evidências de validade da estrutura interna da Escala Kessler de Distresse Psicológico (K10), apontar sua relação com a Escala de Estresse Percebido (PSS-10) e apresentar relações entre o distresse e variáveis sociodemográficas (distribuição social) na amostra. Participaram do estudo 717 residentes do município de Aracaju, Sergipe, por meio de coleta domiciliar. Utilizaram-se questionário sociodemográfico, a K10 e a PSS-10 como instrumentos. Realizou-se análise fatorial exploratória com o software Factor, que indicou a unidimensionalidade fatorial da escala, explicando 69,9% da variância. O alfa de Cronbach foi 0,93 e os índices de ajuste do modelo foram satisfatórios. Observou-se uma associação positiva e estatisticamente significativa entre a K10 e a PSS-10. Quanto à distribuição social, os níveis de distresse foram maiores em mulheres, portadores de doenças crônicas, usuários de medicamentos controlados e desempregados. Concluiu-se que a K10 apresentou propriedades psicométricas robustas para rastreamento do distresse na população geral. (AU)

Este estudio tuvo como objetivo presentar evidencias de validez basadas en la estructura interna de la Escala Kessler de Malestar Psicológico (K10), señalar sus relaciones con la Escala de Estrés Percibido (PSS-10) y las relaciones actuales entre el malestar y las variables sociodemográficas (distribución social) en la presente muestra. Participaron del estudio 717 residentes del municipio de Aracaju, provincia de Sergipe, por medio de la recolección domiciliaria. Se utilizaron el cuestionario sociodemográfico K10 y PSS-10 como instrumentos. El Análisis Factorial Exploratorio se realizó a partir del software Factor, que indicó la unidimensionalidad factorial de la escala, explicando el 69,9% de la varianza. El alfa de Cronbach fue de 0,93 y los índices de ajuste del modelo fueron satisfactorios. Se observó una asociación positiva y estadísticamente significativa entre K10 y PSS-10. En cuanto a la distribución social, los niveles de malestar fueron mayores en mujeres, portadores de enfermedades crónicas, usuarios de medicamentos controlados y desempleados. Se concluyó que la K10 presenta propiedades psicométricas robustas para el rastreo del distrés en la población general. (AU)

Causas de óbitos em hospital de ensino da Amazônia Ocidental brasileira / Causas de fallecimiento en hospital universitario de la Amazonía Occidental brasileña / Causes of death in a teaching hospital of the Brazilian western Amazon

Resumo Objetivo Identificar o perfil epidemiológico dos pacientes que evoluíram para óbito, caracterizar essas mortes segundo variáveis sociodemográficas e clínicas e analisar a relação entre a causa básica e a causa imediata do óbito em um hospital de ensino. Métodos Estudo quantitativo, transversal retrospectivo, com componentes descritivos, utilizando como principal fonte de dados os atestados de óbitos do Sistema de Informações do Sistema Único de Saúde e das declarações de óbitos ocorridos em 2016 da instituição pesquisada. Resultados Dos 634 óbitos, a maioria dos pacientes era do sexo masculino (56,9%), sendo 70% de afrodescendentes, observou-se que quase metade (48,8%) tinha 65 anos ou mais de idade, acometeu 50,7% dos homens acima dos 66 anos e 53,8% das mulheres com menos de 66 anos. As principais causas imediatas de morte foram associadas às neoplasias (45,4%) e às doenças infecciosas e parasitárias (28,9%). Quanto as declarações de óbitos, existe uma subnotificação nas causas consequenciais 2 e 3, de 12,6% e 49,9%, respectivamente. Conclusão A ocorrência de doenças infecciosas e parasitárias, os sinais/sintomas e exames clínicos/laboratoriais alterados, exerceram impacto importante como causa imediata dos óbitos analisados. Destaca-se que os óbitos por neoplasias se mantiveram constantes em todas as categorias (causa imediata, causa consequencial 2, causa consequência 3, causa básica).

Resumen Objetivo Identificar el perfil epidemiológico de los pacientes que fallecieron, caracterizar esas muertes de acuerdo con variables sociodemográficas y clínicas y analizar la relación entre la causa básica y la causa directa del fallecimiento en un hospital universitario. Métodos Estudio cuantitativo, transversal retrospectivo, con componentes descriptivos, utilizando como principal fuente de datos los certificados de defunción del Sistema de Información del Sistema Único de Salud y las declaraciones de las defunciones ocurridas en 2016 en la institución estudiada. Resultados De los 634 fallecimientos, la mayoría de los pacientes era de sexo masculino (56,9 %), el 70 % era afrodescendiente. Se observó que casi la mitad (48,8 %) tenía 65 años o más, el 50,7 % de los hombres tenía más de 66 años y el 53,8 % de las mujeres, menos de 66 años. Las principales causas directas de muerte se asociaron con neoplasias (45,4 %) y enfermedades infecciosas y parasitarias (28,9 %). Respecto a las declaraciones de defunción, existe una subnotificación en la causa antecedente 2 del 12,6 % y en la 3 del 49,9 %. Conclusión Los casos de enfermedades infecciosas y parasitarias, los signos/síntomas y estudios clínicos/de laboratorio alterados ejercieron un importante impacto como causa directa de los fallecimientos analizados. Se observa que los fallecimientos por neoplasias se mantuvieron constantes en todas las categorías (causa directa, causa antecedente 2, causa antecedente 3, causa básica).

Abstract Objectives To identify the epidemiological profile of patients who died, to characterize these deaths according to sociodemographic and clinical variables and to analyze the relation between the underlying cause and immediate cause of death in a teaching hospital. Methods Quantitative cross-sectional study, with descriptive components, using as the main source of data the death certificates of the Information System of the Brazilian Unified Health System and the death declarations that occurred in 2016 in the institution studied. Results Of the 634 deaths, most of the patients were male (56.9%), being 70% Afro-descendants; it was observed that almost half (48.8%) were 65 years of age or older; it affected 50.7% of men over 66 years and 53.8% of women under 66 years. The main immediate causes of death were associated with neoplasms (45.4%) and infectious and parasitic diseases (28.9%). Regarding death declarations, there is an underreporting in consequential causes 2 and 3, of 12.6% and 49.9%, respectively. Conclusion The occurrence of infectious and parasitic diseases, the signs/symptoms and altered clinical/laboratory tests had an important impact as immediate cause of the analyzed deaths. It is noteworthy that deaths from neoplasms remained constant in all categories (immediate cause, consequential cause 2, consequential cause 3, and underlying cause).