Correlation between levels of perceived stress and depressive symptoms in the functional disability of patients with fibromyalgia.

OBJECTIVE: The aim of this study was to evaluate the factors that are most correlated with the levels of functional disability in patients with fibromyalgia. METHODS: This is a cross-sectional descriptive study in which 42 patients diagnosed with fibromyalgia according to the criteria of the American College of Rheumatology reported their status using the following questionnaires: the Beck Depression Inventory, the Perceived Stress Scale 14, the Revised Fibromyalgia Impact Questionnaire, the Visual Analog Pain Scale, and the Health Assessment Questionnaire. RESULTS: Moderate to severe levels of depression (Beck Depression Inventory: 22.35±10.39), moderate to severe functional disability (Health Assessment Questionnaire: 1.28±0.58), and high levels of stress (Perceived Stress Scale 14: 31.59±10.02) were found. The correlation adjusted by multiple regression as a function of the Health Assessment Questionnaire indicated a negligible to weak positive correlation with perceived stress (r=0.11), while a moderately strong positive correlation was observed with the Visual Analog Pain Scale (r=0.55). Regarding physical exercise, one of the pillars of the treatment, a moderate negative correlation was found with the Health Assessment Questionnaire (r=-0.4). CONCLUSION: The pain levels were moderately influenced by depression severity. The factors most linked to functional disability are due to the pain levels but not to the perception of stress.

Correlation between levels of perceived stress and depressive symptoms in the functional disability of patients with fibromyalgia

SUMMARY OBJECTIVE: The aim of this study was to evaluate the factors that are most correlated with the levels of functional disability in patients with fibromyalgia. METHODS: This is a cross-sectional descriptive study in which 42 patients diagnosed with fibromyalgia according to the criteria of the American College of Rheumatology reported their status using the following questionnaires: the Beck Depression Inventory, the Perceived Stress Scale 14, the Revised Fibromyalgia Impact Questionnaire, the Visual Analog Pain Scale, and the Health Assessment Questionnaire. RESULTS: Moderate to severe levels of depression (Beck Depression Inventory: 22.35±10.39), moderate to severe functional disability (Health Assessment Questionnaire: 1.28±0.58), and high levels of stress (Perceived Stress Scale 14: 31.59±10.02) were found. The correlation adjusted by multiple regression as a function of the Health Assessment Questionnaire indicated a negligible to weak positive correlation with perceived stress (r=0.11), while a moderately strong positive correlation was observed with the Visual Analog Pain Scale (r=0.55). Regarding physical exercise, one of the pillars of the treatment, a moderate negative correlation was found with the Health Assessment Questionnaire (r=-0.4). CONCLUSION: The pain levels were moderately influenced by depression severity. The factors most linked to functional disability are due to the pain levels but not to the perception of stress.

Association between disease activity and quality of life among patients with rheumatoid arthritis

Abstract The aim of this study is the association between the scores of disease activity, functional capacity and quality of life among patients diagnosed with rheumatoid arthritis, under clinical treatment at the Regional University Hospital of Campos Gerais - Wallace Thadeu de Mello and Silva. The sample was composed by volunteer patients, who freely underwent 3 research questionnaires. With the results of the survey, the disease activity score was correlated to the functional capacity and the quality-of-life scores. A mean of 3.87 and 1.2 was observed for the disease activity and the functional capacity scores, respectively, yet not achieving a correlation between those two variables. A strong correlation between the disease activity and the "functional capacity", "general health status" and "mental health" domains was found. The lowest average observed corresponded to "physical limitation", from the quality-of-life questionnaire. There was no statistically significant correlation between disease activity and functional capacity, although disease activity seems to affect the mental health, general health status and functional capacity of patients.

Relationship between corticotherapy and increased cardiac risk in patients with rheumatoid arthritis

Rheumatoid arthritis is an autoimmune inflammatory joint disease with global prevalence of 0.4% to 1.0%. Extra-articular manifestations increase its morbidity and severity, and cardiovascular diseases present the greatest risk. Therapeutic approaches have been used to treat rheumatoid arthritis, often involving the use of multiple classes of drugs with different mechanisms and forms of action. Corticosteroid therapy is widely used in this therapeutic combination; however, its use has been widely questioned because of its high toxicity and some negative effects, including the possibility of increased cardiovascular risk, depending on the dosage. Some studies have provided important insights into how glucocorticoids have an impact on cardiac complications in patients with rheumatoid arthritis. Most of these studies have concluded that exposure to these drugs at high or cumulative doses is associated with increased risk of death, as well as possibly being associated with the presence of a positive rheumatoid factor.

Análise da Depressão, dos Fatores de Risco para Sintomas Depressivos e do Uso de Antidepressivos entre Acadêmicos do Curso de Medicina da Universidade Estadual de Ponta Grossa / An Analysis of Depression, the Risk Factors for Depressive Symptoms, and the Use of Antidepressants among Medical Students at Ponta Grossa State University

RESUMO Introdução A depressão entre estudantes de Medicina tem sido uma condição prevalente, porém as pesquisas têm sido metodologicamente insuficientes quanto à análise dos fatores de risco envolvidos e ao tratamento dessa população. Objetivos Determinar a prevalência de sintomas depressivos e de seus fatores de risco, assim como do uso de antidepressivos na amostra analisada. Método Para o screening de sintomas depressivos, foi aplicado o Inventário de Depressão de Beck (BDI), e para a adesão medicamentosa, o teste de Morisky-Green-Levine. O teste exato de Fisher unicaudado foi utilizado para variáveis qualitativas e, para as quantitativas, o teste one-way Anova com análise post-hoc pelo teste de Tukey-Kramer. As diferenças foram consideradas significativas quando p < 0,05. Resultados Mostraram-se estatisticamente significativas as associações entre sintomas depressivos e frequência de atividades de lazer, estresse, satisfação com o desempenho acadêmico e falta de apoio emocional. Não mostraram associação com sintomas depressivos as seguintes variáveis: sexo, viver sozinho, parceiro fixo, álcool, tabagismo, drogas ilícitas e série do curso . A satisfação com o desempenho acadêmico e o alto grau de estresse não apresentaram significância estatística ao serem relacionados com as séries do curso. Conclusão As prevalências de sintomas depressivos nos acadêmicos de Medicina da UEPG e da utilização de medicamentos antidepressivos vão ao encontro dos dados referentes a acadêmicos de Medicina de outras instituições brasileiras e internacionais. Apresentam-se como fatores de risco para os transtornos depressivos a frequência das atividades de lazer, o estresse, a satisfação com o desempenho acadêmico e a falta de apoio emocional no ambiente acadêmico. A prevalência de depressão a partir da quarta série tendeu a aumentar, e apenas a sexta série diferiu de modo estatisticamente significativo em relação às demais quanto às médias do escore BDI, o que sugere a hipótese de que o final do curso de Medicina é o período que apresenta maior quantidade de fatores estressores e depressivos para o acadêmico.

ABSTRACT Introduction Depression among medical students is particularly prevalent, however studies on risk factors and treatment for this group have proved to be methodologically insufficient as the results were not consistent. Aims To determine the prevalence of depressive symptoms, their risk factors, and the use of antidepressants among medical students. Methods Participants answered the Beck’s Inventory (BDI) for detecting depressive symptoms and the Morisky-Green-Levine test to evaluate medication adherence. A one-tailed Fisher’s exact test was performed on qualitative variables, with a one-way Anova test performed on quantitative variables with post-hoc analysis by means of Tukey-Kramer’s test. Differences were considered to be statistically significant when p < 0.05. Results Associations between depressive disorders and the following factors were considered statistically significant: frequency of leisure activities, stress, satisfaction with academic performance, and lack of emotional support. Gender, living alone, steady partner, use of alcohol, smoking tobacco, use of illicit drugs, and Medical school’s grade did not show association with depressive disorders. Satisfaction with academic performance and high level of stress were not statistically significant when they were correlated to Medical school’s grade. Conclusion The prevalence of depression and also use of antidepressants is similar to the results recorded by other studies on medical students performed by Brazilian and international institutions. The following items were considered to be risk factors on the development of depressive disorders: frequency of leisure activities, stress, satisfaction with academic performance, and lack of emotional support in the academic environment. From the fourth grade to the sixth grade, the prevalence of depression seemed to increase and just the sixth grade was statistically significant when compared to other grades through averages of BDI score. It suggests the hypothesis that the end of Medical course is the period of time where there are more stressful and depressive factors for the student.