Translation, cultural adaptation and evaluation of the psychometric properties of the Hamilton Anxiety Scale among a sample of Portuguese adult patients with mental health disorders.

BACKGROUND: Only a few anxiety assessment tools that nurses may administer are validated forthe Portuguese population exist in the literature. Thus, this study aimed to translate and culturally adapt the Hamilton Anxiety Scale for the Portuguese population and assess its psychometric properties in a sample of adult people with mental health disorders. METHODS: This psychometric study uses a convenience sample of adult patients with mental health disorders. RESULTS: The confirmatory factor analysis confirmed the two factors of the original version of the tool. The internal consistency (Cronbach's alpha) was high, at .92, as well as the inter-rater reliability (intraclass correlation coefficient) (.91). CONCLUSIONS: The validity and reliability of the instrument are supported. However, the Hamilton Anxiety Scale should be used cautiously in the Portuguese population because the correlation with the "Anxiety State" subscale of the State-Trait Anxiety Inventory is not statistically significant.

Saúde mental dos jovens do ensino secundário da ilha da madeira: fatores de vulnerabilidade e proteção / Mental health of the young people of the madeira island secondary school: vulnerability factos and protective / Salud mental de los jóvenes de la escuela secundaria de la isla de madeira: factores de vulnerabilidade y protección

Resumo Introdução: Estudo centra-se no conhecimento da literacia e da saúde mental positiva, em jovens do ensino secundário. Objetivos: Identificar os fatores de vulnerabilidade e proteção de jovens do ensino secundário na ilha da Madeira. Metodologia: Investigação quantitativa, descritiva. Estudo piloto realizado na ilha da Madeira, com estudantes do ensino secundário (n=1948), idades entre 15-18 anos, mediante consentimento informado dos participantes e encarregados de educação. Colheita dados: "Questionário de Literacia e Saúde Mental Positiva", versão Estudantes do Ensino Secundário (QSM+VEESec) (Ribeiro, Sequeira, Ferreira, Carvalho e Pires, 2018). Aplicação online entre março/junho 2021. Resultados: Os resultados mostram relevância entre fatores de vulnerabilidade e proteção na saúde mental. Verificou-se que 9,9% dos estudantes referiu ter alguns problemas de saúde mental; 9,3% recorreu a algum serviço de saúde devido a problema saúde mental; 29,7% referiu ter tido ou ter algum acompanhamento psiquiátrico. Dos fatores vulnerabilidade salienta-se: 42,4% não está satisfeito com seu sono; 46,1% considera não dormir horas suficientes para suas necessidades; 4,5% e 4,8%, respetivamente toma medicação regular para dormir e para algum problema saúde mental; 48,6% não pratica exercício físico regular. Dos possíveis fatores protetores, verifica-se que apresentam fracos indicadores, nomeadamente: 78,2% não participa em atividades recreativas; 43,7% não está satisfeito com sua relação afetiva e consomem substâncias (bebidas alcoólicas: 26,4% e drogas mais de três vezes por semana 3,4%). Conclusão: Os jovens apresentam problemas de saúde mental: ansiedade, depressão, consumos álcool, substâncias ilícitas. Destaca-se a falta de interação social, a ausência de participação em atividades recreativas e insatisfação nos relacionamentos afetivos.

Abstract Introduction: Study focuses on the knowledge of literacy and positive mental health, in secondary school youth. Objectives: Identify the vulnerabitity and protective and vulnerability of secondary school students on the Island of Madeira. Methodology: Quantitative, descriptive research. A pilot study conducted on the island of Madeira, with secondary school students (n=1948), aged between 15-18 years, with the informed consent of the participants and parents. Data collection: "Literacy and Positive Mental Health Questionnaire", version Secondary School Students (QSM+VEESec) (Ribeiro, Sequeira, Ferreira, Carvalho and Pires, 2018). Online application between March/June 2021. Results: The results show relevance between vulnerability and protective factors in mental health. It was found that 9.9% of the students reported having some mental health problems 9.3% resorted to some health service due to mental health problem; 9.3% resorted to some health service due to mental health problem; 29.7% reported having had or had some psychiatric follow-up. Of the vulnerability factors, the following stand out: 42.4% are not satisfied with their sleep; 46.1% consider not getting enough sleep for their needs; 4.5% and 4.8%, respectively, take regular medication for sleep and for some mental health problem; 48.6% do not practice regular physical exercise. Of the possible protective factors, it is verified that they present weak indicators, namely: 78.2% do not participate in recreational activities; 43.7% are not satisfied with their affective relationship and consume substances (alcoholic beverages: 26.4% and drugs more than three times a week 3.4%). Conclusion: Young people have mental health problems: anxiety and depression, alcohol consumption and illicit substances. The lack of social interaction, the absence of participation in recreational activities and dissatisfaction in affective relationships stand out.

Resumen Introducción: El estudio se centra en el conocimiento de la alfabetización y la salud mental positiva en jóvenes de secundaria. Objetivos: Identificar los factores de vulnerabilidad y protección de los estudiantes de secundaria en la Isla de Madeira. Metodología: Investigación cuantitativa y descriptiva. Estudio piloto realizado en la isla de Madeira, con estudiantes de secundaria (n=1948), con edades comprendidas entre 15-18 años, con el consentimiento informado de los participantes y padres. Recolección de datos: "Cuestionario de alfabetización y salud mental positiva", versión Estudiantes de secundaria (QSM + VEESec) (Ribeiro, Sequeira, Ferreira, Carvalho y Pires, 2018). Solicitud en línea entre marzo/junio de 2021. Resultados: Los resultados muestran relevancia entre la vulnerabilidad y los factores protectores en salud mental. Se encontró que 9,9% de los estudiantes refirieron tener algún problema de salud mental; 9,3% recurrieron a algún servicio de salud debido a problemas de salud mental; 29,7% refirieron haber tenido o tenido algún seguimiento psiquiátrico. De los factores de vulnerabilidad, se destacan: 42,4% no están satisfechos con su sueño; El 46,1% considera que no duerme lo suficiente para sus necesidades; 4,5% y 4,8%, respectivamente, toman medicamentos regulares para dormir y para algún problema de salud mental; El 48,6% no practica ejercicio físico regular. De los posibles factores protectores, se verifica que presentan indicadores débiles, a saber: 78,2% no participan en actividades recreativas; 43,7% no están satisfechos con su relación afectiva y consumen sustancias (bebidas alcohólicas: 26,4% y drogas más de tres veces a la semana 3,4%). Conclusión: Los jóvenes tienen problemas de salud mental: ansiedad y depresión, consumo de alcohol y sustancias ilícitas. Se destacan la falta de interacción social, la ausencia de participación en actividades recreativas y la insatisfacción en las relaciones afectivas.

A competência emocional dos enfermeiros na prestação de cuidados à pessoa com doença mental / The emotional competence of nurses in providing care to people with mental illness

Introdução: As emoções ocupam um papel fundamental e determinante no desenvolvimento pessoal e profissional dos enfermeiros, assim como na prestação de cuidados que realizam. Objetivos: Conhecer as variáveis sociodemográficas que caraterizam a população em estudo e quais as correlações existentes entre a competência emocional e as suas dimensões. Métodos: Estudo descritivo, exploratório, abordagem quantitativa, desenvolvido num hospital psiquiátrico da Região Norte de Portugal. Para recolha de informação foi utilizada: Escala Veiga da Competência Emocional. A colheita de dados foi realizada durante o mês de dezembro 2021. Foram cumpridos os pressupostos da Comissão de Ética de acordo com Declaração Helsínquia. A população em estudo foi constituída por 40 enfermeiros, sendo os critérios de inclusão: enfermeiros em situação laboral ativa no cuidado à pessoa com doença mental internada. Resultados: Verificou-se que na sua maioria os participantes eram do sexo feminino (58,76%), com idades compreendidas entre 26-55 anos. Quanto às habilitações académicas, a maioria dos participantes (53,4%) apresentava licenciatura, sendo que 38,9% apresentava a especialidade. Relativamente ao grau de importância, atribuído às questões situação profissional, foi considerado numa escala de Likert: 1 “sem importância”, 5 “muito importante”, como sendo, muito importante “relação interpessoal com os outros”, “estabilidade emocional na relação com os outros” e “estabilidade emocional na prestação de cuidados”, 79% (n=31). Conclusão: Verificou-se correlações entre as variáveis sexo/habilitações académicas. No sexo feminino, foi possível verificar que este perceciona-se, “frequentemente”, empático na prestação de cuidados. Enfermeiros com título especialista também se percecionam como profissionais empáticos, quando comparados com enfermeiros de cuidados gerais. (AU)

Introduction: Emotions play a fundamental and decisive role in the personal and professional development of nurses and the provision of care. Objectives: To explore the sociodemographic variables that characterize the sample under study and the correlations between emotional competence and its dimensions. Methods: Descriptive, exploratory study, quantitative approach, developed in a psychiatric hospital in the Northern Region of Portugal. The collection of information was performed using the Veiga Scale of Emotional Competence. Data collection was carried out in December 2021. The Ethics Committee followed the Helsinki Declaration guidelines. The sample consisted of 40 nurses, and the inclusion criteria were: nurses working with hospitalized people with mental illness. Results: Most participants were female (58.76%), aged between 26 and 55. Regarding academic qualifications, most participants (53.4%) had a degree, and 38.9% had a speciality. Concerning the degree of importance attributed to the professional situation issues, a Likert scale was used: 1 «unimportant», 5 «very important», as being very important, «interpersonal relationship with others», «emotional stability in the relationship with others» and «emotional stability in care delivery», 79% (n=31). Conclusion: Correlations were found between gender and academic qualifications. It was possible to verify that women nurses “often” perceive themselves as empathetic in the provision of care. Nurses with a specialist title also perceive themselves as empathetic professionals compared to general care nurses. (AU)

Perinatal mental health counselling programme: A scoping review.

OBJECTIVE: To map the evidence on a Perinatal Mental Health Counselling Programme, identifying its characteristics, participants, and outcomes. METHODS: This review followed the guidelines of the Joanna Briggs Institute and PRISMA-ScR. Published and unpublished studies, from 2011 to 2021, written in English, Portuguese or Spanish were included. RESULTS: Despite the high number of articles identified, only nine articles were included in the final analysis, mainly from Iran, Italy and one Portuguese study. All articles referred to community health care centres and hospitals. The sessions varied between 6 and 16 and lasted 30-90 min. The method used was either individual and/or group, with weekly or monthly sessions or whenever deemed necessary throughout the evaluation. Different techniques were found, but emotional management, problem-solving, relaxation and mindfulness techniques were highlighted. Participants are pregnant women, partners, or family members. All articles suggest a decrease in the levels of stress, anxiety, and depression after the counselling intervention. CONCLUSION: Perinatal counselling programme have varied characteristics and mental health nurses are potential facilitators.

Follow-up da turma piloto do Programa Promotor de Saúde Mental Positiva em adolescentes - O Brilho da Mente / Follow-up of the pilot class of the Positive Mental Health Promoter Program in adolescents - The Brightness of the Mind

Resumo Contexto: Tendo por base os estudos do Modelo Multifatorial Teresa Lluch (1999), foi criado e validado um Programa Promotor Saúde Mental Positiva (SM+) para adolescentes e aplicado numa turma piloto. Após 3 meses do final do programa, procedeu-se ao follow-up na mesma turma, dando origem a novos dados. O trabalho integra-se Projeto Saúde Mental Positiva: CINTESIS/NursID: Centro de Investigação em Tecnologias e Serviços de Saúde/ Escola Superior de Enfermagem do Porto. Objetivo(s): Avaliar o impacto do programa de SM+ em adolescentes após 3 meses do seu término, analisar a eficácia do programa SM+ na promoção da saúde mental dos adolescentes em ambiente escolar e avaliar a vulnerabilidade psicológica dos adolescentes. Métodos: Estudo quantitativo, observacional-descritivo e longitudinal. A amostra foi constituída por 23 alunos com idades entre os 14-16 anos, e como instrumento foi aplicado novamente Escala de Vulnerabilidade Psicológica (EVP) e o Questionário de Saúde Mental Positiva (QSM+). Resultados: Antes do programa o QSM+ da turma era de 94,35, após programa passou a 92,61. Após 3 meses, QSM+ passou para 91,17. Cotações baixas no QSM+ correspondem a níveis mais elevados de SMP, variando entre 39 e 156. Na EVP registou-se alterações, passando de 14,26 após o programa para 15,39 no follow-up. Conclusões: Apesar das diferenças observadas não terem significado estatístico, que nos permita afirmar que o Programa de SM+ teve eficácia na saúde mental dos adolescentes e na sua vulnerabilidade psicológica, foram observadas mudanças a nível comportamental, com maior interajuda entre eles, melhor comunicação e mais ativos nas atividades escolares.

Abstract Background: Based on studies of Teresa Lluch's Multifactorial Model (1999), a Positive Mental Health Promoting Program for adolescents was created and validated and applied to a pilot class. Three months after the end of the program, we followed up in the same class, giving rise to new data. The work is part of the Positive Mental Health Project of CINTESIS / NursID of the Research Center on Health Technologies and Services and the Porto School of Nursing. Aim: To assess the impact of the positive mental health (PMH) program on adolescents 3 months after its end; analyze the effectiveness of the PMP program in promoting adolescent mental health in the school environment and assess the psychological vulnerability of adolescents. Methods: The study was quantitative, observational, descriptive and longitudinal. The sample consisted of 23 students aged 14 to 16 years, and as instrument was applied again the psychological vulnerability scale and the Positive Mental Health Questionnaire (QSM +). Results: Before the program, the class's QSM + was 94.35, after the program it went to 92.61. After 3 months, the QSM + increased to 91.17. Low quotations on the QSM + correspond to higher levels of SMP, ranging from 39 to 156. In EVP, there were changes, going from 14.26 after the program to 15.39 in the follow-up. Conclusions: Although the observed differences have no statistical significance, which allows us to affirm that the PMP Program was effective in the mental health of adolescents and their psychological vulnerability, changes were observed at the behavioral level, with greater mutual help between them, better communication and more active in school activities.

Positive Mental Health in University Students and Its Relations with Psychological Vulnerability, Mental Health Literacy, and Sociodemographic Characteristics: A Descriptive Correlational Study.

This study aimed to evaluate positive mental health (PMH) and its relation with sociodemographic characteristics, mental health literacy, and the psychological vulnerability scale (PVS) in Portuguese university students aged 17 to 62. A descriptive correlational study was carried out. An online survey was conducted to evaluate demographic variables, and several questionnaires were applied to evaluate positive mental health, psychological vulnerability, and mental health literacy. The data was collected from 1 November 2019 to 1 September 2020. Overall, 3405 students participated in the study. The results show that 67.8% of students revealed a high level of PMH, 31.6% presented a medium level of PMH, and 0.6% had a low level of PMH. Male students reported higher personal satisfaction (t (3170) = -2.39, p = 0.017) and autonomy (t (3170) = -3.33, p = 0.001) in PMH compared to female students. Students without a scholarship scored higher (t (3127) = -2.04, p = 0.42) in PMH than students who held a scholarship. Students who were not displaced from their home reported higher (t (3170) = -1.99, p = 0.047) self-control in PMH than those displaced from their home. University students with higher PMH results had lower PVS results and higher literacy results. The findings of this study will contribute to identifying students' PMH intervention needs.

Características de um programa de saúde mental positiva para adultos: um estudo de Focus Group / Characteristics of a positive mental health program for adults: a Focus Group study

Resumo Contexto: O termo "saúde mental positiva" foi designado pela primeira vez por Marie Jahoda em 1958. Ele enquadra a promoção da saúde mental como algo importante na sociedade e no ciclo de vida dinâmico de seus membros. Objetivo: Explorar e identificar os componentes necessários para a criação de um programa modular de promoção da saúde mental positiva em adultos, baseado no Modelo Multifatorial de Teresa Lluch. Metodologia: Realizamos três reuniões de peritos de março a julho de 2018 com um total de 23 profissionais de enfermagem em Portugal. Os dados foram analisados tematicamente pelo método Framework. Usado o COREQ checklist. Resultados: Foram analisados quatro temas previamente identificados: a estrutura do programa, os critérios de inclusão dos participantes, a composição conceptual das sessões e a eficácia do programa. A construção teórica do programa baseou-se no Modelo Multifatorial de Saúde Mental Positiva de Teresa Lluch, composto por seis fatores: satisfação pessoal, atitude pró-social, autocontrolo, autonomia, resolução de problemas e auto-atualização e habilidades de relacionamento interpessoal. Conclusão: Este estudo permitiu identificar, com consenso, um conjunto de intervenções baseadas nos seis fatores do Modelo Multifatorial de Saúde Mental Positiva de Teresa Lluch que devem integrar um programa que promova a saúde mental positiva em adultos em diferentes cenários / contextos adequados às necessidades individuais de cada participante.

Abstract Context: The term 'positive mental health' was first designated by Marie Jahoda in 1958. It frames the promotion of mental health as something important in society and the dynamic life cycle of its members. Objective: To explore and identify the components needed for the creation of a modular program to promote positive mental health in adults, based on Teresa Lluch Multifactorial Model. Methods: We conducted three focus groups from March-July 2018 with a total of 23 nursing professionals in Portugal. The data was thematically analyzed using the Framework method. The COREQ checklist guided reporting. Results: Four previously identified topics were analyzed: the structure of the program, the inclusion criteria of participants, the conceptual composition of the sessions, and the effectiveness of the program. The theoretical construction of the program was based on Teresa Lluch Multifactorial Positive Mental Health Model, composed of six factors: personal satisfaction, prosocial attitude, self-control, autonomy, problem-solving and self-actualization, and interpersonal relationship skills. Conclusion: This study allowed to identify, with consensus, a set of interventions based on the six factors of Teresa Lluch Multifactorial Positive Mental Health Model that should integrate a program that promotes positive mental health in adults in different settings/contexts suited for the individual needs of each participant.

Review of Mental Health First Aid Programs.

Mental health first aid programs are interventions to empower the community to help people with mental health problems/crises. A review of these programs was conducted in accordance with the guidelines of the Joanna Briggs Institute. Published and unpublished works from 2009 to 2019 were considered. The review included 252 studies. Several Mental Health First Aid programs were identified, with varying characteristics, participants, and contexts of implementation. These group interventions were carried out among lay people to health professionals, and in adolescents to the elderly. Additionally, they were conducted in-person and/or virtually, using psychoeducational methods and informational materials. The programs ranged from 30 minutes to 24 hours. These interventions can address nursing foci, and the characteristics of the facilitators are similar to those of mental health nurses. Therefore, this review highlighted the opportunity for nurses to explore Mental Health First Aid programs.

Mental health first aid programs: a scoping review protocol.

OBJECTIVE: This review aims to map mental health first aid programs, and identify the characteristics and participants of such programs and the contexts of their implementation. INTRODUCTION: Mental health first aid is the help provided to a person developing a mental health problem or undergoing a mental health crisis. The first aid is provided until professional help is accessed or the crisis is resolved. INCLUSION CRITERIA: This scoping review will address programs that provide basic mental health first aid skills, with no exclusion criteria in terms of participants or contexts. METHODS: English, Portuguese, and Spanish published studies and unpublished papers, from 2009 to 2019, will be considered. JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be followed. The search will be carried out in databases, scientific repositories and reference lists. Duplicates will be removed and two independent reviewers will screen the titles, abstracts and full-text of the selected studies. Data collection will be performed with a tool developed by the researchers, based on JBI's model instrument for extracting study details, characteristics and results. A summary of the results will be presented in visual representations, narratives and tables.

"Terapias complementares" nas emoções: uma perspetiva sociopoética / 'Complementary therapies' in the emotions: a sociopoetic perspective

The relevance of the theme using the "complementary therapies" (TC) in the management of emotions and your impact on mental health of nursing students, focuses on the realization of our professional practice, as teachers, in different types of school, in There, students of the last year of the course, feel uncomfortable, as the expression of their emotions and feelings, which leads to high levels of anxiety, anguish and panic. Aims: to identify the complementary therapies facilitators in managing emotions and evaluate your effectiveness on mental health of students. Methodology: qualitative research Paradigm, using the sociopóetica perspective. The sample consists of 42 students of the fourth year of the Degree course in nursing, perform the clinical education of Mental Health and Psychiatry. Were held "workshops" of production data. Complied with all ethical assumptions of the investigation, in accordance with the Helsinki Declaration. Results and discussion: The content analysis performed, resulting in the appointment of four "complementary therapies": guided imagination technique, body expression, therapeutic touch and music therapy. Conclusions: importance of this research to the education in nursing is the conception of that theory and clinical experience must be accompanied by educational strategies promoting TC in the management of emotions. To stress, students highlighted the use of music therapy as an asset in the expression of emotions and commented that the TC allow you to deal with emotions and promote your mental health over your career, personal and social

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Criação e validação de um programa promotor de saúde mental positiva em adolescentes / Creation and validation of a program promoter of positive mental health in adolescents

Introduction: The WHO estimates that at least 20% of children and adolescents have at least one mental disorder before reaching the age of 18 years. (PNSE, 2015) Based on the studies of the Multifactorial Model of Teresa Lluch (1999), it was proposed for the present study the conception and validation of a positive mental health promotion program in the field of mental health nursing directed to adolescents who attend the 3rd cycle of studies. Objectives: Elaborate a positive mental health nursing program based on the Multifactorial Model of Teresa Lluch; Implement a positive mental health program within the framework of the primary health care services portfolio, in response to the guidelines of the national school health program (PNSE, 2015); to analyse the effectiveness of the positive mental health program in promoting adolescents' mental health in a school environment; to evaluate the positive mental health levels of adolescents in school settings. Methodology: Mixed, quasi-experimental (through a pilot study) and also observational-descriptive cross-sectional study focused on a Focus Group was chosen. Results: In the pilot group the mean positive mental health questionnaire pre-program, was 94.35, post-program had a decrease, and was at 92.61. Conclusions: Program implementation improved participants' positive mental health. Knowing that mental health is worked on the basis of continuity, it is believed that the time factor was limiting in this study. It would have been an added value to carry out a follow-up at the end of the academic year to analyse positive mental health questionnaire

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A efetividade do exercício físico no tratamento da depressão / The effectiveness of exercise in depression treatment / La efectividad del ejercicio físico en el tratamiento de la depresión

CONTEXTO: Tendo em conta a prevalência das doenças mentais e as comorbilidades a elas associadas, torna-se emergente a atuação na promoção da saúde mental e tratamento. De acordo com a literatura, existem diversos aspetos nos quais o exercício físico exerce relevante influência. No âmbito da saúde mental, importa também perceber se este poderá ter benefícios no tratamento de perturbações depressivas. OBJETIVO: Conhecer a efetividade do exercício físico no tratamento da perturbação depressiva. MÉTODOS: Systematic reviews of effectiveness que utiliza a estratégia PICO e as recomendações PRISMA apresentadas pelo Joanna Briggs Institute e partindo da questão, Qual a efetividade do exercício físico no tratamento da depressão? A pesquisa foi realizada com recurso às seguintes plataformas de acesso: Isi web of knowledge; Scopus; Trip database e EBSCO Host. Esta revisão decorreu ao longo do mês de outubro do ano de 2018. RESULTADOS: Identificaram-se 310 resultados. Foram analisados cinco documentos, quatro resultaram da pesquisa efetuada nas plataformas de acesso e um resulta da consulta de referências bibliográficas. A seleção foi feita após leitura do título; eliminação de duplicados; leitura de resumos e textos integrais. CONCLUSÕES: Utentes com perturbação depressiva major a serem tratados com terapêutica farmacológica e exercício físico, apresentam uma maior redução da sintomatologia depressiva, quando comparados aqueles que são sujeitos apenas ao tratamento com terapêutica farmacológica. O exercício físico revelou-se, também, como uma alternativa ao incremento farmacológico. Como intervenção não farmacológica, é aquela com maiores benefícios na melhoria da depressão e sintomatologia depressiva.

BACKGROUND: Considering the prevalence of mental illnesses and their associated comorbidities, promotion and treatment of mental health become the utmost importance. According to the literature, there are several aspects in which physical exercise has a relevant influence. In the field of mental health, it is also important to understand whether it may have benefits in the treatment of depressive disorders. AIM: To know the effectiveness of physical exercise in the treatment of depression. METHODS: Systematic reviews of effectiveness using the PICO strategy and PRISMA recommendations presented by the Joanna Briggs Institute and based on the question, What is the effectiveness of physical exercise in the treatment of depression? The research was performed using the following databases: Isi web of knowledge; Scopus; Trip database and EBSCO Host. This review took place throughout October of 2018. RESULTS: 310 results were identified. Five documents were analyzed, four were the result of searching the databases and one from bibliographic references. The selection was made after reading the title; elimination of duplicates; reading of abstracts and full texts. CONCLUSIONS: Patients with major depressive disorder to be treated with pharmacological therapy and physical exercise show a greater reduction in depressive symptoms, when compared to those who are subjected only to treatment with pharmacological therapy. Physical exercise has also proved to be an alternative to pharmacological increment. As a non-pharmacological intervention, it is the one with the greatest benefits in improving depression and depressive symptoms.

CONTEXTO: Teniendo en cuenta la prevalencía de las enfermedades mentales, y los transtornos comorbidos asociados a dichas enfermedades, es imperativo tomar acciones para promocionar la salud mental y los tratamientos de la misma. Según la literatura, hay varios aspectos en los que el ejercicio físico ejerce una influencia relevante. En el campo de la salud mental, también es importante comprender si puede tener beneficios en el tratamiento de los trastornos depresivos. OBJETIVO: Conocer la efectividad del ejercicio físico en el tratamiento del trastorno depresivo. METODOLOGÍA: Systematic reviews of effectiveness utilizando la estrategia PICO y las recomendaciones de PRISMA presentadas por el Instituto Joanna Briggs y basadas en la pregunta: ¿Que efectividad tiene el ejercício físico en el tratamiento de lá depresión? La investigación se realizó utilizando las siguientes plataformas de acceso: Isi web of knowledge; Scopus; Trip database y EBSCO Host. Esta revisión tuvo lugar a lo largo de octubre del año 2018. RESULTADOS: 310 resultados fueron identificados. Se analizaron cinco documentos, cuatro fueron el resultado de la búsqueda en las plataformas de acceso y uno resultante de referencias bibliográficas. La selección se realizó después de leer el título; eliminación de duplicados; lectura de resúmenes y textos completos. CONCLUSIONES: Los pacientes con trastorno depresivo mayor que se tratan con terapia farmacológica y ejercicio muestran una mayor reducción en la sintomatología depresiva en comparación con aquellos que están sujetos a tratamiento con terapia farmacológica sola. El ejercicio físico también ha demostrado ser una alternativa al incremento farmacológico. Como una intervención no farmacológica, es la que tiene mayores beneficios para mejorar la depresión y los síntomas depresivos.

Vulnerability and cognitive protection factors in older persons

Estimates from the Portuguese Statistics reveal that 19.0% of the resident popula-tion in Portugal is in the age group with 65 years or older. By 2020, it is expected that the proportion of the elderly (≥ 65 years old) will increase to 20.6%. Cognitive plasticity and reserve capacity are central in studies addressing the ageing process, thus it is extremely important to identify the vulnerability and protection factors. Objective: To identify vulnerability and cognitive protection factors in older persons. Methodology: Epidemiological and transversal study, conducted with a population of 151 persons, with an average age of 70.8 (± 5.4), in the metropolitan area of Porto. results. The results indicate that lifestyles involving physical exercise; eating habits; sleep and rest patterns; leisure activities; satisfactory emotional life and the use of health services can act as vulnerability factors or protective factors. The Mini-Mental State Examination (MMSE) has an average of 26.6 (± 4.4) and the questionnaire of cognitive reserve of 6.3 (± 4.6). The dimensions of the MMSE show an association between items, with empha-sis on MMSE guidance and MMSE attention and calculation, with a correlation of r = .75; p = 0.001 and r = .89; p = 0.001 respectively. Conclusion: The healthy lifestyles, involving physical exercise; proper nutrition; the regular sleep pattern; engagement in leisure activities; a satisfactory emotional life and the use of health services can function as protective factors (present) or vulne-rability (absent)

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