Persistence of symptoms after cognitive therapies is associated with childhood trauma: A six months follow-up study.

This study aims to assess the effect of childhood trauma on the outcomes of brief cognitive therapies for major depressive disorder. This is a follow-up clinical study nested in a randomized clinical trial of cognitive therapies. Sixty-one patients were assessed at baseline, post-intervention and six-month follow-up. The study showed that brief cognitive therapies improved depressive and anxious symptoms at post-intervention and six-month follow-up. Higher childhood trauma scores at baseline were significantly associated with higher severity of depressive and anxious symptoms at six-month follow-up. Longer courses of psychotherapy may be needed to improve the long-lasting effects of traumatic experiences.

Impact of resilience on the improvement of depressive symptoms after cognitive therapies for depression in a sample of young adults.

INTRODUCTION: Few studies have evaluated positive measures for therapeutic response. Thus, the objective of this study was to assess the effects of resilience on severity of depressive and anxious symptoms after brief cognitive psychotherapy for depression. METHODS: This was a clinical follow-up study nested in a randomized clinical trial of cognitive therapies. The Resilience Scale was applied at baseline. The Hamilton Anxiety Rating Scale (HARS) and the Hamilton Depression Rating Scale (HDRS) were used at baseline, post-intervention, and at six-month follow-up. RESULTS: Sixty-one patients were assessed at baseline, post-intervention and at six-month follow-up. Resilience scores were significantly different between baseline and post-intervention assessments (p<0.001), as well as at baseline and at six-month follow-up (p<0.001). We observed a weak negative correlation between baseline resilience scores and HDRS scores at post-intervention (r=-0.295, p=0.015) and at six-month follow-up (r=-0.354, p=0.005). Furthermore, we observed a weak negative correlation between resilience scores and HARS scores at post-intervention (r=-0.292, p=0.016). CONCLUSION: Subjects with higher resilience scores at baseline showed a lower severity of symptoms at post-intervention and at six-month follow-up.

Impact of resilience on the improvement of depressive symptoms after cognitive therapies for depression in a sample of young adults / Impacto da resiliência na melhora dos sintomas depressivos após terapias cognitivas para depressão em uma amostra de adultos jovens

Abstract Introduction Few studies have evaluated positive measures for therapeutic response. Thus, the objective of this study was to assess the effects of resilience on severity of depressive and anxious symptoms after brief cognitive psychotherapy for depression. Methods This was a clinical follow-up study nested in a randomized clinical trial of cognitive therapies. The Resilience Scale was applied at baseline. The Hamilton Anxiety Rating Scale (HARS) and the Hamilton Depression Rating Scale (HDRS) were used at baseline, post-intervention, and at six-month follow-up. Results Sixty-one patients were assessed at baseline, post-intervention and at six-month follow-up. Resilience scores were significantly different between baseline and post-intervention assessments (p<0.001), as well as at baseline and at six-month follow-up (p<0.001). We observed a weak negative correlation between baseline resilience scores and HDRS scores at post-intervention (r=-0.295, p=0.015) and at six-month follow-up (r=-0.354, p=0.005). Furthermore, we observed a weak negative correlation between resilience scores and HARS scores at post-intervention (r=-0.292, p=0.016). Conclusion Subjects with higher resilience scores at baseline showed a lower severity of symptoms at post-intervention and at six-month follow-up.

Resumo Introdução Poucos estudos têm avaliado medidas positivas de resposta terapêutica. Assim, o objetivo deste estudo foi verificar os efeitos da resiliência na severidade dos sintomas depressivos e ansiosos após psicoterapia cognitiva breve para depressão. Métodos Trata-se de um estudo de intervenção clínica aninhado a um ensaio clínico com dois diferentes modelos de terapia cognitiva. A Resilience Scale foi aplicada no baseline, enquanto que a Hamilton Anxiety Rating Scale e a Hamilton Depression Rating Scale foram utilizadas no baseline, após a intervenção e no acompanhamento de seis meses. Resultados Sessenta e um pacientes foram avaliados no baseline, no pós-intervenção e no acompanhamento de seis meses. Os escores de resiliência foram significativamente diferentes entre as avaliações de baseline e pós-intervenção (p<0,001), bem como no baseline vs. acompanhamento de seis meses (p<0,001). Observamos uma correlação negativa fraca entre os escores de resiliência no baseline e os escores de sintomas depressivos no pós-intervenção (r=-0,295; p=0,015) e em seis meses de acompanhamento (r=-0,354; p=0,005). Além disso, observamos uma correlação negativa fraca entre os escores de resiliência e sintomas ansiosos no pós-intervenção (r=-0,292; p=0,016). Conclusão Indivíduos com maiores escores de resiliência na avaliação pré-tratamento apresentaram uma menor severidade de sintomas no pós-intervenção e no acompanhamento de seis meses.

Sexual violence, mood disorders and suicide risk: a population-based study.

This article seeks to analyze the association between sexual violence, manic and depressive episodes, and suicide risk among young adults. This is a cross-sectional population-based study carried out with young people between 18 and 24 years of age in a town in southern Brazil. The sample was selected through clusters. The prevalence of sexual violence, manic, depressive and mixed episodes and suicide risk were evaluated, as well as the association between them. The chi-square test and Poisson regression were used for statistical analysis. The study sample comprised 1,560 subjects. Among these, 3.1% had suffered sexual violence at some point in their life. The prevalence of depressive, mixed episodes, and (hypo)manic episodes were 10%, 2.4% and 2.3%, respectively. Suicide risk had a prevalence of 8.6% in the total sample. Young people who have suffered sexual violence are more likely to be subject to mood changes or suicide risk than those who have not (p < 0.05), except for the occurrence of (hypo)manic episodes. These results revealed a strong association between sexual violence and depressive and mixed episodes and suicide risk.

Sexual violence, mood disorders and suicide risk: a population-based study / Violência sexual, transtornos de humor e risco de suicídio: um estudo de base populacional

Abstract This article seeks to analyze the association between sexual violence, manic and depressive episodes, and suicide risk among young adults. This is a cross-sectional population-based study carried out with young people between 18 and 24 years of age in a town in southern Brazil. The sample was selected through clusters. The prevalence of sexual violence, manic, depressive and mixed episodes and suicide risk were evaluated, as well as the association between them. The chi-square test and Poisson regression were used for statistical analysis. The study sample comprised 1,560 subjects. Among these, 3.1% had suffered sexual violence at some point in their life. The prevalence of depressive, mixed episodes, and (hypo)manic episodes were 10%, 2.4% and 2.3%, respectively. Suicide risk had a prevalence of 8.6% in the total sample. Young people who have suffered sexual violence are more likely to be subject to mood changes or suicide risk than those who have not (p < 0.05), except for the occurrence of (hypo)manic episodes. These results revealed a strong association between sexual violence and depressive and mixed episodes and suicide risk.

Resumo O artigo tem por objetivo analisar a associação entre abuso sexual, episódios maníacos, depressivos e risco de suicídio em jovens adultos. Este é um estudo transversal de base populacional realizado com jovens entre 18 e 24 anos em Pelotas/RS. A seleção da amostra foi realizada por conglomerados. Foram avaliados a prevalência de violência sexual, o episódio de mania, depressão, misto e o risco de suicídio. Para a análise bruta dos dados foi utilizado o teste Qui-Quadrado, posteriormente, a análise ajustada foi realizada por Regressão de Poisson. A amostra do estudo foi de 1560 jovens, dos quais 3,1% haviam sofrido abuso sexual em algum momento de sua vida. O episódio depressivo esteve presente em 10,0% dos jovens entrevistados, seguido pelo maníaco (hipo) (2,3%) e pelo misto (2,4%). O risco de suicídio apresentou prevalência de 8,6% na amostra total. Nos jovens que sofreram abuso sexual, a probabilidade de apresentar alterações de humor ou risco de suicídio foi maior do que naqueles que não haviam sofrido (p < 0,05), exceto para a ocorrência de episódio maníaco (hipo). Os achados deste estudo indicam uma forte associação entre abuso sexual e episódios de depressão, misto e risco de suicídio, ainda, em uma amostra sem nenhum tratamento.

Anxiety disorders in young people: a population-based study

Objective: To assess the prevalence of anxiety disorders and associated factors in young adults. Methods: Cross-sectional population-based study of individuals between the ages of 18 and 24 years randomly selected from 89 census-based sectors to ensure an adequate sample size. Household selection within the sectors was performed according to a systematic sampling process. Anxiety disorders were assessed using the Mini International Neuropsychiatric Interview (MINI). The final sample comprised 1,560 young adults. Results: Of the participants who were diagnosed with anxiety disorders, 12.3% had agoraphobia, 9.7% had generalised anxiety disorder, 4.0% had social phobia, 3.3% had obsessive-compulsive disorder, 2.5% had panic disorder, and 2.1% had post-traumatic stress disorder; only 23.8% had received any previous treatment. Anxiety disorders were associated with sex, socioeconomic status, psychiatric problems in parents, alcohol abuse, and tobacco use. Conclusions: The identification of factors associated with anxiety disorders in young people enables us to develop intervention strategies. Anxiety disorders are not only highly prevalent but are also associated with significant functional impairment, significant reductions in quality of life, lower productivity, and higher rates of comorbidities. .

Anxiety disorders in young people: a population-based study.

OBJECTIVE: To assess the prevalence of anxiety disorders and associated factors in young adults. METHODS: Cross-sectional population-based study of individuals between the ages of 18 and 24 years randomly selected from 89 census-based sectors to ensure an adequate sample size. Household selection within the sectors was performed according to a systematic sampling process. Anxiety disorders were assessed using the Mini International Neuropsychiatric Interview (MINI). The final sample comprised 1,560 young adults. RESULTS: Of the participants who were diagnosed with anxiety disorders, 12.3% had agoraphobia, 9.7% had generalised anxiety disorder, 4.0% had social phobia, 3.3% had obsessive-compulsive disorder, 2.5% had panic disorder, and 2.1% had post-traumatic stress disorder; only 23.8% had received any previous treatment. Anxiety disorders were associated with sex, socioeconomic status, psychiatric problems in parents, alcohol abuse, and tobacco use. CONCLUSIONS: The identification of factors associated with anxiety disorders in young people enables us to develop intervention strategies. Anxiety disorders are not only highly prevalent but are also associated with significant functional impairment, significant reductions in quality of life, lower productivity, and higher rates of comorbidities.

Trauma precoce e transtornos de humor em jovens / Early trauma and mood disorders in youngsters

OBJETIVO: Verificar vivências precoces de abuso e negligência na infância entre jovens com transtorno bipolar (TB), transtorno depressivo maior (TDM) e controles populacionais. MÉTODO: Estudo de caso-controle aninhado a um estudo transversal de base populacional. A confirmação do diagnóstico foi realizada por meio de entrevista clínica estruturada para transtornos de eixo I do DSM-IV (SCID) e os eventos traumáticos foram verificados pelo Questionário sobre traumas na infância (CTQ). RESULTADOS: A amostra foi composta por 231 jovens, sendo 95 indivíduos no grupo controle, 82 com TDM e 54 com TB (32 do tipo I e 22 do tipo II). A prevalência de trauma na infância foi de 42,2%, sendo 54,7% entre aqueles com TB, 62,2% entre os jovens com TDM e 18,1% entre o grupo controle. Os jovens com TB ou TDM apresentaram maiores médias no CTQ total e entre seus componentes quando comparados aos jovens do grupo controle, exceto o componente abuso sexual, em que se observou diferença estatística apenas entre o grupo controle e o grupo de jovens com transtorno bipolar. CONCLUSÃO: O relato de vivências traumáticas precoces foi mais presente entre os jovens com transtornos de humor do que na população geral, confirmando o que a literatura traz sobre o tema. Nesse sentido, as vivências de trauma na infância parecem contribuir para o aparecimento dos transtornos de humor.

OBJECTIVE: To verify early experiences of childhood abuse and neglect among young with bipolar disorder (BD), major depression (MDD), and controls. METHOD: Case-control study nested to a population-based cross-sectional study. The diagnosis was performed via the structured clinical interview for DSM-IV Axis I Disorders (SCID). Traumatic events were analyzed using the Portuguese version - Questionário sobre Traumas na Infância (CTQ) - based on the Childhood Trauma Questionnaire. RESULTS: The sample comprised 231 adolescents with 95 individuals in the control group, 82 with MDD and 54 with BD (32 of type I and 22 type II). The prevalence of trauma or violence in childhood was 42.2%; among those, 54.7% had BD, 62.2% had MDD and 18.1% were in the control group. Young people with BD or MDD obtained higher means in total CTQ and among their components when compared with those in the control group. DISCUSSION: Reports on early traumatic experiences were more frequent among young people with mood disorders than in the general population, corroborating the literature on the subject. In this sense, the traumatic experiences during childhood seemed to contribute to the onset of the disorder.

[Mental common disorders and quality of life in young adulthoods: a population-based sample in Pelotas, Rio Grande do Sul State, Brazil]. / Transtornos mentais comuns e qualidade de vida em jovens: uma amostra populacional de Pelotas, Rio Grande do Sul, Brasil.

This study aimed to assess the prevalence of common mental disorders (CMD) and their association with quality of life among young adults in Pelotas, Rio Grande do Sul State, Brazil. This was a cross-sectional population-based study of young people 18 to 24 years of age. Sampling used simple cluster selection. Investigation of CMD used the Self-Report Questionnaire (SRQ-20), while quality of life was measured with the Medical Outcomes Survey Short-Form General Health Survey (SF-36). Prevalence of CMD in the study sample was 24.5% (N = 382), and was positively associated with: female gender, lower socioeconomic status (classes D or E), not studying, not working, alcohol consumption, smoking, and substance abuse. Young adults with CMD had lower mean scores on the SF-36 in all the assessed quality of life domains. Measures to prevent CMD are necessary to provide better quality of life for this age group.

Transtornos mentais comuns e qualidade de vida em jovens: uma amostra populacional de Pelotas, Rio Grande do Sul, Brasil / Mental common disorders and quality of life in young adulthoods: a population-based sample in Pelotas, Rio Grande do Sul State, Brazil

This study aimed to assess the prevalence of common mental disorders (CMD) and their association with quality of life among young adults in Pelotas, Rio Grande do Sul State, Brazil. This was a cross-sectional population-based study of young people 18 to 24 years of age. Sampling used simple cluster selection. Investigation of CMD used the Self-Report Questionnaire (SRQ-20), while quality of life was measured with the Medical Outcomes Survey Short-Form General Health Survey (SF-36). Prevalence of CMD in the study sample was 24.5 percent (N = 382), and was positively associated with: female gender, lower socioeconomic status (classes D or E), not studying, not working, alcohol consumption, smoking, and substance abuse. Young adults with CMD had lower mean scores on the SF-36 in all the assessed quality of life domains. Measures to prevent CMD are necessary to provide better quality of life for this age group.

O objetivo foi verificar a prevalência de transtornos mentais comuns (TMC) e sua associação com qualidade de vida em jovens da cidade de Pelotas, Rio Grande do Sul, Brasil. Estudo transversal de base populacional com jovens de 18 a 24 anos. A seleção amostral foi realizada por conglomerados. Para a investigação dos transtornos mentais comuns foi aplicado o Self Report Questionnaire (SRQ-20), enquanto os níveis de qualidade de vida foram mensurados por intermédio da Medical Outcomes Survey Short-form General Health Survey (SF-36). A prevalência de TMC na amostra estudada foi de 24,5 por cento (N = 382), apresentando-se mais evidente entre as mulheres, entre aqueles que pertenciam à menor classe socioeconômica (D ou E), não estavam estudando, não estavam trabalhando, consumiram álcool e usaram tabaco pelo menos uma vez na última semana e que fizeram uso de alguma substância ilícita nos últimos três meses. Os jovens com TMC obtiveram uma menor média nos escores da SF-36 em todos os domínios de qualidade de vida avaliados. Deve-se investir em medidas preventivas de TMC no intuito de proporcionar uma melhor qualidade de vida à população.

Depressão pós-parto e percepção de suporte social durante a gestação / Postpartum depression and perceived social support during pregnancy

OBJETIVO: Verificar o impacto da percepção de baixo suporte social durante a gestação como fator de risco para a depressão no período de 30 a 60 dias pós-parto. MÉTODO: Este estudo de coorte teve como população-alvo gestantes atendidas no Sistema Único de Saúde na cidade de Pelotas (RS). Para avaliar depressão pós-parto, foi utilizada a Edinburgh Postnatal Depression Scale (EPDS). Foram consideradas deprimidas as parturientes que atingiram ≥ 13 pontos na escala. RESULTADOS: Das 1.019 mulheres avaliadas, 168 (16,5 por cento) apresentaram depressão pós-parto. Aquelas que não receberam suporte do companheiro (p = 0,000), de familiares (p = 0,000) e de amigos (p = 0,000) demonstraram maior risco de ter depressão pós-parto. CONCLUSÃO: Nossos achados sugerem que a percepção de suporte social durante a gravidez pode ser um fator protetor para a depressão pós-parto.

OBJECTIVE: To assess the impact of low perceived social support during pregnancy as a risk factor for depression within 30 to 60 days postpartum. METHOD: This cohort study included pregnant women treated at public hospitals (Brazilian Unified Health System) in the city of Pelotas, state of Rio Grande do Sul, southern Brazil. Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Women with scores ≥ 13 points were considered to be depressed. RESULTS: Of the total of 1,019 women assessed, 168 (16.5 percent) presented postpartum depression. Women who did not receive support from their partners (p = 0.000), their families (p = 0.000), and friends (p = 0.000) were at higher risk for developing postpartum depression. CONCLUSION: Our findings suggest that perceived social support during pregnancy may be a protective factor against postpartum depression.